| No | Etalase | Produk | Harga | Jumlah | Ongkos Kirim | Total | Penyedia |
|---|---|---|---|---|---|---|---|
| 1 | Jasa Kebersihan Pemerintah Provinsi Jawa Timur | Jasa Cleaning Service | 2.500.000 | 1 | 0 | 2.500.000 | BINTANG JAYA SENTOSA |
| 2 | Makanan dan Minuman Provinsi Jawa Timur | Snack box | 19.000 | 20 | 0 | 380.000 | Gloxinia Catering |
| 3 | Makanan dan Minuman Provinsi Jawa Timur | Nasi ayam bakar | 29.000 | 20 | 0 | 580.000 | Gloxinia Catering |
| 4 | Fasilitas Kesehatan Sektoral Kemenkes | Gentamicin cr salep kulit | 6.500 | 50 | 0 | 325.000 | PT. Antar Mitra Persada |
| 5 | Fasilitas Kesehatan Sektoral Kemenkes | Ibuprofen 400mg tablet | 395 | 5.000 | 0 | 1.975.000 | PT. Antar Mitra Persada |
| 6 | Fasilitas Kesehatan Sektoral Kemenkes | Cairan Infus NaCl | 11.300 | 10 | 0 | 113.000 | PT. Antar Mitra Persada |
| 7 | Fasilitas Kesehatan Sektoral Kemenkes | Amitriptilin 25mg | 1 | 500 | 0 | 500 | PT. Antar Mitra Persada |
| 8 | Fasilitas Kesehatan Sektoral Kemenkes | Erla Tetes Telinga | 17.000 | 10 | 0 | 170.000 | PT. Antar Mitra Persada |
| 9 | Fasilitas Kesehatan Sektoral Kemenkes | Asam Traneksamat 500mg | 1.910 | 500 | 0 | 955.000 | PT. Antar Mitra Persada |
| 10 | Fasilitas Kesehatan Sektoral Kemenkes | Aspilet Tablet | 97.800 | 10 | 0 | 978.000 | PT. Antar Mitra Persada |
| 11 | Fasilitas Kesehatan Sektoral Kemenkes | Caviton Pink 30 gr | 299.500 | 2 | 0 | 599.000 | PT. Antar Mitra Persada |
| 12 | Fasilitas Kesehatan Sektoral Kemenkes | 546 | 979.600 | 1 | 0 | 979.600 | PT. Antar Mitra Persada |
| 13 | Fasilitas Kesehatan Sektoral Kemenkes | Handscoon Ukuran S/ Small | 58.000 | 4 | 0 | 232.000 | PT. Antar Mitra Persada |
| 14 | Fasilitas Kesehatan Sektoral Kemenkes | handscoon nitril ukuran L | 58.000 | 7 | 0 | 406.000 | PT. Antar Mitra Persada |
| 15 | Fasilitas Kesehatan Sektoral Kemenkes | Handscoon Ukuran M/ Medium | 58.000 | 9 | 0 | 522.000 | PT. Antar Mitra Persada |
| 16 | Jasa Kebersihan Pemerintah Provinsi Jawa Timur | Jasa Cleaning Service | 2.500.000 | 1 | 0 | 2.500.000 | BINTANG JAYA SENTOSA |
| 17 | Fasilitas Kesehatan Sektoral Kemenkes | FDI-HM-3 Plus Hematology Analyzer Probe Cleanser | 300.000 | 1 | 21.125 | 321.125 | PT. FOKUS DIAGNOSTIC INDONESIA |
| 18 | Fasilitas Kesehatan Sektoral Kemenkes | Diluent FDI HM-3 Plus | 1.200.000 | 1 | 450.000 | 1.650.000 | PT. FOKUS DIAGNOSTIC INDONESIA |
| 19 | Fasilitas Kesehatan Sektoral Kemenkes | Lyse FDI HM-3 Plus | 1.200.000 | 2 | 50.700 | 2.450.700 | PT. FOKUS DIAGNOSTIC INDONESIA |
| 20 | Fasilitas Kesehatan Sektoral Kemenkes | Diluent FDI HM-3 Plus | 1.200.000 | 1 | 557.700 | 1.757.700 | PT. FOKUS DIAGNOSTIC INDONESIA |
| 21 | Fasilitas Kesehatan Sektoral Kemenkes | Lyse FDI HM-3 Plus | 1.200.000 | 1 | 50.700 | 1.250.700 | PT. FOKUS DIAGNOSTIC INDONESIA |
| 22 | Obat Program Kesehatan Lainnya | Deksametason/ Dexamethasone tablet/kapsul/kaplet 0,5 mg | 106 | 12.000 | 0 | 1.272.000 | PT.Bernofarm |
| 23 | Obat Program Kesehatan Lainnya | Diclofenac sodium/ Natrium diklofenak tablet salut enterik/kaplet salut enterik 50 mg | 192 | 10.000 | 0 | 1.920.000 | PT.Bernofarm |
| 24 | Obat Program Kesehatan Lainnya | Paracetamol/ Parasetamol tablet/kapsul/kaplet 500 mg | 189 | 15.000 | 0 | 2.835.000 | PT.Bernofarm |
| 25 | Obat Program Kesehatan Lainnya | Metilprednisolon/Methylprednisolone tablet/kapsul/kaplet 4 mg | 235 | 5.000 | 0 | 1.175.000 | PT.Bernofarm |
| 26 | Obat Program Jaminan Kesehatan | Amoksisilin/ Amoxicillin/ Amoxicillin Trihydrate tablet/kapsul/kaplet/kaptab 500 mg | 530 | 10.000 | 0 | 5.300.000 | PT.Bernofarm |
| 27 | Obat Program Jaminan Kesehatan | Dexamethason Sodium Phosphate/ Deksamethason/ Deksametason injeksi 5 mg/mL | 1.653 | 100 | 0 | 165.300 | PT.Bernofarm |
| 28 | Obat Program Jaminan Kesehatan | Furosemid/ Furosemide inj 10 mg/mL (i.v./i.m) | 4.438 | 10 | 0 | 44.380 | PT.Bernofarm |
| 29 | Obat Program Jaminan Kesehatan | Difenhidramin/ Diphenhydramine injeksi 10 mg/ml ( i.v./i.m.) | 1.893 | 100 | 0 | 189.300 | PT.Bernofarm |
| 30 | Obat Program Jaminan Kesehatan | Asam traneksamat/Tranexamic acid tablet/kapsul/kaplet salut selaput 500 mg | 1.688 | 1.000 | 0 | 1.688.000 | PT.Bernofarm |
| 31 | Obat Program Jaminan Kesehatan | Water For Injection 50 ml Inj. | 11.827 | 50 | 0 | 591.350 | PT.Bernofarm |
| 32 | Obat Program Jaminan Kesehatan | Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain injeksi 2% | 1.319 | 100 | 0 | 131.900 | PT.Bernofarm |
| 33 | Obat Program Jaminan Kesehatan | CEFIXIME 100 mg TSS | 1.000 | 3.000 | 0 | 3.000.000 | PT.Bernofarm |
| 34 | Obat Program Jaminan Kesehatan | THIAMPHENICOL 500 mg KAPS | 1.349 | 1.000 | 0 | 1.349.000 | PT.Bernofarm |
| 35 | Obat Program Jaminan Kesehatan | Mefenamic acid tablet/kapsul/kaplet/kaptab 500 mg | 279 | 8.000 | 0 | 2.232.000 | PT.Bernofarm |
| 36 | Fasilitas Kesehatan | ASAT (GOT) FS (IFCC mod.) 126019910022 | 499.500 | 2 | 25.000 | 1.024.000 | PT Prodia Diagnostic Line |
| 37 | Fasilitas Kesehatan | ALAT (GPT) FS (IFCC mod.) 127019910022 | 499.500 | 2 | 0 | 999.000 | PT Prodia Diagnostic Line |
| 38 | Fasilitas Kesehatan | Urea FS 131019910022 | 510.600 | 2 | 0 | 1.021.200 | PT Prodia Diagnostic Line |
| 39 | Fasilitas Kesehatan | Creatinine FS 117119910022 | 344.100 | 2 | 0 | 688.200 | PT Prodia Diagnostic Line |
| 40 | Obat Program Jaminan Kesehatan | Amoksisilin/Amoxicillin/Amoxicillin Trihydrate sirup/suspensi kering 125 mg/ 5 ml | 4.560 | 100 | 0 | 456.000 | PT NOVAPHARIN |
| 41 | Obat Program Jaminan Kesehatan | Alopurinol/Allopurinol tablet/kapsul/kaplet 300 mg | 465 | 5.000 | 0 | 2.325.000 | PT NOVAPHARIN |
| 42 | Obat Program Jaminan Kesehatan | Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil tablet/kapsul/kaplet 500 mg | 1.035 | 1.000 | 0 | 1.035.000 | PT NOVAPHARIN |
| 43 | Obat Program Jaminan Kesehatan | Chlorphenamine Maleate/ Klorfeniramin tablet/kapsul/kaplet 4 mg | 73 | 20.000 | 0 | 1.460.000 | PT NOVAPHARIN |
| 44 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride (HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin tablet/kapsul/kaplet 500 mg | 459 | 5.000 | 0 | 2.295.000 | PT NOVAPHARIN |
| 45 | Obat Program Jaminan Kesehatan | Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol (anak) kombinasi tiap 5 ml suspensi: sulfametoksazol 200 mg + trimetoprim 40 mg (susp 240 mg) | 4.651 | 100 | 0 | 465.100 | PT NOVAPHARIN |
| 46 | Obat Program Jaminan Kesehatan | Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol (dewasa) kombinasi: sulfametoksazol 400 mg + trimetoprim 80 mg (tab/kaptab 480 mg) | 266 | 5.000 | 0 | 1.330.000 | PT NOVAPHARIN |
| 47 | Obat Program Jaminan Kesehatan | Domperidon/ Domperidone/ Domperidone Maleate tablet/kapsul/kaplet 10 mg | 163 | 5.000 | 0 | 815.000 | PT NOVAPHARIN |
| 48 | Obat Program Jaminan Kesehatan | Griseofulvin tablet/kapsul/kaplet 125 mg | 357 | 1.000 | 0 | 357.000 | PT NOVAPHARIN |
| 49 | Obat Program Jaminan Kesehatan | Ibuprofen tablet/kapsul/kaplet 400 mg | 209 | 10.000 | 0 | 2.090.000 | PT NOVAPHARIN |
| 50 | Obat Program Jaminan Kesehatan | Alopurinol/Allopurinol tablet/kapsul/kaplet 100 mg | 186 | 10.000 | 0 | 1.860.000 | PT NOVAPHARIN |
| 51 | Obat Program Jaminan Kesehatan | Paracetamol/ Parasetamol sirup 120 mg / 5 ml | 4.186 | 100 | 0 | 418.600 | PT NOVAPHARIN |
| 52 | Obat Program Jaminan Kesehatan | Vitamin B Kompleks/ Vitamin B complex tablet | 81 | 15.000 | 0 | 1.215.000 | PT NOVAPHARIN |
| 53 | Obat Program Jaminan Kesehatan | Hiosina butilbromida tablet 10 mg | 651 | 1.000 | 0 | 651.000 | PT NOVAPHARIN |
| 54 | Obat Program Jaminan Kesehatan | Amlodipine tablet 10 mg | 134 | 10.000 | 0 | 1.340.000 | PT NOVAPHARIN |
| 55 | Obat Program Jaminan Kesehatan | Cetirizine hydrochloride 10 mg tablet | 108 | 10.000 | 0 | 1.080.000 | PT NOVAPHARIN |
| 56 | Obat Program Kesehatan Lainnya | Calcium lactate tablet 500 mg | 116 | 10.000 | 0 | 1.160.000 | PT NOVAPHARIN |
| 57 | Obat Program Kesehatan Lainnya | Ibuprofen tablet 200 mg | 197 | 10.000 | 0 | 1.970.000 | PT NOVAPHARIN |
| 58 | Obat Program Kesehatan Lainnya | PREDNISONE Tablet 5 mg | 122 | 10.000 | 0 | 1.220.000 | PT NOVAPHARIN |
| 59 | Obat Program Kesehatan Lainnya | Vitamin B12 tablet 50 mcg | 77 | 15.000 | 0 | 1.155.000 | PT NOVAPHARIN |
| 60 | Obat Program Kesehatan Lainnya | Vitamin B1 tablet 50 mg | 145 | 10.000 | 0 | 1.450.000 | PT NOVAPHARIN |
| 61 | Obat Program Kesehatan Lainnya | Simvastatin tablet 10 mg | 131 | 8.000 | 0 | 1.048.000 | PT NOVAPHARIN |
| 62 | Obat Program Kesehatan Lainnya | Acetyl cysteine/ N-asetil sistein tablet/kapsul/kaplet 200 mg | 465 | 6.100 | 0 | 2.836.500 | PT NOVAPHARIN |
| 63 | Obat Program Kesehatan Lainnya | Pyridoxine/ Piridoksin (Vitamin B6) tablet/kapsul/kaplet 50 mg | 433 | 15.000 | 0 | 6.495.000 | PT.Phapros Tbk |
| 64 | Obat Non Jaminan Kesehatan | AMBROXOL HCI tablet | 128 | 10.000 | 0 | 1.280.000 | PT NOVAPHARIN |
| 65 | Obat Non Jaminan Kesehatan | VITAMIN C 250 kapsul | 234 | 5.000 | 0 | 1.170.000 | PT NOVAPHARIN |
| 66 | Konsolidasi Obat | Gliseril trinitrat kaps lepas lambat 5 mg | 2.530 | 500 | 0 | 1.265.000 | PT. Kimia Farma Tbk |
| 67 | Fasilitas Kesehatan Sektoral Kemenkes | Amlodipine 5mg tablet | 144 | 3.000 | 0 | 432.000 | PT. Antar Mitra Persada |
| 68 | Fasilitas Kesehatan Sektoral Kemenkes | Bisoprolol 5 mg | 22.500 | 30 | 0 | 675.000 | PT. Antar Mitra Persada |
| 69 | Fasilitas Kesehatan Sektoral Kemenkes | Acetylcysteine tablet 200 mg | 935 | 1.000 | 0 | 935.000 | PT. Antar Mitra Persada |
| 70 | Fasilitas Kesehatan Sektoral Kemenkes | Vitamin C 50mg | 230 | 4.000 | 0 | 920.000 | PT. Antar Mitra Persada |
| 71 | Fasilitas Kesehatan Sektoral Kemenkes | Candesartan 8 mg | 23.500 | 30 | 0 | 705.000 | PT. Antar Mitra Persada |
| 72 | Fasilitas Kesehatan Sektoral Kemenkes | Simvastatin 10mg | 260 | 4.000 | 0 | 1.040.000 | PT. Antar Mitra Persada |
| 73 | Fasilitas Kesehatan Sektoral Kemenkes | Dohixat 100mg tablet | 600 | 500 | 0 | 300.000 | PT. Antar Mitra Persada |
| 74 | Fasilitas Kesehatan Sektoral Kemenkes | Gentamicin cr salep kulit | 6.500 | 50 | 0 | 325.000 | PT. Antar Mitra Persada |
| 75 | Fasilitas Kesehatan Sektoral Kemenkes | Ranitidine 150mg 100s | 335 | 4.000 | 0 | 1.340.000 | PT. Antar Mitra Persada |
| 76 | Fasilitas Kesehatan Sektoral Kemenkes | Guaifenesin 100 mg tablet | 160 | 7.000 | 0 | 1.120.000 | PT. Antar Mitra Persada |
| 77 | Fasilitas Kesehatan Sektoral Kemenkes | Salbutamol tablet 2 mg | 164 | 2.000 | 0 | 328.000 | PT. Antar Mitra Persada |
| 78 | Fasilitas Kesehatan Sektoral Kemenkes | Metformin 500mg isi 200 tablet | 275 | 5.000 | 0 | 1.375.000 | PT. Antar Mitra Persada |
| 79 | Fasilitas Kesehatan Sektoral Kemenkes | Furosemid 40mg tablet | 406 | 500 | 0 | 203.000 | PT. Antar Mitra Persada |
| 80 | Fasilitas Kesehatan Sektoral Kemenkes | Glimepirid 2mg isi 100 tablet | 328 | 7.000 | 0 | 2.296.000 | PT. Antar Mitra Persada |
| 81 | Fasilitas Kesehatan Sektoral Kemenkes | Glibencamide 5 mg tablet | 1 | 1.000 | 0 | 1.000 | PT. Antar Mitra Persada |
| 82 | Fasilitas Kesehatan Sektoral Kemenkes | Bromifar tablet | 230 | 5.000 | 0 | 1.150.000 | PT. Antar Mitra Persada |
| 83 | Fasilitas Kesehatan Sektoral Kemenkes | Isosorbide dinitrate 5mg tablet | 288 | 1.000 | 0 | 288.000 | PT. Antar Mitra Persada |
| 84 | Fasilitas Kesehatan Sektoral Kemenkes | Piroxicam 10 mg tablet | 148 | 5.000 | 0 | 740.000 | PT. Antar Mitra Persada |
| 85 | Fasilitas Kesehatan Sektoral Kemenkes | Metamizole tablet | 335 | 500 | 0 | 167.500 | PT. Antar Mitra Persada |
| 86 | Fasilitas Kesehatan Sektoral Kemenkes | Omeprazole isi 100 kapsul | 398 | 1.000 | 0 | 398.000 | PT. Antar Mitra Persada |
| 87 | Fasilitas Kesehatan Sektoral Kemenkes | PROPANOLOL TABLET 10 MG | 190 | 2.000 | 0 | 380.000 | PT. Antar Mitra Persada |
| 88 | Fasilitas Kesehatan Sektoral Kemenkes | Nifedipin tablet | 270 | 500 | 0 | 135.000 | PT. Antar Mitra Persada |
| 89 | Fasilitas Kesehatan Sektoral Kemenkes | Reco Tetes Mata | 13.500 | 30 | 0 | 405.000 | PT. Antar Mitra Persada |
| 90 | Fasilitas Kesehatan Sektoral Kemenkes | Antasida Tablet | 160 | 7.000 | 0 | 1.120.000 | PT. Antar Mitra Persada |
| 91 | Fasilitas Kesehatan Sektoral Kemenkes | Lansoprazole isi 20 tablet | 8.000 | 40 | 0 | 320.000 | PT. Antar Mitra Persada |
| 92 | Fasilitas Kesehatan Sektoral Kemenkes | Erla Tetes Telinga | 16.000 | 25 | 0 | 400.000 | PT. Antar Mitra Persada |
| 93 | Fasilitas Kesehatan Sektoral Kemenkes | Phenol Glyserol Tetes Telinga | 1 | 4 | 0 | 4 | PT. Antar Mitra Persada |
| 94 | Fasilitas Kesehatan Sektoral Kemenkes | Bioplacenton cr | 35.600 | 10 | 0 | 356.000 | PT. Antar Mitra Persada |
| 95 | Fasilitas Kesehatan Sektoral Kemenkes | Borax Gliserin/GOM | 104.000 | 4 | 0 | 416.000 | PT. Antar Mitra Persada |
| 96 | Fasilitas Kesehatan Sektoral Kemenkes | Ferriz Syrup | 51.600 | 20 | 0 | 1.032.000 | PT. Antar Mitra Persada |
| 97 | Fasilitas Kesehatan Sektoral Kemenkes | Salbutamol Nebul | 17.000 | 10 | 0 | 170.000 | PT. Antar Mitra Persada |
| 98 | Fasilitas Kesehatan Sektoral Kemenkes | Salep 24 | 8.500 | 24 | 0 | 204.000 | PT. Antar Mitra Persada |
| 99 | Fasilitas Kesehatan Sektoral Kemenkes | Betametason salep/cream | 6.500 | 50 | 0 | 325.000 | PT. Antar Mitra Persada |
| 100 | Fasilitas Kesehatan Sektoral Kemenkes | Framicetin Sulfate | 164.700 | 10 | 0 | 1.647.000 | PT. Antar Mitra Persada |
| Total | 108.161.659 | ||||||
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