FORM FA Unit Kerja Penunjang 30815

248
NAMA UNIT PENUNJANG : INSTALASI FARMASI No Nama Facility Activity Cost Driver 1 PELAYANAN RESEP RESEP 2 DISPENSING SEDIAAN RACIK (KAPSUL) /R 3 DISPENSING SEDIAAN RACIK (PUYER) /R 4 REKONSTITUSI SEDIAAN SIRUP /R 5 PELAYANAN KIE PASIEN 6 PELAYANAN KONSELING PASIEN 7 PELAYANAN UDD PASIEN 8 VISITE PASIEN 9 HANDLING SITOSTATIKA /R 10 IV ADMIXTURE /R 11 MUTASI BARANG MUTASI 12 PENGADAAN ORDER 13 PENERIMAAN KEGIATAN 14 PELAYANAN HOME CARE PASIEN 15 PELAYANAN BHP OPERASI RESEP 16 PELAYANAN GAS SENTRAL MUTASI

description

unit cost

Transcript of FORM FA Unit Kerja Penunjang 30815

Page 1: FORM FA Unit Kerja Penunjang 30815

NAMA UNIT PENUNJANG : INSTALASI FARMASI

No Nama Facility Activity Cost Driver

1 PELAYANAN RESEP RESEP

2 DISPENSING SEDIAAN RACIK (KAPSUL) /R

3 DISPENSING SEDIAAN RACIK (PUYER) /R

4 REKONSTITUSI SEDIAAN SIRUP /R

5 PELAYANAN KIE PASIEN

6 PELAYANAN KONSELING PASIEN

7 PELAYANAN UDD PASIEN

8 VISITE PASIEN

9 HANDLING SITOSTATIKA /R

10 IV ADMIXTURE /R

11 MUTASI BARANG MUTASI

12 PENGADAAN ORDER

13 PENERIMAAN KEGIATAN

14 PELAYANAN HOME CARE PASIEN

15 PELAYANAN BHP OPERASI RESEP

16 PELAYANAN GAS SENTRAL MUTASI

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JUMLAH COST DRIVER SELURUH RS

32230

1708

1585

2280

11901

48

3600

3600

36

1800

1875

2138

2138

24

1460

449

F_UC_FA-A1

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Rincian Jumlah Cost Driver

Nama Facility Activity : PELAYANAN RESEP

Nama Cost Driver : RESEP

No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

1 DEPO FARMASI RAWAT JALAN 11481 2 DEPO FARMASI RAWAT INAP 20749

JUMLAH 32230

Rincian Jumlah Cost Driver

Nama Facility Activity : DISPENSING SEDIAAN RACIK (PUYER)Nama Cost Driver : /R

No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

1 DEPO FARMASI RAWAT JALAN 1460 2 DEPO FARMASI RAWAT INAP 125

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JUMLAH 1585

Rincian Jumlah Cost Driver

Nama Facility Activity : PELAYANAN KIENama Cost Driver : PASIEN

No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

1 DEPO FARMASI RAWAT JALAN 11481 2 DEPO FARMASI RAWAT INAP 420

JUMLAH 11901

Rincian Jumlah Cost Driver

Nama Facility Activity : PELAYANAN UDDNama Cost Driver : RESEP

No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

1 DEPO FARMASI RAWAT JALAN 0 2 DEPO FARMASI RAWAT INAP 3600

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JUMLAH 3600

Rincian Jumlah Cost Driver

Nama Facility Activity : HANDLING SITOSTATIKANama Cost Driver : /R

No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

1 DEPO FARMASI RAWAT JALAN 0 2 DEPO FARMASI RAWAT INAP 36

JUMLAH 36

Rincian Jumlah Cost Driver

Nama Facility Activity : MUTASI BARANGNama Cost Driver : MUTASI

No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

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No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

1 DEPO FARMASI RAWAT JALAN 377 2 DEPO FARMASI RAWAT INAP 694 3 OK IBS 7 4 IGD 136 5 RADIOLOGI 14 6 LABORATORIUM 52 7 ANESTESI 24 8 GIZI 1 9 AMBULANCE 32 10 MAWAR 52 11 MELATI 61 12 DAHLIA 27 13 BOUGENVIL 51 14 ANGGREK 42 15 FLAMBOYAN 38 16 ICU 134 17 PERINATOLOGI 36 18 NIFAS 21 19 POLI ANAK 2 20 POLI BEDAH 2 21 POLI GIGI 18 22 POLI DALAM 19 23 POLI THT 7 24 POLI MATA 7 25 POLI OBGYN 11 26 POLI UMUM 10

JUMLAH 1875

Rincian Jumlah Cost Driver

Nama Facility Activity : PENERIMAANNama Cost Driver : KEGIATAN

No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

1 GUDANG FARMASI 2138

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JUMLAH 2138

Rincian Jumlah Cost Driver

Nama Facility Activity : PELAYANAN BHP OPERASINama Cost Driver : RESEP

No Unit/Instalasi/ruang Jumlah Cost Driver No Unit/Instalasi/ruang

1 OK IBS 1400 2 OK IGD 60

JUMLAH 1460

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Rincian Jumlah Cost Driver

Nama Facility Activity : DISPENSING SEDIAAN RACIK (KAPSUL)

Nama Cost Driver : /R

Jumlah Cost Driver No Unit/Instalasi/ruang No

1 DEPO FARMASI RAWAT JALAN 1460 2 DEPO FARMASI RAWAT INAP 248

JUMLAH 1708

Rincian Jumlah Cost Driver

Nama Facility Activity : REKONSTITUSI SEDIAAN SIRUPNama Cost Driver : /R

Jumlah Cost Driver No Unit/Instalasi/ruang No

1 DEPO FARMASI RAWAT JALAN 2190 2 DEPO FARMASI RAWAT INAP 90

Jumlah Cost Driver

Jumlah Cost Driver

F_UC_FA-A2

F_UC_FA-A2

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JUMLAH 2280

Rincian Jumlah Cost Driver

Nama Facility Activity : PELAYANAN KONSELINGNama Cost Driver : PASIEN

Jumlah Cost Driver No Unit/Instalasi/ruang No

1 DEPO FARMASI RAWAT JALAN 48 2 DEPO FARMASI RAWAT INAP 0

JUMLAH 48

Rincian Jumlah Cost Driver

Nama Facility Activity : VISITENama Cost Driver : PASIEN

Jumlah Cost Driver No Unit/Instalasi/ruang No

1 DEPO FARMASI RAWAT JALAN 0 2 DEPO FARMASI RAWAT INAP 3600

Jumlah Cost Driver

Jumlah Cost Driver

F_UC_FA-A2

F_UC_FA-A2

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JUMLAH 3600

Rincian Jumlah Cost Driver

Nama Facility Activity : IV ADMIXTURENama Cost Driver : /R

Jumlah Cost Driver No Unit/Instalasi/ruang No

1 DEPO FARMASI RAWAT JALAN 0 2 DEPO FARMASI RAWAT INAP 1800

JUMLAH 1800

Rincian Jumlah Cost Driver

Nama Facility Activity : PENGADAANNama Cost Driver : ORDER

Jumlah Cost Driver No Unit/Instalasi/ruang No

Jumlah Cost Driver

Jumlah Cost

F_UC_FA-A2

F_UC_FA-A2

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Jumlah Cost Driver No Unit/Instalasi/ruang No

1 GUDANG FARMASI 2138

JUMLAH 2138

Rincian Jumlah Cost Driver

Nama Facility Activity : PELAYANAN HOME CARENama Cost Driver : PASIEN

Jumlah Cost Driver No Unit/Instalasi/ruang No

1 DEPO FARMASI RAWAT JALAN 24 2 DEPO FARMASI RAWAT INAP 0

Driver

Jumlah Cost Driver

F_UC_FA-A2

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JUMLAH 24

Rincian Jumlah Cost Driver

Nama Facility Activity : PELAYANAN GAS SENTRALNama Cost Driver : MUTASI

Jumlah Cost Driver No Unit/Instalasi/ruang No

1 ICU 113 2 IGD 106 3 DAHLIA 18 4 MAWAR 34 5 MELATI 48 6 FLAMBOYAN 15 7 ANGGREK 31 8 AMBULANCE 32 9 NIFAS 2 10 PERINATOLOGI 23 11 ANESTESI 22 12 BOUGENVILE 5

JUMLAH 449

Jumlah Cost Driver

F_UC_FA-A2

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DISPENSING SEDIAAN RACIK (KAPSUL)

Unit/Instalasi/ruang Jumlah Cost Driver

REKONSTITUSI SEDIAAN SIRUP

Unit/Instalasi/ruang Jumlah Cost Driver

F_UC_FA-A2

F_UC_FA-A2

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Unit/Instalasi/ruang Jumlah Cost Driver

Unit/Instalasi/ruang Jumlah Cost Driver

F_UC_FA-A2

F_UC_FA-A2

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Unit/Instalasi/ruang Jumlah Cost Driver

Unit/Instalasi/ruang Jumlah Cost Driver

F_UC_FA-A2

F_UC_FA-A2

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Unit/Instalasi/ruang Jumlah Cost Driver

Unit/Instalasi/ruang Jumlah Cost Driver

F_UC_FA-A2

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Unit/Instalasi/ruang Jumlah Cost Driver

F_UC_FA-A2

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AIC Gedung

No Nama gedung Luas Harga per m2 Tahun Beli Harga Beli (IIC)Keterangan*

(Rp) (Th) (Rp) (Th)

Jumlah* Diisi oleh enumerator. Diisi dengan data masa pakai yang telah melebihi masa ekonomis (lihat daftar umur ekonomis)

Masa Pakai

F_UC_FA-B1

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AIC Gedung

No Nama Gedung Luas Harga per m2 Harga Beli (IIC) Masa Hidup (L) BIAYA DEPRESIASI(Rp.) (th) (Rp.)

Jumlah

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Biaya Depresiasi Alat Non Medis

Facility Activity Pelayanan : ......

No Nama/Jenis BarangHarga Beli Satuan Harga Beli Total

(Rp.) (Rp) (th)

Jumlah Alat Non Medis di Unit

Kerja

Masa Hidup (L)

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Jumlah

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BIAYA DEPRESIASI

(Rp.)

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AIC Alat Non Medis

No Alat Non Medis Jumlah Harga Satuan Tahun Beli Harga Beli (IIC)Masa Pakai

(Rp) (Th) (Rp) (Th)

GUDANG FARMASI1 Lemari Pendingin LG 1

2 Komputer ACER 2

3 CPU ACER 1

4 CPU HDMI 1

5 Printer EPSON LX-300+II 1

6 Lemari Kayu 1

7 Lemari Olympic 2

8 Rak Besi 2

9 Etalase Kaca 1

10 Lemari Kayu (SPM) 5

11 Meja Kerja 2

12 AC LG 1

13 Kursi Kerja 1

14 Kursi Plastik 3

15 Telepon 1

DEPO FARMASI RAWAT JALAN1 Komputer ACER 2

2 Komputer LG 1

3 Meja Kayu 2

F_UC_FA--B2

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4 Meja Kayu Rolling 4

5 Lemari Obat 4

6 AC LG 1

7 Printer EPSON LX-300+II 1

8 Lemari Pendingin LG 1

9 Kursi Kerja 1

10 Kursi Lipat 3

11 Kursi Plastik 3

12 Telepon 1

13 Blender Obat 1

14 Mortir 3

15 Stamper 3

16 Tabung Ukur 1

17 Sealer 1

DEPO FARMASI RAWAT INAP1 Etalase kaca 2x1 m 1

2 Etalase kaca 2x1,5 m 2

3 Etalase kaca 2x2 m 1

4 Etalase kaca 1x2 m 1

5 Lemari Kayu (SPM) 3

6 Komputer ACER 2

7 Printer EPSON LX-300+II 1

8 Rak Kayu 2x2,5 m 1

9 Lemari Pendingin LG 1

10 AC LG 1

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11 Meja Kerja Prodesign 2

12 TV Sharp 1

13 Meja Kayu Front Office 1

14 Meja Kayu (buffet) 1

15 Meja Plastik 1

16 Kursi Plastik 3

17 Filling Kabinet 1

18 Lemari Kayu 1

19 Dispenser 1

20 Lemari Narkotika 1

21 Kipas Angin 3

22 Telepon 1

Jumlah

* Diisi oleh enumerator. Diisi dengan data masa pakai yang telah melebihi masa ekonomis (lihat daftar umur ekonomis)

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Keterangan*

GUDANG FARMASI

FARMASI

FARMASI

DEPO FARMASI RAWAT JALAN

F_UC_FA--B2

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FARMASI

FARMASI

DEPO FARMASI RAWAT INAP

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FARMASI

FARMASI

FARMASI

FARMASI

FARMASI

FARMASI

FARMASI

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Biaya Depresiasi Kendaraan

Facility Activity Pelayanan : ......

NoHarga Beli Satuan Harga Beli Total BIAYA DEPRESIASI

(Rp.) (Rp) (th) (Rp.)

Jumlah

Nama/Jenis Kendaraan

Jumlah Kendaraan

Tahun Pembelian

Masa Hidup (L)

F_UC_FA-B3

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AIC Kendaraan

No Kendaraan Jumlah Harga Satuan Tahun Beli Harga Beli (IIC)Masa Pakai

(Rp) (Th) (Rp) (Th)

Jumlah

F_UC_FA-B3

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* Diisi oleh enumerator. Diisi dengan data masa pakai yang telah melebihi masa ekonomis (lihat daftar umur ekonomis)

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Keterangan*

F_UC_FA-B3

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BIAYA GAJI SDM NON MEDIS Tahun 2014

Nama Facility Activity : ....

No Tunjangan Jasa Pelayanan

1 SOFIATI DIAH BAISUNI, S.FARM, APT.

2 SRI NORHIDAYAH, S.SI, APT.

3 NOVIANDARINI NURMANTY, S.FARM, APT.

4 NIKEN FIRMANINGSIH

5 DEWI WIJAYANTI WULANDARI

6 INDAH MARDYANING TYAS

7 HANA DYAH UTAMI

8 DYAH CANDRA KURNIA DEWI

9 SULIS IKA SETYOWATI

10 NOVI KUSUMA WARDANI

11 SELVI SOFIA W

12 IKA KUSUMARINI

13 EDI SUHERMAWAN

Nama Tenaga Kerja Medis/Paramedis

Jumlah Gaji setahun*

Tunjangan/ Jasa Lain

F_UC_FA-C1

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BIAYA GAJI SDM NON MEDIS Tahun 2014 F_UC_FA-C1

14 MARIUS BENY KRISTANTO

15 MOHAMAD IWAN ASYROFI

16 NOVI RESTRI WULANDARI

17 ERNI HERAWATI

Jumlah* Gaji Kotor

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Total Gaji

PNS

PNS

HONORER

PNS

PNS

PNS

HONORER

HONORER

HONORER

HONORER

HONORER

HONORER

HONORER

F_UC_FA-C1

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F_UC_FA-C1

HONORER

HONORER

HONORER

PNS

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Biaya Bahan Non Medis Habis Pakai Tahun 2014

Nama Facility Activity : ....

No. Nama Bahan Jumlah Total

ACARBOSE 100 MG ASKES 300 TABLET 1,816 544,863

ACARBOSE 50 MG ASKES 300 TABLET 1,127 337,953

ACETOSAL 100 MG ASKES 1,100 TABLET 100 110,001

ACETOSAL 100 MG ASKES 400 TABLET 116 46,358

ACETOSAL 100 MG ASKES 2,000 TABLET 116 231,792

ACLAM DS 5 BOTOL 52,800 264,000

ACLAM DS 6 BOTOL 52,800 316,800

ACLAM TAB 30 TABLET 12,100 363,000

ACLAM TAB 15 TABLET 12,100 181,500

ACLAM TAB 45 TABLET 12,100 544,500

ACRAN INJEKSI 100 AMPUL 19,228 1,922,800

ACRAN INJEKSI 100 AMPUL 19,228 1,922,800

ACRAN INJEKSI 100 AMPUL 19,228 1,922,800

ACRAN INJEKSI 100 AMPUL 19,228 1,922,800

ACRAN INJEKSI 85 AMPUL 19,228 1,634,380

ACRAN INJEKSI 85 AMPUL 19,228 1,634,380

ACRAN INJEKSI 85 AMPUL 19,228 1,634,380

ACRAN INJEKSI 85 AMPUL 19,228 1,634,380

ACRAN INJEKSI 85 AMPUL 19,228 1,634,380

ACRAN INJEKSI 85 AMPUL 19,228 1,634,380

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 170 AMPUL 19,712 3,351,040

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 170 AMPUL 19,712 3,351,040

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 170 AMPUL 19,712 3,351,040

ACRAN INJEKSI 170 AMPUL 19,712 3,351,040

ACRAN INJEKSI 170 AMPUL 19,712 3,351,040

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 120 AMPUL 19,712 2,365,440

ACRAN INJEKSI 60 AMPUL 19,712 1,182,720

ACRAN INJEKSI 170 AMPUL 19,712 3,351,040

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 170 AMPUL 19,712 3,351,040

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 85 AMPUL 19,712 1,675,520

ACRAN INJEKSI 340 AMPUL 19,712 6,702,080

ACRAN INJEKSI 170 AMPUL 19,712 3,351,040

ACRAN TAB 60 TABLET 4,637 278,190

ACRAN TAB 60 TABLET 4,637 278,190

ACRAN TAB 60 TABLET 4,637 278,190

ACRAN TAB 30 TABLET 4,637 139,095

ACRAN TAB 30 TABLET 4,637 139,095

Harga Satuan

F_UC_FA-C2

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ACRAN TAB 60 TABLET 4,637 278,190

ACRAN TAB 30 TABLET 4,637 139,095

ACRAN TAB 30 TABLET 4,637 139,095

ACRAN TAB 60 TABLET 4,637 278,190

ACRAN TAB 30 TABLET 4,637 139,095

ACRAN TAB 60 TABLET 4,637 278,190

ACYCLOVIR 400 MG 100 TABLET 340 34,000

ACYCLOVIR 400 MG 100 TABLET 631 63,050

ADALAT OROS 30 MG ASKES 600 TABLET 3,500 2,100,008

ADALAT OROS 30 MG ASKES 600 TABLET 3,500 2,100,008

ADALAT OROS 30 MG ASKES 600 TABLET 3,500 2,100,140

ADALAT OROS 30 MG ASKES 900 TABLET 3,500 3,150,210

ADALAT OROS 30 MG ASKES 600 TABLET 3,500 2,100,140

ADALAT OROS 30 MG ASKES 1,200 TABLET 3,500 4,200,280

ADALAT OROS 30 MG ASKES 450 TABLET 3,500 1,575,105

ALBAPURE 20% 100 ML ASKES 3 BOTOL 899,976 2,699,928

ALBAPURE 20% 50 ML ASKES 3 BOTOL 413,982 1,241,947

ALBOTHYL CONC 10 ML 10 FLS 27,742 277,420

ALBUMIN BCG 6X100 ML 1 KIT 935,220 935,220

ALBUMIN-BCG 8X20 ML PAKET 1 BOX 1,760,000 1,760,000

ALBUMIN-BCG 8X20 ML PAKET 1 BOX 1,760,000 1,760,000

ALDISA SR TAB 100 TABLET 4,081 408,100

ALINAMIN F INJ 50 AMPUL 14,973 748,627

ALINAMIN F INJ 25 AMPUL 14,973 374,314

ALINAMIN F INJ 50 AMPUL 14,973 748,627

ALINAMIN F INJ 50 AMPUL 14,973 748,627

ALINAMIN F INJ 50 AMPUL 14,973 748,627

ALINAMIN F INJ ASKES 25 AMPUL 9,949 248,731

ALINAMIN F INJ ASKES 50 AMPUL 9,950 497,497

ALINAMIN F INJ ASKES 50 AMPUL 9,949 497,463

ALKOHOL 70% 1 CC 12,000 MILILITER 25 300,036

ALKOHOL 70% 1 CC 20,000 MILILITER 22 430,100

ALKOHOL 70% 1 CC 20,000 MILILITER 22 430,100

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 27 544,500

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 27 544,500

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 27 544,500

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 27 544,500

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 29 574,640

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 29 574,640

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 27 544,500

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 27 544,500

ALKOHOL 70% 1 LITER OM PAKET 20,000 MILILITER 22 430,100

ALKOHOL SWAB OM 120 BOX 13,860 1,663,200

ALKOHOL SWAB OM 48 BOX 10,000 480,005

ALKOHOL SWAB OM 48 BOX 10,000 480,005

ALKOHOL SWAB OM 24 BOX 10,000 240,002

ALLOPURINOL 100 ASKES 1,000 TABLET 131 131,010

ALLOPURINOL 100 ASKES 1,000 TABLET 119 118,800

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ALLOPURINOL 100 ASKES 1,000 TABLET 131 130,900

ALLORIS 100 TABLET 4,323 432,300

ALLORIS 100 TABLET 4,323 432,300

ALLORIS 100 TABLET 4,323 432,300

ALLORIS 100 TABLET 4,323 432,300

ALLORIS 200 TABLET 4,323 864,600

ALLORIS 100 TABLET 4,323 432,300

ALOCLAIR GEL 10 TUBE 79,750 797,500

ALOCLAIR GEL 10 TUBE 79,750 797,500

ALOCLAIR GEL 10 TUBE 82,500 825,000

ALOCLAIR GEL 5 TUBE 82,500 412,500

ALOCLAIR SOLT 6 BOTOL 90,750 544,500

ALOVEL 10 MG TAB 60 TABLET 9,350 561,000

ALOVEL 10 MG TAB 90 TABLET 9,163 824,670

ALOVEL 10 MG TAB 60 TABLET 9,350 561,000

ALOVEL 10 MG TAB 30 TABLET 9,350 280,500

ALOVEL 10 MG TAB 60 TABLET 9,395 563,686

ALOVEL 10 MG TAB 30 TABLET 9,395 281,843

ALPENTIN 300 MG ASKES 750 TABLET 2,650 1,987,524

ALPRAZOLAM 0,5MG 300 TABLET 585 175,501

ALPRAZOLAM 1 MG 300 TABLET 900 269,999

ALT/GPT (IFCC) 8X20 ML PAKET 1 KIT 3,850,000 3,850,000

ALT/GPT (IFCC) 8X20 ML PAKET 1 KIT 3,850,000 3,850,000

ALT/GPT (IFCC) 8X20 ML PAKET 1 KIT 3,850,000 3,850,000

ALT/GPT (IFCC) 8X20 ML PAKET 1 KIT 3,850,000 3,850,000

ALT/GPT 4X50 ML PAKET 1 BOX 1,647,800 1,647,800

AMBROXOL TAB 200 TABLET 125 24,988

AMBROXOL TAB 200 TABLET 264 52,800

AMBROXOL TAB 200 TABLET 125 24,988

AMBROXOL TAB 200 TABLET 127 25,425

AMBROXOL TAB ASKES 200 TABLET 125 24,988

AMBROXOL TAB ASKES 300 TABLET 125 37,481

AMINOPHILIN 200MG TAB 1,100 TABLET 110 121,399

AMINOPHILIN 200MG TAB 1,000 TABLET 99 99,000

AMINOPHILIN 200MG TAB 1,000 TABLET 99 99,000

AMINOPHYLLIN INJ 30 AMPUL 3,000 90,000

AMINOPHYLLIN INJ 60 AMPUL 3,000 180,000

AMINOPHYLLIN INJ 60 AMPUL 3,000 180,000

AMINOPHYLLIN INJ 90 AMPUL 3,000 270,000

AMINOPHYLLIN INJ 90 AMPUL 3,000 270,000

AMINOPHYLLIN INJ 60 AMPUL 2,850 171,000

AMINOPHYLLIN INJ 60 AMPUL 3,000 180,000

AMINOPHYLLIN INJ 30 AMPUL 3,000 90,000

AMINOPHYLLIN INJ 30 AMPUL 3,000 90,000

AMINOPHYLLIN INJ 60 AMPUL 3,000 180,000

AMINOPHYLLIN INJ ASKES 90 AMPUL 2,850 256,500

AMINOPHYLLIN INJ ASKES 120 AMPUL 3,000 360,000

AMINOPHYLLIN INJ ASKES 30 AMPUL 3,240 97,201

AMINOPHYLLIN INJ ASKES 120 AMPUL 3,000 360,000

AMITRIPTYLIN TAB ASKES 500 TABLET 113 56,502

AMITRIPTYLIN TAB ASKES 500 TABLET 120 59,945

AMLODIPIN 10 MG 100 TABLET 1,693 169,279

AMLODIPIN 10 MG 100 TABLET 1,524 152,351

AMLODIPIN 10 MG 150 TABLET 1,691 253,655

AMLODIPIN 10 MG ASKES 1,000 TABLET 846 845,515

AMLODIPIN 10 MG ASKES 250 TABLET 1,691 422,758

AMLODIPIN 10 MG ASKES 250 TABLET 1,691 422,758

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AMLODIPIN 10 MG ASKES 300 TABLET 1,691 507,309

AMLODIPIN 10 MG ASKES 500 TABLET 1,691 845,515

AMLODIPIN 5 MG 100 TABLET 864 86,400

AMLODIPIN 5 MG 100 TABLET 480 48,000

AMLODIPIN 5 MG ASKES 300 TABLET 380 114,005

AMLODIPIN 5 MG ASKES 250 TABLET 480 119,999

AMLODIPIN 5 MG ASKES 500 TABLET 480 239,998

AMOXAN 250 MG 100 TABLET 1,543 154,286

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 200 TABLET 3,161 632,170

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 100 TABLET 3,161 316,085

AMOXAN 500 MG 200 TABLET 3,161 632,170

AMOXAN 500 MG 300 TABLET 3,161 948,255

AMOXAN DROP 3 BOTOL 21,681 65,043

AMOXAN DROP 10 BOTOL 21,681 216,810

AMOXAN INJ 10 AMPUL 21,681 216,810

AMOXAN INJ 20 AMPUL 21,681 433,620

AMOXAN INJ 20 AMPUL 21,681 433,620

AMOXAN INJ 10 AMPUL 21,681 216,810

AMOXAN INJ 10 AMPUL 21,681 216,810

AMOXAN INJ 10 AMPUL 21,681 216,810

AMOXAN INJ 20 AMPUL 21,681 433,620

AMOXAN SYR 6 BOTOL 21,681 130,086

AMOXAN SYR 6 BOTOL 21,681 130,086

AMOXAN SYR 6 BOTOL 21,681 130,086

AMOXAN SYR 5 BOTOL 21,681 108,405

AMOXAN SYR 6 BOTOL 21,681 130,086

AMOXAN SYR 6 BOTOL 21,681 130,086

AMOXAN SYR 10 BOTOL 21,681 216,810

AMOXAN SYR 6 BOTOL 21,681 130,086

AMOXAN SYR 6 BOTOL 21,681 130,086

AMOXAN SYR 10 BOTOL 21,681 216,810

AMOXAN SYR 10 BOTOL 21,681 216,810

AMOXAN SYR 25 BOTOL 21,681 542,025

AMOXAN SYR 20 BOTOL 21,681 433,620

AMOXAN SYR FORTE 5 BOTOL 30,921 154,605

AMOXAN SYR FORTE 6 BOTOL 30,921 185,526

AMOXAN SYR FORTE 5 BOTOL 30,921 154,605

AMOXAN SYR FORTE 5 BOTOL 30,921 154,605

AMOXYCILLIN SYRP ASKES 10 BOTOL 3,511 35,112

AMOXYCILLIN SYRP ASKES 10 BOTOL 3,511 35,112

AMOXYCILLIN SYRP ASKES 10 BOTOL 4,290 42,900

AMPICILLIN INJ ASKES 100 VIAL 4,000 400,004

AMPICILLIN INJ ASKES 200 VIAL 6,600 1,320,000

AMPICILLIN INJ ASKES 100 VIAL 6,600 660,000

ANALSIK 300 TABLET 1,166 349,800

ANALSIK 300 TABLET 1,166 349,800

ANALSIK 300 TABLET 1,166 349,800

ANALSIK 300 TABLET 1,166 349,800

Page 43: FORM FA Unit Kerja Penunjang 30815

ANALSIK 300 TABLET 1,166 349,800

ANALSIK 600 TABLET 1,166 699,600

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 60 TABLET 6,600 396,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 90 TABLET 6,600 594,000

ANALTRAM TAB 150 TABLET 6,600 990,000

ANALTRAM TAB 300 TABLET 6,600 1,980,000

ANBACIM INJ 28 VIAL 70,785 1,981,980

ANBACIM INJ 28 VIAL 70,785 1,981,980

ANBACIM INJ 28 VIAL 70,785 1,981,980

ANBACIM INJ 28 VIAL 70,785 1,981,980

ANBACIM INJ 28 VIAL 72,556 2,031,568

ANBACIM INJ 28 VIAL 72,556 2,031,568

ANBACIM INJ 28 VIAL 72,556 2,031,568

ANBACIM INJ 4 VIAL 72,556 290,224

ANBACIM INJ 28 VIAL 72,556 2,031,568

ANBACIM INJ 28 VIAL 72,556 2,031,568

ANBACIM INJ 28 VIAL 72,556 2,031,568

ANTASIDA SYR 10 BOTOL 3,850 38,500

ANTASIDA SYRP ASKES 100 BOTOL 2,416 241,560

ANTASIDA SYRP ASKES 50 BOTOL 2,416 120,780

ANTASIDA SYRP ASKES 30 BOTOL 2,310 69,300

ANTASIDA SYRP ASKES 100 BOTOL 3,850 385,000

ANTASIDA SYRP ASKES 90 BOTOL 3,850 346,500

ANTASIDA SYRP ASKES 100 BOTOL 3,850 385,000

ANTASIDA SYRP ASKES 100 BOTOL 3,850 385,000

ANTASIDA SYRP ASKES 100 BOTOL 3,850 385,000

ANTASIDA SYRP ASKES 60 BOTOL 3,850 231,000

ANTIHEMOROID SUPP ASKES 200 3,000 600,006

ANTRAIN INJ 100 AMPUL 8,547 854,700

ANTRAIN INJ 100 AMPUL 8,547 854,700

ANTRAIN INJ 100 AMPUL 8,547 854,700

ANTRAIN INJ 50 AMPUL 8,778 438,900

ANTRAIN INJ 100 AMPUL 8,547 854,700

ANTRAIN INJ 50 AMPUL 8,547 427,350

ANTRAIN INJ 50 AMPUL 8,547 427,350

ANTRAIN INJ 50 AMPUL 8,547 427,350

ANTRAIN INJ 50 AMPUL 8,547 427,350

ANTRAIN INJ 50 AMPUL 8,547 427,350

ANTRAIN INJ 50 AMPUL 8,547 427,350

APIALYS DROP 10 FLS 30,250 302,500

SUPPOSITORIA

Page 44: FORM FA Unit Kerja Penunjang 30815

APIALYS DROP 5 FLS 30,250 151,250

APIALYS DROP 15 FLS 30,250 453,750

APIALYS DROP 10 FLS 30,250 302,500

APIALYS DROP 10 FLS 30,250 302,500

APIALYS DROP 20 FLS 30,250 605,000

APIALYS DROP 10 FLS 33,000 330,000

APIALYS DROP 15 FLS 33,000 495,000

APIALYS SYR 10 BOTOL 26,400 264,000

APIALYS SYR 5 BOTOL 26,400 132,000

APIALYS SYR 5 BOTOL 26,400 132,000

APIALYS SYR 10 BOTOL 26,400 264,000

APIALYS SYR 10 BOTOL 26,400 264,000

APIALYS SYR 10 BOTOL 26,400 264,000

APIALYS SYR 10 BOTOL 27,500 275,000

AQUA PRO INJ 600 FLS 1,680 1,007,820

AQUA PRO INJ 480 FLS 3,190 1,531,200

AQUA PRO INJ 296 FLS 3,190 944,240

AQUA PRO INJ 480 FLS 1,680 806,256

AQUA PRO INJ ASKES 600 FLS 1,680 1,007,820

AQUA PRO INJ ASKES 480 FLS 3,190 1,531,200

AQUA PRO INJ ASKES 480 FLS 1,680 806,256

AQUA PRO INJ ASKES 480 FLS 1,680 806,256

AQUA PRO INJ ASKES 480 FLS 1,680 806,256

AQUA PRO INJ ASKES 480 FLS 1,680 806,256

AQUA PRO INJ ASKES 2,400 FLS 1,680 4,031,280

AQUADEMIN 5 L PAKET 4 GALON 41,580 166,320

AQUADEMIN 5 L PAKET 8 GALON 41,580 332,640

AQUADEMIN 5 L PAKET 10 GALON 41,580 415,800

AQUADEMIN 5 L PAKET 4 GALON 41,580 166,320

AQUADEMIN 5 L PAKET 10 GALON 41,580 415,800

AQUADEMIN 5 L PAKET 6 GALON 41,580 249,480

AQUADEMIN 5 L PAKET 8 GALON 36,960 295,680

AQUADEMIN 5 L PAKET 10 GALON 41,580 415,800

ARCUS DILUENT 44441 PAKET 2 GALON 4,840,000 9,680,000

AROMA NORMAL PAKET 1 SAK 127,600 127,600

ASAM ASKORBAT 250 250 TABLET 128 31,999

ASAM MEFENAMAT 500 MG 1,000 TABLET 121 121,000

ASAM MEFENAMAT 500 MG 2,000 TABLET 180 360,008

ASAM MEFENAMAT 500 MG 1,000 TABLET 127 126,500

ASAM MEFENAMAT 500 MG 500 TABLET 127 63,250

ASAM MEFENAMAT 500 MG 1,500 TABLET 132 198,000

ASAM MEFENAMAT TAB ASKES 1,000 TABLET 171 171,072

ASAM MEFENAMAT TAB ASKES 2,000 TABLET 171 342,848

ASAM MEFENAMAT TAB ASKES 4,500 TABLET 180 810,018

ASAM MEFENAMAT TAB ASKES 4,500 TABLET 158 712,800

ASAM MEFENAMAT TAB ASKES 2,000 TABLET 218 435,600

ASAM MEFENAMAT TAB ASKES 5,000 TABLET 112 560,010

ASAM TRANEKSAMAT INJ ASKES 480 AMPUL 5,891 2,827,440

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

ASAM TRANEKSAMAT INJ ASKES 120 AMPUL 5,544 665,280

ASAM TRANEKSAMAT INJ ASKES 120 AMPUL 5,544 665,280

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

Page 45: FORM FA Unit Kerja Penunjang 30815

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

ASAM TRANEKSAMAT INJ ASKES 240 AMPUL 5,544 1,330,560

ASAM TRANEKSAMAT INJ ASKES 100 AMPUL 5,544 554,400

ASAM TRANEKSAMAT INJ NOVEL 240 AMPUL 6,930 1,663,200

ASAM TRANEKSAMAT INJ NOVEL 100 AMPUL 6,930 693,000

ASAM TRANEKSAMAT INJ NOVEL 100 AMPUL 6,930 693,000

ASAM TRANEKSAMAT TAB ASKES 500 TABLET 941 470,250

ASAM TRANEKSAMAT TAB ASKES 200 TABLET 941 188,100

ASAM URSODEOXYCHOLIC 250 MG ASKES 150 TABLET 4,389 658,350

ASEPTIK GEL 500 ML PAKET 66 BOTOL 19,250 1,270,500

ASERING INFUS 40 FLS 11,274 450,956

ASERING INFUS 100 FLS 15,901 1,590,050

ASERING INFUS ASKES 40 BOTOL 9,000 360,008

ASERING INFUS ASKES 60 BOTOL 8,812 528,720

ASERING INFUS ASKES 20 BOTOL 9,000 180,004

ASERING INFUS ASKES 20 BOTOL 9,000 180,004

ASERING INFUS ASKES 20 BOTOL 9,000 180,004

ASERING INFUS ASKES 20 BOTOL 9,000 180,004

ASERING INFUS ASKES 40 BOTOL 9,000 360,008

ASERING INFUS ASKES 60 BOTOL 9,000 540,012

ASERING INFUS ASKES 60 BOTOL 9,000 540,012

ASERING INFUS ASKES 200 BOTOL 9,000 1,800,040

ASPAR K 100 TABLET 2,248 224,796

ASPAR K 200 TABLET 2,248 449,592

ASPAR K 100 TABLET 2,248 224,796

ASPAR K 100 TABLET 2,248 224,796

AST/GOT (IFCC) 8X20 ML PAKET 1 KIT 3,850,000 3,850,000

AST/GOT (IFCC) 8X20 ML PAKET 1 KIT 3,850,000 3,850,000

AST/GOT (IFCC) 8X20 ML PAKET 1 KIT 3,850,000 3,850,000

AST/GOT (IFCC) 8X20 ML PAKET 1 KIT 3,850,000 3,850,000

AST/GOT 4X50 ML PAKET 1 BOX 1,647,800 1,647,800

ASTATIN TAB 40 TABLET 6,468 258,720

ASTHAROL TAB 100 TABLET 1,045 104,500

ASTHAROL TAB 200 TABLET 1,073 214,500

ASTHENOF ED 10 FLS 17,738 177,375

ASTHENOF ED 10 FLS 17,738 177,375

ASTHENOF ED 15 FLS 23,100 346,500

ASTHENOF ED 10 FLS 23,100 231,000

ASTHENOF ED 5 FLS 23,100 115,500

ASTHENOF ED 10 FLS 23,100 231,000

ATARAX 0,5 MG 300 TABLET 1,359 407,550

ATARAX 0,5 MG 500 TABLET 350 174,999

ATROPINE 0,25 INJ 150 AMPUL 1,264 189,564

ATROPINE 0,25 INJ 150 AMPUL 1,264 189,564

ATROPINE 0,25 INJ 300 AMPUL 1,800 539,999

ATS 1500 20 AMPUL 107,364 2,147,284

ATS 1500 20 AMPUL 126,500 2,530,000

ATS 1500 20 AMPUL 123,338 2,466,750

ATS 1500 3 AMPUL 126,500 379,500

ATS 1500 25 AMPUL 126,500 3,162,500

ATS 1500 20 AMPUL 123,338 2,466,750

ATS 1500 30 AMPUL 123,338 3,700,125

ATS 1500 20 AMPUL 123,338 2,466,750

ATS 1500 20 AMPUL 123,338 2,466,750

ATS 1500 50 AMPUL 123,338 6,166,875

ATS 1500 60 AMPUL 123,338 7,400,250

Page 46: FORM FA Unit Kerja Penunjang 30815

ATS 1500 20 AMPUL 123,338 2,466,750

ATS 1500 30 AMPUL 123,338 3,700,125

ATS 1500 50 AMPUL 123,338 6,166,875

ATS 1500 ASKES 30 AMPUL 123,338 3,700,125

AUGENTONIC 5ML 5 BOTOL 27,638 138,188

AVAMYS NASAL SPRAY ASKES 3 BOTOL 111,995 335,985

AVAMYS NASAL SPRAY ASKES 5 BOTOL 119,999 599,995

BAMGETOL 200 300 TABLET 1,881 564,300

BAMGETOL 200 300 TABLET 1,881 564,300

BAMGETOL 200 500 TABLET 1,881 940,500

BAMGETOL 200 500 TABLET 1,931 965,250

BAMGETOL 200 300 TABLET 1,881 564,300

BAMGETOL 200 500 TABLET 1,881 940,500

BAQUINOR 250 TAB 60 TABLET 6,199 371,910

BAQUINOR 250 TAB 60 TABLET 6,199 371,910

BAQUINOR 250 TAB 40 TABLET 6,199 247,940

BAQUINOR 250 TAB 60 TABLET 6,199 371,910

BAQUINOR 250 TAB 40 TABLET 6,199 247,940

BAQUINOR 250 TAB 100 TABLET 6,199 619,850

BAQUINOR ED 5 FLS 31,900 159,500

BAQUINOR ED 6 FLS 32,698 196,185

BAQUINOR ED 6 FLS 32,698 196,185

BAQUINOR ED 6 FLS 32,698 196,185

BAQUINOR ED 10 FLS 32,698 326,975

BAQUINOR ED 10 FLS 32,698 326,975

BAQUINOR ED 5 FLS 32,698 163,488

BAQUINOR FORTE 60 TABLET 12,881 772,860

BAQUINOR FORTE 60 TABLET 12,881 772,860

BAQUINOR FORTE 60 TABLET 12,881 772,860

BAQUINOR FORTE 60 TABLET 12,881 772,860

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 40 TABLET 13,206 528,220

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 60 TABLET 13,206 792,330

BAQUINOR FORTE 100 TABLET 13,206 1,320,550

BAQUINOR INF 5 FLS 219,725 1,098,625

BAQUINOR INF 5 FLS 219,725 1,098,625

BAQUINOR INF 3 FLS 225,220 675,659

BAQUINOR INF 6 FLS 225,220 1,351,317

BAQUINOR INF 6 FLS 225,220 1,351,317

BATUGIN ELIXIR 300 ML 5 BOTOL 32,000 160,001

BAYCLIN 1000 ML 15,000 MILILITER 19 280,500

BAYCLIN 1000 ML 20,000 MILILITER 19 374,000

BAYCLIN 1000 ML 15,000 MILILITER 19 280,500

BECLOV INJ 50 AMPUL 33,154 1,657,700

BECLOV INJ 25 AMPUL 33,154 828,850

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BECLOV INJ 25 AMPUL 33,154 828,850

BECLOV INJ 25 AMPUL 33,154 828,850

BECOM C 200 TABLET 1,221 244,200

BECOM C 100 TABLET 1,221 122,100

BECOM C 100 TABLET 1,221 122,100

BECOM C 100 TABLET 1,254 125,400

BECOM C 100 TABLET 1,254 125,400

BECOM C 100 TABLET 1,254 125,400

BECOM C 100 TABLET 1,254 125,400

BECOM C 100 TABLET 1,254 125,400

BECOM ZET 100 TABLET 1,628 162,800

BECOM ZET 200 TABLET 1,628 325,600

BENUTRION VE 1 FLS 100,298 100,298

BEROTEC INHALER 5 BOTOL 129,476 647,378

BEROTEC INHALER 5 BOTOL 129,476 647,378

BEROTEC INHALER ASKES 10 BOTOL 81,000 810,000

BEROTEC INHALER ASKES 10 BOTOL 81,000 810,000

BEROTEC INHALER ASKES 10 BOTOL 72,900 729,000

BETA ONE 2,5 MG ASKES 750 TABLET 1,020 764,998

BETADINE GARGLE 100 CC 30 BOTOL 8,140 244,200

BETADINE GARGLE 100 CC 10 BOTOL 8,470 84,700

BETAGENTAM ED 5 BOTOL 50,710 253,550

BETAHISTIN 6 MG ASKES 150 TABLET 924 138,600

BETAHISTIN 6 MG ASKES 150 TABLET 924 138,600

BETAHISTIN 6 MG ASKES 150 TABLET 785 117,810

BETAHISTIN 6 MG ASKES 90 TABLET 906 81,497

BETAHISTIN 6 MG ASKES 300 TABLET 832 249,480

BIOFIX ( 2 GRAM X 2 ) 1 SET 511,500 511,500

BIOSANBE 100 TABLET 935 93,500

BIOSANBE 100 TABLET 935 93,500

BIOTHICOL SYR 5 BOTOL 19,305 96,525

BIOTHICOL SYR 10 BOTOL 19,789 197,890

BIOTHICOL SYR 5 BOTOL 19,789 98,945

BIPRO TAB ASKES 600 TABLET 1,075 644,952

BISOLVON INJ 10 AMPUL 39,940 399,399

BISOPROLOL 5MG 90 TABLET 1,625 146,265

BISOPROLOL 5MG 200 TABLET 1,161 232,166

BISOPROLOL ASKES 300 TABLET 1,074 322,199

BISOPROLOL ASKES 300 TABLET 599 179,695

BISOPROLOL ASKES 300 TABLET 599 179,695

BLADE 11 REG 100 PCS 2,426 242,550

BLADE 11 REG 100 PCS 2,703 270,270

BLADE 11 REG 100 PCS 2,703 270,270

BLADE 15 REG 100 PCS 2,703 270,270

BLADE 15 REG 100 PCS 2,703 270,270

BLADE 20 REG 100 PCS 2,426 242,550

BLADE 20 REG 100 PCS 2,703 270,270

BLADE 20 REG 300 PCS 3,003 900,900

BLADE ELEKTRODE 70 MM 552R 1 PCS 209,000 209,000

BLEDSTOP INJ 30 AMPUL 6,793 203,775

BLEDSTOP INJ 50 AMPUL 6,793 339,625

BLEDSTOP INJ 50 AMPUL 6,793 339,625

BLEDSTOP INJ 50 AMPUL 6,963 348,150

BLEDSTOP INJ 100 AMPUL 6,963 696,300

BLEDSTOP INJ 100 AMPUL 6,963 696,300

BLEDSTOP INJ 50 AMPUL 6,963 348,150

BLEDSTOP TAB 200 TABLET 457 91,300

Page 48: FORM FA Unit Kerja Penunjang 30815

BLEOCIN INJ ASKES 7 VIAL 365,000 2,554,999

BLEOCIN INJ ASKES 7 VIAL 365,000 2,554,999

BLESIFEN 40 TABLET 11,897 475,860

BLESIFEN 40 TABLET 11,897 475,860

BLESIFEN 40 TABLET 11,897 475,860

BLESIFEN 40 TABLET 11,897 475,860

BLOOD CONTROL PAKET 1 VIAL 440,000 440,000

BLOOD LANCET ON CALL 100" 10 BOX 68,750 687,500

BLOOD LANCET REG 500 PCS 699 349,250

BLOODSET ONE MED ASKES 50 PCS 7,150 357,500

BLOODSET ONE MED ASKES 100 PCS 6,435 643,500

BLOODSET ONE MED ASKES 50 PCS 6,435 321,750

BLOODSET ONE MED ASKES 50 PCS 6,435 321,750

BLOODSET TERUMO 100 BIJI 20,790 2,079,000

BLOODSET TERUMO 50 BIJI 21,945 1,097,250

BLOODSET TERUMO 100 BIJI 21,945 2,194,500

BLOODSET TERUMO 50 BIJI 21,945 1,097,250

BLOODSET TERUMO 150 BIJI 21,945 3,291,750

BLOODSET TERUMO 100 BIJI 21,945 2,194,500

BLOODSET TERUMO 50 BIJI 21,945 1,097,250

BLOODSET TERUMO 100 BIJI 21,945 2,194,500

BLOODSET TERUMO 100 BIJI 21,945 2,194,500

BLOODSET TERUMO 100 BIJI 21,945 2,194,500

BLOODSET WIN ASKES 100 PCS 12,100 1,210,000

BLOODSET WIN ASKES 200 PCS 12,100 2,420,000

BLOODSET WIN ASKES 100 PCS 12,100 1,210,000

BLOODSET WIN ASKES 200 PCS 12,100 2,420,000

BLOODSET WIN ASKES 40 PCS 12,100 484,000

BLOODSET WIN ASKES 40 PCS 12,100 484,000

BLOODSET WIN ASKES 60 PCS 12,100 726,000

BLOODSET WIN ASKES 100 PCS 12,100 1,210,000

BLOODSET WIN ASKES 100 PCS 12,100 1,210,000

BLOODSET WIN ASKES 100 PCS 12,100 1,210,000

BLOODSET WIN ASKES 60 PCS 12,100 726,000

BLOODSET WIN ASKES 200 PCS 12,100 2,420,000

BLUE TIPS IHS 1,000 PCS 132 132,000

BLUE TIPS IHS 500 PCS 132 66,000

BLUE TIPS REG 500 PCS 290 145,200

BLUE TIPS REG 500 PCS 290 145,200

BONDING PAKET 1 KIT 290,400 290,400

BONDING PAKET 1 KIT 422,400 422,400

BORAGINOL N SUPPOS 20 8,239 164,779

BORAGINOL S SUPP 20 PCS 9,441 188,818

BORAGINOL S SUPP 30 PCS 9,441 283,227

BOTOL PLASTIK 60 ML 200 BOTOL 770 154,000

BRAIN ACT 250 INJ 15 AMPUL 45,100 676,500

BRAINACT 500 INJ 5 AMPUL 69,740 348,700

BRAINACT 500 INJ 25 AMPUL 69,740 1,743,500

BRALIFEX ED 6 FLS 31,741 190,443

BRALIFEX PLUS ED 5 BOTOL 41,855 209,275

BRALIFEX PLUS ED 6 BOTOL 41,855 251,130

BRALIFEX PLUS ED 5 BOTOL 42,900 214,500

BRALIFEX PLUS ED 5 BOTOL 42,900 214,500

BRALIFEX PLUS ED 10 BOTOL 42,900 429,000

BRALIFEX PLUS ED 10 BOTOL 42,900 429,000

BRALIFEX PLUS ED 20 BOTOL 42,900 858,000

SUPPOSITORIA

Page 49: FORM FA Unit Kerja Penunjang 30815

BRAUNOL 1 CC 5,000 MILILITER 132 660,000

BRAUNOL 1 CC 5,000 MILILITER 132 660,000

BRAUNOL 1 CC 10,000 MILILITER 132 1,320,000

BRAUNOL 1 CC 2,000 MILILITER 132 264,000

BRAUNOL 1 CC 5,000 MILILITER 132 660,000

BRAUNOL 1 CC 5,000 MILILITER 132 660,000

BRAUNOL 1 CC 6,000 MILILITER 132 792,000

BRAXIDIN 300 TABLET 847 254,100

BRAXIDIN 300 TABLET 847 254,100

BRAXIDIN 300 TABLET 847 254,100

BRAXIDIN 300 TABLET 847 254,100

BRAXIDIN 200 TABLET 847 169,400

BRAXIDIN 600 TABLET 847 508,200

BREATHY TETES HIDUNG 10 BOTOL 16,170 161,700

BREXEL 20 MG INJ 1 VIAL 1,200,000 1,200,000

BREXEL 20 MG INJ 1 VIAL 1,200,000 1,200,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 20 MG INJ 1 VIAL 1,100,000 1,100,000

BREXEL 80 MG INJ 1 VIAL 4,000,000 4,000,000

BREXEL 80 MG INJ 1 VIAL 4,000,000 4,000,000

BREXEL 80 MG INJ 1 VIAL 4,000,000 4,000,000

BREXEL 80 MG INJ 1 VIAL 4,000,000 4,000,000

BREXEL 80 MG INJ 1 VIAL 4,000,000 4,000,000

BREXEL 80 MG INJ 1 VIAL 4,000,000 4,000,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BREXEL 80 MG INJ 1 VIAL 3,800,000 3,800,000

BROAD PLATE 10 HOLE 1 PCS 851,620 851,620

BROAD PLATE 10 HOLE 1 PCS 851,620 851,620

BROAD PLATE 10 HOLE 1 PCS 851,620 851,620

Page 50: FORM FA Unit Kerja Penunjang 30815

BROAD PLATE 9 HOLE 1 PCS 792,220 792,220

BUFECT 10 BOTOL 13,365 133,650

BUFECT 10 BOTOL 13,365 133,650

BUFECT 10 BOTOL 13,701 137,005

BUFECT 6 BOTOL 13,701 82,203

BUFECT 10 BOTOL 13,701 137,005

BUFECT 10 BOTOL 13,701 137,005

BUFECT 10 BOTOL 13,701 137,005

BUFECT 10 BOTOL 13,701 137,005

BUFECT 10 BOTOL 13,701 137,005

BUFECT 10 BOTOL 13,701 137,005

BUFECT 15 BOTOL 13,701 205,508

BUFECT 10 BOTOL 13,701 137,005

BUFECT 20 BOTOL 13,701 274,010

BUFECT FORTE SYRUP 5 BOTOL 19,338 96,690

BUFECT FORTE SYRUP 5 BOTOL 19,338 96,690

BUR DIAMOND KODE A EDENTA 3 PCS 25,300 75,900

BURNAZIN CREAM 5 TUBE 40,233 201,163

BURNAZIN CREAM 3 TUBE 44,256 132,767

BURNAZIN CREAM 5 TUBE 44,256 221,279

BURNAZIN CREAM 2 TUBE 44,256 88,512

BURNAZIN CREAM 6 TUBE 44,256 265,535

BURNAZIN CREAM 3 TUBE 44,256 132,767

BUSCOPAN TAB 200 TABLET 2,177 435,348

BUSCOPAN TAB 200 TABLET 2,177 435,348

CA GLUCONAS 48 AMPUL 13,500 648,001

CA GLUCONAS 72 AMPUL 13,500 972,027

CA GLUCONAS INJ ASKES 144 AMPUL 13,500 1,944,002

0 #DIV/0! 0

0 #DIV/0! 0

CAL 95 90 TABLET 3,520 316,800

CAL 95 60 TABLET 3,520 211,200

CAL 95 60 TABLET 3,850 231,000

CALXYL BLUE PAKET 1 BIJI 514,800 514,800

CANCELLOUS 6.5 FULL TH L-60 MM 3 PCS 217,030 651,090

CANDESARTAN 16 MG ASKES 450 TABLET 5,799 2,609,714

CANDESARTAN 16 MG ASKES 300 TABLET 5,799 1,739,810

CANDESARTAN 16 MG ASKES 300 TABLET 4,900 1,469,998

CANDESARTAN 8 MG 150 TABLET 3,300 494,951

CANDESARTAN 8 MG ASKES 300 TABLET 3,300 989,901

CANDESARTAN 8 MG ASKES 750 TABLET 3,300 2,474,753

CANDESARTAN 8 MG ASKES 450 TABLET 3,300 1,484,852

CANDESARTAN 8 MG ASKES 300 TABLET 3,100 929,999

420 TABLET 4,900 2,057,799

280 TABLET 4,900 1,371,866

450 TABLET 3,300 1,484,852

56 TABLET 3,100 173,602

812 TABLET 3,100 2,516,921

CANUL PARTEX NO.7 1 PCS 1,500,000 1,500,000

CAPRENEM 0,5 MG INJ 5 VIAL 225,500 1,127,500

CAPTOPRIL 25 MG 200 TABLET 138 27,551

CARBAMAZEPINE 200 MG ASKES 1,000 TABLET 246 246,004

CAHAYA BERLIAN SAKTITgl Bill:04-06-2014

CAHAYA BERLIAN SAKTITgl Bill:27-06-2014

CANDESARTAN TI 16 MG ASK ( BLOPRESS)

CANDESARTAN TI 16 MG ASK ( BLOPRESS)

CANDESARTAN TI 8 MG ASK ( BLOPRESS )

CANDESARTAN TI 8 MG ASK ( BLOPRESS )

CANDESARTAN TI 8 MG ASK ( BLOPRESS )

Page 51: FORM FA Unit Kerja Penunjang 30815

CARDISAN 10 MG 50 TABLET 9,713 485,650

CARDISAN 10 MG 50 TABLET 9,713 485,650

CARDISAN 5 MG 50 TABLET 5,467 273,350

CARDISAN 5 MG 50 TABLET 5,467 273,350

CARDISAN 5 MG 50 TABLET 5,467 273,350

CARTRID NSK PANA AIR 1 PACK 957,000 957,000

CARTRIDGE CC PAKET 25 PCS 178,200 4,455,000

CAT GUT CHROMIC PRECUT 2 TRITON 12 PCS 17,424 209,088

CAT GUT CHROMIC PRECUT 2 TRITON 48 PCS 17,424 836,352

CAT GUT CROMIC 2 PER 1 CM 5,000 330 1,650,000

CAT GUT CROMIC 2 PER 1 CM 5,000 330 1,650,000

CAT GUT CROMIC 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT CROMIC 2/0 PER 1 CM 20,000 165 3,300,000

CAT GUT CROMIC 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT CROMIC 2/0 PER 1 CM 20,000 165 3,300,000

CAT GUT CROMIC 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT CROMIC 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT CROMIC 3 PER 1 CM 5,000 304 1,518,000

CAT GUT CROMIC 3 PER 1 CM 5,000 330 1,650,000

CAT GUT CROMIC 3 PER 1 CM 5,000 330 1,650,000

CAT GUT CROMIC 3 PER 1 CM 5,000 330 1,650,000

CAT GUT CROMIC 3 PER 1 CM 5,000 330 1,650,000

CAT GUT CROMIC 3/0 PER 1 CM 10,000 165 1,650,000

CAT GUT CROMIC 4/0 PER 1 CM 10,000 202 2,024,000

CAT GUT PLAIN 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT PLAIN 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT PLAIN 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT PLAIN 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT PLAIN 2/0 PER 1 CM 10,000 165 1,650,000

CAT GUT PLAIN 3/0 PER 1 CM 10,000 165 1,650,000

CAT GUT PLAIN 4/0 PER 1 CM 10,000 202 2,024,000

CATACHOL 18 FLS 49,500 891,000

CATACHOL 5 FLS 49,500 247,500

CATACHOL 14 FLS 38,500 539,000

CATACHOL 3 FLS 49,500 148,500

CATACHOL 21 FLS 38,500 808,500

CATACHOL 23 FLS 49,500 1,138,500

CATHEJELL 12,5 G 5 TUBE 51,920 259,600

CAVITON PAKET 1 BIJI 88,000 88,000

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

Page 52: FORM FA Unit Kerja Penunjang 30815

CEFACEF SYRUP 5 BOTOL 72,853 364,265

CEFACEF SYRUP 20 BOTOL 72,853 1,457,060

CEFACEF TAB 60 TABLET 17,105 1,026,300

CEFACEF TAB 30 TABLET 17,105 513,150

CEFACEF TAB 60 TABLET 17,534 1,052,040

CEFACEF TAB 60 TABLET 17,534 1,052,040

CEFADROXIL 500 MG 1,000 TABLET 840 840,004

CEFADROXIL 500 MG 1,000 TABLET 580 580,019

CEFADROXIL 500 MG ASKES 2,000 TABLET 580 1,160,038

CEFADROXIL 500 MG ASKES 2,000 TABLET 580 1,160,038

CEFADROXIL 500 MG ASKES 2,000 TABLET 580 1,160,038

CEFADROXIL SYRP ASKES 5 BOTOL 6,500 32,500

CEFADROXIL SYRP ASKES 5 BOTOL 6,500 32,500

CEFADROXIL SYRP ASKES 5 BOTOL 6,500 32,500

CEFADROXIL SYRP ASKES 10 BOTOL 5,904 59,037

CEFAT 250MG 100 TABLET 5,104 510,400

CEFAT 250MG 100 TABLET 5,104 510,400

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT 500MG 200 TABLET 10,087 2,017,400

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT 500MG 200 TABLET 10,087 2,017,400

CEFAT 500MG 200 TABLET 10,087 2,017,400

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT 500MG 100 TABLET 10,087 1,008,700

CEFAT FORTE SYR 6 BOTOL 71,500 429,000

CEFAT FORTE SYR 3 BOTOL 71,500 214,500

CEFAT SYR 6 BOTOL 41,580 249,480

CEFAT SYR 5 BOTOL 41,580 207,900

CEFAT SYR 10 BOTOL 41,580 415,800

CEFAT SYR 6 BOTOL 41,580 249,480

CEFAT SYR 5 BOTOL 41,580 207,900

CEFAT SYR 3 BOTOL 41,580 124,740

CEFAT SYR 3 BOTOL 41,580 124,740

CEFAT SYR 6 BOTOL 41,580 249,480

CEFAT SYR 5 BOTOL 41,580 207,900

CEFAT SYR 5 BOTOL 41,580 207,900

CEFAT SYR 6 BOTOL 41,580 249,480

CEFAT SYR 10 BOTOL 41,580 415,800

CEFAT SYR 10 BOTOL 41,580 415,800

CEFEPIME 1G INJ 4 VIAL 145,200 580,800

CEFEPIME 1G INJ 6 VIAL 145,200 871,200

CEFEPIME 1G INJ 10 VIAL 145,200 1,452,000

CEFEPIME 1G INJ 12 VIAL 145,200 1,742,400

CEFEPIME 1G INJ 10 VIAL 145,200 1,452,000

CEFEPIME 1G INJ 12 VIAL 145,200 1,742,400

CEFEPIME 1G INJ 20 VIAL 145,200 2,904,000

CEFEPIME 1G INJ 20 VIAL 145,200 2,904,000

CEFEPIME 1G INJ 20 VIAL 145,200 2,904,000

CEFEPIME 1G INJ 30 VIAL 145,200 4,356,000

CEFEPIME 1G INJ ASKES 20 VIAL 48,061 961,224

CEFEPIME 1G INJ ASKES 20 VIAL 48,061 961,224

CEFEPIME 1G INJ ASKES 20 VIAL 48,061 961,224

Page 53: FORM FA Unit Kerja Penunjang 30815

CEFILA 100 60 TABLET 15,400 924,000

CEFILA 100 90 TABLET 15,400 1,386,000

CEFILA 100 90 TABLET 15,400 1,386,000

CEFILA 100 90 TABLET 15,400 1,386,000

CEFILA 100 90 TABLET 15,400 1,386,000

CEFILA 100 90 TABLET 15,400 1,386,000

CEFILA 100 60 TABLET 15,400 924,000

CEFILA 100 90 TABLET 16,500 1,485,000

CEFILA DROP 10 FLS 74,800 748,000

CEFILA DROP 10 FLS 74,800 748,000

CEFILA DROP 5 FLS 74,800 374,000

CEFILA DROP 5 FLS 74,800 374,000

CEFILA DROP 10 FLS 74,800 748,000

CEFIXIM SYRUP 15 BOTOL 30,250 453,750

CEFIXIM SYRUP 15 BOTOL 30,250 453,750

CEFIXIM SYRUP 10 BOTOL 30,250 302,500

CEFIXIM TAB 500 TABLET 2,395 1,197,295

CEFIXIM TAB 150 TABLET 2,395 359,189

CEFIXIM TAB 350 TABLET 2,395 838,107

CEFIXIM TAB 300 TABLET 2,392 717,661

CEFIXIM TAB 150 TABLET 2,586 387,927

CEFIXIM TAB 250 TABLET 2,395 598,648

CEFIXIM TAB 200 TABLET 2,395 478,918

CEFIXIM TAB 300 TABLET 2,395 718,377

CEFIXIM TAB 250 TABLET 2,395 598,648

CEFIXIM TAB 500 TABLET 2,395 1,197,295

CEFIXIM TAB 500 TABLET 2,395 1,197,295

CEFIXIME 100 MG ASKES 300 TABLET 1,000 299,993

CEFIXIME 100 MG ASKES 500 TABLET 859 429,501

CEFIXIME SYRUP ASKES 10 BOTOL 25,410 254,100

CEFIXIME SYRUP ASKES 20 BOTOL 24,200 484,000

CEFOTAXIM INJ ASKES 500 VIAL 6,800 3,399,996

CEFOTAXIM INJ ASKES 200 VIAL 3,001 600,138

CEFOTAXIM INJ ASKES 200 VIAL 4,000 800,030

CEFOTAXIM INJ ASKES 300 VIAL 3,382 1,014,552

CEFOTAXIM BERNOFARM 100 VIAL 6,653 665,280

CEFOTAXIM BERNOFARM 100 VIAL 6,800 679,999

CEFOTAXIM BERNOFARM 100 VIAL 6,800 679,999

CEFOTAXIM DEXA 130 VIAL 4,792 622,908

CEFOTAXIM INJEKSI ASKES 500 FLS 2,950 1,474,990

CEFRIEX 3 VIAL 187,000 561,000

CEFRIEX 1 VIAL 187,000 187,000

CEFRIEX 5 VIAL 187,000 935,000

CEFRIEX 8 VIAL 183,260 1,466,080

CEFRIEX 6 VIAL 187,000 1,122,000

CEFTIZOXIM INJ 6 VIAL 110,000 660,000

CEFTIZOXIM INJ 4 VIAL 110,000 440,000

CEFTIZOXIM INJ 6 VIAL 110,000 660,000

CEFTIZOXIM INJ 6 VIAL 110,000 660,000

CEFTRIAXON BERNOFARM 200 VIAL 4,501 900,123

CEFTRIAXON DEXA 320 VIAL 4,501 1,440,212

CEFTRIAXON INJ ASKES 2,500 VIAL 4,501 11,251,543

CEFTRIAXON INJ ASKES 400 VIAL 4,500 1,800,040

CEFTRIAXON INJ ASKES 576 VIAL 4,500 2,592,058

CEFTRIAXON INJ DEXA ASKES 1,000 VIAL 3,300 3,300,088

CEFTRIAXON INJ DEXA ASKES 100 VIAL 3,300 330,009

CEFXON 10 VIAL 192,500 1,925,000

Page 54: FORM FA Unit Kerja Penunjang 30815

CEFXON 10 VIAL 192,500 1,925,000

CEFXON 10 VIAL 192,500 1,925,000

CEFXON 10 VIAL 192,500 1,925,000

CEFXON 10 VIAL 192,500 1,925,000

CEFXON 10 VIAL 192,500 1,925,000

CEFXON 5 VIAL 192,500 962,500

CEFXON 10 VIAL 192,500 1,925,000

CEFXON 10 VIAL 192,500 1,925,000

CEFXON 10 VIAL 192,500 1,925,000

CELLPACK PAKET 1 BOX 1,980,000 1,980,000

CELLPACK PAKET 2 BOX 1,980,000 3,960,000

CELLPACK PAKET 2 BOX 1,980,000 3,960,000

CELLPACK PAKET 2 BOX 1,980,000 3,960,000

CELLPACK PAKET 1 BOX 1,980,000 1,980,000

CELLPACK PAKET 1 BOX 1,980,000 1,980,000

CELLPACK PAKET 1 BOX 1,980,000 1,980,000

CELLPACK PAKET 1 BOX 1,980,000 1,980,000

CENFRESH ED 5 ML 6 FLS 38,363 230,175

CENFRESH ED 5 ML 10 FLS 38,363 383,625

CENFRESH ED 5 ML 20 FLS 38,363 767,250

CENFRESH ED 5 ML 11 FLS 38,363 421,988

CENFRESH MD 20 FLS 19,388 387,750

CENFRESH MD 20 FLS 19,388 387,750

CENFRESH MD 20 FLS 19,388 387,750

CENFRESH MD 20 FLS 19,388 387,750

CENFRESH MD 20 FLS 25,300 506,000

CENFRESH MD 20 FLS 25,300 506,000

CENFRESH MD 20 FLS 25,300 506,000

CENFRESH MD 20 FLS 25,300 506,000

CENFRESH MD 10 FLS 25,300 253,000

CENFRESH MD 20 FLS 25,300 506,000

CENFRESH MD 20 FLS 25,300 506,000

CENFRESH MD 20 FLS 25,300 506,000

CENFRESH MD 20 FLS 25,300 506,000

CENFRESH MD 60 FLS 25,300 1,518,000

CERAM X 3 GRAM 4 TUBE 498,300 1,993,200

CERATOME 2.75 21 PCS 154,000 3,234,000

CEREMAX INF 50 ML 5 BOTOL 242,550 1,212,750

CEREMAX INF 50 ML 6 BOTOL 291,500 1,749,000

CEREMAX INF 50 ML 6 BOTOL 291,500 1,749,000

CEREMAX INF 50 ML 6 BOTOL 291,500 1,749,000

CEREMAX INF 50 ML 5 BOTOL 291,500 1,457,500

CEREMAX INF 50 ML ASKES 1 BOTOL 194,999 194,999

CERINI 100 TABLET 3,163 316,250

CERINI 60 TABLET 3,163 189,750

CERINI 40 TABLET 3,245 129,800

CERINI 20 TABLET 3,245 64,900

CERINI 40 TABLET 3,245 129,800

CERINI 60 TABLET 3,245 194,700

CERINI 60 TABLET 3,245 194,700

CERINI 60 TABLET 3,245 194,700

CETAMID 5 ML 10 BOTOL 12,375 123,750

CETAMID 5 ML 10 BOTOL 12,375 123,750

CETAMID 5 ML 10 BOTOL 12,375 123,750

CETAMID 5 ML 10 BOTOL 12,375 123,750

CETAMID 5 ML 10 BOTOL 12,375 123,750

CETAMID 5 ML 10 BOTOL 12,375 123,750

Page 55: FORM FA Unit Kerja Penunjang 30815

CETAMID 5 ML 20 BOTOL 12,375 247,500

CETAMID 5 ML 10 BOTOL 12,375 123,750

CETAMID 5 ML 10 BOTOL 12,375 123,750

CETAMID 5 ML 10 BOTOL 12,375 123,750

CETIRIZIN SYR ASKES 3 BOTOL 10,440 31,320

CETIRIZINE SYRUP 15 BOTOL 10,440 156,602

CETIRIZINE SYRUP 10 BOTOL 10,440 104,401

CETIRIZINE TAB 150 TABLET 314 47,025

CETIRIZINE TAB 100 TABLET 305 30,536

CETIRIZINE TAB 120 TABLET 302 36,274

CETIRIZINE TAB ASKES 250 TABLET 314 78,375

CETIRIZINE TAB ASKES 600 TABLET 302 181,368

CHOLESTEROL 12X20 ML PAKET 1 PACK 3,850,000 3,850,000

CHOLESTEROL 12X20 ML PAKET 1 PACK 3,850,000 3,850,000

CHOLESTEROL 12X20 ML PAKET 1 PACK 3,850,000 3,850,000

CHOLESTEROL CHOD-PAP 8X20 ML 1 KIT 1,001,000 1,001,000

CIMETIDIN ASKES 100 TABLET 111 11,086

CINAM INJ 20 VIAL 132,000 2,640,000

CINAM INJ 20 VIAL 132,000 2,640,000

CINAM INJ 20 VIAL 132,000 2,640,000

CINAM INJ 20 VIAL 132,000 2,640,000

CINAM INJ 20 VIAL 132,000 2,640,000

CINAM INJ 20 VIAL 132,000 2,640,000

CINAM INJ 20 VIAL 132,000 2,640,000

CINAM INJ 20 VIAL 135,300 2,706,000

CINAM INJ 20 VIAL 135,300 2,706,000

CINAM INJ 20 VIAL 135,300 2,706,000

CINAM INJ 20 VIAL 135,300 2,706,000

CINAM INJ 20 VIAL 135,300 2,706,000

CINAM INJ 20 VIAL 135,300 2,706,000

CINAM INJ 20 VIAL 135,300 2,706,000

CINAM INJ 2 VIAL 135,300 270,600

CINAM INJ 20 VIAL 135,300 2,706,000

CINAM INJ 40 VIAL 135,300 5,412,000

CINAM INJ 40 VIAL 135,300 5,412,000

CINAM INJ 20 VIAL 135,300 2,706,000

CINOLON 5 TUBE 15,505 77,523

CINOLON 5 TUBE 15,505 77,523

CINOLON N 3 TUBE 16,555 49,665

CINOLON N 6 TUBE 16,555 99,330

CINOLON N 5 TUBE 16,555 82,775

CINOLON N 6 TUBE 16,973 101,838

CINOLON N 6 TUBE 16,973 101,838

CINOLON N 5 TUBE 16,973 84,865

CINOLON N 6 TUBE 16,973 101,838

CINOLON N 5 TUBE 16,973 84,865

CINOLON N 6 TUBE 16,973 101,838

CINOLON N 6 TUBE 16,973 101,838

CINOLON N 6 TUBE 16,973 101,838

CINOLON N 6 TUBE 16,973 101,838

CIPREC 500 MG 40 TABLET 12,227 489,060

CIPREC 500 MG 40 TABLET 12,227 489,060

CIPREC 500 MG 40 TABLET 12,227 489,060

CIPROFLOXACIN 500 MG TAB 1,000 TABLET 385 385,000

CIPROFLOXACIN 500 MG TAB 1,000 TABLET 385 385,000

CIPROFLOXACIN 500 MG TAB 1,000 TABLET 308 308,000

CIPROFLOXACIN 500 MG TAB 2,500 TABLET 308 770,000

Page 56: FORM FA Unit Kerja Penunjang 30815

CIPROFLOXACIN INF 24 BOTOL 57,000 1,367,995

CIPROFLOXACIN INF 32 BOTOL 57,000 1,823,994

CIPROFLOXACIN INF 50 BOTOL 45,001 2,250,025

CIPROFLOXACIN INF ASKES 50 BOTOL 25,650 1,282,496

CIPROFLOXACIN INF ASKES 50 BOTOL 25,650 1,282,504

CIPROFLOXACIN INF ASKES 50 BOTOL 45,001 2,250,025

CIPROFLOXACIN INF ASKES 80 BOTOL 22,000 1,760,000

CIPROFLOXACIN INF ASKES 50 BOTOL 25,650 1,282,504

CIPROFLOXACIN INFUS BPJS 18 BOTOL 18,876 339,768

CIPROFLOXACIN INFUS BPJS 32 BOTOL 13,000 416,000

CIPROFLOXACIN INFUS BPJS 50 BOTOL 12,829 641,438

CIPROFLOXACIN INFUS BPJS 50 BOTOL 13,000 649,992

CIPROFLOXACIN INFUS BPJS 80 BOTOL 13,000 1,040,001

CIPROFLOXACIN INFUS BPJS 32 BOTOL 13,000 416,000

CIPROFLOXACIN TAB ASKES 2,000 TABLET 284 567,424

CIPROFLOXACIN TAB ASKES 2,000 TABLET 250 499,994

CIPROFLOXACIN TAB ASKES 1,000 TABLET 308 308,000

CIPROFLOXACIN TAB ASKES 2,000 TABLET 308 616,000

CIPROFLOXACIN TAB ASKES 5,000 TABLET 308 1,540,000

CISPLATIN 50 MG INJ ASKES 2 VIAL 158,000 315,999

CISPLATIN 50 MG INJ ASKES 2 VIAL 158,000 315,999

CISPLATIN 50 MG INJ ASKES 2 VIAL 158,000 315,999

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,440 1,144,000

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,001 1,100,055

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,440 1,144,000

CITICHOLIN 250 INJ ASKES 50 AMPUL 11,440 572,000

CITICHOLIN 250 INJ ASKES 50 AMPUL 11,001 550,028

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,001 1,100,055

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,440 1,144,000

CITICHOLIN 250 INJ ASKES 50 AMPUL 11,001 550,028

CITICHOLIN 250 INJ ASKES 50 AMPUL 11,001 550,028

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,006 1,100,550

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,006 1,100,550

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,006 1,100,550

CITICHOLIN 250 INJ ASKES 100 AMPUL 11,006 1,100,550

CITICHOLIN 250 INJ ASKES 150 AMPUL 11,006 1,650,825

CITICHOLIN 250 MG INJ 50 AMPUL 14,300 715,000

CITICHOLIN 250 MG INJ 100 AMPUL 13,200 1,320,000

CITICHOLIN 250 MG INJ 50 AMPUL 11,001 550,028

CITICHOLIN 250 MG INJ 20 AMPUL 14,300 286,000

CITICOLIN 500 MG ASKES 30 TABLET 6,600 198,000

CITICOLIN 500 MG ASKES 60 TABLET 6,600 396,000

CLANEKSI 500 MG 30 TABLET 11,424 342,705

CLANEKSI 500 MG 90 TABLET 11,424 1,028,115

CLANEKSI 500 MG 30 TABLET 11,424 342,705

CLANEKSI 500 MG 30 TABLET 11,424 342,705

CLANEKSI 500 MG 60 TABLET 11,424 685,410

CLANEKSI 500 MG 90 TABLET 11,424 1,028,115

CLANEKSI 500 MG 150 TABLET 11,424 1,713,525

CLANEKSI FORTE SYR 5 BOTOL 66,748 333,740

CLANEKSI FORTE SYR 5 BOTOL 66,748 333,740

CLANEKSI SYR 10 BOTOL 48,620 486,200

CLANEKSI SYR 10 BOTOL 48,620 486,200

CLANEKSI SYR 10 BOTOL 48,620 486,200

CLANEKSI SYR 10 BOTOL 48,620 486,200

CLANEKSI SYR 10 BOTOL 48,620 486,200

CLANEKSI SYR 5 BOTOL 49,836 249,178

Page 57: FORM FA Unit Kerja Penunjang 30815

CLANEKSI SYR 5 BOTOL 49,836 249,178

CLANEKSI SYR 10 BOTOL 49,836 498,355

CLANEKSI SYR 10 BOTOL 49,836 498,355

CLANEKSI SYR 10 BOTOL 49,836 498,355

CLANEKSI SYR 10 BOTOL 49,836 498,355

CLANEKSI SYR 15 BOTOL 49,836 747,533

CLINMAS 300 60 TABLET 6,600 396,000

CLOPIDOGREL ASKES 300 TABLET 4,000 1,200,002

CLOPIDOGREL ASKES 600 TABLET 3,400 2,039,796

CLOPRAMEL INJ 125 AMPUL 8,316 1,039,500

CLOPRAMEL INJ ASKES 250 AMPUL 2,300 575,025

CLOPRAMEL INJ ASKES 250 AMPUL 2,300 575,025

CLORAETHYL INJ PAKET 3 BOTOL 198,000 594,000

CO AMOXICLAV 625 MG 90 TABLET 4,924 443,185

CO AMOXICLAV 625 MG 90 TABLET 4,924 443,185

CO AMOXICLAV 625 MG 60 TABLET 4,800 288,000

CO AMOXICLAV 625 MG 150 TABLET 4,924 738,642

CODEIN 10 MG 500 TABLET 508 253,798

CODEIN 10 MG 500 TABLET 508 253,798

CODEIN 10 MG 1,000 TABLET 508 507,595

CODEIN 20 MG 500 TABLET 1,129 564,300

CODEIN 20 MG 500 TABLET 1,129 564,300

COLME TETES TELINGA 20 FLS 19,855 397,100

COLME TETES TELINGA 10 FLS 19,855 198,550

COLME TETES TELINGA 20 FLS 19,333 386,650

COMBIVENT INJ 40 AMPUL 11,192 447,678

COMBIVENT INJ 60 AMPUL 11,192 671,517

COMBIVENT INJ 60 AMPUL 11,192 671,517

COMBIVENT INJ 40 AMPUL 11,192 447,678

COMBO ONE 18 G 10 PCS 22,000 220,000

COMBO ONE 18 G 20 PCS 22,000 440,000

COMBO ONE 18 G 15 PCS 22,000 330,000

COMBO ONE 18 G 10 PCS 22,000 220,000

COMBO ONE 20 G 10 PCS 22,000 220,000

COMBO ONE 20 G 14 PCS 22,000 308,000

COMBO ONE 20 G 10 PCS 22,000 220,000

COMBO ONE 20 G 50 PCS 22,000 1,100,000

COMBO ONE 20 G 50 PCS 22,000 1,100,000

COMBO ONE 20 G 40 PCS 22,000 880,000

COMBO ONE 20 G 40 PCS 22,000 880,000

COMBO ONE 20 G 40 PCS 22,000 880,000

COMBO ONE 20 G 40 PCS 22,000 880,000

COMBO ONE 20 G 40 PCS 22,000 880,000

COMBO ONE 20 G 40 PCS 22,000 880,000

COMBO ONE 20 G 20 PCS 22,000 440,000

COMBO ONE 20 G 20 PCS 22,000 440,000

COMBO ONE 20 G 20 PCS 22,000 440,000

COMBO ONE 20 G 20 PCS 22,000 440,000

COMBO ONE 20 G 40 PCS 22,000 880,000

COMBO ONE 20 G 80 PCS 22,000 1,760,000

COMBO ONE 20 G 40 PCS 22,000 880,000

COMBO ONE 24 G 10 PCS 22,000 220,000

CONDOM L 10 PCS 4,059 40,590

CONDOM L 10 PCS 4,059 40,590

CONDOM L 10 PCS 3,850 38,500

CONDOM L 10 PCS 4,059 40,590

CONDOM L ASKES 3 PCS 4,059 12,177

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CONDOM L ASKES 10 PCS 3,850 38,500

CONDOM L ASKES 10 PCS 4,059 40,590

CONDOM M 10 PCS 4,059 40,590

CONDOM M 10 PCS 4,059 40,590

CONDOM M 10 PCS 4,059 40,590

CONDOM M ASKES 10 PCS 4,059 40,590

CONDOM M ASKES 10 PCS 4,059 40,590

CONDOM S 10 PCS 4,059 40,590

CONDOM S ASKES 10 PCS 4,059 40,590

CONVER 2% 5 FLS 14,300 71,500

CONVER 2% 5 FLS 14,300 71,500

CONVER 2% 6 FLS 14,300 85,800

CONVER 2% 5 FLS 14,300 71,500

CORTICAL BONE SCREW 3,5 L-24 5 PCS 119,790 598,950

CORTICAL BONE SCREW 3,5 L-24 6 PCS 119,790 718,740

CORTICAL SCREW 3,5 L 26 6 PCS 119,790 718,740

CORTICAL SCREW 3.5 L 18 6 PCS 119,790 718,740

CORTICAL SCREW 3.5 L 20 6 PCS 119,790 718,740

CORTICAL SCREW 3.5 L 20 7 PCS 119,790 838,530

CORTICAL SCREW 4,5 L-38 9 PCS 113,410 1,020,690

CORTICAL SCREW 4,5 L-38 11 PCS 113,410 1,247,510

CORTICAL SCREW 4,5 L-38 10 PCS 113,410 1,134,100

CORTICAL SCREW 4,5 L-38 9 PCS 113,410 1,020,690

CORTICAL SCREW 4,5 L-38 12 PCS 113,410 1,360,920

CORTICAL SCREW 4,5 L-38 10 PCS 113,410 1,134,100

CORTICAL SCREW 4,5 L-38 10 PCS 113,410 1,134,100

CORTICAL SCREW 4.5 L 28 10 PCS 113,410 1,134,100

CORTIDEX INJ 50 AMPUL 5,896 294,800

CORTIDEX INJ 50 AMPUL 5,896 294,800

CORTIDEX INJ 30 AMPUL 5,896 176,880

CORTIDEX INJ 30 AMPUL 5,896 176,880

CORTIDEX INJ 100 AMPUL 5,896 589,600

CORTIDEX INJ 50 AMPUL 5,896 294,800

CORTIDEX INJ 60 AMPUL 5,896 353,760

CORTIDEX TAB 100 TABLET 231 23,100

CORTIDEX TAB 200 TABLET 237 47,300

CORTIDEX TAB 100 TABLET 237 23,650

CORTIDEX TAB 200 TABLET 237 47,300

CORTIDEX TAB 200 TABLET 237 47,300

COTRIMOXAZOL 480 ASKES 200 TABLET 158 31,680

COTRIMOXAZOL 480 ASKES 100 TABLET 181 18,132

COTRIMOXAZOL 480 ASKES 200 TABLET 181 36,265

COTRIMOXAZOL 480 ASKES 200 TABLET 181 36,265

COTRIMOXAZOL 480 MG 300 TABLET 165 49,451

COTRIMOXAZOL 480 MG 200 TABLET 158 31,680

COTRIMOXAZOL 480 MG 300 TABLET 181 54,397

COTRIMOXAZOL 480 MG 300 TABLET 191 57,173

CREATININE (ENZ) 4X30 ML 1 BOX 3,300,000 3,300,000

2 KIT 6,160,000 12,320,000

CREATININE 400 ML PAKET 1 KIT 1,008,700 1,008,700

CROME INJ 50 MG 20 AMPUL 20,350 407,000

CROME INJ 50 MG 20 AMPUL 20,350 407,000

CRP C-REACTIVE PROTEIN ACON PA 25 PCS 75,625 1,890,625

CRP C-REACTIVE PROTEIN ACON PA 50 PCS 75,625 3,781,250

CRP DEVICE 20 TES ABON 40 PCS 49,500 1,980,000

CRP DEVICE 20 TES ABON 20 PCS 75,625 1,512,500

CREATININE (ENZYMATIC) 4X60 ML PAKET

Page 59: FORM FA Unit Kerja Penunjang 30815

CRP DEVICE 20 TES ABON 60 PCS 75,625 4,537,500

CRYPTAL INFUS 5 BOTOL 198,000 990,000

CRYPTAL INFUS 6 BOTOL 198,000 1,188,000

CRYPTAL INFUS 6 BOTOL 198,000 1,188,000

CRYPTAL INFUS 6 BOTOL 198,000 1,188,000

CRYPTAL INFUS 5 BOTOL 198,000 990,000

CRYPTAL INFUS 5 BOTOL 198,000 990,000

CRYPTAL INFUS 5 BOTOL 198,000 990,000

CRYPTAL INFUS 1 BOTOL 198,000 198,000

CRYPTAL INFUS 3 BOTOL 198,000 594,000

CRYPTAL INFUSS 3 BOTOL 79,992 239,976

CURACIL 250 MG INJ ASKES 12 AMPUL 24,500 294,000

CURACIL INJ 500 MG ASKES 6 AMPUL 34,601 207,603

CURACIL INJ 500 MG ASKES 6 AMPUL 34,601 207,603

CURACIL INJ 500 MG ASKES 6 AMPUL 34,601 207,603

CURACIL INJ 500 MG ASKES 6 AMPUL 34,601 207,603

CURACIL INJ 500 MG ASKES 6 AMPUL 34,600 207,600

CURACIL INJ 500 MG ASKES 6 AMPUL 34,600 207,600

CURACIL INJ 500 MG ASKES 6 AMPUL 34,600 207,600

CURACIL INJ 500 MG ASKES 6 AMPUL 34,600 207,600

CURACIL INJ 500 MG ASKES 6 AMPUL 34,600 207,600

CURACIL INJ 500 MG ASKES 6 AMPUL 34,600 207,600

CURCUMA 2,000 TABLET 726 1,452,000

CURCUMA 600 TABLET 726 435,600

CUTTON BUDS PAKET 480 BIJI 33 15,840

CYCLOVID 500 MG 2 VIAL 286,371 572,741

CYCLOVID 500 MG 1 VIAL 286,371 286,371

CYCLOVID 500 MG 3 VIAL 286,371 859,112

CYTOSTOL TAB 90 TABLET 10,285 925,650

CYTOSTOL TAB ASKES 300 TABLET 6,171 1,851,300

D 10+0,18NS 20 FLS 11,501 230,010

D 10+0,18NS 40 FLS 11,501 460,020

D 10+0,18NS 20 FLS 11,501 230,010

D 10+0,18NS 20 FLS 11,501 230,010

D 10+0,18NS 40 FLS 11,501 460,020

D 10+0,18NS 40 FLS 11,501 460,020

D10 B BRAUN ASKES 60 FLS 5,500 330,000

D10 B BRAUN ASKES 20 FLS 5,500 110,000

D10 B BRAUN ASKES 30 FLS 5,500 165,000

D10 B BRAUN ASKES 30 FLS 5,500 165,000

D10 WIDA 40 FLS 5,727 229,064

D10 WIDATRA ASKES 20 FLS 5,500 110,000

D10 WIDATRA ASKES 20 FLS 5,700 114,004

D10 WIDATRA ASKES 40 FLS 5,700 228,008

D40 % INJ ASKES 40 AMPUL 1,980 79,200

D40 % INJ ASKES 60 AMPUL 1,980 118,800

D40 % INJ ASKES 120 AMPUL 1,980 237,600

D40% 60 AMPUL 3,080 184,800

D40% 80 AMPUL 3,080 246,400

D40% 29 AMPUL 3,960 114,840

D40% 60 AMPUL 3,960 237,600

D40% 120 AMPUL 3,960 475,200

D5 1/2 NS WIDA 100 BOTOL 10,293 1,029,325

D5 1/2 NS WIDATRA ASKES 100 FLS 7,560 756,030

D5 1/2 NS WIDATRA ASKES 100 FLS 7,700 770,000

D5 1/2 NS WIDATRA ASKES 100 FLS 7,700 770,000

D5 1/2 NS WIDATRA ASKES 100 FLS 7,700 770,000

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D5 1/4 WIDATRA ASKES 40 FLS 7,560 302,412

D5 1/4 WIDATRA ASKES 60 FLS 7,700 462,000

D5 1/4 WIDATRA ASKES 40 FLS 7,700 308,000

D5 1/4 WIDATRA ASKES 60 FLS 7,700 462,000

D5 WIDATRA ASKES 200 FLS 4,895 979,000

D5 WIDATRA ASKES 400 FLS 5,313 2,125,200

D5 WIDATRA ASKES 200 FLS 5,200 1,039,940

D5 WIDATRA ASKES 200 FLS 5,200 1,039,999

D5 WIDATRA ASKES 100 FLS 5,200 520,000

D5 WIDATRA ASKES 100 FLS 5,200 519,970

D5 WIDATRA ASKES 100 FLS 5,200 519,970

D5 WIDATRA ASKES 200 FLS 5,200 1,039,940

D5 WIDATRA ASKES 60 FLS 5,200 312,000

D5 WIDATRA ASKES 200 FLS 5,200 1,039,940

D700 EYE DRAPE 18 PCS 49,500 891,000

D700 EYE DRAPE 5 PCS 49,500 247,500

D700 EYE DRAPE 14 PCS 44,000 616,000

D700 EYE DRAPE 3 PCS 49,500 148,500

D700 EYE DRAPE 21 PCS 44,000 924,000

D700 EYE DRAPE 23 PCS 49,500 1,138,500

DACLON 3/0 REG 6 PCS 55,000 330,000

DAFILON 2/0 SACHET 3 PCS 69,795 209,385

DAFILON 3/0 SACHET 10 SACHET 68,805 688,050

DAFILON 3/0 SACHET 3 SACHET 68,805 206,415

DAFILON 4/0 SACHET 6 SACHET 53,955 323,730

DAFILON 4/0 SACHET 12 SACHET 53,955 647,460

DAFILON 5/0 SACHET 5 SACHET 56,925 284,625

DAMABEN INJ 170 AMPUL 8,476 1,440,835

DAMABEN INJ 170 AMPUL 8,476 1,440,835

DAMABEN INJ 85 AMPUL 8,476 720,418

DAMABEN INJ 100 AMPUL 8,476 847,550

DAMABEN INJ 85 AMPUL 8,476 720,418

DAMABEN INJ 170 AMPUL 8,476 1,440,835

DAMABEN INJ 85 AMPUL 8,476 720,418

DAMABEN INJ 85 AMPUL 8,476 720,418

DAMABEN INJ 170 AMPUL 8,690 1,477,300

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN INJ 25 AMPUL 8,690 217,250

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN INJ 170 AMPUL 8,690 1,477,300

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN INJ 170 AMPUL 8,690 1,477,300

DAMABEN INJ 170 AMPUL 8,690 1,477,300

DAMABEN INJ 85 AMPUL 8,690 738,650

DAMABEN SYR 3 BOTOL 8,938 26,813

DAMABEN TAB 500 TABLET 396 198,000

DAMABEN TAB 500 TABLET 396 198,000

DAMABEN TAB 500 TABLET 407 203,500

DAMABEN TAB 200 TABLET 407 81,400

DAMABEN TAB 500 TABLET 407 203,500

DAMABEN TAB 500 TABLET 407 203,500

DAMABEN TAB 300 TABLET 407 122,100

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DAY-CAL TAB 80 TABLET 1,425 113,960

DAY-CAL TAB 48 TABLET 1,425 68,376

DAY-CAL TAB 80 TABLET 1,463 117,040

DAY-CAL TAB 80 TABLET 1,463 117,040

DAY-CAL TAB 80 TABLET 1,463 117,040

DAY-CAL TAB 80 TABLET 1,463 117,040

DAY-CAL TAB 48 TABLET 1,463 70,224

DAY-CAL TAB 64 TABLET 1,463 93,632

DECRILIP TAB 100 TABLET 4,004 400,400

DECRILIP TAB 100 TABLET 4,004 400,400

DECRILIP TAB 200 TABLET 4,103 820,600

DECRILIP TAB 100 TABLET 4,103 410,300

DECULIN 15 MG ASKES 300 TABLET 4,000 1,199,887

DECULIN 15 MG ASKES 300 TABLET 4,000 1,199,887

0 #DIV/0! 0

DENGUE IGG/IGM DEVICE PAKET 10 PCS 137,500 1,375,000

DEPAKENE SYRUP ASKES 10 BOTOL 73,800 738,001

DEPAKOTE ER 250 MG ASKES 1,000 TABLET 2,900 2,899,589

DEPAKOTE ER 250 MG ASKES 500 TABLET 2,793 1,396,500

DE-PROTEINIZER WITH DILUTOR AFT 1 PACK 722,150 722,150

DEVELOPER 20 LT 1 GALON 1,221,000 1,221,000

DEXAMETHASON INJ 100 AMPUL 1,952 195,195

DEXAMETHASON INJ 200 AMPUL 1,361 272,272

DEXAMETHASON INJ 200 AMPUL 1,562 312,312

DEXAMETHASON INJ 200 AMPUL 1,562 312,312

DEXAMETHASON INJ ASKES 500 AMPUL 1,550 775,000

DEXAMETHASON INJ ASKES 200 AMPUL 1,952 390,390

DEXAMETHASON INJ ASKES 200 AMPUL 1,502 300,300

DEXAMETHASON INJ ASKES 200 AMPUL 2,002 400,400

DEXAMETHASON INJ ASKES 200 AMPUL 1,562 312,312

DEXAMETHASON INJ ASKES 200 AMPUL 1,562 312,312

DIAGIT 100 TABLET 875 87,505

DIAGIT 200 TABLET 875 175,010

DIANERAL VANILA 10 PCS 35,200 352,000

DIAPHRAGM PUMP ASSY NO. 45 1 PCS 956,340 956,340

DIATRO CLEANER PAKET 1 BOTOL 2,200,000 2,200,000

DIATRO CLEANER PAKET 2 BOTOL 2,200,000 4,400,000

DIATRO CLEANER PAKET 1 BOTOL 2,200,000 2,200,000

DIATRO DILUEN PAKET 1 GALON 4,840,000 4,840,000

DIATRO DILUEN PAKET 1 GALON 4,840,000 4,840,000

DIATRO DILUEN PAKET 1 GALON 4,840,000 4,840,000

DIATRO DILUEN PAKET 2 GALON 4,840,000 9,680,000

DIATRO DILUEN PAKET 1 GALON 4,840,000 4,840,000

DIATRO DILUEN PAKET 1 GALON 4,840,000 4,840,000

DIATRO DILUEN PAKET 2 GALON 4,840,000 9,680,000

DIATRO LYSE PAKET 1 BOTOL 4,400,000 4,400,000

DIATRO LYSE PAKET 2 BOTOL 4,400,000 8,800,000

DIATRO LYSE PAKET 1 BOTOL 4,400,000 4,400,000

DIAZEPAM 2 MG ASKES 1,000 TABLET 32 31,900

DIAZOL INF ASKES 750 BOTOL 8,000 6,000,225

DIAZOL INF ASKES 500 BOTOL 8,000 4,000,150

DIAZOL INF ASKES 250 BOTOL 8,000 2,000,075

DIAZOL INF ASKES 250 BOTOL 8,000 2,000,075

DIAZOL INF ASKES 250 BOTOL 8,000 2,000,075

DIAZOL INF ASKES 250 BOTOL 8,000 2,000,075

DIAZOL INF ASKES 500 BOTOL 8,000 4,000,150

DEMKA SAKTI PT.Tgl Bill:13-01-2014

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DIGOXIN 300 TABLET 139 41,785

DIGOXIN ASKES 200 TABLET 139 27,856

DIOVAN FCT 160 MG ASKES 420 TABLET 6,500 2,730,009

DIOVAN FCT 80 MG ASKES 280 TABLET 4,000 1,119,999

DIPHENHIDRAMIN INJ 90 AMPUL 936 84,240

DIPHENHIDRAMIN INJ 150 AMPUL 936 140,400

DIPHENHIDRAMIN INJ 60 AMPUL 960 57,600

DIPHENHIDRAMINE INJ ASKES 150 AMPUL 800 120,000

DIPHENHIDRAMINE INJ ASKES 90 AMPUL 960 86,400

DIVENS TAB 120 TABLET 2,723 326,700

DOCETAXEL 20 MG INJ 1 VIAL 1,386,000 1,386,000

DOCETERE 20 MG INJ 1 VIAL 1,100,022 1,100,022

DOCETERE 20 MG INJ 1 VIAL 1,100,022 1,100,022

DOCETERE 20 MG INJ 1 VIAL 1,100,022 1,100,022

DOXORUBICIN 10 MG INJ ASKES 1 VIAL 63,000 63,000

DOXORUBICIN 10 MG INJ ASKES 1 VIAL 63,000 63,000

DOXORUBICIN 10 MG INJ ASKES 1 VIAL 72,765 72,765

DOXORUBICIN 10 MG INJ ASKES 5 VIAL 72,765 363,825

DOXORUBICIN 10 MG INJ ASKES 2 VIAL 62,000 124,000

DOXORUBICIN 10MG INJ 1 VIAL 169,400 169,400

DOXORUBICIN 50 MG INJ 1 BOX 766,535 766,535

DOXORUBICIN 50 MG INJ 1 BOX 766,535 766,535

DOXORUBICIN 50 MG INJ ASKES 1 VIAL 325,001 325,001

DOXORUBICIN 50 MG INJ ASKES 1 VIAL 325,001 325,001

DOXORUBICIN 50 MG INJ ASKES 1 VIAL 325,001 325,001

DOXORUBICIN 50 MG INJ ASKES 1 VIAL 320,000 320,000

DOXORUBICIN 50 MG INJ ASKES 1 VIAL 320,000 320,000

DOXORUBICIN 50 MG INJ ASKES 1 VIAL 320,000 320,000

DOXORUBICIN 50 MG INJ ASKES 1 VIAL 320,000 320,000

DOXORUBICIN 50 MG INJ ASKES 1 VIAL 320,000 320,000

DOXYCYCLIN 100 MG ASKES 200 TABLET 304 60,720

DRILLBIT 3,2X130 MM 1 PCS 797,500 797,500

DRILLBIT 4,0X130 MM 1 PCS 797,500 797,500

ECAL 5X3 ML PAKET 1 KIT 1,771,000 1,771,000

ECG PAPER 50X30 OM 4 ROL 33,000 132,000

ECG PAPER 50X30 SONOMED PAKET 10 PCS 26,400 264,000

ECG PAPER 50X30 SONOMED PAKET 10 PCS 26,400 264,000

ECG PAPER 50X30 SONOMED PAKET 10 PCS 26,400 264,000

ECG PAPER 50X30 SONOMED PAKET 10 PCS 26,400 264,000

EFLAGEN 25 MG 50 TABLET 1,188 59,400

EFLAGEN 25 MG 100 TABLET 1,221 122,100

EFLAGEN 25 MG 100 TABLET 1,221 122,100

EFLAGEN 25 MG 150 TABLET 1,221 183,150

EFLAGEN 25 MG 50 TABLET 1,221 61,050

EFLAGEN 25 MG 100 TABLET 1,221 122,100

EFLAGEN 25 MG 100 TABLET 1,221 122,100

EFLAGEN 50 MG 50 TABLET 1,947 97,350

EFLAGEN 50 MG 100 TABLET 1,997 199,650

EFLAGEN 50 MG 100 TABLET 1,997 199,650

EFLAGEN 50 MG 100 TABLET 1,997 199,650

EFLAGEN 50 MG 150 TABLET 1,997 299,475

EFLAGEN 50 MG 200 TABLET 1,997 399,300

EFLAGEN 50 MG 100 TABLET 1,997 199,650

EFLAGEN 50 MG 150 TABLET 1,997 299,475

EFLAGEN 50 MG 50 TABLET 1,997 99,825

EFLAGEN 50 MG 100 TABLET 1,997 199,650

EFLAGEN 50 MG 100 TABLET 1,997 199,650

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EFLAGEN 50 MG 100 TABLET 1,997 199,650

EFLAGEN 50 MG 100 TABLET 1,997 199,650

ELASTOMUL 10 CM X 4 M 3 ROL 39,328 117,985

ELASTOMUL 12 CM X 4 M 2 ROL 45,882 91,764

300 PCS 2,178 653,400

250 PCS 2,178 544,500

300 PCS 2,178 653,400

300 PCS 2,178 653,400

ELEKTRODA CONDITIONER AFT 1 PACK 541,750 541,750

ELEKTRODA OM 150 PCS 2,178 326,700

ELEKTRODA OM 120 PCS 2,888 346,500

ELEKTRODA OM 250 PCS 2,178 544,500

ELEKTRODA OM 200 PCS 2,178 435,600

ELEKTRODE ONE DOT 200 PCS 5,720 1,144,000

ELEKTRODE ONE DOT 100 PCS 5,720 572,000

ELEKTRODE ONE DOT 150 PCS 5,720 858,000

ELEKTRODE ONE DOT 200 PCS 3,036 607,200

ELEKTRODE ONE DOT 150 PCS 7,074 1,061,158

ELEKTRODE ONE DOT 200 PCS 7,074 1,414,877

ELEKTRODE ONE DOT ASKES 100 PCS 5,720 572,000

ELEKTRODE ONE DOT ASKES 200 PCS 5,720 1,144,000

ELEKTRODE ONE DOT ASKES 150 PCS 5,720 858,000

ELEKTRODE ONE DOT ASKES 200 PCS 3,036 607,200

ELEKTRODE ONE DOT ASKES 200 PCS 3,947 789,360

ELEKTRODE ONE DOT ASKES 150 PCS 7,074 1,061,158

ELEKTRODE ONE DOT ASKES 300 PCS 7,074 2,122,316

ELEKTRODE ONE DOT ASKES 100 PCS 7,074 707,439

ELKANA CL SYRUP 6 BOTOL 43,918 263,505

ELKANA CL SYRUP 5 BOTOL 45,018 225,088

ELKANA CL SYRUP 10 BOTOL 45,018 450,175

ELKANA CL SYRUP 10 BOTOL 45,018 450,175

ELKANA CL SYRUP 10 BOTOL 45,018 450,175

ELKANA CL SYRUP 10 BOTOL 45,018 450,175

ELKANA CL SYRUP 15 BOTOL 45,018 675,263

ELKANA SYRUP 5 BOTOL 19,745 98,725

ELKANA SYRUP 6 BOTOL 20,240 121,440

ELKANA SYRUP 5 BOTOL 20,240 101,200

ELKANA SYRUP 10 BOTOL 20,240 202,400

ELKANA SYRUP 15 BOTOL 20,240 303,600

ELKANA SYRUP 10 BOTOL 20,240 202,400

ELKANA TAB 100 TABLET 677 67,650

ENYSTIN DROP ASKES 3 BOTOL 33,000 99,000

ENZYLINE ALAT/GPT 20 1 BOX 1,936,000 1,936,000

EPEXOL 30 MG TAB 200 TABLET 759 151,800

EPEXOL 30 MG TAB 100 TABLET 759 75,900

EPEXOL 30 MG TAB 200 TABLET 781 156,200

EPEXOL 30 MG TAB 300 TABLET 781 234,300

EPEXOL 30 MG TAB 200 TABLET 781 156,200

EPEXOL 30 MG TAB 200 TABLET 781 156,200

EPEXOL 30 MG TAB 200 TABLET 781 156,200

EPEXOL 30 MG TAB 200 TABLET 781 156,200

EPEXOL SYR 6 BOTOL 15,785 94,710

EPEXOL SYR 10 BOTOL 15,785 157,850

EPEXOL SYR 3 BOTOL 16,181 48,543

ELEKTRODA ASKES ( SKINTACT FOAM 35X50 )

ELEKTRODA ASKES ( SKINTACT FOAM 35X50 )

ELEKTRODA ASKES ( SKINTACT FOAM 35X50 )

ELEKTRODA ASKES ( SKINTACT FOAM 35X50 )

Page 64: FORM FA Unit Kerja Penunjang 30815

EPEXOL SYR 5 BOTOL 16,181 80,905

EPEXOL SYR 10 BOTOL 16,181 161,810

EPHINEPRINE 0.1% 200 AMPUL 8,550 1,709,998

EPHINEPRINE 0.1% 100 AMPUL 9,025 902,499

EPIRUBICIN 10 MG ASKES 1 VIAL 160,001 160,001

EPIRUBICIN 10 MG ASKES 2 VIAL 160,001 320,001

EPIRUBICIN 10 MG ASKES 2 VIAL 160,001 320,001

EPIRUBICIN 10 MG ASKES 1 VIAL 173,250 173,250

EPIRUBICIN 10 MG ASKES 2 VIAL 160,001 320,001

EPIRUBICIN 10 MG ASKES 2 VIAL 160,001 320,001

EPIRUBICIN 10 MG ASKES 1 VIAL 160,001 160,001

EPIRUBICIN 10 MG ASKES 1 VIAL 160,001 160,001

EPIRUBICIN 10 MG ASKES 1 VIAL 160,001 160,001

EPIRUBICIN 10 MG ASKES 1 VIAL 170,000 170,000

EPIRUBICIN 10 MG ASKES 2 VIAL 170,000 340,000

EPIRUBICIN 10 MG ASKES 2 VIAL 170,000 340,000

EPIRUBICIN 10 MG ASKES 2 VIAL 170,000 340,000

EPIRUBICIN 10 MG ASKES 2 VIAL 170,000 340,000

EPIRUBICIN 10 MG ASKES 2 VIAL 170,000 340,000

EPIRUBICIN 10 MG ASKES 2 VIAL 170,000 340,000

EPIRUBICIN 10 MG ASKES 2 VIAL 170,000 340,000

EPIRUBICIN 10 MG ASKES 2 VIAL 128,000 256,000

EPIRUBICIN 10 MG ASKES 2 VIAL 128,000 256,000

EPIRUBICIN 10 MG ASKES 2 VIAL 128,000 256,000

EPIRUBICIN 10 MG ASKES 4 VIAL 173,250 693,000

EPIRUBICIN 10 MG ASKES 2 VIAL 128,000 256,000

EPIRUBICIN 10 MG ASKES 2 VIAL 128,000 256,000

EPIRUBICIN 50 MG ASKES 1 VIAL 835,000 835,000

EPIRUBICIN 50 MG ASKES 1 VIAL 835,000 835,000

EPIRUBICIN 50 MG ASKES 1 VIAL 835,000 835,000

EPIRUBICIN 50 MG ASKES 1 VIAL 835,000 835,000

EPIRUBICIN 50 MG ASKES 1 VIAL 835,000 835,000

EPIRUBICIN 50 MG ASKES 1 VIAL 835,000 835,000

EPIRUBICIN 50 MG ASKES 2 VIAL 835,000 1,670,000

EPIRUBICIN 50 MG ASKES 2 VIAL 835,000 1,670,000

EPIRUBICIN 50 MG ASKES 1 VIAL 825,000 825,000

EPIRUBICIN 50 MG ASKES 1 VIAL 825,000 825,000

EPIRUBICIN 50 MG ASKES 1 VIAL 825,000 825,000

EPIRUBICIN 50 MG ASKES 1 VIAL 825,000 825,000

EPIRUBICIN 50 MG ASKES 1 VIAL 825,000 825,000

EPIRUBICIN 50 MG ASKES 1 VIAL 825,000 825,000

EPIRUBICIN 50 MG ASKES 1 VIAL 550,000 550,000

EPIRUBICIN 50 MG ASKES 1 VIAL 550,000 550,000

EPIRUBICIN 50 MG ASKES 1 VIAL 550,000 550,000

EPIRUBICIN 50 MG ASKES 1 VIAL 550,000 550,000

EPIRUBICIN 50 MG ASKES 2 VIAL 550,000 1,100,000

EPIRUBICIN 50 MG ASKES 1 VIAL 550,000 550,000

EPIRUBICIN 50 MG ASKES 1 VIAL 550,000 550,000

EPISAN SYRUP 2 BOTOL 46,255 92,510

EPISAN SYRUP 10 BOTOL 46,255 462,550

EPISAN SYRUP 10 BOTOL 46,255 462,550

EPISAN SYRUP 5 BOTOL 46,255 231,275

EPISAN SYRUP 10 BOTOL 46,255 462,550

EPISAN SYRUP 10 BOTOL 46,255 462,550

EPISAN SYRUP 4 BOTOL 46,255 185,020

EPISAN SYRUP 10 BOTOL 46,255 462,550

EPISAN SYRUP 10 BOTOL 46,255 462,550

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EPISAN SYRUP 10 BOTOL 46,255 462,550

EPISAN SYRUP 15 BOTOL 46,255 693,825

EPOCH 525 P 20 5 PCS 330,000 1,650,000

EPOCH 525 P 20 3 PCS 330,000 990,000

EPRINOC 100 TABLET 3,262 326,150

EPRINOC 100 TABLET 3,262 326,150

ERYSANBE 200 MG 100 TABLET 1,502 150,150

ERYSANBE 200 MG 100 TABLET 1,502 150,150

ERYSANBE DRY SYR 6 BOTOL 20,801 124,806

ERYSANBE DRY SYR 5 BOTOL 20,801 104,005

ERYSANBE DRY SYR 6 BOTOL 20,801 124,806

ERYSANBE DRY SYR 6 BOTOL 20,801 124,806

ERYSANBE DRY SYR 10 BOTOL 20,801 208,010

ERYSANBE DRY SYR 10 BOTOL 20,801 208,010

ERYSANBE DRY SYR 10 BOTOL 20,801 208,010

ESTAZOR 90 TABLET 7,700 693,000

ESTAZOR 90 TABLET 7,700 693,000

ESTAZOR 90 TABLET 7,700 693,000

ESTAZOR 90 TABLET 7,700 693,000

ESTAZOR 90 TABLET 7,700 693,000

ESTAZOR 60 TABLET 7,700 462,000

ETHILON 10/0 PER CM 360 6,982 2,513,610

ETHILON 10/0 PER CM 360 6,982 2,513,610

ETHILON 10/0 PER CM 360 6,982 2,513,610

ETT CLEAR 6,5 ASKES 5 PCS 63,250 316,250

ETT CLEAR 6.5 RUSCH 5 PCS 63,250 316,250

ETT CLEAR 7 ASKES 10 PCS 63,250 632,500

ETT CLEAR 7 ASKES 5 PCS 69,300 346,500

ETT CLEAR 7 ASKES 10 PCS 63,250 632,500

ETT CLEAR 7 ASKES 10 PCS 63,250 632,500

ETT CLEAR 7 RUSCH 10 PCS 63,250 632,500

ETT CLEAR 7 RUSCH 5 PCS 69,300 346,500

ETT CLEAR 7.5 ASKES 10 PCS 63,250 632,500

ETT CLEAR 7.5 ASKES 10 PCS 63,250 632,500

ETT CLEAR 7.5 ASKES 10 PCS 63,250 632,500

ETT CLEAR 7.5 RUSCH 10 PCS 63,250 632,500

ETT NKK CLEAR 5 RUSH 2 PCS 319,000 638,000

ETT NKK CLEAR 5,5 RUSH 2 PCS 319,000 638,000

ETT NKK CLEAR 6 RUSH 2 PCS 319,000 638,000

ETT NKK CLEAR 6,5 RUSH 2 PCS 319,000 638,000

ETT NKK CLEAR 7 RUSH 2 PCS 319,000 638,000

ETT NKK CLEAR 7,5 RUSH 2 PCS 319,000 638,000

EUTHYROX 100 ASKES 300 TABLET 850 255,001

EYEFRESH PLUS 20 FLS 33,275 665,500

EYEVIT SYRUP 6 BOTOL 38,500 231,000

EYEVIT SYRUP 6 BOTOL 38,500 231,000

EYEVIT SYRUP 4 BOTOL 38,500 154,000

EYEVIT SYRUP 6 BOTOL 38,500 231,000

EYEVIT SYRUP 6 BOTOL 38,500 231,000

EYEVIT SYRUP 6 BOTOL 38,500 231,000

EYEVIT SYRUP 10 BOTOL 38,500 385,000

EYEVIT SYRUP 10 BOTOL 38,500 385,000

EYEVIT SYRUP 10 BOTOL 38,500 385,000

EYEVIT SYRUP 10 BOTOL 38,500 385,000

EYEVIT SYRUP 10 BOTOL 38,500 385,000

CENTIMETER

CENTIMETER

CENTIMETER

Page 66: FORM FA Unit Kerja Penunjang 30815

EYEVIT SYRUP 10 BOTOL 55,000 550,000

EYEVIT SYRUP 5 BOTOL 55,000 275,000

EYEVIT SYRUP 10 BOTOL 55,000 550,000

EYEVIT SYRUP 20 BOTOL 55,000 1,100,000

EYEVIT TAB 150 TABLET 3,685 552,750

EYEVIT TAB 150 TABLET 3,685 552,750

EYEVIT TAB 90 TABLET 3,685 331,650

EYEVIT TAB 90 TABLET 3,685 331,650

EYEVIT TAB 150 TABLET 3,685 552,750

EYEVIT TAB 150 TABLET 3,685 552,750

EYEVIT TAB 150 TABLET 3,685 552,750

EYEVIT TAB 90 TABLET 4,400 396,000

EYEVIT TAB 60 TABLET 4,400 264,000

EYEVIT TAB 150 TABLET 4,400 660,000

EYEVIT TAB 150 TABLET 4,400 660,000

FAKTU 40 7,838 313,500

FAKTU 30 7,838 235,125

FARBIVENT INJ 20 AMPUL 8,800 176,000

FARBIVENT INJ 20 AMPUL 8,800 176,000

FARBIVENT INJ 30 AMPUL 8,800 264,000

FARBIVENT INJ ASKES 20 AMPUL 7,250 145,006

FARBIVENT INJ ASKES 30 AMPUL 7,250 217,510

FARBIVENT INJ ASKES 30 AMPUL 7,250 217,510

FARBIVENT INJ ASKES 30 AMPUL 7,250 217,510

FARGOXIN INJEKSI 25 AMPUL 38,500 962,500

FARGOXIN INJEKSI 15 AMPUL 38,500 577,500

FARGOXIN INJEKSI 25 AMPUL 38,500 962,500

FARGOXIN INJEKSI 25 AMPUL 38,500 962,500

FARMABES INJ 10 VIAL 121,000 1,210,000

FARMABES INJ 10 VIAL 121,000 1,210,000

FARMABES INJ ASKES 10 VIAL 55,999 559,988

FARMABES INJ ASKES 14 VIAL 55,999 783,983

FARMABES INJ ASKES 10 VIAL 55,999 559,988

FARMABES INJ ASKES 10 VIAL 55,999 559,988

FARMABES INJ ASKES 10 VIAL 55,999 559,988

FARMASAL 100 TABLET 660 66,000

FARMASAL 200 TABLET 660 132,000

FARMASAL 200 TABLET 660 132,000

FARMASAL 500 TABLET 660 330,000

FARSIX INJ 50 AMPUL 4,648 232,375

FARSORBID 10 MG ASKES 1,000 TABLET 190 189,981

FARSORBID INJ ASKES 20 VIAL 54,998 1,099,956

FARSORBID INJ ASKES 20 VIAL 54,998 1,099,956

FARSORBID INJ ASKES 40 VIAL 54,998 2,199,912

FARSORBID INJ ASKES 20 VIAL 54,998 1,099,956

FARSORBID INJ ASKES 20 VIAL 54,998 1,099,956

FARSORBID INJ ASKES 20 VIAL 54,998 1,099,956

FARSORBID INJ ASKES 40 VIAL 54,998 2,199,912

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 8 VIAL 54,998 439,982

FARSORBID INJ ASKES 8 VIAL 54,998 439,982

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 16 VIAL 54,998 879,965

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

SUPPOSITORIA

SUPPOSITORIA

Page 67: FORM FA Unit Kerja Penunjang 30815

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 2 VIAL 54,998 109,996

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJ ASKES 18 VIAL 54,998 989,960

FARSORBID INJEKSI 10 VIAL 66,000 660,000

FARSORBID INJEKSI 10 VIAL 66,000 660,000

FARSORBID INJEKSI 20 VIAL 66,000 1,320,000

FEEDING TUBE 5 TRM ASKES 10 PCS 16,929 169,290

FEEDING TUBE 6 JMS 10 PCS 12,870 128,700

FEEDING TUBE 6 JMS 10 PCS 12,870 128,700

FEEDING TUBE 6 JMS ASKES 10 PCS 12,870 128,700

FEEDING TUBE 6 JMS ASKES 20 PCS 12,870 257,400

FEEDING TUBE 6 JMS ASKES 10 PCS 12,870 128,700

FEEDING TUBE 6 JMS ASKES 20 PCS 12,870 257,400

FEEDING TUBE 6 JMS ASKES 10 PCS 12,870 128,700

FEEDING TUBE 6 JMS ASKES 4 PCS 12,870 51,480

FEEDING TUBE 6 JMS ASKES 10 PCS 12,870 128,700

FEEDING TUBE 6 UROPLAS 20 PCS 14,300 286,000

FEEDING TUBE 8 10 BIJI 16,929 169,290

FEEDING TUBE 8 10 BIJI 16,929 169,290

FEEDING TUBE 8 10 BIJI 12,870 128,700

FEEDING TUBE 8 ASKES 10 PCS 16,929 169,290

FEEDING TUBE 8 ASKES 10 PCS 16,929 169,290

FEEDING TUBE 8 ASKES 10 PCS 16,929 169,290

FEEDING TUBE 8 ASKES 10 PCS 16,929 169,290

FEEDING TUBE 8 JMS ASKES 10 PCS 12,870 128,700

FEEDING TUBE 8 JMS ASKES 10 PCS 12,870 128,700

FEEDING TUBE 8 UROPLAST ASK 20 PCS 14,300 286,000

FEMISIC 500 MG 100 TABLET 1,084 108,350

FEMISIC 500 MG 200 TABLET 1,084 216,700

FEMISIC 500 MG 100 TABLET 1,084 108,350

FEMISIC 500 MG 100 TABLET 1,084 108,350

FENOFIBRAT 100 MG ASKES 150 TABLET 1,075 161,250

FILM CENTURI 30X40 CM 100 PCS 18,583 1,858,320

FILM CENTURIA 24X30 CM 100 PCS 12,150 1,215,000

FILM CENTURIA 35X35 CM 200 PCS 19,634 3,926,879

FILM DVB 125SH 20X25 (8X10) 3 BOX 2,772,000 8,316,000

FILM DVB 125SH 20X25 (8X10) 3 BOX 2,772,000 8,316,000

FILM DVB 125SH 20X25 (8X10) 2 BOX 2,772,000 5,544,000

FILM DVB 125SH 20X25 (8X10) 3 BOX 2,772,000 8,316,000

FILM DVB 125SH 20X25 (8X10) 3 BOX 2,772,000 8,316,000

FILM DVB 125SH 28X35 (11X14) 3 BOX 5,148,000 15,444,000

FILM DVB 125SH 28X35 (11X14) 3 BOX 5,148,000 15,444,000

FILM DVB 125SH 28X35 (11X14) 3 BOX 5,148,000 15,444,000

FILM DVB 125SH 35X43 1 BOX 7,524,000 7,524,000

FILM FUJI 24X30 PAKET 1 BOX 2,197,800 2,197,800

FILM FUJI 30X40 PAKET 1 BOX 3,494,700 3,494,700

FILM FUJI 35X35 PAKET 1 BOX 3,795,000 3,795,000

2 BOX 275,000 550,000

FIXER 20 LT FUJI 1 GALON 753,500 753,500

FLADYSTIN OVULA 50 BIJI 12,177 608,850

FLADYSTIN OVULA 50 BIJI 12,177 608,850

FLAMAR 25 MG 100 TABLET 759 75,900

FILM HANSIN PLUS DEVELOPER + FIXER

Page 68: FORM FA Unit Kerja Penunjang 30815

FLAMAR 25 MG 200 TABLET 759 151,800

FLAMAR 25 MG 200 TABLET 781 156,200

FLAMAR 25 MG 200 TABLET 781 156,200

FLAMAR 25 MG 100 TABLET 781 78,100

FLAMAR 25 MG 200 TABLET 781 156,200

FLAMAR 25 MG 200 TABLET 781 156,200

FLAMAR 25 MG 200 TABLET 781 156,200

FLAMAR 25 MG 500 TABLET 781 390,500

FLAMAR 50 MG 100 TABLET 1,650 165,000

FLAMAR 50 MG 100 TABLET 1,650 165,000

FLAMAR 50 MG 200 TABLET 1,650 330,000

FLAMAR 50 MG 100 TABLET 1,694 169,400

FLAMAR 50 MG 200 TABLET 1,694 338,800

FLAMAR 50 MG 100 TABLET 1,694 169,400

FLAMAR 50 MG 100 TABLET 1,694 169,400

FLAMAR 50 MG 200 TABLET 1,694 338,800

FLAMAR 50 MG 200 TABLET 1,694 338,800

FLAMAR 50 MG 500 TABLET 1,694 847,000

FLAMAR ED 6 FLS 32,258 193,545

FLAMAR ED 6 FLS 33,066 198,396

FLAMAR ED 15 FLS 33,066 495,990

FLEET ENEMA 10 BOTOL 99,220 992,200

FLEET ENEMA ASKES 30 BOTOL 51,793 1,553,785

FLEET ENEMA ASKES 60 BOTOL 51,793 3,107,570

FLUXAR 150 MG 5 TABLET 56,056 280,280

FLUXAR 150 MG 15 TABLET 57,200 858,000

FLUXAR 150 MG 15 TABLET 56,056 840,840

FLUXAR 150 MG 15 TABLET 56,056 840,840

FLUXAR 150 MG 15 TABLET 57,200 858,000

FLUXAR 150 MG 10 TABLET 56,056 560,560

FLUXAR 150 MG 15 TABLET 56,056 840,840

FOCUS SLIT KNIFE 2,75 18 PCS 165,000 2,970,000

FOCUS SLIT KNIFE 2,75 5 PCS 159,500 797,500

FOCUS SLIT KNIFE 2,75 14 PCS 159,500 2,233,000

FOCUS SLIT KNIFE 2,75 23 PCS 165,000 3,795,000

FOCUS STAB KNIFE 15 DEGREE 18 PCS 165,000 2,970,000

FOCUS STAB KNIFE 15 DEGREE 5 PCS 159,500 797,500

FOCUS STAB KNIFE 15 DEGREE 23 PCS 165,000 3,795,000

FOLAMIL GENIO SOFT 150 TABLET 3,069 460,350

FOLAMIL GENIO SOFT 150 TABLET 3,069 460,350

FOLAMIL GENIO SOFT 150 TABLET 3,069 460,350

FOLAMIL GENIO SOFT 60 TABLET 3,069 184,140

FOLEY CATH 12 BARDIA 10 BIJI 22,550 225,500

FOLEY CATH 12 EUROMED ASKES 10 PCS 18,700 187,000

FOLEY CATH 12 EUROMED ASKES 10 PCS 18,700 187,000

FOLEY CATH 14 RUSCH 10 BIJI 18,700 187,000

FOLEY CATH 14 UROCARE ASKES 10 PCS 18,700 187,000

FOLEY CATH 16 BARDIA 50 PCS 19,250 962,500

FOLEY CATH 16 BARDIA 50 PCS 22,550 1,127,500

FOLEY CATH 16 BARDIA 30 PCS 22,550 676,500

FOLEY CATH 16 BARDIA 20 PCS 22,550 451,000

FOLEY CATH 16 BARDIA 20 PCS 22,550 451,000

FOLEY CATH 16 BARDIA 50 PCS 22,550 1,127,500

FOLEY CATH 16 BARDIA 30 PCS 22,550 676,500

FOLEY CATH 16 COSMOMED ASK 100 PCS 14,850 1,485,000

FOLEY CATH 16 COSMOMED ASK 50 PCS 14,850 742,500

FOLEY CATH 16 COSMOMED ASK 80 PCS 14,850 1,188,000

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FOLEY CATH 16 EUROMED ASKES 100 PCS 18,700 1,870,000

FOLEY CATH 16 EUROMED ASKES 60 PCS 18,700 1,122,000

FOLEY CATH 16 EUROMED ASKES 60 PCS 18,700 1,122,000

FOLEY CATH 16 EUROMED ASKES 50 PCS 18,700 935,000

FOLEY CATH 16 EUROMED ASKES 50 PCS 18,700 935,000

FOLEY CATH 16 EUROMED ASKES 30 PCS 18,700 561,000

FOLEY CATH 16 EUROMED ASKES 50 PCS 18,700 935,000

FOLEY CATH 16 RUSCH 10 BIJI 20,790 207,900

FOLEY CATH 16 RUSCH 50 BIJI 20,790 1,039,500

FOLEY CATH 16 RUSCH 100 BIJI 20,790 2,079,000

FOLEY CATH 16 RUSCH 50 BIJI 20,790 1,039,500

FOLEY CATH 16 UROCARE ASKES 50 PCS 8,000 400,015

FOLEY CATH 16 UROCARE ASKES 30 PCS 8,000 240,009

FOLEY CATH 18 BARDIA 20 BIJI 22,550 451,000

FOLEY CATH 18 BARDIA 20 BIJI 22,550 451,000

FOLEY CATH 18 BARDIA ASKES 30 PCS 19,250 577,500

FOLEY CATH 18 BARDIA ASKES 50 PCS 22,550 1,127,500

FOLEY CATH 18 BARDIA ASKES 20 PCS 22,550 451,000

FOLEY CATH 18 EUROMED ASKES 20 BIJI 18,700 374,000

FOLEY CATH 18 EUROMED ASKES 20 BIJI 18,700 374,000

FOLEY CATH 18 EUROMED ASKES 20 BIJI 18,700 374,000

FOLEY CATH 18 EUROMED ASKES 10 BIJI 18,700 187,000

FOLEY CATH 18 RUSCH 10 BIJI 20,790 207,900

FOLEY CATH 18 RUSCH 10 BIJI 20,790 207,900

FOLEY CATH 3WAY 24 RUSCH 10 BIJI 66,000 660,000

FOLEY CATH 8 EUROMED ASKES 10 PCS 64,350 643,500

FOLEY CATHETER 10 BARDEX 10 PCS 118,800 1,188,000

FOLEY CATHETER 12 EUROMED 10 PCS 18,700 187,000

FOLEY CATHETER 14 UROCARE 10 PCS 11,880 118,800

FOLEY CATHETER 16 EUROMED 50 PCS 18,700 935,000

FOLEY CATHETER 16 EUROMED 50 PCS 18,700 935,000

FOLEY CATHETER 18 EUROMED 20 PCS 18,700 374,000

FOLEY CATHETER 18 EUROMED 10 PCS 18,700 187,000

FOLEY CATHETER 8 EUROMED 10 PCS 64,350 643,500

FORBETES 500 100 TABLET 924 92,400

FORINFEC GARGLE 10 BOTOL 19,250 192,500

FORMALIN 3 % 1 ML 10,000 MILILITER 42 419,980

FORMUNO EXTRA 6 BOX 90,145 540,870

FORMUNO TAB 90 TABLET 5,808 522,720

FORMUNO TAB 90 TABLET 5,957 536,085

FORMUNO TAB 90 TABLET 5,957 536,085

FORMYCO CREAM 3 TUBE 16,973 50,919

FORMYCO CREAM 5 TUBE 16,973 84,865

FORNEURO TAB 60 TABLET 4,987 299,200

FORNEURO TAB 60 TABLET 4,987 299,200

FORNEURO TAB 60 TABLET 4,987 299,200

FORNEURO TAB 60 TABLET 4,987 299,200

FORNEURO TAB 60 TABLET 4,987 299,200

FORNEURO TAB 90 TABLET 4,987 448,800

FORUMEN EAR DROP 10 FLS 24,101 241,010

FORUMEN EAR DROP 10 FLS 24,101 241,010

FORUMEN EAR DROP 10 FLS 24,101 241,010

FORUMEN EAR DROP 10 FLS 24,101 241,010

FORUMEN EAR DROP 10 FLS 24,101 241,010

FORUMEN EAR DROP 10 FLS 24,101 241,010

FORUMEN EAR DROP 20 FLS 24,101 482,020

Page 70: FORM FA Unit Kerja Penunjang 30815

FREGO 5 MG 50 TABLET 5,434 271,700

FUJI IX ART MP 1 BOX 858,000 858,000

FUROSEMID 500 TABLET 102 50,991

FUROSEMID TAB ASKES 500 TABLET 90 45,001

FUROSEMID TAB ASKES 1,000 TABLET 85 84,997

FUROSEMID TAB ASKES 500 TABLET 102 50,991

FUROSEMIDE INJ 100 AMPUL 1,830 183,000

FUROSEMIDE INJ 100 AMPUL 2,058 205,801

FUROSEMIDE INJ 50 AMPUL 2,058 102,901

FUROSEMIDE INJ ASKES 250 AMPUL 1,830 457,501

FUROSEMIDE INJ ASKES 250 AMPUL 1,830 457,501

FUROSEMIDE INJ ASKES 250 AMPUL 1,829 457,251

FUROSEMIDE INJ ASKES 150 AMPUL 1,830 274,501

FUROSEMIDE INJ ASKES 500 AMPUL 1,829 914,502

FUSYCOM CREAM 5 TUBE 44,000 220,000

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INF 24 FLS 40,949 982,775

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INF 72 FLS 40,949 2,948,325

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INF 24 FLS 40,949 982,775

FUTROLIT INF 24 FLS 40,949 982,775

FUTROLIT INF 24 FLS 40,949 982,775

FUTROLIT INF 24 FLS 40,949 982,775

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INF 48 FLS 40,949 1,965,550

FUTROLIT INFUS ASKES 48 FLS 40,949 1,965,550

FUTROLIT INFUS ASKES 72 FLS 40,949 2,948,325

FUTROLIT INFUS ASKES 48 FLS 40,949 1,965,550

FUTROLIT INFUS ASKES 72 FLS 40,949 2,948,325

FUTROLIT INFUS ASKES 96 FLS 40,949 3,931,099

FUTROLIT INFUS ASKES 72 FLS 40,949 2,948,325

FUTROLIT INFUS ASKES 72 FLS 40,949 2,948,325

FUTROLIT INFUS ASKES 72 FLS 40,949 2,948,325

FUTROLIT INFUS ASKES 48 FLS 40,949 1,965,550

FUTROLIT INFUS ASKES 48 FLS 40,949 1,965,550

FUTROLIT INFUS ASKES 24 FLS 40,949 982,775

FUTROLIT INFUS ASKES 48 FLS 40,949 1,965,550

FUTROLIT INFUS ASKES 48 FLS 40,949 1,965,550

FUTROLIT INFUS ASKES 120 FLS 40,949 4,913,874

FUTROLIT INFUS ASKES 96 FLS 40,949 3,931,099

FUTROLIT INFUS ASKES 120 FLS 40,949 4,913,874

FUTROLIT INFUS ASKES 96 FLS 40,949 3,931,099

FUTROLIT INFUS ASKES 120 FLS 40,949 4,913,874

FUTROLIT INFUS ASKES 48 FLS 40,949 1,965,550

FUTROLIT INFUS ASKES 192 FLS 40,949 7,862,199

GAMEX 6,5 REG 40 PCS 15,950 638,000

GAMEX 6,5 REG 40 PCS 15,950 638,000

GAMEX 6,5 REG 120 PCS 15,950 1,914,000

GAMEX 6,5 REG 40 PCS 15,950 638,000

GAMEX 6,5 REG 40 PCS 15,950 638,000

GAMEX 6,5 REG 40 PCS 15,950 638,000

GAMEX 6,5 REG 40 PCS 15,950 638,000

Page 71: FORM FA Unit Kerja Penunjang 30815

GAMEX 7 REG 40 BIJI 15,950 638,000

GAMEX 7 REG 80 BIJI 15,950 1,276,000

GAMEX 7 REG 40 BIJI 15,950 638,000

GAMEX 7 REG 80 BIJI 15,950 1,276,000

GAMEX 7 REG 40 BIJI 15,950 638,000

GAMEX 7 REG 40 BIJI 15,950 638,000

GAMEX 7 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 40 BIJI 15,950 638,000

GAMEX 7.5 REG 120 BIJI 15,950 1,914,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 160 BIJI 15,950 2,552,000

GAMEX 7.5 REG 40 BIJI 15,950 638,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 7.5 REG 80 BIJI 15,950 1,276,000

GAMEX 8 REG 40 BIJI 15,950 638,000

GAMEX 8 REG 80 BIJI 15,950 1,276,000

GAMEX 8 REG 120 BIJI 15,950 1,914,000

GAMEX 8 REG 40 BIJI 15,950 638,000

GAMEX 8 REG 40 BIJI 15,950 638,000

GAMEX 8 REG 80 BIJI 15,950 1,276,000

GAMEX 8,5 REG 40 PCS 15,950 638,000

GAMEX 8,5 REG 80 PCS 15,950 1,276,000

GAMEX 8,5 REG 80 PCS 15,950 1,276,000

GAMEX 8,5 REG 40 PCS 15,950 638,000

GAMEX 8,5 REG 80 PCS 15,950 1,276,000

GAMEX 8,5 REG 80 PCS 15,950 1,276,000

GASTRUL TABLET 30 TABLET 10,450 313,500

GELITASPON REG 10 PCS 47,300 473,000

GENOINT EO ASK 200 TUBE 3,960 792,000

GENTA 0,3% ED 5 FLS 31,213 156,063

GENTA 0,3% EO 5 TUBE 40,013 200,063

GENTAMICIN 0,3% ED ASKES 50 FLS 3,000 150,002

GENTAMICIN INJ 50 AMPUL 3,508 175,382

GENTAMICIN INJ 50 AMPUL 3,600 179,997

GENTAMICIN INJ 50 AMPUL 3,399 169,950

GENTAMICIN INJ ASKES 100 AMPUL 3,100 310,002

GENTAMICIN INJ ASKES 50 AMPUL 3,399 169,950

GENTAMICIN INJ ASKES 50 AMPUL 3,100 155,001

GENTAMICIN INJ ASKES 50 AMPUL 3,600 179,997

GENTAMICIN INJ ASKES 50 AMPUL 3,600 179,997

GENTAMICIN INJ ASKES 50 AMPUL 3,399 169,950

GENTAMICIN INJ ASKES 50 AMPUL 3,600 179,997

GENTAMISIN SALEP KULIT ASK 25 TUBE 1,698 42,438

GENTAMYCIN CREAM 10 TUBE 1,850 18,502

GENTAMYCIN CREAM 10 TUBE 1,850 18,502

GIFLOX 0.6 ML MD 1 STRIP 88,275 88,275

GIFLOX 0.6 ML MD 5 STRIP 88,275 441,375

GIFLOX 0.6 ML MD 5 STRIP 88,275 441,375

GIFLOX 0.6 ML MD 6 STRIP 88,275 529,650

GIFLOX 0.6 ML MD 10 STRIP 88,275 882,750

GIFLOX 0.6 ML MD 10 STRIP 88,275 882,750

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GIFLOX 0.6 ML MD 15 STRIP 88,275 1,324,125

GIFLOX 0.6 ML MD 20 STRIP 88,275 1,765,500

GINKONA TAB 90 TABLET 4,290 386,100

GIP STORE PAKET 1 KILOGRAM 31,680 31,680

GITAS INJ 50 AMPUL 12,210 610,500

GITAS INJ 50 AMPUL 12,719 635,938

GITAS INJ 50 AMPUL 12,719 635,938

GITAS INJ 50 AMPUL 12,719 635,938

GITAS PLUS TAB 50 TABLET 1,928 96,401

GITAS PLUS TAB 100 TABLET 1,928 192,803

GLAUCON 200 TABLET 4,180 836,000

GLAUCON 100 TABLET 4,180 418,000

GLAUCON 200 TABLET 4,180 836,000

GLAUCON 100 TABLET 4,180 418,000

GLAUCON 100 TABLET 4,180 418,000

GLAUCON 200 TABLET 4,180 836,000

GLAUCON 200 TABLET 4,180 836,000

GLAUCON 200 TABLET 4,180 836,000

GLAUCON TAB ASKES 1,100 TABLET 1,800 1,980,000

GLAUCON TAB ASKES 2,000 TABLET 1,800 3,600,000

GLAUCON TAB ASKES 2,000 TABLET 1,800 3,600,000

GLIMEPIRIDE 1 MG ASKES/50 250 TABLET 418 104,511

GLIMEPIRIDE 1 MG ASKES/50 250 TABLET 418 104,511

GLIMEPIRIDE 1 MG ASKES/50 500 TABLET 265 132,495

GLIMEPIRIDE 2 MG ASKES/50 100 TABLET 1,433 143,328

GLIMEPIRIDE 2 MG ASKES/50 100 TABLET 788 78,830

GLIMEPIRIDE 2 MG ASKES/50 250 TABLET 788 197,076

GLIMEPIRIDE 2 MG ASKES/50 250 TABLET 788 197,076

GLIMEPIRIDE 2 MG ASKES/50 500 TABLET 788 394,152

GLIMEPIRIDE 3 MG ASKES/50 250 TABLET 1,075 268,741

GLIMEPIRIDE 3 MG ASKES/50 250 TABLET 1,075 268,741

GLIMEPIRIDE 3 MG ASKES/50 500 TABLET 404 202,004

GLIMEPIRIDE 4 MG ASKES 250 TABLET 1,433 358,322

GLIMEPIRIDE 4 MG ASKES 300 TABLET 2,345 703,580

GLIMEPIRIDE 4 MG ASKES 500 TABLET 430 214,995

GLIQUIDON 30 MG ASKES 500 TABLET 950 475,002

GLIQUIDON 30 MG ASKES 500 TABLET 927 463,320

GLUCOBAY 100 MG ASKES 300 TABLET 1,575 472,501

GLUCOBAY 100 MG ASKES 250 TABLET 1,575 393,740

GLUCOBAY 50 MG ASKES 300 TABLET 975 292,499

GLUCOBAY 50 MG ASKES 250 TABLET 975 243,744

GLUCOBAY 50 MG ASKES 250 TABLET 975 243,744

GLUCOSE 8X20 ML PAKET 1 PACK 2,860,000 2,860,000

GLUCOSE 8X20 ML PAKET 1 PACK 2,860,000 2,860,000

GLUCOSE 8X20 ML PAKET 2 PACK 2,860,000 5,720,000

GLUCOSE STRIP PAKET 20 BOX 237,600 4,752,000

GLUCOSE STRIP PAKET 10 BOX 237,600 2,376,000

GLUCOSE STRIP PAKET 20 BOX 237,600 4,752,000

GLUCOSE STRIP PAKET 15 BOX 237,600 3,564,000

GLUCOSE STRIP PAKET 30 BOX 237,600 7,128,000

GLUCOSE STRIP PAKET 20 BOX 237,600 4,752,000

GLUCOSE STRIP PAKET 25 BOX 237,600 5,940,000

GLUCOSE STRIP PAKET 30 BOX 237,600 7,128,000

GLUCOSE STRIP PAKET 20 BOX 237,600 4,752,000

GLUCOSE STRIP PAKET 20 BOX 237,600 4,752,000

GLUCOSE STRIP PAKET 25 BOX 237,600 5,940,000

GOLONGAN DARAH ANTI A PAKET 1 VIAL 138,380 138,380

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GOLONGAN DARAH ANTI A PAKET 1 VIAL 213,400 213,400

GOLONGAN DARAH ANTI A PAKET 2 VIAL 213,400 426,800

GOLONGAN DARAH ANTI A PAKET 3 VIAL 213,400 640,200

GOLONGAN DARAH ANTI A PAKET 2 VIAL 213,400 426,800

GOLONGAN DARAH ANTI A PAKET 1 VIAL 121,000 121,000

GOLONGAN DARAH ANTI AB PAKET 1 VIAL 138,380 138,380

GOLONGAN DARAH ANTI AB PAKET 1 VIAL 213,400 213,400

GOLONGAN DARAH ANTI AB PAKET 2 VIAL 213,400 426,800

GOLONGAN DARAH ANTI AB PAKET 3 VIAL 213,400 640,200

GOLONGAN DARAH ANTI AB PAKET 2 VIAL 213,400 426,800

GOLONGAN DARAH ANTI AB PAKET 1 VIAL 121,000 121,000

GOLONGAN DARAH ANTI B PAKET 1 VIAL 138,380 138,380

GOLONGAN DARAH ANTI B PAKET 1 VIAL 213,400 213,400

GOLONGAN DARAH ANTI B PAKET 2 VIAL 213,400 426,800

GOLONGAN DARAH ANTI B PAKET 3 VIAL 213,400 640,200

GOLONGAN DARAH ANTI B PAKET 2 VIAL 213,400 426,800

GOLONGAN DARAH ANTI B PAKET 1 VIAL 121,000 121,000

GOLONGAN DARAH ANTI D PAKET 1 VIAL 207,350 207,350

GOLONGAN DARAH ANTI D PAKET 1 VIAL 337,150 337,150

GOLONGAN DARAH ANTI D PAKET 2 VIAL 337,150 674,300

GOLONGAN DARAH ANTI D PAKET 3 VIAL 337,150 1,011,450

GOLONGAN DARAH ANTI D PAKET 2 VIAL 337,150 674,300

GOLONGAN DARAH ANTI D PAKET 1 VIAL 147,400 147,400

GUEDEL AIRWAY 100 MM ASKES 5 PCS 11,880 59,400

GUEDEL AIRWAY 100MM 6 PCS 11,880 71,280

GUEDEL AIRWAY 60MM 3 PCS 11,880 35,640

GUEDEL AIRWAY 60MM 5 PCS 11,880 59,400

GUEDEL AIRWAY 70MM 3 PCS 11,880 35,640

GUEDEL AIRWAY 70MM 5 PCS 11,880 59,400

GUEDEL AIRWAY 80 MM ASKES 6 PCS 26,950 161,700

GUEDEL AIRWAY 80 MM ASKES 3 PCS 11,880 35,640

GUEDEL AIRWAY 80 MM ASKES 6 PCS 13,200 79,200

GUEDEL AIRWAY 80MM 5 PCS 11,880 59,400

GUEDEL AIRWAY 90 MM ASKES 5 PCS 26,950 134,750

GUEDEL AIRWAY 90 MM ASKES 5 PCS 11,880 59,400

GUEDEL AIRWAY 90 MM ASKES 6 PCS 26,950 161,700

GUEDEL AIRWAY 90 MM ASKES 5 PCS 11,880 59,400

GUEDEL AIRWAY 90 MM ASKES 6 PCS 16,500 99,000

GUEDEL AIRWAY 90 MM ASKES 6 PCS 26,950 161,700

GUEDEL AIRWAY 90 MM ASKES 6 PCS 11,880 71,280

GUEDEL AIRWAY 90 MM ASKES 15 PCS 11,880 178,200

GUEDEL AIRWAY 90MM 5 PCS 26,950 134,750

GUEDEL AIRWAY 90MM 6 PCS 11,880 71,280

GUEDEL AIRWAY 90MM 6 PCS 11,880 71,280

GUEDEL AIRWAY 90MM 6 PCS 11,880 71,280

GUEDEL AIRWAY 90MM 6 PCS 26,950 161,700

GUEDEL AIRWAY 90MM 5 PCS 11,880 59,400

GUEDEL AIRWAY 90MM 6 PCS 11,880 71,280

GYPSONA 4 ASKES 6 ROL 38,134 228,802

GYPSONA 4 ASKES 6 ROL 38,134 228,802

GYPSONA 4" 6 BIJI 38,134 228,802

GYPSONA 4" 6 BIJI 38,134 228,802

GYPSONA 4" 6 BIJI 38,134 228,802

GYPSONA 4" 6 BIJI 38,134 228,802

GYPSONA 4" 6 BIJI 38,134 228,802

GYPSONA 4" 6 BIJI 38,134 228,802

GYPSONA 4" 6 BIJI 38,134 228,802

Page 74: FORM FA Unit Kerja Penunjang 30815

GYPSONA 4" 6 BIJI 38,134 228,802

GYPSONA 6" 6 BIJI 50,006 300,036

GYPSONA 6" 6 BIJI 50,006 300,036

GYPSONA 6" 6 BIJI 50,006 300,036

GYPSONA 6” ASKES 6 ROL 38,134 228,802

GYPSONA 6” ASKES 6 ROL 50,006 300,036

GYPSONA 6” ASKES 6 ROL 50,006 300,036

GYPSONA 6” ASKES 6 ROL 50,006 300,036

H2O2 3% PER 1 ML 8,000 MILILITER 21 168,344

H2O2 3% PER 1 ML 4,000 MILILITER 21 84,172

H2O2 3% PER 1 ML 8,000 MILILITER 21 168,344

HALOPERIDOL 1.5 MG ASKES 200 TABLET 70 14,038

HALOPERIDOL 5 MG ASKES 100 TABLET 104 10,394

HANDSCOON MAXITEC DUPLEX 7,5 25 PASANG 15,840 396,000

HANDSCOON OBGYN 50 PCS 11,880 594,000

HANDSCOON OBGYN 50 PCS 11,880 594,000

HANDSCOON OBGYN 50 PCS 11,880 594,000

HANDSCOON OBGYN 50 PCS 13,200 660,000

HANSAPLAST SILVERCARE 100 PKT 10 BOX 19,250 192,500

HANSAPLAST SILVERCARE 100 PKT 10 BOX 21,175 211,750

HANSAPLAST SILVERCARE 100 PKT 10 BOX 19,250 192,500

HANSAPLAST SILVERCARE 100 PKT 10 BOX 19,250 192,500

HANSAPLAST SILVERCARE 100 PKT 10 BOX 19,250 192,500

HANSAPLAST SILVERCARE 100 PKT 10 BOX 19,250 192,500

HANSAPLAST SILVERCARE 100 PKT 10 BOX 21,175 211,750

HANSAPLAST SILVERCARE 100 PKT 10 BOX 19,250 192,500

HANSAPLAST SILVERCARE 100 PKT 10 BOX 21,175 211,750

HANSAPLAST SILVERCARE 100 PKT 10 BOX 19,250 192,500

HANSAPLAST SILVERCARE 100 PKT 20 BOX 19,250 385,000

HBA1C 2X14 ML PAKET 1 BOX 9,680,000 9,680,000

HBS AG STRIP INST-ANSWER 50 PCS 5,280 264,000

HBS AG STRIP PAKET 50 PCS 13,750 687,500

HBS AG STRIP PAKET 100 PCS 13,750 1,375,000

HBS AG STRIP PAKET 50 PCS 13,750 687,500

HBS AG STRIP PAKET 50 PCS 13,750 687,500

HCG DEVICE URINE 40TEST PAKET 40 PCS 14,953 598,136

HCG DEVICE URINE 40TEST PAKET 80 PCS 15,730 1,258,400

1 KIT 8,140,000 8,140,000

HEPA-MERZ GRANULATE 20 SACHET 39,930 798,600

HEPATOSOL 12 BOX 80,850 970,200

HEPATOSOL 12 BOX 80,850 970,200

HEPATOSOL 6 BOX 80,850 485,100

HEPATOSOL 10 BOX 80,850 808,500

HEPTASAN 100 TABLET 220 22,000

HEPTASAN 100 TABLET 220 22,000

HEPTASAN 100 TABLET 220 22,000

HERVIS EO 6 TUBE 40,425 242,550

HEXAQUART PLUS PER ML 1,000 MILILITER 272 272,250

HEXYMER 2 MG ASKES 1,250 TABLET 274 342,898

HGB UNIT (C2/XS ) 1 PCS 2,779,370 2,779,370

HIBERIX PFS 1 PCS 174,900 174,900

HIBERIX PFS 1 PCS 174,900 174,900

HIBERIX PFS 1 PCS 174,900 174,900

HDL CHOLESTEROL PLUS 6X24 ML PAKET

Page 75: FORM FA Unit Kerja Penunjang 30815

HIBISCRUB 5 L PAKET 5,000 MILILITER 242 1,210,000

HISTAPAN 100 TABLET 605 60,500

HISTAPAN 100 TABLET 605 60,500

HISTAPAN 100 TABLET 605 60,500

HUMAN ALBUMIN 20% 100 ML ASKES 3 BOTOL 750,000 2,249,999

HYALOPH ED 3 BOTOL 61,001 183,002

HYALOPH ED 6 BOTOL 61,001 366,003

HYALOPH ED 10 BOTOL 61,001 610,005

HYALOPH ED 10 BOTOL 61,001 610,005

HYALOPH ED 10 BOTOL 61,001 610,005

HYALOPH ED 3 BOTOL 61,001 183,002

HYALOPH ED 15 BOTOL 61,001 915,008

HYALUB MD 20 STRIP 52,250 1,045,000

HYALUB MD 20 STRIP 52,250 1,045,000

HYALUB MD 9 STRIP 52,250 470,250

HYALUB MD 20 STRIP 52,250 1,045,000

HYALUB MD 20 STRIP 52,250 1,045,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 10 STRIP 62,700 627,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 20 STRIP 62,700 1,254,000

HYALUB MD 40 STRIP 62,700 2,508,000

HYDREX PER 1 ML 5,000 MILILITER 244 1,221,000

HYDROMAL 6 FLS 65,714 394,284

HYDROMAL 10 FLS 65,714 657,140

HYDROMAL 14 FLS 65,714 919,996

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 48 FLS 65,714 3,154,272

HYDROMAL 24 FLS 65,714 1,577,136

HYDROMAL 24 FLS 65,714 1,577,136

HYOCINE-N-BUTYLBROMIDE INJ ASKES 100 AMPUL 6,000 599,984

HYOCINE-N-BUTYLBROMIDE INJ ASKES 100 AMPUL 6,000 599,984

HYOCINE-N-BUTYLBROMIDE INJ ASKES 25 AMPUL 7,200 180,004

HYOCINE-N-BUTYLBROMIDE INJ ASKES 95 AMPUL 6,801 646,061

HYPAFIX 5X1 24 BIJI 11,405 273,715

HYPAVIX 20X5 PER CM 5,000 385 1,927,035

HYPAVIX 20X5 PER CM 5,000 385 1,927,035

CENTIMETER

CENTIMETER

Page 76: FORM FA Unit Kerja Penunjang 30815

HYPAVIX 20X5 PER CM 5,000 385 1,927,035

HYPAVIX 20X5 PER CM 5,000 385 1,927,035

HYPAVIX 20X5 PER CM 2,000 385 770,814

HYPAVIX 20X5 PER CM 2,000 385 770,814

HYPAVIX 20X5 PER CM 2,500 385 963,518

HYPAVIX 20X5 PER CM 5,000 393 1,965,700

HYPAVIX 20X5 PER CM 1,500 393 589,710

ID BAND BLUE ANAK 100 PCS 2,365 236,500

ID BAND BLUE ANAK 100 PCS 2,365 236,500

ID BAND BLUE DWS 100 PCS 2,365 236,500

ID BAND BLUE DWS 100 PCS 2,365 236,500

ID BAND BLUE DWS 100 PCS 2,365 236,500

ID BAND BLUE DWS 100 PCS 2,365 236,500

ID BAND BLUE DWS 100 PCS 2,365 236,500

ID BAND BLUE DWS 100 PCS 2,365 236,500

ID BAND PINK ANAK 100 PCS 2,365 236,500

ID BAND PINK ANAK 100 PCS 2,365 236,500

ID BAND PINK DWS 100 PCS 2,057 205,700

ID BAND PINK DWS 100 PCS 2,365 236,500

ID BAND PINK DWS 100 PCS 2,365 236,500

ID BAND PINK DWS 200 PCS 2,365 473,000

ID BAND PINK DWS 100 PCS 2,365 236,500

ID BAND PINK DWS 100 PCS 2,365 236,500

ID BAND PINK DWS 100 PCS 2,365 236,500

ID BAND RED ANAK 100 PCS 2,365 236,500

ID BAND RED DEWASA 100 PCS 2,365 236,500

ID BAND YELLOW ANAK 100 PCS 2,365 236,500

ID BAND YELLOW DEWASA 100 PCS 2,365 236,500

ILLIADIN DROP 0,025% 15 FLS 41,206 618,097

ILLIADIN DROP 0,025% 15 FLS 41,206 618,097

ILLIADIN SPRAY 0,05% 20 FLS 42,973 859,469

IMUNOS 40 TABLET 5,500 220,000

IMUNOS 60 TABLET 5,500 330,000

IMUNOS 40 TABLET 5,500 220,000

IMUNOS 40 TABLET 5,500 220,000

IMUNOS 100 TABLET 5,500 550,000

IMUNOS 60 TABLET 6,050 363,000

IMUNOS 60 TABLET 6,050 363,000

IMUNOS SYR 10 BOTOL 55,000 550,000

IMUNOS SYR 10 BOTOL 55,000 550,000

IMUNOS SYR 10 BOTOL 55,000 550,000

IMUNOS SYR 10 BOTOL 57,750 577,500

IMUNOS SYR 10 BOTOL 57,750 577,500

IMUNOS SYR 5 BOTOL 57,750 288,750

INCEPHIN 10 AMPUL 176,000 1,760,000

INCEPHIN 10 AMPUL 176,000 1,760,000

INCEPHIN 10 AMPUL 176,000 1,760,000

INCEPHIN 10 AMPUL 176,000 1,760,000

INCEPHIN 10 AMPUL 176,000 1,760,000

INCEPHIN 10 AMPUL 176,000 1,760,000

INDOP 200 MG 10 VIAL 33,000 330,000

INDOP 200 MG 10 VIAL 33,000 330,000

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

Page 77: FORM FA Unit Kerja Penunjang 30815

INFIX 100 60 TABLET 13,035 782,100

INFIX 100 90 TABLET 13,035 1,173,150

INFIX 100 90 TABLET 13,035 1,173,150

INFIX 100 60 TABLET 13,035 782,100

INFIX 100 30 TABLET 13,035 391,050

INFIX 100 60 TABLET 13,035 782,100

INFUSAN D10% 24 SOFTBAG 15,217 365,211

INFUSAN D10% 24 SOFTBAG 15,217 365,211

INFUSAN D10% 48 SOFTBAG 15,217 730,422

INFUSAN D10% 24 SOFTBAG 15,217 365,211

INFUSAN D10% 24 SOFTBAG 15,217 365,211

INFUSAN D10% 24 SOFTBAG 15,217 365,211

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 24 FLS 12,470 299,277

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 24 FLS 12,470 299,277

INFUSAN D5 SP 48 FLS 12,470 598,554

INFUSAN D5 SP 72 FLS 12,470 897,831

INFUSAN D5 SP 24 FLS 12,470 299,277

INFUSAN D5+1/2 NS SP 72 FLS 12,656 911,196

INFUSAN D5+1/2 NS SP 72 FLS 12,656 911,196

INFUSAN D5+1/2 NS SP 48 FLS 12,656 607,464

INFUSAN D5+1/2 NS SP 48 FLS 12,656 607,464

INFUSAN D5+1/2 NS SP 24 FLS 12,656 303,732

INFUSAN D5+1/2 NS SP 24 FLS 12,656 303,732

INFUSAN D5+1/2 NS SP 48 FLS 12,656 607,464

INFUSAN D5+1/2 NS SP 48 FLS 12,656 607,464

INFUSAN D5+1/2 NS SP 48 FLS 12,656 607,464

INFUSAN D5+1/2 NS SP 72 FLS 12,656 911,196

INFUSAN D5+1/4 NS SP 48 FLS 12,561 602,910

INFUSAN D5+1/4 NS SP 48 FLS 12,561 602,910

INFUSAN D5+1/4 NS SP 48 FLS 12,561 602,910

INFUSAN D5+1/4 NS SP 24 FLS 12,561 301,455

INFUSAN D5+1/4 NS SP 48 FLS 12,561 602,910

INFUSAN D5+1/4 NS SP 48 FLS 12,561 602,910

INFUSAN D5+1/4 NS SP 24 FLS 12,561 301,455

INFUSAN D5+1/4 NS SP 24 FLS 12,561 301,455

INFUSAN D5+1/4 NS SP 48 FLS 12,561 602,910

INFUSAN D5+1/4 NS SP 48 FLS 12,561 602,910

INFUSAN D5+1/4 NS SP 72 FLS 12,561 904,365

INFUSAN D5+1/4 NS SP 48 FLS 12,561 602,910

INFUSAN D5+1/4 NS SP 72 FLS 12,561 904,365

INFUSAN M-20 24 FLS 57,338 1,376,100

INFUSAN M-20 24 FLS 57,338 1,376,100

INFUSAN M-20 24 FLS 57,338 1,376,100

INFUSAN M-20 48 FLS 57,338 2,752,200

INFUSAN M-20 ASKES 24 FLS 57,338 1,376,100

INFUSAN NS 100ML 30 FLS 13,104 393,121

INFUSAN NS 100ML 30 FLS 13,104 393,121

INFUSAN NS 100ML 30 FLS 13,104 393,121

INFUSAN NS 100ML 30 FLS 13,104 393,121

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INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 96 FLS 11,835 1,136,124

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 72 FLS 11,835 852,093

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 120 FLS 11,835 1,420,155

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN NS SP 240 FLS 11,835 2,840,310

INFUSAN R+D SP 24 FLS 12,746 305,910

INFUSAN R+D SP 48 FLS 12,746 611,820

INFUSAN R+D SP 24 FLS 12,746 305,910

INFUSAN R+D SP 24 FLS 12,746 305,910

INFUSAN R+D SP 24 FLS 12,746 305,910

INFUSAN R+D SP 24 FLS 12,746 305,910

INFUSAN R+D SP 24 FLS 12,746 305,910

INFUSAN R+D SP 24 FLS 12,746 305,910

INFUSAN R+D SP 48 FLS 12,746 611,820

INFUSAN R+D SP 24 FLS 12,746 305,910

INFUSAN RING-AS SP 48 FLS 11,318 543,285

INFUSAN RING-AS SP 24 FLS 11,318 271,643

INFUSAN RING-AS SP 48 FLS 11,318 543,285

INFUSAN RING-AS SP 24 FLS 11,318 271,643

INFUSAN RING-AS SP 48 FLS 11,318 543,285

INFUSAN RING-AS SP 48 FLS 11,318 543,285

INFUSAN RING-AS SP 48 FLS 11,318 543,285

INFUSAN RING-AS SP 24 FLS 11,318 271,643

INFUSAN RING-AS SP 48 FLS 11,318 543,285

INFUSAN RING-AS SP 24 FLS 11,318 271,643

INFUSAN RING-AS SP 48 FLS 11,318 543,285

INFUSAN RING-AS SP 72 FLS 11,318 814,928

INFUSAN RING-AS SP 48 FLS 11,318 543,285

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 120 FLS 12,152 1,458,270

Page 79: FORM FA Unit Kerja Penunjang 30815

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 72 FLS 12,152 874,962

INFUSAN RL SP 192 FLS 12,152 2,333,232

INFUSAN RL SP 72 FLS 12,152 874,962

INFUSAN RL SP 72 FLS 12,152 874,962

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 120 FLS 12,152 1,458,270

INFUSAN RL SP 72 FLS 12,152 874,962

INFUSSET ANAK HOSPITEC ASKES 60 PCS 8,360 501,600

INFUSSET ANAK OM ASKES 50 PCS 5,500 275,000

INFUSSET ANAK TERUMO 50 BIJI 15,246 762,300

INFUSSET ANAK TERUMO 50 BIJI 18,920 946,000

INFUSSET ANAK TERUMO 50 BIJI 18,920 946,000

INFUSSET ANAK TERUMO 50 BIJI 17,028 851,400

INFUSSET ANAK TERUMO 100 BIJI 17,028 1,702,800

INFUSSET ANAK TERUMO 50 BIJI 18,920 946,000

INFUSSET DEWASA MEDIGLOVE ASKES 300 PCS 4,376 1,312,740

INFUSSET DEWASA STERA ASKES 100 PCS 3,200 319,990

INFUSSET DEWASA STERA ASKES 100 PCS 3,200 319,990

INFUSSET DEWASA TERUMO 50 BIJI 10,890 544,500

INFUSSET DEWASA TERUMO 100 BIJI 11,495 1,149,500

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DEWASA TERUMO 100 BIJI 11,495 1,149,500

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DEWASA TERUMO 100 BIJI 11,495 1,149,500

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DEWASA TERUMO 100 BIJI 11,495 1,149,500

INFUSSET DEWASA TERUMO 50 BIJI 11,495 574,750

INFUSSET DWS OM ASKES 50 PCS 4,862 243,100

INFUSSET DWS OM ASKES 50 PCS 4,862 243,100

INFUSSET DWS OM ASKES 50 PCS 4,862 243,100

INFUSSET DWS OM ASKES 100 PCS 4,862 486,200

INFUSSET DWS OM ASKES 100 PCS 4,862 486,200

INFUSSET DWS OM ASKES 100 PCS 4,862 486,200

INFUSSET DWS OM ASKES 50 PCS 4,376 218,790

INFUSSET DWS OM ASKES 50 PCS 4,376 218,790

INFUSSET DWS OM ASKES 50 PCS 4,376 218,790

INFUSSET WITH Y CONECTOR DEWASA 100 PCS 10,120 1,012,000

INJECTOMAT EXTENTION 150 25 PCS 11,550 288,750

INJECTOMAT EXTENTION 150 50 PCS 11,550 577,500

INJECTOMAT EXTENTION 150 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 25 PCS 13,750 343,750

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INJECTOMAT EXTENTION 150 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 ASKES 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 ASKES 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 ASKES 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 ASKES 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 ASKES 25 PCS 13,750 343,750

INJECTOMAT EXTENTION 150 ASKES 25 PCS 13,750 343,750

INJECTOMAT PVC 150 ASKES 25 PCS 22,770 569,250

INMATROL ED ASKES 15 BOTOL 7,400 110,996

INMATROL ED ASKES 50 BOTOL 7,923 396,144

INMATROL ED ASKES 100 BOTOL 7,400 739,974

INODEX INJ ASKES 5 AMPUL 32,991 164,956

INODEX INJ ASKES 10 AMPUL 32,991 329,912

INODEX INJ ASKES 25 AMPUL 32,991 824,780

INOTROP INJ 9 VIAL 108,900 980,100

INOTROP INJ ASKES 10 VIAL 31,995 319,948

INPEPSA SYR 6 BOTOL 50,600 303,600

INPEPSA SYR 10 BOTOL 50,600 506,000

INPEPSA SYR 6 BOTOL 50,600 303,600

INPEPSA SYRUP 200 ML 5 BOTOL 80,300 401,500

INTERHISTIN 100 TABLET 620 62,040

INTERHISTIN 200 TABLET 620 124,080

INTERMOXIL 500 MG 100 TABLET 2,712 271,163

INVITEC TAB 300 TABLET 10,083 3,025,001

IOPAMIRO 370/50 ML 10 BOTOL 314,600 3,146,000

IRETENSA 60 TABLET 8,800 528,000

IRINOTECAN 100 MG INJ 2 VIAL 1,639,953 3,279,906

IRINOTECAN 100 MG INJ 2 VIAL 1,639,953 3,279,906

IRINOTECAN 100 MG INJ 2 VIAL 1,639,953 3,279,906

IRINOTECAN 100 MG INJ 4 VIAL 1,639,953 6,559,813

IRINOTECAN 100 MG INJ 2 VIAL 1,639,953 3,279,906

IRINOTECAN 100 MG INJ 2 VIAL 1,639,953 3,279,906

IRINOTECAN 100 MG INJ 2 VIAL 1,639,953 3,279,906

IRINOTECAN 100 MG INJ 2 VIAL 1,639,953 3,279,906

ISDN 200 TABLET 80 16,001

ISDN 200 TABLET 88 17,600

ISDN 1,000 TABLET 95 94,820

ISDN TAB 5 MG ASKES 2,000 TABLET 80 160,006

ISDN TAB 5 MG ASKES 1,500 TABLET 80 120,005

ISDN TAB 5 MG ASKES 2,000 TABLET 88 176,000

ISDN TAB 5 MG ASKES 1,000 TABLET 88 88,000

ISDN TAB 5 MG ASKES 1,200 TABLET 97 116,820

ISDN TAB 5 MG ASKES 5,000 TABLET 97 486,255

ISOFLURAN PER 1 ML 750 MILILITER 7,150 5,362,500

ISOFLURAN PER 1 ML 250 MILILITER 7,150 1,787,500

ISOFLURAN PER 1 ML 250 MILILITER 7,150 1,787,500

ISOFLURAN PER 1 ML 250 MILILITER 7,150 1,787,500

ISOFLURAN PER 1 ML 250 MILILITER 7,150 1,787,500

ISOFLURAN PER 1 ML 500 MILILITER 7,150 3,575,000

ISOTIC ADRETOR 0,5 ASKES 24 BOTOL 12,500 300,010

ISOTIC ADRETOR 0,5 ASKES 6 BOTOL 12,500 75,002

ISOTIC ADRETOR 0,5 ASKES 40 BOTOL 12,500 500,016

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ISOTIC ADRETOR 0,5 ASKES 5 BOTOL 12,500 62,502

ISOTIC NEOLYSON ASKES 60 BOTOL 7,700 461,984

ISOTIC NEOLYSON ASKES 60 BOTOL 7,700 461,984

ISOTIC NEOLYSON ASKES 60 BOTOL 7,700 461,984

IV CATH 16 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 18 TERUMO 100 BIJI 21,978 2,197,800

IV CATH 18 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 18 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 18 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 18 TERUMO 50 BIJI 24,255 1,212,750

IV CATH 20 TERUMO 150 BIJI 21,978 3,296,700

IV CATH 20 TERUMO 100 BIJI 21,978 2,197,800

IV CATH 20 TERUMO 100 BIJI 21,978 2,197,800

IV CATH 20 TERUMO 100 BIJI 21,978 2,197,800

IV CATH 20 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 20 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 20 TERUMO 100 BIJI 21,978 2,197,800

IV CATH 20 TERUMO 100 BIJI 21,978 2,197,800

IV CATH 20 TERUMO 100 BIJI 21,978 2,197,800

IV CATH 20 TERUMO 100 BIJI 24,255 2,425,500

IV CATH 20 TERUMO 100 BIJI 24,255 2,425,500

IV CATH 20 TERUMO 100 BIJI 24,255 2,425,500

IV CATH 20 WINFLON ASKES 100 PCS 13,200 1,320,000

IV CATH 20 WINFLON ASKES 200 PCS 14,850 2,970,000

IV CATH 20 WINFLON ASKES 200 PCS 14,850 2,970,000

IV CATH 20 WINFLON ASKES 200 PCS 14,850 2,970,000

IV CATH 20 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATH 20 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATH 20 WINFLON ASKES 100 PCS 17,050 1,705,000

IV CATH 20 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATH 20 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATH 20 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATH 20 WINFLON ASKES 100 PCS 17,050 1,705,000

IV CATH 20 WINFLON ASKES 100 PCS 17,050 1,705,000

IV CATH 20 WINFLON ASKES 100 PCS 17,050 1,705,000

IV CATH 22 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 22 TERUMO 50 BIJI 24,255 1,212,750

IV CATH 22 TERUMO 50 BIJI 24,255 1,212,750

IV CATH 22 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATH 24 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 24 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 24 TERUMO 100 BIJI 21,978 2,197,800

IV CATH 24 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 24 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 24 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 24 TERUMO 50 BIJI 21,978 1,098,900

IV CATH 24 TERUMO 50 BIJI 24,255 1,212,750

IV CATH 24 TERUMO 100 BIJI 24,255 2,425,500

IV CATH HOSPITEC 16 ASKES 100 PCS 17,050 1,705,000

IV CATH POLYFLEX 26 ASKES 100 PCS 25,300 2,530,000

IV CATH POLYFLEX 26 ASKES 100 PCS 25,300 2,530,000

IV CATH POLYFLEX 26 ASKES 50 PCS 25,300 1,265,000

IV CATH POLYFLEX 26 ASKES 50 PCS 25,300 1,265,000

IV CATH POLYFLEX 26 ASKES 100 PCS 25,300 2,530,000

IV CATH POLYFLEX 26 ASKES 100 PCS 25,300 2,530,000

IV CATH POLYFLEX 26 ASKES 50 PCS 25,300 1,265,000

IV CATH POLYFLEX 26 G 100 PCS 25,300 2,530,000

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IV CATH POLYFLEX 26 G 50 PCS 25,300 1,265,000

IV CATH POLYFLEX 26 G 50 PCS 25,300 1,265,000

IV CATH POLYFLEX 26 G 50 PCS 25,300 1,265,000

IV CATH POLYFLEX 26 G 50 PCS 25,300 1,265,000

IV CATH POLYFLEX 26 G 50 PCS 25,300 1,265,000

IV CATH POLYFLEX 26 G 100 PCS 25,300 2,530,000

IV CATH WINFLON 24 ASKES 100 PCS 18,150 1,815,000

IV CATHETER 18 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATHETER 18 WINFLON ASKES 100 PCS 17,050 1,705,000

IV CATHETER 18 WINFLON ASKES 100 PCS 17,050 1,705,000

IV CATHETER 18 WINFLON ASKES 100 PCS 17,050 1,705,000

IV CATHETER 18 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATHETER 18 WINFLON ASKES 100 PCS 14,850 1,485,000

IV CATHETER 18 WINFLON ASKES 100 PCS 14,850 1,485,000

JARUM MANI SE TH 36 24 PCS 8,708 209,000

JARUM MANI SE-ME 18 12 PCS 8,708 104,500

JARUM MANI SE-ME 21 24 PCS 8,250 198,000

JARUM MANI SE-ME 24 24 PCS 8,250 198,000

JARUM MANI SE-ME 28 12 PCS 8,708 104,500

JARUM MANI SE-ME 28 24 PCS 8,708 209,000

JARUM MANI SE-ME 32 12 PCS 8,708 104,500

JARUM MANI SE-ME 32 12 PCS 8,708 104,500

JARUM MANI SE-ME 32 12 PCS 8,708 104,500

JARUM MANI SE-ME 32 48 PCS 8,708 418,000

JARUM MANI SE-ME 32 36 PCS 8,708 313,500

JARUM MANI SE-ME 36 12 PCS 8,708 104,500

JARUM MANI SE-ME 36 60 PCS 8,708 522,500

JARUM MANI SE-ME 36 24 PCS 8,708 209,000

JARUM MANI SE-ME 36 24 PCS 8,708 209,000

JARUM MANI SE-MH 18 12 PCS 8,708 104,500

JARUM MANI SE-MH 21 12 PCS 8,708 104,500

JARUM MANI SE-MH 24 36 PCS 8,708 313,500

JARUM MANI SE-MH 24 24 PCS 8,708 209,000

JARUM MANI SE-MH 24 24 PCS 8,708 209,000

JARUM MANI SE-MH 24 IGD 36 BIJI 8,708 313,500

JARUM MANI SE-MH 24 IGD 60 BIJI 8,708 522,500

JARUM MANI SE-MH 28 36 PCS 8,708 313,500

JARUM MANI SE-MH 28 24 PCS 8,708 209,000

JARUM MANI SE-MH 28 24 PCS 8,708 209,000

JARUM MANI SE-MH 28 IGD 36 BIJI 8,708 313,500

JARUM MANI SE-MH 28 IGD 60 BIJI 8,708 522,500

JARUM MANI SE-MH 32 36 PCS 8,708 313,500

JARUM MANI SE-MH 32 24 PCS 8,708 209,000

JARUM MANI SE-MH 32 24 PCS 8,708 209,000

JARUM MANI SE-MH 32 IGD 36 BIJI 8,708 313,500

JARUM MANI SE-MH 32 IGD 60 BIJI 8,708 522,500

JARUM MANI SE-MH 36 12 PCS 8,708 104,500

JARUM MANI SE-MH 40 12 PCS 8,708 104,500

JARUM MANI SE-TE 45 48 PCS 8,708 418,000

JARUM MANI SE-TE 45 36 PCS 8,708 313,500

JARUM MANI SE-TH 24 12 PCS 8,708 104,500

JARUM MANI SE-TH 24 12 PCS 8,708 104,500

JARUM MANI SE-TH 24 24 PCS 8,708 209,000

JARUM MANI SE-TH 28 24 PCS 8,250 198,000

JARUM MANI SE-TH 28 12 PCS 8,708 104,500

JARUM MANI SE-TH 32 12 PCS 8,708 104,500

JARUM MANI SE-TH 40 12 PCS 8,708 104,500

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JARUM MANI SE-TH 45 12 PCS 8,708 104,500

JARUM MANI SE-TH 50 12 PCS 8,708 104,500

JARUM MANI SE-TH 50 12 PCS 8,708 104,500

JARUM MANI SE-TH 55 12 PCS 8,708 104,500

JARUM MANI SE-TH 55 12 PCS 8,708 104,500

KA-EN 3B ASKES 20 FLS 10,000 200,002

KA-EN 3B ASKES 20 FLS 16,610 332,200

KA-EN 3B ASKES 40 FLS 10,000 400,004

KA-EN 3B ASKES 20 FLS 10,000 200,002

KALIPAR TAB ASKES 300 TABLET 750 225,000

KALIPAR TAB ASKES 500 TABLET 750 375,000

KALIPAR TAB ASKES 500 TABLET 700 350,000

KALIUM DIKLOFENAK 50 MG ASKES 150 TABLET 708 106,204

KALIUM DIKLOFENAK 50 MG ASKES 500 TABLET 708 354,013

KALXETIN 10 MG ASKES 60 TABLET 3,630 217,800

KAMAR HITUNG ASSISTANT 5 PCS 704,000 3,520,000

KAPAS 500 GR PAKET 10 BIJI 43,362 433,620

KAPAS 500 GR PAKET 10 BIJI 43,362 433,620

KAPAS 500 GR PAKET 5 BIJI 43,362 216,810

KAPAS 500 GR PAKET 6 BIJI 43,362 260,172

KAPAS 500 GR PAKET 10 BIJI 43,362 433,620

KAPAS BERLEMAK 500G PAKET 1 ROL 16,500 16,500

KAPAS BERLEMAK 500G PAKET 5 ROL 16,500 82,500

KAPSUL 00 3,000 BIJI 57 171,600

KAPSUL 00 2,000 BIJI 62 123,992

KARBONDIOKSIDA 5 KG 1 TABUNG 96,800 96,800

KASA 16X16 HEXA 200 BIJI 3,267 653,400

KASA 16X16 HEXA 200 BIJI 3,267 653,400

KASA BAGG HAZZ 170 ROL 8,250 1,402,500

KASA BAGG HAZZ 68 ROL 8,250 561,000

KASA BAGG HAZZ 170 ROL 8,250 1,402,500

KASA BAGG HAZZ 170 ROL 8,250 1,402,500

KASA BULATAN 192 BIJI 10,313 1,980,000

KASA BULATAN 160 BIJI 8,766 1,402,500

KASA BULATAN 160 BIJI 8,766 1,402,500

KASA BULATAN 192 BIJI 10,313 1,980,000

KASA BULATAN 160 BIJI 8,766 1,402,500

KASA BULATAN 192 BIJI 10,313 1,980,000

KASA BULATAN 320 BIJI 8,766 2,805,000

KASA BULATAN 192 BIJI 10,313 1,980,000

KASA BULATAN 192 BIJI 8,766 1,683,000

KASA BULATAN 320 BIJI 8,766 2,805,000

KASA HEXA ASKES 200 PCS 3,267 653,400

KASA HEXA ASKES 200 PCS 3,267 653,400

KASA HEXA ASKES 200 PCS 3,267 653,400

KASA HEXA ASKES 200 PCS 3,267 653,400

KASA HEXA ASKES 200 PCS 3,267 653,400

KASA HEXA ASKES 200 PCS 3,267 653,400

KASA HEXA ASKES 200 PCS 3,267 653,400

KASA HEXA ASKES 200 PCS 3,267 653,400

KASA ROL X-RAY PAKET 5 ROL 280,500 1,402,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

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KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASA STERIL OM 100 BOX 6,435 643,500

KASSA ROL PAKET 10 ROL 165,000 1,650,000

KASSA ROL PAKET 10 ROL 165,000 1,650,000

KASSA ROL PAKET 10 ROL 165,000 1,650,000

KASSA ROL PAKET 10 ROL 165,000 1,650,000

KASSA ROL PAKET 10 ROL 165,000 1,650,000

KASSA ROL PAKET 10 ROL 165,000 1,650,000

KASSA ROL PAKET 10 ROL 165,000 1,650,000

KASSA ROL PAKET 10 ROL 165,000 1,650,000

KERTAS PERKAMEN 500 LEMBAR 946 473,000

KERTAS PERKAMEN 500 LEMBAR 946 473,000

KERTAS USG SONY UPP 110 HG 6 ROL 387,200 2,323,200

KERTAS USG SONY UPP 110 HG 5 ROL 387,200 1,936,000

KERTAS USG SONY UPP 110 HG 5 ROL 387,200 1,936,000

KERTAS USG SONY UPP 110 HG 3 ROL 387,200 1,161,600

KETALAR 100 MG INJ 20 MILILITER 30,989 619,775

KETALAR 100 MG INJ 80 MILILITER 30,989 2,479,101

KETALAR 100 MG INJ 70 MILILITER 30,989 2,169,213

KETALAR 100 MG INJ 100 MILILITER 30,989 3,098,876

KETOCONAZOLE CREAM ASKES 12 TUBE 7,000 84,000

KETOKONAZOLE 250 TABLET 410 102,498

KETOKONAZOLE 100 TABLET 410 40,999

KETOKONAZOLE 150 TABLET 410 61,499

KETOKONAZOLE 150 TABLET 410 61,499

KETOKONAZOLE 150 TABLET 410 61,499

KETOKONAZOLE CREAM 10 TUBE 7,000 70,004

KETOKONAZOLE CREAM 12 TUBE 7,000 84,000

KETOROLAC INJ 100 AMPUL 12,029 1,202,850

KETOROLAC INJ 100 AMPUL 12,050 1,204,988

KETOROLAC INJ 100 AMPUL 13,365 1,336,500

KETOROLAC INJ 100 AMPUL 13,365 1,336,500

KETOROLAC INJ ASKES 300 AMPUL 7,801 2,340,264

KETOROLAC INJ ASKES 300 AMPUL 7,801 2,340,264

KETOROLAC INJ ASKESS 300 AMPUL 2,300 690,037

KETOROLAC INJ ASKESS 500 AMPUL 2,300 1,150,061

KETOROLAC INJ ASKESS 50 AMPUL 2,300 115,006

KETOROLAC INJ ASKESS 500 AMPUL 2,300 1,150,061

KETOROLAC INJ ASKESS 300 AMPUL 2,300 690,037

KETOROLAC INJ DEXA 100 AMPUL 2,300 230,012

KUTOIN INJ 20 AMPUL 78,114 1,562,275

KUTOIN INJ 10 AMPUL 78,114 781,138

KUTOIN INJ 20 AMPUL 78,114 1,562,275

KUTOIN INJ 20 AMPUL 78,114 1,562,275

KUTOIN INJ 20 AMPUL 78,114 1,562,275

KUTOIN INJ ASKES 20 AMPUL 24,000 480,000

KUTOIN INJ ASKES 20 AMPUL 24,000 480,000

KUTOIN TAB 200 TABLET 1,202 240,350

KUTOIN TAB 200 TABLET 1,202 240,350

K-WIRE 1,2 MM 3 PCS 169,400 508,200

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K-WIRE 1,2 MM 2 PCS 169,400 338,800

K-WIRE 1,4 1 PCS 169,400 169,400

K-WIRE 1,4 2 PCS 169,400 338,800

K-WIRE 1,6 MM 3 PCS 154,000 462,000

K-WIRE 1,6 MM 1 PCS 169,400 169,400

K-WIRE 1,8 2 PCS 154,000 308,000

LACBON 100 TABLET 1,430 143,000

LACTO B 80 TABLET 3,773 301,840

LACTO B 40 TABLET 3,773 150,920

LACTO B 40 TABLET 3,773 150,920

LACTO B 80 TABLET 3,773 301,840

LACTO B 80 TABLET 4,043 323,400

LACTOPAIN INJ 50 AMPUL 30,250 1,512,500

LACTOPAIN INJ 50 AMPUL 30,250 1,512,500

LACTOPAIN INJ 50 AMPUL 31,350 1,567,500

LACTOPAIN INJ 100 AMPUL 31,350 3,135,000

LACTULAX SYRUP ASKES 10 BOTOL 39,600 396,000

LAMESON 125 INJ 20 VIAL 85,800 1,716,000

LAMESON 125 INJ 20 VIAL 85,800 1,716,000

LAMESON 125 INJ 20 VIAL 85,800 1,716,000

LAMESON 125 INJ 30 VIAL 85,800 2,574,000

LAMESON 125 INJ 30 VIAL 85,800 2,574,000

LAMESON 125 INJ 10 VIAL 85,800 858,000

LAMESON 125 INJ 10 VIAL 85,800 858,000

LAMESON 125 INJ 20 VIAL 88,000 1,760,000

LAMESON 125 INJ 10 VIAL 88,000 880,000

LAMESON 16 MG 100 TABLET 7,150 715,000

LAMESON 16 MG 100 TABLET 7,150 715,000

LAMESON 4 MG 100 TABLET 2,915 291,500

LAMESON 4 MG 200 TABLET 3,025 605,000

LAMESON 4 MG 300 TABLET 3,025 907,500

LAMESON 8 MG 100 TABLET 4,620 462,000

LAMESON 8 MG 100 TABLET 4,620 462,000

LAMINARIA 20 BIJI 88,000 1,760,000

LANSOPRAZOLE TAB 150 TABLET 1,297 194,591

LANSOPRAZOLE TAB 60 TABLET 1,351 81,081

LANSOPRAZOLE TAB 100 TABLET 946 94,595

LANSOPRAZOLE TAB 100 TABLET 1,777 177,703

LANSOPRAZOLE TAB ASKES/20 600 TABLET 550 330,000

LANSOPRAZOLE TAB ASKES/20 600 TABLET 550 330,000

LANSOPRAZOLE TAB ASKES/20 600 TABLET 550 330,000

LANSOPRAZOLE TAB ASKES/30 200 TABLET 600 119,999

LANSOPRAZOLE TAB ASKES/30 300 TABLET 1,297 389,182

LANSOPRAZOLE TAB ASKES/30 400 TABLET 945 377,991

LAPIBAL 500 MG 100 TABLET 1,925 192,500

LAPIBAL 500 MG 100 TABLET 1,925 192,500

LAPIBAL 500 MG 100 TABLET 1,925 192,500

LAPIBAL INJ 25 AMPUL 19,800 495,000

LAPIBAL INJ 10 AMPUL 19,800 198,000

LAPIBAL INJ 10 AMPUL 19,800 198,000

LAPIBAL INJ 10 AMPUL 19,800 198,000

LAPIBAL INJ 10 AMPUL 19,800 198,000

LAPIBAL INJ 15 AMPUL 19,800 297,000

LAPIBAL INJ 25 AMPUL 20,900 522,500

LAPIFLOX 500 60 TABLET 12,100 726,000

LAPIFLOX 500 60 TABLET 12,100 726,000

LAPIFLOX 500 30 TABLET 12,100 363,000

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LAPIFLOX 500 60 TABLET 12,100 726,000

LAPIFLOX 500 60 TABLET 12,100 726,000

LAPIFLOX 500 60 TABLET 12,100 726,000

LAPIFLOX 500 60 TABLET 12,100 726,000

LAPIFLOX 500 60 TABLET 12,100 726,000

LAPIMOX 500 100 TABLET 2,200 220,000

LAPIMOX 500 100 TABLET 2,200 220,000

LAPISTAN 500 MG 200 TABLET 880 176,000

LAPISTAN 500 MG 200 TABLET 880 176,000

LAPISTAN 500 MG 200 TABLET 990 198,000

LAPISTAN 500 MG 200 TABLET 990 198,000

LAPIXIME 5 VIAL 132,000 660,000

LAPRAZ 60 TABLET 11,330 679,800

LAPRAZ 120 TABLET 11,330 1,359,600

LAPRAZ 60 TABLET 11,330 679,800

LAPRAZ 60 TABLET 11,330 679,800

L-BIO 150 SACHET 4,290 643,500

L-BIO 90 SACHET 4,290 386,100

L-BIO 60 SACHET 4,290 257,400

L-BIO 90 SACHET 4,290 386,100

L-BIO 60 SACHET 4,290 257,400

L-BIO 60 SACHET 4,290 257,400

L-BIO 90 SACHET 4,290 386,100

L-BIO 90 SACHET 5,500 495,000

L-BIO 150 SACHET 5,500 825,000

L-BIO 150 SACHET 5,500 825,000

LDL CHOLESTEROL 6X50 ML 1 KIT 3,085,500 3,085,500

LENTIKULAR 20 FLS 33,138 662,750

LENTIKULAR 20 FLS 33,138 662,750

LENTIKULAR 20 FLS 33,138 662,750

LENTIKULAR 20 FLS 36,575 731,500

LENTIKULAR 20 FLS 36,575 731,500

LENTIKULAR 20 FLS 36,575 731,500

LENTIKULAR 20 FLS 36,575 731,500

LENTIKULAR 10 FLS 36,575 365,750

LENTIKULAR 33 FLS 36,575 1,206,975

LENTIKULAR 20 FLS 36,575 731,500

LENTIKULAR 20 FLS 36,575 731,500

LENTIKULAR 20 FLS 36,575 731,500

LENTIKULAR 40 FLS 36,575 1,463,000

LEPARSON TAB ASKES 300 TABLET 2,100 630,000

LEPARSON TAB ASKES 1,500 TABLET 2,100 3,149,999

LEUCOVORIN INJ 6 VIAL 220,000 1,320,000

LEUCOVORIN INJ 6 VIAL 220,000 1,320,000

LEUCOVORIN INJ 8 VIAL 220,000 1,760,000

LEUCOVORIN INJ 7 VIAL 220,000 1,540,000

LEUCOVORIN INJ 1 VIAL 220,000 220,000

LEUCOVORIN INJ 8 VIAL 220,000 1,760,000

LEUCOVORIN INJ 8 VIAL 220,000 1,760,000

LEUCOVORIN INJ 8 VIAL 220,000 1,760,000

LEUCOVORIN INJ 8 VIAL 220,000 1,760,000

LEUCOVORIN INJ 8 VIAL 220,000 1,760,000

LEUCOVORIN INJ 8 VIAL 220,000 1,760,000

LEUCOVORIN INJ 8 VIAL 220,000 1,760,000

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 39,023 390,225

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 41,388 413,875

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 39,023 390,225

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LEUKOPLAST 4,5MX7,5CM PAKET 20 BIJI 41,388 827,750

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 41,388 413,875

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 41,388 413,875

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 41,388 413,875

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 39,023 390,225

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 41,388 413,875

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 39,023 390,225

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 41,388 413,875

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 41,388 413,875

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 39,023 390,225

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 42,213 422,125

LEUKOPLAST 4,5MX7,5CM PAKET 10 BIJI 42,213 422,125

LEUKOPLAST 4,5MX7,5CM PAKET 20 BIJI 39,820 796,400

LEVEMIR FLEXPEN INJ ASKES 125 PCS 111,996 13,999,561

LEVEMIR FLEXPEN INJ ASKES 25 PCS 85,007 2,125,183

LEVEMIR FLEXPEN INJ ASKES 50 PCS 85,007 4,250,365

LEVOCIN 500MG 54 TABLET 34,953 1,887,435

LEVOCIN 500MG 36 TABLET 34,953 1,258,290

LEVOCIN 500MG 36 TABLET 34,953 1,258,290

LEVOCIN 500MG 18 TABLET 35,827 644,886

LEVOCIN 500MG 18 TABLET 35,827 644,886

LEVOCIN 500MG 36 TABLET 35,827 1,289,772

LEVOCIN ED 20 FLS 72,435 1,448,700

LEVOCIN ED 20 FLS 72,435 1,448,700

LEVOCIN ED 10 FLS 72,435 724,350

LEVOCIN ED 10 FLS 72,435 724,350

LEVOCIN ED 20 FLS 74,250 1,485,000

LEVOCIN ED 20 FLS 74,250 1,485,000

LEVOCIN ED 20 FLS 74,250 1,485,000

LEVOCIN ED 20 FLS 74,250 1,485,000

LEVOCIN ED 10 FLS 74,250 742,500

LEVOCIN ED 20 FLS 74,250 1,485,000

LEVOCIN ED 20 FLS 74,250 1,485,000

LEVOCIN ED 20 FLS 74,250 1,485,000

LEVOCIN ED 20 FLS 74,250 1,485,000

LEVOCIN ED 10 FLS 74,250 742,500

LEVOCIN INF 20 FLS 293,425 5,868,500

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 20 FLS 293,425 5,868,500

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 15 FLS 293,425 4,401,375

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 15 FLS 293,425 4,401,375

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

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LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 10 FLS 293,425 2,934,250

LEVOCIN INF 20 FLS 293,425 5,868,500

LEVOCIN INF 20 FLS 293,425 5,868,500

LEVOFLOXACIN INFUS ASKES 10 BOTOL 74,800 748,000

LFX MD 5 STRIP 75,900 379,500

LFX MD 10 STRIP 75,900 759,000

LFX MD 10 STRIP 75,900 759,000

LFX MD 20 STRIP 75,900 1,518,000

LIDOCAIN 5% INJ 10 AMPUL 22,000 220,000

LIDOCAIN COMP 2% 90 AMPUL 1,136 102,198

LIDOCAIN COMP 2% 90 AMPUL 1,136 102,198

LIDOCAIN INJ 100 AMPUL 1,010 101,000

LIDOCAIN INJ 100 AMPUL 1,010 101,000

LIDOCAIN INJ 200 AMPUL 1,151 230,278

LIDOCAIN INJ 100 AMPUL 985 98,475

LIDOCAIN INJ 300 AMPUL 850 255,001

LIDOCAIN INJ 300 AMPUL 808 242,398

LIDOCAIN INJ 200 AMPUL 839 167,794

LIDOCAIN INJ 200 AMPUL 839 167,794

LIDOCAIN INJ 200 AMPUL 831 166,115

LIDOCAIN INJ 200 AMPUL 839 167,794

LIDOCAIN INJ ASKES 100 AMPUL 1,091 109,079

LIDOCAIN INJ ASKES 200 AMPUL 985 196,951

LIDOCAIN INJ ASKES 200 AMPUL 850 170,001

LIDOCAIN INJ ASKES 200 AMPUL 808 161,599

LIDOCAIN INJ ASKES 200 AMPUL 850 170,001

LIDOCAIN INJ ASKES 100 AMPUL 839 83,897

LIDOCAIN INJ ASKES 200 AMPUL 831 166,115

1 PACK 722,150 722,150

LIPOTROL 5X3 ML 1 BOX 2,909,500 2,909,500

LIPROXY TAB 90 TABLET 6,358 572,220

LIPROXY TAB 60 TABLET 6,358 381,480

LIPROXY TAB 90 TABLET 6,518 586,575

LIPROXY TAB 90 TABLET 6,518 586,575

LODIA 120 TABLET 924 110,880

LODIA 120 TABLET 946 113,520

LODIA 60 TABLET 946 56,760

LODIA 60 TABLET 946 56,760

LODIA 120 TABLET 946 113,520

LODIA 120 TABLET 946 113,520

LODIA 120 TABLET 946 113,520

LODIA 120 TABLET 946 113,520

LODOMER INJ 12 AMPUL 11,897 142,768

LODOMER INJ 12 AMPUL 12,210 146,525

LODOMER INJ 12 AMPUL 12,210 146,525

LODOMER INJ 12 AMPUL 12,210 146,525

LODOMER INJ 12 AMPUL 12,210 146,525

LOMATUELL ASKES 100 PCS 13,585 1,358,500

LOMATUELL ASKES 100 PCS 13,585 1,358,500

LOMATUELL ASKES 70 PCS 13,585 950,950

LOMATUELL ASKES 150 PCS 13,585 2,037,750

LOMATUELL ASKES 60 PCS 13,585 815,100

LOMATULL 100 BIJI 13,585 1,358,500

LOMATULL 50 BIJI 13,585 679,250

LOMATULL 50 BIJI 13,585 679,250

LINEARITY CONTROL MATERIAL (H/M/L) AFT

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LOMATULL 100 BIJI 13,585 1,358,500

LOPERAMIDE TAB ASKES 200 TABLET 81 16,182

LORATADINE 10 50 TABLET 324 16,222

LORATADINE 10 100 TABLET 333 33,275

LORATADINE 10 100 TABLET 283 28,312

LORATADINE 10 200 TABLET 323 64,618

LORATADINE 10 MG ASKES 100 TABLET 333 33,275

LORATADINE 10 MG ASKES 250 TABLET 333 83,270

LORATADINE 10 MG ASKES 300 TABLET 283 84,936

LORATADINE 10 MG ASKES 250 TABLET 266 66,615

LYTEERS 15 ML 15 FLS 18,975 284,625

LYTEERS 15 ML 5 FLS 24,750 123,750

LYTEERS 15 ML 10 FLS 23,018 230,175

LYTEERS 15 ML ED ASKES 100 FLS 17,250 1,725,020

LYTEERS 15 ML ED ASKES 190 FLS 17,250 3,277,538

LYTEERS 15 ML ED ASKES 200 FLS 17,250 3,450,040

LYTEERS 15 ML ED ASKES 100 FLS 17,250 1,725,020

LYTEERS 15 ML ED ASKES 100 FLS 17,250 1,725,020

LYTEERS 15 ML ED ASKES 100 FLS 17,250 1,725,020

LYTEERS 15 ML ED ASKES 200 FLS 17,250 3,450,040

LYTEERS 15 ML ED ASKES 100 FLS 17,250 1,725,020

L-ZINC SYRUP 20 BOTOL 30,250 605,000

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 15 BOTOL 30,250 453,750

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 20 BOTOL 30,250 605,000

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 20 BOTOL 30,250 605,000

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,250 302,500

L-ZINC SYRUP 10 BOTOL 30,800 308,000

L-ZINC SYRUP 5 BOTOL 30,800 154,000

L-ZINC SYRUP 10 BOTOL 30,800 308,000

L-ZINC SYRUP 10 BOTOL 30,800 308,000

L-ZINC SYRUP 10 BOTOL 30,800 308,000

L-ZINC SYRUP 40 BOTOL 30,800 1,232,000

L-ZINC SYRUP 40 BOTOL 30,800 1,232,000

MALARIA TEST ACON PAKET 25 PCS 31,460 786,500

MALTOFER DROP 2 BOTOL 60,500 121,000

MANITOL 20 ASKES 20 BOTOL 39,500 789,998

MANITOL 20 ASKES 20 BOTOL 39,500 789,998

MANITOL 20 ASKES 40 BOTOL 39,500 1,579,996

MANITOL 20 ASKES 10 BOTOL 39,500 394,999

MANTOUX INJ 100 TEST 34,234 3,423,420

MASKER TIE ON 2,000 BIJI 1,122 2,244,000

MASKER TIE ON 1,000 BIJI 1,122 1,122,000

MASKER TIE ON 1,000 BIJI 660 660,000

MASKER TIE ON 1,000 BIJI 660 660,000

MASKER TIE ON 1,000 BIJI 330 330,000

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MASKER TIE ON 1,000 BIJI 330 330,000

MASKER TIE ON 3,000 BIJI 330 990,000

MASTER BOND 5 ML PAKET 1 PCS 290,400 290,400

MAXIFLOW ANAK 10 PCS 14,850 148,500

MAXIFLOW ANAK ASKES 10 PCS 22,000 220,000

MAXIFLOW ANAK ASKES 10 PCS 14,850 148,500

MAXIFLOW ANAK ASKES 10 PCS 14,850 148,500

MAXIFLOW ANAK ASKES 10 PCS 13,365 133,650

MAXIFLOW DEWASA ASKES 10 PCS 14,850 148,500

MAXIFLOW DEWASA ASKES 20 PCS 14,850 297,000

MAXIFLOW DEWASA ASKES 10 PCS 14,850 148,500

MAXIFLOW DEWASA ASKES 10 PCS 14,850 148,500

MAXIFLOW DEWASA ASKES 10 PCS 25,300 253,000

MAXIFLOW DEWASA ASKES 10 PCS 14,850 148,500

MAXIFLOW DEWASA ASKES 25 PCS 14,850 371,250

MAXIFLOW REBREATING ANAK 10 PCS 52,580 525,800

MAXIFLOW REBREATING DWS 20 PCS 45,650 913,000

MAXIFLOW REBREATING DWS 10 PCS 41,800 418,000

MAXIFLOW REBREATING DWS 10 PCS 52,580 525,800

MAXIFLOW REBREATING DWS 10 PCS 52,580 525,800

MAXIFLOW REBREATING DWS 50 PCS 52,580 2,629,000

MAXIFLOW REBREATING DWS 10 PCS 52,580 525,800

MAXIFLOW REBREATING DWS 10 PCS 52,580 525,800

MAXIFLOW REBREATING DWS 10 PCS 52,580 525,800

MAXIFLOW REBREATING DWS 10 PCS 52,580 525,800

MAXIFLOW REBREATING DWS 10 PCS 52,580 525,800

MAXIFLOW REBREATING DWS ASKES 10 PCS 52,580 525,800

MAXTER 7,5 ASKES 300 PASANG 4,950 1,485,000

MEBO 20 G SK 3 TUBE 84,700 254,100

MEDE BLUE 18 FLS 49,500 891,000

MEDE BLUE 5 FLS 49,500 247,500

MEDE BLUE 14 FLS 44,000 616,000

MEDE BLUE 3 FLS 49,500 148,500

MEDE BLUE 21 FLS 44,000 924,000

MEDE BLUE 23 FLS 49,500 1,138,500

MEDERMA 3 BIJI 151,250 453,750

MEFINAL 250 MG 100 TABLET 556 55,550

MEFINAL 250 MG 100 TABLET 556 55,550

MEFINAL 250 MG 100 TABLET 572 57,200

MEFINAL 250 MG 200 TABLET 572 114,400

MEFINAL 250 MG 200 TABLET 572 114,400

MEFINAL 500 MG 500 TABLET 1,221 610,500

MEFINAL 500 MG 500 TABLET 1,221 610,500

MEFINAL 500 MG 500 TABLET 1,221 610,500

MEFINAL 500 MG 500 TABLET 1,221 610,500

MEFINAL 500 MG 500 TABLET 1,221 610,500

MEFINAL 500 MG 500 TABLET 1,221 610,500

MEFINAL 500 MG 1,000 TABLET 1,254 1,254,000

MEFINAL 500 MG 500 TABLET 1,254 627,000

MEFINAL 500 MG 1,000 TABLET 1,254 1,254,000

MEFINAL 500 MG 600 TABLET 1,254 752,400

MEFINAL 500 MG 1,000 TABLET 1,254 1,254,000

MEFINAL 500 MG 100 TABLET 1,254 125,400

MEFINAL 500 MG 1,000 TABLET 1,254 1,254,000

MEFINAL 500 MG 1,000 TABLET 1,254 1,254,000

MEFINAL 500 MG 1,000 TABLET 1,254 1,254,000

MEFINAL 500 MG 1,000 TABLET 1,254 1,254,000

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MEFINTER 500 MG 200 TABLET 1,285 257,070

MEFINTER 500 MG 100 TABLET 1,252 125,153

MEFINTER 500 MG 100 TABLET 1,252 125,153

MEGABAL 300 TABLET 1,524 457,050

MEGABAL 200 TABLET 1,524 304,700

MEGABAL 200 TABLET 1,562 312,400

MEGABAL 200 TABLET 1,562 312,400

MEGABAL 200 TABLET 1,562 312,400

MEGABAL 100 TABLET 1,562 156,200

MELOXICAM 15 MG ASKES 750 TABLET 500 374,996

MELOXICAM 15 MG ASKES 150 TABLET 500 74,999

MELOXICAM 7,5 150 TABLET 400 60,001

MELOXICAM 7,5 100 TABLET 692 69,190

MEROPENEM INJ 10 VIAL 209,000 2,090,000

MEROPENEM INJ 10 VIAL 220,000 2,200,000

MEROPENEM INJ 15 VIAL 220,000 3,300,000

MEROPENEM INJ 3 VIAL 209,000 627,000

MEROPENEM INJ 7 VIAL 220,000 1,540,000

MEROPENEM INJ 20 VIAL 220,000 4,400,000

MEROSAN 1GR INJ 5 VIAL 510,318 2,551,588

MEROSAN 1GR INJ 3 VIAL 510,318 1,530,953

MEROSAN 1GR INJ 3 VIAL 510,318 1,530,953

MEROSAN 1GR INJ 3 VIAL 510,318 1,530,953

MEROSAN 1GR INJ 5 VIAL 510,318 2,551,588

MEROSAN 1GR INJ 3 VIAL 510,318 1,530,953

MERTIGO 100 TABLET 2,742 274,230

MERTIGO 100 TABLET 2,742 274,230

MERTIGO 200 TABLET 2,742 548,460

MERTIGO 200 TABLET 2,742 548,460

MERTIGO 200 TABLET 2,742 548,460

MERTIGO 200 TABLET 2,742 548,460

MERTIGO 100 TABLET 2,742 274,230

MERTIGO 200 TABLET 2,742 548,460

MERTIGO 100 TABLET 2,742 274,230

MERTIGO SR TAB 100 TABLET 4,569 456,885

METFORMIN 500 MG ASKES 5,000 TABLET 174 871,200

METFORMIN 500 MG ASKES 2,000 TABLET 172 344,850

METFORMIN 500 MG ASKES 2,000 TABLET 182 363,000

METFORMIN 500 MG ASKES 5,000 TABLET 121 605,055

METFORMIN 500 MG ASKES 5,000 TABLET 121 605,055

METHYL PREDNISOLON INJ ASKES 20 VIAL 33,000 660,000

METHYL PREDNISOLON INJ ASKES 20 VIAL 32,999 659,977

METHYL PREDNISOLON INJ ASKES 30 VIAL 32,999 989,965

METHYL PREDNISOLON INJ ASKES 30 VIAL 25,003 750,083

METHYL PREDNISOLON INJ ASKES 50 VIAL 25,003 1,250,139

METHYL PREDNISOLON INJ ASKES 5 VIAL 21,808 109,038

METHYL PREDNISOLON INJ ASKES 50 VIAL 25,003 1,250,139

METHYL PREDNISOLON INJ ASKES 20 VIAL 25,003 500,056

METHYL PREDNISOLON INJ ASKES 20 VIAL 26,000 519,992

METHYL PREDNISOLON INJ ASKES 50 VIAL 19,200 960,000

METHYLPREDNISOLON 16 MG 30 TABLET 1,169 35,065

METHYLPREDNISOLON 16 MG ASKES 300 TABLET 1,035 310,500

METHYLPREDNISOLON 16 MG ASKES 300 TABLET 635 190,506

METHYLPREDNISOLON 4 MG ASKES 400 TABLET 441 176,220

METHYLPREDNISOLON 4 MG ASKES 500 TABLET 308 154,220

METHYLPREDNISOLON 4 MG ASKES 300 TABLET 333 99,848

METHYLPREDNISOLON 4 MG ASKES 300 TABLET 440 132,033

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METHYLPREDNISOLON 4MG 300 TABLET 418 125,433

METHYLPREDNISOLON 4MG 200 TABLET 441 88,110

METHYLPREDNISOLON 4MG 200 TABLET 441 88,110

METHYLPREDNISOLON 4MG 300 TABLET 418 125,433

METHYLPREDNISOLON 4MG 300 TABLET 441 132,165

METHYLPREDNISOLON 4MG 600 TABLET 441 264,330

METHYLPREDNISOLON 8 MG ASKES 500 TABLET 468 234,003

METHYLPREDNISOLON 8 MG ASKES 300 TABLET 585 175,501

METHYLPREDNISOLON INJ 10 VIAL 35,475 354,750

METHYLPREDNISOLON INJ 20 VIAL 35,475 709,500

METHYLPREDNISOLON INJ 10 VIAL 35,475 354,750

METOKLORPRAMID TAB ASKES 2,000 TABLET 110 220,000

METOKLORPRAMID TAB ASKES 3,000 TABLET 79 236,412

METOKLORPRAMID TAB ASKES 2,500 TABLET 110 275,000

METOLON INJ ASKES 1,000 AMPUL 960 960,080

METOLON INJ ASKES 2,500 AMPUL 960 2,400,200

METOLON INJ ASKES 750 AMPUL 960 720,060

METRONIDAZOL INF ASKES 160 BOTOL 24,001 3,840,165

METRONIDAZOL INF ASKES 160 BOTOL 24,001 3,840,165

METRONIDAZOL INFUS NOVEL 36 BOTOL 29,500 1,061,993

METRONIDAZOL TAB ASKES 1,000 TABLET 180 180,004

METRONIDAZOLE 500 TAB 200 TABLET 220 43,956

METRONIDAZOLE 500 TAB 300 TABLET 220 65,934

METRONIDAZOLE 500 TAB 300 TABLET 220 65,934

METRONIDAZOLE 500 TAB 300 TABLET 165 49,500

METRONIDAZOLE INF 50 BOTOL 35,400 1,770,010

METRONIDAZOLE INF 80 BOTOL 24,001 1,920,083

METRONIDAZOLE INF 50 BOTOL 35,400 1,770,010

METRONIDAZOLE INF 160 BOTOL 24,001 3,840,165

METRONIDAZOLE INF 80 BOTOL 24,001 1,920,083

METRONIDAZOLE INF 80 BOTOL 24,001 1,920,083

METRONIDAZOLE INF 48 BOTOL 24,001 1,152,050

MGSO4 20 % ASKES 30 AMPUL 2,701 81,015

MGSO4 20 % ASKES 30 AMPUL 2,701 81,015

MGSO4 20% INJ 30 AMPUL 6,050 181,500

MGSO4 40 % ASKES 60 AMPUL 3,700 222,024

MGSO4 40 % ASKES 60 AMPUL 3,700 222,024

MGSO4 40% INJ 30 AMPUL 6,050 181,500

MGSO4 40% INJ 30 AMPUL 6,050 181,500

MIDAZOLAM 5 MG INJ 25 AMPUL 20,328 508,200

MIDAZOLAM 5 MG INJ 25 AMPUL 20,328 508,200

MILOZ INJ 100 AMPUL 21,560 2,156,000

MILOZ INJ 200 AMPUL 21,560 4,312,000

MINIASPI 80 MG ASKES 2,000 TABLET 314 627,000

MINIASPI 80 MG ASKES 1,000 TABLET 314 313,500

MIXTARD HM 100UI ASKES 6 VIAL 214,997 1,289,979

MONOSYN 1 HR REG 36 PCS 130,680 4,704,480

MONOSYN 1 HR REG 36 PCS 130,680 4,704,480

MONOSYN 1 HR REG 36 PCS 130,680 4,704,480

MONOSYN 1 HR REG 24 PCS 130,680 3,136,320

MONOSYN 1 HR REG 24 PCS 130,680 3,136,320

MONOSYN 1 HR REG 24 PCS 130,680 3,136,320

MONOSYN 1 HR REG 24 PCS 130,680 3,136,320

MONOSYN 2/0 HR REG 36 PCS 111,375 4,009,500

MONOSYN 2/0 HR REG 18 PCS 111,375 2,004,750

MONOSYN 2/0 HR REG 12 PCS 111,375 1,336,500

MONOSYN 2/0 HR REG 5 PCS 111,375 556,875

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MONOSYN 4/0 REG 6 PCS 123,750 742,500

MSHG 1,0 ML 18 PCS 302,500 5,445,000

MSHG 1,0 ML 5 PCS 302,500 1,512,500

MSHG 1,0 ML 14 PCS 297,000 4,158,000

MULTI DRUG 6 PANEL GLORY 1 KIT 2,090,000 2,090,000

MY JELLY PAKET 5 TUBE 24,750 123,750

MY JELLY PAKET 5 TUBE 24,750 123,750

MY JELLY PAKET 6 TUBE 24,750 148,500

MY JELLY PAKET 5 TUBE 24,750 123,750

MY JELLY PAKET 5 TUBE 24,750 123,750

MY JELLY PAKET 6 TUBE 24,750 148,500

MY JELLY PAKET 5 TUBE 24,750 123,750

MY JELLY SACHET 40 SACHET 1,881 75,240

MY JELLY SACHET 20 SACHET 1,881 37,620

MY JELLY SACHET 60 SACHET 1,881 112,860

MY JELLY SACHET 40 SACHET 1,881 75,240

MY JELLY SACHET 40 SACHET 1,881 75,240

MY JELLY SACHET 40 SACHET 1,881 75,240

MYCOS EO 1 TUBE 22,138 22,138

MYCOS EO 5 TUBE 22,138 110,688

MYCOS EO 5 TUBE 28,875 144,375

MYCOS EO 6 TUBE 28,875 173,250

MYCOS EO 6 TUBE 28,875 173,250

MYCOS EO 6 TUBE 28,875 173,250

MYCOS EO 10 TUBE 28,875 288,750

MYDRIATYL 1 % ASKES 25 BOTOL 36,700 917,500

MYDRIATYL 1 % ASKES 15 BOTOL 36,700 550,500

MYDRIATYL 1 % ASKES 8 BOTOL 42,075 336,600

MYDRIATYL 1 % ASKES 20 BOTOL 42,075 841,500

MYDRIATYL 1 % ASKES 20 BOTOL 36,700 734,000

MYDRIATYL 1 % ASKES 30 BOTOL 36,700 1,101,000

MYDRIATYL 1 % ASKES 30 BOTOL 42,075 1,262,250

NA DIKLOFENAC 50 MG 250 TABLET 218 54,423

NA DIKLOFENAC 50 MG 500 TABLET 217 108,724

NA DIKLOFENAC 50 MG 500 TABLET 212 106,123

NA DIKLOFENAC 50 MG 500 TABLET 207 103,410

NA DIKLOFENAC 50 MG 500 TABLET 196 97,965

NA DIKLOFENAC 50 MG 250 TABLET 218 54,423

NA DIKLOFENAC 50 MG 500 TABLET 261 130,603

NA DIKLOFENAK 25 ASKES 1,000 TABLET 134 134,002

NA DIKLOFENAK 25 ASKES 1,650 TABLET 134 221,103

NA DIKLOFENAK 25 ASKES 2,500 TABLET 163 408,733

NA DIKLOFENAK 25 ASKES 1,500 TABLET 133 199,221

NA DIKLOFENAK 25 ASKES 1,250 TABLET 132 165,069

NA DIKLOFENAK 25 MG 150 TABLET 201 30,182

NA DIKLOFENAK 50 ASKES 550 TABLET 218 119,730

NA DIKLOFENAK 50 ASKES 500 TABLET 218 108,845

NA DIKLOFENAK 50 ASKES 250 TABLET 218 54,423

NA DIKLOFENAK 50 ASKES 500 TABLET 207 103,410

NACL 0,9% INJ 30 AMPUL 3,740 112,200

NACL 0,9% INJ 30 AMPUL 3,740 112,200

NACL 0,9% INJ 30 AMPUL 3,740 112,200

NARROW PLATE 8 HOLES 1 PCS 569,910 569,910

NARROW PLATE 9 HOLE 1 PCS 615,230 615,230

NARROW PLATE 9 HOLE 1 PCS 615,230 615,230

NASAL CANULA ADULT 50 PCS 16,335 816,750

NASAL CANULA ADULT 30 PCS 18,700 561,000

Page 94: FORM FA Unit Kerja Penunjang 30815

NASAL CANULA ADULT 50 PCS 18,700 935,000

NASAL CANULA ADULT 20 PCS 18,700 374,000

NASAL CANULA ADULT 20 PCS 18,700 374,000

NASAL CANULA ADULT 50 PCS 18,700 935,000

NASAL CANULA ADULT 30 PCS 18,700 561,000

NASAL CANULA ADULT 20 PCS 18,700 374,000

NASAL CANULA ADULT 20 PCS 18,700 374,000

NASAL CANULA ADULT 20 PCS 18,700 374,000

NASAL CANULA ADULT 20 PCS 18,700 374,000

NASAL CANULA ADULT 30 PCS 18,700 561,000

NASAL CANULA ADULT 30 PCS 18,700 561,000

NASAL CANULA ADULT 30 PCS 18,700 561,000

NASAL CANULA ADULT 30 PCS 18,700 561,000

NASAL CANULA ADULT 20 PCS 18,700 374,000

NASAL CANULA ADULT 60 PCS 18,700 1,122,000

NASAL CANULA CHILD 10 PCS 18,700 187,000

NASAL CANULA CHILD 10 PCS 18,700 187,000

NASAL CANULA CHILD 10 PCS 18,700 187,000

NASAL CANULA CHILD 10 PCS 18,700 187,000

NASAL CANULA CHILD 10 PCS 18,700 187,000

NASAL CANULA CHILD 10 PCS 18,700 187,000

NASAL CANULA CHILD 10 PCS 18,700 187,000

NASAL CANULA INFANT 10 BIJI 20,900 209,000

NASAL CANULA INFANT 20 BIJI 20,900 418,000

NASAL CANULA INFANT 10 BIJI 20,900 209,000

NASAL CANULA INFANT 10 BIJI 20,900 209,000

NASAL CANULA INFANT 10 BIJI 20,900 209,000

NASAL CANULA INFANT 10 BIJI 20,900 209,000

NASAL CANULA INFANT 10 BIJI 20,900 209,000

NASAL CANULA INFANT 10 BIJI 20,900 209,000

NATACEN MD 10 FLS 45,788 457,875

NEBULIZER OMRON 1 BOX 650,004 650,004

NEEDLE 24 G 100 PCS 1,188 118,800

NEEDLE NOVOFINE 32 G 200 PCS 2,310 462,000

NEEDLE NOVOFINE 32 G 100 PCS 2,310 231,000

NEEDLE NOVOFINE 32 G ASKES 100 PCS 2,310 231,000

NEEDLE SEPTOJEC 100 BIJI 1,848 184,800

NEO KAOLANA 10 BOTOL 11,715 117,150

NEO KAOLANA 10 BOTOL 11,715 117,150

NEO KAOLANA 15 BOTOL 11,715 175,725

NEO KAOLANA 10 BOTOL 12,012 120,120

NEO KAOLANA 10 BOTOL 12,012 120,120

NEO KAOLANA 10 BOTOL 12,012 120,120

NEO KAOLANA 10 BOTOL 12,012 120,120

NEO KAOLANA 10 BOTOL 12,012 120,120

NEO KAOLANA 10 BOTOL 12,012 120,120

NEO KAOLANA 10 BOTOL 12,012 120,120

NEO KAOLANA 10 BOTOL 12,012 120,120

NEO KAOLANA 20 BOTOL 12,012 240,240

NEOSTIGMIN HAMELN INJ 10 AMPUL 16,940 169,400

NEOSTIGMIN HAMELN INJ 10 AMPUL 16,940 169,400

NEOSTIGMIN HAMELN INJ 25 AMPUL 16,940 423,500

NEOSTIGMINE INJ ASKES 25 AMPUL 12,500 312,499

NEPHRISOL 10 PCS 42,350 423,500

NEPHRISOL 6 PCS 42,350 254,100

NEPHRISOL 10 PCS 42,350 423,500

NEPHRISOL 20 PCS 42,350 847,000

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N-EPI INJ 25 AMPUL 86,240 2,156,000

N-EPI INJ 25 AMPUL 86,240 2,156,000

N-EPI INJ 15 AMPUL 86,240 1,293,600

N-EPI INJ 10 AMPUL 86,240 862,400

N-EPI INJ 10 AMPUL 86,240 862,400

NEUCITI 250 INJ 50 AMPUL 31,900 1,595,000

NEUCITI 250 INJ 25 AMPUL 31,900 797,500

NEUCITI 250 INJ 15 AMPUL 31,900 478,500

NEUCITI 250 INJ 50 AMPUL 31,900 1,595,000

NEUCITI 250 INJ 50 AMPUL 31,900 1,595,000

NEUCITI 250 INJ 25 AMPUL 31,900 797,500

NEUCITI 250 INJ 50 AMPUL 31,900 1,595,000

NEUCITI 250 INJ 50 AMPUL 31,900 1,595,000

NEUCITI 250 INJ 25 AMPUL 34,100 852,500

NEUCITI 500 MG INJ 25 AMPUL 44,000 1,100,000

NEUCITI 500 MG INJ 25 AMPUL 44,000 1,100,000

NEUCITI 500 MG INJ 25 AMPUL 44,000 1,100,000

NEUCITI 500 MG INJ 25 AMPUL 44,000 1,100,000

NEUCITI 500 MG INJ 30 AMPUL 44,000 1,320,000

NEUCITI 500 MG INJ 50 AMPUL 44,000 2,200,000

NEUCITI 500 MG INJ 25 AMPUL 44,000 1,100,000

NEUCITI 500 MG INJ 50 AMPUL 44,000 2,200,000

NEUCITI 500 MG INJ 50 AMPUL 48,400 2,420,000

NEUCITI 500 MG INJ 25 AMPUL 48,400 1,210,000

NEUCITI 500 MG INJ 50 AMPUL 48,400 2,420,000

NEUCITI TAB 30 TABLET 8,800 264,000

NEUCITI TAB 60 TABLET 8,800 528,000

NEUCITI TAB 60 TABLET 8,800 528,000

NEURODEX TAB ASKES 2,000 TABLET 240 480,040

NEUROSANBE 5000 INJ 30 AMPUL 4,670 140,085

NEUROSANBE 5000 INJ 30 AMPUL 4,785 143,550

NEUROSANBE 5000 INJ 30 AMPUL 4,785 143,550

NEUROSANBE 5000 INJ 30 AMPUL 4,785 143,550

NEUROSANBE 5000 INJ 50 AMPUL 4,785 239,250

NEUROSANBE 5000 TAB 100 TABLET 2,184 218,350

NEUROSANBE 5000 TAB 100 TABLET 2,184 218,350

NEUROSANBE 5000 TAB 100 TABLET 2,184 218,350

NEUROSANBE 5000 TAB 100 TABLET 2,239 223,850

NEUROSANBE 5000 TAB 100 TABLET 2,239 223,850

NEUROSANBE 5000 TAB 200 TABLET 2,239 447,700

NEUROSANBE 5000 TAB 100 TABLET 2,239 223,850

NEUROSANBE 5000 TAB 100 TABLET 2,239 223,850

NEUROSANBE 5000 TAB 200 TABLET 2,239 447,700

NEUROSANBE PLUS 200 TABLET 946 189,200

NEUROSANBE PLUS 100 TABLET 946 94,600

NEUROSANBE PLUS 100 TABLET 974 97,350

NEUROSANBE PLUS 100 TABLET 974 97,350

NEUROSANBE PLUS 100 TABLET 974 97,350

NEUROSANBE PLUS 100 TABLET 974 97,350

NEUROSANBE PLUS 300 TABLET 974 292,050

NEUROSANBE TAB 100 TABLET 1,007 100,650

NEUROSANBE TAB 100 TABLET 1,007 100,650

NEUROSANBE TAB 100 TABLET 1,007 100,650

NEUROSANBE TAB 100 TABLET 1,007 100,650

NEUROSANBE TAB 100 TABLET 1,007 100,650

NEUROSANBE TAB 200 TABLET 1,034 206,800

NEUROSANBE TAB 200 TABLET 1,034 206,800

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NEUROSANBE TAB 100 TABLET 1,034 103,400

NEUROSANBE TAB 200 TABLET 1,034 206,800

NEUROSANBE TAB 200 TABLET 1,034 206,800

NEUROSANBE TAB 200 TABLET 1,034 206,800

NEUROSANBE TAB 200 TABLET 1,034 206,800

NEUROSANBE TAB 200 TABLET 1,034 206,800

NEUROSANBE TAB 300 TABLET 1,034 310,200

NIFEDIPIN ASKES 500 TABLET 116 57,750

NIFEDIPIN ASKES 500 TABLET 129 64,499

NIMOTOP INF 3 BOTOL 247,456 742,368

NIMOTOP INF 3 BOTOL 247,456 742,368

NITRISOL 9 PCS 44,000 396,000

NITRISOL 6 PCS 44,000 264,000

NITRISOL 10 PCS 44,000 440,000

NITRISOL 10 PCS 44,000 440,000

NITRISOL 5 PCS 44,000 220,000

NITRISOL 3 PCS 44,000 132,000

NITRISOL 6 PCS 44,000 264,000

NITRISOL 5 PCS 44,000 220,000

NITRISOL 7 PCS 44,000 308,000

NITRISOL 5 PCS 44,000 220,000

NITROUS OXIDE 7 KG 1 TABLET 708,400 708,400

NITROUS OXIDE 7 KG 1 TABLET 677,600 677,600

NITROUS OXIDE 8 KG 1 TABUNG 774,400 774,400

NOLIPO 500 MG 100 TABLET 4,488 448,800

NONEMI 300 TABLET 1,210 363,000

NONEMI 300 TABLET 1,210 363,000

NONEMI 300 TABLET 1,210 363,000

NONFLAMIN 240 KAPSUL 3,888 933,076

NONFLAMIN 180 KAPSUL 3,888 699,807

NONFLAMIN 180 KAPSUL 3,888 699,807

NORELUT 100 TABLET 3,713 371,250

NORELUT 100 TABLET 3,713 371,250

NORELUT 150 TABLET 3,713 556,875

NORELUT 100 TABLET 3,713 371,250

NORELUT 100 TABLET 3,713 371,250

NORELUT ASKES 150 TABLET 2,750 412,459

NORMAFIT TAB 180 TABLET 6,096 1,097,249

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 180 TABLET 6,096 1,097,249

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 144 TABLET 6,096 877,800

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 180 TABLET 6,096 1,097,249

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORMAFIT TAB 270 TABLET 6,096 1,645,874

NORMAFIT TAB 360 TABLET 6,096 2,194,499

NORTROL 10 X 5 PAKET 1 KIT 2,783,000 2,783,000

NOTRIXUM 25 MG INJ 25 AMPUL 43,120 1,078,000

NOTRIXUM 25 MG INJ 50 AMPUL 44,000 2,200,000

NOTRIXUM 25 MG INJ 25 AMPUL 43,120 1,078,000

NOVELL SMOOTHING CREAM 3 TUBE 237,160 711,480

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NOVELLMYCIN 1GR INJ 10 VIAL 86,240 862,400

NOVELLMYCIN 1GR INJ 10 VIAL 86,240 862,400

NOVELLMYCIN 1GR INJ 10 VIAL 86,240 862,400

NOVERON INJ PER ML 60 MILILITER 18,973 1,138,368

NOVERON INJ PER ML 60 MILILITER 19,360 1,161,600

NOVERON INJ PER ML 60 MILILITER 18,973 1,138,368

NOVESTROL INJ 10 VIAL 64,680 646,800

NOVESTROL INJ 10 VIAL 64,680 646,800

NOVESTROL INJ 10 VIAL 64,680 646,800

NOVESTROL INJ 6 VIAL 66,000 396,000

NOVESTROL INJ 10 VIAL 64,680 646,800

NOVESTROL INJ 10 VIAL 64,680 646,800

NOVESTROL INJ 10 VIAL 64,680 646,800

NOVOMIX 30 FLEXPEN INJ ASKES 75 AMPUL 117,005 8,775,350

NOVOMIX 30 FLEXPEN INJ ASKES 25 AMPUL 106,000 2,650,000

NOVORAPID FLEXPEN INJ ASKES 5 AMPUL 101,989 509,944

NOVORAPID FLEXPEN INJ ASKES 5 AMPUL 85,345 426,725

NURSE CAP 500 PCS 495 247,500

NURSE CAP 300 PCS 495 148,500

NURSE CAP 200 PCS 495 99,000

NURSE CAP 300 PCS 495 148,500

NYMIKO DROP 10 BIJI 30,360 303,600

NYMIKO DROP 10 BIJI 30,360 303,600

NYMIKO DROP 10 BIJI 31,119 311,190

NYMIKO DROP 5 BIJI 31,119 155,595

NYMIKO DROP 6 BIJI 31,119 186,714

NYMIKO DROP 10 BIJI 31,119 311,190

NYMIKO DROP ASKES 5 FLS 31,119 155,595

OBH BOTOL ASKES 14 BOTOL 9,193 128,696

OBH BOTOL ASKES 28 BOTOL 9,193 257,391

OBH BOTOL ASKES 20 BOTOL 7,321 146,410

OBH BOTOL ASKES 20 BOTOL 7,321 146,410

OBJECK GLASS IHS 1,000 PCS 178 178,200

OBJECK GLASS IHS 500 PCS 178 89,100

OBJECK GLASS IHS 1,440 PCS 241 346,500

OBJECT GLASS PAKET 5 BOX 31,350 156,750

OBJECT GLASS REG 360 PCS 435 156,749

OBJECT GLASS REG 360 PCS 435 156,749

OBUCORT SWINGHALER ASKES 3 PCS 112,500 337,501

OCUSON 100 TABLET 1,221 122,100

OCUSON 100 TABLET 1,254 125,400

ODEX 0,5 L PER ML 1,000 MILILITER 139 138,600

ODEX 0,5 L PER ML 2,500 MILILITER 139 346,500

ODEX 0,5 L PER ML 10,000 MILILITER 124 1,237,500

ODR 4 MG INJ 50 AMPUL 22,000 1,100,000

ODR 4 MG INJ 50 AMPUL 22,000 1,100,000

ODR 4 MG INJ 35 AMPUL 22,000 770,000

ODR 4 MG INJ 100 AMPUL 22,000 2,200,000

ODR 4 MG INJ 50 AMPUL 22,000 1,100,000

ODR 4 MG INJ 50 AMPUL 22,000 1,100,000

ODR 4 MG INJ 50 AMPUL 22,000 1,100,000

ODR 4 MG INJ 100 AMPUL 22,000 2,200,000

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ODR 4 MG INJ 100 AMPUL 22,000 2,200,000

ODR 4 MG INJ 50 AMPUL 22,000 1,100,000

ODR 4 MG INJ 100 AMPUL 22,000 2,200,000

ODR 4 MG INJ 50 AMPUL 22,000 1,100,000

ODR 4 MG INJ 50 AMPUL 22,000 1,100,000

ODR 4 MG INJ 150 AMPUL 22,000 3,300,000

OFLOXACINE INFUS 8 BOTOL 60,500 484,000

OMEPRAZOL 20 MG ASKES 450 TABLET 347 156,044

OMEPRAZOL 20 MG ASKES 60 TABLET 327 19,599

OMEPRAZOL 20 MG ASKES 400 TABLET 408 163,174

OMEPRAZOL 20 MG ASKES 600 TABLET 367 220,295

OMEPRAZOL INJ 6 VIAL 74,800 448,800

OMEPRAZOLE 150 TABLET 398 59,664

OMEPRAZOLE 150 TABLET 325 48,753

OMEPRAZOLE 120 TABLET 398 47,731

OMEPRAZOLE 100 TABLET 408 40,794

OMEPRAZOLE 100 TABLET 408 40,794

OMEPRAZOLE 100 TABLET 408 40,794

OMEPRAZOLE 200 TABLET 408 81,587

OMEPRAZOLE 180 TABLET 408 73,428

OMEPRAZOLE 300 TABLET 408 122,496

OMEPRAZOLE 400 TABLET 408 163,174

OMEPRAZOLE INJ ASKES 20 VIAL 40,003 800,061

OMEPRAZOLE INJ ASKES 50 VIAL 40,003 2,000,152

OMEPRAZOLE INJ ASKES 26 VIAL 36,001 936,032

OMEPRAZOLE INJ ASKES 50 VIAL 36,001 1,800,062

OMEPRAZOLE INJ ASKES 15 VIAL 36,001 540,019

OMEPRAZOLE INJ ASKES 10 VIAL 36,001 360,012

OMEPRAZOLE INJ ASKES 15 VIAL 36,001 540,019

OMEPROZ 90 TABLET 3,735 336,105

OMNIFIX 20CM X 5M 2,000 290 580,800

OMNIFIX 20CM X 5M 2,500 290 726,000

OMNIFIX 20CM X 5M 2,500 290 726,000

OMNIFIX 5X1 10 PCS 6,600 66,000

OMNIFIX 5X1 20 PCS 6,600 132,000

ONDANSETRON 4 MG INJ 50 AMPUL 7,700 385,000

ONDANSETRON 4 MG INJ 50 AMPUL 7,700 385,000

ONDANSETRON 4 MG INJ 280 AMPUL 7,700 2,156,000

ONDANSETRON 4 MG INJ ASKES 100 AMPUL 4,400 440,000

ONDAVELL 4MG INJ 50 AMPUL 29,106 1,455,300

ONDAVELL 4MG INJ 50 AMPUL 29,106 1,455,300

ONDAVELL 8MG INJ 50 AMPUL 48,510 2,425,500

ONDAVELL 8MG INJ 25 AMPUL 48,510 1,212,750

ONDAVELL 8MG INJ 15 AMPUL 48,510 727,650

ONDAVELL 8MG INJ 25 AMPUL 48,510 1,212,750

ONDAVELL 8MG INJ 50 AMPUL 48,510 2,425,500

ONE CLEAN PAKET 20 BOTOL 11,880 237,600

ONE SCRUB 5000 ML 5,000 MILILITER 84 419,980

ONE SCRUB 5000 ML 5,000 MILILITER 84 419,980

ONE THIRD TUBULAR PLATE 5 HOLE 1 PCS 249,480 249,480

ONE THIRD TUBULAR PLATE 6 HOLE 1 PCS 272,030 272,030

ONE THIRD TUBULAR PLATE 6 HOLE 1 PCS 272,030 272,030

OPSITE POST OP 25X10CM 20 BIJI 33,000 660,000

CENTIMETER

CENTIMETER

CENTIMETER

Page 99: FORM FA Unit Kerja Penunjang 30815

OPSITE POST OP 25X10CM 20 BIJI 33,000 660,000

OPSITE POST OP 25X10CM 20 BIJI 33,000 660,000

OPTIMA 524 P 19 5 PCS 104,500 522,500

OPTIMA 524 P 19 4 PCS 82,500 330,000

OPTIMA 524 P 20 4 PCS 104,500 418,000

OPTIMA 524 P 20 4 PCS 82,500 330,000

OPTIMA 524 P 20 7 PCS 82,500 577,500

OPTIMA 524 P 21 6 PCS 104,500 627,000

OPTIMA 524 P 21 3 PCS 82,500 247,500

OPTIMA 524 P 21 7 PCS 82,500 577,500

OPTIMA 524 P 22 1 PCS 104,500 104,500

OPTIMA 524 P 22 7 PCS 82,500 577,500

OPTIMA 524 P 22,5 3 PCS 82,500 247,500

OPTIMA 553 P 20 5 PCS 104,500 522,500

OPTIMA 553 P 21 5 PCS 104,500 522,500

OPTIMA 553 P 22 5 PCS 104,500 522,500

OPTIMA 553 P 23 5 PCS 104,500 522,500

OPTIMA 553 P 24 3 PCS 104,500 313,500

OPTIMA 603H P 22,5 2 PCS 104,500 209,000

OSMETIN ZUPER 20 SACHET 18,326 366,520

OSMETIN ZUPER 20 SACHET 18,326 366,520

OSMETIN ZUPER 20 SACHET 19,943 398,860

OSSORAL 800 120 TABLET 3,861 463,320

OSSORAL 800 120 TABLET 3,861 463,320

OSSORAL 800 120 TABLET 3,861 463,320

OSSORAL 800 120 TABLET 3,861 463,320

OSTELOX 15 40 TABLET 8,690 347,600

OSTELOX 15 40 TABLET 8,690 347,600

OSTELOX 7,5 MG 40 TABLET 5,346 213,840

OSTELOX 7,5 MG 40 TABLET 5,346 213,840

OSTELOX 7,5 MG 40 TABLET 5,346 213,840

OSTELOX 7,5 MG 40 TABLET 5,346 213,840

OSTEOCAL ASKES 720 TABLET 560 403,191

OSTEOCAL ASKES 432 TABLET 560 241,915

OSTEOCAL ASKES 720 TABLET 560 403,191

OSTEOR C 5 TUBE 105,105 525,525

OSTEOR C 6 TUBE 103,488 620,928

OSTEOR C 6 TUBE 103,488 620,928

OTSU-SALIN 3 3 BOTOL 12,650 37,950

OTSU-SALIN 3 10 BOTOL 12,650 126,500

OTTOPAIN EAR DROPS 20 BOTOL 32,134 642,675

OTTOPAIN EAR DROPS 10 BOTOL 31,288 312,881

OTTOPAIN EAR DROPS 20 BOTOL 31,288 625,763

OTTOPAIN EAR DROPS 10 BOTOL 33,388 333,878

OTTOPAIN EAR DROPS 10 BOTOL 33,388 333,878

OTTOPAIN EAR DROPS 10 BOTOL 32,509 325,091

OTTOPAIN EAR DROPS 10 BOTOL 32,509 325,091

OXOFERIN 10 BOTOL 67,925 679,250

OXOFERIN 10 BOTOL 67,925 679,250

OXYFLOW ANAK ASKES 10 PCS 6,930 69,300

OXYFLOW ANAK ASKES 20 PCS 6,930 138,600

OXYFLOW ANAK ASKES 10 PCS 6,930 69,300

OXYFLOW BAYI 10 PCS 10,890 108,900

OXYFLOW BAYI ASKES 20 PCS 10,890 217,800

OXYFLOW BAYI ASKES 20 PCS 7,227 144,540

OXYFLOW BAYI ASKES 10 PCS 7,227 72,270

OXYFLOW BAYI ASKES 20 PCS 7,227 144,540

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OXYFLOW BAYI ASKES 10 PCS 6,930 69,300

OXYFLOW DWS 50 PCS 6,930 346,500

OXYFLOW DWS ASKES 50 PCS 7,700 385,000

OXYFLOW DWS ASKES 50 PCS 7,700 385,000

OXYFLOW DWS ASKES 50 PCS 6,930 346,500

OXYFLOW DWS ASKES 50 PCS 6,930 346,500

OXYFLOW DWS ASKES 50 PCS 6,930 346,500

OXYFLOW DWS ASKES 50 PCS 6,930 346,500

OXYFLOW DWS ASKES 50 PCS 6,930 346,500

OXYFLOW DWS ASKES 50 PCS 7,700 385,000

OXYFLOW DWS ASKES 100 PCS 7,700 770,000

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 2 BOTOL 41,800 83,600

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 3 BOTOL 41,800 125,400

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 2 BOTOL 41,800 83,600

OXYGEN 1 M3 AMB 2 BOTOL 41,800 83,600

OXYGEN 1 M3 AMB 2 BOTOL 41,800 83,600

OXYGEN 1 M3 AMB 4 BOTOL 41,800 167,200

OXYGEN 1 M3 AMB 3 BOTOL 41,800 125,400

OXYGEN 1 M3 AMB 4 BOTOL 41,800 167,200

OXYGEN 1 M3 AMB 3 BOTOL 41,800 125,400

OXYGEN 1 M3 AMB 3 BOTOL 41,800 125,400

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 4 BOTOL 41,800 167,200

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 3 BOTOL 41,800 125,400

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 2 BOTOL 41,800 83,600

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 4 BOTOL 41,800 167,200

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 2 BOTOL 41,800 83,600

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 3 BOTOL 41,800 125,400

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 2 BOTOL 41,800 83,600

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 1 BOTOL 41,800 41,800

OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 2 BOTOL 47,850 95,700

OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 3 BOTOL 47,850 143,550

OXYGEN 1 M3 AMB 2 BOTOL 47,850 95,700

OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 2 BOTOL 47,850 95,700

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OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 2 BOTOL 47,850 95,700

OXYGEN 1 M3 AMB 1 BOTOL 47,850 47,850

OXYGEN 1 M3 AMB 2 BOTOL 47,850 95,700

OXYGEN 1,5 M3 2 TABUNG 41,800 83,600

OXYGEN 2 M3 MR 1 TABUNG 41,800 41,800

OXYGEN 2 M3 MR 1 TABUNG 41,800 41,800

OXYGEN 2 M3 MR 1 TABUNG 41,800 41,800

OXYGEN 2 M3 MR 1 TABUNG 41,800 41,800

OXYGEN 2 M3 MR 1 TABUNG 48,400 48,400

OXYGEN 2 M3 MR 1 TABUNG 47,850 47,850

OXYGEN 2 M3 MR 1 TABUNG 47,850 47,850

OXYGEN 2 M3 MR 1 TABUNG 47,850 47,850

OXYGEN 2 M3 MR 1 TABUNG 47,850 47,850

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 9 BOTOL 64,900 584,100

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 14 BOTOL 64,900 908,600

OXYGEN GAS 6 M3 12 BOTOL 64,900 778,800

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 5 BOTOL 64,900 324,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 9 BOTOL 64,900 584,100

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

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OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 7 BOTOL 64,900 454,300

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 25 BOTOL 64,900 1,622,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 5 BOTOL 64,900 324,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 20 BOTOL 64,900 1,298,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 20 BOTOL 64,900 1,298,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 12 BOTOL 64,900 778,800

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 20 BOTOL 64,900 1,298,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 13 BOTOL 64,900 843,700

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 7 BOTOL 64,900 454,300

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

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OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 20 BOTOL 64,900 1,298,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 4 BOTOL 64,900 259,600

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 13 BOTOL 64,900 843,700

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 64,900 973,500

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 20 BOTOL 64,900 1,298,000

OXYGEN GAS 6 M3 10 BOTOL 64,900 649,000

OXYGEN GAS 6 M3 15 BOTOL 72,600 1,089,000

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 5 BOTOL 71,500 357,500

OXYGEN GAS 6 M3 6 BOTOL 71,500 429,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 8 BOTOL 71,500 572,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 9 BOTOL 71,500 643,500

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 9 BOTOL 71,500 643,500

OXYGEN GAS 6 M3 3 BOTOL 71,500 214,500

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 27 BOTOL 71,500 1,930,500

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

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OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 10 BOTOL 71,500 715,000

OXYGEN GAS 6 M3 20 BOTOL 71,500 1,430,000

OXYGEN GAS 6 M3 15 BOTOL 71,500 1,072,500

OXYGEN GAS 6 M3 20 BOTOL 71,500 1,430,000

OXYGEN GAS 6 M3 20 BOTOL 71,500 1,430,000

OXYGEN GAS 7 M3 1 TABUNG 64,900 64,900

OXYGEN GAS 7 M3 1 TABUNG 64,900 64,900

OXYGEN GAS 7 M3 3 TABUNG 64,900 194,700

OXYGEN GAS 7 M3 5 TABUNG 64,900 324,500

OXYGEN GAS 7 M3 5 TABUNG 64,900 324,500

OXYGEN GAS 7 M3 1 TABUNG 64,900 64,900

OXYGEN GAS 7 M3 8 TABUNG 64,900 519,200

OXYGEN GAS 7 M3 10 TABUNG 64,900 649,000

OXYGEN GAS 7 M3 5 TABUNG 64,900 324,500

OXYGEN GAS 7 M3 2 TABUNG 64,900 129,800

OXYGEN GAS 7 M3 8 TABUNG 64,900 519,200

OXYGEN GAS 7 M3 15 TABUNG 64,900 973,500

OXYGEN GAS 7 M3 5 TABUNG 64,900 324,500

OXYGEN GAS 7 M3 6 TABUNG 64,900 389,400

OXYGEN GAS 7 M3 2 TABUNG 68,200 136,400

OXYGEN GAS 7 M3 5 TABUNG 75,350 376,750

OXYGEN GAS 7 M3 10 TABUNG 75,350 753,500

OXYGEN GAS 7 M3 5 TABUNG 75,350 376,750

OXYGEN GAS 7 M3 4 TABUNG 75,350 301,400

OXYGEN GAS 7 M3 2 TABUNG 75,350 150,700

OXYGEN GAS 7 M3 1 TABUNG 75,350 75,350

OXYGEN GAS 7 M3 7 TABUNG 75,350 527,450

OXYGEN GAS 7 M3 3 TABUNG 75,350 226,050

OXYGEN GAS 7 M3 5 TABUNG 75,350 376,750

OXYTOCIN 10 IU ASKES 600 AMPUL 1,820 1,091,970

OXYTOCIN 10 IU ASKES 500 AMPUL 2,613 1,306,250

OXYTOCIN 10 IU ASKES 500 AMPUL 1,820 909,975

OXYTOCIN 10 IU ASKES 300 AMPUL 1,820 545,985

OXYTOCIN S 10 I U 200 AMPUL 1,820 363,990

OXYTOCIN S 10 I U 500 AMPUL 2,613 1,306,250

OXYTOCIN S 10 I U 200 AMPUL 1,820 363,990

PACLITAXEL INJ 7 VIAL 520,905 3,646,335

PACLITAXEL INJ 7 VIAL 520,905 3,646,335

PAN-AMIN G ASKES 3 SOFTBAG 49,500 148,500

PAN-AMIN G ASKES 10 SOFTBAG 49,500 495,000

PANTOCAIN 0,5% ED ASKES 15 FLS 13,338 200,063

PANTOCAIN 0,5% ED ASKES 20 FLS 13,338 266,750

PANTOCAIN 0,5% ED ASKES 10 FLS 13,338 133,375

PANTOCAIN 0,5% ED ASKES 30 FLS 13,338 400,125

PANTOCAIN 0,5% ED ASKES 30 FLS 13,338 400,125

PANTOCAIN 0,5% ED ASKES 30 FLS 13,338 400,125

PANTOCAIN 0,5% ED ASKES 30 FLS 13,338 400,125

PANTOPRAZOLE INJ ASKES 5 VIAL 57,200 286,000

PANTOPRAZOLE INJ ASKES 20 VIAL 57,200 1,144,000

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PANTOPRAZOLE INJ ASKES 10 VIAL 57,200 572,000

PANTOPRAZOLE INJ ASKES 10 VIAL 57,200 572,000

PANTOPRAZOLE INJ ASKES 10 VIAL 57,200 572,000

PANTOPRAZOLE INJ ASKES 10 VIAL 57,200 572,000

PANTOPRAZOLE INJ ASKES 10 VIAL 57,200 572,000

PANTOPRAZOLE INJ ASKES 20 VIAL 57,200 1,144,000

PANTOPRAZOLE INJ ASKES 20 VIAL 57,200 1,144,000

PANTOPRAZOLE INJ ASKES 20 VIAL 57,200 1,144,000

PANTOPRAZOLE INJ ASKES 20 VIAL 57,200 1,144,000

PANTOPRAZOLE INJ ASKES 10 VIAL 57,200 572,000

PARASETAMOL INFUS ASKES 5 BOTOL 37,400 187,000

PARASETAMOL INFUS ASKES 20 BOTOL 49,500 990,000

PARASETAMOL INFUS ASKES 20 BOTOL 37,400 748,000

PARASETAMOL INFUS ASKES 10 BOTOL 47,025 470,250

PARASETAMOL INFUS ASKES 20 BOTOL 37,400 748,000

PARASETAMOL INFUS ASKES 10 BOTOL 47,025 470,250

PARASETAMOL INFUS ASKES 20 BOTOL 47,025 940,500

PARASETAMOL INFUS ASKES 20 BOTOL 37,400 748,000

PARASETAMOL INFUS ASKES 20 BOTOL 47,025 940,500

PARASETAMOL INFUS ASKES 20 BOTOL 37,400 748,000

PARASETAMOL INFUS ASKES 20 BOTOL 37,400 748,000

PARASETAMOL INFUS ASKES 20 BOTOL 47,025 940,500

PARASETAMOL INFUS ASKES 20 BOTOL 47,025 940,500

PARASETAMOL INFUS ASKES 24 BOTOL 37,400 897,600

PARASETAMOL INFUS ASKES 24 BOTOL 37,400 897,600

PARASETAMOL INFUS ASKES 24 BOTOL 37,400 897,600

PARASETAMOL INFUS ASKES 20 BOTOL 47,025 940,500

PARASETAMOL INFUS ASKES 24 BOTOL 37,400 897,600

PARASETAMOL INFUS ASKES 20 BOTOL 44,550 891,000

PARASETAMOL INFUS ASKES 24 BOTOL 37,400 897,600

PARASETAMOL INFUS ASKES 48 BOTOL 37,400 1,795,200

PARASETAMOL INFUS ASKES 48 BOTOL 37,400 1,795,200

PARASETAMOL SYRP ASKES 10 BOTOL 2,298 22,979

PARASETAMOL SYRP ASKES 10 BOTOL 2,298 22,979

PARASETAMOL SYRP ASKES 10 BOTOL 2,100 20,999

PARASETAMOL TAB ASKES 300 TABLET 105 31,469

PARASETAMOL TAB ASKES 1,000 TABLET 88 88,000

PAXUS 100 MG INJEKSI ASKES 2 VIAL 1,500,000 3,000,000

PAXUS 100 MG INJEKSI ASKES 2 VIAL 1,500,000 3,000,000

PAXUS 100 MG INJEKSI ASKES 2 VIAL 1,500,000 3,000,000

PAXUS 30 MG INJ ASKES 7 VIAL 495,000 3,465,000

PAXUS 30 MG INJ ASKES 1 VIAL 451,000 451,000

PAXUS 30 MG INJ ASKES 1 VIAL 451,000 451,000

PAXUS 30 MG INJ ASKES 3 VIAL 451,000 1,353,000

PAXUS 30 MG INJ ASKES 4 VIAL 451,000 1,804,000

PAXUS 30 MG INJ ASKES 1 VIAL 451,000 451,000

PEDIACEL INJ 1 VIAL 430,238 430,238

PEHACAIN INJ 50 AMPUL 5,604 280,175

PEHACAIN INJ 40 AMPUL 2,724 108,957

PEHAMOXIL 1 G INJ ASKES 2 VIAL 8,450 16,900

PEHAMOXIL 1 G INJ ASKES 18 VIAL 8,450 152,104

PEHAMOXIL 1 G INJ ASKES 10 VIAL 8,450 84,502

PEHAMOXIL 1 G INJ ASKES 16 VIAL 8,450 135,203

PETHIDIN INJ 100 AMPUL 13,191 1,319,142

PETHIDIN INJ 100 AMPUL 13,191 1,319,142

PETHIDIN INJ 50 AMPUL 13,191 659,571

PETHIDIN INJ ASKES 100 AMPUL 13,191 1,319,142

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PETHIDIN INJ ASKES 100 AMPUL 13,191 1,319,142

PETHIDIN INJ ASKES 100 AMPUL 13,191 1,319,142

PETHIDIN INJ ASKES 50 AMPUL 13,191 659,571

PHADILON 125 MG INJ ASKES 20 VIAL 25,488 509,762

PHENTAL INJ 50 AMPUL 9,075 453,750

PHENYTOIN INJ 20 AMPUL 20,250 405,000

PHENYTOIN INJ ASKES 30 AMPUL 20,250 607,500

PHENYTOIN KAPSUL 800 KAPSUL 605 484,000

PHENYTOIN TAB ASKES 2,400 KAPSUL 210 504,002

PHYTOMENADION INJ 150 AMPUL 1,740 261,002

PHYTOMENADION INJ 90 AMPUL 1,740 156,601

PHYTOMENADION INJ 150 AMPUL 1,697 254,476

PHYTOMENADION INJ 150 AMPUL 1,697 254,476

PHYTOMENADION INJ 150 AMPUL 1,740 261,002

PHYTOMENADION INJ 150 AMPUL 1,653 247,952

PHYTOMENADION INJ ASKES 90 AMPUL 1,740 156,601

PHYTOMENADION INJ ASKES 150 AMPUL 1,697 254,476

PHYTOMENADION INJ ASKES 150 AMPUL 1,697 254,476

PHYTOMENADION INJ ASKES 150 AMPUL 1,697 254,476

PHYTOMENADION INJ ASKES 60 AMPUL 1,740 104,401

PHYTOMENADION INJ ASKES 150 AMPUL 1,740 261,002

PHYTOMENADION INJ ASKES 150 AMPUL 1,740 261,002

PHYTOMENADION INJ ASKES 150 AMPUL 1,653 247,952

PIOGLITAZONE TI 15 MG ASKES 280 TABLET 3,088 864,639

PIPET KACA 100 PCS 1,320 132,000

PIRACETAM 1 G INJ 25 AMPUL 5,610 140,250

PIRACETAM 3 GR INJ 40 AMPUL 17,105 684,200

PIRACETAM 3 GR INJ 40 AMPUL 17,105 684,200

PIRACETAM 3 GR INJ 40 AMPUL 20,625 825,000

PIRACETAM 3 GR INJ 40 AMPUL 17,105 684,200

PIRACETAM 3 GR INJ 40 AMPUL 20,625 825,000

PIRACETAM 3 GR INJ 40 AMPUL 16,501 660,048

PIRACETAM 3G INJ ASKES 40 AMPUL 16,500 660,000

PIRACETAM 3G INJ ASKES 40 AMPUL 16,501 660,048

PIRACETAM 3G INJ ASKES 40 AMPUL 16,500 660,000

PIRACETAM 3G INJ ASKES 32 AMPUL 17,037 545,171

PIRACETAM 3G INJ ASKES 40 AMPUL 16,501 660,048

PIROXICAM 10 MG 100 TABLET 101 10,090

PIROXICAM 10 MG 100 TABLET 111 11,099

PIROXICAM 10 MG 240 TABLET 84 20,180

PIROXICAM 20 MG 100 TABLET 107 10,680

PLADOGREL TAB 60 TABLET 12,100 726,000

PLADOGREL TAB 60 TABLET 12,100 726,000

PLADOGREL TAB 60 TABLET 12,100 726,000

PLADOGREL TAB 60 TABLET 12,100 726,000

PLADOGREL TAB 60 TABLET 12,100 726,000

PLADOGREL TAB 60 TABLET 12,100 726,000

PLADOGREL TAB 30 TABLET 12,100 363,000

PLASMINEX INJ 100 AMPUL 11,495 1,149,500

PLASMINEX INJ 50 AMPUL 11,495 574,750

PLASMINEX INJ 50 AMPUL 11,781 589,050

PLASMINEX INJ 50 AMPUL 11,781 589,050

PLASMINEX INJ 50 AMPUL 11,781 589,050

PLASMINEX INJ 50 AMPUL 11,781 589,050

PLASMINEX INJ 50 AMPUL 11,781 589,050

PLASMINEX INJ 50 AMPUL 11,781 589,050

PLASMINEX INJ 50 AMPUL 11,781 589,050

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PLASMINEX INJ 100 AMPUL 11,781 1,178,100

PLASMINEX INJ 50 AMPUL 11,781 589,050

PLASMINEX INJ 100 AMPUL 11,781 1,178,100

PLASMINEX TAB 100 TABLET 2,492 249,150

PLASMINEX TAB 100 TABLET 2,492 249,150

PLASMINEX TAB 200 TABLET 2,492 498,300

PLASMINEX TAB 100 TABLET 2,558 255,750

PLASMINEX TAB 200 TABLET 2,558 511,500

PLASMINEX TAB 100 TABLET 2,558 255,750

PLASMINEX TAB 100 TABLET 2,558 255,750

PLASMINEX TAB 100 TABLET 2,558 255,750

PLASMINEX TAB 100 TABLET 2,558 255,750

PLASMINEX TAB 200 TABLET 2,558 511,500

PLATOSIN 50 MG INJ ASKES 2 VIAL 367,659 735,317

PLAVIX TAB 140 TABLET 6,500 910,003

PLETAAL 50 MG 100 TABLET 7,296 729,619

POLIDEMISIN ED 10 FLS 23,210 232,100

POLIDEMISIN ED 10 FLS 23,210 232,100

POLIDEMISIN ED 20 FLS 23,210 464,200

POLIDEMISIN ED 20 FLS 23,210 464,200

POLIDEMISIN ED 20 FLS 23,793 475,860

POLIDEMISIN ED 20 FLS 23,793 475,860

POLIDEMISIN ED 10 FLS 23,793 237,930

POLIDEMISIN ED 20 FLS 23,793 475,860

POLIDEMISIN ED 10 FLS 23,793 237,930

POLIDEMISIN ED 10 FLS 23,793 237,930

POLIDEMISIN ED 20 FLS 23,793 475,860

POLIDEMISIN ED 20 FLS 23,793 475,860

POLIDEMISIN ED 50 FLS 23,793 1,189,650

POLIDEMISIN ED 48 FLS 23,793 1,142,064

POLYGRAN 5 ML 20 FLS 30,250 605,000

POLYGRAN 5 ML 3 FLS 30,250 90,750

POLYGRAN 5 ML 20 FLS 30,250 605,000

POLYGRAN 5 ML 20 FLS 30,250 605,000

POLYGRAN 5 ML 10 FLS 34,788 347,875

POLYGRAN 5 ML 10 FLS 34,788 347,875

POLYGRAN 5 ML 10 FLS 34,788 347,875

POLYGRAN 5 ML 10 FLS 34,788 347,875

POLYGRAN 5 ML 20 FLS 34,788 695,750

POLYGRAN 5 ML 10 FLS 34,788 347,875

POLYGRAN 5 ML 10 FLS 34,788 347,875

POLYGRAN 5 ML 20 FLS 34,788 695,750

POLYGRAN EO 10 FLS 20,350 203,500

POLYGRAN EO 10 FLS 20,350 203,500

POLYGRAN EO 10 FLS 20,350 203,500

POLYMED POLYVAC 12 FG 3 BOX 187,000 561,000

POLYMED POLYVAC 12 FG 3 BOX 187,000 561,000

POLYMED POLYVAC 12 FG 3 BOX 187,000 561,000

POLYMED POLYVAC 14 FG 10 BOX 187,000 1,870,000

POLYMED POLYVAC 14 FG 6 BOX 187,000 1,122,000

POLYMED POLYVAC 14 FG 4 BOX 187,000 748,000

POLYMED POLYVAC 14 FG 5 BOX 187,000 935,000

POLYMED POLYVAC 14 FG 3 BOX 187,000 561,000

POLYMED POLYVAC 14 FG 3 BOX 187,000 561,000

POLYMED POLYVAC 14 FG 3 BOX 187,000 561,000

POLYMED POLYVAC 14 FG 5 BOX 187,000 935,000

POSPARGIN INJ ASKES 100 AMPUL 6,050 605,000

Page 108: FORM FA Unit Kerja Penunjang 30815

POSPARGIN INJ ASKES 100 AMPUL 6,050 605,000

POT SPUTCUM PUTIH 500 PCS 4,620 2,310,000

POT SPUTUM REG 200 PCS 4,620 924,000

POT URINE NON STERIL 300 PCS 3,163 948,750

POT URINE NON STERIL 500 PCS 3,163 1,581,250

POT URINE NON STERIL 100 PCS 2,310 231,000

POT URINE NON STERIL 500 PCS 3,163 1,581,250

POVIDON IODIN 1 L PKET 10 BOTOL 55,935 559,350

POVIDON IODIN 1 L PKET 10 BOTOL 55,935 559,350

POVIDON IODIN 30 ML ASKES 50 FLS 2,900 144,980

POWER CHANGE PAKET 1 PCS 178,200 178,200

POWER CHANGE PAKET 1 PCS 178,200 178,200

POWER O PAKET 1 PCS 46,200 46,200

PRALAX SYR 6 BOTOL 49,500 297,000

PRALAX SYR 5 BOTOL 49,500 247,500

PRALAX SYR 6 BOTOL 49,500 297,000

PRANZA INJ 6 VIAL 140,250 841,500

PREABOR 30 TABLET 3,212 96,360

PREDNISON 1,000 TABLET 152 151,998

PREDNISON 500 TABLET 152 75,999

PREDNISON 1,000 TABLET 152 151,998

PREDNISON 500 TABLET 152 75,999

PREDNISON ASKES 500 TABLET 152 75,999

PREDNISON ASKES 1,000 TABLET 152 151,998

PREDNISON ASKES 1,500 TABLET 152 227,997

PREDNISON ASKES 2,000 TABLET 152 303,996

PREMILEN MESH (30X30)/ 5X10 18 PCS 121,759 2,191,662

PREMILEN MESH (30X30)/ 5X10 18 PCS 121,759 2,191,662

PREMILEN MESH (30X30)/ 5X10 18 PCS 121,759 2,191,662

PREMILEN MESH 5 X 10 5 PCS 299,376 1,496,880

PRIMOLUT N ASKES 60 TABLET 2,618 157,080

PROANES INJ 10 AMPUL 61,892 618,923

PROBIOKID 10 SACHET 12,100 121,000

PROBIOKID 50 SACHET 12,100 605,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 50 SACHET 12,100 605,000

PROBIOKID 200 SACHET 12,100 2,420,000

PROBIOKID 200 SACHET 12,100 2,420,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 200 SACHET 12,100 2,420,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 50 SACHET 12,100 605,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 50 SACHET 12,100 605,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 100 SACHET 12,100 1,210,000

PROBIOKID 150 SACHET 12,100 1,815,000

PROBIOKID 200 SACHET 12,100 2,420,000

PROFECOM 100 MG SUPP ASKES 100 5,017 501,721

PROFECOM 100 MG SUPP ASKES 100 4,900 490,032

PROFECOM 100 MG SUPP ASKES 100 5,717 571,725

SUPPOSITORIA

SUPPOSITORIA

SUPPOSITORIA

Page 109: FORM FA Unit Kerja Penunjang 30815

PROFECOM 100 MG SUPP ASKES 50 8,894 444,675

PROLIC 300 100 TABLET 6,809 680,900

PROLIC 300 100 TABLET 6,809 680,900

PROLIC 300 100 TABLET 6,809 680,900

PROLIC 300 100 TABLET 6,809 680,900

PROMAVIT TAB 120 TABLET 1,760 211,200

PROMAVIT TAB 120 TABLET 1,760 211,200

PRONTOSAN SOL 6X4 ML 1 AMPUL 55,000 55,000

PROPANOLOL 10 ASKES 500 TABLET 77 38,500

PROPANOLOL 10 ASKES 600 TABLET 70 42,002

PROPYLTHIOURACIL 100MG 500 TABLET 300 149,787

PROPYLTHIOURACIL 100MG 300 TABLET 360 107,910

PROPYLTHIOURACIL 100MG 300 TABLET 360 107,910

PROPYLTHIOURACYL 100 MG ASKES 1,000 TABLET 291 291,005

PROPYRETIC 160 24 7,058 169,400

PROPYRETIC 160 24 7,058 169,400

PROPYRETIC 160 24 7,058 169,400

PROPYRETIC SUPP 80 24 6,655 159,720

PROPYRETIC SUPP 80 36 6,655 239,580

PROPYRETIC SUPP 80 24 6,655 159,720

PROSOGAN INJ ASKES 6 VIAL 82,045 492,269

PROSOGAN INJ ASKES 5 VIAL 82,036 410,181

PROSOGAN INJ ASKES 5 VIAL 82,036 410,181

PROSOGAN INJ ASKES 20 VIAL 82,036 1,640,724

PROSTAM SR 60 TABLET 6,600 396,000

PROSTAM SR ASKES 90 TABLET 6,600 594,000

PROXIME TAB 90 TABLET 1,073 96,525

PROXIME TAB 150 TABLET 1,100 165,000

PROXIME TAB 90 TABLET 1,100 99,000

PROXIME TAB 150 TABLET 1,100 165,000

PROXIME TAB 180 TABLET 1,100 198,000

PROXIME TAB 150 TABLET 1,100 165,000

PROXIME TAB 150 TABLET 1,100 165,000

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 42 VIAL 140,250 5,890,500

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 5 VIAL 140,250 701,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

SUPPOSITORIA

SUPPOSITORIA

SUPPOSITORIA

SUPPOSITORIA

SUPPOSITORIA

SUPPOSITORIA

SUPPOSITORIA

Page 110: FORM FA Unit Kerja Penunjang 30815

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 21 VIAL 140,250 2,945,250

PUMPICEL INJ 42 VIAL 140,250 5,890,500

PUMPITOR 40 TABLET 12,518 500,720

PUMPITOR 60 TABLET 12,518 751,080

PUMPITOR 40 TABLET 12,518 500,720

PUMPITOR 40 TABLET 12,832 513,260

PUMPITOR 40 TABLET 12,832 513,260

PUMPITOR 60 TABLET 12,832 769,890

PUMPITOR INJ 20 VIAL 142,153 2,843,060

PUMPITOR INJ 20 VIAL 142,153 2,843,060

PUMPITOR INJ 30 VIAL 142,153 4,264,590

PUMPITOR INJ 30 VIAL 142,153 4,264,590

PUMPITOR INJ 50 VIAL 142,153 7,107,650

PUMPITOR INJ 30 VIAL 142,153 4,264,590

PUMPITOR INJ 30 VIAL 142,153 4,264,590

PUMPITOR INJ 18 VIAL 142,153 2,558,754

PUMPITOR INJ ASKES 20 VIAL 72,711 1,454,225

PUMPITOR INJ ASKES 25 VIAL 72,711 1,817,781

PUMPITOR INJ ASKES 10 VIAL 72,711 727,113

PUMPITOR INJEKSI 10 VIAL 70,936 709,361

PUMPITOR INJEKSI 10 VIAL 70,936 709,361

PUMPITOR INJEKSI 20 VIAL 70,936 1,418,722

PUMPITOR INJEKSI 20 VIAL 72,711 1,454,225

PURICEMIA 200 TABLET 2,673 534,600

PURICEMIA 200 TABLET 2,673 534,600

PURICEMIA 100 TABLET 2,673 267,300

PURICEMIA 100 TABLET 2,673 267,300

PURICEMIA 100 TABLET 2,673 267,300

PURICEMIA 200 TABLET 2,673 534,600

PURICEMIA 100 TABLET 2,673 267,300

PURICEMIA 200 TABLET 2,673 534,600

PURICEMIA 100 TABLET 2,673 267,300

PURICEMIA 200 TABLET 2,673 534,600

PZ 100ML/PIGGYBACK 20 AMPUL 7,700 154,000

PZ 100ML/PIGGYBACK 30 AMPUL 11,110 333,300

PZ B BRAUN ASKES 500 FLS 4,700 2,350,018

PZ B BRAUN ASKES 300 FLS 4,901 1,470,150

PZ B BRAUN ASKES 200 FLS 4,901 980,100

PZ B BRAUN ASKES 50 FLS 4,700 235,003

PZ B BRAUN ASKES 500 FLS 4,700 2,350,018

PZ B BRAUN ASKES 500 FLS 4,901 2,450,250

PZ B BRAUN ASKES 800 FLS 4,901 3,920,400

PZ WIDA 60 FLS 9,510 570,570

PZ WIDA OGB 100 FLS 4,901 490,050

PZ WIDA OGB 100 FLS 4,901 490,050

PZ WIDA OGB 100 FLS 4,700 470,030

PZ WIDA OGB 100 FLS 4,700 470,030

PZ WIDA OGB 100 FLS 4,700 470,030

PZ WIDA OGB 60 FLS 4,700 282,018

PZ WIDA OGB 100 FLS 4,700 470,030

PZ WIDATRA ASKES 600 FLS 4,700 2,820,180

PZ WIDATRA ASKES 200 FLS 4,901 980,100

PZ WIDATRA ASKES 600 FLS 4,901 2,940,300

PZ WIDATRA ASKES 400 FLS 4,700 1,880,120

PZ WIDATRA ASKES 600 FLS 4,700 2,820,180

PZ WIDATRA ASKES 200 FLS 4,700 940,001

Page 111: FORM FA Unit Kerja Penunjang 30815

PZ WIDATRA ASKES 400 FLS 4,700 1,880,120

PZ WIDATRA ASKES 200 FLS 4,700 940,060

PZ WIDATRA ASKES 400 FLS 4,700 1,880,120

PZ WIDATRA ASKES 200 FLS 4,700 940,060

PZ WIDATRA ASKES 600 FLS 4,700 2,820,180

PZ WIDATRA ASKES 400 FLS 4,700 1,880,120

PZ WIDATRA ASKES 200 FLS 4,700 940,001

PZ WIDATRA ASKES 600 FLS 4,700 2,820,180

RANITIDIN INJ 200 AMPUL 3,465 693,000

RANITIDIN INJ 240 AMPUL 3,465 831,600

RANITIDIN INJ 200 AMPUL 3,465 693,000

RANITIDIN INJ 200 AMPUL 3,465 693,000

RANITIDIN INJ 200 AMPUL 3,465 693,000

RANITIDIN INJ 240 AMPUL 3,465 831,600

RANITIDIN INJ 100 AMPUL 3,465 346,500

RANITIDIN INJ 200 AMPUL 3,465 693,000

RANITIDIN INJ ASKES 2,000 AMPUL 1,140 2,280,080

RANITIDIN INJ ASKES 2,000 AMPUL 1,140 2,280,080

RANITIDIN INJ ASKES/25 1,800 AMPUL 1,928 3,470,386

RANITIDIN INJ ASKES/25 1,800 AMPUL 1,129 2,032,074

RANITIDIN INJ ASKES/25 1,200 AMPUL 1,128 1,353,990

RANITIDIN TAB 1,000 TABLET 203 203,302

RANITIDIN TAB 1,000 TABLET 150 150,480

RANITIDIN TAB ASKES 1,000 TABLET 105 104,995

RANITIDIN TAB ASKES 1,000 TABLET 165 165,022

RANITIDIN TAB ASKES 1,000 TABLET 178 178,200

RANITIDIN TAB ASKES 1,000 TABLET 165 165,022

RANITIDIN TAB ASKES 2,000 TABLET 150 300,960

RATIVOL INJ 25 AMPUL 33,825 845,625

RATIVOL INJ 25 AMPUL 33,825 845,625

RATIVOL INJ 50 AMPUL 33,825 1,691,250

RATIVOL INJ 50 AMPUL 33,825 1,691,250

RATIVOL INJ 50 AMPUL 33,825 1,691,250

RATIVOL INJ 50 AMPUL 34,672 1,733,600

RATIVOL INJ 100 AMPUL 34,672 3,467,200

RATIVOL INJ 50 AMPUL 34,672 1,733,600

RATIVOL INJ 50 AMPUL 34,672 1,733,600

RATIVOL INJ 50 AMPUL 34,672 1,733,600

RATIVOL INJ 50 AMPUL 34,672 1,733,600

RATIVOL INJ 50 AMPUL 34,672 1,733,600

RATIVOL INJ 50 AMPUL 34,672 1,733,600

RATIVOL INJ 100 AMPUL 34,672 3,467,200

RATIVOL INJ 100 AMPUL 34,672 3,467,200

RATIVOL INJ 50 AMPUL 34,672 1,733,600

RATIVOL INJ 100 AMPUL 34,672 3,467,200

RATIVOL INJ 170 AMPUL 34,672 5,894,240

RD OTSUKA ASKES 20 FLS 10,921 218,416

RD OTSUKA ASKES 20 FLS 10,921 218,416

RD OTSUKA ASKES 20 FLS 10,921 218,416

RD OTSUKA ASKES 40 FLS 10,921 436,832

REAGENT PACK ELEKTROLIT AFT 1 KIT 4,400,000 4,400,000

REAGENT PACK ELEKTROLIT AFT 1 KIT 4,400,000 4,400,000

REAGENT PACK ELEKTROLIT AFT 1 KIT 4,400,000 4,400,000

REAGENT PACK ELEKTROLIT AFT 1 KIT 4,400,000 4,400,000

REAGENT PACK ELEKTROLIT AFT 1 KIT 4,400,000 4,400,000

REAGENT PACK ELEKTROLIT AFT 1 KIT 4,400,000 4,400,000

REAGENT PACK ELEKTROLIT AFT 1 KIT 4,400,000 4,400,000

Page 112: FORM FA Unit Kerja Penunjang 30815

REAGENT PACK ELEKTROLIT AFT 1 KIT 4,400,000 4,400,000

RECTAL TUBE 28 3 BIJI 13,200 39,600

RECTAL TUBE 28 3 BIJI 13,200 39,600

RECTAL TUBE 28 6 BIJI 13,200 79,200

RECTAL TUBE 32 3 BIJI 13,200 39,600

RECTAL TUBE 32 3 BIJI 13,200 39,600

1 PACK 1,353,000 1,353,000

REGIVELL INJ 50 AMPUL 59,290 2,964,500

REGIVELL INJ 25 AMPUL 59,290 1,482,250

REGIVELL INJ 25 AMPUL 59,290 1,482,250

REGIVELL INJ 25 AMPUL 59,290 1,482,250

REGIVELL INJ 50 AMPUL 59,290 2,964,500

REGIVELL INJ 50 AMPUL 59,290 2,964,500

REGIVELL INJ 50 AMPUL 59,290 2,964,500

REGIVELL INJ 25 AMPUL 59,290 1,482,250

REGIVELL INJ 25 AMPUL 59,290 1,482,250

REGIVELL INJ 50 AMPUL 58,080 2,904,000

REGIVELL INJ 50 AMPUL 59,290 2,964,500

REGIVELL INJ 50 AMPUL 59,290 2,964,500

REGUMEN 60 TABLET 3,245 194,700

REGUMEN 90 TABLET 3,245 292,050

REGUMEN 60 TABLET 3,245 194,700

REGUMEN 180 TABLET 3,245 584,100

REGUMEN 90 TABLET 3,245 292,050

REGUMEN 90 TABLET 3,245 292,050

REGUMEN 90 TABLET 3,245 292,050

REGUMEN 90 TABLET 3,245 292,050

REGUMEN 150 TABLET 3,245 486,750

RENADINAC 50 MG 500 TABLET 182 90,750

RENADINAC 75 INJ 25 AMPUL 19,800 495,000

RENADINAC 75 INJ 15 AMPUL 19,800 297,000

RENADINAC 75 INJ 25 AMPUL 19,800 495,000

RENADINAC 75 INJ 15 AMPUL 19,800 297,000

RENADINAC 75 INJ 10 AMPUL 19,800 198,000

RENADINAC 75 INJ 25 AMPUL 19,800 495,000

RENALYT 5 BOTOL 14,300 71,500

RENALYT 6 BOTOL 14,300 85,800

RENALYT 6 BOTOL 14,300 85,800

RENALYT 10 BOTOL 14,300 143,000

RENOSAN 5 BOTOL 227,348 1,136,740

RENOSAN 6 BOTOL 227,348 1,364,088

RENOSAN 12 BOTOL 227,348 2,728,176

RENOSAN 6 BOTOL 227,348 1,364,088

RENOSAN 6 BOTOL 227,348 1,364,088

RENOSAN 12 BOTOL 227,348 2,728,176

RENOSAN 3 BOTOL 227,348 682,044

RENOSAN 5 BOTOL 227,348 1,136,740

RENOSAN 3 BOTOL 227,348 682,044

RENOSAN 6 BOTOL 227,348 1,364,088

RENOSAN 5 BOTOL 227,348 1,136,740

RENOSAN 5 BOTOL 227,348 1,136,740

RETIVIT PLUS TAB 100 TABLET 6,402 640,200

RETIVIT PLUS TAB 100 TABLET 6,402 640,200

RETIVIT PLUS TAB 100 TABLET 6,402 640,200

RETIVIT PLUS TAB 100 TABLET 6,402 640,200

RETIVIT PLUS TAB 100 TABLET 6,402 640,200

REFIL SOLUTION FOR REF ELEKTRODES AFT

Page 113: FORM FA Unit Kerja Penunjang 30815

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 200 TABLET 6,567 1,313,400

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 100 TABLET 6,567 656,700

RETIVIT PLUS TAB 300 TABLET 6,567 1,970,100

RETIVIT TAB 200 TABLET 3,498 699,600

RETIVIT TAB 200 TABLET 3,498 699,600

RETIVIT TAB 300 TABLET 3,498 1,049,400

RETIVIT TAB 200 TABLET 3,498 699,600

RETIVIT TAB 200 TABLET 3,586 717,200

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 200 TABLET 3,586 717,200

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 200 TABLET 3,586 717,200

RETIVIT TAB 400 TABLET 3,586 1,434,400

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 200 TABLET 3,586 717,200

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 200 TABLET 3,586 717,200

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 200 TABLET 3,586 717,200

RETIVIT TAB 200 TABLET 3,586 717,200

RETIVIT TAB 200 TABLET 3,586 717,200

RETIVIT TAB 300 TABLET 3,586 1,075,800

RETIVIT TAB 1,500 TABLET 3,586 5,379,000

REVOLAN 3G INJ 10 AMPUL 49,693 496,925

REVOLAN 3G INJ 30 AMPUL 50,936 1,528,065

REVOLAN 3G INJ 25 AMPUL 50,936 1,273,388

REVOLAN 3G INJ 25 AMPUL 50,936 1,273,388

REVOLAN 3G INJ 50 AMPUL 50,936 2,546,775

REVOLAN 3G INJ 30 AMPUL 50,936 1,528,065

REVOLAN INJ 50 AMPUL 17,380 869,000

RIFAMPISIN 300 MG ASKES 100 TABLET 480 47,952

RL B BRAUN ASKES 300 FLS 4,895 1,468,513

RL B BRAUN ASKES 200 FLS 5,200 1,039,940

RL B BRAUN ASKES 200 FLS 5,200 1,039,940

RL B BRAUN ASKES 600 FLS 5,200 3,119,820

RL WIDATRA ASKES 400 FLS 5,200 2,079,880

RL WIDATRA ASKES 100 FLS 5,200 519,970

RL WIDATRA ASKES 400 FLS 5,200 2,079,880

RL WIDATRA ASKES 300 FLS 4,895 1,468,500

RL WIDATRA ASKES 400 FLS 5,200 2,079,880

RL WIDATRA ASKES 200 FLS 5,200 1,039,999

RL WIDATRA ASKES 200 FLS 5,200 1,039,940

RL WIDATRA ASKES 400 FLS 5,200 2,079,880

RL WIDATRA ASKES 400 FLS 5,200 2,079,880

RL WIDATRA ASKES 400 FLS 5,200 2,079,880

Page 114: FORM FA Unit Kerja Penunjang 30815

RL WIDATRA ASKES 600 FLS 5,200 3,119,820

ROBUMIN 20% 100 ML 2 BOTOL 1,534,500 3,069,000

ROBUMIN 20% 100 ML 4 BOTOL 1,534,500 6,138,000

SABU ( BIOSAVE ) 2 AMPUL 400,961 801,921

SABU ( BIOSAVE ) 10 AMPUL 461,175 4,611,750

SABU ( BIOSAVE ) 1 AMPUL 461,175 461,175

SABU ( BIOSAVE ) 20 AMPUL 461,175 9,223,500

SABU ( BIOSAVE ) 10 AMPUL 461,175 4,611,750

SABU ( BIOSAVE ) 9 AMPUL 461,175 4,150,575

SABU ( BIOSAVE ) 8 AMPUL 461,175 3,689,400

SABU ( BIOSAVE ) ASKES 10 VIAL 461,175 4,611,750

SAFEGLOVE 7,5 200 PCS 8,800 1,760,000

SAFEGLOVE 7,5 150 PCS 8,800 1,320,000

SAFEGLOVE 7,5 50 PCS 8,800 440,000

SAFEGLOVE 7,5 100 PCS 8,800 880,000

SAFEGLOVE 7,5 100 PCS 8,800 880,000

SAFEGLOVE 7,5 200 PCS 8,800 1,760,000

SAFEGLOVE 7,5 300 PCS 8,800 2,640,000

SAFEGLOVE 7,5 150 PCS 8,800 1,320,000

SAFEGLOVE 7,5 200 PCS 8,800 1,760,000

SAFEGLOVE 7,5 ASKES 200 PCS 5,500 1,100,000

SAFEGLOVE 7,5 ASKES 200 PCS 5,500 1,100,000

SAFEGLOVE 7,5 ASKES 200 PCS 5,500 1,100,000

SAFEGLOVE 7,5 ASKES 200 PCS 4,950 990,000

SAFEGLOVE EXAM M 500 PCS 650 325,006

SAFEGLOVE EXAM M 500 PCS 650 325,006

SAFEGLOVE EXAM M ASKES 500 PASANG 650 325,006

SAFEGLOVE EXAM M PAKET 20 BOX 32,501 650,012

SAFEGLOVE EXAM M PAKET 10 BOX 32,501 325,006

SAFEGLOVE EXAM M PAKET 20 BOX 32,501 650,012

SAFEGLOVE EXAM M PAKET 30 BOX 32,501 975,018

SAFEGLOVE EXAM M PAKET 20 BOX 32,500 649,990

SAFEGLOVE EXAM S PAKET 10 BOX 32,501 325,006

SAFEGLOVE EXAM S PAKET 10 BOX 32,501 325,006

SAFEGLOVE EXAM S PAKET 10 BOX 32,500 324,995

SAFIL 1 REG 12 SACHET 96,525 1,158,300

SAFIL 1 REG 12 SACHET 96,525 1,158,300

SAFIL 1 REG 6 SACHET 96,525 579,150

SAFIL 1 REG 6 SACHET 96,525 579,150

SAFIL 1 REG 6 SACHET 96,525 579,150

SAFIL 2 REG 6 SACHET 123,255 739,530

SAFOL INJ 5 AMPUL 91,630 458,150

SAFOL INJ 15 AMPUL 91,630 1,374,450

SAGESTAM CREAM 12 TUBE 11,275 135,300

SAGESTAM CREAM 12 TUBE 11,275 135,300

SAGESTAM CREAM 10 TUBE 11,275 112,750

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM CREAM 12 TUBE 11,561 138,732

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM CREAM 10 TUBE 11,561 115,610

SAGESTAM INJ 15 AMPUL 9,229 138,435

Page 115: FORM FA Unit Kerja Penunjang 30815

SALBUTAMOL 2 MG 200 TABLET 82 16,368

SALBUTAMOL 2 MG 200 TABLET 84 16,806

SALBUTAMOL 4 MG 100 TABLET 97 9,749

SALMONELLA P TYPHI AO 2 VIAL 198,000 396,000

SALMONELLA P TYPHI AO 1 VIAL 198,000 198,000

SALMONELLA P TYPHI AO 1 VIAL 184,525 184,525

SALMONELLA P TYPHI AO 1 VIAL 198,000 198,000

SALMONELLA P TYPHI AO 1 VIAL 198,000 198,000

SALMONELLA P TYPHI AO 1 VIAL 184,525 184,525

SALMONELLA P TYPHI AO 1 VIAL 184,525 184,525

SALMONELLA P TYPHI BO 2 VIAL 198,000 396,000

SALMONELLA P TYPHI BO 1 VIAL 198,000 198,000

SALMONELLA P TYPHI BO 1 VIAL 184,525 184,525

SALMONELLA P TYPHI BO 1 VIAL 198,000 198,000

SALMONELLA P TYPHI BO 1 VIAL 198,000 198,000

SALMONELLA P TYPHI BO 1 VIAL 184,525 184,525

SALMONELLA P TYPHI BO 1 VIAL 184,525 184,525

SALMONELLA TYPHI H 2 VIAL 198,000 396,000

SALMONELLA TYPHI H 1 VIAL 198,000 198,000

SALMONELLA TYPHI H 1 VIAL 184,525 184,525

SALMONELLA TYPHI H 1 VIAL 198,000 198,000

SALMONELLA TYPHI H 1 VIAL 198,000 198,000

SALMONELLA TYPHI H 1 VIAL 184,525 184,525

SALMONELLA TYPHI H 1 VIAL 184,525 184,525

SALMONELLA TYPHI O 2 VIAL 198,000 396,000

SALMONELLA TYPHI O 1 VIAL 198,000 198,000

SALMONELLA TYPHI O 1 VIAL 184,525 184,525

SALMONELLA TYPHI O 1 VIAL 198,000 198,000

SALMONELLA TYPHI O 1 VIAL 198,000 198,000

SALMONELLA TYPHI O 1 VIAL 184,525 184,525

SALMONELLA TYPHI O 1 VIAL 184,525 184,525

SAMPLES CUP 2 ML 1000 PCS 1,000 PCS 1,210 1,210,000

SAMPLES CUP 2 ML 1000 PCS 1,000 PCS 1,210 1,210,000

SAMPLES CUP 2 ML 1000 PCS 1,000 PCS 1,210 1,210,000

SAMPLES CUP 2 ML 1000 PCS 1,000 PCS 1,210 1,210,000

SAMPLES CUP 2 ML 1000 PCS 1,000 PCS 1,210 1,210,000

SAMPLES CUP 2 ML 1000 PCS 2,000 PCS 1,210 2,420,000

SAMPLES CUP 2 ML 1000 PCS 1,000 PCS 1,210 1,210,000

SAN B-PLEK DROP 10 FLS 15,934 159,335

SAN B-PLEK DROP 6 FLS 15,934 95,601

SAN B-PLEK DROP 10 FLS 16,335 163,350

SAN B-PLEK DROP 10 FLS 16,335 163,350

SAN B-PLEK DROP 10 FLS 16,335 163,350

SANBE HEST 130 DP 24 FLS 161,007 3,864,168

SANBE HEST 130 DP ASKES 24 SOFTBAG 161,007 3,864,168

SANBE KIDS EMULSION 5 BOTOL 33,550 167,750

SANBE KIDS EMULSION 18 BOTOL 33,550 603,900

SANBE KIDS EMULSION 6 BOTOL 33,550 201,300

SANEXON 125 MG INJ 20 VIAL 84,563 1,691,250

SANEXON 125 MG INJ 21 VIAL 84,563 1,775,813

SANEXON 125 MG INJ 20 VIAL 84,563 1,691,250

SANEXON 125 MG INJ 20 VIAL 86,680 1,733,600

SANEXON 125 MG INJ 30 VIAL 86,680 2,600,400

SANEXON 125 MG INJ 30 VIAL 86,680 2,600,400

SANEXON 125 MG INJ 40 VIAL 86,680 3,467,200

SANEXON 125 MG INJ 20 VIAL 86,680 1,733,600

SANEXON 125 MG INJ 20 VIAL 86,680 1,733,600

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SANEXON 125 MG INJ 30 VIAL 86,680 2,600,400

SANEXON 125 MG INJ 10 VIAL 86,680 866,800

SANEXON 125 MG INJ 10 VIAL 86,680 866,800

SANEXON 125 MG INJ 20 VIAL 86,680 1,733,600

SANEXON 125 MG INJ 30 VIAL 86,680 2,600,400

SANEXON 125 MG INJ 30 VIAL 86,680 2,600,400

SANEXON 125 MG INJ 30 VIAL 86,680 2,600,400

SANEXON 4 MG 100 TABLET 2,068 206,800

SANEXON 4 MG 100 TABLET 2,068 206,800

SANEXON 4 MG 100 TABLET 2,068 206,800

SANEXON 4 MG 200 TABLET 2,068 413,600

SANEXON 500 MG INJ 2 VIAL 201,372 402,743

SANFULIQ TAB 150 TABLET 4,620 693,000

SANFULIQ TAB 60 TABLET 4,620 277,200

SANFULIQ TAB 90 TABLET 4,620 415,800

SANFULIQ TAB 60 TABLET 4,620 277,200

SANFULIQ TAB 150 TABLET 4,620 693,000

SANFULIQ TAB 90 TABLET 4,620 415,800

SANMAG SYR 24 BOTOL 23,073 553,740

SANMAG SYR 24 BOTOL 23,073 553,740

SANMAG SYR 24 BOTOL 23,073 553,740

SANMAG SYR 24 BOTOL 23,073 553,740

SANMAG SYR 24 BOTOL 23,073 553,740

SANMAG SYR 24 BOTOL 23,073 553,740

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 48 BOTOL 23,650 1,135,200

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG SYR 48 BOTOL 23,650 1,135,200

SANMAG SYR 24 BOTOL 23,650 567,600

SANMAG TAB 300 TABLET 699 209,550

SANMAG TAB 300 TABLET 699 209,550

SANMAG TAB 300 TABLET 699 209,550

SANMAG TAB 300 TABLET 699 209,550

SANMAG TAB 300 TABLET 699 209,550

SANMOL DROP 10 BOTOL 14,383 143,825

SANMOL DROP 10 BOTOL 14,746 147,455

SANMOL DROP 10 BOTOL 14,746 147,455

SANMOL DROP 10 BOTOL 14,746 147,455

SANMOL DROP 10 BOTOL 14,746 147,455

SANMOL INFUS 20 BOTOL 56,375 1,127,500

SANMOL INFUS 12 BOTOL 57,783 693,396

SANMOL INFUS 20 BOTOL 57,783 1,155,660

SANMOL INFUS 20 BOTOL 57,783 1,155,660

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SANMOL INFUS 20 BOTOL 57,783 1,155,660

SANMOL INFUS 12 BOTOL 57,783 693,396

SANMOL INFUS 12 BOTOL 57,783 693,396

SANMOL INFUS 24 BOTOL 57,783 1,386,792

SANMOL INFUS 12 BOTOL 57,783 693,396

SANMOL INFUS 36 BOTOL 57,783 2,080,188

SANMOL SYR 24 BOTOL 10,643 255,420

SANMOL SYR 24 BOTOL 10,643 255,420

SANMOL SYR 24 BOTOL 10,643 255,420

SANMOL SYR 24 BOTOL 10,643 255,420

SANMOL SYR 24 BOTOL 10,912 261,888

SANMOL SYR 24 BOTOL 10,912 261,888

SANMOL SYR 24 BOTOL 10,912 261,888

SANMOL SYR 24 BOTOL 10,912 261,888

SANMOL SYR 20 BOTOL 10,912 218,240

SANMOL SYR 24 BOTOL 10,912 261,888

SANMOL SYR 24 BOTOL 10,912 261,888

SANMOL SYR 24 BOTOL 10,912 261,888

SANMOL SYR 48 BOTOL 10,912 523,776

SANMOL TAB 300 TABLET 253 75,900

SANMOL TAB 300 TABLET 253 75,900

SANMOL TAB 200 TABLET 253 50,600

SANMOL TAB 300 TABLET 264 79,200

SANMOL TAB 300 TABLET 264 79,200

SANMOL TAB 200 TABLET 264 52,800

SANMOL TAB 200 TABLET 264 52,800

SANMOL TAB 200 TABLET 264 52,800

SANMOL TAB 200 TABLET 264 52,800

SANMOL TAB 200 TABLET 264 52,800

SANMOL TAB 200 TABLET 264 52,800

SANMOL TAB 600 TABLET 264 158,400

SANPICILLIN INJ 20 VIAL 14,773 295,460

SANPICILLIN INJ 10 VIAL 14,773 147,730

SANPICILLIN INJ 10 VIAL 14,773 147,730

SANPICILLIN INJ 20 VIAL 14,773 295,460

SANPICILLIN INJ 10 VIAL 14,773 147,730

SANPICILLIN INJ 10 VIAL 14,773 147,730

SANPICILLIN INJ 20 VIAL 14,773 295,460

SANPICILLIN INJ 10 VIAL 15,147 151,470

SANPICILLIN INJ 10 VIAL 15,147 151,470

SANPICILLIN INJ 20 VIAL 15,147 302,940

SANPICILLIN INJ 30 VIAL 15,147 454,410

SANPICILLIN INJ 20 VIAL 15,147 302,940

SANPICILLIN INJ 10 VIAL 15,147 151,470

SANPICILLIN INJ 10 VIAL 15,147 151,470

SANPICILLIN INJ 10 VIAL 15,147 151,470

SANPICILLIN INJ 10 VIAL 15,147 151,470

SANPICILLIN INJ 20 VIAL 15,147 302,940

SANPICILLIN INJ 40 VIAL 15,147 605,880

SANPRIMA 100 TABLET 836 83,600

SANPRIMA FORTE 100 TABLET 1,826 182,600

SANPRIMA FORTE 100 TABLET 1,876 187,550

SANPRIMA SYR 10 BOTOL 24,074 240,735

SANPRIMA SYR 5 BOTOL 24,074 120,368

SANPRIMA SYR 10 BOTOL 24,074 240,735

SANPRIMA SYR 10 BOTOL 24,074 240,735

SANPRIMA SYR 10 BOTOL 24,074 240,735

Page 118: FORM FA Unit Kerja Penunjang 30815

SANSULIN N INJ 25 AMPUL 118,223 2,955,563

SANSULIN N INJ 10 AMPUL 121,182 1,211,815

SANSULIN PEN INJ 5 BOX 260,029 1,300,145

SANSULIN PEN INJ 5 BOX 260,029 1,300,145

SANSULIN PEN INJ 10 BOX 260,029 2,600,290

SANSULIN PEN INJ 6 BOX 260,029 1,560,174

SANSULIN PEN INJ 10 BOX 260,029 2,600,290

SANSULIN R INJ 5 AMPUL 118,223 591,113

SANTAGESIK INJ ASKES 170 AMPUL 5,600 951,972

SANTAGESIK INJ ASKES 170 AMPUL 5,600 951,972

SANTAGESIK INJ ASKES 255 AMPUL 5,600 1,427,958

SANTAGESIK INJEKSI 170 AMPUL 8,569 1,456,730

SANTAGESIK INJEKSI 170 AMPUL 8,569 1,456,730

SANTAGESIK INJEKSI 255 AMPUL 8,569 2,185,095

SANTAGESIK INJEKSI 85 AMPUL 8,569 728,365

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 255 AMPUL 8,784 2,239,793

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 255 AMPUL 8,784 2,239,793

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 170 AMPUL 8,784 1,493,195

SANTAGESIK INJEKSI 680 AMPUL 8,784 5,972,780

SANTAGESIK INJEKSI 85 AMPUL 8,784 746,598

SANTOCYN INJ 30 AMPUL 10,582 317,460

SANTOCYN INJ 30 AMPUL 10,582 317,460

SANTOCYN INJ 50 AMPUL 10,582 529,100

SANTOCYN INJ 50 AMPUL 10,582 529,100

SANTOCYN INJ 50 AMPUL 10,582 529,100

SANTOCYN INJ 50 AMPUL 10,582 529,100

SANTOCYN INJ 50 AMPUL 10,582 529,100

SANTOCYN INJ 50 AMPUL 10,846 542,300

SANTOCYN INJ 50 AMPUL 10,846 542,300

SANVITA - B SYR 5 BOTOL 11,259 56,293

SANVITA - B SYR 6 BOTOL 11,259 67,551

SANVITA - B SYR 10 BOTOL 11,259 112,585

SANVITA - B SYR 5 BOTOL 11,539 57,695

SANVITA - B SYR 5 BOTOL 11,539 57,695

SANVITA - B SYR 10 BOTOL 11,539 115,390

SCABICID 12 TUBE 28,500 341,999

SCABICID 24 TUBE 28,500 683,998

SENSI GLOVE M 500 PASANG 1,287 643,500

SENSI GLOVE M 500 PASANG 1,287 643,500

SENSI GLOVE M 500 PASANG 1,287 643,500

SENSI GLOVE M 500 PASANG 1,287 643,500

SENSI GLOVE M 500 PASANG 1,287 643,500

SENSI GLOVE M ASKES 500 PASANG 1,287 643,500

SENSI GLOVE M ASKES 500 PASANG 1,287 643,500

Page 119: FORM FA Unit Kerja Penunjang 30815

SENSI GLOVE M ASKES 500 PASANG 1,287 643,500

SENSI GLOVE M ASKES 500 PASANG 1,287 643,500

SENSI GLOVE M ASKES 500 PASANG 1,287 643,500

SENSI GLOVE S 500 PASANG 1,287 643,500

SENSI GLOVES L PAKET 10 BOX 64,350 643,500

SENSI GLOVES L PAKET 10 BOX 64,350 643,500

SENSI GLOVES L PAKET 10 BOX 64,350 643,500

SENSI GLOVES L PAKET 10 BOX 39,325 393,250

SENSI GLOVES M PAKET 20 BOX 64,350 1,287,000

SENSI GLOVES M PAKET 10 BOX 71,500 715,000

SENSI GLOVES M PAKET 30 BOX 64,350 1,930,500

SENSI GLOVES M PAKET 20 BOX 64,350 1,287,000

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 20 BOX 64,350 1,287,000

SENSI GLOVES M PAKET 20 BOX 64,350 1,287,000

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 20 BOX 64,350 1,287,000

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 10 BOX 64,350 643,500

SENSI GLOVES M PAKET 20 BOX 64,350 1,287,000

SENSI GLOVES M PAKET 20 BOX 39,325 786,500

SENSI GLOVES M PAKET 20 BOX 39,325 786,500

SENSI GLOVES S PAKET 10 BOX 64,350 643,500

SENSI GLOVES S PAKET 10 BOX 64,350 643,500

SENSI GLOVES S PAKET 10 BOX 64,350 643,500

SENSI GLOVES S PAKET 10 BOX 64,350 643,500

SENSI GLOVES S PAKET 10 BOX 64,350 643,500

SENSI GLOVES S PAKET 10 BOX 39,325 393,250

SENSI GLOVES S PAKET 20 BOX 39,325 786,500

SEROLIN 30 TAB 42 TABLET 13,226 555,500

SIBRO 20 G 3 TUBE 84,700 254,100

SIBRO 20 G 3 TUBE 84,700 254,100

SIFROL 0,375 MG ASKES 90 TABLET 15,553 1,399,778

SIFROL 0,375 MG ASKES 90 TABLET 7,200 648,000

SIFROL 0,375 MG ASKES 90 TABLET 7,200 648,000

SILET TATRA 200 SACHET 385 77,000

SILK BLACK 1 PER 1 CM 10,000 83 825,000

SILK BLACK 2/0 PER CM 10,000 72 715,000

SILK BLACK 2/0 PER CM 20,000 72 1,430,000

SILK BLACK 3/0 PER 1 CM 10,000 62 621,500

SILK BLACK 3/0 PER 1 CM 10,000 59 594,000

SILK BLACK 3/0 PER 1 CM 10,000 62 621,500

SILK BLACK 3/0 PER 1 CM 10,000 62 621,500

SILK T-ROL 2 TRITON 5,000 89 445,500

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

Page 120: FORM FA Unit Kerja Penunjang 30815

SILK T-ROL 3/0 TRITON 10,000 45 445,500

SILK T-ROL 3/0 TRITON 10,000 45 445,500

SILK T-ROL 3/0 TRITON 10,000 45 445,500

SILK T-ROL 3/0 TRITON 10,000 45 445,500

SILKAM 2/0 TAPER REG 12 PCS 61,600 739,200

SILKAM 2/0 TAPER REG 12 PCS 49,500 594,000

SILKAM 2/0 TAPER REG 30 PCS 55,440 1,663,200

SILKAM 2/0 TAPER REG 12 PCS 55,440 665,280

SILKAM 2/0 TAPER REG 12 PCS 55,440 665,280

SILKAM 2/0 TAPER REG 6 PCS 55,440 332,640

SILOXAN 5 FLS 58,025 290,125

SILOXAN 3 FLS 58,025 174,075

SILOXAN 5 FLS 58,025 290,125

SIMVASTATIN 10 MG ASKES 450 TABLET 241 108,500

SIMVASTATIN 10 MG ASKES 300 TABLET 200 60,004

SISTENOL 60 TABLET 1,386 83,160

SISTENOL 60 TABLET 1,386 83,160

SISTENOL 60 TABLET 1,386 83,160

SISTENOL 60 TABLET 1,386 83,160

SISTENOL 60 TABLET 1,386 83,160

SLIT KNIFE 2.75 3 PCS 159,500 478,500

SOFNOLINE 1 GALON 539,000 539,000

SOFTAMAN 500 ML 2,500 MILILITER 178 445,500

SOFTAMAN 500 ML 5,000 MILILITER 178 891,000

SOFTAMAN 500 ML PAKET 19 BOTOL 89,100 1,692,900

SOFTBAN BIRU 4 ASKES 6 PCS 20,634 123,803

SOFTBAN BIRU 4" 6 BIJI 20,634 123,803

SOFTBAN BIRU 4" 6 BIJI 20,634 123,803

SOFTBAN BIRU 4" 6 BIJI 20,634 123,803

SOFTBAN BIRU 4" 3 BIJI 20,634 61,901

SOFTBAN BIRU 6" 3 BIJI 29,662 88,985

SOLARE ANT PAKET 1 TUBE 376,200 376,200

SOLARE X PAKET 1 PCS 376,200 376,200

SOLARE X PAKET 1 PCS 376,200 376,200

SOLO SET 15 BIJI 79,530 1,192,950

SOLO SET 10 BIJI 71,577 715,770

SOLO SET 20 BIJI 79,530 1,590,600

SOLO SET 25 BIJI 79,530 1,988,250

SOLO SET 25 BIJI 79,530 1,988,250

SOLO SET 25 BIJI 98,450 2,461,250

SOLO SET 6 BIJI 98,450 590,700

SOLO SET ASKES 10 PCS 71,577 715,770

SOLO SET ASKES 25 PCS 79,530 1,988,250

SOLO SET ASKES 25 PCS 79,530 1,988,250

SOLO SET ASKES 10 PCS 98,450 984,500

SOLO SET ASKES 25 PCS 98,450 2,461,250

SOTATIC INJ ASKES 300 AMPUL 2,500 750,024

SOTATIC INJ ASKES 375 AMPUL 2,500 937,530

SOTATIC INJ ASKES 375 AMPUL 2,500 937,530

SOTATIC INJ ASKES 395 AMPUL 2,500 987,532

SOTATIC INJ ASKES 395 AMPUL 2,500 987,532

SOTATIC INJ ASKES 395 AMPUL 2,500 987,532

CENTIMETER

CENTIMETER

CENTIMETER

CENTIMETER

Page 121: FORM FA Unit Kerja Penunjang 30815

SOTATIC INJ ASKES 395 AMPUL 2,500 987,532

SOTATIC INJ ASKES 170 AMPUL 2,500 425,014

SPINOCAIN 25 25 BIJI 35,200 880,000

SPINOCAIN 25 50 BIJI 35,200 1,760,000

SPINOCAIN 25 25 BIJI 35,200 880,000

SPINOCAIN 25 25 BIJI 35,200 880,000

SPINOCAIN 25 50 BIJI 35,200 1,760,000

SPINOCAIN 25 25 BIJI 35,200 880,000

SPINOCAIN 25 25 BIJI 35,200 880,000

SPINOCAIN 25 25 BIJI 35,200 880,000

SPINOCAIN 25 50 BIJI 35,200 1,760,000

SPINOCAIN 26 25 PCS 37,400 935,000

SPINOCAIN 26 25 PCS 37,400 935,000

SPINOCAIN 26 25 PCS 37,400 935,000

SPINOCAIN 26 50 PCS 37,400 1,870,000

SPINOCAIN 26 25 PCS 37,400 935,000

SPINOCAIN 26 25 PCS 37,400 935,000

SPINOCAIN 26 25 PCS 37,400 935,000

SPIRAMYCIN 500 MG ASKES 100 TABLET 1,498 149,820

SPIRANTER 500 100 TABLET 4,782 478,225

SPIRASIN TABLET 100 TABLET 5,665 566,500

SPIRASIN TABLET 100 TABLET 5,665 566,500

SPIRONOLACTON 100 MG ASKES 500 TABLET 950 474,991

SPIRONOLACTON 100 MG ASKES 500 TABLET 1,055 527,478

SPIRONOLACTON 25 MG ASKES 500 TABLET 315 157,597

SPM SPUIT 3 CC BD 600 PCS 2,869 1,721,221

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 90 TABLET 18,700 1,683,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 90 TABLET 18,700 1,683,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 90 TABLET 18,700 1,683,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 90 TABLET 18,700 1,683,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 90 TABLET 18,700 1,683,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 90 TABLET 18,700 1,683,000

SPORETIK 100 MG 150 TABLET 18,700 2,805,000

SPORETIK 100 MG 240 TABLET 18,700 4,488,000

SPORETIK 50 MG 30 TABLET 8,932 267,960

SPORETIK 50 MG 30 TABLET 8,932 267,960

SPORETIK 50 MG 30 TABLET 8,932 267,960

SPORETIK 50 MG 60 TABLET 8,932 535,920

SPORETIK DS 10 BOTOL 77,110 771,100

SPORETIK DS 10 BOTOL 77,110 771,100

SPORETIK DS 10 BOTOL 77,110 771,100

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SPORETIK DS 10 BOTOL 77,110 771,100

SPORETIK DS 10 BOTOL 79,041 790,405

SPORETIK DS 5 BOTOL 79,041 395,203

SPORETIK DS 10 BOTOL 79,041 790,405

SPORETIK DS 6 BOTOL 79,041 474,243

SPORETIK DS 10 BOTOL 79,041 790,405

SPORETIK DS 5 BOTOL 79,041 395,203

SPORETIK DS 10 BOTOL 79,041 790,405

SPORETIK DS 10 BOTOL 79,041 790,405

SPORETIK DS 10 BOTOL 79,041 790,405

SPUIT 1 CC TB STERA ASKES 100 BIJI 650 65,000

SPUIT 1 CC TB STERA ASKES 100 BIJI 650 65,000

SPUIT 1 CC TRM INSULIN 100 BIJI 4,840 484,000

SPUIT 1 CC TRM INSULIN 100 BIJI 4,356 435,600

SPUIT 1 CC TRM INSULIN 100 BIJI 4,356 435,600

SPUIT 1 CC TRM INSULIN 100 BIJI 4,356 435,600

SPUIT 1 CC TRM INSULIN ASKES 100 PCS 4,840 484,000

SPUIT 1 CC TRM INSULIN ASKES 200 PCS 4,356 871,200

SPUIT 1 CC TRM INSULIN ASKES 100 PCS 4,356 435,600

SPUIT 1 CC TRM INSULIN ASKES 100 PCS 4,356 435,600

SPUIT 1 CC TRM INSULIN ASKES 100 PCS 4,356 435,600

SPUIT 1 CC TRM INSULIN ASKES 100 PCS 4,356 435,600

SPUIT 1 CC TRM INSULIN ASKES 200 PCS 4,356 871,200

SPUIT 1 CC TRM TUBERCULIN 100 BIJI 3,960 396,000

SPUIT 1 CC TRM TUBERCULIN 100 BIJI 3,960 396,000

SPUIT 1 CC TRM TUBERCULIN 200 BIJI 3,960 792,000

SPUIT 1 CC TRM TUBERCULIN 100 BIJI 3,960 396,000

SPUIT 1 CC TUBERCULIN ASKES 100 PCS 3,960 396,000

SPUIT 1 CC TUBERCULIN ASKES 100 PCS 4,400 440,000

SPUIT 1 CC TUBERCULIN ASKES 100 PCS 3,960 396,000

SPUIT 1 CC TUBERCULIN ASKES 100 PCS 3,960 396,000

SPUIT 1 CC TUBERCULIN ASKES 200 PCS 3,960 792,000

SPUIT 1 CC TUBERCULIN ASKES 100 PCS 3,960 396,000

SPUIT 1 CC TUBERCULIN ASKES 300 PCS 3,960 1,188,000

SPUIT 1 CC TUBERCULIN ASKES 100 PCS 3,960 396,000

SPUIT 1 CC TUBERCULIN ASKES 200 PCS 3,960 792,000

SPUIT 1 CC TUBERCULIN ASKES 200 PCS 3,960 792,000

SPUIT 10 CC BD 400 BIJI 4,158 1,663,200

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 400 BIJI 4,533 1,813,284

SPUIT 10 CC BD 800 BIJI 4,533 3,626,568

SPUIT 10 CC ONE MED ASKES 800 BIJI 1,931 1,544,400

SPUIT 10 CC ONE MED ASKES 800 BIJI 1,931 1,544,400

SPUIT 10 CC ONE MED ASKES 800 BIJI 1,931 1,544,400

SPUIT 10 CC ONE MED ASKES 800 BIJI 1,931 1,544,400

SPUIT 10 CC ONE MED ASKES 800 BIJI 1,931 1,544,400

SPUIT 10 CC ONE MED ASKES 800 BIJI 1,931 1,544,400

SPUIT 10 CC STERA ASKES 800 PCS 1,017 813,991

SPUIT 10 CC STERA ASKES 800 PCS 925 740,001

SPUIT 10 CC STERA ASKES 800 PCS 925 740,001

Page 123: FORM FA Unit Kerja Penunjang 30815

SPUIT 3 CC BD 800 BIJI 2,624 2,098,800

SPUIT 3 CC BD 800 BIJI 2,624 2,098,800

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 200 BIJI 2,860 572,022

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 1,600 BIJI 2,860 4,576,176

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD 4,000 BIJI 2,860 11,440,440

SPUIT 3 CC BD PAKET 800 BIJI 2,624 2,098,800

SPUIT 3 CC BD PAKET 800 BIJI 2,624 2,098,800

SPUIT 3 CC BD PAKET 800 BIJI 2,860 2,288,088

SPUIT 3 CC BD PAKET 800 BIJI 2,860 2,288,088

SPUIT 3 CC OM ASKES 1,200 PCS 990 1,188,000

SPUIT 3 CC OM ASKES 1,200 PCS 990 1,188,000

SPUIT 3 CC OM ASKES 1,200 PCS 990 1,188,000

SPUIT 3 CC OM ASKES 2,400 PCS 990 2,376,000

SPUIT 3 CC OM ASKES 1,200 PCS 990 1,188,000

SPUIT 3 CC OM ASKES 1,200 PCS 990 1,188,000

SPUIT 3 CC OM ASKES 1,200 PCS 990 1,188,000

SPUIT 3 CC OM ASKES 1,200 PCS 990 1,188,000

SPUIT 3CC STERA ASKES 1,200 BIJI 650 780,001

SPUIT 3CC STERA ASKES 1,200 BIJI 650 780,001

SPUIT 3CC STERA ASKES 1,200 BIJI 650 780,001

SPUIT 3CC STERA ASKES 1,200 BIJI 650 780,001

SPUIT 3CC STERA ASKES 1,200 BIJI 650 780,001

SPUIT 3CC STERA ASKES 1,200 BIJI 650 780,001

SPUIT 3CC STERA ASKES 1,200 BIJI 650 780,001

SPUIT 5 CC BD 400 BIJI 3,267 1,306,800

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 300 BIJI 3,561 1,068,309

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 800 BIJI 3,561 2,848,824

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 400 BIJI 3,561 1,424,412

SPUIT 5 CC BD 800 BIJI 3,561 2,848,824

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,265 1,012,000

Page 124: FORM FA Unit Kerja Penunjang 30815

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC OM ASKES 800 PCS 650 520,001

SPUIT 5 CC OM ASKES 800 PCS 1,139 910,800

SPUIT 5 CC STERA ASKES 1,000 PCS 750 750,002

SPUIT 5 CC STERA ASKES 800 PCS 750 600,002

SPUIT 5 CC STERA ASKES 800 PCS 750 600,002

SPUIT 5 CC STERA ASKES 500 PCS 750 375,001

SPUIT 5 CC STERA ASKES 800 PCS 750 600,002

SPUIT 50 CC ONE MED 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED 40 PCS 7,920 316,800

SPUIT 50 CC ONE MED 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED 40 PCS 7,920 316,800

SPUIT 50 CC ONE MED 20 PCS 8,800 176,000

SPUIT 50 CC ONE MED ASKES 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED ASKES 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED ASKES 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED ASKES 40 PCS 7,920 316,800

SPUIT 50 CC ONE MED ASKES 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED ASKES 20 PCS 7,920 158,400

SPUIT 50 CC ONE MED ASKES 20 PCS 8,800 176,000

SPUIT 50 CC ONE MED ASKES 20 PCS 8,800 176,000

SPUIT 50 CC WIN 25 PCS 6,710 167,750

SPUIT 50 CC WIN ASKES 25 PCS 6,710 167,750

SPUIT 60 CC ONE MED 30 BIJI 10,395 311,850

SPUIT 60 CC ONE MED 30 BIJI 10,395 311,850

SPUIT 60 CC ONE MED 30 BIJI 10,395 311,850

SPUIT 60 CC ONE MED 30 BIJI 10,395 311,850

SPUIT 60 OM ASKES 30 PCS 10,395 311,850

SPUIT 60 OM ASKES 30 PCS 10,395 311,850

SPUIT 60 OM ASKES 30 PCS 10,395 311,850

SPUIT 60 OM ASKES 30 PCS 10,395 311,850

SPUIT ABL PICO 70 1 BOX 3,960,000 3,960,000

STAB KNIFE 15 DEGREE 3 PCS 159,500 478,500

STABIMED PER ML 1,000 MILILITER 871 871,200

STABIMED PER ML 1,000 MILILITER 871 871,200

STABIMED PER ML 2,000 MILILITER 871 1,742,400

STABIMED PER ML 1,000 MILILITER 871 871,200

STABIMED PER ML 2,000 MILILITER 871 1,742,400

STARDINE 60ML 40 BOTOL 18,288 731,500

STARDINE 60ML 40 BOTOL 18,288 731,500

STARDINE 60ML 40 BOTOL 18,288 731,500

STARDINE 60ML 40 BOTOL 18,288 731,500

STATROL 5 FLS 20,075 100,375

Page 125: FORM FA Unit Kerja Penunjang 30815

STATROL 6 FLS 20,075 120,450

STATROL 10 FLS 20,075 200,750

STERACATH 18G ASKES 50 PCS 3,801 190,025

STERACATH 20 G 100 PCS 3,801 380,050

STERACATH 20 G ASKES 100 PCS 10,890 1,089,000

STESOLID 10 MG SUPPOS 25 35,640 891,000

STESOLID 5 MG SUPPOS 25 23,760 594,000

STESOLID INJ 250 AMPUL 11,440 2,860,000

STESOLID INJ ASKES 250 AMPUL 4,001 1,000,142

STESOLID INJ ASKES 250 AMPUL 4,001 1,000,142

STESOLID INJ ASKES 45 AMPUL 4,001 180,026

STOMACH TUBE 12 6 BIJI 19,899 119,394

STOMACH TUBE 12 TRM ASKES 6 PCS 22,110 132,660

STOMACH TUBE 12 TRM ASKES 10 PCS 19,899 198,990

STOMACH TUBE 16 10 BIJI 17,820 178,200

STOMACH TUBE 16 10 BIJI 19,800 198,000

STOMACH TUBE 16 10 BIJI 19,800 198,000

STOMACH TUBE 16 20 BIJI 17,820 356,400

STOMACH TUBE 16 10 BIJI 19,899 198,990

STOMACH TUBE 16 10 BIJI 19,899 198,990

STOMACH TUBE 16 20 BIJI 19,899 397,980

STOMACH TUBE 16 10 BIJI 19,899 198,990

STOMACH TUBE 16 10 BIJI 19,899 198,990

STOMACH TUBE 16 10 BIJI 19,899 198,990

STOMACH TUBE 16 10 BIJI 19,899 198,990

STOMACH TUBE 16 20 BIJI 19,899 397,980

STOMACH TUBE 16 10 BIJI 19,899 198,990

STOMACH TUBE 16 TRM ASKES 10 PCS 17,820 178,200

STOMACH TUBE 16 TRM ASKES 10 PCS 17,820 178,200

STOMACH TUBE 16 TRM ASKES 10 PCS 19,800 198,000

STOMACH TUBE 16 TRM ASKES 10 PCS 19,800 198,000

STOMACH TUBE 16 TRM ASKES 10 PCS 22,110 221,100

STOMACH TUBE 16 TRM ASKES 10 PCS 19,899 198,990

STOMACH TUBE 16 TRM ASKES 10 PCS 19,899 198,990

STOMACH TUBE 16 TRM ASKES 20 PCS 19,899 397,980

STOMACH TUBE 16 TRM ASKES 10 PCS 19,899 198,990

STOMACH TUBE 16 TRM ASKES 20 PCS 19,899 397,980

STOMACH TUBE 16 TRM ASKES 10 PCS 19,899 198,990

STOMACH TUBE 16 TRM ASKES 10 PCS 19,899 198,990

STOMACH TUBE 16 TRM ASKES 10 PCS 19,899 198,990

STOMACH TUBE 18 10 BIJI 19,899 198,990

STOMACH TUBE 18 TRM ASKES 10 PCS 17,820 178,200

STOMACH TUBE 18 TRM ASKES 10 PCS 19,899 198,990

STROMATOLYSER 4 DL PAKET 1 BOTOL 3,158,375 3,158,375

STROMATOLYSER 4 DL PAKET 1 BOTOL 3,158,375 3,158,375

STROMATOLYSER 4 DL PAKET 2 BOTOL 3,158,375 6,316,750

STROMATOLYSER 4 DL PAKET 1 BOTOL 3,158,375 3,158,375

STROMATOLYSER 4 DL PAKET 1 BOTOL 3,158,375 3,158,375

STROMATOLYSER 4 DL PAKET 1 BOTOL 3,158,375 3,158,375

STROMATOLYSER 4 DL PAKET 1 BOTOL 3,158,375 3,158,375

STROMATOLYSER 4 DL PAKET 1 BOTOL 3,158,375 3,158,375

STROMATOLYSER 4 DS PAKET 1 SACHET 2,953,500 2,953,500

STROMATOLYSER 4 DS PAKET 2 SACHET 2,953,500 5,907,000

STROMATOLYSER 4 DS PAKET 1 SACHET 2,953,500 2,953,500

STROMATOLYSER 4 DS PAKET 1 SACHET 2,953,500 2,953,500

STROMATOLYSER 4 DS PAKET 1 SACHET 2,953,500 2,953,500

SUPPOSITORIA

SUPPOSITORIA

Page 126: FORM FA Unit Kerja Penunjang 30815

STROMATOLYSER 4 DS PAKET 1 SACHET 2,953,500 2,953,500

SUCTION CATH + FINGER 10 ASKES 10 PCS 4,059 40,590

SUCTION CATH WITH CONTROL 10 30 PCS 7,810 234,300

SUCTION CATH WITH CONTROL 10 30 PCS 7,810 234,300

SUCTION CATH WITH CONTROL 10 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 10 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 10 20 PCS 7,810 156,200

30 PCS 6,710 201,300

30 PCS 6,710 201,300

30 PCS 7,810 234,300

30 PCS 7,810 234,300

30 PCS 7,810 234,300

30 PCS 7,810 234,300

30 PCS 7,810 234,300

30 PCS 7,810 234,300

30 PCS 7,810 234,300

20 PCS 7,810 156,200

20 PCS 7,810 156,200

30 PCS 7,810 234,300

SUCTION CATH WITH CONTROL 8 30 PCS 7,810 234,300

SUCTION CATH WITH CONTROL 8 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 8 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 8 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 8 ASK 30 PCS 6,710 201,300

SUCTION CATH WITH CONTROL 8 ASK 50 PCS 7,810 390,500

SUCTION CATH WITH CONTROL 8 ASK 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 8 ASK 30 PCS 7,810 234,300

SUCTION CATH WITH CONTROL 8 ASK 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 8 ASK 30 PCS 7,810 234,300

SUCTION CATH WITH CONTROL 8 ASK 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 8 ASK 20 PCS 7,810 156,200

SUCTION CATH WITH CONTROL 8 ASK 50 PCS 7,810 390,500

SULFOLYSER PAKET 1 BOTOL 772,338 772,338

SULFOLYSER PAKET 1 BOTOL 772,338 772,338

SULFOLYSER PAKET 2 BOTOL 772,338 1,544,675

SULFOLYSER PAKET 1 BOTOL 772,338 772,338

SULFOLYSER PAKET 1 BOTOL 772,338 772,338

SULFOLYSER PAKET 1 BOTOL 772,338 772,338

SULFOLYSER PAKET 1 BOTOL 772,338 772,338

SUPRASORB A 6 PCS 67,925 407,550

SUPRASORB A 10 PCS 67,925 679,250

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

SUCTION CATH WITH CONTROL 10 ASKES

Page 127: FORM FA Unit Kerja Penunjang 30815

SUPRASORB A 6 PCS 67,925 407,550

SUPRASORB A 6 PCS 67,925 407,550

SUPRASORB A 10 PCS 67,925 679,250

SUPRASORB G 3 PCS 99,275 297,825

SUPRASORB G 5 PCS 104,500 522,500

SUPRASORB H STANDART 10X10 6 PCS 62,700 376,200

SURG MONOFILAMEN 3/0 REG 12 PCS 108,350 1,300,200

SURG MONOFILAMEN 4/0 REG 12 PCS 104,500 1,254,000

SURGEON CAP 300 PCS 772 231,660

SURGEON CAP 300 PCS 772 231,660

SURGEON CAP 300 PCS 772 231,660

SURGEON CAP 300 PCS 772 231,660

SURGICRYL 1 REG 12 PCS 86,350 1,036,200

SURGICRYL 1 REG 12 PCS 86,350 1,036,200

SURGICRYL 1 REG 24 PCS 86,350 2,072,400

SURGICRYL 1 REG 12 PCS 86,350 1,036,200

SURGICRYL 1 REG 12 PCS 101,200 1,214,400

SURGICRYL 1 REG 24 PCS 86,350 2,072,400

SURGICRYL 1 REG 12 PCS 86,350 1,036,200

SURGICRYL 1 REG 24 PCS 86,350 2,072,400

SURGICRYL 1 REG 12 PCS 86,350 1,036,200

SURGICRYL 1 REG 12 PCS 86,350 1,036,200

SURGICRYL 2/0 REG 12 PCS 78,100 937,200

SURGICRYL 2/0 REG 12 PCS 78,100 937,200

SURGICRYL 2/0 REG 12 PCS 78,100 937,200

SURGICRYL 4/0 REG 12 PCS 79,200 950,400

SURGIPEN 2,35 MM 508 L-3 REG 50 TEST 26,125 1,306,250

SURGIPEN 2,35 MM 508 L-3 REG 50 TEST 26,125 1,306,250

3 PCS 302,500 907,500

21 PCS 297,000 6,237,000

23 PCS 302,500 6,957,500

SYSMUCO TAB 60 TABLET 3,300 198,000

TABUNG CENTRIFUGE PLASTIK 40 PCS 8,250 330,000

TAMOFEN 20 MG ASKES 150 TABLET 2,100 314,985

TAMOXIFEN 20 MG ASKES 420 TABLET 2,102 883,039

TAPROZ INJ 1 VIAL 1,105,000 1,105,000

TAPROZ INJ 1 VIAL 1,104,959 1,104,959

TARIVID OTIC SOL 10 FLS 74,800 748,000

TARIVID OTIC SOL 5 FLS 74,800 374,000

TARIVID OTIC SOL 10 FLS 74,800 748,000

TARIVID OTIC SOL 10 FLS 74,800 748,000

TARIVID OTIC SOL 6 FLS 74,800 448,800

TARIVID OTIC SOL 10 FLS 74,800 748,000

TARIVID OTIC SOL 10 FLS 74,800 748,000

TARIVID OTIC SOL 10 FLS 74,800 748,000

TARIVID OTIC SOL 10 FLS 74,800 748,000

TARIVID OTIC SOL 20 FLS 74,800 1,496,000

TARIVID OTIC SOL 10 FLS 74,800 748,000

TAXEGRAM 5 AMPUL 135,273 676,363

TAXEGRAM 5 AMPUL 135,273 676,363

TAXEGRAM 5 AMPUL 135,273 676,363

TEBOKAN SPESIAL 60 TABLET 11,715 702,900

TEBOKAN SPESIAL 60 TABLET 11,715 702,900

TENCELL CUVETTE REG 10,800 PCS 750 8,095,982

TENCELL CUVETTE REG 10,800 PCS 750 8,095,982

SURVISC( SODIUM HYALURONATE 1 ML )

SURVISC( SODIUM HYALURONATE 1 ML )

SURVISC( SODIUM HYALURONATE 1 ML )

Page 128: FORM FA Unit Kerja Penunjang 30815

TENCELL CUVETTE REG 10,800 PCS 750 8,095,982

TENCELL CUVETTES PAKET 1 KIT 8,096,000 8,096,000

TENCELL CUVETTES PAKET 1 KIT 8,096,000 8,096,000

TENSI DIG HEM-7111 OMRON 1 PCS 375,001 375,001

TENSILO INJ ASK 3 VIAL 134,992 404,976

TENSOCREPE 4 ASKES 6 ROL 66,300 397,802

TENSOCREPE 4 ASKES 6 ROL 66,300 397,802

TENSOCREPE 4 ASKES 6 ROL 66,300 397,802

TENSOCREPE 4 ASKES 6 ROL 66,300 397,802

TENSOCREPE 4 ASKES 6 ROL 66,300 397,802

TENSOCREPE 4 ASKES 6 ROL 66,300 397,802

TENSOCREPE 4 ASKES 6 ROL 66,300 397,802

TENSOCREPE 4 ASKES 6 ROL 66,300 397,802

TENSOCREPE 4 ASKES 12 ROL 67,650 811,800

TENSOCREPE 4" 6 BIJI 66,300 397,802

TENSOCREPE 4" 6 BIJI 66,300 397,802

TENSOCREPE 4" 6 BIJI 66,300 397,802

TENSOCREPE 4" 6 BIJI 66,300 397,802

TENSOCREPE 4" 6 BIJI 66,300 397,802

TENSOCREPE 4" 6 BIJI 66,300 397,802

TENSOCREPE 4" 6 BIJI 66,300 397,802

TENSOCREPE 4" 6 BIJI 66,300 397,802

TENSOCREPE 4" 6 BIJI 66,297 397,782

TENSOCREPE 4" 6 BIJI 67,650 405,900

TENSOCREPE 4" 6 BIJI 67,650 405,900

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 87,077 522,463

TENSOCREPE 6 ASKES 6 BIJI 88,825 532,950

TENSOCREPE 6" 6 BIJI 87,077 522,463

TENSOCREPE 6" 6 BIJI 87,077 522,463

TENSOCREPE 6" 6 BIJI 87,077 522,463

TENSOCREPE 6" 6 BIJI 87,077 522,463

TENSOCREPE 6" 6 BIJI 87,077 522,463

TENSOCREPE 6" 6 BIJI 87,077 522,463

TENSOCREPE 6" 12 BIJI 87,077 1,044,925

TENSOCREPE 6" 12 BIJI 88,825 1,065,900

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

Page 129: FORM FA Unit Kerja Penunjang 30815

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 15 AMPUL 199,953 2,999,288

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 28 AMPUL 199,953 5,598,670

TERFACEF 84 AMPUL 199,953 16,796,010

TERREL 1 ML 500 MILILITER 6,160 3,080,000

TERREL 1 ML 250 MILILITER 6,160 1,540,000

TERREL 1 ML 500 MILILITER 6,160 3,080,000

TETAGAM INJ ASKES 24 VIAL 174,992 4,199,818

TETAGAM INJ ASKES 12 VIAL 174,992 2,099,909

TETAGAM INJ ASKES 24 VIAL 174,992 4,199,818

TETAGAM INJ ASKES 12 VIAL 174,992 2,099,909

TETAGAM INJ ASKES 12 VIAL 174,992 2,099,909

TETAGAM INJ ASKES 24 VIAL 174,992 4,199,818

TETAGAM INJ ASKES 30 VIAL 174,992 5,249,772

TETAGAM INJ ASKES 24 VIAL 174,992 4,199,818

TETAGAM INJ ASKES 24 VIAL 174,992 4,199,818

TETAGAM INJ ASKES 24 VIAL 170,000 4,080,000

TETAGAM INJ ASKES 12 VIAL 170,000 2,040,000

TETAGAM INJ ASKES 2 VIAL 174,993 349,985

TETAGAM INJ ASKES 22 VIAL 174,992 3,849,833

TGF TAB 54 TABLET 5,821 314,325

TGF TAB 90 TABLET 5,821 523,875

TGF TAB 90 TABLET 5,821 523,875

TGF TAB 180 TABLET 5,821 1,047,749

THIAMIN TAB 2,000 TABLET 51 101,200

THIAMPHENICOL 500 ASKES 200 TABLET 565 113,098

1 PCS 340,010 340,010

1 PCS 340,010 340,010

1 PCS 340,010 340,010

THORACIC CATH MALINCKRODT 32 2 PCS 193,050 386,100

THORACIC CHAT MALINCRODT 28 2 PCS 193,050 386,100

THYROZOL 5 MG ASKES 300 TABLET 563 168,901

TIMOL 0,25% 6 FLS 33,550 201,300

TIMOL 0,5% 20 FLS 52,525 1,050,500

TIMOL 0,5% 10 FLS 52,525 525,250

TIMOL 0,5% 15 FLS 52,525 787,875

TIMOL 0,5% 20 FLS 48,848 976,965

TIMOL 0,5% 20 FLS 52,525 1,050,500

TIP CLEANER PAKET 6 PCS 36,575 219,450

TIRIZ DROP 9 BOTOL 55,000 495,000

TIRIZ DROP 10 BOTOL 55,000 550,000

TOBROSON ED 5 ML 10 FLS 39,050 390,500

TOBROSON ED 5 ML 20 FLS 39,050 781,000

TOBROSON ED 5 ML 10 FLS 50,875 508,750

TOBROSON ED 5 ML 10 FLS 50,875 508,750

TOBROSON ED 5 ML 10 FLS 50,875 508,750

TOBROSON ED 5 ML 20 FLS 50,875 1,017,500

TOBROSON ED 5 ML 20 FLS 50,875 1,017,500

TOBROSON ED 5 ML 10 FLS 50,875 508,750

TOBROSON ED 5 ML 20 FLS 50,875 1,017,500

THICK ONE THIRD TUBULAR PLATE 6 HOLE

THICK ONE THIRD TUBULAR PLATE 6 HOLE

THICK ONE THIRD TUBULAR PLATE 6 HOLE

Page 130: FORM FA Unit Kerja Penunjang 30815

TOBROSON ED 5 ML 10 FLS 50,875 508,750

TOBROSON MD 20 FLS 24,475 489,500

TOBROSON MD 20 FLS 24,475 489,500

TOBROSON MD 20 FLS 24,475 489,500

TOBROSON MD 20 FLS 31,900 638,000

TOBROSON MD 20 FLS 31,900 638,000

TOBROSON MD 20 FLS 31,900 638,000

TOBROSON MD 20 FLS 31,900 638,000

TOBROSON MD 10 FLS 31,900 319,000

TOBROSON MD 20 FLS 31,900 638,000

TOBROSON MD 20 FLS 31,900 638,000

TOBROSON MD 20 FLS 31,900 638,000

TOBROSON MD 20 FLS 31,900 638,000

TOFEDEX INJEKSI 25 AMPUL 42,900 1,072,500

TOFEDEX INJEKSI 15 AMPUL 42,900 643,500

TOFEDEX TAB 30 TABLET 5,720 171,600

TOFEDEX TAB 60 TABLET 5,720 343,200

TOFEDEX TAB 60 TABLET 5,720 343,200

TOFEDEX TAB 90 TABLET 5,720 514,800

TOFEDEX TAB 60 TABLET 5,720 343,200

TOFEDEX TAB 30 TABLET 5,720 171,600

TOFEDEX TAB 30 TABLET 5,720 171,600

TOFEDEX TAB 60 TABLET 5,720 343,200

TOFEDEX TAB 120 TABLET 5,720 686,400

TOMIT INJ 100 AMPUL 7,733 773,300

TOMIT INJ 50 AMPUL 7,733 386,650

TOMIT INJ 50 AMPUL 7,530 376,475

TOMIT INJ 50 AMPUL 7,530 376,475

TOMIT INJ 50 AMPUL 7,733 386,650

TOMIT INJ 100 AMPUL 7,530 752,950

TOMIT INJ 100 AMPUL 7,530 752,950

TONGUE SPATEL PAKET 5 PACK 14,355 71,775

TONGUE SPATEL PAKET 15 PACK 14,355 215,325

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 15 VIAL 126,500 1,897,500

TOPAZOL INJ 15 VIAL 126,500 1,897,500

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 15 VIAL 126,500 1,897,500

TOPAZOL INJ 5 VIAL 126,500 632,500

TOPAZOL INJ 5 VIAL 126,500 632,500

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 10 VIAL 126,500 1,265,000

TOPAZOL INJ 5 VIAL 126,500 632,500

TOPAZOL INJ 5 VIAL 126,500 632,500

TOPAZOL INJ 10 VIAL 137,500 1,375,000

TOPAZOL INJ 10 VIAL 137,500 1,375,000

TOPAZOL INJ 20 VIAL 137,500 2,750,000

TOTAL PROTEIN PLUS 12X20 PAKET 1 KIT 2,530,000 2,530,000

TRACHEOSTOMY TUBE NO 7 RUSCH 2 BIJI 238,700 477,400

TRACHEOSTOMY TUBE NO 7,5 RUSCH 2 PCS 238,700 477,400

TRADOSIK INJ 30 AMPUL 14,872 446,160

TRADOSIK INJ 50 AMPUL 14,872 743,600

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TRADOSIK INJ 30 AMPUL 15,246 457,380

TRADOSIK INJ 50 AMPUL 15,246 762,300

TRADOSIK INJ 50 AMPUL 15,246 762,300

TRADOSIK INJ 30 AMPUL 15,246 457,380

TRADOSIK INJ 50 AMPUL 15,246 762,300

TRADOSIK INJ 100 AMPUL 15,246 1,524,600

TRAMADOL 100 TABLET 322 32,199

TRAMADOL 50 TABLET 322 16,100

TRAMADOL INJ ASKES 120 AMPUL 5,200 624,041

TRAMADOL INJ ASKES 100 AMPUL 5,200 520,022

TRAMADOL INJ ASKES 200 AMPUL 2,395 479,006

TRAMADOL INJ ASKES 200 AMPUL 2,395 479,006

TRAMADOL INJEKSI 50 AMPUL 5,762 288,090

TRAMADOL INJEKSI 50 AMPUL 6,402 320,100

TRAMADOL INJEKSI 25 AMPUL 6,076 151,896

TRAMADOL TAB ASKES 100 TABLET 321 32,143

TRAMADOL TAB ASKES 500 TABLET 235 117,502

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 50 PCS 29,700 1,485,000

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREE WAY STOPCOCK JMS ASKES 25 PCS 29,700 742,500

TREEWAY STOPCOCK JMS 25 BIJI 29,700 742,500

TREEWAY STOPCOCK JMS 50 BIJI 29,700 1,485,000

TREEWAY STOPCOCK JMS 25 BIJI 29,700 742,500

TREEWAY STOPCOCK JMS 25 BIJI 29,700 742,500

TREEWAY STOPCOCK JMS 25 BIJI 29,700 742,500

TREEWAY STOPCOCK JMS 25 BIJI 29,700 742,500

TREEWAY STOPCOCK JMS 25 BIJI 29,700 742,500

TREEWAY STOPCOCK JMS 25 BIJI 29,700 742,500

TREEWAY STOPCOCK JMS 25 BIJI 29,700 742,500

TREMENZA 300 TABLET 1,073 321,750

TREMENZA 300 TABLET 1,073 321,750

TREMENZA 300 TABLET 1,073 321,750

TREMENZA 300 TABLET 1,073 321,750

TREMENZA 500 TABLET 1,073 536,250

TREMENZA 300 TABLET 1,073 321,750

TREMENZA SYR 6 BOTOL 15,477 92,862

TREMENZA SYR 10 BOTOL 15,477 154,770

TREMENZA SYR 15 BOTOL 15,477 232,155

TREMENZA SYR 10 BOTOL 15,477 154,770

TREMENZA SYR 15 BOTOL 15,477 232,155

TRIATIMOL 0,5 % ASKES 40 PCS 23,300 932,008

TRIATIMOL 0,5 % ASKES 50 PCS 23,300 1,165,010

TRIATIMOL 0,5 % ASKES 50 PCS 23,300 1,165,000

TRIATIMOL 0,5 % ASKES 50 PCS 23,300 1,165,000

TRIAXITROL ED ASKES 114 FLS 10,500 1,196,943

TRIAXITROL ED ASKES 100 FLS 10,500 1,049,950

TRIAXITROL ED ASKES 100 FLS 10,500 1,050,000

TRIAXITROL ED ASKES 100 FLS 10,500 1,050,000

TRIAXITROL ED ASKES 50 FLS 10,500 525,000

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TRICHODAZOL 500 MG 100 TABLET 1,502 150,150

TRICHODAZOL 500 MG 100 TABLET 1,502 150,150

TRICHODAZOL 500 MG 100 TABLET 1,540 154,000

TRICHODAZOL 500 MG 100 TABLET 1,540 154,000

TRICHODAZOL 500 MG 100 TABLET 1,540 154,000

TRICHODAZOL INF 20 FLS 82,445 1,648,900

TRICHODAZOL INF 20 FLS 84,508 1,690,150

TRICHODAZOL INF 15 FLS 84,508 1,267,613

TRICHODAZOL INF 10 FLS 84,508 845,075

TRICHODAZOL INF 20 FLS 84,508 1,690,150

TRICHODAZOL INF 30 FLS 84,508 2,535,225

TRICHODAZOL SUPP 18 17,771 319,869

TRICHODAZOL SUPP 12 17,771 213,246

TRIDEX 100 10 FLS 17,947 179,473

TRIDEX 27B 24 BOTOL 16,503 396,066

TRIDEX 27B 48 BOTOL 16,503 792,132

TRIDEX 27B 48 BOTOL 16,503 792,132

TRIDEX 27B 24 BOTOL 16,503 396,066

TRIDEX 27B 24 BOTOL 16,503 396,066

TRIDEX 27B 72 BOTOL 16,503 1,188,198

TRIDEX 27B 24 BOTOL 16,503 396,066

TRIDEX 27B 48 BOTOL 16,503 792,132

TRIDEX 27B 48 BOTOL 16,503 792,132

TRIDEX 27B 24 BOTOL 16,503 396,066

TRIDEX 27B 72 BOTOL 16,503 1,188,198

TRIDEX 27B 48 BOTOL 16,503 792,132

TRIDEX 27B 96 BOTOL 16,503 1,584,264

TRIDEX 27B 48 BOTOL 16,503 792,132

TRIGLYCERIDES 12X20 ML PAKET 1 BOX 5,280,000 5,280,000

TRIGLYCERIDES 12X20 ML PAKET 1 BOX 5,280,000 5,280,000

TRIGLYCERIDES 12X20 ML PAKET 1 BOX 5,280,000 5,280,000

TRILAC INJ 2 VIAL 91,630 183,260

TRILAC INJ 2 VIAL 91,630 183,260

TRILAC INJ 2 VIAL 97,020 194,040

TRILAC INJ 2 VIAL 97,020 194,040

TROCHANTER PLATE 15 HOLE 1 PCS 2,574,000 2,574,000

TROLIP 100 MG ASKES 300 TABLET 2,000 599,930

TROVENSIS 4 MG TAB 20 TABLET 11,275 225,500

TROVENSIS 4 MG TAB 30 TABLET 11,561 346,830

TROVENSIS 4 MG TAB 30 TABLET 11,561 346,830

TROVENSIS 4 MG TAB 100 TABLET 11,561 1,156,100

TROVENSIS 8 MG INJ 25 AMPUL 65,159 1,628,963

TROVENSIS 8 MG INJ 25 AMPUL 65,159 1,628,963

TROVENSIS 8 MG INJ 25 AMPUL 65,159 1,628,963

TROVENSIS 8 MG INJ 50 AMPUL 65,159 3,257,925

TROVENSIS 8MG 30 TABLET 16,319 489,555

TROVENSIS 8MG 30 TABLET 16,319 489,555

TROVENSIS 8MG 50 TABLET 16,319 815,925

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 25 AMPUL 31,988 799,700

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 100 AMPUL 31,988 3,198,800

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 25 AMPUL 31,988 799,700

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

SUPPOSITORIA

SUPPOSITORIA

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TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 100 AMPUL 31,988 3,198,800

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 100 AMPUL 31,988 3,198,800

TROVENSIS INJ 4 ML 100 AMPUL 31,988 3,198,800

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 50 AMPUL 31,988 1,599,400

TROVENSIS INJ 4 ML 100 AMPUL 31,988 3,198,800

TROVENSIS INJ 4 ML 100 AMPUL 31,988 3,198,800

TROVENSIS INJ 4 ML 255 AMPUL 31,988 8,156,940

TS SWEET DIABIX 150S 3 PACK 75,900 227,700

TS SWEET DIABIX 150S 5 PACK 75,900 379,500

TS SWEET DIABIX 25S 5 BOX 18,700 93,500

TS SWEET DIABIX 50S 3 BOX 33,000 99,000

TUBE POLYURETHANE 1,8 MM X 3,4 MM 1 PACK 331,540 331,540

TUBE TEFLON 1,0 MMID X 2,0 MMOD 1 PACK 1,868,570 1,868,570

TUZALOS 300 TABLET 688 206,250

TYARIT INJ 25 VIAL 24,750 618,750

TYARIT INJ ASKES 10 AMPUL 16,501 165,008

UDOPA INJ ASKES 50 AMPUL 12,320 616,000

ULCORI MD 20 BIJI 21,588 431,750

ULCORI MD 10 BIJI 21,588 215,875

ULCORI MD 20 BIJI 21,588 431,750

ULCORI MD 20 BIJI 21,588 431,750

ULCORI MD 20 BIJI 21,588 431,750

ULCORI MD 20 BIJI 21,588 431,750

ULCORI MD 40 BIJI 21,588 863,500

ULSAFATE SYRUP ASKES 10 BOTOL 13,424 134,244

ULTRAFIX 1X5 50 BIJI 3,366 168,300

ULTRAFIX 1X5 50 BIJI 3,366 168,300

ULTRAFIX 1X5 30 BIJI 3,366 100,980

ULTRAFIX 1X5 30 BIJI 3,366 100,980

ULTRAFIX 1X5 50 BIJI 3,366 168,300

ULTRAFIX 5X1 ASKES 200 PCS 3,366 673,200

ULTRAFIX 5X1 ASKES 100 PCS 3,366 336,600

ULTRAFIX 5X1 ASKES 100 PCS 3,366 336,600

ULTRAFIX 5X1 ASKES 100 PCS 3,366 336,600

ULTRAFIX 5X1 ASKES 100 PCS 3,366 336,600

ULTRAFIX 5X1 ASKES 100 PCS 3,366 336,600

ULTRAFIX 5X1 ASKES 100 PCS 3,366 336,600

ULTRAFIX 5X1 ASKES 100 PCS 3,366 336,600

ULTRAFIX 5X1 ASKES 200 PCS 3,366 673,200

ULTRAFIX 5X1 ASKES 100 PCS 3,366 336,600

ULTRASONIC GEL PAKET 6 PCS 27,500 165,000

ULTRASONIC GEL PAKET 6 PCS 24,750 148,500

ULTRASONIC GEL PAKET 6 PCS 24,750 148,500

ULTRASONIC GEL PAKET 6 PCS 24,750 148,500

ULTRASONIC GEL PAKET 5 PCS 24,750 123,750

ULTRASONIC GEL PAKET 10 PCS 24,750 247,500

ULTRASONIC GEL PAKET 6 PCS 26,730 160,380

ULTRASONIC GEL PAKET 12 PCS 26,730 320,760

ULTRASONIC GEL PAKET 12 PCS 24,750 297,000

UMBILICAL CLAM OM ASKES 50 PCS 2,475 123,750

UMBILICAL CLAM OM ASKES 50 PCS 2,475 123,750

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UMBILICAL CLAM OM ASKES 50 PCS 2,475 123,750

UMBILICAL CLAM OM ASKES 50 PCS 2,475 123,750

UMBILICAL CLAM OM ASKES 50 PCS 1,000 49,995

UMBILICAL CLAM OM ASKES 50 PCS 2,750 137,500

UMBILICAL CLAM OM ASKES 50 PCS 1,000 49,995

UMBILICAL CORD CLAM ONE MED 100 BIJI 2,475 247,500

UMBILICAL CORD CLAM ONE MED 50 BIJI 2,475 123,750

UMBILICAL CORD CLAM ONE MED 50 BIJI 2,475 123,750

UMBILICAL CORD CLAM ONE MED 50 BIJI 2,750 137,500

UNDER PAD SENSI PADS 300 PCS 3,333 999,900

UNDER PAD SENSI PADS 50 PCS 6,325 316,250

UNDER PAD SENSI PADS 100 PCS 6,325 632,500

UNDER PAD SENSI PADS 200 PCS 6,325 1,265,000

UNDER PAD SENSI PADS 100 PCS 6,325 632,500

UNDER PAD SENSI PADS 100 PCS 7,590 759,000

UNDER PAD SENSI PADS 150 PCS 6,325 948,750

UNDER PAD SENSI PADS 100 PCS 6,325 632,500

UNDER PAD SENSI PADS 100 PCS 6,325 632,500

UNDER PAD SENSI PADS 150 PCS 6,325 948,750

UNDER PAD SENSI PADS 150 PCS 6,325 948,750

UNDER PAD SENSI PADS 100 PCS 6,325 632,500

UNDER PAD SENSIPAD ASKES 300 PCS 3,333 999,900

UNDER PAD SENSIPAD ASKES 100 PCS 6,325 632,500

UNDER PAD SENSIPAD ASKES 100 PCS 6,325 632,500

UNDER PAD SENSIPAD ASKES 100 PCS 7,590 759,000

UNDER PAD SENSIPAD ASKES 150 PCS 6,325 948,750

UNDER PAD SENSIPAD ASKES 100 PCS 6,325 632,500

UNDER PAD SENSIPAD ASKES 100 PCS 6,325 632,500

UNDER PAD SENSIPAD ASKES 150 PCS 6,325 948,750

UNDER PAD U-PAD ONE MED 100 PCS 6,325 632,500

UNDER PED OM ASKES 100 PCS 4,950 495,000

UNDER PED OM ASKES 100 PCS 4,950 495,000

UNDER PED OM ASKES 100 PCS 4,950 495,000

UNDER PED OM ASKES 150 PCS 4,950 742,507

UNDER PED OM ASKES 150 PCS 6,325 948,750

UNDER PED OM ASKES 150 PCS 6,325 948,750

UNDER PED OM ASKES 100 PCS 6,325 632,500

UNDER PED OM ASKES 100 PCS 6,325 632,500

UNDER PED OM ASKES 100 PCS 6,325 632,500

UNDER PED OM ASKES 100 PCS 6,325 632,500

UREA 12X20 ML PAKET 1 KIT 4,070,000 4,070,000

UREA 12X20 ML PAKET 1 KIT 4,070,000 4,070,000

UREA 12X20 ML PAKET 1 KIT 4,070,000 4,070,000

UREA 12X20 ML PAKET 1 KIT 4,070,000 4,070,000

UREA COLOR 1X100 ML PAKET 1 KIT 561,000 561,000

URESIX 100 TABLET 798 79,750

URESIX INJ 50 AMPUL 7,706 385,275

URESIX INJ 50 AMPUL 7,706 385,275

URESIX INJ 50 AMPUL 7,706 385,275

URESIX INJ 50 AMPUL 7,706 385,275

URESIX INJ 50 AMPUL 7,898 394,900

URESIX INJ 50 AMPUL 7,898 394,900

URESIX INJ 50 AMPUL 7,898 394,900

URESIX INJ 50 AMPUL 7,898 394,900

URESIX INJ 50 AMPUL 7,898 394,900

URESIX INJ 50 AMPUL 7,898 394,900

URIC ACID (AOX) 8X20 ML 1 BOX 3,630,000 3,630,000

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URIC ACID (AOX) 8X20 ML 1 BOX 3,630,000 3,630,000

URINALYSIS 10 SG INSIGHT EXPERT 5 TUBE 385,000 1,925,000

URINALYSIS 10 SG INSIGHT EXPERT 5 TUBE 481,800 2,409,000

URINALYSIS 10 SG INSIGHT EXPERT 5 TUBE 481,800 2,409,000

URINALYSIS 10 SG INSIGHT EXPERT 5 TUBE 481,800 2,409,000

URINE 3-P FERIFY PAKET 500 STRIP 1,188 594,000

URINE BAG OM 100 PCS 3,000 299,970

URINE BAG OM 100 PCS 3,000 299,970

URINE BAG OM 100 PCS 3,000 299,970

URINE BAG OM ASKES 100 PCS 4,455 445,500

URINE BAG OM ASKES 150 PCS 4,455 668,250

URINE BAG OM ASKES 100 PCS 4,455 445,500

URINE BAG OM ASKES 100 PCS 4,455 445,500

URINE BAG OM ASKES 100 PCS 3,000 299,970

URINE BAG OM ASKES 100 PCS 3,000 299,970

URINE BAG OM ASKES 100 PCS 3,000 299,970

URINE BAG ONE MED 150 BIJI 4,455 668,250

URINE BAG ONE MED 100 BIJI 4,455 445,500

URINE BAG ONE MED 150 BIJI 4,455 668,250

UROTRACTIN 120 TABLET 2,981 357,720

UTROGESTAN 100 MG 60 TABLET 6,930 415,800

VACUM EDTA 3 ML IHS 1,000 TABUNG 1,870 1,870,000

VACUM EDTA 3 ML IHS 1,200 TABUNG 1,870 2,244,000

VACUM EDTA 3 ML IHS 1,200 TABUNG 1,870 2,244,000

VACUM EDTA 3 ML IHS 900 TABUNG 1,870 1,683,000

VACUM EDTA 3 ML REG 500 TABUNG 3,300 1,650,000

VACUM EDTA 3 ML REG 500 TABUNG 3,300 1,650,000

VACUM EDTA 3 ML REG 1,000 TABUNG 3,300 3,300,000

VACUM KIMIA KLINIK 4 ML REG 500 TABUNG 3,014 1,507,000

VACUM KIMIA KLINIK 4 ML REG 1,000 TABUNG 3,014 3,014,000

VACUM KIMIA KLINIK 4 ML REG 1,000 TABUNG 3,014 3,014,000

VACUM NA CITRAT 2,7 ML REG 100 TABUNG 3,619 361,900

VACUM TUBE 4 ML PAKET 5 BOX 301,400 1,507,000

VACUM TUBE 4 ML PAKET 5 BOX 301,400 1,507,000

VACUM TUBE 4 ML PAKET 10 BOX 301,400 3,014,000

VACUM TUBE K3EDTA 3 ML PAKET 5 BOX 231,000 1,155,000

VACUM TUBE K3EDTA 3 ML PAKET 10 BOX 330,000 3,300,000

VACUM TUBE K3EDTA 3 ML PAKET 10 BOX 330,000 3,300,000

VACUM TUBE K3EDTA 3 ML PAKET 5 BOX 330,000 1,650,000

VACUM TUBE K3EDTA 3 ML PAKET 10 BOX 330,000 3,300,000

VALAMIN INF 5 BOTOL 55,347 276,737

VALAMIN INF 6 BOTOL 55,347 332,084

VALAMIN INF 5 BOTOL 55,347 276,737

VALAMIN INF 6 BOTOL 55,347 332,084

VALAMIN INF 5 BOTOL 55,347 276,737

VALEMIA 10 MG 60 TABLET 8,690 521,400

VALEMIA 10 MG 90 TABLET 8,690 782,100

VALEMIA 10 MG 60 TABLET 8,690 521,400

VALEMIA 10 MG 60 TABLET 8,690 521,400

VALEMIA 10 MG 60 TABLET 8,690 521,400

VALEMIA 10 MG 30 TABLET 8,690 260,700

VALEMIA 10 MG 60 TABLET 8,690 521,400

VALEMIA 10 MG 60 TABLET 8,690 521,400

VALEMIA 10 MG 90 TABLET 8,690 782,100

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VALEMIA 10 MG 90 TABLET 8,690 782,100

VALEMIA 10 MG 150 TABLET 8,690 1,303,500

VALEMIA 5 MG 60 TABLET 5,104 306,240

VALEMIA 5 MG 90 TABLET 5,104 459,360

VALEMIA 5 MG 60 TABLET 5,236 314,160

VALEMIA 5 MG 30 TABLET 5,236 157,080

VALEMIA 5 MG 30 TABLET 5,236 157,080

VALEMIA 5 MG 60 TABLET 5,236 314,160

VALEMIA 5 MG 150 TABLET 5,236 785,400

VALISANBE 2 MG 200 TABLET 165 33,000

VALISANBE 2 MG 200 TABLET 165 33,000

VALISANBE 5 MG 200 TABLET 253 50,600

VALISANBE 5 MG 100 TABLET 253 25,300

VALSARTAN 160 MG ASKES 180 TABLET 6,100 1,098,003

VALSARTAN 80 MG ASKES 300 TABLET 4,000 1,200,002

VALSARTAN 80 MG ASKES 600 TABLET 4,000 2,400,004

VASACON A 15ML 5 FLS 24,613 123,063

VASACON ED 5 FLS 17,875 89,375

VASACON ED 6 FLS 17,875 107,250

VASACON ED 10 FLS 17,875 178,750

VASCON INJ ASK 15 VIAL 69,300 1,039,500

VASCON INJ ASK 5 VIAL 69,300 346,500

VASCON INJ ASK 10 VIAL 69,300 693,000

VASCON INJ ASK 10 VIAL 69,300 693,000

VASCON INJ ASK 10 VIAL 69,300 693,000

VASCON INJ ASK 5 VIAL 69,300 346,500

VASCON INJ ASK 5 VIAL 69,300 346,500

VASCON INJ ASK 10 VIAL 69,300 693,000

VECTRINE 60 TABLET 3,812 228,690

VECTRINE 200 TABLET 3,812 762,300

VECTRINE SYR 5 BOTOL 33,660 168,300

VECTRINE SYR 2 BOTOL 33,660 67,320

VELAZOL INF 10 BOTOL 70,070 700,700

VELAZOL INF 24 BOTOL 71,500 1,716,000

VELAZOL INF 29 BOTOL 70,070 2,032,030

VELAZOL INF 1 BOTOL 71,500 71,500

VELAZOL INF 12 BOTOL 70,070 840,840

VELAZOL INF 12 BOTOL 70,070 840,840

VELAZOL INF 12 BOTOL 70,070 840,840

VELAZOL INF 20 BOTOL 70,070 1,401,400

VELAZOL INF 12 BOTOL 70,070 840,840

VELAZOL INF 12 BOTOL 70,070 840,840

VELAZOL INF 18 BOTOL 70,070 1,261,260

VENTOLIN INHALER 5 BOTOL 73,500 367,499

VENTOLIN INHALER ASKES 3 PACK 87,780 263,340

VENTOLIN NEBULES 60 AMPUL 8,800 528,000

VENTOLIN NEBULES 40 AMPUL 8,800 352,000

VENTOLIN NEBULES 100 AMPUL 8,800 880,000

VENTOLIN NEBULES 100 AMPUL 8,360 836,000

VENTOLIN NEBULES 60 AMPUL 8,360 501,600

VENTOLIN NEBULES ASKES 100 AMPUL 7,400 739,998

VENTOLIN NEBULES ASKES 100 AMPUL 7,400 739,998

VERBAN 10 CM 50 BIJI 1,703 85,140

VERBAN 10 CM 50 BIJI 1,703 85,140

VERBAN 10 CM 50 BIJI 1,703 85,140

VERBAN 10 CM 50 BIJI 1,703 85,140

VERBAN 10 CM 50 BIJI 1,703 85,140

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VERBAN 10 CM 50 BIJI 1,703 85,140

VERBAN 10 CM 50 BIJI 1,703 85,140

VERBAN 10 CM 50 BIJI 1,703 85,140

VERBAN 10 CM 50 BIJI 1,703 85,140

VERBAN 10CM ASKES 50 ROL 1,703 85,140

VERBAN 10CM ASKES 50 ROL 1,703 85,140

VERBAN 10CM ASKES 50 ROL 1,703 85,140

VERBAN 10CM ASKES 50 ROL 1,703 85,140

VERTIKAF 8 MG ASKES 500 TABLET 1,640 820,001

VESTEC CUVVETES L 400 PCS 9,625 3,850,000

VESTEC CUVVETES L 200 PCS 9,625 1,925,000

VESTEC CUVVETES L 200 PCS 9,625 1,925,000

VICCILIN-SX INJ 10 VIAL 82,500 825,000

VICCILIN-SX INJ 50 VIAL 82,500 4,125,000

VICCILIN-SX INJ 60 VIAL 82,500 4,950,000

VICRIL CTD 6/0 540 4,939 2,667,060

VINCRISTIN 2 MG INJ 1 VIAL 214,500 214,500

VINCRISTIN 2 MG INJ 1 VIAL 214,500 214,500

VINCRISTIN 2 MG INJ ASKES 1 VIAL 115,000 115,000

VINCRISTIN 2 MG INJ ASKES 1 VIAL 115,000 115,000

VIT B 6 1,000 TABLET 34 34,155

VIT B 6 1,000 TABLET 23 22,660

VITAMIN K TAB ASKES 500 TABLET 65 32,670

VITANORM TAB 600 TABLET 3,663 2,197,800

VITANORM TAB 90 TABLET 3,663 329,670

VITAPLEX 1 PACK 627,000 627,000

VITROLENTA MD 15 FLS 24,200 363,000

VITROLENTA MD 20 FLS 24,200 484,000

VITROLENTA MD 20 FLS 24,200 484,000

VITROLENTA MD 10 FLS 31,488 314,875

VITROLENTA MD 20 FLS 31,488 629,750

VOMETA DROP 5 BOTOL 37,125 185,625

VOMETA SYR 6 BOTOL 37,125 222,750

VOMETA SYR 5 BOTOL 37,125 185,625

VOMETA SYR 6 BOTOL 37,125 222,750

VOMETA SYR 10 BOTOL 37,125 371,250

VOMETA SYR 5 BOTOL 37,125 185,625

VOSEDON SYR 5 BOTOL 26,840 134,200

VOSEDON SYR 10 BOTOL 26,840 268,400

VOSEDON SYR 6 BOTOL 27,511 165,066

VOSEDON SYR 6 BOTOL 27,511 165,066

VOSEDON SYR 6 BOTOL 27,511 165,066

VOSEDON SYR 6 BOTOL 27,511 165,066

VOSEDON SYR 6 BOTOL 27,511 165,066

VOSEDON SYR 6 BOTOL 27,511 165,066

VOSEDON SYR 6 BOTOL 27,511 165,066

VOSEDON SYR 5 BOTOL 27,511 137,555

VOSEDON TAB 100 TABLET 2,134 213,400

VOSEDON TAB 100 TABLET 2,189 218,900

VOSEDON TAB 100 TABLET 2,189 218,900

VOSEDON TAB 100 TABLET 2,189 218,900

WALL DISP ASEPTIC 66 PCS 34,650 2,286,900

WASH FLUID 8X20 ML 1 KIT 935,000 935,000

WIDA NSI TWIST OFF 30 BIJI 13,970 419,100

WIDA NSI TWIST OFF 40 BIJI 13,970 558,800

WIDA NSI TWIST OFF 30 BIJI 13,970 419,100

CENTIMETER

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WIDA NSI TWIST OFF 20 BIJI 13,970 279,400

WIDA WI ASKES 10 BOTOL 8,000 80,003

WIDAHES UNICAP ASKES 20 FLS 52,250 1,045,000

WIN GLOVE 7 ASKES 100 PCS 7,150 715,000

WIN GLOVE 7,5 250 PASANG 6,050 1,512,500

WIN GLOVE 7,5 250 PASANG 6,050 1,512,500

WIN GLOVE 7,5 250 PASANG 7,150 1,787,500

WIN GLOVE 7,5 250 PASANG 7,150 1,787,500

WIN GLOVE 7,5 150 PASANG 7,150 1,072,500

WIN GLOVE 7,5 150 PASANG 7,150 1,072,500

WIN GLOVE 7,5 ASKES 250 PASANG 6,050 1,512,500

WIN GLOVE 7,5 ASKES 250 PASANG 7,150 1,787,500

WIN GLOVE 7,5 ASKES 250 PASANG 7,150 1,787,500

WIN GLOVE 7,5 ASKES 150 PASANG 7,150 1,072,500

WIN GLOVE 7,5 ASKES 150 PASANG 7,150 1,072,500

WIN GLOVE 7,5 ASKES 250 PASANG 7,150 1,787,500

WIN GLOVE 7,5 ASKES 250 PASANG 7,150 1,787,500

WIN GLOVE 7,5 ASKES 150 PASANG 7,150 1,072,500

WIN GLOVE 7,5 ASKES 250 PASANG 7,150 1,787,500

WIN GLOVE 7,5 ASKES 100 PASANG 7,150 715,000

WIN GLOVE 7,5 ASKES 250 PASANG 7,150 1,787,500

WIN GLOVE 7,5 ASKES 200 PASANG 7,150 1,430,000

WIN GLOVE M 1,000 PASANG 1,573 1,573,000

WIN GLOVE M 1,000 PASANG 1,573 1,573,000

WIN GLOVE M 500 PASANG 1,573 786,500

WIN GLOVE M 500 PASANG 1,573 786,500

WIN GLOVE M 500 PASANG 1,573 786,500

WIN GLOVE M 500 PASANG 1,573 786,500

WIN GLOVE M 500 PASANG 1,573 786,500

WIN GLOVE M 500 PASANG 1,573 786,500

WIN GLOVE S PAKET 10 BOX 78,650 786,500

WWZ 2 L 1 BIJI 24,200 24,200

WWZ 2 L 1 BIJI 24,200 24,200

WWZ 2 L 2 BIJI 24,200 48,400

XEVOLAC INJ 30 AMPUL 33,957 1,018,710

XEVOLAC INJ 60 AMPUL 33,957 2,037,420

XEVOLAC INJ 60 AMPUL 33,957 2,037,420

XEVOLAC INJ 60 AMPUL 33,957 2,037,420

XEVOLAC INJ 60 AMPUL 33,957 2,037,420

XEVOLAC INJ 30 AMPUL 33,957 1,018,710

XITROL ED 5 FLS 29,975 149,875

XITROL EO 10 FLS 28,188 281,875

XYLOCAINE 10% SPRAY PAKET 2 BOTOL 313,500 627,000

YELLOW TIP NO BRAND PAKET 1 PACK 182,600 182,600

YELLOW TIPS DELTA LAB PAKET 1 BOX 206,250 206,250

YELLOW TIPS IHS 2,000 PCS 55 110,000

YELLOW TIPS IHS 1,000 PCS 55 55,000

YELLOW TIPS IHS 1,000 PCS 55 55,000

YELLOW TIPS IHS 1,000 PCS 55 55,000

YELLOW TIPS IHS 2,000 PCS 55 110,000

YELLOW TIPS REG 1,000 PCS 183 182,600

YELLOW TIPS REG 1,000 PCS 183 182,600

ZIEHL NELSON 500 ML PAKET 1 SET 457,600 457,600

ZIEHL NELSON 500 ML PAKET 1 SET 457,600 457,600

ZINCPRO SYRP 10 BOTOL 31,900 319,000

TOTAL 5,195,863,571

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Biaya Bahan Non Medis Habis Pakai Tahun 2014

Nama Facility Activity : ....

No. Nama Bahan Jumlah Harga Satuan Total

Etiket plastik klipkresekplastik beningATK

Jumlah

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tanya ke bagian gudang umum ttg belanja ATK untuk instalasi

farmasi tahun 2014

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Biaya Umum Tahun 2014 Listrik, Air, Telpon dan Internet

Nama Facility Activity : …

No Bulan Listrik Telpon/internet Air Jumlah Biaya

Jumlah

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* Form ini diisi bila biaya telepon/Air/Internet/listrik dibayar sendiri oleh unit- unit produksi (instalasi/ruang/unit)

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Biaya Lain-lain (Diklat dll. ) Tahuun 2014

Nama Facility Activity : …

No. Bulan Biaya Untuk Jumlah Biaya

1 Pelatihan Apoteker

2 Pelatihan Asisten Apoteker

Jumlah

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*Biaya Diklat dll termasuk biaya perjalanan, biaya harian dan biaya penginapan

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tanya di bagian kepegawaian data pelatihan untuk Instalasi

Farmasi tahun 2014

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Biaya Pemeliharaan Tahun 2014

Nama Facility Activity : …

No. Bulan Biaya Untuk Jumlah Biaya

Jumlah

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*Diisi oleh enumerator. Jumlah biaya diambil dari data bagian umum atau keuangan RS.