LAPORAN PEMAKAIAN DAN STOCK BHP MEDIS

INSTALASI FARMASI
RSUD. SULTAN SY. MUHAMMAD ALKADRI
KOTA PONTIANAK
02 JANUARI 2022 - 31 DESEMBER 2022

NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
1 3-way stop Cock Pcs Rp 4,176.00
2 3-way stop Cock Pcs Rp 12,744.00
3 3-way stop cock ( Tro Venoflow ) Pcs Rp 32,010.00
4 3-way stop cock ( Tro Venoflow ) with ext. 10 cm pcs Rp 32,010.00
5 Advantime 3/0 3/8 XC 24 mm 70 cm Pcs Rp 93,850.42
6 Advantime 3/0 3/8 XC 24 mm 70 cm pcs Rp 65,000.00
7 AH Plus Box Rp 1,309,000.00
8 Alkaside 1 LT botol Rp 2,702,700.00
9 Alkazyme Sachet 25 mg Pack Rp 859,333.33
10 ALKOHOL 70% btl Rp 50,600.00
11 ALKOHOL 70% btl Rp 60,000.00
12 ALKOHOL 70% 100 ML btl Rp 3,190.00
13 ALKOHOL SWAB box Rp 28,292.00
14 ALKOHOL SWAB box Rp 38,500.00
15 ALKOHOL SWAB bh Rp 13,924.00
16 ALKOHOL SWAB box Rp 26,400.00

17 ALKOHOL SWAB pcs Rp 135.30

18 Allevyn Non Adhesive 10x10 Pcs Rp 31,274.00
19 Anasthesia Breathing System Dewasa Pcs Rp 100,642.00
20 Anasthesia Breathing System Dewasa With Heather Pcs Rp 603,520.00
21 Anti HIV kit Rp 3,819,200.00
22 APRON PCS Rp 5,225.00
23 ARM SLING L pcs Rp 40,000.40
24 ARM SLING L pcs Rp 19,425.00
25 ARM SLING M Pcs Rp 40,000.40
26 ARM SLING M Pcs Rp 19,425.00
27 Articulating paper pcs Rp 187,000.00
28 Bactigras 10x10 cm Pcs Rp 5,212.00
29 Bactigras 15x20 cm Pcs Rp 23,165.00
30 Baju APD Disp pcs Rp 90,000.00
31 Baju APD Disp (Universal set) pcs Rp 593,300.00
32 Baju Operasi Uk. L Helai Rp 473,000.00
33 BiCart Sodium Bicarbonate 650gr Buah Rp 112,750.00
34 Bioglue Surgical adhesive pcs Rp 3,304,210.00
35 Bioglue Surgical adhesive pcs Rp 3,940,750.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
36 Blood Glucose ( Acchu check ) Pcs Rp 3,359.99
37 Blood Glucose ( Acchu check ) Pcs Rp 3,360.005
38 Blood Glucose ( Acchu check ) Pcs Rp 3,359.95
39 Blood Glucose ( Contour plus ) kit Rp 219,600.00
40 Blood Lancet 28 G Box Rp 17,404.80
41 Blood Lancet 28 G Box Rp 23,650.00
42 Blood stop PCS Rp 100,000.00
43 Blood Tranfusion set PCS Rp 17,595.00
44 Blood Tranfusion set PCS Rp 11,555.10
45 Blood Tranfusion set PCS Rp 15,000.00
46 Blood Tranfusion set (cosmomed) PCS Rp 10,520.00
47 Blood Tranfusion set (cosmomed) PCS Rp 11,600.00
48 Blood Tranfusion set (Nipro) PCS Rp 16,761.00
49 Bloodline Tubing System Buah Rp 112,750.00
50 Bloodline Tubing System Buah Rp 107,800.00
51 Bonding pcs Rp 1,672,000.00
52 Bonding One Coat 7 Universal Botol Rp 1,848,000.00
53 Bone graft 2 gr Btl Rp 607,750.00
54 Bone Wax Pcs Rp 51,800.00
55 Bone Wax Pcs Rp 52,700.00
56 Bowie and Dick Indokator Sheet pack Rp 2,527,655.50
57 Bowie and Dick Indokator Sheet pack Rp 2,497,683.00
58 Bowie dick test pack Pcs Rp 99,000.00
59 Breathing Circuit Neonatus Pack Rp 10,169,500.00
60 Brush CA Pcs Rp 11,100.00
61 Bur Enhance Finishing Disc Refill Box Rp 1,078,000.00
62 Bur Enhance Finishing Point Refill Box Rp 1,078,000.00
63 Bur Fissure ( Pita kuning ) Pcs Rp 66,000.00
64 Bur Flame ( Pita Kuning ) Pcs Rp 66,000.00
65 Bur Round ( Pita Biru ) Pcs Rp 66,000.00
66 Cairan Acid Concentrate 5 liter Buah Rp 86,900.00
67 Cairan Acid Concentrate 5 liter Buah Rp 99,000.00
68 CANNOFIX-PU I.V Cannula Fixation Polyurethane 6 CM X 8 CM P pcs Rp 6,820.00
69 Cannovix - PU 6 cm x 8 cm Pcs Rp 6,850.00
70 Catgut Chromic 0 90 cm pcs Rp 49,579.00
71 Catgut Chromic 1 Pcs Rp 58,243.00
72 Catgut Chromic 1 90 cm pcs Rp 63,100.00
73 Catgut Chromic 1 90 cm ( Triton ) pcs Rp 71,610.00
74 Catgut Chromic 2/0 BOX Rp 140,000.00
75 Catgut Chromic 2/0 Pcs Rp 57,800.00
76 Catgut Chromic 2/0 90 cm pcs Rp 49,579.00
77 Catgut Chromic 2/0 90 cm 35 mm ( Triton) sach Rp 55,100.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
78 Catgut Chromic 2/0 90 cm 40 mm ( Triton) pcs Rp 63,714.00
79 Catgut Chromic 3/0 76 cm pcs Rp 58,700.00
80 Catgut Plain 1 sach Rp 60,060.00
81 Catgut Plain 1 sach Rp 55,100.01
82 Catgut Plain 2/0 sach Rp 56,900.00
83 Catgut Plain 2/0 76 cm pcs Rp 47,267.00
84 Catgut Plain 3/0 sach Rp 56,900.00
85 Catgut Plain 4/0 76 cm pcs Rp 53,100.00
86 Catgut Plain 4/0 76 cm ( Triton ) pcs Rp 58,386.00
87 Catgut Silk 1 Pcs Rp 50,400.01
88 Catgut Silk 1 Tapper Cutting Pcs Rp 53,769.10
89 Catgut Silk 2/0 Pcs Rp 37,064.00
90 Catgut Silk 2/0 t Pcs Rp 43,429.15
91 Catgut Silk 3/0 Pcs Rp 25,600.00
92 Catgut Silk 3/0 Tapper Pcs Rp 36,582.00
93 Catheter Mount Flexi Elastomeric Elbow Connector pcs Rp 53,400.00
94 CATRIDGE GENXPERT pcs Rp 259,175.00
95 CATRIDGE GENXPERT pcs Rp 224,253.60
96 cavidagel 15 gr tube Rp 41,000.00
97 cavidagel 15 gr tube Rp 50,600.00
98 cavidagel 15 gr tube Rp 51,059.00
99 CAVITON Pink Pcs Rp 166,155.00
100 CAVITON WHITE Pcs Rp 174,900.00
101 CAVITON WHITE Pcs Rp 166,155.00
102 Cellulose matrix strip Pcs Rp 192,500.00
103 Centrifuge Tube with graduation Tube Rp 112,200.00
104 Certofix Duo Paed No. 413 Pcs Rp 1,207,800.00
105 Cervical collar rigid uk. L ( collar neck ) Pcs Rp 258,720.00
106 Cervical collar rigid uk. M ( collar neck ) Pcs Rp 258,720.00
107 Cervical collar rigid uk. S ( collar neck ) Pcs Rp 258,720.00
108 Cetakan Kapsul No. 00 Pcs Rp 110,000.00
109 Cetakan Kapsul No. 2 Pcs Rp 110,000.00
110 CHLOROPHENOL CHAMPHORMENTOL / CHKM Pcs Rp 75,000.00
111 CHLOROPHENOL CHAMPHORMENTOL / CHKM btl Rp 116,600.00
112 CHLOROPHENOL CHAMPHORMENTOL / CHKM btl Rp 99,000.00
113 Circuit BC 161-10/ CPAP ( Fisher & Paykel) Pcs Rp 1,977,800.00
114 Citric Acid kg Rp 29,700.00
115 CK Ject 30 G Box Rp 275,000.00
116 Cletira 750 mL Btl Rp 220,000.00
117 Cletira 750 mL Btl Rp 242,000.00
118 Cold box vaccine carrier Unit Rp 1,200,000.00
119 Cold Sterilant Concentrate 10 L (Renalin) btl Rp 5,522,000.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
120 coll s basic comford 10 x 10 Pcs Rp 47,488.00
121 Colostomy Bag Pcs Rp 49,500.00
122 Composite Pasta solare A1 Pcs Rp 393,800.00
123 Composite Pasta solare A2 Pcs Rp 393,800.00
124 Composite Pasta solare A3 Pcs Rp 393,800.00
125 Condom Chateter M Pcs Rp 8,470.00
126 Condom Chateter S Buah Rp 38,000.00
127 Conductive Paste Pot Rp 1,243,000.00
128 CONNECTING TUBE ( Aximed) PCS Rp 24,864.00
129 CONNECTING TUBE ( Aximed) PCS Rp 17,948.00
130 CONNECTING TUBE ( with yankuer) PCS Rp 49,500.00
131 Corolen 6/0 RC pcs Rp 119,695.00
132 Corolen 6/0 TP pcs Rp 181,555.00
133 Corolene 2/0 RC-26-3/8 Pcs Rp 91,003.00
134 Corolene 3/0 RC 19 mm 3/8 Pcs Rp 95,040.00
135 Corolene 4/0 RC pcs Rp 98,010.00
136 Corolene 5/0 1/2 tp 18 mm 75 cm double armed pcs Rp 121,007.00
137 Corolene 5/0 3/8 rcx 16 mm 75 cm single armed pcs Rp 89,723.00
138 Corolene 6/0 RC double armed pcs Rp 164,522.11
139 Corolene 7/0 double armed tp 10 mm box Rp 424,464.78
140 Corolene 7/0 double armed tp 10 mm pcs Rp 393,470.00
141 COROLENE Non Absorbable Blu Polypropylene Monofilament Type 4/0 USP pcs Rp 88,000.00
142 COROLENE Non Absorbable Blu Polypropylene Monofilament Type 4/0 USP 1.5 MET Rp 88,000.00
143 Cotton roll ( kecil ) Pcs Rp 60,210.00
144 Cotton Roll Besar Roll Rp 72,150.00
145 Cotton Roll Kecil Pak Isi 12 Rp 130,350.00
146 Covid-19 Ag Standard tes strip Rp -
147 Cresent Knife Angled pcs Rp 175,000.00
148 Cresotin liquid btl Rp 357,500.00
149 Cresotin Pasta btl Rp 265,000.00
150 CSF 16MM Medium Pressure Pcs Rp 8,305,000.00
151 Cuticell Clasic 10x10 pcs Rp 5,520.00
152 CUTIMED SILTEC SILICON Sach Rp 35,460.00
153 CVC TRIPLEE lumen 4,5FR 8 CM pcs Rp 999,000.00
154 CVC TRIPLEE lumen 7 FR 20 CM Pcs Rp 999,000.00
155 DeckGlass 18 x 18 Bok Rp 132,030.94
156 Delta Lite 3" 7.5cm x 3.6m Sach Rp 279,290.00
157 Dental syringe box Rp 4,400,000.00
158 Devital tehnodent 5 gr Pcs Rp 260,000.00
159 Devitalizer (Pulp X)) box Rp 374,000.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
160 Disposable dental needle 16 ( citoject ) box Rp 96,800.00
161 Disposable Sterile Syringe 10 ml pcs Rp 1,616.16
162 Disposable Sterile Syringe 10 ml pcs Rp 2,167.00
163 Disposable Sterile Syringe 10 ml pcs Rp 2,200.00
164 Disposable Sterile Syringe 10 ml pcs Rp 1,333.00
165 Disposable Sterile Syringe 10 ml pcs Rp 1,332.00
166 Disposable Sterile Syringe 10 ml Pcs Rp 1,100.90
167 Disposable Sterile Syringe 20 ml pcs Rp 1,916.00
168 Disposable Sterile Syringe 20 ml pcs Rp 3,366.00
169 Disposable Sterile Syringe 3 ml pcs Rp 1,101.897
170 Disposable Sterile Syringe 3 ml pcs Rp 3,036.00
171 Disposable Sterile Syringe 3 ml pcs Rp 1,342.00
172 Disposable Sterile Syringe 3 ml pcs Rp 1,331.00
173 Disposable Sterile Syringe 5 ml pcs Rp 1,182.15
174 Disposable Sterile Syringe 5 ml pcs Rp 1,430.00

175 Disposable Sterile Syringe 5 ml pcs Rp 1,815.00

176 Disposable Sterile Syringe 5 ml pcs Rp 1,110.00
177 Disposable Sterile Syringe 5 ml pcs Rp 2,587.20
178 Disposable Sterile Syringe 5 ml pcs Rp 1,109.00
179 Disposable Sterile Syringe 5 ml pcs Rp 1,111.00
180 Disposable Sterile Syringe 5 ml pcs Rp 693.00
181 DISPOSABLE SYRINGE 50CC CT PCS Rp 7,260.00
182 DISPOSABLE SYRINGE 50CC CT PCS Rp 4,425.00
183 DISPOSABLE SYRINGE 50CC ST PCS Rp 23,320.00
184 DISPOSABLE SYRINGE 50CC ST PCS Rp 4,425.00
185 DISPOSABLE SYRINGE 50CC ST PCS Rp 18,700.00
186 DISPOSABLE SYRINGE 50CC ST PCS Rp 15,620.00
187 DISPOSABLE SYRINGE 50CC ST PCS Rp 9,762.50
188 DOP MATA (NON STERILL) PCS Rp 11,550.00
189 DOP MATA (NON STERILL) pcs Rp 14,900.00
190 DOP MATA (STERILL) pcs Rp 25,000.00
191 Double lumen Rp 1,408,000.00
192 Double lumen ( Farcath / CDL ) pcs Rp 990,000.00
193 Double lumen ( Farcath / CDL ) pcs Rp 999,000.00
194 Dycal Box Rp 723,800.00
195 ECG Paper 110 mm x 25 cm roll Rp 119,900.00
196 ECG Paper 110 mm x 30 cm roll Rp 143,000.00
197 ECG Paper 110 mm x 30 cm roll Rp 143,000.00
198 ECG Paper 80 mm x 25 m roll Rp 88,000.00
199 ECG Paper 80 mm x 30 m roll Rp 78,100.00
200 Electroda Monitor EKG bayi 50 Pcs / Pak Rp 195,690.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
201 Elektroda dewasa 50 Pcs / Pak Rp 72,500.00
202 Elektroda dewasa 50 Pcs / Pak Rp 165,000.00
203 Elektroda dewasa 50 Pcs / Pak Rp 166,500.00
204 Elektrode Anak Pack Rp 194,700.00
205 Endo Frost Botol Rp 583,000.00
206 Etchant gel ( scotchbond ) pcs Rp 195,800.00
207 Etchant gel ( scotchbond ) pcs Rp 207,900.00
208 Etsa pcs Rp 353,100.00
209 ETT Non Kinking No. 4,5 mm Pcs Rp 162,840.00
210 ETT Non Kinking No. 5,5 mm Pcs Rp 29,766.00
211 ETT Non Kinking No. 6,0 mm Pcs Rp 29,766.00
212 ETT Non Kinking No. 6,5 mm ( With intub ) Pcs Rp 29,766.00
213 ETT Non Kinking No. 7,0 mm Pcs Rp 29,766.00
214 ETT Non Kinking No. 7,0 mm ( with intub ) Pcs Rp 162,840.00
215 ETT Non Kinking No. 7,5 mm Pcs Rp 162,840.00
216 ETT Non Kinking No. 8,0 mm ( with intub ) Pcs Rp 29,766.00
217 ETT Plastik No. 2 ( uncuffed ) Pcs Rp 18,110.00
218 ETT Plastik No. 2,5 Pcs Rp 18,110.00
219 ETT Plastik No. 3 Pcs Rp 27,666.67
220 ETT Plastik No. 3,5 Pcs Rp 59,400.00
221 ETT Plastik No. 3,5 ( uncuffed 3,5 ) Pcs Rp 27,666.67
222 ETT Plastik No. 4,5 Pcs Rp 18,110.00
223 ETT Plastik No. 5 ( with intub ) Pcs Rp 18,110.00
224 ETT Plastik No. 7 Pcs Rp 53,142.00
225 ETT Plastik No. 7,5 ( with intub ) Pcs Rp 53,142.00
226 ETT Reinforced Cuff Uk. 4.0 - Forsch Pcs Rp 43,450.00
227 ETT Reinforced Cuff Uk. 5.0 - Forsch Pcs Rp 43,450.00
228 ETT UNCUFF 2,5 Pcs Rp 29,375.00
229 ETT Uncuffed 4 Pcs Rp 29,374.00
230 ETT Uncuffed No. 3 Pcs Rp 26,705.00
231 ETT Uncuffed No. 4,5 Pcs Rp 29,375.00
232 ETT Uncuffed No. 5 Pcs Rp 29,375.00
233 ETT With Cuff No. 5,5 pcs Rp 29,700.00
234 ETT With Cuff No. 6,0 pcs Rp 29,700.00
235 ETT With Cuff No. 6,5 pcs Rp 29,666.67
236 ETT With Cuff No. 7,0 pcs Rp 29,700.00
237 ETT With Cuff No. 8,0 pcs Rp 29,666.67
238 ETT With Cuffed 3.5 Pcs Rp 116,600.00
239 ETT With Cuffed 4 Pcs Rp 116,600.00
240 ETT With Cuffed 4 Pcs Rp 31,119.00
241 ETT with Cuffed No. 3,0 Pcs Rp 34,650.00
242 ETT With Cuffed No. 4,5 Pcs Rp 29,700.00
NO NAMA OBAT SATUAN HARGA DASAR

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243 ETT with Cuffed No. 4,5 Pcs Rp 34,650.00
244 ETT With Cuffed No. 5 Pcs Rp 29,700.00
245 ETT With Cuffed No. 7 Pcs Rp 28,416.00
246 ETT With Cuffed No. 7,5 Pcs Rp 29,700.00
247 Extention Tube Pcs Rp 25,575.00
248 Extention Tube Pcs Rp 38,500.00
249 Extention Tube 150 cm Pcs Rp 25,807.50
250 EYE DRAPE PRE CUT UKURAN 100CM X 80CM Pcs Rp 119,999.00
251 Eye Drape Regular Pcs Rp 115,000.00
252 Eye Drape Regular Pcs Rp 120,000.00
253 farma algi 10 x 10 Pcs Rp 26,000.00
254 Film DI-HL 26x36 box Rp 5,060,000.00
255 Film DI-HL 26x36 box Rp 5,110,600.00
256 Film DI-HL 26x36 sheet Rp 39,600.00
257 Film DI-HL 35x43 Box Rp 5,280,000.00
258 Film DI-HL 35x43 Box Rp 5,332,800.00
259 Filtek Z350 XT Univ Restortive A2B Pcs Rp 549,900.00
260 Filtek Z350 XT Univ Restortive A2B Pcs Rp 584,100.00
261 Filtek Z350 XT Univ Restortive A3.5B Pcs Rp 549,900.00
262 Filtek Z350 XT Univ Restortive A3.5B Pcs Rp 584,100.00
263 Filtek Z350 XT Univ Restortive A3B pcs Rp 549,900.00
264 Filtek Z350 XT Univ Restortive A3B pcs Rp 584,100.00
265 Filtex supreme Flowable A2 pcs Rp 625,900.00
266 Filtex supreme Flowable A2 pcs Rp 589,000.00
267 Fixomul 10 cm roll Rp 70,903.00
268 FLUSHING FLAT BOTTOM SET Rp 3,950,000.00
269 Folley Catheter 2 way no. 16 pcs Rp 13,966.00
270 Folley Catheter 2 way no. 16 pcs Rp 15,318.00
271 Folley Chateter 2 way No. 10 pcs Rp 15,318.00
272 Folley Chateter 2 way No. 10 bh Rp 12,430.00
273 Folley Chateter 2 way No. 12 bh Rp 8,400.00
274 Folley Chateter 2 way No. 12 bh Rp 12,430.00
275 Folley Chateter 2 way No. 12 Pcs Rp 15,318.00
276 Folley Chateter 2 way No. 14 bh Rp 8,400.00
277 Folley Chateter 2 way No. 14 bh Rp 12,430.00
278 Folley Chateter 2 way No. 18 pcs Rp 8,400.00
279 Folley Chateter 2 way No. 18 pcs Rp 15,318.00
280 Folley Chateter 2 way No. 20 bh Rp 10,440.00
281 Folley Chateter 2 way No. 20 bh Rp 8,400.00
282 Folley Chateter 2 way No. 22 Box Rp 12,430.00
283 Folley Chateter 2 way No. 24 Pcs Rp 13,688.00
284 Folley Chateter 2 way No. 24 Pcs Rp 12,430.00
NO NAMA OBAT SATUAN HARGA DASAR

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285 Folley Chateter 2 way No. 6 Pcs Rp 20,460.00
286 Folley Chateter 2 way No. 8 bh Rp 31,500.00
287 Folley Chateter 2 way No. 8 Pcs Rp 15,318.00
288 Free style optium H Blood Keton test strip box Rp 19,250.00
289 Fuji II Pcs Rp 376,200.00
290 Fuji IX Pcs Rp 863,170.00
291 Fuji IX Pcs Rp 908,600.00
292 Fuji IX extra A3 Pcs Rp 1,476,200.00
293 Fuji IX extra A3,5 Pcs Rp 915,750.00
294 Fuji VII Pink Pcs Rp 803,000.00
295 Fuji VII White Pcs Rp 1,177,000.00
296 Garam Kasar (Nacl Teknis) Kg Rp 12,100.00
297 Gel & Clot Activator 4 mL pack Rp 308,000.00
298 Gel & Clot Activator Tube 13x100mm 6ml (Kuning) - Sunway Box Rp 198,000.00
299 Gelang Bayi Blue box Rp 1,100.00
300 Gelang Bayi Pink box Rp 1,100.00
301 Gelas ukur 100 ml pcs Rp 154,000.00
302 Gelas ukur 50 ml pcs Rp 132,000.00
303 GELSPON STANDRAD 80X50X10 MM BOX Rp 99,000.00
304 Greater Curve Tofflemire Band (Dental Curve) pack Rp 332,200.00
305 Gudel Airway 040 mm No. 00 bh Rp 16,266.67
306 Gudel Airway 070 mm No. 1 bh Rp 13,200.00
307 Gudel Airway 070 mm No. 2 bh Rp 13,203.39
308 Gudel Airway 070 mm No. 2 Pcs Rp 13,203.06
309 Gudel Airway 070 mm No. 2 Pcs Rp 14,066.67
310 Gudel Airway 070 mm No. 2 Pcs Rp 40,150.00
311 Gudel Airway 080 mm No. 2 bh Rp 17,660.10
312 Gudel Airway 100 mm No. 5 Pcs Rp 13,205.19
313 Gudel Airway 100 mm No. 5 pcs Rp 16,600.00
314 Gudel Airway No. 3 90 mm Pcs Rp 17,660.10
315 Gudel Airway No. 90 mm pcs Rp 15,538.00
316 Guedel No. 0 ( 60 mm ) Pcs Rp 38,500.00
317 Guedel No. 00 ( 50 mm ) Pcs Rp 38,500.00
318 Guide wire 0,036 150 cm Pcs Rp 319,000.00
319 GUTTA PERCHA 15-40 Box Rp 195,000.00
320 H2O2 2 % 750 mL ( Oxiter ) Botol Rp 237,996.00
321 H2O2 3 % 1 Lt Botol Rp 44,000.00
322 H2O2 3 % 800 mL Botol Rp 58,300.00
323 Handrub 500 ml btl Rp 73,150.00
324 Handsanitizer 5 Lt ken Rp 1,463,000.00
325 Handsanitizer 500 ml + bracket btl Rp 143,000.00
326 Handscoon disposible L Box Rp 51,049.00
NO NAMA OBAT SATUAN HARGA DASAR

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327 Handscoon disposible L Box Rp 178,200.00
328 Handscoon disposible L FREE Box Rp 195,000.00
329 Handscoon disposible L FREE Box Rp 228,350.00
330 Handscoon disposible L FREE Box Rp 61,523.00
331 Handscoon disposible M Box Rp 51,049.00
332 Handscoon disposible M Box Rp 66,000.00
333 Handscoon disposible M Box Rp 192,500.00
334 Handscoon disposible M FREE Box Rp 228,350.00
335 Handscoon disposible M FREE pcs Rp 1,344.20
336 Handscoon disposible M FREE box Rp 209,000.00
337 Handscoon disposible nitril L FREE Box Rp 250,000.00
338 Handscoon disposible S Box Rp 51,049.00
339 Handscoon disposible S Box Rp 75,000.00
340 Handscoon disposible S Box Rp 66,000.00
341 Handscoon disposible S FREE Box Rp 195,000.00
342 Handscoon disposible S FREE Box Rp 228,350.00
343 Handscoon no. 6 Pcs Rp 6,595.00
344 Handscoon Sterill No. 6.5 ( Trosensosurge plus ) pasang Rp 13,563.00
345 Handscoon Sterill No. 6.5 ( Trosensosurge plus ) pasang Rp 13,686.19
346 Handscoon Sterill No. 6.5 ( Trosensosurge plus ) pasang Rp 13,178.00
347 Handscoon Sterill No. 6.5 ( Trosensosurge plus ) pasang Rp 16,390.00
348 Handscoon Sterill No. 7,5 ( Trosensosurge Plus ) pasang Rp 13,686.19
349 Handscoon Sterill No. 7,5 ( Trosensosurge Plus ) pasang Rp 16,390.00
350 Handscoon Sterill No. 7.0 Pcs Rp 6,595.00
351 Handscoon Sterill No. 7.0 ( Trosensosurge Plus ) pasang Rp 13,686.00
352 Handscoon Sterill No. 7.0 ( Trosensosurge Plus ) pasang Rp 13,563.00
353 Handscoon Sterill No. 7.0 ( Trosensosurge Plus ) pasang Rp 16,390.00
354 Handscoon Sterill No. 8 bks Rp 7,147.25
355 Handscoon Sterill No. 8 ( Trosensosurge plus ) pasang Rp 13,686.19
356 Handscoon Sterill No. 8 ( Trosensosurge plus ) pasang Rp 16,390.00
357 Handscoon Sterill obgyn No. 6.5 ( Trogynosurge ) pasang Rp 40,733.00
358 Handscoon Sterill obgyn No. 6.5 ( Trogynosurge ) pasang Rp 43,400.60
359 Handscoon Sterill obgyn No. 7,5 ( Trogynosurge ) pasang Rp 40,733.00
360 Handscoon Sterill obgyn No. 7,5 ( Trogynosurge ) pasang Rp 43,400.60
361 Handscoon Sterill obgyn No. 8,5 ( Trogynosurge ) pasang Rp 40,733.00
362 Handsrub 500 ml btl Rp 85,000.00
363 Harum Plate Bipo Adult Non Cable Pcs Rp 198,000.00
364 Harum Plate Mono Adult Non Cable Pcs Rp 198,000.00
365 HbsAg Pcs Rp 7,805.00
366 HbsAg Pcs Rp 5,725.24
367 HD chateter triple lumen pcs Rp 1,221,000.00
368 HD chateter triple lumen Pcs Rp 1,721,500.00
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369 Hemodialisis Pack Pack Rp 42,350.00
370 Hemodialisis Pack Pack Rp 48,400.00
371 High Flow Nasal Cannula dewasa L Pcs Rp 804,375.00
372 High Flow Nasal Cannula dewasa M Pcs Rp 804,375.00
373 High Flow Nasal Cannula dewasa S Pcs Rp 804,375.00
374 HMEF Filter pcs Rp 77,000.00
375 Hyflex CM 06/25 #25mm Pcs Rp 2,145,000.00
376 Hyflex CM File 04/20 #25mm Pcs Rp 1,295,800.00
377 Hyflex CM File 04/20 #25mm (04/25) Pcs Rp 2,145,000.00
378 Hyflex EDM 10.05 Glidepath file 25mm Pcs Rp 2,057,000.00
379 Hyflex EDM 10.05 Glidepath file 25mm Pcs Rp 1,295,800.00
380 Hyflex EDM 25/08 One File #25mm Pack Rp 2,057,000.00
381 Hyflex EDM 25/12 Orifice Opener #15mm Pack Rp 2,057,000.00
382 I.V catheter No. 14 Pcs Rp 6,270.00
383 I.V catheter No. 18 Pcs Rp 6,270.00
384 Incifilm 45 X 55 pcs Rp 194,482.00
385 Infant Bonet Uk. 22-25 cm Pcs Rp 819,500.00
386 Infant Bonet Uk. 25-29 cm Pcs Rp 842,600.00
387 Infant Bonet Uk. 29-36 cm Pcs Rp 877,800.00
388 Infuset Makro bh Rp 11,000.00
389 Infuset Makro Pcs Rp 8,880.00
390 Infuset Makro for Pump bh Rp 21,780.00
391 Infuset Makro for Pump Pcs Rp 61,050.00
392 Infuset Makro for Pump Pcs Rp 50,820.00
393 Infusion set anak Pcs Rp 9,130.00
394 Infusion Set Anak pcs Rp 5,916.00
395 Infusion Set Dewasa pcs Rp 5,328.00
396 Infusion Set With Y Injection Set Pcs Rp 10,615.00
397 Infusion Set -Y dewasa pcs Rp 7,992.00
398 Infusion Set -Y dewasa pcs Rp 6,900.00
399 Infusion Set -Y Pediatrik pcs Rp 7,457.50
400 intubation stylet uk L (no 14 ) Pcs Rp 115,280.00
401 intubation stylet uk L (no 14 ) Pcs Rp 105,600.00
402 intubation stylet uk m (no 10 ) Pcs Rp 115,280.00
403 intubation stylet uk m (no 10 ) Pcs Rp 105,600.00
404 intubation stylet uk s ( no 6 ) Pcs Rp 115,280.00
405 intubation stylet uk s ( no 6 ) Pcs Rp 105,600.00
406 IO Blue 1ml (Trypan Blue) Pcs Rp 123,750.00
407 IO Chol 1ml (Carbhachol) Pcs Rp 115,000.00
408 IO Chol 1ml (Carbhachol) Pcs Rp 123,750.00
409 IO Gel 2ml PFS (HPMC) Pcs Rp 136,000.00
410 IO Gel 2ml PFS (HPMC) Pcs Rp 137,307.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
411 IV canula With Injection Valve and Wings No 18 Pcs Rp 7,455.00
412 IV canula With Injection Valve and Wings No 20 pcs Rp 7,455.00
413 IV canula With Injection Valve and Wings No 20 pcs Rp 11,000.00
414 IV canula With Injection Valve and Wings No 22 pcs Rp 7,455.00
415 IV canula With Injection Valve and Wings No 24 pcs Rp 7,455.00
416 IV canula With Injection Valve and Wings No 26 pcs Rp 7,455.00
417 Iv Catheter With Inj. Port No. 16 pcs Rp 31,900.00
418 IV Chateter Safety With Injc Port No. 20 Pcs Rp 17,438.00
419 IV Chateter Safety With Injc Port No. 22 Pcs Rp 17,438.00
420 IV Chateter Safety With Injc Port No. 24 Pcs Rp 17,438.00
421 IV Chateter Safety With Injc Port No. 26 Pcs Rp 18,171.00
422 JARUM CITOJECT NO. 12 BOX Rp 172,150.00
423 JARUM CITOJECT NO. 16 BOX Rp 172,150.00
424 Jarum Irigasi 1 Sisi Uk. 30G PACK Rp 521,500.00
425 Jelly / Ultrasonic Gel 250 mL Botol Rp 330,000.00
426 Jelly / Ultrasonic Gel 250 mL Botol Rp 15,246.00
427 Jelly / Ultrasonic Gel 250 mL Botol Rp 19,000.00
428 Jelly / Ultrasonic Gel 5L roll Rp 330,000.00
429 Kapas 250gr roll Rp 20,250.00
430 KAPSUL KOSONG NO. 0 PACK Rp 51,150.00
431 KAPSUL KOSONG NO. 1 PACK Rp 49,450.00
432 KAPSUL KOSONG NO. 1 PACK Rp 82,500.00
433 KAPSUL KOSONG NO. 2 PACK Rp 47,750.00
434 KAPSUL KOSONG NO. 2 PACK Rp 60,000.00
435 KAPSUL KOSONG NO. 2 PACK Rp 55,000.00
436 KAPSUL KOSONG NO.00 PACK Rp 133,100.00
437 KAPSUL KOSONG NO.00 PACK Rp 95,625.00
438 KAPSUL KOSONG NO.00 PACK Rp 110,000.00
439 KAPSUL KOSONG NO.00 PACK Rp 121,000.00
440 KARMAN CURRETE NO 6 PCS Rp 132,000.00
441 KARMAN CURRETE NO 7 PCS Rp 132,000.00
442 KARMAN CURRETE NO 8 PCS Rp 132,000.00
443 Kartu Golongan Darah Lembar Rp 330.00
444 Kartu Golongan Darah Lembar Rp 1,100.00
445 Kasa 16x 16 Box Rp 3,850.00
446 Kasa 16x 20 Box Rp 11,000.00
447 Kasa 2,5 x 10 cm Roll Rp 2,300.00
448 Kasa 3 x 5 cm Roll Rp 950.00
449 Kasa 80X40 New DRC Roll Rp 156,600.00
450 Kasa hydrofill 80X40 Roll Rp 220,000.00

451 Kasa Hydrophil 16cmx 20 cm ktk Rp 11,000.00

452 Kasa Lipat 10 x 10 cm lbr Rp 3,080.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
453 Kasa lipat 5 x 10 cm lbr Rp 1,540.00
454 Kasa Steril 40x80 Roll Rp 149,500.00
455 Kasa Sterill 16x16 ktk Rp 4,950.00
456 Kendal Steril Water btl Rp 54,600.00
457 Kertas CTG FC 700 ( 215 mm x 25 m ) 8" Roll Rp 191,400.00
458 Kertas EKG 110x140x142 lusin Rp 220,000.00
459 Kertas EKG OP-222TE Roll Rp 157,300.00
460 KERTAS EKG DIXION 1012 EXP PACK Rp 499,500.00
461 Kertas EKG Dixion/Sharp M3708A Pack Rp 514,800.00
462 Kertas EKG Fetatrack 310 PACK Rp 567,800.00
463 Kertas EKG OP-69 TE Fukuda 210mmx30 m Roll Rp 166,500.00
464 Kertas EKG OP-69 TE Fukuda 210mmx30 m Roll Rp 165,000.00
465 Kertas EKG OP-69 TE Fukuda 210mmx30 m Roll Rp 176,000.00
466 Kertas Lakmus merah box Rp 64,900.00
467 Kertas Puyer Pack Rp 220,000.00
468 K-FILE # 10 31 MM 6 Pcs / Box Rp 191,400.00
469 K-FILE M-Acces 25mm #008 Pcs Rp 176,000.00
470 K-FILE M-Acces 25mm #010 Box Rp 198,000.00
471 K-FILE M-Acces 25mm #010 Pcs Rp 176,000.00
472 K-FILE M-Acces 25mm #010 Pcs Rp 55,000.00
473 K-FILE M-Acces 25mm #015 Box Rp 198,000.00
474 K-FILE M-Acces 31mm #015 Box Rp 198,000.00
475 K-File Svenska 10-L25 Pcs Rp 200,000.00
476 Killbac wound Irrigation Btl Rp 45,000.00
477 Laringeal Mask Airway (LMA) 2 Pcs Rp 141,166.67
478 Laringeal Mask Airway (LMA) 2,5 Pcs Rp 141,166.67
479 Laringeal Mask Airway (LMA) 3 Pcs Rp 141,166.67
480 Laringeal Mask Airway (LMA) 4 Pcs Rp 141,166.67
481 Laringeal Mask Airway (LMA) 5 Pcs Rp 141,166.67
482 Larutan Ziehl neelsen Botol Rp 324,363.00
483 Le Forte Auto Screw 16-NF-004 PCS Rp 529,500.00
484 Le Forte Auto Screw 16-NF-005 PCS Rp 529,500.00
485 Le Forte Micro System 12-CD-012 PCS Rp 1,217,500.00
486 Le Forte Micro System 12-DY-106 PCS Rp 1,044,800.00
487 Le Forte Micro System 12-LL-004 PCS Rp 869,000.00
488 Le Forte Micro System 12-LR-004 PCS Rp 869,000.00
489 Le Forte Micro System 12-ST-018 pcs Rp 1,564,000.00
490 Light curing LED 8 woodpecker Pcs Rp 1,650,000.00
491 LS 1.5 x 4mm Hex Head Screws (4/pack) PCS Rp 4,052,000.00
492 LS 1.5/0.5 Mesh Panel 100mm x 100mm 20x20 Hole PCS Rp 15,380,000.00
493 Lyostypt 5 X 8 cm Pcs Rp 82,800.00
494 Manset Monitor Adult Pcs Rp 610,500.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
495 Masker 3 Ply (prog HIV) box Rp 114,500.00
496 MASKER Bedah box Rp 54,000.00
497 MASKER Bedah box Rp 22,000.00
498 Masker N 95 pcs Rp 24,000.00
499 Masker N 95 pcs Rp 48,000.00
500 Masker N 95 PCS Rp 45,895.00
501 Masker N 95 pcs Rp -
502 Masker N 95 pcs Rp 20,125.05
503 Masker N 95 pcs Rp 37,125.00
504 Masker Nebulizer Anak Pcs Rp 19,372.00
505 Masker Nebulizer Anak Pcs Rp 21,445.20
506 Masker Nebulizer Dewasa Pcs Rp 20,350.00
507 Masker Nebulizer Dewasa Pcs Rp 24,750.00
508 Masker Nebulizer Dewasa Pcs Rp 26,444.00
509 Masker NIV Pcs Rp 2,088,900.00
510 Masker Non Rebreathing Dewasa Pcs Rp 24,055.56
511 Masker Non Rebreathing Dewasa Pcs Rp 15,400.00
512 Masker Non Rebreathing Dewasa Pcs Rp 15,080.00
513 Masker Non Rebreating Anak Pcs Rp 66,300.00
514 Masker Non Rebreating Anak Pcs Rp 65,000.00
515 Masker Non Rebreating Anak Pcs Rp 23,833.33
516 Masker oxygen Anak Pcs Rp 25,867.00
517 Masker Rebreating Anak Pcs Rp 43,800.00
518 Masker Rebreating Anak Pcs Rp 61,975.00
519 Masker Tipe earloop Pcs Rp 990.00
520 Masker Tipe earloop pcs Rp 1,584.00
521 Masker Tipe jilbab box Rp 37,400.00
522 Maxgenol Pcs Rp 44,000.00
523 Maxiflow anak ( masker nebu ) Pcs Rp 14,229.60
524 medifix line PCS Rp 325,000.00
525 Metracide 1 L btl Rp 2,618,000.00
526 Metraclin spray 750 mL Pcs Rp 145,000.00
527 Microbrush Pack Rp 313,500.00
528 Microbrush Pack Rp 200,000.00
529 Microtube (@100 pcs) Pak Rp 340,670.00
530 Monosyn 3/0 ds 24 Pcs Rp 88,244.00
531 Monosyn 4/0 ds 24 Pcs Rp 85,105.00
532 Mortal Pastle 16 cm set Rp 106,700.00
533 MUCUS EXTRACTOR - LOTUS PCS Rp 17,600.00
534 MY Jelly Pcs Rp 55,500.00
535 MY Jelly Pcs Rp 55,000.00
536 Nasal Prong 3.0 mm/2.0 mm/ BC 3020 Pcs Rp 305,800.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
537 Nasal Prong 3.5 mm/2.0 mm/ BC 3520 Pcs Rp 305,800.00
538 Nasal Prong 4.0 mm/3.0 mm/ BC 4030 Pcs Rp 305,800.00
539 Nasal Prong 4.5 mm/4.0 mm/ BC 4540 Pcs Rp 305,800.00
540 Nasal Tubing 50 / BC 190 Pcs Rp 701,800.00
541 Nasal Tubing 50 / BC 191 Pcs Rp 701,800.00
542 Nasal Tubing 50 / BC 192 Pcs Rp 701,800.00
543 Neddle Fistula Set Rp 31,350.00
544 Neddle Fistula Set Rp 33,440.00
545 Needle 23G pcs Rp 660.00
546 Needle 23G pcs Rp 1,650.00
547 Needle 25G Pcs Rp 311.02
548 Needle 25G Pcs Rp 709.50
549 Needle 25G Pcs Rp 1,430.00
550 Needle 27G Pcs Rp 841.50
551 NGT No. 10 pcs Rp 39,405.00
552 NGT no. 12 Pcs Rp 9,420.57
553 NGT No. 14 pcs Rp 9,420.57
554 NGT No. 16 pcs Rp 31,279.80
555 NGT No. 16 pcs Rp 9,420.57
556 NGT No. 16 pcs Rp 42,900.00
557 NGT No. 18 pcs Rp 31,279.80
558 NGT No. 18 pcs Rp 10,010.00
559 NGT No. 3,5 pcs Rp 42,680.00
560 NGT No. 3,5 pcs Rp 36,800.00
561 NGT No. 5 (100 cm) pcs Rp 14,080.00
562 NGT No. 5 (40 cm) pcs Rp 14,080.00
563 NGT No. 8 (100 cm) Pcs Rp 14,080.00
564 NGT No. 8 (40 CM) Pcs Rp 14,080.00
565 Nursecap Pcs Rp 1,155.00
566 Nursecap Pack Rp 50,000.00
567 Nursecap/ medical caps Pcs Rp 52,500.00
568 Object Glass 72 Pcs / Box Rp 29,700.00
569 Oly MD400 W&H Pcs Rp 583,000.00
570 One scrub 5 L Galon Rp 462,000.00
571 Ophtalmic 10/0 2 x DLM 6S Nylon ( Davilon / Peter nylon ) PCS Rp 176,400.00
572 Opsite Post op 6,5x5 cm Pcs Rp 5,525.00
573 Opsite Post op 9,5x8,5 cm Pcs Rp 15,755.00
574 Optime 1 1/2 TP 48 mm 90 cm Pcs Rp 68,020.00
575 Optime 1 1/2 TP 48 mm 90 cm Pcs Rp 62,000.00
576 Optime 2/0 cutting pcs Rp 76,533.00
577 Optime 2/0 cutting pcs Rp 86,483.52
578 Optime 2/0 cutting Rp 62,000.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
579 Optime 2/0 RC 3/8 Pcs Rp 77,000.00
580 Optime 2/0 tapper pcs Rp 75,997.44
581 Optime 2/0 tapper pcs Rp 74,030.00
582 Optime 3/0 Pcs Rp 68,706.00
583 Optime 3/0 TP Pcs Rp 55,000.00
584 Optime R 2/0 1/2 TC 36 mm, 90 cm Pcs Rp 44,000.00
585 Optime R 2/0 1/2 TC 36 mm, 90 cm Pcs Rp 65,997.00
586 Optime R 2/0 Tapercut Pcs Rp 44,000.00
587 Optime R 3/0 Pcs Rp 90,465.00
588 Optime R 3/0 Cutting Pcs Rp 69,000.00
589 Optime R 3/0 RC 3/8 Pcs Rp 89,647.00
590 Oxyflow Anak ( selang oksigen ) Pcs Rp 5,775.00
591 Oxygen Flowmeters Nipple 1504 Pcs Rp 57,200.00
592 OXYGEN MASK NEBULIZER PAEDIATRIC PCS Rp 12,180.00
593 OXYGEN MASK NEBULIZER PAEDIATRIC BMED PCS Rp 20,350.00
594 Paper Points Protaper F1 Box Rp 825,000.00
595 Paper Points Protaper F2 Box Rp 825,000.00
596 Paper Points Protaper F3 Box Rp 825,000.00
597 Paper PTS Protaper Ass F4-F5 Box Rp 825,000.00
598 Paper PTS Protaper Ass F1-F3 Box Rp 825,000.00
599 Paper Tape 7,5 x 9,14 cm Roll Rp 37,892.40
600 Parafilm 4" pack Rp 2,354,000.00
601 Pasta Mumifikasi Pcs Rp 390,500.00
602 Pencil Couter pcs Rp 59,180.00
603 Perban elastis 3 rol Rp 17,515.00
604 Perban elastis 3" (7,5x4,5 M) rol Rp 13,875.00
605 Perban elastis 3" (7,5x4,5 M) rol Rp 12,600.00
606 Perban elastis 4" (10x4,5 M) rol Rp 17,760.00
607 Perban elastis 4" (10x4,5 M) rol Rp 15,875.00
608 Perban Elastis 6" Roll Rp 29,189.00
609 Perban Elastis 6" (15x4,5 M) Roll Rp 26,529.00
610 Perban Elastis 6" (15x4,5 M) Roll Rp 24,200.00
611 Performa cath 6F-pigtail 110 cm ( Angiograpic ) Pcs Rp 610,500.00
612 Perfusor Tube White 150 cm pcs Rp 37,000.00
613 Perfusor Tube White 200 cm pcs Rp 39,000.00
614 PERITONEAL TUBE MEDIUM PCS Rp 2,400,000.00
615 Peter Silk 2/0 1/2 TP 30 mm, 75 cm Pcs Rp 40,590.00
616 Peter Silk 2/0 1/2 TP 30 mm, 75 cm Rp 32,500.00
617 PETERS Silk Type 1 USP 4 MET 3/8 Cutting 40 mm 75 cm thread pcs Rp 40,000.00
618 PETERS Silk Type 2/0 USP 3 MET 1/2 Taper point 25 mm 75 cm thread pcs Rp 32,500.00
619 PETERS Silk Type 3/0 USP 2 MET 1/2 Taper point 25 mm 75 cm thread pcs Rp 34,000.00
620 PETERS Silk Type 3/0 USP 2 MET 3/8 Cutting 25 mm 75 cm thread pcs Rp 34,000.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
621 PETERS Silk Type 4/0 USP 1.5 MET 3/8 Cutting 20 mm 75 cm thread pcs Rp 34,000.00
622 Petersilk 4/0 Pcs Rp 34,000.00
623 Pharma Algi F Pcs Rp 29,970.00
624 Pharma Algi F Pcs Rp 29,969.74
625 Pharma Superfoam Carbon Silver 10x10 Pcs Rp 88,637.00
626 Pharma Superfoam Carbon Silver 10x10 Pcs Rp 88,637.00
627 Pharmacol S basic 10 x 10 pcs Rp 47,448.00
628 Pharmafix 10x500cm roll Rp 61,050.00
629 Pharmafix 10x500cm Pcs Rp 61,604.68
630 Pharmafix 15 cm x 500 cm Box Rp 82,500.00
631 Pharmafix 5x500cm Box Rp 31,900.00
632 PIPET LED Pcs Rp 19,800.00
633 PIPET LED Pcs Rp 19,980.00
634 PISAU BEDAH NO. 15 Pcs Rp 3,552.00
635 PISAU BEDAH NO. 23 Pcs Rp 4,364.52
636 PISAU BEDAH NO. 23 Pcs Rp 5,005.00
637 Plastik Instrument Tray Pcs Rp 22,200.00
638 Plester 7,5cm x 4,5m ROLL Rp 54,667.50
639 Plester 7,5cm x 4,5m ROLL Rp 64,900.00
640 Plester Flexible 10 cm x 10 m Roll Rp 84,043.20
641 Plester Flexible 10 cm x 10 m Roll Rp 86,144.00
642 Plester Flexible 10 cm x 10 m ( Syncera Elextofix 10x 10 ) box Rp 152,636.88
643 Plester Flexible 5 cm x 10 m Roll Rp 55,063.00
644 Plester Flexible 5 cm x 10 m ( Syncera Elextofix 5x 10 ) box Rp 67,243.88
645 Plester Silikon Pcs Rp 155,000.00
646 Plesterin bulat box Rp 36,750.00
647 Plesterin bulat box Rp 20,350.00
648 PMMA IOL, ANTERIOR CHAMBER Box Rp 275,000.00
649 PMMA IOL, ANTERIOR CHAMBER Box Rp 254,300.00
650 PMMA IOL, POSTERIOR CHAMBER ( Bioflex ) Box Rp 181,500.00
651 PMMA Posterior Lens Size : 15.5 Pcs Rp 173,250.00
652 PMMA Posterior (Trulens) No. 21 Pcs Rp 250,000.00
653 PMMA Posterior Chamber, Clear, Round Edge Standard Lens Size : 22 Pcs Rp 250,000.00
654 Poliban 10 cm x 2,7 M pcs Rp 15,099.997
655 Poliban 15 cm x 2,7 M pcs Rp 20,300.005
656 Poliban 5 cm x 2,7 M pcs Rp 7,800.001
657 Poliban 7,5 cm x 2,7 M pcs Rp 11,699.996
658 Poliban Natural 10 cm pcs Rp 17,700.001
659 Poliban Natural 15 cm pcs Rp 27,500.000
660 Poliban Natural 7,5 cm pcs Rp 13,999.997
661 Polikasa 42 yard x 110 cm roll Rp 869,000.00
662 Polikasa 42 yard x 110 cm roll Rp 348,900.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
663 Polyamix Membran Dialyser Tipe Polyflux L Buah Rp 226,050.00
664 Polyamix Membrane Dialyser Tipe Polyflux L Buah Rp 236,170.00
665 Polypropylene 2/0 HR25 box Rp 88,916.67
666 Postifix 10x15 cm Pcs Rp 17,306.00
667 Postofix 10 cm x 10 cm Pcs Rp 16,189.00
668 postofix 10 x 25 Pcs Rp 29,379.00
669 Pot salep 10 ml PCS Rp 2,200.00
670 Pot salep 30 ml Pcs Rp 2,350.00
671 Pot salep 50 ml Pcs Rp 2,500.00
672 Pot Urine 100 ml Pcs Rp 2,700.00
673 Pot Urine 100 ml Pcs Rp 1,980.00
674 Pouches Gussetted 200 x 55 x 100 Roll Rp 1,351,000.00
675 Pouches Sterill Flat 10 cm x 200m Roll Rp 665,000.00
676 Pouches Sterill Flat 10 cm x 200m Roll Rp 731,500.00
677 Pouches Sterill Flat 15 cm x 200m Roll Rp 1,025,000.00
678 Pouches Sterill Flat 15 cm x 200m Roll Rp 1,127,500.00
679 Pouches Sterill Flat 15cm x 200m Roll Rp 1,354,000.00
680 Pouches Sterill Flat 20cm x 200m Roll Rp 1,648,000.00
681 Pouches Sterill Flat 20cm x 200m Roll Rp 1,330,000.00
682 Pouches Sterill Flat 20cm x 200m Roll Rp 1,463,000.00
683 Pouches Sterill Flat 25 cm x 200m Roll Rp 1,575,000.00
684 Pouches Sterill Flat 30 cm x 200m Roll Rp 1,925,000.00
685 Pouches Sterill Flat 5 cm x 200m Roll Rp 350,000.00
686 Pouches Sterill Flat 7,5cm x 200m Roll Rp 755,000.00
687 Pouches Sterill Flat 7,5cm x 200m Roll Rp 525,000.00
688 Pouches Sterill Flat 7,5cm x 200m Roll Rp 577,500.00
689 POVIDON IODIN 1000 ML Btl Rp 80,850.00
690 POVIDON IODIN 1000 ML btl Rp 132,000.00
691 POVIDON IODIN 1000 ML btl Rp 132,000.00
692 POVIDON IODIN 1000 ML btl Rp 79,200.00
693 POVIDON IODIN 60 ML btl Rp 12,100.00
694 Prelude introducer sheat 6F 11 cm Pcs Rp 396,000.00
695 Premilen 2/0 DS 24 Pcs Rp 52,000.00
696 Premilen 3/0 75 cm ds 24 Pcs Rp 52,000.00
697 Premilen 5/0 pcs Rp 70,027.00
698 Premilen 6/0 45 cm ds 12 Pcs Rp 57,185.66
699 Premilen 7/0 75 cm Pcs Rp 185,700.00
700 Premilene MESH 30x30 cm Pcs Rp 1,311,100.00
701 Premilene MESH 5x10 cm pcs Rp 218,562.30
702 Probe LC LED Pcs Rp 528,000.00
703 Promesh 150x150 mm Pcs Rp 519,200.00
704 Promesh 300x300 mm Pcs Rp 1,650,000.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
705 Protaper F4 - F5 21mm 6 Pcs / Box Rp 1,538,900.00
706 Protaper F4 - F5 25mm 6 Pcs / Box Rp 1,538,900.00
707 Protaper Next GP Points X3 Box Rp 913,000.00
708 PROTAPER NEXT GP POINTS X4-X5 BOX Rp 913,000.00
709 Protaper Universal FHU F1 25mm Blister Rp 1,468,500.00
710 Protaper Universal FHU F2 25mm Blister Rp 1,468,500.00
711 PROTAPER UNIVERSAL FHU F4 21MM BOX Rp 1,212,800.00
712 Quicky suction 500 cc FG 14 pcs Rp 204,380.00
713 Quicky suction 500 cc FG 16 pcs Rp 204,380.00
714 RAPID I HIV (SD BIOLINE) TES Rp 11,738.00
715 RAPID I HIV (SD BIOLINE) box@25 Rp 249,742.00
716 RAPID I HIV (SD BIOLINE) pcs
717 RAPID I HIV 1/2 Ab 3 line pcs Rp 11,750.00
718 RAPID I HIV Diagnostar pcs Rp 11,500.00
719 Rapid Covid one step pcs Rp 210,000.00
720 Rapid tes Antigen pcs Rp -
721 Rapid tes Antigen pcs Rp 97,000.00
722 Rapid tes syphilis tes Rp 333,229.00
723 Rapid tes syphilis SD Bioline tes Rp 7,250.00
724 Reagen Golongan Darah Anti D vial Rp 176,000.00
725 Resuscitator set adult ( Ambubag ) Pcs Rp 696,300.00
726 Resuscitator set adult ( Ambubag ) Pcs Rp 333,000.00
727 Ring Pesarium Uk. 6,5 Pcs Rp 110,000.00
728 Ring Pesarium Uk. 7,0 Pcs Rp 110,000.00
729 Ring Pesarium Uk. 7,5 Pcs Rp 110,000.00
730 Ring Pesarium Uk. 8,5 Pcs Rp 110,000.00
731 Saccarum Lactis kg Rp 313,500.00
732 Safe T Pro Uno ( Blood lancet ) Pcs Rp 671.9955
733 SAFETY BOX 10 L Pcs Rp 38,500.00
734 SAFETY BOX 12,5L PCS Rp 46,999.70
735 SAFETY BOX 12,5L PCS Rp 21,450.00
736 Safil 0 HR 40s pcs Rp 94,765.00
737 Safil 1 HR 48 90 cm Pcs Rp 99,550.00
738 Safil 2/0 90 cm hr26 pcs Rp 103,800.00
739 Safil 4/0 HR 22 Rp 91,050.00
740 Safil 8/0 30 cm Pcs Rp 176,400.00
741 SALIVA EJECTOR PACK Rp 100,000.00
742 Sample Container 40 ml pcs Rp 3,960.00
743 Sample Container 60 ml Pcs Rp 23,028.00
744 Sample Container 60 ml Pcs Rp 3,300.00
745 Scotchbond Pcs Rp 284,900.00
746 SELANG OKSIGEN BAYI Pcs Rp 8,087.67
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
747 Selang Oksigen Dewasa pcs Rp 7,433.33
748 Selang Oksigen Dewasa pcs Rp 10,450.00
749 Selang Oksigen Dewasa pcs Rp 8,250.00
750 Selang Oksigen Dewasa pcs Rp 6,333.00
751 Selang Oxygen Infant ( anak ) Pcs Rp 8,087.67
752 Sensor Anak SPO2 Pcs Rp 3,701,500.00
753 Sensor Oximetri/SPO2 Pcs Rp 715,330.00
754 Sensor Oximetri/SPO2 Pcs Rp 715,550.00
755 SEPTALKAN Alcohol Free Cleaner Disinfectant pcs Rp 166,016.00
756 SEPTALKAN Alcohol Free Cleaner Disinfectant pcs Rp 166,016.00
757 SEPTALKAN Lingettes/Wipes Alcohol Free Cleaner Disinfectant pcs Rp 142,000.00
758 Silk 1 3/8 TC 40 mm 75 cm pcs Rp 40,000.00
759 Silk 2/0 (Triton) Pcs Rp 46,200.00
760 Silk 3/0 76 Cm reverse cutting Pcs Rp 41,400.00
761 Silk 4/0 1/2 TP 16 mm 75 mm pcs Rp 32,500.00
762 Silk 4/0 cutting Pcs Rp 45,430.00
763 Single Bond Universal Btl Rp 1,854,600.00
764 Single Bond Universal Btl Rp 1,061,500.00
765 Single Bond Universal Btl Rp 999,000.00
766 Skin Prep Gel Tube Rp 990,000.00
767 Slit Anggled 2.75mm pcs Rp 175,000.00
768 Soda lime 5 L Ken Rp 863,500.00
769 Sodium citrat tube 3,2% pack Rp 198,000.00
770 Solution Administration Set for pump Pcs Rp 21,780.00
771 Solven ( Formalin ) 1000 ml Btl Rp 247,500.00
772 Spalk 10 cm x 100 cm Pcs Rp 117,975.00
773 Spalk 10 cm x 80 cm Pcs Rp 90,750.00
774 Spalk 10 cm x 90 cm Pcs Rp 99,825.00
775 Spalk 5x50 Pcs Rp 110,000.00
776 Spalk 6 cm x 20 cm Pcs Rp 18,150.00
777 Spalk 7 cm x 30 cm Pcs Rp 32,670.00
778 Spalk 7 cm x 40 cm Pcs Rp 49,500.00
779 Spalk 7 cm x 50 cm Pcs Rp 54,450.00
780 Spalk 7x100 Pcs Rp 185,000.00
781 Spalk 7x50 Pcs Rp 110,000.00
782 Spalk 7x70 Pcs Rp 165,000.00
783 Spalk 8 cm x 60 cm Pcs Rp 63,525.00
784 Spalk 8 cm x 70 cm Pcs Rp 81,675.00
785 Spinocain no. 23 Pcs Rp 32,000.00
786 Spinocan / Atraucan 26 Pcs Rp 32,000.00
787 Spinocan G 25 Pcs Rp 47,740.00
788 Spinocan G 25 Pcs Rp 47,740.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
789 Spinocan G 27 Pcs Rp 51,700.00
790 Spinocan G 27 Pcs Rp 51,700.00
791 Spuit 1 cc Pcs Rp 1,573.00
792 Spuit 1 cc Pcs Rp 4,224.00
793 Spuit 1cc Tuberculin pcs Rp 2,719.27
794 Spuit 1cc Tuberculin pcs Rp 1,430.00
795 Spuit 1cc Tuberculin pcs Rp 1,021.96
796 Stab Knife 15 degree pcs Rp 175,000.00
797 Steam adhesive tape 500 cm x 1,9 cm Roll Rp 162,800.00
798 Steam indicator strip type 4 10 cmx1,6 cm Sanpack Box Rp 250,000.00
799 STERICLIN Medical Packaging - FLAT, 42CM /200M pcs Rp 3,520,000.00
800 STERICLIN Medical Packaging - GUSSET, 30CM x 6.5CM x 100M pcs Rp 1,706,100.00
801 STERICLIN Medical Packaging - GUSSET, 38CM x 8CM x 100M pcs Rp 2,227,500.00
802 Steriflo 350 mL Botol Rp 38,265.70
803 Suction Chateter ( no 10 ) PCS Rp 3,596.00
804 Suction Chateter No. 12 PCS Rp 9,470.00
805 Suction Chateter No. 12 Pcs Rp 4,730.00
806 Suction Chateter No. 14 Pcs Rp 4,562.25
807 Suction Chateter No. 16 Pcs Rp 4,562.25
808 Suction Chateter No. 18 Pcs Rp 4,562.25
809 Suction Chateter No. 6 Pcs Rp 4,400.00
810 Suction Chateter No. 8 Pcs Rp 3,124.00
811 Suction Chateter No. 8 Pcs Rp 4,730.00
812 Suction Tube Pcs Rp 24,354.00
813 Suctionpro 72 Duel Lumen (Close Suction) pcs Rp 178,480.00
814 Surgical Sterile Powder Free Gloves Size 6.0 pcs Rp 5,390.00
815 Surgical Sterile Powder Free Gloves Size 6.5 pcs Rp 5,390.00
816 SURPLUG ET 20 CM PCS Rp 43,212.00
817 SURPLUG ET 20 CM Pcs Rp 143,000.00
818 T Bond Polyester 1 75 cm J needle pcs Rp 80,700.02
819 T- Hernia mesh 5 cm x 10 cm Pcs Rp 129,580.00
820 T- Hernia mesh 6 cm x 10 cm Pcs Rp 168,080.00
821 T Skin Marker Steril Reguler Pcs Rp 37,367.00
822 T vio 1 90 cm pcs Rp 85,910.00
823 T vio 1 90 cm pcs Rp 86,691.00
824 T vio 3/0 RC pcs Rp 72,150.00
825 T vio 8/0 pcs Rp 95,305.00
826 T vio 8/0 25 cm pcs Rp 108,000.09
827 Tabung Venoject EDTA K3 PACK Rp 189,255.00
828 Tabung Venoject EDTA K3 PACK Rp 187,550.00
829 Tabung Venoject EDTA K3 PACK Rp 187,000.00
830 Tabung Venoject EDTA K3 PACK Rp 159,500.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
831 Tarazym 1 L Botol Rp 1,300,000.00
832 Tarazym 1 L Botol Rp 1,430,000.00
833 T-Dio 1 Pcs Rp 147,180.00
834 Test lung Infant Pcs Rp 1,650,000.00
835 Test Tube 12 X 75 mm Pcs Rp 800.00
836 Test Tube 16x100 pcs Rp 487,850.00
837 T-Hemocel 5 x 7,5 cm Pcs Rp 74,500.00
838 T-Hemovine 8 x 3 cm Pcs Rp 112,500.00
839 T-Hemovine 8 x 5 x 1 cm Pcs Rp 75,000.00
840 THERMOTRACH TRACHEOSTOMY HME PCS Rp 35,035.00
841 THERMOTRACH TRACHEOSTOMY HME PCS Rp 35,030.00
842 Thoracic Trocar Chateter FG 24 Pcs Rp 289,850.00
843 T-Lene 1 Pcs Rp 91,630.00
844 Tofflemire matrix holder Pcs Rp 156,200.00
845 Tourniquet Pcs Rp 22,000.00
846 Tourniquet Pcs Rp 25,300.00
847 Tracheostomy Kit No. 4 box Rp 587,400.00
848 Tracheostomy Kit No. 7 box Rp 2,090,000.00
849 TRANSOFIX PCS Rp 14,300.00
850 Tro soluset autostop Pcs Rp 26,062.58
851 T-Vio 1 Pcs Rp 85,910.00
852 T-Vio 2/0 Pcs Rp 78,650.00
853 T-Vio 3/0 Pcs Rp 71,500.00
854 Tyvex 100m x 15cm sanpack Roll Rp 3,250,000.00
855 Tyvex 100m x 30cm sanpack Roll Rp 6,350,000.00
856 Tyvex 100m x 7,5cm sanpack Roll Rp 1,650,000.00
857 UDF CARBON FILTER Pcs Rp 105,600.00
858 Ultra Filter U 9000 Pcs Rp 2,200,000.00
859 Umbilical cord Pcs Rp 2,310.00
860 Urimeter pcs Rp 126,350.00
861 Urine Bag w/o Hanger Pcs Rp 7,150.00
862 Urine Bag With Hanger Pcs Rp 9,009.00
863 Urocare Foley Cath 3 Way No. 20 Box Rp 341,250.00
864 USG Paper Roll Rp 312,345.00
865 Vagina Speculum Disp Uk. M Pcs Rp 18,000.00
866 Vagina Speculum Disp Uk. S Pcs Rp 18,000.00
867 Vaselin swab Pcs Rp 9,075.00
868 Vaselin swab Pcs Rp 9,157.50

869 Vaselin swab Pcs Rp 6,300.00

870 Venoject Plain Clot Activator 3ml PACK Rp 183,700.00
871 Venoject Plain Clot Activator 3ml (monotes vacum tube red ) Pack Rp 187,000.00
872 Ventiseal Oral Nasal ET Without Cuff Tube No. 2,5 pcs Rp 28,750.00
NO NAMA OBAT SATUAN HARGA DASAR

1 2 3 4
873 Ventiseal Oral Nasal ET Without Cuff Tube No. 3 pcs Rp 28,750.00
874 Ventiseal Oral Nasal ET Without Cuff Tube No. 3,5 pcs Rp 28,750.00
875 Verban 4x10 Roll Rp 2,620.00
876 Verban 4x5 Roll Rp 1,500.00
877 Verband 3,6 m x 10cm Roll Rp 2,439.50
878 Verband 3,6 m x 10cm Roll Rp 1,575.00

879 Verband 3,6 m x 5 cm Roll Rp 786.67

880 VERBAND 4X10 GID CARE PACK Rp 31,442.00
881 VERBAND 4X5 GID CARE PACK Rp 18,005.00
882 Volumetric Pipette 3ml - Iwaki Pyrex Pcs Rp 146,300.00
883 Volumetric Pipette 5ml - Iwaki Pyrex Pcs Rp 172,700.00
884 Volumetric set for pump pcs Rp 57,596.00
885 VTM Pcs
886 VTM JUN NUO Pcs Rp 80,000.00
887 VTM Lakebio Pcs Rp 33,418.00
888 WATER AND ADPTER RESPIX20 (Steril water ) BOTOL Rp 44,400.00
889 WATER AND ADPTER RESPIX20 (Steril water ) BOTOL Rp 64,999.00
890 Wing Neddle No. 23 Pcs Rp 1,470.00
891 Wing Neddle No. 25 Pcs Rp 1,470.00
892 Wing Neddle No. 27 Pcs Rp 1,827.00
893 Wing Neddle No. 27 Pcs Rp 15,750.00
894 Wraping Paper Reliance Uk. 120x120cm Box Rp 2,849,000.00
895 X-tra Base Caps 16x0.25g Universal Box Rp 1,573,000.00
896 Yellow Tip Pak Rp 121,000.00
897 Yellow Tip Pak Rp 71,500.00
898 Zitemp denpro Pcs Rp 77,700.00

Mengetahui
Direktur RSUD. Sultan Sy. Muhammad Alkadrie
Kota Pontianak

dr. Rifka, MM
NIP. 19740303 200212 2 006