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RSU SUNDARI

JL. TB. SIMATUPANG (PINANG BARIS) NO. 31


MEDAN - 20127
Telp : 061 8452541, 8452536
Fax : 061 8452536

LAPORAN PEMAKAIAN OBAT DAN ALKES PERIODE : 1 Januari 2018 s/d 31

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

A-B VASK 5 MG TAB Tablet 10.00 0.00 0.00 0.00 0.00

ABBOCATH 14 Pcs 7.00 22.00 0.00 0.00 0.00

ABBOCATH 16 Pcs 1.00 4.00 0.00 0.00 0.00

ABBOCATH 18 Pcs 565.00 3,517.00 0.00 43.00 0.00

ABBOCATH 20 Pcs 34.00 221.00 0.00 2.00 0.00

ABBOCATH 22 Pcs 310.00 4,712.00 0.00 31.00 0.00

ABBOCATH 24 Pcs 569.00 2,559.00 0.00 16.00 0.00

ABBOCATH 26 Pcs 176.00 451.00 0.00 0.00 0.00

ACRAN - 1,405.00 20.00 0.00 0.00 0.00

ACRAN INJ Ampul 757.00 1.00 0.00 4.00 0.00

ACTAVOL DROP Botol 16.00 0.00 0.00 0.00 0.00

ACYCLOVIR 200 MG TAB Tablet 153.00 181.00 0.00 20.00 0.00

ACYCLOVIR 400 MG TAB Tablet 343.00 934.00 0.00 70.00 0.00

ACYCLOVIR ZALF Tube 44.00 46.00 0.00 8.00 0.00

AKILEN Botol 66.00 157.00 0.00 3.00 0.00

AKTA-VOL DROP Botol 13.00 0.00 0.00 0.00 0.00

ALBENDAZOLE TAB Box 0.00 22.00 0.00 0.00 0.00

ALBOTHYL Botol 1.00 0.00 0.00 0.00 0.00

ALBOTHYL OVULA SUPP supp 117.00 0.00 0.00 0.00 0.00

ALBUMIN 25% INJ Vial 6.00 1.00 0.00 0.00 0.00

ALBUMIN 50 ML INJ Ampul 2.00 2.00 0.00 0.00 0.00

ALDISA SR - 680.00 10.00 0.00 0.00 0.00

ALERNITIS - 20.00 0.00 0.00 0.00 0.00

ALINAMIN F INJ Ampul 40.00 293.00 0.00 0.00 0.00

ALKOHOL SWABS Pcs 14.00 0.00 0.00 0.00 0.00

ALLUPURINOL 100 MG TAB Tablet 233.00 3,256.00 0.00 8.00 0.00

ALLUPURINOL 300 MG TAB Tablet 667.00 7,053.00 0.00 0.00 0.00

ALORIS - 10.00 14.00 0.00 0.00 0.00

ALPRAZOLAM - 936.00 1,840.00 0.00 14.00 0.00

AMBACIN INJ Ampul 47.00 157.00 0.00 15.00 0.00

AMBEVEN TAB Tablet 264.00 2,277.00 0.00 0.00 0.00

AMBROXOL Tablet 125.00 2,475.00 0.00 0.00 0.00

AMBROXOL SYR Botol 207.00 2,760.00 0.00 15.00 0.00

AMINOFIUID INF Fls 11.00 26.00 0.00 0.00 0.00

AMINOPHILIN INJ Ampul 51.00 603.00 0.00 0.00 0.00

AMINOPHYLIN TAB Tablet 534.00 11,301.00 0.00 10.00 0.00


AMITRIPTILIN 25 MG TAB Tablet 81.00 1,910.00 0.00 6.00 0.00

AMLODIPIN 10 MG TAB Tablet 829.00 8,208.00 0.00 135.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

AMLODIPIN 5 MG TAB Tablet 1,551.00 7,805.00 0.00 42.00 0.00

AMOKSISILIN SYR Botol 0.00 46.00 0.00 2.00 0.00

AMOXAN DROP Botol 338.00 4.00 0.00 3.00 0.00

AMOXICILLIN 500 MG TAB Tablet 1,518.00 3,290.00 0.00 93.00 0.00

AMOXICILLIN SYR Botol 17.00 199.00 0.00 4.00 0.00

AMOXSAN 250 - 50.00 0.00 0.00 0.00 0.00

AMOXSAN 500 - 1,096.00 10.00 0.00 0.00 0.00

AMOXSAN FORTE SYR Botol 56.00 0.00 0.00 0.00 0.00

AMOXSAN SYR Botol 148.00 3.00 0.00 1.00 0.00

AMPICILIN / SANPICILIN INJ Ampul 296.00 737.00 0.00 11.00 0.00

ANALSIK - 584.00 11.00 0.00 0.00 0.00

ANALTRAM - 299.00 5.00 0.00 0.00 0.00

ANDALAN SUNTIK 3 BULAN Pcs 2.00 1.00 0.00 0.00 0.00

ANDALAN TCU Pcs 2.00 0.00 0.00 0.00 0.00

ANTALGIN TAB Tablet 26.00 6.00 0.00 0.00 0.00

ANTANGIN DEWASA SYR Botol 0.00 4.00 0.00 0.00 0.00

ANTANGIN DEWASA TAB Tablet 30.00 65.00 0.00 0.00 0.00

ANTASIDA DOEN SYR Botol 550.00 8,324.00 0.00 37.00 0.00

ANTASIDA TAB Tablet 563.00 4,195.00 0.00 24.00 0.00

ANTIMO ANAK TAB Tablet 3.00 0.00 0.00 0.00 0.00

ANTIMO DEWASA TAB Tablet 1.00 0.00 0.00 0.00 0.00

APIALIS SYR Botol 146.00 2.00 0.00 0.00 0.00

APIALYS DROP Botol 26.00 0.00 0.00 0.00 0.00

APIDRA INSULIN Vial 7.00 156.00 0.00 0.00 0.00

APTOR (ASETOSAL) 100 MG TAB Tablet 249.00 8,972.00 0.00 143.00 0.00

AQUABIDES BOTOL KACA INF Fls 2.00 14.00 0.00 0.00 0.00

AQUADES INJ Ampul 1,558.00 10,713.00 0.00 83.00 0.00

AS. TRANEKSAMAT 250 MG INJ Ampul 22.00 91.00 0.00 0.00 0.00

AS. TRANEKSAMAT 500 MG INJ Ampul 434.00 4,939.00 0.00 19.00 0.00

ASAM MEFENAMAT 500 MG TAB Tablet 6,316.00 26,210.00 0.00 322.00 0.00

ASAM TRANEKSAMAT 500 MG TAB Tablet 1,103.00 5,105.00 0.00 84.00 0.00

ASPILET - 52.00 1,677.00 0.00 20.00 0.00

ATROPIN INJ Ampul 68.00 372.00 0.00 5.00 0.00

ATS INJ Ampul 4.00 4.00 0.00 0.00 0.00

AUTOCLAVE KERING OZONE ELECTRA OM Pcs 0.00 2.00 0.00 2.00 0.00

BABY COUGH SYR Botol 1.00 1.00 0.00 0.00 0.00

BACTODERM 10 GR Tube 8.00 0.00 0.00 1.00 0.00

BACTODERM 5 GR Tube 133.00 5.00 0.00 3.00 0.00


BALPIRIK KUNING ZALF Tube 0.00 2.00 0.00 0.00 0.00

BAQUINOR FORTE - 1,266.00 6.00 0.00 0.00 0.00

BECOM C TAB Tablet 3,472.00 5.00 0.00 0.00 0.00

BEDAK KOCOK Botol 3.00 25.00 0.00 0.00 0.00

BENANG CAT CHROMIC 2 Pcs 0.00 1.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

BENANG CAT PLAIN 1 Pcs 1.00 6.00 0.00 0.00 0.00

BENANG CAT PLAIN 2/0 Pcs 0.00 1.00 0.00 0.00 0.00

BENANG CAT PLAIN 3 Pcs 2.00 0.00 0.00 0.00 0.00

BENANG CHROMIC NO 1 SACHET Pcs 1.00 2.00 0.00 0.00 0.00

BENANG CHROMIC NO 2 SACHET Pcs 2.00 11.00 0.00 0.00 0.00

BENANG PLAIN 3/0 Pcs 1.00 0.00 0.00 0.00 0.00

BENANG PLAIN NO 1 SACHET Pcs 2.00 53.00 0.00 0.00 0.00

BENANG SILK 2/0 (3 METRIK) Pcs 0.00 13.00 0.00 0.00 0.00

BENANG SILK BLACK 2/0 Pcs 1.00 0.00 0.00 0.00 0.00

BENANG T.SILK 3/0 Pcs 0.00 1.00 0.00 0.00 0.00

BENANG T.VIO NO 2 Pcs 134.00 1,126.00 0.00 15.00 0.00

BENANG T.VIO 4-0 Pcs 0.00 2.00 0.00 0.00 0.00

BENANG T.VIO 5/0 Pcs 0.00 1.00 0.00 0.00 0.00

BENANG T.VIO BP2 (1) Pcs 166.00 1,330.00 0.00 13.00 0.00

BENANG T.VIO NO 2/0 Pcs 3.00 5.00 0.00 0.00 0.00

BENANG T.VIO NO 3/0 Pcs 1.00 4.00 0.00 1.00 0.00

BETADINE 1 L Botol 9.00 0.00 0.00 0.00 0.00

BETADINE 5 ML Botol 235.00 0.00 0.00 0.00 0.00

BETAHISTIN 6 MG TAB Tablet 1,113.00 13,203.00 0.00 71.00 0.00

BETAMETASONE ZALF Tube 84.00 236.00 0.00 4.00 0.00

BETARHIN - 15.00 0.00 0.00 0.00 0.00

BETASON N ZALF Tube 24.00 3.00 0.00 0.00 0.00

BETRIX INJ Ampul 34.00 0.00 0.00 0.00 0.00

BICNAT TAB Tablet 1,365.00 10,636.00 0.00 0.00 0.00

BIOCREAM ZALF Tube 2.00 0.00 0.00 0.00 0.00

BIOPANCA Pcs 1,571.00 2,318.00 0.00 32.00 0.00

BIOPLACENTON ZALF Tube 6.00 0.00 0.00 0.00 0.00

BIOTHICOL 250 - 106.00 0.00 0.00 0.00 0.00

BIOTHICOL 500 - 1,049.00 20.00 0.00 0.00 0.00

BIOTHICOL FORTE SYR Botol 55.00 0.00 0.00 0.00 0.00

BIOTHICOL SYR Botol 152.00 4.00 0.00 0.00 0.00

BISOLVON INJ Ampul 0.00 1.00 0.00 0.00 0.00

BISOPROLOL 5 MG TAB Tablet 431.00 3,327.00 0.00 68.00 0.00

BLEDSTOP Tablet 65.00 46.00 0.00 15.00 0.00

BLOOD PRESSURE MONITOR Pcs 0.00 1.00 0.00 0.00 0.00


BLOOD SET Pcs 72.00 389.00 0.00 3.00 0.00

BODREX FLU DAN BATUK TAB Tablet 4.00 0.00 0.00 0.00 0.00

BOTOL DOT HUKI 60 ML Pcs 2.00 0.00 0.00 0.00 0.00

BOTOL DOT PIGEON 120 ML Pcs 28.00 0.00 0.00 0.00 0.00

BOTOL DOT PIGEON 160 ML Pcs 12.00 0.00 0.00 0.00 0.00

BOTOL DOT PIGEON 240 ML Pcs 14.00 0.00 0.00 0.00 0.00

BOTOL DOT PIGEON 50 ML Pcs 412.00 0.00 0.00 0.00 0.00

BOTOL H2O2 Pcs 3.00 7.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

BREATHY Botol 9.00 0.00 0.00 0.00 0.00

BUFECT FORTE SYR Botol 57.00 0.00 0.00 0.00 0.00

BUFECT SYR Botol 64.00 2.00 0.00 0.00 0.00

BUNASCAN / BUCAIN / REGIVEL Ampul 146.00 1,168.00 0.00 14.00 0.00

BURNAZIN PLUS Tube 44.00 0.00 0.00 0.00 0.00

BUSCOPAN - 1,170.00 153.00 0.00 4.00 0.00

BYE BYE FEVER ANAK Pcs 76.00 0.00 0.00 0.00 0.00

BYE BYE FEVER BAYI Pcs 101.00 0.00 0.00 0.00 0.00

CAIRAN 4:1 INF Fls 90.00 137.00 0.00 0.00 0.00

CAL 95 TAB Tablet 2,524.00 0.00 0.00 0.00 0.00

CALSIUM LACTAT TAB Tablet 240.00 3,349.00 0.00 415.00 0.00

CANDESARTAN - 1.00 0.00 0.00 0.00 0.00

CANDISTIN DROP Botol 65.00 0.00 0.00 0.00 0.00

CAPTROPIL 12,5 MG TAB Tablet 207.00 166.00 0.00 0.00 0.00

CAPTROPIL 25 MG TAB Tablet 810.00 768.00 0.00 6.00 0.00

CARBAZOCHROME SODIUM SULFONATE Ampul 1.00 111.00 0.00 0.00 0.00

CARMED 10% ZALF Tube 5.00 34.00 0.00 0.00 0.00

CATAFLAM 25 - 50.00 0.00 0.00 0.00 0.00

CATAFLAM 50 - 279.00 0.00 0.00 0.00 0.00

CAVICUR TAB Tablet 821.00 7,820.00 0.00 51.00 0.00

CEFADROXIL 500 MG TAB Tablet 6,812.00 45,820.00 0.00 361.00 0.00

CEFADROXIL SYR Botol 66.00 832.00 0.00 4.00 0.00

CEFAT 250 - 44.00 0.00 0.00 0.00 0.00

CEFAT 500 - 946.00 5.00 0.00 0.00 0.00

CEFAT FORTE SYR Botol 35.00 0.00 0.00 0.00 0.00

CEFAT SYR Botol 75.00 0.00 0.00 0.00 0.00

CEFILA - 762.00 0.00 0.00 0.00 0.00

CEFILA SYR Botol 10.00 1.00 0.00 0.00 0.00

CEFIXIME SYR Botol 38.00 0.00 0.00 0.00 0.00

CEFIXIME TAB Tablet 1,729.00 53.00 0.00 81.00 0.00

CEFOTAXIME INJ Ampul 653.00 7,279.00 0.00 43.00 0.00


CEFSPAN SYR Botol 3.00 0.00 0.00 0.00 0.00

CEFTRIAXONE INJ Ampul 2,628.00 26,242.00 0.00 167.00 0.00

CEFXON INJ Ampul 201.00 0.00 0.00 18.00 0.00

CELEMEK Pcs 1.00 0.00 0.00 0.00 0.00

CELESTAMINE - 1.00 0.00 0.00 0.00 0.00

CELESTAMINE SYR Botol 45.00 0.00 0.00 0.00 0.00

CENDO ASTHENOF Strip 0.00 4.00 0.00 0.00 0.00

CENDO CARPIN Strip 5.00 51.00 0.00 0.00 0.00

CENDO FLOXA Strip 145.00 1,879.00 0.00 3.00 0.00

CENDO GENTA Strip 0.00 12.00 0.00 0.00 0.00

CENDO LYTEERS Strip 0.00 1.00 0.00 0.00 0.00

CENDO MYDRIATIL Strip 31.00 447.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

CENDO PANTOCAIN Strip 0.00 34.00 0.00 0.00 0.00

CENDO POLIDEX Strip 0.00 18.00 0.00 0.00 0.00

CENDO TIMOL Strip 20.00 512.00 0.00 0.00 0.00

CENDO TROBOSAN Strip 88.00 930.00 0.00 0.00 0.00

CENDO XITROL STRIP - 73.00 191.00 0.00 0.00 0.00

CENDO XYTROL Strip 18.00 6.00 0.00 0.00 0.00

CEPEZET - 15.00 30.00 0.00 0.00 0.00

CEREBROVIT X-CEL Tablet 24.00 0.00 0.00 0.00 0.00

CERINI - 376.00 0.00 0.00 0.00 0.00

CERINI SYR Botol 41.00 0.00 0.00 0.00 0.00

CETADOP / DOPAMIN INJ Ampul 0.00 3.00 0.00 0.00 0.00

CETINAL SYR Botol 0.00 1.00 0.00 0.00 0.00

CETIRIZINE 10 MG TAB Tablet 2,632.00 13,204.00 0.00 140.00 0.00

CETIRIZINE SYR Botol 98.00 254.00 0.00 3.00 0.00

CHATETER NO 10 Pcs 2.00 2.00 0.00 0.00 0.00

CHATETER NO 12 Pcs 1.00 2.00 0.00 0.00 0.00

CHATETER NO 14 Pcs 5.00 26.00 0.00 0.00 0.00

CHATETER NO 16 Pcs 150.00 1,113.00 0.00 13.00 0.00

CHATETER NO 18 Pcs 15.00 90.00 0.00 3.00 0.00

CHATETER NO 18 TREWAY Pcs 0.00 2.00 0.00 0.00 0.00

CHATETER NO 20 BARDIA Pcs 45.00 162.00 0.00 6.00 0.00

CHATETER NO 20 TREWAY Pcs 6.00 35.00 0.00 1.00 0.00

CHATETER NO 6 Pcs 4.00 2.00 0.00 0.00 0.00

CHATETER NO 8 Pcs 2.00 1.00 0.00 0.00 0.00

CHLORAMPENICOL 250 MG TAB Tablet 239.00 8,329.00 0.00 18.00 0.00

CIMETIDIN 200 MG TAB Tablet 120.00 684.00 0.00 20.00 0.00

CIPROFLOKSASIN INF Fls 28.00 432.00 0.00 0.00 0.00

CIPROFLOXACIN 500 MG TAB Tablet 1,852.00 8,277.00 0.00 60.00 0.00


CITICOLIN INJ Ampul 21.00 0.00 0.00 0.00 0.00

CITICOLIN TAB Tablet 18.00 0.00 0.00 0.00 0.00

CLANEKSI SYR Botol 2.00 0.00 0.00 0.00 0.00

CLINDAMICIN 150 MG TAB Tablet 49.00 295.00 0.00 0.00 0.00

CLINDAMICIN 300 MG TAB Tablet 377.00 1,192.00 0.00 55.00 0.00

CLINMAS 300 - 43.00 9.00 0.00 0.00 0.00

CLOPIDOGREL - 126.00 1,025.00 0.00 52.00 0.00

CODEIN - 1,381.00 20,699.00 0.00 77.00 0.00

COLSACETINE INJ Ampul 52.00 192.00 0.00 5.00 0.00

COMBANTRIN 250MG TAB Tablet 0.00 1.00 0.00 0.00 0.00

COMBANTRIN SYR Botol 2.00 1.00 0.00 0.00 0.00

COMBIVENT INJ Ampul 16.00 8.00 0.00 0.00 0.00

CONFIDENCE XL ISI 8 Bungkus 2.00 0.00 0.00 0.00 0.00

CORTIDEX - 2,593.00 52.00 0.00 0.00 0.00

CORTIDEX INJ Ampul 41.00 30.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

COTRIMAKSAZOL 480 MG TAB Tablet 794.00 4,124.00 0.00 10.00 0.00

COTRIMOKSAZOL SYR Botol 64.00 465.00 0.00 3.00 0.00

CPG - 8.00 124.00 0.00 0.00 0.00

CRAVOX 500 - 335.00 4.00 0.00 0.00 0.00

CRAVOX 500 INJ Ampul 99.00 0.00 0.00 0.00 0.00

CRAVOX 750 INJ Ampul 35.00 0.00 0.00 0.00 0.00

CTM TAB Tablet 714.00 1,683.50 0.00 5.00 0.00

CURCUMA PLUS SYR Botol 3.00 29.00 0.00 0.00 0.00

CYANOCOBALAMIN INJ Box 5.00 0.00 0.00 0.00 0.00

CYCLOFEM Pcs 34.00 0.00 0.00 0.00 0.00

CYGEST 400 SUPP supp 57.00 11.00 0.00 0.00 0.00

DAKTARIN ORAL GEL Botol 1.00 0.00 0.00 0.00 0.00

DAMABEN - 61.00 0.00 0.00 0.00 0.00

DARYANT TULLE Box 11.00 0.00 0.00 0.00 0.00

DEGRIUM - 2.00 0.00 0.00 0.00 0.00

DEKSTRO 10% INF Fls 5.00 120.00 0.00 0.00 0.00

DEKSTRO 40% INF Fls 9.00 119.00 0.00 0.00 0.00

DEKSTRO 5% 100 ML INF Fls 4.00 13.00 0.00 0.00 0.00

DEKSTRO 5% INF Fls 8.00 181.00 0.00 0.00 0.00

DERMAFIX NON WATER 10X25CM Lembar 11.00 85.00 0.00 2.00 0.00

DERMAVIX 10X15 Pcs 17.00 142.00 0.00 0.00 0.00

DERMAVIX 10X25 Pcs 262.00 1,960.00 0.00 23.00 0.00

DERMAVIX S Pcs 0.00 1.00 0.00 0.00 0.00

DESOLEX ZALF Tube 1.00 0.00 0.00 0.00 0.00


DEXAMETHASONE 0,5 MG TAB Tablet 964.00 2,621.00 0.00 10.00 0.00

DEXAMETHASONE INJ Ampul 651.00 4,919.00 0.00 35.00 0.00

DIAZEPAM - 194.00 127.00 0.00 26.00 0.00

DIGOXIN 0,25 MG TAB Tablet 36.00 328.00 0.00 0.00 0.00

DISFLATYL - 32.00 6.00 0.00 0.00 0.00

DISPOSABLE VOLUMETIC Pcs 0.00 1.00 0.00 0.00 0.00

DOBUTEL / DOBUTAMIN INJ Ampul 1.00 6.00 0.00 0.00 0.00

DOCARE/ EASYCARE Pcs 106.00 417.00 0.00 5.00 0.00

DOKSISIKLIN 100 MG TAB Tablet 723.00 3,177.00 0.00 10.00 0.00

DOM - 10.00 1.00 0.00 0.00 0.00

DOMPERIDONE 10 MG TAB Tablet 2,810.00 39,280.00 0.00 232.00 0.00

DOMPERIDONE SYR Botol 102.00 595.00 0.00 8.00 0.00

DULCOLAC - 139.00 1,663.00 0.00 0.00 0.00

DULCOLAC 10 SUPP supp 70.00 248.00 0.00 5.00 0.00

DULCOLAC 5 SUPP supp 14.00 52.00 0.00 2.00 0.00

DULCULATOL SYR Botol 19.00 0.00 0.00 0.00 0.00

EASY CARE Pcs 770.00 3,597.00 0.00 45.00 0.00

EDORISON DROP Botol 195.00 1.00 0.00 1.00 0.00

ELASTIS VERBAN B Pcs 5.00 18.00 0.00 1.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

ELASTIS VERBAN U Pcs 9.00 0.00 0.00 0.00 0.00

ELEKTRODA Pcs 0.00 81.00 0.00 0.00 0.00

ELKANA - 7,483.00 0.00 0.00 0.00 0.00

ELKANA CL Botol 4.00 0.00 0.00 0.00 0.00

ELKANA SYR Botol 1.00 0.00 0.00 0.00 0.00

ENTROSTOP TAB Tablet 10.00 0.00 0.00 0.00 0.00

ENYSTIN DROP Botol 45.00 186.00 0.00 0.00 0.00

EPEXOL - 23.00 0.00 0.00 0.00 0.00

EPEXOL DROP Botol 171.00 0.00 0.00 1.00 0.00

EPEXOL SYR Botol 53.00 0.00 0.00 0.00 0.00

EPHEDRIN INJ Ampul 26.00 245.00 0.00 4.00 0.00

EPIDOSIN INJ Ampul 44.00 230.00 0.00 4.00 0.00

EPINEPRIN INJ Ampul 8.00 91.00 0.00 0.00 0.00

EPISAN SYR Botol 254.00 4.00 0.00 6.00 0.00

ERYSANBE - 177.00 20.00 0.00 0.00 0.00

ERYSANBE SYR Botol 24.00 1.00 0.00 0.00 0.00

ERYTROMICIN 500 MG SYR Botol 5.00 56.00 0.00 0.00 0.00

ERYTROMICIN 500 MG TAB Tablet 26.00 526.00 0.00 15.00 0.00

ESILGAN - 469.00 0.00 0.00 0.00 0.00

ETAMBUTOL 500 MG TAB Tablet 1,059.00 6,825.00 0.00 172.00 0.00

ETHIPERAN / CLOPRAMEL INJ Ampul 955.00 13,614.00 0.00 88.00 0.00


ETHYL CHLORIDE Pcs 0.00 4.00 0.00 0.00 0.00

ETT NO 3,5 Pcs 0.00 2.00 0.00 0.00 0.00

ETT NO 4 Pcs 0.00 2.00 0.00 0.00 0.00

ETT NO 4,5 Pcs 0.00 3.00 0.00 0.00 0.00

ETT NO 5 Pcs 0.00 1.00 0.00 0.00 0.00

ETT NO 6,5 Pcs 0.00 3.00 0.00 0.00 0.00

ETT NO 7 Pcs 1.00 8.00 0.00 0.00 0.00

ETT NO 7,5 Pcs 3.00 12.00 0.00 0.00 0.00

EUTHYROX - 14.00 134.00 0.00 0.00 0.00

EXT TUBE Pcs 2.00 10.00 0.00 0.00 0.00

FACTU SUPP supp 53.00 0.00 0.00 0.00 0.00

FENTANYL - 28.00 113.00 0.00 1.00 0.00

FG. TROCHES - 1,159.00 0.00 0.00 0.00 0.00

FLAGYSTATIN SUPP supp 6.00 0.00 0.00 0.00 0.00

FLAMAR 25 - 345.00 0.00 0.00 0.00 0.00

FLAMAR 50MG Box 15.00 0.00 0.00 0.00 0.00

FLIXIOTIDE INJ Nebul 70.00 1,065.00 0.00 0.00 0.00

FLIXOTIDE INJ Ampul 127.00 1,273.00 0.00 0.00 0.00

FLUCADEX TAB Tablet 0.00 10.00 0.00 0.00 0.00

FOLAVIT - 43,676.00 611.00 0.00 80.00 0.00

FOLIC ACID/AS.FOLAT TAB Tablet 680.00 6,137.00 0.00 243.00 0.00

FORANE (OK) Botol 1.00 0.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

FORBETES - 85.00 0.00 0.00 0.00 0.00

FORMUNO - 602.00 16.00 0.00 7.00 0.00

FORMYCO - 32.00 0.00 0.00 0.00 0.00

FORMYCO ZALF Tube 11.00 0.00 0.00 0.00 0.00

FORUMEN Botol 14.00 8.00 0.00 1.00 0.00

FREGO - 147.00 14.00 0.00 0.00 0.00

FRISIUM - 20.00 0.00 0.00 0.00 0.00

FUCOHELIX SYR Botol 4.00 0.00 0.00 0.00 0.00

FUROSEMID INJ Ampul 193.00 2,878.00 0.00 3.00 0.00

FUROSEMID TAB Tablet 654.00 7,010.00 0.00 116.00 0.00

FUTROLIT INJ Ampul 19.00 6.00 0.00 0.00 0.00

GABAPENTIN - 59.00 2,388.00 0.00 6.00 0.00

GENOCLOM - 129.00 0.00 0.00 0.00 0.00

GENOIN SALEP MATA Strip 15.00 35.00 0.00 1.00 0.00

GENOIN TETES MATA Strip 0.00 1.00 0.00 0.00 0.00

GENOIN ZALF Tube 0.00 2.00 0.00 0.00 0.00

GENTAMISIN ZALF Tube 219.00 2,451.00 0.00 34.00 0.00


GENTANAL / GENTAMISIN INJ Ampul 571.00 3,898.00 0.00 43.00 0.00

GENTIAN VIOLET Tube 9.00 6.00 0.00 0.00 0.00

GG TAB Tablet 585.00 8,801.00 0.00 20.00 0.00

GLAUKON/ GLAUSETA - 385.00 4,626.00 0.00 0.00 0.00

GLIBENCLAMID TAB Tablet 154.00 66.00 0.00 0.00 0.00

GLICUIDONE Tablet 26.00 4,907.00 0.00 14.00 0.00

GLIMEPIRIDE 2 MG TAB Tablet 304.00 13,748.00 0.00 223.00 0.00

GLUCOPHAGE - 9.00 0.00 0.00 0.00 0.00

GLUKOSAMINE - 705.00 19,674.00 0.00 31.00 0.00

GLURENOM TAB Tablet 5.00 211.00 0.00 0.00 0.00

GOM Tube 10.00 68.00 0.00 0.00 0.00

GRAFOLA DHA - 977.00 0.00 0.00 0.00 0.00

GUDEL Pcs 0.00 1.00 0.00 0.00 0.00

H2O2 Botol 84.00 146.00 0.00 5.00 0.00

HAEMOCAIN ZALF Fls 6.00 1.00 0.00 0.00 0.00

HALOPERIDOL 0,5 TAB Box 0.00 82.00 0.00 0.00 0.00

HALOPERIDOL TAB Tablet 0.00 341.00 0.00 0.00 0.00

HANSCOON NO 6,5 Pcs 461.00 3,387.00 0.00 37.00 0.00

HANSCOON NO 7 Pcs 408.00 2,760.00 0.00 28.00 0.00

HANSCOON NO 7,5 Pcs 207.00 1,644.00 0.00 14.00 0.00

HANSCOON NO 7,5 GAMEX Pcs 221.00 1,452.00 0.00 17.00 0.00

HANSCOON NO 8 Pcs 43.00 269.00 0.00 8.00 0.00

HANSCOON NO 8 GAMEX Pcs 130.00 800.00 0.00 5.00 0.00

HANSCOON NON STERIL Pcs 3.00 0.00 0.00 0.00 0.00

HANSCOON OBGYN (VK) Pcs 0.00 1.00 0.00 0.00 0.00

HARNAL - 13.00 239.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

HARNAL OCAS - 4.00 12.00 0.00 0.00 0.00

HEMOTASE Pcs 3.00 14.00 0.00 0.00 0.00

HEPATIN - 144.00 0.00 0.00 0.00 0.00

HEPATITIS INJ Ampul 82.00 312.00 0.00 9.00 0.00

HEPTASAN - 80.00 0.00 0.00 0.00 0.00

HIDROCLOROTIAZID (HCT) TAB Tablet 93.00 832.00 0.00 0.00 0.00

HISTOLAN - 217.00 42.00 0.00 10.00 0.00

HYDROCORTISON ZALF Tube 20.00 93.00 0.00 0.00 0.00

HYOSINE INJ Ampul 47.00 221.00 0.00 2.00 0.00

HYOSINE TAB Tablet 412.00 3,088.00 0.00 7.00 0.00

HYPAFIX Pcs 2.00 1.00 0.00 0.00 0.00

IBUPROFEN 200 MG TAB Tablet 10.00 189.00 0.00 0.00 0.00

IBUPROFEN 400 MG TAB Tablet 913.00 8,667.00 0.00 30.00 0.00

IBUPROFEN SYR Botol 55.00 212.00 0.00 0.00 0.00


IKAGEN ZALF Tube 16.00 0.00 0.00 0.00 0.00

ILIADIN 0,025% Botol 7.00 2.00 0.00 0.00 0.00

ILIADIN 0,05% Botol 40.00 94.00 0.00 3.00 0.00

IMBOOST FORCE - 315.00 0.00 0.00 0.00 0.00

IMODIUM - 272.00 8.00 0.00 0.00 0.00

IMUNOS - 1,119.00 22.00 0.00 0.00 0.00

IMUNOS PLUS - 80.00 0.00 0.00 4.00 0.00

IMUNOS PLUS SYR Botol 2.00 0.00 0.00 0.00 0.00

IMUNOS SYR Botol 23.00 0.00 0.00 0.00 0.00

INF MANITOL Botol 5.00 34.00 0.00 0.00 0.00

INFUSET MAKRO Pcs 693.00 4,352.00 0.00 50.00 0.00

INFUSET MIKRO Pcs 145.00 361.00 0.00 3.00 0.00

INH 300MG Tablet 532.00 3,501.00 0.00 35.00 0.00

IRBERSATAN TAB Tablet 125.00 3,397.00 0.00 7.00 0.00

ISONIAZID (INH 300 MG) TAB Tablet 4.00 63.00 0.00 0.00 0.00

ISOPRINOSINE SYR Botol 3.00 0.00 0.00 0.00 0.00

ISOSORBID DINITRAT 10MG TAB Box 17.00 1,296.00 0.00 81.00 0.00

ISOSORBID DINITRAT 5 MG TAB Tablet 232.00 9,900.00 0.00 96.00 0.00

ITZOL - 209.00 0.00 0.00 0.00 0.00

KAEN 3B INF Fls 270.00 441.00 0.00 0.00 0.00

KAFLAM - 2.00 0.00 0.00 0.00 0.00

KALNEX - 10.00 0.00 0.00 0.00 0.00

KALTROPEN SUPP supp 223.00 469.00 0.00 3.00 0.00

KANAMISIN INJ Ampul 2.00 2.00 0.00 0.00 0.00

KANINA SYR Botol 4.00 27.00 0.00 0.00 0.00

KAOLIN PACTIN /KANINA SYR Botol 3.00 8.00 0.00 1.00 0.00

KAPAS Pcs 2.00 0.00 0.00 0.00 0.00

KAPEDOSIN (INH 400 MG) TAB Tablet 1,032.00 3,554.00 0.00 38.00 0.00

KARET DOT DODO L Pcs 3.00 0.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

KARET DOT DODO M Pcs 5.00 0.00 0.00 0.00 0.00

KARET DOT DODO S Pcs 21.00 0.00 0.00 0.00 0.00

KARET DOT DODO XL Pcs 2.00 0.00 0.00 0.00 0.00

KARET DOT PIGEON L Pcs 7.00 0.00 0.00 0.00 0.00

KARET DOT PIGEON M Pcs 21.00 0.00 0.00 0.00 0.00

KARET DOT PIGEON S Pcs 103.00 0.00 0.00 0.00 0.00

KARET DOT YOUNG M Pcs 4.00 0.00 0.00 0.00 0.00

KARET DOT YOUNG S Pcs 1.00 0.00 0.00 0.00 0.00

KASSA GULUNG Pcs 1.00 0.00 0.00 0.00 0.00

KASSA STERIL Pcs 348.00 1.00 0.00 0.00 0.00


KCL INF Fls 10.00 108.00 0.00 0.00 0.00

KENALOG Botol 4.00 0.00 0.00 0.00 0.00

KENALOG CREAM Tube 14.00 1.00 0.00 0.00 0.00

KERTAS EKG Pcs 18.00 155.00 0.00 2.00 0.00

KETESSE - 532.00 0.00 0.00 0.00 0.00

KETOKOANAZOL TAB Tablet 215.00 433.00 0.00 0.00 0.00

KETOKONAZOL ZALF Tube 45.00 86.00 0.00 2.00 0.00

KETOMED SS Botol 1.00 0.00 0.00 0.00 0.00

KETOMED ZALF Tube 12.00 2.00 0.00 0.00 0.00

KETOROLAK INJ Ampul 1,877.00 24,424.00 0.00 184.00 0.00

KETOROLAK TAB Tablet 352.00 81.00 0.00 0.00 0.00

KLODERM 5 GR ZALF Tube 9.00 0.00 0.00 0.00 0.00

KOMPENG PIGEON Pcs 1.00 0.00 0.00 0.00 0.00

KONDOM SUTRA Pcs 2.00 0.00 0.00 0.00 0.00

KSR - 215.00 236.00 0.00 0.00 0.00

KTM INJ Ampul 13.00 57.00 0.00 0.00 0.00

LACTACYD BABY Botol 15.00 1.00 0.00 0.00 0.00

LACTAMOM - 287.00 150.00 0.00 0.00 0.00

LACTAMOR - 20.00 0.00 0.00 0.00 0.00

LACTO-B - 6.00 0.00 0.00 0.00 0.00

LACTOPAIN INJ Ampul 266.00 1.00 0.00 31.00 0.00

LAGESIL - 728.00 0.00 0.00 0.00 0.00

LAGESIL SYR Botol 66.00 0.00 0.00 1.00 0.00

LAMESON - 700.00 0.00 0.00 0.00 0.00

LAMINARIA Pcs 1.00 2.00 0.00 0.00 0.00

LANAKELOID ZALF Tube 9.00 5.00 0.00 1.00 0.00

LANSOPRAZOLE TAB Tablet 1,102.00 45.00 0.00 50.00 0.00

LANTUS INJ Ampul 5.00 122.00 0.00 0.00 0.00

LAPIBAL - 136.00 0.00 0.00 0.00 0.00

LAPICEF - 1,852.00 16.00 0.00 0.00 0.00

LAPICEF 125 SYR Botol 143.00 1.00 0.00 0.00 0.00

LAPICEF 250 SYR Botol 28.00 0.00 0.00 0.00 0.00

LAPIFLOX - 917.00 14.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

LAPIMOX - 651.00 0.00 0.00 0.00 0.00

LAPIMOX 125 SYR Botol 33.00 0.00 0.00 1.00 0.00

LAPIMOX 250 ML Botol 29.00 0.00 0.00 0.00 0.00

LAPISIV SYR Botol 19.00 0.00 0.00 0.00 0.00

LAPISTAN - 2,498.00 25.00 0.00 0.00 0.00

LAPIXIME INJ Ampul 164.00 0.00 0.00 0.00 0.00

LAPRAZ - 126.00 18.00 0.00 0.00 0.00


LASAL - 14.00 0.00 0.00 0.00 0.00

LASAL EKSPEKTORAN SYR Botol 40.00 0.00 0.00 0.00 0.00

LASAL SYR Botol 17.00 0.00 0.00 0.00 0.00

LASGAN - 644.00 0.00 0.00 0.00 0.00

LASIX - 37.00 0.00 0.00 0.00 0.00

LAXANA TAB Box 92.00 619.00 0.00 0.00 0.00

LAXING TAB Tablet 0.00 25.00 0.00 0.00 0.00

L-BIO - 687.00 6.00 0.00 0.00 0.00

LEVOCIN Botol 22.00 0.00 0.00 0.00 0.00

LEVOCIN 500 - 153.00 10.00 0.00 0.00 0.00

LEVOCIN 500 INJ Ampul 14.00 0.00 0.00 0.00 0.00

LEVOFLOXACIN 500 MG TAB Tablet 1,674.00 15,310.00 0.00 164.00 0.00

LEVOFLOXACIN INJ Ampul 41.00 7.00 0.00 6.00 0.00

LIDOCAIN INJ Ampul 326.00 1,676.00 0.00 24.00 0.00

LIDODEX INJ Ampul 0.00 3.00 0.00 0.00 0.00

LIFE CARE L1 Pcs 37.00 0.00 0.00 0.00 0.00

LIFE CARE M1 Pcs 24.00 0.00 0.00 0.00 0.00

LIFE FREE L8 Pcs 8.00 0.00 0.00 0.00 0.00

LIFE KINS M ISI 10 Bungkus 1.00 0.00 0.00 0.00 0.00

LIFEE FREE XL7 Pcs 4.00 0.00 0.00 0.00 0.00

LIFREE DWS L1 Pcs 39.00 0.00 0.00 0.00 0.00

LIFREE DWS M9 Pcs 5.00 0.00 0.00 0.00 0.00

LODIA TAB Tablet 1,405.00 46.00 0.00 38.00 0.00

LOMATULE Pcs 3.00 2.00 0.00 0.00 0.00

LOMATULE Lembar 5.00 0.00 0.00 0.00 0.00

LOPERAMID TAB Tablet 1,127.00 9,002.00 0.00 30.00 0.00

LORATADINE 10 MG TAB Tablet 332.00 4,789.00 0.00 31.00 0.00

LQ 500 - 16.00 0.00 0.00 0.00 0.00

LUTENYL - 50.00 0.00 0.00 0.00 0.00

LUTENYL TAB Box 73.00 79.00 0.00 0.00 0.00

L-ZINK SYR Botol 121.00 20.00 0.00 1.00 0.00

MAGNESIUM SULFAT 20% INF Fls 4.00 15.00 0.00 0.00 0.00

MAGNESIUM SULFAT 40% INF Fls 61.00 294.00 0.00 11.00 0.00

MAMY LOVE PANTS XL 7+1 Bungkus 2.00 0.00 0.00 0.00 0.00

MAMY POKO M ISI 4 Bungkus 3.00 0.00 0.00 0.00 0.00

MAMY POKO NEUBORN ISI 1 Bungkus 81.00 0.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

MAMY POKO NEUBORN ISI 14 Bungkus 1.00 0.00 0.00 0.00 0.00

MAMY POKO NEUBORN ISI 4 Bungkus 139.00 0.00 0.00 0.00 0.00

MAMY POKO PANTS ISI M9 Bungkus 28.00 0.00 0.00 0.00 0.00
MAMY POKO PANTS L ISI 1 Bungkus 4.00 0.00 0.00 0.00 0.00

MAMY POKO PANTS L ISI 8 Bungkus 15.00 1.00 0.00 0.00 0.00

MAMY POKO PANTS M ISI 1 Bungkus 59.00 0.00 0.00 0.00 0.00

MAMY POKO PANTS S 12 Pcs 32.00 0.00 0.00 0.00 0.00

MAMY POKO PANTS S ISI 1 Bungkus 36.00 0.00 0.00 0.00 0.00

MAMY POKO PANTS XL ISI 3 Bungkus 2.00 0.00 0.00 0.00 0.00

MAMY POKO PANTS XXL ISI 6 Bungkus 7.00 0.00 0.00 0.00 0.00

MAMY POKO XL7 Pcs 21.00 0.00 0.00 0.00 0.00

MARCAIN INJ Vial 6.00 13.00 0.00 0.00 0.00

MASKER Pcs 916.00 0.00 0.00 0.00 0.00

MEBO CREAM Tube 15.00 0.00 0.00 0.00 0.00

MECOBALAMIN 500 MG TAB Tablet 1,108.00 17,732.00 0.00 125.00 0.00

MEDIKLIM ZALF Tube 1.00 0.00 0.00 0.00 0.00

MEDSCAB CREAM Tube 4.00 0.00 0.00 0.00 0.00

MEFINAL 500 - 3,448.00 45.00 0.00 6.00 0.00

MEFLAM 15 - 669.00 7.00 0.00 0.00 0.00

MELOXICAM 15 MG TAB Tablet 794.00 19,052.00 0.00 80.00 0.00

MELOXICAM 7,5 MG TAB Tablet 426.00 2,849.00 0.00 0.00 0.00

MENARA LIMA ZALF Tube 1.00 0.00 0.00 0.00 0.00

MENTOL SPRITUS Botol 2.00 7.00 0.00 0.00 0.00

MERISLON 6 - 40.00 0.00 0.00 0.00 0.00

MEROPENEM INJ Pcs 6.00 15.00 0.00 0.00 0.00

MEROSAN INJ Pcs 13.00 0.00 0.00 0.00 0.00

MERTIGO - 660.00 21.00 0.00 0.00 0.00

MESS Pcs 2.00 0.00 0.00 0.00 0.00

METFORMIN 500 MG TAB Tablet 1,921.00 23,579.00 0.00 420.00 0.00

METHYCOBAL - 39.00 15.00 0.00 0.00 0.00

METHYLPREDNISOLON 4 MG TAB Tablet 3,832.00 29,093.00 0.00 259.00 0.00

METHYLPREDNISOLON 8 MG TAB Tablet 90.00 793.00 0.00 0.00 0.00

METHYLPREDNISOLON INJ Ampul 47.00 33.00 0.00 0.00 0.00

METRONIDAZOLE 500 MG TAB Tablet 1,964.00 9,116.00 0.00 89.00 0.00

METRONIDAZOLE INF Fls 160.00 1,714.00 0.00 17.00 0.00

METRONIDAZOLE SYR Botol 4.00 18.00 0.00 1.00 0.00

MEYLON INF Fls 0.00 13.00 0.00 0.00 0.00

MICONAZOLE ZALF Tube 23.00 7.00 0.00 0.00 0.00

MICROLAX Botol 14.00 0.00 0.00 0.00 0.00

MILOZ 15 MG - 2.00 5.00 0.00 0.00 0.00

MINYAK CAP AYAM 12 ML Botol 36.00 0.00 0.00 0.00 0.00

MINYAK CAP AYAM 150 ML Botol 1.00 0.00 0.00 0.00 0.00

MINYAK CAP AYAM 25 ML Botol 62.00 0.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN
MINYAK CAP AYAM 40 ML Botol 32.00 0.00 0.00 0.00 0.00

MINYAK CAP LANG 120 ML Botol 3.00 0.00 0.00 0.00 0.00

MINYAK CAP LANG 15 ML Botol 43.00 0.00 0.00 0.00 0.00

MINYAK CAP LANG 30 ML Botol 72.00 0.00 0.00 0.00 0.00

MINYAK CAP LANG 60 ML Botol 39.00 0.00 0.00 0.00 0.00

MINYAK TELON PLUS 60 ML Botol 68.00 0.00 0.00 0.00 0.00

MIOMERGIN / POSPARGIN INJ Ampul 532.00 2,975.00 0.00 36.00 0.00

MIPROS - 492.00 2,321.00 0.00 25.00 0.00

MOLAFATE / SUKRAFLAT SYR Botol 49.00 28.00 0.00 4.00 0.00

MOLOCO B12 - 70.00 6.00 0.00 0.00 0.00

MOVIX - 86.00 0.00 0.00 0.00 0.00

MST CONTINIUS - 60.00 0.00 0.00 0.00 0.00

MUCOHEXIN SYR Botol 9.00 0.00 0.00 0.00 0.00

MUCOS DROP Botol 109.00 1.00 0.00 1.00 0.00

MUCOS SYR Botol 104.00 0.00 0.00 0.00 0.00

MULTY GYN SUPP Pcs 5.00 0.00 0.00 0.00 0.00

MYCO Z ZALF Tube 37.00 1.00 0.00 0.00 0.00

MYONAL - 56.00 0.00 0.00 0.00 0.00

NACL 0,9 100 ML INF Fls 166.00 17.00 0.00 0.00 0.00

NACL 0,9 500 ML INF Fls 512.00 8,341.00 0.00 61.00 0.00

NACL 0,9% 1000 ML INF Fls 0.00 15.00 0.00 0.00 0.00

NACL 0,9% 500ML Botol 6.00 116.00 0.00 2.00 0.00

NACL 3% INF Fls 13.00 78.00 0.00 0.00 0.00

NALD 18 Box 2.00 1.00 0.00 0.00 0.00

NALD 23 Pcs 1,831.00 9,859.00 0.00 97.00 0.00

NALD 25 Box 2.00 9.00 0.00 0.00 0.00

NALD 26 Pcs 1,310.00 6,944.00 0.00 51.00 0.00

NALD HECTING CUT NO 14 Pcs 0.00 1.00 0.00 0.00 0.00

NALD INSULIN Pcs 1,287.00 549.00 0.00 1.00 0.00

NAPREX SYR Botol 36.00 0.00 0.00 0.00 0.00

NASACORT AQ Botol 8.00 66.00 0.00 2.00 0.00

NATRIUM DICLOFENAC 25 M TAB Tablet 20.00 1,785.00 0.00 0.00 0.00

NATRIUM DICLOFENAC 50 MG TAB - 4,031.00 69,423.00 0.00 448.00 0.00

NATRIUM PHENYTOIN INJ Ampul 8.00 23.00 0.00 0.00 0.00

NEBACETIN ZALF Tube 8.00 2.00 0.00 0.00 0.00

NEO DIAFORM TAB Tablet 10.00 9.00 0.00 0.00 0.00

NEO GYNOXA SUPP supp 338.00 63.00 0.00 0.00 0.00

NEO KAOLANA SYR Botol 16.00 0.00 0.00 0.00 0.00

NEOSTIGMIN / PROSTIGMIN INJ Ampul 15.00 67.00 0.00 0.00 0.00

NERFECO - 544.00 0.00 0.00 0.00 0.00

NEULIN 250 INJ Ampul 115.00 0.00 0.00 0.00 0.00

NEULIN PS - 392.00 0.00 0.00 0.00 0.00

NEUROBION 5000 INJ Ampul 36.00 0.00 0.00 0.00 0.00


Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

NEUROBION FORTE - 173.00 0.00 0.00 0.00 0.00

NEUROBION TAB Tablet 40.00 0.00 0.00 0.00 0.00

NEURODEX - 375.00 12.00 0.00 74.00 0.00

NEUROSANBE - 1,291.00 5.00 0.00 0.00 0.00

NEUROSANBE INJ Ampul 77.00 0.00 0.00 1.00 0.00

NEW DIATAB / AKITA TAB Tablet 767.00 1,686.00 0.00 44.00 0.00

NGT 10 Pcs 1.00 2.00 0.00 0.00 0.00

NGT 12 Pcs 0.00 1.00 0.00 0.00 0.00

NGT 14 Pcs 1.00 1.00 0.00 0.00 0.00

NGT 16 Pcs 16.00 71.00 0.00 0.00 0.00

NGT 16 Pcs 8.00 42.00 0.00 0.00 0.00

NGT 18 Pcs 0.00 12.00 0.00 0.00 0.00

NGT 3,5 Pcs 8.00 27.00 0.00 0.00 0.00

NGT 5 Pcs 29.00 63.00 0.00 1.00 0.00

NGT 8 Pcs 7.00 1.00 0.00 0.00 0.00

NIPEDIPINE TAB Tablet 426.00 1,047.00 0.00 47.00 0.00

NONEMI - 2,274.00 0.00 0.00 0.00 0.00

NORFLAM - 16.00 0.00 0.00 0.00 0.00

NORIT TAB Tablet 0.00 12.00 0.00 0.00 0.00

NOSTYRA TAB Tablet 57.00 1,253.00 0.00 15.00 0.00

NOVA T Pcs 16.00 1.00 0.00 0.00 0.00

NOVA T Pcs 4.00 1.00 0.00 0.00 0.00

NOVABION / HUFABION / RAMABION / STARBION Tablet 3,306.00 25,487.00 0.00 592.00 0.00
TAB

NOVADIAR SYR Botol 0.00 14.00 0.00 0.00 0.00

NOVADRYL SYR Botol 133.00 2,815.00 0.00 26.00 0.00

NOVALDO INJ Ampul 639.00 4,881.00 0.00 81.00 0.00

NOVALGIN INJ Ampul 21.00 36.00 0.00 1.00 0.00

NOVERON INJ Ampul 3.00 26.00 0.00 0.00 0.00

NOVOMIX INJ Ampul 6.00 662.00 0.00 0.00 0.00

NOVORAPID INJ Ampul 32.00 694.00 0.00 1.00 0.00

NUTRI BABY SOYA 1 Box 2.00 0.00 0.00 0.00 0.00

NUTRI BABY SOYA 2 Box 1.00 0.00 0.00 0.00 0.00

NUTRIBABY 1 Box 1.00 0.00 0.00 0.00 0.00

NUTRIBABY ROYAL PDF 400GR Kaleng 1.00 0.00 0.00 0.00 0.00

NUTRIBREAST - 11.00 0.00 0.00 0.00 0.00

NUTRIFLAM TAB Box 179.00 18.00 0.00 0.00 0.00

NUTRILON BABY ACTYDUODIO Box 15.00 0.00 0.00 0.00 0.00

NYMIKO DROP Botol 105.00 0.00 0.00 0.00 0.00

OBH COMBI 60 ML SYR Botol 1.00 3.00 0.00 0.00 0.00

OBH COMBI BERDAHAK 100 ML SYR Botol 0.00 5.00 0.00 0.00 0.00
OBH SYR Botol 30.00 176.00 0.00 3.00 0.00

OBP SYR Botol 2.00 0.00 0.00 0.00 0.00

OCTENIC GEL Tube 7.00 0.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

OCUSON - 240.00 0.00 0.00 0.00 0.00

OMEPRAZOLE 20 MG TAB Tablet 2,926.00 67,310.00 0.00 253.00 0.00

OMEPRAZOLE INJ Ampul 94.00 2,362.00 0.00 11.00 0.00

OMNIPAQ Box 0.00 1.00 0.00 0.00 0.00

ONDANSENTRON 4 MG TAB Tablet 2,524.00 0.00 0.00 10.00 0.00

ONDANSENTRON 8 MG TAB Tablet 32.00 0.00 0.00 0.00 0.00

ONDANSENTRON INJ Ampul 479.00 0.00 0.00 0.00 0.00

OROXIN SYR Botol 1.00 0.00 0.00 0.00 0.00

OSFIT DHA Tablet 8,123.00 110.00 0.00 150.00 0.00

OXOFERIN Botol 5.00 0.00 0.00 0.00 0.00

OXOPECT SYR Botol 1.00 0.00 0.00 0.00 0.00

OXORIL SYR Botol 72.00 0.00 0.00 2.00 0.00

OZID REGULER Vial 0.00 6.00 0.00 0.00 0.00

PARAETAMOL INF Botol 33.00 72.00 0.00 0.00 0.00

PARASETAMOL DROP Botol 24.00 266.00 0.00 4.00 0.00

PARASETAMOL SYR Botol 95.00 1,452.00 0.00 15.00 0.00

PARASETAMOL TAB Tablet 3,200.00 68,187.00 0.00 357.00 0.00

PAROLIT / BIORALIT TAB Tablet 478.00 4,458.00 0.00 21.00 0.00

PEDIALYTE SYR Botol 138.00 2.00 0.00 0.00 0.00

PEHACAIN INJ Ampul 31.00 124.00 0.00 1.00 0.00

PENJEPIT TALI PUSAT / UMBILICAL Pcs 110.00 939.00 0.00 11.00 0.00

PEPZOL - 143.00 0.00 0.00 0.00 0.00

PEPZOL INJ Ampul 49.00 0.00 0.00 8.00 0.00

PERBAN ELASTIS UMUM Pcs 1.00 1.00 0.00 0.00 0.00

PERMEN WOODS Tablet 118.00 0.00 0.00 0.00 0.00

PETHIDINE - 29.00 42.00 0.00 1.00 0.00

PGB - 30.00 2.00 0.00 0.00 0.00

PHENITOIN TAB Tablet 134.00 3,265.00 0.00 0.00 0.00

PHENOBARBITAL - 1,503.00 10,448.00 0.00 14.00 0.00

PHISOHEX Botol 15.00 0.00 0.00 1.00 0.00

PIBAKSIN CREAM Tube 1.00 0.00 0.00 0.00 0.00

PIL KB ANDALAN Pcs 30.00 128.00 0.00 1.00 0.00

PIRACETAM 1G INJ Ampul 43.00 3,433.00 0.00 22.00 0.00

PIRACETAM 3G INJEKSI Ampul 0.00 8.00 0.00 0.00 0.00

PIRACETAM 400 MG TAB Tablet 6.00 130.00 0.00 0.00 0.00

PIRACETAM 800MG TAB Tablet 263.00 6,954.00 0.00 115.00 0.00

PIROXICAM 10 MG TAB Tablet 80.00 33.00 0.00 0.00 0.00


PIROXICAM 20 MG TAB Tablet 0.00 32.00 0.00 0.00 0.00

PISPOT Pcs 0.00 1.00 0.00 0.00 0.00

PITOGEN / INDUKSI INJ Ampul 958.00 5,899.00 0.00 80.00 0.00

PLASMINEX - 369.00 6.00 0.00 0.00 0.00

PLEETAL 50 - 26.00 0.00 0.00 0.00 0.00

POLIDEMISIN Botol 19.00 1,118.00 0.00 2.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

POLYBAN Pcs 1.00 6.00 0.00 0.00 0.00

POLYGYP Pcs 2.00 6.00 0.00 0.00 0.00

POSPARGIN 0.125 MG TAB Tablet 3,336.00 10,342.00 0.00 108.00 0.00

PRACETAM 800 MG TAB Tablet 0.00 3.00 0.00 0.00 0.00

PRAXION SYR Botol 9.00 0.00 0.00 0.00 0.00

PRAXION FORTE SYR Botol 7.00 0.00 0.00 0.00 0.00

PREDNISON TAB Tablet 367.00 3,343.00 0.00 14.00 0.00

PREMASTON - 181.00 27.00 0.00 15.00 0.00

PRIMOLUT N - 1,229.00 49.00 0.00 40.00 0.00

PRIMPERAN SYR Botol 1.00 0.00 0.00 0.00 0.00

PRO K INJ Ampul 0.00 1.00 0.00 0.00 0.00

PROANES / SAFOL INJ Ampul 51.00 209.00 0.00 0.00 0.00

PROBIOKID - 1,455.00 2.00 0.00 5.00 0.00

PROCELES SYR Botol 6.00 0.00 0.00 0.00 0.00

PROFELIN - 88.00 0.00 0.00 0.00 0.00

PROHEM INJ Ampul 468.00 1,816.00 0.00 28.00 0.00

PROLIC - 231.00 10.00 0.00 10.00 0.00

PROMAG TAB Tablet 20.00 0.00 0.00 0.00 0.00

PROMAVIT - 3,934.00 1.00 0.00 40.00 0.00

PROMUBA SYR Botol 17.00 0.00 0.00 0.00 0.00

PRONICY - 40.00 0.00 0.00 0.00 0.00

PROPANOLOL 10 MG TAB Tablet 509.00 3,435.00 0.00 88.00 0.00

PROPERTYL - 105.00 0.00 0.00 0.00 0.00

PROPOFOL INJ Vial 1.00 2.00 0.00 0.00 0.00

PRORIS FORTE SYR Botol 15.00 0.00 0.00 0.00 0.00

PRORIS SYR Botol 27.00 1.00 0.00 0.00 0.00

PROTIRA - 1,236.00 14.00 0.00 0.00 0.00

PTU TAB Tablet 0.00 485.00 0.00 0.00 0.00

PULMICORT INJ Vial 62.00 254.00 0.00 0.00 0.00

PULVIS BOTOL Botol 3.00 21.00 0.00 0.00 0.00

PULVIS PERKAMEN Pcs 137.00 1,713.00 0.00 5.00 0.00

PULVIS POT can 12.00 89.00 0.00 0.00 0.00

PUMPISEL INJ Ampul 169.00 0.00 0.00 0.00 0.00

PUMPITOR - 80.00 5.00 0.00 0.00 0.00


PUMPITOR INJ Ampul 3.00 0.00 0.00 0.00 0.00

PYRAZINAMID 500 MG TAB Tablet 1,230.00 6,456.00 0.00 66.00 0.00

QUANTIDEX SYR Botol 20.00 120.00 0.00 1.00 0.00

RAMAFLU TAB Tablet 220.00 4,457.00 0.00 60.00 0.00

RANICHO SYR Botol 54.00 22.00 0.00 0.00 0.00

RANITIDIN INJ Ampul 2,650.00 34,682.00 0.00 258.00 0.00

RANITIDINE TAB Tablet 3,974.00 24,439.00 0.00 127.00 0.00

RATIVOL INJ Ampul 75.00 110.00 0.00 10.00 0.00

RETAPYL TAB Tablet 13.00 0.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

RHINOFED SYR Botol 25.00 0.00 0.00 0.00 0.00

RHINOS JUNIOR SYR Botol 69.00 0.00 0.00 1.00 0.00

RHINOS NEO DROP Botol 73.00 1.00 0.00 1.00 0.00

RHINOS SR - 274.00 0.00 0.00 10.00 0.00

RIFAMPISIN 300 MG TAB Tablet 564.00 1,354.00 0.00 54.00 0.00

RIFAMPISIN 450 MG TAB Tablet 921.00 4,369.00 0.00 133.00 0.00

RIFAMPISIN 600 MG TAB Tablet 201.00 1,943.00 0.00 14.00 0.00

RINGER ASERING INF Fls 2,450.00 52.00 0.00 3.00 0.00

RINGER LACTAT INF Fls 676.00 6,579.00 0.00 18.00 0.00

RINGER LACTAT SANBE INF Fls 5,215.00 52,231.00 0.00 488.00 0.00

RINGER SOLUTION INF Fls 34.00 4.00 0.00 0.00 0.00

SAGESTAM DROP Botol 40.00 1.00 0.00 1.00 0.00

SAGESTAM ZALF Tube 215.00 5.00 0.00 0.00 0.00

SALBUTAMOL 2 MG TAB Tablet 498.00 4,760.00 0.00 0.00 0.00

SALBUTAMOL 4 MG TAB Tablet 100.00 1,611.00 0.00 15.00 0.00

SALBUTAMOL SYR Botol 30.00 481.00 0.00 0.00 0.00

SALICYL TALKUM Botol 2.00 9.50 0.00 0.00 0.00

SANADRYL DMP SYR Botol 336.00 5.00 0.00 0.00 0.00

SANADRYL EXPEKTORAN SYR Botol 131.00 2.00 0.00 0.00 0.00

SANAFLU SYR Botol 46.00 0.00 0.00 0.00 0.00

SANBE KIDS SYR Botol 339.00 2.00 0.00 0.00 0.00

SANBE TEARS Botol 26.00 1,884.00 0.00 3.00 0.00

SANBEHES 130 INJ Ampul 246.00 0.00 0.00 0.00 0.00

SANFULIG - 72.00 0.00 0.00 0.00 0.00

SANMAG - 324.00 0.00 0.00 0.00 0.00

SANMAG SYR Botol 360.00 7.00 0.00 1.00 0.00

SANMOL - 7,282.00 55.00 0.00 36.00 0.00

SANMOL DROP Botol 365.00 1.00 0.00 1.00 0.00

SANMOL INJ Ampul 147.00 0.00 0.00 0.00 0.00

SANMOL SYR Botol 461.00 8.00 0.00 0.00 0.00


SANPRIMA - 648.00 0.00 0.00 10.00 0.00

SANPRIMA FORTE - 356.00 0.00 0.00 0.00 0.00

SANPRIMA SYR Botol 70.00 0.00 0.00 0.00 0.00

SANTA E - 530.00 10.00 0.00 0.00 0.00

SANTA E 400 - 149.00 0.00 0.00 0.00 0.00

SCABIMITE 5% ZALF Tube 3.00 6.00 0.00 1.00 0.00

SEDACUM 5 MG - 34.00 169.00 0.00 1.00 0.00

SELANG NEBUL ANAK Pcs 2.00 2.00 0.00 0.00 0.00

SELANG NEBUL DEWASA Pcs 3.00 8.00 0.00 0.00 0.00

SELANG O2 ANAK Pcs 19.00 30.00 0.00 1.00 0.00

SELANG O2 BAYI Pcs 14.00 27.00 0.00 0.00 0.00

SELANG O2 DEWASA Pcs 65.00 428.00 0.00 4.00 0.00

SELANG SUCTION 14 Pcs 1.00 1.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

SIDIADRYL / DELADRYL INJ Ampul 1.00 0.00 0.00 0.00 0.00

SILEX SYR Botol 174.00 6.00 0.00 1.00 0.00

SIMVASTATIN 10 MG TAB Tablet 445.00 2,971.00 0.00 0.00 0.00

SIMVASTATIN 20 MG TAB Tablet 667.00 10,046.00 0.00 89.00 0.00

SISTENOL - 59.00 652.00 0.00 0.00 0.00

SKINCOOL ZALF Tube 1.00 0.00 0.00 0.00 0.00

SPINOCAN 25 Pcs 32.00 203.00 0.00 1.00 0.00

SPINOCAN 26 Pcs 43.00 386.00 0.00 5.00 0.00

SPINOCAN 27 Pcs 94.00 715.00 0.00 9.00 0.00

SPIRONOLAKTON 100 MG TAB Tablet 40.00 444.00 0.00 0.00 0.00

SPIRONOLAKTON 25 MG TAB Tablet 279.00 3,221.00 0.00 95.00 0.00

SPORETIK 100MG Tablet 65.00 0.00 0.00 0.00 0.00

SPORETIK 200 TAB Tablet 20.00 0.00 0.00 0.00 0.00

SPORETIK 50 - 20.00 0.00 0.00 0.00 0.00

SPORETIK SYR Botol 285.00 4.00 0.00 0.00 0.00

SPUIT 1 CC Pcs 833.00 3,161.00 0.00 38.00 0.00

SPUIT 10 CC Pcs 1,430.00 5,368.00 0.00 77.00 0.00

SPUIT 20 CC Pcs 5.00 7.00 0.00 0.00 0.00

SPUIT 3 CC Pcs 3,303.00 19,316.00 0.00 206.00 0.00

SPUIT 5 CC Pcs 1,073.00 8,603.00 0.00 70.00 0.00

SPUIT 5 CC TERUMO Pcs 114.00 961.00 0.00 8.00 0.00

SPUIT 50 CC Pcs 10.00 24.00 0.00 0.00 0.00

SPUIT 60 CC Pcs 29.00 119.00 0.00 0.00 0.00

STARMUNO - 173.00 0.00 0.00 0.00 0.00

STARMUNO SYR Botol 39.00 0.00 0.00 0.00 0.00

STESOLID 10 MG - 11.00 1.00 0.00 1.00 0.00

STESOLID 5 MG - 36.00 17.00 0.00 0.00 0.00


STESOLID SYR Botol 16.00 1.00 0.00 0.00 0.00

STIMUNO SYR Botol 4.00 0.00 0.00 0.00 0.00

SUKRALFATE SYR Botol 85.00 44.00 0.00 8.00 0.00

SULFADIAZIN ZALF Tube 17.00 18.00 0.00 0.00 0.00

SUNGKUP NON REBRITING DEWASA Pcs 7.00 34.00 0.00 0.00 0.00

SUNGKUP REBRITING ANAK Pcs 3.00 2.00 0.00 0.00 0.00

SUNGKUP REBRITING DEWASA Pcs 1.00 9.00 0.00 0.00 0.00

SUPERHOID SUPP supp 5.00 24.00 0.00 0.00 0.00

SUSU NUTRI BABY ACTIVDUO 1 Box 28.00 0.00 0.00 0.00 0.00

SUSU NUTRIBABY PREMATURE Kotak 46.00 0.00 0.00 0.00 0.00

SUSU NUTRYBABY 1 Box 1.00 0.00 0.00 0.00 0.00

SUSU SGM ANANDA 1 Kotak 275.00 0.00 0.00 0.00 0.00

SUSU SGM BBLR Kotak 39.00 0.00 0.00 0.00 0.00

SUSU SGM LLM Kotak 39.00 0.00 0.00 0.00 0.00

SUSU SGM SOYA 0-6 Kotak 31.00 0.00 0.00 0.00 0.00

TARIVID OTIC Botol 38.00 3.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

TERFACEF INJ Ampul 245.00 1.00 0.00 0.00 0.00

TERMOMETER DIGITAL Pcs 70.00 0.00 0.00 0.00 0.00

TERMOMETER DIGITAL RUANGAN Pcs 1.00 0.00 0.00 0.00 0.00

TESPEK (2000) Pcs 42.00 0.00 0.00 0.00 0.00

TETAGRAM INJ Ampul 125.00 2.00 0.00 0.00 0.00

THIAMPHENICOL SYR Botol 41.00 1,111.00 0.00 5.00 0.00

THIAMPHENICOL TAB Tablet 341.00 6,981.00 0.00 72.00 0.00

THREE WAY B.BRAUN / GEA Pcs 583.00 3,663.00 0.00 34.00 0.00

THROMBOPHOB GEL 10 GR Tube 131.00 0.00 0.00 1.00 0.00

THROMBOPHOB GEL 20G ZALF Tube 12.00 0.00 0.00 0.00 0.00

THROMBOPHOB OINTMENT ZALF Tube 5.00 0.00 0.00 0.00 0.00

THYROZOL 10 - 485.00 2,386.00 0.00 88.00 0.00

THYROZOL 5 - 420.00 576.00 0.00 7.00 0.00

TISU 12 SHEET (1000) Bungkus 6.00 0.00 0.00 0.00 0.00

TISU BASAH BESAR Bungkus 87.00 0.00 0.00 0.00 0.00

TISU REFILL 250 Kotak 172.00 0.00 0.00 0.00 0.00

TIVOMIT / METOCLOPRAMIDE TAB Tablet 730.00 2,602.00 0.00 55.00 0.00

TOMIT INJ Ampul 3.00 221.00 0.00 0.00 0.00

TONOTAN - 278.00 645.00 0.00 0.00 0.00

TOPAZOL INJ Ampul 117.00 0.00 0.00 0.00 0.00

TOPI OPERASI Pcs 16.00 368.00 0.00 3.00 0.00

TRAMADOL INJ Ampul 89.00 688.00 0.00 11.00 0.00

TRAMADOL TAB Tablet 178.00 2,116.00 0.00 16.00 0.00


TRAMAL SUPP supp 52.00 4.00 0.00 0.00 0.00

TREMENZA - 255.00 0.00 0.00 20.00 0.00

TREMENZA SYR Botol 3.00 2.00 0.00 0.00 0.00

TRICHODAZOLE - 80.00 0.00 0.00 0.00 0.00

TRICHODAZOLE PLUS SUPP supp 36.00 0.00 0.00 0.00 0.00

TRIHEXIPHENIDRIL TAB Tablet 44.00 2,150.00 0.00 0.00 0.00

TRITON MESH Pcs 3.00 0.00 0.00 0.00 0.00

TROLAC - 133.00 0.00 0.00 0.00 0.00

TROLIT - 564.00 6.00 0.00 0.00 0.00

TROMBO GAL 10G ZALF Tube 3.00 0.00 0.00 0.00 0.00

TRUXANTHIN - 472.00 3.00 0.00 0.00 0.00

TT INJ Ampul 4.00 1.00 0.00 0.00 0.00

TUZALOS TAB Tablet 1,942.00 154.00 0.00 0.00 0.00

ULTIMAX JOINT Tablet 112.00 0.00 0.00 0.00 0.00

ULTRAVITA - 160.00 0.00 0.00 0.00 0.00

UNDERPAD Pcs 478.00 3,126.00 0.00 29.00 0.00

UNIVIT SYR Botol 199.00 3,985.00 0.00 25.00 0.00

URDAFALK - 0.00 2.00 0.00 0.00 0.00

URINE BAG Pcs 171.00 1,227.00 0.00 16.00 0.00

UTROGESTAN 100 - 2,127.00 15.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

UTROGESTAN 200 - 99.00 7.00 0.00 0.00 0.00

VAGISTIN SUPP supp 36.00 80.00 0.00 0.00 0.00

VALAMIN INF Fls 12.00 0.00 0.00 0.00 0.00

VALISANBE - 13.00 23.00 0.00 0.00 0.00

VALISANBE 2 - 417.00 13.00 0.00 0.00 0.00

VALISANBE 5 - 66.00 0.00 0.00 1.00 0.00

VALOS-OD DROP Botol 2.00 0.00 0.00 0.00 0.00

VALPORIC SYR Botol 7.00 144.00 0.00 0.00 0.00

VALSARTAN /DIOVAN Box 940.00 12,435.00 0.00 65.00 0.00

VALSARTAN TAB Tablet 343.00 6,396.00 0.00 86.00 0.00

VASCON INJ Ampul 3.00 9.00 0.00 0.00 0.00

VENTOLIN INHALER Botol 6.00 30.00 0.00 0.00 0.00

VENTOLIN INJ Ampul 377.00 2,928.00 0.00 0.00 0.00

VENTOLIN ROTACAPS - 88.00 2,064.00 0.00 0.00 0.00

VENTOLIN ROTAHELER Pcs 0.00 17.00 0.00 0.00 0.00

VERBAN GULUNG BESAR (VGB) Pcs 23.00 269.00 0.00 0.00 0.00

VERBAN GULUNG KECIL (VGK) Pcs 309.00 771.00 0.00 8.00 0.00

VIBRION - 80.00 0.00 0.00 0.00 0.00

VIP ALBUMIN - 239.00 95.00 0.00 0.00 0.00

VISANNE - 65.00 3.00 0.00 0.00 0.00


VIT B12 INJ Ampul 1.00 0.00 0.00 0.00 0.00

VIT B6 TAB Tablet 591.00 761.00 0.00 39.00 0.00

VIT BCOMP ANAK TAB Tablet 55.00 35.00 0.00 0.00 0.00

VIT BCOMP DEWASA TAB Tablet 2,720.00 30,237.00 0.00 330.00 0.00

VIT C ANAK TAB Tablet 566.00 1,092.00 0.00 35.00 0.00

VIT K INJ Ampul 2.00 19.00 0.00 0.00 0.00

VITACIMIN TAB Tablet 2.00 0.00 0.00 0.00 0.00

VITADION INJ Vial 7.00 7.00 0.00 0.00 0.00

VITAGROW SYR Botol 0.00 1.00 0.00 0.00 0.00

VITAMAM 2 Box 2,332.00 65.00 0.00 30.00 0.00

VITAMAM 3 Box 45.00 0.00 0.00 0.00 0.00

VOLUVEN (WIDAHEST) INF Botol 34.00 404.00 0.00 6.00 0.00

VOMETA DROP Botol 45.00 0.00 0.00 0.00 0.00

VOMETA SYR Botol 49.00 0.00 0.00 0.00 0.00

VOMITAS FDT TAB Tablet 292.00 0.00 0.00 0.00 0.00

VOSEDON - 3,408.00 15.00 0.00 20.00 0.00

VOSEDON SYR Botol 101.00 2.00 0.00 0.00 0.00

VOSTEM - 4.00 0.00 0.00 0.00 0.00

WECARE L ISI 2 Bungkus 115.00 0.00 0.00 0.00 0.00

WECARE L ISI 8 Bungkus 17.00 0.00 0.00 0.00 0.00

WECARE M ISI 10 Bungkus 13.00 0.00 0.00 0.00 0.00

WECARE M ISI 2 Bungkus 77.00 0.00 0.00 0.00 0.00

WECARE XL ISI 2 Bungkus 169.00 0.00 0.00 0.00 0.00

Farmasi

ASURANSI /
URAIAN SATUAN UMUM BPJS INHEALTH PERUSAHAAN MEDAN

WECARE XL ISI 8 Bungkus 32.00 0.00 0.00 0.00 0.00

WIDA KDN (KAEN 3B) Botol 27.00 52.00 0.00 0.00 0.00

WIDAHES INF Fls 125.00 896.00 0.00 3.00 0.00

WOODS EXPEKTORAN SYR Botol 10.00 0.00 0.00 0.00 0.00

WOODS SYR Botol 14.00 0.00 0.00 0.00 0.00

XILON TAB Box 71.00 0.00 0.00 0.00 0.00

ZINC PRO DROP Botol 62.00 2.00 0.00 1.00 0.00

ZINS PRO SYR Botol 125.00 191.00 0.00 1.00 0.00

ZIRCUM KIDS Botol 8.00 89.00 0.00 1.00 0.00


31 Desember 2018

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 10.00

0.00 0.00 0.00 0.00 29.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 4,125.00

0.00 0.00 0.00 0.00 257.00

0.00 0.00 0.00 0.00 5,053.00

0.00 0.00 0.00 0.00 3,144.00

0.00 0.00 0.00 0.00 627.00

0.00 0.00 0.00 0.00 1,425.00

0.00 0.00 0.00 0.00 762.00

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 354.00

0.00 0.00 0.00 0.00 1,347.00

0.00 0.00 0.00 0.00 98.00

0.00 0.00 0.00 0.00 226.00

0.00 0.00 0.00 0.00 13.00

0.00 0.00 0.00 0.00 22.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 117.00

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 690.00

0.00 0.00 0.00 0.00 20.00

0.00 0.00 0.00 0.00 333.00

0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 3,497.00

0.00 0.00 0.00 0.00 7,720.00

0.00 0.00 0.00 0.00 24.00

0.00 0.00 0.00 0.00 2,790.00

0.00 0.00 0.00 0.00 219.00

0.00 0.00 0.00 0.00 2,541.00

0.00 0.00 0.00 0.00 2,600.00

0.00 0.00 0.00 0.00 2,982.00

0.00 0.00 0.00 0.00 37.00

0.00 0.00 0.00 0.00 654.00

0.00 0.00 0.00 0.00 11,845.00


0.00 0.00 0.00 0.00 1,997.00

0.00 0.00 0.00 0.00 9,172.00

Halaman 1

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 9,398.00

0.00 0.00 0.00 0.00 48.00

0.00 0.00 0.00 0.00 345.00

0.00 0.00 0.00 0.00 4,901.00

0.00 0.00 0.00 0.00 220.00

0.00 0.00 0.00 0.00 50.00

0.00 0.00 0.00 0.00 1,106.00

0.00 0.00 0.00 0.00 56.00

0.00 0.00 0.00 0.00 152.00

0.00 0.00 0.00 0.00 1,044.00

0.00 0.00 0.00 0.00 595.00

0.00 0.00 0.00 0.00 304.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 95.00

0.00 0.00 0.00 0.00 8,911.00

0.00 0.00 0.00 0.00 4,782.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 148.00

0.00 0.00 0.00 0.00 26.00

0.00 0.00 0.00 0.00 163.00

0.00 0.00 0.00 0.00 9,364.00

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 12,354.00

0.00 0.00 0.00 0.00 113.00

0.00 0.00 0.00 0.00 5,392.00

0.00 0.00 0.00 0.00 32,848.00

0.00 0.00 0.00 0.00 6,292.00

0.00 0.00 0.00 0.00 1,749.00

0.00 0.00 0.00 0.00 445.00

0.00 0.00 0.00 0.00 8.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 141.00


0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 1,272.00

0.00 0.00 0.00 0.00 3,477.00

0.00 0.00 0.00 0.00 28.00

0.00 0.00 0.00 0.00 1.00

Halaman 2

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 13.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 55.00

0.00 0.00 0.00 0.00 13.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1,275.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1,509.00

0.00 0.00 0.00 0.00 8.00

0.00 0.00 0.00 0.00 6.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 235.00

0.00 0.00 0.00 0.00 14,387.00

0.00 0.00 0.00 0.00 324.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 27.00

0.00 0.00 0.00 0.00 34.00

0.00 0.00 0.00 0.00 12,001.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 3,921.00

0.00 0.00 0.00 0.00 6.00

0.00 0.00 0.00 0.00 106.00

0.00 0.00 0.00 0.00 1,069.00

0.00 0.00 0.00 0.00 55.00

0.00 0.00 0.00 0.00 156.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 3,826.00

0.00 0.00 0.00 0.00 126.00

0.00 0.00 0.00 0.00 1.00


0.00 0.00 0.00 0.00 464.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 28.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 412.00

0.00 0.00 0.00 0.00 10.00

Halaman 3

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 57.00

0.00 0.00 0.00 0.00 66.00

0.00 0.00 0.00 0.00 1,328.00

0.00 0.00 0.00 0.00 44.00

0.00 0.00 0.00 0.00 1,327.00

0.00 0.00 0.00 0.00 76.00

0.00 0.00 0.00 0.00 101.00

0.00 0.00 0.00 0.00 227.00

0.00 0.00 0.00 0.00 2,524.00

0.00 0.00 0.00 0.00 4,004.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 65.00

0.00 0.00 0.00 0.00 373.00

0.00 0.00 0.00 0.00 1,584.00

0.00 0.00 0.00 0.00 112.00

0.00 0.00 0.00 0.00 39.00

0.00 0.00 0.00 0.00 50.00

0.00 0.00 0.00 0.00 279.00

0.00 0.00 0.00 0.00 8,692.00

0.00 0.00 0.00 0.00 52,993.00

0.00 0.00 0.00 0.00 902.00

0.00 0.00 0.00 0.00 44.00

0.00 0.00 0.00 0.00 951.00

0.00 0.00 0.00 0.00 35.00

0.00 0.00 0.00 0.00 75.00

0.00 0.00 0.00 0.00 762.00

0.00 0.00 0.00 0.00 11.00

0.00 0.00 0.00 0.00 38.00

0.00 0.00 0.00 0.00 1,863.00

0.00 0.00 0.00 0.00 7,975.00


0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 29,037.00

0.00 0.00 0.00 0.00 219.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 45.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 56.00

0.00 0.00 0.00 0.00 2,027.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 478.00

Halaman 4

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 34.00

0.00 0.00 0.00 0.00 18.00

0.00 0.00 0.00 0.00 532.00

0.00 0.00 0.00 0.00 1,018.00

0.00 0.00 0.00 0.00 264.00

0.00 0.00 0.00 0.00 24.00

0.00 0.00 0.00 0.00 45.00

0.00 0.00 0.00 0.00 24.00

0.00 0.00 0.00 0.00 376.00

0.00 0.00 0.00 0.00 41.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 15,976.00

0.00 0.00 0.00 0.00 355.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 31.00

0.00 0.00 0.00 0.00 1,276.00

0.00 0.00 0.00 0.00 108.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 213.00

0.00 0.00 0.00 0.00 42.00

0.00 0.00 0.00 0.00 6.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 8,586.00

0.00 0.00 0.00 0.00 824.00

0.00 0.00 0.00 0.00 460.00

0.00 0.00 0.00 0.00 10,189.00


0.00 0.00 0.00 0.00 21.00

0.00 0.00 0.00 0.00 18.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 344.00

0.00 0.00 0.00 0.00 1,624.00

0.00 0.00 0.00 0.00 52.00

0.00 0.00 0.00 0.00 1,203.00

0.00 0.00 0.00 0.00 22,157.00

0.00 0.00 0.00 0.00 249.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 24.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 2,645.00

0.00 0.00 0.00 0.00 71.00

Halaman 5

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 4,928.00

0.00 0.00 0.00 0.00 532.00

0.00 0.00 0.00 0.00 132.00

0.00 0.00 0.00 0.00 339.00

0.00 0.00 0.00 0.00 99.00

0.00 0.00 0.00 0.00 35.00

0.00 0.00 0.00 0.00 2,402.50

0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 34.00

0.00 0.00 0.00 0.00 68.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 61.00

0.00 0.00 0.00 0.00 11.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 125.00

0.00 0.00 0.00 0.00 128.00

0.00 0.00 0.00 0.00 17.00

0.00 0.00 0.00 0.00 189.00

0.00 0.00 0.00 0.00 98.00

0.00 0.00 0.00 0.00 159.00

0.00 0.00 0.00 0.00 2,245.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1.00


0.00 0.00 0.00 0.00 3,595.00

0.00 0.00 0.00 0.00 5,605.00

0.00 0.00 0.00 0.00 347.00

0.00 0.00 0.00 0.00 364.00

0.00 0.00 0.00 0.00 38.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 528.00

0.00 0.00 0.00 0.00 3,910.00

0.00 0.00 0.00 0.00 11.00

0.00 0.00 0.00 0.00 42,322.00

0.00 0.00 0.00 0.00 705.00

0.00 0.00 0.00 0.00 1,802.00

0.00 0.00 0.00 0.00 323.00

0.00 0.00 0.00 0.00 68.00

0.00 0.00 0.00 0.00 19.00

0.00 0.00 0.00 0.00 4,412.00

0.00 0.00 0.00 0.00 197.00

0.00 0.00 0.00 0.00 24.00

Halaman 6

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 81.00

0.00 0.00 0.00 0.00 7,483.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 10.00

0.00 0.00 0.00 0.00 231.00

0.00 0.00 0.00 0.00 23.00

0.00 0.00 0.00 0.00 172.00

0.00 0.00 0.00 0.00 53.00

0.00 0.00 0.00 0.00 275.00

0.00 0.00 0.00 0.00 278.00

0.00 0.00 0.00 0.00 99.00

0.00 0.00 0.00 0.00 264.00

0.00 0.00 0.00 0.00 197.00

0.00 0.00 0.00 0.00 25.00

0.00 0.00 0.00 0.00 61.00

0.00 0.00 0.00 0.00 567.00

0.00 0.00 0.00 0.00 469.00

0.00 0.00 0.00 0.00 8,056.00

0.00 0.00 0.00 0.00 14,657.00


0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 148.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 53.00

0.00 0.00 0.00 0.00 142.00

0.00 0.00 0.00 0.00 1,159.00

0.00 0.00 0.00 0.00 6.00

0.00 0.00 0.00 0.00 345.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 1,135.00

0.00 0.00 0.00 0.00 1,400.00

0.00 0.00 0.00 0.00 10.00

0.00 0.00 0.00 0.00 44,367.00

0.00 0.00 0.00 0.00 7,060.00

0.00 0.00 0.00 0.00 1.00

Halaman 7

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 85.00

0.00 0.00 0.00 0.00 625.00

0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 11.00

0.00 0.00 0.00 0.00 23.00

0.00 0.00 0.00 0.00 161.00

0.00 0.00 0.00 0.00 20.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 3,074.00

0.00 0.00 0.00 0.00 7,780.00

0.00 0.00 0.00 0.00 25.00

0.00 0.00 0.00 0.00 2,453.00

0.00 0.00 0.00 0.00 129.00

0.00 0.00 0.00 0.00 51.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 2,704.00


0.00 0.00 0.00 0.00 4,512.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 9,406.00

0.00 0.00 0.00 0.00 5,011.00

0.00 0.00 0.00 0.00 220.00

0.00 0.00 0.00 0.00 4,947.00

0.00 0.00 0.00 0.00 14,275.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 20,410.00

0.00 0.00 0.00 0.00 216.00

0.00 0.00 0.00 0.00 78.00

0.00 0.00 0.00 0.00 977.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 235.00

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 82.00

0.00 0.00 0.00 0.00 341.00

0.00 0.00 0.00 0.00 3,885.00

0.00 0.00 0.00 0.00 3,196.00

0.00 0.00 0.00 0.00 1,865.00

0.00 0.00 0.00 0.00 1,690.00

0.00 0.00 0.00 0.00 320.00

0.00 0.00 0.00 0.00 935.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 252.00

Halaman 8

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 17.00

0.00 0.00 0.00 0.00 144.00

0.00 0.00 0.00 0.00 403.00

0.00 0.00 0.00 0.00 80.00

0.00 0.00 0.00 0.00 925.00

0.00 0.00 0.00 0.00 269.00

0.00 0.00 0.00 0.00 113.00

0.00 0.00 0.00 0.00 270.00

0.00 0.00 0.00 0.00 3,507.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 199.00

0.00 0.00 0.00 0.00 9,610.00

0.00 0.00 0.00 0.00 267.00


0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 137.00

0.00 0.00 0.00 0.00 315.00

0.00 0.00 0.00 0.00 280.00

0.00 0.00 0.00 0.00 1,141.00

0.00 0.00 0.00 0.00 84.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 23.00

0.00 0.00 0.00 0.00 39.00

0.00 0.00 0.00 0.00 5,095.00

0.00 0.00 0.00 0.00 509.00

0.00 0.00 0.00 0.00 4,068.00

0.00 0.00 0.00 0.00 3,529.00

0.00 0.00 0.00 0.00 67.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 1,394.00

0.00 0.00 0.00 0.00 10,228.00

0.00 0.00 0.00 0.00 209.00

0.00 0.00 0.00 0.00 711.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 10.00

0.00 0.00 0.00 0.00 695.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 31.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 4,624.00

0.00 0.00 0.00 0.00 3.00

Halaman 9

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 21.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 21.00

0.00 0.00 0.00 0.00 103.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 349.00


0.00 0.00 0.00 0.00 118.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 175.00

0.00 0.00 0.00 0.00 532.00

0.00 0.00 0.00 0.00 648.00

0.00 0.00 0.00 0.00 133.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 26,485.00

0.00 0.00 0.00 0.00 433.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 451.00

0.00 0.00 0.00 0.00 70.00

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 437.00

0.00 0.00 0.00 0.00 20.00

0.00 0.00 0.00 0.00 6.00

0.00 0.00 0.00 0.00 298.00

0.00 0.00 0.00 0.00 728.00

0.00 0.00 0.00 0.00 67.00

0.00 0.00 0.00 0.00 700.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 1,197.00

0.00 0.00 0.00 0.00 127.00

0.00 0.00 0.00 0.00 136.00

0.00 0.00 0.00 0.00 1,868.00

0.00 0.00 0.00 0.00 144.00

0.00 0.00 0.00 0.00 28.00

0.00 0.00 0.00 0.00 931.00

Halaman 10

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 651.00

0.00 0.00 0.00 0.00 34.00

0.00 0.00 0.00 0.00 29.00

0.00 0.00 0.00 0.00 19.00

0.00 0.00 0.00 0.00 2,523.00

0.00 0.00 0.00 0.00 164.00

0.00 0.00 0.00 0.00 144.00


0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 40.00

0.00 0.00 0.00 0.00 17.00

0.00 0.00 0.00 0.00 644.00

0.00 0.00 0.00 0.00 37.00

0.00 0.00 0.00 0.00 711.00

0.00 0.00 0.00 0.00 25.00

0.00 0.00 0.00 0.00 693.00

0.00 0.00 0.00 0.00 22.00

0.00 0.00 0.00 0.00 163.00

0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 17,148.00

0.00 0.00 0.00 0.00 54.00

0.00 0.00 0.00 0.00 2,026.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 37.00

0.00 0.00 0.00 0.00 24.00

0.00 0.00 0.00 0.00 8.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 39.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 1,489.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 10,159.00

0.00 0.00 0.00 0.00 5,152.00

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 50.00

0.00 0.00 0.00 0.00 152.00

0.00 0.00 0.00 0.00 142.00

0.00 0.00 0.00 0.00 19.00

0.00 0.00 0.00 0.00 366.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 81.00

Halaman 11

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 139.00

0.00 0.00 0.00 0.00 28.00


0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 59.00

0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 36.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 21.00

0.00 0.00 0.00 0.00 19.00

0.00 0.00 0.00 0.00 916.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 18,965.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 3,499.00

0.00 0.00 0.00 0.00 676.00

0.00 0.00 0.00 0.00 19,926.00

0.00 0.00 0.00 0.00 3,275.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 40.00

0.00 0.00 0.00 0.00 21.00

0.00 0.00 0.00 0.00 13.00

0.00 0.00 0.00 0.00 681.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 25,920.00

0.00 0.00 0.00 0.00 54.00

0.00 0.00 0.00 0.00 33,184.00

0.00 0.00 0.00 0.00 883.00

0.00 0.00 0.00 0.00 80.00

0.00 0.00 0.00 0.00 11,169.00

0.00 0.00 0.00 0.00 1,891.00

0.00 0.00 0.00 0.00 23.00

0.00 0.00 0.00 0.00 13.00

0.00 0.00 0.00 0.00 30.00

0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 36.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 62.00

Halaman 12

ASKES JASA JKK GRATIS / LAIN TOTAL


0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 43.00

0.00 0.00 0.00 0.00 72.00

0.00 0.00 0.00 0.00 39.00

0.00 0.00 0.00 0.00 68.00

0.00 0.00 0.00 0.00 3,543.00

0.00 0.00 0.00 0.00 2,838.00

0.00 0.00 0.00 0.00 81.00

0.00 0.00 0.00 0.00 76.00

0.00 0.00 0.00 0.00 86.00

0.00 0.00 0.00 0.00 60.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 111.00

0.00 0.00 0.00 0.00 104.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 38.00

0.00 0.00 0.00 0.00 56.00

0.00 0.00 0.00 0.00 183.00

0.00 0.00 0.00 0.00 8,914.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 124.00

0.00 0.00 0.00 0.00 91.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 11,787.00

0.00 0.00 0.00 0.00 11.00

0.00 0.00 0.00 0.00 8,305.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1,837.00

0.00 0.00 0.00 0.00 36.00

0.00 0.00 0.00 0.00 76.00

0.00 0.00 0.00 0.00 1,805.00

0.00 0.00 0.00 0.00 73,902.00

0.00 0.00 0.00 0.00 31.00

0.00 0.00 0.00 0.00 10.00

0.00 0.00 0.00 0.00 19.00

0.00 0.00 0.00 0.00 401.00

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 82.00

0.00 0.00 0.00 0.00 544.00

0.00 0.00 0.00 0.00 115.00

0.00 0.00 0.00 0.00 392.00

0.00 0.00 0.00 0.00 36.00

Halaman 13
ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 173.00

0.00 0.00 0.00 0.00 40.00

0.00 0.00 0.00 0.00 461.00

0.00 0.00 0.00 0.00 1,296.00

0.00 0.00 0.00 0.00 78.00

0.00 0.00 0.00 0.00 2,497.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 87.00

0.00 0.00 0.00 0.00 50.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 35.00

0.00 0.00 0.00 0.00 93.00

0.00 0.00 0.00 0.00 8.00

0.00 0.00 0.00 0.00 1,520.00

0.00 0.00 0.00 0.00 2,274.00

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 1,325.00

0.00 0.00 0.00 0.00 17.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 29,385.00

0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 2,974.00

0.00 0.00 0.00 0.00 5,601.00

0.00 0.00 0.00 0.00 58.00

0.00 0.00 0.00 0.00 29.00

0.00 0.00 0.00 0.00 668.00

0.00 0.00 0.00 0.00 727.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 11.00

0.00 0.00 0.00 0.00 197.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 105.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 5.00


0.00 0.00 0.00 0.00 209.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 7.00

Halaman 14

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 240.00

0.00 0.00 0.00 0.00 70,489.00

0.00 0.00 0.00 0.00 2,467.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 2,534.00

0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 479.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 8,383.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 74.00

0.00 0.00 0.00 0.00 6.00

0.00 0.00 0.00 0.00 105.00

0.00 0.00 0.00 0.00 294.00

0.00 0.00 0.00 0.00 1,562.00

0.00 0.00 0.00 0.00 71,744.00

0.00 0.00 0.00 0.00 4,957.00

0.00 0.00 0.00 0.00 140.00

0.00 0.00 0.00 0.00 156.00

0.00 0.00 0.00 0.00 1,060.00

0.00 0.00 0.00 0.00 143.00

0.00 0.00 0.00 0.00 57.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 118.00

0.00 0.00 0.00 0.00 72.00

0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 3,399.00

0.00 0.00 0.00 0.00 11,965.00

0.00 0.00 0.00 0.00 16.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 159.00

0.00 0.00 0.00 0.00 3,498.00

0.00 0.00 0.00 0.00 8.00

0.00 0.00 0.00 0.00 136.00

0.00 0.00 0.00 0.00 7,332.00

0.00 0.00 0.00 0.00 113.00


0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 6,937.00

0.00 0.00 0.00 0.00 375.00

0.00 0.00 0.00 0.00 26.00

0.00 0.00 0.00 0.00 1,139.00

Halaman 15

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 8.00

0.00 0.00 0.00 0.00 13,786.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 9.00

0.00 0.00 0.00 0.00 7.00

0.00 0.00 0.00 0.00 3,724.00

0.00 0.00 0.00 0.00 223.00

0.00 0.00 0.00 0.00 1,318.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 260.00

0.00 0.00 0.00 0.00 1,462.00

0.00 0.00 0.00 0.00 6.00

0.00 0.00 0.00 0.00 88.00

0.00 0.00 0.00 0.00 2,312.00

0.00 0.00 0.00 0.00 251.00

0.00 0.00 0.00 0.00 20.00

0.00 0.00 0.00 0.00 3,975.00

0.00 0.00 0.00 0.00 17.00

0.00 0.00 0.00 0.00 40.00

0.00 0.00 0.00 0.00 4,032.00

0.00 0.00 0.00 0.00 105.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 15.00

0.00 0.00 0.00 0.00 28.00

0.00 0.00 0.00 0.00 1,250.00

0.00 0.00 0.00 0.00 485.00

0.00 0.00 0.00 0.00 316.00

0.00 0.00 0.00 0.00 24.00

0.00 0.00 0.00 0.00 1,855.00

0.00 0.00 0.00 0.00 101.00

0.00 0.00 0.00 0.00 169.00

0.00 0.00 0.00 0.00 85.00


0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 7,752.00

0.00 0.00 0.00 0.00 141.00

0.00 0.00 0.00 0.00 4,737.00

0.00 0.00 0.00 0.00 76.00

0.00 0.00 0.00 0.00 37,590.00

0.00 0.00 0.00 0.00 28,540.00

0.00 0.00 0.00 0.00 195.00

0.00 0.00 0.00 0.00 13.00

Halaman 16

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 25.00

0.00 0.00 0.00 0.00 70.00

0.00 0.00 0.00 0.00 75.00

0.00 0.00 0.00 0.00 284.00

0.00 0.00 0.00 0.00 1,972.00

0.00 0.00 0.00 0.00 5,423.00

0.00 0.00 0.00 0.00 2,158.00

0.00 0.00 0.00 0.00 2,505.00

0.00 0.00 0.00 0.00 7,273.00

0.00 0.00 0.00 0.00 57,934.00

0.00 0.00 0.00 0.00 38.00

0.00 0.00 0.00 0.00 42.00

0.00 0.00 0.00 0.00 220.00

0.00 0.00 0.00 0.00 5,258.00

0.00 0.00 0.00 0.00 1,726.00

0.00 0.00 0.00 0.00 511.00

0.00 0.00 0.00 0.00 11.50

0.00 0.00 0.00 0.00 341.00

0.00 0.00 0.00 0.00 133.00

0.00 0.00 0.00 0.00 46.00

0.00 0.00 0.00 0.00 341.00

0.00 0.00 0.00 0.00 1,913.00

0.00 0.00 0.00 0.00 246.00

0.00 0.00 0.00 0.00 72.00

0.00 0.00 0.00 0.00 324.00

0.00 0.00 0.00 0.00 368.00

0.00 0.00 0.00 0.00 7,373.00

0.00 0.00 0.00 0.00 367.00

0.00 0.00 0.00 0.00 147.00

0.00 0.00 0.00 0.00 469.00


0.00 0.00 0.00 0.00 658.00

0.00 0.00 0.00 0.00 356.00

0.00 0.00 0.00 0.00 70.00

0.00 0.00 0.00 0.00 540.00

0.00 0.00 0.00 0.00 149.00

0.00 0.00 0.00 0.00 10.00

0.00 0.00 0.00 0.00 204.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 11.00

0.00 0.00 0.00 0.00 50.00

0.00 0.00 0.00 0.00 41.00

0.00 0.00 0.00 0.00 497.00

0.00 0.00 0.00 0.00 2.00

Halaman 17

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 181.00

0.00 0.00 0.00 0.00 3,416.00

0.00 0.00 0.00 0.00 10,802.00

0.00 0.00 0.00 0.00 711.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 236.00

0.00 0.00 0.00 0.00 434.00

0.00 0.00 0.00 0.00 818.00

0.00 0.00 0.00 0.00 484.00

0.00 0.00 0.00 0.00 3,595.00

0.00 0.00 0.00 0.00 65.00

0.00 0.00 0.00 0.00 20.00

0.00 0.00 0.00 0.00 20.00

0.00 0.00 0.00 0.00 289.00

0.00 0.00 0.00 0.00 4,032.00

0.00 0.00 0.00 0.00 6,875.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 22,825.00

0.00 0.00 0.00 0.00 9,746.00

0.00 0.00 0.00 0.00 1,083.00

0.00 0.00 0.00 0.00 34.00

0.00 0.00 0.00 0.00 148.00

0.00 0.00 0.00 0.00 173.00

0.00 0.00 0.00 0.00 39.00

0.00 0.00 0.00 0.00 13.00

0.00 0.00 0.00 0.00 53.00


0.00 0.00 0.00 0.00 17.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 137.00

0.00 0.00 0.00 0.00 35.00

0.00 0.00 0.00 0.00 41.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 10.00

0.00 0.00 0.00 0.00 29.00

0.00 0.00 0.00 0.00 28.00

0.00 0.00 0.00 0.00 46.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 275.00

0.00 0.00 0.00 0.00 39.00

0.00 0.00 0.00 0.00 39.00

0.00 0.00 0.00 0.00 31.00

0.00 0.00 0.00 0.00 41.00

Halaman 18

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 246.00

0.00 0.00 0.00 0.00 70.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 42.00

0.00 0.00 0.00 0.00 127.00

0.00 0.00 0.00 0.00 1,157.00

0.00 0.00 0.00 0.00 7,394.00

0.00 0.00 0.00 0.00 4,280.00

0.00 0.00 0.00 0.00 132.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 2,959.00

0.00 0.00 0.00 0.00 1,003.00

0.00 0.00 0.00 0.00 6.00

0.00 0.00 0.00 0.00 87.00

0.00 0.00 0.00 0.00 172.00

0.00 0.00 0.00 0.00 3,387.00

0.00 0.00 0.00 0.00 224.00

0.00 0.00 0.00 0.00 923.00

0.00 0.00 0.00 0.00 117.00

0.00 0.00 0.00 0.00 387.00

0.00 0.00 0.00 0.00 788.00

0.00 0.00 0.00 0.00 2,310.00


0.00 0.00 0.00 0.00 56.00

0.00 0.00 0.00 0.00 275.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 80.00

0.00 0.00 0.00 0.00 36.00

0.00 0.00 0.00 0.00 2,194.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 133.00

0.00 0.00 0.00 0.00 570.00

0.00 0.00 0.00 0.00 3.00

0.00 0.00 0.00 0.00 475.00

0.00 0.00 0.00 0.00 5.00

0.00 0.00 0.00 0.00 2,096.00

0.00 0.00 0.00 0.00 112.00

0.00 0.00 0.00 0.00 160.00

0.00 0.00 0.00 0.00 3,633.00

0.00 0.00 0.00 0.00 4,209.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 1,414.00

0.00 0.00 0.00 0.00 2,142.00

Halaman 19

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 106.00

0.00 0.00 0.00 0.00 116.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 36.00

0.00 0.00 0.00 0.00 430.00

0.00 0.00 0.00 0.00 67.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 151.00

0.00 0.00 0.00 0.00 13,440.00

0.00 0.00 0.00 0.00 6,825.00

0.00 0.00 0.00 0.00 12.00

0.00 0.00 0.00 0.00 36.00

0.00 0.00 0.00 0.00 3,305.00

0.00 0.00 0.00 0.00 2,152.00

0.00 0.00 0.00 0.00 17.00

0.00 0.00 0.00 0.00 292.00

0.00 0.00 0.00 0.00 1,088.00

0.00 0.00 0.00 0.00 80.00

0.00 0.00 0.00 0.00 334.00

0.00 0.00 0.00 0.00 68.00


0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 1,391.00

0.00 0.00 0.00 0.00 90.00

0.00 0.00 0.00 0.00 33,287.00

0.00 0.00 0.00 0.00 1,693.00

0.00 0.00 0.00 0.00 21.00

0.00 0.00 0.00 0.00 2.00

0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 1.00

0.00 0.00 0.00 0.00 2,427.00

0.00 0.00 0.00 0.00 45.00

0.00 0.00 0.00 0.00 444.00

0.00 0.00 0.00 0.00 45.00

0.00 0.00 0.00 0.00 49.00

0.00 0.00 0.00 0.00 292.00

0.00 0.00 0.00 0.00 3,443.00

0.00 0.00 0.00 0.00 103.00

0.00 0.00 0.00 0.00 4.00

0.00 0.00 0.00 0.00 115.00

0.00 0.00 0.00 0.00 17.00

0.00 0.00 0.00 0.00 13.00

0.00 0.00 0.00 0.00 77.00

0.00 0.00 0.00 0.00 169.00

Halaman 20

ASKES JASA JKK GRATIS / LAIN TOTAL

0.00 0.00 0.00 0.00 32.00

0.00 0.00 0.00 0.00 79.00

0.00 0.00 0.00 0.00 1,024.00

0.00 0.00 0.00 0.00 10.00

0.00 0.00 0.00 0.00 14.00

0.00 0.00 0.00 0.00 71.00

0.00 0.00 0.00 0.00 65.00

0.00 0.00 0.00 0.00 317.00

0.00 0.00 0.00 0.00 98.00

MEDAN, 20/03/2019

DEWI SUSANTI
Halaman 21
LAPORAN PEMAKAIAN OBAT PERIODE : 1 Januari 2018 s/d 31 Desember 2018

ASURANSI
NO URAIAN SATUAN UMUM BPJS INHEALTH / GRATIS / TOTAL
PERUSAHA LAIN
AN
1 ACYCLOVIR 200 MG TAB Tablet 153.00 181.00 0.00 20.00 0.00 354.00
2 ACYCLOVIR 400 MG TAB Tablet 343.00 934.00 0.00 70.00 0.00 1,347.00
3 ACYCLOVIR ZALF Tube 44.00 46.00 0.00 8.00 0.00 98.00
4 AKILEN Botol 66.00 157.00 0.00 3.00 0.00 226.00
5 ALINAMIN F INJ Ampul 40.00 293.00 0.00 0.00 0.00 333.00
6 ALKOHOL SWABS Pcs 14.00 0.00 0.00 0.00 0.00 14.00
7 ALLUPURINOL 100 MG TAB Tablet 233.00 3,256.00 0.00 8.00 0.00 3,497.00
8 ALLUPURINOL 300 MG TAB Tablet 667.00 7,053.00 0.00 0.00 0.00 7,720.00
9 ALPRAZOLAM - 936.00 1,840.00 0.00 14.00 0.00 2,790.00
10 AMBACIN INJ Ampul 47.00 157.00 0.00 15.00 0.00 219.00
11 AMBEVEN TAB Tablet 264.00 2,277.00 0.00 0.00 0.00 2,541.00
12 AMBROXOL Tablet 125.00 2,475.00 0.00 0.00 0.00 2,600.00
13 AMBROXOL SYR Botol 207.00 2,760.00 0.00 15.00 0.00 2,982.00
14 AMINOPHYLIN TAB Tablet 534.00 11,301.00 0.00 10.00 0.00 11,845.00
15 AMITRIPTILIN 25 MG TAB Tablet 81.00 1,910.00 0.00 6.00 0.00 1,997.00
16 AMLODIPIN 10 MG TAB Tablet 829.00 8,208.00 0.00 135.00 0.00 9,172.00
17 AMLODIPIN 5 MG TAB Tablet 1,551.00 7,805.00 0.00 42.00 0.00 9,398.00
18 AMOKSISILIN SYR Botol 0.00 46.00 0.00 2.00 0.00 48.00
19 AMOXICILLIN 500 MG TAB Tablet 1,518.00 3,290.00 0.00 93.00 0.00 4,901.00
20 AMOXICILLIN SYR Botol 17.00 199.00 0.00 4.00 0.00 220.00
21 APTOR (ASETOSAL) 100 MG TAB Tablet 249.00 8,972.00 0.00 143.00 0.00 9,364.00
22 ASAM MEFENAMAT 500 MG TAB Tablet 6,316.00 26,210.00 0.00 322.00 0.00 32,848.00
23 ASAM TRANEKSAMAT 500 MG Tablet 1,103.00 5,105.00 0.00 84.00 0.00 6,292.00
TAB
ASPILET - 52.00 1,677.00 0.00 20.00 0.00 1,749.00
24
25 BETAHISTIN 6 MG TAB Tablet 1,113.00 13,203.00 0.00 71.00 0.00 14,387.00
26 BETAMETASONE ZALF Tube 84.00 236.00 0.00 4.00 0.00 324.00
27 BICNAT TAB Tablet 1,365.00 10,636.00 0.00 0.00 0.00 12,001.00
28 BISOPROLOL 5 MG TAB Tablet 431.00 3,327.00 0.00 68.00 0.00 3,826.00
29 BUNASCAN / BUCAIN / REGIVEL Ampul 146.00 1,168.00 0.00 14.00 0.00 1,328.00
30 CALSIUM LACTAT TAB Tablet 240.00 3,349.00 0.00 415.00 0.00 4,004.00
31 CAPTROPIL 12,5 MG TAB Tablet 207.00 166.00 0.00 0.00 0.00 373.00
32 CAPTROPIL 25 MG TAB Tablet 810.00 768.00 0.00 6.00 0.00 1,584.00
33 CARBAZOCHROME SODIUM Ampul 1.00 111.00 0.00 0.00 0.00 112.00
SULFONATE
CAVICUR TAB Tablet 821.00 7,820.00 0.00 51.00 0.00 8,692.00
34
35 CEFADROXIL 500 MG TAB Tablet 6,812.00 45,820.00 0.00 361.00 0.00 52,993.00
36 CEFADROXIL SYR Botol 66.00 832.00 0.00 4.00 0.00 902.00
37 CENDO ASTHENOF Strip 0.00 4.00 0.00 0.00 0.00 4.00
38 CENDO CARPIN Strip 5.00 51.00 0.00 0.00 0.00 56.00
39 CENDO FLOXA Strip 145.00 1,879.00 0.00 3.00 0.00 2,027.00
40 CENDO GENTA Strip 0.00 12.00 0.00 0.00 0.00 12.00
41 CENDO LYTEERS Strip 0.00 1.00 0.00 0.00 0.00 1.00
42 CENDO MYDRIATIL Strip 31.00 447.00 0.00 0.00 0.00 478.00
43 CENDO PANTOCAIN Strip 0.00 34.00 0.00 0.00 0.00 34.00
44 CENDO POLIDEX Strip 0.00 18.00 0.00 0.00 0.00 18.00
45 CENDO TIMOL Strip 20.00 512.00 0.00 0.00 0.00 532.00
46 CENDO TROBOSAN Strip 88.00 930.00 0.00 0.00 0.00 1,018.00
47 CENDO XITROL STRIP - 73.00 191.00 0.00 0.00 0.00 264.00
48 CENDO XYTROL Strip 18.00 6.00 0.00 0.00 0.00 24.00
49 CEPEZET - 15.00 30.00 0.00 0.00 0.00 45.00
50 CETIRIZINE 10 MG TAB Tablet 2,632.00 13,204.00 0.00 140.00 0.00 15,976.00
51 CETIRIZINE SYR Botol 98.00 254.00 0.00 3.00 0.00 355.00
52 CHLORAMPENICOL 250 MG TAB Tablet 239.00 8,329.00 0.00 18.00 0.00 8,586.00
53 CIMETIDIN 200 MG TAB Tablet 120.00 684.00 0.00 20.00 0.00 824.00
54 CIPROFLOXACIN 500 MG TAB Tablet 1,852.00 8,277.00 0.00 60.00 0.00 10,189.00
55 CLINDAMICIN 150 MG TAB Tablet 49.00 295.00 0.00 0.00 0.00 344.00
56 CLINDAMICIN 300 MG TAB Tablet 377.00 1,192.00 0.00 55.00 0.00 1,624.00
57 COTRIMAKSAZOL 480 MG TAB Tablet 794.00 4,124.00 0.00 10.00 0.00 4,928.00
58 COTRIMOKSAZOL SYR Botol 64.00 465.00 0.00 3.00 0.00 532.00
59 CPG - 8.00 124.00 0.00 0.00 0.00 132.00
60 CTM TAB Tablet 714.00 1,683.50 0.00 5.00 0.00 2,402.50
61 DEXAMETHASONE 0,5 MG TAB Tablet 964.00 2,621.00 0.00 10.00 0.00 3,595.00
62 DIAZEPAM - 194.00 127.00 0.00 26.00 0.00 347.00
63 DIGOXIN 0,25 MG TAB Tablet 36.00 328.00 0.00 0.00 0.00 364.00
64 DOKSISIKLIN 100 MG TAB Tablet 723.00 3,177.00 0.00 10.00 0.00 3,910.00
65 DOMPERIDONE 10 MG TAB Tablet 2,810.00 39,280.00 0.00 232.00 0.00 42,322.00
66 DOMPERIDONE SYR Botol 102.00 595.00 0.00 8.00 0.00 705.00
67 DULCOLAC - 139.00 1,663.00 0.00 0.00 0.00 1,802.00
68 DULCOLAC 10 SUPP supp 70.00 248.00 0.00 5.00 0.00 323.00
69 DULCOLAC 5 SUPP supp 14.00 52.00 0.00 2.00 0.00 68.00
70 ERYTROMICIN 500 MG SYR Botol 5.00 56.00 0.00 0.00 0.00 61.00
71 ERYTROMICIN 500 MG TAB Tablet 26.00 526.00 0.00 15.00 0.00 567.00
72 ETAMBUTOL 500 MG TAB Tablet 1,059.00 6,825.00 0.00 172.00 0.00 8,056.00
73 EUTHYROX - 14.00 134.00 0.00 0.00 0.00 148.00
74 FOLIC ACID/AS.FOLAT TAB Tablet 680.00 6,137.00 0.00 243.00 0.00 7,060.00
75 FUROSEMID TAB Tablet 654.00 7,010.00 0.00 116.00 0.00 7,780.00
76 GENOIN SALEP MATA Strip 15.00 35.00 0.00 1.00 0.00 51.00
77 GENOIN TETES MATA Strip 0.00 1.00 0.00 0.00 0.00 1.00
78 GENOIN ZALF Tube 0.00 2.00 0.00 0.00 0.00 2.00
79 GENTAMISIN ZALF Tube 219.00 2,451.00 0.00 34.00 0.00 2,704.00
80 GG TAB Tablet 585.00 8,801.00 0.00 20.00 0.00 9,406.00
81 GLAUKON/ GLAUSETA - 385.00 4,626.00 0.00 0.00 0.00 5,011.00
82 GLIBENCLAMID TAB Tablet 154.00 66.00 0.00 0.00 0.00 220.00
83 GLICUIDONE Tablet 26.00 4,907.00 0.00 14.00 0.00 4,947.00
84 GLIMEPIRIDE 2 MG TAB Tablet 304.00 13,748.00 0.00 223.00 0.00 14,275.00
85 GLUKOSAMINE - 705.00 19,674.00 0.00 31.00 0.00 20,410.00
86 GLURENOM TAB Tablet 5.00 211.00 0.00 0.00 0.00 216.00
87 GOM Tube 10.00 68.00 0.00 0.00 0.00 78.00
88 H2O2 Botol 84.00 146.00 0.00 5.00 0.00 235.00
89 HALOPERIDOL 0,5 TAB Box 0.00 82.00 0.00 0.00 0.00 82.00
90 HALOPERIDOL TAB Tablet 0.00 341.00 0.00 0.00 0.00 341.00
91 HIDROCLOROTIAZID (HCT) TAB Tablet 93.00 832.00 0.00 0.00 0.00 925.00
92 HYDROCORTISON ZALF Tube 20.00 93.00 0.00 0.00 0.00 113.00
93 HYOSINE TAB Tablet 412.00 3,088.00 0.00 7.00 0.00 3,507.00
94 IBUPROFEN 200 MG TAB Tablet 10.00 189.00 0.00 0.00 0.00 199.00
95 IBUPROFEN 400 MG TAB Tablet 913.00 8,667.00 0.00 30.00 0.00 9,610.00
96 IBUPROFEN SYR Botol 55.00 212.00 0.00 0.00 0.00 267.00
97 INH 300MG Tablet 532.00 3,501.00 0.00 35.00 0.00 4,068.00
98 IRBERSATAN TAB Tablet 125.00 3,397.00 0.00 7.00 0.00 3,529.00
99 ISONIAZID (INH 300 MG) TAB Tablet 4.00 63.00 0.00 0.00 0.00 67.00
100 ISOSORBID DINITRAT 10MG Box 17.00 1,296.00 0.00 81.00 0.00 1,394.00
TAB
ISOSORBID DINITRAT 5 MG TAB Tablet 232.00 9,900.00 0.00 96.00 0.00 10,228.00
101
102 KALTROPEN SUPP supp 223.00 469.00 0.00 3.00 0.00 695.00
103 KAOLIN PACTIN /KANINA SYR Botol 3.00 8.00 0.00 1.00 0.00 12.00
104 KAPEDOSIN (INH 400 MG) TAB Tablet 1,032.00 3,554.00 0.00 38.00 0.00 4,624.00
105 LANSOPRAZOLE TAB Tablet 1,102.00 45.00 0.00 50.00 0.00 1,197.00
106 LAXANA TAB Box 92.00 619.00 0.00 0.00 0.00 711.00
107 LEVOFLOXACIN 500 MG TAB Tablet 1,674.00 15,310.00 0.00 164.00 0.00 17,148.00
108 LODIA TAB Tablet 1,405.00 46.00 0.00 38.00 0.00 1,489.00
109 LOPERAMID TAB Tablet 1,127.00 9,002.00 0.00 30.00 0.00 10,159.00
110 LORATADINE 10 MG TAB Tablet 332.00 4,789.00 0.00 31.00 0.00 5,152.00
111 LUTENYL TAB Box 73.00 79.00 0.00 0.00 0.00 152.00
112 MELOXICAM 15 MG TAB Tablet 794.00 19,052.00 0.00 80.00 0.00 19,926.00
113 MELOXICAM 7,5 MG TAB Tablet 426.00 2,849.00 0.00 0.00 0.00 3,275.00
114 METFORMIN 500 MG TAB Tablet 1,921.00 23,579.00 0.00 420.00 0.00 25,920.00
115 METHYCOBAL - 39.00 15.00 0.00 0.00 0.00 54.00
116 METHYLPREDNISOLON 4 MG Tablet 3,832.00 29,093.00 0.00 259.00 0.00 33,184.00
TAB
METHYLPREDNISOLON 8 MG Tablet 90.00 793.00 0.00 0.00 0.00 883.00
117
TAB
METRONIDAZOLE 500 MG TAB Tablet 1,964.00 9,116.00 0.00 89.00 0.00 11,169.00
118
119 METRONIDAZOLE SYR Botol 4.00 18.00 0.00 1.00 0.00 23.00
120 MICONAZOLE ZALF Tube 23.00 7.00 0.00 0.00 0.00 30.00
121 MOLAFATE / SUKRAFLAT SYR Botol 49.00 28.00 0.00 4.00 0.00 81.00
122 NASACORT AQ Botol 8.00 66.00 0.00 2.00 0.00 76.00
123 NATRIUM DICLOFENAC 25 M Tablet 20.00 1,785.00 0.00 0.00 0.00 1,805.00
TAB
NATRIUM DICLOFENAC 50 MG - 4,031.00 69,423.00 0.00 448.00 0.00 73,902.00
124
TAB
NEO DIAFORM TAB Tablet 10.00 9.00 0.00 0.00 0.00 19.00
125
126 NEO GYNOXA SUPP supp 338.00 63.00 0.00 0.00 0.00 401.00
127 NEW DIATAB / AKITA TAB Tablet 767.00 1,686.00 0.00 44.00 0.00 2,497.00
128 NIPEDIPINE TAB Tablet 426.00 1,047.00 0.00 47.00 0.00 1,520.00
129 NORIT TAB Tablet 0.00 12.00 0.00 0.00 0.00 12.00
130 NOSTYRA TAB Tablet 57.00 1,253.00 0.00 15.00 0.00 1,325.00
131 NOVABION / HUFABION / Tablet 3,306.00 25,487.00 0.00 592.00 0.00 29,385.00
132 RAMABION / STARBION TAB
133 NOVADIAR SYR Botol 0.00 14.00 0.00 0.00 0.00 14.00
134 NOVADRYL SYR Botol 133.00 2,815.00 0.00 26.00 0.00 2,974.00
135 NOVOMIX INJ Ampul 6.00 662.00 0.00 0.00 0.00 668.00
136 NOVORAPID INJ Ampul 32.00 694.00 0.00 1.00 0.00 727.00
137 OBH SYR Botol 30.00 176.00 0.00 3.00 0.00 209.00
138 OMEPRAZOLE 20 MG TAB Tablet 2,926.00 67,310.00 0.00 253.00 0.00 70,489.00
139 PARASETAMOL DROP Botol 24.00 266.00 0.00 4.00 0.00 294.00
140 PARASETAMOL SYR Botol 95.00 1,452.00 0.00 15.00 0.00 1,562.00
141 PARASETAMOL TAB Tablet 3,200.00 68,187.00 0.00 357.00 0.00 71,744.00
142 PAROLIT / BIORALIT TAB Tablet 478.00 4,458.00 0.00 21.00 0.00 4,957.00
143 PHENITOIN TAB Tablet 134.00 3,265.00 0.00 0.00 0.00 3,399.00
144 PHENOBARBITAL - 1,503.00 10,448.00 0.00 14.00 0.00 11,965.00
145 PIRACETAM 400 MG TAB Tablet 6.00 130.00 0.00 0.00 0.00 136.00
146 PIRACETAM 800MG TAB Tablet 263.00 6,954.00 0.00 115.00 0.00 7,332.00
147 PIROXICAM 10 MG TAB Tablet 80.00 33.00 0.00 0.00 0.00 113.00
148 PIROXICAM 20 MG TAB Tablet 0.00 32.00 0.00 0.00 0.00 32.00
149 POSPARGIN 0.125 MG TAB Tablet 3,336.00 10,342.00 0.00 108.00 0.00 13,786.00
150 PREDNISON TAB Tablet 367.00 3,343.00 0.00 14.00 0.00 3,724.00
151 PROPANOLOL 10 MG TAB Tablet 509.00 3,435.00 0.00 88.00 0.00 4,032.00
152 PTU TAB Tablet 0.00 485.00 0.00 0.00 0.00 485.00
153 PYRAZINAMID 500 MG TAB Tablet 1,230.00 6,456.00 0.00 66.00 0.00 7,752.00
154 QUANTIDEX SYR Botol 20.00 120.00 0.00 1.00 0.00 141.00
155 RAMAFLU TAB Tablet 220.00 4,457.00 0.00 60.00 0.00 4,737.00
156 RANITIDINE TAB Tablet 3,974.00 24,439.00 0.00 127.00 0.00 28,540.00
157 RIFAMPISIN 300 MG TAB Tablet 564.00 1,354.00 0.00 54.00 0.00 1,972.00
158 RIFAMPISIN 450 MG TAB Tablet 921.00 4,369.00 0.00 133.00 0.00 5,423.00
159 RIFAMPISIN 600 MG TAB Tablet 201.00 1,943.00 0.00 14.00 0.00 2,158.00
160 SALBUTAMOL 2 MG TAB Tablet 498.00 4,760.00 0.00 0.00 0.00 5,258.00
161 SALBUTAMOL 4 MG TAB Tablet 100.00 1,611.00 0.00 15.00 0.00 1,726.00
162 SALBUTAMOL SYR Botol 30.00 481.00 0.00 0.00 0.00 511.00
163 SANBE TEARS Botol 26.00 1,884.00 0.00 3.00 0.00 1,913.00
164 SIMVASTATIN 10 MG TAB Tablet 445.00 2,971.00 0.00 0.00 0.00 3,416.00
165 SIMVASTATIN 20 MG TAB Tablet 667.00 10,046.00 0.00 89.00 0.00 10,802.00
166 SISTENOL - 59.00 652.00 0.00 0.00 0.00 711.00
167 SPIRONOLAKTON 100 MG TAB Tablet 40.00 444.00 0.00 0.00 0.00 484.00
168 SPIRONOLAKTON 25 MG TAB Tablet 279.00 3,221.00 0.00 95.00 0.00 3,595.00
169 SUKRALFATE SYR Botol 85.00 44.00 0.00 8.00 0.00 137.00
170 SULFADIAZIN ZALF Tube 17.00 18.00 0.00 0.00 0.00 35.00
171 THIAMPHENICOL SYR Botol 41.00 1,111.00 0.00 5.00 0.00 1,157.00
172 THIAMPHENICOL TAB Tablet 341.00 6,981.00 0.00 72.00 0.00 7,394.00
173 THYROZOL 10 - 485.00 2,386.00 0.00 88.00 0.00 2,959.00
174 THYROZOL 5 - 420.00 576.00 0.00 7.00 0.00 1,003.00
175 TIVOMIT / METOCLOPRAMIDE Tablet 730.00 2,602.00 0.00 55.00 0.00 3,387.00
TAB
TRAMADOL TAB Tablet 178.00 2,116.00 0.00 16.00 0.00 2,310.00
176
177 TRIHEXIPHENIDRIL TAB Tablet 44.00 2,150.00 0.00 0.00 0.00 2,194.00
178 UNIVIT SYR Botol 199.00 3,985.00 0.00 25.00 0.00 4,209.00
179 VAGISTIN SUPP supp 36.00 80.00 0.00 0.00 0.00 116.00
180 VALPORIC SYR Botol 7.00 144.00 0.00 0.00 0.00 151.00
181 VALSARTAN /DIOVAN Box 940.00 12,435.00 0.00 65.00 0.00 13,440.00
182 VALSARTAN TAB Tablet 343.00 6,396.00 0.00 86.00 0.00 6,825.00
183 VIT B6 TAB Tablet 591.00 761.00 0.00 39.00 0.00 1,391.00
184 VIT BCOMP ANAK TAB Tablet 55.00 35.00 0.00 0.00 0.00 90.00
185 VIT BCOMP DEWASA TAB Tablet 2,720.00 30,237.00 0.00 330.00 0.00 33,287.00
186 VIT C ANAK TAB Tablet 566.00 1,092.00 0.00 35.00 0.00 1,693.00
187 ZINC PRO DROP Botol 62.00 2.00 0.00 1.00 0.00 65.00
188 ZINS PRO SYR Botol 125.00 191.00 0.00 1.00 0.00 317.00
189 ZIRCUM KIDS Botol 8.00 89.00 0.00 1.00 0.00 98.00
190 WIDA KDN (KAEN 3B) Botol 27.00 52.00 0.00 0.00 0.00 79.00
191 WIDAHES INF Fls 125.00 896.00 0.00 3.00 0.00 1,024.00
192 VIT K INJ Ampul 2.00 19.00 0.00 0.00 0.00 21.00
193 VENTOLIN INJ Ampul 377.00 2,928.00 0.00 0.00 0.00 3,305.00
194 VENTOLIN ROTACAPS - 88.00 2,064.00 0.00 0.00 0.00 2,152.00
195 VENTOLIN ROTAHELER Pcs 0.00 17.00 0.00 0.00 0.00 17.00
196 VALISANBE - 13.00 23.00 0.00 0.00 0.00 36.00
197 VALISANBE 2 - 417.00 13.00 0.00 0.00 0.00 430.00
198 TRAMADOL INJ Ampul 89.00 688.00 0.00 11.00 0.00 788.00
199 TOMIT INJ Ampul 3.00 221.00 0.00 0.00 0.00 224.00
200 PROANES / SAFOL INJ Ampul 51.00 209.00 0.00 0.00 0.00 260.00
201 PITOGEN / INDUKSI INJ Ampul 958.00 5,899.00 0.00 80.00 0.00 6,937.00
202 PIRACETAM 1G INJ Ampul 43.00 3,433.00 0.00 22.00 0.00 3,498.00
203 PETHIDINE - 29.00 42.00 0.00 1.00 0.00 72.00
204 PEHACAIN INJ Ampul 31.00 124.00 0.00 1.00 0.00 156.00
205 OMEPRAZOLE INJ Ampul 94.00 2,362.00 0.00 11.00 0.00 2,467.00
206 NOVALDO INJ Ampul 639.00 4,881.00 0.00 81.00 0.00 5,601.00
207 NEOSTIGMIN / PROSTIGMIN INJ Ampul 15.00 67.00 0.00 0.00 0.00 82.00
208 NACL 0,9 500 ML INF Fls 512.00 8,341.00 0.00 61.00 0.00 8,914.00
209 MIOMERGIN / POSPARGIN INJ Ampul 532.00 2,975.00 0.00 36.00 0.00 3,543.00
210 MIPROS - 492.00 2,321.00 0.00 25.00 0.00 2,838.00
211 METRONIDAZOLE INF Fls 160.00 1,714.00 0.00 17.00 0.00 1,891.00
212 METHYLPREDNISOLON INJ Ampul 47.00 33.00 0.00 0.00 0.00 80.00
213 MEROPENEM INJ Pcs 6.00 15.00 0.00 0.00 0.00 21.00
214 MARCAIN INJ Vial 6.00 13.00 0.00 0.00 0.00 19.00
215 MAGNESIUM SULFAT 20% INF Fls 4.00 15.00 0.00 0.00 0.00 19.00
216 MAGNESIUM SULFAT 40% INF Fls 61.00 294.00 0.00 11.00 0.00 366.00
217 LEVOFLOXACIN INJ Ampul 41.00 7.00 0.00 6.00 0.00 54.00
218 LIDOCAIN INJ Ampul 326.00 1,676.00 0.00 24.00 0.00 2,026.00
219 LANTUS INJ Ampul 5.00 122.00 0.00 0.00 0.00 127.00
220 KETOROLAK INJ Ampul 1,877.00 24,424.00 0.00 184.00 0.00 26,485.00
221 KETOROLAK TAB Tablet 352.00 81.00 0.00 0.00 0.00 433.00
222 INF MANITOL Botol 5.00 34.00 0.00 0.00 0.00 39.00
223 ILIADIN 0,05% Botol 40.00 94.00 0.00 3.00 0.00 137.00
224 GENTANAL / GENTAMISIN INJ Ampul 571.00 3,898.00 0.00 43.00 0.00 4,512.00
225 FUTROLIT INJ Ampul 19.00 6.00 0.00 0.00 0.00 25.00
226 GENOCLOM - 129.00 0.00 0.00 0.00 0.00 129.00
227 FUROSEMID INJ Ampul 193.00 2,878.00 0.00 3.00 0.00 3,074.00
228 FLIXOTIDE INJ Ampul 127.00 1,273.00 0.00 0.00 0.00 1,400.00
229 FENTANYL - 28.00 113.00 0.00 1.00 0.00 142.00
230 ETHIPERAN / CLOPRAMEL INJ Ampul 955.00 13,614.00 0.00 88.00 0.00 14,657.00
231 EPHEDRIN INJ Ampul 26.00 245.00 0.00 4.00 0.00 275.00
232 EPIDOSIN INJ Ampul 44.00 230.00 0.00 4.00 0.00 278.00
233 EPINEPRIN INJ Ampul 8.00 91.00 0.00 0.00 0.00 99.00
234 DEXAMETHASONE INJ Ampul 651.00 4,919.00 0.00 35.00 0.00 5,605.00
235 DEKSTRO 10% INF Fls 5.00 120.00 0.00 0.00 0.00 125.00
236 DEKSTRO 40% INF Fls 9.00 119.00 0.00 0.00 0.00 128.00
237 DEKSTRO 5% 100 ML INF Fls 4.00 13.00 0.00 0.00 0.00 17.00
238 DEKSTRO 5% INF Fls 8.00 181.00 0.00 0.00 0.00 189.00
239 CORTIDEX INJ Ampul 41.00 30.00 0.00 0.00 0.00 71.00
240 COLSACETINE INJ Ampul 52.00 192.00 0.00 5.00 0.00 249.00
241 CIPROFLOKSASIN INF Fls 28.00 432.00 0.00 0.00 0.00 460.00
242 CEFTRIAXONE INJ Ampul 2,628.00 26,242.00 0.00 167.00 0.00 29,037.00
243 CEFOTAXIME INJ Ampul 653.00 7,279.00 0.00 43.00 0.00 7,975.00
244 CEFIXIME TAB Tablet 1,729.00 53.00 0.00 81.00 0.00 1,863.00
245 CARBAZOCHROME SODIUM Ampul 1.00 111.00 0.00 0.00 0.00 112.00
SULFONATE
CARMED 10% ZALF Tube 5.00 34.00 0.00 0.00 0.00 39.00
246
247 CAIRAN 4:1 INF Fls 90.00 137.00 0.00 0.00 0.00 227.00
248 BUNASCAN / BUCAIN / REGIVEL Ampul 146.00 1,168.00 0.00 14.00 0.00 1,328.00
249 BEDAK KOCOK Botol 3.00 25.00 0.00 0.00 0.00 28.00
250 ATROPIN INJ Ampul 68.00 372.00 0.00 5.00 0.00 445.00
251 AS. TRANEKSAMAT 250 MG INJ Ampul 22.00 91.00 0.00 0.00 0.00 113.00
252 AS. TRANEKSAMAT 500 MG INJ Ampul 434.00 4,939.00 0.00 19.00 0.00 5,392.00
253 AQUADES INJ Ampul 1,558.00 10,713.00 0.00 83.00 0.00 12,354.00
254 AQUABIDES BOTOL KACA INF Fls 2.00 14.00 0.00 0.00 0.00 16.00
255 APIDRA INSULIN Vial 7.00 156.00 0.00 0.00 0.00 163.00
256 AMPICILIN / SANPICILIN INJ Ampul 296.00 737.00 0.00 11.00 0.00 1,044.00
LAPORAN PEMAKAIAN ALKES PERIODE : 1 Januari 2018 s/d 31 Desember 2018

ASURANSI /
NO URAIAN SATUAN UMUM BPJS INHEALT PERUSAHAAN GRATIS / TOTAL
H LAIN

1 ABBOCATH 14 Pcs 7.00 22.00 0.00 0.00 0.00 29.00


2 ABBOCATH 16 Pcs 1.00 4.00 0.00 0.00 0.00 5.00
3 ABBOCATH 18 Pcs 565.00 3,517.00 0.00 43.00 0.00 4,125.00
4 ABBOCATH 20 Pcs 34.00 221.00 0.00 2.00 0.00 257.00
5 ABBOCATH 22 Pcs 310.00 4,712.00 0.00 31.00 0.00 5,053.00
6 ABBOCATH 24 Pcs 569.00 2,559.00 0.00 16.00 0.00 3,144.00
7 ABBOCATH 26 Pcs 176.00 451.00 0.00 0.00 0.00 627.00
8 ALKOHOL SWABS Pcs 14.00 0.00 0.00 0.00 0.00 14.00
9 BENANG CAT CHROMIC 2 Pcs 0.00 1.00 0.00 0.00 0.00 1.00
10 BENANG CAT PLAIN 1 Pcs 1.00 6.00 0.00 0.00 0.00 7.00
11 BENANG CAT PLAIN 2/0 Pcs 0.00 1.00 0.00 0.00 0.00 1.00
12 BENANG CAT PLAIN 3 Pcs 2.00 0.00 0.00 0.00 0.00 2.00
13 BENANG CHROMIC NO 1 Pcs 1.00 2.00 0.00 0.00 0.00 3.00
SACHET
BENANG CHROMIC NO 2 Pcs 2.00 11.00 0.00 0.00 0.00 13.00
14
SACHET
BENANG PLAIN 3/0 Pcs 1.00 0.00 0.00 0.00 0.00 1.00
15
16 BENANG PLAIN NO 1 SACHET Pcs 2.00 53.00 0.00 0.00 0.00 55.00
17 BENANG SILK 2/0 (3 METRIK) Pcs 0.00 13.00 0.00 0.00 0.00 13.00
18 BENANG SILK BLACK 2/0 Pcs 1.00 0.00 0.00 0.00 0.00 1.00
19 BENANG T.SILK 3/0 Pcs 0.00 1.00 0.00 0.00 0.00 1.00
20 BENANG T.VIO NO 2 Pcs 134.00 1,126.00 0.00 15.00 0.00 1,275.00
21 BENANG T.VIO 4-0 Pcs 0.00 2.00 0.00 0.00 0.00 2.00
22 BENANG T.VIO 5/0 Pcs 0.00 1.00 0.00 0.00 0.00 1.00
23 BENANG T.VIO BP2 (1) Pcs 166.00 1,330.00 0.00 13.00 0.00 1,509.00
24 BENANG T.VIO NO 2/0 Pcs 3.00 5.00 0.00 0.00 0.00 8.00
25 BENANG T.VIO NO 3/0 Pcs 1.00 4.00 0.00 1.00 0.00 6.00
26 BIOPANCA Pcs 1,571.00 2,318.00 0.00 32.00 0.00 3,921.00
27 BLOOD SET Pcs 72.00 389.00 0.00 3.00 0.00 464.00
28 CHATETER NO 10 Pcs 2.00 2.00 0.00 0.00 0.00 4.00
29 CHATETER NO 12 Pcs 1.00 2.00 0.00 0.00 0.00 3.00
30 CHATETER NO 14 Pcs 5.00 26.00 0.00 0.00 0.00 31.00
31 CHATETER NO 16 Pcs 150.00 1,113.00 0.00 13.00 0.00 1,276.00
32 CHATETER NO 18 Pcs 15.00 90.00 0.00 3.00 0.00 108.00
33 CHATETER NO 18 TREWAY Pcs 0.00 2.00 0.00 0.00 0.00 2.00
34 CHATETER NO 20 BARDIA Pcs 45.00 162.00 0.00 6.00 0.00 213.00
35 CHATETER NO 20 TREWAY Pcs 6.00 35.00 0.00 1.00 0.00 42.00
36 CHATETER NO 6 Pcs 4.00 2.00 0.00 0.00 0.00 6.00
37 CHATETER NO 8 Pcs 2.00 1.00 0.00 0.00 0.00 3.00
38 DARYANT TULLE Box 11.00 0.00 0.00 0.00 0.00 11.00
39 DERMAFIX NON WATER Lembar 11.00 85.00 0.00 2.00 0.00 98.00
10X25CM
DERMAVIX 10X15 Pcs 17.00 142.00 0.00 0.00 0.00 159.00
40
41 DERMAVIX 10X25 Pcs 262.00 1,960.00 0.00 23.00 0.00 2,245.00
42 DERMAVIX S Pcs 0.00 1.00 0.00 0.00 0.00 1.00
43 EASY CARE Pcs 770.00 3,597.00 0.00 45.00 0.00 4,412.00
44 ELASTIS VERBAN B Pcs 5.00 18.00 0.00 1.00 0.00 24.00
45 ELASTIS VERBAN U Pcs 9.00 0.00 0.00 0.00 0.00 9.00
46 ELEKTRODA Pcs 0.00 81.00 0.00 0.00 0.00 81.00
47 ETT NO 3,5 Pcs 0.00 2.00 0.00 0.00 0.00 2.00
48 ETT NO 4 Pcs 0.00 2.00 0.00 0.00 0.00 2.00
49 ETT NO 4,5 Pcs 0.00 3.00 0.00 0.00 0.00 3.00
50 ETT NO 5 Pcs 0.00 1.00 0.00 0.00 0.00 1.00
51 ETT NO 6,5 Pcs 0.00 3.00 0.00 0.00 0.00 3.00
52 ETT NO 7 Pcs 1.00 8.00 0.00 0.00 0.00 9.00
53 ETT NO 7,5 Pcs 3.00 12.00 0.00 0.00 0.00 15.00
54 EXT TUBE Pcs 2.00 10.00 0.00 0.00 0.00 12.00
55 GUDEL Pcs 0.00 1.00 0.00 0.00 0.00 1.00
56 HANSCOON NO 6,5 Pcs 461.00 3,387.00 0.00 37.00 0.00 3,885.00
57 HANSCOON NO 7 Pcs 408.00 2,760.00 0.00 28.00 0.00 3,196.00
58 HANSCOON NO 7,5 Pcs 207.00 1,644.00 0.00 14.00 0.00 1,865.00
59 HANSCOON NO 7,5 GAMEX Pcs 221.00 1,452.00 0.00 17.00 0.00 1,690.00
60 HANSCOON NO 8 Pcs 43.00 269.00 0.00 8.00 0.00 320.00
61 HANSCOON NO 8 GAMEX Pcs 130.00 800.00 0.00 5.00 0.00 935.00
62 HANSCOON NON STERIL Pcs 3.00 0.00 0.00 0.00 0.00 3.00
63 HANSCOON OBGYN (VK) Pcs 0.00 1.00 0.00 0.00 0.00 1.00
64 INFUSET MAKRO Pcs 693.00 4,352.00 0.00 50.00 0.00 5,095.00
65 INFUSET MIKRO Pcs 145.00 361.00 0.00 3.00 0.00 509.00
66 KASSA STERIL Pcs 348.00 1.00 0.00 0.00 0.00 349.00
67 KERTAS EKG Pcs 18.00 155.00 0.00 2.00 0.00 175.00
68 NALD 18 Box 2.00 1.00 0.00 0.00 0.00 3.00
69 NALD 23 Pcs 1,831.00 9,859.00 0.00 97.00 0.00 11,787.00
70 NALD 25 Box 2.00 9.00 0.00 0.00 0.00 11.00
71 NALD 26 Pcs 1,310.00 6,944.00 0.00 51.00 0.00 8,305.00
72 NALD HECTING CUT NO 14 Pcs 0.00 1.00 0.00 0.00 0.00 1.00
73 NALD INSULIN Pcs 1,287.00 549.00 0.00 1.00 0.00 1,837.00
74 NGT 10 Pcs 1.00 2.00 0.00 0.00 0.00 3.00
75 NGT 12 Pcs 0.00 1.00 0.00 0.00 0.00 1.00
76 NGT 14 Pcs 1.00 1.00 0.00 0.00 0.00 2.00
77 NGT 16 Pcs 16.00 71.00 0.00 0.00 0.00 87.00
78 NGT 16 Pcs 8.00 42.00 0.00 0.00 0.00 50.00
79 NGT 18 Pcs 0.00 12.00 0.00 0.00 0.00 12.00
80 NGT 3,5 Pcs 8.00 27.00 0.00 0.00 0.00 35.00
81 NGT 5 Pcs 29.00 63.00 0.00 1.00 0.00 93.00
82 NGT 8 Pcs 7.00 1.00 0.00 0.00 0.00 8.00
83 NOVA T Pcs 16.00 1.00 0.00 0.00 0.00 17.00
84 POLYBAN Pcs 1.00 6.00 0.00 0.00 0.00 7.00
85 POLYGYP Pcs 2.00 6.00 0.00 0.00 0.00 8.00
86 SELANG NEBUL ANAK Pcs 2.00 2.00 0.00 0.00 0.00 4.00
87 SELANG NEBUL DEWASA Pcs 3.00 8.00 0.00 0.00 0.00 11.00
88 SELANG O2 ANAK Pcs 19.00 30.00 0.00 1.00 0.00 50.00
89 SELANG O2 BAYI Pcs 14.00 27.00 0.00 0.00 0.00 41.00
90 SELANG O2 DEWASA Pcs 65.00 428.00 0.00 4.00 0.00 497.00
91 SELANG SUCTION 14 Pcs 1.00 1.00 0.00 0.00 0.00 2.00
92 SPINOCAN 25 Pcs 32.00 203.00 0.00 1.00 0.00 236.00
93 SPINOCAN 26 Pcs 43.00 386.00 0.00 5.00 0.00 434.00
94 SPINOCAN 27 Pcs 94.00 715.00 0.00 9.00 0.00 818.00
95 SPUIT 1 CC Pcs 833.00 3,161.00 0.00 38.00 0.00 4,032.00
96 SPUIT 10 CC Pcs 1,430.00 5,368.00 0.00 77.00 0.00 6,875.00
97 SPUIT 20 CC Pcs 5.00 7.00 0.00 0.00 0.00 12.00
98 SPUIT 3 CC Pcs 3,303.00 19,316.00 0.00 206.00 0.00 22,825.00
99 SPUIT 5 CC Pcs 1,073.00 8,603.00 0.00 70.00 0.00 9,746.00
100 SPUIT 5 CC TERUMO Pcs 114.00 961.00 0.00 8.00 0.00 1,083.00
101 SPUIT 50 CC Pcs 10.00 24.00 0.00 0.00 0.00 34.00
102 SPUIT 60 CC Pcs 29.00 119.00 0.00 0.00 0.00 148.00
103 SUNGKUP NON REBRITING Pcs 7.00 34.00 0.00 0.00 0.00 41.00
DEWASA
SUNGKUP REBRITING ANAK Pcs 3.00 2.00 0.00 0.00 0.00 5.00
104
105 SUNGKUP REBRITING DEWASA Pcs 1.00 9.00 0.00 0.00 0.00 10.00
106 TERMOMETER DIGITAL Pcs 70.00 0.00 0.00 0.00 0.00 70.00
107 TERMOMETER DIGITAL Pcs 1.00 0.00 0.00 0.00 0.00 1.00
RUANGAN
THREE WAY B.BRAUN / GEA Pcs 583.00 3,663.00 0.00 34.00 0.00 4,280.00
108
109 TOPI OPERASI Pcs 16.00 368.00 0.00 3.00 0.00 387.00
110 UNDERPAD Pcs 478.00 3,126.00 0.00 29.00 0.00 3,633.00
111 URINE BAG Pcs 171.00 1,227.00 0.00 16.00 0.00 1,414.00
112 WECARE L ISI 2 Bungkus 115.00 0.00 0.00 0.00 0.00 115.00
113 WECARE L ISI 8 Bungkus 17.00 0.00 0.00 0.00 0.00 17.00
114 WECARE M ISI 10 Bungkus 13.00 0.00 0.00 0.00 0.00 13.00
115 WECARE M ISI 2 Bungkus 77.00 0.00 0.00 0.00 0.00 77.00
116 WECARE XL ISI 2 Bungkus 169.00 0.00 0.00 0.00 0.00 169.00