| No | Etalase | Produk | Harga | Jumlah | Ongkos Kirim | Total | Penyedia |
|---|---|---|---|---|---|---|---|
| 1 | Alat Tulis Kantor Provinsi Jawa Timur | registerroll | 8.500 | 30 | 0 | 255.000 | karya makmur sejahtera lkd |
| 2 | Alat Tulis Kantor Provinsi Jawa Timur | kertas hvs 70 gr | 59.000 | 130 | 0 | 7.670.000 | karya makmur sejahtera lkd |
| 3 | Obat Program Jaminan Kesehatan | Dexamethason Sodium Phosphate/ Deksamethason/ Deksametason injeksi 5 mg/mL | 1.653 | 500 | 0 | 826.500 | PT.Bernofarm |
| 4 | Obat Program Kesehatan Lainnya | Betahistin/Betahistine Mesilate/Betahistine Mesylate tablet/kapsul/kaplet 6 mg | 355 | 10.000 | 0 | 3.550.000 | PT.Bernofarm |
| 5 | 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 |
| 6 | Obat Program Kesehatan Lainnya | Salbutamol sulfate/ Salbutamol tablet/kapsul/kaplet 2 mg | 183 | 5.000 | 0 | 915.000 | PT.Bernofarm |
| 7 | Obat Program Jaminan Kesehatan | Amoksisilin/ Amoxicillin/ Amoxicillin Trihydrate tablet/kapsul/kaplet/kaptab 500 mg | 530 | 30.000 | 0 | 15.900.000 | PT.Bernofarm |
| 8 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride (HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin tablet/kapsul/kaplet 500 mg | 475 | 5.000 | 0 | 2.375.000 | PT.Bernofarm |
| 9 | Obat Program Jaminan Kesehatan | Domperidon/ Domperidone/ Domperidone Maleate tablet/kapsul/kaplet 10 mg | 283 | 5.000 | 0 | 1.415.000 | PT.Bernofarm |
| 10 | Obat Program Jaminan Kesehatan | Amoksisilin/Amoxicillin/Amoxicillin Trihydrate sirup/suspensi kering 125 mg/ 5 ml | 5.500 | 500 | 0 | 2.750.000 | PT.Bernofarm |
| 11 | Obat Program Jaminan Kesehatan | Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol tablet /kaptab (dewasa) kombinasi: sulfametoksazol 400 mg + trimetoprim 80 mg | 275 | 5.000 | 0 | 1.375.000 | PT.Bernofarm |
| 12 | Obat Program Jaminan Kesehatan | ATTAPULGIT/ATTAPULGITE 600 MG/TABLET/KAPLET/KAPSUL | 300 | 5.000 | 0 | 1.500.000 | PT. TRIMAN |
| 13 | Obat Program Jaminan Kesehatan | Asam mefenamat t4b 500 mg | 219 | 10.000 | 0 | 2.190.000 | PT. TRIMAN |
| 14 | Obat Program Jaminan Kesehatan | Ibuprofen tab 400 mg | 275 | 10.000 | 0 | 2.750.000 | PT. TRIMAN |
| 15 | Obat Program Jaminan Kesehatan | Ambroxol HCI/Ambroksol/T4blet/K4psul/Kaplet 30 mg | 134 | 10.000 | 0 | 1.340.000 | PT. TRIMAN |
| 16 | Fasilitas Kesehatan Sektoral Kemenkes | Domperidone 10mg tablet | 220 | 3.000 | 0 | 660.000 | PT. Antar Mitra Persada |
| 17 | Fasilitas Kesehatan Sektoral Kemenkes | Borax Gliserin/GOM | 1 | 6 | 0 | 6 | PT. Antar Mitra Persada |
| 18 | Fasilitas Kesehatan Sektoral Kemenkes | Paracetamol 500mg tablet | 250 | 3.000 | 0 | 750.000 | PT. Antar Mitra Persada |
| 19 | Fasilitas Kesehatan Sektoral Kemenkes | Guaifenesin 100 mg tablet | 165 | 5.000 | 0 | 825.000 | PT. Antar Mitra Persada |
| 20 | Fasilitas Kesehatan Sektoral Kemenkes | Dexamethasone 0,5mg isi 100 tablet | 150 | 5.000 | 0 | 750.000 | PT. Antar Mitra Persada |
| 21 | Fasilitas Kesehatan Sektoral Kemenkes | Asam Mefenamat 500mg tab | 310 | 5.000 | 0 | 1.550.000 | PT. Antar Mitra Persada |
| 22 | Fasilitas Kesehatan Sektoral Kemenkes | Silk Suture With Needle 3/0 | 130.758 | 15 | 0 | 1.961.370 | PT Jayamas Medica Industri |
| 23 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll, PU 5 cm x 2 m | 15.318 | 150 | 0 | 2.297.700 | PT Jayamas Medica Industri |
| 24 | Obat Program Jaminan Kesehatan | Antasida tablet kunyah | 300 | 10.000 | 0 | 3.000.000 | PT. Kimia Farma Tbk |
| 25 | Obat Program Jaminan Kesehatan | Vitamin B Kompleks/ Vitamin B complex tablet | 111 | 15.000 | 0 | 1.665.000 | PT. Kimia Farma Tbk |
| 26 | Fasilitas Kesehatan Sektoral Kemenkes | AUTOCHECK register Total Cholesterol Test Strip | 238.650 | 80 | 0 | 19.092.000 | PT. Setia Andalan Sukses |
| 27 | Fasilitas Kesehatan Sektoral Kemenkes | AUTOCHECK register Uric Acid Test Strip | 140.415 | 20 | 0 | 2.808.300 | PT. Setia Andalan Sukses |
| 28 | Fasilitas Kesehatan Sektoral Kemenkes | TISSUE LENSA | 29.800 | 4 | 0 | 119.200 | PT. Setia Andalan Sukses |
| 29 | Fasilitas Kesehatan Sektoral Kemenkes | KONTROL 3 DIFF NORMAL | 675.000 | 2 | 0 | 1.350.000 | PT. Setia Andalan Sukses |
| 30 | Fasilitas Kesehatan Sektoral Kemenkes | TABUNG REAKSI 12 X 75 (500) | 227.000 | 2 | 0 | 454.000 | PT. Setia Andalan Sukses |
| 31 | Fasilitas Kesehatan Sektoral Kemenkes | AUTOCHECK register Total Cholesterol Test Strip | 238.650 | 60 | 0 | 14.319.000 | PT. Setia Andalan Sukses |
| 32 | Fasilitas Kesehatan Sektoral Kemenkes | TABUNG CENTRIFUGE 15 ML | 218.000 | 1 | 0 | 218.000 | PT. Setia Andalan Sukses |
| 33 | Fasilitas Kesehatan Sektoral Kemenkes | AQUADEST 20L | 128.000 | 2 | 0 | 256.000 | PT. Setia Andalan Sukses |
| 34 | Fasilitas Kesehatan Sektoral Kemenkes | Bromhexine HCL Tablet 8 Mg | 13.320 | 50 | 0 | 666.000 | GATRA PERSADA |
| 35 | Fasilitas Kesehatan Sektoral Kemenkes | Vitamin B6 (Piridoksin) Tablet 10 mg | 16.650 | 50 | 0 | 832.500 | GATRA PERSADA |
| 36 | Fasilitas Kesehatan Sektoral Kemenkes | Carbamazepine Tablet 200 mg | 166.500 | 15 | 0 | 2.497.500 | GATRA PERSADA |
| 37 | Fasilitas Kesehatan Sektoral Kemenkes | Vitamin B12 Tablet 50 mcg | 12.210 | 50 | 0 | 610.500 | GATRA PERSADA |
| 38 | Fasilitas Kesehatan Sektoral Kemenkes | Vitamin B1 Tablet 50mg | 17.649 | 50 | 0 | 882.450 | GATRA PERSADA |
| 39 | Fasilitas Kesehatan Sektoral Kemenkes | Metformin Tablet 500mg | 66.600 | 80 | 0 | 5.328.000 | GATRA PERSADA |
| 40 | Fasilitas Kesehatan Sektoral Kemenkes | Metronidazole Tablet 500 mg | 28.860 | 50 | 0 | 1.443.000 | GATRA PERSADA |
| 41 | Obat Program Jaminan Kesehatan | Tridexon/ Deksametason/ Dexamethasone tablet/kapsul/kaplet 0,5 mg | 136 | 10.000 | 0 | 1.360.000 | PT. TRIMAN |
| 42 | Obat Program Jaminan Kesehatan | PARACETAMOL/ PARASETAMOL T4BLET/KAPSUL/KAPLET 500 MG | 210 | 8.000 | 0 | 1.680.000 | PT. TRIMAN |
| 43 | Obat Program Jaminan Kesehatan | Cetirizin3 hydrochloride(HCl)/ Cetirizin3/ Setirizin tablet/kapsul/kaplet 10 mg | 104 | 10.000 | 0 | 1.040.000 | PT. TRIMAN |
| 44 | Obat Program Jaminan Kesehatan | ALLOPURIN0L 100 MG | 209 | 5.000 | 0 | 1.045.000 | PT. TRIMAN |
| 45 | Obat Program Jaminan Kesehatan | Asam mefenamat t4b 500 mg | 260 | 15.000 | 0 | 3.900.000 | PT. TRIMAN |
| 46 | Obat Program Jaminan Kesehatan | Ambroxol HCI/Ambroksol/T4blet/K4psul/Kaplet 30 mg | 134 | 9.800 | 0 | 1.313.200 | PT. TRIMAN |
| 47 | Obat Program Jaminan Kesehatan | Kalsium Laktat/ Calcium lactate (Kalk) tab500mg | 204 | 10.000 | 0 | 2.040.000 | PT. TRIMAN |
| 48 | Obat Program Jaminan Kesehatan | Difenhidramin/ Diphenhydramine injeksi 10 mg/ml ( i.v./i.m.) | 1.893 | 1.000 | 0 | 1.893.000 | PT.Bernofarm |
| 49 | Obat Program Jaminan Kesehatan | Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain injeksi 2% | 1.319 | 500 | 0 | 659.500 | PT.Bernofarm |
| 50 | Obat Program Jaminan Kesehatan | Chlorphenamine Maleate/ Klorfeniramin tablet/kapsul/kaplet 4 mg | 73 | 8.000 | 0 | 584.000 | PT NOVAPHARIN |
| 51 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride (HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin tablet/kapsul/kaplet 500 mg | 459 | 8.000 | 0 | 3.672.000 | PT NOVAPHARIN |
| 52 | Obat Program Jaminan Kesehatan | Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol (dewasa) kombinasi: sulfametoksazol 400 mg + trimetoprim 80 mg (tab/kaptab 480 mg) | 266 | 6.500 | 0 | 1.729.000 | PT NOVAPHARIN |
| 53 | Obat Program Jaminan Kesehatan | Tetrasiklin/ Tetracycline/ Tetracycline Hydrochloride tablet/kapsul/kaplet 500 mg | 586 | 4.900 | 0 | 2.871.400 | PT NOVAPHARIN |
| 54 | Obat Program Jaminan Kesehatan | Vitamin B Kompleks/ Vitamin B complex tablet | 81 | 10.000 | 0 | 810.000 | PT NOVAPHARIN |
| 55 | Fasilitas Kesehatan Sektoral Kemenkes | Guaifenesin 100 mg tablet | 165 | 10.000 | 0 | 1.650.000 | PT. Antar Mitra Persada |
| 56 | Fasilitas Kesehatan Sektoral Kemenkes | Flutamol tablet | 648 | 2.000 | 0 | 1.296.000 | PT. Antar Mitra Persada |
| 57 | Fasilitas Kesehatan Sektoral Kemenkes | Caviplex tablet | 930 | 1.000 | 0 | 930.000 | PT. Antar Mitra Persada |
| 58 | Fasilitas Kesehatan Sektoral Kemenkes | Etabion tablet | 350 | 3.000 | 0 | 1.050.000 | PT. Antar Mitra Persada |
| 59 | Fasilitas Kesehatan Sektoral Kemenkes | Captopril 25 mg | 185 | 5.000 | 0 | 925.000 | PT. Antar Mitra Persada |
| 60 | Fasilitas Kesehatan Sektoral Kemenkes | Aminophylin tab | 585 | 1.000 | 0 | 585.000 | PT. Antar Mitra Persada |
| 61 | Obat Program Jaminan Kesehatan | Asiklovir/Acyclovir/Aciclovir tablet/kapsul/kaplet 400 mg | 848 | 1.700 | 0 | 1.441.600 | PT. Kimia Farma Tbk |
| 62 | Obat Program Jaminan Kesehatan | Furosemid/ Furosemide tablet/kapsul/kaplet 40 mg | 222 | 500 | 0 | 111.000 | PT. Kimia Farma Tbk |
| 63 | Obat Program Jaminan Kesehatan | Acetyl cysteine/ N-asetil sistein tablet/kapsul/kaplet 200 mg KF | 1.054,5 | 1.500 | 0 | 1.581.750 | PT. Kimia Farma Tbk |
| 64 | 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 |
| 65 | Obat Program Kesehatan Lainnya | Simvastatin tablet/kapsul/kaplet 10 mg | 230 | 7.000 | 0 | 1.610.000 | PT.Bernofarm |
| 66 | Obat Program Jaminan Kesehatan | Ringer Laktat/Ringer Lactate, @500 mL | 8.498 | 450 | 0 | 3.824.100 | PT. SATORIA ANEKA INDUSTRI |
| 67 | Obat Program Jaminan Kesehatan | Air untuk injeksi, cairan inj 25 mL | 2.955 | 360 | 0 | 1.063.800 | PT. SATORIA ANEKA INDUSTRI |
| 68 | Konsolidasi Obat | Hidroklorotiazid tab 25 mg | 148 | 1.000 | 0 | 148.000 | PT. Kimia Farma Tbk |
| 69 | Obat Non Jaminan Kesehatan | Oxytetracycline HCl 3% Salep Kulit | 1.881 | 200 | 0 | 376.200 | PT. Kimia Farma Tbk |
| 70 | Obat Program Jaminan Kesehatan | Amoksisilin/ Amoxicillin/ Amoxicillin Trihydrate tablet/kapsul/kaplet/kaptab 500 mg | 477 | 5.000 | 0 | 2.385.000 | PT NOVAPHARIN |
| 71 | Obat Program Jaminan Kesehatan | Alopurinol/Allopurinol tablet/kapsul/kaplet 100 mg | 186 | 10.000 | 0 | 1.860.000 | PT NOVAPHARIN |
| Total | 158.421.576 | ||||||
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