| No | Etalase | Produk | Harga | Jumlah | Ongkos Kirim | Total | Penyedia |
|---|---|---|---|---|---|---|---|
| 1 | Fasilitas Kesehatan Sektoral Kemenkes | STERA Plasma Sterilizer Cassette | 9.250.000 | 3 | 0 | 27.750.000 | PT. HOSPI NIAGA UTAMA |
| 2 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 16GX2 INCH (50MM) | 5.550 | 100 | 0 | 555.000 | PT. SINAR RODA UTAMA |
| 3 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 18G X 1-1/4 INCH (32MM) | 6.660 | 750 | 0 | 4.995.000 | PT. SINAR RODA UTAMA |
| 4 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 20GX1-1/4 INCH (32MM) | 5.550 | 100 | 0 | 555.000 | PT. SINAR RODA UTAMA |
| 5 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 20G X 1-1/4 INCH (32MM) | 6.660 | 2.000 | 0 | 13.320.000 | PT. SINAR RODA UTAMA |
| 6 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 22G X 1 INCH (25MM) | 6.660 | 1.200 | 0 | 7.992.000 | PT. SINAR RODA UTAMA |
| 7 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 24GX 1 INCH (25MM) | 6.660 | 750 | 0 | 4.995.000 | PT. SINAR RODA UTAMA |
| 8 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 10 ML LUER LOCK WITH NEEDLE 21GX1-1/2INCH (38MM) | 1.443 | 15.000 | 0 | 21.645.000 | PT. SINAR RODA UTAMA |
| 9 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 3 ML LUER LOCK WITH NEEDLE 23GX1-1/4INCH (32MM) | 999 | 20.000 | 0 | 19.980.000 | PT. SINAR RODA UTAMA |
| 10 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 5 ML LUER LOCK WITH NEEDLE 22GX1-1/2INCH (38MM) | 1.110 | 10.000 | 0 | 11.100.000 | PT. SINAR RODA UTAMA |
| 11 | Konsolidasi Obat | Lorazepam tab 2 mg | 1.100 | 7.000 | 0 | 7.700.000 | PT. Mersifarma Tirmaku Mercusana |
| 12 | Obat Program Jaminan Kesehatan | Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil tablet/kapsul/kaplet 500 mg | 820 | 10.000 | 0 | 8.200.000 | PT. Hexpharm Jaya Laboratories |
| 13 | Obat Program Jaminan Kesehatan | Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil sirup kering 125 mg/5ml | 8.000 | 100 | 0 | 800.000 | PT. Hexpharm Jaya Laboratories |
| 14 | Obat Program Jaminan Kesehatan | Cefotaxime sodium/ Cefotaxime/ Sefotaksim serb inj 1.000 mg | 4.800 | 6.000 | 0 | 28.800.000 | PT. Hexpharm Jaya Laboratories |
| 15 | Obat Program Jaminan Kesehatan | Ceftriaxone/ Ceftriaxone Sodium/ Seftriakson inj 1.000 mg | 4.500 | 16.000 | 0 | 72.000.000 | PT. Hexpharm Jaya Laboratories |
| 16 | Konsolidasi Obat | Kalsium laktat (kalk) tab 500 mg | 84 | 60.000 | 0 | 5.040.000 | PT. Mersifarma Tirmaku Mercusana |
| 17 | Obat Program Jaminan Kesehatan | Clindamycin hydrochloride (HCl)/ Clindamycin/ Klindamisin tablet/kapsul/kaplet 300 mg | 1.000 | 8.000 | 0 | 8.000.000 | PT. Mersifarma Tirmaku Mercusana |
| 18 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride(HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin inf 2 mg/ml | 10.500 | 180 | 0 | 1.890.000 | P.T. Dexa Medica |
| 19 | Obat Program Jaminan Kesehatan | Desoksimetason/ Desoximetasone krim 0,25% (2,5 mg/g) | 14.000 | 900 | 0 | 12.600.000 | P.T. Dexa Medica |
| 20 | Obat Program Jaminan Kesehatan | Dopamin / Dopamine hidrochloride injeksi 40 mg/ml | 6.000 | 1.000 | 0 | 6.000.000 | P.T. Dexa Medica |
| 21 | Obat Program Jaminan Kesehatan | Nicardipine hydrochloride (HCl)/ Nicardipine/ Nikardipin inj 1 mg/mL | 16.300 | 2.500 | 0 | 40.750.000 | P.T. Dexa Medica |
| 22 | Obat Program Jaminan Kesehatan | Hidrokortison/ Hydrocortisone krim 2,5% | 2.800 | 600 | 0 | 1.680.000 | PT. Kimia Farma Tbk |
| 23 | Obat Program Jaminan Kesehatan | Rifampicin/ Rifampisin tablet/kapsul/kaplet 450 mg | 1.832 | 1.000 | 0 | 1.832.000 | PT. Kimia Farma Tbk |
| 24 | Fasilitas Kesehatan Sektoral Kemenkes | Sangotonik Syrup | 30.000 | 30 | 0 | 900.000 | PT. Antar Mitra Persada |
| 25 | Fasilitas Kesehatan Sektoral Kemenkes | SANGOTONIK FE DROP | 28.000 | 20 | 0 | 560.000 | PT. Antar Mitra Persada |
| 26 | Obat Program Jaminan Kesehatan | METOCLOPRAMIDE HYDROCLORIDE Injeksi | 1.823 | 3.000 | 0 | 5.469.000 | PT. MEPROFARM |
| 27 | Obat Program Jaminan Kesehatan | CO-AMOXICLAV Film Coated Tablet | 3.515 | 1.350 | 0 | 4.745.250 | PT. MEPROFARM |
| 28 | Konsolidasi Obat | Kolkisin tab 500 mcg | 1.399 | 1.800 | 0 | 2.518.200 | PT Pratapa Nirmala |
| 29 | Fasilitas Kesehatan Sektoral Kemenkes | SINGLE USE BONNET SIZE SMALL (1215-10) | 292.207 | 20 | 0 | 5.844.140 | PT. AMPM HEALTHCARE INDONESIA |
| 30 | Fasilitas Kesehatan Sektoral Kemenkes | SINGLE USE BONNET SIZE MEDIUM (1216-10) | 292.207 | 20 | 0 | 5.844.140 | PT. AMPM HEALTHCARE INDONESIA |
| 31 | Fasilitas Kesehatan Sektoral Kemenkes | SINGLE USE BONNET SIZE LARGE (1217-10) | 292.207 | 20 | 0 | 5.844.140 | PT. AMPM HEALTHCARE INDONESIA |
| 32 | Fasilitas Kesehatan Sektoral Kemenkes | SINGLE USE BONNET SIZE XL (1218-10) | 303.030 | 15 | 0 | 4.545.450 | PT. AMPM HEALTHCARE INDONESIA |
| 33 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE M (1200-05 ) | 281.385 | 20 | 0 | 5.627.700 | PT. AMPM HEALTHCARE INDONESIA |
| 34 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE XL (1200-07 ) | 313.852 | 3 | 0 | 941.556 | PT. AMPM HEALTHCARE INDONESIA |
| 35 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE S (1200-04 ) | 281.385 | 15 | 0 | 4.220.775 | PT. AMPM HEALTHCARE INDONESIA |
| 36 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE L (1200-06 ) | 281.385 | 20 | 0 | 5.627.700 | PT. AMPM HEALTHCARE INDONESIA |
| 37 | Obat Program Jaminan Kesehatan | Amlodipine besilate 5 mg | 72 | 118.000 | 0 | 8.496.000 | PT. Mega Lifesciences Indonesia |
| 38 | Obat Program Jaminan Kesehatan | Amlodipine Besilate 10 mg | 95 | 113.000 | 0 | 10.735.000 | PT. Mega Lifesciences Indonesia |
| 39 | Obat Program Jaminan Kesehatan | Asam traneksamat/Tranexamic acid tablet/kapsul/kaplet salut selaput 500 mg | 1.500 | 9.000 | 0 | 13.500.000 | PT. Hexpharm Jaya Laboratories |
| 40 | Obat Program Jaminan Kesehatan | Atorvastatin/ Atorvastatin Calcium Trihydrate tablet salut selaput / kaplet salut selaput 20 mg | 590 | 40.000 | 0 | 23.600.000 | PT. Hexpharm Jaya Laboratories |
| 41 | Obat Program Jaminan Kesehatan | Cefixime trihydrate/ Cefixime/ Sefiksim tablet/kapsul/kaplet 100 mg | 600 | 80.000 | 0 | 48.000.000 | PT. Hexpharm Jaya Laboratories |
| 42 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride (HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin tablet/kapsul/kaplet 500 mg | 350 | 3.600 | 0 | 1.260.000 | PT. Hexpharm Jaya Laboratories |
| 43 | Obat Program Jaminan Kesehatan | Levofloxacin hemihydrate/ Levofloxacin/Levofloksasin tablet salut selaput/kaplet salut selaput/ kaptab salut selaput 500 mg | 760 | 1.500 | 0 | 1.140.000 | PT. Hexpharm Jaya Laboratories |
| 44 | Fasilitas Kesehatan Sektoral Kemenkes | STERISTAR CLASS 5 LAMINATED INTEGRATOR C-1055 | 133.200 | 45 | 0 | 5.994.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 45 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 25 cm x 100 m | 646.800 | 11 | 0 | 7.114.800 | PT Jayamas Medica Industri |
| 46 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 20 cm x 100 m | 519.960 | 11 | 0 | 5.719.560 | PT Jayamas Medica Industri |
| 47 | Fasilitas Kesehatan Sektoral Kemenkes | Steril Pouch Roll Tyvex with Indicator 250mm x 100 meter | 2.273.280 | 6 | 0 | 13.639.680 | PT Jayamas Medica Industri |
| 48 | Fasilitas Kesehatan Sektoral Kemenkes | Steril Pouch Roll Tyvex with Indicator 200mm x 100 meter | 1.507.380 | 6 | 0 | 9.044.280 | PT Jayamas Medica Industri |
| 49 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator 9 cm x 26 cm | 59.718 | 45 | 0 | 2.687.310 | PT Jayamas Medica Industri |
| 50 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Anggur | 65.000 | 6 | 0 | 390.000 | CV.PEDULI |
| 51 | Bahan Makanan dan Minuman Provinsi Jawa Timur | APEL HIJAU | 31.000 | 9 | 0 | 279.000 | CV.PEDULI |
| 52 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Apel Merah | 64.000 | 8 | 0 | 512.000 | CV.PEDULI |
| 53 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Asem Jawa | 36.000 | 1 | 0 | 36.000 | CV.PEDULI |
| 54 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bakso | 39.000 | 6 | 0 | 234.000 | CV.PEDULI |
| 55 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Ikan bandeng utuh | 54.000 | 165 | 0 | 8.910.000 | CV.PEDULI |
| 56 | Bahan Makanan dan Minuman Provinsi Jawa Timur | BAWANG BOMBAY | 49.000 | 6 | 0 | 294.000 | CV.PEDULI |
| 57 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bawang Merah kupas | 54.000 | 28 | 0 | 1.512.000 | CV.PEDULI |
| 58 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bawang Putih kupas | 58.000 | 28 | 0 | 1.624.000 | CV.PEDULI |
| 59 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bayam | 3.000 | 900 | 0 | 2.700.000 | CV.PEDULI |
| 60 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Belimbing | 21.000 | 5 | 0 | 105.000 | CV.PEDULI |
| 61 | Bahan Makanan dan Minuman Provinsi Jawa Timur | BIHUN | 13.000 | 10 | 0 | 130.000 | CV.PEDULI |
| 62 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Blokoli | 23.000 | 80 | 0 | 1.840.000 | CV.PEDULI |
| 63 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Buncis | 23.000 | 90 | 0 | 2.070.000 | CV.PEDULI |
| 64 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Cabe Merah | 58.000 | 16 | 0 | 928.000 | CV.PEDULI |
| 65 | Bahan Makanan dan Minuman Provinsi Jawa Timur | ayam potong | 48.000 | 815 | 0 | 39.120.000 | CV.PEDULI |
| 66 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daging Giling (Baksoan) | 108.000 | 95 | 0 | 10.260.000 | CV.PEDULI |
| 67 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daging Sapi | 152.000 | 95 | 0 | 14.440.000 | CV.PEDULI |
| 68 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun Bawang | 33.000 | 15 | 0 | 495.000 | CV.PEDULI |
| 69 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun jeruk | 4.500 | 10 | 0 | 45.000 | CV.PEDULI |
| 70 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun pandan | 4.000 | 14 | 0 | 56.000 | CV.PEDULI |
| 71 | Bahan Makanan dan Minuman Provinsi Jawa Timur | DAUN SALAM | 2.500 | 9 | 0 | 22.500 | CV.PEDULI |
| 72 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Ikan dori Fillet | 65.000 | 170 | 0 | 11.050.000 | CV.PEDULI |
| 73 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Gambas | 15.000 | 45 | 0 | 675.000 | CV.PEDULI |
| 74 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jagung | 17.000 | 163 | 0 | 2.771.000 | CV.PEDULI |
| 75 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jahe | 44.000 | 3 | 0 | 132.000 | CV.PEDULI |
| 76 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jambu | 19.000 | 7 | 0 | 133.000 | CV.PEDULI |
| 77 | Bahan Makanan dan Minuman Provinsi Jawa Timur | jamur kuping basah | 10.000 | 5 | 0 | 50.000 | CV.PEDULI |
| 78 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jeruk mandarin | 64.000 | 9 | 0 | 576.000 | CV.PEDULI |
| 79 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jeruk nipis | 33.000 | 1 | 0 | 33.000 | CV.PEDULI |
| 80 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jinten | 14.000 | 2 | 0 | 28.000 | CV.PEDULI |
| 81 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kacang Panjang | 19.000 | 90 | 0 | 1.710.000 | CV.PEDULI |
| 82 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kangkung | 1.700 | 60 | 0 | 102.000 | CV.PEDULI |
| 83 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kelapa | 16.000 | 55 | 0 | 880.000 | CV.PEDULI |
| 84 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kemiri | 70.000 | 18 | 0 | 1.260.000 | CV.PEDULI |
| 85 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kencur | 48.000 | 1 | 0 | 48.000 | CV.PEDULI |
| 86 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kentang | 35.000 | 226 | 0 | 7.910.000 | CV.PEDULI |
| 87 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kluwek | 84.000 | 2 | 0 | 168.000 | CV.PEDULI |
| 88 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Krai | 20.000 | 90 | 0 | 1.800.000 | CV.PEDULI |
| 89 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kulit lumpia | 19.000 | 5 | 0 | 95.000 | CV.PEDULI |
| 90 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kulit Pangsit | 20.000 | 2 | 0 | 40.000 | CV.PEDULI |
| 91 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kunci | 17.000 | 2 | 0 | 34.000 | CV.PEDULI |
| 92 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kunyit | 25.000 | 5 | 0 | 125.000 | CV.PEDULI |
| 93 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Air | 24.000 | 70 | 0 | 1.680.000 | CV.PEDULI |
| 94 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Kuning | 28.000 | 6 | 0 | 168.000 | CV.PEDULI |
| 95 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Siam | 12.500 | 91 | 0 | 1.137.500 | CV.PEDULI |
| 96 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Laos | 20.000 | 3 | 0 | 60.000 | CV.PEDULI |
| 97 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Melon | 22.000 | 85 | 0 | 1.870.000 | CV.PEDULI |
| 98 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Nugget Ayam | 52.000 | 20 | 0 | 1.040.000 | CV.PEDULI |
| 99 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Nanas | 13.000 | 5 | 0 | 65.000 | CV.PEDULI |
| 100 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Paprika | 10.000 | 6 | 0 | 60.000 | CV.PEDULI |
| 101 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pear | 53.000 | 8 | 0 | 424.000 | CV.PEDULI |
| 102 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pepaya | 16.000 | 115 | 0 | 1.840.000 | CV.PEDULI |
| 103 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Ambon | 2.350 | 2.000 | 0 | 4.700.000 | CV.PEDULI |
| 104 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Cavendish | 5.300 | 55 | 0 | 291.500 | CV.PEDULI |
| 105 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Kepok | 34.000 | 5 | 0 | 170.000 | CV.PEDULI |
| 106 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang susu | 24.000 | 95 | 0 | 2.280.000 | CV.PEDULI |
| 107 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pok Coy | 18.000 | 90 | 0 | 1.620.000 | CV.PEDULI |
| 108 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pre/Seledri | 32.000 | 20 | 0 | 640.000 | CV.PEDULI |
| 109 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Roti tawar putih | 15.000 | 16 | 0 | 240.000 | CV.PEDULI |
| 110 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sawi Ijo | 1.800 | 250 | 0 | 450.000 | CV.PEDULI |
| 111 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sawi Putih | 19.000 | 96 | 0 | 1.824.000 | CV.PEDULI |
| 112 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Selada | 34.000 | 15 | 0 | 510.000 | CV.PEDULI |
| 113 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Semangka | 21.000 | 150 | 0 | 3.150.000 | CV.PEDULI |
| 114 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sereh | 15.000 | 5 | 0 | 75.000 | CV.PEDULI |
| 115 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Snack | 4.350 | 225 | 0 | 978.750 | CV.PEDULI |
| 116 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sosis | 56.000 | 8 | 0 | 448.000 | CV.PEDULI |
| 117 | Bahan Makanan dan Minuman Provinsi Jawa Timur | tahu | 2.700 | 2.700 | 0 | 7.290.000 | CV.PEDULI |
| 118 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Taoge Panjang | 16.000 | 14 | 0 | 224.000 | CV.PEDULI |
| 119 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Taoge Pendek | 34.000 | 2 | 0 | 68.000 | CV.PEDULI |
| 120 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Telur Ayam | 36.000 | 295 | 0 | 10.620.000 | CV.PEDULI |
| 121 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Tempe | 3.300 | 1.900 | 0 | 6.270.000 | CV.PEDULI |
| 122 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Terasi | 4.000 | 1 | 0 | 4.000 | CV.PEDULI |
| 123 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Terong | 15.000 | 70 | 0 | 1.050.000 | CV.PEDULI |
| 124 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Timun | 18.000 | 60 | 0 | 1.080.000 | CV.PEDULI |
| 125 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Tomat | 22.000 | 30 | 0 | 660.000 | CV.PEDULI |
| 126 | Bahan Makanan dan Minuman Provinsi Jawa Timur | ikan tongkol segar | 62.000 | 150 | 0 | 9.300.000 | CV.PEDULI |
| 127 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Wortel | 23.000 | 400 | 0 | 9.200.000 | CV.PEDULI |
| 128 | Konsolidasi Obat | Aripiprazol oral solution 1 mg/mL | 189.990 | 25 | 0 | 4.749.750 | PT. Otsuka Indonesia |
| 129 | Bahan Pokok Provinsi Jawa Timur | ABON | 105.000 | 26 | 0 | 2.730.000 | CV MULYA JAYA ABADI |
| 130 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL ISI ULANG GALON | 25.000 | 21 | 0 | 525.000 | CV MULYA JAYA ABADI |
| 131 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL 120ML | 30.000 | 20 | 0 | 600.000 | CV MULYA JAYA ABADI |
| 132 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL 330ML | 2.500 | 720 | 0 | 1.800.000 | CV MULYA JAYA ABADI |
| 133 | Bahan Pokok Provinsi Jawa Timur | BERAS BRAMU SUPER | 20.000 | 800 | 0 | 16.000.000 | CV MULYA JAYA ABADI |
| 134 | Bahan Pokok Provinsi Jawa Timur | BISKUIT GABIN | 7.000 | 85 | 0 | 595.000 | CV MULYA JAYA ABADI |
| 135 | Bahan Pokok Provinsi Jawa Timur | ROTI KABIN CRACKERS | 18.000 | 10 | 0 | 180.000 | CV MULYA JAYA ABADI |
| 136 | Bahan Pokok Provinsi Jawa Timur | GARAM | 4.000 | 180 | 0 | 720.000 | CV MULYA JAYA ABADI |
| 137 | Bahan Pokok Provinsi Jawa Timur | GULA BATOK MERAH | 25.000 | 4 | 0 | 100.000 | CV MULYA JAYA ABADI |
| 138 | Bahan Pokok Provinsi Jawa Timur | GULA PASIR | 22.000 | 230 | 0 | 5.060.000 | CV MULYA JAYA ABADI |
| 139 | Bahan Pokok Provinsi Jawa Timur | Kaldu Bubuk | 42.000 | 14 | 0 | 588.000 | CV MULYA JAYA ABADI |
| 140 | Bahan Pokok Provinsi Jawa Timur | KECAP ASIN | 16.000 | 1 | 0 | 16.000 | CV MULYA JAYA ABADI |
| 141 | Bahan Pokok Provinsi Jawa Timur | KECAP INGGRIS | 51.000 | 1 | 0 | 51.000 | CV MULYA JAYA ABADI |
| 142 | Bahan Pokok Provinsi Jawa Timur | KECAP MANIS | 28.000 | 16 | 0 | 448.000 | CV MULYA JAYA ABADI |
| 143 | Bahan Pokok Provinsi Jawa Timur | KETUMBAR BUBUK | 23.000 | 1 | 0 | 23.000 | CV MULYA JAYA ABADI |
| 144 | Bahan Pokok Provinsi Jawa Timur | Lada Bubuk | 83.000 | 2 | 0 | 166.000 | CV MULYA JAYA ABADI |
| 145 | Bahan Pokok Provinsi Jawa Timur | MAKARONI SEDANI | 47.000 | 2 | 0 | 94.000 | CV MULYA JAYA ABADI |
| 146 | Bahan Pokok Provinsi Jawa Timur | BLUE BAND 250GR | 14.000 | 30 | 0 | 420.000 | CV MULYA JAYA ABADI |
| 147 | Bahan Pokok Provinsi Jawa Timur | MAYONAISE MAESTRO | 44.000 | 3 | 0 | 132.000 | CV MULYA JAYA ABADI |
| 148 | Bahan Pokok Provinsi Jawa Timur | Minyak Goreng | 25.000 | 216 | 0 | 5.400.000 | CV MULYA JAYA ABADI |
| 149 | Bahan Pokok Provinsi Jawa Timur | SAGU MUTIARA | 3.000 | 30 | 0 | 90.000 | CV MULYA JAYA ABADI |
| 150 | Bahan Pokok Provinsi Jawa Timur | SANTAN INSTAN 200ML | 16.000 | 5 | 0 | 80.000 | CV MULYA JAYA ABADI |
| 151 | Bahan Pokok Provinsi Jawa Timur | Saos Tiram | 75.000 | 1 | 0 | 75.000 | CV MULYA JAYA ABADI |
| 152 | Bahan Pokok Provinsi Jawa Timur | Saos Tomat | 28.000 | 6 | 0 | 168.000 | CV MULYA JAYA ABADI |
| 153 | Bahan Pokok Provinsi Jawa Timur | SUSU BBLR | 160.000 | 6 | 0 | 960.000 | CV MULYA JAYA ABADI |
| 154 | Bahan Pokok Provinsi Jawa Timur | Susu Diabetasol Vanila | 280.000 | 6 | 0 | 1.680.000 | CV MULYA JAYA ABADI |
| 155 | Bahan Pokok Provinsi Jawa Timur | SUSU TETP | 170.000 | 10 | 0 | 1.700.000 | CV MULYA JAYA ABADI |
| 156 | Bahan Pokok Provinsi Jawa Timur | SUSU FORMULA SGM | 15.000 | 50 | 0 | 750.000 | CV MULYA JAYA ABADI |
| 157 | Bahan Pokok Provinsi Jawa Timur | SUSU FORMULA MORINAGA | 125.000 | 4 | 0 | 500.000 | CV MULYA JAYA ABADI |
| 158 | Bahan Pokok Provinsi Jawa Timur | SUSU SGM GAIN 100 | 135.000 | 1 | 0 | 135.000 | CV MULYA JAYA ABADI |
| 159 | Bahan Pokok Provinsi Jawa Timur | Susu Hepar | 185.000 | 5 | 0 | 925.000 | CV MULYA JAYA ABADI |
| 160 | Bahan Pokok Provinsi Jawa Timur | Susu Kental Manis | 21.500 | 10 | 0 | 215.000 | CV MULYA JAYA ABADI |
| 161 | Bahan Pokok Provinsi Jawa Timur | Susu Khusus Renal | 105.000 | 85 | 0 | 8.925.000 | CV MULYA JAYA ABADI |
| 162 | Bahan Pokok Provinsi Jawa Timur | Susu Neomune | 47.000 | 30 | 0 | 1.410.000 | CV MULYA JAYA ABADI |
| 163 | Bahan Pokok Provinsi Jawa Timur | Susu Panenteral | 39.000 | 60 | 0 | 2.340.000 | CV MULYA JAYA ABADI |
| 164 | Bahan Pokok Provinsi Jawa Timur | SUSU PEPTIBREN | 101.000 | 10 | 0 | 1.010.000 | CV MULYA JAYA ABADI |
| 165 | Bahan Pokok Provinsi Jawa Timur | Susu Rendah Laktosa | 165.000 | 7 | 0 | 1.155.000 | CV MULYA JAYA ABADI |
| 166 | Bahan Pokok Provinsi Jawa Timur | SUSU SKIM | 240.000 | 24 | 0 | 5.760.000 | CV MULYA JAYA ABADI |
| 167 | Bahan Pokok Provinsi Jawa Timur | SUSU SOYA | 77.000 | 2 | 0 | 154.000 | CV MULYA JAYA ABADI |
| 168 | Bahan Pokok Provinsi Jawa Timur | SUSU TETP ANAK | 370.000 | 2 | 0 | 740.000 | CV MULYA JAYA ABADI |
| 169 | Bahan Pokok Provinsi Jawa Timur | Susu UHT | 9.500 | 180 | 0 | 1.710.000 | CV MULYA JAYA ABADI |
| 170 | Bahan Pokok Provinsi Jawa Timur | SWEETENER NON KALORI | 120.000 | 3 | 0 | 360.000 | CV MULYA JAYA ABADI |
| 171 | Bahan Pokok Provinsi Jawa Timur | TEA | 3.500 | 100 | 0 | 350.000 | CV MULYA JAYA ABADI |
| 172 | Bahan Pokok Provinsi Jawa Timur | TEPUNG BERAS | 20.000 | 80 | 0 | 1.600.000 | CV MULYA JAYA ABADI |
| 173 | Bahan Pokok Provinsi Jawa Timur | TEPUNG TAPIOKA | 20.000 | 3 | 0 | 60.000 | CV MULYA JAYA ABADI |
| 174 | Bahan Pokok Provinsi Jawa Timur | TEPUNG MAIZENA | 9.500 | 2 | 0 | 19.000 | CV MULYA JAYA ABADI |
| 175 | Bahan Pokok Provinsi Jawa Timur | TEPUNG PANIR | 35.000 | 1 | 0 | 35.000 | CV MULYA JAYA ABADI |
| 176 | Bahan Pokok Provinsi Jawa Timur | TEPUNG TERIGU | 19.000 | 36 | 0 | 684.000 | CV MULYA JAYA ABADI |
| 177 | Obat Program Jaminan Kesehatan | Albumin serum normal (human Albumin) inj 20% | 950.000 | 20 | 0 | 19.000.000 | PT. DANKOS FARMA |
| 178 | Obat Program Jaminan Kesehatan | Albumin serum normal (human Albumin) inj 25% , 50 ml | 800.000 | 80 | 0 | 64.000.000 | PT. DANKOS FARMA |
| 179 | Bahan Pokok Provinsi Jawa Timur | AGAR-AGAR | 6.000 | 24 | 0 | 144.000 | CV MULYA JAYA ABADI |
| 180 | Konsolidasi Obat | Deksametason tab 0,5 mg | 60 | 10.000 | 0 | 600.000 | PT. Holi Pharma |
| 181 | Konsolidasi Obat | Ibuprofen tab 400 mg | 189 | 6.000 | 0 | 1.134.000 | PT. Holi Pharma |
| 182 | Konsolidasi Obat | Ibuprofen susp 100 mg/5 mL | 4.249 | 130 | 0 | 552.370 | PT. Holi Pharma |
| 183 | Obat Program Kesehatan Lainnya | AMBROXOL HYDROCHLORIDE TAB 30 GENERIK | 122 | 26.000 | 0 | 3.172.000 | PT. ERRITA PHARMA |
| 184 | Obat Program Kesehatan Lainnya | Piracetam 12 G/ 60 ml Larutan Infus | 56.577 | 120 | 0 | 6.789.240 | PT.Bernofarm |
| 185 | Obat Program Kesehatan Lainnya | AMBROXOL HCl 15 mg ELIXIR | 6.500 | 100 | 0 | 650.000 | PT.Bernofarm |
| 186 | Obat Program Kesehatan Lainnya | KETOPROFEN 100 mg TSE | 719 | 5.000 | 0 | 3.595.000 | PT.Bernofarm |
| 187 | Obat Program Kesehatan Lainnya | METAMIZOLE SODIUM MONOHYDRATE 500 mg KAPLET | 240 | 3.000 | 0 | 720.000 | PT.Bernofarm |
| 188 | Obat Program Jaminan Kesehatan | Propofol injeksi 1% | 12.210 | 600 | 0 | 7.326.000 | PT. ETERCON PHARMA |
| 189 | Obat Program Jaminan Kesehatan | Atracurium Besilate/ Atrakurium injeksi 10 mg/mL (i.v) 2,5 ml | 8.880 | 1.200 | 0 | 10.656.000 | PT. ETERCON PHARMA |
| 190 | Obat Program Jaminan Kesehatan | Isosorbid dinitrat / Isosorbide Dinitrate inj 1 mg/mL | 14.430 | 1.500 | 0 | 21.645.000 | PT. ETERCON PHARMA |
| 191 | Obat Program Jaminan Kesehatan | Sodium bicarbonate/Natrium Bikarbonat inj 8,4% (i.v.), ampul @25 mL | 8.305 | 420 | 0 | 3.488.100 | PT. Otsuka Indonesia |
| 192 | Obat Program Jaminan Kesehatan | Magnesium sulfat injeksi 20% (i.v.) @ 25 mL. | 5.470 | 150 | 0 | 820.500 | PT. Otsuka Indonesia |
| 193 | Obat Program Jaminan Kesehatan | Magnesium sulfat injeksi 40% (i.v.) @ 25 mL. | 6.227 | 300 | 0 | 1.868.100 | PT. Otsuka Indonesia |
| 194 | Obat Program Jaminan Kesehatan | Levofloxacin hemihydrate/ Levofloxacin/Levofloksasin tts mata 0,5% | 17.000 | 250 | 0 | 4.250.000 | PT Ferron Par Pharmaceuticals |
| 195 | Obat Non Jaminan Kesehatan | MECOBALAMIN Injeksi 500 mcg | 5.772 | 7.000 | 0 | 40.404.000 | PT. Nulab Pharmaceutical Indonesia |
| 196 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 250 | 0 | 121.822.500 | PT. SINAR RODA UTAMA |
| 197 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 200 | 0 | 97.458.000 | PT. SINAR RODA UTAMA |
| 198 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 3.0 | 255.411 | 20 | 0 | 5.108.220 | PT. SARANA LINTAS MEDIKA |
| 199 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 4.0 | 255.411 | 35 | 0 | 8.939.385 | PT. SARANA LINTAS MEDIKA |
| 200 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 250 | 0 | 121.822.500 | PT. SINAR RODA UTAMA |
| 201 | Fasilitas Kesehatan | SPINOCAN 25GX3 1/2 (0.53X88 MM) | 34.248 | 500 | 0 | 17.124.000 | PT. B.BRAUN MEDICAL INDONESIA |
| 202 | Fasilitas Kesehatan | SPINOCAN 26GX3 1/2 (0.47X88 MM) | 34.248 | 200 | 0 | 6.849.600 | PT. B.BRAUN MEDICAL INDONESIA |
| 203 | Fasilitas Kesehatan Sektoral Kemenkes | INNOQ Disposable Bacterial/Viral Filter Adult | 18.000 | 400 | 0 | 7.200.000 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 204 | Obat Program Jaminan Kesehatan | Metoclopramide hydrochloride (HCl)/ Metoclopramide/ Metoklopramid tablet/kapsul/kaplet 10 mg | 151 | 4.500 | 0 | 679.500 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 205 | Obat Program Jaminan Kesehatan | Loperamid tablet/kapsul/kaplet 2 mg | 78 | 2.000 | 0 | 156.000 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 206 | Obat Program Jaminan Kesehatan | Deferasiroks / Deferasirox tablet dispersible 250 mg | 9.900 | 120 | 0 | 1.188.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 207 | Obat Program Jaminan Kesehatan | Dutasteride kapsul lunak 0,5 mg | 2.997 | 6.000 | 0 | 17.982.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 208 | Obat Program Jaminan Kesehatan | Fondaparinux / Fondaparinuks inj 2,5 mg/0,5 mL | 165.000 | 300 | 0 | 49.500.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 209 | Obat Program Jaminan Kesehatan | Asam Ibandronat inj 1 mg/ml / Ibandronic Acid | 444.000 | 4 | 0 | 1.776.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 210 | Obat Program Jaminan Kesehatan | Lamivudine/ Lamivudin tablet salut selaput 150 mg | 1.332 | 4.500 | 0 | 5.994.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 211 | Obat Program Jaminan Kesehatan | Diazepam enema 10 mg/2,5 mL | 12.210 | 60 | 0 | 732.600 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 212 | Obat Program Jaminan Kesehatan | Diazepam enema 5 mg/2,5 mL | 9.990 | 80 | 0 | 799.200 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 213 | Obat Program Jaminan Kesehatan | Efedrin/Ephedrine HCl Inj 50 mg/ml | 6.600 | 1.000 | 0 | 6.600.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 214 | Konsolidasi Obat | N-asetil sistein kaps 200 mg | 320 | 41.000 | 0 | 13.120.000 | P.T. Dexa Medica |
| 215 | Konsolidasi Obat | Glimepirid tab 1 mg | 99 | 20.000 | 0 | 1.980.000 | P.T. Dexa Medica |
| 216 | Konsolidasi Obat | Glimepirid tab 2 mg | 175 | 38.200 | 0 | 6.685.000 | P.T. Dexa Medica |
| 217 | Konsolidasi Obat | Valproat sir 250 mg/5 ml | 12.210 | 125 | 0 | 1.526.250 | P.T. Dexa Medica |
| 218 | Konsolidasi Obat | Betahistin tab 6 mg | 189 | 18.000 | 0 | 3.402.000 | P.T. Dexa Medica |
| 219 | Konsolidasi Obat | Bisoprolol tab 2,5 mg | 124 | 38.000 | 0 | 4.712.000 | P.T. Dexa Medica |
| 220 | Konsolidasi Obat | Klozapin tab 25 mg | 450 | 13.000 | 0 | 5.850.000 | P.T. Dexa Medica |
| 221 | Konsolidasi Obat | Fenofibrat kaps 300 mg | 657 | 3.000 | 0 | 1.971.000 | P.T. Dexa Medica |
| 222 | Konsolidasi Obat | Gabapentin kaps 100 mg | 750 | 15.000 | 0 | 11.250.000 | P.T. Dexa Medica |
| 223 | Konsolidasi Obat | Gliklazid tab 80 mg | 309 | 25.000 | 0 | 7.725.000 | P.T. Dexa Medica |
| 224 | Konsolidasi Obat | Glikuidon tab 30 mg | 1.000 | 20.000 | 0 | 20.000.000 | P.T. Dexa Medica |
| 225 | Konsolidasi Obat | Lisinopril tab 5 mg | 175 | 6.000 | 0 | 1.050.000 | P.T. Dexa Medica |
| 226 | Konsolidasi Obat | Natrium diklofenak tab sal enterik 50 mg | 110 | 60.000 | 0 | 6.600.000 | P.T. Dexa Medica |
| 227 | Konsolidasi Obat | Spironolakton tab 25 mg | 250 | 150.000 | 0 | 37.500.000 | P.T. Dexa Medica |
| 228 | Konsolidasi Obat | Spironolakton tab 100 mg | 646 | 15.000 | 0 | 9.690.000 | P.T. Dexa Medica |
| 229 | Konsolidasi Obat | Kandesartan tab 8 mg | 285 | 78.000 | 0 | 22.230.000 | P.T. Dexa Medica |
| 230 | Konsolidasi Obat | Akarbose tab 100 mg | 848 | 60.000 | 0 | 50.880.000 | P.T. Dexa Medica |
| 231 | Konsolidasi Obat | Asam ursodeoksikolat kaps 250 mg | 1.559 | 22.500 | 0 | 35.077.500 | P.T. Dexa Medica |
| 232 | Obat Program Jaminan Kesehatan | Amoksisilin/Amoxicillin/Amoxicillin Trihydrate sirup/suspensi kering 125 mg/ 5 ml | 3.480 | 150 | 0 | 522.000 | PT. Mersifarma Tirmaku Mercusana |
| 233 | Obat Program Jaminan Kesehatan | Amoksisilin/ Amoxicillin/ Amoxicillin Trihydrate tablet/kapsul/kaplet/kaptab 500 mg | 490 | 6.000 | 0 | 2.940.000 | PT. Mersifarma Tirmaku Mercusana |
| 234 | Fasilitas Kesehatan | INTERSURGICAL I-Gel Supraglottic Airway size 4 | 2.700.000 | 1 | 0 | 2.700.000 | PT Madesa Sejahtera Utama |
| 235 | Fasilitas Kesehatan | INTERSURGICAL I-Gel Supraglottic Airway size 3 | 2.700.000 | 1 | 0 | 2.700.000 | PT Madesa Sejahtera Utama |
| 236 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 7.5 | 19.400 | 60 | 0 | 1.164.000 | PT.Dwiasri Graha (dwigraha medical) |
| 237 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 7.0 | 19.400 | 60 | 0 | 1.164.000 | PT.Dwiasri Graha (dwigraha medical) |
| 238 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 4.5 | 19.400 | 15 | 0 | 291.000 | PT.Dwiasri Graha (dwigraha medical) |
| 239 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 4.0 | 19.400 | 5 | 0 | 97.000 | PT.Dwiasri Graha (dwigraha medical) |
| 240 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 5.5 | 19.400 | 15 | 0 | 291.000 | PT.Dwiasri Graha (dwigraha medical) |
| 241 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 5.0 | 19.400 | 15 | 0 | 291.000 | PT.Dwiasri Graha (dwigraha medical) |
| 242 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 6.5 | 19.400 | 30 | 0 | 582.000 | PT.Dwiasri Graha (dwigraha medical) |
| 243 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 6.0 | 19.400 | 30 | 0 | 582.000 | PT.Dwiasri Graha (dwigraha medical) |
| 244 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 7.0 | 134.260 | 20 | 0 | 2.685.200 | PT.Dwiasri Graha (dwigraha medical) |
| 245 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 2.5 | 134.260 | 3 | 0 | 402.780 | PT.Dwiasri Graha (dwigraha medical) |
| 246 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced size 3.0 | 134.260 | 3 | 0 | 402.780 | PT.Dwiasri Graha (dwigraha medical) |
| 247 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 3.5 | 134.260 | 3 | 0 | 402.780 | PT.Dwiasri Graha (dwigraha medical) |
| 248 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 4.5 | 134.260 | 8 | 0 | 1.074.080 | PT.Dwiasri Graha (dwigraha medical) |
| 249 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 5.0 | 134.260 | 7 | 0 | 939.820 | PT.Dwiasri Graha (dwigraha medical) |
| 250 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 5.5 | 134.260 | 10 | 0 | 1.342.600 | PT.Dwiasri Graha (dwigraha medical) |
| 251 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 6.0 | 134.260 | 30 | 0 | 4.027.800 | PT.Dwiasri Graha (dwigraha medical) |
| 252 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 6.5 | 134.260 | 20 | 0 | 2.685.200 | PT.Dwiasri Graha (dwigraha medical) |
| 253 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 7.5 | 134.260 | 30 | 0 | 4.027.800 | PT.Dwiasri Graha (dwigraha medical) |
| 254 | Obat Program Jaminan Kesehatan | Isofluran/ isoflurane inhalasi 250 ml | 405.150 | 80 | 0 | 32.412.000 | PT. Mersifarma Tirmaku Mercusana |
| 255 | Obat Program Jaminan Kesehatan | Metronidazole/ Metronidazol infus 5 mg/ ml | 11.988 | 6.000 | 0 | 71.928.000 | PT. Mersifarma Tirmaku Mercusana |
| 256 | Fasilitas Kesehatan | Pembalut Elastis 15 cm x 4,55 m | 45.600 | 150 | 0 | 6.840.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 257 | Fasilitas Kesehatan | Pembalut Elastis 7,5 cm x 4,55 m | 23.500 | 120 | 0 | 2.820.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 258 | Fasilitas Kesehatan | Pembalut Elastis 10 cm x 4,55 m | 34.800 | 252 | 0 | 8.769.600 | PT Sinaraya Nugraha Ahmadaris Medika |
| 259 | Fasilitas Kesehatan | POLYFLEX IV CANNULA WITH INJECTION PORT 26G X 3/4 INCHI P1019B | 9.934 | 2.000 | 0 | 19.868.000 | PT. MEGAH MEDIKA PHARMA |
| 260 | Fasilitas Kesehatan Sektoral Kemenkes | Alert Snap Yellow Fall Risk 300 EC | 517.800 | 10 | 0 | 5.178.000 | PT. DOCARE LARAS INDONESIA |
| 261 | Obat Program Jaminan Kesehatan | Digoxin tablet 0,25 mg | 189 | 7.000 | 0 | 1.323.000 | PT Yarindo Farmatama |
| 262 | Obat Program Jaminan Kesehatan | Isosorbid Dinitrat/ Isosorbide dinitrate tablet/kapsul/kaplet 5 mg | 140 | 65.000 | 0 | 9.100.000 | PT Yarindo Farmatama |
| 263 | Fasilitas Kesehatan Sektoral Kemenkes | M-Y Jelly 5gram, sachet | 47.508 | 100 | 0 | 4.750.800 | PT Jayamas Medica Industri |
| 264 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock with Tube | 179.820 | 12 | 0 | 2.157.840 | PT Jayamas Medica Industri |
| 265 | Fasilitas Kesehatan Sektoral Kemenkes | Cervical Collar | 97.680 | 50 | 0 | 4.884.000 | PT Jayamas Medica Industri |
| 266 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Colostomy Bag | 219.780 | 5 | 0 | 1.098.900 | PT Jayamas Medica Industri |
| 267 | Fasilitas Kesehatan Sektoral Kemenkes | Condom Catheter S | 5.883 | 10 | 0 | 58.830 | PT Jayamas Medica Industri |
| 268 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix S IV | 49.728 | 100 | 0 | 4.972.800 | PT Jayamas Medica Industri |
| 269 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix T Type A 10x25 cm | 108.780 | 10 | 0 | 1.087.800 | PT Jayamas Medica Industri |
| 270 | Fasilitas Kesehatan Sektoral Kemenkes | Double Spike | 108.780 | 20 | 0 | 2.175.600 | PT Jayamas Medica Industri |
| 271 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7,5 | 250.000 | 68 | 0 | 17.000.000 | PT Jayamas Medica Industri |
| 272 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7 | 250.000 | 30 | 0 | 7.500.000 | PT Jayamas Medica Industri |
| 273 | Fasilitas Kesehatan Sektoral Kemenkes | Povidone Iodine Larutan Antiseptik 30 ml | 4.481 | 100 | 0 | 448.100 | PT Jayamas Medica Industri |
| 274 | Fasilitas Kesehatan Sektoral Kemenkes | Eye Protector | 37.000 | 50 | 0 | 1.850.000 | PT Jayamas Medica Industri |
| 275 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 4 | 16.428 | 30 | 0 | 492.840 | PT Jayamas Medica Industri |
| 276 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed Anesthesia Mask Size 5 | 16.428 | 50 | 0 | 821.400 | PT Jayamas Medica Industri |
| 277 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 6 | 16.428 | 5 | 0 | 82.140 | PT Jayamas Medica Industri |
| 278 | Fasilitas Kesehatan Sektoral Kemenkes | Maxiflow Dewasa | 10.323 | 500 | 0 | 5.161.500 | PT Jayamas Medica Industri |
| 279 | Fasilitas Kesehatan Sektoral Kemenkes | Guedel Airway 70 mm disp steril | 14.208 | 10 | 0 | 142.080 | PT Jayamas Medica Industri |
| 280 | Fasilitas Kesehatan Sektoral Kemenkes | Guedel Airway 90 mm disp steril | 14.208 | 50 | 0 | 710.400 | PT Jayamas Medica Industri |
| 281 | Fasilitas Kesehatan Sektoral Kemenkes | Guedel Airway 100 mm disp steril | 14.208 | 60 | 0 | 852.480 | PT Jayamas Medica Industri |
| 282 | Fasilitas Kesehatan Sektoral Kemenkes | Guedel Airway 110 mm disp steril | 14.208 | 30 | 0 | 426.240 | PT Jayamas Medica Industri |
| 283 | Fasilitas Kesehatan Sektoral Kemenkes | Oxyflow Anak (Nasal oxygen cannula) | 5.400 | 50 | 0 | 270.000 | PT Jayamas Medica Industri |
| 284 | Fasilitas Kesehatan Sektoral Kemenkes | Oxyflow Dewasa (Nasal oxygen cannula) | 5.400 | 1.000 | 0 | 5.400.000 | PT Jayamas Medica Industri |
| 285 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR10, 120CM | 7.992 | 15 | 0 | 119.880 | PT Jayamas Medica Industri |
| 286 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR10, 40CM | 7.992 | 15 | 0 | 119.880 | PT Jayamas Medica Industri |
| 287 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR12, 125cm | 7.992 | 50 | 0 | 399.600 | PT Jayamas Medica Industri |
| 288 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR14, 125cm | 7.992 | 50 | 0 | 399.600 | PT Jayamas Medica Industri |
| 289 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR5, 100cm | 7.992 | 10 | 0 | 79.920 | PT Jayamas Medica Industri |
| 290 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR8, 100cm | 7.992 | 40 | 0 | 319.680 | PT Jayamas Medica Industri |
| 291 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock | 108.780 | 20 | 0 | 2.175.600 | PT Jayamas Medica Industri |
| 292 | Fasilitas Kesehatan Sektoral Kemenkes | Ventiflow Dewasa | 70.818 | 50 | 0 | 3.540.900 | PT Jayamas Medica Industri |
| 293 | Fasilitas Kesehatan Sektoral Kemenkes | P180 T-Plain Catgut Plain 2-0, 90 cm Round Bodied, 1/2 circle, 37 mm | 56.166 | 120 | 0 | 6.739.920 | PT Medihop |
| 294 | Fasilitas Kesehatan Sektoral Kemenkes | S25 T-Silk Silk/Sutera 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 46.620 | 96 | 0 | 4.475.520 | PT Medihop |
| 295 | Fasilitas Kesehatan Sektoral Kemenkes | S21 T-Silk Silk/Sutera 3-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 45.510 | 36 | 0 | 1.638.360 | PT Medihop |
| 296 | Fasilitas Kesehatan Sektoral Kemenkes | S61 T-Silk Silk/Sutera 3-0, 76 cm Round Bodied, 1/2 circle, 17 mm | 46.176 | 48 | 0 | 2.216.448 | PT Medihop |
| 297 | Fasilitas Kesehatan Sektoral Kemenkes | S77 T-Silk Silk/Sutera 4-0, 76 cm Reverse Cutting, 3/8 circle, 19 mm | 45.843 | 24 | 0 | 1.100.232 | PT Medihop |
| 298 | Fasilitas Kesehatan Sektoral Kemenkes | V10 T-Vio Polyglycolide 2-0, 90 cm Round Bodied, 1/2 circle, 25 mm | 79.365 | 360 | 0 | 28.571.400 | PT Medihop |
| 299 | Fasilitas Kesehatan Sektoral Kemenkes | PUIND Disposable Infusion Set A103C Airvent Y With Cap | 5.595 | 2.000 | 0 | 11.190.000 | FARIZTA JAYA AGUNG |
| 300 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED Dermafix Tulle | 31.080 | 50 | 0 | 1.554.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 301 | Fasilitas Kesehatan | C55 T-Chromic Catgut Chromic 1, 90 cm Heavy Round Bodied, 1/2 circle, 40 mm | 72.261 | 144 | 0 | 10.405.584 | PT Medihop |
| 302 | Fasilitas Kesehatan | C98 T-Chromic Catgut Chromic 1, 100 cm Blunt Point, 1/2 circle, 64.6 mm | 86.802 | 36 | 0 | 3.124.872 | PT Medihop |
| 303 | Fasilitas Kesehatan | C26 T-Chromic Catgut Chromic 2-0, 90 cm Round Bodied, 1/2 circle, 40 mm | 63.714 | 60 | 0 | 3.822.840 | PT Medihop |
| 304 | Fasilitas Kesehatan | C96 T-Chromic Catgut Chromic 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 64.602 | 60 | 0 | 3.876.120 | PT Medihop |
| 305 | Fasilitas Kesehatan | C99 T-Chromic Catgut Chromic 2, 90 cm Round Bodied, 1/2 circle, 48 mm | 62.715 | 36 | 0 | 2.257.740 | PT Medihop |
| 306 | Fasilitas Kesehatan | C67 T-Chromic Catgut Chromic 3-0, 76 cm Reverse Cutting, 3/8 circle, 24 mm | 64.602 | 24 | 0 | 1.550.448 | PT Medihop |
| 307 | Fasilitas Kesehatan | D73 T-Dio Polydioxanone 1 Loop, 180 cm Round Bodied, 1/2 circle, 48 mm | 148.518 | 120 | 0 | 17.822.160 | PT Medihop |
| 308 | Fasilitas Kesehatan | L36 T-Lene Polyvinylidene 2-0, 76 cm Round Bodied, 1/2 circle, 30 mm | 82.917 | 12 | 0 | 995.004 | PT Medihop |
| 309 | Fasilitas Kesehatan | M51 T-Mono Polyglecaprone25 3-0, 76 cm Reverse Cutting, 3/8 circle, 24 mm | 107.781 | 12 | 0 | 1.293.372 | PT Medihop |
| 310 | Fasilitas Kesehatan | N170 T-Nylon Nylon 10-0, 30 cm Micropoint Spatula (double needle), 3/8 circle, 6 mm | 195.138 | 12 | 0 | 2.341.656 | PT Medihop |
| 311 | Fasilitas Kesehatan | N90 T-Nylon Nylon 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 55.833 | 600 | 0 | 33.499.800 | PT Medihop |
| 312 | Fasilitas Kesehatan | N32 T-Nylon Nylon 3-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 48.396 | 168 | 0 | 8.130.528 | PT Medihop |
| 313 | Fasilitas Kesehatan | N37 T-Nylon Nylon 4-0, 76 cm Reverse Cutting, 3/8 circle, 18 mm | 48.396 | 96 | 0 | 4.646.016 | PT Medihop |
| 314 | Fasilitas Kesehatan | N46 T-Nylon Nylon 5-0, 76 cm Reverse Cutting, 3/8 circle, 15 mm | 50.838 | 96 | 0 | 4.880.448 | PT Medihop |
| 315 | Fasilitas Kesehatan | P30 T-Plain Catgut Plain 4-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.937 | 36 | 0 | 2.265.732 | PT Medihop |
| 316 | Fasilitas Kesehatan | S84 T-Silk Silk/Sutera 1, 90 cm Round Bodied, 1/2 circle, 40 mm | 55.389 | 24 | 0 | 1.329.336 | PT Medihop |
| 317 | Fasilitas Kesehatan | S24 T-Silk Silk/Sutera 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 40.737 | 24 | 0 | 977.688 | PT Medihop |
| 318 | Fasilitas Kesehatan | V15 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 40 mm | 86.691 | 120 | 0 | 10.402.920 | PT Medihop |
| 319 | Fasilitas Kesehatan | V16 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 48 mm | 86.691 | 84 | 0 | 7.282.044 | PT Medihop |
| 320 | Fasilitas Kesehatan | V38 T-Vio Polyglycolide 5-0, 76 cm Round Bodied, 1/2 circle, 16 mm | 81.585 | 12 | 0 | 979.020 | PT Medihop |
| 321 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Pediatric Elongated (M) | 16.275 | 200 | 0 | 3.255.000 | PT. BUANA INTIPRIMA USAHA |
| 322 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Adult Elongated (XL) | 16.275 | 300 | 0 | 4.882.500 | PT. BUANA INTIPRIMA USAHA |
| 323 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Non Rebreathing Oxygen Mask Pediatric Elongated(M) | 15.484 | 50 | 0 | 774.200 | PT. BUANA INTIPRIMA USAHA |
| 324 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Non Rebreathing Oxygen Mask Adult Elongated(XL) | 15.484 | 200 | 0 | 3.096.800 | PT. BUANA INTIPRIMA USAHA |
| 325 | Fasilitas Kesehatan | Electrosurgical (ESU) Pencil | 35.298 | 100 | 0 | 3.529.800 | PT Jayamas Medica Industri |
| 326 | Fasilitas Kesehatan | Kasa Steril 7.5 x 7.5 cm - 16 ply isi 10 LD, 71610 LD | 11.800 | 1.200 | 0 | 14.160.000 | PT Jayamas Medica Industri |
| 327 | Fasilitas Kesehatan | Lap Sponge Abdominal Steril, 45 cm x 45 cm 8 ply isi 1 | 278.388 | 5 | 0 | 1.391.940 | PT Jayamas Medica Industri |
| 328 | Obat Program Jaminan Kesehatan | Amitriptyline hydrochloride tablet 25 mg | 210 | 30.000 | 0 | 6.300.000 | PT Yarindo Farmatama |
| 329 | Obat Program Jaminan Kesehatan | Diazepam tablet/kapsul/kaplet 2 mg | 170 | 6.000 | 0 | 1.020.000 | PT Yarindo Farmatama |
| 330 | Obat Program Jaminan Kesehatan | Air untuk injeksi, cairan inj 25 mL | 2.808 | 15.600 | 0 | 43.804.800 | PT. SATORIA ANEKA INDUSTRI |
| 331 | Obat Program Jaminan Kesehatan | Air untuk injeksi/ Aqua pro injeksi/ Aqua pro injection/ Water for injection 250 mL | 5.905 | 330 | 0 | 1.948.650 | PT. SATORIA ANEKA INDUSTRI |
| 332 | Obat Program Jaminan Kesehatan | Glukosa larutan infus 10% 500 mL | 7.628 | 800 | 0 | 6.102.400 | PT. SATORIA ANEKA INDUSTRI |
| 333 | Obat Program Jaminan Kesehatan | Glukosa larutan infus 5% 500 mL | 7.022 | 1.200 | 0 | 8.426.400 | PT. SATORIA ANEKA INDUSTRI |
| 334 | Obat Program Jaminan Kesehatan | NACL / SODIUM CHLORIDE 0.9%, @250 ML | 6.969 | 400 | 0 | 2.787.600 | PT. SATORIA ANEKA INDUSTRI |
| 335 | Obat Program Jaminan Kesehatan | NaCl 0.9% / Sodium Chloride 0.9%, 500 mL | 7.205 | 20.000 | 0 | 144.100.000 | PT. SATORIA ANEKA INDUSTRI |
| 336 | Obat Program Jaminan Kesehatan | NaCl 0.9% / Sodium Chloride 0.9%, 500 mL | 7.205 | 20.000 | 0 | 144.100.000 | PT. SATORIA ANEKA INDUSTRI |
| 337 | Obat Program Jaminan Kesehatan | NaCl 0.9% / Sodium Chloride 0.9%, 500 mL | 7.205 | 20.000 | 0 | 144.100.000 | PT. SATORIA ANEKA INDUSTRI |
| 338 | Obat Program Jaminan Kesehatan | Ringer Laktat/Ringer Lactate, @500 mL | 8.084 | 18.000 | 0 | 145.512.000 | PT. SATORIA ANEKA INDUSTRI |
| 339 | Obat Program Jaminan Kesehatan | NaCl / Sodium Chloride 0.9%, @100 mL | 6.515 | 15.000 | 0 | 97.725.000 | PT. SATORIA ANEKA INDUSTRI |
| 340 | Obat Program Jaminan Kesehatan | Larutan mengandung asam amino + elektrolit + Karbohidrat + Lipid (Glukosa 85 g, Asam amino 38 g, Elektrolit, Lipid 34 g dengan Fish Oil 5.1 g) Smofkabiven Peripheral 1206 | 384.748 | 120 | 0 | 46.169.760 | PT. Fresenius Kabi Combiphar |
| 341 | Obat Program Jaminan Kesehatan | Dexamethason Sodium Phosphate/ Deksamethason/ Deksametason injeksi 5 mg/mL | 1.269 | 10.020 | 0 | 12.715.380 | PT. Mersifarma Tirmaku Mercusana |
| 342 | Obat Program Jaminan Kesehatan | GLARITUS Insulin Glargine 100 iu | 74.925 | 500 | 0 | 37.462.500 | PT.INFION |
| 343 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Safety Box 5 L | 15.428 | 500 | 0 | 7.714.000 | PT. Likuid Pharmalab Indonesia |
| 344 | Fasilitas Kesehatan Sektoral Kemenkes | bayMEDIKA Enzymatic Detergent 5 L | 1.300.600 | 10 | 0 | 13.006.000 | PT. Likuid Pharmalab Indonesia |
| 345 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 10 | 0 | 2.788.990 | PT. Likuid Pharmalab Indonesia |
| 346 | Fasilitas Kesehatan | OTSUKA Micro Elasty Ball Disposable Infusion Set | 9.663 | 300 | 0 | 2.898.900 | PT. Otsuka Indonesia |
| 347 | Konsolidasi Obat | Alopurinol tab 100 mg | 155 | 9.000 | 0 | 1.395.000 | PT. Hexpharm Jaya Laboratories |
| 348 | Konsolidasi Obat | Alopurinol tab 300 mg | 360 | 10.000 | 0 | 3.600.000 | PT. Hexpharm Jaya Laboratories |
| 349 | Konsolidasi Obat | Glimepirid tab 4 mg | 308 | 4.000 | 0 | 1.232.000 | PT. Hexpharm Jaya Laboratories |
| 350 | Konsolidasi Obat | Glimepirid tab 3 mg | 285 | 63.000 | 0 | 17.955.000 | PT. Hexpharm Jaya Laboratories |
| 351 | Konsolidasi Obat | Asam mefenamat tab 500 mg | 155 | 45.000 | 0 | 6.975.000 | PT. Hexpharm Jaya Laboratories |
| 352 | Konsolidasi Obat | Bisoprolol tab 5 mg | 200 | 38.500 | 0 | 7.700.000 | PT. Hexpharm Jaya Laboratories |
| 353 | Konsolidasi Obat | Fenofibrat kaps 100 mg | 504 | 15.000 | 0 | 7.560.000 | PT. Hexpharm Jaya Laboratories |
| 354 | Konsolidasi Obat | Gabapentin kaps 300 mg | 645 | 40.000 | 0 | 25.800.000 | PT. Hexpharm Jaya Laboratories |
| 355 | Konsolidasi Obat | Lansoprazol kaps 30 mg | 384 | 40.000 | 0 | 15.360.000 | PT. Hexpharm Jaya Laboratories |
| 356 | Konsolidasi Obat | Loratadin tab 10 mg | 115 | 7.000 | 0 | 805.000 | PT. Hexpharm Jaya Laboratories |
| 357 | Konsolidasi Obat | Metilprednisolon tab 4 mg | 160 | 70.000 | 0 | 11.200.000 | PT. Hexpharm Jaya Laboratories |
| 358 | Konsolidasi Obat | Kandesartan tab 16 mg | 420 | 102.000 | 0 | 42.840.000 | PT. Hexpharm Jaya Laboratories |
| 359 | Konsolidasi Obat | Metformin tab 500 mg | 162 | 131.000 | 0 | 21.222.000 | PT. Hexpharm Jaya Laboratories |
| 360 | Konsolidasi Obat | Valproat tab salut enterik 250 mg | 888 | 20.000 | 0 | 17.760.000 | PT. Hexpharm Jaya Laboratories |
| 361 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP359H) | 5.187.585 | 3 | 0 | 15.562.755 | PT Johnson and Johnson Indonesia Two |
| 362 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP317H) | 4.834.855 | 1 | 0 | 4.834.855 | PT Johnson and Johnson Indonesia Two |
| 363 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP303H) | 4.400.000 | 1 | 0 | 4.400.000 | PT Johnson and Johnson Indonesia Two |
| 364 | Fasilitas Kesehatan | Cetricide 30 | 488.400 | 10 | 0 | 4.884.000 | Samudra Medika Laboratories |
| 365 | Makanan dan Minuman Provinsi Jawa Timur | paket snack 06 | 19.000 | 150 | 0 | 2.850.000 | CV. BAROKAH |
| 366 | Makanan dan Minuman Provinsi Jawa Timur | paket makan 08 | 29.500 | 150 | 0 | 4.425.000 | CV. BAROKAH |
| 367 | Konsolidasi Obat | Ivabradin tab 5 mg | 9.610 | 616 | 0 | 5.919.760 | PT Darya Varia |
| 368 | Konsolidasi Obat | Amiodaron tab 200 mg | 1.543 | 2.000 | 0 | 3.086.000 | PT Darya Varia |
| 369 | Konsolidasi Obat | Metildopa tab 250 mg | 1.832 | 10.000 | 0 | 18.320.000 | PT ACTAVIS INDONESIA |
| 370 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | BAKTERI CAIR IPAL (aerob) | 181.000 | 50 | 0 | 9.050.000 | cv.bahtera |
| 371 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | GARAM KROSOK | 360.000 | 10 | 0 | 3.600.000 | cv.bahtera |
| 372 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | GARAM HD | 390.000 | 12 | 0 | 4.680.000 | cv.bahtera |
| 373 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | KAPORIT | 121.000 | 4 | 0 | 484.000 | cv.bahtera |
| 374 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | PEMUTIH PAKAIAN | 35.000 | 120 | 0 | 4.200.000 | cv.bahtera |
| 375 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | Citric acid - sitrun | 750.000 | 25 | 0 | 18.750.000 | cv.bahtera |
| 376 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | PENCUCI PIRING | 17.000 | 30 | 0 | 510.000 | cv.bahtera |
| 377 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | KRESEK HITAM BESAR | 23.000 | 200 | 0 | 4.600.000 | cv.bahtera |
| 378 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | KANTONG SAMPAH KUNING JUMBO | 79.000 | 200 | 0 | 15.800.000 | cv.bahtera |
| 379 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | KRESEK KUNING BESAR | 35.000 | 200 | 0 | 7.000.000 | cv.bahtera |
| 380 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | KANTONG SAMPAH HITAM JUMBO | 90.000 | 200 | 0 | 18.000.000 | cv.bahtera |
| 381 | Bahan Dan Peralatan Kebersihan Pemerintah Daerah Kabupaten Mojokerto | GULA MERAH IPAL | 25.000 | 20 | 0 | 500.000 | cv.bahtera |
| 382 | Obat Program Kesehatan Lainnya | FURAMIN INJECTIONS | 11.544 | 360 | 0 | 4.155.840 | PT. MEPROFARM |
| 383 | Konsolidasi Obat | Diltiazem kaps lepas lambat 100 mg | 5.059 | 6.000 | 0 | 30.354.000 | PT MITSUBISHI TANABE PHARMA INDONESIA |
| 384 | Konsolidasi Obat | Diltiazem kaps lepas lambat 200 mg | 5.485 | 7.000 | 0 | 38.395.000 | PT MITSUBISHI TANABE PHARMA INDONESIA |
| 385 | Obat Program Jaminan Kesehatan | Renabetic/Glibenklamid/Glibenclamide 5 mg | 250 | 4.000 | 0 | 1.000.000 | PT Pratapa Nirmala |
| 386 | Obat Program Jaminan Kesehatan | Azitromisin/Azithromycin dihydrate tablet salut selaput/kaplet salut selaput 500 mg | 3.100 | 5.000 | 0 | 15.500.000 | PT Pratapa Nirmala |
| 387 | Obat Program Jaminan Kesehatan | Metoprolol tartrate/ Metoprolol tartat inj 1 mg/ml | 149.850 | 15 | 0 | 2.247.750 | PT Pratapa Nirmala |
| 388 | Obat Program Jaminan Kesehatan | Naloxone hydrochloride injeksi 0,4 mg | 68.265 | 5 | 0 | 341.325 | PT Pratapa Nirmala |
| 389 | Konsolidasi Obat | Metotreksat tab 2,5 mg | 1.500 | 6.000 | 0 | 9.000.000 | PT. DANKOS FARMA |
| 390 | Peralatan dan Perlengkapan Kantor Kabupaten Mojokerto | PLASTIK ROLL | 650.000 | 10 | 0 | 6.500.000 | cv.bahtera |
| 391 | Fasilitas Kesehatan | LEICA BOND Ready-to-Use (RTU) Primary Antibody Progesterone Receptor (16) | 2.264.400 | 1 | 0 | 2.264.400 | PT.BIOGEN SCIENTIFIC |
| 392 | Fasilitas Kesehatan | LEICA BOND Ready-to-Use (RTU) Primary Antibody Estrogen Receptor (6F11) | 2.264.400 | 1 | 0 | 2.264.400 | PT.BIOGEN SCIENTIFIC |
| 393 | Fasilitas Kesehatan | LEICA BOND Ki67 (MM1) | 2.164.500 | 1 | 0 | 2.164.500 | PT.BIOGEN SCIENTIFIC |
| 394 | Fasilitas Kesehatan | LEICA BOND Dewax Solution | 1.554.000 | 1 | 0 | 1.554.000 | PT.BIOGEN SCIENTIFIC |
| 395 | Fasilitas Kesehatan | LEICA BOND Epitope Retrieval Solution 2 | 3.485.400 | 1 | 0 | 3.485.400 | PT.BIOGEN SCIENTIFIC |
| 396 | Fasilitas Kesehatan | LEICA BOND Epitope Retrieval Solution 1 | 3.030.300 | 1 | 0 | 3.030.300 | PT.BIOGEN SCIENTIFIC |
| 397 | Fasilitas Kesehatan | LEICA BOND Polymer Refine Detection | 17.171.700 | 1 | 0 | 17.171.700 | PT.BIOGEN SCIENTIFIC |
| 398 | Fasilitas Kesehatan Sektoral Kemenkes | Surgipath Reagent Alcohol | 488.400 | 10 | 0 | 4.884.000 | PT.BIOGEN SCIENTIFIC |
| 399 | Fasilitas Kesehatan Sektoral Kemenkes | SURGIPATH 10 Neutral Buffered Formalin | 399.600 | 11 | 0 | 4.395.600 | PT.BIOGEN SCIENTIFIC |
| 400 | Fasilitas Kesehatan Sektoral Kemenkes | Harris Hematoxyline (LEICA) | 366.300 | 2 | 0 | 732.600 | PT.BIOGEN SCIENTIFIC |
| 401 | Fasilitas Kesehatan Sektoral Kemenkes | SURGIPATH EOSIN | 277.500 | 2 | 0 | 555.000 | PT.BIOGEN SCIENTIFIC |
| 402 | Fasilitas Kesehatan Sektoral Kemenkes | Surgipath EA50 | 288.600 | 1 | 0 | 288.600 | PT.BIOGEN SCIENTIFIC |
| 403 | Fasilitas Kesehatan Sektoral Kemenkes | LEICA : LEICA Slide White Apex Superior Adhesive | 910.200 | 2 | 0 | 1.820.400 | PT.BIOGEN SCIENTIFIC |
| 404 | Fasilitas Kesehatan Sektoral Kemenkes | LEICA BOND Ready-to-Use Primary Antibody c-erbB-2 Oncoprotein | 2.164.500 | 1 | 0 | 2.164.500 | PT.BIOGEN SCIENTIFIC |
| 405 | Fasilitas Kesehatan Sektoral Kemenkes | LEICA - SURGIPATH DECALCIFIER I | 594.405 | 1 | 0 | 594.405 | PT.BIOGEN SCIENTIFIC |
| 406 | Fasilitas Kesehatan | VITAL-CATH Closed 67120 | 250.500 | 30 | 0 | 7.515.000 | PT Surgika Alkesindo |
| 407 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 250 | 0 | 121.822.500 | PT. SINAR RODA UTAMA |
| 408 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 250 | 0 | 121.822.500 | PT. SINAR RODA UTAMA |
| 409 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 300 | 0 | 146.187.000 | PT. SINAR RODA UTAMA |
| 410 | Konsolidasi Obat | Ranitidin tab 150 mg | 149 | 12.000 | 0 | 1.788.000 | PT. Hexpharm Jaya Laboratories |
| 411 | Konsolidasi Obat | Simvastatin tab 10 mg | 105 | 5.000 | 0 | 525.000 | PT. Hexpharm Jaya Laboratories |
| 412 | Konsolidasi Obat | Valsartan tab 80 mg | 397 | 37.050 | 0 | 14.708.850 | PT. Hexpharm Jaya Laboratories |
| 413 | Konsolidasi Obat | Kandesartan tab 16 mg | 420 | 102.000 | 0 | 42.840.000 | PT. Hexpharm Jaya Laboratories |
| 414 | Obat Program Jaminan Kesehatan | Heparin, Na injeksi 5.000 IU | 41.602 | 3.000 | 0 | 124.806.000 | PT Pratapa Nirmala |
| 415 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 250 | 0 | 121.822.500 | PT. SINAR RODA UTAMA |
| 416 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 250 | 0 | 121.822.500 | PT. SINAR RODA UTAMA |
| 417 | Konsolidasi Obat | Kombinasi KDT/FDC mengandung a. Benserazid 25 mg b. Levodopa 100 mg tab | 1.330 | 6.000 | 0 | 7.980.000 | PT. MEPROFARM |
| 418 | Obat Program Jaminan Kesehatan | OCTREOTIDE ACETATE 0.1 mg | 104.895 | 100 | 0 | 10.489.500 | PT Pratapa Nirmala |
| 419 | Konsolidasi Obat | Olanzapin tab sal selaput 5 mg | 719 | 3.510 | 0 | 2.523.690 | P.T. Dexa Medica |
| 420 | Konsolidasi Obat | Pioglitazon tab 30 mg | 747 | 22.500 | 0 | 16.807.500 | P.T. Dexa Medica |
| 421 | Konsolidasi Obat | Propiltiourasil tab 100 mg | 410 | 7.500 | 0 | 3.075.000 | P.T. Dexa Medica |
| 422 | Konsolidasi Obat | Risperidon tab 2 mg | 185 | 35.000 | 0 | 6.475.000 | P.T. Dexa Medica |
| 423 | Konsolidasi Obat | Risperidon tab 3 mg | 324 | 2.500 | 0 | 810.000 | P.T. Dexa Medica |
| 424 | Konsolidasi Obat | Nifedipin tab 10 mg | 144 | 4.500 | 0 | 648.000 | P.T. Dexa Medica |
| 425 | Konsolidasi Obat | Ramipril tab 5 mg | 155 | 7.000 | 0 | 1.085.000 | P.T. Dexa Medica |
| 426 | Konsolidasi Obat | Valsartan tab 160 mg | 718 | 25.050 | 0 | 17.985.900 | P.T. Dexa Medica |
| 427 | Obat Program Jaminan Kesehatan | Analog Insulin Co-Formulation inj 100 IU/ml Ultra Long Acting Insulin Degludec 70U/Rapid Acting Insulin Aspart 30U (kemasan vial, disposable cartridge, penfill cartridge) | 113.018 | 50 | 0 | 5.650.900 | PT Ferron Par Pharmaceuticals |
| 428 | Konsolidasi Obat | Kombinasi KDT/FDC mengandung: Salmeterol 50 mcg dan Flutikason Propionat 100 mcg serb ih | 119.131 | 12 | 0 | 1.429.572 | PT Glaxo Wellcome Indonesia |
| 429 | Konsolidasi Obat | Kombinasi KDT/FDC, setiap mL mengandung: Salmeterol 50 mcg dan Flutikason propionat 250 mcg ih 250 mcg puff | 132.693 | 20 | 0 | 2.653.860 | PT Glaxo Wellcome Indonesia |
| 430 | Obat Program Jaminan Kesehatan | Sulfadiazine silver/ Perak sulfadiazin krim 1% | 23.030 | 100 | 0 | 2.303.000 | PT Darya Varia |
| 431 | Konsolidasi Obat | Levetirasetam tab 500 mg | 3.762 | 1.200 | 0 | 4.514.400 | PT Pratapa Nirmala |
| 432 | Konsolidasi Obat | Sertralin tab sal 50 mg | 1.332 | 3.000 | 0 | 3.996.000 | PT Pratapa Nirmala |
| 433 | Konsolidasi Obat | Sulfasalazin kapl sal enterik 500 mg | 3.541 | 3.600 | 0 | 12.747.600 | PT Pratapa Nirmala |
| 434 | Konsolidasi Obat | Kombinasi KDT/FDC setiap dosis mengandung Budesonid 160 mcg/Formoterol 4,5 mcg Ih 60 dosis, Turbuhaler | 144.402 | 130 | 0 | 18.772.260 | PT AstraZeneca Indonesia |
| 435 | Konsolidasi Obat | Kombinasi KDT/FDC setiap dosis mengandung Budesonid 80 mcg/Formoterol 4,5 mcg Ih 60 dosis , Turbuhaler | 144.402 | 10 | 0 | 1.444.020 | PT AstraZeneca Indonesia |
| 436 | Konsolidasi Obat | Bikalutamid tab sal 150 mg | 32.281 | 84 | 0 | 2.711.604 | PT AstraZeneca Indonesia |
| 437 | Konsolidasi Obat | Asam folat tab 1 mg | 60 | 10.000 | 0 | 600.000 | PT. MARIN LIZA FARMASI |
| 438 | Konsolidasi Obat | Piridoksin (vitamin B6) tab 10 mg* | 64 | 12.000 | 0 | 768.000 | PT. MARIN LIZA FARMASI |
| 439 | Konsolidasi Obat | Kombinasi KDT/FDC mengandung: a. Fe sulfat/ Fe fumarat/ Fe glukonat (setara dengan 60 mg Fe elemental) b. asam folat 0,4 mg tab sal | 176 | 60.000 | 0 | 10.560.000 | PT. MARIN LIZA FARMASI |
| 440 | Konsolidasi Obat | Karvedilol tab 6,25 mg | 1.110 | 15.000 | 0 | 16.650.000 | PT KALBE FARMA Tbk |
| 441 | Konsolidasi Obat | Tamoksifen tab 10 mg | 2.225 | 25.200 | 0 | 56.070.000 | PT KALBE FARMA Tbk |
| 442 | Obat Program Jaminan Kesehatan | Vagistin - Nystatin Metronidazole | 4.995 | 200 | 0 | 999.000 | PT. COMBINED IMPERIAL PHARMACEUTICALS |
| 443 | Obat Program Jaminan Kesehatan | Sukralfat / Sucralfate susp 500 mg/5 mL, 100 mL | 7.150 | 3.000 | 0 | 21.450.000 | PT. COMBINED IMPERIAL PHARMACEUTICALS |
| 444 | Konsolidasi Obat | Metformin tab 500 mg | 162 | 131.000 | 0 | 21.222.000 | PT. Hexpharm Jaya Laboratories |
| 445 | Konsolidasi Obat | Valproat tab salut enterik 250 mg | 888 | 20.000 | 0 | 17.760.000 | PT. Hexpharm Jaya Laboratories |
| 446 | Fasilitas Kesehatan Sektoral Kemenkes | INNOQ Disposable Bacterial Viral/Filter Adult HMEF | 22.000 | 150 | 0 | 3.300.000 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 447 | Fasilitas Kesehatan Sektoral Kemenkes | OYICARE Alkohol 70% 1000ML | 20.000 | 72 | 0 | 1.440.000 | FIRDAUS INDAH SANTOSA |
| 448 | Fasilitas Kesehatan Sektoral Kemenkes | PRO HISTO Microscope Cover Glass 24X40 MM | 610.500 | 1 | 0 | 610.500 | PT.MIDIF FARMA |
| 449 | Fasilitas Kesehatan Sektoral Kemenkes | PRO - HISTO MICROSCOPE SLIDE (Frosted) | 21.878 | 10 | 0 | 218.780 | PT.MIDIF FARMA |
| 450 | Fasilitas Kesehatan Sektoral Kemenkes | E-CARE Lubricant Gel | 28.000 | 30 | 0 | 840.000 | PT Enseval Medika Prima |
| 451 | Fasilitas Kesehatan Sektoral Kemenkes | SCW Medicath Connecting Tubing 42.02.90002 | 89.000 | 50 | 0 | 4.450.000 | PT. SARANA LINTAS MEDIKA |
| 452 | Fasilitas Kesehatan | CARESTREAM Dryview DVE Laser Imaging Film 35x43 | 6.697.600 | 8 | 0 | 53.580.800 | PT TAWADA HEALTHCARE - PUSAT |
| 453 | Konsolidasi Obat | Beraprost Sodium tab 20 mcg | 3.164 | 3.000 | 0 | 9.492.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 454 | Konsolidasi Obat | Tenofovir Tab Sal Selaput 300 mg | 2.189 | 1.200 | 0 | 2.626.800 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 455 | Konsolidasi Obat | Tiamazol Tab 5 mg | 555 | 9.000 | 0 | 4.995.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 456 | Konsolidasi Obat | Kalsitriol Kaps Lunak 0,25 mcg | 1.332 | 10.020 | 0 | 13.346.640 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 457 | Konsolidasi Obat | Tiamazol Tab 10 mg | 888 | 6.000 | 0 | 5.328.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 458 | Obat Program Jaminan Kesehatan | ONDANSETRON 4 mg | 227 | 17.000 | 0 | 3.859.000 | PT. Mega Lifesciences Indonesia |
| 459 | Obat Program Jaminan Kesehatan | ONDANSETRON 8 mg | 228 | 10.000 | 0 | 2.280.000 | PT. Mega Lifesciences Indonesia |
| 460 | Obat Program Jaminan Kesehatan | ASIKLOVIR/ACYCLOVIR/ACICLOVIR KRIM 5 % | 4.990,01 | 75 | 0 | 374.250,75 | PT. Interbat |
| 461 | Obat Program Jaminan Kesehatan | PAMOL SUPPOSITORIA 125 MG_Paracetamol/ Parasetamol suppo 125 mg | 14.427 | 144 | 0 | 2.077.488 | PT. Interbat |
| 462 | Obat Program Jaminan Kesehatan | Urinter 400 mg kaplet salut selaput | 1.829 | 2.000 | 0 | 3.658.000 | PT. Interbat |
| 463 | Konsolidasi Obat | Asetazolamid tab 250 mg | 3.355 | 600 | 0 | 2.013.000 | PT SANBE FARMA |
| 464 | Konsolidasi Obat | Kalsium folinat (leucovorin, Ca) inj 10 mg/mL | 22.220 | 50 | 0 | 1.111.000 | PT SANBE FARMA |
| 465 | Fasilitas Kesehatan Sektoral Kemenkes | STERISTAR CLASS 5 LAMINATED INTEGRATOR C-1055 | 133.200 | 45 | 0 | 5.994.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 466 | Perlengkapan Perkantoran Provinsi Jawa Timur | baterai C | 76.500 | 24 | 0 | 1.836.000 | CV. Bintang Lima |
| 467 | Perlengkapan Perkantoran Provinsi Jawa Timur | OVERPAL | 36.550 | 10 | 0 | 365.500 | CV. Bintang Lima |
| 468 | Perlengkapan Perkantoran Provinsi Jawa Timur | WASSER JET TOILET | 348.500 | 15 | 0 | 5.227.500 | CV. Bintang Lima |
| 469 | Perlengkapan Perkantoran Provinsi Jawa Timur | GEMBOK | 187.000 | 10 | 0 | 1.870.000 | CV. Bintang Lima |
| 470 | Perlengkapan Perkantoran Provinsi Jawa Timur | MATA BOR 8 | 66.000 | 4 | 0 | 264.000 | CV. Bintang Lima |
| 471 | Perlengkapan Perkantoran Provinsi Jawa Timur | MATA BOR | 45.000 | 4 | 0 | 180.000 | CV. Bintang Lima |
| 472 | Perlengkapan Perkantoran Provinsi Jawa Timur | MIC WERELESS | 750.000 | 5 | 0 | 3.750.000 | CV. Bintang Lima |
| 473 | Perlengkapan Perkantoran Provinsi Jawa Timur | kawat las | 850.000 | 5 | 0 | 4.250.000 | CV. Bintang Lima |
| 474 | Perlengkapan Perkantoran Provinsi Jawa Timur | Lem G | 18.000 | 10 | 0 | 180.000 | CV. Bintang Lima |
| 475 | Perlengkapan Perkantoran Provinsi Jawa Timur | kran | 90.000 | 20 | 0 | 1.800.000 | CV. Bintang Lima |
| 476 | Perlengkapan Perkantoran Provinsi Jawa Timur | stop kontak | 40.500 | 12 | 0 | 486.000 | CV. Bintang Lima |
| 477 | Perlengkapan Perkantoran Provinsi Jawa Timur | baterai AA | 33.300 | 144 | 0 | 4.795.200 | CV. Bintang Lima |
| 478 | Perlengkapan Perkantoran Provinsi Jawa Timur | baterai kotak | 88.200 | 12 | 0 | 1.058.400 | CV. Bintang Lima |
| 479 | Perlengkapan Perkantoran Provinsi Jawa Timur | set up box | 1.500.000 | 5 | 0 | 7.500.000 | CV. Bintang Lima |
| 480 | Perlengkapan Perkantoran Provinsi Jawa Timur | kunci locker | 90.000 | 20 | 0 | 1.800.000 | CV. Bintang Lima |
| 481 | Perlengkapan Perkantoran Provinsi Jawa Timur | pesawat telepon | 600.000 | 10 | 0 | 6.000.000 | CV. Bintang Lima |
| 482 | Fasilitas Kesehatan Sektoral Kemenkes | CERTOFIX Duo P S413 - Akses Vena Sentral | 743.098 | 2 | 0 | 1.486.196 | PT. B.BRAUN MEDICAL INDONESIA |
| 483 | Fasilitas Kesehatan Sektoral Kemenkes | CERTOFIX Duo HFV 1220 - Akses Vena Sentral | 994.160 | 5 | 0 | 4.970.800 | PT. B.BRAUN MEDICAL INDONESIA |
| 484 | Fasilitas Kesehatan | Certofix Duo HF V 1215 | 842.312 | 5 | 0 | 4.211.560 | PT. B.BRAUN MEDICAL INDONESIA |
| 485 | Fasilitas Kesehatan | Radifocus Introducer II sheath 6Fr / 10cm, FEMORAL - RS*A60K10SQ | 137.500 | 5 | 0 | 687.500 | TERUMO INDONESIA |
| 486 | Obat Program Jaminan Kesehatan | Antasida Doen susp | 2.739 | 600 | 0 | 1.643.400 | PT. LUCAS DJAJA |
| 487 | Obat Program Jaminan Kesehatan | Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng oksida 120 mg + sup ad 2 g | 3.250 | 300 | 0 | 975.000 | PT. Kimia Farma Tbk |
| 488 | Obat Program Jaminan Kesehatan | Betametason/Betamethasone Valerate krim 0,1% | 1.998 | 500 | 0 | 999.000 | PT. Kimia Farma Tbk |
| 489 | Obat Program Jaminan Kesehatan | Furosemid/ Furosemide tablet/kapsul/kaplet 40 mg | 222 | 100.000 | 0 | 22.200.000 | PT. Kimia Farma Tbk |
| 490 | Obat Program Jaminan Kesehatan | Ketokonazol/ Ketoconazole krim 2% | 3.499,83 | 100 | 0 | 349.983 | PT. Kimia Farma Tbk |
| 491 | Obat Program Jaminan Kesehatan | Atropin inj 0,25 mg/mL (i.v./s.k.) | 4.117 | 500 | 0 | 2.058.500 | PT Ethica Industri Farmasi |
| 492 | Konsolidasi Obat | Fluorourasil inj 50 mg/mL | 19.200 | 250 | 0 | 4.800.000 | PT Ferron Par Pharmaceuticals |
| 493 | Konsolidasi Obat | Sisplatin inj 1 mg/mL, Vial 10 mg | 22.584 | 120 | 0 | 2.710.080 | PT Ferron Par Pharmaceuticals |
| 494 | Konsolidasi Obat | Sisplatin inj 1 mg/mL, Vial 50 mg | 86.162 | 60 | 0 | 5.169.720 | PT Ferron Par Pharmaceuticals |
| 495 | Konsolidasi Obat | Letrozol tab 2,5 mg | 1.568 | 7.500 | 0 | 11.760.000 | PT Ferron Par Pharmaceuticals |
| 496 | Konsolidasi Obat | Anastrozol tab 1 mg | 2.642 | 900 | 0 | 2.377.800 | PT Ferron Par Pharmaceuticals |
| 497 | Konsolidasi Obat | Kapesitabin tab sal 500 mg | 5.445 | 1.800 | 0 | 9.801.000 | PT Ferron Par Pharmaceuticals |
| 498 | Konsolidasi Obat | Siklofosfamid inj 1.000 mg (i.v.) | 181.000 | 200 | 0 | 36.200.000 | PT Ferron Par Pharmaceuticals |
| 499 | Obat Program Jaminan Kesehatan | Methylergometrine Maleate/ Methylergometrine/ Metilergometrin tablet/kapsul/kaplet 0,125 mg | 1.554 | 3.000 | 0 | 4.662.000 | PT.Bernofarm |
| 500 | Obat Program Jaminan Kesehatan | Methylprednisolone Sodium Succinate/ Metilprednisolon/ Methylprednisolone inj 125 mg | 15.748 | 1.500 | 0 | 23.622.000 | PT.Bernofarm |
| 501 | Obat Program Jaminan Kesehatan | Ondansetron hydrochloride (HCl)/ Ondansetron HCl dihydrate /Ondansetron inj 2 mg/mL @4mg | 4.000 | 4.000 | 0 | 16.000.000 | PT.Bernofarm |
| 502 | Obat Program Jaminan Kesehatan | TRAMADOL 50 mg TSS | 830 | 15.000 | 0 | 12.450.000 | PT.Bernofarm |
| 503 | Obat Program Jaminan Kesehatan | Fentanil/ Fentanyl injeksi 0,05 mg/ml (i.m/i.v) ampul/vial @ 2 mL | 30.000 | 2.500 | 0 | 75.000.000 | PT. Mahakam Beta Farma |
| 504 | Obat Program Jaminan Kesehatan | Kalsium polistirena sulfonat / Calcium Polystyrene Sulfonate serb 5 g | 5.500 | 400 | 0 | 2.200.000 | PT DIPA PHARMALAB INTERSAINS |
| 505 | Obat Program Jaminan Kesehatan | Cefixime trihydrate/ Cefixime/ Sefiksim sirup/ sirup kering 100 mg/ 5 ml | 9.750 | 360 | 0 | 3.510.000 | P.T. Dexa Medica |
| 506 | Obat Program Jaminan Kesehatan | Fluconazole / Flukonazol injeksi/ infus 2 mg/ml | 21.900 | 60 | 0 | 1.314.000 | P.T. Dexa Medica |
| 507 | Obat Program Jaminan Kesehatan | Furosemid/ Furosemide inj 10 mg/mL (i.v./i.m) | 3.100 | 12.000 | 0 | 37.200.000 | P.T. Dexa Medica |
| 508 | Obat Program Jaminan Kesehatan | Fenitoin/ Phenytoin Sodium Injeksi 50 mg/ml (100 mg/ 2 mL) | 3.650 | 2.000 | 0 | 7.300.000 | P.T. Dexa Medica |
| 509 | Obat Program Kesehatan Lainnya | PIRACETAM 1200 mg KSS | 820 | 10.000 | 0 | 8.200.000 | PT.Bernofarm |
| 510 | Obat Program Kesehatan Lainnya | PIRACETAM 800 mg KSS | 564 | 5.000 | 0 | 2.820.000 | PT.Bernofarm |
| 511 | Obat Program Kesehatan Lainnya | Citicoline Sodium 250 mg/2 ml Injeksi | 4.300 | 6.000 | 0 | 25.800.000 | PT.Bernofarm |
| 512 | Pemeliharaan Alat Kedokteran Provinsi Jawa Timur | HAMILTON C-SERIES OXYGEN CELL | 6.970.000 | 2 | 0 | 13.940.000 | PT. IDS Medical Systems Indonesia Cabang Surabaya |
| 513 | Obat Program Jaminan Kesehatan | Clonazepam/ Klonazepam tablet/kapsul/kaplet 2 mg | 6.360 | 300 | 0 | 1.908.000 | PT. Mersifarma Tirmaku Mercusana |
| 514 | Alat Tulis Kantor Provinsi Jawa Timur | LABEL BARCODE SEMICOATED PUTIH UKURAN 70MM X 50MM (1 LINE) ISI 1500PCS/ROLL | 127.650 | 100 | 0 | 12.765.000 | CV. Surya Indo Connection |
| 515 | Alat Tulis Kantor Provinsi Jawa Timur | LABEL BARCODE SEMICOATED PUTIH UKURAN 50mmx30mm (2 LINE) ISI 5000PCS/ROLL | 294.150 | 100 | 0 | 29.415.000 | CV. Surya Indo Connection |
| 516 | Alat Tulis Kantor Provinsi Jawa Timur | THERMAL PAPER (KERTAS THERMAL) Ukuran 80 X 80 | 24.420 | 500 | 0 | 12.210.000 | CV. Surya Indo Connection |
| 517 | Konsolidasi Obat | Tikagrelor tab 90 mg | 8.325 | 1.080 | 0 | 8.991.000 | PT Pratapa Nirmala |
| 518 | Konsolidasi Obat | Antasida tab kunyah | 90 | 3.000 | 0 | 270.000 | PT. Mersifarma Tirmaku Mercusana |
| 519 | Konsolidasi Obat | Klozapin tab 100 mg | 990 | 4.000 | 0 | 3.960.000 | PT. Mersifarma Tirmaku Mercusana |
| 520 | Konsolidasi Obat | Flufenazin dekanoat inj 25 mg/mL (i.m.) | 67.950 | 60 | 0 | 4.077.000 | PT. Mersifarma Tirmaku Mercusana |
| 521 | Konsolidasi Obat | Trifluoperazin tab sal selaput 5 mg | 234 | 28.000 | 0 | 6.552.000 | PT. Mersifarma Tirmaku Mercusana |
| 522 | Konsolidasi Obat | Triheksifenidil tab 2 mg | 119 | 140.000 | 0 | 16.660.000 | PT. Holi Pharma |
| 523 | Konsolidasi Obat | Alprazolam tab 0,5 mg | 150 | 32.000 | 0 | 4.800.000 | PT. Mersifarma Tirmaku Mercusana |
| 524 | Konsolidasi Obat | Alprazolam tab 1 mg | 190 | 4.000 | 0 | 760.000 | PT. Mersifarma Tirmaku Mercusana |
| 525 | Inovasi Kesehatan dan Obat | CURCUMA | 46.900 | 250 | 0 | 11.725.000 | PT. SOHO Industri Pharmasi |
| 526 | Obat Program Jaminan Kesehatan | Difenhidramin/ Diphenhydramine injeksi 10 mg/ml ( i.v./i.m.) | 1.800 | 4.000 | 0 | 7.200.000 | PT.Bernofarm |
| 527 | Konsolidasi Obat | Donepezil Tab Sal Selaput 5 mg | 1.553 | 600 | 0 | 931.800 | PT. ETERCON PHARMA |
| 528 | Obat Program Jaminan Kesehatan | Fitomenadion/ Phytomenadione/ Phytomenadion (Vitamin K1) injeksi 10 mg/mL | 6.900 | 2.000 | 0 | 13.800.000 | PT.Phapros Tbk |
| 529 | Obat Program Jaminan Kesehatan | Epinefrin/ Epinephrine (Adrenalin) injeksi 1 mg/mL | 5.828 | 2.010 | 0 | 11.714.280 | PT.Phapros Tbk |
| 530 | Obat Program Jaminan Kesehatan | Etoricoxib 60 mg Tablet SS | 2.545 | 600 | 0 | 1.527.000 | PT. Nulab Pharmaceutical Indonesia |
| 531 | Obat Program Kesehatan Lainnya | Celecoxib 100 mg Kaps | 2.165 | 600 | 0 | 1.299.000 | PT. Nulab Pharmaceutical Indonesia |
| 532 | Obat Program Kesehatan Lainnya | FLUNARIZINE HCI 10 mg Tablet | 1.440 | 6.000 | 0 | 8.640.000 | PT. Nulab Pharmaceutical Indonesia |
| 533 | Obat Program Kesehatan Lainnya | FLUNARIZINE HCI 5 mg Tablet | 832 | 6.000 | 0 | 4.992.000 | PT. Nulab Pharmaceutical Indonesia |
| 534 | Konsolidasi Obat | Hidroklorotiazid tab 25 mg | 148 | 30.000 | 0 | 4.440.000 | PT. Kimia Farma Tbk |
| 535 | Konsolidasi Obat | Gliseril trinitrat kaps lepas lambat 5 mg | 2.530 | 20.000 | 0 | 50.600.000 | PT. Kimia Farma Tbk |
| 536 | Konsolidasi Obat | Gliseril trinitrat kaps lepas lambat 2,5 mg | 1.655 | 60.000 | 0 | 99.300.000 | PT. Kimia Farma Tbk |
| 537 | Obat Program Jaminan Kesehatan | Hiosin butilbromid/Hyoscine butylbromide/Hyoscine N Butylbromide inj 20 mg/ml | 7.900 | 720 | 0 | 5.688.000 | PT. OTTO Pharmaceutical Industries |
| 538 | Obat Program Jaminan Kesehatan | Oxymetazoline/ Oksimetazolin tetes hidung 0,050% | 71.040 | 30 | 0 | 2.131.200 | PT. Merck Tbk |
| 539 | Obat Program Jaminan Kesehatan | Oxymetazoline/ Oksimetazolin tetes hidung 0,025% | 68.820 | 5 | 0 | 344.100 | PT. Merck Tbk |
| 540 | Obat Program Jaminan Kesehatan | Triamcinolone acetonide/ Triamsinolon asetonid inj 10 mg/mL | 33.300 | 20 | 0 | 666.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 541 | Obat Program Jaminan Kesehatan | Fitomenadion/ Phytomenadione/ Phytomenadion (Vitamin K1) injeksi 2 mg/ml | 3.330 | 1.200 | 0 | 3.996.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 542 | Obat Program Jaminan Kesehatan | Iron Sucrose / Low molecule feri sucrose inj 20 mg/mL (100mg/5mL) | 20.535 | 60 | 0 | 1.232.100 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 543 | Fasilitas Kesehatan Sektoral Kemenkes | IMASKE Swab Isopropyl Alcohol 70% (by volume) | 7.992 | 720 | 0 | 5.754.240 | PT. Industri Masker Kreatif Teknologi |
| 544 | Obat Program Jaminan Kesehatan | KETOROLAC TROMETAMOL Injeksi | 1.276,5 | 16.500 | 0 | 21.062.250 | PT. MEPROFARM |
| 545 | Obat Program Jaminan Kesehatan | Ketoprofen 100 mg Suppositoria | 3.552 | 600 | 0 | 2.131.200 | PT. MEPROFARM |
| 546 | Obat Program Jaminan Kesehatan | Lactulose/ Laktulosa sir 3,335 g/5 mL | 12.533 | 600 | 0 | 7.519.800 | PT Ikapharmindo Putramas |
| 547 | Obat Program Jaminan Kesehatan | Analog Insulin Long Acting inj Insulin Detemir 100 IU/mL (kemasan vial, disposable cartridge, penfill cartridge) | 89.799 | 150 | 0 | 13.469.850 | PT. Beta Pharmacon |
| 548 | Obat Program Jaminan Kesehatan | Manitol inf 20% | 34.965 | 750 | 0 | 26.223.750 | PT SANBE FARMA |
| 549 | Obat Non Jaminan Kesehatan | MELOXICAM 15 | 133 | 42.000 | 0 | 5.586.000 | PT. TROPICA MAS PHARMACEUTICALS |
| 550 | Obat Program Jaminan Kesehatan | Asiklovir/Acyclovir/Aciclovir tablet/kapsul/kaplet 400 mg | 650 | 1.100 | 0 | 715.000 | PT. Hexpharm Jaya Laboratories |
| 551 | Obat Program Jaminan Kesehatan | Meropenem/ Meropenem Trihydrate serb inj 1.000 mg | 34.000 | 1.500 | 0 | 51.000.000 | PT. Hexpharm Jaya Laboratories |
| 552 | Obat Program Jaminan Kesehatan | Metronidazole/Metronidazol tablet/kapsul/kaplet 500 mg | 233 | 6.000 | 0 | 1.398.000 | PT. Holi Pharma |
| 553 | Obat Program Jaminan Kesehatan | Paracetamol/ Parasetamol infus 10 mg/mL | 12.527 | 7.500 | 0 | 93.952.500 | PT Darya Varia |
| 554 | Fasilitas Kesehatan Sektoral Kemenkes | IALURIL PREFILL | 1.533.187 | 5 | 0 | 7.665.935 | PT DIPA PHARMALAB INTERSAINS |
| 555 | Fasilitas Kesehatan Sektoral Kemenkes | Latex Medical Examination Gloves XS,S,M,L Powder Free | 42.180 | 200 | 0 | 8.436.000 | PT Jayamas Medica Industri |
| 556 | Obat Program Jaminan Kesehatan | Insulin Prandial Analog | 90.314 | 200 | 0 | 18.062.800 | PT Aventis Pharma |
| 557 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 5.0 | 255.411 | 10 | 0 | 2.554.110 | PT. SARANA LINTAS MEDIKA |
| 558 | Fasilitas Kesehatan Sektoral Kemenkes | Jackson Rees Dewasa | 235.000 | 100 | 0 | 23.500.000 | PT Jayamas Medica Industri |
| 559 | Fasilitas Kesehatan Sektoral Kemenkes | ID Band Anak Warna Pink | 71.928 | 3 | 0 | 215.784 | PT Jayamas Medica Industri |
| 560 | Fasilitas Kesehatan Sektoral Kemenkes | ID Band Anak Blue | 71.928 | 3 | 0 | 215.784 | PT Jayamas Medica Industri |
| 561 | Fasilitas Kesehatan Sektoral Kemenkes | Headstrap Dewasa | 58.608 | 30 | 0 | 1.758.240 | PT Jayamas Medica Industri |
| 562 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7 | 250.000 | 20 | 0 | 5.000.000 | PT Jayamas Medica Industri |
| 563 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7,5 | 250.000 | 60 | 0 | 15.000.000 | PT Jayamas Medica Industri |
| 564 | Fasilitas Kesehatan Sektoral Kemenkes | Hidrogen Peroxide 3 | 27.528 | 20 | 0 | 550.560 | PT Jayamas Medica Industri |
| 565 | Fasilitas Kesehatan Sektoral Kemenkes | Plester Ukuran XL | 23.088 | 15 | 0 | 346.320 | PT Jayamas Medica Industri |
| 566 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED Dermafix Tulle | 31.080 | 100 | 0 | 3.108.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 567 | Fasilitas Kesehatan Sektoral Kemenkes | TERUMO Volumetric Administration Set - TS*M270LA | 49.494 | 200 | 0 | 9.898.800 | TERUMO INDONESIA |
| 568 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP316H) | 5.096.292 | 1 | 0 | 5.096.292 | PT Johnson and Johnson Indonesia Two |
| 569 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 24GX 1 INCH (25MM) | 6.660 | 1.500 | 0 | 9.990.000 | PT. SINAR RODA UTAMA |
| 570 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 22G X 1 INCH (25MM) | 6.660 | 2.500 | 0 | 16.650.000 | PT. SINAR RODA UTAMA |
| 571 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 20G X 1-1/4 INCH (32MM) | 6.660 | 5.000 | 0 | 33.300.000 | PT. SINAR RODA UTAMA |
| 572 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 18G X 1-1/4 INCH (32MM) | 6.660 | 1.500 | 0 | 9.990.000 | PT. SINAR RODA UTAMA |
| 573 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 1 ML LUER SLIP / 26GX1/2INCH (13MM) | 1.110 | 1.000 | 0 | 1.110.000 | PT. SINAR RODA UTAMA |
| 574 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 5 ML LUER LOCK WITH NEEDLE 22GX1-1/2INCH (38MM) | 1.110 | 18.700 | 0 | 20.757.000 | PT. SINAR RODA UTAMA |
| 575 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 10 ML LUER LOCK WITH NEEDLE 21GX1-1/2INCH (38MM) | 1.443 | 30.000 | 0 | 43.290.000 | PT. SINAR RODA UTAMA |
| 576 | Obat Program Jaminan Kesehatan | PEHACAIN / Lidocaine Hydrochloride | 3.707 | 1.000 | 0 | 3.707.000 | PT.Phapros Tbk |
| 577 | Obat Program Jaminan Kesehatan | BIOSAT | 167.888 | 100 | 0 | 16.788.800 | PT. BIO FARMA |
| 578 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Anggur | 60.500 | 8 | 0 | 484.000 | CV.PEDULI |
| 579 | Bahan Makanan dan Minuman Provinsi Jawa Timur | APEL HIJAU | 28.000 | 8 | 0 | 224.000 | CV.PEDULI |
| 580 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Apel Merah | 62.000 | 5 | 0 | 310.000 | CV.PEDULI |
| 581 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Asem Jawa | 34.000 | 1 | 0 | 34.000 | CV.PEDULI |
| 582 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bakso | 35.000 | 8 | 0 | 280.000 | CV.PEDULI |
| 583 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Ikan bandeng utuh | 52.000 | 125 | 0 | 6.500.000 | CV.PEDULI |
| 584 | Bahan Makanan dan Minuman Provinsi Jawa Timur | BAWANG BOMBAY | 47.000 | 5 | 0 | 235.000 | CV.PEDULI |
| 585 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bawang Merah kupas | 55.000 | 31 | 0 | 1.705.000 | CV.PEDULI |
| 586 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bawang Putih kupas | 60.000 | 31 | 0 | 1.860.000 | CV.PEDULI |
| 587 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bayam | 2.700 | 800 | 0 | 2.160.000 | CV.PEDULI |
| 588 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Belimbing | 20.000 | 3 | 0 | 60.000 | CV.PEDULI |
| 589 | Bahan Makanan dan Minuman Provinsi Jawa Timur | BIHUN | 13.000 | 18 | 0 | 234.000 | CV.PEDULI |
| 590 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Blokoli | 21.000 | 35 | 0 | 735.000 | CV.PEDULI |
| 591 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Buncis | 22.000 | 40 | 0 | 880.000 | CV.PEDULI |
| 592 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Cabe Merah | 60.000 | 16 | 0 | 960.000 | CV.PEDULI |
| 593 | Bahan Makanan dan Minuman Provinsi Jawa Timur | ayam potong | 45.000 | 810 | 0 | 36.450.000 | CV.PEDULI |
| 594 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daging Giling (Baksoan) | 103.000 | 98 | 0 | 10.094.000 | CV.PEDULI |
| 595 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daging Sapi | 148.000 | 70 | 0 | 10.360.000 | CV.PEDULI |
| 596 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun Bawang | 31.000 | 8 | 0 | 248.000 | CV.PEDULI |
| 597 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun jeruk | 5.200 | 7 | 0 | 36.400 | CV.PEDULI |
| 598 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun pandan | 5.200 | 15 | 0 | 78.000 | CV.PEDULI |
| 599 | Bahan Makanan dan Minuman Provinsi Jawa Timur | DAUN SALAM | 2.500 | 8 | 0 | 20.000 | CV.PEDULI |
| 600 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Ikan dori Fillet | 60.000 | 175 | 0 | 10.500.000 | CV.PEDULI |
| 601 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Gambas | 15.000 | 70 | 0 | 1.050.000 | CV.PEDULI |
| 602 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jagung | 15.000 | 190 | 0 | 2.850.000 | CV.PEDULI |
| 603 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jahe | 42.000 | 5 | 0 | 210.000 | CV.PEDULI |
| 604 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jambu | 20.000 | 6 | 0 | 120.000 | CV.PEDULI |
| 605 | Bahan Makanan dan Minuman Provinsi Jawa Timur | jamur kuping basah | 12.000 | 10 | 0 | 120.000 | CV.PEDULI |
| 606 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jeruk mandarin | 62.000 | 7 | 0 | 434.000 | CV.PEDULI |
| 607 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jeruk nipis | 32.000 | 1 | 0 | 32.000 | CV.PEDULI |
| 608 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jinten | 15.000 | 4 | 0 | 60.000 | CV.PEDULI |
| 609 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kacang Panjang | 17.000 | 100 | 0 | 1.700.000 | CV.PEDULI |
| 610 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kangkung | 1.500 | 800 | 0 | 1.200.000 | CV.PEDULI |
| 611 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kelapa | 16.000 | 55 | 0 | 880.000 | CV.PEDULI |
| 612 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kencur | 46.000 | 1 | 0 | 46.000 | CV.PEDULI |
| 613 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kentang | 35.000 | 240 | 0 | 8.400.000 | CV.PEDULI |
| 614 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kluwek | 85.000 | 2 | 0 | 170.000 | CV.PEDULI |
| 615 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Krai | 20.000 | 80 | 0 | 1.600.000 | CV.PEDULI |
| 616 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kulit Pangsit | 29.000 | 2 | 0 | 58.000 | CV.PEDULI |
| 617 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kunci | 19.000 | 1 | 0 | 19.000 | CV.PEDULI |
| 618 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kunyit | 27.000 | 7 | 0 | 189.000 | CV.PEDULI |
| 619 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Air | 22.000 | 100 | 0 | 2.200.000 | CV.PEDULI |
| 620 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Kuning | 27.000 | 10 | 0 | 270.000 | CV.PEDULI |
| 621 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Siam | 12.000 | 90 | 0 | 1.080.000 | CV.PEDULI |
| 622 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Laos | 18.000 | 7 | 0 | 126.000 | CV.PEDULI |
| 623 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Melon | 22.000 | 100 | 0 | 2.200.000 | CV.PEDULI |
| 624 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Nugget Ayam | 51.000 | 30 | 0 | 1.530.000 | CV.PEDULI |
| 625 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Paprika | 10.000 | 3 | 0 | 30.000 | CV.PEDULI |
| 626 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pear | 53.000 | 6 | 0 | 318.000 | CV.PEDULI |
| 627 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pepaya | 17.000 | 130 | 0 | 2.210.000 | CV.PEDULI |
| 628 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Ambon | 2.000 | 2.050 | 0 | 4.100.000 | CV.PEDULI |
| 629 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Cavendish | 5.000 | 50 | 0 | 250.000 | CV.PEDULI |
| 630 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Kepok | 35.000 | 5 | 0 | 175.000 | CV.PEDULI |
| 631 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang susu | 24.000 | 150 | 0 | 3.600.000 | CV.PEDULI |
| 632 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pok Coy | 16.000 | 115 | 0 | 1.840.000 | CV.PEDULI |
| 633 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pre/Seledri | 30.000 | 17 | 0 | 510.000 | CV.PEDULI |
| 634 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Roti tawar putih | 15.000 | 22 | 0 | 330.000 | CV.PEDULI |
| 635 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sawi Putih | 19.000 | 130 | 0 | 2.470.000 | CV.PEDULI |
| 636 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Semangka | 20.000 | 130 | 0 | 2.600.000 | CV.PEDULI |
| 637 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sereh | 14.000 | 6 | 0 | 84.000 | CV.PEDULI |
| 638 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Snack | 4.000 | 270 | 0 | 1.080.000 | CV.PEDULI |
| 639 | Bahan Makanan dan Minuman Provinsi Jawa Timur | tahu | 2.500 | 2.850 | 0 | 7.125.000 | CV.PEDULI |
| 640 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Taoge Panjang | 14.000 | 12 | 0 | 168.000 | CV.PEDULI |
| 641 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Taoge Pendek | 34.000 | 2 | 0 | 68.000 | CV.PEDULI |
| 642 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Telur Ayam | 32.000 | 290 | 0 | 9.280.000 | CV.PEDULI |
| 643 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Tempe | 3.000 | 2.450 | 0 | 7.350.000 | CV.PEDULI |
| 644 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Terasi | 4.500 | 20 | 0 | 90.000 | CV.PEDULI |
| 645 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Terong | 13.000 | 80 | 0 | 1.040.000 | CV.PEDULI |
| 646 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Tomat | 23.000 | 35 | 0 | 805.000 | CV.PEDULI |
| 647 | Bahan Makanan dan Minuman Provinsi Jawa Timur | ikan tongkol segar | 60.000 | 160 | 0 | 9.600.000 | CV.PEDULI |
| 648 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Wortel | 23.000 | 410 | 0 | 9.430.000 | CV.PEDULI |
| 649 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Nanas | 13.000 | 2 | 0 | 26.000 | CV.PEDULI |
| 650 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Selada | 35.000 | 16 | 0 | 560.000 | CV.PEDULI |
| 651 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Timun | 19.000 | 41 | 0 | 779.000 | CV.PEDULI |
| 652 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sawi Ijo | 1.750 | 420 | 0 | 735.000 | CV.PEDULI |
| 653 | Obat Program Jaminan Kesehatan | Ofloxacin/ Ofloksasin tets telinga 3% | 37.974 | 90 | 0 | 3.417.660 | PT SANBE FARMA |
| 654 | Obat Program Jaminan Kesehatan | Kombinasi, setiap mL mengandung: natrium klorida 4,40 mg + kalium klorida 0,80 mg, tts mata | 15.541 | 600 | 0 | 9.324.600 | PT SANBE FARMA |
| 655 | Obat Program Jaminan Kesehatan | Tropikamid 1% tetes mata | 33.745 | 6 | 0 | 202.470 | PT SANBE FARMA |
| 656 | Obat Program Jaminan Kesehatan | Albumin serum normal (human Albumin) inj 25%(250 g/1.000 mL), @ 100 mL | 1.550.000 | 30 | 0 | 46.500.000 | PT. DANKOS FARMA |
| 657 | Obat Program Jaminan Kesehatan | Aminofilin/Aminophylline inj 24 mg/ml | 11.336 | 168 | 0 | 1.904.448 | PT Ethica Industri Farmasi |
| 658 | Bahan Pokok Provinsi Jawa Timur | ABON | 105.000 | 35 | 0 | 3.675.000 | CV MULYA JAYA ABADI |
| 659 | Bahan Pokok Provinsi Jawa Timur | AGAR-AGAR | 8.500 | 24 | 0 | 204.000 | CV MULYA JAYA ABADI |
| 660 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL 120ML | 30.000 | 20 | 0 | 600.000 | CV MULYA JAYA ABADI |
| 661 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL 330ML | 4.500 | 480 | 0 | 2.160.000 | CV MULYA JAYA ABADI |
| 662 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL GELAS | 44.000 | 40 | 0 | 1.760.000 | CV MULYA JAYA ABADI |
| 663 | Bahan Pokok Provinsi Jawa Timur | BERAS BRAMU SUPER | 20.700 | 900 | 0 | 18.630.000 | CV MULYA JAYA ABADI |
| 664 | Bahan Pokok Provinsi Jawa Timur | BISKUIT GABIN | 8.500 | 40 | 0 | 340.000 | CV MULYA JAYA ABADI |
| 665 | Bahan Pokok Provinsi Jawa Timur | ROTI KABIN CRACKERS | 21.000 | 5 | 0 | 105.000 | CV MULYA JAYA ABADI |
| 666 | Bahan Pokok Provinsi Jawa Timur | GARAM | 7.500 | 140 | 0 | 1.050.000 | CV MULYA JAYA ABADI |
| 667 | Bahan Pokok Provinsi Jawa Timur | GULA BATOK MERAH | 25.000 | 5 | 0 | 125.000 | CV MULYA JAYA ABADI |
| 668 | Bahan Pokok Provinsi Jawa Timur | GULA PASIR | 22.000 | 200 | 0 | 4.400.000 | CV MULYA JAYA ABADI |
| 669 | Bahan Pokok Provinsi Jawa Timur | Kaldu Bubuk | 43.000 | 15 | 0 | 645.000 | CV MULYA JAYA ABADI |
| 670 | Bahan Pokok Provinsi Jawa Timur | KECAP MANIS | 28.000 | 17 | 0 | 476.000 | CV MULYA JAYA ABADI |
| 671 | Bahan Pokok Provinsi Jawa Timur | KEJU | 20.000 | 15 | 0 | 300.000 | CV MULYA JAYA ABADI |
| 672 | Bahan Pokok Provinsi Jawa Timur | KETUMBAR BUBUK | 25.000 | 2 | 0 | 50.000 | CV MULYA JAYA ABADI |
| 673 | Bahan Pokok Provinsi Jawa Timur | Lada Bubuk | 80.000 | 1 | 0 | 80.000 | CV MULYA JAYA ABADI |
| 674 | Bahan Pokok Provinsi Jawa Timur | MAKARONI SEDANI | 47.000 | 5 | 0 | 235.000 | CV MULYA JAYA ABADI |
| 675 | Bahan Pokok Provinsi Jawa Timur | BLUE BAND 250GR | 13.500 | 30 | 0 | 405.000 | CV MULYA JAYA ABADI |
| 676 | Bahan Pokok Provinsi Jawa Timur | Minyak Goreng | 25.000 | 240 | 0 | 6.000.000 | CV MULYA JAYA ABADI |
| 677 | Bahan Pokok Provinsi Jawa Timur | SAGU MUTIARA | 4.000 | 25 | 0 | 100.000 | CV MULYA JAYA ABADI |
| 678 | Bahan Pokok Provinsi Jawa Timur | Saos Tiram | 72.000 | 1 | 0 | 72.000 | CV MULYA JAYA ABADI |
| 679 | Bahan Pokok Provinsi Jawa Timur | Saos Tomat | 28.000 | 6 | 0 | 168.000 | CV MULYA JAYA ABADI |
| 680 | Bahan Pokok Provinsi Jawa Timur | SUSU BBLR | 160.000 | 6 | 0 | 960.000 | CV MULYA JAYA ABADI |
| 681 | Bahan Pokok Provinsi Jawa Timur | Susu Diabetasol Vanila | 280.000 | 3 | 0 | 840.000 | CV MULYA JAYA ABADI |
| 682 | Bahan Pokok Provinsi Jawa Timur | SUSU FORMULA SGM | 20.000 | 60 | 0 | 1.200.000 | CV MULYA JAYA ABADI |
| 683 | Bahan Pokok Provinsi Jawa Timur | Susu Khusus Renal | 100.000 | 48 | 0 | 4.800.000 | CV MULYA JAYA ABADI |
| 684 | Bahan Pokok Provinsi Jawa Timur | Susu Neomune | 47.000 | 30 | 0 | 1.410.000 | CV MULYA JAYA ABADI |
| 685 | Bahan Pokok Provinsi Jawa Timur | Susu Panenteral | 39.000 | 40 | 0 | 1.560.000 | CV MULYA JAYA ABADI |
| 686 | Bahan Pokok Provinsi Jawa Timur | SUSU SKIM | 240.000 | 36 | 0 | 8.640.000 | CV MULYA JAYA ABADI |
| 687 | Bahan Pokok Provinsi Jawa Timur | SUSU SOYA | 82.000 | 3 | 0 | 246.000 | CV MULYA JAYA ABADI |
| 688 | Bahan Pokok Provinsi Jawa Timur | SUSU TETP | 168.000 | 12 | 0 | 2.016.000 | CV MULYA JAYA ABADI |
| 689 | Bahan Pokok Provinsi Jawa Timur | Susu UHT | 11.500 | 72 | 0 | 828.000 | CV MULYA JAYA ABADI |
| 690 | Bahan Pokok Provinsi Jawa Timur | SWEETENER NON KALORI | 120.000 | 3 | 0 | 360.000 | CV MULYA JAYA ABADI |
| 691 | Bahan Pokok Provinsi Jawa Timur | TEA | 6.000 | 130 | 0 | 780.000 | CV MULYA JAYA ABADI |
| 692 | Bahan Pokok Provinsi Jawa Timur | TEPUNG TERIGU | 20.000 | 36 | 0 | 720.000 | CV MULYA JAYA ABADI |
| 693 | Bahan Pokok Provinsi Jawa Timur | TEPUNG BERAS | 20.000 | 30 | 0 | 600.000 | CV MULYA JAYA ABADI |
| 694 | Bahan Pokok Provinsi Jawa Timur | TEPUNG TAPIOKA | 20.000 | 1 | 0 | 20.000 | CV MULYA JAYA ABADI |
| 695 | Bahan Pokok Provinsi Jawa Timur | TEPUNG MAIZENA | 12.500 | 3 | 0 | 37.500 | CV MULYA JAYA ABADI |
| 696 | Bahan Pokok Provinsi Jawa Timur | TEPUNG PANIR | 37.000 | 1 | 0 | 37.000 | CV MULYA JAYA ABADI |
| 697 | Bahan Pokok Provinsi Jawa Timur | Kemiri | 85.000 | 15 | 0 | 1.275.000 | CV MULYA JAYA ABADI |
| 698 | Bahan Pokok Provinsi Jawa Timur | Susu Rendah Laktosa | 128.000 | 5 | 0 | 640.000 | CV MULYA JAYA ABADI |
| 699 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL ISI ULANG GALON | 25.000 | 25 | 0 | 625.000 | CV MULYA JAYA ABADI |
| 700 | Obat Program Jaminan Kesehatan | Fitomenadion/ Phytomenadion (Vitamin K1) tablet/kapsul/kaplet 10 mg | 825 | 1.000 | 0 | 825.000 | PT. MARIN LIZA FARMASI |
| 701 | Obat Program Jaminan Kesehatan | Aminofilin/Aminophylline tablet/kapsul/kaplet 200 mg | 276 | 7.000 | 0 | 1.932.000 | PT. MARIN LIZA FARMASI |
| 702 | Obat Program Jaminan Kesehatan | Cefazolin sodium/ Sefazolin serbuk injeksi 1.000 mg | 10.030 | 3.500 | 0 | 35.105.000 | P.T. Dexa Medica |
| 703 | Obat Program Jaminan Kesehatan | Ceftazidime/ Ceftazidime Pentahydrate/ Seftazidim serb inj 1.000 mg | 10.750 | 600 | 0 | 6.450.000 | P.T. Dexa Medica |
| 704 | Obat Program Jaminan Kesehatan | Streptokinase inj 1,5 juta IU | 3.950.000 | 5 | 0 | 19.750.000 | P.T. Dexa Medica |
| 705 | Obat Program Jaminan Kesehatan | Asam traneksamat/Tranexamic acid injeksi 100 mg/ml | 2.550 | 9.000 | 0 | 22.950.000 | P.T. Dexa Medica |
| 706 | Obat Program Jaminan Kesehatan | Cetirizine hydrochloride(HCl)/ Cetirizine/ Setirizin sirup 5 mg/5 ml | 3.800 | 360 | 0 | 1.368.000 | PT. Sampharindo Perdana |
| 707 | Konsolidasi Obat | Simvastatin tab 20 mg | 172 | 25.000 | 0 | 4.300.000 | PT. Sampharindo Perdana |
| 708 | Konsolidasi Obat | Setirizin tab 10 mg | 72 | 30.000 | 0 | 2.160.000 | PT. Sampharindo Perdana |
| 709 | Konsolidasi Obat | Paklitaksel inj 6 mg/mL, Vial 16,7 mL | 136.500 | 50 | 0 | 6.825.000 | PT FONKO INTERNATIONAL PHARMACEUTICALS |
| 710 | Konsolidasi Obat | Bisoprolol tab 1,25 mg | 2.029 | 15.000 | 0 | 30.435.000 | PT. Merck Tbk |
| 711 | Konsolidasi Obat | Kalium klorida tab lepas lambat 600 mg | 1.962 | 7.500 | 0 | 14.715.000 | PT. Merck Tbk |
| 712 | Obat Non Jaminan Kesehatan | FLUCADEX - OBAT BATUK & FLU KOMBINASI : PARACETAMOL 500 MG + GUAIFENESIN 50 MG + PPA 15 MG + DEXTROMETHORPHANE 15 MG + CTM 1 MG | 788 | 3.000 | 0 | 2.364.000 | PT. Graha Farma |
| 713 | Obat Non Jaminan Kesehatan | MECOBALAMIN / MEKOBALAMIN 500 MCG | 430 | 40.000 | 0 | 17.200.000 | PT. Graha Farma |
| 714 | Obat Non Jaminan Kesehatan | SANGOTONIK FE DROP - Tiap 1 ml drops mengandung: Sodium Feredetate 57,7 mg setara 7,5 mg besi elemen. | 16.500 | 100 | 0 | 1.650.000 | PT. Graha Farma |
| 715 | Peralatan atau Perlengkapan Kantor dan Rumah Tangga | Castor 6 inch Double Wheel | 1.738.250 | 20 | 0 | 34.765.000 | CV. Rom Poer Sejahtera |
| 716 | Peralatan atau Perlengkapan Kantor dan Rumah Tangga | CASTOR 5 INCH DOUBLE WHEEL | 1.650.375 | 60 | 0 | 99.022.500 | CV. Rom Poer Sejahtera |
| 717 | Konsolidasi Obat | Olanzapin tab sal selaput 10 mg | 3.600 | 6.000 | 0 | 21.600.000 | PT. Amarox Pharma Global |
| 718 | Konsolidasi Obat | Propranolol tab 10 mg | 58 | 10.000 | 0 | 580.000 | PT. Holi Pharma |
| 719 | Konsolidasi Obat | Propranolol tab 40 mg | 120 | 3.000 | 0 | 360.000 | PT. Holi Pharma |
| 720 | Obat Program Jaminan Kesehatan | Quetiapine Fumarate XR 200 mg / Quetiapin Tablet Pelepasan Lambat 200 mg | 10.530 | 2.000 | 0 | 21.060.000 | PT. Amarox Pharma Global |
| 721 | Konsolidasi Obat | Salbutamol tab 2 mg | 62 | 30.000 | 0 | 1.860.000 | PT.Imfarmind Farmasi Industri |
| 722 | Konsolidasi Obat | Vitamin B kompleks mengandung: a. Vitamin B1 b. Vitamin B6 c. Vitamin B12 tab | 60 | 30.000 | 0 | 1.800.000 | PT.Imfarmind Farmasi Industri |
| 723 | Konsolidasi Obat | Tiamin (Vitamin B1) tab 50 mg* | 78 | 600 | 0 | 46.800 | PT.Imfarmind Farmasi Industri |
| 724 | Obat Non Jaminan Kesehatan | Salbutamol tab 4 mg | 124 | 25.000 | 0 | 3.100.000 | PT.Imfarmind Farmasi Industri |
| 725 | Obat Program Jaminan Kesehatan | Norepinephrine bitartate/ Norepinephrine bitartate monohydrate / Norepinephrine/ Norepinephrine base/ Norepinefrin inj 1 mg/ml | 13.800 | 4.500 | 0 | 62.100.000 | P.T. Dexa Medica |
| 726 | Obat Program Jaminan Kesehatan | Human tetanus imunoglobulin inj 250 IU (i.m.) | 195.000 | 300 | 0 | 58.500.000 | P.T. Dexa Medica |
| 727 | Konsolidasi Obat | Vinkristin inj 1 mg/mL, Vial 2 mL | 92.875 | 5 | 0 | 464.375 | PT SANBE FARMA |
| 728 | Konsolidasi Obat | Goserelin asetat inj 3,6 mg/depot | 1.052.590 | 50 | 0 | 52.629.500 | PT AstraZeneca Indonesia |
| 729 | Konsolidasi Obat | Tamsulosin Tab Lepas Lambat 0,4 mg | 2.800 | 36.000 | 0 | 100.800.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 730 | Konsolidasi Obat | Klobazam tab 10 mg | 409 | 30.000 | 0 | 12.270.000 | PT. Mersifarma Tirmaku Mercusana |
| 731 | Konsolidasi Obat | Klopidogrel tab 75 mg | 644 | 75.000 | 0 | 48.300.000 | PT. Beta Pharmacon |
| 732 | Obat Program Jaminan Kesehatan | SODIUM BICARBONATE 500 MG | 70 | 15.000 | 0 | 1.050.000 | PT. PIM Pharmaceuticals |
| 733 | Obat Program Jaminan Kesehatan | VITAMIN D3 1000 IU | 180 | 60.000 | 0 | 10.800.000 | PT. PIM Pharmaceuticals |
| 734 | Obat Program Jaminan Kesehatan | BEDAK SALICYL 2% | 6.408 | 24 | 0 | 153.792 | PT. PIM Pharmaceuticals |
| 735 | Konsolidasi Obat | Eksemestan tab sal 25 mg | 35.964 | 600 | 0 | 21.578.400 | PT Pratapa Nirmala |
| 736 | Fasilitas Kesehatan | Sensor Electrodes ES GS 43 T Pouch isi 50 pcs | 60.000 | 100 | 0 | 6.000.000 | PT. JAYA ABADI MEDIKA |
| 737 | Fasilitas Kesehatan | POLYVAC SET 12 FG | 86.580 | 60 | 0 | 5.194.800 | PT. MEGAH MEDIKA PHARMA |
| 738 | Fasilitas Kesehatan | POLYVAC SET 14 FG | 86.580 | 120 | 0 | 10.389.600 | PT. MEGAH MEDIKA PHARMA |
| 739 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Bag Liner with solidifier w/Single Tandem Tube, 2000ml | 48.497 | 15 | 0 | 727.455 | PT. ENERGI MEDISTRON |
| 740 | Fasilitas Kesehatan Sektoral Kemenkes | Gauze Swab Steril 7.5 cm x 7.5 cm x 16 ply (10 pcs) | 19.000 | 1.508 | 0 | 28.652.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 741 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Syringe 50 cc Ec tip without needle | 75.258 | 25 | 0 | 1.881.450 | PT Jayamas Medica Industri |
| 742 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Mount | 31.080 | 500 | 0 | 15.540.000 | PT Jayamas Medica Industri |
| 743 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Tip | 145.188 | 7 | 0 | 1.016.316 | PT Jayamas Medica Industri |
| 744 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed Anesthesia Mask Size 5 | 16.428 | 20 | 0 | 328.560 | PT Jayamas Medica Industri |
| 745 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 4 | 16.428 | 20 | 0 | 328.560 | PT Jayamas Medica Industri |
| 746 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed Anesthesia Mask Size 3 | 16.428 | 10 | 0 | 164.280 | PT Jayamas Medica Industri |
| 747 | Fasilitas Kesehatan Sektoral Kemenkes | Oxyflow Oxygen Nasal Cannula Dewasa | 5.400 | 1.500 | 0 | 8.100.000 | PT Jayamas Medica Industri |
| 748 | Fasilitas Kesehatan Sektoral Kemenkes | Mucus Extractor Finger Control | 5.550 | 10 | 0 | 55.500 | PT Jayamas Medica Industri |
| 749 | Fasilitas Kesehatan Sektoral Kemenkes | M-Y Jelly 5gram, sachet | 47.508 | 75 | 0 | 3.563.100 | PT Jayamas Medica Industri |
| 750 | Fasilitas Kesehatan Sektoral Kemenkes | Maxiflow Anak | 10.323 | 100 | 0 | 1.032.300 | PT Jayamas Medica Industri |
| 751 | Fasilitas Kesehatan | 15 cm x 2.7 m | 36.400 | 120 | 0 | 4.368.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 752 | Fasilitas Kesehatan | 7.5 cm x 2.7 m | 15.400 | 144 | 0 | 2.217.600 | PT Sinaraya Nugraha Ahmadaris Medika |
| 753 | Fasilitas Kesehatan | 15 cm x 2.7 m | 25.300 | 144 | 0 | 3.643.200 | PT Sinaraya Nugraha Ahmadaris Medika |
| 754 | Fasilitas Kesehatan | Lap Sponge Abdominal Steril, 45 cm x 45 cm 8 ply isi 1 | 278.388 | 15 | 0 | 4.175.820 | PT Jayamas Medica Industri |
| 755 | Fasilitas Kesehatan | Kasa Steril 7.5 x 7.5 cm - 16 ply isi 10 LD, 71610 LD | 11.800 | 3.000 | 0 | 35.400.000 | PT Jayamas Medica Industri |
| 756 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 8.0 | 134.260 | 5 | 0 | 671.300 | PT.Dwiasri Graha (dwigraha medical) |
| 757 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 4.5 | 134.260 | 5 | 0 | 671.300 | PT.Dwiasri Graha (dwigraha medical) |
| 758 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 4.0 | 134.260 | 10 | 0 | 1.342.600 | PT.Dwiasri Graha (dwigraha medical) |
| 759 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced size 3.0 | 134.260 | 10 | 0 | 1.342.600 | PT.Dwiasri Graha (dwigraha medical) |
| 760 | Fasilitas Kesehatan | V16 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 48 mm | 86.691 | 60 | 0 | 5.201.460 | PT Medihop |
| 761 | Fasilitas Kesehatan | V15 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 40 mm | 86.691 | 144 | 0 | 12.483.504 | PT Medihop |
| 762 | Fasilitas Kesehatan | S25 T-Silk Silk/Sutera 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 46.620 | 60 | 0 | 2.797.200 | PT Medihop |
| 763 | Fasilitas Kesehatan | S24 T-Silk Silk/Sutera 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 40.737 | 24 | 0 | 977.688 | PT Medihop |
| 764 | Fasilitas Kesehatan | S84 T-Silk Silk/Sutera 1, 90 cm Round Bodied, 1/2 circle, 40 mm | 55.389 | 36 | 0 | 1.994.004 | PT Medihop |
| 765 | Fasilitas Kesehatan | N37 T-Nylon Nylon 4-0, 76 cm Reverse Cutting, 3/8 circle, 18 mm | 48.396 | 36 | 0 | 1.742.256 | PT Medihop |
| 766 | Fasilitas Kesehatan | N32 T-Nylon Nylon 3-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 48.396 | 240 | 0 | 11.615.040 | PT Medihop |
| 767 | Fasilitas Kesehatan | C96 T-Chromic Catgut Chromic 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 64.602 | 48 | 0 | 3.100.896 | PT Medihop |
| 768 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE XL (1200-07 ) | 313.852 | 3 | 0 | 941.556 | PT. AMPM HEALTHCARE INDONESIA |
| 769 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE M (1200-05 ) | 281.385 | 20 | 0 | 5.627.700 | PT. AMPM HEALTHCARE INDONESIA |
| 770 | Fasilitas Kesehatan Sektoral Kemenkes | Ureteral Stent 5.0 FR 26 CM BOTH ENDS OPEN | 372.953 | 50 | 0 | 18.647.650 | PT. EDISON DUTA SARANA |
| 771 | Fasilitas Kesehatan Sektoral Kemenkes | Guide Wire 0.032 x 150 CM (STRAIGHT TIP) PTFE | 270.680 | 20 | 0 | 5.413.600 | PT. EDISON DUTA SARANA |
| 772 | Fasilitas Kesehatan Sektoral Kemenkes | MASTER GYNAECOLOGICAL | 14.500 | 500 | 0 | 7.250.000 | SINAR PANCA MEDIKA |
| 773 | Fasilitas Kesehatan Sektoral Kemenkes | TANIYUK Latex Examination Gloves, Powder Free | 42.200 | 300 | 0 | 12.660.000 | PT. Anata Watashi Wha |
| 774 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 3 ML LUER LOCK WITH NEEDLE 23GX1-1/4INCH (32MM) | 999 | 28.800 | 0 | 28.771.200 | PT. SINAR RODA UTAMA |
| 775 | Obat Program Jaminan Kesehatan | ATTAPULGIT/ATTAPULGITE 600 MG/TABLET/KAPLET/KAPSUL | 299 | 1.000 | 0 | 299.000 | PT. TRIMAN |
| 776 | Obat Program Jaminan Kesehatan | VITAMIN C 50 MG | 154 | 10.000 | 0 | 1.540.000 | PT. TRIMAN |
| 777 | Obat Program Jaminan Kesehatan | Domperidon/ Domperidone tablet/kapsul/kaplet 10 mg | 107 | 18.000 | 0 | 1.926.000 | PT. TRIMAN |
| 778 | Fasilitas Kesehatan | Electrosurgical Return Electrodes/Paid Patient Cover/E7510-25 | 217.600 | 10 | 0 | 2.176.000 | PT. Medtronic Indonesia |
| 779 | Fasilitas Kesehatan Sektoral Kemenkes | SINGLE USE BONNET SIZE MEDIUM (1216-10) | 303.030 | 20 | 0 | 6.060.600 | PT. AMPM HEALTHCARE INDONESIA |
| 780 | Obat Program Jaminan Kesehatan | Larutan mengandung Asam Amino (Asam Amino 79.9 g, Total N 12.2 g, Na+ 14 mEq, Cl 94 mEq), @ 500 mL | 74.475 | 24 | 0 | 1.787.400 | PT. Otsuka Indonesia |
| 781 | Obat Program Jaminan Kesehatan | Larutan mengandung Elektrolit (Na 130 mEq, K 4 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq) ASERING softbag @ 500 mL | 8.750 | 300 | 0 | 2.625.000 | PT. Otsuka Indonesia |
| 782 | Obat Program Jaminan Kesehatan | Dextrose monohydrat - Dextrose anhydrat 40%, ampul 25 mL | 8.547 | 6.000 | 0 | 51.282.000 | PT. Otsuka Indonesia |
| 783 | Obat Program Jaminan Kesehatan | Oxytocin/ Oksitosin inj 10 IU/ml | 2.967 | 3.600 | 0 | 10.681.200 | PT Ethica Industri Farmasi |
| 784 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 1.000 | 0 | 487.290.000 | PT. SINAR RODA UTAMA |
| 785 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 1.350 | 0 | 657.841.500 | PT. SINAR RODA UTAMA |
| 786 | Konsolidasi Obat | Parasetamol tab 500 mg | 100 | 40.000 | 0 | 4.000.000 | PT. TRIMAN |
| 787 | Obat Program Jaminan Kesehatan | Poly (0-2 Hydroxyethyl) Starch 130 60 g/ Sodium chloride 6,02 g/ Sodium acetate 4,63 g/ Potassium chloride 0,30 g/ Mg Chloride Hexahydrate 0,30 g Infus | 52.250 | 500 | 0 | 26.125.000 | PT. Fresenius Kabi Combiphar |
| 788 | Konsolidasi Obat | Leuprorelin asetat serb inj 3,75 mg | 720.000 | 2 | 0 | 1.440.000 | PT.Takeda Indonesia |
| 789 | Fasilitas Kesehatan Sektoral Kemenkes | N-Flow Refill 1x2g A3 | 375.000 | 10 | 0 | 3.750.000 | PT.MURSMEDIC |
| 790 | Fasilitas Kesehatan Sektoral Kemenkes | N-Bond Universal Ref. Btl 1x6g | 1.465.000 | 3 | 0 | 4.395.000 | PT.MURSMEDIC |
| 791 | Fasilitas Kesehatan Sektoral Kemenkes | N-Flow Refill 1x2g A3.5 | 375.000 | 10 | 0 | 3.750.000 | PT.MURSMEDIC |
| 792 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Non Rebreathing Oxygen Mask Adult Elongated(XL) | 15.484 | 100 | 0 | 1.548.400 | PT. BUANA INTIPRIMA USAHA |
| 793 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Adult Elongated (XL) | 16.275 | 300 | 0 | 4.882.500 | PT. BUANA INTIPRIMA USAHA |
| 794 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Pediatric Elongated (M) | 16.275 | 300 | 0 | 4.882.500 | PT. BUANA INTIPRIMA USAHA |
| 795 | Fasilitas Kesehatan Sektoral Kemenkes | BIOPTIMAL CVC Double Lumen: 7Fr x 20cm with Kink Resistance Guidewire, Y needle (CVN-702-20Y) | 477.725 | 10 | 0 | 4.777.250 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 796 | Fasilitas Kesehatan | SUREFIT Dual Dispersive Electrode (410-2000) | 77.000 | 200 | 0 | 15.400.000 | PT. Hospi Medik Indonesia |
| 797 | Fasilitas Kesehatan | V5 T-Vio Polyglycolide 3-0, 76 cm Round Bodied, 1/2 circle, 20 mm | 87.135 | 60 | 0 | 5.228.100 | PT Medihop |
| 798 | Fasilitas Kesehatan Sektoral Kemenkes | STERA Plasma Sterilizer Cassette | 9.250.000 | 5 | 0 | 46.250.000 | PT. HOSPI NIAGA UTAMA |
| 799 | Obat Program Jaminan Kesehatan | Tramadol Injeksi 50 mg/ml | 2.900 | 6.000 | 0 | 17.400.000 | PT. Interbat |
| 800 | Obat Program Jaminan Kesehatan | Omeprazol/Omeprazole/ Omeoprazole Sodium inj 40 mg | 5.093 | 12.000 | 0 | 61.116.000 | PT. Mahakam Beta Farma |
| 801 | Pekerjaan Konstruksi Pemeliharaan Bangunan Gedung Provinsi Jawa Timur | Pemasangan Atap U_PVC | 230.000 | 166 | 0 | 38.180.000 | CV.KARYA LANGGENG |
| 802 | Fasilitas Kesehatan | Cetricide 30 | 488.400 | 5 | 0 | 2.442.000 | Samudra Medika Laboratories |
| 803 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Safety Box 5 L | 15.428 | 500 | 0 | 7.714.000 | PT. Likuid Pharmalab Indonesia |
| 804 | Fasilitas Kesehatan Sektoral Kemenkes | bayMEDIKA Enzymatic Detergent 5 L | 1.300.600 | 5 | 0 | 6.503.000 | PT. Likuid Pharmalab Indonesia |
| 805 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 5 | 0 | 1.394.495 | PT. Likuid Pharmalab Indonesia |
| 806 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4% ukuran 500 ml | 30.725 | 300 | 0 | 9.217.500 | PT. Likuid Pharmalab Indonesia |
| 807 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Blood Transfusion Set | 8.075 | 2.000 | 0 | 16.150.000 | PT. BUANA INTIPRIMA USAHA |
| 808 | Fasilitas Kesehatan Sektoral Kemenkes | BIOMED CSF FLOW CONTROL VALVE BURR-HOLE, 16MM, LOW PRESSURE | 5.311.350 | 2 | 0 | 10.622.700 | Ganes Global Medika |
| 809 | Fasilitas Kesehatan Sektoral Kemenkes | MAX-CORE Disposable Core Biopsy Instrument 18 g x 20 cm | 961.530 | 1 | 0 | 961.530 | PT. PRO HEALTH INTERNATIONAL |
| 810 | Fasilitas Kesehatan | CUTIMED SORBACT Swab 7 x 9cm | 3.356.700 | 1 | 0 | 3.356.700 | PT. ESSITY HYGIENE AND HEALTH INDONESIA |
| 811 | Fasilitas Kesehatan | 20 cm x 5 m | 159.124 | 72 | 0 | 11.456.928 | PT Sinaraya Nugraha Ahmadaris Medika |
| 812 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Endoscopic Trocar FLTC12 | 935.064 | 3 | 0 | 2.805.192 | PT. EDISON DUTA SARANA |
| 813 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Endoscopic Trocar FLTC5 | 935.064 | 3 | 0 | 2.805.192 | PT. EDISON DUTA SARANA |
| 814 | Konsolidasi Obat | Risedronat tab sal selaput 35 mg | 29.645 | 360 | 0 | 10.672.200 | PT KALBE FARMA Tbk |
| 815 | Fasilitas Kesehatan | EQUICEL Oxidised Regenerated Cellulose Gauze 5 x 7,5cm | 89.910 | 60 | 0 | 5.394.600 | PT. BINTANG SHAFWAN |
| 816 | Fasilitas Kesehatan Sektoral Kemenkes | EQUISPON Absorbable Gelatin Sponge 80x50x10mm | 66.483 | 60 | 0 | 3.988.980 | PT. BINTANG SHAFWAN |
| 817 | Fasilitas Kesehatan Sektoral Kemenkes | EQUIWAX Bone wax 2,5 grams | 72.527 | 30 | 0 | 2.175.810 | PT. BINTANG SHAFWAN |
| 818 | Fasilitas Kesehatan Sektoral Kemenkes | OYICARE Alkohol 70% 1000ML | 20.000 | 120 | 0 | 2.400.000 | FIRDAUS INDAH SANTOSA |
| 819 | Obat Program Jaminan Kesehatan | Procainebenzylpenicillin / Prokain Benzilpenisilin serbuk injeksi 3 juta IU (i.m) | 17.982 | 100 | 0 | 1.798.200 | PT.Meiji Indonesia |
| 820 | Obat Program Jaminan Kesehatan | Generik Kombinasi: Ampisilin 1000 mg + Sulbaktam 500 mg serb inj 1500 mg | 20.000 | 300 | 0 | 6.000.000 | PT.Meiji Indonesia |
| 821 | Obat Program Kesehatan Lainnya | ARIPIPRAZOL10 | 9.990 | 5.000 | 0 | 49.950.000 | PT. Amarox Pharma Global |
| 822 | Obat Program Jaminan Kesehatan | Eritromisin/ Erythromycin/tablet/kapsul/kaplet 500 mg | 1.439 | 1.500 | 0 | 2.158.500 | PT Yarindo Farmatama |
| 823 | Fasilitas Kesehatan Sektoral Kemenkes | IALURIL PREFILL | 1.533.187,6 | 10 | 0 | 15.331.876 | PT DIPA PHARMALAB INTERSAINS |
| 824 | Konsolidasi Obat | Pregabalin kaps 75 mg | 1.013 | 10.020 | 0 | 10.150.260 | P.T. Dexa Medica |
| 825 | Konsolidasi Obat | Vildagliptin tab 50 mg | 1.754 | 300 | 0 | 526.200 | P.T. Dexa Medica |
| 826 | Fasilitas Kesehatan Sektoral Kemenkes | CERTOFIX Duo P S513 - Akses Vena Sentral | 747.162 | 1 | 0 | 747.162 | PT. B.BRAUN MEDICAL INDONESIA |
| 827 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 6,5 | 250.000 | 2 | 0 | 500.000 | PT Jayamas Medica Industri |
| 828 | Bahan Pokok Provinsi Jawa Timur | ABON | 105.000 | 35 | 0 | 3.675.000 | CV MULYA JAYA ABADI |
| 829 | Bahan Pokok Provinsi Jawa Timur | AGAR-AGAR | 7.500 | 24 | 0 | 180.000 | CV MULYA JAYA ABADI |
| 830 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL 120ML | 30.000 | 20 | 0 | 600.000 | CV MULYA JAYA ABADI |
| 831 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL 330ML | 4.500 | 840 | 0 | 3.780.000 | CV MULYA JAYA ABADI |
| 832 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL GELAS | 42.000 | 40 | 0 | 1.680.000 | CV MULYA JAYA ABADI |
| 833 | Bahan Pokok Provinsi Jawa Timur | AIR MINERAL ISI ULANG GALON | 29.000 | 25 | 0 | 725.000 | CV MULYA JAYA ABADI |
| 834 | Bahan Pokok Provinsi Jawa Timur | BERAS BRAMU SUPER | 20.000 | 900 | 0 | 18.000.000 | CV MULYA JAYA ABADI |
| 835 | Bahan Pokok Provinsi Jawa Timur | BISKUIT GABIN | 8.500 | 50 | 0 | 425.000 | CV MULYA JAYA ABADI |
| 836 | Bahan Pokok Provinsi Jawa Timur | ROTI KABIN CRACKERS | 21.000 | 5 | 0 | 105.000 | CV MULYA JAYA ABADI |
| 837 | Bahan Pokok Provinsi Jawa Timur | GARAM | 7.000 | 160 | 0 | 1.120.000 | CV MULYA JAYA ABADI |
| 838 | Bahan Pokok Provinsi Jawa Timur | GULA BATOK MERAH | 27.000 | 5 | 0 | 135.000 | CV MULYA JAYA ABADI |
| 839 | Bahan Pokok Provinsi Jawa Timur | GULA PASIR | 27.000 | 250 | 0 | 6.750.000 | CV MULYA JAYA ABADI |
| 840 | Bahan Pokok Provinsi Jawa Timur | Kaldu Bubuk | 43.000 | 15 | 0 | 645.000 | CV MULYA JAYA ABADI |
| 841 | Bahan Pokok Provinsi Jawa Timur | KECAP MANIS | 30.000 | 17 | 0 | 510.000 | CV MULYA JAYA ABADI |
| 842 | Bahan Pokok Provinsi Jawa Timur | KEJU | 20.000 | 15 | 0 | 300.000 | CV MULYA JAYA ABADI |
| 843 | Bahan Pokok Provinsi Jawa Timur | Kemiri | 85.000 | 15 | 0 | 1.275.000 | CV MULYA JAYA ABADI |
| 844 | Bahan Pokok Provinsi Jawa Timur | KETUMBAR BUBUK | 23.000 | 2 | 0 | 46.000 | CV MULYA JAYA ABADI |
| 845 | Bahan Pokok Provinsi Jawa Timur | Lada Bubuk | 85.000 | 1 | 0 | 85.000 | CV MULYA JAYA ABADI |
| 846 | Bahan Pokok Provinsi Jawa Timur | MAKARONI SEDANI | 42.000 | 5 | 0 | 210.000 | CV MULYA JAYA ABADI |
| 847 | Bahan Pokok Provinsi Jawa Timur | BLUE BAND 250GR | 16.500 | 30 | 0 | 495.000 | CV MULYA JAYA ABADI |
| 848 | Bahan Pokok Provinsi Jawa Timur | MAYONAISE MAESTRO | 44.000 | 6 | 0 | 264.000 | CV MULYA JAYA ABADI |
| 849 | Bahan Pokok Provinsi Jawa Timur | Minyak Goreng | 25.000 | 264 | 0 | 6.600.000 | CV MULYA JAYA ABADI |
| 850 | Bahan Pokok Provinsi Jawa Timur | Saos Tiram | 70.000 | 1 | 0 | 70.000 | CV MULYA JAYA ABADI |
| 851 | Bahan Pokok Provinsi Jawa Timur | Saos Tomat | 28.000 | 6 | 0 | 168.000 | CV MULYA JAYA ABADI |
| 852 | Bahan Pokok Provinsi Jawa Timur | SUSU BBLR | 160.000 | 7 | 0 | 1.120.000 | CV MULYA JAYA ABADI |
| 853 | Bahan Pokok Provinsi Jawa Timur | Susu Diabetasol Vanila | 280.000 | 6 | 0 | 1.680.000 | CV MULYA JAYA ABADI |
| 854 | Bahan Pokok Provinsi Jawa Timur | SUSU FORMULA SGM | 20.000 | 60 | 0 | 1.200.000 | CV MULYA JAYA ABADI |
| 855 | Bahan Pokok Provinsi Jawa Timur | Susu Kental Manis | 21.000 | 5 | 0 | 105.000 | CV MULYA JAYA ABADI |
| 856 | Bahan Pokok Provinsi Jawa Timur | Susu Khusus Renal | 105.000 | 72 | 0 | 7.560.000 | CV MULYA JAYA ABADI |
| 857 | Bahan Pokok Provinsi Jawa Timur | Susu Neomune | 47.000 | 50 | 0 | 2.350.000 | CV MULYA JAYA ABADI |
| 858 | Bahan Pokok Provinsi Jawa Timur | Susu Panenteral | 39.000 | 40 | 0 | 1.560.000 | CV MULYA JAYA ABADI |
| 859 | Bahan Pokok Provinsi Jawa Timur | SUSU PEPTISOL | 130.000 | 10 | 0 | 1.300.000 | CV MULYA JAYA ABADI |
| 860 | Bahan Pokok Provinsi Jawa Timur | Susu Rendah Laktosa | 155.000 | 5 | 0 | 775.000 | CV MULYA JAYA ABADI |
| 861 | Bahan Pokok Provinsi Jawa Timur | SUSU SKIM | 240.000 | 36 | 0 | 8.640.000 | CV MULYA JAYA ABADI |
| 862 | Bahan Pokok Provinsi Jawa Timur | SUSU SOYA | 82.000 | 3 | 0 | 246.000 | CV MULYA JAYA ABADI |
| 863 | Bahan Pokok Provinsi Jawa Timur | SUSU TETP | 168.000 | 12 | 0 | 2.016.000 | CV MULYA JAYA ABADI |
| 864 | Bahan Pokok Provinsi Jawa Timur | Susu UHT | 12.500 | 108 | 0 | 1.350.000 | CV MULYA JAYA ABADI |
| 865 | Bahan Pokok Provinsi Jawa Timur | SWEETENER NON KALORI | 120.000 | 3 | 0 | 360.000 | CV MULYA JAYA ABADI |
| 866 | Bahan Pokok Provinsi Jawa Timur | TEA | 5.000 | 130 | 0 | 650.000 | CV MULYA JAYA ABADI |
| 867 | Bahan Pokok Provinsi Jawa Timur | TEPUNG BERAS | 20.000 | 70 | 0 | 1.400.000 | CV MULYA JAYA ABADI |
| 868 | Bahan Pokok Provinsi Jawa Timur | TEPUNG TAPIOKA | 20.000 | 2 | 0 | 40.000 | CV MULYA JAYA ABADI |
| 869 | Bahan Pokok Provinsi Jawa Timur | TEPUNG MAIZENA | 13.500 | 3 | 0 | 40.500 | CV MULYA JAYA ABADI |
| 870 | Bahan Pokok Provinsi Jawa Timur | TEPUNG PANIR | 34.000 | 1 | 0 | 34.000 | CV MULYA JAYA ABADI |
| 871 | Bahan Pokok Provinsi Jawa Timur | TEPUNG TERIGU | 20.000 | 48 | 0 | 960.000 | CV MULYA JAYA ABADI |
| 872 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Anggur | 45.500 | 8 | 0 | 364.000 | CV.PEDULI |
| 873 | Bahan Makanan dan Minuman Provinsi Jawa Timur | APEL HIJAU | 22.000 | 8 | 0 | 176.000 | CV.PEDULI |
| 874 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Apel Merah | 58.000 | 5 | 0 | 290.000 | CV.PEDULI |
| 875 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Asem Jawa | 28.000 | 1 | 0 | 28.000 | CV.PEDULI |
| 876 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bakso | 30.000 | 8 | 0 | 240.000 | CV.PEDULI |
| 877 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Ikan bandeng utuh | 47.000 | 100 | 0 | 4.700.000 | CV.PEDULI |
| 878 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bawang Merah kupas | 50.000 | 31 | 0 | 1.550.000 | CV.PEDULI |
| 879 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bawang Putih kupas | 55.000 | 31 | 0 | 1.705.000 | CV.PEDULI |
| 880 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bayam | 2.200 | 800 | 0 | 1.760.000 | CV.PEDULI |
| 881 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Belimbing | 17.000 | 3 | 0 | 51.000 | CV.PEDULI |
| 882 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Blokoli | 20.000 | 35 | 0 | 700.000 | CV.PEDULI |
| 883 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Buncis | 20.000 | 40 | 0 | 800.000 | CV.PEDULI |
| 884 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Cabe Merah | 45.000 | 16 | 0 | 720.000 | CV.PEDULI |
| 885 | Bahan Makanan dan Minuman Provinsi Jawa Timur | ayam potong | 40.000 | 810 | 0 | 32.400.000 | CV.PEDULI |
| 886 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daging Giling (Baksoan) | 80.000 | 88 | 0 | 7.040.000 | CV.PEDULI |
| 887 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daging Sapi | 144.000 | 70 | 0 | 10.080.000 | CV.PEDULI |
| 888 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun Bawang | 30.000 | 8 | 0 | 240.000 | CV.PEDULI |
| 889 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun jeruk | 5.000 | 7 | 0 | 35.000 | CV.PEDULI |
| 890 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Daun pandan | 5.000 | 15 | 0 | 75.000 | CV.PEDULI |
| 891 | Bahan Makanan dan Minuman Provinsi Jawa Timur | DAUN SALAM | 2.000 | 8 | 0 | 16.000 | CV.PEDULI |
| 892 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Ikan dori Fillet | 57.000 | 175 | 0 | 9.975.000 | CV.PEDULI |
| 893 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Gambas | 13.000 | 70 | 0 | 910.000 | CV.PEDULI |
| 894 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jagung | 13.000 | 190 | 0 | 2.470.000 | CV.PEDULI |
| 895 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jahe | 40.000 | 7 | 0 | 280.000 | CV.PEDULI |
| 896 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jambu | 18.000 | 8 | 0 | 144.000 | CV.PEDULI |
| 897 | Bahan Makanan dan Minuman Provinsi Jawa Timur | jamur kuping basah | 10.000 | 10 | 0 | 100.000 | CV.PEDULI |
| 898 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jeruk mandarin | 58.000 | 7 | 0 | 406.000 | CV.PEDULI |
| 899 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Jeruk nipis | 25.000 | 3 | 0 | 75.000 | CV.PEDULI |
| 900 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kacang Panjang | 10.000 | 100 | 0 | 1.000.000 | CV.PEDULI |
| 901 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kangkung | 1.000 | 800 | 0 | 800.000 | CV.PEDULI |
| 902 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kelapa | 13.000 | 70 | 0 | 910.000 | CV.PEDULI |
| 903 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kencur | 40.000 | 1 | 0 | 40.000 | CV.PEDULI |
| 904 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kentang | 30.000 | 250 | 0 | 7.500.000 | CV.PEDULI |
| 905 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Krai | 20.000 | 80 | 0 | 1.600.000 | CV.PEDULI |
| 906 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kulit Pangsit | 27.000 | 2 | 0 | 54.000 | CV.PEDULI |
| 907 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kunci | 19.000 | 1 | 0 | 19.000 | CV.PEDULI |
| 908 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kunyit | 20.000 | 12 | 0 | 240.000 | CV.PEDULI |
| 909 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Air | 20.000 | 100 | 0 | 2.000.000 | CV.PEDULI |
| 910 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Kuning | 25.000 | 10 | 0 | 250.000 | CV.PEDULI |
| 911 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Labu Siam | 10.000 | 100 | 0 | 1.000.000 | CV.PEDULI |
| 912 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Laos | 18.000 | 7 | 0 | 126.000 | CV.PEDULI |
| 913 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Nanas | 12.000 | 2 | 0 | 24.000 | CV.PEDULI |
| 914 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Nugget Ayam | 45.000 | 30 | 0 | 1.350.000 | CV.PEDULI |
| 915 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Paprika | 10.000 | 3 | 0 | 30.000 | CV.PEDULI |
| 916 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pear | 48.000 | 6 | 0 | 288.000 | CV.PEDULI |
| 917 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pepaya | 16.000 | 150 | 0 | 2.400.000 | CV.PEDULI |
| 918 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Ambon | 1.900 | 2.050 | 0 | 3.895.000 | CV.PEDULI |
| 919 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Cavendish | 5.000 | 50 | 0 | 250.000 | CV.PEDULI |
| 920 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang Kepok | 30.000 | 7 | 0 | 210.000 | CV.PEDULI |
| 921 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pisang susu | 24.000 | 150 | 0 | 3.600.000 | CV.PEDULI |
| 922 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pok Coy | 16.000 | 120 | 0 | 1.920.000 | CV.PEDULI |
| 923 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Pre/Seledri | 27.000 | 17 | 0 | 459.000 | CV.PEDULI |
| 924 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sawi Ijo | 1.700 | 420 | 0 | 714.000 | CV.PEDULI |
| 925 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sawi Putih | 18.000 | 130 | 0 | 2.340.000 | CV.PEDULI |
| 926 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Selada | 28.000 | 16 | 0 | 448.000 | CV.PEDULI |
| 927 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Semangka | 19.000 | 130 | 0 | 2.470.000 | CV.PEDULI |
| 928 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Kluwek | 70.000 | 2 | 0 | 140.000 | CV.PEDULI |
| 929 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Melon | 20.000 | 100 | 0 | 2.000.000 | CV.PEDULI |
| 930 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Timun | 18.000 | 41 | 0 | 738.000 | CV.PEDULI |
| 931 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sereh | 14.000 | 6 | 0 | 84.000 | CV.PEDULI |
| 932 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Sosis | 47.000 | 10 | 0 | 470.000 | CV.PEDULI |
| 933 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Snack | 3.500 | 350 | 0 | 1.225.000 | CV.PEDULI |
| 934 | Bahan Makanan dan Minuman Provinsi Jawa Timur | tahu | 1.900 | 3.000 | 0 | 5.700.000 | CV.PEDULI |
| 935 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Taoge Panjang | 14.000 | 12 | 0 | 168.000 | CV.PEDULI |
| 936 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Taoge Pendek | 32.000 | 2 | 0 | 64.000 | CV.PEDULI |
| 937 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Telur Ayam | 30.000 | 260 | 0 | 7.800.000 | CV.PEDULI |
| 938 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Tempe | 2.400 | 2.550 | 0 | 6.120.000 | CV.PEDULI |
| 939 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Terasi | 4.000 | 20 | 0 | 80.000 | CV.PEDULI |
| 940 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Terong | 11.000 | 80 | 0 | 880.000 | CV.PEDULI |
| 941 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Tomat | 20.000 | 38 | 0 | 760.000 | CV.PEDULI |
| 942 | Bahan Makanan dan Minuman Provinsi Jawa Timur | ikan tongkol segar | 44.000 | 160 | 0 | 7.040.000 | CV.PEDULI |
| 943 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Wortel | 20.000 | 410 | 0 | 8.200.000 | CV.PEDULI |
| 944 | Bahan Makanan dan Minuman Provinsi Jawa Timur | bawang bombai | 42.000 | 7 | 0 | 294.000 | CV.PEDULI |
| 945 | Bahan Makanan dan Minuman Provinsi Jawa Timur | JINTENN | 14.000 | 4 | 0 | 56.000 | CV.PEDULI |
| 946 | Bahan Makanan dan Minuman Provinsi Jawa Timur | ROTI TAWAR | 12.000 | 25 | 0 | 300.000 | CV.PEDULI |
| 947 | Bahan Makanan dan Minuman Provinsi Jawa Timur | Bihun putih | 12.000 | 20 | 0 | 240.000 | CV.PEDULI |
| 948 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 1.000 | 0 | 487.290.000 | PT. SINAR RODA UTAMA |
| 949 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 700 | 0 | 341.103.000 | PT. SINAR RODA UTAMA |
| 950 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | PEKERJAAN PENGECATAN INTERIOR GEDUNG | 42.000 | 967 | 0 | 40.614.000 | CV.KARYA LANGGENG |
| 951 | Obat Program Jaminan Kesehatan | Amiodaron inj 50 mg/ml (150 mg/ 3 mL) | 10.620 | 400 | 0 | 4.248.000 | PT Ethica Industri Farmasi |
| 952 | Fasilitas Kesehatan Sektoral Kemenkes | Refill 2x2 g | 440.000 | 5 | 0 | 2.200.000 | PT.MURSMEDIC |
| 953 | Obat Program Jaminan Kesehatan | BEROTEC Fenoterol Hydromide/ Fenoterol HBr aerosol 100 mcg/puff0000 | 81.030 | 300 | 0 | 24.309.000 | PT Tunggal Idaman Abdi |
| 954 | Obat Program Jaminan Kesehatan | Gentamycin / Gentamicin Sulfate Salep Mata | 6.740 | 312 | 0 | 2.102.880 | PT.ERELA |
| 955 | Obat Program Jaminan Kesehatan | GLARITUS Insulin Glargine 100 iu | 74.925 | 500 | 0 | 37.462.500 | PT.INFION |
| 956 | Obat Program Jaminan Kesehatan | METAMIZOLE SODIUM MONOHYDRATE Injeksi | 3.449 | 30.000 | 0 | 103.470.000 | PT. MEPROFARM |
| 957 | Obat Program Jaminan Kesehatan | METRONIDAZOLE BENZOATE Suspensi | 3.765 | 30 | 0 | 112.950 | PT. MEPROFARM |
| 958 | Konsolidasi Obat | Eksemestan tab sal 25 mg | 35.964 | 600 | 0 | 21.578.400 | PT Pratapa Nirmala |
| 959 | Obat Program Jaminan Kesehatan | Nimodipine | 3.950 | 300 | 0 | 1.185.000 | PT Bayer Indonesia |
| 960 | Obat Program Jaminan Kesehatan | Rivaroxaban 15 mg | 24.551 | 56 | 0 | 1.374.856 | PT Bayer Indonesia |
| 961 | Obat Program Jaminan Kesehatan | Rivaroxaban 2o mg | 24.551 | 112 | 0 | 2.749.712 | PT Bayer Indonesia |
| 962 | Obat Program Jaminan Kesehatan | / NIFEDIPIN GITS/TABLET LEPAS LAMBAT | 4.424 | 36.000 | 0 | 159.264.000 | PT Bayer Indonesia |
| 963 | Obat Program Jaminan Kesehatan | Kaptopril/ Captopril tablet/kapsul/kaplet 12,5 mg | 85 | 600 | 0 | 51.000 | P.T. Dexa Medica |
| 964 | Obat Program Jaminan Kesehatan | Ondansetron hydrochloride (HCl)/ Ondansetron HCl dihydrate /Ondansetron inj 2 mg/mL | 1.400 | 30.000 | 0 | 42.000.000 | P.T. Dexa Medica |
| 965 | Obat Program Jaminan Kesehatan | Cotrimoxazole/ Cotrimoksazole/ Kotrimoksazol (dewasa) kombinasi: sulfametoksazol 400 mg + trimetoprim 80 mg (tab/kaptab 480 mg) | 240 | 12.000 | 0 | 2.880.000 | PT. Mersifarma Tirmaku Mercusana |
| 966 | Obat Program Jaminan Kesehatan | Ranitidine hydrochloride (HCl)/ Ranitidin injeksi 25 mg/ml | 1.332 | 29.000 | 0 | 38.628.000 | PT. Mersifarma Tirmaku Mercusana |
| 967 | Obat Program Jaminan Kesehatan | KALIUM DIKLOFENAK TAB 50 MG | 360 | 1.000 | 0 | 360.000 | PT. ZAYN REYCHI ETERNAL |
| 968 | Obat Program Jaminan Kesehatan | MICROGEST 100 MG | 630 | 150 | 0 | 94.500 | PT. ZAYN REYCHI ETERNAL |
| 969 | Obat Program Jaminan Kesehatan | Triamcinolone Acetonide 40mg/ml | 67.500 | 20 | 0 | 1.350.000 | PT. ZAYN REYCHI ETERNAL |
| 970 | Obat Program Jaminan Kesehatan | Deksmedetomidin inj 100 mcg/mL | 108.000 | 300 | 0 | 32.400.000 | PT KALBE FARMA Tbk |
| 971 | Obat Non Jaminan Kesehatan | CLIXID Tablet SS | 779 | 15.000 | 0 | 11.685.000 | PT. Nulab Pharmaceutical Indonesia |
| 972 | Obat Program Jaminan Kesehatan | Midazolam hydrochloride/ Midazolam injeksi 1 mg/ml (i.v.) | 9.778 | 600 | 0 | 5.866.800 | PT Ethica Industri Farmasi |
| 973 | Obat Program Jaminan Kesehatan | Dakarbazin/Dacarbazine inj 200 mg | 272.500 | 10 | 0 | 2.725.000 | PT DIPA PHARMALAB INTERSAINS |
| 974 | Obat Program Jaminan Kesehatan | Streptokinase inj 1,5 juta IU | 3.950.000 | 10 | 0 | 39.500.000 | P.T. Dexa Medica |
| 975 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Blood Transfusion Set | 8.075 | 1.500 | 0 | 12.112.500 | PT. BUANA INTIPRIMA USAHA |
| 976 | Fasilitas Kesehatan | Nessy split, VIO, ICC, ACC, contact surface 85 cm equipotential ring 23 cm, without connecting cable | 37.525 | 20 | 0 | 750.500 | PT Surgika Alkesindo |
| 977 | Fasilitas Kesehatan | NESSY, split, VIO, ICC, ACC, non ERBE units, International contact surface 85 cm, equipotential ring 23 cm, with connecting cable 4 m | 95.000 | 10 | 0 | 950.000 | PT Surgika Alkesindo |
| 978 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 10 | 0 | 2.788.990 | PT. Likuid Pharmalab Indonesia |
| 979 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR12 | 10.767 | 30 | 0 | 323.010 | PT. MEGAH MEDIKA PHARMA |
| 980 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY FR10 | 28.971 | 30 | 0 | 869.130 | PT. MEGAH MEDIKA PHARMA |
| 981 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR14 | 10.767 | 60 | 0 | 646.020 | PT. MEGAH MEDIKA PHARMA |
| 982 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR16 | 10.767 | 100 | 0 | 1.076.700 | PT. MEGAH MEDIKA PHARMA |
| 983 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR18 | 10.767 | 100 | 0 | 1.076.700 | PT. MEGAH MEDIKA PHARMA |
| 984 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR20 | 11.766 | 60 | 0 | 705.960 | PT. MEGAH MEDIKA PHARMA |
| 985 | Fasilitas Kesehatan | BALLON CATHETER 2 WAY FR6 | 38.000 | 10 | 0 | 380.000 | PT. MEGAH MEDIKA PHARMA |
| 986 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY FR8 | 28.971 | 20 | 0 | 579.420 | PT. MEGAH MEDIKA PHARMA |
| 987 | Fasilitas Kesehatan | D73 T-Dio Polydioxanone 1 Loop, 180 cm Round Bodied, 1/2 circle, 48 mm | 148.518 | 120 | 0 | 17.822.160 | PT Medihop |
| 988 | Fasilitas Kesehatan | N90 T-Nylon Nylon 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 55.833 | 480 | 0 | 26.799.840 | PT Medihop |
| 989 | Fasilitas Kesehatan | N32 T-Nylon Nylon 3-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 48.396 | 300 | 0 | 14.518.800 | PT Medihop |
| 990 | Fasilitas Kesehatan | N37 T-Nylon Nylon 4-0, 76 cm Reverse Cutting, 3/8 circle, 18 mm | 48.396 | 72 | 0 | 3.484.512 | PT Medihop |
| 991 | Fasilitas Kesehatan | N62 T-Nylon Nylon 6-0, 45 cm Reverse Cutting, 3/8 circle, 12 mm | 67.821 | 12 | 0 | 813.852 | PT Medihop |
| 992 | Fasilitas Kesehatan | P180 T-Plain Catgut Plain 2-0, 90 cm Round Bodied, 1/2 circle, 37 mm | 56.166 | 120 | 0 | 6.739.920 | PT Medihop |
| 993 | Fasilitas Kesehatan | P86 T-Plain Catgut Plain 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 60.051 | 72 | 0 | 4.323.672 | PT Medihop |
| 994 | Fasilitas Kesehatan | P121 T-Plain Catgut Plain 3-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.604 | 12 | 0 | 751.248 | PT Medihop |
| 995 | Fasilitas Kesehatan | P30 T-Plain Catgut Plain 4-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.937 | 36 | 0 | 2.265.732 | PT Medihop |
| 996 | Fasilitas Kesehatan | S24 T-Silk Silk/Sutera 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 40.737 | 48 | 0 | 1.955.376 | PT Medihop |
| 997 | Fasilitas Kesehatan | S61 T-Silk Silk/Sutera 3-0, 76 cm Round Bodied, 1/2 circle, 17 mm | 46.176 | 48 | 0 | 2.216.448 | PT Medihop |
| 998 | Fasilitas Kesehatan | V5 T-Vio Polyglycolide 3-0, 76 cm Round Bodied, 1/2 circle, 20 mm | 87.135 | 60 | 0 | 5.228.100 | PT Medihop |
| 999 | Fasilitas Kesehatan | M51 T-Mono Polyglecaprone25 3-0, 76 cm Reverse Cutting, 3/8 circle, 24 mm | 107.781 | 12 | 0 | 1.293.372 | PT Medihop |
| 1000 | Fasilitas Kesehatan | S25 T-Silk Silk/Sutera 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 46.620 | 48 | 0 | 2.237.760 | PT Medihop |
| 1001 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP316H) | 5.096.292 | 1 | 0 | 5.096.292 | PT Johnson and Johnson Indonesia Two |
| 1002 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP310H) | 4.356.596 | 1 | 0 | 4.356.596 | PT Johnson and Johnson Indonesia Two |
| 1003 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 1 ML LUER SLIP / 26GX1/2INCH (13MM) | 1.110 | 2.500 | 0 | 2.775.000 | PT. SINAR RODA UTAMA |
| 1004 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 5 ML LUER LOCK WITH NEEDLE 22GX1-1/2INCH (38MM) | 1.110 | 20.400 | 0 | 22.644.000 | PT. SINAR RODA UTAMA |
| 1005 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 22G X 1 INCH (25MM) | 6.660 | 1.000 | 0 | 6.660.000 | PT. SINAR RODA UTAMA |
| 1006 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 20G X 1-1/4 INCH (32MM) | 6.660 | 2.000 | 0 | 13.320.000 | PT. SINAR RODA UTAMA |
| 1007 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 16GX2 INCH (50MM) | 5.550 | 100 | 0 | 555.000 | PT. SINAR RODA UTAMA |
| 1008 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 18G X 1-1/4 INCH (32MM) | 5.550 | 100 | 0 | 555.000 | PT. SINAR RODA UTAMA |
| 1009 | Fasilitas Kesehatan | Medical Recording Chart Paper, Kertas ECG / EKG Paper ukuran 63MM X 100MM X 300 Lembar, Z-Fold (Pack), FDALPHA1000 | 79.200 | 50 | 0 | 3.960.000 | PT. ENDO Indonesia |
| 1010 | Fasilitas Kesehatan Sektoral Kemenkes | CARBON STEEL SCALPEL BLADES / CARBON STEEL BLADES PAGAR 11 / BB511 | 286.582 | 2 | 0 | 573.164 | PT. B.BRAUN MEDICAL INDONESIA |
| 1011 | Fasilitas Kesehatan Sektoral Kemenkes | CARBON STEEL SCALPEL BLADES / CARBON STEEL BLADES PAGAR15 / BB515 | 286.582 | 3 | 0 | 859.746 | PT. B.BRAUN MEDICAL INDONESIA |
| 1012 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Non Rebreathing Oxygen Mask Adult Elongated(XL) | 15.484 | 200 | 0 | 3.096.800 | PT. BUANA INTIPRIMA USAHA |
| 1013 | Fasilitas Kesehatan | ECG Z-Fold Paper 80mm x 90mm x 280sh | 55.000 | 30 | 0 | 1.650.000 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 1014 | Fasilitas Kesehatan | 10 cm x 2.7 m | 27.100 | 48 | 0 | 1.300.800 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1015 | Fasilitas Kesehatan | Pembalut Elastis 7,5 cm x 4,55 m | 23.500 | 240 | 0 | 5.640.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1016 | Fasilitas Kesehatan | Pembalut Elastis 10 cm x 4,55 m | 34.800 | 192 | 0 | 6.681.600 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1017 | Fasilitas Kesehatan | Pembalut Elastis 15 cm x 4,55 m | 45.600 | 240 | 0 | 10.944.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1018 | Fasilitas Kesehatan | 10 cm x 2.7 m | 19.380 | 144 | 0 | 2.790.720 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1019 | Fasilitas Kesehatan | 7.5 cm x 2.7 m | 15.400 | 144 | 0 | 2.217.600 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1020 | Fasilitas Kesehatan | Lap Sponge Abdominal Steril, 45 cm x 45 cm 8 ply isi 1 | 278.388 | 5 | 0 | 1.391.940 | PT Jayamas Medica Industri |
| 1021 | Fasilitas Kesehatan | Kasa Steril 7.5 x 7.5 cm - 16 ply isi 10 LD, 71610 LD | 11.800 | 3.000 | 0 | 35.400.000 | PT Jayamas Medica Industri |
| 1022 | Fasilitas Kesehatan | VITAL-CATH Closed 67120 | 250.500 | 30 | 0 | 7.515.000 | PT Surgika Alkesindo |
| 1023 | Fasilitas Kesehatan Sektoral Kemenkes | PAKET INSTALASI NURSECALL TWO WAY COMMUNICATION (1 TITIK) | 8.929.002 | 41 | 0 | 366.089.082 | PT. SURICON GEMILANG KARYA |
| 1024 | Konsolidasi Obat | Kodein tab 10 mg | 600 | 10.000 | 0 | 6.000.000 | PT. Kimia Farma Tbk |
| 1025 | Konsolidasi Obat | Morfin tab 10 mg | 1.199 | 1.020 | 0 | 1.222.980 | PT. Kimia Farma Tbk |
| 1026 | Obat Program Jaminan Kesehatan | Asam Ibandronat inj 1 mg/ml / Ibandronic Acid | 444.000 | 10 | 0 | 4.440.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1027 | Obat Program Jaminan Kesehatan | Triamcinolone acetonide/ Triamsinolon asetonid inj 10 mg/mL | 33.300 | 20 | 0 | 666.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1028 | Obat Program Jaminan Kesehatan | Lansoprazole inj | 89.632 | 30 | 0 | 2.688.960 | PT Pratapa Nirmala |
| 1029 | Konsolidasi Obat | Lisinopril tab 10 mg | 270 | 6.000 | 0 | 1.620.000 | PT.Bernofarm |
| 1030 | Konsolidasi Obat | Lorazepam tab 2 mg | 1.100 | 12.000 | 0 | 13.200.000 | PT. Mersifarma Tirmaku Mercusana |
| 1031 | Obat Program Jaminan Kesehatan | Morfin Injeksi 10 mg/ml (i.m/s.k/ i.v) | 34.359,5 | 200 | 0 | 6.871.900 | PT. Kimia Farma Tbk |
| 1032 | Fasilitas Kesehatan Sektoral Kemenkes | Ureteral Stent 5.0 FR 26 CM BOTH ENDS OPEN | 372.953 | 40 | 0 | 14.918.120 | PT. EDISON DUTA SARANA |
| 1033 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Endoscopic Trocar FLTC12 | 935.064 | 3 | 0 | 2.805.192 | PT. EDISON DUTA SARANA |
| 1034 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Endoscopic Trocar FLTC5 | 935.064 | 3 | 0 | 2.805.192 | PT. EDISON DUTA SARANA |
| 1035 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR16, 125cm | 7.992 | 150 | 0 | 1.198.800 | PT Jayamas Medica Industri |
| 1036 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR8, 40cm | 7.992 | 50 | 0 | 399.600 | PT Jayamas Medica Industri |
| 1037 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR8, 100cm | 7.992 | 50 | 0 | 399.600 | PT Jayamas Medica Industri |
| 1038 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 6 | 16.428 | 5 | 0 | 82.140 | PT Jayamas Medica Industri |
| 1039 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed Anesthesia Mask Size 5 | 16.428 | 50 | 0 | 821.400 | PT Jayamas Medica Industri |
| 1040 | Fasilitas Kesehatan Sektoral Kemenkes | Eye Protector | 37.000 | 50 | 0 | 1.850.000 | PT Jayamas Medica Industri |
| 1041 | Fasilitas Kesehatan Sektoral Kemenkes | Double Spike | 108.780 | 20 | 0 | 2.175.600 | PT Jayamas Medica Industri |
| 1042 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix T Type A 10x25 cm | 108.780 | 10 | 0 | 1.087.800 | PT Jayamas Medica Industri |
| 1043 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix S IV | 49.728 | 60 | 0 | 2.983.680 | PT Jayamas Medica Industri |
| 1044 | Fasilitas Kesehatan Sektoral Kemenkes | Condom Catheter S | 5.883 | 20 | 0 | 117.660 | PT Jayamas Medica Industri |
| 1045 | Fasilitas Kesehatan Sektoral Kemenkes | Condom Catheter M | 5.883 | 50 | 0 | 294.150 | PT Jayamas Medica Industri |
| 1046 | Fasilitas Kesehatan Sektoral Kemenkes | Condom Catheter Tipe L | 5.883 | 50 | 0 | 294.150 | PT Jayamas Medica Industri |
| 1047 | Fasilitas Kesehatan Sektoral Kemenkes | Cervical Collar | 89.688 | 50 | 0 | 4.484.400 | PT Jayamas Medica Industri |
| 1048 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock | 108.780 | 12 | 0 | 1.305.360 | PT Jayamas Medica Industri |
| 1049 | Fasilitas Kesehatan Sektoral Kemenkes | ID Band Anak Warna Pink | 71.928 | 5 | 0 | 359.640 | PT Jayamas Medica Industri |
| 1050 | Fasilitas Kesehatan Sektoral Kemenkes | ID Band Anak Blue | 71.928 | 5 | 0 | 359.640 | PT Jayamas Medica Industri |
| 1051 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed ID Band Dewasa Pink | 71.928 | 15 | 0 | 1.078.920 | PT Jayamas Medica Industri |
| 1052 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed ID Band Dewasa Blue | 71.928 | 15 | 0 | 1.078.920 | PT Jayamas Medica Industri |
| 1053 | Fasilitas Kesehatan Sektoral Kemenkes | Headstrap Dewasa | 58.608 | 30 | 0 | 1.758.240 | PT Jayamas Medica Industri |
| 1054 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7 | 250.000 | 40 | 0 | 10.000.000 | PT Jayamas Medica Industri |
| 1055 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7,5 | 250.000 | 90 | 0 | 22.500.000 | PT Jayamas Medica Industri |
| 1056 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free 8 | 250.000 | 20 | 0 | 5.000.000 | PT Jayamas Medica Industri |
| 1057 | Fasilitas Kesehatan Sektoral Kemenkes | Hidrogen Peroxide 3 | 27.528 | 20 | 0 | 550.560 | PT Jayamas Medica Industri |
| 1058 | Fasilitas Kesehatan Sektoral Kemenkes | Extension Tube 150 cm Sterile | 6.105 | 500 | 0 | 3.052.500 | PT Jayamas Medica Industri |
| 1059 | Fasilitas Kesehatan Sektoral Kemenkes | Enema Set | 19.758 | 5 | 0 | 98.790 | PT Jayamas Medica Industri |
| 1060 | Fasilitas Kesehatan Sektoral Kemenkes | Arm Sling Comfort M | 18.648 | 75 | 0 | 1.398.600 | PT Jayamas Medica Industri |
| 1061 | Fasilitas Kesehatan Sektoral Kemenkes | Arm Sling Comfort L | 18.648 | 60 | 0 | 1.118.880 | PT Jayamas Medica Industri |
| 1062 | Fasilitas Kesehatan Sektoral Kemenkes | Umbilical Cord Clamp | 89.910 | 3 | 0 | 269.730 | PT Jayamas Medica Industri |
| 1063 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Syringe 20 cc Ec tip without needle | 64.380 | 3 | 0 | 193.140 | PT Jayamas Medica Industri |
| 1064 | Fasilitas Kesehatan Sektoral Kemenkes | Latex Examination Gloves Powder Free Size M | 42.200 | 1.050 | 0 | 44.310.000 | SINAR PANCA MEDIKA |
| 1065 | Fasilitas Kesehatan Sektoral Kemenkes | TRO-SOLUSET ( TROGE) Autostop | 27.096,21 | 100 | 0 | 2.709.621 | PT.GLOBAL DISPOMEDIKA |
| 1066 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Blood Transfusion Set | 8.075 | 2.000 | 0 | 16.150.000 | PT. BUANA INTIPRIMA USAHA |
| 1067 | Fasilitas Kesehatan Sektoral Kemenkes | Oxyflow Dewasa (Nasal oxygen cannula) | 5.400 | 500 | 0 | 2.700.000 | PT Jayamas Medica Industri |
| 1068 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 15 cm x 5 m | 67.488 | 75 | 0 | 5.061.600 | PT Jayamas Medica Industri |
| 1069 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 5 cm x 5 m | 24.198 | 100 | 0 | 2.419.800 | PT Jayamas Medica Industri |
| 1070 | Obat Program Jaminan Kesehatan | Amikasin/Amikacin/Amikacin sulfate injeksi 250 mg/ml | 19.375 | 30 | 0 | 581.250 | PT Ethica Industri Farmasi |
| 1071 | Fasilitas Kesehatan | Plesterin Roll non woven roll 20 cm x 5 m | 79.920 | 20 | 0 | 1.598.400 | PT Jayamas Medica Industri |
| 1072 | Konsolidasi Obat | Kalsitriol Kaps Lunak 0,25 mcg | 1.332 | 10.020 | 0 | 13.346.640 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1073 | Obat Program Jaminan Kesehatan | Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil Dry Syrup | 7.148 | 100 | 0 | 714.800 | PT. MEPROFARM |
| 1074 | Fasilitas Kesehatan Sektoral Kemenkes | TANIYUK Latex Examination Gloves, Powder Free | 42.200 | 1.050 | 0 | 44.310.000 | PT. Anata Watashi Wha |
| 1075 | Fasilitas Kesehatan Sektoral Kemenkes | bayMEDIKA Enzymatic Detergent 5 L | 1.300.600 | 5 | 0 | 6.503.000 | PT. Likuid Pharmalab Indonesia |
| 1076 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Safety Box 5 L | 15.428 | 500 | 0 | 7.714.000 | PT. Likuid Pharmalab Indonesia |
| 1077 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 5 | 0 | 1.394.495 | PT. Likuid Pharmalab Indonesia |
| 1078 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4% ukuran 500 ml | 30.725 | 300 | 0 | 9.217.500 | PT. Likuid Pharmalab Indonesia |
| 1079 | Obat Program Jaminan Kesehatan | Bupivakain inj 0,5% | 51.803 | 500 | 0 | 25.901.500 | PT.Bernofarm |
| 1080 | Obat Program Jaminan Kesehatan | Ioheksol inj 350 mg iodium/ml | 158.111 | 100 | 0 | 15.811.100 | PT.Bernofarm |
| 1081 | Obat Program Jaminan Kesehatan | Ketanaest Injeksi 50 mg/ml | 80.142 | 60 | 0 | 4.808.520 | PT.Bernofarm |
| 1082 | Obat Program Kesehatan Lainnya | Rebamipide 100 mg tablet salut selaput | 1.300 | 1.500 | 0 | 1.950.000 | PT. Interbat |
| 1083 | Obat Program Kesehatan Lainnya | DEXKETOPROFEN TROMETAMOL 25 MG TABLET | 1.526 | 3.500 | 0 | 5.341.000 | PT. Interbat |
| 1084 | Konsolidasi Obat | Eksemestan tab sal 25 mg | 35.964 | 1.200 | 0 | 43.156.800 | PT Pratapa Nirmala |
| 1085 | Obat Program Jaminan Kesehatan | Quetiapine Fumarate / Quetiapin Tablet Pelepasan Lambat 200 mg | 10.131 | 2.000 | 0 | 20.262.000 | PT. Amarox Pharma Global |
| 1086 | Obat Program Jaminan Kesehatan | Analog Insulin Co-Formulation inj 100 IU/ml Ultra Long Acting Insulin Degludec 70U/Rapid Acting Insulin Aspart 30U (kemasan vial, disposable cartridge, penfill cartridge) | 113.018 | 50 | 0 | 5.650.900 | PT Ferron Par Pharmaceuticals |
| 1087 | Konsolidasi Obat | Mesna inj 100 mg/mL | 95.500 | 30 | 0 | 2.865.000 | PT SANBE FARMA |
| 1088 | Fasilitas Kesehatan Sektoral Kemenkes | OXISTER Pro ACLTD Hydrogen Peroxide 7,5% 20000 ml | 5.500.000 | 2 | 0 | 11.000.000 | PT MULTI REZEKI GLOBAL |
| 1089 | Fasilitas Kesehatan | CARESTREAM Dryview DVE Laser Imaging Film 35x43 | 6.697.600 | 8 | 0 | 53.580.800 | PT TAWADA HEALTHCARE - PUSAT |
| 1090 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE M (1200-05 ) | 281.385 | 20 | 0 | 5.627.700 | PT. AMPM HEALTHCARE INDONESIA |
| 1091 | Fasilitas Kesehatan | PORTEX Blue Line Ultra Tracheostomy Kit 7.0 mm ID | 550.000 | 5 | 0 | 2.750.000 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 1092 | Fasilitas Kesehatan | PORTEX Blue Line Ultra Tracheostomy Kit 7.5 mm ID | 550.000 | 3 | 0 | 1.650.000 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 1093 | Fasilitas Kesehatan Sektoral Kemenkes | Maxiflow Anak | 10.323 | 100 | 0 | 1.032.300 | PT Jayamas Medica Industri |
| 1094 | Fasilitas Kesehatan Sektoral Kemenkes | Maxiflow Dewasa | 10.323 | 500 | 0 | 5.161.500 | PT Jayamas Medica Industri |
| 1095 | Fasilitas Kesehatan Sektoral Kemenkes | TERUMO Volumetric Administration Set - TS*M270LA | 49.494 | 200 | 0 | 9.898.800 | TERUMO INDONESIA |
| 1096 | Fasilitas Kesehatan Sektoral Kemenkes | BIOPTIMAL CVC Triple Lmn: 7Fr x 20cm, Kink Resistance Guidewire, Y needle (CVN-703-20Y) | 517.125 | 20 | 0 | 10.342.500 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 1097 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 7.5 | 19.400 | 60 | 0 | 1.164.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1098 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 8.0 | 19.400 | 20 | 0 | 388.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1099 | Fasilitas Kesehatan Sektoral Kemenkes | Guide Wire 0.032 x 150 CM (STRAIGHT TIP) PTFE | 270.500 | 20 | 0 | 5.410.000 | PT. EDISON DUTA SARANA |
| 1100 | Konsolidasi Obat | Valsartan tab 80 mg | 397 | 37.020 | 0 | 14.696.940 | PT. Hexpharm Jaya Laboratories |
| 1101 | Obat Program Jaminan Kesehatan | Natamycin/ Natamisin tts mata 5% (50 mg/ml) | 8.316 | 60 | 0 | 498.960 | PT. CENDO |
| 1102 | Obat Non Jaminan Kesehatan | Polyvinylpyrrolidone 20,00 mg | 7.167 | 600 | 0 | 4.300.200 | PT. CENDO |
| 1103 | Fasilitas Kesehatan Sektoral Kemenkes | IS hCG Pregnancy Rapid Test | 400.000 | 3 | 0 | 1.200.000 | PT. Anugerah Santosa Abadi |
| 1104 | Fasilitas Kesehatan Sektoral Kemenkes | HBsAG Rapid Test MD | 214.500 | 4 | 0 | 858.000 | PT. Anugerah Santosa Abadi |
| 1105 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 700 | 0 | 341.103.000 | PT. SINAR RODA UTAMA |
| 1106 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Adult Elongated (XL) | 16.275 | 300 | 0 | 4.882.500 | PT. BUANA INTIPRIMA USAHA |
| 1107 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Pediatric Elongated (M) | 16.275 | 200 | 0 | 3.255.000 | PT. BUANA INTIPRIMA USAHA |
| 1108 | Fasilitas Kesehatan Sektoral Kemenkes | OYICARE Alkohol 70% 1000ML | 20.000 | 120 | 0 | 2.400.000 | FIRDAUS INDAH SANTOSA |
| 1109 | Fasilitas Kesehatan Sektoral Kemenkes | CERTOFIX Duo P S413 - Akses Vena Sentral | 743.098 | 3 | 0 | 2.229.294 | PT. B.BRAUN MEDICAL INDONESIA |
| 1110 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 1.300 | 0 | 633.477.000 | PT. SINAR RODA UTAMA |
| 1111 | Fasilitas Kesehatan | MINICOLLECT TUBE 9NC Coagulation sodium citrate 3.2% 1mL | 131.081 | 4 | 0 | 524.324 | PT. SABA INDOMEDIKA |
| 1112 | Fasilitas Kesehatan Sektoral Kemenkes | SINGLE USE BONNET SIZE LARGE (1217-10) | 292.206 | 15 | 0 | 4.383.090 | PT. AMPM HEALTHCARE INDONESIA |
| 1113 | Fasilitas Kesehatan Sektoral Kemenkes | SINGLE USE BONNET SIZE MEDIUM (1216-10) | 292.206 | 15 | 0 | 4.383.090 | PT. AMPM HEALTHCARE INDONESIA |
| 1114 | Fasilitas Kesehatan Sektoral Kemenkes | AQUADEST 20 L | 218.000 | 10 | 0 | 2.180.000 | PT BUMI SARANA MAJU |
| 1115 | Fasilitas Kesehatan Sektoral Kemenkes | STERISTAR H2O2 Gas Plasma Indicator model C-1080 | 439.542 | 25 | 0 | 10.988.550 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1116 | Fasilitas Kesehatan Sektoral Kemenkes | STERISTAR Class 5 Integrator model C-1005 | 455.100 | 30 | 0 | 13.653.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1117 | Fasilitas Kesehatan Sektoral Kemenkes | Steril Pouch Roll Tyvex with Indicator 250mm x 100 meter | 2.273.280 | 8 | 0 | 18.186.240 | PT Jayamas Medica Industri |
| 1118 | Fasilitas Kesehatan Sektoral Kemenkes | Steril Pouch Roll Tyvex with Indicator 200mm x 100 meter | 1.507.380 | 8 | 0 | 12.059.040 | PT Jayamas Medica Industri |
| 1119 | Fasilitas Kesehatan Sektoral Kemenkes | Steril Pouch Roll Tyvex with Indicator 400mm x 100 meter | 3.207.900 | 4 | 0 | 12.831.600 | PT Jayamas Medica Industri |
| 1120 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 20 cm x 100 m | 519.960 | 5 | 0 | 2.599.800 | PT Jayamas Medica Industri |
| 1121 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 40 cm x 100 m | 957.600 | 5 | 0 | 4.788.000 | PT Jayamas Medica Industri |
| 1122 | Fasilitas Kesehatan Sektoral Kemenkes | ON-CALL Plus Blood Glucose Test Strip (2x25) | 167.286 | 40 | 0 | 6.691.440 | PT. Mitra Bahagia Citra Medika |
| 1123 | Fasilitas Kesehatan | Medical Recording Chart Paper, Kertas ECG / EKG Paper ukuran 210MM X 280MM X 200 Lembar, Z-Fold (Pack), WA940180000 | 462.000 | 5 | 0 | 2.310.000 | PT. ENDO Indonesia |
| 1124 | Obat Program Jaminan Kesehatan | Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain injeksi 2% | 1.203 | 1.500 | 0 | 1.804.500 | PT.Bernofarm |
| 1125 | Obat Program Jaminan Kesehatan | Budesonid cairan inhalasi 0,5 mg/mL, respoules 2 mL | 15.795 | 800 | 0 | 12.636.000 | PT AstraZeneca Indonesia |
| 1126 | Obat Program Jaminan Kesehatan | D5 1/2NS - Larutan mengandung karbohidrat+elektrolit | 10.268 | 600 | 0 | 6.160.800 | PT SANBE FARMA |
| 1127 | Obat Program Jaminan Kesehatan | D5 1/4NS - Larutan mengandung karbohidrat+elektrolit | 10.268 | 500 | 0 | 5.134.000 | PT SANBE FARMA |
| 1128 | Obat Program Jaminan Kesehatan | Meropenem/ Meropenem Trihydrate serb inj 1.000 mg | 34.000 | 1.500 | 0 | 51.000.000 | PT. Hexpharm Jaya Laboratories |
| 1129 | Obat Program Jaminan Kesehatan | MISOPROSTOL 200 MCG TABLET | 3.608 | 480 | 0 | 1.731.840 | PT. Mahakam Beta Farma |
| 1130 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Mount | 21.978 | 500 | 0 | 10.989.000 | PT Jayamas Medica Industri |
| 1131 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Tip | 145.188 | 7 | 0 | 1.016.316 | PT Jayamas Medica Industri |
| 1132 | Fasilitas Kesehatan Sektoral Kemenkes | Povidone Iodine Larutan Antiseptik 30 ml | 4.481 | 50 | 0 | 224.050 | PT Jayamas Medica Industri |
| 1133 | Fasilitas Kesehatan Sektoral Kemenkes | P146675053 Reservoir | 61.415.000 | 1 | 100.000 | 61.515.000 | PT. INDOMEDIK NIAGA PERKASA |
| 1134 | Fasilitas Kesehatan Sektoral Kemenkes | Nurse Cap | 33.300 | 500 | 0 | 16.650.000 | SINAR PANCA MEDIKA |
| 1135 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 6 | 0 | 1.673.394 | PT. Likuid Pharmalab Indonesia |
| 1136 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 25 cm x 100 m | 646.800 | 8 | 0 | 5.174.400 | PT Jayamas Medica Industri |
| 1137 | Fasilitas Kesehatan | POLYVAC SET 14 FG | 86.580 | 60 | 0 | 5.194.800 | PT. MEGAH MEDIKA PHARMA |
| 1138 | Fasilitas Kesehatan | POLYFLEX IV CANNULA WITH INJECTION PORT 26G X 3/4 INCHI P1019B | 9.933,39 | 2.000 | 0 | 19.866.780 | PT. MEGAH MEDIKA PHARMA |
| 1139 | Fasilitas Kesehatan Sektoral Kemenkes | Alert Snap Yellow Fall Risk 300 EC | 517.800 | 10 | 0 | 5.178.000 | PT. DOCARE LARAS INDONESIA |
| 1140 | Konsolidasi Obat | Omeprazol kaps 20 mg | 215 | 23.010 | 0 | 4.947.150 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 1141 | Fasilitas Kesehatan | C26 T-Chromic Catgut Chromic 2-0, 90 cm Round Bodied, 1/2 circle, 40 mm | 63.714 | 36 | 0 | 2.293.704 | PT Medihop |
| 1142 | Fasilitas Kesehatan | P121 T-Plain Catgut Plain 3-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.604 | 12 | 0 | 751.248 | PT Medihop |
| 1143 | Fasilitas Kesehatan | P30 T-Plain Catgut Plain 4-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.937 | 36 | 0 | 2.265.732 | PT Medihop |
| 1144 | Fasilitas Kesehatan | S84 T-Silk Silk/Sutera 1, 90 cm Round Bodied, 1/2 circle, 40 mm | 55.389 | 60 | 0 | 3.323.340 | PT Medihop |
| 1145 | Fasilitas Kesehatan | S24 T-Silk Silk/Sutera 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 40.737 | 60 | 0 | 2.444.220 | PT Medihop |
| 1146 | Fasilitas Kesehatan | S25 T-Silk Silk/Sutera 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 46.620 | 96 | 0 | 4.475.520 | PT Medihop |
| 1147 | Fasilitas Kesehatan | S21 T-Silk Silk/Sutera 3-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 45.510 | 24 | 0 | 1.092.240 | PT Medihop |
| 1148 | Fasilitas Kesehatan | S61 T-Silk Silk/Sutera 3-0, 76 cm Round Bodied, 1/2 circle, 17 mm | 46.176 | 48 | 0 | 2.216.448 | PT Medihop |
| 1149 | Fasilitas Kesehatan | V15 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 40 mm | 86.691 | 144 | 0 | 12.483.504 | PT Medihop |
| 1150 | Fasilitas Kesehatan | V16 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 48 mm | 86.691 | 60 | 0 | 5.201.460 | PT Medihop |
| 1151 | Fasilitas Kesehatan | V10 T-Vio Polyglycolide 2-0, 90 cm Round Bodied, 1/2 circle, 25 mm | 79.365 | 144 | 0 | 11.428.560 | PT Medihop |
| 1152 | Fasilitas Kesehatan | BV02 T-Hemovine 80x50x10mm | 75.682 | 60 | 0 | 4.540.920 | PT Medihop |
| 1153 | Fasilitas Kesehatan | ORC-01 T-Hemocel Absorbable Hemostatic Sheet uk 5cm x 7.5cm | 75.177 | 30 | 0 | 2.255.310 | PT Medihop |
| 1154 | Konsolidasi Obat | Alopurinol tab 300 mg | 360 | 10.000 | 0 | 3.600.000 | PT. Holi Pharma |
| 1155 | Obat Program Jaminan Kesehatan | Glukosa Larutan Infus 5% , 100 mL | 8.100 | 120 | 0 | 972.000 | PT. Otsuka Indonesia |
| 1156 | Obat Program Jaminan Kesehatan | Larutan mengandung Asam Amino 7% ,total protein 17,5 g, @ 200 mL | 54.620 | 250 | 0 | 13.655.000 | PT. Otsuka Indonesia |
| 1157 | Obat Program Jaminan Kesehatan | Larutan mengandung Elektrolit (Na 130 mEq, K 4 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq) ASERING softbag @ 500 mL | 8.750 | 600 | 0 | 5.250.000 | PT. Otsuka Indonesia |
| 1158 | Obat Program Jaminan Kesehatan | Larutan mengandung Asam Amino (Asam Amino 79.9 g, Total N 12.2 g, Na+ 14 mEq, Cl 94 mEq), @ 500 mL | 74.475 | 24 | 0 | 1.787.400 | PT. Otsuka Indonesia |
| 1159 | Obat Program Jaminan Kesehatan | Larutan mengandung Karbohidrat + Elektrolit (NaCl 0,875 g, KCl 0,75 g, Na Lactat 1,12 g, Dekstrosa monohydrate 14,85 g) , Softbag @ 500 mL | 13.409 | 600 | 0 | 8.045.400 | PT. Otsuka Indonesia |
| 1160 | Konsolidasi Obat | Valproat sir 250 mg/5 ml | 12.210 | 125 | 0 | 1.526.250 | PT. MEPROFARM |
| 1161 | Obat Program Jaminan Kesehatan | Atropin inj 0,25 mg/mL (i.v./s.k.) | 4.117 | 500 | 0 | 2.058.500 | PT Ethica Industri Farmasi |
| 1162 | Obat Program Jaminan Kesehatan | NaCl / Sodium Chloride 0,9% (1000 mL) | 14.985 | 480 | 0 | 7.192.800 | PT SANBE FARMA |
| 1163 | Obat Program Jaminan Kesehatan | Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr, Dekstrosa 27 gr) | 13.320 | 480 | 0 | 6.393.600 | PT SANBE FARMA |
| 1164 | Konsolidasi Obat | Goserelin asetat inj 3,6 mg/depot | 1.052.590 | 50 | 0 | 52.629.500 | PT AstraZeneca Indonesia |
| 1165 | Fasilitas Kesehatan | SPINOCAN 26GX3 1/2 (0.47X88 MM) | 34.248 | 200 | 0 | 6.849.600 | PT. B.BRAUN MEDICAL INDONESIA |
| 1166 | Fasilitas Kesehatan | SPINOCAN 25GX3 1/2 (0.53X88 MM) | 34.248 | 300 | 0 | 10.274.400 | PT. B.BRAUN MEDICAL INDONESIA |
| 1167 | Obat Program Jaminan Kesehatan | Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng oksida 120 mg + sup ad 2 g | 3.250 | 300 | 0 | 975.000 | PT. Kimia Farma Tbk |
| 1168 | Konsolidasi Obat | Kalsium laktat (kalk) tab 500 mg | 84 | 60.000 | 0 | 5.040.000 | PT. Mersifarma Tirmaku Mercusana |
| 1169 | Konsolidasi Obat | Karboplatin inj 10 mg/mL, Vial 45 mL | 275.000 | 10 | 0 | 2.750.000 | PT Ferron Par Pharmaceuticals |
| 1170 | Obat Program Jaminan Kesehatan | CEFOPERAZONE SODIUM Serbuk Injeksi | 10.878 | 60 | 0 | 652.680 | PT. MEPROFARM |
| 1171 | Konsolidasi Obat | Dosetaksel inj 80 mg | 661.189 | 5 | 0 | 3.305.945 | PT. CKD OTTO Pharmaceuticals |
| 1172 | Konsolidasi Obat | Dosetaksel inj 20 mg | 168.214 | 5 | 0 | 841.070 | PT. CKD OTTO Pharmaceuticals |
| 1173 | Konsolidasi Obat | Gemsitabin inj 200 mg | 87.628 | 50 | 0 | 4.381.400 | PT. CKD OTTO Pharmaceuticals |
| 1174 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Bag Liner with solidifier w/Single Tandem Tube, 2000ml | 51.211 | 15 | 0 | 768.165 | PT. ENERGI MEDISTRON |
| 1175 | Fasilitas Kesehatan Sektoral Kemenkes | MM17 T-Hernia Mesh Medium Mesh Square 6cm x 10cm | 152.514 | 12 | 0 | 1.830.168 | PT Medihop |
| 1176 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE L (1200-06 ) | 281.385 | 20 | 0 | 5.627.700 | PT. AMPM HEALTHCARE INDONESIA |
| 1177 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 3.0 | 250.000 | 20 | 0 | 5.000.000 | PT. SARANA LINTAS MEDIKA |
| 1178 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 4.0 | 250.000 | 30 | 0 | 7.500.000 | PT. SARANA LINTAS MEDIKA |
| 1179 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Blood Transfusion Set | 8.075 | 3.000 | 0 | 24.225.000 | PT. BUANA INTIPRIMA USAHA |
| 1180 | Fasilitas Kesehatan Sektoral Kemenkes | CERTOFIX Trio HF V 1220 - Akses Vena Sentral | 991.364 | 3 | 0 | 2.974.092 | PT. B.BRAUN MEDICAL INDONESIA |
| 1181 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED Dermafix Tulle | 31.080 | 100 | 0 | 3.108.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1182 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED ElastoOne Cohesive Bandage lebar 10CM X4M | 18.870 | 10 | 0 | 188.700 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1183 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED ElastoOne Cohesive Bandage lebar 12CM X 4M | 21.090 | 10 | 0 | 210.900 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1184 | Fasilitas Kesehatan Sektoral Kemenkes | Ultrasonic Gel 5 liter | 158.730 | 4 | 0 | 634.920 | PT Jayamas Medica Industri |
| 1185 | Fasilitas Kesehatan Sektoral Kemenkes | Surgical Drape Universal,Standard | 297.780 | 10 | 0 | 2.977.800 | PT Jayamas Medica Industri |
| 1186 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Colostomy Bag | 219.780 | 5 | 0 | 1.098.900 | PT Jayamas Medica Industri |
| 1187 | Fasilitas Kesehatan Sektoral Kemenkes | Plester Ukuran XL | 23.088 | 15 | 0 | 346.320 | PT Jayamas Medica Industri |
| 1188 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 6,5 | 250.000 | 2 | 0 | 500.000 | PT Jayamas Medica Industri |
| 1189 | Fasilitas Kesehatan Sektoral Kemenkes | Extension Tube | 6.105 | 500 | 0 | 3.052.500 | PT Jayamas Medica Industri |
| 1190 | Fasilitas Kesehatan Sektoral Kemenkes | Jackson Rees Dewasa | 235.000 | 25 | 0 | 5.875.000 | PT Jayamas Medica Industri |
| 1191 | Fasilitas Kesehatan Sektoral Kemenkes | Kapas Putih 250 gram | 14.430 | 10 | 0 | 144.300 | PT Jayamas Medica Industri |
| 1192 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed Anesthesia Mask Size 3 | 16.428 | 10 | 0 | 164.280 | PT Jayamas Medica Industri |
| 1193 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 6 | 16.428 | 5 | 0 | 82.140 | PT Jayamas Medica Industri |
| 1194 | Fasilitas Kesehatan Sektoral Kemenkes | M-Y Jelly 5gram, sachet | 50.283 | 75 | 0 | 3.771.225 | PT Jayamas Medica Industri |
| 1195 | Fasilitas Kesehatan Sektoral Kemenkes | Guedel Airway 80 mm disp steril | 14.208 | 20 | 0 | 284.160 | PT Jayamas Medica Industri |
| 1196 | Fasilitas Kesehatan Sektoral Kemenkes | Guedel Airway 90 mm disp steril | 14.208 | 20 | 0 | 284.160 | PT Jayamas Medica Industri |
| 1197 | Fasilitas Kesehatan Sektoral Kemenkes | Guedel Airway 110 mm disp steril | 14.208 | 20 | 0 | 284.160 | PT Jayamas Medica Industri |
| 1198 | Fasilitas Kesehatan Sektoral Kemenkes | Urobag 2000 | 5.000 | 1.000 | 0 | 5.000.000 | PT Jayamas Medica Industri |
| 1199 | Fasilitas Kesehatan Sektoral Kemenkes | Ventiflow Dewasa | 70.818 | 50 | 0 | 3.540.900 | PT Jayamas Medica Industri |
| 1200 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Mount | 21.978 | 200 | 0 | 4.395.600 | PT Jayamas Medica Industri |
| 1201 | Fasilitas Kesehatan Sektoral Kemenkes | Mucus Extractor | 6.438 | 20 | 0 | 128.760 | PT Jayamas Medica Industri |
| 1202 | Fasilitas Kesehatan | Certofix Trio V 720 | 793.777 | 2 | 0 | 1.587.554 | PT. B.BRAUN MEDICAL INDONESIA |
| 1203 | Fasilitas Kesehatan Sektoral Kemenkes | N3 Suction Connecting Tube Standar | 18.000 | 100 | 0 | 1.800.000 | PT BUMI SARANA MAJU |
| 1204 | Fasilitas Kesehatan Sektoral Kemenkes | INNOQ Disposable Bacterial/Viral Filter Adult | 18.000 | 300 | 0 | 5.400.000 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 1205 | Obat Program Jaminan Kesehatan | Albumin serum normal (human Albumin) inj 25% , 50 ml | 800.000 | 40 | 0 | 32.000.000 | PT. DANKOS FARMA |
| 1206 | Fasilitas Kesehatan | Thoracic Trocar Catheter GS-5030 | 120.690 | 5 | 0 | 603.450 | PT. ENDO Indonesia |
| 1207 | Konsolidasi Obat | Kolkisin tab 500 mcg | 1.399 | 1.800 | 0 | 2.518.200 | PT Pratapa Nirmala |
| 1208 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 3.0 | 19.400 | 2 | 0 | 38.800 | PT.Dwiasri Graha (dwigraha medical) |
| 1209 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 3.5 | 19.400 | 2 | 0 | 38.800 | PT.Dwiasri Graha (dwigraha medical) |
| 1210 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 7.0 | 19.400 | 60 | 0 | 1.164.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1211 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 4.0 | 19.400 | 3 | 0 | 58.200 | PT.Dwiasri Graha (dwigraha medical) |
| 1212 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 7.5 | 19.400 | 30 | 0 | 582.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1213 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 8.0 | 19.400 | 5 | 0 | 97.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1214 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 24GX 1 INCH (25MM) | 6.593,4 | 1.000 | 0 | 6.593.400 | PT. SINAR RODA UTAMA |
| 1215 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 20G X 1-1/4 INCH (32MM) | 6.593,4 | 1.000 | 0 | 6.593.400 | PT. SINAR RODA UTAMA |
| 1216 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 18G X 1-1/4 INCH (32MM) | 6.593,4 | 3.000 | 0 | 19.780.200 | PT. SINAR RODA UTAMA |
| 1217 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 10 ML LUER LOCK WITH NEEDLE 21GX1-1/2INCH (38MM) | 1.428,57 | 15.000 | 0 | 21.428.550 | PT. SINAR RODA UTAMA |
| 1218 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 16GX2 INCH (50MM) | 5.494,5 | 150 | 0 | 824.175 | PT. SINAR RODA UTAMA |
| 1219 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 20GX1-1/4 INCH (32MM) | 5.494,5 | 100 | 0 | 549.450 | PT. SINAR RODA UTAMA |
| 1220 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 3 ML LUER LOCK WITH NEEDLE 23GX1-1/4INCH (32MM) | 989,01 | 14.400 | 0 | 14.241.744 | PT. SINAR RODA UTAMA |
| 1221 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Mobilisasi dan Demobilisasi | 3.690.750 | 1 | 0 | 3.690.750 | CV. DWI KARYA CEMERLANG |
| 1222 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Pengurasan dan Pembersihan Equalisasi, Reaktor, Media Biofilter | 67.171.650 | 1 | 0 | 67.171.650 | CV. DWI KARYA CEMERLANG |
| 1223 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Tutup Manhole Fiberglass 70 x 70 cm | 1.328.000 | 12 | 0 | 15.936.000 | CV. DWI KARYA CEMERLANG |
| 1224 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Tutup Manhole Fiberglass 130 x 80 cm | 1.993.000 | 1 | 0 | 1.993.000 | CV. DWI KARYA CEMERLANG |
| 1225 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Tutup Manhole Fiberglass 70 x 40 cm | 1.107.225 | 8 | 0 | 8.857.800 | CV. DWI KARYA CEMERLANG |
| 1226 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Tutup Manhole Fiberglass 62 x 150 cm | 1.993.000 | 4 | 0 | 7.972.000 | CV. DWI KARYA CEMERLANG |
| 1227 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Dosing Pump Createc E0309 3bar 9L/jam + Instalasi IP09 | 6.643.000 | 1 | 0 | 6.643.000 | CV. DWI KARYA CEMERLANG |
| 1228 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Sedot WC + Pembuangan | 1.845.375 | 32,5 | 0 | 59.974.687,5 | CV. DWI KARYA CEMERLANG |
| 1229 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | Tutup Pengaman Terpal Tinggi 2 Meter | 21.000 | 200 | 0 | 4.200.000 | CV. DWI KARYA CEMERLANG |
| 1230 | Fasilitas Kesehatan Sektoral Kemenkes | bayMEDIKA Enzymatic Detergent 5 L | 1.300.600 | 10 | 0 | 13.006.000 | PT. Likuid Pharmalab Indonesia |
| 1231 | Fasilitas Kesehatan Sektoral Kemenkes | CETRIMED Lite Desinfektan | 351.870 | 10 | 0 | 3.518.700 | Samudra Medika Laboratories |
| 1232 | Fasilitas Kesehatan Sektoral Kemenkes | CENDO ASTHENOF 5ML | 20.979 | 12 | 0 | 251.748 | GREAT MATARAM |
| 1233 | Fasilitas Kesehatan Sektoral Kemenkes | CENDO CATARLENT EYE DROP 15ML | 30.595 | 60 | 0 | 1.835.700 | GREAT MATARAM |
| 1234 | Fasilitas Kesehatan Sektoral Kemenkes | CENDO LYTEERS EYE DROP 15ML | 22.478 | 24 | 0 | 539.472 | GREAT MATARAM |
| 1235 | Fasilitas Kesehatan Sektoral Kemenkes | CENDO STATROL 5ML | 18.232 | 12 | 0 | 218.784 | GREAT MATARAM |
| 1236 | Fasilitas Kesehatan Sektoral Kemenkes | CENDO VITROLENTA | 32.717 | 30 | 0 | 981.510 | GREAT MATARAM |
| 1237 | Fasilitas Kesehatan Sektoral Kemenkes | CENDO XITROL 5ML | 27.223 | 36 | 0 | 980.028 | GREAT MATARAM |
| 1238 | Pemeliharaan Bangunan Gedung Pemerintah Daerah Kabupaten Mojokerto | PENGECATAN PLAFON INTERIOR GEDUNG | 40.000 | 649,23 | 0 | 25.969.200 | CV.KARYA LANGGENG |
| 1239 | Konsolidasi Obat | Irinotekan inj 20 mg/mL, Vial 5 mL | 313.000 | 10 | 0 | 3.130.000 | PT SANBE FARMA |
| 1240 | Konsolidasi Obat | Vinkristin inj 1 mg/mL, Vial 2 mL | 92.875 | 5 | 0 | 464.375 | PT SANBE FARMA |
| 1241 | Obat Non Jaminan Kesehatan | MECOBALAMIN / MEKOBALAMIN 500 MCG | 430 | 40.000 | 0 | 17.200.000 | PT. Graha Farma |
| 1242 | Konsolidasi Obat | Gliseril trinitrat kaps lepas lambat 5 mg | 2.530 | 20.000 | 0 | 50.600.000 | PT. Kimia Farma Tbk |
| 1243 | Obat Non Jaminan Kesehatan | Pantoprazole 40 mg Kaplet Salut Enterik | 3.500 | 140 | 0 | 490.000 | PT. Interbat |
| 1244 | Obat Non Jaminan Kesehatan | DAILY C 500 MG / VITAMIN C 500 MG | 380 | 6.000 | 0 | 2.280.000 | PT. Interbat |
| 1245 | Obat Program Jaminan Kesehatan | PEHACAIN / Lidocaine Hydrochloride | 3.151 | 2.000 | 0 | 6.302.000 | PT.Phapros Tbk |
| 1246 | Konsolidasi Obat | Pramipeksol tab lepas lambat 0,750 mg | 8.541 | 600 | 0 | 5.124.600 | PT. SOHO Industri Pharmasi |
| 1247 | Fasilitas Kesehatan | Cetrimed | 1.309.800 | 10 | 0 | 13.098.000 | Samudra Medika Laboratories |
| 1248 | Fasilitas Kesehatan | Antiseptik & Desinfektan | 715.395 | 10 | 0 | 7.153.950 | Samudra Medika Laboratories |
| 1249 | Konsolidasi Obat | Propranolol tab 40 mg | 120 | 3.000 | 0 | 360.000 | PT. Holi Pharma |
| 1250 | Obat Program Jaminan Kesehatan | Analog Insulin Co-Formulation inj 100 IU/ml Ultra Long Acting Insulin Degludec 70U/Rapid Acting Insulin Aspart 30U (kemasan vial, disposable cartridge, penfill cartridge) | 113.018 | 50 | 0 | 5.650.900 | PT Ferron Par Pharmaceuticals |
| 1251 | Obat Program Jaminan Kesehatan | Sedang Disinkronkan | 53.550 | 400 | 0 | 21.420.000 | PT. FINUSOLPRIMA FARMA INTERNASIONAL |
| 1252 | Konsolidasi Obat | Risedronat tab sal selaput 35 mg | 29.645 | 200 | 0 | 5.929.000 | PT KALBE FARMA Tbk |
| 1253 | Konsolidasi Obat | Risperidon tab 3 mg | 324 | 2.500 | 0 | 810.000 | P.T. Dexa Medica |
| 1254 | Konsolidasi Obat | Terazosin tab 1 mg | 580 | 600 | 0 | 348.000 | P.T. Dexa Medica |
| 1255 | Obat Program Jaminan Kesehatan | Rocuronium bromide/ Rokuronium inj 10 mg/ml | 53.000 | 30 | 0 | 1.590.000 | P.T. Dexa Medica |
| 1256 | Konsolidasi Obat | Epirubisin inj 2 mg/mL, ampul/vial 5 mL | 79.966 | 100 | 0 | 7.996.600 | PT. CKD OTTO Pharmaceuticals |
| 1257 | Konsolidasi Obat | Epirubisin inj 2 mg/mL, ampul/vial 25 mL | 395.195 | 50 | 0 | 19.759.750 | PT. CKD OTTO Pharmaceuticals |
| 1258 | Konsolidasi Obat | Paklitaksel inj 6 mg/mL, Vial 16,7 mL | 136.500 | 50 | 0 | 6.825.000 | PT FONKO INTERNATIONAL PHARMACEUTICALS |
| 1259 | Konsolidasi Obat | Paklitaksel inj 6 mg/mL, Vial 5 mL | 108.000 | 50 | 0 | 5.400.000 | PT FONKO INTERNATIONAL PHARMACEUTICALS |
| 1260 | Konsolidasi Obat | Vitamin B kompleks mengandung, a. Vitamin B1 b. Vitamin B6 c. Vitamin B12 tab | 60 | 30.000 | 0 | 1.800.000 | PT. MARIN LIZA FARMASI |
| 1261 | Konsolidasi Obat | Tiamin (Vitamin B1) tab 50 mg* | 78 | 500 | 0 | 39.000 | PT. MARIN LIZA FARMASI |
| 1262 | Fasilitas Kesehatan Sektoral Kemenkes | SURGIPATH 10 Neutral Buffered Formalin | 399.600 | 16 | 0 | 6.393.600 | PT.BIOGEN SCIENTIFIC |
| 1263 | Konsolidasi Obat | Salbutamol tab 2 mg | 62 | 30.000 | 0 | 1.860.000 | PT.Imfarmind Farmasi Industri |
| 1264 | Obat Program Jaminan Kesehatan | Salbutamol sulfate/ Salbutamol tablet/kapsul/kaplet 2 mg-KF | 77 | 30.000 | 0 | 2.310.000 | PT. Kimia Farma Tbk |
| 1265 | Obat Non Jaminan Kesehatan | Salbutamol tab 4 mg | 136 | 25.000 | 0 | 3.400.000 | PT.Imfarmind Farmasi Industri |
| 1266 | Obat Program Jaminan Kesehatan | NaCl 3% Larutan, Softbag @ 500 mL | 36.101 | 140 | 0 | 5.054.140 | PT. Otsuka Indonesia |
| 1267 | Konsolidasi Obat | Timolol tts mata 0,5% | 12.100 | 120 | 0 | 1.452.000 | PT Ferron Par Pharmaceuticals |
| 1268 | Konsolidasi Obat | Kalsium folinat (leucovorin, Ca) inj 10 mg/mL | 22.220 | 30 | 0 | 666.600 | PT Ferron Par Pharmaceuticals |
| 1269 | Fasilitas Kesehatan | Kasa Steril 7.5 x 7.5 cm - 16 ply isi 10 LD, 71610 LD | 11.800 | 4.980 | 0 | 58.764.000 | PT Jayamas Medica Industri |
| 1270 | Obat Program Jaminan Kesehatan | XR Analog Insulin Basal, Insulin Glargine Inj 300 IU/mL | 140.082 | 100 | 0 | 14.008.200 | PT Aventis Pharma |
| 1271 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Safety Box 5 L | 15.428 | 500 | 0 | 7.714.000 | PT. Likuid Pharmalab Indonesia |
| 1272 | Fasilitas Kesehatan | 20 cm x 5 m | 164.150 | 60 | 0 | 9.849.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1273 | Fasilitas Kesehatan | Pembalut Elastis 7,5 cm x 4,55 m | 23.500 | 240 | 0 | 5.640.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1274 | Fasilitas Kesehatan | Plesterin Roll non woven roll 20 cm x 5 m | 79.920 | 30 | 0 | 2.397.600 | PT Jayamas Medica Industri |
| 1275 | Fasilitas Kesehatan | Electrosurgical Return Electrodes/Valleylab REM Polyhesive Adult Cordless Patient Return Electrode /E7509 | 52.800 | 60 | 0 | 3.168.000 | PT. Medtronic Indonesia |
| 1276 | Fasilitas Kesehatan Sektoral Kemenkes | Indodent Saliva Ejector | 43.068 | 10 | 0 | 430.680 | PT Jayamas Medica Industri |
| 1277 | Fasilitas Kesehatan Sektoral Kemenkes | Dental Bib Bag isi 125 pcs | 58.608 | 8 | 0 | 468.864 | PT Jayamas Medica Industri |
| 1278 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 10 cm x 5 m | 41.958 | 100 | 0 | 4.195.800 | PT Jayamas Medica Industri |
| 1279 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Syringe 50 cc Ec tip without needle | 75.258 | 10 | 0 | 752.580 | PT Jayamas Medica Industri |
| 1280 | Fasilitas Kesehatan | Bone Wax | 1.321.424 | 1 | 0 | 1.321.424 | PT. B.BRAUN MEDICAL INDONESIA |
| 1281 | Fasilitas Kesehatan | D73 T-Dio Polydioxanone 1 Loop, 180 cm Round Bodied, 1/2 circle, 48 mm | 148.518 | 120 | 0 | 17.822.160 | PT Medihop |
| 1282 | Fasilitas Kesehatan Sektoral Kemenkes | GRIFOLS DG Gel Coombs | 3.929.400 | 2 | 0 | 7.858.800 | PT Frismed Hoslab Indonesia |
| 1283 | Fasilitas Kesehatan Sektoral Kemenkes | DG Gel Sol | 1.265.400 | 2 | 0 | 2.530.800 | PT Frismed Hoslab Indonesia |
| 1284 | Fasilitas Kesehatan Sektoral Kemenkes | Refill 2x2 g | 440.000 | 6 | 0 | 2.640.000 | PT.MURSMEDIC |
| 1285 | Fasilitas Kesehatan Sektoral Kemenkes | N-Flow Bulk Fill Ref. 1x2g IVA | 415.000 | 10 | 0 | 4.150.000 | PT.MURSMEDIC |
| 1286 | Fasilitas Kesehatan Sektoral Kemenkes | N-Ceram Bulk Fill Ref. 1x3.5g IVA | 680.000 | 10 | 0 | 6.800.000 | PT.MURSMEDIC |
| 1287 | Fasilitas Kesehatan Sektoral Kemenkes | Anaesthetic Breathing System, Mapelson C Pediatric 1,8m 1L Bag | 268.897,5 | 3 | 0 | 806.692,5 | PT. SARANA LINTAS MEDIKA |
| 1288 | Fasilitas Kesehatan | Nessy split, VIO, ICC, ACC, contact surface 85 cm equipotential ring 23 cm, without connecting cable | 37.525 | 20 | 0 | 750.500 | PT Surgika Alkesindo |
| 1289 | Fasilitas Kesehatan | NESSY, split, VIO, ICC, ACC, non ERBE units, International contact surface 85 cm, equipotential ring 23 cm, with connecting cable 4 m | 95.000 | 10 | 0 | 950.000 | PT Surgika Alkesindo |
| 1290 | Fasilitas Kesehatan | ALTECH Single Heated Wire Circuit - AL 4411-020/2.V.001 | 714.400 | 2 | 0 | 1.428.800 | PT Surgika Alkesindo |
| 1291 | Obat Program Jaminan Kesehatan | CO-AMOXICLAV Film Coated Tablet | 2.988 | 1.320 | 0 | 3.944.160 | PT. MEPROFARM |
| 1292 | Konsolidasi Obat | Leuprorelin asetat serb inj 3,75 mg | 720.000 | 3 | 0 | 2.160.000 | PT KALBE FARMA Tbk |
| 1293 | Obat Program Jaminan Kesehatan | Analog Insulin : insulin basal injeksi 100 IU/mL | 74.000 | 100 | 0 | 7.400.000 | PT KALBE FARMA Tbk |
| 1294 | Fasilitas Kesehatan Sektoral Kemenkes | Surgical Mask Earloop Plus, 3 ply | 14.000 | 1.000 | 0 | 14.000.000 | PT Jayamas Medica Industri |
| 1295 | Fasilitas Kesehatan Sektoral Kemenkes | Surgical Face Mask Ear Loop | 13.000 | 1.000 | 0 | 13.000.000 | PT. MEGAH MEDIKA PHARMA |
| 1296 | Fasilitas Kesehatan Sektoral Kemenkes | Steam Sterilization Indicator Tape (Biru) | 45.510 | 30 | 0 | 1.365.300 | PT Jayamas Medica Industri |
| 1297 | Fasilitas Kesehatan Sektoral Kemenkes | Plasma Indicator Tape | 65.490 | 30 | 0 | 1.964.700 | PT Jayamas Medica Industri |
| 1298 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 1.200 | 0 | 584.748.000 | PT. SINAR RODA UTAMA |
| 1299 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 800 | 0 | 389.832.000 | PT. SINAR RODA UTAMA |
| 1300 | Fasilitas Kesehatan Sektoral Kemenkes | PDS Plus (PDP127H) | 7.175.817 | 1 | 0 | 7.175.817 | PT Johnson and Johnson Indonesia Two |
| 1301 | Fasilitas Kesehatan Sektoral Kemenkes | Surgipath Reagent Alcohol | 488.400 | 12 | 0 | 5.860.800 | PT.BIOGEN SCIENTIFIC |
| 1302 | Fasilitas Kesehatan Sektoral Kemenkes | SURGIPATH EOSIN | 277.500 | 2 | 0 | 555.000 | PT.BIOGEN SCIENTIFIC |
| 1303 | Fasilitas Kesehatan Sektoral Kemenkes | Harris Hematoxyline (LEICA) | 410.700 | 2 | 0 | 821.400 | PT.BIOGEN SCIENTIFIC |
| 1304 | Fasilitas Kesehatan Sektoral Kemenkes | LEICA PARAPLAST | 288.600 | 20 | 0 | 5.772.000 | PT.BIOGEN SCIENTIFIC |
| 1305 | Fasilitas Kesehatan Sektoral Kemenkes | LEICA : LEICA Slide White Apex Superior Adhesive | 910.200 | 2 | 0 | 1.820.400 | PT.BIOGEN SCIENTIFIC |
| 1306 | Fasilitas Kesehatan Sektoral Kemenkes | ON-CALL Plus Blood Glucose Test Strip (2x25) | 167.286 | 50 | 0 | 8.364.300 | PT. Mitra Bahagia Citra Medika |
| 1307 | Fasilitas Kesehatan Sektoral Kemenkes | LEICA BOND Ready-to-Use Primary Antibody c-erbB-2 Oncoprotein | 2.164.500 | 1 | 0 | 2.164.500 | PT.BIOGEN SCIENTIFIC |
| 1308 | Fasilitas Kesehatan | LEICA BOND Ready-to-Use (RTU) Primary Antibody Progesterone Receptor (16) | 2.264.400 | 1 | 0 | 2.264.400 | PT.BIOGEN SCIENTIFIC |
| 1309 | Fasilitas Kesehatan | LEICA BOND Ready-to-Use (RTU) Primary Antibody Estrogen Receptor (6F11) | 2.264.400 | 1 | 0 | 2.264.400 | PT.BIOGEN SCIENTIFIC |
| 1310 | Fasilitas Kesehatan | LEICA BOND Ki67 (MM1) | 2.164.500 | 1 | 0 | 2.164.500 | PT.BIOGEN SCIENTIFIC |
| 1311 | Fasilitas Kesehatan | LEICA BOND Epitope Retrieval Solution 2 | 3.485.400 | 1 | 0 | 3.485.400 | PT.BIOGEN SCIENTIFIC |
| 1312 | Fasilitas Kesehatan | LEICA BOND Epitope Retrieval Solution 1 | 3.030.300 | 1 | 0 | 3.030.300 | PT.BIOGEN SCIENTIFIC |
| 1313 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 15 cm x 5 m | 67.488 | 100 | 0 | 6.748.800 | PT Jayamas Medica Industri |
| 1314 | Fasilitas Kesehatan Sektoral Kemenkes | Oxyflow Dewasa (Nasal oxygen cannula) | 5.400 | 750 | 0 | 4.050.000 | PT Jayamas Medica Industri |
| 1315 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock | 108.780 | 2 | 0 | 217.560 | PT Jayamas Medica Industri |
| 1316 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Tip | 145.188 | 10 | 0 | 1.451.880 | PT Jayamas Medica Industri |
| 1317 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix S IV | 49.728 | 60 | 0 | 2.983.680 | PT Jayamas Medica Industri |
| 1318 | Fasilitas Kesehatan Sektoral Kemenkes | Umbilical Cord Clamp | 89.910 | 3 | 0 | 269.730 | PT Jayamas Medica Industri |
| 1319 | Obat Program Jaminan Kesehatan | Kalsium glukonat/ Calcium gluconate inj 10% | 8.880 | 300 | 0 | 2.664.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1320 | Obat Program Jaminan Kesehatan | Dakarbazin/Dacarbazine inj 200 mg | 272.500 | 10 | 0 | 2.725.000 | PT DIPA PHARMALAB INTERSAINS |
| 1321 | Obat Program Jaminan Kesehatan | Albendazol/ Albendazole tablet/kapsul/kaplet 400 mg | 777 | 100 | 0 | 77.700 | PT. Holi Pharma |
| 1322 | Obat Program Jaminan Kesehatan | Zinc sulfate/ Zinc sulfate monohydrate/Zinc/ Zinc tablet dispersible 20 mg | 256 | 1.500 | 0 | 384.000 | PT. Holi Pharma |
| 1323 | Obat Program Jaminan Kesehatan | Atapulgit tablet/kapsul/kaplet 600 mg | 319 | 1.000 | 0 | 319.000 | PT. Holi Pharma |
| 1324 | Obat Program Jaminan Kesehatan | Zinc sulfate/ Zinc sulfate monohydrate/ Zinc/ Zink sir 20 mg/5 ml | 5.330 | 50 | 0 | 266.500 | PT. Holi Pharma |
| 1325 | Fasilitas Kesehatan | MAK Premium Couch 2 Sections 34219 | 24.775.200 | 1 | 0 | 24.775.200 | PT. MEGA ANDALAN KALASAN |
| 1326 | Fasilitas Kesehatan Sektoral Kemenkes | E-CARE Lubricant Gel | 28.000 | 20 | 0 | 560.000 | PT Enseval Medika Prima |
| 1327 | Fasilitas Kesehatan Sektoral Kemenkes | Ureteral Stent 5.0 FR 26 CM BOTH ENDS OPEN | 372.953 | 50 | 0 | 18.647.650 | PT. EDISON DUTA SARANA |
| 1328 | Fasilitas Kesehatan Sektoral Kemenkes | CUTTING ELECTRODE (SINGLE STEM) S 24 CH | 967.032 | 5 | 0 | 4.835.160 | PT. EDISON DUTA SARANA |
| 1329 | Fasilitas Kesehatan Sektoral Kemenkes | IMASKE Swab Isopropyl Alcohol 70% (by volume) | 7.992 | 720 | 0 | 5.754.240 | PT. Industri Masker Kreatif Teknologi |
| 1330 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR12, 125cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1331 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR14, 125cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1332 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR16, 125cm | 7.992 | 120 | 0 | 959.040 | PT Jayamas Medica Industri |
| 1333 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR18, 125cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1334 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR8, 40cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1335 | Fasilitas Kesehatan Sektoral Kemenkes | OYICARE Alkohol 70% 1000ML | 20.000 | 120 | 0 | 2.400.000 | FIRDAUS INDAH SANTOSA |
| 1336 | Fasilitas Kesehatan Sektoral Kemenkes | Alert Snap Red Allergy 300 EC | 519.797 | 1 | 0 | 519.797 | PT. DOCARE LARAS INDONESIA |
| 1337 | Fasilitas Kesehatan | B107 T-Bond Polyester 2, 4 x 75 cm Heavy Tapercut, 1/2 circle, 48 mm | 212.454 | 24 | 0 | 5.098.896 | PT Medihop |
| 1338 | Fasilitas Kesehatan | L36 T-Lene Polyvinylidene 2-0, 76 cm Round Bodied, 1/2 circle, 30 mm | 82.917 | 24 | 0 | 1.990.008 | PT Medihop |
| 1339 | Fasilitas Kesehatan | N90 T-Nylon Nylon 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 55.833 | 480 | 0 | 26.799.840 | PT Medihop |
| 1340 | Fasilitas Kesehatan | P86 T-Plain Catgut Plain 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 60.051 | 48 | 0 | 2.882.448 | PT Medihop |
| 1341 | Fasilitas Kesehatan | S61 T-Silk Silk/Sutera 3-0, 76 cm Round Bodied, 1/2 circle, 17 mm | 46.176 | 48 | 0 | 2.216.448 | PT Medihop |
| 1342 | Fasilitas Kesehatan | S77 T-Silk Silk/Sutera 4-0, 76 cm Reverse Cutting, 3/8 circle, 19 mm | 45.843 | 12 | 0 | 550.116 | PT Medihop |
| 1343 | Fasilitas Kesehatan | V10 T-Vio Polyglycolide 2-0, 90 cm Round Bodied, 1/2 circle, 25 mm | 79.365 | 144 | 0 | 11.428.560 | PT Medihop |
| 1344 | Fasilitas Kesehatan | SILKPRO H40802 | 50.000 | 24 | 0 | 1.200.000 | PT. Efada Medical Industries Indonesia |
| 1345 | Fasilitas Kesehatan Sektoral Kemenkes | Nam Medical Spalk First Aid 40 x 7 | 12.650 | 40 | 0 | 506.000 | PT Mulawarman Kesada Medicalindo |
| 1346 | Fasilitas Kesehatan Sektoral Kemenkes | Nam Medical Spalk First Aid 60 x 10 x 8 | 22.350 | 60 | 0 | 1.341.000 | PT Mulawarman Kesada Medicalindo |
| 1347 | Fasilitas Kesehatan Sektoral Kemenkes | NAM MEDICAL SPALK FIRST AID 90 X 10 X 8 | 28.050 | 60 | 0 | 1.683.000 | PT Mulawarman Kesada Medicalindo |
| 1348 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 10 | 0 | 2.788.990 | PT. Likuid Pharmalab Indonesia |
| 1349 | Fasilitas Kesehatan Sektoral Kemenkes | Clean Enzymatic Plus | 2.631.810 | 15 | 0 | 39.477.150 | P.T. INTERGASTRA nusantara |
| 1350 | Fasilitas Kesehatan Sektoral Kemenkes | PUIND Disposable Infusion Set A103C Airvent Y With Cap | 5.550 | 1.000 | 0 | 5.550.000 | FARIZTA JAYA AGUNG |
| 1351 | Fasilitas Kesehatan | INTERSURGICAL I-Gel Supraglottic Airway size 3 | 2.600.000 | 1 | 0 | 2.600.000 | PT Madesa Sejahtera Utama |
| 1352 | Fasilitas Kesehatan | INTERSURGICAL I-Gel Supraglottic Airway size 4 | 2.600.000 | 1 | 0 | 2.600.000 | PT Madesa Sejahtera Utama |
| 1353 | Konsolidasi Obat | Alopurinol tab 100 mg | 155 | 9.000 | 0 | 1.395.000 | PT. Hexpharm Jaya Laboratories |
| 1354 | Konsolidasi Obat | Bisoprolol tab 5 mg | 200 | 38.500 | 0 | 7.700.000 | PT. Hexpharm Jaya Laboratories |
| 1355 | Konsolidasi Obat | Ranitidin tab 150 mg | 149 | 12.000 | 0 | 1.788.000 | PT. Hexpharm Jaya Laboratories |
| 1356 | Obat Program Jaminan Kesehatan | Kalsium polistirena sulfonat / Calcium Polystyrene Sulfonate serb 5 g | 2.450 | 300 | 0 | 735.000 | PT. ZAYN REYCHI ETERNAL |
| 1357 | Obat Program Jaminan Kesehatan | Ceftazidime/ Ceftazidime Pentahydrate/ Seftazidim serb inj 1.000 mg | 10.750 | 500 | 0 | 5.375.000 | P.T. Dexa Medica |
| 1358 | Obat Program Jaminan Kesehatan | Human tetanus imunoglobulin inj 250 IU (i.m.) | 195.000 | 300 | 0 | 58.500.000 | P.T. Dexa Medica |
| 1359 | Obat Program Jaminan Kesehatan | Celecoxib 100 mg Kaps | 2.098 | 600 | 0 | 1.258.800 | PT. Nulab Pharmaceutical Indonesia |
| 1360 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride (HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin tablet/kapsul/kaplet 500 mg | 350 | 3.000 | 0 | 1.050.000 | PT. Hexpharm Jaya Laboratories |
| 1361 | Konsolidasi Obat | Sisplatin inj 1 mg/mL, Vial 50 mg | 95.735 | 40 | 0 | 3.829.400 | PT Ferron Par Pharmaceuticals |
| 1362 | Konsolidasi Obat | Epirubisin inj 2 mg/mL, Vial 5 mL | 79.000 | 100 | 0 | 7.900.000 | PT Ferron Par Pharmaceuticals |
| 1363 | Konsolidasi Obat | Epirubisin inj 2 mg/mL, Vial 25 mL | 395.000 | 50 | 0 | 19.750.000 | PT Ferron Par Pharmaceuticals |
| 1364 | Obat Program Jaminan Kesehatan | Dobutamin/ Dobutamin HCl/ Dobutamine HCl injeksi 50 mg/mL | 13.500 | 100 | 0 | 1.350.000 | PT.Bernofarm |
| 1365 | Obat Program Jaminan Kesehatan | Ioheksol inj 350 mg iodium/ml | 158.111 | 100 | 0 | 15.811.100 | PT.Bernofarm |
| 1366 | Obat Program Jaminan Kesehatan | Lidocaine Hydrochloride/ Lidocaine/ Lidocain/ Lidokain injeksi 2% | 1.202 | 2.000 | 0 | 2.404.000 | PT.Bernofarm |
| 1367 | Obat Program Jaminan Kesehatan | Citicoline Sodium 250 mg/2 ml Inj | 4.300 | 3.000 | 0 | 12.900.000 | PT.Bernofarm |
| 1368 | Konsolidasi Obat | Diazepam tab 2 mg | 127 | 6.000 | 0 | 762.000 | PT. Kimia Farma Tbk |
| 1369 | Obat Program Jaminan Kesehatan | Dutasteride / Dutasterid kapsul lunak 0,5 mg | 2.997 | 6.000 | 0 | 17.982.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1370 | Konsolidasi Obat | Gemsitabin inj 1.000 mg | 289.983 | 20 | 0 | 5.799.660 | PT. CKD OTTO Pharmaceuticals |
| 1371 | Obat Program Jaminan Kesehatan | Gentamycin / Gentamicin Sulfate Salep Mata | 6.740 | 312 | 0 | 2.102.880 | PT.ERELA |
| 1372 | Obat Program Jaminan Kesehatan | Analog Insulin : insulin basal injeksi 100 IU/mL | 74.000 | 500 | 0 | 37.000.000 | PT KALBE FARMA Tbk |
| 1373 | Konsolidasi Obat | Asetazolamid tab 250 mg | 3.355 | 600 | 0 | 2.013.000 | PT SANBE FARMA |
| 1374 | Konsolidasi Obat | Vinkristin inj 1 mg/mL, Vial 2 mL | 92.875 | 5 | 0 | 464.375 | PT SANBE FARMA |
| 1375 | Obat Program Kesehatan Lainnya | KETOPROFEN 100 mg TSE | 719 | 5.000 | 0 | 3.595.000 | PT.Bernofarm |
| 1376 | Obat Program Jaminan Kesehatan | Ketoprofen 100 mg Suppositoria | 3.352 | 600 | 0 | 2.011.200 | PT. MEPROFARM |
| 1377 | Konsolidasi Obat | Indakaterol serb ih 150 mcg | 12.836 | 900 | 0 | 11.552.400 | PT Novartis Indonesia |
| 1378 | Obat Program Jaminan Kesehatan | Procainebenzylpenicillin / Prokain Benzilpenisilin serbuk injeksi 3 juta IU (i.m) | 17.982 | 100 | 0 | 1.798.200 | PT.Meiji Indonesia |
| 1379 | Konsolidasi Obat | Sulfasalazin kapl sal enterik 500 mg | 3.541 | 3.000 | 0 | 10.623.000 | PT Pratapa Nirmala |
| 1380 | Konsolidasi Obat | Tenofovir Tab Sal Selaput 300 mg | 2.189 | 1.200 | 0 | 2.626.800 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1381 | Obat Program Jaminan Kesehatan | Insulin Prandial Analog | 83.083 | 200 | 0 | 16.616.600 | PT Aventis Pharma |
| 1382 | Fasilitas Kesehatan Sektoral Kemenkes | Major Surgery Set | 93.700.000 | 1 | 300.000 | 94.000.000 | PT. Asvia Laguna Medis |
| 1383 | Fasilitas Kesehatan Sektoral Kemenkes | Minor Surgery Set | 64.200.000 | 1 | 220.000 | 64.420.000 | PT. Asvia Laguna Medis |
| 1384 | Fasilitas Kesehatan | Sensor Electrodes ES GS 43 T Pouch isi 50 pcs | 60.000 | 100 | 0 | 6.000.000 | PT. JAYA ABADI MEDIKA |
| 1385 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR18 | 10.767 | 50 | 0 | 538.350 | PT. MEGAH MEDIKA PHARMA |
| 1386 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR16 | 10.767 | 300 | 0 | 3.230.100 | PT. MEGAH MEDIKA PHARMA |
| 1387 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR14 | 10.767 | 100 | 0 | 1.076.700 | PT. MEGAH MEDIKA PHARMA |
| 1388 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR12 | 10.767 | 60 | 0 | 646.020 | PT. MEGAH MEDIKA PHARMA |
| 1389 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 4.0 | 255.411 | 10 | 0 | 2.554.110 | PT. SARANA LINTAS MEDIKA |
| 1390 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 3.0 | 255.411 | 15 | 0 | 3.831.165 | PT. SARANA LINTAS MEDIKA |
| 1391 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 2.0 | 255.411 | 5 | 0 | 1.277.055 | PT. SARANA LINTAS MEDIKA |
| 1392 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Non Rebreathing Oxygen Mask Adult Elongated(XL) | 15.450 | 200 | 0 | 3.090.000 | PT. BUANA INTIPRIMA USAHA |
| 1393 | Fasilitas Kesehatan Sektoral Kemenkes | Maxiflow Dewasa | 10.323 | 200 | 0 | 2.064.600 | PT Jayamas Medica Industri |
| 1394 | Fasilitas Kesehatan Sektoral Kemenkes | Maxiflow Bayi | 11.988 | 50 | 0 | 599.400 | PT Jayamas Medica Industri |
| 1395 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 6 | 16.428 | 10 | 0 | 164.280 | PT Jayamas Medica Industri |
| 1396 | Fasilitas Kesehatan Sektoral Kemenkes | Jackson Rees Dewasa | 235.000 | 100 | 0 | 23.500.000 | PT Jayamas Medica Industri |
| 1397 | Fasilitas Kesehatan Sektoral Kemenkes | Headstrap Dewasa | 58.608 | 30 | 0 | 1.758.240 | PT Jayamas Medica Industri |
| 1398 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7 | 250.000 | 40 | 0 | 10.000.000 | PT Jayamas Medica Industri |
| 1399 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 6,5 | 250.000 | 6 | 0 | 1.500.000 | PT Jayamas Medica Industri |
| 1400 | Fasilitas Kesehatan Sektoral Kemenkes | Hidrogen Peroxide 3 | 27.528 | 20 | 0 | 550.560 | PT Jayamas Medica Industri |
| 1401 | Fasilitas Kesehatan Sektoral Kemenkes | Caesarean Drape Set | 421.800 | 10 | 0 | 4.218.000 | PT Jayamas Medica Industri |
| 1402 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock | 108.780 | 10 | 0 | 1.087.800 | PT Jayamas Medica Industri |
| 1403 | Fasilitas Kesehatan | Medical Recording Chart Paper, Kertas ECG / EKG Paper ukuran 63MM X 100MM X 300 Lembar, Z-Fold (Pack), FDALPHA1000 | 88.000 | 50 | 0 | 4.400.000 | PT. ENDO Indonesia |
| 1404 | Obat Program Jaminan Kesehatan | Levofloxacin hemihydrate/ Levofloxacin/ Levofloksasin inf 500 mg/100Ml (levo 500) TD | 17.000 | 100 | 0 | 1.700.000 | PT.Bernofarm |
| 1405 | Obat Program Jaminan Kesehatan | Analog insulin rapid acting inj 100 IU/mL | 95.326 | 75 | 0 | 7.149.450 | PT. Beta Pharmacon |
| 1406 | Obat Program Jaminan Kesehatan | Analog Insulin Long Acting inj Insulin Detemir 100 IU/mL (kemasan vial, disposable cartridge, penfill cartridge) | 89.799 | 150 | 0 | 13.469.850 | PT. Beta Pharmacon |
| 1407 | Obat Program Jaminan Kesehatan | Sukralfat / Sucralfate susp 500 mg/5 mL, 100 mL | 7.150 | 2.000 | 0 | 14.300.000 | PT. COMBINED IMPERIAL PHARMACEUTICALS |
| 1408 | Obat Program Jaminan Kesehatan | Larutan mengandung asam amino + elektrolit + Karbohidrat + Lipid (Glukosa 85 g, Asam amino 38 g, Elektrolit, Lipid 34 g dengan Fish Oil 5.1 g) Smofkabiven Peripheral 1206 | 384.748 | 60 | 0 | 23.084.880 | PT. Fresenius Kabi Combiphar |
| 1409 | Konsolidasi Obat | Risedronat tab sal selaput 35 mg | 29.645 | 200 | 0 | 5.929.000 | PT KALBE FARMA Tbk |
| 1410 | Konsolidasi Obat | Paklitaksel inj 6 mg/mL, Vial 5 mL | 108.000 | 100 | 0 | 10.800.000 | PT FONKO INTERNATIONAL PHARMACEUTICALS |
| 1411 | Konsolidasi Obat | Paklitaksel inj 6 mg/mL, Vial 16,7 mL | 136.000 | 100 | 0 | 13.600.000 | PT FONKO INTERNATIONAL PHARMACEUTICALS |
| 1412 | Obat Program Jaminan Kesehatan | MISOPROSTOL DISPERSION 200 MCG TABLET | 4.746 | 600 | 0 | 2.847.600 | PT. Mahakam Beta Farma |
| 1413 | Konsolidasi Obat | Ibuprofen tab 400 mg | 189 | 6.000 | 0 | 1.134.000 | PT. TRIMAN |
| 1414 | Konsolidasi Obat | Gabapentin kaps 100 mg | 750 | 15.000 | 0 | 11.250.000 | PT. Hexpharm Jaya Laboratories |
| 1415 | Konsolidasi Obat | Bisoprolol tab 1,25 mg | 2.029 | 10.000 | 0 | 20.290.000 | PT. Merck Tbk |
| 1416 | Obat Program Jaminan Kesehatan | Bisakodil/Bisacodyl tablet salut/kaplet salut 5 mg | 269 | 600 | 0 | 161.400 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 1417 | Obat Program Jaminan Kesehatan | Metronidazole/Metronidazol tablet/kapsul/kaplet 500 mg | 258 | 6.000 | 0 | 1.548.000 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 1418 | Konsolidasi Obat | Asam ursodeoksikolat kaps 250 mg | 1.559 | 22.500 | 0 | 35.077.500 | PT. MEPROFARM |
| 1419 | Konsolidasi Obat | Klozapin tab 25 mg | 450 | 13.000 | 0 | 5.850.000 | PT. MEPROFARM |
| 1420 | Obat Program Jaminan Kesehatan | Aminofilin/Aminophylline inj 24 mg/ml | 7.770 | 150 | 0 | 1.165.500 | PT.Phapros Tbk |
| 1421 | Fasilitas Kesehatan Sektoral Kemenkes | TRO-SOLUSET ( TROGE) Autostop | 27.096,21 | 100 | 0 | 2.709.621 | PT.GLOBAL DISPOMEDIKA |
| 1422 | Fasilitas Kesehatan | LEICA BOND Polymer Refine Detection | 17.171.700 | 1 | 0 | 17.171.700 | PT.BIOGEN SCIENTIFIC |
| 1423 | Fasilitas Kesehatan Sektoral Kemenkes | GRIFOLS DG Gel Coombs | 3.929.400 | 3 | 0 | 11.788.200 | PT Frismed Hoslab Indonesia |
| 1424 | Fasilitas Kesehatan Sektoral Kemenkes | DG Gel Sol | 1.265.400 | 3 | 0 | 3.796.200 | PT Frismed Hoslab Indonesia |
| 1425 | Fasilitas Kesehatan Sektoral Kemenkes | SILICONE NASAL MASK SIZE M (1200-05 ) | 281.385 | 25 | 0 | 7.034.625 | PT. AMPM HEALTHCARE INDONESIA |
| 1426 | Obat Program Jaminan Kesehatan | Bupivakain inj 0,5% | 51.803 | 500 | 0 | 25.901.500 | PT.Bernofarm |
| 1427 | Konsolidasi Obat | Tikagrelor tab 90 mg | 7.908 | 1.080 | 0 | 8.540.640 | P.T. Dexa Medica |
| 1428 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 500 | 0 | 243.645.000 | PT. SINAR RODA UTAMA |
| 1429 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 1.000 | 0 | 487.290.000 | PT. SINAR RODA UTAMA |
| 1430 | Fasilitas Kesehatan Sektoral Kemenkes | SINGLE USE BONNET SIZE MEDIUM (1216-10) | 295.260 | 20 | 0 | 5.905.200 | PT. AMPM HEALTHCARE INDONESIA |
| 1431 | Fasilitas Kesehatan | MINICOLLECT TUBE 9NC Coagulation sodium citrate 3.2% 1mL | 131.081 | 2 | 0 | 262.162 | PT. SABA INDOMEDIKA |
| 1432 | Fasilitas Kesehatan Sektoral Kemenkes | O2 sensor capsule | 6.079.447,6 | 2 | 0 | 12.158.895,2 | PT Draeger Medical Indonesia |
| 1433 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator 9 cm x 26 cm | 59.718 | 30 | 0 | 1.791.540 | PT Jayamas Medica Industri |
| 1434 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Safety Box 5 L | 15.428 | 500 | 0 | 7.714.000 | PT. Likuid Pharmalab Indonesia |
| 1435 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 10 | 0 | 2.788.990 | PT. Likuid Pharmalab Indonesia |
| 1436 | Konsolidasi Obat | Karvedilol tab 6,25 mg | 1.110 | 15.000 | 0 | 16.650.000 | PT KALBE FARMA Tbk |
| 1437 | Fasilitas Kesehatan Sektoral Kemenkes | Operating Table Century E101A With Orthopedic Basic + Spine Surgery Frame | 712.730.000 | 1 | 0 | 712.730.000 | PT. INDOMEDIK NIAGA PERKASA |
| 1438 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 6 | 0 | 1.673.394 | PT. Likuid Pharmalab Indonesia |
| 1439 | Obat Program Jaminan Kesehatan | ASPILETS | 538 | 30.000 | 0 | 16.140.000 | PT Darya Varia |
| 1440 | Konsolidasi Obat | Alprazolam tab 0,5 mg | 150 | 30.000 | 0 | 4.500.000 | PT. Mersifarma Tirmaku Mercusana |
| 1441 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED Dermafix Tulle | 31.080 | 100 | 0 | 3.108.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1442 | Fasilitas Kesehatan Sektoral Kemenkes | Alert Snap Red Allergy 300 EC | 517.800 | 1 | 0 | 517.800 | PT. DOCARE LARAS INDONESIA |
| 1443 | Fasilitas Kesehatan | Plesterin Roll non woven roll 20 cm x 5 m | 79.920 | 50 | 0 | 3.996.000 | PT Jayamas Medica Industri |
| 1444 | Fasilitas Kesehatan | Disposable Syringe without Needle 20 ml | 64.380 | 5 | 0 | 321.900 | PT Jayamas Medica Industri |
| 1445 | Fasilitas Kesehatan | Opthalmic Drape | 29.082 | 30 | 0 | 872.460 | PT Jayamas Medica Industri |
| 1446 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP316H) | 5.096.292 | 1 | 0 | 5.096.292 | PT Johnson and Johnson Indonesia Two |
| 1447 | Fasilitas Kesehatan Sektoral Kemenkes | ETHICON VICRYL Plus (VCP310H) | 4.356.596 | 1 | 0 | 4.356.596 | PT Johnson and Johnson Indonesia Two |
| 1448 | Fasilitas Kesehatan Sektoral Kemenkes | INNOQ Disposable Bacterial/Viral Filter Adult | 18.000 | 600 | 0 | 10.800.000 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 1449 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix T Type A 10x25 cm | 108.780 | 6 | 0 | 652.680 | PT Jayamas Medica Industri |
| 1450 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Syringe 50 cc Ec tip without needle | 75.258 | 25 | 0 | 1.881.450 | PT Jayamas Medica Industri |
| 1451 | Fasilitas Kesehatan Sektoral Kemenkes | Kapas Putih 250 gram | 14.430 | 30 | 0 | 432.900 | PT Jayamas Medica Industri |
| 1452 | Fasilitas Kesehatan Sektoral Kemenkes | Bacterial Filter HMEF | 21.978 | 100 | 0 | 2.197.800 | PT Jayamas Medica Industri |
| 1453 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Tip | 145.188 | 10 | 0 | 1.451.880 | PT Jayamas Medica Industri |
| 1454 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 15 cm x 5 m | 67.488 | 30 | 0 | 2.024.640 | PT Jayamas Medica Industri |
| 1455 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix S IV | 49.728 | 60 | 0 | 2.983.680 | PT Jayamas Medica Industri |
| 1456 | Fasilitas Kesehatan Sektoral Kemenkes | Povidone Iodine Larutan Antiseptik 30 ml | 4.481 | 30 | 0 | 134.430 | PT Jayamas Medica Industri |
| 1457 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free 8 | 250.000 | 10 | 0 | 2.500.000 | PT Jayamas Medica Industri |
| 1458 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7 | 250.000 | 40 | 0 | 10.000.000 | PT Jayamas Medica Industri |
| 1459 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7,5 | 250.000 | 60 | 0 | 15.000.000 | PT Jayamas Medica Industri |
| 1460 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 6,5 | 250.000 | 6 | 0 | 1.500.000 | PT Jayamas Medica Industri |
| 1461 | Fasilitas Kesehatan Sektoral Kemenkes | Arm Sling Comfort L | 18.648 | 60 | 0 | 1.118.880 | PT Jayamas Medica Industri |
| 1462 | Fasilitas Kesehatan | V16 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 48 mm | 86.691 | 144 | 0 | 12.483.504 | PT Medihop |
| 1463 | Fasilitas Kesehatan | S80 T-Silk Silk/Sutera 5-0, 76 cm Reverse Cutting, 3/8 circle, 19 mm | 53.169 | 12 | 0 | 638.028 | PT Medihop |
| 1464 | Fasilitas Kesehatan | S77 T-Silk Silk/Sutera 4-0, 76 cm Reverse Cutting, 3/8 circle, 19 mm | 45.843 | 12 | 0 | 550.116 | PT Medihop |
| 1465 | Fasilitas Kesehatan | S25 T-Silk Silk/Sutera 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 46.620 | 144 | 0 | 6.713.280 | PT Medihop |
| 1466 | Fasilitas Kesehatan | S24 T-Silk Silk/Sutera 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 40.737 | 60 | 0 | 2.444.220 | PT Medihop |
| 1467 | Fasilitas Kesehatan | P30 T-Plain Catgut Plain 4-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.937 | 12 | 0 | 755.244 | PT Medihop |
| 1468 | Fasilitas Kesehatan | P121 T-Plain Catgut Plain 3-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.604 | 24 | 0 | 1.502.496 | PT Medihop |
| 1469 | Fasilitas Kesehatan | N46 T-Nylon Nylon 5-0, 76 cm Reverse Cutting, 3/8 circle, 15 mm | 50.838 | 24 | 0 | 1.220.112 | PT Medihop |
| 1470 | Fasilitas Kesehatan | N62 T-Nylon Nylon 6-0, 45 cm Reverse Cutting, 3/8 circle, 12 mm | 67.821 | 48 | 0 | 3.255.408 | PT Medihop |
| 1471 | Fasilitas Kesehatan | N37 T-Nylon Nylon 4-0, 76 cm Reverse Cutting, 3/8 circle, 18 mm | 48.396 | 120 | 0 | 5.807.520 | PT Medihop |
| 1472 | Fasilitas Kesehatan | M51 T-Mono Polyglecaprone25 3-0, 76 cm Reverse Cutting, 3/8 circle, 24 mm | 107.781 | 12 | 0 | 1.293.372 | PT Medihop |
| 1473 | Fasilitas Kesehatan | L59 T-Lene Polyvinylidene 1, 100 cm Round Bodied, 1/2 circle, 40 mm | 92.463 | 12 | 0 | 1.109.556 | PT Medihop |
| 1474 | Fasilitas Kesehatan | C99 T-Chromic Catgut Chromic 2, 90 cm Round Bodied, 1/2 circle, 48 mm | 62.715 | 36 | 0 | 2.257.740 | PT Medihop |
| 1475 | Fasilitas Kesehatan | D73 T-Dio Polydioxanone 1 Loop, 180 cm Round Bodied, 1/2 circle, 48 mm | 148.518 | 60 | 0 | 8.911.080 | PT Medihop |
| 1476 | Fasilitas Kesehatan | C26 T-Chromic Catgut Chromic 2-0, 90 cm Round Bodied, 1/2 circle, 40 mm | 63.714 | 36 | 0 | 2.293.704 | PT Medihop |
| 1477 | Fasilitas Kesehatan | BV02 T-Hemovine 80x50x10mm | 75.682 | 60 | 0 | 4.540.920 | PT Medihop |
| 1478 | Fasilitas Kesehatan | V10 T-Vio Polyglycolide 2-0, 90 cm Round Bodied, 1/2 circle, 25 mm | 79.365 | 240 | 0 | 19.047.600 | PT Medihop |
| 1479 | Fasilitas Kesehatan | V15 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 40 mm | 86.691 | 180 | 0 | 15.604.380 | PT Medihop |
| 1480 | Fasilitas Kesehatan | N32 T-Nylon Nylon 3-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 48.396 | 300 | 0 | 14.518.800 | PT Medihop |
| 1481 | Fasilitas Kesehatan | Kasa Steril 7.5 x 7.5 cm - 16 ply isi 10 LD, 71610 LD | 11.800 | 4.980 | 0 | 58.764.000 | PT Jayamas Medica Industri |
| 1482 | Konsolidasi Obat | Alopurinol tab 300 mg | 360 | 10.000 | 0 | 3.600.000 | PT. Holi Pharma |
| 1483 | Konsolidasi Obat | Antasida tab kunyah | 90 | 3.000 | 0 | 270.000 | PT. Holi Pharma |
| 1484 | Konsolidasi Obat | Ibuprofen susp 100 mg/5 mL | 4.249 | 130 | 0 | 552.370 | PT. Holi Pharma |
| 1485 | Obat Program Jaminan Kesehatan | Ioheksol inj 350 mg iodium/ml | 158.111 | 100 | 0 | 15.811.100 | PT.Bernofarm |
| 1486 | Obat Program Jaminan Kesehatan | Amoksisilin/ Amoxicillin/ Amoxicillin Trihydrate tablet/kapsul/kaplet/kaptab 500 mg | 471 | 6.000 | 0 | 2.826.000 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 1487 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Blood Transfusion Set | 8.075 | 2.000 | 0 | 16.150.000 | PT. BUANA INTIPRIMA USAHA |
| 1488 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Adult Elongated (XL) | 16.275 | 200 | 0 | 3.255.000 | PT. BUANA INTIPRIMA USAHA |
| 1489 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Pediatric Elongated (M) | 16.275 | 100 | 0 | 1.627.500 | PT. BUANA INTIPRIMA USAHA |
| 1490 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 5 ML LUER LOCK WITH NEEDLE 22GX1-1/2INCH (38MM) | 1.110 | 15.300 | 0 | 16.983.000 | PT. SINAR RODA UTAMA |
| 1491 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 1 ML LUER SLIP / 26GX1/2INCH (13MM) | 1.110 | 1.000 | 0 | 1.110.000 | PT. SINAR RODA UTAMA |
| 1492 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 22G X 1 INCH (25MM) | 6.660 | 1.500 | 0 | 9.990.000 | PT. SINAR RODA UTAMA |
| 1493 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 24GX 1 INCH (25MM) | 6.660 | 500 | 0 | 3.330.000 | PT. SINAR RODA UTAMA |
| 1494 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 20G X 1-1/4 INCH (32MM) | 6.660 | 3.000 | 0 | 19.980.000 | PT. SINAR RODA UTAMA |
| 1495 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 10 ML LUER LOCK WITH NEEDLE 21GX1-1/2INCH (38MM) | 1.443 | 10.000 | 0 | 14.430.000 | PT. SINAR RODA UTAMA |
| 1496 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 20GX1-1/4 INCH (32MM) | 5.550 | 500 | 0 | 2.775.000 | PT. SINAR RODA UTAMA |
| 1497 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 3 ML LUER LOCK WITH NEEDLE 23GX1-1/4INCH (32MM) | 999 | 9.600 | 0 | 9.590.400 | PT. SINAR RODA UTAMA |
| 1498 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 18G X 1-1/4 INCH (32MM) | 5.550 | 200 | 0 | 1.110.000 | PT. SINAR RODA UTAMA |
| 1499 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 22GX1 INCH (25MM) | 5.550 | 200 | 0 | 1.110.000 | PT. SINAR RODA UTAMA |
| 1500 | Obat Program Jaminan Kesehatan | / NIFEDIPIN GITS/TABLET LEPAS LAMBAT | 4.424 | 36.000 | 0 | 159.264.000 | PT Bayer Indonesia |
| 1501 | Obat Non Jaminan Kesehatan | CURVIPLEX SYRUP - SIRUP MENGANDUNG CURCUMA DAN MULTIVITAMIN ANAK | 9.000 | 100 | 0 | 900.000 | PT. Graha Farma |
| 1502 | Fasilitas Kesehatan Sektoral Kemenkes | Operating Table Tipe Century E101A | 408.500.000 | 1 | 0 | 408.500.000 | PT. INDOMEDIK NIAGA PERKASA |
| 1503 | Konsolidasi Obat | Kalsitriol Kaps Lunak 0,25 mcg | 1.332 | 10.020 | 0 | 13.346.640 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1504 | Obat Program Jaminan Kesehatan | Cefotaxime sodium/ Cefotaxime/ Sefotaksim serb inj 1.000 mg | 4.800 | 3.000 | 0 | 14.400.000 | PT. Hexpharm Jaya Laboratories |
| 1505 | Obat Program Jaminan Kesehatan | Diclofenac Potassium/ Kalium diklofenak tablet salut selaput / kaplet salut selaput 50 mg | 470 | 1.000 | 0 | 470.000 | PT. Hexpharm Jaya Laboratories |
| 1506 | Konsolidasi Obat | Asam folat tab 1 mg | 60 | 10.000 | 0 | 600.000 | PT. MARIN LIZA FARMASI |
| 1507 | Obat Program Jaminan Kesehatan | Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/ Moksifloksasin tts mata 0,5% (G) | 50.000 | 30 | 0 | 1.500.000 | PT Ferron Par Pharmaceuticals |
| 1508 | Konsolidasi Obat | Kolkisin tab 500 mcg | 1.399 | 3.000 | 0 | 4.197.000 | PT Pratapa Nirmala |
| 1509 | Obat Non Jaminan Kesehatan | CLIXID Tablet SS | 779 | 15.000 | 0 | 11.685.000 | PT. Nulab Pharmaceutical Indonesia |
| 1510 | Obat Program Jaminan Kesehatan | HESROID DIOSMIN 450 MG HESPERIDIN 50 MG KSS | 2.775 | 1.020 | 0 | 2.830.500 | PT. Mahakam Beta Farma |
| 1511 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride(HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin inf 2 mg/ml | 10.200 | 180 | 0 | 1.836.000 | P.T. Dexa Medica |
| 1512 | Obat Program Jaminan Kesehatan | Dopamin / Dopamine hidrochloride injeksi 40 mg/ml | 5.200 | 1.000 | 0 | 5.200.000 | P.T. Dexa Medica |
| 1513 | Obat Program Jaminan Kesehatan | Streptokinase inj 1,5 juta IU | 3.950.000 | 15 | 0 | 59.250.000 | P.T. Dexa Medica |
| 1514 | Konsolidasi Obat | Ivabradin tab 5 mg | 9.610 | 616 | 0 | 5.919.760 | PT Darya Varia |
| 1515 | Konsolidasi Obat | Epirubisin inj 2 mg/mL, Vial 5 mL | 79.000 | 150 | 0 | 11.850.000 | PT Ferron Par Pharmaceuticals |
| 1516 | Konsolidasi Obat | Epirubisin inj 2 mg/mL, Vial 25 mL | 395.000 | 50 | 0 | 19.750.000 | PT Ferron Par Pharmaceuticals |
| 1517 | Konsolidasi Obat | Bisoprolol tab 2,5 mg | 124 | 38.000 | 0 | 4.712.000 | P.T. Dexa Medica |
| 1518 | Konsolidasi Obat | Kandesartan tab 8 mg | 275 | 78.000 | 0 | 21.450.000 | P.T. Dexa Medica |
| 1519 | Konsolidasi Obat | Fenofibrat kaps 300 mg | 657 | 3.000 | 0 | 1.971.000 | P.T. Dexa Medica |
| 1520 | Konsolidasi Obat | Gliklazid tab 80 mg | 309 | 25.000 | 0 | 7.725.000 | P.T. Dexa Medica |
| 1521 | Konsolidasi Obat | Glikuidon tab 30 mg | 1.000 | 20.000 | 0 | 20.000.000 | P.T. Dexa Medica |
| 1522 | Obat Program Jaminan Kesehatan | Gentamisin/ Gentamycin / Gentamycin sulfate tetes mata 0,3% | 9.402 | 48 | 0 | 451.296 | PT.ERELA |
| 1523 | Konsolidasi Obat | Metildopa tab 250 mg | 1.832 | 10.000 | 0 | 18.320.000 | PT ACTAVIS INDONESIA |
| 1524 | Obat Program Jaminan Kesehatan | Cefixime trihydrate/ Cefixime/ Sefiksim tablet/kapsul/kaplet 100 mg | 587 | 40.000 | 0 | 23.480.000 | PT. PHARMA LABORATORIES |
| 1525 | Obat Program Jaminan Kesehatan | Kalsium polistirena sulfonat / Calcium Polystyrene Sulfonate serb 5 g | 5.500 | 300 | 0 | 1.650.000 | PT DIPA PHARMALAB INTERSAINS |
| 1526 | Obat Program Jaminan Kesehatan | Fondaparinux / Fondaparinuks inj 2,5 mg/0,5 mL | 165.000 | 300 | 0 | 49.500.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1527 | Obat Program Jaminan Kesehatan | Lamivudine/ Lamivudin tablet salut selaput 150 mg | 1.332 | 2.040 | 0 | 2.717.280 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1528 | Obat Program Jaminan Kesehatan | Atorvastatin Tab Brand | 444 | 30.000 | 0 | 13.320.000 | PT Darya Varia |
| 1529 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY FR10 | 28.971 | 10 | 0 | 289.710 | PT. MEGAH MEDIKA PHARMA |
| 1530 | Fasilitas Kesehatan | BALLON CATHETER 2 WAY FR6 | 37.999,74 | 10 | 0 | 379.997,4 | PT. MEGAH MEDIKA PHARMA |
| 1531 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY FR8 | 28.971 | 5 | 0 | 144.855 | PT. MEGAH MEDIKA PHARMA |
| 1532 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR12 | 10.767 | 60 | 0 | 646.020 | PT. MEGAH MEDIKA PHARMA |
| 1533 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR14 | 10.767 | 30 | 0 | 323.010 | PT. MEGAH MEDIKA PHARMA |
| 1534 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR16 | 10.767 | 600 | 0 | 6.460.200 | PT. MEGAH MEDIKA PHARMA |
| 1535 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Bag Liner with solidifier w/Single Tandem Tube, 2000ml | 51.171 | 30 | 0 | 1.535.130 | PT. ENERGI MEDISTRON |
| 1536 | Fasilitas Kesehatan | 7.5 cm x 2.7 m | 15.400 | 200 | 0 | 3.080.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1537 | Fasilitas Kesehatan | 10 cm x 2.7 m | 19.480 | 144 | 0 | 2.805.120 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1538 | Fasilitas Kesehatan | 15 cm x 2.7 m | 25.308 | 144 | 0 | 3.644.352 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1539 | Fasilitas Kesehatan | 10 cm x 2.7 m | 27.100 | 60 | 0 | 1.626.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1540 | Fasilitas Kesehatan | 15 cm x 2.7 m | 36.400 | 72 | 0 | 2.620.800 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1541 | Fasilitas Kesehatan | SUREFIT Dual Dispersive Electrode (410-2000) | 75.460 | 200 | 0 | 15.092.000 | PT. Hospi Medik Indonesia |
| 1542 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED ElastoOne Cohesive Bandage lebar 12CM X 4M | 21.090 | 10 | 0 | 210.900 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1543 | Fasilitas Kesehatan Sektoral Kemenkes | CERTOFIX Duo HFV 1220 - Akses Vena Sentral | 991.364 | 5 | 0 | 4.956.820 | PT. B.BRAUN MEDICAL INDONESIA |
| 1544 | Fasilitas Kesehatan Sektoral Kemenkes | BIOPTIMAL CVC Double Lumen: 7Fr x 20cm with Kink Resistance Guidewire, Y needle (CVN-702-20Y) | 477.725 | 5 | 0 | 2.388.625 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 1545 | Fasilitas Kesehatan Sektoral Kemenkes | GRIFOLS DG Gel Coombs | 3.929.400 | 3 | 0 | 11.788.200 | PT Frismed Hoslab Indonesia |
| 1546 | Fasilitas Kesehatan Sektoral Kemenkes | DG Gel Sol | 1.265.400 | 3 | 0 | 3.796.200 | PT Frismed Hoslab Indonesia |
| 1547 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 7.5 | 134.260 | 20 | 0 | 2.685.200 | PT.Dwiasri Graha (dwigraha medical) |
| 1548 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 3.0 | 19.400 | 5 | 0 | 97.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1549 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 3.5 | 19.400 | 5 | 0 | 97.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1550 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 7.5 | 19.400 | 60 | 0 | 1.164.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1551 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 7.0 | 19.400 | 40 | 0 | 776.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1552 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 8.0 | 19.400 | 5 | 0 | 97.000 | PT.Dwiasri Graha (dwigraha medical) |
| 1553 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 7.0 | 134.260 | 20 | 0 | 2.685.200 | PT.Dwiasri Graha (dwigraha medical) |
| 1554 | Fasilitas Kesehatan Sektoral Kemenkes | Ureteral Stent 5.0 FR 26 CM BOTH ENDS OPEN | 372.000 | 50 | 0 | 18.600.000 | PT. EDISON DUTA SARANA |
| 1555 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Colostomy Bag | 219.780 | 2 | 0 | 439.560 | PT Jayamas Medica Industri |
| 1556 | Fasilitas Kesehatan Sektoral Kemenkes | Urobag 2000 | 5.000 | 1.000 | 0 | 5.000.000 | PT Jayamas Medica Industri |
| 1557 | Fasilitas Kesehatan Sektoral Kemenkes | Extension Tube 150 cm Sterile | 6.105 | 600 | 0 | 3.663.000 | PT Jayamas Medica Industri |
| 1558 | Fasilitas Kesehatan Sektoral Kemenkes | Double Spike | 108.780 | 20 | 0 | 2.175.600 | PT Jayamas Medica Industri |
| 1559 | Fasilitas Kesehatan | Certofix Duo HF V 1215 | 842.312 | 5 | 0 | 4.211.560 | PT. B.BRAUN MEDICAL INDONESIA |
| 1560 | Fasilitas Kesehatan Sektoral Kemenkes | STERA Plasma Sterilizer Cassette | 9.250.000 | 1 | 0 | 9.250.000 | PT. HOSPI NIAGA UTAMA |
| 1561 | Fasilitas Kesehatan | Nessy split, VIO, ICC, ACC, contact surface 85 cm equipotential ring 23 cm, without connecting cable | 37.000 | 40 | 0 | 1.480.000 | PT Surgika Alkesindo |
| 1562 | Fasilitas Kesehatan | NESSY, split, VIO, ICC, ACC, non ERBE units, International contact surface 85 cm, equipotential ring 23 cm, with connecting cable 4 m | 93.000 | 20 | 0 | 1.860.000 | PT Surgika Alkesindo |
| 1563 | Fasilitas Kesehatan | ALTECH Single Heated Wire Circuit - AL 4411-020/2.V.001 | 700.000 | 3 | 0 | 2.100.000 | PT Surgika Alkesindo |
| 1564 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Non Rebreathing Oxygen Mask Adult Elongated(XL) | 15.450 | 300 | 0 | 4.635.000 | PT. BUANA INTIPRIMA USAHA |
| 1565 | Fasilitas Kesehatan Sektoral Kemenkes | PUIND Disposable Infusion Set A103C Airvent Y With Cap | 5.550 | 500 | 0 | 2.775.000 | FARIZTA JAYA AGUNG |
| 1566 | Fasilitas Kesehatan Sektoral Kemenkes | Maxiflow Dewasa | 10.323 | 500 | 0 | 5.161.500 | PT Jayamas Medica Industri |
| 1567 | Fasilitas Kesehatan Sektoral Kemenkes | Headstrap Dewasa | 58.608 | 50 | 0 | 2.930.400 | PT Jayamas Medica Industri |
| 1568 | Fasilitas Kesehatan Sektoral Kemenkes | E-CARE Lubricant Gel | 28.000 | 30 | 0 | 840.000 | PT Enseval Medika Prima |
| 1569 | Obat Program Jaminan Kesehatan | Digoksin/Digoxin injeksi 0,25 mg/ml ampul/vial | 20.600 | 200 | 0 | 4.120.000 | PT Pratapa Nirmala |
| 1570 | Obat Program Jaminan Kesehatan | Metoprolol tartrate/ Metoprolol tartat inj 1 mg/ml | 149.850 | 50 | 0 | 7.492.500 | PT Pratapa Nirmala |
| 1571 | Obat Program Jaminan Kesehatan | Neostigmin injeksi 0,5 mg/ml | 11.000 | 30 | 0 | 330.000 | PT Pratapa Nirmala |
| 1572 | Konsolidasi Obat | Leuprorelin asetat serb inj 3,75 mg | 720.000 | 10 | 0 | 7.200.000 | PT KALBE FARMA Tbk |
| 1573 | Fasilitas Kesehatan Sektoral Kemenkes | Sarung Tangan Obgyn | 17.000 | 300 | 0 | 5.100.000 | PT Jayamas Medica Industri |
| 1574 | Obat Program Jaminan Kesehatan | Clindamycin hydrochloride (HCl)/ Clindamycin/ Klindamisin tablet/kapsul/kaplet 300 mg | 1.000 | 6.000 | 0 | 6.000.000 | PT. Mersifarma Tirmaku Mercusana |
| 1575 | Fasilitas Kesehatan Sektoral Kemenkes | Anaesthetic Breathing System, Mapelson C Pediatric 1,8m 1L Bag | 268.065 | 3 | 0 | 804.195 | PT. SARANA LINTAS MEDIKA |
| 1576 | Fasilitas Kesehatan Sektoral Kemenkes | HAMILTON Bonnet nCPAP-PS Medium | 259.324 | 10 | 0 | 2.593.240 | PT. SARANA LINTAS MEDIKA |
| 1577 | Fasilitas Kesehatan Sektoral Kemenkes | HAMILTON Bonnet nCPAP-PS Large | 259.324 | 10 | 0 | 2.593.240 | PT. SARANA LINTAS MEDIKA |
| 1578 | Fasilitas Kesehatan Sektoral Kemenkes | HAMILTON MASK nCPAP-PS Large | 247.669 | 20 | 0 | 4.953.380 | PT. SARANA LINTAS MEDIKA |
| 1579 | Fasilitas Kesehatan Sektoral Kemenkes | HAMILTON Mask nCPAP-PS Small | 247.669 | 10 | 0 | 2.476.690 | PT. SARANA LINTAS MEDIKA |
| 1580 | Fasilitas Kesehatan Sektoral Kemenkes | LG Flat Panel Digital X-ray Detector Unit Only | 378.932.000 | 1 | 0 | 378.932.000 | PT LG ELECTRONICS INDONESIA |
| 1581 | Fasilitas Kesehatan | SPINOCAN 25GX3 1/2 (0.53X88 MM) | 34.248 | 500 | 0 | 17.124.000 | PT. B.BRAUN MEDICAL INDONESIA |
| 1582 | Fasilitas Kesehatan | SPINOCAN 26GX3 1/2 (0.47X88 MM) | 34.248 | 200 | 0 | 6.849.600 | PT. B.BRAUN MEDICAL INDONESIA |
| 1583 | Fasilitas Kesehatan | 20 cm x 5 m | 164.150 | 120 | 0 | 19.698.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1584 | Fasilitas Kesehatan Sektoral Kemenkes | PUIND Oxygen Nasal Cannula Infant | 5.328 | 60 | 0 | 319.680 | FARIZTA JAYA AGUNG |
| 1585 | Fasilitas Kesehatan | Electrosurgical Return Electrodes/Valleylab REM Polyhesive Adult Cordless Patient Return Electrode /E7509 | 52.800 | 60 | 0 | 3.168.000 | PT. Medtronic Indonesia |
| 1586 | Fasilitas Kesehatan | Electrosurgical Return Electrodes/Paid Patient Cover/E7510-25 | 217.600 | 20 | 0 | 4.352.000 | PT. Medtronic Indonesia |
| 1587 | Fasilitas Kesehatan Sektoral Kemenkes | Guide Wire 0.032 x 150 CM (STRAIGHT TIP) PTFE | 269.500 | 20 | 0 | 5.390.000 | PT. EDISON DUTA SARANA |
| 1588 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Mount | 21.978 | 500 | 0 | 10.989.000 | PT Jayamas Medica Industri |
| 1589 | Fasilitas Kesehatan Sektoral Kemenkes | Mucus Extractor | 6.438 | 20 | 0 | 128.760 | PT Jayamas Medica Industri |
| 1590 | Fasilitas Kesehatan Sektoral Kemenkes | Oxyflow Anak (Nasal oxygen cannula) | 5.400 | 50 | 0 | 270.000 | PT Jayamas Medica Industri |
| 1591 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR10, 120CM | 7.992 | 15 | 0 | 119.880 | PT Jayamas Medica Industri |
| 1592 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR12, 125cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1593 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR14, 125cm | 7.992 | 60 | 0 | 479.520 | PT Jayamas Medica Industri |
| 1594 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR16, 125cm | 7.992 | 150 | 0 | 1.198.800 | PT Jayamas Medica Industri |
| 1595 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR18, 125cm | 7.992 | 50 | 0 | 399.600 | PT Jayamas Medica Industri |
| 1596 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR8, 100cm | 7.992 | 50 | 0 | 399.600 | PT Jayamas Medica Industri |
| 1597 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR8, 40cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1598 | Fasilitas Kesehatan Sektoral Kemenkes | Ventiflow Dewasa | 70.818 | 100 | 0 | 7.081.800 | PT Jayamas Medica Industri |
| 1599 | Fasilitas Kesehatan Sektoral Kemenkes | Umbilical Cord Clamp | 89.910 | 3 | 0 | 269.730 | PT Jayamas Medica Industri |
| 1600 | Obat Program Jaminan Kesehatan | NYSTATIN DROPS 100.000 iu/ml | 14.807,4 | 150 | 0 | 2.221.110 | PT LAPI LABORATORIES |
| 1601 | Konsolidasi Obat | Gemsitabin inj 200 mg | 87.628 | 30 | 0 | 2.628.840 | PT. CKD OTTO Pharmaceuticals |
| 1602 | Konsolidasi Obat | Gemsitabin inj 1.000 mg | 289.983 | 20 | 0 | 5.799.660 | PT. CKD OTTO Pharmaceuticals |
| 1603 | Obat Program Kesehatan Lainnya | DEXKETOPROFEN TROMETAMOL 25 MG TABLET | 1.526 | 3.500 | 0 | 5.341.000 | PT. Interbat |
| 1604 | Fasilitas Kesehatan Sektoral Kemenkes | Urethane Foam Mattress PE-6001 | 2.670.000 | 20 | 0 | 53.400.000 | PT.PARAMOUNT BED INDONESIA |
| 1605 | Obat Non Jaminan Kesehatan | PAMOL SUPPOSITORIA 125 MG_Paracetamol/ Parasetamol suppo 125 mg | 14.427 | 144 | 0 | 2.077.488 | PT. Interbat |
| 1606 | Konsolidasi Obat | Propranolol tab 10 mg | 58 | 10.000 | 0 | 580.000 | PT. Holi Pharma |
| 1607 | Obat Program Jaminan Kesehatan | Analog Insulin Co-Formulation inj 100 IU/ml Ultra Long Acting Insulin Degludec 70U/Rapid Acting Insulin Aspart 30U (kemasan vial, disposable cartridge, penfill cartridge) | 113.018 | 100 | 0 | 11.301.800 | PT Ferron Par Pharmaceuticals |
| 1608 | Obat Program Jaminan Kesehatan | Propofol injeksi 1% | 12.210 | 600 | 0 | 7.326.000 | PT. ETERCON PHARMA |
| 1609 | Konsolidasi Obat | Karboplatin inj 10 mg/mL, Vial 45 mL | 275.000 | 10 | 0 | 2.750.000 | PT Ferron Par Pharmaceuticals |
| 1610 | Konsolidasi Obat | Letrozol tab 2,5 mg | 1.568 | 6.000 | 0 | 9.408.000 | PT Ferron Par Pharmaceuticals |
| 1611 | Konsolidasi Obat | Natrium diklofenak tab sal enterik 50 mg | 110 | 60.000 | 0 | 6.600.000 | P.T. Dexa Medica |
| 1612 | Konsolidasi Obat | Propiltiourasil tab 100 mg | 410 | 7.500 | 0 | 3.075.000 | P.T. Dexa Medica |
| 1613 | Konsolidasi Obat | Spironolakton tab 25 mg | 250 | 150.000 | 0 | 37.500.000 | P.T. Dexa Medica |
| 1614 | Obat Program Jaminan Kesehatan | Ketanaest Injeksi 50 mg/ml | 80.142 | 60 | 0 | 4.808.520 | PT.Bernofarm |
| 1615 | Obat Program Jaminan Kesehatan | Kombinasi, setiap mL mengandung: natrium klorida 4,40 mg + kalium klorida 0,80 mg, tts mata | 15.541 | 600 | 0 | 9.324.600 | PT SANBE FARMA |
| 1616 | Konsolidasi Obat | Levetirasetam tab 500 mg | 3.762 | 1.200 | 0 | 4.514.400 | PT Pratapa Nirmala |
| 1617 | Konsolidasi Obat | Eksemestan tab sal 25 mg | 35.964 | 1.500 | 0 | 53.946.000 | PT Pratapa Nirmala |
| 1618 | Obat Program Jaminan Kesehatan | Isosorbid Dinitrat/ Isosorbide dinitrate tablet/kapsul/kaplet 5 mg | 250 | 65.000 | 0 | 16.250.000 | PT Yarindo Farmatama |
| 1619 | Obat Program Jaminan Kesehatan | Omeprazole 20 mg/ Omeprazol 20 mg/100 | 210 | 23.000 | 0 | 4.830.000 | PT. Mega Lifesciences Indonesia |
| 1620 | Konsolidasi Obat | Kalsium folinat (leucovorin, Ca) inj 10 mg/mL | 22.220 | 20 | 0 | 444.400 | PT SANBE FARMA |
| 1621 | Konsolidasi Obat | Irinotekan inj 20 mg/mL, Vial 5 mL | 313.000 | 6 | 0 | 1.878.000 | PT SANBE FARMA |
| 1622 | Konsolidasi Obat | Kombinasi KDT/FDC mengandung: Salmeterol 50 mcg dan Flutikason Propionat 100 mcg serb ih | 119.131 | 10 | 0 | 1.191.310 | PT Glaxo Wellcome Indonesia |
| 1623 | Obat Program Jaminan Kesehatan | Paracetamol/ Parasetamol drops 100 mg/ml (60mg/0,6ml) | 9.111 | 30 | 0 | 273.330 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 1624 | Fasilitas Kesehatan Sektoral Kemenkes | Granisetron HCL 3 mg/ 3 mL Injeksi | 23.727 | 10 | 0 | 237.270 | PT. Mahakam Beta Farma |
| 1625 | Obat Program Jaminan Kesehatan | Rocuronium bromide/ Rokuronium inj 10 mg/ml | 52.500 | 30 | 0 | 1.575.000 | P.T. Dexa Medica |
| 1626 | Obat Program Jaminan Kesehatan | Paracetamol/ Parasetamol sirup 120 mg / 5 ml | 2.999 | 100 | 0 | 299.900 | PT. Mersifarma Tirmaku Mercusana |
| 1627 | Fasilitas Kesehatan Sektoral Kemenkes | Spirolog Flowsensor | 4.700.000 | 2 | 0 | 9.400.000 | PT Draeger Medical Indonesia |
| 1628 | Pekerjaan Konstruksi Pembangunan/Pemeliharaan/Rehabilitasi Bangunan Gedung Kota Mojokerto | PENUTUP ATAP BANGUNAN | 280.000 | 24 | 0 | 6.720.000 | CV.KARYA LANGGENG |
| 1629 | Konsolidasi Obat | Anastrozol tab 1 mg | 2.642 | 900 | 0 | 2.377.800 | PT Ferron Par Pharmaceuticals |
| 1630 | Fasilitas Kesehatan Sektoral Kemenkes | Umbilical Catheter | 42.300 | 20 | 0 | 846.000 | PT. ENDO Indonesia |
| 1631 | Fasilitas Kesehatan | Thoracic Trocar Catheter GS-5030 | 120.690 | 5 | 0 | 603.450 | PT. ENDO Indonesia |
| 1632 | Fasilitas Kesehatan Sektoral Kemenkes | Dental Bib Bag isi 125 pcs | 58.608 | 10 | 0 | 586.080 | PT Jayamas Medica Industri |
| 1633 | Fasilitas Kesehatan Sektoral Kemenkes | Indodent Saliva Ejector | 43.068 | 5 | 0 | 215.340 | PT Jayamas Medica Industri |
| 1634 | Konsolidasi Obat | Timolol tts mata 0,5% | 12.100 | 120 | 0 | 1.452.000 | PT Ferron Par Pharmaceuticals |
| 1635 | Konsolidasi Obat | Gabapentin kaps 300 mg | 645 | 15.000 | 0 | 9.675.000 | PT. Kimia Farma Tbk |
| 1636 | Konsolidasi Obat | Hidroklorotiazid tab 25 mg | 148 | 100.000 | 0 | 14.800.000 | PT. Kimia Farma Tbk |
| 1637 | Konsolidasi Obat | Kodein tab 10 mg | 600 | 10.000 | 0 | 6.000.000 | PT. Kimia Farma Tbk |
| 1638 | Konsolidasi Obat | Tiamazol Tab 10 mg | 888 | 6.000 | 0 | 5.328.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1639 | Konsolidasi Obat | Warfarin tab 2 mg | 555 | 10.000 | 0 | 5.550.000 | PT Pratapa Nirmala |
| 1640 | Obat Program Jaminan Kesehatan | Streptomycin sulfate/ Streptomycin/ Streptomisin serbuk inj 1000 mg | 7.770 | 56 | 0 | 435.120 | PT.Phapros Tbk |
| 1641 | Obat Program Jaminan Kesehatan | Air untuk injeksi, cairan inj 25 mL | 2.512 | 3.600 | 0 | 9.043.200 | PT. SATORIA ANEKA INDUSTRI |
| 1642 | Obat Program Jaminan Kesehatan | Triamcinolone acetonide/ Triamsinolon asetonid inj 10 mg/mL | 33.200 | 10 | 0 | 332.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1643 | Obat Program Jaminan Kesehatan | Asam askorbat (vitamin C) tablet/kapsul/kaplet 50 mg | 95 | 10.000 | 0 | 950.000 | PT.Imfarmind Farmasi Industri |
| 1644 | Fasilitas Kesehatan Sektoral Kemenkes | Infuse Stand-4 Hook (MI400) | 2.220.000 | 10 | 0 | 22.200.000 | Medina Teknik Alkesindo |
| 1645 | Jasa Pemeliharaan dan Perbaikan Peralatan Fasilitas Pelayanan Kesehatan | BATTERY LITHIUM ION 14 VAc | 24.500.000 | 2 | 0 | 49.000.000 | RIZIA MITRA SEJATI |
| 1646 | Fasilitas Kesehatan | S84 T-Silk Silk/Sutera 1, 90 cm Round Bodied, 1/2 circle, 40 mm | 55.389 | 144 | 0 | 7.976.016 | PT Medihop |
| 1647 | Fasilitas Kesehatan | MM17 T-Hernia Mesh Medium Mesh Square 6cm x 10cm | 152.514 | 24 | 0 | 3.660.336 | PT Medihop |
| 1648 | Fasilitas Kesehatan | V5 T-Vio Polyglycolide 3-0, 76 cm Round Bodied, 1/2 circle, 20 mm | 87.135 | 36 | 0 | 3.136.860 | PT Medihop |
| 1649 | Fasilitas Kesehatan | V10 T-Vio Polyglycolide 2-0, 90 cm Round Bodied, 1/2 circle, 25 mm | 79.365 | 120 | 0 | 9.523.800 | PT Medihop |
| 1650 | Fasilitas Kesehatan | S24 T-Silk Silk/Sutera 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 40.737 | 60 | 0 | 2.444.220 | PT Medihop |
| 1651 | Fasilitas Kesehatan | P30 T-Plain Catgut Plain 4-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.937 | 24 | 0 | 1.510.488 | PT Medihop |
| 1652 | Fasilitas Kesehatan | P86 T-Plain Catgut Plain 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 60.051 | 48 | 0 | 2.882.448 | PT Medihop |
| 1653 | Fasilitas Kesehatan | P180 T-Plain Catgut Plain 2-0, 90 cm Round Bodied, 1/2 circle, 37 mm | 56.166 | 48 | 0 | 2.695.968 | PT Medihop |
| 1654 | Fasilitas Kesehatan | N90 T-Nylon Nylon 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 55.833 | 420 | 0 | 23.449.860 | PT Medihop |
| 1655 | Fasilitas Kesehatan | M51 T-Mono Polyglecaprone25 3-0, 76 cm Reverse Cutting, 3/8 circle, 24 mm | 107.781 | 12 | 0 | 1.293.372 | PT Medihop |
| 1656 | Fasilitas Kesehatan | D73 T-Dio Polydioxanone 1 Loop, 180 cm Round Bodied, 1/2 circle, 48 mm | 148.518 | 60 | 0 | 8.911.080 | PT Medihop |
| 1657 | Fasilitas Kesehatan | C96 T-Chromic Catgut Chromic 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 64.602 | 24 | 0 | 1.550.448 | PT Medihop |
| 1658 | Fasilitas Kesehatan | C26 T-Chromic Catgut Chromic 2-0, 90 cm Round Bodied, 1/2 circle, 40 mm | 63.714 | 36 | 0 | 2.293.704 | PT Medihop |
| 1659 | Fasilitas Kesehatan | C55 T-Chromic Catgut Chromic 1, 90 cm Heavy Round Bodied, 1/2 circle, 40 mm | 72.261 | 36 | 0 | 2.601.396 | PT Medihop |
| 1660 | Fasilitas Kesehatan | BV02 T-Hemovine 80x50x10mm | 75.682 | 60 | 0 | 4.540.920 | PT Medihop |
| 1661 | Fasilitas Kesehatan | ORC-01 T-Hemocel Absorbable Hemostatic Sheet uk 5cm x 7.5cm | 75.177 | 30 | 0 | 2.255.310 | PT Medihop |
| 1662 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 1.300 | 0 | 633.477.000 | PT. SINAR RODA UTAMA |
| 1663 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 700 | 0 | 341.103.000 | PT. SINAR RODA UTAMA |
| 1664 | Konsolidasi Obat | Goserelin asetat inj 3,6 mg/depot | 1.052.590 | 50 | 0 | 52.629.500 | PT AstraZeneca Indonesia |
| 1665 | Konsolidasi Obat | Alopurinol tab 100 mg | 155 | 15.000 | 0 | 2.325.000 | PT. Hexpharm Jaya Laboratories |
| 1666 | Konsolidasi Obat | Akarbose tab 100 mg | 848 | 60.000 | 0 | 50.880.000 | P.T. Dexa Medica |
| 1667 | Konsolidasi Obat | Sisplatin inj 1 mg/mL, Vial 10 mg | 25.093 | 120 | 0 | 3.011.160 | PT Ferron Par Pharmaceuticals |
| 1668 | Konsolidasi Obat | Sisplatin inj 1 mg/mL, Vial 50 mg | 95.735 | 40 | 0 | 3.829.400 | PT Ferron Par Pharmaceuticals |
| 1669 | Konsolidasi Obat | Ifosfamid inj 1.000 mg | 1.662.950 | 5 | 0 | 8.314.750 | PT MENARINI INDRIA LABORATORIES |
| 1670 | Konsolidasi Obat | Doksorubisin inj 50 mg (i.v.) | 215.384 | 20 | 0 | 4.307.680 | PT. CKD OTTO Pharmaceuticals |
| 1671 | Konsolidasi Obat | Doksorubisin inj 10 mg (i.v.) | 42.302 | 20 | 0 | 846.040 | PT. CKD OTTO Pharmaceuticals |
| 1672 | Obat Program Jaminan Kesehatan | Dakarbazin/Dacarbazine inj 200 mg | 272.500 | 30 | 0 | 8.175.000 | PT DIPA PHARMALAB INTERSAINS |
| 1673 | Obat Program Jaminan Kesehatan | Amlodipine 5mg/amlodipine/amlodipin | 80 | 50.000 | 0 | 4.000.000 | PT. Mega Lifesciences Indonesia |
| 1674 | Obat Program Jaminan Kesehatan | Amlodipine 10mg/amlodipine/amlodipin | 95 | 50.000 | 0 | 4.750.000 | PT. Mega Lifesciences Indonesia |
| 1675 | Obat Program Jaminan Kesehatan | Fentanil/ Fentanyl injeksi 0,05 mg/ml (i.m/i.v) ampul/vial @ 2 mL | 30.000 | 2.500 | 0 | 75.000.000 | PT. Mahakam Beta Farma |
| 1676 | Konsolidasi Obat | Vinkristin inj 1 mg/mL, Vial 2 mL | 92.875 | 15 | 0 | 1.393.125 | PT SANBE FARMA |
| 1677 | Obat Program Jaminan Kesehatan | Moxifloxacin hydrochloride (HCl)/ Moxifloxacin/ Moksifloksasin infus 1,6 mg/mL (400mg/250ml) | 65.000 | 30 | 0 | 1.950.000 | P.T. Dexa Medica |
| 1678 | Fasilitas Kesehatan Sektoral Kemenkes | SYMMEX Bak Instruments Bertutup 250x300x50mm | 2.760.000 | 10 | 0 | 27.600.000 | PT. SYMMEX MEDICAL INDONESIA |
| 1679 | Fasilitas Kesehatan Sektoral Kemenkes | SYMMEX Instruments Bedah Umum Klem BOZEMANN 26cm | 820.000 | 10 | 0 | 8.200.000 | PT. SYMMEX MEDICAL INDONESIA |
| 1680 | Fasilitas Kesehatan Sektoral Kemenkes | SYMMEX Round Bowl 80x40mm | 345.000 | 10 | 0 | 3.450.000 | PT. SYMMEX MEDICAL INDONESIA |
| 1681 | Fasilitas Kesehatan Sektoral Kemenkes | M-Y Jelly 5gram, sachet | 50.283 | 40 | 0 | 2.011.320 | PT Jayamas Medica Industri |
| 1682 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock | 108.780 | 10 | 0 | 1.087.800 | PT Jayamas Medica Industri |
| 1683 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock with Tube | 179.820 | 6 | 0 | 1.078.920 | PT Jayamas Medica Industri |
| 1684 | Fasilitas Kesehatan Sektoral Kemenkes | Surgical Drape Universal,Standard | 297.780 | 10 | 0 | 2.977.800 | PT Jayamas Medica Industri |
| 1685 | Fasilitas Kesehatan Sektoral Kemenkes | Caesarean Drape Set | 421.800 | 10 | 0 | 4.218.000 | PT Jayamas Medica Industri |
| 1686 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 10 cm x 5 m | 41.958 | 24 | 0 | 1.006.992 | PT Jayamas Medica Industri |
| 1687 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 15 cm x 5 m | 67.488 | 90 | 0 | 6.073.920 | PT Jayamas Medica Industri |
| 1688 | Fasilitas Kesehatan Sektoral Kemenkes | N3 Suction Connecting Tube Standar | 17.500 | 300 | 0 | 5.250.000 | PT BUMI SARANA MAJU |
| 1689 | Fasilitas Kesehatan Sektoral Kemenkes | N3 Suction Connecting Tube With Yankauer | 19.000 | 100 | 0 | 1.900.000 | PT BUMI SARANA MAJU |
| 1690 | Fasilitas Kesehatan Sektoral Kemenkes | N-Flow Bulk Fill Ref. 1x2g IVA | 450.000 | 20 | 0 | 9.000.000 | PT.MURSMEDIC |
| 1691 | Fasilitas Kesehatan Sektoral Kemenkes | Refill 2x2 g | 460.000 | 10 | 0 | 4.600.000 | PT.MURSMEDIC |
| 1692 | Fasilitas Kesehatan Sektoral Kemenkes | OXISTER Pro ACLTD Hydrogen Peroxide 7,5% 20000 ml | 5.500.000 | 1 | 0 | 5.500.000 | PT MULTI REZEKI GLOBAL |
| 1693 | Fasilitas Kesehatan Sektoral Kemenkes | PO132R GRASPING FCPS.2X4T.D:5/310MM | 24.536.000 | 2 | 0 | 49.072.000 | PT. B.BRAUN MEDICAL INDONESIA |
| 1694 | Fasilitas Kesehatan Sektoral Kemenkes | PO237R MARYLAND DISS. W/CROSS TEETHING D:5/310MM | 31.936.000 | 1 | 0 | 31.936.000 | PT. B.BRAUN MEDICAL INDONESIA |
| 1695 | Fasilitas Kesehatan Sektoral Kemenkes | Sensor pressure aquastar | 4.200.000 | 1 | 0 | 4.200.000 | PT. MEDMAX GLOBAL INDOTAMA |
| 1696 | Fasilitas Kesehatan | POLYVAC SET 14 FG | 86.580 | 60 | 0 | 5.194.800 | PT. MEGAH MEDIKA PHARMA |
| 1697 | Fasilitas Kesehatan | POLYVAC SET 12 FG | 86.580 | 30 | 0 | 2.597.400 | PT. MEGAH MEDIKA PHARMA |
| 1698 | Fasilitas Kesehatan Sektoral Kemenkes | MANI Dia-Burs Rounded Shoulder Diamond Bur | 130.000 | 2 | 0 | 260.000 | PT.MURSMEDIC |
| 1699 | Fasilitas Kesehatan Sektoral Kemenkes | MANI Dia-Burs Ball Round Diamond Bur | 130.000 | 4 | 0 | 520.000 | PT.MURSMEDIC |
| 1700 | Fasilitas Kesehatan Sektoral Kemenkes | MANI Dia-Burs Flame Ogival End Diamond Bur | 130.000 | 6 | 0 | 780.000 | PT.MURSMEDIC |
| 1701 | Fasilitas Kesehatan | SPINOCAN 25GX3 1/2 (0.53X88 MM) | 34.248 | 300 | 0 | 10.274.400 | PT. B.BRAUN MEDICAL INDONESIA |
| 1702 | Fasilitas Kesehatan | SPINOCAN 26GX3 1/2 (0.47X88 MM) | 34.248 | 200 | 0 | 6.849.600 | PT. B.BRAUN MEDICAL INDONESIA |
| 1703 | Fasilitas Kesehatan Sektoral Kemenkes | SCALPEL BLADES NO 10 (100 PCS) | 301.000 | 5 | 0 | 1.505.000 | PT. B.BRAUN MEDICAL INDONESIA |
| 1704 | Fasilitas Kesehatan Sektoral Kemenkes | ZILBOX Safety Box 12.5 L | 22.999,2 | 250 | 0 | 5.749.800 | PT.INFION |
| 1705 | Fasilitas Kesehatan Sektoral Kemenkes | ZILBOX Safety Box 5 L | 14.549,88 | 250 | 0 | 3.637.470 | PT.INFION |
| 1706 | Fasilitas Kesehatan Sektoral Kemenkes | WaterLock WaterTrap 2 | 5.897.000 | 1 | 0 | 5.897.000 | PT Draeger Medical Indonesia |
| 1707 | Fasilitas Kesehatan Sektoral Kemenkes | Latex Examination Gloves Powder Free Size S | 42.200 | 500 | 0 | 21.100.000 | SINAR PANCA MEDIKA |
| 1708 | Fasilitas Kesehatan Sektoral Kemenkes | Latex Examination Gloves Powder Free Size M | 42.200 | 500 | 0 | 21.100.000 | SINAR PANCA MEDIKA |
| 1709 | Fasilitas Kesehatan Sektoral Kemenkes | Latex Examination Gloves Powder Free Size L | 42.200 | 50 | 0 | 2.110.000 | SINAR PANCA MEDIKA |
| 1710 | Fasilitas Kesehatan Sektoral Kemenkes | GRIFOLS DG Gel Coombs | 3.929.400 | 3 | 0 | 11.788.200 | PT Frismed Hoslab Indonesia |
| 1711 | Fasilitas Kesehatan Sektoral Kemenkes | DG Gel Sol | 1.265.400 | 3 | 0 | 3.796.200 | PT Frismed Hoslab Indonesia |
| 1712 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 20 cm x 100 m | 519.960 | 10 | 0 | 5.199.600 | PT Jayamas Medica Industri |
| 1713 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 25 cm x 100 m | 646.800 | 10 | 0 | 6.468.000 | PT Jayamas Medica Industri |
| 1714 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 40 cm x 100 m | 957.600 | 3 | 0 | 2.872.800 | PT Jayamas Medica Industri |
| 1715 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator 9 cm x 26 cm | 59.718 | 25 | 0 | 1.492.950 | PT Jayamas Medica Industri |
| 1716 | Fasilitas Kesehatan Sektoral Kemenkes | Latex Examination Gloves Powder Free | 42.200 | 1.050 | 0 | 44.310.000 | NAGA SUKSES JAYA |
| 1717 | Fasilitas Kesehatan Sektoral Kemenkes | CETRIMED Lite Desinfektan | 351.870 | 10 | 0 | 3.518.700 | Samudra Medika Laboratories |
| 1718 | Fasilitas Kesehatan | Cetrimed | 1.309.800 | 15 | 0 | 19.647.000 | Samudra Medika Laboratories |
| 1719 | Fasilitas Kesehatan | Cetricide 30 | 488.400 | 10 | 0 | 4.884.000 | Samudra Medika Laboratories |
| 1720 | Konsolidasi Obat | Vildagliptin tab 50 mg | 1.754 | 900 | 0 | 1.578.600 | P.T. Dexa Medica |
| 1721 | Konsolidasi Obat | Kapesitabin tab sal 500 mg | 5.445 | 1.800 | 0 | 9.801.000 | PT Ferron Par Pharmaceuticals |
| 1722 | Obat Program Jaminan Kesehatan | Generik Kombinasi: Ampisilin 1000 mg + Sulbaktam 500 mg serb inj 1500 mg | 20.000 | 300 | 0 | 6.000.000 | PT.Meiji Indonesia |
| 1723 | Obat Program Jaminan Kesehatan | Atropin inj 0,25 mg/mL (i.v./s.k.) | 4.117 | 500 | 0 | 2.058.500 | PT Ethica Industri Farmasi |
| 1724 | Konsolidasi Obat | Beraprost Sodium tab 20 mcg | 3.164 | 3.000 | 0 | 9.492.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1725 | Obat Program Jaminan Kesehatan | Asam traneksamat/Tranexamic acid tablet/kapsul/kaplet salut selaput 500 mg | 1.500 | 6.000 | 0 | 9.000.000 | PT. Hexpharm Jaya Laboratories |
| 1726 | Obat Program Jaminan Kesehatan | Atracurium Besilate/ Atrakurium injeksi 10 mg/mL (i.v) 2,5 ml | 8.880 | 1.200 | 0 | 10.656.000 | PT. ETERCON PHARMA |
| 1727 | Fasilitas Kesehatan | Laparascopy Bedah - Maryland Dissector 5mm 310mm / PO102R | 20.000.000 | 1 | 0 | 20.000.000 | PT. B.BRAUN MEDICAL INDONESIA |
| 1728 | Fasilitas Kesehatan | Kasa Steril 7.5 x 7.5 cm - 16 ply isi 10 LD, 71610 LD | 11.800 | 2.100 | 0 | 24.780.000 | PT Jayamas Medica Industri |
| 1729 | Fasilitas Kesehatan | Lap Sponge Abdominal Steril, 45 cm x 45 cm 8 ply isi 1 | 278.388 | 5 | 0 | 1.391.940 | PT Jayamas Medica Industri |
| 1730 | Fasilitas Kesehatan Sektoral Kemenkes | Arm Sling Comfort S | 18.648 | 10 | 0 | 186.480 | PT Jayamas Medica Industri |
| 1731 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix T Type A 10x25 cm | 108.780 | 10 | 0 | 1.087.800 | PT Jayamas Medica Industri |
| 1732 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix S IV | 49.728 | 60 | 0 | 2.983.680 | PT Jayamas Medica Industri |
| 1733 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Syringe 50 cc Ec tip without needle | 75.258 | 30 | 0 | 2.257.740 | PT Jayamas Medica Industri |
| 1734 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Tip | 145.188 | 7 | 0 | 1.016.316 | PT Jayamas Medica Industri |
| 1735 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Syringe 20 cc Ec tip without needle | 64.380 | 4 | 0 | 257.520 | PT Jayamas Medica Industri |
| 1736 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Colostomy Bag | 219.780 | 2 | 0 | 439.560 | PT Jayamas Medica Industri |
| 1737 | Fasilitas Kesehatan Sektoral Kemenkes | Extension Tube | 6.105 | 300 | 0 | 1.831.500 | PT Jayamas Medica Industri |
| 1738 | Fasilitas Kesehatan Sektoral Kemenkes | Headstrap Dewasa | 58.608 | 50 | 0 | 2.930.400 | PT Jayamas Medica Industri |
| 1739 | Fasilitas Kesehatan Sektoral Kemenkes | Maxiflow Dewasa | 10.323 | 750 | 0 | 7.742.250 | PT Jayamas Medica Industri |
| 1740 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR16, 125cm | 7.992 | 180 | 0 | 1.438.560 | PT Jayamas Medica Industri |
| 1741 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR18, 125cm | 7.992 | 50 | 0 | 399.600 | PT Jayamas Medica Industri |
| 1742 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR8, 40cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1743 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR5, 40cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1744 | Fasilitas Kesehatan Sektoral Kemenkes | Umbilical Cord Clamp | 89.910 | 2 | 0 | 179.820 | PT Jayamas Medica Industri |
| 1745 | Fasilitas Kesehatan Sektoral Kemenkes | Urobag 2000 | 5.000 | 1.000 | 0 | 5.000.000 | PT Jayamas Medica Industri |
| 1746 | Fasilitas Kesehatan Sektoral Kemenkes | Bacterial Filter HMEF | 21.978 | 100 | 0 | 2.197.800 | PT Jayamas Medica Industri |
| 1747 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 2 | 16.428 | 5 | 0 | 82.140 | PT Jayamas Medica Industri |
| 1748 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed Anesthesia Mask Size 5 | 16.428 | 30 | 0 | 492.840 | PT Jayamas Medica Industri |
| 1749 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 6 | 16.428 | 5 | 0 | 82.140 | PT Jayamas Medica Industri |
| 1750 | Obat Program Jaminan Kesehatan | NaCl 0.9% / Sodium Chloride 0.9%, 500 mL | 6.138 | 10.000 | 0 | 61.380.000 | PT. SATORIA ANEKA INDUSTRI |
| 1751 | Konsolidasi Obat | Betahistin tab 6 mg | 189 | 10.000 | 0 | 1.890.000 | P.T. Dexa Medica |
| 1752 | Konsolidasi Obat | Morfin tab 10 mg | 1.199 | 1.020 | 0 | 1.222.980 | PT. Kimia Farma Tbk |
| 1753 | Konsolidasi Obat | Parasetamol tab 500 mg | 100 | 30.000 | 0 | 3.000.000 | PT. TRIMAN |
| 1754 | Fasilitas Kesehatan Sektoral Kemenkes | ETHICON VICRYL Plus (VCP303H) | 4.400.000 | 1 | 0 | 4.400.000 | PT Johnson and Johnson Indonesia Two |
| 1755 | Fasilitas Kesehatan Sektoral Kemenkes | ETHICON VICRYL Plus (VCP310H) | 4.356.596 | 1 | 0 | 4.356.596 | PT Johnson and Johnson Indonesia Two |
| 1756 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP317H) | 4.834.855 | 1 | 0 | 4.834.855 | PT Johnson and Johnson Indonesia Two |
| 1757 | Fasilitas Kesehatan Sektoral Kemenkes | PDS Plus (PDP127H) | 7.175.817 | 1 | 0 | 7.175.817 | PT Johnson and Johnson Indonesia Two |
| 1758 | Fasilitas Kesehatan | S61 T-Silk Silk/Sutera 3-0, 76 cm Round Bodied, 1/2 circle, 17 mm | 46.176 | 48 | 0 | 2.216.448 | PT Medihop |
| 1759 | Fasilitas Kesehatan | C98 T-Chromic Catgut Chromic 1, 100 cm Blunt Point, 1/2 circle, 64.6 mm | 86.802 | 12 | 0 | 1.041.624 | PT Medihop |
| 1760 | Fasilitas Kesehatan | L36 T-Lene Polyvinylidene 2-0, 76 cm Round Bodied, 1/2 circle, 30 mm | 82.917 | 12 | 0 | 995.004 | PT Medihop |
| 1761 | Fasilitas Kesehatan | M51 T-Mono Polyglecaprone25 3-0, 76 cm Reverse Cutting, 3/8 circle, 24 mm | 107.781 | 12 | 0 | 1.293.372 | PT Medihop |
| 1762 | Fasilitas Kesehatan | S21 T-Silk Silk/Sutera 3-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 45.510 | 36 | 0 | 1.638.360 | PT Medihop |
| 1763 | Fasilitas Kesehatan | V5 T-Vio Polyglycolide 3-0, 76 cm Round Bodied, 1/2 circle, 20 mm | 87.135 | 36 | 0 | 3.136.860 | PT Medihop |
| 1764 | Fasilitas Kesehatan | V16 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 48 mm | 86.691 | 60 | 0 | 5.201.460 | PT Medihop |
| 1765 | Fasilitas Kesehatan | V15 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 40 mm | 86.691 | 60 | 0 | 5.201.460 | PT Medihop |
| 1766 | Fasilitas Kesehatan | N37 T-Nylon Nylon 4-0, 76 cm Reverse Cutting, 3/8 circle, 18 mm | 48.396 | 60 | 0 | 2.903.760 | PT Medihop |
| 1767 | Fasilitas Kesehatan | ORC-01 T-Hemocel Absorbable Hemostatic Sheet uk 5cm x 7.5cm | 75.177 | 30 | 0 | 2.255.310 | PT Medihop |
| 1768 | Fasilitas Kesehatan | MIDAS REX HIGH SPEED DRILL - NEURO SPINE | 748.000.000 | 1 | 6.500.000 | 754.500.000 | PT. Medtronic Indonesia |
| 1769 | Obat Program Jaminan Kesehatan | Larutan mengandung Elektrolit (Na 130 mEq, K 4 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq) ASERING softbag @ 500 mL | 8.750 | 600 | 0 | 5.250.000 | PT. Otsuka Indonesia |
| 1770 | Obat Program Jaminan Kesehatan | Larutan mengandung Asam Amino (Asam Amino 15 g, Glukosa 37,5 g, Tiamin HCl 0,75 mg, elektrolit), @ 500 mL | 107.690 | 120 | 0 | 12.922.800 | PT. Otsuka Indonesia |
| 1771 | Obat Program Jaminan Kesehatan | Omeprazol/Omeprazole/ Omeoprazole Sodium inj 40 mg | 5.000 | 2.000 | 0 | 10.000.000 | PT. Mahakam Beta Farma |
| 1772 | Obat Program Jaminan Kesehatan | Nicardipine hydrochloride (HCl)/ Nicardipine/ Nikardipin inj 1 mg/mL | 13.000 | 2.000 | 0 | 26.000.000 | P.T. Dexa Medica |
| 1773 | Konsolidasi Obat | Risedronat tab sal selaput 35 mg | 29.645 | 400 | 0 | 11.858.000 | PT KALBE FARMA Tbk |
| 1774 | Obat Non Jaminan Kesehatan | CURVIPLEX SYRUP - SIRUP MENGANDUNG CURCUMA DAN MULTIVITAMIN ANAK | 9.000 | 200 | 0 | 1.800.000 | PT. Graha Farma |
| 1775 | Obat Program Jaminan Kesehatan | ARZOLA - Aripiprazol Oral Solution 1 mg/ml | 168.720 | 20 | 0 | 3.374.400 | PT. SIMEX PHARMACEUTICAL INDONESIA |
| 1776 | Konsolidasi Obat | Setirizin tab 10 mg | 72 | 30.000 | 0 | 2.160.000 | PT. Sampharindo Perdana |
| 1777 | Konsolidasi Obat | Simvastatin tab 20 mg | 172 | 15.000 | 0 | 2.580.000 | PT. Sampharindo Perdana |
| 1778 | Obat Program Jaminan Kesehatan | ESITALOPRAM 20 | 5.850 | 300 | 0 | 1.755.000 | PT. Amarox Pharma Global |
| 1779 | Obat Program Jaminan Kesehatan | Aminofilin/Aminophylline inj 24 mg/ml | 7.770 | 150 | 0 | 1.165.500 | PT.Phapros Tbk |
| 1780 | Obat Program Jaminan Kesehatan | PANTOPRAZOLE SODIUM SESQUIHYDRATE 40MG SERBUK INJEKSI | 10.000 | 1.000 | 0 | 10.000.000 | PT. Mahakam Beta Farma |
| 1781 | Obat Program Jaminan Kesehatan | Cefixime trihydrate/ Cefixime/ Sefiksim sirup/ sirup kering 100 mg/ 5 ml | 8.280 | 200 | 0 | 1.656.000 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 1782 | Obat Program Jaminan Kesehatan | Dakarbazin/Dacarbazine inj 200 mg | 272.500 | 30 | 0 | 8.175.000 | PT DIPA PHARMALAB INTERSAINS |
| 1783 | Fasilitas Kesehatan Sektoral Kemenkes | ON-CALL Plus Blood Glucose Test Strip (2x25) | 167.286 | 100 | 0 | 16.728.600 | PT. Mitra Bahagia Citra Medika |
| 1784 | Fasilitas Kesehatan Sektoral Kemenkes | Surgipath Reagent Alcohol | 488.400 | 6 | 0 | 2.930.400 | PT.BIOGEN SCIENTIFIC |
| 1785 | Fasilitas Kesehatan Sektoral Kemenkes | SURGIPATH EOSIN | 277.500 | 2 | 0 | 555.000 | PT.BIOGEN SCIENTIFIC |
| 1786 | Fasilitas Kesehatan Sektoral Kemenkes | Harris Hematoxyline (LEICA) | 410.700 | 2 | 0 | 821.400 | PT.BIOGEN SCIENTIFIC |
| 1787 | Fasilitas Kesehatan Sektoral Kemenkes | SURGIPATH 10 Neutral Buffered Formalin | 399.600 | 16 | 0 | 6.393.600 | PT.BIOGEN SCIENTIFIC |
| 1788 | Fasilitas Kesehatan Sektoral Kemenkes | Surgipath EA50 | 288.600 | 1 | 0 | 288.600 | PT.BIOGEN SCIENTIFIC |
| 1789 | Fasilitas Kesehatan Sektoral Kemenkes | Surgipath Orange G-6 | 333.000 | 1 | 0 | 333.000 | PT.BIOGEN SCIENTIFIC |
| 1790 | Fasilitas Kesehatan Sektoral Kemenkes | BOND Printer Ribbon & Labels Cxi (1Pack) | 7.059.600 | 1 | 0 | 7.059.600 | PT.BIOGEN SCIENTIFIC |
| 1791 | Fasilitas Kesehatan Sektoral Kemenkes | SURGIPATH Xylene | 1.087.800 | 2 | 0 | 2.175.600 | PT.BIOGEN SCIENTIFIC |
| 1792 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 10 ML LUER LOCK WITH NEEDLE 21GX1-1/2INCH (38MM) | 1.443 | 14.000 | 0 | 20.202.000 | PT. SINAR RODA UTAMA |
| 1793 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 1 ML LUER SLIP / 26GX1/2INCH (13MM) | 1.110 | 1.000 | 0 | 1.110.000 | PT. SINAR RODA UTAMA |
| 1794 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 3 ML LUER LOCK WITH NEEDLE 23GX1-1/4INCH (32MM) | 999 | 9.600 | 0 | 9.590.400 | PT. SINAR RODA UTAMA |
| 1795 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 5 ML LUER LOCK WITH NEEDLE 22GX1-1/2INCH (38MM) | 1.110 | 8.500 | 0 | 9.435.000 | PT. SINAR RODA UTAMA |
| 1796 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 20G X 1-1/4 INCH (32MM) | 6.660 | 3.000 | 0 | 19.980.000 | PT. SINAR RODA UTAMA |
| 1797 | Fasilitas Kesehatan Sektoral Kemenkes | Urine Container 60 ml non steril | 999 | 600 | 0 | 599.400 | PT Jayamas Medica Industri |
| 1798 | Konsolidasi Obat | Sacubitril Valsartan tab sal selaput 48,6/51,4 mg | 8.538 | 140 | 0 | 1.195.320 | PT Novartis Indonesia |
| 1799 | Obat Non Jaminan Kesehatan | KETORENAL - KAPLET | 2.597 | 7.500 | 0 | 19.477.500 | PT. SOHO Industri Pharmasi |
| 1800 | Obat Program Jaminan Kesehatan | CEFOPERAZONE SODIUM SERBUK INJEKSI 1G | 8.500 | 60 | 0 | 510.000 | PT. RAMA EMERALD MULTI SUKSES |
| 1801 | Obat Program Jaminan Kesehatan | Analog Insulin : insulin basal injeksi 100 IU/mL | 74.000 | 500 | 0 | 37.000.000 | PT KALBE FARMA Tbk |
| 1802 | Obat Program Jaminan Kesehatan | Amoksisilin/Amoxicillin/Amoxicillin Trihydrate sirup/suspensi kering 125 mg/ 5 ml | 3.480 | 150 | 0 | 522.000 | PT. Mersifarma Tirmaku Mercusana |
| 1803 | Konsolidasi Obat | Klopidogrel tab 75 mg | 560 | 75.000 | 0 | 42.000.000 | PT. Beta Pharmacon |
| 1804 | Konsolidasi Obat | Latanoprost tts mata 0,005% | 64.103 | 50 | 0 | 3.205.150 | PT SANBE FARMA |
| 1805 | Obat Program Jaminan Kesehatan | Digoxin tablet 0,25 mg | 300 | 5.000 | 0 | 1.500.000 | PT Yarindo Farmatama |
| 1806 | Obat Program Jaminan Kesehatan | Eritromisin/ Erythromycin/tablet/kapsul/kaplet 500 mg | 1.439 | 1.000 | 0 | 1.439.000 | PT Yarindo Farmatama |
| 1807 | Obat Program Jaminan Kesehatan | Ofloxacin/ Ofloksasin tets telinga 3% | 37.974 | 60 | 0 | 2.278.440 | PT SANBE FARMA |
| 1808 | Obat Program Jaminan Kesehatan | Domperidon/ Domperidone tablet/kapsul/kaplet 10 mg | 107 | 9.000 | 0 | 963.000 | PT. TRIMAN |
| 1809 | Obat Program Jaminan Kesehatan | Antasida Doen susp | 2.471 | 100 | 0 | 247.100 | PT. LUCAS DJAJA |
| 1810 | Konsolidasi Obat | Trifluoperazin tab sal selaput 5 mg | 234 | 15.000 | 0 | 3.510.000 | PT. Mersifarma Tirmaku Mercusana |
| 1811 | Konsolidasi Obat | Asam mefenamat tab 500 mg | 155 | 45.000 | 0 | 6.975.000 | PT. Hexpharm Jaya Laboratories |
| 1812 | Konsolidasi Obat | Lansoprazol kaps 30 mg | 384 | 30.000 | 0 | 11.520.000 | PT. Hexpharm Jaya Laboratories |
| 1813 | Konsolidasi Obat | N-asetil sistein kaps 200 mg | 320 | 40.000 | 0 | 12.800.000 | P.T. Dexa Medica |
| 1814 | Konsolidasi Obat | Pioglitazon tab 30 mg | 747 | 12.000 | 0 | 8.964.000 | P.T. Dexa Medica |
| 1815 | Konsolidasi Obat | Ramipril tab 5 mg | 155 | 6.000 | 0 | 930.000 | P.T. Dexa Medica |
| 1816 | Konsolidasi Obat | Valsartan tab 160 mg | 718 | 25.020 | 0 | 17.964.360 | P.T. Dexa Medica |
| 1817 | Obat Program Jaminan Kesehatan | Cefazolin sodium/ Sefazolin serbuk injeksi 1.000 mg | 9.800 | 2.000 | 0 | 19.600.000 | P.T. Dexa Medica |
| 1818 | Obat Program Jaminan Kesehatan | Ceftriaxone/ Ceftriaxone Sodium/ Seftriakson inj 1.000 mg | 4.500 | 10.000 | 0 | 45.000.000 | P.T. Dexa Medica |
| 1819 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride(HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin inf 2 mg/ml | 10.100 | 180 | 0 | 1.818.000 | P.T. Dexa Medica |
| 1820 | Konsolidasi Obat | Siklofosfamid inj 1.000 mg (i.v.) | 181.000 | 100 | 0 | 18.100.000 | PT Ferron Par Pharmaceuticals |
| 1821 | Konsolidasi Obat | Dosetaksel inj 80 mg | 610.000 | 10 | 0 | 6.100.000 | PT Ferron Par Pharmaceuticals |
| 1822 | Konsolidasi Obat | Dosetaksel inj 20 mg | 160.000 | 10 | 0 | 1.600.000 | PT Ferron Par Pharmaceuticals |
| 1823 | Konsolidasi Obat | Fluorourasil inj 50 mg/mL | 19.200 | 100 | 0 | 1.920.000 | PT Ferron Par Pharmaceuticals |
| 1824 | Konsolidasi Obat | Vinorelbin inj 10 mg/mL, Vial 1 mL | 349.000 | 4 | 0 | 1.396.000 | PT Ferron Par Pharmaceuticals |
| 1825 | Konsolidasi Obat | Paklitaksel inj 6 mg/mL, Vial 5 mL | 108.000 | 50 | 0 | 5.400.000 | PT FONKO INTERNATIONAL PHARMACEUTICALS |
| 1826 | Konsolidasi Obat | Paklitaksel inj 6 mg/mL, Vial 16,7 mL | 136.500 | 50 | 0 | 6.825.000 | PT FONKO INTERNATIONAL PHARMACEUTICALS |
| 1827 | Konsolidasi Obat | Gemsitabin inj 200 mg | 87.629 | 30 | 0 | 2.628.870 | PT FONKO INTERNATIONAL PHARMACEUTICALS |
| 1828 | Obat Program Jaminan Kesehatan | Ciprofloxacin hydrochloride (HCl)/ Ciprofloxacin Lactate/ Ciprofloxacin/ Siprofloksasin tablet/kapsul/kaplet 500 mg | 350 | 3.000 | 0 | 1.050.000 | PT. Hexpharm Jaya Laboratories |
| 1829 | Obat Program Jaminan Kesehatan | Kombinasi: sefoperazon/ cefoperazone sodium 500 mg + sulbaktam/ sulbactam sodium 500 mg, serb inj 1.000 mg | 20.000 | 60 | 0 | 1.200.000 | PT.Bernofarm |
| 1830 | Obat Program Jaminan Kesehatan | Levofloxacin hemihydrate/ Levofloxacin/Levofloksasin tts mata 0,5% | 17.000 | 150 | 0 | 2.550.000 | PT Ferron Par Pharmaceuticals |
| 1831 | Fasilitas Kesehatan | 10 cm x 2.7 m | 19.480 | 72 | 0 | 1.402.560 | PT Sinaraya Nugraha Ahmadaris Medika |
| 1832 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED ElastoOne Cohesive Bandage lebar 12CM X 4M | 21.090 | 5 | 0 | 105.450 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1833 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED ElastoOne Cohesive Bandage lebar 10CM X4M | 18.870 | 5 | 0 | 94.350 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1834 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY FR10 | 28.971 | 10 | 0 | 289.710 | PT. MEGAH MEDIKA PHARMA |
| 1835 | Fasilitas Kesehatan | POLYFLEX IV CANNULA WITH INJECTION PORT 26G X 3/4 INCHI P1019B | 9.933,39 | 600 | 0 | 5.960.034 | PT. MEGAH MEDIKA PHARMA |
| 1836 | Fasilitas Kesehatan | POLYVAC SET 12 FG | 86.580 | 60 | 0 | 5.194.800 | PT. MEGAH MEDIKA PHARMA |
| 1837 | Fasilitas Kesehatan Sektoral Kemenkes | HAMILTON Bonnet nCPAP-PS Small | 259.324 | 6 | 0 | 1.555.944 | PT. SARANA LINTAS MEDIKA |
| 1838 | Fasilitas Kesehatan Sektoral Kemenkes | HAMILTON Mask nCPAP-PS Medium | 247.669 | 15 | 0 | 3.715.035 | PT. SARANA LINTAS MEDIKA |
| 1839 | Fasilitas Kesehatan | ECG Roll Paper 63mm x 30m | 21.000 | 30 | 0 | 630.000 | PT IDS MEDICAL SYSTEMS INDONESIA |
| 1840 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 16GX2 INCH (50MM) | 5.550 | 150 | 0 | 832.500 | PT. SINAR RODA UTAMA |
| 1841 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 22G X 1 INCH (25MM) | 6.660 | 1.600 | 0 | 10.656.000 | PT. SINAR RODA UTAMA |
| 1842 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 20 ML LUER SLIP WITHOUT NEEDLE | 2.109 | 100 | 0 | 210.900 | PT. SINAR RODA UTAMA |
| 1843 | Fasilitas Kesehatan Sektoral Kemenkes | PUIND Disposable Infusion Set A103C Airvent Y With Cap | 5.550 | 200 | 0 | 1.110.000 | FARIZTA JAYA AGUNG |
| 1844 | Fasilitas Kesehatan Sektoral Kemenkes | Ureteral Stent 5.0 FR 26 CM BOTH ENDS OPEN | 331.514 | 20 | 0 | 6.630.280 | PT. EDISON DUTA SARANA |
| 1845 | Fasilitas Kesehatan Sektoral Kemenkes | Ultrasonic Gel 5 liter | 158.730 | 4 | 0 | 634.920 | PT Jayamas Medica Industri |
| 1846 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock | 108.780 | 10 | 0 | 1.087.800 | PT Jayamas Medica Industri |
| 1847 | Fasilitas Kesehatan Sektoral Kemenkes | Electrosurgical (ESU) Pencil | 29.748 | 20 | 0 | 594.960 | PT Jayamas Medica Industri |
| 1848 | Fasilitas Kesehatan Sektoral Kemenkes | Hidrogen Peroxide 3 | 27.528 | 20 | 0 | 550.560 | PT Jayamas Medica Industri |
| 1849 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free 8 | 250.000 | 4 | 0 | 1.000.000 | PT Jayamas Medica Industri |
| 1850 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 4 | 16.428 | 20 | 0 | 328.560 | PT Jayamas Medica Industri |
| 1851 | Fasilitas Kesehatan Sektoral Kemenkes | M-Y Jelly 5gram, sachet | 50.283 | 50 | 0 | 2.514.150 | PT Jayamas Medica Industri |
| 1852 | Fasilitas Kesehatan Sektoral Kemenkes | Oxyflow Dewasa (Nasal oxygen cannula) | 5.400 | 450 | 0 | 2.430.000 | PT Jayamas Medica Industri |
| 1853 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 10 cm x 5 m | 41.958 | 40 | 0 | 1.678.320 | PT Jayamas Medica Industri |
| 1854 | Obat Program Jaminan Kesehatan | Furosemid/ Furosemide tablet/kapsul/kaplet 40 mg | 222 | 60.000 | 0 | 13.320.000 | PT. Kimia Farma Tbk |
| 1855 | Obat Program Jaminan Kesehatan | Bupivakain inj 0,5% | 51.803 | 500 | 0 | 25.901.500 | PT.Bernofarm |
| 1856 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 15H | 487.290 | 500 | 0 | 243.645.000 | PT. SINAR RODA UTAMA |
| 1857 | Fasilitas Kesehatan Sektoral Kemenkes | Paket Hemodialisa Dewasa Lengkap Elisio 13H | 487.290 | 1.500 | 0 | 730.935.000 | PT. SINAR RODA UTAMA |
| 1858 | Obat Program Kesehatan Lainnya | Rebamipide 100 mg FC Tablet | 1.300 | 1.500 | 0 | 1.950.000 | PT. Interbat |
| 1859 | Konsolidasi Obat | Tenofovir Tab Sal Selaput 300 mg | 2.189 | 2.520 | 0 | 5.516.280 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1860 | Konsolidasi Obat | Sulfasalazin Kapl Sal Enterik 500 mg | 3.541 | 3.000 | 0 | 10.623.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1861 | Fasilitas Kesehatan | Medical Recording Chart Paper, Kertas ECG / EKG Paper ukuran 210MM X 280MM X 200 Lembar, Z-Fold (Pack), WA940180000 | 462.000 | 4 | 0 | 1.848.000 | PT. ENDO Indonesia |
| 1862 | Obat Program Jaminan Kesehatan | Deksametason/ Dexamethasone tablet/kaplet 0,5 mg | 80 | 6.000 | 0 | 480.000 | PT.Imfarmind Farmasi Industri |
| 1863 | Konsolidasi Obat | Metotreksat tab 2,5 mg | 1.500 | 3.000 | 0 | 4.500.000 | PT. DANKOS FARMA |
| 1864 | Obat Program Kesehatan Lainnya | KETOPROFEN 100 mg TSE | 799 | 5.000 | 0 | 3.995.000 | PT.Bernofarm |
| 1865 | Obat Program Jaminan Kesehatan | Ranitidine hydrochloride (HCl)/ Ranitidin injeksi 25 mg/ml | 1.200 | 15.000 | 0 | 18.000.000 | PT.Phapros Tbk |
| 1866 | Konsolidasi Obat | Sertralin tab sal 50 mg | 1.332 | 3.000 | 0 | 3.996.000 | PT Pratapa Nirmala |
| 1867 | Obat Program Jaminan Kesehatan | Fluconazole / Flukonazol injeksi/ infus 2 mg/ml | 22.000 | 60 | 0 | 1.320.000 | P.T. Dexa Medica |
| 1868 | Obat Program Jaminan Kesehatan | Methylergometrine Maleate/ Methylergometrine/ Metilergometrin inj 0,2 mg/ml | 2.300 | 150 | 0 | 345.000 | P.T. Dexa Medica |
| 1869 | Obat Program Jaminan Kesehatan | Ondansetron hydrochloride (HCl)/ Ondansetron HCl dihydrate /Ondansetron inj 2 mg/mL | 1.195 | 20.000 | 0 | 23.900.000 | P.T. Dexa Medica |
| 1870 | Konsolidasi Obat | Sitagliptin tab sal selaput 100 mg | 2.975 | 308 | 0 | 916.300 | PT. Amarox Pharma Global |
| 1871 | Fasilitas Kesehatan Sektoral Kemenkes | SUPLASYNregister Sterile Sodium Hyaluronate Solution | 2.325.173 | 2 | 0 | 4.650.346 | PT DIPA PHARMALAB INTERSAINS |
| 1872 | Obat Program Kesehatan Lainnya | KETOROLAK TABLET SS 10 MG | 950 | 300 | 0 | 285.000 | PT.INFION |
| 1873 | Konsolidasi Obat | Alopurinol tab 100 mg | 155 | 15.000 | 0 | 2.325.000 | PT. Hexpharm Jaya Laboratories |
| 1874 | Konsolidasi Obat | Glimepirid tab 3 mg | 285 | 30.000 | 0 | 8.550.000 | PT. Hexpharm Jaya Laboratories |
| 1875 | Konsolidasi Obat | Ranitidin tab 150 mg | 149 | 12.000 | 0 | 1.788.000 | PT. Hexpharm Jaya Laboratories |
| 1876 | Obat Program Jaminan Kesehatan | Sukralfat / Sucralfate susp 500 mg/5 mL, 100 mL | 7.150 | 2.000 | 0 | 14.300.000 | PT. COMBINED IMPERIAL PHARMACEUTICALS |
| 1877 | Konsolidasi Obat | Diltiazem kaps lepas lambat 200 mg | 5.485 | 3.000 | 0 | 16.455.000 | PT MITSUBISHI TANABE PHARMA INDONESIA |
| 1878 | Konsolidasi Obat | Glimepirid tab 4 mg | 308 | 4.000 | 0 | 1.232.000 | P.T. Dexa Medica |
| 1879 | Konsolidasi Obat | Nifedipin tab 10 mg | 144 | 3.000 | 0 | 432.000 | P.T. Dexa Medica |
| 1880 | Obat Program Jaminan Kesehatan | Kalsium glukonat / Calcium gluconate inj 10% | 8.879 | 300 | 0 | 2.663.700 | PT Ethica Industri Farmasi |
| 1881 | Obat Program Jaminan Kesehatan | Paracetamol/ Parasetamol infus 10 mg/mL | 11.200 | 5.000 | 0 | 56.000.000 | PT Darya Varia |
| 1882 | Konsolidasi Obat | Hidroksiklorokuin tab 200 mg | 2.628 | 1.500 | 0 | 3.942.000 | PT Imedco Djaja |
| 1883 | Obat Program Jaminan Kesehatan | Air untuk injeksi, cairan inj 25 mL | 2.512 | 3.600 | 0 | 9.043.200 | PT. SATORIA ANEKA INDUSTRI |
| 1884 | Obat Program Jaminan Kesehatan | NaCl / Sodium Chloride 0.9%, @100 mL | 6.056 | 3.000 | 0 | 18.168.000 | PT. SATORIA ANEKA INDUSTRI |
| 1885 | Obat Program Jaminan Kesehatan | NaCl 0.9% / Sodium Chloride 0.9%, 500 mL | 6.139 | 12.500 | 0 | 76.737.500 | PT. SATORIA ANEKA INDUSTRI |
| 1886 | Obat Program Jaminan Kesehatan | NYSTATIN DROPS 100.000 iu/ml | 14.807,4 | 150 | 0 | 2.221.110 | PT LAPI LABORATORIES |
| 1887 | Obat Program Jaminan Kesehatan | Paracetamol/ Parasetamol sirup 120 mg / 5 ml | 2.999 | 300 | 0 | 899.700 | PT. Mersifarma Tirmaku Mercusana |
| 1888 | Konsolidasi Obat | Leuprorelin asetat serb inj 3,75 mg | 720.000 | 10 | 0 | 7.200.000 | PT KALBE FARMA Tbk |
| 1889 | Obat Program Jaminan Kesehatan | Levofloxacin hemihydrate/ Levofloxacin/ Levofloksasin inf 500 mg/100Ml (levo 500) TD | 16.999 | 100 | 0 | 1.699.900 | PT.Bernofarm |
| 1890 | Fasilitas Kesehatan Sektoral Kemenkes | ZILBOX Safety Box 12.5 L | 22.999 | 500 | 0 | 11.499.500 | PT.INFION |
| 1891 | Fasilitas Kesehatan Sektoral Kemenkes | Sarung Tangan Obgyn | 17.000 | 300 | 0 | 5.100.000 | PT Jayamas Medica Industri |
| 1892 | Fasilitas Kesehatan Sektoral Kemenkes | Surgical Mask Earloop Plus, 3 ply | 14.000 | 1.000 | 0 | 14.000.000 | PT Jayamas Medica Industri |
| 1893 | Fasilitas Kesehatan Sektoral Kemenkes | bayMEDIKA Enzymatic Detergent 5 L | 1.300.600 | 10 | 0 | 13.006.000 | PT. Likuid Pharmalab Indonesia |
| 1894 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4 % ukuran 5L | 278.899 | 10 | 0 | 2.788.990 | PT. Likuid Pharmalab Indonesia |
| 1895 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Chlorhexidine 4% ukuran 500 ml | 30.725 | 500 | 0 | 15.362.500 | PT. Likuid Pharmalab Indonesia |
| 1896 | Fasilitas Kesehatan Sektoral Kemenkes | CETRIMED Lite Desinfektan | 351.870 | 10 | 0 | 3.518.700 | Samudra Medika Laboratories |
| 1897 | Fasilitas Kesehatan | Cetricide 30 | 488.400 | 10 | 0 | 4.884.000 | Samudra Medika Laboratories |
| 1898 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Adult Elongated (XL) | 17.850 | 100 | 0 | 1.785.000 | PT. BUANA INTIPRIMA USAHA |
| 1899 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Pediatric Elongated (M) | 17.850 | 100 | 0 | 1.785.000 | PT. BUANA INTIPRIMA USAHA |
| 1900 | Fasilitas Kesehatan | VITAL-CATH Closed 63120 | 193.920 | 3 | 0 | 581.760 | PT Surgika Alkesindo |
| 1901 | Fasilitas Kesehatan | VITAL-CATH Closed 67140 | 253.440 | 2 | 0 | 506.880 | PT Surgika Alkesindo |
| 1902 | Fasilitas Kesehatan Sektoral Kemenkes | Jackson Rees Dewasa | 235.000 | 55 | 0 | 12.925.000 | PT Jayamas Medica Industri |
| 1903 | Fasilitas Kesehatan | Kasa Steril 7.5 x 7.5 cm - 16 ply isi 10 LD, 71610 LD | 11.800 | 3.990 | 0 | 47.082.000 | PT Jayamas Medica Industri |
| 1904 | Konsolidasi Obat | Pramipeksol tab lepas lambat 0,750 mg | 8.541 | 900 | 0 | 7.686.900 | PT. SOHO Industri Pharmasi |
| 1905 | Obat Program Jaminan Kesehatan | Ringer Laktat/Ringer Lactate, @500 mL | 6.799 | 3.000 | 0 | 20.397.000 | PT. SATORIA ANEKA INDUSTRI |
| 1906 | Konsolidasi Obat | Doksorubisin inj 10 mg (i.v.) | 42.302 | 20 | 0 | 846.040 | PT. CKD OTTO Pharmaceuticals |
| 1907 | Konsolidasi Obat | Tiamazol Tab 5 mg | 555 | 6.000 | 0 | 3.330.000 | PT. NOVELL PHARMACEUTICAL LABORATORIES |
| 1908 | Fasilitas Kesehatan Sektoral Kemenkes | Aminophylline 200mg Tab | 284 | 6.000 | 0 | 1.704.000 | PT. Imar Karya Tama |
| 1909 | Fasilitas Kesehatan Sektoral Kemenkes | Curcuma Tablet | 496 | 20.000 | 0 | 9.920.000 | PT. Imar Karya Tama |
| 1910 | Obat Program Jaminan Kesehatan | Cetirizine hydrochloride(HCl)/ Cetirizine/ Setirizin sirup 5 mg/5 ml | 3.800 | 100 | 0 | 380.000 | PT. Sampharindo Perdana |
| 1911 | Obat Non Jaminan Kesehatan | IKAPHEN KAPSUL | 955 | 6.000 | 0 | 5.730.000 | PT Ikapharmindo Putramas |
| 1912 | Konsolidasi Obat | Kalsium folinat (leucovorin, Ca) inj 10 mg/mL | 22.220 | 30 | 0 | 666.600 | PT Ferron Par Pharmaceuticals |
| 1913 | Konsolidasi Obat | Epirubisin inj 2 mg/mL, Vial 25 mL | 395.000 | 50 | 0 | 19.750.000 | PT Ferron Par Pharmaceuticals |
| 1914 | Konsolidasi Obat | Oksaliplatin serb inj 50 mg | 238.650 | 4 | 0 | 954.600 | PT Ferron Par Pharmaceuticals |
| 1915 | Konsolidasi Obat | Asam zoledronat inf 4 mg/100 mL | 444.000 | 5 | 0 | 2.220.000 | PT Ferron Par Pharmaceuticals |
| 1916 | Konsolidasi Obat | Fluoksetin tab/kaps 20 mg | 232 | 10.020 | 0 | 2.324.640 | PT. Mersifarma Tirmaku Mercusana |
| 1917 | Konsolidasi Obat | Klobazam tab 10 mg | 409 | 20.000 | 0 | 8.180.000 | P.T. Dexa Medica |
| 1918 | Konsolidasi Obat | Ifosfamid inj 1.000 mg | 1.662.950 | 5 | 0 | 8.314.750 | PT MENARINI INDRIA LABORATORIES |
| 1919 | Obat Program Jaminan Kesehatan | Lactulose/ Laktulosa sir 3,335 g/5 mL | 12.533 | 300 | 0 | 3.759.900 | PT Ikapharmindo Putramas |
| 1920 | Obat Program Jaminan Kesehatan | Cefadroxil monohydrate/ Cefadroxil/ Sefadroksil tablet/kapsul/kaplet 500 mg | 820 | 6.000 | 0 | 4.920.000 | PT. Hexpharm Jaya Laboratories |
| 1921 | Obat Program Jaminan Kesehatan | Meropenem/ Meropenem Trihydrate serb inj 1.000 mg | 32.000 | 1.500 | 0 | 48.000.000 | PT. Hexpharm Jaya Laboratories |
| 1922 | Obat Program Jaminan Kesehatan | Albumin serum normal (human Albumin) inj 20% | 1.363.000 | 10 | 0 | 13.630.000 | PT. DANKOS FARMA |
| 1923 | Obat Program Jaminan Kesehatan | Albumin serum normal (human Albumin) inj 25%(250 g/1.000 mL), @ 100 mL | 1.859.000 | 10 | 0 | 18.590.000 | PT. DANKOS FARMA |
| 1924 | Obat Program Jaminan Kesehatan | Albumin serum normal (human Albumin) inj 25% , 50 ml | 1.015.000 | 30 | 0 | 30.450.000 | PT. DANKOS FARMA |
| 1925 | Obat Program Jaminan Kesehatan | Methylergometrine Maleate/ Methylergometrine/ Metilergometrin tablet/kapsul/kaplet 0,125 mg | 990 | 1.200 | 0 | 1.188.000 | PT.Bernofarm |
| 1926 | Obat Program Jaminan Kesehatan | ONDANSETRON 4 mg | 227 | 9.000 | 0 | 2.043.000 | PT. Mega Lifesciences Indonesia |
| 1927 | Obat Program Jaminan Kesehatan | ONDANSETRON 8 mg | 227 | 9.000 | 0 | 2.043.000 | PT. Mega Lifesciences Indonesia |
| 1928 | Konsolidasi Obat | Asam ursodeoksikolat kaps 250 mg | 1.559 | 22.500 | 0 | 35.077.500 | PT. MEPROFARM |
| 1929 | Konsolidasi Obat | Irinotekan inj 20 mg/mL, Vial 5 mL | 313.000 | 10 | 0 | 3.130.000 | PT SANBE FARMA |
| 1930 | Konsolidasi Obat | Vinkristin inj 1 mg/mL, Vial 2 mL | 92.875 | 20 | 0 | 1.857.500 | PT SANBE FARMA |
| 1931 | Obat Non Jaminan Kesehatan | PURGATIX ENEMA | 36.985 | 75 | 0 | 2.773.875 | PT. MEPROFARM |
| 1932 | Obat Program Jaminan Kesehatan | Clindamycin hydrochloride (HCl)/ Clindamycin/ Klindamisin tablet/kapsul/kaplet 150 mg | 708 | 1.000 | 0 | 708.000 | P.T. Dexa Medica |
| 1933 | Konsolidasi Obat | Goserelin asetat inj 10,8 mg/depot | 2.944.150 | 2 | 0 | 5.888.300 | PT AstraZeneca Indonesia |
| 1934 | Fasilitas Kesehatan Sektoral Kemenkes | N3 Alkohol 70% Antiseptic 1000 mL | 18.000 | 72 | 0 | 1.296.000 | PT BUMI SARANA MAJU |
| 1935 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix T Type A 10x25 cm | 105.228 | 15 | 0 | 1.578.420 | PT Jayamas Medica Industri |
| 1936 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix T 5x7 | 31.080 | 2 | 0 | 62.160 | PT Jayamas Medica Industri |
| 1937 | Fasilitas Kesehatan Sektoral Kemenkes | Dermafix S IV | 49.728 | 60 | 0 | 2.983.680 | PT Jayamas Medica Industri |
| 1938 | Fasilitas Kesehatan Sektoral Kemenkes | 3 Way Stopcock | 108.780 | 10 | 0 | 1.087.800 | PT Jayamas Medica Industri |
| 1939 | Fasilitas Kesehatan Sektoral Kemenkes | Extension Tube | 6.105 | 500 | 0 | 3.052.500 | PT Jayamas Medica Industri |
| 1940 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7,5 | 250.000 | 24 | 0 | 6.000.000 | PT Jayamas Medica Industri |
| 1941 | Fasilitas Kesehatan Sektoral Kemenkes | MEDIGLOVES Surgical Sterile Gloves Powder Free Size 7 | 250.000 | 13 | 0 | 3.250.000 | PT Jayamas Medica Industri |
| 1942 | Fasilitas Kesehatan Sektoral Kemenkes | Headstrap Dewasa | 58.608 | 50 | 0 | 2.930.400 | PT Jayamas Medica Industri |
| 1943 | Fasilitas Kesehatan Sektoral Kemenkes | Eye Protector | 37.000 | 20 | 0 | 740.000 | PT Jayamas Medica Industri |
| 1944 | Fasilitas Kesehatan Sektoral Kemenkes | Onemed Anesthesia Mask Size 5 | 16.428 | 30 | 0 | 492.840 | PT Jayamas Medica Industri |
| 1945 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 6 | 16.428 | 5 | 0 | 82.140 | PT Jayamas Medica Industri |
| 1946 | Fasilitas Kesehatan Sektoral Kemenkes | Guedel Airway 100 mm disp steril | 14.208 | 12 | 0 | 170.496 | PT Jayamas Medica Industri |
| 1947 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Mount | 21.978 | 150 | 0 | 3.296.700 | PT Jayamas Medica Industri |
| 1948 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR12, 125cm | 7.992 | 20 | 0 | 159.840 | PT Jayamas Medica Industri |
| 1949 | Fasilitas Kesehatan Sektoral Kemenkes | Stomach Tube FR14, 125cm | 7.992 | 50 | 0 | 399.600 | PT Jayamas Medica Industri |
| 1950 | Fasilitas Kesehatan Sektoral Kemenkes | Oxyflow Anak (Nasal oxygen cannula) | 5.400 | 50 | 0 | 270.000 | PT Jayamas Medica Industri |
| 1951 | Fasilitas Kesehatan Sektoral Kemenkes | Feeding Tube FR8, 40cm | 7.992 | 30 | 0 | 239.760 | PT Jayamas Medica Industri |
| 1952 | Fasilitas Kesehatan Sektoral Kemenkes | Plesterin Roll non woven roll 15 cm x 5 m | 67.488 | 90 | 0 | 6.073.920 | PT Jayamas Medica Industri |
| 1953 | Konsolidasi Obat | Vinorelbin inj 10 mg/mL, Vial 1 mL | 349.000 | 4 | 0 | 1.396.000 | PT Ferron Par Pharmaceuticals |
| 1954 | Obat Program Jaminan Kesehatan | Generik Kombinasi: Ampisilin 1000 mg + Sulbaktam 500 mg serb inj 1500 mg | 16.900 | 300 | 0 | 5.070.000 | PT.Meiji Indonesia |
| 1955 | Obat Program Jaminan Kesehatan | Pantoprazole 40 mg tablet 30 | 3.450 | 150 | 0 | 517.500 | PT. Mahakam Beta Farma |
| 1956 | Obat Program Jaminan Kesehatan | Pirazinamid/Pyrazinamide tablet/kapsul/kaplet 500 mg | 448 | 200 | 0 | 89.600 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 1957 | Obat Program Jaminan Kesehatan | Doksisiklin/ Doxycycline/ Doxycycline hyclate tablet/kapsul/kaplet 100 mg | 430 | 200 | 0 | 86.000 | PT. IFARS PHARMACEUTICAL LABORATORIES |
| 1958 | Konsolidasi Obat | Bisoprolol tab 1,25 mg | 2.029 | 10.000 | 0 | 20.290.000 | PT. Merck Tbk |
| 1959 | Konsolidasi Obat | Kombinasi KDT/FDC setiap dosis mengandung Budesonid 80 mcg/Formoterol 4,5 mcg Ih 60 dosis , Turbuhaler | 144.402 | 10 | 0 | 1.444.020 | PT AstraZeneca Indonesia |
| 1960 | Obat Program Kesehatan Lainnya | LIDOCAIN 5% | 64.935 | 30 | 0 | 1.948.050 | PT.Bernofarm |
| 1961 | Konsolidasi Obat | Tamoksifen tab 10 mg | 2.225 | 18.000 | 0 | 40.050.000 | PT KALBE FARMA Tbk |
| 1962 | Konsolidasi Obat | Gliklazid tab lepas lambat 60 mg | 3.210 | 300 | 0 | 963.000 | PT Ferron Par Pharmaceuticals |
| 1963 | Fasilitas Kesehatan | MINICOLLECT TUBE 9NC Coagulation sodium citrate 3.2% 1mL | 165.390 | 5 | 0 | 826.950 | PT. SABA INDOMEDIKA |
| 1964 | Obat Program Jaminan Kesehatan | Citicoline Sodium 250 mg/2 ml Inj | 3.500 | 3.000 | 0 | 10.500.000 | PT.Bernofarm |
| 1965 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 20 cm x 100 m | 519.960 | 10 | 0 | 5.199.600 | PT Jayamas Medica Industri |
| 1966 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 25 cm x 100 m | 646.800 | 10 | 0 | 6.468.000 | PT Jayamas Medica Industri |
| 1967 | Fasilitas Kesehatan Sektoral Kemenkes | Sterile Pouch with Indicator (Roll) Gusset 40 cm x 100 m | 957.600 | 1 | 0 | 957.600 | PT Jayamas Medica Industri |
| 1968 | Fasilitas Kesehatan Sektoral Kemenkes | STERISTAR Class 5 Integrator model C-1005 | 455.100 | 120 | 0 | 54.612.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 1969 | Obat Program Jaminan Kesehatan | Eritropoetin-alfa injeksi 3.000 IU | 80.000 | 10 | 0 | 800.000 | PT ETANA BIOTECHNOLOGIES INDONESIA |
| 1970 | Obat Non Jaminan Kesehatan | PEHADOXIN FORTE TABLET | 943,5 | 300 | 0 | 283.050 | PT.Phapros Tbk |
| 1971 | Fasilitas Kesehatan | B107 T-Bond Polyester 2, 4 x 75 cm Heavy Tapercut, 1/2 circle, 48 mm | 212.454 | 24 | 0 | 5.098.896 | PT Medihop |
| 1972 | Fasilitas Kesehatan | C26 T-Chromic Catgut Chromic 2-0, 90 cm Round Bodied, 1/2 circle, 40 mm | 63.714 | 12 | 0 | 764.568 | PT Medihop |
| 1973 | Fasilitas Kesehatan | C99 T-Chromic Catgut Chromic 2, 90 cm Round Bodied, 1/2 circle, 48 mm | 62.715 | 12 | 0 | 752.580 | PT Medihop |
| 1974 | Fasilitas Kesehatan | D73 T-Dio Polydioxanone 1 Loop, 180 cm Round Bodied, 1/2 circle, 48 mm | 148.518 | 96 | 0 | 14.257.728 | PT Medihop |
| 1975 | Fasilitas Kesehatan | M51 T-Mono Polyglecaprone25 3-0, 76 cm Reverse Cutting, 3/8 circle, 24 mm | 107.781 | 12 | 0 | 1.293.372 | PT Medihop |
| 1976 | Fasilitas Kesehatan | N90 T-Nylon Nylon 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 55.833 | 360 | 0 | 20.099.880 | PT Medihop |
| 1977 | Fasilitas Kesehatan | N32 T-Nylon Nylon 3-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 48.396 | 144 | 0 | 6.969.024 | PT Medihop |
| 1978 | Fasilitas Kesehatan | N62 T-Nylon Nylon 6-0, 45 cm Reverse Cutting, 3/8 circle, 12 mm | 67.821 | 12 | 0 | 813.852 | PT Medihop |
| 1979 | Fasilitas Kesehatan | P180 T-Plain Catgut Plain 2-0, 90 cm Round Bodied, 1/2 circle, 37 mm | 56.166 | 60 | 0 | 3.369.960 | PT Medihop |
| 1980 | Fasilitas Kesehatan | P121 T-Plain Catgut Plain 3-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.604 | 12 | 0 | 751.248 | PT Medihop |
| 1981 | Fasilitas Kesehatan | P30 T-Plain Catgut Plain 4-0, 76 cm Reverse Cutting, 3/8 circle, 16 mm | 62.937 | 36 | 0 | 2.265.732 | PT Medihop |
| 1982 | Fasilitas Kesehatan | S24 T-Silk Silk/Sutera 2-0, 76 cm Reverse Cutting, 3/8 circle, 26 mm | 40.737 | 60 | 0 | 2.444.220 | PT Medihop |
| 1983 | Fasilitas Kesehatan | S61 T-Silk Silk/Sutera 3-0, 76 cm Round Bodied, 1/2 circle, 17 mm | 46.176 | 48 | 0 | 2.216.448 | PT Medihop |
| 1984 | Fasilitas Kesehatan | S80 T-Silk Silk/Sutera 5-0, 76 cm Reverse Cutting, 3/8 circle, 19 mm | 53.169 | 12 | 0 | 638.028 | PT Medihop |
| 1985 | Fasilitas Kesehatan | V15 T-Vio Polyglycolide 1, 90 cm Heavy Round Bodied, 1/2 circle, 40 mm | 86.691 | 120 | 0 | 10.402.920 | PT Medihop |
| 1986 | Fasilitas Kesehatan | V10 T-Vio Polyglycolide 2-0, 90 cm Round Bodied, 1/2 circle, 25 mm | 79.365 | 180 | 0 | 14.285.700 | PT Medihop |
| 1987 | Fasilitas Kesehatan | V38 T-Vio Polyglycolide 5-0, 76 cm Round Bodied, 1/2 circle, 16 mm | 81.585 | 24 | 0 | 1.958.040 | PT Medihop |
| 1988 | Fasilitas Kesehatan | S25 T-Silk Silk/Sutera 2-0, 76 cm Round Bodied, 1/2 circle, 25 mm | 46.620 | 24 | 0 | 1.118.880 | PT Medihop |
| 1989 | Fasilitas Kesehatan | S77 T-Silk Silk/Sutera 4-0, 76 cm Reverse Cutting, 3/8 circle, 19 mm | 45.843 | 12 | 0 | 550.116 | PT Medihop |
| 1990 | Fasilitas Kesehatan Sektoral Kemenkes | CERTOFIX Duo HFV 1220 - Akses Vena Sentral | 994.160 | 2 | 0 | 1.988.320 | PT. B.BRAUN MEDICAL INDONESIA |
| 1991 | Fasilitas Kesehatan Sektoral Kemenkes | JASA INSTALASI GAS MEDIS OXYGEN BONGKAR BEDHEAD | 845.000 | 108 | 0 | 91.260.000 | PT. SURICON GEMILANG KARYA |
| 1992 | Fasilitas Kesehatan Sektoral Kemenkes | JASA INSTALASI GAS MEDIS OXYGEN PASANG BEDHEAD | 970.000 | 123 | 0 | 119.310.000 | PT. SURICON GEMILANG KARYA |
| 1993 | Fasilitas Kesehatan Sektoral Kemenkes | PEKERJAAN INSTALASI GAS MEDIS OXYGEN 1 TITIK - TIPE E | 6.465.000 | 4 | 0 | 25.860.000 | PT. SURICON GEMILANG KARYA |
| 1994 | Fasilitas Kesehatan Sektoral Kemenkes | GRIFOLS DG Gel Coombs | 3.929.400 | 3 | 0 | 11.788.200 | PT Frismed Hoslab Indonesia |
| 1995 | Fasilitas Kesehatan Sektoral Kemenkes | DG Gel Sol | 1.265.400 | 3 | 0 | 3.796.200 | PT Frismed Hoslab Indonesia |
| 1996 | Obat Non Jaminan Kesehatan | Glucosamine tab 250 mg | 595 | 20.000 | 0 | 11.900.000 | PT. Hexpharm Jaya Laboratories |
| 1997 | Obat Program Jaminan Kesehatan | Sodium bicarbonate/Natrium Bikarbonat inj 8,4% (i.v.), ampul @25 mL | 8.305 | 300 | 0 | 2.491.500 | PT. Otsuka Indonesia |
| 1998 | Obat Program Jaminan Kesehatan | Magnesium sulfat injeksi 40% (i.v.) @ 25 mL. | 6.227 | 120 | 0 | 747.240 | PT. Otsuka Indonesia |
| 1999 | Obat Program Jaminan Kesehatan | NaCl 3% Larutan, Softbag @ 500 mL | 36.101 | 300 | 0 | 10.830.300 | PT. Otsuka Indonesia |
| 2000 | Obat Program Jaminan Kesehatan | Sedang Disinkronkan | 53.000 | 300 | 0 | 15.900.000 | PT. FINUSOLPRIMA FARMA INTERNASIONAL |
| 2001 | Fasilitas Kesehatan Sektoral Kemenkes | CONSUMEPATH Adhesive Slide-White | 843.600 | 1 | 0 | 843.600 | PT. PABRIKASI SARANA DIAGNOSTIK |
| 2002 | Fasilitas Kesehatan Sektoral Kemenkes | STERA Plasma Sterilizer Cassette | 9.250.000 | 6 | 0 | 55.500.000 | PT. HOSPI NIAGA UTAMA |
| 2003 | Fasilitas Kesehatan | Sensor Electrodes ES GS 43 T Pouch isi 50 pcs | 71.509 | 40 | 0 | 2.860.360 | PT. JAYA ABADI MEDIKA |
| 2004 | Fasilitas Kesehatan Sektoral Kemenkes | STERISTAR CLASS 5 LAMINATED INTEGRATOR C-1055 | 133.200 | 120 | 0 | 15.984.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 2005 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY STANDARD FR20 | 11.766 | 10 | 0 | 117.660 | PT. MEGAH MEDIKA PHARMA |
| 2006 | Fasilitas Kesehatan | BALLOON CATHETER 2 WAY FR8 | 28.971 | 5 | 0 | 144.855 | PT. MEGAH MEDIKA PHARMA |
| 2007 | Fasilitas Kesehatan | POLYVAC SET 14 FG | 86.580 | 45 | 0 | 3.896.100 | PT. MEGAH MEDIKA PHARMA |
| 2008 | Fasilitas Kesehatan Sektoral Kemenkes | HAMILTON Bonnet nCPAP-PS Large | 258.075 | 3 | 0 | 774.225 | PT. SARANA LINTAS MEDIKA |
| 2009 | Fasilitas Kesehatan Sektoral Kemenkes | HAMILTON Bonnet nCPAP-PS Medium | 258.075 | 10 | 0 | 2.580.750 | PT. SARANA LINTAS MEDIKA |
| 2010 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 3.0 | 249.195 | 20 | 0 | 4.983.900 | PT. SARANA LINTAS MEDIKA |
| 2011 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 4.0 | 249.195 | 20 | 0 | 4.983.900 | PT. SARANA LINTAS MEDIKA |
| 2012 | Fasilitas Kesehatan Sektoral Kemenkes | DAMI Disposible Medical Laryngeal Mask Size 5.0 | 249.195 | 5 | 0 | 1.245.975 | PT. SARANA LINTAS MEDIKA |
| 2013 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Blood Transfusion Set | 8.075 | 750 | 0 | 6.056.250 | PT. BUANA INTIPRIMA USAHA |
| 2014 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Adult Elongated (XL) | 17.850 | 200 | 0 | 3.570.000 | PT. BUANA INTIPRIMA USAHA |
| 2015 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Nebulizer Mask - Pediatric Elongated (M) | 17.850 | 200 | 0 | 3.570.000 | PT. BUANA INTIPRIMA USAHA |
| 2016 | Fasilitas Kesehatan Sektoral Kemenkes | CHRONA CARE Non Rebreathing Oxygen Mask Adult Elongated(XL) | 16.983 | 200 | 0 | 3.396.600 | PT. BUANA INTIPRIMA USAHA |
| 2017 | Fasilitas Kesehatan Sektoral Kemenkes | ONEMED Dermafix Tulle | 31.080 | 100 | 0 | 3.108.000 | PT INTISUMBER HASIL SEMPURNA GLOBAL |
| 2018 | Fasilitas Kesehatan | 20 cm x 5 m | 164.150 | 120 | 0 | 19.698.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 2019 | Fasilitas Kesehatan | 15 cm x 2.7 m | 36.400 | 72 | 0 | 2.620.800 | PT Sinaraya Nugraha Ahmadaris Medika |
| 2020 | Fasilitas Kesehatan | 15 cm x 2.7 m | 25.300 | 60 | 0 | 1.518.000 | PT Sinaraya Nugraha Ahmadaris Medika |
| 2021 | Fasilitas Kesehatan Sektoral Kemenkes | VICRYL Plus (VCP316H) | 5.096.292 | 1 | 0 | 5.096.292 | PT Johnson and Johnson Indonesia Two |
| 2022 | Fasilitas Kesehatan Sektoral Kemenkes | TRO-SOLUSET ( TROGE) Autostop | 27.096,21 | 100 | 0 | 2.709.621 | PT.GLOBAL DISPOMEDIKA |
| 2023 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 7.5 | 19.400 | 30 | 0 | 582.000 | PT.Dwiasri Graha (dwigraha medical) |
| 2024 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Size 8.0 | 19.400 | 5 | 0 | 97.000 | PT.Dwiasri Graha (dwigraha medical) |
| 2025 | Fasilitas Kesehatan Sektoral Kemenkes | FORSCH MEDICAL Endotracheal Tube Reinforced Size 7.0 | 134.260 | 10 | 0 | 1.342.600 | PT.Dwiasri Graha (dwigraha medical) |
| 2026 | Fasilitas Kesehatan Sektoral Kemenkes | WING-CATH IV CANNULA WITH INJECTION PORT & WING ETFE RADIOPAQUE CATHETER 20G X 1-1/4 INCH (32MM) | 6.660 | 1.250 | 0 | 8.325.000 | PT. SINAR RODA UTAMA |
| 2027 | Fasilitas Kesehatan Sektoral Kemenkes | SAFELET CATH IV CANNULA PU RADIOPAQUE CATHETER 22GX1 INCH (25MM) | 5.550 | 200 | 0 | 1.110.000 | PT. SINAR RODA UTAMA |
| 2028 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 1 ML LUER SLIP / 26GX1/2INCH (13MM) | 1.110 | 2.000 | 0 | 2.220.000 | PT. SINAR RODA UTAMA |
| 2029 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 10 ML LUER LOCK WITH NEEDLE 21GX1-1/2INCH (38MM) | 1.443 | 14.000 | 0 | 20.202.000 | PT. SINAR RODA UTAMA |
| 2030 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 20 ML LUER SLIP WITHOUT NEEDLE | 2.109 | 100 | 0 | 210.900 | PT. SINAR RODA UTAMA |
| 2031 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 3 ML LUER LOCK WITH NEEDLE 23GX1-1/4INCH (32MM) | 999 | 9.600 | 0 | 9.590.400 | PT. SINAR RODA UTAMA |
| 2032 | Fasilitas Kesehatan Sektoral Kemenkes | SYRINGE 5 ML LUER LOCK WITH NEEDLE 22GX1-1/2INCH (38MM) | 1.110 | 8.500 | 0 | 9.435.000 | PT. SINAR RODA UTAMA |
| 2033 | Fasilitas Kesehatan Sektoral Kemenkes | PUIND Disposable Infusion Set A103C Airvent Y With Cap | 5.550 | 500 | 0 | 2.775.000 | FARIZTA JAYA AGUNG |
| 2034 | Fasilitas Kesehatan Sektoral Kemenkes | PUIND Oxygen Nasal Cannula Infant | 5.328 | 50 | 0 | 266.400 | FARIZTA JAYA AGUNG |
| 2035 | Fasilitas Kesehatan | Nessy split, VIO, ICC, ACC, contact surface 85 cm equipotential ring 23 cm, without connecting cable | 37.525 | 40 | 0 | 1.501.000 | PT Surgika Alkesindo |
| 2036 | Fasilitas Kesehatan | NESSY, split, VIO, ICC, ACC, non ERBE units, International contact surface 85 cm, equipotential ring 23 cm, with connecting cable 4 m | 95.000 | 20 | 0 | 1.900.000 | PT Surgika Alkesindo |
| 2037 | Fasilitas Kesehatan Sektoral Kemenkes | Zebra 0.032 X 150 CM | 1.669.694 | 5 | 0 | 8.348.470 | PT. EDISON DUTA SARANA |
| 2038 | Fasilitas Kesehatan Sektoral Kemenkes | Guide Wire 0.032 x 150 CM (STRAIGHT TIP) PTFE | 269.500 | 20 | 0 | 5.390.000 | PT. EDISON DUTA SARANA |
| 2039 | Fasilitas Kesehatan Sektoral Kemenkes | BAYMED Crutch Size M | 131.000 | 15 | 0 | 1.965.000 | PT. Likuid Pharmalab Indonesia |
| 2040 | Fasilitas Kesehatan Sektoral Kemenkes | Anesthesia Mask Size 4 | 16.428 | 15 | 0 | 246.420 | PT Jayamas Medica Industri |
| 2041 | Fasilitas Kesehatan Sektoral Kemenkes | Catheter Tip | 145.188 | 4 | 0 | 580.752 | PT Jayamas Medica Industri |
| 2042 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Syringe 50 cc Ec tip without needle | 75.258 | 25 | 0 | 1.881.450 | PT Jayamas Medica Industri |
| 2043 | Fasilitas Kesehatan Sektoral Kemenkes | Ventiflow Dewasa | 70.818 | 50 | 0 | 3.540.900 | PT Jayamas Medica Industri |
| 2044 | Fasilitas Kesehatan Sektoral Kemenkes | KASA PERBAN 15CM X 2M | 1.498,5 | 1.500 | 0 | 2.247.750 | CV.NUSATEX |
| 2045 | Fasilitas Kesehatan | SPINOCAN 26GX3 1/2 (0.47X88 MM) | 34.248 | 300 | 0 | 10.274.400 | PT. B.BRAUN MEDICAL INDONESIA |
| 2046 | Fasilitas Kesehatan Sektoral Kemenkes | E-CARE Lubricant Gel | 28.000 | 30 | 0 | 840.000 | PT Enseval Medika Prima |
| 2047 | Fasilitas Kesehatan Sektoral Kemenkes | ELCON-110-120 SCALPEL BLADES 20 (REF. 1110920) | 301.000 | 3 | 0 | 903.000 | PT. B.BRAUN MEDICAL INDONESIA |
| 2048 | Fasilitas Kesehatan | CARESTREAM Dryview DVE Laser Imaging Film 35x43 | 6.697.600 | 8 | 0 | 53.580.800 | PT TAWADA HEALTHCARE - PUSAT |
| 2049 | Fasilitas Kesehatan Sektoral Kemenkes | Electrosurgical EI.ESU8 | 399.900.000 | 1 | 0 | 399.900.000 | PT. ENDO Indonesia |
| 2050 | Fasilitas Kesehatan Sektoral Kemenkes | Ureteral Stent 5.0 FR 26 CM BOTH ENDS OPEN | 331.514 | 30 | 0 | 9.945.420 | PT. EDISON DUTA SARANA |
| 2051 | Fasilitas Kesehatan Sektoral Kemenkes | Disposable Syringe 20 cc Ec tip without needle | 64.380 | 6 | 0 | 386.280 | PT Jayamas Medica Industri |
| 2052 | Fasilitas Kesehatan Sektoral Kemenkes | Povidone Iodine Larutan Antiseptik 30 ml | 4.551 | 30 | 0 | 136.530 | PT Jayamas Medica Industri |
| Total | 25.876.667.500,35 | ||||||
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