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NO CHARGE ISI / BX DESCRIPTION OP IP

CODE HITS
PREVIOUS
1 51010134 100 PROLIC Cap 300 mg - Clindamycin 12,873 12,873
2 51010823 100 SCOPAMIN TAB 3,371 3,371
3 51020502 1 TAPROS 1.88MG INJ 1,394,184 1,394,184
4 51020038 1 NEXIUM 40 mg inj - O 274,686 274,686
5 51020112 5 NOKOBA 0.4mg/ml inj 2ml - Naloxone 134,231 134,231
6 51020320 1 IKAPHEN INJ 141,977 141,977
7 51020482 5 TROVENSIS 4MG/2ML INJ 107,928 107,928
8 51030396 1 BAQUINOR INFUS SOFTBAG 365,717 365,717
9 51010133 100 PROLIC Cap 150 mg - Clindamycin 6,643 6,643
10 51030063 1 LEVOCIN Infus - Levofloxacin 473,214 473,214
11 51030153 1 Aminofusin Paed 250ml 162,602 162,602
12 51020093 1 PELASTIN inj 1 g - Imipenem 500 mg, 523,952 523,952
13 51030150 1 Triofusin E 1000 165,077 165,077
14 51010681 30 OSCAL 0.5MG CAP 18,475 18,475
15 51020381 5 SCOPAMIN INJ 24,897 24,897
16 51120030 1 TANTUM VERDE 63,767 63,767
17 51020252 1 Merosan 1g Inj 835,142 835,142
18 51010477 50 Forres 50mg Tab 9,292 9,292
19 51030385 1 AMINOFLUID L 500ML 210,452 210,452
20 51010179 50 CYTOTEC tab 200 mcg - Misoprostol 33,381 33,381
21 51040157 1 CEFILA DS drop 30ml 158,924 158,924
22 51020040 1 PANTOZOL 40 mg inj - 252,539 252,539
23 51020577 5 NICARDEX INJEKSI 261,800 261,800
24 51010232 30 CO-AMOXICLAV 625MG TAB 9,550 9,550
25 51010512 30 Lipantyl 200M Tab 26,923 26,923
26 51044104 1 ELKANA CL SYRUP 79,217 79,217
27 51020162 5 PROSTIGMIN 0.5mg amp 37,568 37,568
28 51040024 1 TEMPRA 160mg/ 5ml syr 60ml - Parace 59,977 59,977
29 51020165 5 RANTIN 50MG/ML INJ 34,664 34,664
30 51030108 1 AMINOFLUID 1000ml 324,302 324,302
31 51010239 100 DOXYCYCLINE 100MG TAB 861 861
32 51020507 5 FARGOXIN INJ 62,714 62,714
33 51020310 1 CRAVIT I.V 456,302 456,302
34 51020339 1 OMZ Inj 209,061 209,061
35 51010050 28 NEXIUM 20 mg Tab - Esomeprazole 25,958 25,958
36 51040049 1 RYVELL syr 60 ml - Citirizine HCl 5 97,316 97,316
37 51020610 5 SALTICIN 80 MG INJ ( 27,989 27,989
38 51010123 100 NEUROSANBE tab - vit B1 100 mg, Vi 3,267 3,267
39 51020396 10 ISORBID INJ 109,980 109,980
40 51010438 100 Buscopan Plus Tab 6,983 6,983
41 51011408 28 PRO TB4 TABLET 9,995 9,995
42 51010149 10 TROVENSIS tab 8 mg - Ondansetron 30,130 30,130
43 51020234 1 Engerix B 0.5 ml Inj 127,558 127,558
44 51100013 1 AMOXSAN FORTE SYR-am 57,778 57,778
45 51020410 1 ROBUMIN 20% 100 ML I 2,733,302 2,733,302
46 51010192 60 LACTAMAM kapl (Ekstrak biji Fenugre 5,147 5,147
47 51010574 100 RANTIN 150MG TAB 8,123 8,123
48 51010109 60 ANVOMER B6 tab - Pyrathiazine chlo 4,140 4,140
49 51040312 1 Neurotam Syr 110,061 110,061
50 51020070 10 CORTIDEX Vial - Dexamethason 12,656 12,656
51 51010653 100 EUPHYLLIN RETARD 5,764 5,764
52 51030146 1 Neurotam 12g Infus 333,481 333,481
53 51020158 5 DAMABEN INJ (methoclopramide HCl 5 18,123 18,123
54 51010061 30 VIOSTIN DS tab - Glukosamine HCl 50 9,160 9,160
55 51020092 10 OXYLA 10IU/ML INJ 18,718 18,718
56 51100027 5 STESOLID 10MG RECTAL TUBE 62,857 62,857
57 51010439 30 Cal-95 Kaplet 8,779 8,779
58 51180315 30 SPIRIVA KAPSUL BPJS 23,898 23,898
59 51010988 30 OSTE FORTE TAB 14,259 14,259
60 51100020 10 Boraginol S Suppo 21,543 21,543
61 51011275 30 CANDERIN8 MG TAB 10,556 10,556
62 51011091 30 FORTIBI CAP 6,100 6,100
63 51010412 250 THEOPHYLLIN 250g 897 897
64 51010371 100 ALLORIS tab 8,738 8,738
65 51020314 1 GARDASIL INJ 1,256,811 1,256,811
66 51020306 1 CEFTUM 1G INJ 334,113 334,113
67 51020329 5 Lantus Solostar Pen @ 5 256,748 256,748
68 51010648 30 DIVASK 10MG TAB 18,802 18,802
69 52910284 4 OCTENIC BODY WASH (B 8,008 8,008
70 51030380 1 AMINOSTERIL 6% INFANT 100ML 124,652 124,652
71 51020238 1 Flamicort 10mg/ml IAD 193,382 193,382
72 51010117 100 THERAGRAN M tab - Vit A 10.000 UI + 8,540 8,540
73 51010522 100 Medixon 8mg Tab 7,550 7,550
74 51020445 5 NEOSTIGMIN HAMELN 0.5MG INJ 26,153 26,153
75 51010379 30 IMBOOST FORCE tab 10,225 10,225
76 51020557 5 SAFOL (NUPOVEL) INJE 124,756 124,756
77 51020244 1 Havrix 720 Junior 382,311 382,311
78 51010060 30 VIOSTIN-X TAB 11,545 11,545
79 51010478 50 Frego 5mg Tab 10,696 10,696
80 51010702 100 LAMESON 8MG TAB 9,944 9,944
81 51010177 10 CODIPRONT CUM EXPECTORANT CAP 17,492 17,492
82 51010649 30 DIVASK 5MG TAB 11,408 11,408
83 51011411 30 BICROLID 500MG TABLET 33,992 33,992
84 51011276 30 CANDERIN160 MG TAB 14,681 14,681
85 51010296 20 ROCER 20MG TAB - omeprazole 20mg 20,481 20,481
86 51010360 100 BIOTHICOL 500mg cap 6,877 6,877
87 51010493 20 Imunos Tab 12,606 12,606
88 51010517 30 Lutenyl Cap 19,334 19,334
89 51010143 30 SPORETIK 100 mg Kaps - Cefiksim 31,168 31,168
90 51020174 1 VAKSIN TETANUS (TT) 123,393 123,393
91 51010145 100 TRADOSIK 50 mg Kaps - tramadol 7,692 7,692
92 51010583 1000 Theophyllin 1gram 958 958
93 51011280 30 NATTO 10 TAB 15,785 15,785
94 51070021 1 SERETIDE DISCUS 100 234,429 234,429
95 51090149 1 DECUBAL CREAM 40GR 67660 67660
96 51030426 24 INFUSAN M20 500ML 121,414 121,414
97 51020505 1 PUMPITOR INJ 225,508 225,508
98 51060046 1 POLYDEX 5ML EYE DROP 70,642 70,642
99 51020179 1 VAKSIN CAMPAK 10 DS 149,206 149,206
100 51020567 5 NICARDIPINE HCL 1MG INJEKSI 200,200 200,200
101 51011440 30 TELMISARTAN 40 MG 6,032 6,032
102 51090154 1 QV CREAM 100GR 198,219 198,219
103 51020148 1 TETAGAM P 250IU x 1ml amp 293,454 293,454
104 51020522 5 AETHOXYSKLEROL 3% 2 184,489 184,489
105 51020287 1 VERORAB INJ 272,551 272,551
106 51020573 1 TOPAZOL INJ 261,096 261,096
107 51120033 1 ALKOHOL 96% 1L ( BRATACO ) 103,202 103,202
108 51020563 1 AMIKASIN 500 INJ 212,161 212,161
109 51020392 10 RANITIDIN INJ OGB NOVELL 5,411 5,411
110 51010170 100 CEFAT Kapsul 500 mg - Cefadroxil 17,131 17,131
111 51011300 90 RENALOF CAP 16,797 16,797
112 51010406 100 NOLIPO 500mg cap 8,785 8,785
113 51020535 5 ACRAN INJEKSI 35,554 35,554
114 51120074 1 BETADINE VAGINAL DOU 83,661 83,661
115 51040359 1 CURVIT CL EMULSION 175ML SYR 76,780 76,780
116 51020099 5 SAGESTAM inj 2 ml - Gentamycin sulf 19,369 19,369
117 51020231 1 Dobutamin Giulini 1g Inj 398,717 398,717
118 51010666 30 HEPAMAX CAP 13,560 13,560
119 51010447 30 Celebrex 100mg Tab 16,399 16,399
120 51011316 30 ARTRODAR 50MG CAP 14,991 14,991
121 51010367 50 RHINOS SR CAP (Larotadine 5 mg, pse 8,300 8,300
122 51010437 30 BRAIN ACT 500MG TAB 20,847 20,847
123 51010120 18 LEVOCIN Tab 500 mg - Levofloxacin 57,113 57,113
124 51020371 2 LOVENOX 40MG INJ 253,544 253,544
125 51020509 10 MECOBALAMIN 500MG INJ 15,279 15,279
126 51020236 6 Extrace 200mg Inj 18,300 18,300
127 51020545 5 SANDOSTATIN INJ 465,644 465,644
128 51020574 1 PUMPICEL INJ 219,022 219,022
129 51020558 5 REGIVEL INEJEKSI 106,948 106,948
130 51011065 60 NEUROVIT E TAB 1,931 1,931
131 51180336 6 EPODION 2000 BPJS 101,660 101,660
132 51100026 12 Propyretic 80mg Suppo 12,342 12,342
133 51020585 10 CARBAZOCHROME 50MG/10ML INJ 18,605 18,605
134 51011432 10 SPORETIK 200 MG KAP 38,831 38,831
135 51020152 100 NEEDLE NOVOFINE 5,021 5,021
136 51020443 1 PROTAMIN INJ 201,443 201,443
137 51180201 25 FUROSEMID INJ BPJS 3,050 3,050
138 51011418 30 VELACOM PLUS 2 / 500 MG TAB 3,862 3,862
139 51010474 60 Fluimucil 200mg Kap 12,533 12,533
140 51180184 6 RECORMON 2000 INJ BPJS 207,259 207,259
141 51040152 1 IMUNOS SYR 60ML 118,569 118,569
142 51010830 60 MST CONTINUS 10MG TA 23,432 23,432
143 51011367 100 ARKINE 2MG TAB 1,362 1,362
144 51100024 12 Propyretic 160mg Suppo 12,983 12,983
145 51040141 1 DULCOLACTOL syr 96,475 96,475
146 51080020 1 VAKSIN HEPATITIS B 0.5 ML 92,780 92,780
147 51010541 100 Neurontin 300mg Tab 19,591 19,591
148 51020201 1 ACTRAPID HM 100IU/ml 457,363 457,363
149 51020483 5 TROVENSIS 2MG/2ML INJ 55,487 55,487
150 51011416 36 NEURO AID CAPSUL 32,533 32,533
151 51180235 30 AVODART TAB BPJS 10,643 10,643
152 51010224 100 CARBAMAZEPINE 200MG TAB 548 548
153 51020589 10 CHROME INJ 50 MG 30,201 30,201
154 51010520 30 Medixon 16mg Tab 11,324 11,324
155 51020183 1 SERUM ANTI TETANUS 1.500 SI vial 249,691 249,691
156 51020015 5 DOBUJECT 250mg/ 5ml 212,600 212,600
157 51020297 6 Torasic 30mg Inj 56,341 56,341
158 51010947 60 HYPERIL 5MG TAB 13,496 13,496
159 51180048 24 FUTROLIT INFUS BPJS 69,444 69,444
160 51011392 150 DEXTRAL CAPSUL 891 891
161 51011254 30 LIPANTHYL PENTA 145 TAB 33,173 33,173
162 51020002 24 AMINOPHYLLIN 24 MG INJ 10,811 10,811
163 51010411 1 CYCLO-PROGYNOVA 21 tab 203,109 203,109
164 51011415 30 INBUMIN TAB 7,733 7,733
165 51010281 120 PIROXICAM 10MG KAP 385 385
166 51020508 100 DEXAMETHASONE INJEKSI 3,345 3,345
167 51010944 30 NEULIN PS TAB 20,219 20,219
168 51011117 20 DUPHASTON TAB 29,660 29,660
169 51010572 20 Pumpitor Cap 21,728 21,728
170 51010658 50 FREGO 10MG TAB 12,426 12,426
171 51040109 1 APYALIS 100ml syr 56,442 56,442
172 51010928 100 GLUCOVANCE 500MG/5MG TAB 7,516 7,516
173 51020579 10 MILOZ 5 MG / ML INJ 29,536 29,536
174 51020599 1 ICUNES INJ 100MCG/ML 536,416 536,416
175 51020569 5 NOTRIXUM 500 MG INJ 110,735 110,735
176 51010042 100 SANPRIMA tab - Co-trimoxsazole: Tri 1,962 1,962
177 51020029 30 VITAMIN K3 10 mg/ml inj - Menadion 8,095 8,095
178 51030116 1 Cravox Inf 100ml 419,100 419,100
179 51010900 100 ASAM MEFENAMAT 500MG TAB OGB BERNOFARM 690 690
180 51020400 5 NOVOMIX 30 FLEXPEN 245,088 245,088
181 51020235 1 Engerix B 20mcg Inj 151,311 151,311
182 51100025 12 Propyretic 240mg Suppo 14,863 14,863
183 51010813 30 FORMUNO TAB 11,265 11,265
184 51011363 100 ACARBOSE 100MG TAB 2,741 2,741
185 51020160 24 CA GLUCONAS 10% inj 29,662 29,662
186 51020565 2 CEFPIROME INJ 203,179 203,179
187 51030422 1 RENOSAN INFUS 342,449 342,449
188 51020103 1 TERFACEF Vial 1 gr - seftriakson 1 333,872 333,872
189 51010119 20 LAPRAZ caps 30 mg - Lansoprazole 18,894 18,894
190 51030119 1 Hidonac 20% Inf 561,737 561,737
191 51010137 100 RIFAMTIBI caps 600 mg - rifampicin 10,012 10,012
192 51100029 6 DULCOLAX 5MG CHILD SUPPO 25,456 25,456
193 51010167 20 BAQUINOR FORTE cap - Ciprofloxacin 21,330 21,330
194 51180030 20 AZITHROMYCIN 500 TAB 6,746 6,746
195 51100019 10 Boraginol N Suppo 16,526 16,526
196 51020246 10 Herbesser 50mg Inj 369,625 369,625
197 51011356 100 CISAPRIDE 5MG TAB 1,182 1,182
198 51020357 1 PEDIACEL VAKSIN 1,050,302 1,050,302
199 51020575 1 CEFORIM INJ 434,189 434,189
200 51020132 5 EXTRACE 500mg/5ml inj - Ascorbic a 29,662 29,662
201 51011385 100 EPERISONE TAB 2,326 2,326
202 51180345 1 SALBULIN INHAELER B 47,581 47,581
203 51011164 30 LIPROQY CAP 12,128 12,128
204 51090155 1 ERYMED CREAM 20 GR 46,405 46,405
205 51030123 24 Infusan D5+ 1/2NS SP 24 22,078 22,078
206 51180288 100 MINI ASPI TAB BPJS 306 306
207 51011417 30 VELACOM PLUS 1 /250 MG TAB 2,670 2,670
208 51011360 100 RAMIPRIL 5MG TAB 988 988
209 51010286 100 PROPYLTHIOURACYL (PTU)100MG TAB 755 755
210 51010878 100 METRONIDAZOLE 500MG TAB OGB BERNOFARM 767 767
211 51011351 100 ALPRAZOLAM 0.25MG TAB 911 911
212 51180171 1 SERETIDE DISKUS 100 146,834 146,834
213 51020451 5 NEULIN 500MG INJ 105,871 105,871
214 51180046 1 TUTOFUSIN OPS ( BPJS 60,062 60,062
215 51020598 10 PLASMINEX 500MG INJ 18,104 18,104
216 51011357 100 CLOBAZAM 10MG TAB 1,565 1,565
217 51020337 10 Neurotam 1g Inj 25,648 25,648
218 51011355 100 ACARBOSE 50MG TAB 1,765 1,765
219 51010869 100 ETHAMBUTOL 500MG TAB OGB BERNOFARM 2,329 2,329
220 51011347 50 IRBESARTAN 300 TAB 5,260 5,260
221 51010282 120 PIROXICAM 20MG KAP 357 357
222 51030384 1 TRIOFUSIN 1600 INF 161,211 161,211
223 51180273 100 THYROZOL TAB BPJS 1,711 1,711
224 51020459 1 CEFEPIME 1G INJ 233,811 233,811
225 51150049 1000 KAPSUL NO 1 87 87
226 51011344 100 TRIAMCINOLONE 4MG TAB 1,196 1,196
227 51180198 10 FLUCONAZOLE CAP ( BP 26,306 26,306
228 51180198 10 FLUCONAZOLE TAB, BPJS 26,306 26,306
229 51011352 100 ALPRAZOLAM 0.5MG TAB 1,107 1,107
230 51180224 1 ACTRAPID HM 10 INJ B 202,092 202,092
231 51011358 30 GABAPENTIN 300 CAP 7,963 7,963
232 51020592 1 E SOFER INJ 208,593 208,593
233 51011361 100 SPIRONOLACTONE 100MG TAB 1,532 1,532
234 51020173 1 VAKSIN DIFTERI TETANUS (DT) 5ml via 102,323 102,323
235 51020101 10 SYNTOCINON 1 ml Amp- 22,142 22,142
236 51020205 250 ISOFLURAN 250ml 10,207 10,207
237 51011331 10 PROBIOKIDS SACHET 19,242 19,242
238 51011261 30 CIFLON TAB 11,989 11,989
239 51010237 100 DILTIAZEM 30MG TAB 552 552
240 51010875 5 DUROGESIC 12.5MG 154,856 154,856
241 51101137 6 TRICHODAZOLE PLUS VAG SUPP 20,000 20,000
242 51011365 30 CLOPIDOGREL 75MG TAB 13,903 13,903
243 51011343 100 MECOBALAMIN 500MG CAP 1,325 1,325
244 51010911 100 CEFIXIME 100MG TAB OGB BERNOFARM 6,284 6,284
245 51180071 100 TYROZOL 10MG TAB BPJ 1,647 1,647
246 51020596 20 KIFACAIN INJ 4,044 4,044
247 51180327 28 ARICEPT 10MG BPJS 16,793 16,793
248 51180266 100 ASAM FOLAT TABLET 361 361
249 51180338 24 INFUSAN RL SP 500 ML 9,726 9,726
250 51011387 30 URSODEOXYCHOLIC ACID 250 TAB 6,526 6,526
251 51180287 20 COMBIVENT UDV BPJS 8,099 8,099
252 51011353 100 ALPRAZOLAM 1MG TAB 1,615 1,615
253 51180337 24 INFUSAN RING AS SP 500 ML 11,159 11,159
254 51180319 5 FIMA HES 200 (BPJS) 117,550 117,550
255 51120091 1000 STARDINE 1 ML 336 336
256 51150051 1000 KAPSUL NO 00 107 107
257 51011386 100 REBAMIPIDE TAB 2,873 2,873
258 51010507 20 Lasgan 30mg Kaps 22,466 22,466
259 51020606 5 FURAMIN INJEKSI 13,585 13,585
260 51120098 1000 SACCARUM LACTIS ( LAKTOSUM ) 357 357
261 51011425 30 ANALTRAM TABLET ( PCT 325+TRAMADOL 37,5 ) 11,028 11,028
262 51180341 24 INFUSAN D5 1/2 NS SP 20,453 20,453
263 51180344 5 NEFROFER INJ BPJS 94,822 94,822
264 51020198 1 SERUM ANTI BISA ULAR 5ml 712,541 712,541
265 51180181 100 ERYTHROMYCIN 500 MG TAB 1,994 1,994
266 51010142 100 SANTIBI 1,631 1,631
267 51010961 100 FARSORBID 5MG TAB 523 523
268 51180340 24 INFUSAN D5 1/4 NS SP 18,311 18,311
269 51150047 1000 KAPSUL NO 3 79 79
270 51020571 10 NTG INJ 83,784 83,784
271 51020141 20 NEUROBION 5000 inj 9,782 9,782
272 51020114 10 AMOXSAN INJ-amoxicil 35,692 35,692
273 51011010 100 HALOPERIDOL 1,5 MG TAB 304 304
274 51011421 30 PROBIOSTIM KAPSUL 13,502 13,502
275 51011410 100 CHROME TABLET 3,018 3,018
276 51010234 100 DEXAMETHASON 0.5MG TAB 339 339
277 51011011 100 HALOPERIDOL 5 MG TAB 362 362
278 51010299 100 SALBUTAMOL 4MG TAB 325 325
279 51011325 50 RISPERIDON 2 MG TAB 3,402 3,402
280 51010957 100 ALLOPURINOL 100MG TAB BERNOFARM 542 542
281 51011342 30 LISINOPRIL 5MG TAB 2,474 2,474
282 51020587 20 ZYFORT INJEKSI 9,002 9,002
283 51011180 200 NEURODEX TAB 1,150 1,150
284 51020572 5 BUPIVACAIN SPINAL 5M 47,319 47,319
285 51020249 5 Ketesse Inj 79,710 79,710
286 51010502 200 Kalmethasone Tab 258 258
287 51011362 100 SPIRONOLACTONE 25MG TAB 611 611
288 51150048 1000 KAPSUL NO 2 72 72
289 51011438 90 FOSRENOL TABLET 28,704 28,704
290 51150045 10000 KERTAS PUYER BERLOGO 66 66
291 51180339 24 INFUSAN NS SP 500 ML BPJS 9,013 9,013
292 51080006 1 VAKSIN POLIO 10 DS vial 50,845 50,845
293 51011389 30 PREGABALIN 75MG TAB 9,815 9,815
294 51180148 100 ISOSORBID DINITRATE 240 240
295 51010274 100 NIFEDIPINE TAB 560 560
296 51010485 250 Glyceril Guaicolat 100mg Tab @ 1000 655 655
297 51010298 100 SALBUTAMOL 2MG TAB 360 360
298 51010620 150 ASPILET TROMBO TAB 2,128 2,128
299 51020608 10 VAKSIN BIO TD 0,5 MG 52,845 52,845
300 51180335 1 ECOSOL NACL 500ML (B 11,104 11,104
301 51180291 100 SIMARC 2MG TAB BPJS 2,500 2,500
302 51011323 100 MEXTRIL TABLET 567 567
303 51090124 1 SCABIMATE 10G CREAM 72,973 72,973
304 51180242 100 STARFOLAT 0.4MG TAB ( BPJS ) 263 263
305 51010602 100 Vitamin A 6000 SI tab 322 322
306 51010736 100 Propanolol 10mg Tab OGB Dexa @ 100 295 295
307 51010024 100 CAPTOPRIL 12,5 mg Tab 392 392
308 51010737 100 Propanolol 40mg Tab OGB Dexa @ 100 361 361
309 51011340 30 BETAHISTIN 6 MG TAB 1,407 1,407
310 51010760 100 Trihexyphenidyl 2mg Tab 241 241
311 51010025 100 CAPTOPRIL 25 mg Tab 386 386
312 51010573 100 Pyridoxine (Vit B6 ) 10mg Tab KF @ 163 163
313 51011341 30 LISINOPRIL 10MG TAB 4,101 4,101
314 51030141 1000 HYDROGEN PEROKSIDA 50% 1L 84 84
315 51010311 100 VITAMIN B COMPLEK TAB 102 102
316 51080007 1000 FORMALIN 1ML 129 129
317 51020609 5 VENODENOL INJEKSI 9,022 9,022
KENAIKAN HARGA
51010520 30 Medixon 16mg Tab 11,324 11,324
51010225 100 CEFADROXIL 500MG TAB BERNOFARM 2,281 2,281
51010231 50 CLINDAMYCIN 300MG KAP 5,081 5,081
51010845 100 LAMESON 16MG TAB 12,736 12,736
51040416 1 L-ZINC SYR 59,776 59,776
51030394 24 INFUSAN D5 500ML DP 24 41,946 41,946
51030142 24 INFUSAN RL DP 24 48,154 48,154
51030423 24 INFUMAL DP 10% 500 ML 134,291 134,291
51010665 100 HEMOBION TAB 5,829 5,829
51030041 1 MEYLON 8.4% inf 25 ml - Na Bicarbon 36,295 36,295
51030035 20 KA-EN 3B infus 500 ml- Na 50 meq + 53,086 53,086
51030413 1 GELAFUSAL INFUS 291,561 291,561
51020421 1 METHYLPREDNISOLON 125MG INJ BERNOFARM 80,787 80,787
51010485 100 Glyceril Guaicolat 100mg Tab @ 1000 703 703
51120090 1 BETADINE OBAT KUMUR 190 ML 49,781 49,781
51010735 10 Profertil Tab 25,430 25,430
51011040 30 TRUVAS 10MG TAB 23,523 23,523
51020225 1 Cepraz 1g Inj 322,520 322,520
51020195 1 CEFXON 1g inj 368,558 368,558
51020393 1 LAMESON 125MG INJ 159,322 159,322
51180256 1 ULSAFATE SYR ( SUCRALFAT ) BPJS 28,088 28,088
51010205 50 ACYCLOVIR 400MG TAB 1,304 1,304

Prepared by,

(Dwi Sari)
CURRENT
FAKTUR / BX FAKTUR SATUAN FAKTUR 4,444 30%
COST PRICE HNA HNA HNA +PPN COST TOTAL COST MARGIN
SATUAN NEW
7.332 683,500 6,835 7,519 44 7,563 9,832
1,750 178,063 1,781 1,959 44 2,003 2,604
893,025 982,328 982,328 1,080,561 4,444 1,085,005 1,410,506
164,390 164,390 164,390 180,829 4,444 185,273 240,855
85.8 407,550 81,510 89,661 889 90,550 117,715
87.45 83,078 83,078 91,386 4,444 95,830 124,579
70.191 327,100 65,420 71,962 889 72,851 94,706
236.61 220,500 220,500 242,550 4,444 246,994 321,092
3.608 336,500 3,365 3,702 44 3,746 4,870
308.275 287,300 287,300 316,030 4,444 320,474 416,616
101.2 96,140 96,140 105,754 4,444 110,198 143,257
342.1 318,800 318,800 350,680 4,444 355,124 461,661
102.85 97,708 97,708 107,479 4,444 111,923 145,500
11.256 337,700 11,257 12,382 148 12,530 16,290
15.73 72,751 14,550 16,005 889 16,894 21,962
35.31 35,310 35,310 38,841 4,444 43,285 56,271
549.56 512,100 512,100 563,310 4,444 567,754 738,080
4.84 250,000 5,000 5,500 89 5,589 7,266
121,000 126,445 126,445 139,090 4,444 143,534 186,594
22.11 1,105,500 22,110 24,321 89 24,410 31,733
85.8 83,000 83,000 91,300 4,444 95,744 124,467
152,900 168,190 168,190 168,190 4,444 172,634 224,424
187 935,000 187,000 205,700 889 206,589 268,565
5.808 174,244 5,808 6,389 148 6,537 8,498
17,467 576,400 19,213 21134.66667 148 21,283 27,668
48.51 45,300 45,300 49,830 4,444 54,274 70,556
22.594 112,970 22,594 24,853 889 25,742 33,465
35.64 33,400 33,400 36,740 4,444 41,184 53,539
23.109 91,438 18,288 20,116 889 21,005 27,307
190,000 198,550 198,550 218,405 4,444 222,849 289,704
478 43,490 435 478 44 523 680
38.5 192,500 38,500 42,350 889 43,239 56,210
270,000 282,150 282,150 310,365 4,444 314,809 409,252
130.9 119,000 119,000 130,900 4,444 135,344 175,947
16.833 485,456 17,338 19,071 159 19,230 24,999
55 50,000 50,000 55,000 4,444 59,444 77,277
72,500 73,769 14,754 16,229 889 17,118 22,253
1.128 150,500 1,505 1,656 44 1,700 2,210
72.6 689,700 68,970 75,867 444 76,311 99,205
4.233 384,800 3,848 4,233 44 4,277 5,560
5.426 151,946 5,427 5,969 159 6,128 7,966
17.589 163,900 16,390 18,029 444 18,473 24,015
61,000 67,100 67,100 73,810 4,444 78,254 101,730
29,535 32,489 32,489 35,738 4,444 40,182 52,236
1,650,000 1,724,250 1,724,250 1,896,675 4,444 1,901,119 2,471,455
3.3 168,300 2,805 3,086 74 3,160 4,107
4.73 449,350 4,494 4,943 44 4,987 6,483
2.64 134,640 2,244 2,468 74 2,542 3,305
58,000 57,420 57,420 63,162 4,444 67,606 87,888
6.369 59,350 5,935 6,529 444 6,973 9,065
284,941 2,849 3,134 44 3,179 4,132
210,000 207,900 207,900 228,690 4,444 233,134 303,074
9.361 46,805 9,361 10,297 889 11,186 14,542
5.866 170,720 5,691 6,260 148 6,408 8,330
12.65 115,000 11,500 12,650 444 13,094 17,023
39.204 196,020 39,204 43,124 889 44,013 57,217
4.84 144,000 4,800 5,280 148 5,428 7,057
13,727 453,000 15,100 16,610 148 16,758 21,786
7.925 203,940 6,798 7,478 148 7,626 9,914
11.717 117,167 11,717 12,888 444 13,333 17,333
198,000 6,600 7260 148 7,408 9,631
3.3 99,000 3,300 3,630 148 3,778 4,912
408 139,125 557 612 18 630 819
4.681 436,500 4,365 4,802 44 4,846 6,300
675,000 705,375 705,375 775,913 4,444 780,357 1,014,463
209 210,000 210,000 231,000 4,444 235,444 306,077
183.391 945,430 189,086 207,995 889 208,883 271,548
11.55 315,000 10,500 11,550 148 11,698 15,208
4,000 14,080 3,520 3,872 1,111 4,983 6,478
75.9 75,900 75,900 83,490 4,444 87,934 114,314
132 120,000 120,000 132,000 4,444 136,444 177,377
4.356 452,980 4,530 4,983 44 5,027 6,535
4,070 400,000 4,000 4,400 44 4,444 5,778
17.6 80,000 16,000 17,600 889 18,489 24,035
6.234 170,000 5,667 6,233 148 6,381 8,296
85,000 397,375 79,475 87,423 889 88,311 114,805
220,000 242,000 242,000 266,200 4,444 270,644 351,837
6.38 181,830 6,061 6,667 148 6,815 8,860
6.353 300,000 6,000 6,600 89 6,689 8,696
5.39 530,000 5,300 5,830 44 5,874 7,637
10.503 95,480 9,548 10,503 444 10,947 14,231
6.6 180,000 6,000 6,600 148 6,748 8,773
25.091 701,400 23,380 25,718 148 25,866 33,626
280,500 9,350 10285 148 10,433 13,563
13.2 244,200 12,210 13,431 222 13,653 17,749
3.63 347,000 3,470 3,817 44 3,861 5,020
7.15 140,000 7,000 7,700 222 7,922 10,299
8,900 371,531 12,384 13,623 148 13,771 17,902
20.185 564,300 18,810 20,691 148 20,839 27,091
70,840 75,976 75,976 83,574 4,444 88,018 114,423
3.977 370,500 3,705 4,076 44 4,120 5,356
680 618 618 680 4 684 890
8,250 267,300 8,910 9,801 148 9,949 12,934
148.302 148,302 148,302 163,132 4,444 167,576 217,849
39,930 39,930 43,923 4,444 48,367 62,877
84.48 1,890,000 78,750 86,625 185 86,810 112,853
153.12 142,700 142,700 156,970 4,444 161,414 209,838
43.258 36,572 36,572 40,229 4,444 44,673 58,075
87,000 93,308 93,308 102,639 4,444 107,083 139,208
143 650,000 130,000 143,000 889 143,889 187,055
100,320 3,344 3,678 148 3,827 4,974
145.475 145,475 145,475 160,023 4,444 164,467 213,806
206.8 188,000 188,000 206,800 4,444 211,244 274,617
120,000 600,000 120,000 132,000 889 132,889 172,755
158,636 174,500 174,500 191,950 4,444 196,394 255,312
151.8 147,000 147,000 161,700 4,444 166,144 215,987
71.174 63,636 63,636 70,000 4,444 74,444 96,777
145.2 145,200 145,200 159,720 4,444 164,164 229,830
31,500 3,150 3,465 444 3,909 5,082
10.615 989,500 9,895 10,885 44 10,929 14,208
10.999 989,890 10,999 12,099 49 12,148 15,792
4.851 452,000 4,520 4,972 44 5,016 6,521
21.252 99,100 19,820 21,802 889 22,691 29,498
40,500 44,550 44,550 49,005 4,444 53,449 69,484
49.5 46,500 46,500 51,150 4,444 55,594 72,272
9.922 46,300 9,260 10,186 889 11,075 14,397
258.61 258,610 258,610 284,471 4,444 288,915 375,590
8.8 264,000 8,800 9,680 148 9,828 12,777
10.68 320,395 10,680 11,748 148 11,896 15,465
9.754 292,600 9,753 10,729 148 10,877 14,140
5.225 237,500 4,750 5,225 89 5,314 6,908
13.2 360,000 12,000 13,200 148 13,348 17,353
37.675 631,800 35,100 38,610 247 38,857 50,514
165.284 330,569 165,285 181,813 2,222 184,035 239,245
8.8 80,000 8,000 8,800 444 9,244 12,018
11 60,000 10,000 11,000 741 11,741 15,263
307.12 1,535,600 307,120 337,832 889 338,721 440,337
151.03 140,800 140,800 154,880 4,444 159,324 207,121
66 350,000 70,000 77,000 889 77,889 101,255
1.167 63,650 1,061 1,167 74 1,241 1,613
462,000 77,000 84,700 741 85,441 111,073
6.875 82,500 6,875 7,563 370 7,933 10,313
13.112 119,200 11,920 13,112 444 13,556 17,623
271,700 27,170 29,887 444 30,331 39,431
2.31 273,350 2,734 3,007 44 3,051 3,967
130,000 130,000 130,000 143,000 4,444 147,444 191,677
2.058 46,773 1,871 2,058 178 2,236 2,907
53,900 1,797 1976.333333 148 2,124 2,762
5.638 338,250 5,638 6,201 74 6,275 8,158
121.433 728,597 121,433 133,576 741 134,317 174,612
63.25 66,000 66,000 72,600 4,444 77,044 100,157
14,200 937,200 15,620 17,182 74 17,256 22,433
0 64,350 644 708 44 752 978
7.334 88,000 7,333 8,067 370 8,437 10,968
61.71 60,584 60,584 66,642 4,444 71,086 92,412
64.13 58,300 58,300 64,130 4,444 68,574 89,146
11,695 1,157,826 11,578 12,736 44 12,781 16,615
319,000 350,900 350,900 385,990 4,444 390,434 507,564
34.485 160,700 32,140 35,354 889 36,243 47,116
693,000 19,250 21,175 123 21,298 27,688
7.75 211,364 7,045 7,750 148 7,898 10,268
246 22,400 224 246 44 291 378
22 200,000 20,000 22,000 444 22,444 29,178
6.234 187,500 6,250 6,875 148 7,023 9,130
165 165,000 165,000 181,500 4,444 185,944 241,727
135,000 631,125 126,225 138,848 889 139,736 181,657
33,333 198,000 33,000 36,300 741 37,041 48,153
8.25 480,000 8,000 8,800 74 8,874 11,536
40.317 992,280 41,345 45,480 185 45,665 59,364
506 75,900 506 557 30 586 762
15.079 591,500 19,717 21,688 148 21,836 28,387
135,000 5,625 6,188 185 6,373 8,284
128.205 155,129 155,129 170,642 4,444 175,086 227,612
7733 135,000 4,500 4,950 148 5,098 6,628
179 23,656 197 217 37 254 330
2.402 196,560 1,966 2,162 44 2,207 2,869
12.1 360,000 12,000 13,200 148 13,348 17,353
17.617 352,330 17,617 19,378 222 19,600 25,480
13.816 257,500 12,875 14,163 222 14,385 18,700
8.14 370,000 7,400 8,140 89 8,229 10,698
30.25 30,000 30,000 33,000 4,444 37,444 48,677
4.507 477,678 4,777 5,254 44 5,299 6,889
22 198,000 19,800 21,780 444 22,224 28,892
471.9 363,000 363,000 399,300 4,444 403,744 524,867
375,000 75,000 82,500 889 83,389 108,405
902 76,670 767 843 44 888 1,154
4.967 143,000 4,767 5,243 148 5,391 8,626
242 250,000 250,000 275,000 4,444 279,444 363,277
218 19,729 197 217 44 261 340
152,807 840,436 168,087 184,896 889 185,785 241,520
80,000 88,000 88,000 96,800 4,444 101,244 131,617
8.709 104,500 8,708 9,579 370 9,950 12,934
6.435 180,000 6,000 6,600 148 6,748 8,773
1.912 173,800 1,738 1,912 44 1,956 2,543
17.966 431,200 17,967 19,763 185 19,949 25,933
126,500 278,300 139,150 153,065 2,222 155,287 201,873
233,900 233,900 257,290 4,444 261,734 340,254
215.38 200,700 200,700 220,770 4,444 225,214 292,778
12.232 228,000 11,400 12,540 222 12,762 16,591
367.29 387,200 387,200 425,920 4,444 430,364 559,473
5.863 546,500 5,465 6,012 44 6,056 7,873
15.771 89,882 14,980 16,478 741 17,219 22,385
13.86 258,300 12,915 14,207 222 14,429 18,757
4,091 90,000 4,500 4,950 222 5,172 6,724
9.76 97,598 9,760 10,736 444 11,180 14,534
270,000 2,970,000 297,000 326,700 444 327,144 425,288
756 68,705 687 756 44 800 1,040
630,000 693,000 693,000 762,300 44,444 806,744 1,048,767
321.695 299,800 299,800 329,780 4,444 334,224 434,491
22 100,000 20,000 22,000 889 22,889 29,755
1.54 140,000 1,400 1,540 44 1,584 2,060
26,727 29,400 29,400 32,340 4,444 36,784 47,819
7.04 198,000 6,600 7,260 148 7,408 9,631
28,655 28,655 31,521 4,444 35,965 46,754
16.983 369,624 15,401 16,941 185 17,126 22,264
104 11,400 114 125 44 170 221
34,650 1,155 1270.5 148 1,419 1,844
639 57,727 577 635 44 679 883
431 43,164 432 475 44 519 675
220 28,600 286 315 44 359 467
531 53,130 531 584 44 629 818
91,666 100,883 100,883 110,971 4,444 115,415 150,040
67.1 330,000 66,000 72,600 889 73,489 95,535
35,455 39,001 39,001 42,901 4,444 47,345 61,549
12.683 110,517 11,052 12,157 444 12,601 16,382
1.045 95,000 950 1,045 44 1,089 1,416
17.6 158,400 15,840 17,424 444 17,868 23,229
1.186 107,800 1,078 1,186 44 1,230 1,599
689 67,721 677 745 44 789 1,026
3,455 185,274 3,705 4,076 89 4,165 5,414
178 23,195 193 213 37 250 325
107.474 112,200 112,200 123,420 4,444 127,864 166,223
119,500 1,195 1314.5 44 1,359 1,767
132,000 145,200 145,200 159720 4,444 164,164 213,413
41,000 41 45 4 50 64
798 72,450 725 797 44 841 1,094
17,018 187,200 18,720 20,592 444 21,036 27,347
187,200 18,720 20592 444 21,036 27,347
671 67,100 671 738 44 783 1,017
130,454 143,499 143,499 157,849 4,444 162,293 210,981
5.5 150,000 5,000 5,500 148 5,648 7,343
148.5 148,500 148,500 163,350 4,444 167,794 218,132
1.055 94,946 949 1,044 44 1,089 1,415
77,990 70,900 70,900 77,990 4,444 82,434 107,164
12,649 139,134 13,913 15,305 444 15,749 20,474
7.26 1,650,000 6,600 7,260 18 7,278 9,461
13.024 121,400 12,140 13,354 444 13,798 17,938
7.7 231,000 7,700 8,470 148 8,618 11,204
190 16,415 164 181 44 225 293
103,686 570,273 114,055 125,460 889 126,349 164,254
13.365 74,700 12,450 13,695 741 14,436 18,766
2.2 270,000 9,000 9,900 148 10,048 13,063
880 70,000 700 770 44 814 1,059
2.395 152,062 1,521 1,673 44 1,717 2,232
1,086 119,501 1,195 1,315 44 1,359 1,767
2.475 49,500 2,475 2,723 222 2,945 3,828
12.485 349,580 12,485 13,734 159 13,892 18,060
135 12,250 123 135 44 179 233
171,600 7,150 7,865 185 8,050 10,465
4.62 126,000 4,200 4,620 148 4,768 6,199
5.495 103,636 5,182 5,700 222 5,922 7,699
1.034 103,400 1,034 1,137 44 1,182 1,536
198,048 8,252 9,077 185 9,262 12,041
80,000 440,000 88,000 96,800 889 97,689 126,995
150 148,500 149 163 4 168 185
77,000 77 85 4 89 116
2.09 188,100 1,881 2,069 44 2,114 2,748
13.2 280,000 14,000 15,400 222 15,622 20,309
10.45 47,500 9,500 10,450 889 11,339 14,740
235 235,000 235 259 4 263 342
247,500 8,250 9,075 148 9,223 11,990
14,000 369,600 15,400 16,940 185 17,125 22,263
65,000 357,500 71,500 78,650 889 79,539 103,400
640.53 624,517 624,517 686,969 4,444 691,413 898,837
130,625 1,306 1436.875 44 1,481 1,926
95,000 950 1045 44 1,089 1,416
223 20,300 203 223 44 268 348
12,502 338,886 14,120 15,532 185 15,717 20,433
38,000 38 41.8 4 46 60
650,000 65,000 71,500 444 71,944 93,528
7,267 148,689 7,434 8,178 222 8,400 10,920
19,710 205,970 20,597 22,657 4,445 27,102 35,232
10,311 103 113.421 44 158 205
9.983 279,300 9,310 10,241 148 10,389 13,506
2.2 209,000 2,090 2,299 44 2,343 3,046
154 12,320 123 136 44 180 234
13,439 134 147.829 44 192 250
121 9,130 91 100 44 145 188
118,745 2,375 2,612 89 2,701 3,512
215 15,000 150 165 44 209 272
1,333 44,000 1,467 1,613 148 1,761 2,290
5,750 126,500 6,325 6,958 222 7,180 9,334
605 110,000 550 605 22 627 815
24,000 132,000 26,400 29,040 4,444 33,484 43,529
51.7 330,000 66,000 72,600 889 73,489 95,535
110 22,000 110 121 22 143 186
347 31,488 315 346 44 391 508
38,500 39 42 4 47 61
1,980,000 22,000 24200 49 24,249 31,524
0 660,000 66 73 0 73 95
6.601 162,408 6,767 7,444 185 7,629 9,918
47.3 47,300 47,300 52,030 4,444 56,474 73,416
7.15 192,500 6,417 7,058 148 7,206 9,368
80 8,800 88 97 44 141 184
193 17,590 176 193 44 238 309
94 18,250 73 80 18 98 127
76 8,403 84 92 44 137 178
1 106,313 709 780 30 809 1,052
363,000 36,300 39,930 444 40,374 52,487
6,500 6,292 6,292 6,921 4,444 11,365 14,775
1.502 136,500 1,365 1,502 44 1,546 2,010
436 44,000 440 484 44 528 687
41.25 39,600 39,600 43,560 4,444 48,004 62,405
130 11,818 118 130 44 174 227
161 12,342 123 136 44 180 234
77 7,315 73 80 44 125 162
112 10,227 102 112 44 157 204
121 11,495 115 126 44 171 222
46,200 1,540 1694 148 1,842 2,395
161 4,121 41 45 44 90 117
138 12,523 125 138 44 182 237
37 14,801 148 163 44 207 269
2,267 74,800 2,493 2,743 148 2,891 3,758
44 55,000 55 61 4 65 84
34 14,388 144 158 44 203 264
47 550,000 550 605 4 609 792
5.5 275,000 55,000 60,500 889 61,389 79,805

187,500 6,250 6,875 148 7,023 9,130


76,364 764 840 44 884 1,150
125,040 2,501 2,751 89 2,840 3,692
800,000 8,000 8,800 44 8,844 11,498
33,000 33,000 36,300 4,444 40,744 52,967
446,400 18,600 20,460 185 20,645 26,839
438,000 18,250 20,075 185 20,260 26,338
2,076,000 86,500 95,150 185 95,335 123,936
171,528 1,715 1,887 44 1,931 2,511
13,800 13,800 15,180 4,444 19,624 25,511
440,000 22,000 24,200 222 24,422 31,749
175,000 175,000 192,500 4,444 196,944 256,027
24,750 24,750 27,225 4,444 31,669 41,170
8,800 88 97 44 141 184
17,750 17,750 19,525 4,444 23,969 31,160
150,000 15,000 16,500 444 16,944 22,028
440,000 14,667 16,133 148 16,281 21,166
94,500 94,500 103,950 4,444 108,394 140,912
210,000 210,000 231,000 4,444 235,444 306,077
92,000 92,000 101,200 4,444 105,644 137,337
12,700 12,700 13,970 4,444 18,414 23,938
31,525 631 694 89 782 1,017
PENGAJUAN PENGAJUA PROPOSAL 2018
HET MARGIN RENCANA REMARK OP
50% 70% NEW MARGIN
9,164 11,344 14,370 NAIK 12,873 13,000 72%
3,005 3,405 NAIK 3,405 3,405 70%
1,627,507 1,844,508 NAIK ### ### 30%
277,910 314,964 NAIK 277,910 277,910 50%
135,825 153,935 NAIK 135,825 135,825 50%
143,745 162,911 NAIK 143,745 143,745 50%
109,276 123,846 NAIK 109,276 109,276 50%
370,491 419,890 NAIK 370,491 370,491 50%
4,400 5,619 6,743 NAIK 6,743 6,743 80%
480,711 544,806 NAIK 480,711 480,711 50%
165,297 187,337 NAIK 165,297 165,297 50%
532,686 603,711 NAIK 532,686 532,686 50%
167,884 190,269 NAIK 167,884 167,884 50%
15,010 18,796 21,302 NAIK 18,796 18,796 50%
25,341 28,720 NAIK 25,341 25,341 50%
64,928 73,585 NAIK 64,928 64,928 50%
851,631 965,182 NAIK 851,631 851,631 50%
6,454 8,383 9,501 NAIK 9,501 9,501 70%
215,300 317,209 NAIK 215,300 215,300 50%
34,174 41,497 NAIK 34,174 34,174 40%
107,250 143,616 162,765 NAIK 162,765 162,765 70%
258,951 293,478 NAIK 258,951 258,951 50%
309,883 351,201 NAIK 268,565 268,565 30%
6,825 9,806 11,113 NAIK 9,806 9,806 50%
31,924 36,181 NAIK 27,668 27,668 30%
59,126 81,411 92,266 NAIK 81,411 81,411 50%
38,613 43,762 NAIK 38,613 38,613 50%
44,550 61,776 70,013 NAIK 61,776 61,776 50%
31,508 35,709 NAIK 35,709 35,709 70%
334,274 378,843 NAIK 334,274 334,274 50%
646 784 889 NAIK 889 889 70%
64,858 73,506 NAIK 64,858 64,858 50%
472,214 535,175 NAIK 472,214 472,214 50%
203,016 216,550 NAIK 216,550 216,550 60%
18,853 26,922 32,691 NAIK 26,922 26,922 40%
89,166 101,055 NAIK 101,055 101,055 70%
25,677 29,101 NAIK 29,101 29,101 70%
2,550 3,400 NAIK 3,400 3,400 100%
114,467 129,729 NAIK 114,467 114,467 50%
6,175 6,416 7,271 NAIK 7,271 7,271 70%
6,783 9,192 10,418 NAIK 10,418 10,418 70%
21,986 27,710 31,405 NAIK 31,405 31,405 70%
117,381 133,032 NAIK 133,032 133,032 70%
60,273 68,309 NAIK 60,273 60,273 50%
3,206 2,851,679 3,231,902 NAIK ### ### 50%
4,739 5,371 NAIK 5,371 5,371 70%
6,310 7,481 8,478 NAIK 8,478 8,478 70%
3,814 4,322 NAIK 4,322 4,322 70%
101,409 114,930 NAIK 114,930 114,930 70%
10,459 13,249 NAIK 13,249 13,249 90%
4,290 4,768 6,040 NAIK 6,040 6,040 90%
349,701 396,328 NAIK 349,701 349,701 50%
16,779 19,016 NAIK 19,016 19,016 70%
9,612 10,893 NAIK 9,612 9,612 50%
19,642 22,260 NAIK 19,642 19,642 50%
66,020 74,822 NAIK 66,020 66,020 50%
8,142 9,228 NAIK 9,228 9,228 70%
304,878 25,137 28,489 NAIK 25,137 25,137 50%
11,439 12,964 NAIK 14,259 15,000 97%
19,999 22,666 NAIK 22,666 22,666 70%
11,112 12,594 NAIK 11,112 11,112 50%
5,667 6,423 NAIK 6,423 6,423 70%
945 1,071 NAIK 945 945 50%
5,851 7,269 9,207 NAIK 9,207 9,207 90%
1,170,535 1,326,606 NAIK ### ### 70%
353,166 400,255 NAIK 353,166 353,166 50%
313,325 355,102 NAIK 271,548 271,548 30%
15,400 17,547 19,887 NAIK 19,887 19,887 70%
7,475 8,471 NAIK 8,471 8,471 70%
131,901 149,488 NAIK 131,901 131,901 50%
204,666 231,955 NAIK 204,666 204,666 50%
5,445 7,541 9,049 NAIK 9,049 9,049 80%
5,430 6,667 8,000 NAIK 8,000 8,000 80%
27,733 31,431 NAIK 27,733 27,733 50%
9,572 10,848 NAIK 10,848 10,848 70%
132,467 150,129 NAIK 132,467 132,467 50%
405,966 460,095 NAIK 405,966 405,966 50%
10,223 12,267 NAIK 12,267 12,267 80%
8,470 10,033 11,371 NAIK 11,371 11,371 70%
4,194 8,812 10,574 NAIK 10,574 10,574 80%
16,421 18,610 NAIK 18,610 18,610 70%
8,800 10,122 12,147 NAIK 12,147 12,147 80%
31,364 36,213 43,972 NAIK 36,213 36,213 40%
15,650 17,736 NAIK 15,650 15,650 50%
21,845 23,210 NAIK 21,845 21,845 60%
4,538 5,792 7,337 NAIK 7,337 7,337 90%
11,883 13,468 NAIK 13,468 13,468 70%
20,656 23,411 NAIK 20,656 20,656 50%
25,231 31,259 33,343 NAIK 33,343 33,343 60%
132,026 149,630 NAIK 132,026 132,026 50%
6,180 8,240 NAIK 8,240 8,240 100%
1,026 1,163 NAIK 1,026 1,026 50%
14,924 16,914 NAIK 16,914 16,914 70%
251,364 284,880 NAIK 251,364 251,364 50%
72,551 82,224 NAIK 72,551 72,551 50%
130,215 147,577 NAIK 130,215 130,215 50%
242,121 274,404 NAIK 242,121 242,121 50%
65,000 67,010 75,944 NAIK 75,944 75,944 70%
160,624 214,166 NAIK 160,624 160,624 50%
215,833 244,611 NAIK 215,833 215,833 50%
10,593 5,740 6,505 NAIK 6,505 6,505 70%
246,700 279,593 NAIK 213,806 213,806 30%
316,866 359,115 NAIK 316,866 316,866 50%
199,333 332,222 NAIK 199,333 199,333 50%
28,502 294,591 333,870 NAIK 294,591 294,591 50%
249,216 282,445 NAIK 282,445 282,445 70%
111,665 126,554 NAIK 111,665 111,665 50%
203,200 246,246 279,079 NAIK 229,830 229,830 40%
5,864 6,646 NAIK 5,864 5,864 50%
13,269 16,393 18,579 NAIK 18,579 18,579 70%
18,222 20,652 NAIK 18,222 18,222 50%
6,064 7,525 9,531 NAIK 9,531 9,531 90%
26,565 34,036 38,574 NAIK 38,574 38,574 70%
80,174 90,863 NAIK 90,863 90,863 70%
83,391 94,510 NAIK 83,391 83,391 50%
16,612 21,042 NAIK 21,042 21,042 90%
433,373 491,156 NAIK 433,373 433,373 50%
14,742 16,708 NAIK 14,742 14,742 50%
13,019 17,844 20,223 NAIK 17,844 17,844 50%
16,315 18,491 NAIK 16,315 16,315 50%
7,971 9,034 NAIK 9,034 9,034 70%
20,022 22,692 NAIK 22,692 22,692 70%
58,285 62,171 NAIK 62,171 62,171 60%
276,052 312,859 NAIK 276,052 276,052 50%
13,867 16,640 NAIK 16,640 16,640 80%
17,611 19,959 NAIK 19,959 19,959 70%
508,081 575,825 NAIK 508,081 508,081 50%
238,986 270,851 NAIK 238,986 238,986 50%
116,833 132,411 NAIK 116,833 116,833 50%
1,861 2,110 NAIK 2,110 2,110 70%
128,161 145,249 NAIK 111,073 111,073 30%
11,899 13,486 NAIK 13,486 13,486 70%
20,335 23,046 NAIK 20,335 20,335 50%
36,438 42,464 51,563 NAIK 42,464 42,464 40%
4,577 5,492 NAIK 5,492 5,492 80%
221,166 250,655 NAIK 221,166 221,166 50%
3,354 3,801 NAIK 3,354 3,354 50%
3,423 3,187 4,249 NAIK 4,249 4,249
11,703 9,413 13,806 NAIK 13,806 13,806 120%
201,475 228,339 NAIK 228,339 228,339 70%
115,566 130,975 NAIK 130,975 130,975 70%
25,884 29,335 NAIK 25,884 25,884 50%
1,128 1,505 NAIK 1,505 1,505 100%
12,656 14,343 NAIK 14,343 14,343 70%
70,125 106,630 120,847 NAIK 106,630 106,630 50%
102,861 116,576 NAIK 102,861 102,861 50%
19,171 21,727 NAIK 21,727 21,727 70%
585,651 663,738 NAIK 507,564 507,564 30%
54,364 61,613 NAIK 61,613 61,613 70%
31,948 36,207 NAIK 36,207 36,207 70%
11,847 13,427 NAIK 11,847 11,847 50%
436 611 NAIK 611 611 110%
33,667 38,155 NAIK 33,667 33,667 50%
8,317 10,535 12,642 NAIK 12,642 12,642 80%
278,916 316,105 NAIK 278,916 278,916 50%
209,604 237,552 NAIK 237,552 237,552 70%
55,561 62,969 NAIK 62,969 62,969 70%
13,311 15,086 NAIK 15,086 15,086 70%
68,497 77,630 NAIK 77,630 77,630 70%
879 997 NAIK 997 997 70%
32,755 37,122 NAIK 37,122 37,122 70%
9,559 12,108 NAIK 12,108 12,108 90%
180,500 227,612 297,646 NAIK 227,612 227,612 30%
6,335 7,647 8,667 NAIK 8,667 8,667 70%
381 432 NAIK 432 432 70%
3,310 3,751 NAIK 3,751 3,751 70%
16,138 20,022 22,692 NAIK 22,692 22,692 70%
20,020 29,401 33,321 NAIK 33,321 33,321 70%
17,270 21,577 24,454 NAIK 24,454 24,454 70%
11,454 12,343 13,989 NAIK 13,989 13,989 70%
56,166 63,655 NAIK 63,655 63,655 70%
6,114 8,478 9,008 NAIK 8,478 8,478 60%
33,337 37,781 NAIK 33,337 33,337 50%
605,616 686,365 NAIK 605,616 605,616 50%
125,083 141,761 NAIK 125,083 125,083 50%
1,128 1,332 2,220 NAIK 2,220 2,220 150%
8,087 9,165 NAIK 9,165 9,165 70%
419,166 475,055 NAIK 475,055 475,055 70%
238 392 784 NAIK 784 784 200%
278,677 315,834 NAIK 278,677 278,677 50%
151,866 172,115 NAIK 172,115 172,115 70%
14,924 16,914 NAIK 16,914 16,914 70%
8,044 10,122 12,821 NAIK 12,821 12,821 90%
2,677 2,934 3,130 NAIK 3,130 3,130 60%
29,923 33,912 NAIK 33,912 33,912 70%
232,931 263,988 NAIK 232,931 232,931 50%
392,601 444,948 NAIK 392,601 392,601 50%
337,821 382,864 NAIK 382,864 382,864 70%
19,143 21,696 NAIK 21,696 21,696 70%
645,546 731,619 NAIK 645,546 645,546 50%
7,329 9,084 11,506 NAIK 11,506 11,506 90%
25,829 29,272 NAIK 29,272 29,272 70%
17,325 21,643 24,529 NAIK 24,529 24,529 70%
7,758 8,793 NAIK 7,758 7,758 50%
16,770 19,006 NAIK 19,006 19,006 70%
490,717 556,145 NAIK 425,288 425,288 30%
1,200 1,360 NAIK 1,360 1,360 70%
1,210,116 1,371,465 NAIK ### ### 50%
501,336 568,181 NAIK 501,336 501,336 50%
34,333 38,911 NAIK 34,333 34,333 50%
2,079 2,377 2,694 NAIK 2,694 2,694 70%
55,176 69,890 NAIK 55,176 55,176 50%
8,800 11,112 14,075 NAIK 14,075 14,075 90%
53,947 61,140 NAIK 53,947 53,947 50%
25,689 29,115 NAIK 25,689 25,689 50%
255 357 NAIK 357 357 110%
2,200 2,128 3,121 NAIK 3,121 3,121 120%
857 1,019 1,155 NAIK 1,155 1,155 70%
404 779 883 NAIK 883 883 70%
372 539 898 NAIK 898 898 150%
943 1,069 NAIK 1,069 1,069 70%
173,123 196,206 NAIK 173,123 173,123 50%
110,233 124,931 NAIK 124,931 124,931 70%
71,018 80,487 NAIK 71,018 71,018 50%
18,902 21,422 NAIK 21,422 21,422 70%
1,634 1,852 NAIK 1,852 1,852 70%
26,803 30,376 NAIK 30,376 30,376 70%
1,660 1,845 2,091 NAIK 2,091 2,091 70%
929 1,184 2,763 NAIK 2,763 2,763 250%
6,247 7,080 NAIK 6,247 6,247 50%
142 374 424 NAIK 424 424 70%
191,796 217,369 NAIK 191,796 191,796 50%
1,225 2,038 2,310 NAIK 2,038 2,038 50%
246,246 279,079 NAIK 279,079 279,079 70%
74 104 NAIK 104 104 110%
1,262 1,430 NAIK 1,430 1,430 70%
47,004 31,555 35,762 NAIK 31,555 31,555 50%
29,700 31,555 35,762 NAIK 31,555 31,555 50%
1,174 1,330 NAIK 1,330 1,330 70%
243,439 275,898 NAIK 243,439 243,439 50%
2,310 8,472 9,602 NAIK 9,602 9,602 70%
251,691 285,250 NAIK 251,691 251,691 50%
1,424 1,633 1,851 NAIK 1,851 1,851 70%
123,651 140,138 NAIK 123,651 123,651 50%
261,701 23,624 26,774 NAIK 26,774 26,774 70%
10,917 12,372 NAIK 12,372 12,372 70%
20,698 23,457 NAIK 23,457 23,457 70%
12,927 14,651 NAIK 14,651 14,651 70%
208 338 675 NAIK 675 675 200%
189,523 214,793 NAIK 189,523 189,523 50%
21,654 24,541 NAIK 24,541 24,541 70%
13,860 14,067 17,082 NAIK 17,082 17,082 70%
1,222 1,629 NAIK 1,629 1,629 100%
6,188 2,576 7,727 NAIK 7,727 7,727 350%
2,038 2,310 NAIK 2,038 2,038 50%
4,417 5,006 NAIK 5,006 5,006 70%
20,838 23,617 NAIK 20,838 20,838 50%
800 269 448 NAIK 448 448 150%
12,075 13,685 NAIK 12,075 12,075 50%
6,237 7,152 8,106 NAIK 8,106 8,106 70%
8,883 10,068 NAIK 10,068 10,068 70%
1,773 2,009 NAIK 2,009 2,009 70%
13,894 15,746 NAIK 13,894 13,894 50%
146,533 166,071 NAIK 146,533 146,533 50%
252 419 NAIK 419 419 150%
134 152 NAIK 134 134 50%
3,170 3,593 NAIK 3,593 3,593 70%
16,500 23,433 28,120 NAIK 28,120 28,120 80%
17,008 19,276 NAIK 17,008 17,008 50%
394 447 NAIK 447 447 70%
10,313 13,835 15,679 NAIK 13,835 13,835 50%
25,688 37,847 NAIK 25,688 25,688 50%
119,308 135,216 NAIK 119,308 119,308 50%
1,037,119 1,175,402 NAIK 898,837 898,837 30%
1,833 2,222 2,518 NAIK 2,518 2,518 70%
1,272 1,634 2,070 NAIK 2,070 2,070 90%
300 402 669 NAIK 669 669 150%
23,576 40,079 NAIK 23,576 23,576 50%
69 102 NAIK 102 102 120%
107,917 122,305 NAIK 107,917 107,917 50%
12,600 14,280 NAIK 12,600 12,600 50%
40,653 46,073 NAIK 46,073 46,073 70%
112 237 395 NAIK 395 395 150%
15,584 17,662 NAIK 17,662 17,662 70%
2,935 3,515 3,984 NAIK 3,984 3,984 70%
300 270 450 NAIK 450 450 150%
165 288 481 NAIK 481 481 150%
136 217 435 NAIK 435 435 200%
3,206 4,052 4,592 NAIK 4,592 4,592 70%
344 314 733 NAIK 733 733 250%
8,800 2,642 3,347 NAIK 3,347 3,347 90%
27,504 10,770 12,205 NAIK 12,205 12,205 70%
941 1,568 NAIK 1,568 1,568 150%
65,294 110,999 NAIK 65,294 65,294 95%
110,233 124,931 NAIK 110,233 110,233 50%
150 215 358 NAIK 358 358 150%
468 586 860 NAIK 860 860 120%
70 103 NAIK 103 103 120%
36,374 41,224 NAIK 41,224 41,224 70%
110 124 NAIK 95 95 30%
11,443 12,969 NAIK 12,969 12,969 70%
84,711 96,006 NAIK 73,416 73,416 30%
12,031 10,810 14,413 NAIK 14,413 14,413 100%
212 353 NAIK 353 353 150%
261 357 833 NAIK 833 833 250%
983 167 NAIK 983 983 902%
205 547 NAIK 547 547 300%
2,784 1,214 3,237 NAIK 3,237 3,237 300%
60,562 80,749 NAIK 80,749 80,749 100%
17,048 28,981 NAIK 17,048 17,048 50%
2,002 2,319 3,865 NAIK 3,865 3,865 150%
503 793 898 NAIK 898 898 70%
99,264 72,006 120,010 NAIK 120,010 120,010 150%
293 262 436 NAIK 436 436 150%
270 541 NAIK 541 541 200%
104 187 500 NAIK 500 500 300%
235 706 NAIK 706 706 350%
169 256 684 NAIK 684 684 300%
1,435 2,763 3,132 NAIK 2,763 2,763 50%
135 494 NAIK 494 494 450%
186 273 820 NAIK 820 820 350%
311 352 NAIK 352 352 70%
8,800 4,336 5,493 NAIK 4,336 9,000 211%
97 227 NAIK 227 227 250%
304 345 NAIK 304 304 50%
914 1,036 NAIK 914 914 50%
92,083 104,361 NAIK 92,083 92,083 50%

10,535 12,642 12,642 NAIK 14,063 30%


1,327 1,504 2,281 MAINTAIN 2,965 30%
4,260 4,828 5,081 MAINTAIN 5,081 30%
13,267 15,036 13,267 NAIK 13,267 30%
61,116 69,265 61,116 NAIK 61,116 30%
30,968 35,097 41,946 MAINTAIN 41,946
30,390 34,442 48,154 MAINTAIN 48,154
143,003 162,070 143,003 NAIK 143,003
2,897 3,283 5,829 MAINTAIN 5,829
29,436 33,361 36,295 MAINTAIN 36,295
36,633 41,518 53,086 MAINTAIN 53,086
295,416 315,110 315,110 NAIK 315,110 30%
47,504 53,837 80,787 MAINTAIN 80,787
212 240 703 MAINTAIN 703
35,954 40,747 49,781 MAINTAIN 49,781
25,417 28,805 28,805 NAIK 28,805
24,422 27,678 24,422 NAIK 24,422
162,591 184,270 322,520 MAINTAIN 322,520
353,166 376,710 376,710 NAIK 376,710
158,466 169,030 169,030 NAIK 169,030
27,621 29,462 29,462 NAIK 29,462
1,174 1,408 1,408 NAIK 1,408

Approved by,

(Nor Azlina Jemain)


PROPOSAL 2018
OP IP
MARGIN NEW MARGIN
1% 13,650 80% 6%
1% 3,576 79% 6%
1% ### 37% 6%
1% 291,805 58% 6%
1% 142,616 58% 6%
1% 150,932 58% 6%
1% 114,740 58% 6%
1% 389,016 58% 6%
2% 7,080 89% 7%
2% 504,747 58% 7%
2% 173,562 58% 7%
2% 559,320 58% 7%
2% 176,278 58% 7%
2% 19,735 58% 7%
2% 26,608 58% 7%
2% 68,174 58% 7%
2% 894,213 58% 7%
2% 9,976 79% 7%
2% 226,065 57% 7%
2% 35,883 47% 7%
2% 170,903 79% 8%
3% 271,899 58% 8%
3% 281,994 37% 8%
3% 10,296 58% 8%
3% 29,051 37% 8%
3% 85,482 58% 8%
3% 40,544 58% 8%
3% 64,865 58% 8%
3% 37,494 79% 8%
3% 350,988 58% 8%
3% 933 79% 8%
3% 68,101 58% 9%
3% 495,825 58% 9%
4% 227,378 68% 9%
4% 28,268 47% 9%
4% 106,108 79% 9%
4% 30,556 79% 9%
4% 3,570 110% 9%
4% 120,190 58% 9%
4% 7,635 79% 9%
4% 10,939 79% 9%
4% 32,975 79% 9%
4% 139,683 79% 10%
4% 63,287 58% 10%
4% ### 58% 10%
4% 5,640 79% 10%
4% 8,902 79% 10%
4% 4,538 79% 10%
4% 120,677 79% 10%
5% 13,911 100% 10%
5% 6,342 100% 10%
5% 367,186 58% 10%
5% 19,967 79% 10%
5% 10,092 58% 10%
5% 20,624 58% 10%
5% 69,321 58% 10%
5% 9,689 79% 10%
5% 26,394 58% 10%
5% 15,750 107% 10%
5% 23,799 79% 10%
5% 11,668 58% 11%
5% 6,744 79% 11%
5% 992 58% 11%
5% 9,668 100% 11%
6% ### 79% 11%
6% 370,824 58% 11%
6% 285,126 37% 11%
6% 20,881 79% 11%
6% 8,895 79% 11%
6% 138,496 58% 11%
6% 214,899 58% 11%
6% 9,501 89% 11%
6% 8,400 89% 11%
6% 29,120 58% 11%
6% 11,391 79% 11%
6% 139,090 58% 11%
6% 426,264 58% 11%
6% 12,881 89% 12%
6% 11,940 79% 12%
6% 11,103 89% 12%
6% 19,541 79% 12%
6% 12,754 89% 12%
7% 38,023 47% 12%
7% 16,432 58% 12%
7% 22,937 68% 12%
7% 7,704 100% 12%
7% 14,141 79% 12%
7% 21,689 58% 12%
7% 35,010 68% 12%
7% 138,628 58% 12%
7% 8,652 110% 12%
7% 1,078 58% 12%
7% 17,759 79% 13%
7% 263,933 58% 13%
7% 76,179 58% 13%
7% 136,726 58% 13%
7% 254,227 58% 13%
8% 79,742 79% 13%
8% 168,655 58% 13%
8% 226,625 58% 13%
8% 6,830 79% 13%
8% 224,497 37% 13%
8% 332,709 58% 13%
8% 209,300 58% 13%
8% 309,321 58% 13%
8% 296,567 79% 14%
8% 117,249 58% 14%
8% 241,321 47% 14%
8% 6,157 58% 14%
8% 19,508 79% 14%
8% 19,133 58% 14%
8% 10,008 100% 14%
8% 40,503 79% 14%
9% 95,406 79% 14%
9% 87,561 58% 14%
9% 22,094 100% 14%
9% 455,041 58% 14%
9% 15,479 58% 14%
9% 18,736 58% 14%
9% 17,131 58% 14%
9% 9,485 79% 14%
9% 23,826 79% 14%
9% 65,280 68% 14%
9% 289,855 58% 14%
9% 17,472 89% 14%
9% 20,957 79% 15%
9% 533,485 58% 15%
9% 250,935 58% 15%
9% 122,675 58% 15%
9% 2,215 79% 15%
9% 116,627 37% 15%
9% 14,160 79% 15%
9% 21,351 58% 15%
9% 44,587 47% 15%
9% 5,767 89% 15%
10% 232,224 58% 15%
10% 3,521 58% 15%
10% 4,461 110% 16%
10% 14,496 131% 16%
10% 239,755 79% 16%
10% 137,524 79% 16%
10% 27,178 58% 16%
10% 1,580 110% 16%
10% 15,060 79% 16%
11% 111,961 58% 16%
11% 108,004 58% 16%
11% 22,813 79% 16%
11% 532,942 37% 17%
11% 64,693 79% 17%
11% 38,018 79% 17%
11% 12,440 58% 17%
11% 641 121% 17%
11% 35,350 58% 17%
12% 13,274 89% 17%
12% 292,862 58% 17%
12% 249,430 79% 17%
12% 66,118 79% 17%
12% 15,840 79% 17%
12% 81,511 79% 17%
12% 1,046 79% 17%
12% 38,978 79% 17%
12% 12,713 100% 18%
12% 238,992 37% 18%
12% 9,100 79% 18%
12% 453 79% 18%
12% 3,939 79% 18%
12% 23,826 79% 18%
12% 34,987 79% 18%
13% 25,677 79% 18%
13% 14,689 79% 18%
13% 66,838 79% 18%
13% 8,902 68% 18%
13% 35,003 58% 19%
13% 635,897 58% 19%
13% 131,337 58% 19%
13% 2,331 163% 19%
13% 9,624 79% 19%
13% 498,808 79% 19%
14% 824 215% 19%
14% 292,611 58% 19%
14% 180,721 79% 19%
14% 17,760 79% 19%
14% 13,463 100% 20%
14% 3,286 68% 20%
14% 35,608 79% 20%
15% 244,578 58% 20%
15% 412,231 58% 20%
15% 402,007 79% 20%
15% 22,781 79% 21%
15% 677,823 58% 21%
15% 12,082 100% 21%
15% 30,736 79% 21%
15% 25,755 79% 21%
15% 8,146 57% 21%
15% 19,957 79% 21%
15% 446,552 37% 21%
15% 1,428 79% 21%
15% ### 58% 21%
15% 526,403 58% 21%
16% 36,050 58% 22%
16% 2,828 79% 22%
16% 57,935 58% 22%
16% 14,779 100% 22%
16% 56,644 58% 22%
16% 26,974 58% 22%
17% 374 121% 22%
17% 3,277 131% 23%
17% 1,213 79% 23%
17% 927 79% 23%
17% 942 163% 23%
17% 1,123 79% 23%
18% 181,779 58% 24%
18% 131,178 79% 24%
18% 74,569 58% 24%
18% 22,493 79% 24%
18% 1,945 79% 24%
18% 31,895 79% 24%
18% 2,196 79% 24%
19% 2,901 268% 25%
19% 6,560 58% 25%
19% 446 79% 25%
19% 201,386 58% 25%
19% 2,140 58% 25%
19% 293,033 79% 25%
20% 109 121% 26%
20% 1,502 79% 26%
20% 33,132 58% 26%
20% 33,132 58% 26%
20% 1,397 79% 26%
20% 255,611 58% 26%
21% 10,082 79% 27%
21% 264,276 58% 27%
21% 1,944 79% 27%
21% 129,834 58% 27%
21% 28,112 79% 27%
21% 12,991 79% 27%
22% 24,630 79% 28%
22% 15,383 79% 28%
22% 709 215% 28%
22% 198,999 58% 29%
23% 25,768 79% 29%
23% 17,936 79% 29%
23% 1,710 110% 29%
23% 8,113 373% 29%
24% 2,140 58% 30%
24% 5,256 79% 30%
24% 21,880 58% 30%
24% 470 163% 30%
24% 12,679 58% 30%
24% 8,511 79% 30%
24% 10,571 79% 31%
24% 2,110 79% 31%
25% 14,588 58% 31%
25% 153,860 58% 31%
25% 440 163% 31%
25% 140 58% 31%
25% 3,773 79% 31%
25% 29,526 89% 31%
25% 17,859 58% 31%
25% 469 79% 31%
25% 14,526 58% 32%
26% 26,972 58% 32%
26% 125,274 58% 32%
26% 943,778 37% 32%
26% 2,644 79% 33%
27% 2,173 100% 33%
28% 703 163% 34%
29% 24,755 58% 35%
29% 107 131% 35%
29% 113,312 58% 35%
29% 13,230 58% 35%
29% 48,377 79% 36%
30% 414 163% 36%
31% 18,545 79% 37%
32% 4,183 79% 39%
33% 472 163% 39%
33% 505 163% 39%
34% 456 215% 40%
35% 4,822 79% 42%
35% 770 268% 42%
35% 3,514 100% 42%
36% 12,816 79% 42%
36% 1,646 163% 43%
38% 68,559 105% 45%
38% 115,745 58% 45%
39% 376 163% 46%
41% 903 131% 48%
43% 108 131% 50%
44% 43,285 79% 51%
44% 100 37% 51%
44% 13,618 79% 51%
44% 77,087 37% 52%
47% 15,134 110% 54%
47% 371 163% 54%
49% 874 268% 56%
50% 1,032 952% 58%
52% 575 320% 60%
52% 3,399 320% 60%
53% 84,786 110% 60%
54% 17,900 58% 61%
55% 4,058 163% 62%
58% 943 79% 66%
64% 126,011 163% 73%
66% 458 163% 74%
68% 568 215% 76%
69% 525 320% 78%
80% 742 373% 89%
89% 718 320% 99%
96% 2,901 58% 106%
105% 518 478% 115%
112% 861 373% 123%
116% 370 79% 127%
119% 9,450 227% 130%
171% 239 268% 184%
198% 319 58% 213%
609% 960 58% 644%
921% 96,687 58% 972%

15,287 35%
3,262
5,589
14,593
67,228
46,141
52,969
157,303
6,412
39,925
58,395
346,621
88,866
773
54,759
31,686
26,864
354,772
414,381
185,933
32,409
1,549

y,

main)
52040017 KAPAS PEMBALUT HID DRC 500 GR 65.856 62.72
52040030 PEMPERS ADULT L 19.6 18.667
52040031 PEMPERS ADULT M 15.969 15.209
52040033 PEMPERS ADULT XL 19.316 18.396
52040053 SPATEL LIDAH 2.159 2.056
52040054 SPATEL OBGYN 9 4.103 3.908
52040057 THERMOMETER DIGITAL 73.5 73.5
52040070 ASEPTANIOS TERMINAL HPH 3,617,592 3,445,326
52040072 DERMANIOS SCRUB CHLORHEXIDINE 1,941,994 1,849,518
52040075 CHLORAETYL SPRAY 100ML 146.378 138.455
52040076 KARTU GOLONGAN DARAH ISI 100 17.216 17.216
52040078 THERMOVENT O2 478.281 455.506
52040079 THERMOVENT T 292.64 278.705
52040080 XYLOCAIN JELLY 10GR 92.758 88.341
52040082 ANIOSYME DDI 5 LTR 2,792,218 2,659,255
52040086 KACAMATA POSEY
52040087 ANIOS DDSH 482.462 459.488
52040088 KAPAS LIDI 867 826
52040091 PRESEPT 2.5GR "J&J 8.85 8.429
52040112 ANIOSGEL 85,500ML 290.547 276.711
52040117 STERANIOS 2% (382.034) 895.705 853.052
52040118 THERMAL PAPER FOR DINAMAP 474.774 252.166
52040121 ANIOSGEL 85, 5 LT 1,521,294 1,448,851
52040123 MAMY POKO NB28+2 (MNB30) 4.695 4.471
52040200 CUTTON BUDS FLUFFY 138 131
52040204 SANIFRESH 57.02 54.305
52040205 SOAPY CHLOROSCRUB 4 51.501 51.501
52040213 AQUAPAK 340ML 113.036 113.036
52040218 LIFREE POPOK PEREKAT L3 (ULPPB) 11.604 11.051
52040219 LIFREE POPOK PEREKAT XL2B 14.242 13.563
52040220 LIFREE POPOK PEREKAT M4 9.206 8.767
52060001 IV CATHETER 14G X2 "SURFLO" (ABBOCATH) 72.001 68.572
52060002 IV CATHETER 16G "ABBOTH" (ABBOCATH) 82.073 78.165
52060003 IV CATHETER 18G "ABBOTH" (ABBOCATH) 34.783 33.127
52060008 CONDOM CATHETER L 12.28 11.695
52060009 CONDOM CATHETER M 12.28 11.695
52060010 CONDOM CATHETER S 12.28 11.695
52060015 FEEDING TUBE 5 40 CM "TERUMO" 35.28 33.6
52060017 FEEDING TUBE 8 120 CM "TERUMO" 33.165 31.586
52060035 FOL CATH 3 WAY 24 "RUSCH" 121.925 116.119
52060036 FOL CATH SILICON 2 WAY 16 "RUSCH" 210 200
52060037 GUEDEL AIRWAIYS 0 "PORTEX" 118.203 112.574
52060038 GUEDEL AIRWAIYS 00 "PORTEX" 237.862 226.535
52060039 GUEDEL AIRWAIYS 000 "PORTEX" 250.575 238.643
52060040 GUEDEL AIRWAIYS 1 "PORTEX" 237.862 226.535
52060041 GUEDEL AIRWAIYS 2 "PORTEX" 125.743 119.755
52060042 GUEDEL AIRWAIYS 3 "PORTEX" 136.937 130.416
52060061 NASAL OXYGEN CANULA PAED "SALTER" 68.801 65.525
52060067 STOMACH TUBE 12 "TERUMO" 35.502 33.811
52060068 STOMACH TUBE 14 "TERUMO" 94.344 89.851
52060069 STOMACH TUBE 16 "TERUMO" 66.132 62.983
52060070 STOMACH TUBE 18 "TERUMO" 66.132 62.983
52060072 SUCTION CATH 6 "HOSPITEC" 36.105 34.386
52060073 SUCTION CATH 8 "REMEDI" 21.096 20.091
52060074 SUCTION CATH 10 "REMEDI" 21.096 20.091
52060081 IV CATH PORT 18 "TERUMO" (SURFLO) 54.203 51.622
52060082 IV CATH PORT 20 "TERUMO" (SURFLO) 55.898 53.236
52060083 IV CATH PORT 22 "TERUMO" (SURFLO) 56.377 53.692
52060084 IV CATH PORT 24 "TERUMO" (SURFLO) 58.185 55.414
52060085 IV CATH PORT 26 "TERUMO" (SURFLO) 80.577 76.74
52060091 THORACIC TROCAR/CANULA 20 "PORTEX" 979.477 932.835
52060092 THORACIC TROCAR/CANULA 24 "PORTEX" 936.023 891.45
52060099 FOL CATH 2 WAY 16 "RUSCH" 44.646 44.646
52060100 FEEDING TUBE 8 40CM "TERUMO" 35.499 33.809
52060107 THORACIC TROCAR/CANULA 28 "PORTEX" 570.062 542.916
52060108 CONECTOR TUBING 60" "OPTIVAN" 132.882 126.554
52060109 FEEDING TUBE 5 100CM "TERUMO" 40.546 38.615
52060110 FEEDING TUBE 8 100CM "TERUMO" 40.546 38.615
52060117 FOL CATH 2 WAY GOLD 14 "RUSCH" 38.23 38.23
52060131 TUBE CIT GH 4.5 "BD 8.874 8.451
52060136 TUBE MICRO 0.5ML "BD" 10.562 10.059
52060137 TUBE SST 3.5ML "BD" 7.069 6.732
52060138 TUBE SST 5.0ML "BD" 7.312 6.964
52060139 Y ADAPTOR TUBING DUAL CHECK 442.283 421.222
52060140 ENDOTRACHEAL KK 2 "RUSH" 143.798 143.798
52060141 ENDOTRACHEAL KK 7 "RUSH" 150.988 143.798
52060142 ENDOTRACHEAL KK 8 "RUSCH" 150.988 143.798
52060143 ENDOTRACHEAL KK 8,5 RUSH" 162.362 154.63
52060144 ENDOTRACHEAL NKK 3.5 "RUSH" 850.628 810.122
52060145 ENDOTRACHEAL NKK 4 "RUSH" 898.87 856.067
52060146 ENDOTRACHEAL NKK 4.5 "RUSH" 898.87 856.067
52060147 ENDOTRACHEAL NKK 5 "RUSH" 898.87 856.067
52060148 ENDOTRACHEAL NKK 5.5 "RUSH" 898.87 856.067
52060149 ENDOTRACHEAL NKK 6 "RUSH" 898.87 856.067
52060150 ENDOTRACHEAL NKK 6.5 "RUSH" 898.871 856.067
52060151 ENDOTRACHEAL NKK 8.5 "RUSH" 898.87 856.067
52060152 EPIDURAL MINIPACK 16G "PORTEX" 489.087 465.797
52060153 EPIDURAL MINIPACK 18G "PORTEX" 489.087 465.797
52060154 FOL CATH 2 WAY GOLD 8 "RUSCH" 42.356 42.356
52060155 FOL CATH 2 WAY GOLD 22 "RUSCH" 38.201 36.382
52060156 GUEDEL AIRWAIYS 4 "PORTEX" 136.937 130.416
52060157 THORACIC CATH 16 "PORTEX" 596.405 596.405
52060158 THORACIC CATH 20 "PORTEX" 596.405 568.005
52060159 THORACIC CATH 24 "PORTEX" 625.828 596.027
52060160 THORACIC CATH 28 "PORTEX" 625.828 596.027
52060162 ENDOTRACHEAL NKK 7 "RUSH" 817.877 778.93
52060163 ENDOTRACHEAL NKK 7.5 "RUSH" 817.877 778.93
52060164 FEEDING TUBE 12 40.546 38.615
52060167 FEEDING TUBE 18 40.546 38.615
52060168 FEEDING TUBE 3.5 100CM "TERUMO " 40.546 38.615
52060170 FOL CATH 2 WAY GOLD 20 "RUSCH" 37.007 35.245
52060171 FOL CATH 2 WAY GOLD 22 "RUSCH" 52.266 52.266
52060173 GUEDEL AIRWAIYS 8 "RUSCH" 120.726 120.726
52060174 GUEDEL AIRWAIYS 9 "RUSCH" 120.726 120.726
52060176 RECTAL TUBE 28 FG "TROGE" 27.773 26.45
52060180 THORACIC TROCAR/CANULA 32 "PORTEX" 1,025,740 976.895
52060181 VENOCATH 12 110.821 105.544
52060185 Syringe Multipak Optistar 530.224 504.975
52060192 GAUZE PAD NON XRAY 10 X10 CM"HOSPILAB" 4.948 4.712
52060208 ENDOTRACHEAL NKK 8 "RUSCH" 720.789 686.466
52060213 FEMALE CATHETER 14G 37.974 36.166
52060214 Syringe w/handifill 200 Ml single 437.553 416.717
52060219 FOL CATH 2 WAY GOLD NO 10 "RUSCH" 121.109 115.342
52060221 LEFT HEART VENT CATHETER 1,407,628 1,340,598
52060222 NELATHON CATHETER 10 "RUSCH" 43.508 41.436
52060225 SUCTION CATH 16 "REMEDI" 24.11 22.962
52060226 FOL CATH 3 WAY 22 "RUSCH" 173.587 165.315
52060228 SUCTION CATH 12 "REMEDI" 24.11 22.962
52060229 SUCTION CATH 14 "REMEDI" 24.11 22.962
52060232 ENDOTRACHEAL NKK 7 "PORTEX" 983.296 936.472
52060235 ENDOTRACHEAL NKK 7,5 "PORTEX" 960.23 914.505
52060237 OXYGEN TUBING " SALTER" 28.834 27.461
52060238 FOL CATH 3 WAY GOLD 24 "RUSH" 145.847 138.902
52060239 IV CATHETER 18G X2" "SURFLO" (ABBOCATH) 43.748 41.665
52060244 FOL CATH 3 WAY GOLD 16 "RUSH" 145.847 138.902
52060246 STOMATH TUBE NO. 16 "SILICON" 425.17 404.924
52060247 KERT T. TUBE NO 4 "RUSCH" 356.62 339.638
52060250 NELATON CATETER NO. 16 "RUSH" 29.531 28.125
52060251 NELATON CATETHER NO. 18 "RUSCH" 29.531 28.125
52060252 FOL CATH 2 WAY 12 RUSCH "GOLD" 43.472 43.472
52060254 ENDOTRACHEAL NKK NO. 6.5 PORTEX (100-110-065) 916.562 872.916
52060255 ENDOTRACHEAL NKK NO 6 PORTEX (100-110-060) 916.562 872.916
52060259 FEEDING TUBE NO 3 JMS 45.745 43.567
52060260 CYSTOFIX CH 10 12CM BBRAUN 802.134 763.937
52060261 CASE DUAL PACK W/ CHECK VALVES (844023) 1,098,339 1,046,038
52060262 TRACHEOSTOMY MASKER HUDSON 1075 49.97 47.59
52070081 POT URINE STERIL 7.571 7.21
52070083 FAECES CONTAENER 30ML 21.627 20.597
52070090 NEEDLE FLASHBACK 22X1 5.097 4.854
52070091 MEDISAFE FINE TOUCH 4.642 4.421
52070092 MEDISAFE TEST SRIP 16.627 15.835
52070120 CELLCLEAN 2,032,559 1,935,770
52070121 E CHECK 4,460,831 4,248,410
52070135 HELICOTEC UT PLUS (IR-160C) 209.061 209.061
52070150 SYRINGE ASTRUP 3 ML (402324 QUICK ABG) 44.007 41.911
52070160 OPTIUM XCEED KETONES II 10 COUNTS (99113) 68.625 65.357
52070178 CARDIACT PROBNP 3,340,598 3,340,598
52070215 ACCU CHECK SAFE T- PRO UNO 2.339 2.228
52070317 RAPID TES 190 190
52100001 INTRODUCER SHEATH 6F RADIAL "CORDIS" 167.382 167.382
52100003 THREE WAY ROTATING 98.334 93.651
52100004 NICHIBAND 141.458 134.722
52100005 GUIDE WIRE FLOPPY GW "ABBOTH" 2,301,558 2,301,558
52100006 GUIDE WIRE INTERMEDIATE GW "ABBOTH" 2,111,478 2,111,478
52100007 GUIDE WIRE STANDARD GW "ABBOTH" 2,271,303 2,162,886
52100008 GUIDE WIRE CROSS IT "ABBOTH" 2,111,478 2,111,478
52100009 GUIDE WIRE EXTRA SPORT GW "ABBOTH" 2,301,558 2,301,558
52100010 GUIDE WIRE BALANCE MIDDLEWEIGH "ABBOTH" 2,870,330 2,870,330
52100011 GUIDE WIRE WHISPER "ABBOTH" 2,765,908 2,634,198
52100012 GUIDE WIRE PILOT "ABBOTH" (ALL SZ) 2,634,198 2,634,198
52100013 DOC EXTENSION WIRE "ABBOTH" 2,217,052 2,111,478
52100014 GUIDING CATHETER "ABBOTH" (ALL TYPE & SI 2,732,222 2,602,116
52100015 INDEFLATOR 20/30 "ABBOTH" 2,664,268 2,537,398
52100016 GUIDE WIRE ACCESSORIES KIT "ABBOTH" 833.718 833.718
52100017 COPILOT BLEEDBACK CONTROL VALVE "ABBOTH" 761.676 725.406
52100018 DES XIENCE V "ABBOTH" (ALL SIZE) 37,752,099 35,954,380
52100019 DES XIENCE PRIME LL "ABBOTH" (ALL SIZE) 37,752,099 35,954,380
52100020 CS MULTILINK ULTRA "ABBOTH" (ALL SIZE) 20,160,306 19,200,291
52100021 CS MULTILINK MINI VISION "ABBOTH" (ALL S 22,399,562 21,332,916
52100022 CS MULTILINK VISION "ABBOTH" (ALL SIZE) 23,079,058 21,980,055
52100023 BALLON VOYAGER "ABBOTH" (ALL SIZE) 8,732,598 8,732,598
52100024 OTW VOYAGER "ABBOTH" (ALL SIZE) 9,440,462 8,990,916
52100025 BALLON POWERSAIL "ABBOTH" (ALL SIZE) 9,169,228 8,732,598
52100026 BALLON VOYAGER NC "ABBOTH" (ALL SIZE) 8,732,598 8,732,598
52100027 INTRODUCER SHEATH "TERUMO" (ALL SIZE) 520.938 520.938
52100028 GUIDE WIRE "TERUMO" (ALL SIZE) 816.268 777.398
52100029 YASHIRO CATHETER "TERUMO" 916.579 916.579
52100030 TORANOMON CATHETER "TERUMO" 711.208 711.208
52100031 SIROLIMUS ELUTING CORONARY STENT 30,325,749 28,881,666
52100032 GUIDING CATHETER HEARTRAIL II 3,551,694 3,382,566
52100033 RUNTHROUGH NS FLOPPY "TERUMO" 3,542,233 3,373,555
52100034 PROGREAT MICRO CATH. 2.7 "TERUMO" 11,460,598 11,460,598
52100035 RYUJIN OXYGENATOR SYSYTEM "TERUMO" 13,220,598 13,220,598
52100036 TSUNAMI STENT "TERUMO" 23,334,313 22,223,155
52100037 DES NOBORI STENT "TERUMO" 32,762,499 31,202,380
52100038 GAZELLE STENT "BIOSENSORS" (ALL SIZE) 15,729,628 14,980,598
52100039 DES BIOMATRIX A9 "BIOSENSORS" (ALL SIZE) 38,999,499 37,142,380
52100040 POWER LINE BALLON "BIOSENSORS" (ALL SIZE 9,261,628 8,820,598
52100041 MASLA JUST BALLON "ASAHI" (ALL SIZE) 8,582,874 8,174,166
52100042 OTTIMMO BALLON "KANEKA" (ALL SIZE) 11,109,628 10,580,598
52100043 FORTIS HIGH PRESSURE BALLON "KANEKA" (AL 10,401,999 9,906,666
52100044 MANIFOLD 3GMF "BIOSENSORS" 252.628 240.598
52100045 MEDEX INFLATION DEVICE "BIOSENSORS" 2,793,628 2,660,598
52100046 NEO ASAHI WIRE ROUTE/ RINATO "ASAHI INTEC" 2,660,598 2,660,598
52100047 FIELDER/FIELDER FC "ASAHI INTEC" 3,717,628 3,540,598
52100048 FIELDER XT "ASAHI INTEC" 3,532,828 3,364,598
52100049 CTO WIRE MIRACLE & CONQUEST SERIES 4,771,374 4,544,166
52100050 TORNUS CATHETER "ASAHI INTEC" 9,261,628 8,820,598
52100051 MICROCATHETER - STRIDE "ASAHI INTEC" 7,861,933 7,487,555
52100052 GUIDING CATHETER - G STAGE "ASAHI INTEC" 2,608,828 2,484,598
52100053 MICROGUIDE - STREAMING "ASAHI INTEC" 3,437,349 3,273,666
52100054 THROMBUSTER "KANEKA" 16,697,683 15,902,555
52100055 OPTITORQUE "TERUMO" (ALL SIZE) 1,191,182 1,134,459
52100057 GUIDE WIRE 0.038" 150CM "MERIT" 350.598 350.598
52100058 TRANDUCER HAEMODINAMIK (DOME 1/5) 258.99 258.99
52100059 NEEDLE ONE WALL 18G "MERIT" 184.272 175.497
52100060 INTRODUCER SHEATH 11CM (ALL FRAME) MM 66.786 66.786
52100062 INTRODUCER SHEATH 11CM FEMORAL (ALL FRAME) MERIT 406.673 387.308
52100063 INTRODUCER SHEATH RADIAL "UMBRA" (MM) 616.92 587.543
52100064 MANIFOLD "MERIT" MM 201.917 192.302
52100065 MONITORING LINE 12INCH "MERIT" MM 106.108 101.055
52100066 MONITORING LINE 60INCH "MERIT" MM 106.108 101.055
52100067 INDEFLATOR "MEDISENSE" MM 2,239,228 2,132,598
52100068 ELECT CORONARY BALLON CATH "BIOTRONIK" 7,413,628 7,060,598
52100069 HIGH PRESSURE FLEX TUBING 200 "MERIT" 450.93 429.457
52100070 HIGH PRESSURE FLEX TUBING 480 "MERIT" 382.485 364.272
52100071 ANGIOPLASTY PACK (Y CONNECTOR) "MERIT" 695.158 662.055
52100072 BASIC INDEFLATOR IN 4330 "MERIT" (REKA) 2,829,247 2,694,521
52100073 BRIO BALLON PEGASSO CATHETER 6,936,300 6,606,000
52100074 JIVE "MICROPORT" (REGULER) 7,280,598 7,280,598
52100075 MUSTANG "MICROPORT" (REGULER) 14,436,028 13,748,598
52100076 TANGO "MICROPORT" (REGULER) 22,470,373 21,400,355
52100077 FIRE BIRD 2 STENT "MICROPORT" (REGULER) 31,396,596 29,901,520
52100078 GUIDE WIRE 0.035" 150CM REKA 350.598 350.598
52100079 DES JANUS OPTIMA "SORIN" 36,981,628 35,220,598
52100080 PERFORMA CATH. "MERIT" (ALL TYPE & SIZE) 960.032 914.316
52100086 NEEDLE ONE WALL (REKA) 93.695 89.233
52100088 BASIC INDEFLATOR IN 4130 "MERIT" MM 2,734,100 2,603,905
52100089 BASIC INDEFLATOR IN 4530 "MERIT" 2,516,428 2,396,598
52100092 CHRONO COBALT CROME CARBOSTENT "SORIN" 18,501,628 17,620,598
52100093 PRO HP BALLON "SORIN" 8,337,628 7,940,598
52100094 BIPOLAR TEMPORARY LEAD 5&6F 4,239,393 4,037,518
52100095 ANGIOSEAL 8F "ST JUDE" 6,644,493 6,328,088
52100097 ACCESS GUIDING CATH. (ALL SIZE) "IHT" 2,798,923 2,665,641
52100099 HUNTER HYDROPHILIC EXTRACTION CATH "IHT" 9,261,628 8,820,598
52100100 INTRODUCER SHEATH L11CM "MEDTRONIC" (ALL 391.228 372.598
52100101 INTRODUCER SHEATH L23CM "MEDTRONIC" (ALL 788.357 750.816
52100102 DIAGNOSTIC CATHETER "MEDTRONIC" (ALL SZ 400.633 381.555
52100103 GUIDE WIRE "MEDTRONIC" (ALL SZ) 280.348 266.998
52100104 LAUNCHER GUIDING CATH. "MEDTRONIC" 2,793,628 2,660,598
52100105 INDEFLATOR EVEREST "MEDTRONIC" 2,793,628 2,660,598
52100106 COUGAR PTCA WIRE 0.014" "MEDTRONIC" 2,953,183 2,812,555
52100107 BALLON NC SPRINTER "MEDTRONIC" 10,401,999 9,906,666
52100108 MICRO/DRIVER STENT "MEDTRONIC" 19,827,266 18,883,110
52100109 MULLINS TRANSEPTAL ADULT 8F "MEDTRONIC" 7,413,628 7,060,598
52100110 DES ENDEAVOR RESOLUTE "MEDTRONIC" 40,558,749 38,627,380
52100111 EXPORT ASPIRATION CATHETER "MEDTRONIC" 12,033,628 11,460,598
52100112 AGGRASTAT TIROFIBAN "MEDTRONIC" 9,825,433 9,357,555
52100113 BROCKENBROUGH CURVED NEEDLE "MEDTRONIC" 8,820,598 8,820,598
52100116 CRUISER GUIDE WIRE PTCA "BIOTRONIK" (ALL 2,364,133 2,251,555
52100117 CONCIERGE GUIDING CATH. (ALL) "MERIT" 2,424,028 2,308,598
52100118 SENSIA SSI "MEDTRONIC" 30,308,424 28,865,166
52100119 SENSIA SR (SESR01) "MEDTRONIC" 39,854,499 37,956,666
52100121 FINALE COMPRESSION REGULAR "MERIT" 426.857 406.531
52100122 INTRODUCER SHEATH FEMORAL "MERIT" (MM) 455.618 433.922
52100123 INTRODUCER SHEATH 5F TRANSRADIAL 797.498 759.522
52100124 INTRODUCER SHEATH 6F TRANSRADIAL 788.548 750.998
52100125 INTRODUCER SHEATH 8F TRANSRADIAL 797.886 759.891
52100126 DES GENOUS BIO ENGINEERED 34,321,749 32,687,380
52100127 BMS BLAZER "ORBUSNEICH" 14,100,598 14,100,598
52100128 BALLON SAPPHIRE "ORBUSNEICH" 8,669,499 8,256,666
52100129 BALLON SAPPHIRE NC "ORBUSNEICH" 12,033,628 11,460,598
52100130 BARE METAL CORONARY STENT "H-STENT" 14,100,598 14,100,598
52100132 BALLON DILATION CATHETER "HOPER" 6,180,598 6,180,598
52100133 CATHETER PIG 4F (538450S) "CORDIS" 751.588 715.798
52100134 CATHETER MPA 2 5F (534-542T) "CORDIS" 751.588 715.798
52100135 CRANIAL PERFORATOR 9/12 MM HUDSON SHANK (GB302R 5,826,196 5,548,758
52100136 HI LINE XS CRANIOTOME CUTTER II (GE520R) 2,481,078 2,481,078
52100137 HI LINE XS DIAMOND BURR II D4.0MM (GE517R) 1,623,078 1,623,078
52100138 CONCIERGE GUIDING CATH. (ALL) REKA 2,516,428 2,396,598
52100139 BIOMIME DES- COBALT CR (STENT) 35,219,130 35,219,130
52100141 NEXGAN BMW -COBALT CR (BALLON) 14,099,130 14,099,130
52100146 AMAZONIA CROCO STENT BMS 11,809,790 11,809,790
52100147 YANGTZE U BALLON 8,322,999 7,926,666
52100148 AMAZONIA PAX STENT DES 25,180,290 25,180,290
52100149 INDEFLATOR KIT (MINVASYS) 2,371,790 2,371,790
52100150 GUIDE WIRE 0,035 150CM TERUMO (GA35153M) 665.349 633.666
52100151 GUIDE WIRE 0,035 180CM TERUMO (GA35183M) 699.999 666.666
52100152 ASAP 100 (REKA) 11,027,029 11,027,029
52100153 DANUBIO MINFASIF 15,406,914 14,673,251
52100154 AMAZONIA SIR 27,043,539 25,755,751
52100156 SYRINGE ILLUMENA W/ HAND-FIL 150ML (900103) 384.717 366.397
52100157 ANGIOLATE DES "IVASCULAR" 20,276,589 19,311,037
52100158 MERIT GUIDING CATH 5F (ALL TYPE) "MERIT" 2,403,668 2,289,207
52100159 FIELDER XT A "ASAHI INTEC" 4,055,318 3,862,207
52100160 STENT DES "BIOFREEDOM" 20,276,589 19,311,037
52100161 COMBO PLUS (DUAL THERAPY STENT) "ORI 22,221,714 21,163,537
52100162 BALLON SAPPHIRE II "ORBUSNEICH" 5,323,014 5,069,537
52100163 BALLON SCOREFLEX "ORBUSNEICH" 6,217,089 5,921,037
52100164 STENT XIENCE PRO A 14,338,839 13,656,037
52100165 ANGIOSEAL ALL SIZE "TERUMO" 4,135,464 3,938,537
52100166 GUIDE WIRE 0.035, 150CM "MERIT" TWD 315.632 300.602
52100167 GUIDE WIRE 0.038, 150CM "MERIT" TWD 315.632 300.602
52100168 PAKET PCI COROFLEX DES (UMUM) 17,751,066 16,905,777
52100169 APD 1 (CATHLAB) 992.638 992.638
52100170 APD 2 (CATHLAB) 444.665 444.665
52110062 PLATES COMPR, BROAD 183MM 11 H 2,639,984 2,514,270
52110063 PLATES COMPR, BROAD 199 MM 12 2,788,823 2,656,022
52110064 MONO PLATE 140 4,252,058 4,049,579
52110066 HOLE STRAIGHT PLATE 10 "OSTEOMED" (218-0038 GT) 2,156,068 2,053,398
52110067 HOLE STRAIGHT PLATE 24MM 4 "OSTEOMED" (210-0030 GT 3,200,237 3,047,845
52110068 AUTO DRIVE SCREW 1.6X6MM "OSTEOMED" (211-1606 GT 704.649 671.094
52110069 SCREW 2.0X10MM "OSTEOMED" (202-2010 GT) 668.035 636.224
52120003 GYPSONA 3 INC (3.5mx7.5cm) 58.497 55.711
52120004 GYPSONA 4 INC (3.5mx10cm) 71.336 67.939
52120005 GYPSONA 6 INC (3.5mx15cm) 92.465 88.062
52120008 CUTICEL CLASSIC 10CM X 10CM 29.007 27.626
52120010 HANSAPLAST JUMBO 3.735 3.557
52120011 LAKMUS RED PAPER 2.5 2.381
52120015 LAPARATOMY SPONGES 35 X 35 CM 1 1
52120025 MICROPORE TAPE 1 INC "3M" (15351) 46.762 44.535
52120026 MICROPORE TAPE 1/2 INC "3M" (15352) 23.009 21.913
52120028 OPSITE POST OP 25 X 10 75.406 71.815
52120029 SOFFBAND 3 INC 51.45 49
52120030 SOFFBAND 4 INC 56.784 54.08
52120031 SOFFBAND 6 INC 69.456 66.149
52120040 TEGADERM GEN IV 6X7CM (1623W) 15.75 15
52120041 TEGADERM 10X25CM (1627W) 79.8 76
52120047 VELBAND 3" (7.5CM) 46.274 44.07
52120048 VELBAND 4" (10CM) 56.166 53.491
52120051 MICROPORE TAPE 2 INC "3M" (15352) 93.522 89.069
52120052 TEGADERM PLUS 7X8.5CM (1633W) 20.038 19.084
52120053 IOBAN 6650 518.146 493.472
52120054 TEGADERM PAED (1610W) 33.459 31.866
52120055 TEGADERM PAED 3591 102.419 97.542
52120056 TEGADERM PAED 3590 66.122 66.122
52120058 CUTIMED SORBACT DRESSING PAD 10X10CM 162.374 154.642
52120059 CUTISORB STERILE 10X10CM (9762) 28.748 28.748
52120060 DURAPREP SURGICAL 26ML "3M" (8630A) 176.108 167.722
52120061 GAUZE PAD XRAY 10X10CM "HOSPILAB" 5.232 4.983
52120062 GAUZE PAD NON XRAY 6X6CM "HOSPILAB" 3.065 2.919
52120065 IOBAN ANTIMICROBIAL 60X85CM "3M" 794.614 756.775
52120066 LAPARATOMY SPONGES XRAY 35X35CM 30.118 30.118
52120067 STERI DRAPE ARTHRO 225X304CM "3M" 1,044,661 994.915
52120068 STERI DRAPE ISOLATION 50X25CM "3M" 828.676 789.215
52120069 STERI DRAPE ORTHO "3M" (9012L) 1,773,504 1,689,049
52120070 STERI DRAPE U 120X130CM "3M" 598.843 570.327
52120071 STOCKINET 2"X25YDS '3M" 852.238 811.655
52120072 STOCKINET 3"X25YDS '3M" 1,136,945 1,082,805
52120073 STOCKINET 4"X25YDS '3M" 1,696,543 1,615,755
52120074 STOCKINET 5"X25YDS '3M" 1,912,749 1,821,666
52120075 TEGADERM 10X12CM (1626W) 35.7 34
52120076 TEGADERM GEN IV 8.5X10.5CM (1635W) 44.436 42.35
52120077 TENSOCREPE 3" (7.5CMX4.55M) 118.968 113.303
52120078 TENSOCREPE 4" (10CMX4.55M) 140.317 133.635
52120079 TENSOCREPE 6" (15CMX4.55M) 178.482 169.983
52120080 VELBAND 6" (15CM) 70.669 67.304
52120081 CURASPON STANDARD 114.719 109.256
52120083 CELL PACK 2,424,241 2,308,801
52120084 MICROPORE 2" (SUDAH ADA) 73.102 73.102
52120085 STROMATOLYSER 4DL 4,967,734 4,731,175
52120086 STROMATOLYSER 4DS 4,575,034 4,357,175
52120087 SULFOLYSER 1,221,376 1,163,215
52120088 TEGADERM PAD 3586 49.813 47.441
52120089 DELTA DRY 3" (7,5CMX 2,4M) 245.306 233.625
52120091 TENSOPLAST STK CHILD 2" 142.324 135.547
52120092 CAST PADDING SYNTHETIC 3"X4 "3M" 47.481 47.481
52120093 CAST PADDING SYNTHETIC 4"X4 "3M" 63.211 63.211
52120094 CAST PADDING SYNTHETIC 6"X4 "3M" 78.226 78.226
52120095 DEPPER BALL SMALL 1.996 1.901
52120098 DELTA LITE 4" 351.825 335.071
52120100 CUTIMED SORBAC CURTISORB SWAB 7X9 CM 98.7 94
52120104 CARDIOVASCULAR SET "HOGY" (LCS02) 1,444,520 1,302,658
52120105 DELTA LITE CONFORMABLE 3" (7.5CMX3.6M) 331.8 316
52120108 INTRASITE GEL 15G/1X10 167.539 159.561
52120111 DURAPORE 1 INC "3M" 83.129 79.17
52120112 GURITA BIDADARI 52.486 52.486
52120113 IOBAN "3M" (TM 6657) 382.391 364.182
52120116 REM POLYHESIVE II 219.241 208.801
52120118 TRYPAN BLUE 1% 1ML 115.925 110.405
52120119 CARBACHOL 1% 1ML 108.409 103.247
52120121 CERATOME 2,8 ML "JM-JE-2" 206.428 196.598
52120122 LANCE TIP STRAIGHT 15' "JM-JC2-15" 206.428 196.598
52120123 OPTEM "ARRON/ BOUVIE" 483.628 460.598
52120124 MQA TANGKAI " EYE SPOENGES" 160.228 152.598
52120125 HPMC 2ML 194.465 185.205
52120126 HEALON GV 0.85 ML 945.628 900.598
52120127 SURVISC (SODIUM HYALURONATE 1 ML) 622.228 592.598
52120128 CRESCENT JE-2 204.283 194.555
52120129 OPTIMA 553 (PMMA) ALL SIZE 206.428 196.598
52120130 OPTIMA FOLD "ASPHERIC" (ALL SIZE) 1,222,828 1,164,598
52120131 OCUSOL 500 ML (BSS) 371.18 353.505
52120132 DEPPER BALL MEDIUM "SURGILAB" 5.143 4.898
52120135 SURGICAL GOWN UK L "HOGY" 169.399 169.399
52120136 SURGICAL GOWN UK M "HOGY" 192.054 182.908
52120137 ELEKTROSURGICAL PENCIL 'VALLYLAB" (E2516 171.87 163.686
52120138 INFANT REM POLYHESIVE (E 7510-25) 382.539 364.323
52120139 ANGIO DRAPE (AG-0103B) 331.321 315.544
52120140 SLIT ANGLED 2,75MM KNIFE "MANI" 314.729 299.742
52120141 STRAIGHT 15 KNIFE "MANI" 314.729 299.742
52120144 BONGROS- HA 3,540,598 3,540,598
52120145 ADULT POLYHESIVE II-W/CABLE (E7509) 133.886 127.511
52120146 DELTA LITE 5" 425.959 405.676
52120147 ELASTOMUL HAFT 10X4M "BSN" 82.95 79
52120149 SURGICAL GOWN XL 173.331 165.077
52120150 ANGIO DRAPE (AG-0202B) 648.819 617.923
52120152 CUTISORB SORBACT RIBON 5X200CM 253.406 253.406
52120153 CUTISORB SORBACT RIBBON 2X50CM 131.676 131.676
52120155 CUTIMED CAVITY 15X2CM 108.219 108.219
52120156 CUTICELL EPIGRAFT 10X15 (72650-03) 320.003 304.765
52120157 CUTIMED SILTEC 10X10 151.218 144.017
52120158 CUTIMED GEL 15 GR 129.15 123
52120159 CUTIMED HYDRO B 10X10CM 68.141 64.896
52120160 DELTA DRY 4" (10CMX 2,4M) 174.368 166.065
52120161 CRESCENT (MANI/KAI/FOCUS) 440.124 419.166
52120162 BVI SLIT 2,75MM DB SAFETY (3085527) 317.13 302.029
52120165 VISITEC LASIK PVA SPEARS (3058055) 52.675 50.167
52120166 CONFORMING BANDAGE 2" X 4.1 SOLAMED 9.988 9.512
52120167 CONFORMING BANDAGE 4" X 4.1 SOLAMED 17.043 16.231
52120168 EYE DRAPE PLAIN (MEDEQ) 89.944 85.661
52120169 DOP MATA STERIL (MEDEQ) 31.5 30
52120170 HPMC AEROVISC (MEDEQ) 136.937 130.416
52120173 SURVISC VISCO SUPREME 1.8% 483.437 460.416
52120174 AQUACEL SILVER 10X10CM (403708) 307.469 292.828
52120175 W CARE AH B3 86.186 82.082
52120177 APPENDECTOMY DRAPE 275.419 275.419
52120178 MAYO STAND COVER FILM 97.956 97.956
52120181 LEUKOMED IV FILM 6X8CM BSN 4.198 4.198
52120186 CURAVAC M 1,447,779 1,378,837
52120187 CANISTER 600ML 636.969 606.637
52120188 FLUORESCEIN SODIUM OPHTHALMIC STRIPS 6.82 6.495
52120189 ORTHOPEDIC SET ORS 2130 1,829,160 1,742,057
52120190 LEUKOMED SORBACT 5X7,2 CM BSN 19.646 18.711
52120191 LEUKOMED SORBACT 8X10 CM BSN 32.86 31.295
52120192 CURAPORT TRANSPARANT 25X10CM 49.116 46.777
52120193 ORTHOPEDIC SET (TKR) ORS 2138 1,227,109 1,168,675
52120194 ORTHOPEDIC SET (THR) ORS 2139 1,418,400 1,350,857
52120197 JASLAB DISPOSABLE 25.108 23.912
52120198 PAKET APD 3 (HMD) 1,367,554 1,367,554
52120199 BAJU ASTRONOT COVID 19 IMPORT 896.406 853.72
52120200 GOWN WITH MASK & 2TOWEL (SURREM) LL 153.937 146.606
52120202 APD JH 21.109 20.104
52120203 BAJU ASTRONOT COVID 19 LOKAL 252.039 240.037
52200001 AUTOCLAVE TAPE 1/2 INC 184.864 176.061
52200002 AUTOCLAVE TAPE 1/4 INCH 168.94 160.895
52200003 LINA PEN SINGLE 202.167 192.54
52200004 BISTURI AESCULAP 10 6.774 6.451
52200005 BISTURI AESCULAP 11 6.404 6.099
52200006 BISTURI AESCULAP 15 6.404 6.099
52200007 BISTURI AESCULAP 20 6.404 6.099
52200008 BISTURI AESCULAP 21 4.081 3.887
52200009 SANDAL KAMAR OPERASI 29.341 27.944
52200010 SANDAL PASIEN RS.MBSD 27.633 26.317
52200012 TRACHEAOSTOMY BLUE FEN KIT 7 1,527,141 1,454,420
52200020 BOWIE DICK TEST 3,328,611 3,170,106
52200063 AUTOCLAVE TAPE 3/4 INC 264.866 252.253
52200080 CELITE ACT REAGENT TUBES 34.138 32.512
52200081 VITAL OXYGENATOR 10,218,133 9,731,555
52200084 PERCUTANEOUS INTRODUCER SHEATH "VANTEX" 1,519,828 1,447,455
52200085 CVC VANTEX TRIPLE LUMEN 1,472,308 1,402,198
52200086 HAEMOCONCENTRATOR ADULT DHF 02 (077117) 3,775,565 3,595,776
52200087 SLS CLIP SMALL 202.861 193.201
52200088 SLS CLIP MEDIUM 188.182 179.221
52200089 ANTEGRADE ANTEPLEGIA CARDIOPLEGIA 1,053,366 1,053,366
52200091 SWAN GANZ COMBO 5,724,249 5,451,666
52200092 MANOMETER LINE PT 84 125.949 119.951
52200093 Y CONNECTOR 3/8X3/8X3/8 96.29 91.705
52200094 CURVED TIP ARTERIAL CANNULA NO 24 1,501,535 1,430,034
52200095 VENOUS CANNULA 28 1,676,908 1,597,055
52200097 CHEST DRAIN PLEUR EVAC 1,651,564 1,572,918
52200099 BLOWER 2,821,846 2,687,473
52200100 TIP CLEANER 107.388 102.274
52200101 NELATHON CATHETER NO 08 "RUSH" 29.585 28.176
52200104 MONITORING KIT DOUBLE "BIOSENSOR" (BRT2-4812) 1,036,807 987.435
52200105 MONITORING KIT TRIPLE "BIOSENSOR" (BRT3-4812) 1,546,515 1,472,872
52200106 CARDIOLPLEGIA INFUSION & MONITORING SET 1,074,838 1,074,838
52200107 RETROGRADE CARDIOPLEGIA 1,808,799 1,722,666
52200108 TWO STAGE VC2 VENOUS CANNULA 34 1,775,549 1,690,999
52200109 THERMODILUTION CATH KIT 7FR, 4 LUMEN 4,595,428 4,376,598
52200110 PERCUTANEOUS INTRODUCER SHEATH "ARROW" 1,342,948 1,278,998
52200111 CVC SET 3 LUMEN 7FR-E "ARROW" (CV-15703E 1,379,908 1,314,198
52200114 MEDTRONIC OFF PUMP SYSTEM 45,282,533 45,282,533
52200115 CARDIOTOMIE RESERVOIR (REF-05263) 2,818,998 2,818,998
52200116 VENOUS CANNULA 31 1,676,908 1,597,055
52200119 VASCULAR TOURNIQUET KIT 31.036 31.036
52200120 MEDICAL TUBING 1/4 (LOT 10034416) 187.948 178.998
52200121 STRAIGHT CONNECTOR 1/4X3/8 (LOT 6020127) 81.086 81.086
52200125 CVC SET 2 LUMEN 7F "ARROW" (CV-17702E) 1,037,340 987.943
52200127 VITAL OXYGENATOR "MEDTRONIC" 14,270,589 13,591,037
52200128 AORTIC PUNCH 4.0 MM "MEDTRONIC" (CAT.AP5 1,689,153 1,608,718
52200129 AORTIC ROOT CANNULA 9FR (CAT.20012) 1,340,598 1,340,598
52200131 CARDIOPLEGIA SET ADULT LOVELL (28000-000) 2,914,535 2,775,748
52200134 SKIN STAPLER 35 STAPLER WIDE (PMW35) 492.197 468.759
52200135 SKIN STAPLER EXTRACTOR 253.37 241.305
52200137 IAB CATHETER 8FR 30CC 24,054,868 22,909,398
52200138 IAB CATHETER 8 FR, 40CC (IAB-S840C) 24,054,868 22,909,398
52200139 ARGOTRANDUCER (041584505A) 1,224,122 1,165,830
52200140 LIGASUR MAX (LS 3092) 1,193,415 1,136,586
52200142 KATUB MECHANICAL MITRAL 29MM "SORIN" 27,259,224 27,259,224
52200143 CARPENTIER EDWARD BIOPROTHESIS HEART VAL 34,540,566 32,895,777
52200144 CVC 14GA SINGLE LUMEN ARROW 7FR 525.398 525.398
52200147 Y ADAPTER -10005 (PBA) 749.308 713.627
52200148 Y ADAPTER -10003 (PBA) 926.858 882.722
52200158 IAB CATHETER 7,5 FR 40CC (IAB-06840-4) 27,033,339 25,746,037
52200159 OCTOBASE SUTURE HOLDING SET 2,709,039 2,580,037
52200160 MACRO SUCKER SUCTION TUBE 20FR (10061) 1,221,537 1,221,537
52200163 THORAMETRIC DRAIN 1 BOTOL 1100CC 907.239 864.037
52200164 BLUE RHENO/PDT 7,975,108 7,595,341
52300002 ARTERIAL FILT 125 X 2,185,468 2,081,398
52300003 TRILLIUM OXYGENATOR COMPLETE "MEDTRONIC"(PERMAT 14,560,350 13,867,000
52300004 GLO-TIP ERCP CATHETER,ULTRA TAPER TO 4FR 2,608,828 2,484,598
52300005 GLO-TIP II DOUBLE LUMEN ERCP CATH.W/RADI 2,405,548 2,290,998
52300006 HUIBREGTSE-KATON ERCP CATHETER (GT-2-T-R 1,971,433 1,877,555
52300007 SIDE ARM ADAPTER,ROTATABLE (ALL SIZE) WI 1,389,148 1,322,998
52300008 HIWIRE HYDROPHILIC WIRE GUIDE 0.025", 26 1,912,749 1,821,666
52300009 ROADRUNNER PC WIRE GUIDE 0.035", 260 CM 1,971,433 1,877,555
52300010 TMD WIRE GUIDE STRAIGHT 0.021", 480CM (M 5,839,528 5,561,455
52300011 TMD WIRE GUIDE STRAIGHT 0.025, 480 CM (M 5,741,353 5,467,955
52300012 TMD WIRE GUIDE STRAIGHT 0.035", 480 CM ( 5,741,353 5,467,955
52300013 STANDART WIRE GUIDE STRAIGHT 0.035", 480 3,169,168 3,018,255
52300014 TRI TOME PC PROTECTOR TRIPLE LUMEN SPHIN 5,909,331 5,627,934
52300015 COTTON CANNULATOME II PC PROTECTOR DOUBL 6,114,418 5,823,255
52300016 HUIBREGTSE SINGLE LUMEN NEEDLE KNIFE (HP 5,639,548 5,370,998
52300017 QUANTUM TTC BILIARY BALLON DILATOR, 6X3 7,228,828 6,884,598
52300018 QUANTUM TTC BILIARY BALLON DILATOR, 8X3 7,228,828 6,884,598
52300019 QUANTUM TTC BULIARY BALLON DILATOR, 10X3 7,228,828 6,884,598
52300020 COTTON GRADUATED DILATION CATHETER, 10 F 2,619,388 2,494,655
52300021 COTTON GRADUATED DILATION CATHETER, 8.5 2,619,388 2,494,655
52300022 GREENEN GRADUATED DILATION CATHETER (GGD 2,479,468 2,361,398
52300023 SPHERE INFLATION DEVICE (CID -20-30) 2,265,958 2,158,055
52300024 CYTOMAX II DOUBLE LUMEN BILIARY CYTOLOGY 3,403,468 3,241,398
52300026 THE WEB EXTRACTION BASKET, 2X4CM (WEB-2X 7,312,153 6,963,955
52300027 THE WEB EXTRACTION BASKET, 3X6 CM (WEB-3 7,312,153 6,963,955
52300028 THE WEB II DOUBLE LUMEN EXTRACTION BASKE 7,312,153 6,963,955
52300029 MEMORY BASKET EIGHT WIRE, 2X4CM (MB5-2X4 14,537,833 13,845,555
52300030 MEMORY BASKET EIGHT WIRE, 3X6 CM (MB5-3X 14,537,833 13,845,555
52300031 SOEHENDRA LITHOTRIPTOR HANDLE 17,090,383 16,276,555
52300032 SOEHENDRA LITHOTRIPTOR CABLE (SLC-2) 6,192,958 5,898,055
52300033 LIGUORY NASAL BILIARY DRAINAGE CAT. 7 FR 4,974,268 4,737,398
52300034 STENT INTRODUCER, 5 FR (PC-5) 1,421,653 1,353,955
52300035 COTTON LEUNG PLASTIC BILIARY STENT 7FR, 2,462,308 2,345,055
52300036 COTTON LEUNG PLASTIC BILIARY STENT 8.5 F 2,403,403 2,288,955
52300037 COTTON LEUNG PLASTIC BILIARY STENT 10 FR 2,403,403 2,288,955
52300038 GREENEN PLASTIC PANCREATIC STENT 5 FR, L 2,479,468 2,361,398
52300039 ZIMMON PANCREAATIC STENT 5 FR, LENGTH 5, 2,479,468 2,361,398
52300040 ST-20 SOEHENDRA TANNENBAUM PLASTIC BILIA 2,403,403 2,288,955
52300041 ZIMMON BILIARY STENT 10 FR, LENGTH 4,7,1 2,331,628 2,220,598
52300042 SOLUS DOUBLE PIGTAIL STENT SET 10 FR 5,976,973 5,692,355
52300043 ZILFER BILIARY SELF EXPANDING STENT 10MM 31,203,249 29,717,380
52300044 FUSION WIRE GUIDE LOCKING DEVICE (FS-WL- 557.548 530.998
52300045 FUSION WIRE GUIDE LOCKING DEVICE FOR PEN 557.548 530.998
52300046 FUSION OASIS FOR 10 FR PLASTIC BILIARY S 3,743,706 3,565,434
52300047 FUSION BILIARY DILATION CATHETER (FS-BDC 6,563,548 6,250,998
52300048 MAXUM REUSABLE GASTROSCOPE BIOSPY FORCEP 12,440,188 11,847,798
52300049 MAXUM REUSABLE COLONOSCOPE BIOPSY FORCE 12,440,188 11,847,798
52300050 MAXUM REUSABLE GRASPING FORCEPS RAT TOOT 12,440,188 11,847,798
52300051 CAPTURE DISPOSABLE HOT BIOPSY FORCEPS 2. 1,270,198 1,270,198
52300052 CAESAR GRASPING FORCEPS, 3-PRONG (CGF-1- 4,666,998 4,666,998
52300053 SONNET SHORT THROW POLYPECTOMY SNARE 2,5 1,284,208 1,223,055
52300054 GERCULES 3 STAGE WIRE GUIDED BALLON, (HB 13,801,398 13,801,398
52300055 HERCULES 3 STAGE WIRE GUIDED BALLON (HBD 14,491,468 13,801,398
52300056 HERCULES 3 STAGE WIRE GUIDED BALLON (HBD 14,491,468 13,801,398
52300057 HERCULES 3 STAGE WIRE GUIDED BALLON (HBD 14,491,468 13,801,398
52300058 HERCULES 3 STAGE WIRE GUIDED BALLON (HBD 14,491,468 13,801,398
52300059 DILATION SYRINGE 1,869,628 1,780,598
52300061 EVOLUTION CONTROLLED RELEASE ESOPHAGEAL 31,203,249 29,717,380
52300062 EVOLUTION CONTROLLED RELEASE COLONIC STE 31,203,249 29,717,380
52300063 INJECTAFLOW VARIABLE INJECTION NEEDLE AL 1,637,638 1,559,655
52300064 ECHOTIP ULTRA ENDOSCOPIC ULTRASOUND NEED 11,435,503 10,890,955
52300065 ECHOTIP ULTRA CELIAC PLEXUX NEUROLYSYS L 15,676,663 14,930,155
52300068 SSS HEMORRHOIDAL MULTI BAND LIGANTOR W/T 1,559,098 1,484,855
52300069 TRICLIP ENDOSCOPIC CLIPPING DEVICE 7 FR 2,324,863 2,214,155
52300070 QUICKSILVER BIPOLAR PROBE, 7 FR, 350CM ( 9,002,908 8,574,198
52300071 PEG 24 FR FULL TYPE (PEG-24-PULL-S) 3,866,210 3,682,105
52300072 FLOW 20 FR PULL TYPE (FLOW-20-PULL-S) 3,478,998 3,478,998
52300073 BALLON REPLACEMENT GASTROSTOMY TUBE 24 F 1,278,268 1,217,398
52300075 CAPTURA DISPOSABLE BRONCHOSCOPE BIOPSY F 29,806,480 29,806,480
52300076 BRONCHOSCOPY DISPOSABLE CYTOLOGY BRUSH ( 680.598 680.598
52300077 GENIUS TAXCOR I (DES PACLITAXEL) ALL SIZ 31,067,380 31,067,380
52300078 GENIUS MAGIC (COBALT CHROMIUM ) ALL SIZE 20,820,598 20,820,598
52300079 GENIUS MEGAFLEX (BMS) ALL SIZE "EUROCOR" 10,817,380 10,817,380
52300080 AMADEUS SUPERCROSS-RX PTCA BALLON ALL SI 9,893,991 9,422,849
52300081 DIOR (DEB- PACLITAXEL ELUTING) " ERUROCO 24,020,598 24,020,598
52300082 AQUA SEAL CHEST DRAINAGE UNIT 2,630,534 2,505,270
52300083 HPF 200E "MERIT" (MM) 317.308 302.198
52300084 HPF 480 E "MERIT" (MM) 317.308 302.198
52300085 GUIDE WIRE 0,0038 "MERIT" REKA 298.828 284.598
52300089 STENT DES COROFLEX PLEASE 3.0 X13MM 35,122,609 33,450,104
52300090 STENT DES COROFLEX PLEASE 3.5 X13MM 35,122,609 33,450,104
52300091 STENT DES COROFLEX PLEASE 2.75 X16 MM 35,122,609 33,450,104
52300092 STENT DES COROFLEX PLEASE 4.0 X 16 MM 35,122,609 33,450,104
52300093 STENT DES COROFLEX PLEASE 3.0 X19 MM 35,122,609 33,450,104
52300094 STENT DES COROFLEX 3.5 X 19MM 35,122,609 33,450,104
52300096 STENT DES COROFLEX PLEASE 4.0 X32 MM 35,122,609 33,450,104
52300097 BALLON SEQUENT PLEASE 2.0 X 15MM 6,951,628 6,620,598
52300098 BALLON SEQUENT PLEASE 2.0 X 17MM 6,321,628 6,020,598
52300099 BALLON SEQUENT PLEASE 2.75 X 26 MM 6,321,628 6,020,598
52300100 PERFORMA PIGTAIL 6 F (7509-11) 596.983 568.555
52300101 PERFORMA MPA 2-6F (7513-23) 479.173 456.355
52300102 PERFORMA MPA 1 6F (7513-13) 518.443 493.755
52300106 GUIDE WIRE M 0,035" STRAIGHT "TERUMO" (RF*GS35153 816.268 777.398
52300107 CHATETER NIH WOVEN 6F 100CM "MEDTRONIC" 2,331,628 2,220,598
52300108 CATHETER NIH WOVEN 6FR 80CM "MEDTRONIC" 2,331,628 2,220,598
52300110 AMPLATZER GUIDE WIRE 1,546,228 1,472,598
52300111 AMPLATZER SIZING BALLON (ALL SIZE) 5,103,628 4,860,598
52300112 AMPLATZER DELIVERY SYSTEM (ALL SIZE) 10,185,628 9,700,598
52300113 ASO (ALL SIZE) 42,897,624 40,854,880
52300115 AMPLATZER PDA OCCLUDER (ADO) ALL SIZE 25,431,628 24,220,598
52300116 AMPLATZER GUIDE WIRE (ADO) 1,546,228 1,472,598
52300117 AMPLATZER DELIVERY SYSTEM (ADO) ALL SIZE 10,185,628 9,700,598
52300118 STOPCOCK "MARQUIS SERIES" (M3RLC) 106.108 101.055
52300119 STENT DES COROFLEX PLEASE 3,0 X16 MM 31,994,880 31,994,880
52300120 STENT DES COROFLEX PLEASE 4,0 X19 MM 35,122,609 33,450,104
52300121 STENT DES COROFLEX PLEASE 2,5 X 25MM 35,122,609 33,450,104
52300122 STENT DES COROFLEX PLEASE 2,75 X25MM 35,122,609 33,450,104
52300123 STENT DES COROFLEX PLEASE 3,5 X25 MM 35,122,609 33,450,104
52300124 BASIX INFLATION SYRINGE (IN 4330) "MM" 2,364,133 2,251,555
52300125 PANTERA BALLON (ALL SIZE) BIOTRONIK "MM" 9,261,628 8,820,598
52300126 BALLON RX MINI TREK (ALL SIZE) "ABBOTT" (KPA) 8,582,874 8,174,166
52300127 BALLON RX TREK (ALL SIZE) "ABBOTT" (KPA) 8,582,874 8,174,166
52300128 BASIC INDEFLATOR IN 4330 "MERIT" MM 2,267,917 2,159,921
52300129 GUIDE WIRE SION BLUE "ASAHI INTECC" 2,793,628 2,660,598
52300130 PRESSURE MONITORING KIT SINGLE (B-KT-164E) 557.713 531.155
52300131 HI TORQUE PROGRESS, ALL SIZE "ABBOTT" 2,667,628 2,540,598
52300132 HI TORQUE BMW ELITE "ABBOTT" 2,516,428 2,396,598
52300133 DIDECO HAEMOCONCENTRATOR DHF06 ADULT (BISAWI) 3,196,751 3,044,525
52300134 DIDECO COMPACTFLO EVO OXYGENATOR COMPLETE (BISA 9,594,268 9,137,398
52300135 BICARBON MITRAL MECHANICAL HEART VALVE (BISAWI) 27,705,398 27,705,398
52300137 DES CRE8 "CID" 33,594,624 31,994,880
52300138 BMS AVANGARDE "CID" 18,501,628 17,620,598
52300139 PERFORMA CATHETER "MERIT" (MM) 596.983 568.555
52300159 INTRODUCER SHEATH 23 ALL FRAME (ASKES) MM 733.398 733.398
52300160 INTRODUCER SHEATH TRANSRADIAL ALL FRAME "MERIT" 996.184 948.747
52300161 GUIDE WIRE 038 260CM (ASKES) MM 574.998 574.998
52300170 GUIDING CATHETER ZENYTE ASAHI 3,181,708 3,030,198
52300176 TISSUE HEART VALVE BIOCOR BOVINE B30 (AORTIC&MITR 30,820,598 30,820,598
52300177 INFLATION DEVICE (BTS) 1,428,598 1,428,598
52300178 CLICK Y WITH EXTENTION 25CM (BTS) 474.264 451.68
52300179 GUIDEWIRE 150CM, 0.35", J TIP (BTS) 273.429 273.429
52300180 GUIDEWIRE 150CM, 0.038 , J TIP (BTS) 225.561 225.561
52300191 HIGH PRESSURE TUBING ALL SIZE (BTS) 204.283 194.555
52300192 IINTRODUCER SET 6F (BTS) 371.18 353.505
52300193 INTRODUCER NEEDLE 18G X7.0CM (BTS) 81.086 81.086
52300194 DISP TRANSDUCER SINGLE (BTS) 548.308 522.198
52300195 SLS CLIP SMALL HORISON 175.052 166.716
52300196 SLS CLIP MEDIUM HORISON 214.1 203.905
52300197 AORTIC PUNCH DP 36 "TELEFLEX" 988.598 988.598
52300198 AORTIC PUNCH DP 40 "TELEFLEX" 988.598 988.598
52300199 CHEST DRAIN A8000 "TELEFLEX" 1,319,478 1,319,478
52300200 AORTIC ROOT CANNULA 10FR 'ANDOCOR" 1,067,798 1,067,798
52300201 AORTIC ROOT CANNULA 7 FR "ANDOCOR" 1,067,798 1,067,798
52300202 THORACIC CHATETER FG 20 "WELLMED" 184.311 184.311
52300203 THORACIC CHATETER FG 24 "WELLMED" 231.564 220.537
52300204 THORACIC CHATETER FG 28 "WELLMED" 243.553 231.955
52300205 THORACIC CHATETER FG 32 "WELLMED" 243.553 231.955
52300206 TWO STAGE VENOUS CANUL NO. 34 'ANDOCOR" 1,173,398 1,173,398
52300207 TWO STAGE VENOUS CANUL NO. 36 'ANDOCOR" 1,412,758 1,412,758
52300208 PAKET APOLLO REKA (ASKES) 18,501,628 17,620,598
52300209 IMPRESS CATHETER ULTIMATE, ALL SIZE ALL TYPE (REKA) 720.172 685.878
52300210 FLUYDO BALLON (REKA) 7,060,598 7,060,598
52300211 FLUYDO BALLON (REKA) "ASKES" 6,620,598 6,620,598
52300212 SHUNT FLOW AXIUS CORONARY 1.50MM"MEDTRONIC" 2,837,038 2,701,941
52300213 SHUNT FLOW AXIUS CORONARY 1.75MM"MEDTRONIC" 2,942,038 2,801,941
52300214 SHUNT FLOW AXIUS CORONARY 2.00MM"MEDTRONIC" 2,837,038 2,701,941
52300215 3 GANG MANIFOLD RHT (BTS) 184.648 175.855
52300216 DES "PROLIMUS" 31,203,249 29,717,380
52300217 BMS "PRECISION" 12,033,628 11,460,598
52300220 PACLITAXEL DRUG ELUTING BALLON "PRIMUS" (ASKES) 27,741,628 26,420,598
52300221 BALLON TAZUNA (ASKES) 10,420,598 10,420,598
52300222 BALLON TAZUNA (REGULER) 12,020,598 12,020,598
52300223 FAST CATH LONG SHEATH 940.595 895.805
52300224 PAKET DIAGNOSTIK FEMORAL ASKES (REKA) 2,275,775 2,167,405
52300225 PAKET DIAGNOSTIK TRANSRADIAL ASKES (REKA) 2,318,692 2,208,278
52300226 ROTATING ADAPTOR 122.793 122.793
52300227 FINECROSS 1,8FR 130CM (TERUMO) 11,538,693 10,989,231
52300228 BALLON RYUJIN 1,50MM - 15MM (TERUMO) 9,119,105 8,684,862
52300229 MICRO CATHETER ALL SIZE (REKA) 8,124,930 7,738,029
52300230 PAKET TINDAKAN DIAGNOSTIK FEMORAL 2,562,437 2,440,416
52300231 PAKET TINDAKAN DIAGNOSTIK RADIAL 2,484,474 2,366,166
52300232 PAKET TINDAKAN PCI FEMORAL (DES) 35,684,021 33,984,782
52300233 PAKET TINDAKAN PCI RADIAL (DES) 34,620,870 32,972,257
52300234 PAKET TINDAKAN PCI FEMORAL (TANPA DES) 17,982,549 17,982,549
52300235 PAKET TINDAKAN PCI RADIAL (TANPA DES) 18,031,455 18,031,455
52300236 ORSIRO BIOLUTE SIROLIMUS DES (MM) 29,419,141 29,419,141
52300237 PRO KINETIC ENERGY CC STENT (MM) 15,599,499 14,856,666
52300238 CONCIERGE GUIDING CATH JETMASTER (MM) 1,946,043 1,946,043
52300239 GUIDEWIRE CONQUEST PRO 12 "ASAHI INTECC" 4,338,249 4,131,666
52300240 DLP SUCTION TUBE 20 FR (10061) PB 2,265,821 2,157,925
52300242 DLP CORONARY OSTIAL PERFUSION CANUL 12 FR 2,641,196 2,515,425
52300243 GUIDE WIRE M 0.035 260CM (RF*GA35263M) 1,315,037 1,252,416
52300250 PANTERA LUX DEB (ALL TYPE) BIOMETRIK 24,031,466 24,031,466
52300256 GUIDE WIRE SION ASAHI INTEC 2,258,589 2,151,037
52300257 GUIDE WIRE GAIA 3ND "ASAHI INTECC" 4,060,389 3,867,037
52300258 GUIDE WIRE GAIA 2ND "ASAHI INTECC" 4,060,389 3,867,037
52300259 HEETY INTRODUCER SHEATH 6F (ALL SIZE) 676.943 644.707
52300260 EXPERIENCE BALLON "IVASCULAR" UMUM 6,012,339 5,726,037
52370003 SOFT SEAL LARYNGEAL MASK 3 421.38 401.314
52370004 SOFT SEAL LARYNGEAL MASK 4 421.38 401.314
52370008 AMBICOR PEMB. TALI PUSAT 5.242 4.993
52370009 BABY HALER 353.788 336.941
52370010 BLOOD ADM TRANSFUSION SET "TERUMO" 55.902 53.24
52370025 CERVICAL COLLAR L 464.858 442.722
52370026 CERVICAL COLLAR SUPPORT M 464.858 442.722
52370027 CERVICAL COLLAR S 358.662 341.583
52370028 COLOSTOMY BAG F1 113.548 108.141
52370029 CTG PAPER (FETAL MONITORING RECORDING PAPER) M10 284.968 271.398
52370039 CYTOBRUSH 6.917 6.588
52370041 DISPOSIBLE SUCTION BAG GREEN 124.297 118.378
52370042 DISPOSIBLE SUCTION BAG WHITE 131.806 125.53
52370047 ELEKTRODA BLUE SENSOR 11.206 10.672
52370049 ENDOTRACHEAL NKK 20 "RUSCH" 568.243 541.184
52370050 ENDOTRACHEAL NKK 22 "RUSCH" 529.515 504.3
52370051 ENDOTRACHEAL NKK 24 "RUSCH" 445.621 445.621
52370052 ENDOTRACHEAL NKK 26 "RUSCH" 529.515 504.3
52370053 ENDOTRACHEAL NKK 28 "RUSCH" 604.871 576.068
52370054 ENDOTRACHEAL NKK 30 "RUSCH" 604.871 576.068
52370055 ENDOTRACHEAL NKK 20 "RUSCH" 529.515 504.3
52370056 ENDOTRACHEAL KK 2,5 "RUSCH" 123.538 123.538
52370057 ENDOTRACHEAL KK 3 "RUSCH" 123.538 123.538
52370058 ENDOTRACHEAL KK 3,5 "RUSCH" 121.166 121.166
52370059 ENDOTRACHEAL KK 4 "RUSCH" 121.166 121.166
52370060 ENDOTRACHEAL KK 4,5 "RUSCH" 121.166 121.166
52370061 ENDOTRACHEAL KK 5 "RUSCH" 134.637 128.266
52370062 ENDOTRACHEAL KK 5,5 "RUSCH" 127.224 121.166
52370063 ENDOTRACHEAL KK 6 "RUSCH" 127.224 121.166
52370064 ENDOTRACHEAL KK 6,5 "RUSCH" 127.224 121.166
52370065 ENDOTRACHEAL KK 7,5 "RUSCH" 127.224 121.166
52370066 ENDOTRACHEAL 2 "PORTEX" 104.35 99.381
52370067 ENDOTRACHEAL 2,5 "PORTEX" 114.598 109.141
52370068 ENDOTRACHEAL 3 "PORTEX" 114.179 108.742
52370069 ENDOTRACHEAL 3,5 "PORTEX" 136.937 130.416
52370070 ENDOTRACHEAL 4 "PORTEX" 148.352 141.288
52370071 ENDOTRACHEAL 4.5 "PORTEX" 133.551 127.191
52370072 ENDOTRACHEAL 5 "PORTEX" 172.059 163.865
52370073 ENDOTRACHEAL 5,5 "PORTEX" 172.059 163.865
52370074 ENDOTRACHEAL 6 "PORTEX" 182.684 173.985
52370075 ENDOTRACHEAL 6,5 "PORTEX" 171.587 163.416
52370076 ENDOTRACHEAL 7 "PORTEX" 171.587 163.416
52370077 ENDOTRACHEAL 7,5 "PORTEX" 171.587 163.416
52370078 ENDOTRACHEAL 8 "PORTEX" 154.626 146.916
52370079 ENDOTRACHEAL 8,5 "PORTEX" 164.894 157.042
52370091 ID BRACELETT INFANT BLUE 3.694 3.518
52370092 ID BRACELETT INFANT PINK 5.447 5.187
52370093 ID BRACELETT ADULT BLUE 3.813 3.631
52370094 ID BRACELETT ADULT PINK 5.447 5.187
52370095 ID BRACELETT RED 3.694 3.518
52370096 HAND SCOON STERIL 6 "GAMEX" 29.87 28.448
52370097 HAND SCOON STERIL 6,5 "GAMEX" 32.743 31.184
52370098 HAND SCOON STERIL 7 "GAMEX" 24.485 23.319
52370100 HAND SCOON STERIL 8 "GAMEX" 40.674 38.737
52370119 INFUSION SET MICRODRIP BURET 137.534 130.985
52370122 INFUSION SOL. ADM SET. PED. 31.666 31.666
52370127 KASA GULUNG 4Y X 10 CM DRC 6.511 6.511
52370128 KASA GULUNG 4Y X 5 CM DRC 5.326 5.072
52370129 KASA GULUNG 4Y X 7,5 CM DRC 9.921 9.449
52370138 MASKER AEROSOL ADULT 51.307 48.864
52370139 MASKER AEROSOL PEDIATRK 60.723 57.831
52370141 MASKER HIJAU TIE ON "HOSPILAB" 4.422 4.211
52370146 MASKER NEBULIZER ADULT 68.608 65.341
52370147 MASKER NEBULIZER PEDIATRK 82.546 78.615
52370150 MASKER REBREATHING ADULT "SALTER" 55.149 52.523
52370151 MASKER REBREATHING PEDIATRIK "SALTER" 246.084 234.366
52370153 NASAL OXYGEN CANULA ADULT "SALTER" 31.837 30.321
52370159 EEG PAPER 5,203,798 5,203,798
52370161 TREADMIL PAPER 997.372 949.878
52370188 NURSE CAP WOMAN "HOSPILAB" 2.874 2.737
52370194 URINE COLECTOR PED 100 ML "JMS" 83.86 79.867
52370197 WASHLAP PUTIH LOGO RS. BSD 21.026 20.025
52370199 N/A - HYPAFIX 5 X 5 M PER CM 16.736 16.736
52370215 BABY WIPES "PIGEON" 20,5 16.736 16.736
52370216 THICK WIPES CUSSONS BABY 55 16.736 16.736
52370225 EL-MED INFUS SPALK SIZE 4 X 12 CM 24.536 24.536
52370237 ANIOZYNE 16.173 16.173
52372011 ELEKTRODA 16.736 16.736
52372029 HAND SCOON STERIL 8 "BBRAUN" 16.811 16.811
52372033 INFUSION SET "BBRAUN" (INTRAFIX) 58.985 56.176
52372034 MEDIFIX LINE 90CM WITH INTRAFIX 214.744 204.518
52372035 MEDIFIX MANOMETER SCALER 367.204 349.718
52372037 APRON FILM WHITE "HOSPILAB " ISI 100 7.641 7.277
52372038 CLIP CARTRIDGE "MASLECH" M 750.242 714.516
52372040 ESPOCAN "BBRAUN" 891.508 849.055
52372041 HYPAFIX 5 X 5 M "BSN" 123.9 118
52372042 HYPAFIX 10 X 5 M "BSN" 300.3 286
52372043 HYPAFIX 15 X 5 M "BSN" 499.8 476
52372049 STERISTRIP ISI 50 "3M" (R1541) 11.406 10.683
52372050 TONGUE SPATULA ISI 100 18.137 17.273
52372053 UROGARD PLUS 168.184 160.175
52372054 ARM SLING L 56.611 53.916
52372055 ARM SLING M 56.611 53.916
52372056 INTUBATION STYLET NO. 4 249.122 249.122
52372057 MITELA 52.486 52.486
52372059 OXYGEN MASK 0 873.318 873.318
52372060 OXYGEN MASK 1 873.318 873.318
52372061 OXYGEN MASK 2 943.542 943.542
52372062 OXYGEN MASK 3 943.542 943.542
52372063 OXYGEN MASK 4 943.542 943.542
52372064 OXYGEN MASK 5 943.542 943.542
52372067 NASAL OXYGEN CANULA NEONATE "SALTER" 113.52 108.114
52372068 PISAU CUKUR "GILLETE" 18.261 17.391
52372069 SARUNG TANGAN PANJANG STERIL 39.759 39.759
52372071 STERISTRIP ISI 50 "3M" (R1547) 22.707 21.626
52372073 SUCTION PRO DUEL LUMEN 14Fr "PORTEX" 455.037 455.037
52372077 TRANSOFIX "BBRAUN" 13.707 13.054
52372081 HANDSCHOON WRP STERIL 7.5 46.296 44.091
52372084 BAROVAC PS 400ML M 1,011,760 963.581
52372092 OPSITE POST OP 6,5X5CM/1 31.747 30.235
52372093 OPSITE POST OP 9,5X8,5CM/1 40.276 38.358
52372094 MATHERNITY NAPKINS 6.639 6.323
52372104 SOFT SEAL LARYNGEAL MASK 2,5 414.377 394.645
52373000 WASHLAP POLOS 19.596 19.596
52373008 ANAESTHESI MASK SIZE 1 (1121) 265.142 252.516
52373009 ANAESTHESI MASK SIZE 2 (1122) 265.142 252.516
52373010 ANAESTHESI SIZE 3 (1123) 249.549 237.666
52373011 ANAESTHESI MASK SIZE 4 (1124) 249.549 237.666
52373012 ANAESTHESI MASK SIZE 5 (1125) 249.549 237.666
52373014 T SCRUB BRUSH 35.845 34.139
52373015 HAND SCOON SIZE M RUBBERCARE 3.443 3.279
52373018 HAND SCOON NON STERIL UKURAN M 2.292 2.183
52373019 HAND SCOON NON STERIL UKURAN S 2.521 2.401
52373020 CANULA FOR VACUM CURETTE FG 7 156.86 156.86
52373026 NASOPHARYNGEAL AIRWAY 6 "PORTEX" 314.53 299.552
52373027 NASOPHARYNGEAL AIRWAY 7 "PORTEX" 314.53 299.552
52373028 NASOPHARYNGEAL AIRWAY 8 "PORTEX" 309.332 294.602
52373031 OBJECT GLASS 361 361
52373039 INTRODUCER SHEATH FEMORAL ALL SIZE (REKA) 433.922 433.922
52373040 MANIFOLD "MERIT" 298.348 284.141
52373042 MOUTHPIECES 15.75 15.75
52373044 SUCTION CONECTING TUBE 3.0M 165.9 158
52373049 SIMPLE MASK ADULT "SALTER" 44.726 42.596
52373053 TOURNIQUET 45.114 42.966
52373058 SPALEK TANGAN KECIL 6 X 30CM 31.335 29.843
52373061 MASKER NON REBREATHING ADULT "SALTER" 68.016 64.777
52373062 MASKER NON REBREATHING PEDIATRIK " SALTER" 124.116 118.206
52373063 BREATHING SYSTEM "INTER" (2025) 708.482 708.482
52373067 CLIP POUCH 45.73 43.552
52373070 MUCUS EXTRACTOR "SAFETY" 40.095 38.186
52373071 SURGEON CAP "HOSPILAB" 3.351 3.191
52373072 PRISMAFLEX M60 PRE SET (106696) 11,264,678 10,728,265
52373073 HEMOSOL BO (109124) 1,014,004 965.718
52373075 BIOPSY FORCEPS, OVAL SHAPE WITH NEEDLE FOR COLOSC 1,098,088 1,045,798
52373076 CODMAN SURGICAL MARKER (431030) 106.108 101.055
52373087 SPALK ANAK UK 15 X5 "AS" 24.398 23.236
52373089 HEMODIALYSIS CATH SET 2 LUMEN 20CM "KFLOW" KIMAL 2,079,798 2,079,798
52373094 NEBULIZER KIT W/TEE & MOUTHPIECE 61.757 58.816
52373096 DISPOSABLE MANUAL RESUSITATOR ADULT (KM-806A) 606.966 578.063
52373097 FACE MASK NON INVASIVE UK L 1,211,766 1,211,766
52373100 URINAL PLASTIK 33.339 31.751
52373101 TRACHEOSTOMY FILTER WITH OXYGEN TUBING 80.631 76.791
52373103 CLOSED SUCTION NO 14FR ALTECH 639.882 609.411
52373104 CLOSED SUCTION NO 12 FR ALTECH 725.199 690.666
52373106 SPALK TANGAN DEWASA 7X 50CM 35.318 33.636
52373107 SPALK KAKI 65X10CM 40.344 38.423
52373108 SPALK KAKI 90X10CM 41.846 39.853
52373110 MASKER N95 3M 179.234 170.699
52373111 ALERT SNAPS RED (ALLERGY) "DOCARE" 3.72 3.542
52373112 ALERT SNAPS YELLOW (ALL RISK) "DOCARE" 3.903 3.717
52373113 ALERT SNAPS PURPLE (DNR) "DOCARE" 3.72 3.542
52373114 ALERT SNAPS GREEN (NO LATEX) "DOCARE" 3.72 3.542
52373116 DOUBEL J 4,5 SURGIMEDIK (OPEN) 501.411 477.534
52373117 DISP SPO2 SENSO MEDKE 279.083 265.793
52373119 SKIN TRACTION ADULT BSN ADHESIVE 195.842 186.516
52373120 SKIN TRACTION ADULT BSN NON ADHESIVE 195.253 185.955
52373122 VISION URETER CATH 5FR CLOSE TIP 290.818 290.818
52373123 VISION URETER CATH 5FR OPEN TIP 290.818 290.818
52373124 PNCL LUNDERQUEST GW 866.393 866.393
52373125 AMPLATZ SHEAT ALL SIZE 866.393 866.393
52373126 PUNCTURE NEEDLE 866.393 866.393
52373127 DILATORS DOR DRAINAGE CATH TIP 866.393 866.393
52373128 CERTOFIX TRIO V122O BBRAUN (CDL) 1,593,114 1,517,251
52373129 STENT BIORESORBABLE VASCULAR SCAFFOLD 42,915,751 42,915,751
52373132 GIGLI WIRE SAW OLIVERONA 40CM 491.624 468.213
52373134 INTUBATION STYLET (550 0002 1) 5.0-8.0 MM 119.471 119.471
52373138 OCTENIC HAIR WASH 39.858 37.96
52373139 BREATING ALTERA 1121 270.336 270.336
52373142 ARM SLING S 39.391 39.391
52373150 KASA STERIL 16X16 CM ONEMED 1.7 1.619
52373154 UNIVERSAL DRAPE TITAN 1,117,165 1,063,967
52373155 STERIL GENERAL HD SET 44.1 42
52373156 TRIPLE DISPOSABLE PRESSURE TRANDUCER 1,379,606 1,313,910
52373157 TRIPLE DISPOSABLE PRESSURE TRANDUCER 1,379,606 1,313,910
52373159 SINGLE HEATED WIRE CIRCUIT ADULT AMPM 571.053 543.86
52373160 HAND SCOON STERIL 7.5 "GAMEX" 18.145 17.281
52373161 URINAL PLASTIK PLUS TUTUP 45.679 43.504
52373162 LMA SUPREME SU SIZE 3 "TELEFLEX" 794.627 756.787
52373163 LMA SUPREME SU SIZE 4 "TELEFLEX" 794.627 756.787
52373164 LMA SUPREME SU SIZE 5 "TELEFLEX" 794.627 756.787
52373165 UNIVERSAL DRAPE SOLIDA 835.437 835.437
52373166 BREATHING CIRCUIT BUBBLE CPAP 2,258,589 2,151,037
52373167 TALI PENGIKAT PASIEN (RESTRAIN) 41.584 39.604
52373169 LMA SUPREME SU SIZE 2 "TELEFLEX' 794.627 756.787
52373170 HD CATHETER KIT 2L 12FR 16CM (BAIHE) 952.284 906.937
52373171 BREATHING CIRCUIT INTELIFLOW "FLEXICARE" 276.609 263.437
52373172 BAKTERIAL FILTER FLEXICARE (03841360) 63.997 90.949
52373173 HD CATHETER 2L 12FR 15CM (SHUNMEI) 948.189 903.038
52373174 SURGICAL HAT 1.965 1.871
52373175 MASKER KN 95 44.31 42.2
52373176 SET C SECTION WITH 3 SURGICAL GOWNS 1,180,262 1,124,059
52373177 APD ODP 10.006 10.006
52373178 APD PDP 425 425
52420001 DISP NEEDLE 18 G "TERUMO" 5.739 5.466
52420002 DISP NEEDLE 20 G "TERUMO" 3.776 3.596
52420003 DISP NEEDLE 21 G "TERUMO" 3.614 3.442
52420004 DISP NEEDLE 22 G "TERUMO" 3.614 3.442
52420005 DISP NEEDLE 23 G "TERUMO" 4.2 4
52420006 DISP NEEDLE 24 G "TERUMO" 3.614 3.442
52420007 DISP NEEDLE 25 G "TERUMO" 5.913 5.631
52420008 DISP NEEDLE 26 G "TERUMO" 5.295 5.043
52420020 SYRINGE 1 CC INSULIN 80 IU 10.486 9.987
52420021 SYRINGE 1 CC TUBERCULIN "TERUMO" 14.583 13.889
52420024 SYRINGE 10 CC "TERUMO" 14.413 13.727
52420030 SYRINGE 20 CC "TERUMO" 23.711 22.582
52420032 SYRINGE 3 CC "TERUMO" 9.112 8.678
52420036 SYRINGE 5 CC "TERUMO" 12.377 11.788
52420038 SYRINGE 50 CC "TERUMO" 42.023 40.022
52420039 SYRINGE 50 CC CAT. TIP "TERUMO" 78.937 75.178
52420041 WING NEEDLE 21 22.15 21.095
52420042 WING NEEDLE 23 22.15 21.095
52420043 WING NEEDLE 25 22.15 21.095
52420044 WING NEEDLE 27 36.483 34.746
52420049 SPINAL NEEDLE 25G "BBRAUN" (SPINOCAN) 78.857 75.102
52420050 SPINAL NEEDLE 26G "BBRAUN" (SPINOCAN) 78.857 75.102
52420051 SPINAL NEEDLE 27G "BBRAUN" (SPINOCAN) 87.34 83.181
52420052 SPINAL NEEDLE 29G "BBRAUN" (SPINOCAN) 87.34 83.181
52420053 IV CATHETER 18G "BBRAUN" (VASOFIX) 61.08 58.171
52420054 IV CATHETER 20G "BBRAUN" (VASOFIX) 61.08 58.171
52420055 IV CATHETER 22G "BBRAUN" (VASOFIX) 61.08 58.171
52420056 IV CATHETER 24G "BBRAUN" (VASOFIX) 61.08 58.171
52420057 VENOCATH 16 240.887 229.416
52420058 VENOCATH 18 240.887 229.416
52420059 VENTILATOR ADAPTOR 523.034 498.128
52420063 INTROCAN SAFETY 23G "BBRAUN" 48.491 48.491
52420065 DISP NEEDLE 27 G "TERUMO" 3.614 3.442
52420066 SPINAL NEEDLE 23 "TERUMO" 59.219 59.219
52420068 SPINAL NEEDLE 23G "BBRAUN" (SPINOCAN) 53.274 53.274
52420069 SPINAL NEEDLE 27 "BD" 70.702 70.702
52420071 WING NEEDLE 19 19.597 18.664
52420076 SURFLO FLASH IV CAT. 20G X 2 "TERUMO" 42.859 42.859
52420079 SPINAL NEEDLE WHITACRE 27GA 104.662 99.678
52420080 SPINAL NEEDLE WHITACRE 25GA "BD" 91.114 86.775
52420081 SPINAL PAJUNK 27GX31/2 (121151-27A) 163.049 155.285
52420083 SPINAL PAJUNK 25GX 31/2 (90MM) 154.262 146.916
52420085 SPINAL NEEDLE 22G "BBRAUN" (SPINOCAN) 82.836 78.891
52500006 BLOOD LINE ARTERIAL & VENOUS FOR DIALOG BLOOD LINE 231.642 220.611
52500007 DIACAN ARTERIAL G16 30MM 32.438 30.893
52500008 DIACAP LOPS 15; PS-DIALYSATOR, GAMMA 488.99 465.705
52500011 AV FISTULA 1 1/4 21.589 20.561
52500014 SOL CART B (494/496) 239.626 228.215
52500015 ELISIO (720354101D) 265.33 265.33
52500016 ALKALINE HD 5% 10L 184.783 184.783
52500017 HD CONC ACIDIC HDM 303 10000ML 27 27
52500021 STERIL ATANDART HD SET 42.075 40.071
52500022 DIALYSER F-7 281.114 267.727
52500024 BI BAG 5008 120.003 114.288
52500025 BLOODLINE TUBBING SYSTEM 143.726 136.882
52500026 HD SOLUTION 136.219 129.732
52500027 FISTULA NEEDLE 22.255 21.195
52500028 SAS-MA 300 ACID CONCENTRATE 123.297 123.297
52570002 KNEE SUPORT 1022 XL 460.598 460.598
52570003 KRUK KETIAK "POLICARE" 316.92 301.829
52570004 STOCKING UK S "SIGVARIS" (222AG-S) 510.422 486.116
52570005 STOCKING UK M "SIGVARIS" (222AG-M) 1,089,812 1,037,916
52570006 STOCKING UK L "SIGVARIS" (222AG-L) 224.255 213.576
52570010 LUMBAL CORSET 2060 520.298 495.522
52570011 LUMBAL CORSET 2064 16.736 16.736
52570012 LUMBAL CORSET 2164 936.098 891.522
52570013 LUMBAL CORSET OPPO 17.573 16.736
52570016 CANADIAN KRUCK "POLICARE" 632.102 602.002
52570017 CORRUGATED TUBE "BMED" 41.596 39.616
52570020 KRUCK"POLICARE" 849.341 808.896
52570023 TLSO 1,087,858 1,036,055
52570024 QUADRIPOD 494.038 494.038
52570025 WALKER "POLICARE' 1,489,590 1,418,657
52570030 ADJUSTABLE ANKLE SUPPORT 768 (ALL SIZE) 182.684 173.985
52570038 COMPRESSION STOCKING 520.406 495.625
52570039 SPIRO BALL 498.808 475.055
52570040 SIGVARIS STOCKING CO2AG-M 1,180,828 1,124,598
52570045 TENNIS ELBOW BRACE 1,133,124 1,079,166
52570046 LUMBAL CORSET (OXY SUPPORT) ALL SIZE 613.374 584.166
52570047 HOT/COLD PACK (OXY MEDICA) 51.501 51.501
52570048 AIR STIRR UP ANKLE 2,154,361 2,154,361
52570049 STOCKING VENOSAN UK XL 802.134 763.937
52570050 CERVICAL COLLAR FOAM UK M 163.997 156.187
52570052 LUMBAL CORSET GLOBAL LITE 3,227,057 3,073,387
52572243 TLSO BRACE XL 2,657,934 2,657,934
52620073 N/A - SURGIPRO 7-0 111.35 106.048
52620086 N/A - VICRYL 5/0 9105 111.51 111.51
52620101 BIOSYN 3/0 "USSDG" (SM693) 216.878 206.55
52620106 CHROMIC GUT 0 "ETHICON" (G128T) 97.908 93.246
52620107 CHROMIC GUT 0 "USSDG" (594-61) 102.205 97.339
52620108 CHROMIC GUT 1 "USSDG" (594-71) 102.467 97.588
52620109 CHROMIC GUT 1 "ETHICON" (G129T) 142.359 135.58
52620110 CHROMIC GUT 2/0 "ETHICON" (G127T) 97.908 93.246
52620111 CHROMIC GUT 2/0 "SYNETURE" (594-51) 112.977 107.598
52620112 CHROMIC GUT 3/0 "USSDG" (583-41) 92.896 88.473
52620113 MERSILK BLACK 2/0 "ETHICON" (W2512) 100.359 95.58
52620114 MERSILK BLACK 3/0 "ETHICON" (W2511) 92.225 87.833
52620115 MONOCRYL 3.0 "ETHICON" PS-1 (Y936H) 183.12 174.4
52620124 POLYSORB 1 "USSDG" (CL-925) 186.753 177.86
52620125 POLYSORB 2/0 "USSDG" (GL-123) 179.078 170.55
52620126 POLYSORB 2/0 "USSDG" (SL-586) 155.698 148.284
52620127 POLYSORB 3/0 "USSDG" (GL122) 176.936 168.51
52620128 POLYSORB 3/0 "USSDG" (SL-693) 169.979 161.885
52620129 POLYSORB 4/0 "USSDG" (UL-203) 215.024 204.785
52620130 PROLENE 1 "ETHICON" (W742) 188.56 179.581
52620131 PROLENE 2/0 "ETHICON" (8685H) 196.047 186.711
52620132 PROLENE 3/0 "ETHICON" (W8684) 226.236 215.463
52620133 PROLENE 4/0 "ETHICON" (W8683) 196.619 187.256
52620134 PROLENE 5/0 "ETHICON" (W8890) 162.918 155.16
52620144 SURGIPRO 1 "USSDG" (CP-535) 192.502 183.335
52620145 SURGIPRO 2/0 "USSDG" (SP-685) 171.712 163.535
52620146 SURGIPRO 3/0 "USSDG" (SP-684) 184.763 175.965
52620147 SURGIPRO 4/0 "USSDG" (SP-683) 194.607 185.34
52620148 SURGIPRO 5/0 "USSDG" (SP-661) 186.779 177.885
52620149 SURGIPRO MESH 15x15cm (SPM-66W) 355.538 355.538
52620150 VICRYL 0 "ETHICON" (W9141) 149.298 142.189
52620151 VICRYL 1 "ETHICON" (J347H) 217.973 207.593
52620152 VICRYL 2/0 "ETHICON" (W9121) 195.048 185.76
52620153 VICRYL 2/0 "ETHICON" (W9522T) 145.409 138.485
52620154 VICRYL 3/0 "ETHICON" (W9120) 195.048 185.76
52620155 VICRYL 3/0 "ETHICON" (W9890) 122.265 116.443
52620156 VICRYL 4/0 "ETHICON" (W9113) 123.938 118.036
52620157 BLACK SILK 3/0 "BBRAUN" 105.034 105.034
52620158 BLACK SILK 4/0 "BBRAUN" 74.651 74.651
52620160 DAFILON BLUE 4/0 "BBRAUN" 123.116 117.253
52620164 PREMILENE BLUE 6/0 "BBRAUN" 238.225 226.881
52620166 SILK 3/0 75CM "VIGILENZ" (S37CD240) 78.416 74.682
52620167 SILK 3/0 75CM "VIGILENZ" (S37RH220) 98.934 94.233
52620168 SILK 2/0 75CM "VIGILENZ" (S27CD240) 71.937 68.511
52620171 SURGICEL ABSORBABLE 5X7CM "ETHICON" (W1913T) 207.284 197.413
52620172 BONEWAX 2.5GR "ETHICON" (W810) 144.758 137.864
52620173 SOFSILK 3-0 GS 832 97.214 92.585
52620174 SOFSILK 2-0 GS-833 104.144 99.185
52620175 SAFIL 1 HR 40s "BBRAUN" (C1048557) 160.791 160.791
52620176 ETHILON 10/0 "ETHICON" (U7003) 339.288 323.131
52620177 SILK BLACK (SILKAM) 4/0 DS 19 "BBRAUN" 78.941 78.941
52620178 SOFSILK 3/0 "SYNETURE" (SS-684) 131.775 125.5
52620179 SOFSILK 4/0 "SYNETURE" (SS-683) 108.213 103.06
52620183 BONE WAX 2.5G "BBRAUN" (102975/4) 99.898 99.898
52620184 LYOSTYPT 5X8CM (106915/2) 286.165 272.538
52620185 NNS SILKAM 3/0 13X60 105.034 105.034
52620186 PREMICRON 2/0 2XHRT 26 "BBRAUN" (C0026446) 268.511 255.725
52620187 PREMICRON 3/0 2XHR 26 "BBRAUN" (C0026815) 218.403 208.003
52620188 PREMICRON 4/0 2XHRT 17 "BBRAUN" (C0026414) 172.926 172.926
52620189 PREMILENE 5/0 2XHRT 17 "BBRAUN" (C009092/5) 292.107 278.197
52620190 PREMILENE 6/0 2XDRC 12 "BBRAUN" (C009055/5) 593.265 565.015
52620191 PREMILENE 7/0 2XDRC 10 "BBRAUN" (C0090545) 364.477 364.477
52620192 PREMILENE 8/0 2XDRM V8 "BBRAUN" (G0095060) 398.998 398.998
52620193 SAFIL 2/0 HRT 37 "BBRAUN" (C1048532) 199.624 190.118
52620194 SAFIL QUICK 4/0 DS 19 'BBRAUN" (C1046420) 153.619 146.304
52620195 SILKAM 0 DS 30 "BBRAUN" (C0076248) 179.878 171.312
52620196 SILKAM 1 HR 35 "BBRAUN" (C0077044/2) 107.231 102.125
52620197 SILKAM 3/0 HR 26 "BBRAUN" (C0076041/2) 126.745 120.709
52620198 STAINLESS STEEL 3/0 HRT 26 "BBRAUN" (C00 836.046 796.234
52620199 STAINLESS STEEL 5 HRS 60 'BBRAUN" (G0617 796.148 758.236
52620200 SOFSILK 0 "SYNETURE" (CS424) 118.449 112.809
52620201 PLAIN GUT 0 "SYNETURE" (8661) 98.425 93.738
52620202 SOFSILK 2-0 "SYNETURE" (SS 685) 133.739 127.37
52620203 BIOSYN 4/0 "SYNETURE" (SM-691) 204.153 194.431
52620204 PLEDJET 3X7MM "SYNETURE" (8677-01) 527.54 502.419
52620206 SURGIPRO 7/0 "SYNETURE" (VP-713X) 332.493 316.66
52620207 TICRON 2/0 "SYNETURE" (3167-51) 224.908 214.198
52620208 SILKAM 3/0 13 X60CM "BBRAUN" (C026385) 148.141 141.086
52620211 SILKAM 1 13X60CM "BBRAUN" (C026389/2) 163.946 156.139
52620212 ETHILOOP 247.676 235.882
52620214 PROLENE 4/0 "ETHICON" (W8521) 278.987 265.702
52620215 NYLON TAPE "ETHICON" (W21301) 70.725 67.357
52620216 MERSILK 2/0 "ETHICON" (W275) 217.508 207.15
52620217 PREMICRON 2/0 6X3 "BBRAUN" (M0027786) 1,847,692 1,759,707
52620218 PREMICRON 2/0 3X3 "BBRAUN" (M0027781) 2,035,394 1,938,470
52620220 SOFSILK 1 "SYNETURE" (CS-425) 114.104 108.67
52620221 MERSILK 2/0 "ETHICON" (W213) 157.349 149.856
52620222 ETHIBON ROUND BODIED NO. 2 "ETHICON" (W4843) 383.184 363.937
52620224 JARUM OTOT "TRITON" (EN RB25) 4.751 4.525
52620226 VICRYL 1/0 "ETHICON" (VCP347H) 185.836 176.987
52620227 SAFIL 3/0 DS 24 "BBRAUN" (C1046235) 162.688 154.941
52620228 SAFIL 4/0 DS 24 "BBRAUN" (C1046234) 164.016 164.016
52620229 VICRYL RAPIDE 2/0 "ETHICON" (W9962) 147.056 140.053
52620230 VICRYL 2/0 "ETHICON" (W9452) 205.519 195.732
52620231 SURGIGUT CHROMIC 4-0 GG121 127.848 121.76
52620232 SOFSILK 0 (SS-678) 128.073 121.974
52620234 BENANG UV SUTURE 10.0 193.527 184.311
52620235 PLAIN GUT 3.0 (GG-322) "SYNETURE" 104.727 99.74
52620236 POLYSORB 5.0 (SL-5687) "SYNETURE" 186.753 177.86
52620237 CATGUT PLAIN 3.0,75 CM "HR-27" (209) 81.162 77.297
52620238 CATGUT PLAIN 2.0, 90 CM "HRG-38" (223N) 81.162 77.297
52620239 CHROMIC 2-0 (CG-811) 130.132 123.935
52620241 ASSUCRYL 1 "HRG 50" (43437H) 167.019 159.066
52620242 MERSILK 4.0 75 CM (W586) "ETHICON" 78.527 74.788
52620243 MERSILK 3.0 75CM (W570) "ETHICON" 90.983 86.65
52620244 COROLONE 4-0 CIRCLE 18MM (20S15F) 217.311 217.311
52620245 COROLONE 3-0 CIRCLE 22MM (20S15C) 207.411 207.411
52620246 COROLONE 3-0 CIRCLE 19MM (20S20H) 183.131 174.411
52620247 COROLONE 2-0 CIRCLE 26MM (20S30B) 183.131 174.411
52620248 FILAPEAU 3/0 (REF 87300) "PETERS" 106.691 101.61
52620249 FILAPEAU 4/0 (REF 87003) "PETERS" 106.691 101.61
52620250 COROLENE 6-0 3/8 TP, (20S07B) 245.501 233.811
52620251 COROLENE 7-0 3/8 TP, (20S05B) 354.267 337.398
52620252 PROLENE MESH 8X15CM (PMII) 1,007,354 959.385
52620253 PLAIN GUT 4.0 (KOREA) 63.842 60.802
52620254 PLAIN GUT 3.0 (CINA) 26.882 25.602
52620255 SURGIPRO II 5-0 (VP-556-X) 231.914 220.87
52620256 SURGIPRO VP-557X 4-0 275.111 262.01
52620257 ACIER-2 (31763) A60107 714.793 680.755
52620260 COROLENE 5/0 CS10H (A60156) 243.553 231.955
52620261 SURGIPRO 6-0 (VP-703X) 308.49 293.8
52620262 TICRON 3-0 (3256-41) 177.377 168.93
52620263 TICRON 3-0 (3167-41) 206.829 196.98
52620264 FLEXON 3-0 (2586-43) 548.598 548.598
52620265 ASSUCRYL 2/0 HRG 50 (43438) 167.019 159.066
52620266 POLYSORB 2-0 CL 923 177.762 169.297
52620267 CATGUT PLAIN 3-0 76 (PROGUT) DOLPHIN 71.076 71.076
52620268 COROLENE 6-0 3/8 TP (20S07D) 337.398 337.398
52620270 CHROMIC GUT 3/0 SG 636 "SYNETURE 108.668 103.494
52620272 CHROMIC GUT 2-0 GG130 148.03 140.981
52620273 CATGUT CHROMIC 3-0 TS 24 (ASSUT SUTURES) 79.908 76.103
52620274 VICRYL 2.0 J602H URG 213.751 203.572
52620275 SURGICAL STAINLESS STEEL 6 M654G "ETHICON" 1,997,958 1,997,958
52620276 CHROMIC 3-0 GG122 "SYNETURE" 125.392 119.421
52620277 SOFSILK 2-0 SS 679 CUTTING "SYNETURE" 136.143 129.66
52620278 PDS 6.0 (W9858T) "ETHICON" 293.874 279.88
52620279 PDS 5.0 (W9098H/Z1013H) 193.8 184.571
52620280 CHROMIC 4-0 UG203 COVIDIEN 130.521 124.306
52620281 NYLON SINUSPOINT 8500 10-0 (SP500) 320.23 304.981
52620282 SURGIPRO 6-0 VP 776X 294.719 280.685
52620283 BENANG MERSILK 2-0 W321H 84.397 84.397
52620284 COROLENE 5-0 (20S10H) 193.105 193.105
52620285 ACIER 6 (31764) 1,219,749 1,161,666
52620286 FILASILK 3.0 (SLK300882) 106.042 106.042
52620288 SURGIPRO 4.0 VP 557X TAPPER 258.09 258.09
52620289 CATGUT CHROMIC 3/0 75 (C37RH260) VIGILENZ 101.451 96.62
52620290 ECOLANE 2.0 (R20RH262) 180.685 172.081
52620292 SILK 2/0 S26-P150 PRE CUT 66.56 66.56
52620294 ECOLANE 4.0 CUTTING (R47CD190) VIGILENZ 147.457 140.435
52620295 ECOSYN 3.0 (Y37CD240) VIGILENZ 172.101 163.906
52620296 T BOND ROUND BODIED 1 75CM 112.778 112.778
52620302 CHROMIC 3/0 75CM ONEMED 7.909 7.533
52620303 POLYSORB 4/0 GL-181 153.329 146.028
52620304 PREMICRON 2/0 2XHRT17 BBRAUN 4,893,722 4,660,687
52620305 PREMILENE 7/0 2X75CM (G0095560) 1,765,496 1,681,425
52620306 BENANG FSSB PGA 8/0 (R) 450.978 429.503
52620307 SILKAM 2/0 HR 26 "BBRAUN" (C0076042/0) 97.645 92.996
52620308 SILKAM 3/0 DS 24 " BBRAUN" (C0076235/0) 90.356 86.054
52620309 PROLENE BLU 60CM 7.0 (W8702) 406.266 406.266
52620310 POLYSORB 1-0 CL 905 195.369 186.066
52620311 POLYSORB 5/0 UL 202 (TAPPER) 165.341 157.468
52720001 KODAK DVB FILM 8X10 INCH ISI 125 37.353 35.574
52720002 KODAK DVB FILM 11X14 INCH ISI 125 69.286 65.987
52720003 KODAK DVB FILM 14X17 INCH ISI 125 101.219 96.399
52720004 Kodak DVB Film 8x10 In Isi 100 37.377 35.597
52720006 Kodak DVB Film 14 x17 in isi 100 101.243 96.422
52740001 IOPAMIRO 370/30ML 403.412 384.202
52740002 IOPAMIRO 370/50ML 550.156 523.958
52740003 IOPAMIRO 370/100ML 1,136,144 1,082,042
52740004 IOMERON 400/100ML 1,036,180 986.838
52740005 Microbar Powder 80.162 80.162
52740006 OMNIPAQUE 300MGI/20ML 160.09 152.467
52740007 OMNIPAQUE 300MGI/50 ML 439.023 418.117
52740008 OMNIPAQUE 350MGI/100 ML 1,026,722 977.83
52740009 OMNISCAN 0.5MMOL/10 ML 658.613 627.25
52740010 VISIPAQUE 320MGI/50ML 826.025 786.69
52740013 IOPAMIRO 300/50ML 469.48 447.124
52740014 IOPAMIRO 300/100 ML 855.71 814.962
52740016 MULTIHANCE 10ML 621.938 592.322
52900012 ENDOTRACHEAL TUBE KK NO. 5.0 "BICAKCILLAR" 76.655 73.005
52900013 ENDOTRACHEAL TUBE KK NO. 4.5 "BICAKCILLAR" 66.786 66.786
52900017 INFUSION SET "STARDEC" 15.064 14.347
52900022 NASAL CANULE ADULT "GEA" 28.083 26.746
52900023 NASAL CANULE PEADIATRIK "GEA" 28.083 26.746
52900030 ENDOTRACHEAL TUBE KK NO. 8.0 "BICAKCILLAR" 66.786 66.786
52900031 ENDOTRACHEAL TUBE KK NO 8.5 "BICAKCILLAR" 66.786 66.786
52900033 ENDOTRACHEAL TUBE NKK NO .3.5 "BICAKCILL 372.748 354.998
52900038 ENDOTRACHEAL TUBE NKK NO.5.5 "BICAKCILLA 408.034 388.604
52900039 ENDOTRACHEAL TUBE NKK NO.6.0 "BICAKCILLA 372.748 354.998
52900054 Bisturi No 17 " Aesculap" AK 4.785 4.785
52900056 Bisturi No 19 " Aesculap" AK 4.785 4.785
52900079 STOMACH TUBE NO. 14 "BICAKCILAR" 36.567 34.826
52900080 STOMACH TUBE NO. 16 "BICAKCILAR" 36.567 34.826
52900081 STOMACH TUBE NO. 18 "BICAKCILAR" 36.567 34.826
52900097 HAND SCOON STERIL NO. 8.0 "SMART CARE" 11.629 11.629
52900565 THORACIC TROCAR 20CH "BICAKCILAR" 368.431 350.887
52900566 THORACIC TROCAR 24CH "BICAKCILAR" 368.431 350.887
52900567 THORACIC TROCAR 28CH "BICAKCILAR" 368.431 350.887
52900568 THORACIC TROCAR NO. 32 "BICAKCILAR" (18432011) 368.431 350.887
52910000 ALKOHOL SWAB REMEDI (BPJS) 1.617 1.54
52910001 BLOOD SET REMEDI (BPJS) 16.959 16.152
52910002 MASKER 3 PLY GREEN COLOR (BPJS) 5.189 4.942
52910010 SYRINGE 1CC ONEMED (BPJS) 3.198 3.046
52910011 SYRINGE 3CC ONEMED (BPJS) 2.468 2.35
52910012 SYRINGE 5CC ONEMED (BPJS) 2.917 2.778
52910013 SYRINGE 10CC ONEMED (BPJS) 4.907 4.673
52910014 URINE BAG REMEDI (BPJS) 15.371 14.639
52910020 UNDERPAD TOP (BPJS) 9.323 8.879
52910021 NACAL CANNULA NEONATES REMEDI (BPJS) 46.968 44.731
52910023 NASAL CANNULA PAEDIATRIK GEA (BPJS) 21.122 20.116
52910024 IV SET THERAPY NO. 18 POLYMED (BPJS) 40.114 38.204
52910025 IV SET THERAPY NO. 20 POLYMED (BPJS) 40.114 38.204
52910026 IV SET THERAPY NO. 22 POLYMED (BPJS) 41.669 39.685
52910027 IV SET THERAPY NO. 24 POLYMED (BPJS) 40.114 38.204
52910029 HANDSCOON STERIL NO. 6 REMEDI (BPJS) 13.067 12.445
52910030 HANDSCOON STERIL NO. 6,5 REMEDI (BPJS) 13.067 12.445
52910031 HANDSCOON STERIL 7.0 REMEDI (BPJS) 13.72 13.067
52910032 HANDSCOON STERIL NO. 7,5 REMEDI (BPJS) 15.125 14.405
52910033 HANDSCOON STERIL NO. 8.0 REMEDI (BPJS) 14.346 13.663
52910038 MASKER NEBULIZER PEADIATRIK (BPJS) 51.13 48.695
52910039 MASKER NON REBREATING ADULT (BPJS) 45.114 42.966
52910040 MASKER NON REBEATING PEADIATRIK (BPJS) 38.766 38.766
52910041 SUCTION CATHETER 8 BICAKCILAR (BPJS) 22.253 21.193
52910042 SUCTION CATHETER 10 BICAKCILAR (BPJS) 20.936 19.939
52910043 SUCTION CATHETER 12 BICAKCILAR 22.253 21.193
52910044 SUCTION CATHETER 14 BICAKCILAR (BPJS) 25.698 24.474
52910045 SUCTION CATHETER 16 BICAKCILAR (BPJS) 22.253 21.193
52910050 BREATHING CIRCUIT LIMBO 72 (BPJS) 272.592 259.611
52910051 CATHETER MOUNT ALTECH AL-17300 (BPJS) 57.873 55.117
52910052 THERMOVENT HEPA AL- 08022 (BPJS) 72.461 69.01
52910053 TRACHEOSTOMY FILTER WITH OXY TUBING AL 60.115 60.115
52910057 ENDOTRACHEAL TUBE KK NO. 6.0 BICAKCILAR (BPJS) 76.655 73.005
52910058 ENDOTRACHEAL TUBE KK NO. 6.5 BICAKCILAR (BPJS) 76.655 73.005
52910059 ENDOTRACHEAL TUBE KK NO. 7.0 BICAKCILAR (BPJS) 76.655 73.005
52910060 ENDOTRACHEAL TUBE KK NO. 7.5 BICAKCILAR (BPJS) 76.655 73.005
52910061 ENDOTRACHEAL TUBE NKK NO. 7.0 BICAKCILAR 291.476 277.596
52910062 ENDOTRACHEAL TUBE NKK NO. 7.5 BICAKCILAR (BPJS) 291.476 277.596
52910067 GUDEL AIRWAY SIZE 3 L100MM SUMI (BPJS) 58.984 56.175
52910068 GUDEL AIRWAY SIZE 4 L100MM SUMI (BPJS) 58.984 56.175
52910074 RECTAL TUBE NO. 20 BICAKCILAR (BPJS) 22.229 21.17
52910075 RECTAL TUBE NO. 22 BICAKCILAR (BPJS) 22.229 21.17
52910078 STOMACT TUBE NO. 14 BICAKCILAR (BPJS) 30.513 29.06
52910079 STOMACT TUBE NO. 16 BICAKCILAR (BPJS) 30.513 29.06
52910080 STOMACT TUBE NO. 18 BICAKCILAR (BPJS) 30.513 29.06
52910081 SYRINGE 20CC ONEMED (BPJS) 8.418 8.018
52910082 SYRINGE 50CC ONEMED (BPJS) 13.077 12.454
52910092 DISP SUCTION BAG GREEN (BPJS) 109.685 104.462
52910093 DISP SUCTION BAG WHITE (BPJS) 108.115 102.967
52910116 UMBILICAL CORD CLAMP (BPJS) 3.15 3
52910128 WOUND DRAIN 400ML M AXIMED (BPJS) 236.413 225.155
52910136 CUTICELL CLASSIC 10X10CM (BPJS) 22.622 22.622
52910147 SYRINGE 50CC WITH CATHTIP ONEMED (BPJS) 18.578 17.693
52910149 AMAZONIA CRONO STENT BMS (BPJS) 9,548,195 9,093,519
52910150 YANGTZE U BALLON (BPJS) 7,469,233 7,113,555
52910151 AMAZONIA PAX STENT DES (BPJS) 16,529,408 15,742,293
52910152 OPTIME 1 18S40G (GDM) 187.587 178.654
52910153 OPTIME 3/0 18S20K (GDM) 135.376 135.376
52910154 CHROMIC 1 C07358 (GDM) 122.318 122.318
52910155 CHROMIC 3/0 C07202 (GDM) 103.685 103.685
52910156 CHROMIC 2/0 C7250 (GDM) 137.567 137.567
52910157 OPTIME 2/0 18S30G (GDS) 144.726 137.869
52910158 OPTIME R 2/0 12S30AL (GDM) 147.531 140.506
52910159 ADVANTIME 3/0 15D20G (GDM) 184.156 184.156
52910160 SILK 2/0 S25339 (GDM) 92.868 88.446
52910161 COROLENE 4/0 20S15K (GDM) 198.582 189.126
52910162 OPTIME 0 18S35G (GDM) 161.472 153.783
52910163 CAESAREAN SET (OB-213) TRITON 240.603 240.603
52910165 FOL CATH 3 WAY 20 REMEDI (BPJS) 71.479 68.075
52910167 IV CATH PORT NO 18 POLYMED (BPJS) 20.93 19.933
52910168 IV CATH PORT NO 20 POLYMED (BPJS) 20.93 19.933
52910169 IV CATH PORT NO 22 POLIMED (BPJS) 20.93 19.933
52910170 IV CATH PORT NO 24 POLYMED (BPJS) 20.93 19.933
52910171 OMNIPAQUE 300/50ML (BPJS) 497.558 473.865
52910173 WASH GLOVE "EASY CARE" (BPJS) 12.366 11.777
52910174 GUDEL AIRWAY SIZE 2 L 90MM (BPJS) 58.984 56.175
52910175 NASAL CANUL ADULT (BPJS) 14.145 13.471
52910177 XLIMUS DES (BPJS) 26,293,080 25,041,029
52910178 THREE WAY STOP COCK POLYMED (BPJS) 28.256 26.911
52910179 THREE WAY STOP COCK TUBING POLIMED (BPJS) 28.237 26.892
52910184 MASKER NEBULIZER ADULT(BPJS) 51.13 48.695
52910186 FOL CATH 2 WAY NO. 16 CHROMA (BPJS) 25.828 24.598
52910187 IV CATH PORT NO.26 POLIMED (BPJS) 25.885 24.652
52910189 FOL CATH 2 WAY NO 14 (BPJS) 25.828 24.598
52910190 FOL CATH 2 WAY NO 18 (BPJS) 25.828 24.598
52910191 PAKET DIAGNOSTIK FEMORAL MM (BPJS) 1,667,876 1,588,453
52910192 PAKET DIAGNOSTIK RADIAL MM (BPJS) 1,667,970 1,588,543
52910193 PAKET PCI FEMORAL 1 BMS 1 BALLON MM (BPJS) 25,091,370 23,896,543
52910194 PAKET PCI RADIAL 1 BMS 1 BALLON MM (BPJS) 23,579,616 22,456,777
52910195 PAKET PCI FEMORAL 1DES 1 BALLON MM (BPJS) 33,647,171 32,044,925
52910196 PAKET PCI RADIAL 1 DES 1 BALLON (BPJS) 33,647,171 32,044,925
52910197 STOMACT TUBE NO. 16 (BPJS) 20.34 19.371
52910198 STOMACT TUBE NO. 14 (BPJS) 23.036 21.939
52910199 ELEKTROSURGICAL PENCIL EVERSHINE (BPJS) 121.816 116.015
52910200 ALPHAMED MONO GROUNDING PAD ADULT W0/ CABLE(BP 110.949 105.666
52910201 MONO GROUNDING PAD ADULT CABLE (BPJS) 249.549 237.666
52910203 SKIN MARKER FINE TIP WITH RULER (BPJS) 98.968 94.255
52910204 SUCTION CATHETER NO. 8 (BPJS) 20.936 19.939
52910205 PRO KINETIC ENERGY CC STENT (BPJS)MM 10,524,071 10,022,925
52910206 LENSA AURO FLEX SPHERIC ALL SIZE (BPJS) 613.374 584.166
52910207 PANTERA CORONARY BALLON CATH (BPJS)MM 6,151,716 5,858,777
52910208 CONCIERGE GUIDING CATH (BPJS)MM 1,739,499 1,656,666
52910209 BASIC INFLATIN SYRINGE (BPJS)MM 1,635,191 1,557,325
52910212 LENSA AUROLENS PMMA ALL SIZE (BPJS) 162.924 155.166
52910216 PARTNER SIROLIMUS STENT SYSTEM (BPJS) 13,168,925 13,168,925
52910217 HOPER PTCA BALLON (BPJS) 5,518,425 5,518,425
52910220 IOPAMIRO 370/100 (BPJS) 581.875 554.167
52910221 HAND CONTROL ELEKTRO PENCIL INTCO (BPJS) 162.924 155.166
52910222 MONOPOLAR WIRELESS PLATE ADULT INTCO (BPJS) 163.425 155.643
52910223 PAKET PCI FEMORAL TANPA WIRE MM(BPJS) 32,151,000 30,620,000
52910224 PAKET PCI RADIAL TANPA WIRE MM(BPJS) 34,610,333 32,962,222
52910225 NASAL CANUL NEONATE (BPJS) 23.402 22.288
52910226 APRON FILM (BPJS) 3.455 3.455
52910227 PAKET DIAGNOSTIK FEMORAL BPJS (REKA) 2,228,284 2,122,175
52910228 PAKET DIAGNOSTIK RADIAL BPJS (REKA) 2,735,687 2,605,416
52910229 PAKET PCI FEMORAL DES BPJS (REKA) 27,926,458 26,596,627
52910230 PAKET PCI RADIAL DES BPJS (REKA) 28,231,261 26,886,915
52910231 PAKET PCI FEMORAL BMS BPJS (REKA) 24,859,712 23,675,916
52910232 PAKET PCI RADIAL BMS BPJS (REKA) 20,823,715 20,823,715
52910233 STENT BIOMATRIX "BIOSENSOR" (BPJS) 21,034,571 20,032,925
52910235 ADMIRAL EXTREME BALLON (BPJS) 5,031,249 4,791,666
52910237 PTCA STENT BMS (BPJS) 10,401,999 9,906,666
52910238 PANTERA LEO NC (BPJS) 5,711,766 5,439,777
52910244 PAKET PCI FEMORAL BMS TANPA WIRE (BPJS) 25,994,499 24,756,666
52910245 MONOPOLAR PLATE WITH CABLE (BPJS) 156.216 148.777
52910246 XOLMETRAS 350/100 ML (BPJS) 794.595 756.757
52910249 PAKET AMAZONIA SIR+YANGTZE U (BPJS) 15,012,611 14,309,153
52910253 XOLMETROS 300/50 ML (BPJS) 414.566 394.825
52910254 PAKET DIAGNOSTIK RADIAL BISAWI (BPJS) 1,657,716 1,578,777
52910255 PAKET DIAGNOSTIK FEMORAL BISAWI (BPJS) 1,445,751 1,445,751
52910257 FOL CATH 2 WAY NO 8 CHROMA (BPJS) 68.824 65.546
52910258 ACROSS CTO 3,948,043 3,948,043
52910261 LUMBAL CORSET (OXY SPINE) BPJS 500.762 476.916
52910264 WASH GLOVE PRO PRODEVICE 9.539 9.539
52910265 BALLON MOZEC (BPJS) TAM 3,426,699 3,263,523
52910266 PAKET TINDAKAN PCI DES BIOMIME (BPJS) TAM 13,866,999 13,206,666
52910267 PAKET TINDAKAN PCI BMS NEXGEN (BPJS) TAM 10,735,648 10,735,648
52910269 ETT NO. 6.5 CANACK (BPJS) 46.08 46.08
52910274 EXTENTION TUBE 150CM (BPJS) 17.423 17.423
52910275 WOUND DRAIN 200ML NO 10 (BPJS) 187.81 178.867
52910282 PAKET PCI BMS ARCHITECT (BPJS) 10,409,361 10,409,361
52910284 OCTENIC BODY WASH (B4) 9.45 9
52910294 BALLON CATHETER EUCA VI 4,514,329 4,299,361
52910297 ENDOTRACHEAL TUBE NKK 4.0 BICAKCILAR (BPJS) 252.885 240.843
52910305 STENT BIOMATRIX ALPHA DES (BPJS) 9,015,339 8,586,037
52910308 HANDSCOON STERIL PD GLOVES NO.7 12.139 11.561
52910309 HANDSCOON STERIL PD GLOVES NO. 7.5 12.139 11.561
52910310 HANDSCOON STERIL PD GLOVES NO. 6.5 12.139 11.561
52910311 DOUBLE LUMEN POLINDROM VK 14,5X19CM 5,229,934 5,229,934
52910312 UNIVERSAL DRAPE TARAFIS (BPJS) 855.437 814.702
52910313 HD CATH CURVE SORTTERM MEDICATH KITS 1,057,389 1,007,037
52910314 DOUBLE LUMEN POLINDROM UL 14.5F X 33CM 5,490,397 5,228,950
52910315 DOUBLE LUMEN POLINDROME UK 14.5F X28CM 5,487,940 5,226,610
52910316 PENCIL CUTTER CARELUCK 81.414 77.537
52910317 PENCIL HARUM PEN (XY-P401-2) 75.392 71.802
52910318 EXPERIENCE BALLON " IVASCULAR" (BPJS) 2,258,589 2,151,037
52910319 ENVIROS DES STENT "IVASCULAR" (BPJS) 8,264,589 7,871,037
52910320 ELEKTROSURGERY PENCIL HEMIPEN 67.884 64.652
52910321 PAKET INDEFLATOR BBRAUN 1,473,714 1,403,537
52910322 PAKET CAG (DIAGNOSTIK) FEMORAL "MERIT" 1,492,824 1,421,737
52910323 PAKET CAG (DIAGNOSTIK) RADIAL "MERIT" 1,492,824 1,421,737
52910325 BALLON "POWERLINE" (BPJS) 3,009,339 2,866,037
52910326 STENT GENOSS DES "GENOSS" 11,567,889 11,017,037
52910327 BALLON GENOSS/ GENOSS NC "GENOSS" 2,483,814 2,365,537
52910328 PAKET PCI COROFLEX DES (BPJS) 11,335,839 10,796,037
52910329 STENT COROFLEX ALL SIZE (BPJS) 9,561,339 9,106,037
52910330 BALLON SEQUENT NEO ALL SIZE (BPJS) 3,009,339 2,866,037
32.45 7/1/2018
5.839 7/1/2018
5.109 7/1/2018
6.812 7/1/2018
407 7/1/2018
1.725 7/1/2018
25.3 7/1/2018
2,632,795 7/1/2018
1,410,750 7/1/2018
77 7/1/2018
406 4/26/2017
263.501 7/1/2018
159.5 7/1/2018
54.45 7/1/2018
2,033,625 7/1/2018
75
316.25 7/1/2018
342 7/1/2018
4.25 7/1/2018
171.6 7/1/2018
651.75 7/1/2018
297 7/1/2018
1,052,700 7/1/2018
2.162 7/1/2018
55 7/1/2018
27.5 7/1/2018
27.5 4/12/2017
79.75 6/7/2018
6.953 9/16/2019
8.111 9/16/2019
5.583 1/8/2020
29.7 7/1/2018
59.994 5/4/2020
19.397 7/1/2018
6.435 7/1/2018
6.435 7/1/2018
6.435 7/1/2018
18.513 7/1/2018
18.491 7/1/2018
21.78 7/1/2018
96.8 7/1/2018
61.776 7/1/2018
58.834 7/1/2018
58.834 7/1/2018
58.834 7/1/2018
66 7/1/2018
82.5 7/1/2018
34.1 7/1/2018
19.8 7/1/2018
36.96 7/1/2018
36.96 7/1/2018
36.96 7/1/2018
19.25 7/1/2018
7.15 7/1/2018
7.15 7/1/2018
32.12 7/1/2018
32.12 7/1/2018
32.12 7/1/2018
33.44 7/1/2018
46.365 7/1/2018
544.282 7/1/2018
357.5 7/1/2018
29.518 3/1/2014
18.513 7/1/2018
357.5 7/1/2018
70 7/1/2018
18.513 7/1/2018
16.83 7/1/2018
21.78 4/26/2017
3.113 7/1/2018
5.72 7/1/2018
2.882 7/1/2018
3.553 7/1/2018
246.4 7/1/2018
89.874 1/2/2015
52.25 7/1/2018
86.515 7/1/2018
86.515 7/1/2018
498.883 7/1/2018
499.125 7/1/2018
499.125 7/1/2018
499.125 7/1/2018
499.125 7/1/2018
499.125 7/1/2018
499.125 7/1/2018
499.125 7/1/2018
179.74 7/1/2018
188.727 7/1/2018
31.35 5/12/2016
22.688 7/1/2018
82.5 7/1/2018
329.677 7/1/2018
329.677 7/1/2018
346.16 7/1/2018
346.16 7/1/2018
453.75 7/1/2018
453.75 7/1/2018
18.513 7/1/2018
18.513 7/1/2018
18.513 7/1/2018
21.78 7/1/2018
33 4/26/2017
86.233 1/2/2015
86.233 1/2/2015
8.219 7/1/2018
570.2 7/1/2018
65.919 7/1/2018
292.6 7/1/2018
2.486 3/5/2019
453.2 7/1/2018
16.83 7/1/2018
240.24 9/28/2018
76.45 7/1/2018
825 7/1/2018
13.2 7/1/2018
7.15 7/1/2018
96.8 7/1/2018
7.15 7/1/2018
7.15 7/1/2018
577.5 7/1/2018
533.5 7/1/2018
8.47 7/1/2018
77 7/1/2018
24.42 7/1/2018
77 7/1/2018
404.924 2/26/2020
212.214 7/1/2018
12.1 7/1/2018
12.1 7/1/2018
21.78 4/26/2017
577.5 7/1/2018
577.5 7/1/2018
28.6 7/1/2018
583 11/13/2018
800 4/17/2020
36.608 3/30/2020
5.5 4/17/2020
3.3 7/1/2018
2.662 7/1/2018
1.796 7/1/2018
9.166 7/1/2018
1,197,900 7/1/2018
2,643,300 7/1/2018
126.5 4/26/2017
16.5 7/1/2018
38.001 7/1/2018
2,454,100 4/26/2017
1.463 7/1/2018
120 4/17/2020
104.614 1/2/2015
55 7/1/2018
77 7/1/2018
1,425,600 4/26/2017
1,319,674 1/2/2015
1,437,480 7/1/2018
1,319,674 1/2/2015
1,425,600 4/26/2017
1,782,000 4/26/2017
1,633,500 7/1/2018
1,633,500 4/26/2017
1,436,600 7/1/2018
1,730,300 7/1/2018
1,573,000 7/1/2018
508.2 4/26/2017
479.16 7/1/2018
26,620,000 7/1/2018
26,620,000 7/1/2018
12,795,750 7/1/2018
14,217,500 7/1/2018
12,925,000 7/1/2018
5,445,000 4/26/2017
5,989,500 7/1/2018
5,989,500 7/1/2018
5,457,874 1/2/2015
325.586 1/2/2015
473 7/1/2018
572.862 1/2/2015
444.505 1/2/2015
19,250,000 7/1/2018
2,250,600 7/1/2018
1,980,000 7/1/2018
7,162,874 1/2/2015
8,262,874 1/2/2015
13,068,000 7/1/2018
22,869,000 7/1/2018
9,350,000 7/1/2018
27,500,000 7/1/2018
5,500,000 7/1/2018
5,445,000 7/1/2018
6,600,000 7/1/2018
6,600,000 7/1/2018
151.25 7/1/2018
1,650,000 7/1/2018
1,650,000 4/26/2017
2,200,000 7/1/2018
2,200,000 7/1/2018
3,025,000 7/1/2018
5,500,000 7/1/2018
4,400,000 7/1/2018
1,650,000 7/1/2018
2,178,000 7/1/2018
9,350,000 7/1/2018
561 3/19/2020
181.5 4/26/2017
161.869 1/2/2015
71.5 10/30/2019
51.374 1/2/2015
297 10/30/2019
385 7/1/2018
121 7/1/2018
55 7/1/2018
55 7/1/2018
1,320,000 7/1/2018
4,400,000 7/1/2018
330 10/30/2019
209 10/30/2019
385 7/1/2018
1,485,000 7/1/2018
4,400,000 7/1/2018
4,537,500 4/26/2017
8,580,000 7/1/2018
12,584,000 7/1/2018
22,136,400 7/1/2018
181.5 4/26/2017
22,000,000 7/1/2018
440 10/30/2019
59.4 7/1/2018
1,188,000 7/1/2018
1,188,000 7/1/2018
11,000,000 7/1/2018
4,950,000 7/1/2018
2,750,000 1/11/2019
2,970,000 11/25/2019
1,772,650 7/1/2018
5,500,000 7/1/2018
220 7/1/2018
496.1 7/1/2018
220 7/1/2018
154 7/1/2018
1,650,000 7/1/2018
1,650,000 7/1/2018
1,650,000 7/1/2018
6,600,000 7/1/2018
11,797,500 7/1/2018
4,400,000 7/1/2018
31,460,000 7/1/2018
7,150,000 7/1/2018
5,500,000 7/1/2018
5,512,874 1/2/2015
1,320,000 7/1/2018
1,100,000 7/1/2018
19,239,000 7/1/2018
25,300,000 7/1/2018
297 10/30/2019
264 7/1/2018
467.5 7/1/2018
385 7/1/2018
502.15 7/1/2018
25,300,000 7/1/2018
9,900,000 4/26/2017
5,500,000 7/1/2018
6,050,000 7/1/2018
8,000,000 4/26/2017
3,862,874 1/2/2015
434.5 7/1/2018
434.5 7/1/2018
1,485,000 7/1/2018
1,550,674 1/2/2015
1,014,424 1/2/2015
1,485,000 7/1/2018
22,011,956 1/2/2015
8,811,956 1/2/2015
8,250,000 7/15/2014
5,280,000 7/1/2018
17,600,000 7/15/2014
1,650,000 7/15/2014
418 7/1/2018
440 7/1/2018
8,470,000 3/12/2015
11,275,000 7/1/2018
19,800,000 7/1/2018
277.2 8/6/2018
14,850,000 8/28/2019
1,760,000 10/30/2019
2,970,000 11/15/2019
14,850,000 1/6/2020
16,275,000 1/6/2020
3,895,000 1/6/2020
4,550,000 1/6/2020
10,500,000 1/8/2020
3,025,000 2/6/2020
231 5/20/2020
231 5/20/2020
13,000,000 3/3/2020
0 3/31/2020
0 3/31/2020
1,671,736 7/1/2018
1,766,237 7/1/2018
2,695,275 7/1/2018
1,270,500 7/1/2018
1,892,029 7/1/2018
406.56 7/1/2018
384.766 7/1/2018
28.327 7/1/2018
42.02 1/9/2020
54.086 2/13/2020
8.278 7/1/2018
584 7/1/2018
1.26 7/1/2018
0 7/2/2013
25.827 7/1/2018
12.705 7/1/2018
41.8 7/1/2018
25.599 1/9/2020
31.002 2/13/2020
44.132 1/9/2020
7.322 7/1/2018
44.468 1/17/2019
23.1 7/1/2018
26.565 4/28/2020
51.653 7/1/2018
10.89 7/1/2018
307.7 7/1/2018
18.7 7/1/2018
57.2 7/1/2018
41.326 1/2/2015
86.522 7/1/2018
22.114 1/2/2015
97.625 7/1/2018
2.706 7/1/2018
1.067 7/1/2018
577.5 4/24/2019
19.866 3/5/2019
580.8 7/1/2018
459.8 7/1/2018
1,124,922 7/1/2018
346.5 4/24/2019
473 7/1/2018
632.5 7/1/2018
946 7/1/2018
1,210,000 7/1/2018
17.325 1/17/2019
24.805 7/1/2018
63.694 1/9/2020
76.85 1/9/2020
100.874 1/9/2020
42.816 1/9/2020
60.5 7/1/2018
1,768,800 7/1/2018
56.232 1/2/2015
2,778,600 7/1/2018
2,558,600 7/1/2018
679.8 7/1/2018
25.981 7/1/2018
102.336 4/28/2020
71.843 7/1/2018
36.524 1/2/2015
48.624 1/2/2015
60.174 1/2/2015
246 7/1/2018
211.754 2/13/2020
67.564 1/9/2020
806.96 7/1/2018
181.06 1/17/2019
99 7/1/2018
46.2 7/1/2018
40.374 1/2/2015
225.5 7/1/2018
110 7/1/2018
60.5 7/1/2018
60.5 7/1/2018
110 7/1/2018
110 7/1/2018
187 7/1/2018
82.5 7/1/2018
104.5 7/1/2018
550 7/1/2018
330 7/1/2018
110 7/1/2018
99 7/1/2018
660 7/1/2018
203.5 7/1/2018
2.024 7/1/2018
104.28 4/13/2018
101.75 4/24/2019
77 7/1/2018
278.3 5/13/2020
181.17 7/1/2018
171.875 7/1/2018
171.875 7/1/2018
2,212,874 1/2/2015
66 7/1/2018
243.1 4/28/2020
51.944 1/9/2020
75.092 7/1/2018
359.04 7/1/2018
168.937 1/2/2015
87.784 1/2/2015
77.299 1/2/2015
227.234 7/1/2018
91.567 7/1/2018
77 1/17/2019
29.416 7/1/2018
127.373 1/9/2020
275 7/1/2018
220 7/1/2018
33 7/1/2018
5.225 7/1/2018
10.45 7/1/2018
49.5 7/1/2018
11 7/1/2018
82.5 7/1/2018
302.5 7/1/2018
224.532 7/1/2018
53.24 7/1/2018
204.82 9/12/2017
68.31 9/12/2017
3.086 1/11/2018
1,056,000 1/17/2019
462 1/17/2019
4.95 2/11/2019
1,335,400 2/7/2019
14.3 6/24/2019
23.98 6/24/2019
35.75 10/7/2019
897.82 11/12/2019
1,037,960 11/12/2019
13.75 3/19/2020
0 3/30/2020
650 3/24/2020
108.13 3/31/2020
15 3/26/2020
180 3/28/2020
90.2 7/1/2018
90.2 7/1/2018
123.916 7/1/2018
3.74 7/1/2018
3 7/1/2018
3.74 7/1/2018
3 7/1/2018
2.242 7/1/2018
9.483 7/1/2018
8.47 7/1/2018
1,322,200 5/31/2019
102.666 7/1/2018
132 7/1/2018
21.23 7/1/2018
5,720,000 7/1/2018
847 7/1/2018
863.5 7/1/2018
2,750,000 8/29/2019
146.667 4/25/2019
100.98 7/1/2018
645.48 4/26/2017
2,630,000 7/1/2018
60.5 4/24/2019
49.5 7/1/2018
836 4/24/2019
935 7/1/2018
970.2 7/1/2018
1,650,000 4/24/2019
55 7/1/2018
12.1 7/1/2018
576.4 7/1/2018
1,100,000 4/24/2019
671.774 1/2/2015
1,144,000 7/1/2018
990 4/24/2019
2,475,000 7/1/2018
715 7/1/2018
726 7/1/2018
43,126,222 7/1/2018
1,761,874 1/2/2015
935 7/1/2018
23.874 1/2/2015
99 7/1/2018
62.374 1/2/2015
748 7/1/2018
10,450,000 8/26/2019
1,078,000 5/27/2019
837.874 1/2/2015
2,200,000 4/24/2019
275 7/1/2018
137.5 7/1/2018
14,305,500 7/1/2018
14,305,500 7/1/2018
715.77 7/1/2018
753.28 7/1/2018
17,303,000 7/1/2018
25,300,000 7/1/2018
328.374 1/2/2015
544.5 7/1/2018
544.5 7/1/2018
19,800,000 4/24/2019
1,980,000 8/28/2019
935 10/16/2019
660 1/20/2020
6,600,000 3/24/2020
1,416,800 7/1/2018
9,900,000 4/24/2019
1,540,000 7/1/2018
1,144,000 7/1/2018
1,100,000 7/1/2018
814 7/1/2018
1,210,000 7/1/2018
1,100,000 7/1/2018
3,267,000 7/1/2018
3,212,000 7/1/2018
3,212,000 7/1/2018
1,771,000 7/1/2018
3,740,000 7/1/2018
3,421,000 7/1/2018
3,344,000 7/1/2018
4,290,000 7/1/2018
4,290,000 7/1/2018
4,290,000 7/1/2018
1,463,000 7/1/2018
1,463,000 7/1/2018
1,463,000 7/1/2018
1,265,000 7/1/2018
2,013,000 7/1/2018
4,092,000 7/1/2018
4,092,000 7/1/2018
4,092,000 7/1/2018
8,140,000 7/1/2018
8,140,000 7/1/2018
9,570,000 7/1/2018
3,465,000 7/1/2018
2,948,000 7/1/2018
792 7/1/2018
1,375,000 7/1/2018
1,342,000 7/1/2018
1,342,000 7/1/2018
1,463,000 7/1/2018
1,463,000 7/1/2018
1,342,000 7/1/2018
1,375,000 7/1/2018
3,344,000 7/1/2018
22,000,000 7/1/2018
319 7/1/2018
319 7/1/2018
2,365,000 7/1/2018
3,894,000 7/1/2018
7,392,000 7/1/2018
7,392,000 7/1/2018
7,392,000 7/1/2018
793.874 1/2/2015
2,916,874 1/2/2015
715 7/1/2018
1,694,000 4/26/2017
8,613,000 7/1/2018
8,613,000 7/1/2018
8,613,000 7/1/2018
8,613,000 7/1/2018
1,100,000 7/1/2018
22,000,000 7/1/2018
22,000,000 7/1/2018
913 7/1/2018
6,402,000 7/1/2018
8,778,000 7/1/2018
869 7/1/2018
1,298,000 7/1/2018
5,346,000 7/1/2018
2,161,500 7/1/2018
2,174,374 1/2/2015
710.575 7/1/2018
22,078,874 4/28/2015
425.374 1/2/2015
23,012,874 4/28/2015
13,012,874 1/2/2015
8,012,874 4/28/2015
4,954,950 7/1/2018
15,012,874 1/2/2015
2,025,700 12/16/2019
176 7/1/2018
176 7/1/2018
165 7/1/2018
22,295,625 7/1/2018
22,295,625 7/1/2018
22,295,625 7/1/2018
22,295,625 7/1/2018
22,295,625 7/1/2018
22,295,625 7/1/2018
22,295,625 7/1/2018
4,087,833 7/1/2018
3,520,000 7/1/2018
3,520,000 7/1/2018
308 7/1/2018
264 7/1/2018
286 7/1/2018
364.21 7/1/2018
1,375,000 7/1/2018
1,375,000 7/1/2018
907.5 7/1/2018
3,025,000 7/1/2018
6,050,000 7/1/2018
30,250,000 7/1/2018
15,125,000 7/1/2018
907.5 7/1/2018
6,050,000 7/1/2018
55 7/1/2018
23,662,874 4/28/2015
22,295,625 7/1/2018
22,295,625 7/1/2018
22,295,625 7/1/2018
22,295,625 7/1/2018
1,320,000 7/1/2018
3,850,000 7/1/2018
5,445,000 7/1/2018
5,445,000 7/1/2018
1,188,000 7/1/2018
1,650,000 7/1/2018
308 7/1/2018
2,200,000 7/1/2018
1,485,000 7/1/2018
2,332,000 7/1/2018
5,698,000 7/1/2018
17,315,874 1/2/2015
23,650,000 7/1/2018
11,000,000 7/1/2018
330 7/1/2018
458.374 1/2/2015
726 10/30/2019
359.374 1/2/2015
1,881,000 7/1/2018
19,262,874 1/2/2015
892.874 1/2/2015
261.25 7/1/2018
198 4/27/2015
150.374 1/2/2015
110 7/1/2018
203.5 7/1/2018
62.374 1/2/2015
313.5 7/1/2018
106.7 7/1/2018
115.5 7/1/2018
617.874 1/2/2015
617.874 1/2/2015
811.8 4/26/2017
667.374 1/2/2015
667.374 1/2/2015
122.874 1/2/2015
165 4/24/2019
165 4/24/2019
165 4/24/2019
733.374 1/2/2015
882.974 1/2/2015
11,000,000 7/1/2018
415.8 7/1/2018
4,400,000 4/26/2017
4,137,874 1/2/2015
1,796,850 7/1/2018
1,796,850 7/1/2018
1,796,850 7/1/2018
99 7/1/2018
22,000,000 7/1/2018
7,150,000 7/1/2018
16,500,000 7/1/2018
6,512,874 1/2/2015
7,512,874 1/2/2015
522.5 7/1/2018
1,270,500 7/1/2018
1,367,300 7/1/2018
94.456 1/2/2015
7,321,710 7/1/2018
6,667,100 7/1/2018
5,720,000 7/1/2018
1,622,500 7/1/2018
1,573,000 7/1/2018
24,270,400 7/1/2018
24,419,450 7/1/2018
13,832,730 1/20/2015
13,870,350 1/20/2015
21,780,000 4/26/2017
9,900,000 7/1/2018
1,485,000 7/6/2015
2,750,000 7/1/2018
1,650,000 7/1/2018
1,925,000 7/1/2018
830.5 7/1/2018
14,300,000 7/1/2018
1,650,000 10/22/2018
2,970,000 1/30/2019
2,970,000 1/30/2019
495 11/23/2019
4,400,000 12/19/2019
227.7 7/1/2018
227.7 7/1/2018
1.719 7/1/2018
217.485 7/1/2018
33 4/28/2020
269.5 7/1/2018
275 7/1/2018
159.72 7/1/2018
67.65 7/1/2018
137.5 7/1/2018
1.32 7/1/2018
69.19 7/1/2018
73.37 3/5/2019
5.61 7/1/2018
356.345 7/1/2018
292.203 7/1/2018
278.513 1/2/2015
292.203 7/1/2018
379.601 7/1/2018
379.601 7/1/2018
292.203 7/1/2018
81.04 4/26/2017
81.04 4/26/2017
86.547 1/2/2015
86.547 1/2/2015
86.547 1/2/2015
81.04 7/1/2018
52.25 7/1/2018
52.25 7/1/2018
52.25 7/1/2018
52.25 7/1/2018
61.81 7/1/2018
68.317 7/1/2018
68.05 7/1/2018
82.5 7/1/2018
89.748 7/1/2018
64.625 7/1/2018
104.5 9/13/2018
104.5 9/12/2018
97.9 7/1/2018
104.5 7/1/2018
104.5 7/1/2018
104.5 7/1/2018
93.5 7/1/2018
100.251 7/1/2018
1.32 7/1/2018
1.1 2/13/2020
1.32 7/1/2018
1.1 2/13/2020
1.32 7/1/2018
17.6 7/1/2018
11.22 7/1/2018
11.22 7/1/2018
22 2/13/2020
95.7 8/26/2019
19.791 1/2/2015
2.42 12/12/2019
2.09 7/1/2018
6.38 7/1/2018
16.5 7/1/2018
18.92 7/1/2018
1.65 7/1/2018
36.96 4/24/2019
41.8 7/1/2018
29.04 7/1/2018
151.8 7/1/2018
12.65 7/1/2018
3,252,374 1/2/2015
440 7/1/2018
908 7/1/2018
52.8 7/1/2018
4.4 7/1/2018
12.874 1/2/2015
12.874 1/2/2015
12.874 1/2/2015
18.874 1/2/2015
12.441 1/2/2015
12.874 1/2/2015
10.507 1/2/2015
33 7/1/2018
104.5 7/1/2018
187 7/1/2018
3.421 7/1/2018
471.9 7/1/2018
495 7/1/2018
63.8 1/17/2019
121 1/17/2019
170.5 1/17/2019
5.095 7/1/2018
454 7/1/2018
81.4 7/1/2018
23.1 7/1/2018
23.1 7/1/2018
148.5 4/26/2017
40.374 1/2/2015
545.824 1/2/2015
545.824 1/2/2015
589.714 1/2/2015
589.714 1/2/2015
589.714 1/2/2015
589.714 1/2/2015
64.35 7/1/2018
7.15 7/1/2018
30.584 1/2/2015
11.924 7/1/2018
284.398 1/2/2015
7.59 7/1/2018
23.65 7/1/2018
502.838 7/1/2018
9.9 7/1/2018
19.8 7/1/2018
2.75 7/1/2018
227.7 7/1/2018
15.074 1/2/2015
163.9 7/1/2018
153.9 7/1/2018
154 7/1/2018
154 7/1/2018
154 7/1/2018
12.1 8/6/2018
1.133 7/1/2018
495 7/1/2018
935 3/31/2020
104.573 1/2/2015
192.5 7/1/2018
192.5 7/1/2018
192.5 7/1/2018
278 3/2/2018
264 4/26/2017
148.5 10/30/2019
3.85 7/1/2018
29.591 1/17/2019
25.874 1/9/2020
24.2 7/1/2018
11 7/1/2018
33.66 7/1/2018
74.36 7/1/2018
435.6 4/26/2017
21.175 7/1/2018
16.5 7/1/2018
1.067 7/1/2018
6,306,300 7/1/2018
590.7 7/1/2018
640.75 7/1/2018
55 7/1/2018
4.95 7/1/2018
1,287,000 4/26/2017
29.7 4/24/2019
440.22 7/1/2018
757.354 1/2/2015
11.22 7/1/2018
46.75 7/1/2018
401.83 7/1/2018
401.83 7/1/2018
14.3 7/1/2018
17.6 7/1/2018
18.7 7/1/2018
130 4/22/2020
2.332 7/1/2018
2.701 4/16/2020
2.332 7/1/2018
2.332 7/1/2018
362.89 7/1/2018
192.5 7/1/2018
105.271 7/1/2018
104.941 7/1/2018
211.75 8/19/2016
211.75 4/26/2017
654.5 4/26/2017
654.5 8/19/2016
654.5 4/26/2017
654.5 8/19/2016
1,155,000 7/1/2018
33,000,000 12/21/2016
355.52 12/19/2019
84.7 5/14/2018
19.36 7/1/2018
200.75 1/19/2018
23.1 4/13/2018
781 10/2/2018
0 2/8/2019
29.7 5/18/2020
1,006,500 5/2/2019
0 5/2/2019
413.71 8/27/2019
13.2 7/8/2019
33 8/23/2019
577.5 9/6/2019
577.5 9/6/2019
577.5 9/6/2019
638 10/16/2019
1,650,000 9/12/2019
30 11/11/2019
577.5 12/12/2019
693 12/3/2019
198 2/7/2020
42.24 3/19/2020
690 3/19/2020
1.346 4/21/2020
32.229 4/27/2020
863.5 5/11/2020
0 5/15/2020
0 5/15/2020
1.98 7/1/2018
1.98 7/1/2018
1.98 7/1/2018
1.98 7/1/2018
1.98 7/1/2018
1.98 7/1/2018
1.98 7/1/2018
1.98 7/1/2018
5.83 7/1/2018
7.04 7/1/2018
8.03 7/1/2018
10.12 7/1/2018
5.06 7/1/2018
6.16 7/1/2018
23.32 7/1/2018
44 7/1/2018
12.32 7/1/2018
12.32 7/1/2018
12.32 7/1/2018
20.35 7/1/2018
44 7/1/2018
44 7/1/2018
44 7/1/2018
44 7/1/2018
17.303 7/1/2018
25.96 7/1/2018
25.96 7/1/2018
35.2 7/1/2018
148.5 7/1/2018
148.5 7/1/2018
327.642 7/1/2018
30.307 1/2/2015
1.98 7/1/2018
42.299 1/2/2015
33.296 1/2/2015
44.189 1/2/2015
10.89 7/1/2018
26.787 1/2/2015
58.19 7/1/2018
50.6 7/1/2018
86.9 7/1/2018
93.5 7/1/2018
60.5 10/7/2019
134.2 7/1/2018
10.89 7/1/2018
269.5 7/1/2018
11.66 4/16/2020
129.8 7/1/2018
253 3/24/2015
141.756 2/25/2016
19 4/26/2017
26.18 12/4/2018
201.3 8/16/2019
83.27 8/16/2019
100.65 8/16/2019
95.15 8/16/2019
11.66 8/16/2019
90.2 10/21/2019
114.95 4/26/2017
159.72 7/1/2018
281.507 7/1/2018
687.5 7/1/2018
137.94 7/1/2018
302.5 7/1/2018
12.874 1/2/2015
550 7/1/2018
0 7/1/2018
369.05 7/1/2018
20.9 7/1/2018
534.82 7/1/2018
605 7/1/2018
308.774 1/2/2015
830.06 7/1/2018
97.9 7/1/2018
287.1 7/1/2018
275 7/1/2018
319 7/1/2018
715 7/1/2018
385 7/1/2018
27.5 11/18/2016
1,650,000 12/8/2017
583 9/6/2019
115.5 9/20/2019
2,359,500 1/21/2020
1,771,956 1/2/2015
71.583 3/12/2013
79.65 1/2/2015
137.5 7/1/2018
59.772 7/1/2018
62.92 7/1/2018
57.75 7/1/2018
103.675 12/30/2019
59.772 7/1/2018
64.9 7/1/2018
56.1 7/1/2018
56.1 7/1/2018
51.296 7/1/2018
102.465 7/1/2018
104.5 7/1/2018
100.1 7/1/2018
86.9 7/1/2018
99 7/1/2018
107.8 7/1/2018
136.4 7/1/2018
119.35 7/1/2018
109.706 7/1/2018
126.317 4/24/2019
109.78 7/1/2018
88.366 7/1/2018
122.1 7/1/2018
108.9 7/1/2018
99 7/1/2018
108.9 7/1/2018
93.5 7/1/2018
253.956 1/2/2015
83.27 7/1/2018
121.99 7/1/2018
108.9 7/1/2018
81.277 7/1/2018
108.9 7/1/2018
77.259 7/1/2018
78.32 7/1/2018
75.024 1/2/2015
57.424 1/2/2015
68.849 7/1/2018
68.849 7/1/2018
43.56 7/1/2018
55.055 7/1/2018
39.93 7/1/2018
115.94 7/1/2018
104.5 4/24/2019
61.6 7/1/2018
66 7/1/2018
107.194 1/2/2015
215.05 7/1/2018
60.724 1/2/2015
73.7 7/1/2018
60.5 7/1/2018
59.4 4/26/2017
206.8 11/13/2018
75.024 1/2/2015
193.875 4/24/2019
193.875 4/24/2019
115.284 1/2/2015
208.67 4/24/2019
302.907 4/24/2019
227.798 1/2/2015
249.374 1/2/2015
130.769 4/24/2019
85.58 7/1/2018
110.594 4/24/2019
59.95 7/1/2018
78.771 4/24/2019
468.246 4/24/2019
468.246 4/24/2019
63.8 7/1/2018
55 7/1/2018
74.8 7/1/2018
129.25 7/1/2018
294.8 7/1/2018
185.9 7/1/2018
121 7/1/2018
82.5 4/24/2019
89.1 4/24/2019
138.631 7/1/2018
155.925 7/1/2018
39.251 7/1/2018
121.483 7/1/2018
1,030,678 7/1/2018
936.98 7/1/2018
63.8 7/1/2018
87.78 7/1/2018
214.299 7/1/2018
2.291 7/1/2018
103.986 7/1/2018
82.014 7/1/2018
109.344 1/2/2015
82.014 7/1/2018
114.766 7/1/2018
71.5 7/1/2018
66 7/1/2018
99 7/1/2018
58.3 7/1/2018
104.5 7/1/2018
46.585 7/1/2018
46.585 7/1/2018
82.5 7/1/2018
93.17 7/1/2018
43.623 7/1/2018
50.6 7/1/2018
144.874 1/2/2015
138.274 1/2/2015
99 7/1/2018
99 7/1/2018
59.4 7/1/2018
59.4 7/1/2018
143 7/1/2018
204.6 7/1/2018
559.9 7/1/2018
30.8 7/1/2018
8.8 7/1/2018
129.8 7/1/2018
154 7/1/2018
396 7/1/2018
132 7/1/2018
172.7 7/1/2018
99 7/1/2018
115.5 7/1/2018
330 4/26/2017
93.17 7/1/2018
99 7/1/2018
41.8 4/26/2017
210.874 1/2/2015
61.05 7/1/2018
93.5 7/1/2018
51.244 7/1/2018
119.625 7/1/2018
1,248,724 1/2/2015
78.1 7/1/2018
75.9 4/1/2019
164.45 7/1/2018
108.386 7/1/2018
82.5 7/1/2018
202.95 7/1/2018
187 7/1/2018
64.55 7/13/2015
138.6 8/31/2015
770 7/1/2018
80.651 12/5/2016
198 3/8/2017
73.7 7/1/2018
132 7/1/2018
50.6 12/28/2017
93.5 7/1/2018
108.9 7/1/2018
86.152 1/8/2018
5.601 11/13/2018
112.2 1/25/2019
3,580,500 4/24/2019
1,288,760 4/24/2019
330 5/24/2019
71.148 7/12/2019
66.066 7/19/2019
312.125 10/16/2019
143 11/7/2019
121 2/7/2020
22.176 7/1/2018
41.184 7/1/2018
60.192 7/1/2018
22.176 7/1/2018
60.192 7/1/2018
232.925 7/1/2018
314.6 7/1/2018
669.075 7/1/2018
603.9 7/1/2018
42.9 4/26/2017
101.2 7/1/2018
278.3 7/1/2018
574.75 7/1/2018
621.259 7/5/2019
484 7/1/2018
262.57 7/1/2018
502.15 7/1/2018
363 7/1/2018
38.5 7/1/2018
51.374 1/2/2015
7.81 7/1/2018
5.5 7/1/2018
5.5 7/1/2018
51.374 1/2/2015
51.374 1/2/2015
180.62 7/1/2018
180.62 7/1/2018
180.62 7/1/2018
2.991 1/2/2015
2.991 1/2/2015
12.65 7/1/2018
12.65 7/1/2018
12.65 7/1/2018
6.111 4/26/2017
201.96 7/1/2018
201.96 7/1/2018
201.96 7/1/2018
201.96 7/1/2018
220 4/17/2020
12.672 9/23/2019
3.601 4/16/2020
781 4/17/2020
770 7/1/2018
825 4/17/2020
1.21 4/17/2020
4.95 7/1/2018
3.245 7/1/2018
24.75 7/1/2018
7.7 7/1/2018
19.877 7/1/2018
16.625 7/1/2018
16.625 7/1/2018
19.877 7/1/2018
6.138 7/1/2018
5.5 7/1/2018
5.5 7/1/2018
5.5 7/1/2018
9.02 7/1/2018
24.2 7/1/2018
24.2 7/1/2018
35.242 1/2/2015
6.71 7/1/2018
6.05 7/1/2018
6.71 7/1/2018
6.71 7/1/2018
6.71 7/1/2018
192.5 7/1/2018
36.3 7/1/2018
40.15 7/1/2018
46.242 1/2/2015
38.5 7/1/2018
38.5 7/1/2018
38.5 7/1/2018
38.5 7/1/2018
180.62 7/1/2018
180.62 7/1/2018
28.6 7/1/2018
28.6 7/1/2018
7.7 7/1/2018
7.7 7/1/2018
12.65 7/1/2018
12.65 7/1/2018
12.65 7/1/2018
1.892 12/5/2018
4.62 7/1/2018
69.19 4/24/2019
68.2 7/1/2018
1.452 7/1/2018
132 7/1/2018
18.852 1/2/2015
10.23 7/1/2018
0 7/1/2018
4,180,000 7/1/2018
0 7/1/2018
104.72 7/1/2018
96.697 10/4/2014
87.37 10/3/2014
74.061 10/3/2014
98.262 10/3/2014
91.542 7/1/2018
82.28 7/1/2018
131.54 10/3/2014
50.82 7/1/2018
110.88 7/1/2018
90.09 7/1/2018
171.859 10/3/2014
39.6 7/1/2018
13.2 7/1/2018
13.2 7/1/2018
13.2 7/1/2018
13.2 7/1/2018
278.3 7/1/2018
5.088 7/1/2018
28.6 7/1/2018
7.48 7/1/2018
19,250,000 7/1/2018
15.73 12/9/2019
15.73 7/1/2018
24.2 7/1/2018
14.025 7/1/2018
16.346 7/1/2018
14.025 7/1/2018
14.025 7/1/2018
990 7/1/2018
990 7/1/2018
18,370,000 7/1/2018
17,270,000 7/1/2018
24,640,000 7/1/2018
24,640,000 7/1/2018
8.47 7/1/2018
8.47 7/1/2018
63.8 7/1/2018
66 7/1/2018
154 7/1/2018
55 7/1/2018
6.05 7/1/2018
7,700,000 7/1/2018
385 7/1/2018
4,180,000 7/1/2018
1,100,000 7/1/2018
1,188,000 7/1/2018
99 7/1/2018
10,129,942 11/16/2015
4,244,942 11/16/2015
369.001 7/1/2018
99 7/1/2018
77 7/1/2018
23,540,000 7/1/2018
23,540,000 7/1/2018
16.5 12/24/2018
2.658 2/10/2016
1,622,500 7/1/2018
1,732,500 7/1/2018
20,454,500 7/1/2018
20,672,300 7/1/2018
15,779,500 7/1/2018
16,018,242 2/11/2016
8,800,000 7/1/2018
3,190,000 7/1/2018
6,600,000 7/1/2018
4,180,000 7/1/2018
16,500,000 7/1/2018
110 7/1/2018
561 7/1/2018
8,800,000 7/1/2018
302.5 7/1/2018
1,210,000 7/1/2018
1,100,000 10/17/2016
45.76 10/29/2018
3,025,000 11/4/2016
313.5 7/1/2018
4.813 2/15/2017
2,500,300 7/1/2018
8,800,000 7/1/2018
8,250,990 4/26/2017
25.344 3/8/2017
13.2 3/8/2017
118.8 7/1/2018
8,000,000 5/18/2017
4.813 1/17/2019
3,300,000 7/1/2018
180.62 1/16/2019
6,600,000 10/22/2018
8.8 10/29/2018
8.8 10/29/2018
8.8 10/29/2018
4,015,825 12/14/2018
622.05 2/8/2019
770 2/1/2019
4,015,825 2/13/2019
4,015,825 2/15/2019
55 2/28/2019
55 3/15/2019
1,650,000 5/16/2019
6,050,000 5/17/2019
49.5 8/27/2019
1,075,000 8/28/2019
1,089,000 10/30/2019
1,089,000 10/30/2019
2,200,000 2/17/2020
8,470,000 2/21/2020
1,815,000 2/21/2020
8,300,000 3/3/2020
7,000,000 3/3/2020
2,200,000 3/3/2020
52910000 ALKOHOL SWAB REMEDI (BPJS) 1.617 1.54
52910001 BLOOD SET REMEDI (BPJS) 16.959 16.152
52910002 MASKER 3 PLY GREEN COLOR (BPJS) 5.189 4.942
52910010 SYRINGE 1CC ONEMED (BPJS) 3.198 3.046
52910011 SYRINGE 3CC ONEMED (BPJS) 2.468 2.35
52910012 SYRINGE 5CC ONEMED (BPJS) 2.917 2.778
52910013 SYRINGE 10CC ONEMED (BPJS) 4.907 4.673
52910014 URINE BAG REMEDI (BPJS) 15.371 14.639
52910020 UNDERPAD TOP (BPJS) 9.323 8.879
52910021 NACAL CANNULA NEONATES REMEDI (BPJS) 46.968 44.731
52910023 NASAL CANNULA PAEDIATRIK GEA (BPJS) 21.122 20.116
52910024 IV SET THERAPY NO. 18 POLYMED (BPJS) 40.114 38.204
52910025 IV SET THERAPY NO. 20 POLYMED (BPJS) 40.114 38.204
52910026 IV SET THERAPY NO. 22 POLYMED (BPJS) 41.669 39.685
52910027 IV SET THERAPY NO. 24 POLYMED (BPJS) 40.114 38.204
52910029 HANDSCOON STERIL NO. 6 REMEDI (BPJS) 13.067 12.445
52910030 HANDSCOON STERIL NO. 6,5 REMEDI (BPJS) 13.067 12.445
52910031 HANDSCOON STERIL 7.0 REMEDI (BPJS) 13.72 13.067
52910032 HANDSCOON STERIL NO. 7,5 REMEDI (BPJS) 15.125 14.405
52910033 HANDSCOON STERIL NO. 8.0 REMEDI (BPJS) 14.346 13.663
52910038 MASKER NEBULIZER PEADIATRIK (BPJS) 51.13 48.695
52910039 MASKER NON REBREATING ADULT (BPJS) 45.114 42.966
52910040 MASKER NON REBEATING PEADIATRIK (BPJS) 38.766 38.766
52910041 SUCTION CATHETER 8 BICAKCILAR (BPJS) 22.253 21.193
52910042 SUCTION CATHETER 10 BICAKCILAR (BPJS) 20.936 19.939
52910043 SUCTION CATHETER 12 BICAKCILAR 22.253 21.193
52910044 SUCTION CATHETER 14 BICAKCILAR (BPJS) 25.698 24.474
52910045 SUCTION CATHETER 16 BICAKCILAR (BPJS) 22.253 21.193
52910050 BREATHING CIRCUIT LIMBO 72 (BPJS) 272.592 259.611
52910051 CATHETER MOUNT ALTECH AL-17300 (BPJS) 57.873 55.117
52910052 THERMOVENT HEPA AL- 08022 (BPJS) 72.461 69.01
52910053 TRACHEOSTOMY FILTER WITH OXY TUBING AL 60.115 60.115
52910057 ENDOTRACHEAL TUBE KK NO. 6.0 BICAKCILAR (BPJS) 76.655 73.005
52910058 ENDOTRACHEAL TUBE KK NO. 6.5 BICAKCILAR (BPJS) 76.655 73.005
52910059 ENDOTRACHEAL TUBE KK NO. 7.0 BICAKCILAR (BPJS) 76.655 73.005
52910060 ENDOTRACHEAL TUBE KK NO. 7.5 BICAKCILAR (BPJS) 76.655 73.005
52910061 ENDOTRACHEAL TUBE NKK NO. 7.0 BICAKCILAR 291.476 277.596
52910062 ENDOTRACHEAL TUBE NKK NO. 7.5 BICAKCILAR (BPJS) 291.476 277.596
52910067 GUDEL AIRWAY SIZE 3 L100MM SUMI (BPJS) 58.984 56.175
52910068 GUDEL AIRWAY SIZE 4 L100MM SUMI (BPJS) 58.984 56.175
52910074 RECTAL TUBE NO. 20 BICAKCILAR (BPJS) 22.229 21.17
52910075 RECTAL TUBE NO. 22 BICAKCILAR (BPJS) 22.229 21.17
52910078 STOMACT TUBE NO. 14 BICAKCILAR (BPJS) 30.513 29.06
52910079 STOMACT TUBE NO. 16 BICAKCILAR (BPJS) 30.513 29.06
52910080 STOMACT TUBE NO. 18 BICAKCILAR (BPJS) 30.513 29.06
52910081 SYRINGE 20CC ONEMED (BPJS) 8.418 8.018
52910082 SYRINGE 50CC ONEMED (BPJS) 13.077 12.454
52910092 DISP SUCTION BAG GREEN (BPJS) 109.685 104.462
52910093 DISP SUCTION BAG WHITE (BPJS) 108.115 102.967
52910116 UMBILICAL CORD CLAMP (BPJS) 3.15 3
52910128 WOUND DRAIN 400ML M AXIMED (BPJS) 236.413 225.155
52910136 CUTICELL CLASSIC 10X10CM (BPJS) 22.622 22.622
52910147 SYRINGE 50CC WITH CATHTIP ONEMED (BPJS) 18.578 17.693
52910149 AMAZONIA CRONO STENT BMS (BPJS) 9,548,195 9,093,519
52910150 YANGTZE U BALLON (BPJS) 7,469,233 7,113,555
52910151 AMAZONIA PAX STENT DES (BPJS) 16,529,408 15,742,293
52910152 OPTIME 1 18S40G (GDM) 187.587 178.654
52910153 OPTIME 3/0 18S20K (GDM) 135.376 135.376
52910154 CHROMIC 1 C07358 (GDM) 122.318 122.318
52910155 CHROMIC 3/0 C07202 (GDM) 103.685 103.685
52910156 CHROMIC 2/0 C7250 (GDM) 137.567 137.567
52910157 OPTIME 2/0 18S30G (GDS) 144.726 137.869
52910158 OPTIME R 2/0 12S30AL (GDM) 147.531 140.506
52910159 ADVANTIME 3/0 15D20G (GDM) 184.156 184.156
52910160 SILK 2/0 S25339 (GDM) 92.868 88.446
52910161 COROLENE 4/0 20S15K (GDM) 198.582 189.126
52910162 OPTIME 0 18S35G (GDM) 161.472 153.783
52910163 CAESAREAN SET (OB-213) TRITON 240.603 240.603
52910165 FOL CATH 3 WAY 20 REMEDI (BPJS) 71.479 68.075
52910167 IV CATH PORT NO 18 POLYMED (BPJS) 20.93 19.933
52910168 IV CATH PORT NO 20 POLYMED (BPJS) 20.93 19.933
52910169 IV CATH PORT NO 22 POLIMED (BPJS) 20.93 19.933
52910170 IV CATH PORT NO 24 POLYMED (BPJS) 20.93 19.933
52910171 OMNIPAQUE 300/50ML (BPJS) 497.558 473.865
52910173 WASH GLOVE "EASY CARE" (BPJS) 12.366 11.777
52910174 GUDEL AIRWAY SIZE 2 L 90MM (BPJS) 58.984 56.175
52910175 NASAL CANUL ADULT (BPJS) 14.145 13.471
52910177 XLIMUS DES (BPJS) 26,293,080 25,041,029
52910178 THREE WAY STOP COCK POLYMED (BPJS) 28.256 26.911
52910179 THREE WAY STOP COCK TUBING POLIMED (BPJS) 28.237 26.892
52910184 MASKER NEBULIZER ADULT(BPJS) 51.13 48.695
52910186 FOL CATH 2 WAY NO. 16 CHROMA (BPJS) 25.828 24.598
52910187 IV CATH PORT NO.26 POLIMED (BPJS) 25.885 24.652
52910189 FOL CATH 2 WAY NO 14 (BPJS) 25.828 24.598
52910190 FOL CATH 2 WAY NO 18 (BPJS) 25.828 24.598
52910191 PAKET DIAGNOSTIK FEMORAL MM (BPJS) 1,667,876 1,588,453
52910192 PAKET DIAGNOSTIK RADIAL MM (BPJS) 1,667,970 1,588,543
52910193 PAKET PCI FEMORAL 1 BMS 1 BALLON MM (BPJS) 25,091,370 23,896,543
52910194 PAKET PCI RADIAL 1 BMS 1 BALLON MM (BPJS) 23,579,616 22,456,777
52910195 PAKET PCI FEMORAL 1DES 1 BALLON MM (BPJS) 33,647,171 32,044,925
52910196 PAKET PCI RADIAL 1 DES 1 BALLON (BPJS) 33,647,171 32,044,925
52910197 STOMACT TUBE NO. 16 (BPJS) 20.34 19.371
52910198 STOMACT TUBE NO. 14 (BPJS) 23.036 21.939
52910199 ELEKTROSURGICAL PENCIL EVERSHINE (BPJS) 121.816 116.015
52910200 ALPHAMED MONO GROUNDING PAD ADULT W0/ CABLE(BP 110.949 105.666
52910201 MONO GROUNDING PAD ADULT CABLE (BPJS) 249.549 237.666
52910203 SKIN MARKER FINE TIP WITH RULER (BPJS) 98.968 94.255
52910204 SUCTION CATHETER NO. 8 (BPJS) 20.936 19.939
52910205 PRO KINETIC ENERGY CC STENT (BPJS)MM 10,524,071 10,022,925
52910206 LENSA AURO FLEX SPHERIC ALL SIZE (BPJS) 613.374 584.166
52910207 PANTERA CORONARY BALLON CATH (BPJS)MM 6,151,716 5,858,777
52910208 CONCIERGE GUIDING CATH (BPJS)MM 1,739,499 1,656,666
52910209 BASIC INFLATIN SYRINGE (BPJS)MM 1,635,191 1,557,325
52910212 LENSA AUROLENS PMMA ALL SIZE (BPJS) 162.924 155.166
52910216 PARTNER SIROLIMUS STENT SYSTEM (BPJS) 13,168,925 13,168,925
52910217 HOPER PTCA BALLON (BPJS) 5,518,425 5,518,425
52910220 IOPAMIRO 370/100 (BPJS) 581.875 554.167
52910221 HAND CONTROL ELEKTRO PENCIL INTCO (BPJS) 162.924 155.166
52910222 MONOPOLAR WIRELESS PLATE ADULT INTCO (BPJS) 163.425 155.643
52910223 PAKET PCI FEMORAL TANPA WIRE MM(BPJS) 32,151,000 30,620,000
52910224 PAKET PCI RADIAL TANPA WIRE MM(BPJS) 34,610,333 32,962,222
52910225 NASAL CANUL NEONATE (BPJS) 23.402 22.288
52910226 APRON FILM (BPJS) 3.455 3.455
52910227 PAKET DIAGNOSTIK FEMORAL BPJS (REKA) 2,228,284 2,122,175
52910228 PAKET DIAGNOSTIK RADIAL BPJS (REKA) 2,735,687 2,605,416
52910229 PAKET PCI FEMORAL DES BPJS (REKA) 27,926,458 26,596,627
52910230 PAKET PCI RADIAL DES BPJS (REKA) 28,231,261 26,886,915
52910231 PAKET PCI FEMORAL BMS BPJS (REKA) 24,859,712 23,675,916
52910232 PAKET PCI RADIAL BMS BPJS (REKA) 20,823,715 20,823,715
52910233 STENT BIOMATRIX "BIOSENSOR" (BPJS) 21,034,571 20,032,925
52910235 ADMIRAL EXTREME BALLON (BPJS) 5,031,249 4,791,666
52910237 PTCA STENT BMS (BPJS) 10,401,999 9,906,666
52910238 PANTERA LEO NC (BPJS) 5,711,766 5,439,777
52910244 PAKET PCI FEMORAL BMS TANPA WIRE (BPJS) 25,994,499 24,756,666
52910245 MONOPOLAR PLATE WITH CABLE (BPJS) 156.216 148.777
52910246 XOLMETRAS 350/100 ML (BPJS) 794.595 756.757
52910249 PAKET AMAZONIA SIR+YANGTZE U (BPJS) 15,012,611 14,309,153
52910253 XOLMETROS 300/50 ML (BPJS) 414.566 394.825
52910254 PAKET DIAGNOSTIK RADIAL BISAWI (BPJS) 1,657,716 1,578,777
52910255 PAKET DIAGNOSTIK FEMORAL BISAWI (BPJS) 1,445,751 1,445,751
52910257 FOL CATH 2 WAY NO 8 CHROMA (BPJS) 68.824 65.546
52910258 ACROSS CTO 3,948,043 3,948,043
52910261 LUMBAL CORSET (OXY SPINE) BPJS 500.762 476.916
52910264 WASH GLOVE PRO PRODEVICE 9.539 9.539
52910265 BALLON MOZEC (BPJS) TAM 3,426,699 3,263,523
52910266 PAKET TINDAKAN PCI DES BIOMIME (BPJS) TAM 13,866,999 13,206,666
52910267 PAKET TINDAKAN PCI BMS NEXGEN (BPJS) TAM 10,735,648 10,735,648
52910269 ETT NO. 6.5 CANACK (BPJS) 46.08 46.08
52910274 EXTENTION TUBE 150CM (BPJS) 17.423 17.423
52910275 WOUND DRAIN 200ML NO 10 (BPJS) 187.81 178.867
52910282 PAKET PCI BMS ARCHITECT (BPJS) 10,409,361 10,409,361
52910284 OCTENIC BODY WASH (B4) 9.45 9
52910294 BALLON CATHETER EUCA VI 4,514,329 4,299,361
52910297 ENDOTRACHEAL TUBE NKK 4.0 BICAKCILAR (BPJS) 252.885 240.843
52910305 STENT BIOMATRIX ALPHA DES (BPJS) 9,015,339 8,586,037
52910308 HANDSCOON STERIL PD GLOVES NO.7 12.139 11.561
52910309 HANDSCOON STERIL PD GLOVES NO. 7.5 12.139 11.561
52910310 HANDSCOON STERIL PD GLOVES NO. 6.5 12.139 11.561
52910311 DOUBLE LUMEN POLINDROM VK 14,5X19CM 5,229,934 5,229,934
52910312 UNIVERSAL DRAPE TARAFIS (BPJS) 855.437 814.702
52910313 HD CATH CURVE SORTTERM MEDICATH KITS 1,057,389 1,007,037
52910314 DOUBLE LUMEN POLINDROM UL 14.5F X 33CM 5,490,397 5,228,950
52910315 DOUBLE LUMEN POLINDROME UK 14.5F X28CM 5,487,940 5,226,610
52910316 PENCIL CUTTER CARELUCK 81.414 77.537
52910317 PENCIL HARUM PEN (XY-P401-2) 75.392 71.802
52910318 EXPERIENCE BALLON " IVASCULAR" (BPJS) 2,258,589 2,151,037
52910319 ENVIROS DES STENT "IVASCULAR" (BPJS) 8,264,589 7,871,037
52910320 ELEKTROSURGERY PENCIL HEMIPEN 67.884 64.652
52910321 PAKET INDEFLATOR BBRAUN 1,473,714 1,403,537
52910322 PAKET CAG (DIAGNOSTIK) FEMORAL "MERIT" 1,492,824 1,421,737
52910323 PAKET CAG (DIAGNOSTIK) RADIAL "MERIT" 1,492,824 1,421,737
52910325 BALLON "POWERLINE" (BPJS) 3,009,339 2,866,037
52910326 STENT GENOSS DES "GENOSS" 11,567,889 11,017,037
52910327 BALLON GENOSS/ GENOSS NC "GENOSS" 2,483,814 2,365,537
52910328 PAKET PCI COROFLEX DES (BPJS) 11,335,839 10,796,037
52910329 STENT COROFLEX ALL SIZE (BPJS) 9,561,339 9,106,037
52910330 BALLON SEQUENT NEO ALL SIZE (BPJS) 3,009,339 2,866,037
220 4/17/2020
12.672 9/23/2019
3.601 4/16/2020
781 4/17/2020
770 7/1/2018
825 4/17/2020
1.21 4/17/2020
4.95 7/1/2018
3.245 7/1/2018
24.75 7/1/2018
7.7 7/1/2018
19.877 7/1/2018
16.625 7/1/2018
16.625 7/1/2018
19.877 7/1/2018
6.138 7/1/2018
5.5 7/1/2018
5.5 7/1/2018
5.5 7/1/2018
9.02 7/1/2018
24.2 7/1/2018
24.2 7/1/2018
35.242 1/2/2015
6.71 7/1/2018
6.05 7/1/2018
6.71 7/1/2018
6.71 7/1/2018
6.71 7/1/2018
192.5 7/1/2018
36.3 7/1/2018
40.15 7/1/2018
46.242 1/2/2015
38.5 7/1/2018
38.5 7/1/2018
38.5 7/1/2018
38.5 7/1/2018
180.62 7/1/2018
180.62 7/1/2018
28.6 7/1/2018
28.6 7/1/2018
7.7 7/1/2018
7.7 7/1/2018
12.65 7/1/2018
12.65 7/1/2018
12.65 7/1/2018
1.892 12/5/2018
4.62 7/1/2018
69.19 4/24/2019
68.2 7/1/2018
1.452 7/1/2018
132 7/1/2018
18.852 1/2/2015
10.23 7/1/2018
0 7/1/2018
4,180,000 7/1/2018
0 7/1/2018
104.72 7/1/2018
96.697 10/4/2014
87.37 10/3/2014
74.061 10/3/2014
98.262 10/3/2014
91.542 7/1/2018
82.28 7/1/2018
131.54 10/3/2014
50.82 7/1/2018
110.88 7/1/2018
90.09 7/1/2018
171.859 10/3/2014
39.6 7/1/2018
13.2 7/1/2018
13.2 7/1/2018
13.2 7/1/2018
13.2 7/1/2018
278.3 7/1/2018
5.088 7/1/2018
28.6 7/1/2018
7.48 7/1/2018
19,250,000 7/1/2018
15.73 12/9/2019
15.73 7/1/2018
24.2 7/1/2018
14.025 7/1/2018
16.346 7/1/2018
14.025 7/1/2018
14.025 7/1/2018
990 7/1/2018
990 7/1/2018
18,370,000 7/1/2018
17,270,000 7/1/2018
24,640,000 7/1/2018
24,640,000 7/1/2018
8.47 7/1/2018
8.47 7/1/2018
63.8 7/1/2018
66 7/1/2018
154 7/1/2018
55 7/1/2018
6.05 7/1/2018
7,700,000 7/1/2018
385 7/1/2018
4,180,000 7/1/2018
1,100,000 7/1/2018
1,188,000 7/1/2018
99 7/1/2018
10,129,942 11/16/2015
4,244,942 11/16/2015
369.001 7/1/2018
99 7/1/2018
77 7/1/2018
23,540,000 7/1/2018
23,540,000 7/1/2018
16.5 12/24/2018
2.658 2/10/2016
1,622,500 7/1/2018
1,732,500 7/1/2018
20,454,500 7/1/2018
20,672,300 7/1/2018
15,779,500 7/1/2018
16,018,242 2/11/2016
8,800,000 7/1/2018
3,190,000 7/1/2018
6,600,000 7/1/2018
4,180,000 7/1/2018
16,500,000 7/1/2018
110 7/1/2018
561 7/1/2018
8,800,000 7/1/2018
302.5 7/1/2018
1,210,000 7/1/2018
1,100,000 10/17/2016
45.76 10/29/2018
3,025,000 11/4/2016
313.5 7/1/2018
4.813 2/15/2017
2,500,300 7/1/2018
8,800,000 7/1/2018
8,250,990 4/26/2017
25.344 3/8/2017
13.2 3/8/2017
118.8 7/1/2018
8,000,000 5/18/2017
4.813 1/17/2019
3,300,000 7/1/2018
180.62 1/16/2019
6,600,000 10/22/2018
8.8 10/29/2018
8.8 10/29/2018
8.8 10/29/2018
4,015,825 12/14/2018
622.05 2/8/2019
770 2/1/2019
4,015,825 2/13/2019
4,015,825 2/15/2019
55 2/28/2019
55 3/15/2019
1,650,000 5/16/2019
6,050,000 5/17/2019
49.5 8/27/2019
1,075,000 8/28/2019
1,089,000 10/30/2019
1,089,000 10/30/2019
2,200,000 2/17/2020
8,470,000 2/21/2020
1,815,000 2/21/2020
8,300,000 3/3/2020
7,000,000 3/3/2020
2,200,000 3/3/2020
ISI/ BOX FAKTUR / BX
HNA

51190001 PARACETAMOL BERN SYR 60ML INH


51190002 PARACETAMOL BERN TAB 500MG INH 1
51190003 ANTALGIN BERN TAB 500MG INH
51190004 KETOROLAC BERN TAB 10MG INH 30
51190005 ASAM MEFENAMAT BERN TAB 500MG INH 100
51190006 SIMVASTATIN BERN TAB 20MG INH 100
51190007 METHYLPREDNISOLON BERN TAB 4MG INH 100
51190008 METHYLPREDNISOLON BERN TAB 8MG INH 100
51190009 DEKSAMETHASONE BERN TAB 0.5MG INH 100
51190010 METFORMIN BERN TAB 850MG INH 100
51190011 METFORMIN BERN TAB 500MG INH 100
51190012 RIFAMPICIN BERN TAB 600MG INH 100
51190013 RIFAMPICIN BERN TAB 450MG INH 100
51190014 CEFADROXIL BERN KAPS 500MG INH 100
51190015 CIPROFLOXACIN BERN TAB 500MG INH 100
51190016 AMOKSISILLIN BERN TAB 500MG INH 100
51190017 LORATADINE 10 BERN TAB 10MG INH 100
51190018 ALLOPURINOL 300MG TAB BERN INH 100
51190019 NATRIUM DIKLOFENAK BERN TAB 50MG INH 100
51190020 EPERISONE HCI 50MG NOVE INH 100
51190021 AMBROXOL 30MG NOVE INH 100
51190022 URSODEOXYCHOLIC ACID 250MG NOVE INH 30
51190023 OMEPRAZOLE 20MG NOVE INH 30
51190024 LANSOPRAZOLE 30MG NOVE INH 20
51190025 ATORVASTATIN 20MG NOVE INH 30
51190026 VALSARTAN 160MG NOVE INH 30
51190027 VALSARTAN 80MG NOVE INH 30
51190028 CANDESARTAN 16MG NOVE INH 30
51190029 CANDESARTAN 8MG NOVE INH 30
51190030 BISOPROLOL 5 MG INH 100
51190031 RAMIPRIL 10 MG TAB INH 100
51190033 METHYLPREDNISOLONE 16MG NOVE INH 100
51190034 CLONIDIN 0,15MG INH 100
51190035 GLIMEPIRID 4 MG KIFA INH 50
51190036 GLIMEPIRID 3MG KIFA INH 50
51190037 GLIMEPIRID 2MG KIFA INH 50
51190038 GLIMEPIRID 1MG KIFA INH 50
51190039 PYRAZINAMID 500MG KIFA INH 100
51190040 ISONIAZID 300MG KIFA INH 100
51190041 VITAMIN C 100MG KIFA INH 100
51190042 SALBUTAMOL 4MG KIFA 2MG INH 100
51190043 SIMVASTATIN TAB 10MG KIFA INH 100
51190044 FUROSEMID 40MG KIFA INH 200
51190045 ALLOPURINOL 100MG INH 100
51190046 NATRIUM DIKLOFENAK 25 MG TSE KIFA INH 50
51190057 BETAHISTINE 6MG NOVE TAB INH 30
51190058 CEFIXIME 200MG NOVE KAPS INH 50
51190059 CLINDAMYCIN 150MG NOVE TAB 50
51190061 AZITHROMYCIN 500MG NOVE TAB INH 20
51190062 PREGABALIN 75MG NOVE KAPS INH 14
51190063 GABAPENTIN 300MG NOVE KAPS INH 100
51190064 CETIRIZINE 10MG NOVE TAB INH 50
51190065 MELOXICAM 15MG NOVE TAB INH 50
51190066 MELOXICAM 7,5MG NOVE TAB INH 50
51190067 LEVOFLOXACIN NOVE TAB 500MG INH 50
51190069 CLOPIDOGREL IKAP TAB 75MG INH 30
51190071 ONDANSENTRON 4MG INJ MBFA 2MG/ML INH 10
51190072 NOREPINEPHRINE BERN 4MG INJ INH 5
51190073 IMIPENEM CILASTATIN BERN 1G VIAL INH 1
51190075 CEFTRIAXONE 1G INJ BERN INH 1
51190078 MEROPENEM 1G BERN INH 1
51190081 PROSOGAN TAKE 30MG INH 1
51190082 ESOFER 40MG FERR INH 1
51190087 ACARBOSE TAB 100MG PRAT INH 100
51190088 SIMARC TAB 2MG PRAT INH 100
51190089 INVICLOT INH 5
51190090 RECOLFAR TAB INH 30
51190091 ASERING OTSU KOMB INH 20
51190092 OTSU NS 500ML 0,9% INH 20
51190093 OTSU D5 500ML 5% GLUCOSE INH 20
51190094 OTSU RL 500ML INH 20
51190095 OTSU MANITOL 20% 500ML INH 20
51190096 OTSU MANITOL 20% 250ML INH 1
51190097 PANTOPRAZOL INJ 40MG MBFA INH 10
51190098 OMEPRAZOLE INJ 40MG MBFA INH 10
51190099 METILPREDNISOLON INJ 125GR MBFA INH 1
51190100 PANTOPRAZOLE TAB 40MG MBFA INH 10
51190101 KALNEX INJ 100MG/ML INH 10
51190103 NEVOX XR TAB 500MG KALB INH 30
51190104 NEPATIC KAPS 300MG DANK INH 50
51190105 V-BLOC TAB 6,25MG INH 30
51190106 V-BLOC TAB 25MG INH 30
51190107 KALNEX TAB 500MG KALB INH 100
51190108 VEISTEIN 175MG/5ML 60ML INH 1
51190109 VEISTEIN 200MG KAPS KALB INH 20
51190110 PROVELYN KAPS 75MG KALB INH 14
51190111 PROVELYN KAPS 150MG KALB INH 14
51190112 FUROSEMIDE 10MG INJ INFA INF 25
51190113 GENTAMICIN INJ 40MG/ML INFA INH 5
51190119 ACETYLCYSTEIN TAB 200MG INFA INH 60
51190120 ONDANSENTRON TAB 8MG INFA INH 12
51190121 ONDANSENTRON TAB 4MG INFA INH 12
51190124 CAPTOPRIL TAB 12,5MG INH 100
51190125 ISOSORBIDE DINITRAT TAB 5MG INFA INH 100
51190129 PARACETAMOL 120MG/5ML INFA 1
51190131 SERETIDE DISKUS 500MCG GLAX INH 1
51190132 SERETIDE DISKUS 250MCG GLAX INH 1
51190133 FLIXOTIDE NEBULES 0,5MCG GLAX INH 20
51190134 AVAMYS 27,5MCG GLAX INH 1
51190135 SYMBICORT TURB 80 ASCA KOMP INH 1
51190136 SYMBICORT TURB 160 ASCA KOMB INH 1
51190137 PULMICORT RESP 0,5MG/ML ASCA INH 20
51190138 PULMICORT RESP 0,25MG/ML ASCA INH 20
51190139 CRESTOR TAB 20MG ASCA INH 28
51190140 CRESTOR TAB 10MG ASCA INH 28
51190141 BRILINTA TAB 90MG INH 56
51190143 DORNER TAB 20MCG INH 30
51190144 HARNAL OCAS TAB 0,4MG ASTE INH 30
51190145 MALTOFER CHEW TAB 100MG COMB INH 30
51190146 DEPAKOTE ER TAB 500MG INH 100
51190147 BETASERC TAB 8MG ABBT INH 100
51190148 HARNAL D TAB 0,2MG ASTE INH 28
51190149 BETASER TAB 24MG ABBT INH 20
51190152 ULSAFATE 500MG/5ML COMB INH 1
51190154 NEW DIATABS 600MG TAB INH 100
51190155 ASPILETS CHEWABLE TAB 80MG INH 100
51190156 CEDOCARD TAB 10MG INH 60
51190157 GRISEOFULVIN TAB 500MG DAVA INH 100
51190162 AMLODIPIN BESYLAT 5MG TAB LAND INH 30
51190166 KSR 600MG TAB MERC INH 100
51190175 NOVORAPID FLEXPEN 100UI/ML NOVO INH 5
51190179 CORDARONE 150MG INJ INH 6
51190181 LOVENOX 40MG AVEN INH 2
51190182 LOVENOX 60MG AVEN INH 2
51190183 BRICASMA INJ 0,5MG/ML INH 10
51190184 DIAMICRON MR 60MG TAB INH 30
51190188 FUTROLIT INH 24
51190189 SAGESTAM 40MG/ML INJ SANB INH 5
51190191 SANMOL INFUS 10MG/ML SANB INH 1
51190192 ELKANA KOMB SYRUP INH 1
51190203 TREMENZA TAB SANB INH 100
51190206 LEVOFLOXACIN 500MG/ 100ML INFUS INH 1
51190208 DEXKETOPROFEN 50MG INJ INH 5
51190217 STARFOLAT 0,4MG TAB DEXA INH 50
51190239 RHINOS SR DEXA INH 50
51190242 DUVADILAN TAB 20MG KIFA INH 60
51190243 CHLORAMPHENICOL SALEP MATA 1% INH 1
51190244 DIAZINK 20MG TAB INH 100
51190246 HIDROKORTISON ASETAT 2,5% KIFA INH 24
51190247 BETASON 0,1% INH 1
51190248 BETAMETASON 0,1% INH 25
51190249 MICONAZOL 2% KIFA INH 24
51190250 PROPRANOLOL 40MG KIFA TAB INH 100
51190251 DILTIAZEM 30MG TAB INH 100
51190253 HIDROKLOROTIAZID 25MG TAB KIFA INH 100
51190255 ASIKLOVIR 400MG TAB KIFA INH 100
51190256 PIROXICAM 10MG TAB KIFA INH 100
51190257 PIROXICAM 20MG TAB KIFA INH 100
51190259 ACARBOSE 50MG TAB PRAT INH 100
51190260 CILOSTAZOL 100MG TAB INH 100
51190265 ETHAMBUTOL 500MG TAB BERN INH 100
51190266 CEFADROXIL 250MG/5ML INH 1
51190269 CEFIXIME 100MG CAP HEXP INH 1
51190270 RANITIDINE HCI 150MG TAB HEXP INH 100
51190271 DOMPERIDONE 5ML (SYRUP) HEXP INH 1
51190273 FENOFIBRATE 100MG HEXP INH 30
51190274 CEFIXIME TRIHYDRATE 100MG/5ML 1
51190275 BINTAMOX 500MG HEXP INH 100
51190276 DICLOFENAC POTASSIUM 50MG TAB HEXP INH 50
51190277 DAPYRIN 500MG TAB HEXP INH 200
51190278 DAPYRIN 125MG/5ML (SYRUP) HEXP INH 1
51190279 BINTAMOX 125MG/5ML INH 1
51190281 METHYLPREDNISOLON INJ INH 1
51190282 KETOROLAC BERN 10MG/ML INJ INH 10
51190283 ONDANSENTRON 2MG/2ML INJ INH 10
51190285 RANITIDINE INJ HEXP 25MG/ML INH 10
51190286 CLANEKSI 500MG KAPL INH 30
51190287 NEUROSANBE INJ INH 10
51190289 BISACODYL 5MG TAB INH 30
51190290 ATORVASTATIN 40MG TAB INH 30
51190291 DOMPERIDONE TABLET INH 100
51190292 PLANTACID FORTE SYR INH 1
51190293 LANTUS SOLOSTAR PEN INH 5
51190294 METRONIDAZOL INFUS 100ML INH 1
51190295 EZELIN INH 1
51190296 VENTOLIN NEBU INH 1
51190297 MUCOSTA TAB INH 100
51190300 ETORVEL TABLET 120MG INH 30
51190301 ETORVEL TABLET 90MG INH 30
51190302 RAMIPRIL 5MG TAB INH 100
51190303 EPODION 2000IU INH 6
51190307 SANMOL TAB INH 100
51190308 OTSU NS 100ML INH 1
51190309 ELKANA TAB INH 100
51190310 NEUROSANBE TAB INH 100
51190311 BREATHY NASAL SPRAY INH 1
51190312 EPODION 3000IU INH 6
51190313 ALBUMINAR 25% 100ML INH 1
51190314 FLUCONAZOL IV INH 1
51190315 MIKAJECT INJ 250MG/2ML INH 1
51190316 MIKACIN INJ 500MG/2ML INH 1
51190317 OTSU WATER 25ML INH 1
51190318 DEPAKENE 250MG/ML SYR INH 1
51190319 FLUIMUCIL INJ INH 5
51190320 CALOS KAPSUL 500MG INH 60
51190321 ARICEF 5MG INJ INH 28
51190322 AMLODIPIN 10MG TAB INH
FAKTUR SATUAN FAKTUR 4,444
HNA HNA +PPN COST TOTAL COST
SATUAN NEW
#DIV/0! #DIV/0! #DIV/0! #DIV/0!
118 129.8 4,444 4,574
0 0 #DIV/0! #DIV/0!
1,380 1518 148 1,666
214 235.4 44 280
430 473 44 517
182 200.2 44 245
400 440 44 484
84 92.4 44 137
0 0 44 44
136 149.6 44 194
2,000 2200 44 2,244
0 0 44 44
550 605 44 649
409 449.9 44 494
315 346.5 44 391
182 200.2 44 245
327 359.7 44 404
0 0 44 44
1,190 1309 44 1,353
182 200.2 44 245
3,360 3696 148 3,844
267 293.7 148 442
514 565.4 222 788
2,182 2400.2 148 2,548
6,500 7150 148 7,298
4,000 4400 148 4,548
3,573 3930.3 148 4,078
2,473 2720.3 148 2,868
500 550 44 594
965 1061.5 44 1,106
941 1035.1 44 1,080
167 183.7 44 228
809 889.9 89 979
591 650.1 89 739
400 440 89 529
257 282.7 89 372
318 349.8 44 394
182 200.2 44 245
100 110 44 154
78 85.8 44 130
173 190.3 44 235
100 110 22 132
147 161.7 44 206
295 324.5 89 413
455 500.5 148 649
2,273 2500.3 89 2,589
724 796.4 89 885
9,000 9900 222 10,122
4,750 5225 317 5,542
4,410 4851 44 4,895
167 183.7 89 273
335 368.5 89 457
255 280.5 89 369
1,049 1153.9 89 1,243
2,700 2970 148 3,118
4,818 5299.8 444 5,744
48,000 52800 889 53,689
159,091 175000.1 4,444 179,444
8,182 9000.2 4,444 13,444
54,545 59999.5 4,444 64,444
109,091 120000.1 4,444 124,444
80,910 89001 4,444 93,445
1,738 1911.8 44 1,956
1,050 1155 44 1,199
63,000 69300 889 70,189
4,700 5170 148 5,318
17,500 19250 222 19,472
9,000 9900 222 10,122
9,000 9900 222 10,122
9,000 9900 222 10,122
63,636 69999.6 222 70,222
36,364 40000.4 4,444 44,444
26,364 29000.4 444 29,445
20,000 22000 444 22,444
18,182 20000.2 4,444 24,444
10,000 11000 444 11,444
8,000 8800 444 9,244
1,180 1298 148 1,446
3,364 3700.4 89 3,789
1,817 1998.7 148 2,147
4,544 4998.4 148 5,147
1,727 1899.7 44 1,944
24,273 26700.3 4,444 31,144
2,500 2750 222 2,972
6,318 6949.8 317 7,267
8,591 9450.1 317 9,768
1,871 2058.1 178 2,236
3,087 3395.7 889 4,285
800 880 74 954
1,126 1238.6 370 1,609
700 770 370 1,140
99 108.9 44 153
150 165 44 209
2,800 3080 4,444 7,524
160,950 177045 4,444 181,489
168,182 185000.2 4,444 189,444
17,052 18757.2 222 18,979
123,480 135828 4,444 140,272
138,182 152000.2 4,444 156,444
190,909 209999.9 4,444 214,444
15,909 17499.9 222 17,722
11,818 12999.8 222 13,222
7,273 8000.3 159 8,159
6,364 7000.4 159 7,159
12,727 13999.7 79 14,079
4,909 5399.9 148 5,548
13,899 15288.9 148 15,437
2,438 2681.8 148 2,830
7,494 8243.4 44 8,288
3,035 3338.5 44 3,383
10,000 11000 159 11,159
8,260 9086 222 9,308
25,080 27588 4,444 32,032
432 475.2 44 520
400 440 44 484
1,318 1449.8 74 1,524
1,273 1400.3 44 1,445
160 176 148 324
2,582 2840.2 44 2,885
160,447 176491.7 889 177,381
23,546 25900.6 741 26,641
107,273 118000.3 2,222 120,222
150,000 165000 2,222 167,222
15,455 17000.5 444 17,445
5,670 6237 148 6,385
40,909 44999.9 185 45,185
9,091 10000.1 889 10,889
40,002 44002.2 4,444 48,446
20,000 22000 4,444 26,444
900 990 44 1,034
40,000 44000 4,444 48,444
18,400 20240 889 21,129
200 220 89 309
4,607 5067.7 89 5,157
4,091 4500.1 74 4,574
2,910 3201 4,444 7,645
436 479.6 44 524
3,000 3300 185 3,485
2,545 2799.5 4,444 7,244
1,818 1999.8 178 2,178
3,104 3414.4 185 3,600
241 265.1 44 310
158 173.8 44 218
135 148.5 44 193
600 660 44 704
100 110 44 154
108 118.8 44 163
996 1095.6 44 1,140
7,125 7837.5 44 7,882
500 550 44 594
11,250 12375 4,444 16,819
891 980.1 4,444 5,424
145 159.5 44 204
6,800 7480 4,444 11,924
1,255 1380.5 148 1,529
10,727 11799.7 4,444 16,244
382 420.2 44 465
245 269.5 89 358
164 180.4 22 203
4,182 4600.2 4,444 9,044
5,455 6000.5 4,444 10,445
18,181 19999.1 4,444 24,443
1,796 1975.6 444 2,420
3,000 3300 444 3,744
1,300 1430 444 1,874
7,000 7700 148 7,848
4,970 5467 444 5,911
288 316.8 148 465
3,400 3740 148 3,888
164 180.4 44 225
21,600 23760 4,444 28,204
129,091 142000.1 889 142,889
7,500 8250 4,444 12,694
81,818 89999.8 4,444 94,444
8,727 9599.7 4,444 14,044
3,227 3549.7 44 3,594
6,639 7302.9 148 7,451
4,546 5000.6 148 5,149
518 569.8 44 614
88,632 97495.2 741 98,236
238 261.8 44 306
10,000 11000 4,444 15,444
646 710.6 44 755
867 953.7 44 998
50,000 55000 4,444 59,444
95,437 104980.7 741 105,721
1,480,000 1628000 4,444 1,632,444
52,500 57750 4,444 62,194
45,000 49500 4,444 53,944
82,727 90999.7 4,444 95,444
5,400 5940 4,444 10,384
90,646 99710.6 4,444 104,155
24,090 26499 889 27,388
875 962.5 74 1,037
0 0 159 159
0 0 #DIV/0! #DIV/0!
30%
MARGIN HET MARGIN
50% 70%
#DIV/0! #DIV/0! #DIV/0!
5,946 6,861 7,775
#DIV/0! #DIV/0! #DIV/0!
2,166 2,499 2,832
364 420 476
673 776 880
318 367 416
630 727 824
178 205 233
58 67 76
252 291 330
2,918 3,367 3,816
58 67 76
844 974 1,104
643 742 840
508 586 665
318 367 416
525 606 687
58 67 76
1,759 2,030 2,301
318 367 416
4,997 5,766 6,535
574 663 751
1,024 1,181 1,339
3,313 3,823 4,332
9,488 10,947 12,407
5,913 6,822 7,732
5,302 6,118 6,933
3,729 4,303 4,876
773 892 1,011
1,438 1,659 1,880
1,403 1,619 1,835
297 342 388
1,272 1,468 1,664
961 1,108 1,256
688 793 899
483 557 632
513 591 670
318 367 416
201 232 263
169 195 221
305 352 399
172 198 225
268 309 350
537 620 703
843 973 1,103
3,366 3,884 4,402
1,151 1,328 1,505
13,159 15,183 17,208
7,205 8,314 9,422
6,364 7,343 8,322
354 409 463
595 686 778
480 554 628
1,616 1,864 2,113
4,054 4,677 5,301
7,467 8,616 9,765
69,795 80,533 91,271
233,277 269,166 305,055
17,477 20,166 22,855
83,777 96,665 109,554
161,777 186,666 211,555
121,479 140,168 158,857
2,543 2,934 3,326
1,559 1,799 2,039
91,245 105,283 119,321
6,914 7,977 9,041
25,314 29,208 33,103
13,159 15,183 17,208
13,159 15,183 17,208
13,159 15,183 17,208
91,288 105,333 119,377
57,778 66,667 75,555
38,278 44,167 50,056
29,178 33,667 38,155
31,777 36,666 41,555
14,878 17,167 19,455
12,018 13,867 15,715
1,880 2,169 2,458
4,926 5,684 6,442
2,791 3,220 3,650
6,690 7,720 8,749
2,527 2,916 3,305
40,488 46,716 52,945
3,864 4,458 5,053
9,447 10,901 12,354
12,698 14,651 16,605
2,907 3,354 3,801
5,570 6,427 7,284
1,240 1,431 1,622
2,092 2,413 2,735
1,482 1,711 1,939
199 230 261
272 314 356
9,781 11,286 12,791
235,936 272,234 308,531
246,277 284,166 322,055
24,673 28,469 32,265
182,354 210,408 238,462
203,377 234,666 265,955
278,777 321,666 364,555
23,039 26,583 30,128
17,189 19,833 22,477
10,607 12,239 13,870
9,307 10,739 12,170
18,303 21,119 23,934
7,212 8,322 9,432
20,068 23,156 26,243
3,679 4,245 4,811
10,774 12,432 14,089
4,398 5,074 5,751
14,506 16,738 18,970
12,101 13,962 15,824
41,642 48,048 54,454
676 779 883
630 727 824
1,981 2,286 2,591
1,878 2,167 2,456
421 486 551
3,750 4,327 4,904
230,595 266,071 301,547
34,634 39,962 45,290
156,289 180,333 204,378
217,389 250,833 284,277
22,678 26,167 29,656
8,301 9,578 10,855
58,741 67,778 76,815
14,156 16,333 18,511
62,980 72,669 82,359
34,377 39,666 44,955
1,345 1,552 1,759
62,977 72,666 82,355
27,467 31,693 35,919
402 463 525
6,704 7,735 8,766
5,946 6,861 7,776
9,939 11,468 12,997
681 786 891
4,531 5,228 5,925
9,417 10,865 12,314
2,831 3,266 3,702
4,679 5,399 6,119
402 464 526
284 327 371
251 289 328
916 1,057 1,198
201 232 263
212 245 278
1,482 1,710 1,938
10,247 11,823 13,399
773 892 1,011
21,865 25,229 28,592
7,051 8,136 9,221
265 306 347
15,501 17,886 20,271
1,987 2,293 2,599
21,117 24,366 27,614
604 697 790
466 538 609
263 304 344
11,757 13,566 15,375
13,578 15,667 17,756
31,776 36,665 41,553
3,146 3,630 4,114
4,868 5,617 6,365
2,437 2,812 3,186
10,203 11,772 13,342
7,685 8,867 10,049
604 697 790
5,055 5,832 6,610
292 337 382
36,665 42,306 47,947
185,756 214,333 242,911
16,502 19,041 21,580
122,777 141,666 160,554
18,257 21,066 23,874
4,672 5,391 6,110
9,686 11,177 12,667
6,693 7,723 8,753
799 921 1,044
127,707 147,354 167,001
398 459 521
20,077 23,166 26,255
982 1,133 1,284
1,298 1,497 1,697
77,277 89,166 101,055
137,438 158,582 179,726
2,122,177 2,448,666 2,775,155
80,852 93,291 105,730
70,127 80,916 91,705
124,077 143,166 162,254
13,499 15,576 17,653
135,401 156,232 177,063
35,604 41,082 46,559
1,348 1,555 1,762
206 238 270
#DIV/0! #DIV/0! #DIV/0!
5.459 5.199 4 6/18/2019
177 169 130 6/20/2019
210 200 154 6/18/2019
2.072 1.973 1.518 6/18/2019
243 231 178 6/18/2019
646 615 473 6/18/2019
410 390 300 6/18/2019
642 611 470 6/18/2019
126 120 92 6/18/2019
410 390 300 6/18/2019
205 195 150 6/18/2019
3.041 2.896 2.228 6/18/2019
2.048 1.95 1.5 6/18/2019
826 787 605 6/18/2019
614 585 450 6/18/2019
475 450 346 6/18/2019
273 260 200 6/18/2019
450 429 330 6/18/2019
218 208 160 6/18/2019
2.312 2.202 1.694 7/23/2019
288 275 211 8/23/2019
5.045 4.805 3.696 12/10/2019
557 531 408 7/23/2019
1.845 1.757 1.351 8/1/2019
3.685 3.51 2.7 8/23/2019
9.76 9.295 7.15 12/9/2019
6.006 5.72 4.4 12/9/2019
9.76 9.295 7.15 8/1/2019
6.757 6.435 4.95 8/1/2019
944 899 692 11/22/2019
1.45 1.381 1.062 11/22/2019
1.413 1.346 1.035 9/16/2019
251 239 184 12/24/2019
1.215 1.157 890 8/23/2019
887 845 650 8/23/2019
601 572 440 8/23/2019
386 368 283 8/23/2019
478 455 350 4/3/2020
273 260 200 4/3/2020
151 144 110 4/3/2020
117 112 86 2/3/2020
259 247 190 4/3/2020
150 143 110 10/7/2019
212 202 155 12/26/2019
444 423 325 7/24/2019
1.261 1.201 924 12/16/2019
3.441 3.277 2.521 11/27/2019
1.087 1.035 796 12/26/2019
13.514 12.87 9.9 11/28/2019
7.132 6.793 5.225 4/3/2020
6.622 6.306 4.851 12/27/2019
526 501 385 10/8/2019
1.637 1.559 1.199 8/22/2019
944 899 692 8/22/2019
1.575 1.5 1.154 8/1/2019
4.092 3.897 2.998 8/23/2019
7.508 7.15 5.5 8/20/2019
72.072 68.64 52.8 10/8/2019
238.875 227.5 175 10/8/2019
15.766 15.015 11.55 7/11/2019
95.823 91.26 70.2 10/8/2019
163.8 156 120 3/12/2020
121.486 115.701 89.001 10/7/2019
2.413 2.298 1.768 10/7/2019
1.577 1.502 1.155 4/29/2020
94.595 90.09 69.3 3/27/2020
7.057 6.721 5.17 3/27/2020
25.901 24.668 18.975 8/23/2019
15.015 14.3 11 8/23/2019
15.015 14.3 11 8/23/2019
13.514 12.87 9.9 8/23/2019
86.863 82.727 63.636 8/21/2019
54.601 52.001 40 8/21/2019
40.268 38.35 29.5 8/21/2019
30.03 28.6 22 8/21/2019
27.3 26 20 8/21/2019
10.92 10.4 8 8/21/2019
12.012 11.44 8.8 10/23/2019
1.722 1.687 1.298 10/23/2019
5.051 4.81 3.7 10/23/2019
2.729 2.599 1.999 10/23/2019
6.823 6.499 4.999 10/23/2019
2.593 2.47 1.9 10/23/2019
36.171 34.449 26.499 10/23/2019
3.754 3.575 2.75 10/23/2019
9.487 9.035 6.95 10/23/2019
12.899 12.285 9.45 10/23/2019
2.809 2.675 2.058 10/7/2019
4.635 4.414 3.396 12/27/2019
1.04 990 825 10/8/2019
1.691 1.611 1.239 4/3/2020
1.051 1.001 770 4/3/2020
137 131 109 12/26/2019
225 215 165 8/23/2019
4.204 4.004 3.08 12/24/2019
241.666 230.159 177.045 3/17/2020
222.431 211.839 162.953 12/17/2019
25.603 24.384 18.757 3/17/2020
185.405 176.576 135.828 10/22/2019
207.48 197.6 152 3/17/2020
286.65 273 210 12/17/2019
21.84 20.8 16 3/17/2020
15.698 14.95 11.5 3/17/2020
10.92 10.4 8 11/22/2019
9.555 9.1 7 11/22/2019
19.11 18.2 14 12/26/2019
7.371 7.02 5.4 12/27/2019
15.425 14.69 11.3 12/27/2019
3.661 3.487 2.682 3/17/2020
11.252 10.716 8.243 12/26/2019
4.558 4.341 3.339 12/26/2019
15.015 14.3 11 12/27/2019
11.592 11.04 8.492 12/26/2019
62.763 59.774 45.98 7/15/2019
648 618 475 9/4/2019
601 572 440 12/26/2019
1.979 1.885 1.45 12/26/2019
1.911 1.82 1.4 12/27/2019
240 229 176 3/17/2020
3.877 3.692 2.84 11/15/2019
240.911 229.439 176.492 6/9/2020
35.354 33.67 25.9 12/26/2019
158.34 150.8 116 12/23/2019
221.13 210.6 162 12/23/2019
23.205 22.1 17 12/26/2019
8.514 8.109 6.237 4/17/2020
61.686 58.749 45 11/8/2019
13.65 13 10 2/19/2020
61.221 58.306 44 2/20/2020
36.309 34.58 22 11/8/2019
1.351 1.287 990 3/12/2020
60.06 57.2 44 7/30/2019
27.628 26.312 20.24 4/3/2020
240 229 176 10/7/2019
5.321 5.068 5.068 2/25/2020
6.142 5.85 4.5 12/27/2019
4.369 4.161 3.201 12/27/2019
655 624 480 12/27/2019
4.505 4.29 3.3 12/27/2019
3.821 3.639 2.8 12/26/2019
2.73 2.6 2 12/26/2019
4.66 4.438 3.414 3/23/2020
362 345 265 3/23/2020
238 226 174 12/27/2019
203 194 149 12/27/2019
901 858 660 10/8/2019
150 143 110 3/23/2020
162 155 119 3/23/2020
1.446 1.377 1.059 10/7/2019
10.699 10.189 7.838 12/26/2019
751 715 550 12/27/2019
16.892 16.088 12.375 12/26/2019
1.091 1.039 799 8/22/2019
218 208 160 8/23/2019
10.21 9.724 7.48 10/21/2019
1.829 1.742 1.34 8/23/2019
15.423 14.689 11.299 12/24/2019
573 546 420 10/21/2019
368 350 270 7/8/2019
246 234 180 8/26/2019
6.279 5.98 4.6 8/26/2019
8.191 7.801 6.001 12/26/2019
105.105 100.1 77 7/11/2019
6.143 5.85 4.5 7/11/2019
4.505 4.29 3.3 8/20/2019
1.952 1.859 1.43 8/23/2019
9.419 8.97 6.9 9/9/2019
7.267 6.921 5.324 9/9/2019
412 412 317 10/21/2019
5.005 5.005 3.85 10/21/2019
244 233 179 12/24/2019
38.711 36.868 23.76 10/11/2019
1,419,601 1,352,001 1,040,001 10/14/2019
11.261 10.725 8.25 10/14/2019
122.85 117 90 10/14/2019
13.104 12.48 9.6 11/15/2019
4.845 4.615 3.55 2/25/2020
9.968 9.493 7.302 2/5/2020
6.826 6.5 5 2/5/2020
841 801 570 5/18/2020
133.081 126.744 97.495 2/5/2020
358 341 262 2/19/2020
11.55 11 11 2/25/2020
971 924 711 3/12/2020
1.302 1.24 954 3/12/2020
75.075 71.5 55 3/6/2020
143.325 136.5 105 3/12/2020
2,777,775 2,645,500 2,035,000 3/31/2020
78.829 75.075 57.75 4/3/2020
74.324 70.785 54.45 4/1/2020
124.215 118.3 91 4/8/2020
8.108 7.722 5.94 4/15/2020
136.105 129.624 99.711 4/8/2020
32.883 31.317 24.09 4/29/2020
1.315 1.252 963 5/30/2020
15.015 14.3 11 6/5/2020
403 384 295 6/5/2020
ISI/ BOX FAKTUR / BX
HNA

1 51180009 AMLODIPINE 10MG TAB BPJS


2 51180010 AMLODIPINE 5MG TAB BPJS 100
3 51180014 LANTUS INJ BPJS 5
4 51180015 NOVOMIX FLEXPEN ( BPJS ) 5
5 51180016 NOVORAPID FLEXPEN ( BPJS ) 5 395,455
6 51180035 ASERING 500ML ( BPJS ) *
7 51180048 FUTROLIT INFUS BPJS 24 36,600
8 51180066 DEPAKOTE 250 ER BPJS 100
9 51180070 SPIRIVA HANDIHALER BPJS 1
10 51180074 HARNAL OCAS TAB ( BPJS ) 30 139,500
11 51180075 HARNAL 0.2MG TAB ( BPJS) 28
12 51180081 SIMVASTATIN 20MG TAB BPJS *
13 51180090 CEFADROXIL 250 FORTE SYR ( BPJS ) *
14 51180100 PROPANOLOL 10MG TAB ( BPJS ) *
15 51180113 MEROPENEM 1G INJ BPJS 10
16 51180124 MICONAZOLE CREAM 10 GR BPJS *
17 51180143 IBUPROFEN 400MG TAB BPJS 100
18 51180148 ISOSORBID DINITRATE 5 MG TAB (BPJS) *
19 51180149 KSR TAB BPJS 100
20 51180151 KANDESARTAN 16MG TAB BPJS 30
21 51180152 KANDESARTAN 8MG TAB BPJS 30
22 51180161 KLOBAZAM TAB BPJS *
23 51180163 KETOROLAC 30MG INJ BPJS 6
24 51180172 SERETTIDE DISKUS 250 BPJS 1
25 51180180 EPINEFRIN INJ BPJS *
26 51180184 RECORMON 2000 INJ BPJS 6
27 51180198 FLUCONAZOLE CAP ( BPJS ) 10
28 51180199 FLIXOTIDE NEB BPJS 20 142,500
29 51180200 ARIXTRA INJ BPJS 10
30 51180201 FUROSEMID INJ BPJS 25
31 51180204 GEMFIBROSIL 300 CAP BPJS *
32 51180205 GENTAMYCIN INJ BPJS 5
33 51180213 NITROKAF RETARD CAP BPJS 100
34 51180224 ACTRAPID HM 10 INJ BPJS 1
35 51180232 DOMPERIDONE SYR ( BPJS ) 1
36 51180235 AVODART TAB BPJS 30
37 51180236 LOVENOX 0.4 INJ BPJS 2
38 51180237 LOVENOX 0.6 INJ BPJS 2
39 51180242 STARFOLAT 0.4MG TAB ( BPJS ) 50 20,000
40 51180256 ULSAFATE SYR ( BPJS ) 1 12,700
41 51180260 VENTOLIN NEBULIZER BPJS 20 72,727
42 51180265 LEVEMIR INJ (BPJS) 5
43 51180266 ASAM FOLAT TABLET *
44 51180273 THYROZOL 10MG TAB BPJS 100
45 51180284 BETAMETASON CREAM BPJS 25
46 51180285 METFORMIN 500MG TAB BPJS 100 12,500
47 51180287 COMBIVENT UDV BPJS 20
48 51180288 MINI ASPI TAB BPJS 100
49 51180291 SIMARC 2MG TAB BPJS 100
50 51180296 SYMBICORT 80/ 4.5 MCG BPJS 1
51 51180303 SIFROL 0.375 TAB BPJS 30
52 51180309 AKILEN EAR DROP 1 60,700
53 51180311 FORUMEN EAR DROP 1
54 51180317 BRILINTA TAB (BPSJ) 56 873,242
55 51180318 ECOSOL RL 500 (BPJS) *
56 51180321 CLOPIDOGREL TAB 75ML (BPJS) 30 270,000
57 51180322 ECOSOL NACL 1000 (BPJS) 10 12,700
58 51180323 ECOSOL NACL 100ML (BPJS) 50
59 51180327 ARICEPT 10MG BPJS 28 317,800
60 51180330 AVAMYS NASAL SP (BPJS) 1 102,251
61 51180332 POVIDONE IODINE INTISUMBER 1 LTR (BPJS) 1000
62 51180333 POVIDONE IODINE 30 ML INTISUMBER (BPJS) 1
63 51180334 BISOPROLOL 5MG "BPJS" 100
64 51180335 ECOSOL NACL 500ML (BPJS) *
65 51180336 EPODIUON 2000 BPJS 6
66 51180337 INFUSAN RING AS 500 ML BPJS 24
67 51180338 INFUSAN RL 500 ML SP BPJS 24 6,936
68 51180339 INFUSAN NS SP 500 ML BPJS 24 10,530
69 51180343 SANMOL INFUS BPJS 1 24,440
70 51180344 NEFROFER INJ BPJS 5 325,000
71 51180348 POVIDONE IODINE 60 ML ONEMED 1
72 51180349 EZELIN INSULIN 1 76,318
73 51180352 ONBREZ 150 MCG INHAELER 1
74 51180353 EPODION INJ DAEWOO 6 400,800
75 51180355 DIAMICRON MR TAB BPJS 30
76 51180347 V-BLOC 6,25 MG TABLET BPJS 30 47,672
77
78
79
80
81
82
83
84
FAKTUR SATUAN FAKTUR 4,444 30%
HNA HNA +PPN COST TOTAL COST MARGIN
SATUAN NEW

- #DIV/0! #DIV/0! #DIV/0!


64 70 44 115 149
76,318 83,950 889 84,839 110,290
100,880 110,968 889 111,857 145,414
79,091 87,000 889 87,889 114,256
8,769 9,646 #VALUE! #VALUE! #VALUE!
36,600 40,260 185 40,445 52,579
2,685 2,954 44 2,998 3,897
151,818 167,000 4,444 171,444 222,877
4,650 5,115 148 5,263 6,842
7,080 7,788 159 7,947 10,331
1,119 1,231 #VALUE! #VALUE! #VALUE!
5,359 5,895 #VALUE! #VALUE! #VALUE!
70 77 #VALUE! #VALUE! #VALUE!
44,000 48,400 444 48,844 63,498
2,955 3,251 #VALUE! #VALUE! #VALUE!
480 528 44 572 744
80 88 #VALUE! #VALUE! #VALUE!
1,675 1,843 44 1,887 2,453
6,500 7,150 148 7,298 9,488
4,500 4,950 148 5,098 6,628
0 - #VALUE! #VALUE! #VALUE!
12,150 13,365 741 14,106 18,337
111,383 122,521 4,444 126,965 165,055
0 - #VALUE! #VALUE! #VALUE!
110,394 121,433 741 122,174 158,826
17,018 18,720 444 19,164 24,913
14,250 15,675 222 15,897 20,666
226,318 248,950 444 249,394 324,212
3,100 3,410 178 3,588 4,664
345 380 #VALUE! #VALUE! #VALUE!
4,600 5,060 889 5,949 7,733
1,418 1,560 44 1,604 2,086
131,602 144,762 4,444 149,206 193,968
13,800 15,180 4,444 19,624 25,511
4,486 4,935 148 5,083 6,608
82,458 90,704 2,222 92,926 120,804
113,986 125,385 2,222 127,607 165,889
200 220 89 309 402
12,700 13,970 4,444 18,414 23,938
3,636 4,000 222 4,222 5,488
76,318 83,950 889 84,839 110,290
120 132 #VALUE! #VALUE! #VALUE!
1,169 1,286 44 1,330 1,729
2,327 2,560 178 2,737 3,559
125 138 44 182 237
4,136 4,550 222 4,772 6,203
95 105 44 149 194
1,400 1,540 44 1,584 2,060
190,325 209,358 4,444 213,802 277,942
7,545 8,300 148 8,448 10,982
60,700 66,770 4,444 71,214 92,578
25,550 28,105 4,444 32,549 42,314
15,594 17,153 79 17,233 22,403
6,936 7,630 #VALUE! #VALUE! #VALUE!
9,000 9,900 148 10,048 13,063
12,700 13,970 444 14,414 18,739
7,000 7,700 89 7,789 10,126
11,350 12,485 159 12,644 16,437
102,251 112,476 4,444 116,920 151,996
85 94 4 98 127
4,200 4,620 4,444 9,064 11,783
500 550 44 594 773
6,500 7,150 #VALUE! #VALUE! #VALUE!
66,800 73,480 741 74,221 96,487
9,613 10,574 185 10,759 13,987
7,115 7,827 185 8,012 10,415
10,530 11,583 185 11,768 15,299
24,440 26,884 4,444 31,328 40,726
65,000 71,500 889 72,389 94,105
6,310 6,941 4,444 11,385 14,801
76,318 83,950 4,444 88,394 114,912
18,782 20,660 4,444 25,104 32,635
66,800 73,480 741 74,221 96,487
2,740 3,014 148 3,162 4,111
1,589 1,748 148 1,896 2,465
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
HET MARGIN
50% 70% IP OP COST PRICE

#DIV/0! #DIV/0! 799 761 104


172 195 822 783 85
127,258 144,226 119.527 113.835 83.95
167,785 190,157 157.192 149.707 110.968
131,833 149,411 127.889 121.799 87
#VALUE! #VALUE! 33.6 32 9.646
60,668 68,757 139.338 132.703 40.259
4,497 5,096 7.133 6.793 2.954
257,166 291,454 388.52 370.019 167
7,895 8,947 10.529 10.027 5.115
11,920 13,509 11.329 10.789 7.788
#VALUE! #VALUE! 2.169 2.169 1.231
#VALUE! #VALUE! 17.025 17.025 5.895
#VALUE! #VALUE! 224 224 77
73,267 83,035 73.71 70.2 44
#VALUE! #VALUE! 13.587 13.587 3.251
859 973 987 940 528
#VALUE! #VALUE! 525 500 97
2,830 3,208 2.61 2.485 1.842
10,947 12,407 9.832 9.832 7.15
7,647 8,667 7.273 7.273 4.95
#VALUE! #VALUE! 1.26 1.26 900
21,159 23,980 16.916 16.916 11.572
190,448 215,841 190.599 181.523 122.521
#VALUE! #VALUE! 10.531 10.531 8.1
183,261 207,696 239.755 228.339 133.576
28,746 32,579 33.132 31.555 20.592
23,846 27,025 21.813 20.775 15.675
374,091 423,970 328.306 328.306 248.84
5,382 6,099 4.226 4.025 3.41
#VALUE! #VALUE! 888 888 380
8,923 10,113 25.607 24.388 5.06
2,406 2,727 2.864 2.728 1.56
223,809 253,651 258.3 246 144.762
29,436 33,361 27.641 26.325 15.18
7,624 8,641 12.44 11.847 7.75
139,389 157,974 303.17 288.733 90.704
191,410 216,931 188.973 179.974 125.385
463 525 525 500 130
27,621 31,304 31.5 30 13.97
6,333 7,177 9.702 9.24 4
127,258 144,226 119.334 113.651 83.95
#VALUE! #VALUE! 525 500 135
1,996 2,262 2.14 2.038 1.314
4,106 4,654 21.633 20.603 2.56
273 309 576 549 154
7,158 8,112 10.571 10.068 5.7
223 253 541 515 105
2,377 2,694 4.162 3.964 1.54
320,702 363,463 216.632 206.316 133.1
12,671 14,361 13.081 12.458 8
106,821 121,064 124.431 118.505 66.77
48,824 55,333 51.937 49.463 27.39
25,849 29,296 22.86 21.772 17.153
#VALUE! #VALUE! 22.505 21.433 7.63
15,072 17,082 3.599 3.428 1.451
21,622 24,504 23.7 23.7 16.5
11,683 13,241 31.019 29.542 10.45
18,966 21,494 24.068 22.922 13.734
175,380 198,764 179.749 171.189 112.476
147 167 123 123 73
13,596 15,409 6.94 6.609 4.62
892 1,011 711 677 260
#VALUE! #VALUE! 17.9 17.048 6.921
111,331 126,175 116.627 111.073 84.7
16,139 18,291 18.299 17.428 10.573
12,018 13,620 13.218 12.589 7.677
17,652 20,006 13.923 13.26 7.121
46,992 53,258 49.35 47 37.224
108,583 123,061 125.274 119.308 78.65
17,078 19,355 10.143 9.66 7.194
132,591 150,269 120.931 115.172 83.95
37,656 42,677 28.437 27.083 20.66
111,331 126,175 84.722 84.722 73.48
4,743 5,376 4.215 4.015 2.933

#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
7/1/2018
7/1/2018
7/1/2018
7/1/2018
7/1/2018
1/17/2019
1/10/2020
7/1/2018
7/1/2018
4/15/2019
5/13/2019
4/26/2017
4/26/2017
4/26/2017
7/1/2018
4/26/2017
2/13/2020
7/1/2018
5/31/2019
4/26/2017
4/26/2017
4/20/2015
4/26/2017
5/13/2019
4/20/2015
7/1/2018
7/1/2018
4/15/2019
3/26/2018
3/13/2019
4/26/2017
5/31/2019
7/1/2018
1/17/2019
10/8/2019
7/1/2018
10/8/2019
6/24/2019
7/1/2018
7/1/2018
7/1/2018
7/1/2018
7/1/2018
7/1/2018
2/20/2020
1/24/2020
7/1/2018
10/8/2019
10/9/2018
7/1/2018
7/1/2018
1/24/2020
7/11/2019
8/23/2019
5/13/2019
7/1/2018
1/11/2018
8/27/2018
4/16/2020
4/15/2019
10/3/2017
4/24/2019
7/1/2018
7/1/2018
7/1/2018
2/13/2020
6/24/2019
8/16/2019
1/17/2019
7/1/2018
1/9/2020
5/29/2019
8/16/2019
10/21/2019
3/18/2020
ISI/ BOX

1 51010001 LACTO B sach - Lactobacillus acidop 40


2 51010004 ASCARDIA 80mg tab - Acetylsalicylic 100
3 51010005 NEW DIATABS tab - Activated attapul 100
4 51010007 EPEXOL 30mg tab - Ambroxol HCl 100
5 51010016 CLINOVIR 200 mg tab - Asiklovior 30
6 51010017 CLINOVIR 400 mg tab - Asiklovior 30
7 51010024 CAPTOPRIL 12,5 mg Tab 100
8 51010025 CAPTOPRIL 25 mg Tab 100
9 51010028 OZEN 10 mg tab - Cetrizine HCl -
10 51010029 RYVELL 10 mg tab - Cetrizine HCl -
11 51010036 ZEUFOR 500 mg tab - Citicoline -
12 51010038 PLAVIX 75 mg Tab - Clopidrogel 28
13 51010042 SANPRIMA tab - Co-trimoxsazole: Tri 100
14 51010045 ELKANA tab - Dibasic Ca phosphate 2 100
15 51010046 DIGOXIN 0,25 mg tab 100
16 51010048 PRORENAL tab - DL-3-methyl-2-oxo-va 100
17 51010049 VOMETA FT 10 mg tab - Domperidone 50
18 51010052 PROFIBRAT 300 mg tab - Fenofibrat 30
19 51010057 LASIX 40 mg Tab - Furosemide 100
20 51010062 BUSCOPAN 10 mg tab Hyoscine-N-butyl 100
21 51010067 DUVADILAN 20 mg tab - Isoksuprin HC 60
22 51010068 ISORBID 5 mg tab - Isorbide dinitra -
23 51010069 CEDOCARD 10 mg - Isosorbide dinitra 60
24 51010070 CEDOCARD 5 mg TAB- Isosorbide dinit 60
25 51010072 CATAFLAM 50 mg tab- Kalium diclofen 50
26 51010073 Q-TEN 100 mg soft gel - Koenzym Q 100
27 51010081 IMODIUM 2mg tab - Loperamide HCl 100
28 51010083 MEFINAL 500mg capl - Mefenamic acid 100
29 51010087 PRIMPERAN 10 MG TAB 100
30 51010092 ZEPRASOL 20mg caps - Omeperazole -
31 51010096 PANTOZOL 40 mg tab - Pantoprazole 7
32 51010098 PANTOZOL 20 mg tab - Pantoprazole 7
33 51010099 PANADOL 500mg tab *
34 51010100 SANMOL 500 mg tab 100
35 51010108 RHINOFED cap - Pseudoephedrine 30 m 50
36 51010112 VENTOLIN 2 mg tab - Salbutamol sulf 30
37 51010113 ZITANID 2 mg tab - Tizanidine HCl 30
38 51010114 TRAMAL RETARD tab - Tramadol 100 mg *
39 51010115 ZALDIAR tab - Tramadol 37.5 mg, PCT 10
40 51010117 THERAGRAN M tab - Vit A 10.000 UI + 100
41 51010118 MOLOCO+B12 tab - Vit B12 20 mcg + P 60
42 51010119 LAPRAZ caps 30 mg - Lansoprazole 20
43 51010120 LEVOCIN Tab 500 mg - Levofloxacin 18
44 51010122 METVELL 0,125 mg tab - Methylergo 30
45 51010123 NEUROSANBE tab - vit B1 100 mg, Vi 100
46 51010129 PHENYTOIN 100 mg Kaps 100
47 51010133 PROLIC Cap 150 mg - Clindamycin 100
48 51010134 PROLIC Cap 300 mg - Clindamycin 100
49 51010137 RIFAMTIBI caps 600 mg - rifampicin 100
50 51010138 RIFAMTIBI tab 450 mg - rifampicin 100
51 51010141 SANPRIMA FORTE Kapl - trimetoprim 1 100
52 51010143 SPORETIK 100 mg Kaps - Cefiksim 30
53 51010144 SPORETIK 50 mg Kaps - Cefiksim *
54 51010145 TRADOSIK 50 mg Kaps - tramadol 100
55 51010147 TREMENZA Tab - pseudoephedrin 60 mg 100
56 51010148 TRICHODAZOL 500mg Tab - metronidazo 100
57 51010149 TROVENSIS tab 8 mg - Ondansetron 10
58 51010150 TUZALOS Kaplet - dmp 10 mg,fenilpro 100
59 51010160 ZELAVEL tab 400 mg - Ofloxacin *
60 51010167 BAQUINOR FORTE cap - Ciprofloxacin 20
61 51010170 CEFAT Kapsul 500 mg - Cefadroxil 100
62 51010171 CLANEKSI 500 mg Kapl - amoxicillin 30
63 51010174 CODEIN 10MG TAB 100
64 51010175 CODEIN 15MG TAB 100
65 51010176 CODIPRONT CAP 100
66 51010177 CODIPRONT CUM EXPECTORANT CAP 10
67 51010184 ERYSANBE kaps 500 mg - erythromycin 100
68 51010187 FOLAVIT tab 400 mcg - Folic acid 100
69 51010202 ZERLIN 50 mg tab - Setraline *
70 51010204 ACYCLOVIR 200MG TAB 50
71 51010205 ACYCLOVIR 400MG TAB 50
72 51010209 AMBROXOL 30MG TAB 100
73 51010213 AMOXSAN 500MG -amoxicillin 100
74 51010223 CALCIUM LACTATE 500MG TAB OGB KF 100
75 51010225 CEFADROXIL 500MG TAB BERNOFARM 100
76 51010227 CELESTAMIN tab 150
77 51010228 CETIRIZINE 10MG TAB 60
78 51010230 CLINDAMYCIN 150MG KAP 50
79 51010231 CLINDAMYCIN 300MG KAP 50
80 51010232 CO-AMOXICLAV 625MG TAB 30
81 51010234 DEXAMETHASON 0.5MG TAB 100
82 51010237 DILTIAZEM 30MG TAB 100
83 51010238 DOMPERIDONE TAB 100
84 51010239 DOXYCYCLINE 100MG TAB 100
85 51010246 FUROSEMIDE 40MG TAB 200
86 51010248 GLUCOPHAGE 500mg tab 100
87 51010254 ISONIAZIDE (INH) 300MG 100
88 51010255 KETOCONAZOLE 200MG TAB 50
89 51010256 LANZOPRAZOLE 30MG TAB 100
90 51010257 LEVOFLOXACIN 500MG TAB 100
91 51010259 LORATADINE 10MG TAB 50
92 51010261 MELOXICAM 15MG TAB 50
93 51010262 MELOXICAM 7.5MG TAB 50
94 51010264 METHYLPREDNISOLONE 16MG TAB 100
95 51010267 MUCOPECT 30mg tab 100
96 51010268 NATRIUM DIKLOFENAK 25MG TAB *
97 51010269 NATRIUM DIKLOFENAK 50MG TAB 100
98 51010271 NEUROBION 1000 tab 250
99 51010272 NEUROBION 5000 tab 250
100 51010273 NEUROSANBE 5000 TAB (VIT B1 100MG) 100
101 51010274 NIFEDIPINE TAB 100
102 51010280 PIRACETAM 1200MG TAB BERNOFARM *
103 51010286 PROPYLTHIOURACYL (PTU)100MG TAB 100
104 51010287 PYRAZINAMIDE 500MG TAB 100
105 51010290 RIFAMPICIN 300MG TAB 100
106 51010298 SALBUTAMOL 2MG TAB 100
107 51010299 SALBUTAMOL 4MG TAB 100
108 51010302 SANGOBION tab 250
109 51010311 VITAMIN B COMPLEK TAB 100
110 51010312 VITAMIN B12 50MCG TAB 100
111 51010313 VITAMIN C 50MG TAB 100
112 51010314 VITAMIN K TAB *
113 51010315 ZOLACAP cap *
114 51010319 CORTIDEX tab 100
115 51010321 DAMABEN TAB (methoclopramide HCl 10 100
116 51010324 GLIQUIDONE 30MG TAB OGB DEXA 100
117 51010325 BRAXIDIN tab 100
118 51010327 FUNDAMIN E tab 100
119 51010330 ANALSIK tab -methampyron 500 mg,dia 100
120 51010333 CARDIO ASPIRIN tab 30
121 51010334 OCUSON tab 100
122 51010335 KETOPROFEN 100mg tab 50
123 51010341 CATAFLAM 25mg tab 50
124 51010345 LAMESON 4mg tab 100
125 51010346 PURECEMIA TAB 100
126 51010351 MERISLON tab 100
127 51010353 UROTRACTIN cap 60
128 51010355 PREABOR TAB (Allylestrenol 5 mg) 30
129 51010360 BIOTHICOL 500mg cap 100
130 51010361 KETOROLAC 10mg tab 30
131 51010364 HP PRO cap 120
132 51010367 RHINOS SR CAP (Larotadine 5 mg, pse 50
133 51010370 URISPAS 200mg tab 30
134 51010371 ALLORIS tab 100
135 51010379 IMBOOST FORCE tab 30
136 51010384 ADALAT OROS 30mg tab 30
137 51010395 CEFILA 100mg tab 30
138 51010399 LIPITOR 10mg tab 30
139 51010400 LIPITOR 20mg tab 30
140 51010401 LIPITOR 40mg tab 30
141 51010406 NOLIPO 500mg cap 100
142 51010407 CRAVOX 500mg tab 10
143 51010411 CYCLO-PROGYNOVA 21 tab 1
144 51010414 GLIBENCLAMIDE 5mg tab 100
145 51010429 Becom C Tab 100
146 51010434 Bisolvon 8mg Tab 100
147 51010437 BRAIN ACT 500MG TAB 30
148 51010438 Buscopan Plus Tab 100
149 51010439 Cal-95 Kaplet 30
150 51010447 Celebrex 100mg Tab 30
151 51010451 CTM 4mg Tab 100
152 51010454 Diabetasol Vanilla 180g 1
153 51010459 Dopamet 250mg Tab 100
154 51010460 Dulcolax 5mg Tab 100
155 51010462 Enervon-C Tab 100
156 51010467 ESILGAN 1MG TAB 100
157 51010468 ESILGAN 2MG TAB 100
158 51010472 FG Throches 120 Tab 120
159 51010474 Fluimucil 200mg Kap 60
160 51010476 Folamil Genio Soft Cap 30
161 51010477 Forres 50mg Tab 50
162 51010478 Frego 5mg Tab 50
163 51010484 Glurenorm 30mg Tab 100
164 51010485 Glyceril Guaicolat 100mg Tab @ 1000 100
165 51010493 Imunos Tab 20
166 51010500 Isosorbide Dinitrate 5mg Tab 100
167 51010502 Kalmethasone Tab 200
168 51010503 Ketesse Tab 50
169 51010505 KSR Tab 100
170 51010507 Lasgan 30mg Kaps 20
171 51010512 Lipantyl 200M Tab 30
172 51010513 Lipantyl Supra Tab 30
173 51010515 Losartan 50mg Tab 50
174 51010517 Lutenyl Cap 30
175 51010520 Medixon 16mg Tab 30
176 51010521 Medixon 4mg Tab 100
177 51010522 Medixon 8mg Tab 100
178 51010525 Mertigo Tab 100
179 51010531 Mucosta Tab 100
180 51010536 Nephrisol Vanilla 180g 1
181 51010544 Nimotop Tab 100
182 51010556 Peptisol Vanilla 180g 1
183 51010562 Pletaal 100mg Tab 30
184 51010563 Pletaal 50mg Tab 100
185 51010566 Prednison 5mg Tab kf 100
186 51010568 Primolut N 5mg Tab 30
187 51010572 Pumpitor Cap 20
188 51010573 Pyridoxine (Vit B6 ) 10mg Tab KF @ 100
189 51010576 SIMVASTATIN 20MG TAB KF 100
190 51010579 Spasminal Tab 100
191 51010580 Strocain P Tab 100
192 51010583 Theophyllin 1gram *
193 51010596 Urdafalk Tab 30
194 51010597 Valisanbe 2mg Tab 100
195 51010598 Valisanbe 5mg Tab 100
196 51010611 Zicho 500mg Tab *
197 51010612 Zolesco Kap *
198 51010617 ARCOXIA 120MG TAB 30
199 51010618 ARICEPT 5MG TAB @ 30 28
200 51010619 ASPILET CHEWABLE TAB 100
201 51010620 ASPILET TROMBO TAB 150
202 51010623 BETASERC 24MG TAB 20
203 51010630 CEFSPAN 100MG TAB 30
204 51010631 CEFSPAN 200MG TAB 10
205 51010632 CELEBREX 200MG TAB 30
206 51010639 CORDARONE TAB 30
207 51010640 CPG TAB 30
208 51010641 CRAVIT 500MG TAB 10
209 51010642 CURCUMA TAB 120
210 51010648 DIVASK 10MG TAB 30
211 51010649 DIVASK 5MG TAB 30
212 51010650 DOLO NEUROBION 100 CAP 100
213 51010653 EUPHYLLIN RETARD TAB 100
214 51010658 FREGO 10MG TAB 50
215 51010663 GLUCOPHAGE XR 500MG TAB 120
216 51010664 HCT 25MG TAB OGB KF 100
217 51010665 HEMOBION TAB 100
218 51010666 HEPAMAX CAP 30
219 51010668 HEPATOSOL VANILLA 1
220 51010671 IMBOOST TAB 50
221 51010673 ISOPRINOSINE TAB 8
222 51010677 LAPIBAL 500MCG CAP 100
223 51010680 METHYCOBAL 500MG CAP 100
224 51010681 OSCAL 0.5MG CAP 30
225 51010685 STARCEF 100MG CAP 30
226 51010686 STARCEF 200MG CAP 10
227 51010687 VECTRIN 300MG CAP 20
228 51010694 KALNEX 250MG TAB 100
229 51010695 KALNEX 500MG TAB 100
230 51010696 KALTROFEN 100MG TAB 30
231 51010697 KALTROFEN 50MG TAB 30
232 51010699 KALXETIN 20MG TAB 30
233 51010700 KETOPROFEN 50MG TAB 50
234 51010702 LAMESON 8MG TAB 100
235 51010716 MYONAL TAB 100
236 51010718 NEUROTAM 1200MG TAB 50
237 51010727 OMZ CAP @ 30 30
238 51010733 PEHADOXIN FRTE TAB @ 350 100
239 51010735 Profertil Tab 10
240 51010736 Propanolol 10mg Tab OGB Dexa @ 100 100
241 51010737 Propanolol 40mg Tab OGB Dexa @ 100 100
242 51010738 Proris Kaplet 50
243 51010744 Sirdalud Tab 100
244 51010745 Sistenol Cap @ 60 60
245 51010751 Sulcolon Tab 100
246 51010763 Urdahex Tab 30
247 51010767 V-Bloc 25mg Tab 30
248 51010768 V-Bloc 6.25mg Tab 30
249 51010772 Voltaren 25mg Tab 50
250 51010773 Voltaren 50mg Tab 50
251 51010774 Voltaren SR 75mg Tab 50
252 51010776 Vomitas FDT Tab 50
253 51010779 Zilop 600mg Tab *
254 51010801 BICNAT TAB 100
255 51010805 LODIA 2MG TAB 60
256 51010808 CODEIN 20MG TAB 100
257 51010813 FORMUNO TAB 30
258 51010831 OMEPRAZOLE 20MG CAP OGB KIMIA FARMA 30
259 51010834 SIMARC 2 TAB 100
260 51010835 ARCOXIA 90MG TAB 30
261 51010840 ALINAMIN F TAB 100
262 51010843 COBAZIM 1000 TAB 100
263 51010844 GLUTROP TAB 30
264 51010845 LAMESON 16MG TAB 100
265 51010850 COLISTINE 250.000 TAB 30
266 51010851 L-BIO SACH 30
267 51010856 ALDISA SR TAB 50
268 51010859 PRONALGES 100MG TAB *
269 51010861 PROFIBRAT 200M TAB 30
270 51010862 CRESTOR 10MG TAB 28
271 51010868 ALLOPURINOL 300MG TAB OGB BERNOFARM 100
272 51010869 ETHAMBUTOL 500MG TAB OGB BERNOFARM 100
273 51010871 RIFAMPICIN 450MG TAB OGB BERNOFARM 100
274 51010872 RIFAMPICIN 600MG TAB OGB BERNOFARM 100
275 51010876 AMOXICILLIN 500MG TAB OGB BERNOFARM 100
276 51010877 CEFIXIME 200MG TAB OGB BERNOFARM 30
277 51010878 METRONIDAZOLE 500MG TAB OGB BERNOFARM 100
278 51010879 RANITIDIN 150MG TAB OGB BERNOFARM 100
279 51010882 BETASERC 8MG TAB 100
280 51010891 GLUCOPHAGE 850MG TAB 120
281 51010893 LAPICEF 500MG CAP 100
282 51010896 DEPAKOTE 250MG TAB 100
283 51010898 DEXTAMIN TAB 100
284 51010900 ASAM MEFENAMAT 500MG TAB OGB BERNOFARM 100
285 51010901 IMDUR 60MG TAB *
286 51010911 CEFIXIME 100MG TAB OGB BERNOFARM 100
287 51010914 ZEGAVIT CAP 50
288 51010919 LESIPAR 300MG CAP 100
289 51010923 SESDEN 30MG CAP 100
290 51010927 GLUCOVANCE 500MG/2.5MG TAB 100
291 51010928 GLUCOVANCE 500MG/5MG TAB 100
292 51010931 MEPTIN 0.05MG TAB 100
293 51010932 THEOBRON CAP 100
294 51010944 NEULIN PS TAB 30
295 51010945 SUMAGESIC TAB 100
296 51010946 TELFAST HD 180MG TAB 10
297 51010947 HYPERIL 5MG TAB 60
298 51010952 GEMFIBROZIL 300MG TAB PHAPROS 100
299 51010953 CIPROFLOXACIN 500MG TAB BERNOFARM 100
300 51010954 METFORMIN 500MG TAB BERNOFARM 100
301 51010955 AMLODIPINE 5MG TAB BERNOFARM 50
302 51010957 ALLOPURINOL 100MG TAB BERNOFARM 100
303 51010959 TRIATEC 5MG TAB 30
304 51010961 FARSORBID 5MG TAB 100
305 51010971 CONCOR 2.5MG TAB 100
306 51010988 OSTE FORTE TAB 30
307 51010997 TRIATEC 10MG TAB 30
308 51011000 ASAM TRANEKSAMAT 500MG TAB BERNOFARM 100
309 51011001 ONDANSETRON 8MG TAB BERNOFARM 30
310 51011003 SIMVASTATIN 10MG TAB BERNOFARM 100
311 51011004 FLUNARIZINE 5MG TAB BERNOFARM 40
312 51011005 GLIMEPIRIDE 2MG TAB BERNOFARM 50
313 51011006 ITRACONAZOLE 100MG TAB BERNOFARM 30
314 51011007 METFORMIN 850MG TAB BERNOFARM 100
315 51011009 HALOPERIDOL 0.5MG TAB INF *
316 51011010 HALOPERIDOL 1.5MG TAB INF *
317 51011011 HALOPERIDOL 5MG TAB INF *
318 51011012 LINCOMYCIN 500MG CAP INF *
319 51011013 TRUVAS 20MG TAB 30
320 51011014 VESTEIN 300MG CAP 20
321 51011015 SANTA E 200MG TAB 100
322 51011016 CONCOR 5MG TAB 100
323 51011018 CAVIT D3 TAB 100
324 51011021 METHYLPREDNISOLON 4MG TAB BERNOFARM 100
325 51011022 ZYLORIC 100MG TAB 60
326 51011023 CRESTOR 20MG TAB 28
327 51011027 PARACETAMOL 500MG TAB BERNOFARM 100
328 51011028 METHYLPREDNISOLON 8MG TAB BERNOFARM 60
329 51011031 BECOM-ZET CAP 100
330 51011032 FLUIMUCIL GRANULE 200MG ADULT 30
331 51011033 ZINKID 20MG TAB 100
332 51011035 BIOSANBE CAP 100
333 51011036 NEUROSANBE PLUS TAB 100
334 51011040 TRUVAS 10MG TAB 30
335 51011041 MEPTIN MINI 0.025MG TAB 100
336 51011043 ZYLORIC 300MG TAB 30
337 51011045 RECOLFAR 0.5MG TAB 30
338 51011046 DIOVAN 80MG TAB *
339 51011050 ASPAR K TAB 100
340 51011055 ZESTRIL 5MG TAB *
341 51011056 AVODART CAP 30
342 51011062 EXFORGE 5/80MG TAB 28
343 51011065 NEUROVIT E TAB 50
344 51011070 SANTIBI 500 TAB 100
345 51011073 CLONIDIN 0.15MG TAB 100
346 51011075 HERBESSER CD 100 CAP 30
347 51011076 FORNEURO TAB 30
348 51011081 OSCAL 0.25MG TAB 30
349 51011083 ACPULSIF 5MG TAB 50
350 51011084 BIO ATP TAB 100
351 51011088 XARELTO TAB 10
352 51011101 EXFORGE 5/160 TAB 28
353 51011104 CORALAN 5MG TAB 56
354 51011111 KETRICIN TAB 100
355 51011112 NAN 1 PROBIOTIK 400G 1
356 51011113 PROVERA 10MG TAB 30
357 51011115 THROMBOLES CAP 100
358 51011117 DUPHASTON TAB 20
359 51011155 GLIMEPIRIDE 3MG TAB BERNOFARM 50
360 51011156 GLIMEPIRIDE 1MG TAB BERNOFARM 50
361 51011164 LIPROQY CAP 30
362 51011166 HEPAMERTZ GRANUL *
363 51011168 DORNER 20 MCG TAB *
364 51011171 TEBOKAN TAB *
365 51011174 SPORACID 100MG TAB 10
366 51011175 DIFLUCAN 150MG TAB 5
367 51011179 STOBLED CAP 16
368 51011180 NEURODEX TAB 200
369 51011190 STESOLID 5MG TAB 100
370 51011199 LAPIFLOX 500MG TAB 30
371 51011200 ERICAF TAB 100
372 51011209 DUROGESIC 25 5
373 51011214 FARSORBID 10MG TAB 100
374 51011216 GRISEOVULFIN 500MG TAB 100
375 51011219 ENTRAMIX VANILLA 180 G 1
376 51011222 NODROF F TAB 100
377 51011235 GLIMEPIRIDE 4MG TAB BERNOFARM 50
378 51011242 DIGOXIN 0,25MG TAB INF 100
379 51011254 LIPANTHYL PENTA 145 TAB 30
380 51011260 CILOSTAZOL 100MG TAB 100
381 51011261 CIFLON TAB 30
382 51011262 POSTOVIT TAB 50
383 51011264 ECLID 100MG TAB 50
384 51011269 HERBESER CD 200MG CAP 30
385 51011270 THYROZOL 10MG TAB 100
386 51011271 AZOMAX 500MG TAB 10
387 51011273 GLUCOSAMIN 500MG TAB 100
388 51011274 CRESTOR 40MG TAB 28
389 51011275 CANDERIN 8MG TAB 30
390 51011278 VALTREX TAB 48
391 51011280 NATTO 10 TAB 30
392 51011281 AB VASK 5MG TAB 30
393 51011283 FLUIMUCIL 600MG EFFERVESCENT *
394 51011285 VIPALBUMIN CAP 30
395 51011287 MOZUKU TAB 30
396 51011289 TANAKAN 40MG TAB 30
397 51011299 KALITAKE SACH 20
398 51011300 RENALOF CAP 90
399 51011310 PLASMIN DUS CAP 36
400 51011316 ARTRODAR 50MG CAP 30
401 51011317 AZITHROMYCIN 500MG TAB 10
402 51011318 BRILINTA 90MG TAB (TICAGRELOR) 56
403 51011321 LIPANTYL 100 TAB 30
404 51011322 SAMSCA 15MG TAB 10
405 51011323 MEXTRIL TABLET 100
406 51011328 SANAZET 500MG TAB 100
407 51011329 PARIET 20MG TAB 14
408 51011330 PROSTAM TAB 30
409 51011331 PROBIOKIDS SACHET 10
410 51011332 PANTOPRAZOLE 20MG TAB 10
411 51011333 PANTOPRAZOLE 40MG TAB 10
412 51011334 ONDANSETRON 4MG TAB 30
413 51011335 GLAUSETA 250 TAB 100
414 51011340 BETAHISTIN 6MG TAB 30
415 51011341 LISINOPRIL 10MG TAB 50
416 51011342 LISINOPRIL 5MG TAB 50
417 51011343 MECOBALAMIN 500MG CAP 100
418 51011344 TRIAMCINOLONE 4MG TAB 100
419 51011345 CITICHOLIN 500MG TAB 30
420 51011346 ACETYLCYSTEIN 200 CAP 60
421 51011350 VIPALBUMIN SACHET 3
422 51011351 ALPRAZOLAM 0.25MG TAB 100
423 51011352 ALPRAZOLAM 0.5MG TAB 100
424 51011353 ALPRAZOLAM 1MG TAB 100
425 51011355 ACARBOSE 50MG TAB 100
426 51011356 CISAPRIDE 5MG TAB 100
427 51011357 CLOBAZAM 10MG TAB 100
428 51011358 GABAPENTIN 300 CAP 30
429 51011360 RAMIPRIL 5MG TAB 100
430 51011361 SPIRONOLACTONE 100MG TAB 100
431 51011362 SPIRONOLACTONE 25MG TAB 100
432 51011363 ACARBOSE 100MG TAB 100
433 51011368 ATORVASTATIN 20MG TAB 30
434 51011370 NUTRIFLAM TAB 30
435 51011374 LAPROSIN TAB 8
436 51011382 ISONIAZID 100MG TAB 100
437 51011384 RESPIRA TAB 10
438 51011385 EPERISONE TAB 50
439 51011386 REBAMIPIDE TAB 100
440 51011387 URSODEOXYCHOLIC ACID 250 TAB 30
441 51011388 GALVUSMET 50/500MG TAB 30
442 51011389 PREGABALIN 75MG TAB 5
443 51011392 DEXTRAL CAPSUL 100
444 51011393 ARDIUM 500 TAB 60
445 51011394 AMLODIPIN 10MG TAB BERNO 30
446 51011402 MADOPAR TAB 30
447 51011403 INFATRINI SUSU CAIR 125 ML
448 51011405 DISOLF TAB 30
449 51011408 PRO TB4 TABLET 28
450 51011409 RICOVIR 300MG 30
451 51011411 BICROLID 500MG TABLET 30
452 51011412 TRAJENTA 5 MG TAB 30
453 51011415 INBUMIN TABLET 30
454 51011416 NEURO AID CAPSUL 60
455 51011417 VELACOM PLUS 1 MG/250 MG 30
456 51011422 TRIZEDON MR TABLET 60
457 51011424 CORMEGA BLISTER 30
458 51011425 ANALTRAM TAB 30
459 51011432 SPORETIK 200 MG KAPSUL 10
460 51011434 UTROGESTAN 100 MG 30
461 51011436 CEFILA 200 MG CAPSUL 10
462 51011437 MONURIL 3 GR 1
463 51011439 GABEXAL 100 MG CAPSUL *
464 51011441 TELMISARTAN 80 MG *
465 51011442 CEFIXIM 100 MG OBG DEXA 100
466 51011443 CEFIXIM 200 MG OBG DEXA *
467 51011446 TOFEDEX TAB 25MG 20
468 51011447 HEXIMER 2MG 100
469 51011448 CEPEZET 100MG 100
470 51011449 RICLONA 2MG 100
471 51011452 NOPRENIA TAB 2MG 30
472 51011456 XEPAZYM TAB 30
473 51011457 CODIPRONT KAPSUL ISI 10/BOX 10
474 51011459 NOPROSOL TAB 30
475 51011460 S-OMEVELL 20 TAB 30
476 51011461 S-OMEVELL 40 TAB 30
477 51011462 DEPRAM 10MG TAB 30
478 51011463 DEPRAM 30MG TAB
479 51011464 MIRZAP 30MG TAB 30
480 51011465 RETIVIT PLUS TABLET 100
481 51011466 GLUCOPHAGE XR 750MG 120
482 51011467 FENOFIBRAT 200 MG 100
483 51011468 LESICHOL 600 MG 30
484 51011469 IBERET FOLIC TABLET 100
485 51011470 DISFLATYL TABLET 100
486 51011471 L-BIO KAPSUL 30
487 51011472 OSTEOKOM TABLET 30
488 51011473 CIVELL MR 1000 TAB 10
489 51011474 XEROLAC 10MG TAB *
490 51011475 PARIET 10MG TAB 28
491 51011476 BUDENOFALK CAP 3MG *
492 51011478 RENVELA 800 MG TABLET 30
493 51011479 NEPRISOL D 1
494 51011480 AMADIAB 4 MG TABLET 50
495 51011481 NORVASK 5 MG TABLET 30
496 51011482 TONICARD KAPSUL 100
497 51011483 SELOXY TABLET 30
498 51011484 ANTIMO TABLET
499 51011485 LUTERON 5MG TAB 30
500 51011486 PROHELIC TAB 30
501 51011487 MEFOZ 4MG TAB 30
502 51011488 SANDIMMUN NEORAL 50MG 50
503 51011489 OSCIFIC TABLET 100
504 51011490 OSTGEN TABLET 30
505 51011491 MEDIGREL TABLET
506 51011492 FIBRAMET 300 MG 30
507 51011493 FORXIGA 10 MG TABLET 28
508 51011494 FEBURIC 300MG TAB 30
509 51011495 SULFASALAZINE TABLET 100
510 51011497 CARDISMO TABLET
511 51011498 THEORAL TABLET 30
512 51011499 RYMONT SACHET
513 51011501 TENSIVASK 10MG 50
514 51011502 LODOZ 5MG TABLET *
515 51011503 EXFORGE 10/160 MG TABLET 28
516 51011504 UBI Q KAPSUL *
517 51011505 UPERIO 50MG TABLET 28
518 51011506 UPERIO 100MG TABLET 28
519 51011507 ARCALION 200MG TABLET 60
520 51011508 XARELTO 200 MG TABLET 20
521 51011510 TWYNSTA 80/5 TABLET 28
522 51011511 CLOZAPIN 5 MG TABLET *
523 51011519 KINA TABLET 288
524 51011521 AMITRIPTYLLIN 25 MG TAB *
525 51011522 EZETROL 10 MG 30'S TAB *
526 51011523 ATORVASTATIN 40 MG-ISI 30'S *
527 51011524 METHYSOPRINOL 500MG TABLET 100
528 51011525 INLACIN 100MG TABLET 30
529 51011526 EUTHYROX 50 MG TABLET *
530 51011527 INVITEC TABLET *
531 51011528 VALSARTAN 160 MG 30
532 51011529 HYOLOQUIN
533 51020002 AMINOPHYLLIN 24 mg/ml 24
534 51020003 ATROPIN SULFAT 0,25 mg/ml inj 1 ml 100
535 51020016 DOPAMINE GIULINI 20 mg/ml inj 10 ml *
536 51020017 EPINEPHRINE Base 1 mg inj 100
537 51020020 INVICLOT 5.000 UI/ml inj 5 ml - Hep 5
538 51020021 BUSCOPAN 20ml/ ml inj 1ml - Hyoscin 10
539 51020025 REMOPAIN 30 mg inj/ml 1 ml - Ketoro 5
540 51020029 VITAMIN K3 10 mg/ml inj - Menadion 30
541 51020040 PANTOZOL 40 mg inj - Pantoprazole *
542 51020050 TRAMAL 50 MG INJ *
543 51020070 CORTIDEX Vial - Dexamethason 10
544 51020086 METHYCOBAL 500MG INJ 10
545 51020087 METVELL 0,2 mg/ml inj - Methylergom 10
546 51020088 MORPHIN 10MG/ML INJ 10
547 51020092 OXYLA 10IU/ML INJ 10
548 51020093 PELASTIN inj 1 g - Imipenem 500 mg, 1
549 51020094 PETHIDIN HCL inj - Pethidin HCl inj 10
550 51020095 PHENYTOIN 200 mg Amp 2ml 10
551 51020099 SAGESTAM inj 2 ml - Gentamycin sulf 5
552 51020101 SYNTOCINON 1 ml Amp- synthetic oxyt *
553 51020103 TERFACEF Vial 1 gr - seftriakson 1 1
554 51020120 BISOLVON 4mg/2ml inj - Bromehexine 10
555 51020126 CORDARONE INJ- amiodarone 6
556 51020128 DICYNONE 250 mg/2 ml inj - Ethamsyl *
557 51020131 EXTRACE 1000 mg/5mL inj - Ascorbic *
558 51020132 EXTRACE 500mg/5ml inj - Ascorbic a 5
559 51020134 KALMETHASON 5MG INJ -dexamethasone *
560 51020136 KETALAR inj 100 mg 1
561 51020137 LASIX inj - Furosemid *
562 51020140 NEO-K INJ- 5
563 51020141 NEUROBION 5000 inj 10
564 51020144 PREVENAR (pneumococcal conjugate va 1
565 51020148 TETAGAM P 250IU x 1ml amp 1
566 51020152 NEEDLE NOVOFINE 100
567 51020158 DAMABEN INJ (methoclopramide HCl 5 5
568 51020160 CA GLUCONAS 10% inj 24
569 51020162 PROSTIGMIN 0.5mg amp 5
570 51020163 KETOROLAC 30mg inj 10
571 51020173 VAKSIN DIFTERI TETANUS (DT) 5ml via *
572 51020174 VAKSIN TETANUS (TT) 5ml vial 10
573 51020175 DECAIN 4ml inj *
574 51020179 VAKSIN CAMPAK 10 DS vial 10
575 51020181 HIPNOZ 5MG/5ML INJ 10
576 51020182 PPD 0.3 ML *
577 51020183 SERUM ANTI TETANUS 1.500 SI vial 10
578 51020185 RECOFOL 10mg/ml inj 20ml 5
579 51020187 RAIVAS inj 4ml 5
580 51020195 CEFXON 1g inj 1
581 51020198 SERUM ANTI BISA ULAR 5ml 1
582 51020201 ACTRAPID HM 100IU/ml x 10ml 1
583 51020203 PPD 1.5ml vial 1
584 51020204 SERUM ANTI DIFTERI 20.000SI Vial *
585 51020205 ISORANE 250ML 250
586 51020207 EPHEDRIN HCL INJ 10
587 51020215 BRAIN ACT 500MG INJ 5
588 51020217 Catapres 0.15mg/ml Inj 10
589 51020225 Cepraz 1g Inj 1
590 51020226 CERVARIX INJ 1
591 51020234 Engerix B 0.5 ml Inj 1
592 51020235 Engerix B 20mcg Inj 1
593 51020236 Extrace 200mg Inj 6
594 51020237 FENTANYL 2MG INJ 5
595 51020238 Flamicort 10mg/ml IAD 1
596 51020239 Flamicort 40mg/ml IM Inj 1
597 51020244 Havrix 720 Junior 1
598 51020246 Herbesser 50mg Inj 10
599 51020249 Ketesse Inj 5
600 51020250 Lapixime 1g Inj 1
601 51020251 Medixon 125mg Inj 1
602 51020252 Merosan 1g Inj 1
603 51020253 Merotik Inj 1
604 51020258 Neurotam 3g Inj 4
605 51020267 Primperan Inj 6
606 51020276 STESOLID 10MG/2ML INJ 5
607 51020277 Streptomycin 1g Inj 100
608 51020285 Vaksin BCG 10
609 51020286 Varilrix Inj 1
610 51020287 VERORAB INJ 1
611 51020300 ARIXTRA 2,5 MG INJ @ 2 10
612 51020301 BROADCED 1G INJ 1
613 51020306 CEFTUM 1G INJ 1
614 51020309 CERNEVIT INJ 10
615 51020321 FUROSEMIDE 10MG/ML INJ 25
616 51020329 Lantus Solostar Pen @ 5 5
617 51020330 Levemir Pen Inj 5
618 51020332 Meropenem 1g Inj 10
619 51020336 Neurosanbe 5000mg Inj 10
620 51020338 Novorapid Flexpen @ 5 5
621 51020339 OMZ Inj 1
622 51020340 Pehacain Inj 20
623 51020358 Ceftazidime 1g Inj @ 1 OGB Novell 1
624 51020363 Infanrix *
625 51020364 Infanrix HIB *
626 51020367 Lapibal 500 Inj 1
627 51020371 LOVENOX 40MG INJ 2
628 51020372 LOVENOX 60MG INJ 2
629 51020374 SANKORBIN 1000MG INJ 5
630 51020375 BACTESYN 1.5G INJ *
631 51020376 CEFTRIAXONE 1G INJ OGB BERNOFARM 100
632 51020377 PIRACETAM 3G INJ OGB BERNOFARM 10
633 51020386 ONDANSETRON 8MG INJ BERNOFARM 10
634 51020392 RANITIDIN INJ NOVEL 10
635 51020393 LAMESON 125MG INJ 1
636 51020395 FLUIMUCIL AMPUL 300MG 5
637 51020396 ISORBID INJ 10
638 51020399 CEFOTAXIME 1G INJ OGB BERNOFARM 10
639 51020400 NOVOMIX 30 FLEXPEN 5
640 51020410 ROBUMIN 20% 100 ML INFUS 1
641 51020411 TRAMADOL 100MG INJ BERNOFARM 10
642 51020412 VAXIGRIP 0.25MG 1
643 51020416 ASAM TRANEKSAMAT 500MG INJ BERNOFARM 10
644 51020418 ONDANSETRON 4MG INJ BERNOFARM 10
645 51020421 METHYLPREDNISOLON 125MG INJ BERNOFARM 1
646 51020426 VAXIGRIP 0.5MG INJ 1
647 51020428 GENTAMICIN 40MG/ML INJ INF 5
648 51020429 SNMC ( STRONGER NEO MINOPHAGEN C ) INJ 1
649 51020434 IKADRYL INJ 1
650 51020442 CARDIOPLEDIC SOL 3 INJ 5
651 51020443 PROTAMIN INJ 1
652 51020445 NEOSTIGMIN HAMELN 0.5MG INJ 5
653 51020448 BRAIN ACT 250MG INJ *
654 51020451 NEULIN 500MG INJ 5
655 51020452 SYNFLORIX VAKSIN 1
656 51020482 TROVENSIS 4MG/2ML INJ 5
657 51020483 TROVENSIS 2MG/2ML INJ 5
658 51020485 CEFOPERAZONE + SULBACTAM 1G INJ OGB BERN 1
659 51020491 PANTOPRAZOLE 40MG INJ BERNOFARM 10
660 51020495 VOMIZOLE 40MG INJ 1
661 51020497 PROANES INJ 5
662 51020501 ECRON 10MG INJ 1
663 51020505 PUMPITOR INJ 1
664 51020507 FARGOXIN INJ 5
665 51020508 DEXAMETHASONE INJEKSI 100
666 51020509 MECOBALAMIN 500MG INJ 10
667 51020513 N-EPI INJ 5
668 51020515 PROTERINE INJ 5
669 51020517 INOVAD INJ 5
670 51020530 TYPIM VI O.5 ML 1
671 51020532 LIDOCAIN INJEKSI 100
672 51020533 RANITIDIN INJEKSI BERNOFARM 100
673 51020535 ACRAN INJEKSI 5
674 51020537 VAKSIN POLIO 10 DS 10
675 51020545 SANDOSTATIN INJ *
676 51020546 FOSULAR INJEKSI 1
677 51020547 ROTARIX VAKSIN 1
678 51020548 OKAVAK VAKSIN ( CACAR ) 1
679 51020549 LODOMER INJ 5
680 51020558 REGIVEL INEJEKSI 5
681 51020566 DOBUTAMIN 50MG INJ GENERIK 1
682 51020567 NICARDIPINE HCL 1MG INJEKSI 10
683 51020568 NOTRIXUM 25MG INJ 5
684 51020569 NOTRIXUM 50MG INJ 5
685 51020571 NTG INJEKSI 10
686 51020573 TOPAZOL INJ 1
687 51020574 PUMPICEL INJ 1
688 51020575 CEFORIM INJ 1
689 51020577 NICARDEX INJEKSI 5
690 51020578 MILOZ 15MG/3ML INJEKSI 10
691 51020579 MILOZ 5 MG / ML INJ 10
692 51020585 CARBAZOCHROME 50MG/10ML INJ 10
693 51020586 DEXKETOPROFEN 50MG INJ 5
694 51020587 ZYFORT INJEKSI 20
695 51020589 CHROME INJ 50 MG 10
696 51020593 VAKSIN PENTABIO 10
697 51020594 URESIX INJ 5
698 51020597 CEFOPERAZONE INJ 1 GR B2 1
699 51020598 PLASMINEX 500MG INJ 10
700 51020602 OMEPRAZOLE INJ MBF 10
701 51020604 FARTISON INJ 2
702 51020606 FURAMIN INJEKSI 5
703 51020610 SALTICIN 80 MG INJ (GENTAMICYN INJ ) 5
704 51020674 TOFEDEX INJ 2MLM 5
705 51020677 ESOLA INJEKSI 1
706 51020679 GRANISETRON 3 MG INJEKSI 5
707 51020680 CITICOLIN 500MG INJ BERNO 10
708 51020683 VITAMIN K1 INJEKSI BERNO 100
709 51020684 DIPHENHYDRAMINE INJEKSI 10
710 51020685 LANSOPRAZOLE INJ 1
711 51020686 NOREPINEPHRIN INJ 5
712 51020688 SANSULIN LOG G 1
713 51020689 VAKSIN MR (MEASLES RUBELA) 1
714 51020690 DUALVIS INJEKSI 1
715 51020691 ETHANYL INJEKSI 5
716 51020692 VALISANBE INJ 5
717 51020693 INDOP INJEKSI (DOPAMIN) 5
718 51020694 NOSORBID INJEKSI *
719 51020695 OMEPRAZOLE INJ DEXA 10
720 51020697 SIBITAL INJEKASI 5
721 51020698 HEPATITIS B RECOMBINAN DEWASA 10
722 51020701 GRANISETRON 1 MG INJEKSI 5
723 51020703 AZITROMYCIN INJEKSI 1
724 51020704 VASCON INJEKSI *
725 51020705 HEPAGUSAN INJEKSI 10
726 51030001 OTSU D40 infus 25 ml - Dextrose 40% 1
727 51030005 OTSU KCL 7,46 mg infus 25 ml 1
728 51030006 STERIL WATER 1 L OTSUKA ( WI 1L ) 1
729 51030007 OTSU D5 1/4 NS infus 500 ml *
730 51030008 OTSU D10,1/5NS 500ML *
731 51030012 OTSU D5 RUBBER 500ML *
732 51030018 OTSU MANITOL 20% infus 250 ml 1
733 51030019 OTSU MANITOL 20% infus 500 ml 1
734 51030020 OTSU MgSO4 20 infus 25ml 1
735 51030022 OTSU MgSO4 40 infus 25ml 1
736 51030031 OTSU NS 100ML PIGGYBACK *
737 51030032 PEDIALYTE sol 500 ml- Na 22,5 meq + *
738 51030034 KA-EN 1B infus 500 ml- Na 38,5 meq 20
739 51030035 KA-EN 3B infus 500 ml- Na 50 meq + 20
740 51030041 MEYLON 8.4% inf 25 ml - Na Bicarbon 1
741 51030043 OTSU SALIN/NS 3% 500ML 1
742 51030044 OTSU RL RUBBER 500ML INFUS *
743 51030050 OTSU WATER INJ 25ML 1
744 51030054 INFUSAN D5 100 ml 60
745 51030058 INFUSAN D5+1/4NS SP SFC 24
746 51030059 FUTROLIT infus 24
747 51030063 LEVOCIN Infus - Levofloxacin 1
748 51030066 INFUSAN NS 100 ml 60
749 51030070 INFUSAN RING AS DP 24 24
750 51030074 TRICHODAZOL Infusion - metronidazol 1
751 51030076 TRIDEX 27 A infus *
752 51030077 TRIDEX 27 B infus 24
753 51030081 OTSU D10 500ML infus 20
754 51030082 INFUSAN D5 500ML SP 24
755 51030084 INFUSAN NS 500ML SANBE INF 24
756 51030087 OTSU-RD5 500ML INF- NaCL 8.6g 20
757 51030093 METRONIDAZOLE INFUS 100ML BERNOFARM 1
758 51030094 TUTOFUSIN OPS 1
759 51030096 CIPROFLOXACIN INFUS BERNOFARM 1
760 51030102 AMINOFUSIN HEPAR 1
761 51030108 AMINOFLUID 1000ml 1
762 51030109 MARTOS 10 infus 500ml 20
763 51030111 TRIOFUSIN 500ml 1
764 51030116 Cravox Inf 100ml 1
765 51030119 Hidonac 20% Inf 1
766 51030122 Infusan D5+ 1/2NS DP 24 24
767 51030123 Infusan D5+ 1/2NS SP 24 24
768 51030130 Nimotop Infus 50ml 1
769 51030134 OTSU NS 25 ML 1
770 51030137 OTSU NS 1000ML *
771 51030139 COMAFUSIN HEPAR 500ML 1
772 51030141 HYDROGEN PEROKSIDA 50% 1L 1
773 51030142 INFUSAN RL DP 24 24
774 51030148 Renxamin Infus 1
775 51030149 Triofusin 1000 Inf 1
776 51030150 Triofusin E 1000 1
777 51030152 Wida WI Twist Off 1 L *
778 51030153 Aminofusin Paed 250ml 1
779 51030154 FIMA HES 200 *
780 51030373 LEVOFLOXACIN INF OGB BERNOFARM 100ML 1
781 51030380 AMINOSTERIL 6% INFANT 100ML 1
782 51030381 INTEGRILIN 100ML INF 1
783 51030382 CLINIMIX N9G15E INF 1
784 51030384 TRIOFUSIN 1600 INF 1
785 51030393 INFUSAN NS 0.9 % 1000 ML *
786 51030394 INFUSAN D5 500ML DP 24 24
787 51030395 SOJOURN 250 ML *
788 51030396 BAQUINOR INFUS SOFTBAG 1
789 51030397 ALBUMINAR 25% 100 ML 1
790 51030398 DEXTRAL 60 ML 1
791 51030399 ROBUMIN 20% 50 ML INFUS
792 51030408 FLUCONAZOLE INFUS 1
793 51030411 AERANE 250 ML 250
794 51030413 GELAFUSAL INFUS 1
795 51030415 ENERTON INFUS 24
796 51030416 OTSU D5 1/2 NS 500ML *
797 51030417 OTSU D5,NS 500ML *
798 51030418 CRAVOX 750 INF 1
799 51030419 PARACETAMOL INFUS BERNOFARM 1
800 51030420 IMIPENEM + CILASTATIN INFUS 1
801 51030421 CLINOLEIQ 20% 100 ML 1
802 51030422 RENOSAN INFUS 1
803 51030423 INFUMAL DP 10% 500 ML 24
804 51030426 INFUSAN M20 500ML 24
805 51030427 SANBE STERIL WATER 1000ML 1
806 51030433 NIMODIPIN INFUS 1
807 51030434 WIDA BES ( ASERING 500 ) 20
808 51030436 WIDA KDN1 500 MG (3B) 20
809 51030437 WIDAHES 130 500 ML 10
810 51030438 SEVODEX 250ML 250
811 51030439 KABIVEN PERIHERAL 1440 ML INFUS 1
812 51030440 GRIFOLS 20% 100ML 1
813 51030441 SEVOFLURANT 250 ML BAXTER 250
814 51040003 AMOXSAN 100MG/ML DROP 1
815 51040004 AMOXSAN 125MG/5ML SYR 60ML 1
816 51040005 CELESTAMINE syr 60 ml - Betamethaso 1
817 51040006 ELKANA syr 60 ml - Ca pantothenate 1
818 51040007 CEFAT 125mg/5ml dry syr 60ml - Cefa 1
819 51040010 OZEN 10 mg/ml drop 12 ml - Cetrizin 1
820 51040011 OZEN 5 mg/ml syr 60 ml - Cetrizine 1
821 51040012 VISTRUM syr 100 ml - Colostrum bovi 1
822 51040015 VOMETA 5mg/ml drop 10ml - Domperido 1
823 51040018 COMTUSI syr 100ml - Glyceryl guaico 1
824 51040019 PRORIS 100mg/5ml susp 60ml - Ibupro 1
825 51040020 POLYSILANE susp 100ml - MG(OH)2 200 1
826 51040023 SANMOL 120mg/ 5ml syr 60ml - Parace 1
827 51040024 TEMPRA 160mg/ 5ml syr 60ml - Parace 1
828 51040026 PRAXION 100mg/ml drops 15 ml - Para 1
829 51040027 PRAXION 120mg/5ml susp 60 ml - Para 1
830 51040028 PRAXION FORTE 250 mg/5ml syr 60 ml 1
831 51040032 INPEPSA 100 ml susp- Sukralfat 500m 1
832 51040037 CEFAT Dry Syr - Cefadroxil 250 mg/5 1
833 51040038 CLANEKSI Dry Syr 125 mg/5 ml - amox 1
834 51040039 CLANEKSI FORTE Dry Syr - Amoxicilli 1
835 51040040 CODIPRONT CUM EXPECTORANT SYR 60ML 1
836 51040041 CODIPRONT SYR 60ML 1
837 51040044 ERYSANBE Dry Syr - erythromycin 200 1
838 51040048 RYVELL 10mg/mL drop 30ml Citirizin 1
839 51040049 RYVELL syr 60 ml - Citirizine HCl 5 1
840 51040050 SANADRYL EXP Syr - difenhydramin HC 1
841 51040051 SAN-B-PLEX baby drops 15 ml - vit A 1
842 51040052 SANMOL drop - paracetamol 60 mg/0.6 1
843 51040054 SPORETIK Dry Syr - sefiksim 1
844 51040055 TREMENZA Syr 60 ml - pseudoephedrin 1
845 51040056 ZAMEL syr 60 ml - Vitamins 1
846 51040057 PRORIS FORTE syr 50ml - Ibuprofen 1
847 51040062 BISOLVON 10 mg/5 ml SOL 50 ml 1
848 51040063 DEXTROSIN SYR- dmp 15,phenylpropala 1
849 51040069 NIFURAL syp 60 ml 1
850 51040072 TEMPRA FORTE 250mg/5ml syr 60 ml - 1
851 51040074 PARACETAMOL syr 1
852 51040075 AMBROXOL syr 1
853 51040087 VERMIC drop 1
854 51040089 SANADARYL DMP 1
855 51040090 RENALYT syr 1
856 51040099 FERRIZ drop 1
857 51040106 ALCO PLUS syr 1
858 51040107 RHINOS JUNIOR syr 1
859 51040109 APYALIS 100ml syr 1
860 51040110 ZIN PRO syr 1
861 51040113 SILEX syr 1
862 51040116 LAXADIN syr 1
863 51040123 CEFIXIME SYR BERNOFARM 1
864 51040129 VECTRIN syr 1
865 51040131 FLUIMUCIL DS 75ml 1
866 51040132 LACTULAX syr 60ml 1
867 51040133 ALCO drop 1
868 51040134 LAPICEF 125mg syr 1
869 51040141 DULCOLACTOL syr 1
870 51040149 MYCOSTATIN DROP 12ML 1
871 51040152 IMUNOS SYR 60ML 1
872 51040157 CEFILA DS drop 30ml 1
873 51040163 CEFSPAN syr 1
874 51040166 DEPAKEN syr 1
875 51040182 Apialys Drop 10ml 1
876 51040193 Enervon C Syr 120ml 1
877 51040195 Ferriz 100ml Syr 1
878 51040202 Magtral Forte Dry Syr 120ml 1
879 51040206 Mucopect 15mg/5ml Syr 60ml 1
880 51040207 Mucopect 30mg/5ml Syr 60ml 1
881 51040219 POLYCROL SYR 100ML 1
882 51040301 BATUGIN ELIXIR 300ML 1
883 51040305 ISOPRINOSINE SYR 1
884 51040315 Osteocare Syr 100ml 1
885 51040320 Vometa Syr 60ml 1
886 51040321 CANDISTIN DROP 1
887 51040322 Tempra Drop 1
888 51040324 Rhinofed Syr 1
889 51040325 Vomitas Syr 60ml 1
890 51040339 POLYCROL FORTE SYR 100ML 1
891 51040346 LASAL EXPECTORANT SYR 100ML 1
892 51040353 OBH IKA 100ML 1
893 51040356 SIRPLUS SIRUP RASA JERUK 100ML 1
894 51040358 LAPICEF FORTE 250MG/ML DRY SYR 1
895 51040359 CURVIT CL EMULSION 175ML SYR 1
896 51040361 MUCOPECT DROP 1
897 51040363 SIRPLUS SIRUP RASA ANGGUR 100ML 1
898 51040364 SIRPLUS SIRUP RASA STROBERI 100ML 1
899 51040371 RANIVEL SIRUP 60 ML 1
900 51040395 LASAL SYR 1
901 51040397 BIOTHICOL DRY SYR 1
902 51040399 CEFADROXIL SYR BERNOFARM 1
903 51040400 TRACETATE SUSPENSI ORAL 1
904 51040403 IMBOOST FORCE SYR 120ML 1
905 51040407 AMOXSAN FORTE DRY SYR 1
906 51040412 AMBROXOL 30MG SYR 1
907 51040415 LAPROSIN SYR 60ML 1
908 51040416 L-ZINC SYR 1
909 51040417 MEXTRIL SYR 1
910 51040418 BIOTHICOL FORTE DRY SYR 60ML 1
911 51040419 MYCOSTATIN SYR 30ML 1
912 51040421 ZINKID SYR 100ML 1
913 51040423 VIPALBUMIN DRY SYRUP 1
914 51044104 ELKANA CL SYRUP 1
915 51044108 FRISOLAC GOLD 1 400GR 1
916 51044109 FRISOLAC GOLD 2 400GR 1
917 51044110 LACTULAC SYR 120 ML 1
918 51044111 CETIRIZINE SYRUP 1
919 51044112 PEPTIFAT 200ML 1
920 51044113 VIVIT R-HIDRATE APEL 200ML 1
921 51044114 VIVITY R-HIDRATE JERUK, 200ML 1
922 51044115 SANADRYL DMP 120 ML SYRUP 1
923 51044116 AZOMAX DRY SYRUP 200MG/ 5ML 1
924 51044182 MONARIN TAB 10MG 1
925 51044183 VOSTRIN DS SYR 60 ML 1
926 51044184 DESTAVELL SRY 60 ML 1
927 51044188 ALCO DMP SYR 1
928 51044189 AZITHROMICIN SYR 1
929 51060001 BAQUINOR TETES MATA - CIPROFLOXACIN 1
930 51060002 BREATHY tetes hidung 6.5mg/Ml - NaC 1
931 51060003 FENICOL 1% 5ml Eye Drop 1
932 51060004 SAGESTAM ear drops 5 ml - Gentamyci 1
933 51060005 XITROL Eye Drop 5 ml - Neomycin 3.5 1
934 51060007 VASACON A MINI DOSE 1
935 51060008 VASACON EYE DROP 1
936 51060011 FENICOL 0.25% 5ml Eye Drop 1
937 51060012 FENICOL EYE OINT 3.5g 1
938 51060013 CONVER Eye Drop 1
939 51060015 EYEFRESH MINI DOSE 1
940 51060017 FLOXA Eye Drop 1
941 51060018 TOBROSON Eye Drop 1
942 51060020 PROTAGENTA A MINI DOSE 1
943 51060022 TARIVID OPTH 5ML EYE DROP 1
944 51060023 CATARLENT 5ML EYE DROP 1
945 51060027 Fenicol 0.5 % 5ml Eye Drop 1
946 51060030 Hialid Eye Drop 5ml 1
947 51060034 Mydriatyl 0.5% 5ml 1
948 51060035 Mydriatyl 1% 5ml 1
949 51060036 Tarivid Otic 1
950 51060037 Pantocain 2% 5ml Eye Drop 1
951 51060038 XITROL MINI DOSES 1
952 51060039 POLYGRAN EYE OINT 3.5G 1
953 51060040 POLYGRAN 0.6ML MINIDOSE 1
954 51060041 LFX MINIDOSE 1
955 51060044 OCULOTECT GEL 10 G 1
956 51060045 LYTEERS 15ML EYE DROP 1
957 51060046 POLYDEX 5ML EYE DROP 1
958 51060048 CENFRESH EYE DROP 5ML 1
959 51060049 EYEFRESH EYE DROP 5ML 1
960 51060050 EFRISEL EYE DROP 5ML 1
961 51060051 TIMOL EYE DROP 5ML 1
962 51060052 HERVIS EYE OINT 3.5G 1
963 51060053 STATROL EYE DROP 5ML 1
964 51060054 VERNACEL EYE DROP 5ML 1
965 51060055 NONCORT MINI DOSE 1
966 51060056 OPTHALGON EYE DROP 3ML 1
967 51060058 POLYNEL 5ML EYE DROP 1
968 51060059 CENFRESH 0.6 MINI DOSE 1
969 51060060 HYALUB MD 1
970 51060061 AFRIN NASAL SPRAY 15ML 1
971 51060062 TROPIN 1% ED 5ML 1
972 51060063 OTOPAIN EAR DROP 8ML 1
973 51060064 OCULENTA EYE OINT 3.5G 1
974 51060066 ILIADIN NASAL DROP 0.25 1
975 51060068 CARPINE 1% ED 5ML 1
976 51060069 CARPINE 2% ED 5ML 1
977 51060070 CARPINE 4% ED 5ML 1
978 51060071 PANTOCAIN 0.5 ED 5ML 1
979 51060072 AUGENTONIC ED 5ML 1
980 51060074 VITROLENTA ED 5ML 1
981 51060075 POLYGRAN ED 5ML 1
982 51060076 TOBROSON 0.6ML MD 1
983 51060082 XITROL EYE OINT 1
984 51060083 ASTHENOF EYE DROP 1
985 51060084 MYCOS EYE OINT 1
986 51060085 MYCOS EYE DROP 1
987 51060086 TOBRO MINI DOSES 1
988 51060087 CATARLENT 15ML EYE DROP 1
989 51060088 CENDO GENTAMYCIN SALEP MATA 1
990 51060090 PROTAGENTA 5 ML 1
991 51060091 OTILON EAR DROP 1
992 51060093 CENDO GALUPEN MINIDOSE ED 1
993 51060094 CENDO P-PRED MINIDOSE 1
994 51060095 CENDO POSOP MINIDOSE 1
995 51062092 BLECIDEX EYE/EAR DROP
996 51070001 FLIXOTIDE 0,5mg/ 2ml nebules - Flut 20
997 51070003 VENTOLIN 2,5 mg nebulise 2,5 ml - S 20
998 51070007 PULMICORT 0.25 mg resp - Budesonide 20
999 51070008 PULMICORT 0.5 mg resp - Budesonide 20
1000 51070011 COMBIVENT 2.5ML UDV 10S 20
1001 51070014 Ventolin Inhaler 1
1002 51070016 STERIMAR ORIGINAL 50ML / DEWASA 1
1003 51070017 STERIMAR BABY 50ML 1
1004 51070019 SERETIDE DISCUS 250 INHALASI 1
1005 51070022 SYMBICORT TURB 160 DOSES 120 1
1006 51070023 AVAMYS NASAL SP 1
1007 51070030 LASAL NEBU (SALBUTAMOL 2,5MG) 20
1008 51070031 BREATHY NASAL SPRAY 1
1009 51080005 VAKSIN BCG 1 DS *
1010 51080006 VAKSIN POLIO 10 DS vial 10
1011 51080007 FORMALIN 1ML *
1012 51080009 SEMAX 0.1 % SOLUTION 1
1013 51080012 GUARDIX SOL 5G *
1014 51080021 VAKSIN FLUBIO 1
1015 51090001 CLINOVIR 5 g cream - Asiklovior 1
1016 51090004 VOLTAREN emulgel 20 g- Diclofenac d 1
1017 51090010 BURNAZIN 10 mg/g cream 35 g - Silve 1
1018 51090011 CINOLON cream 10 g - Fluicinolon As 1
1019 51090012 CINOLON N cream 10 g - Fluicinolon 1
1020 51090013 EMLA cream 5 g - Lidocaine 25 mg, p 1
1021 51090015 ACYCLOVIR 5% CREAM 1
1022 51090016 APOLAR CREAM 10G - DESONIDE 1
1023 51090017 APOLAR-N CREAM 10G - DESONIDE,NEOMY 1
1024 51090018 BIOPLACENTON GEL (neomycin sulfate 1
1025 51090021 FUSYCOM 5gr cream - Fusidic acid 1
1026 51090024 HYDROCORTISONNE 2.5% CREAM 1
1027 51090025 KALMICETINE DERMATOLOG (chloramphen 1
1028 51090028 MICONAZOLE 2% CREAM 1
1029 51090029 THROMBOPHOB gel 1
1030 51090037 KENALOG IN ORABASE 5g 1
1031 51090039 FELDENE gel 0.5% 15g 1
1032 51090040 MYCO-Z 10g oint 1
1033 51090043 FAKTU ointment 20 G - Policresulen 1
1034 51090049 Boraginol N Oint 15g 1
1035 51090050 Boraginol S Oint 15g 1
1036 51090053 Dermovel Cream 10g 1
1037 51090056 Esperson 0.25% Cream 15g 1
1038 51090057 Forderm 10g Cream 1
1039 51090064 Mebo Oint 15g 1
1040 51090066 Salep Ichtyol 15g 1
1041 51090069 BACTODERM 10G OINT 1
1042 51090072 CARMED CREAM 40G 1
1043 51090077 ELOCON CREAM 10G 1
1044 51090081 Ketoconazole 2% Cream 10g OGB Dexa 1
1045 51090082 Mederma Topikal Tube 20g 1
1046 51090090 ELOCON OINT 10G 1
1047 51090091 GENTAMICIN 0.1 % SALEP KULIT 5 G 1
1048 51090094 BACTODERM 5G CREAM 1
1049 51090098 DECUBAL CREAM 20G 1
1050 51090099 KLODERMA CREAM 10G 1
1051 51090100 KLODERMA OINT 10G 1
1052 51090105 COUNTERPAIN CREAM 30G 1
1053 51090106 DIPROGENTA CREAM 10G 1
1054 51090111 BETADINE OINT 10G 1
1055 51090116 ALOCLAIR GELL 8ML 1
1056 51090123 VOLTAREN EMULGEL 50G 1
1057 51090124 SCABIMATE 10G CREAM 1
1058 51090128 VITACID CREAM 0.05% 20 G 1
1059 51090134 NOVELL SMOOTHING CREAM 28.4G 1
1060 51090138 MEDIKLIN CREAM 1
1061 51090146 FORMYCO CREAM 1
1062 51090147 INSTILLAGEL ALMED 10 ML 25
1063 51090150 SCABIMITE 30 GR 1
1064 51090151 MUPIROCYN CREAM 10GR 1
1065 51090153 SAGESTAM CREAM 10GR 1
1066 51090157 KLODERMA LOTION 30ML 1
1067 51090158 PIROTOP CREAM 10GR 1
1068 51090159 MEDICORT CREAM 10 GR 1
1069 51090160 ERYMED GEL 1
1070 51090161 MOMETASON CREAM 10GR 1
1071 51090163 KETOMED SS 60ML 1
1072 51090164 KETOMED CREAM 15GR 1
1073 51090165 MEDSCAB CREAM 30GR 1
1074 51090166 REFAQUIN CREAM 10 GRAM 1
1075 51090167 DESOLEX CREAM 10 GRAM 1
1076 51090168 PARASOL FC SPF 33 20 GRAM 1
1077 51090169 TOPICARE CREAM 100 GR 1
1078 51100001 DULCOLAX 10 mg adult supp - Bisacod 10
1079 51100004 PROFENID 100 mg supp - Ketoprofen 10
1080 51100008 MICROLAX enema 5ml - Na lauryl SO4 1
1081 51100014 DUMIN RECATAL 125MG SUPP- paracetam 5
1082 51100015 DUMIN RECTAL 250MG SUPP- paracetamo 5
1083 51100016 STESOLID 5 MG RECTAL TUBE 5
1084 51100017 FAKTU supp- Policresulen 100 mg, ci 10
1085 51100019 Boraginol N Suppo 10
1086 51100020 Boraginol S Suppo 10
1087 51100022 Fladystin Ovula 10
1088 51100023 Pronalges Suppo 1G 10
1089 51100024 Propyretic 160mg Suppo 12
1090 51100025 Propyretic 240mg Suppo 12
1091 51100026 Propyretic 80mg Suppo 12
1092 51100027 STESOLID 10MG RECTAL TUBE 5
1093 51100028 TRAMAL 100MG SUPPO *
1094 51100029 DULCOLAX 5MG CHILD SUPPO 10
1095 51100032 Proris Suppositoria 10
1096 51101137 TRICHODAZOLE PLUS VAG SUPP *
1097 51120001 LACTACYD LIQUID BABY 60 ml liquid - 1
1098 51120002 XYLOCAIN 50 ml spray - Lidocain 1
1099 51120005 ALKOHOL 70% 1 L ( BRATACO ) 1
1100 51120006 SALICYL TALK 1
1101 51120007 SALICYL TALK MENTHOL 80gr 1
1102 51120008 ALBOTHYL CONC 10 ml - Policresulen 1
1103 51120009 OXOFERIN SOL 30ml - Tetra chlorodec 1
1104 51120022 GARAM INGGRIS 1G 1,000
1105 51120023 BORAX GLISERIN 8ml 1
1106 51120025 ISODINE GARGLE 190ml 1
1107 51120029 GARAM INGGRIS 1kg 1,000
1108 51120032 Acid Salicylk 1kg 1,000
1109 51120033 ALKOHOL 96% 1L ( BRATACO ) 1
1110 51120037 Camphora 500g *
1111 51120040 Condom Sutra @ 12 12
1112 51120041 Fleet Enema 1
1113 51120042 Gentian Violet 1% 10ml 1
1114 51120045 Nebacetin Powder 5g 1
1115 51120047 Nova T 1
1116 51120051 Wash Bensin 1 ml *
1117 51120055 ALOCLAIR ORAL RINSE 60ML 1
1118 51120056 CALCII CARBONAT ( CACO3) 1,000
1119 51120057 COFFEINUM 500G *
1120 51120062 Natrium Chlorida PH 1 Kg 1,000
1121 51120063 Sulfur 1 mg *
1122 51120074 BETADINE VAGINAL DOUCHE 100ML 1
1123 51120076 PK KRISTAL 5G 1
1124 51120082 MINOSEP OBAT KUMUR 150ML 1
1125 51120083 ALKOHOL 70% 100ML 1
1126 51120090 BETADINE OBAT KUMUR 1
1127 51120091 STARDINE 1 ML 1,000
1128 51120092 LACTACYD PINK 60 ML 1
1129 51120096 SOFRA-TULLE 10 X 10 *
1130 51120098 SACCARUM LACTIS ( LAKTOSUM ) 1,000
1131 51120102 LOMATUELL 10X10CM 10
1132 51120105 COMBANTRIN JERUK 10 ML
1133 51150007 POT PLASTIK 10CC 1
1134 51150008 POT PLASTIK 100cc 1
1135 51150009 POT PLASTIK 20CC 1
1136 51150010 POT PLASTIK 200cc 1
1137 51150011 POT PLASTIK 30CC 1
1138 51150012 POT PLASTIK 50CC 1
1139 51150013 POT PLASTIK 75cc 1
1140 51150015 BOTOL COKLAT 100 cc 1
1141 51150016 BOTOL COKLAT 200 cc 1
1142 51150019 BOTOL BELING 150 mL 1
1143 51150040 UNDERPAD SENSI PADS 10
1144 51150044 LOPROX NAIL LACQUER 1
1145 51150045 KERTAS PUYER BERLOGO *
1146 51150046 KERTAS PERKAMEN *
1147 51150047 KAPSUL NO 3 1,000
1148 51150048 KAPSUL NO 2 1,000
1149 51150049 KAPSUL NO 1 1,000
1150 51150050 KAPSUL NO 0 1,000
1151 51150051 KAPSUL NO 00 1,000
1152 51150052 BOTOL 30 CC + PIPET 1
1153 51160001 CONSUMABLE I
1154 51160002 CONSUMABLE II
1155 51020675 INFANRIX HEXA 1
1156 51011440 TELMISARTAN 40 MG #REF!
1157 51011367 ARKINE 2MG 100
1158 51180349 EZELIN INSULIN 1
1159 51044187 SANMOL FORTE SYRUP 1
1160 51020681 UMARON INJ 1
1161 51011435 UTROGESTAN 200MG CAPSSUL 15
1162 51011438 FOSRENOL TABLET 90
1163 51030442 MOXIFLOXACIN INFUS 1
1164
FAKTUR / BX FAKTUR SATUAN FAKTUR 4,444 0
HNA HNA HNA +PPN COST TOTAL COST MARGIN
SATUAN NEW
20,768 5,900 6,490 - 6,490 8,437
850 935 - 935 1,216
512,000 507 558 44 602 783
830 913 - 913 1,187
4,300 4,730 - 4,730 6,149
7,500 8,250 1 8,251 10,727
14,599 133 146 44 191 248
17,206 165 182 44 226 294
3,630 3,993 #VALUE! #VALUE! #VALUE!
3,479 3,827 #VALUE! #VALUE! #VALUE!
10,150 11,165 #VALUE! #VALUE! #VALUE!
24,727 27,200 #VALUE! #VALUE! #VALUE!
820 902 #VALUE! #VALUE! #VALUE!
840 924 #VALUE! #VALUE! #VALUE!
130 143 #VALUE! #VALUE! #VALUE!
462,000 6,000 6,600 44 6,644 8,638
220,000 4,000 4,400 89 4,489 5,836
10,093 11,102 #VALUE! #VALUE! #VALUE!
5,398 5,938 0 5,938 7,720
312,329 3,123 3,435 44 3,480 4,524
250,000 4,167 4,584 74 4,658 6,055
550 605 #VALUE! #VALUE! #VALUE!
1,608 1,769 1 1,770 2,300
1,083 1,191 1 1,193 1,550
312,145 5,675 6,243 89 6,331 8,231
300,000 10,000 11,000 44 11,044 14,358
802,516 7,296 8,026 44 8,070 10,491
133,500 1,335 1,469 44 1,513 1,967
100,000 110,000 0 110,000 143,001
9,100 10,010 #VALUE! #VALUE! #VALUE!
18,857 20,743 6 20,749 26,974
14,857 16,343 0 16,343 21,246
608 669 #VALUE! #VALUE! #VALUE!
29,000 290 319 44 363 472
85,000 2,000 2,200 89 2,289 2,976
2,426 2,669 #VALUE! #VALUE! #VALUE!
156,090 5,500 6,050 1 6,051 7,867
7,700 8,470 #VALUE! #VALUE! #VALUE!
106,920 10,800 11,880 444 12,324 16,022
4,118 4,530 0 4,530 5,889
192,000 3,200 3,520 74 3,594 4,672
239,600 11,980 13,178 222 13,400 17,420
621,027 36,900 40,590 247 40,837 53,088
74,250 2,475 2,723 148 2,871 3,732
119,500 1,195 1,315 44 1,359 1,767
55,000 550 605 44 649 844
3,450 3,795 1 3,796 4,935
7,185 7,904 0 7,904 10,275
5,745 6,320 0 6,320 8,216
4,310 4,741 0 4,741 6,163
1,945 2,140 0 2,140 2,781
19,770 21,747 0 21,747 28,271
7,920 8,712 #VALUE! #VALUE! #VALUE!
400,000 4,000 4,400 44 4,444 5,778
145,500 1,455 1,601 44 1,645 2,138
166,000 1,660 1,826 44 1,870 2,432
172,200 17,220 18,942 444 19,386 25,202
91,500 915 1,007 44 1,051 1,366
12,723 13,995 #VALUE! #VALUE! #VALUE!
271,400 13,570 14,927 22 14,949 19,434
1,014,500 10,145 11,160 44 11,204 14,565
12,100 13,310 #VALUE! #VALUE! #VALUE!
62,270 623 685 44 730 949
123,398 1,122 1,234 0 1,235 1,605
793,760 7,216 7,938 44 7,982 10,377
105,028 9,548 10,503 4 10,507 13,659
2,590 2,849 0 2,849 3,704
83,683 895 985 0 985 1,280
10,945 12,040 #VALUE! #VALUE! #VALUE!
534 587 0 587 764
32,944 631 694 0 694 902
19,008 192 211 44 256 332
320,000 3,200 3,520 44 3,564 4,634
155 171 0 171 222
64,130 583 641 0 642 834
3,775 4,153 0 4,153 5,399
15,416 275 303 74 377 490
724 796 0 796 1,035
62,520 1,250 1,375 89 1,464 1,903
4,000 4,400 2 4,402 5,723
112 123 0 123 160
186 205 1 205 267
367 404 0 404 525
600 660 0 660 858
23,513 113 124 22 147 190
1,704 1,874 0 1,874 2,437
23,840 238 262 44 306 398
373 410 0 411 534
64,864 590 649 44 693 901
103,825 1,038 1,142 44 1,186 1,542
303 333 0 333 433
466 513 1 513 668
358 394 1 395 513
750 825 0 825 1,073
381,143 3,572 3,929 44 3,974 5,166
137 151 #VALUE! #VALUE! #VALUE!
19,800 200 220 44 264 344
402,000 1,608 1,769 18 1,787 2,323
814,200 2,961 3,257 18 3,275 4,257
2,555 2,811 0 2,811 3,654
14,835 135 149 0 149 193
1,176 1,294 #VALUE! #VALUE! #VALUE!
451 496 0 496 645
36,497 342 376 0 376 489
1,275 1,403 #VALUE! #VALUE! #VALUE!
76 84 0 84 109
108 119 0 119 154
1,217 1,339 #VALUE! #VALUE! #VALUE!
12,917 129 142 44 186 242
71 78 0 78 102
10,731 98 108 44 152 198
59 65 #VALUE! #VALUE! #VALUE!
19,360 21,296 #VALUE! #VALUE! #VALUE!
290 319 0 319 415
450 495 #VALUE! #VALUE! #VALUE!
120,445 1,204 1,324 44 1,369 1,779
1,055 1,161 0 1,161 1,509
896 986 #VALUE! #VALUE! #VALUE!
152,500 1,525 1,678 44 1,722 2,239
44,985 1,500 1,650 148 1,798 2,338
1,300 1,430 #VALUE! #VALUE! #VALUE!
78,750 1,227 1,350 89 1,439 1,870
163,557 2,974 3,271 3 3,274 4,257
340,000 3,400 3,740 44 3,784 4,920
2,820 3,102 1 3,103 4,034
4,834 5,317 0 5,317 6,913
195,600 3,260 3,586 74 3,660 4,758
3,180 3,498 0 3,498 4,547
3,650 4,015 0 4,015 5,220
75,900 2,300 2,530 148 2,678 3,482
527,000 5,333 5,866 37 5,903 7,674
250,000 5,500 6,050 89 6,139 7,981
5,083 5,591 5 5,596 7,275
459,000 4,590 5,049 44 5,093 6,621
5,867 6,454 3 6,457 8,394
248,565 8,286 9,115 148 9,263 12,042
19,500 21,450 1 21,451 27,887
18,648 20,513 0 20,513 26,667
19,200 21,120 5 21,125 27,462
20,137 22,151 0 22,151 28,796
4,750 5,225 0 5,225 6,793
371,250 37,500 41,250 444 41,694 54,203
159,924 175,916 0 175,916 228,691
217 239 0 239 310
1,500 1,650 4 1,654 2,151
1,901 2,091 0 2,091 2,718
12,500 13,750 0 13,750 17,875
4,241 4,665 0 4,665 6,065
156,000 5,200 5,720 148 5,868 7,629
309,006 10,300 11,330 148 11,478 14,922
53 58 0 58 76
34,310 34,010 37,411 148 37,559 48,827
187,000 1,870 2,057 44 2,101 2,732
1,716 1,888 0 1,888 2,454
969 1,066 1 1,067 1,388
4,106 4,517 0 4,517 5,872
6,285 6,914 0 6,914 8,988
1,165 1,282 0 1,282 1,666
347,000 5,783 6,361 74 6,435 8,366
114,000 3,800 4,180 148 4,328 5,627
250,000 5,000 5,500 89 5,589 7,266
6,000 6,600 1 6,601 8,582
3,577 3,935 1 3,936 5,117
200 220 1 221 287
147,000 7,350 8,085 222 8,307 10,799
11,000 110 121 44 165 215
220,000 100 110 22 132 172
400,000 8,000 8,800 89 8,889 11,556
316,406 2,876 3,164 44 3,208 4,170
280,000 14,000 15,400 222 15,622 20,309
17,467 19,214 3 19,217 24,982
19,783 21,761 1 21,763 28,292
4,200 4,620 4 4,624 6,012
14,242 15,666 0 15,666 20,366
187,500 6,250 6,875 148 7,023 9,130
250,000 2,500 2,750 44 2,794 3,633
4,000 4,400 0 4,400 5,720
3,400 3,740 1 3,741 4,864
4,498 4,948 0 4,948 6,433
56,000 61,600 0 61,600 80,080
7,511 8,262 0 8,262 10,741
56,100 61,710 0 61,710 80,224
12,831 12,831 14,114 148 14,262 18,541
7,698 8,468 0 8,468 11,008
80 88 0 88 114
5,230 5,753 5 5,758 7,485
270,600 13,530 14,883 222 15,105 19,637
135 149 0 149 193
38,693 387 426 44 470 611
63,800 580 638 44 682 887
2,118 2,330 0 2,330 3,029
582 640 #VALUE! #VALUE! #VALUE!
297,000 10,000 11,000 1 11,001 14,302
220 242 0 242 315
370 407 #VALUE! #VALUE! #VALUE!
19,800 21,780 #VALUE! #VALUE! #VALUE!
11,000 12,100 #VALUE! #VALUE! #VALUE!
512,000 17,067 18,774 148 18,922 24,598
645,140 23,041 25,345 159 25,504 33,155
555 611 #VALUE! #VALUE! #VALUE!
123,400 823 905 30 935 1,215
9,650 10,615 8 10,623 13,810
22,000 24,200 #VALUE! #VALUE! #VALUE!
35,000 38,500 3 38,503 50,054
434,570 14,486 15,935 148 16,083 20,908
241,000 7,303 8,033 148 8,181 10,636
490,875 17,000 18,700 148 18,848 24,503
37,000 40,700 15 40,715 52,929
106,200 885 974 37 1,011 1,314
10,500 11,550 5 11,555 15,021
6,000 6,600 0 6,600 8,581
1,561 1,717 0 1,717 2,233
3,048 3,353 0 3,353 4,359
370,000 7,400 8,140 89 8,229 10,698
2,228 2,451 0 2,451 3,186
116 128 0 128 166
203222 1,847 2,032 0 2,032 2,641
8,733 9,606 0 9,606 12,488
96,000 105,600 0 105,600 137,280
3,100 3,410 0 3,410 4,433
97,650 12,206 13,427 556 13,982 18,177
225,000 2,250 2,475 44 2,519 3,275
405,584 3,687 4,056 44 4,100 5,330
10,233 11,256 19 11,275 14,657
555,000 18,500 20,350 148 20,498 26,648
300,000 30,000 33,000 444 33,444 43,478
5,000 5,500 1 5,501 7,151
1,950 2,145 1 2,146 2,790
335,000 3,350 3,685 4 3,689 4,796
148,500 4,500 4,950 148 5,098 6,628
60,500 1,833 2,016 148 2,164 2,814
200,000 6,667 7,334 0 7,334 9,534
64,000 640 704 89 793 1,031
605,000 5,500 6,050 44 6,094 7,923
785,659 7,142 7,856 0 7,856 10,213
5,300 5,830 2 5,832 7,581
350,000 11,667 12,834 1 12,835 16,686
600 660 0 660 858
165,000 16,500 18,150 444 18,594 24,173
8,412 81 89 0 89 116
127 140 0 140 182
41,140 880 968 9 977 1,270
7,644 8,408 0 8,408 10,931
112,200 2,000 2,200 74 2,274 2,956
7,000 7,700 0 7,700 10,010
9,667 10,634 0 10,634 13,824
210,870 7,100 7,810 2 7,812 10,156
2,667 2,934 0 2,934 3,814
197,146 3,584 3,942 89 4,031 5,241
312,230 6,245 6,870 89 6,958 9,046
8,304 9,134 0 9,134 11,875
4,100 4,510 2 4,512 5,865
3,190 3,509 #VALUE! #VALUE! #VALUE!
53 58 0 58 76
60,000 1,000 1,100 74 1,174 1,526
147,600 1,476 1,624 44 1,668 2,168
204,000 6,800 7,480 148 7,628 9,917
11,136 371 408 148 556 723
1,365 1,502 0 1,502 1,953
14,731 16,204 5 16,209 21,072
1,200 1,320 1 1,321 1,718
4,050 4,455 0 4,455 5,792
495,000 16,500 18,150 148 18,298 23,788
8,400 9,240 0 9,240 12,012
1,150 1,265 0 1,265 1,645
7,000 7,700 5 7,705 10,016
5,370 5,907 0 5,907 7,679
4,250 4,675 #VALUE! #VALUE! #VALUE!
12,100 13,310 0 13,310 17,303
20,573 22,630 0 22,630 29,419
450 495 #VALUE! #VALUE! #VALUE!
68,833 626 689 44 733 953
1,650 1,815 0 1,815 2,360
2,355 2,591 #VALUE! #VALUE! #VALUE!
420 462 0 462 601
104,490 3,483 3,831 148 3,979 5,173
19,200 192 211 44 256 332
14,300 130 143 44 187 244
3,854 4,239 1 4,241 5,513
1,859 2,045 0 2,045 2,659
10,500 11,550 0 11,550 15,016
9,156 10,072 0 10,072 13,093
1,622 1,784 0 1,784 2,319
197 217 0 217 282
4,843 5,327 #VALUE! #VALUE! #VALUE!
129,475 1,521 1,673 44 1,718 2,233
3,600 3,960 0 3,960 5,148
3,500 3,850 #VALUE! #VALUE! #VALUE!
1,839 2,023 0 2,023 2,630
432,728 3,934 4,327 44 4,372 5,683
4,343 4,777 #VALUE! #VALUE! #VALUE!
4,384 4,822 0 4,822 6,269
258,500 2,350 2,585 0 2,585 3,361
360,000 12,000 13,200 148 13,348 17,353
450 495 0 495 644
8,919 9,811 0 9,811 12,754
8,000 8,800 2 8,802 11,443
368 405 0 405 526
409 450 0 450 585
165 182 0 182 236
9,199 167 184 89 273 354
225,000 743 817 44 862 1,120
13,120 14,432 0 14,432 18,762
23,500 235 259 44 303 394
655,006 5,955 6,551 0 6,551 8,516
203,940 6,180 6,798 148 6,946 9,030
13,250 14,575 1 14,576 18,949
1,620 1,782 0 1,782 2,317
76,800 2,560 2,816 148 2,964 3,853
280 308 0 308 400
35,750 813 894 111 1,005 1,307
22,801 456 502 3 505 656
3,600 3,960 0 3,960 5,148
270 297 1 298 388
55 61 #VALUE! #VALUE! #VALUE!
94 103 #VALUE! #VALUE! #VALUE!
122 134 #VALUE! #VALUE! #VALUE!
590 649 #VALUE! #VALUE! #VALUE!
422,400 16,000 17,600 148 17,748 23,073
4,600 5,060 #VALUE! #VALUE! #VALUE!
2,080 2,288 #VALUE! #VALUE! #VALUE!
903,326 8,212 9,033 1 9,035 11,745
206,814 1,880 2,068 44 2,112 2,746
27,940 254 279 44 324 421
2,211 2,432 0 2,432 3,162
23,670 26,037 2 26,039 33,850
195 215 0 215 279
100,000 420 462 74 536 697
2,000 2,200 0 2,200 2,860
6,233 6,856 0 6,856 8,913
2,500 2,750 1 2,751 3,576
1,075 1,183 0 1,183 1,537
1,130 1,243 0 1,243 1,616
14,667 16,134 0 16,134 20,974
2,573 2,830 0 2,830 3,679
4,854 5,339 0 5,339 6,941
5,000 5,500 0 5,500 7,150
11,302 12,432 #VALUE! #VALUE! #VALUE!
2,474 2,721 0 2,721 3,538
6,316 6,948 #VALUE! #VALUE! #VALUE!
8,591 9,450 #VALUE! #VALUE! #VALUE!
12,260 13,486 0 13,486 17,532
1,061 1,167 #VALUE! #VALUE! #VALUE!
- - #VALUE! #VALUE! #VALUE!
164 180 0 180 235
8,203 9,023 #VALUE! #VALUE! #VALUE!
5,075 5,583 #VALUE! #VALUE! #VALUE!
209,000 6,333 6,966 148 7,114 9,249
175,000 3,500 3,850 89 3,939 5,121
2,142 2,356 #VALUE! #VALUE! #VALUE!
315,973 31,597 34,757 444 35,201 45,761
399,064 12,957 14,253 3 14,256 18,533
445,200 7,950 8,745 79 8,824 11,472
344,850 3,300 3,630 4 3,634 4,725
149,834 164,817 3 164,821 214,267
10,468 11,515 3 11,517 14,973
6,083 6,691 0 6,691 8,699
16,015 17,617 0 17,617 22,902
44,420 888 977 89 1,066 1,385
345 380 0 380 493
6,600 7,260 0 7,260 9,438
36,300 39,930 #VALUE! #VALUE! #VALUE!
6,442 7,086 #VALUE! #VALUE! #VALUE!
- - #VALUE! #VALUE! #VALUE!
19,700 21,670 #VALUE! #VALUE! #VALUE!
116,875 128,563 #VALUE! #VALUE! #VALUE!
6,694 7,363 #VALUE! #VALUE! #VALUE!
550 605 #VALUE! #VALUE! #VALUE!
1,694 1,863 #VALUE! #VALUE! #VALUE!
386,100 13,000 14,300 148 14,448 18,783
590,775 5,371 5,908 44 5,953 7,738
1,077,500 215,500 237,050 889 237,939 309,320
398 438 1 439 571
1,690 1,859 0 1,859 2,417
45,000 49,500 889 50,389 65,505
603 663 0 663 862
65,149 1,185 1,304 89 1,392 1,810
104,000 130 143 44 187 244
19,717 21,689 0 21,689 28,195
6,650 7,315 1 7,316 9,511
8,500 9,350 1 9,351 12,157
135,000 2,700 2,970 89 3,059 3,977
2,400 2,640 0 2,640 3,432
12,470 13,717 0 13,717 17,832
1,474 1,621 1 1,622 2,109
363,000 33,000 36,300 444 36,744 47,768
119,763 1,675 1,843 44 1,887 2,453
28,557 31,413 0 31,413 40,837
6,000 6,600 15 6,615 8,599
18,040 19,844 1 19,845 25,798
9,000 9,900 0 9,900 12,870
5,750 6,325 0 6,325 8,223
11,250 12,375 #VALUE! #VALUE! #VALUE!
6,000 6,600 0 6,600 8,580
282,150 9,000 9,900 148 10,048 13,063
5,333 5,866 #VALUE! #VALUE! #VALUE!
346,500 15,750 17,325 222 17,547 22,811
11,100 12,210 2 12,212 15,875
15,000 16,500 #VALUE! #VALUE! #VALUE!
9,300 10,230 7 10,237 13,309
70,000 9,000 9,900 444 10,344 13,448
15,594 17,153 #VALUE! #VALUE! #VALUE!
7,744 8,518 0 8,519 11,074
147,081 161,789 44 161,834 210,384
438 482 #VALUE! #VALUE! #VALUE!
1,270 1,397 0 1,397 1,816
266,453 19,032 20,935 317 21,253 27,628
8,000 8,800 #VALUE! #VALUE! #VALUE!
128,048 13,695 15,065 444 15,509 20,162
80,000 8,000 8,800 444 9,244 12,018
110,000 10,000 11,000 444 11,444 14,878
76,800 1,607 1,768 148 1,916 2,491
4,420 4,862 4 4,866 6,326
840 924 15 939 1,220
550 605 3 608 790
320 352 0 352 458
49,000 490 539 44 583 758
725 798 0 798 1,037
100,000 6,000 6,600 148 6,748 8,773
100,000 1,667 1,834 74 1,908 2,480
60,000 66,000 0 66,000 85,800
483 531 1 533 693
61,000 610 671 44 715 930
94,000 940 1,034 44 1,078 1,402
1,078 1,186 0 1,186 1,542
68,705 687 756 0 756 983
950 1,045 0 1,045 1,359
5,000 5,500 0 5,500 7,150
57,727 577 635 44 679 883
959 1,055 0 1,055 1,371
32,905 315 347 44 391 508
90,791 1,738 1,912 0 1,912 2,486
120,000 4,000 4,400 148 4,548 5,913
6,600 7,260 1 7,261 9,440
9,000 9,900 0 9,900 12,870
130 143 1 144 188
264,000 30,000 33,000 444 33,444 43,478
52,500 1,050 1,155 89 1,244 1,617
1,900 2,090 0 2,090 2,717
4,200 4,620 15 4,635 6,025
6,250 6,875 3 6,878 8,941
175,000 5,833 6,416 889 7,305 9,497
507 558 0 558 725
487,575 7,388 8,127 74 8,201 10,661
247 272 30 301 392
5,720 6,292 0 6,292 8,180
- #DIV/0! #DIV/0! #DIV/0!
231,000 7,000 7,700 148 7,848 10,203
4,933 5,426 0 5,426 7,054
496,500 16,550 18,205 148 18,353 23,859
24,570 27,027 5 27,032 35,142
500,581 16,686 18,355 148 18,503 24,054
341,275 5,833 6,416 5 6,421 8,348
39,884 43,872 0 43,872 57,034
1,500 1,650 5 1,655 2,151
3,267 3,594 0 3,594 4,672
365,000 12,167 13,384 148 13,532 17,591
270,000 9,000 9,900 148 10,048 13,063
285,500 28,550 31,405 444 31,849 41,404
360,000 12,000 13,200 148 13,348 17,353
300,000 30,000 33,000 15 33,015 42,919
180,000 180,000 198,000 444 198,444 257,978
3,685 4,054 #VALUE! #VALUE! #VALUE!
6,000 6,600 #VALUE! #VALUE! #VALUE!
2,177 2,395 4 2,399 3,119
3,667 4,034 #VALUE! #VALUE! #VALUE!
217,800 6,600 7,260 222 7,482 9,727
38,500 385 424 44 468 608
450 495 #VALUE! #VALUE! #VALUE!
732,000 7,320 8,052 2 8,054 10,470
6,800 7,480 1 7,481 9,726
90,750 2,750 3,025 148 3,173 4,125
8,225 9,048 0 9,048 11,762
9,870 10,857 0 10,857 14,114
330,000 12,500 13,750 5 13,755 17,881
443,520 16,800 18,480 148 18,628 24,217
11,000 12,100 0 12,100 15,730
- - #DIV/0! #DIV/0! #DIV/0!
12,500 13,750 5 13,755 17,881
6,965 7,662 0 7,662 9,960
294,126 2,451 2,696 37 2,733 3,553
4,300 4,730 0 4,730 6,149
565,000 18,833 20,716 148 20,864 27,124
3,444 3,788 0 3,789 4,925
505 556 0 556 722
210,000 7,000 7,700 148 7,848 10,203
198,000 6,000 6,600 148 6,748 8,773
25,000 27,500 0 27,500 35,750
6,000 6,600 #VALUE! #VALUE! #VALUE!
8,437 9,281 5 9,286 12,072
- - #VALUE! #VALUE! #VALUE!
555,660 18,522 20,374 148 20,522 26,679
60,000 66,000 5 66,005 85,807
6,800 7,480 #VALUE! #VALUE! #VALUE!
260,869 7,905 8,696 5 8,700 11,311
16,500 18,150 0 18,150 23,595
5,000 5,500 #VALUE! #VALUE! #VALUE!
- - #DIV/0! #DIV/0! #DIV/0!
126,500 3,833 4,216 148 4,364 5,674
165,000 5,500 6,050 148 6,198 8,058
12,500 13,750 #DIV/0! #DIV/0! #DIV/0!
29,417 32,359 3 32,362 42,070
1,510 1,661 1 1,662 2,161
287,100 8,700 9,570 148 9,718 12,634
- - #DIV/0! #DIV/0! #DIV/0!
11,500 12,650 0 12,650 16,445
14,643 16,107 5 16,113 20,946
20,000 22,000 #DIV/0! #DIV/0! #DIV/0!
2,000 2,200 0 2,200 2,860
- - #DIV/0! #DIV/0! #DIV/0!
67,500 2,273 2,500 148 2,648 3,443
- - #DIV/0! #DIV/0! #DIV/0!
10,000 11,000 #DIV/0! #DIV/0! #DIV/0!
8,833 9,716 #VALUE! #VALUE! #VALUE!
362,785 12,957 14,253 159 14,411 18,735
13,352 14,687 #DIV/0! #DIV/0! #DIV/0!
15,000 16,500 #VALUE! #VALUE! #VALUE!
18,761 20,637 6 20,643 26,836
5,822 6,404 #DIV/0! #DIV/0! #DIV/0!
30,093 33,102 #VALUE! #VALUE! #VALUE!
20,972 23,069 0 23,069 29,990
2,900 3,190 #DIV/0! #DIV/0! #DIV/0!
1,233 1,356 #VALUE! #VALUE! #VALUE!
- - #VALUE! #VALUE! #VALUE!
- - #DIV/0! #DIV/0! #DIV/0!
- - #VALUE! #VALUE! #VALUE!
3,000 3,300 #VALUE! #VALUE! #VALUE!
150,000 5,000 5,500 148 5,648 7,343
- - #VALUE! #VALUE! #VALUE!
- - #VALUE! #VALUE! #VALUE!
125,000 6,500 7,150 148 7,298 9,488
- - #VALUE! #VALUE! #VALUE!
5,906 6,497 #VALUE! #VALUE! #VALUE!
2,500 2,750 1 2,751 3,577
71,000 78,100 #VALUE! #VALUE! #VALUE!
8,636 9,500 #VALUE! #VALUE! #VALUE!
330,000 66,000 72,600 889 73,489 95,535
34,277 37,705 #VALUE! #VALUE! #VALUE!
207,900 42,000 46,200 889 47,089 61,215
4,333 4,766 30 4,796 6,235
152,900 168,190 #VALUE! #VALUE! #VALUE!
21,800 23,980 #VALUE! #VALUE! #VALUE!
6,090 6,699 3 6,702 8,713
30,755 33,831 #VALUE! #VALUE! #VALUE!
75,900 8,625 9,488 444 9,932 12,911
340,500 30,955 34,051 444 34,495 44,843
115,000 11,500 12,650 444 13,094 17,023
326,800 359,480 444 359,924 467,902
177,100 17,710 19,481 444 19,925 25,903
325,000 32,500 35,750 44 35,794 46,533
48,700 9,740 10,714 889 11,603 15,084
12,649 13,914 #VALUE! #VALUE! #VALUE!
210,950 210,950 232,045 44 232,089 301,716
52,940 58,234 89 58,323 75,820
40,076 44,084 #VALUE! #VALUE! #VALUE!
41,333 45,466 #VALUE! #VALUE! #VALUE!
30,000 33,000 #VALUE! #VALUE! #VALUE!
121,000 22,000 24,200 889 25,089 32,615
6,500 7,150 #VALUE! #VALUE! #VALUE!
383,845 422,230 #VALUE! #VALUE! #VALUE!
13,771 15,148 #VALUE! #VALUE! #VALUE!
12,400 13,640 #VALUE! #VALUE! #VALUE!
7,267 7,994 #VALUE! #VALUE! #VALUE!
735,422 668,565 735,422 #VALUE! #VALUE! #VALUE!
200,000 200,000 220,000 4,444 224,444 291,777
248,500 2,485 2,734 44 2,778 3,611
46,000 9,200 10,120 889 11,009 14,311
313,600 13,067 14,374 185 14,559 18,927
23,960 26,356 9 26,365 34,274
60,000 6,000 6,600 444 7,044 9,158
70,900 77,990 #VALUE! #VALUE! #VALUE!
95,133 104,646 1 104,647 136,041
54,000 59,400 #VALUE! #VALUE! #VALUE!
127,033 139,736 #VALUE! #VALUE! #VALUE!
21,000 23,100 0 23,100 30,030
19,800 21,780 #VALUE! #VALUE! #VALUE!
150,000 165,000 #VALUE! #VALUE! #VALUE!
475,000 95,000 104,500 889 105,389 137,005
95,000 104,500 #VALUE! #VALUE! #VALUE!
210,000 210,000 231,000 4,444 235,444 306,077
700,000 770,000 889 770,889 1,002,155
319,000 350,900 #VALUE! #VALUE! #VALUE!
702,250 772,475 4,444 776,919 1,009,995
624,113 686,524 #VALUE! #VALUE! #VALUE!
1,650,000 6,600 7,260 18 7,278 9,461
25,000 27,500 444 27,944 36,328
66,600 73,260 #VALUE! #VALUE! #VALUE!
64,082 70,490 2 70,492 91,640
94,500 103,950 444 104,394 135,713
530,000 583,000 #VALUE! #VALUE! #VALUE!
78,077 78,077 85,885 4,444 90,329 117,427
98,097 98,097 107,907 4,444 112,351 146,056
72,600 11,000 12,100 741 12,841 16,693
220,000 44,000 48,400 889 49,289 64,075
125,000 125,000 137,500 4,444 141,944 184,527
120,000 132,000 741 132,741 172,563
258,940 284,834 889 285,723 371,440
270,000 297,000 444 297,444 386,678
235,000 47,000 51,700 889 52,589 68,365
150,000 165,000 889 165,889 215,655
85,000 93,500 444 93,944 122,128
538,150 591,965 889 592,854 770,710
475,000 475,000 522,500 4,444 526,944 685,027
55,000 60,500 111 60,611 78,794
62,000 10,333 11,366 741 12,107 15,739
11,440 12,584 889 13,473 17,515
7,000 7,700 1 7,701 10,011
213,632 234,995 74 235,069 305,590
375,000 412,500 889 413,389 537,405
212,800 212,800 234,080 4,444 238,524 310,081
327,750 360,525 7 360,532 468,692
195,000 214,500 889 215,389 280,005
210,000 231,000 4,444 235,444 306,077
215,000 236,500 1 236,501 307,451
80,500 3,220 3,542 178 3,720 4,836
189,086 207,995 889 208,883 271,548
171,906 189,097 0 189,097 245,826
55,000 60,500 18 60,518 78,673
5,470 6,017 89 6,106 7,938
802,235 160,447 176,492 889 177,381 230,595
119,000 130,900 18 130,918 170,193
2,830 3,113 4 3,117 4,053
37,728 41,501 889 42,390 55,106
220,000 242,000 #VALUE! #VALUE! #VALUE!
312,000 343,200 #VALUE! #VALUE! #VALUE!
147,000 25,000 27,500 4,444 31,944 41,527
157,772 173,549 #VALUE! #VALUE! #VALUE!
236,982 260,680 #VALUE! #VALUE! #VALUE!
29,640 32,604 889 33,493 43,541
171,500 188,650 #VALUE! #VALUE! #VALUE!
910,000 9,100 10,010 44 10,054 13,071
167,940 16,794 18,473 444 18,918 24,593
72,728 7,273 8,000 444 8,445 10,978
27,720 3,150 3,465 4 3,469 4,510
95,000 95,000 104,500 444 104,944 136,428
260,000 52,000 57,200 89 57,289 74,476
66,000 72,600 0 72,600 94,381
6,300 6,930 44 6,974 9,067
160,447 176,492 18 176,509 229,462
650,000 715,000 0 715,000 929,501
55,000 5,000 5,500 444 5,944 7,728
97,750 107,525 18 107,543 139,806
47,730 4,773 5,250 444 5,695 7,403
29,000 2,900 3,190 444 3,634 4,725
21,600 21,600 23,760 4,444 28,204 36,665
133,455 146,801 444 147,245 191,418
980 1,078 89 1,167 1,517
105,000 105,000 115,500 4,444 119,944 155,927
7,350 7,350 8,085 4,444 12,529 16,288
178,181 195,999 18 196,017 254,822
130,000 143,000 4,444 147,444 191,677
16,000 17,600 889 18,489 24,035
- #VALUE! #VALUE! #VALUE!
66,000 72,600 889 73,489 95,535
444,050 488,455 889 489,344 636,147
68,740 75,614 #VALUE! #VALUE! #VALUE!
169,150 33,830 37,213 889 38,102 49,532
100,000 110,000 889 110,889 144,155
370,000 37,000 40,700 444 41,144 53,488
145,000 159,500 889 160,389 208,505
404,250 80,850 88,935 889 89,824 116,771
210,000 210,000 231,000 4,444 235,444 306,077
140,250 150,000 165,000 889 165,889 215,655
200,000 40,000 44,000 889 44,889 58,355
196,560 1,966 2,163 44 2,207 2,869
80,000 8,000 8,800 444 9,244 12,018
90,000 99,000 178 99,178 128,931
19,000 20,900 9 20,909 27,182
242,025 266,228 89 266,316 346,211
199,875 219,863 178 220,040 286,052
90,000 900 990 44 1,034 1,345
202,416 2,124 2,336 44 2,381 3,095
20,320 22,352 36 22,388 29,104
64,999 64,999 71,499 444 71,943 93,526
279,200 307,120 #VALUE! #VALUE! #VALUE!
158,400 180,000 198,000 4,444 202,444 263,177
289,660 263,327 289,660 444 290,104 377,135
275,000 302,500 #VALUE! #VALUE! #VALUE!
11,385 12,524 889 13,412 17,436
350,000 70,000 77,000 889 77,889 101,255
33,726 37,099 #VALUE! #VALUE! #VALUE!
800,000 80,000 88,000 444 88,444 114,978
45,000 49,500 178 49,678 64,581
309,375 75,000 82,500 #VALUE! #VALUE! #VALUE!
650,000 65,000 71,500 44 71,544 93,008
147,000 147,000 161,700 4,444 166,144 215,987
148,050 162,855 #VALUE! #VALUE! #VALUE!
315,000 315,000 346,500 44 346,544 450,508
180,000 198,000 889 198,889 258,555
45,000 49,500 #VALUE! #VALUE! #VALUE!
200,000 20,000 22,000 444 22,444 29,178
119,200 11,920 13,112 444 13,556 17,623
118,008 23,000 25,300 889 26,189 34,045
115,000 5,750 6,325 22 6,347 8,251
20,000 22,000 44 22,044 28,658
1,590,435 144,585 159,044 89 159,132 206,872
8,360 9,196 4 9,200 11,961
40,000 44,000 44 44,044 57,258
12,120 13,332 9 13,341 17,343
250,000 25,000 27,500 444 27,944 36,328
198,550 95,000 104,500 2,222 106,722 138,739
51,425 11,000 12,100 889 12,989 16,885
111,925 23,100 25,410 889 26,299 34,188
247,500 45,000 49,500 889 50,389 65,505
131,588 165,000 181,500 4,444 185,944 241,727
125,000 25,000 27,500 889 28,389 36,905
400,000 40,000 44,000 89 44,089 57,316
4,035 4,439 44 4,483 5,828
7,000 7,700 89 7,789 10,126
90,000 99,000 89 99,089 128,816
300,000 60,000 66,000 889 66,889 86,955
77,276 85,004 89 85,092 110,620
400,000 440,000 89 440,089 572,116
500,000 550,000 889 550,889 716,155
37,000 40,700 18 40,718 52,933
17,990 19,789 18 19,807 25,749
165,000 33,000 36,300 889 37,189 48,345
40,000 44,000 #VALUE! #VALUE! #VALUE!
68,000 74,800 2 74,802 97,242
9,000 9,900 178 10,078 13,101
827,640 79,200 87,120 #VALUE! #VALUE! #VALUE!
125,000 10,000 11,000 889 11,889 15,455
143,000 130,000 143,000 4,444 147,444 191,677
- - #VALUE! #VALUE! #VALUE!
40,002 44,002 89 44,091 57,318
9,100 9,100 10,010 4,444 14,454 18,790
8,300 8,300 9,130 4,444 13,574 17,646
27,900 27,900 30,690 4,444 35,134 45,674
14,000 15,400 #VALUE! #VALUE! #VALUE!
12,000 13,200 #VALUE! #VALUE! #VALUE!
12,000 13,200 #VALUE! #VALUE! #VALUE!
59,506 59,508 65,459 4,444 69,903 90,874
88,200 88,200 97,020 4,444 101,464 131,903
9,100 9,100 10,010 4,444 14,454 18,790
9,100 9,100 10,010 4,444 14,454 18,790
13,800 15,180 #VALUE! #VALUE! #VALUE!
18,555 20,411 #VALUE! #VALUE! #VALUE!
22,000 24,200 222 24,422 31,749
22,000 24,200 #VALUE! #VALUE! #VALUE!
13,800 13,800 15,180 4,444 19,624 25,511
27,577 27,577 30,335 4,444 34,779 45,212
6,500 7,150 #VALUE! #VALUE! #VALUE!
6,322 6,322 6,954 4,444 11,398 14,818
17,400 19,140 74 19,214 24,978
12,503 13,753 #VALUE! #VALUE! #VALUE!
35,698 36,600 40,260 185 40,445 52,579
301,900 301,900 332,090 4,444 336,534 437,494
17,000 17,000 18,700 74 18,774 24,406
22,100 22,100 24,310 185 24,495 31,844
89,300 89,300 98,230 4,444 102,674 133,476
16,000 17,600 #VALUE! #VALUE! #VALUE!
21,550 23,705 8 23,713 30,827
16,100 16,100 17,710 222 17,932 23,312
11,888 13,077 #VALUE! #VALUE! #VALUE!
19,200 19,200 21,120 185 21,305 27,697
16,100 17,710 11 17,721 23,037
30,000 30,000 33,000 #VALUE! #VALUE! #VALUE!
57,200 62,920 185 63,105 82,037
51,818 57,000 11 57,011 74,114
205,000 225,500 #VALUE! #VALUE! #VALUE!
190,000 209,000 185 209,185 271,941
80,000 88,000 1 88,001 114,401
77,000 77,000 84,700 4,444 89,144 115,887
265,000 265,000 291,500 4,444 295,944 384,727
408,000 448,800 1 448,801 583,441
15,477 17,025 185 17,210 22,373
14,001 15,401 185 15,586 20,262
271,018 298,120 1 298,120 387,556
6,322 6,954 185 7,139 9,281
18,000 19,800 #VALUE! #VALUE! #VALUE!
210,000 231,000 1 231,001 300,301
50 55 185 240 312
19,650 19,650 21,615 185 21,800 28,340
96,500 106,150 1 106,151 137,996
84,000 92,400 185 92,585 120,361
93,500 102,850 185 103,035 133,946
11,715 12,887 #VALUE! #VALUE! #VALUE!
92,000 101,200 185 101,385 131,801
120,000 132,000 #VALUE! #VALUE! #VALUE!
40,000 40,000 44,000 4,444 48,444 62,977
77,500 85,250 185 85,435 111,066
2,609,700 2,870,670 #VALUE! #VALUE! #VALUE!
385,000 423,500 4,444 427,944 556,327
102,000 112,200 185 112,385 146,101
16,275 17,903 #VALUE! #VALUE! #VALUE!
20,100 22,110 185 22,295 28,984
10,400 11,440 #VALUE! #VALUE! #VALUE!
231,800 254,980 #VALUE! #VALUE! #VALUE!
1,850,000 1,850,000 2,035,000 4,444 2,039,444 2,651,277
8,700 9,570 #VALUE! #VALUE! #VALUE!
- - #VALUE! #VALUE! #VALUE!
105,000 115,500 4,444 119,944 155,927
3,600 3,960 #VALUE! #VALUE! #VALUE!
175,000 175,000 192,500 4,444 196,944 256,027
78,700 86,570 185 86,755 112,782
15,300 16,830 #VALUE! #VALUE! #VALUE!
11,000 12,100 #VALUE! #VALUE! #VALUE!
336,600 340,000 374,000 4,444 378,444 491,977
18,000 18,000 19,800 4,444 24,244 31,517
200,000 220,000 #VALUE! #VALUE! #VALUE!
176,000 193,600 4,444 198,044 257,457
251,900 277,090 4,444 281,534 365,994
88,700 97,570 #VALUE! #VALUE! #VALUE!
80,750 88,825 185 89,010 115,713
13,800 15,180 4,444 19,624 25,511
175,000 192,500 #VALUE! #VALUE! #VALUE!
9,357 10,293 9 10,302 13,393
343,060 18,011 19,812 222 20,034 26,045
1,643,250 164,325 180,758 444 181,202 235,562
10,800 11,880 0 11,880 15,444
550,000 605,000 222 605,222 786,789
650,000 715,000 444 715,444 930,078
4,400 4,840 0 4,840 6,292
21,850 24,035 222 24,257 31,534
22,500 22,500 24,750 4,444 29,194 37,952
64,300 64,300 70,730 4,444 75,174 97,726
23,100 23,100 25,410 4,444 29,854 38,810
42,900 42,900 47,190 4,444 51,634 67,124
60,000 66,000 4,444 70,444 91,577
50,000 55,000 4,444 59,444 77,277
38,500 42,350 4,444 46,794 60,832
45,000 49,500 4,444 53,944 70,127
52,600 57,860 4,444 62,304 80,995
20,873 23,000 25,300 4,444 29,744 38,667
20,000 20,000 22,000 4,444 26,444 34,377
11,700 11,700 12,870 4,444 17,314 22,508
36,740 33,400 36,740 4,444 41,184 53,539
18,000 19,800 4,444 24,244 31,517
23,000 25,300 4,444 29,744 38,667
27,000 27,000 29,700 4,444 34,144 44,387
55,000 55,000 60,500 4,444 64,944 84,427
74,100 74,100 81,510 4,444 85,954 111,740
53,000 53,000 58,300 4,444 62,744 81,567
70,000 70,400 77,440 4,444 81,884 106,449
61,105 55,550 61,105 4,444 65,549 85,214
51,150 51,150 56,265 4,444 60,709 78,922
22,200 24,420 4,444 28,864 37,523
50,000 55,000 4,444 59,444 77,277
44,000 50,000 55,000 4,444 59,444 77,277
9,257 9,900 10,890 4,444 15,334 19,934
18,600 20,460 4,444 24,904 32,375
15,700 15,700 17,270 4,444 21,714 28,228
83,450 83,450 91,795 4,444 96,239 125,111
20,500 22,550 4,444 26,994 35,092
33,000 37,500 41,250 4,444 45,694 59,402
27,000 29,700 4,444 34,144 44,387
82,372 77,200 84,920 4,444 89,364 116,173
20,000 21,000 23,100 4,444 27,544 35,807
60,300 66,330 4,444 70,774 92,006
36,800 36,800 40,480 4,444 44,924 58,401
5,775 5,250 5,775 4,444 10,219 13,285
3,709 4,080 4,444 8,524 11,081
7,500 8,250 4,444 12,694 16,502
12,000 13,200 4,444 17,644 22,937
16,100 17,710 4,444 22,154 28,800
30,000 33,000 4,444 37,444 48,677
55,000 60,500 4,444 64,944 84,427
36,000 39,600 4,444 44,044 57,257
33,000 36,300 4,444 40,744 52,967
5,710 6,281 4,444 10,725 13,943
53,000 58,300 4,444 62,744 81,567
40,000 40,000 44,000 4,444 48,444 62,977
20,625 20,625 22,688 4,444 27,132 35,271
45,000 49,500 4,444 53,944 70,127
57,000 62,700 4,444 67,144 87,287
44,000 44,000 48,400 4,444 52,844 68,697
72,000 79,200 4,444 83,644 108,737
46,000 50,600 #VALUE! #VALUE! #VALUE!
56,200 61,820 - 61,820 80,366
54,000 59,400 - 59,400 77,220
63,000 69,300 - 69,300 90,090
83,000 83,000 91,300 44 91,344 118,748
99,000 108,900 - 108,900 141,570
172,370 156,700 172,370 4,444 176,814 229,858
40,000 40,000 44,000 4,444 48,444 62,977
15,562 17,118 44 17,163 22,311
30,000 33,000 44 33,044 42,958
30,000 33,000 #VALUE! #VALUE! #VALUE!
51,765 56,942 #VALUE! #VALUE! #VALUE!
61,688 67,857 #VALUE! #VALUE! #VALUE!
16,500 16,500 18,150 4,444 22,594 29,372
39,921 43,913 #VALUE! #VALUE! #VALUE!
98,438 108,282 #VALUE! #VALUE! #VALUE!
60,500 66,550 #VALUE! #VALUE! #VALUE!
42,075 45,000 49,500 4,444 53,944 70,127
36,000 39,600 89 39,689 51,596
39,900 39,900 43,890 4,444 48,334 62,834
27,500 30,250 0 30,250 39,326
42,000 46,200 44 46,244 60,118
25,000 25,000 27,500 74 27,574 35,846
37,125 37,500 41,250 4,444 45,694 59,402
11,000 11,000 12,100 4,444 16,544 21,507
12,155 13,000 14,300 4,444 18,744 24,367
72,500 79,750 89 79,839 103,791
46,500 46,500 51,150 4,444 55,594 72,272
65,958 64,628 71,091 4,444 75,535 98,195
12,155 13,000 14,300 4,444 18,744 24,367
12,155 13,000 14,300 4,444 18,744 24,367
48,400 55,000 60,500 4,444 64,944 84,427
26,000 28,600 6 28,606 37,188
19,400 21,340 0 21,340 27,742
8,945 9,840 #VALUE! #VALUE! #VALUE!
397,100 380,000 418,000 4,444 422,444 549,177
81,000 89,100 89 89,189 115,946
32,000 32,000 35,200 4,444 39,644 51,537
8,100 8,100 8,910 4,444 13,354 17,360
70,000 70,000 77,000 4,444 81,444 105,877
32,670 33,000 36,300 4,444 40,744 52,967
10,000 11,000 0 11,000 14,300
53,600 58,960 74 59,034 76,744
111,000 111,000 122,100 4,444 126,544 164,507
27,500 30,250 247 30,497 39,646
25,000 27,500 148 27,648 35,943
51,150 51,150 56,265 44 56,309 73,202
137,791 137,791 151,570 4,444 156,014 202,818
112,090 123,299 1 123,300 160,291
- - 0 0 1
9,491 10,440 0 10,441 13,573
72,000 72,000 79,200 4,444 83,644 108,737
11,650 12,815 0 12,815 16,660
11,650 12,815 0 12,815 16,660
- - #VALUE! #VALUE! #VALUE!
101,750 92,500 101,750 4,444 106,194 138,052
210,000 7,000 7,700 4,444 12,144 15,787
30,938 37,500 41,250 4,444 45,694 59,402
50,000 55,000 444 55,444 72,078
44,500 48,950 44 48,994 63,693
70,400 64,000 70,400 4,444 74,844 97,297
31,250 34,375 22 34,397 44,716
37,500 41,250 44 41,294 53,683
28,325 31,158 #VALUE! #VALUE! #VALUE!
28,800 31,680 44 31,724 41,242
27,250 29,975 0 29,975 38,968
14,750 16,225 44 16,269 21,150
17,875 19,663 4 19,667 25,567
21,875 24,063 0 24,063 31,281
21,875 21,875 24,063 4,444 28,507 37,058
13,000 14,300 #VALUE! #VALUE! #VALUE!
23,125 25,438 0 25,438 33,069
30,525 33,578 0 33,578 43,651
50,875 55,963 44 56,007 72,809
35,875 39,463 44 39,507 51,359
58,300 64,130 0 64,130 83,369
22,625 24,888 0 24,888 32,354
30,625 33,688 0 33,688 43,794
63,000 69,300 74 69,374 90,186
28,875 31,763 0 31,763 41,291
38,250 42,075 89 42,164 54,813
80,000 88,000 2 88,002 114,403
13,250 14,575 0 14,575 18,948
24,375 26,813 1 26,813 34,857
18,500 20,350 0 20,350 26,455
17,500 19,250 0 19,250 25,025
69,000 75,900 22 75,922 98,699
61,050 67,155 0 67,155 87,302
22,500 24,750 44 24,794 32,233
35,750 39,325 0 39,325 51,123
34,875 38,363 44 38,407 49,929
28,875 31,763 44 31,807 41,349
16,775 18,453 0 18,453 23,988
47,750 52,525 1 52,526 68,284
36,750 40,425 1 40,426 52,554
20,075 22,083 0 22,083 28,707
20,350 22,385 44 22,429 29,158
42,250 46,475 #VALUE! #VALUE! #VALUE!
12,100 13,310 44 13,354 17,361
29,562 32,518 18 32,536 42,297
23,000 25,300 18 25,318 32,913
57,000 62,700 0 62,700 81,511
47,140 51,854 0 51,854 67,410
13,750 15,125 #VALUE! #VALUE! #VALUE!
72,500 72,500 79,750 4,444 84,194 109,452
63,875 70,263 0 70,263 91,341
46,900 51,590 #VALUE! #VALUE! #VALUE!
15,500 17,050 0 17,050 22,165
19,000 20,900 0 20,900 27,170
24,004 26,404 #VALUE! #VALUE! #VALUE!
13,337 14,671 44 14,715 19,130
21,175 23,293 0 23,293 30,280
32,750 36,025 44 36,069 46,890
31,625 34,788 #VALUE! #VALUE! #VALUE!
29,000 31,900 #VALUE! #VALUE! #VALUE!
35,875 39,463 0 39,463 51,302
21,000 23,100 #VALUE! #VALUE! #VALUE!
26,250 28,875 44 28,919 37,595
19,875 21,863 0 21,863 28,421
19,125 21,038 #VALUE! #VALUE! #VALUE!
30,625 33,688 44 33,732 43,852
36,375 40,013 148 40,161 52,209
46,200 50,820 #VALUE! #VALUE! #VALUE!
38,550 42,405 89 42,494 55,242
90,250 99,275 3 99,278 129,061
38,250 42,075 44 42,119 54,755
52,500 57,750 1 57,751 75,076
- #DIV/0! #DIV/0! #DIV/0!
19,140 21,054 4 21,058 27,375
9,437 10,381 0 10,381 13,495
18,073 19,880 0 19,880 25,844
22,416 24,658 7 24,665 32,065
18,111 19,922 2 19,924 25,901
109,250 120,175 89 120,264 156,343
119,790 131,769 5 131,774 171,306
129,800 142,780 44 142,824 185,672
239,893 263,882 3 263,885 343,051
443,563 487,919 148 488,067 634,488
173,250 190,575 1 190,576 247,749
8,000 8,800 0 8,800 11,440
80,000 88,000 5 88,005 114,406
4,562 5,018 #VALUE! #VALUE! #VALUE!
43,000 47,300 0 47,300 61,490
50 55 #VALUE! #VALUE! #VALUE!
1,620,000 1,620,000 1,782,000 4,444 1,786,444 2,322,377
- #VALUE! #VALUE! #VALUE!
99,800 99,800 109,780 4,444 114,224 148,491
32,400 35,640 0 35,640 46,332
70,009 77,010 0 77,010 100,113
53,500 53,500 58,850 4,444 63,294 82,282
16,000 17,600 148 17,748 23,073
18,500 18,500 20,350 4,444 24,794 32,232
52,726 57,999 0 57,999 75,398
3,295 3,625 148 3,773 4,904
31,500 34,650 44 34,694 45,103
35,700 39,270 0 39,270 51,051
17,000 17,000 18,700 4,444 23,144 30,087
40,000 44,000 0 44,000 57,201
3,458 3,804 0 3,804 4,945
12,000 13,200 0 13,200 17,160
3,250 3,575 74 3,649 4,744
49,500 54,450 148 54,598 70,978
52,000 52,000 57,200 4,444 61,644 80,137
74,102 81,512 1 81,514 105,968
71,000 78,100 1 78,101 101,532
98,400 108,240 1 108,241 140,713
71,000 78,100 222 78,322 101,819
96,000 105,600 44 105,644 137,338
65,000 71,500 22 71,522 92,979
131,393 144,532 89 144,621 188,008
37,000 40,700 44 40,744 52,968
79,500 87,450 222 87,672 113,974
4,500 4,950 3 4,953 6,439
54,000 59,400 1 59,401 77,222
29,000 31,900 4 31,904 41,476
97,400 107,140 0 107,140 139,282
6,364 7,000 148 7,149 9,293
170,000 187,000 44 187,044 243,158
91,900 101,090 0 101,090 131,417
2,670 2,937 1 2,938 3,820
41,000 41,000 45,100 4,444 49,544 64,407
21,780 23,958 0 23,958 31,145
31,625 34,788 0 34,788 45,224
31,625 34,788 0 34,788 45,224
32,900 36,190 148 36,338 47,240
90,600 99,660 0 99,660 129,558
14,450 15,895 0 15,895 20,664
77,000 84,700 5 84,705 110,116
157,714 173,485 222 173,708 225,820
40,000 44,000 0 44,000 57,200
27,850 30,635 44 30,679 39,883
220,000 242,000 44 242,044 314,658
22,900 25,190 0 25,190 32,747
18,500 20,350 #VALUE! #VALUE! #VALUE!
63,000 69,300 0 69,300 90,090
71,500 78,650 0 78,650 102,245
30,000 33,000 #VALUE! #VALUE! #VALUE!
12,300 13,530 #VALUE! #VALUE! #VALUE!
69,500 76,450 #VALUE! #VALUE! #VALUE!
55,300 60,830 148 60,978 79,272
55,300 60,830 159 60,989 79,285
28,700 31,570 #VALUE! #VALUE! #VALUE!
50,000 55,000 30 55,030 71,539
40,100 44,110 8 44,118 57,353
26,200 28,820 #VALUE! #VALUE! #VALUE!
65,450 71,995 3 71,998 93,597
42,500 46,750 148 46,898 60,968
22,800 25,080 148 25,228 32,797
51,300 56,430 148 56,578 73,552
137,000 137,500 151,250 4,444 155,694 202,402
20,630 22,693 4 22,697 29,506
12,153 13,368 0 13,369 17,379
18,750 18,750 20,625 0 20,625 26,813
15,510 17,061 0 17,061 22,179
21,670 23,837 0 23,837 30,988
23,760 26,136 18 26,154 34,000
7,500 8,250 0 8,250 10,725
11,200 12,320 0 12,320 16,016
13,500 14,850 0 14,850 19,305
15,000 16,500 0 16,500 21,450
140,000 14,000 15,400 444 15,844 20,598
7,083 7,791 0 7,791 10,129
100,000 8,333 9,166 370 9,537 12,398
6,583 7,241 4 7,245 9,419
35,640 39,204 9 39,213 50,977
15,000 16,500 #VALUE! #VALUE! #VALUE!
14,788 16,267 15 16,282 21,166
4,700 5,170 44 5,214 6,779
12,150 13,365 #VALUE! #VALUE! #VALUE!
20,900 22,990 1 22,991 29,889
279,370 307,307 4 307,311 399,505
50 55 148 203 264
5,842 6,426 148 6,574 8,547
12,600 13,860 0 13,860 18,018
35,000 38,500 89 38,589 50,166
65,000 71,500 44 71,544 93,008
104 114 0 114 149
1,832 2,015 2 2,017 2,622
14,000 15,400 1 15,401 20,022
90,909 100,000 0 100,000 130,000
120 132 0 132 172
64 70 0 70 92
100 110 #VALUE! #VALUE! #VALUE!
1,208 1,329 1 1,330 1,728
97,500 107,250 0 107,250 139,425
1,900 2,090 74 2,164 2,813
20,000 22,000 0 22,000 28,600
289,050 317,955 0 317,955 413,342
20,909 23,000 #VALUE! #VALUE! #VALUE!
82,500 90,750 0 90,750 117,975
77 85 0 85 110
370 407 #VALUE! #VALUE! #VALUE!
700 770 0 770 1,001
25 28 #VALUE! #VALUE! #VALUE!
42,550 46,805 #VALUE! #VALUE! #VALUE!
2,666 2,933 0 2,933 3,812
39,000 42,900 74 42,974 55,866
4,727 5,200 44 5,244 6,817
21,850 24,035 148 24,183 31,438
150 165 0 165 215
21,800 23,980 0 23,980 31,175
20,480 22,528 #VALUE! #VALUE! #VALUE!
214 235 0 235 306
16,250 17,875 0 17,875 23,238
- - #DIV/0! #DIV/0! #DIV/0!
650 715 0 715 930
1,300 1,430 0 1,430 1,859
700 770 5 775 1,007
2,200 2,420 0 2,420 3,146
581 639 #VALUE! #VALUE! #VALUE!
950 1,045 0 1,045 1,359
1,200 1,320 0 1,320 1,716
2,300 2,530 #VALUE! #VALUE! #VALUE!
3,375 3,713 44 3,757 4,884
4,545 5,000 0 5,000 6,499
4,300 4,730 #VALUE! #VALUE! #VALUE!
181,339 199,473 0 199,473 259,315
- - #VALUE! #VALUE! #VALUE!
- - #VALUE! #VALUE! #VALUE!
41,545 42 46 4 51 66
41,545 42 46 4 51 66
41,818 42 46 4 51 66
46,363 46 51 4 55 72
71,818 72 79 4 84 109
- - 0 0 0
- #DIV/0! #DIV/0! #DIV/0!
- #VALUE! #VALUE! #VALUE!
588,060 - 4,444 4,444 5,777
#REF! #REF! #REF! #REF!
69,300 - 44 44 58
76,318 - 4,444 4,444 5,777
25,700 - 4,444 4,444 5,777
175,000 - 4,444 4,444 5,777
330,000 - 296 296 385
2,079,000 - - - -
330,000 - 4,444 4,444 5,777
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
HET MARGIN
50% 70% IP OP COST PRICE
9,735 11,033 9.228 8.789 5,227 7/1/2018
1,403 1,590 1.748 1.665 935 7/1/2018
903 1,024 1.106 1.054 675 1/4/2019
1,370 1,552 2.195 2.09 913 1/24/2020
7,095 8,041 9.524 9.07 473 7/1/2018
12,377 14,028 14.35 13.365 7,714 7/1/2018
286 324 1.363 1.298 146 4/17/2020
339 384 1.315 1.252 181 4/17/2020
#VALUE! #VALUE! 5.912 5.912 4,548 2/20/2014
#VALUE! #VALUE! 5.715 5.715 4,397 2/20/2014
#VALUE! #VALUE! 18.722 18.722 11,165 4/26/2017
#VALUE! #VALUE! 43.244 41.185 272 7/1/2018
#VALUE! #VALUE! 2.331 2.22 843 7/1/2018
#VALUE! #VALUE! 2.321 2.211 924 1/24/2020
#VALUE! #VALUE! 2.191 2.191 1,096 1/2/2015
9,967 11,296 12.029 11.456 66 7/1/2018
6,733 7,631 9.682 9.221 44 4/17/2020
#VALUE! #VALUE! 17.969 17.113 11,102 7/1/2018
8,907 10,095 9.1 8.667 5,938 12/9/2019
5,220 5,916 7.475 7.119 3,436 2/13/2020
6,987 7,918 15.119 14.399 5,042 7/1/2018
#VALUE! #VALUE! 1.045 1.045 550 2/20/2014
2,654 3,008 4.503 4.289 1,769 1/24/2020
1,789 2,027 3.626 3.453 1,192 1/24/2020
9,497 10,763 11.607 11.054 6,243 2/13/2020
16,567 18,776 17.703 16.86 847 7/1/2018
12,105 13,719 13.154 12.528 8,025 5/13/2019
2,269 2,572 2.696 2.567 1,469 11/25/2019
165,001 187,001 2.623 2.623 2,018 2/20/2014
#VALUE! #VALUE! 11.83 11.83 91 8/1/2013
31,124 35,273 34.29 32.657 20,743 7/1/2018
24,514 27,783 27.525 26.214 17,977 7/1/2018
#VALUE! #VALUE! 1.327 1.264 699 7/1/2018
545 618 653 621 319 11/25/2019
3,433 3,891 6.83 6.505 22 4/17/2020
#VALUE! #VALUE! 5.53 5.267 2,668 10/9/2018
9,077 10,288 11.07 10.543 7,386 1/4/2019
#VALUE! #VALUE! 11.203 11.203 8,618 2/20/2014
18,487 20,951 23.081 21.982 10,291 7/1/2018
6,795 7,701 9.501 9.049 4,983 7/1/2018
5,391 6,110 7.106 6.768 352 3/5/2019
20,100 22,780 23.683 22.555 13,178 11/25/2019
61,255 69,423 68.918 65.636 4,059 11/25/2019
4,306 4,880 4.666 4.444 2,396 7/1/2018
2,038 2,310 4.048 3.855 1,315 1/24/2020
974 1,104 1.598 1.522 666 7/1/2018
5,695 6,454 7.447 7.092 3,795 5/13/2019
11,856 13,437 15.451 14.715 7,904 12/26/2019
9,480 10,744 12.699 12.095 632 11/25/2019
7,112 8,060 8.933 8.507 4,741 11/25/2019
3,209 3,637 4.761 4.534 214 9/13/2019
32,621 36,970 36.607 34.864 21,747 11/25/2019
#VALUE! #VALUE! 13.428 13.428 8,712 4/26/2017
6,667 7,556 8.82 8.4 418 1/17/2019
2,467 2,796 3.99 3.8 1,524 1/17/2019
2,806 3,180 5.67 5.4 1,782 1/17/2019
29,080 32,957 34.44 32.8 18,942 11/25/2019
1,576 1,787 1.785 1.7 957 1/17/2019
#VALUE! #VALUE! 17.733 17.733 13,641 2/20/2014
22,424 25,414 26.904 25.623 9,951 11/25/2019
16,806 19,047 19.508 18.579 10,885 7/1/2018
#VALUE! #VALUE! 22.05 21 12,925 1/17/2019
1,095 1,241 1.368 1.303 685 7/1/2018
1,852 2,099 2.773 2.641 1,234 7/1/2018
11,973 13,569 17.491 16.658 7,938 7/1/2018
15,761 17,862 19.541 18.61 10,503 7/1/2018
4,274 4,843 6.95 6.619 2,849 4/15/2019
1,477 1,674 1.856 1.768 985 11/25/2019
#VALUE! #VALUE! 15.422 15.422 11,863 2/20/2014
881 999 1.255 1.195 587 11/13/2018
1,041 1,180 2.058 1.96 966 1/24/2020
383 435 630 600 300 3/5/2019
5,347 6,060 7.233 6.889 352 11/25/2019
256 290 449 428 170 5/11/2020
963 1,091 2.395 2.281 714 7/1/2018
6,229 7,060 6.983 6.65 3,881 3/5/2019
565 640 979 932 313 8/23/2019
1,195 1,354 1.47 1.47 702 4/26/2017
2,196 2,489 5.77 5.495 1,375 8/16/2019
6,604 7,484 10.296 9.806 6,389 7/1/2018
185 209 539 513 140 8/30/2019
308 349 1.155 1.1 203 3/13/2019
606 686 1.103 1.05 484 7/11/2019
990 1,122 1.68 1.6 880 1/24/2020
220 249 630 600 242 3/13/2019
2,812 3,186 3.939 3.751 1,874 12/26/2019
459 521 1.023 975 262 4/17/2020
616 698 1.363 1.298 451 7/1/2018
1,040 1,179 3.15 3 649 7/1/2018
1,779 2,017 2.546 2.424 1,328 4/16/2020
500 567 1.47 1.4 333 4/17/2020
770 873 1.289 1.228 863 8/30/2019
592 671 1.328 1.265 656 8/16/2019
1,238 1,403 1.552 1.478 825 7/1/2018
5,960 6,755 7.001 6.668 3,742 3/13/2019
#VALUE! #VALUE! 611 611 151 4/26/2017
397 450 998 950 341 1/17/2019
2,680 3,037 3.707 3.531 1,769 4/21/2020
4,912 5,567 6.283 5.984 3,257 4/16/2020
4,216 4,779 6.244 5.947 2,811 1/24/2020
223 253 1.05 1 193 7/1/2018
#VALUE! #VALUE! 2.111 2.011 1,138 7/1/2018
744 843 1.082 1.03 496 8/30/2019
564 640 1.094 1.042 376 4/17/2020
#VALUE! #VALUE! 2.289 2.18 1,403 10/8/2019
125 142 575 547 92 7/1/2018
178 202 561 534 107 4/17/2020
#VALUE! #VALUE! 2.466 2.349 1,287 9/13/2019
280 317 525 500 158 7/1/2018
117 133 1.314 1.251 110 5/13/2019
228 259 546 520 350 4/1/2020
#VALUE! #VALUE! 178 178 89 1/2/2015
#VALUE! #VALUE! 28.297 28.297 21,767 2/20/2014
479 543 2.205 2,100 308 1/17/2019
#VALUE! #VALUE! 1.295 1.234 479 9/16/2019
2,053 2,327 2.844 2.708 1,325 5/31/2019
1,741 1,973 3.842 3.659 1,161 3/5/2019
#VALUE! #VALUE! 2.575 2.453 938 9/12/2018
2,583 2,927 3.255 3,100 1,595 1/17/2019
2,697 3,057 2.905 2.767 1,556 7/12/2019
#VALUE! #VALUE! 3.944 3.756 143 5/31/2019
2,158 2,446 3.807 3.626 135 4/24/2019
4,912 5,566 6.011 5.725 3,271 2/13/2020
5,677 6,434 6.513 6.203 374 4/24/2019
4,654 5,275 7.968 7.588 3,102 11/25/2019
7,976 9,040 5.805 8,100 5,849 7/1/2018
5,490 6,222 9.688 9.226 3,586 12/26/2019
5,247 5,947 7.182 6.84 4,031 7/1/2018
6,023 6,826 8.103 7.717 4,015 2/13/2020
4,017 4,553 5.77 5.77 253 4/26/2017
8,855 10,036 13.809 13.151 5,867 1/24/2020
9,208 10,436 11.477 10.931 605 4/17/2020
8,394 9,514 9.584 9.128 462 12/5/2018
7,640 8,659 9.87 9.4 4,923 1/17/2019
9,685 10,976 11.391 10.848 6,233 7/1/2018
13,894 15,747 24.508 23.341 11,586 3/20/2020
32,177 36,468 30.718 29.255 2,145 7/1/2018
30,769 34,872 35.825 34.024 20,533 10/8/2019
31,687 35,912 33.526 31.93 2,112 10/8/2019
33,226 37,656 30.447 28.997 22,151 12/20/2019
7,838 8,883 10.256 9.767 5,225 11/25/2019
62,542 70,880 67.694 64.47 4,125 9/13/2019
263,875 299,058 258.112 245.821 167,539 3/20/2019
358 406 835 795 239 12/9/2019
2,482 2,813 3.635 3.462 165 5/11/2020
3,137 3,555 5.364 5.108 2,091 2/13/2020
20,625 23,375 24.819 23.638 1,375 5/31/2019
6,998 7,931 8.415 8.015 4,666 2/13/2020
8,802 9,976 10.497 9.997 572 4/24/2019
17,217 19,513 19.467 18.54 1,133 10/8/2019
87 99 649 618 135 1/4/2019
56,339 63,851 67.285 64.081 36,135 12/5/2018
3,152 3,572 4.406 4.196 2,263 7/1/2018
2,831 3,209 3.375 3.214 1,888 4/16/2020
1,601 1,815 2.398 2.284 1,066 8/16/2019
6,776 7,679 8.085 7.7 4,517 11/25/2019
10,370 11,753 10.972 10.45 6,914 12/9/2019
1,922 2,179 2.595 2.472 1,281 8/16/2019
9,653 10,940 16.612 15.821 6,362 2/13/2020
6,492 7,358 8.715 8.3 418 1/17/2019
8,383 9,501 9.976 9.501 55 7/1/2018
9,902 11,223 11.94 11.371 66 7/1/2018
5,904 6,692 6.01 6.01 3,935 4/26/2017
331 376 1.386 1.32 235 8/16/2019
12,461 14,122 14.848 14.141 539 4/24/2019
248 281 561 534 123 7/1/2018
198 225 525 500 121 7/1/2018
13,333 15,111 15.996 15.234 88 7/1/2018
4,812 5,454 8.567 8.159 348 7/1/2018
23,433 26,558 29.526 28.12 154 7/1/2018
28,825 32,668 29.051 27.668 21,134 7/1/2018
32,644 36,997 39.588 37.703 21,761 8/30/2019
6,937 7,862 9.35 8.905 3,303 7/1/2018
23,499 26,633 26.189 24.942 15,666 5/13/2019
10,535 11,939 14.766 14.063 6,875 7/1/2018
4,192 4,751 6.069 5.78 253 7/1/2018
6,600 7,480 8.4 8 44 7/1/2018
5,612 6,361 6.282 5.983 3,245 7/1/2018
7,422 8,412 9.66 9.2 4,948 1/17/2019
92,400 104,720 102.197 97.33 616 3/20/2020
12,393 14,046 22.086 21.034 8,262 8/6/2018
92,566 104,908 118.884 113.223 6,171 3/5/2019
21,393 24,246 22.986 21.891 13,442 7/1/2018
12,702 14,395 13.722 13.069 9,315 7/1/2018
132 150 505 481 88 7/1/2018
8,637 9,788 13.57 12.923 5,753 3/20/2020
22,658 25,679 26.847 25.568 1,485 11/25/2019
223 252 525 500 163 7/1/2018
705 799 1.89 1.8 936 7/1/2018
1,024 1,160 1.221 1.163 638 4/21/2020
3,495 3,961 4.919 4.684 3 10/3/2018
#VALUE! #VALUE! 1.078 1.026 680 7/1/2018
16,502 18,703 18.297 17.426 11 2/13/2020
363 411 683 650 242 1/17/2019
#VALUE! #VALUE! 1.155 1.1 407 1/17/2019
#VALUE! #VALUE! 26.933 26.933 20,718 2/20/2014
#VALUE! #VALUE! 15.493 15.493 11,918 2/20/2014
28,383 32,167 29.335 27.938 17,796 3/5/2019
38,256 43,356 40.363 38.441 25,345 7/1/2018
#VALUE! #VALUE! 1.44 1.372 611 2/13/2020
1,402 1,589 3.756 3.577 862 1/24/2020
15,934 18,059 26.298 25.046 11 10/15/2018
#VALUE! #VALUE! 38.52 36.686 242 10/9/2018
57,754 65,455 61.878 58.931 385 8/6/2018
24,124 27,341 25.956 24.72 15,934 10/8/2019
12,272 13,908 16.33 15.553 8,033 2/27/2020
28,272 32,042 27.786 26.463 187 12/9/2019
61,072 69,215 66.705 63.529 42,532 7/1/2018
1,516 1,718 1.817 1.73 974 7/1/2018
17,332 19,643 20.881 19.887 1,155 7/1/2018
9,901 11,221 12.754 12.147 66 7/1/2018
2,576 2,920 3.957 3.769 1,717 10/8/2019
5,029 5,700 6.342 6.04 3,134 7/1/2018
12,343 13,989 14.689 13.989 814 7/1/2018
3,676 4,166 5.363 5.108 2,696 7/1/2018
191 217 525 500 141 7/1/2018
3,048 3,454 6.746 6.424 2,032 3/5/2019
14,409 16,331 16.253 15.479 9,607 10/21/2019
158,400 179,520 177.662 169.202 110,352 7/1/2018
5,115 5,797 6.929 6.599 341 3/20/2019
20,973 23,770 22.636 21.558 13,293 7/1/2018
3,779 4,283 5 4.761 2,475 4/24/2019
6,150 6,970 7.478 7.122 4,056 7/1/2018
16,912 19,167 19.735 18.796 12,382 7/1/2018
30,747 34,847 33.328 31.741 2,035 5/13/2019
50,167 56,855 46.2 44 33 1/17/2019
8,251 9,352 10.471 9.973 55 4/17/2020
3,220 3,649 5.159 4.913 2,145 4/17/2020
5,534 6,272 9.236 8.796 3,685 2/13/2020
7,647 8,667 9.436 8.987 495 7/1/2018
3,247 3,680 6.405 6.1 275 7/1/2018
11,001 12,468 10.966 10.444 6,514 7/1/2018
1,189 1,348 1.737 1.654 704 7/1/2018
9,142 10,361 11.522 10.973 605 4/24/2019
11,784 13,356 12.563 11.965 7,857 7/1/2018
8,748 9,914 9.892 9.421 5,772 7/1/2018
19,253 21,820 22.285 21.224 12,833 7/1/2018
990 1,122 2.27 2.162 660 7/1/2018
27,892 31,610 33.27 31.685 1,815 2/13/2020
134 151 541 515 89 10/8/2019
210 237 1.103 1.05 139 7/4/2019
1,465 1,661 1.902 1.811 968 7/1/2018
12,613 14,294 13.399 13.399 8,408 4/26/2017
3,411 3,866 3.986 3.986 165 4/26/2017
11,550 13,090 16.719 15.923 847 7/1/2018
15,951 18,077 17.507 16.673 10,633 4/16/2020
11,719 13,281 14.152 13.478 781 12/26/2019
4,401 4,987 8.09 7.705 3,153 9/13/2019
6,047 6,853 7.805 7.434 3,943 4/21/2020
10,438 11,829 11.986 11.415 6,869 3/19/2020
13,702 15,528 14.06 13.39 9,135 10/8/2019
6,768 7,670 9.407 8.959 451 4/17/2020
#VALUE! #VALUE! 5.34 5.34 4,108 2/20/2014
87 99 655 624 58 2/13/2020
1,761 1,996 3.446 3.282 11 11/25/2019
2,502 2,836 3.594 3.423 1,331 7/1/2018
11,442 12,968 14.885 14.176 748 11/25/2019
834 946 2.922 2.783 660 4/17/2020
2,253 2,553 4.757 4.757 193 1/16/2018
24,314 27,555 29.545 28.138 16,204 3/5/2019
1,982 2,247 4.243 4.041 132 12/26/2019
6,683 7,574 8.987 8.559 4,455 10/8/2019
27,447 31,107 25.879 24.647 1,815 3/13/2019
13,860 15,708 14.041 13.373 924 4/15/2019
1,898 2,151 3.453 3.289 1,392 7/1/2018
11,557 13,098 14.904 14.194 77 4/24/2019
8,861 10,042 10.703 10.194 5,907 4/17/2020
#VALUE! #VALUE! 8.336 8.336 4,675 4/26/2017
19,965 22,627 21.341 20.325 1,331 7/1/2018
33,945 38,472 36.874 35.118 2,263 8/30/2019
#VALUE! #VALUE! 1.736 1.654 495 3/5/2019
1,100 1,246 3.35 3.19 880 3/13/2019
2,723 3,086 2.819 2.685 187 8/16/2019
#VALUE! #VALUE! 3.807 3.626 259 1/24/2020
694 786 3.501 3.334 462 7/11/2019
5,969 6,765 6.871 6.544 4,214 7/1/2018
383 435 886 844 286 10/8/2019
281 319 472 450 220 7/1/2018
6,361 7,209 7.76 7.39 4,239 7/1/2018
3,068 3,477 5.209 4.961 24 9/5/2018
17,326 19,636 18.189 17.323 1,045 7/1/2018
15,107 17,122 17.108 16.293 10,072 7/1/2018
2,676 3,033 4.319 4.113 1,766 7/1/2018
325 368 1.05 1 217 7/1/2018
#VALUE! #VALUE! 9.904 9.904 6,603 1/2/2015
2,576 2,920 8.113 7.727 1,673 7/1/2018
5,940 6,732 7.085 6.748 352 3/20/2020
#VALUE! #VALUE! 11.648 11.094 5,005 3/5/2019
3,035 3,440 4.579 4.361 2,225 7/1/2018
6,558 7,432 9.132 8.697 4,327 4/21/2020
#VALUE! #VALUE! 8.902 8.478 5,254 7/1/2018
7,234 8,198 8.063 7.679 4,822 4/24/2019
3,878 4,395 3.859 3.676 2,585 1/10/2020
20,022 22,692 23.826 22.692 132 7/1/2018
743 842 1.298 1.236 495 8/16/2019
14,716 16,679 18.522 17.64 9,811 4/17/2020
13,204 14,964 15.84 15.086 88 7/1/2018
607 688 1.614 1.537 546 7/11/2019
675 765 1.431 1.363 667 9/13/2019
272 309 632 602 100 7/1/2018
409 463 3.582 3.411 207 5/31/2019
1,293 1,465 1.082 1.03 220 8/16/2019
21,648 24,534 21.429 20.408 14,432 9/13/2019
454 515 1.215 1.157 259 5/13/2019
9,826 11,137 11.799 11.237 655 2/20/2020
10,419 11,808 15.75 15 7,478 7/1/2018
21,865 24,780 23.837 23.837 15,892 1/2/2015
2,673 3,029 4.223 4.022 1,782 4/24/2019
4,446 5,039 5.291 5.039 2,816 7/1/2018
462 524 3.652 3.652 643 11/15/2017
1,508 1,709 3.99 3.8 983 1/17/2019
757 858 2.638 2.512 1,433 7/1/2018
5,940 6,732 9.004 8.575 484 7/1/2018
447 507 1.753 1.669 429 4/17/2020
#VALUE! #VALUE! 269 269 180 1/2/2015
#VALUE! #VALUE! 525 500 113 7/1/2018
#VALUE! #VALUE! 525 500 147 7/1/2018
#VALUE! #VALUE! 1.699 1.699 649 4/26/2017
26,622 30,172 25.949 24.713 176 12/9/2019
#VALUE! #VALUE! 9.642 9.183 506 3/20/2020
#VALUE! #VALUE! 5.25 5 2,079 1/17/2019
13,552 15,359 13.937 13.273 9,033 6/24/2019
3,169 3,591 4.306 4.101 2,068 3/5/2019
486 551 578 551 279 7/1/2018
3,648 4,135 5.769 5.494 2,432 7/1/2018
39,058 44,266 41.571 39.591 26,037 9/13/2019
322 365 1.195 1.138 177 7/11/2019
804 911 2.522 2.402 462 2/27/2020
3,300 3,740 5.234 4.985 22 5/11/2020
10,284 11,656 11.328 10.788 6,472 5/13/2019
4,126 4,676 5.965 5.681 3,025 7/1/2018
1,774 2,010 1.945 1.852 1,045 7/1/2018
1,865 2,113 2.415 2.3 1,128 1/17/2019
24,201 27,427 25.643 25.643 16,133 7/1/2018
4,245 4,812 5.843 5.565 283 3/13/2019
8,009 9,077 10.194 9.709 5,874 7/1/2018
8,250 9,350 10.067 9.587 55 11/25/2019
#VALUE! #VALUE! 20.666 20.666 12,432 4/26/2017
4,082 4,626 5.865 5.586 2,721 10/8/2019
#VALUE! #VALUE! 10.226 10.226 7,866 2/20/2014
#VALUE! #VALUE! 18.415 17.538 10,395 7/1/2018
20,229 22,926 25.792 24.564 1,873 7/26/2018
#VALUE! #VALUE! 2.215 2.11 1,167 7/1/2018
#VALUE! #VALUE! 2.917 2.917 1,945 1/2/2015
271 307 765 728 266 3/13/2019
#VALUE! #VALUE! 23.74 22.61 8,593 9/25/2018
#VALUE! #VALUE! 13.96 13.295 5,583 7/1/2018
10,672 12,095 12.149 12.149 6,966 4/26/2017
5,908 6,696 8.327 7.93 385 7/1/2018
#VALUE! #VALUE! 5.09 5.09 3,394 1/2/2015
52,802 59,842 59.254 56.432 34,757 3/20/2020
21,384 24,235 25.961 25.961 1,705 4/26/2017
13,237 15,001 21.915 20.871 962 7/1/2018
5,452 6,179 7.122 6.782 472 1/4/2019
247,231 280,195 258.028 258.028 164,817 4/26/2017
17,276 19,580 20.53 19.552 11,515 3/5/2019
10,037 11,375 14.412 13.726 837 7/23/2018
26,425 29,948 34.987 33.321 19,378 7/1/2018
1,599 1,812 3.465 3.3 1,075 1/17/2019
569 645 2.067 1.969 627 7/1/2018
10,890 12,342 14.779 14.075 726 7/1/2018
#VALUE! #VALUE! 60.501 57.62 3,993 7/1/2018
#VALUE! #VALUE! 17.015 17.015 9,566 9/18/2017
#VALUE! #VALUE! 8.258 8.258 6,352 8/1/2013
#VALUE! #VALUE! 37.459 35.675 21,453 7/1/2018
#VALUE! #VALUE! 195.522 186.212 128,563 2/27/2020
#VALUE! #VALUE! 13.667 13.016 8,099 7/1/2018
#VALUE! #VALUE! 1.646 1.568 605 7/1/2018
#VALUE! #VALUE! 2.607 2.483 1,863 1/10/2020
21,672 24,562 22.932 21.84 143 8/21/2018
8,929 10,119 11.529 10.98 5,908 2/13/2020
356,908 404,496 321.271 321.271 23,705 12/11/2019
659 747 903 860 361 7/1/2018
2,789 3,161 2.602 2.478 1,859 9/13/2019
75,583 85,661 97.401 92.763 495 7/1/2018
995 1,128 1.446 1.377 708 7/1/2018
2,089 2,367 6.316 6.015 1,693 5/13/2019
281 319 535 500 143 7/1/2018
32,533 36,871 38.978 37.122 21,688 7/1/2018
10,974 12,437 16.572 15.783 8,047 7/1/2018
14,027 15,898 16.878 16.074 935 8/30/2019
4,588 5,200 6.312 6.011 297 7/1/2018
3,960 4,488 5.625 5.357 264 8/20/2019
20,576 23,319 25.084 23.89 13,717 12/26/2019
2,433 2,758 3.988 3.988 2,659 1/2/2015
55,117 62,465 60.9 58 363 1/17/2019
2,830 3,208 3.368 3.208 1,843 7/1/2018
47,119 53,402 50.454 48.051 31,413 2/13/2020
9,922 11,245 11.668 11.112 726 7/1/2018
29,767 33,736 29.071 27.687 1,804 7/1/2018
14,850 16,830 17.759 16.914 9,801 7/1/2018
9,488 10,753 11.35 10.81 6,435 8/20/2019
#VALUE! #VALUE! 20.625 19.643 13,613 7/1/2018
9,900 11,220 11.603 11.05 66 7/1/2018
15,072 17,082 19.747 18.807 99 3/5/2019
#VALUE! #VALUE! 12.008 12.008 88 4/25/2016
26,321 29,830 32.748 31.188 24,877 9/5/2018
18,317 20,760 21.253 20.241 12,217 2/21/2020
#VALUE! #VALUE! 26.565 25.3 165 5/13/2019
15,356 17,404 17.968 17.112 1,023 1/24/2020
15,517 17,585 17.936 17.082 99 7/1/2018
#VALUE! #VALUE! 31.482 29.983 17,153 9/13/2019
12,778 14,482 16.46 15.676 8,433 7/1/2018
242,750 275,117 284.05 284.05 2,185 12/14/2017
#VALUE! #VALUE! 1.05 1 484 7/1/2018
2,096 2,375 3.36 3.2 1,364 1/17/2019
31,879 36,129 41.42 39.448 20,498 7/1/2018
#VALUE! #VALUE! 14.414 14.414 961 1/2/2015
23,263 26,365 27.785 26.462 15,065 11/25/2019
13,867 15,715 13.695 13.043 8,800 7/1/2018
17,167 19,455 21.15 20.143 11 7/1/2018
2,874 3,257 3.017 2.873 1,767 7/1/2018
7,300 8,273 7.837 7.464 6,321 6/4/2019
1,408 1,596 2.901 2.763 1,694 7/1/2018
912 1,034 9.45 9 2,743 7/1/2018
528 599 3.514 3.347 1,613 7/1/2018
875 992 3.351 3.192 880 5/18/2020
1,196 1,356 1.502 1.43 797 7/1/2018
10,122 11,472 14.524 13.833 7,333 7/11/2019
2,862 3,243 3.563 3.394 1,833 10/9/2018
99,000 112,200 109.627 104.407 858 3/5/2019
799 906 1.123 1.069 584 7/1/2018
1,073 1,216 1.397 1.33 738 7/1/2018
1,618 1,833 2.11 2.009 1,137 7/1/2018
1,779 2,016 2.196 2.091 1,186 7/1/2018
1,134 1,285 1.428 1.36 756 7/1/2018
1,568 1,777 1.945 1.852 1,045 7/1/2018
8,250 9,350 12.574 11.975 55 4/17/2020
1,019 1,155 1.213 1.155 635 7/1/2018
1,582 1,793 1.944 1.851 1,044 7/1/2018
586 665 1.05 1 346 7/1/2018
2,868 3,251 3.286 3.13 1,912 7/1/2018
6,822 7,732 8.118 7.732 44 7/5/2018
10,892 12,345 19.831 18.887 693 3/5/2019
14,850 16,830 15.724 14.975 9,801 7/1/2018
217 246 849 809 157 7/1/2018
50,167 56,855 47.009 44.771 33 3/5/2019
1,866 2,115 3.465 3.3 1,694 7/4/2019
3,135 3,553 3.773 3.593 2,069 7/1/2018
6,952 7,879 8.511 8.106 462 7/1/2018
10,317 11,693 11.622 11.622 6,875 4/26/2017
10,958 12,419 16.863 16.06 715 9/12/2018
837 948 1.157 1.102 557 8/16/2019
12,301 13,941 15.368 14.636 8,126 5/31/2019
452 512 1.66 1.581 272 5/13/2019
9,438 10,696 11.165 11.165 8,151 3/10/2016
#DIV/0! #DIV/0! 53.361 53.361 29,091 6/15/2016
11,772 13,342 19.559 18.628 715 7/1/2018
8,139 9,225 10.939 10.418 5,969 7/1/2018
27,530 31,200 33.129 33.129 2,508 10/4/2016
40,548 45,954 39.959 38.056 27,027 11/25/2019
27,754 31,455 28.228 26.884 18,355 5/11/2020
9,632 10,916 9.555 9.1 6,417 1/17/2019
65,809 74,583 58.562 55.773 43,884 3/5/2019
2,482 2,813 3.277 3.121 127 7/1/2018
5,391 6,109 6.009 5.723 46 9/5/2018
20,298 23,004 18.659 17.771 13,383 2/27/2020
15,072 17,082 15.847 15.093 99 4/24/2019
47,774 54,144 47.361 45.106 31,405 11/25/2019
20,022 22,692 18.392 17.517 132 4/15/2019
49,522 56,125 40.261 40.261 3,025 2/1/2018
297,667 337,355 314.496 299.52 198 2/13/2020
#VALUE! #VALUE! 5.582 5.582 4,054 4/26/2018
#VALUE! #VALUE! 9.337 8.892 4,792 7/1/2018
3,599 4,079 3.116 3.116 2,395 4/23/2018
#VALUE! #VALUE! 5.337 5.337 4,034 4/24/2018
11,223 12,720 10.27 9.781 726 5/13/2019
702 795 649 618 424 5/11/2020
#VALUE! #VALUE! 739 704 495 9/15/2018
12,081 13,692 11.06 10.534 8,052 5/8/2020
11,222 12,719 10.422 9.925 748 9/7/2018
4,760 5,394 5.255 5.005 3,025 2/13/2020
13,572 15,381 12.984 12.365 9,048 9/25/2018
16,286 18,457 14.932 14.221 10,846 11/15/2018
20,632 23,383 18.98 18.076 1,375 2/28/2019
27,942 31,668 25.437 24.226 1,848 2/27/2019
18,150 20,570 16.728 15.932 121 2/27/2019
#DIV/0! #DIV/0! 33.245 31.662 242 2/27/2019
20,632 23,383 18.98 18.077 1,375 2/28/2019
11,492 13,025 10.523 10.022 7,662 2/27/2020
4,100 4,646 3.733 3.555 2,696 4/1/2019
7,095 8,041 9.551 9.096 6,765 4/1/2019
31,297 35,470 36.728 34.979 26,752 4/8/2019
5,683 6,441 6.37 6.066 462 4/8/2019
833 944 822 783 556 4/15/2019
11,772 13,342 10.722 10.212 77 5/31/2019
10,122 11,472 9.22 8.781 66 6/10/2019
41,250 46,750 38.171 36.353 275 6/24/2019
#VALUE! #VALUE! 9.326 8.882 66 6/24/2019
13,929 15,786 28.624 27.261 2,097 6/27/2019
#VALUE! #VALUE! 43.606 41.53 31,946 7/16/2019
30,784 34,888 26.698 25.426 19,404 8/9/2019
99,008 112,209 96.429 91.837 66 8/20/2019
#VALUE! #VALUE! 10.337 9.845 748 8/20/2019
13,051 14,791 12.09 11.514 8,696 11/18/2019
27,225 30,855 26.954 25.67 197 9/5/2019
#VALUE! #VALUE! 7.719 7.351 55 9/10/2019
#DIV/0! #DIV/0! 778 741 570 9/18/2019
6,547 7,420 5.967 5.682 4,216 10/23/2019
9,297 10,537 8.47 8.066 605 10/7/2019
#DIV/0! #DIV/0! 19.403 18.479 1,375 10/7/2019
48,542 55,015 44.296 42.187 32,359 9/26/2019
2,494 2,826 2.33 2.219 1,661 10/7/2019
14,577 16,521 13.294 12.661 957 11/25/2019
#DIV/0! #DIV/0! 19.13 18.22 1,386 10/7/2019
18,975 21,505 17.479 16.647 1,265 10/7/2019
24,169 27,391 30.749 29.285 20,979 10/7/2019
#DIV/0! #DIV/0! 30.239 28.799 22 10/11/2019
3,300 3,740 3.066 2.92 22 11/8/2019
#DIV/0! #DIV/0! 3.885 3.7 28 11/12/2019
3,973 4,502 3.624 3.452 25 12/9/2019
#DIV/0! #DIV/0! 9.921 9.449 6,833 12/12/2019
#DIV/0! #DIV/0! 18.544 17.661 13,585 12/20/2019
#VALUE! #VALUE! 13.475 12.833 9,717 1/10/2020
21,617 24,499 19.681 18.744 14,252 1/10/2020
#DIV/0! #DIV/0! 20.259 19.294 14,687 1/10/2020
#VALUE! #VALUE! 22.749 21.666 165 1/10/2020
30,964 35,093 28.396 27.043 20,637 1/10/2020
#DIV/0! #DIV/0! 8.847 8.426 6,404 1/10/2020
#VALUE! #VALUE! 45.411 43.248 33,102 1/10/2020
34,604 39,218 34.844 33.185 25,361 1/10/2020
#DIV/0! #DIV/0! 4.481 4.268 319 2/21/2020
#VALUE! #VALUE! 1.874 1.785 1,357 3/23/2020
#VALUE! #VALUE! 326 311 193 3/24/2020
#DIV/0! #DIV/0! 26.878 25.598 19,536 3/24/2020
#VALUE! #VALUE! 4.956 4.72 3,476 3/23/2020
#VALUE! #VALUE! 4.631 4.411 33 4/17/2020
8,472 9,602 7.719 7.351 55 4/21/2020
#VALUE! #VALUE! 2.111 2.01 15 5/4/2020
#VALUE! #VALUE! 19.856 18.91 145 5/4/2020
10,947 12,407 6.217 5.921 44 5/15/2020
#VALUE! #VALUE! 24.88 23.696 1,815 5/22/2020
#VALUE! #VALUE! 13.349 12.713 6,497 5/13/2019
4,127 4,678 6.349 6.047 275 2/13/2020
#VALUE! #VALUE! 124.407 118.483 781 7/1/2018
#VALUE! #VALUE! 18.986 18.082 95 7/1/2018
110,233 124,931 117.117 111.54 726 8/16/2019
#VALUE! #VALUE! 68.361 65.105 37,705 4/17/2020
70,633 80,051 75.146 71.568 462 7/1/2018
7,194 8,153 9.624 9.165 5,243 7/1/2018
#VALUE! #VALUE! 271.899 258.951 16,819 7/1/2018
#VALUE! #VALUE! 40.934 40.934 2,398 4/26/2017
10,053 11,393 14.7 14 6,699 1/17/2019
#VALUE! #VALUE! 54.584 51.985 33,831 7/1/2018
14,898 16,884 18.488 17.608 9,488 7/1/2018
51,742 58,641 51.649 49.189 37,455 9/23/2019
19,642 22,260 20.624 19.642 1,265 7/1/2018
539,887 611,871 491.567 491.567 35,948 12/11/2019
29,888 33,873 29.793 28.374 19,481 2/20/2020
53,692 60,851 99.75 95 75,606 1/17/2019
17,404 19,725 23.911 22.772 10,714 12/26/2019
#VALUE! #VALUE! 28.112 26.774 15,305 7/1/2018
348,134 394,552 412.65 393 22,638 1/17/2019
87,484 99,149 89.622 85.355 58,234 8/16/2019
#VALUE! #VALUE! 68.39 65.133 44,083 2/13/2020
#VALUE! #VALUE! 73.5 70 45,467 7/1/2018
#VALUE! #VALUE! 51.66 51.66 33 4/26/2017
37,633 42,651 39.655 37.766 242 5/11/2020
#VALUE! #VALUE! 14.864 14.864 715 4/26/2017
#VALUE! #VALUE! 504.713 504.713 340,877 4/26/2017
#VALUE! #VALUE! 33.524 33.524 15,148 4/26/2017
#VALUE! #VALUE! 25.274 24.07 1,364 7/1/2018
#VALUE! #VALUE! 13.23 12.6 8,178 7/1/2018
#VALUE! #VALUE! 1,010,380 962.267 735,422 2/13/2020
336,666 381,555 364.508 347.15 220 4/17/2020
4,167 4,722 5.767 5.492 3,007 7/1/2018
16,513 18,715 21.518 20.494 1,012 5/11/2020
21,838 24,750 37.8 36 17,967 1/17/2019
39,547 44,820 47.294 45.042 26,356 3/13/2019
10,567 11,975 18.976 18.976 13,365 1/17/2019
#VALUE! #VALUE! 129.834 123.651 7,799 7/1/2018
156,971 177,900 166.337 158.416 935 3/20/2019
#VALUE! #VALUE! 78.413 78.413 60,318 2/20/2014
#VALUE! #VALUE! 245.71 234.009 139,736 2/13/2020
34,650 39,270 29.714 29.714 19,809 1/2/2015
#VALUE! #VALUE! 170.202 170.202 117,381 1/2/2015
#VALUE! #VALUE! 292.862 278.916 1,815 7/1/2018
158,083 179,161 166.982 159.03 1,045 7/1/2018
#VALUE! #VALUE! 170.1 162 1,045 1/17/2019
353,166 400,255 395.546 376.71 231 7/1/2018
1,156,333 1,310,511 1,007,037 1,007,037 770 12/12/2019
#VALUE! #VALUE! 479.985 479.985 3,509 12/11/2019
1,165,379 1,320,762 1,159,094 1,103,899 844,078 1/24/2020
#VALUE! #VALUE! 811.347 811.347 624,113 8/1/2013
10,917 12,372 12.991 12.372 726 7/1/2018
41,917 47,505 39.174 37.309 27,225 7/1/2018
#VALUE! #VALUE! 119.341 113.658 7,326 7/1/2018
105,738 119,836 140.131 133.458 100,995 5/13/2019
156,592 177,470 158.76 151.2 10,395 6/24/2019
#VALUE! #VALUE! 929.567 885.302 6,413 7/1/2018
135,493 153,559 143.874 137.023 93,336 11/7/2018
168,526 190,996 227.617 216.778 107,907 5/18/2020
19,261 21,829 23.053 21.955 121 5/11/2020
73,933 83,791 87.572 83.402 484 7/1/2018
212,916 241,305 223.65 213 1,375 1/17/2019
199,111 225,659 223.616 212.967 132 3/13/2019
428,584 485,729 410.993 391.422 284,834 2/27/2020
446,167 505,655 446.552 425.288 3,267 7/1/2018
78,883 89,401 115.745 110.233 726 7/1/2018
248,833 282,011 249.626 237.739 165 3/5/2019
140,917 159,705 134.552 134.552 825 4/26/2017
889,281 1,007,851 939.61 894.867 591,965 2/13/2020
790,416 895,805 685.287 685.287 5,225 12/11/2019
90,917 103,039 97.017 92.397 5,324 7/1/2018
18,160 20,582 23.213 22.108 11,367 7/1/2018
20,209 22,904 24.984 23.794 12,584 7/1/2018
11,552 13,092 28.246 26.901 9,703 10/18/2018
352,604 399,618 354.092 337.23 234,995 2/27/2020
620,083 702,761 563.144 563.144 4,125 12/11/2019
357,786 405,491 340.254 324.051 23,408 4/16/2020
540,799 612,905 492.978 492.978 360,525 12/11/2019
323,083 366,161 349.602 332.954 200,558 7/1/2018
353,166 400,255 370.824 353.166 207,995 7/1/2018
354,751 402,051 340.191 323.992 2,365 5/4/2020
5,580 6,324 11.271 11.15 3,542 11/25/2019
313,325 355,102 313.637 298.702 207,995 11/25/2019
283,645 321,464 266.752 266.752 189,097 4/26/2017
90,777 102,880 366.777 349.311 847 7/1/2018
9,159 10,380 11.55 11 5,467 1/17/2019
266,071 301,547 270.21 257.342 176,492 10/21/2019
196,377 222,560 227.378 216.55 1,309 7/1/2018
4,676 5,300 7.29 6.943 3,082 7/1/2018
63,584 72,062 142.769 135.971 4,565 1/24/2020
#VALUE! #VALUE! 382.311 382.311 254,874 1/2/2015
#VALUE! #VALUE! 534.111 534.111 356,074 1/2/2015
47,916 54,305 48.444 46.137 242 7/1/2018
#VALUE! #VALUE! 304.347 289.855 173,549 5/13/2019
#VALUE! #VALUE! 357.109 340.104 26,068 2/13/2020
50,239 56,938 49.675 47.31 29,568 11/25/2019
#VALUE! #VALUE! 244.536 244.536 163,024 1/2/2015
15,082 17,093 60.842 57.945 1,001 7/1/2018
28,377 32,160 40.407 38.483 20,526 8/30/2019
12,667 14,356 19.273 18.356 88 8/6/2018
5,204 5,898 6.157 5.864 3,465 7/1/2018
157,417 178,405 183.269 174.542 1,045 4/24/2019
85,933 97,391 101.274 96.452 572 2/13/2020
108,901 123,421 120.19 114.467 75,867 7/1/2018
10,462 11,857 22.949 21.856 693 2/20/2020
264,764 300,066 307.241 292.611 176,492 8/23/2019
1,072,501 1,215,501 2,994,262 2,851,679 1,896,675 7/1/2018
8,917 10,105 26.179 24.932 55 7/1/2018
161,314 182,823 146.811 146.811 97,874 1/2/2015
8,542 9,681 34.532 32.887 693 9/16/2019
5,452 6,178 11.192 10.659 319 7/1/2018
42,306 47,947 157.81 150.295 27,225 3/19/2020
220,867 250,316 195.962 195.962 139,973 1/2/2015
1,750 1,984 11.558 11.008 1,078 7/1/2018
179,916 203,905 206.85 197 1,155 1/17/2019
18,794 21,299 24.075 22.929 8,894 7/1/2018
294,025 333,229 483.557 460.53 195,999 4/15/2019
221,166 250,655 285.879 272.265 17,604 8/28/2019
27,733 31,431 46.591 44.373 176 4/16/2020
#VALUE! #VALUE! 72.259 72.259 38,031 1/2/2015
110,233 124,931 131.178 124.931 726 7/1/2018
734,016 831,884 665.684 665.684 488,455 12/11/2019
#VALUE! #VALUE! 120.546 114.806 75,614 11/25/2019
57,153 64,773 66.15 63 363 1/17/2019
166,333 188,511 212.667 202.54 110 10/9/2018
61,717 69,945 88.631 84.41 407 8/6/2018
240,583 272,661 258.089 245.799 1,595 4/17/2020
134,736 152,700 144.615 137.729 88,935 11/25/2019
353,166 400,255 430.5 410 231 1/17/2019
248,833 282,011 260.4 248 15,884 1/17/2019
67,333 76,311 81.469 77.59 44 11/25/2019
3,311 3,752 4.065 3.871 2,196 12/9/2019
13,867 15,715 17.472 16.64 88 7/1/2018
148,767 168,602 158.193 150.66 81,675 7/1/2018
31,363 35,545 29.162 27.774 209 10/19/2018
399,475 452,738 423.316 423.316 325,682 8/31/2015
330,060 374,068 306.451 291.858 219,863 3/20/2020
1,552 1,759 8.4 8 176 1/17/2019
3,571 4,047 11.587 11.036 26 8/29/2018
33,581 38,059 42 40 22,352 1/17/2019
107,915 122,304 115.239 109.752 71,499 1/24/2020
#VALUE! #VALUE! 420.881 420.881 30,712 12/11/2019
303,666 344,155 291.561 291.561 194,374 1/2/2015
435,156 493,177 397.31 397.31 28,966 12/11/2019
#VALUE! #VALUE! 473.061 473.061 315,374 1/2/2015
20,118 22,801 31.686 30.177 13,776 7/1/2018
116,833 132,411 122.675 116.833 77 7/1/2018
#VALUE! #VALUE! 87.557 83.388 4,081 7/1/2018
132,667 150,355 226.625 215.833 143 7/1/2018
74,517 84,452 67.957 67.957 495 10/14/2016
#VALUE! #VALUE! 131.337 125.083 825 7/1/2018
107,317 121,626 113.312 107.917 715 7/1/2018
249,216 282,445 296.567 282.445 1,617 7/1/2018
#VALUE! #VALUE! 277.748 264.521 162,855 11/25/2019
519,817 589,126 462.61 462.61 33,803 12/11/2019
298,333 338,111 281.994 268.656 2,057 7/1/2018
#VALUE! #VALUE! 67.469 67.469 495 4/26/2017
33,667 38,155 35.003 33.337 2,178 7/1/2018
20,335 23,046 21.351 20.335 13,112 7/1/2018
39,283 44,521 36.009 36.009 27,699 11/24/2015
9,521 10,790 12.816 12.205 6,958 7/1/2018
33,067 37,476 35.35 33.667 22 7/1/2018
238,699 270,525 255.864 243.68 159,044 4/28/2020
13,801 15,641 23.724 22.595 9,196 11/25/2019
66,067 74,876 127.304 121.242 44 1/15/2019
20,011 22,680 23.064 21.966 13,332 3/5/2019
41,917 47,505 70.209 66.865 3,498 3/13/2019
160,083 181,427 160.1 152.931 1,045 10/26/2018
19,483 22,081 19.638 18.703 121 8/6/2018
39,448 44,708 36.896 35.139 253 4/28/2020
75,583 85,661 69.674 66.356 495 5/31/2019
278,916 316,105 270.9 258 1,815 1/17/2019
42,583 48,261 76.343 72.707 55 8/27/2018
66,133 74,951 60.694 57.804 44 8/27/2018
6,724 7,621 9.698 9.236 704 11/27/2018
11,683 13,241 11.144 10.614 77 11/27/2018
148,633 168,451 141.474 134.737 99 1/18/2019
100,333 113,711 91.358 87.007 66 2/11/2019
127,639 144,657 253.67 241.59 18,491 8/16/2019
660,133 748,151 606.939 578.037 440 3/15/2019
826,333 936,511 2,258,589 2,151,037 1,650,000 3/21/2019
61,077 69,220 56.823 54.117 407 7/10/2019
29,710 33,672 27.678 26.36 19,789 2/20/2020
55,783 63,221 50.429 48.027 363 8/27/2019
#VALUE! #VALUE! 57.804 57.804 44 10/21/2019
112,203 127,163 102.19 97.324 748 11/22/2019
15,117 17,132 14.147 13.474 99 2/10/2020
#VALUE! #VALUE! 119.552 113.859 8,712 4/30/2020
17,833 20,211 40.706 38.768 275 4/16/2020
221,166 250,655 201.534 191.937 143 4/30/2020
#VALUE! #VALUE! 166.598 158.665 121,121 4/28/2020
66,137 74,955 60.697 57.807 44,002 6/9/2020
21,681 24,572 63.041 60.039 10,461 7/1/2018
20,361 23,076 31.527 30.026 9,541 7/1/2018
52,701 59,728 46.2 44 3,069 5/18/2020
#VALUE! #VALUE! 47.539 45.275 1,567 7/1/2018
#VALUE! #VALUE! 36.561 36.561 132 4/26/2017
#VALUE! #VALUE! 34.326 34.326 132 4/26/2017
104,854 118,835 142.223 135.45 65,459 5/13/2019
152,196 172,489 141.617 134.873 882 9/13/2018
21,681 24,572 31.117 29.635 1,001 7/1/2018
21,681 24,572 38.268 36.446 1,001 10/26/2018
#VALUE! #VALUE! 34.552 34.552 121 4/26/2017
#VALUE! #VALUE! 44.001 44.001 31,429 1/2/2015
36,633 41,518 50.059 47.675 242 3/13/2019
#VALUE! #VALUE! 55.74 53.086 242 7/1/2018
29,436 33,361 38.11 36.295 1,518 7/1/2018
52,168 59,124 71.663 68.25 39,435 2/15/2019
#VALUE! #VALUE! 31.884 31.884 22,774 1/2/2015
17,097 19,377 45.15 43 6,954 1/17/2019
28,821 32,664 49.926 47.548 1,914 10/21/2019
#VALUE! #VALUE! 44.49 42.371 15,128 7/1/2018
60,668 68,757 160.81 153.152 4,015 11/25/2019
504,801 572,108 443.602 443.602 32,395 12/11/2019
28,161 31,916 51.005 48.576 187 11/25/2019
36,743 41,642 60.774 57.88 2,431 11/25/2019
154,011 174,546 168 160 9,581 1/17/2019
#VALUE! #VALUE! 48.434 48.434 32,289 1/2/2015
35,569 40,312 56.506 53.815 23,705 11/25/2019
26,898 30,485 54.963 52.346 1,771 7/4/2019
#VALUE! #VALUE! 17.251 17.251 13,077 10/21/2019
31,958 36,219 57.442 54.707 2,112 11/25/2019
26,582 30,126 25.371 24.163 1,771 11/28/2018
#VALUE! #VALUE! 78.391 74.658 3,982 8/16/2019
94,658 107,279 111.575 106.262 6,292 4/24/2019
85,516 96,919 255.452 243.288 53,295 7/1/2018
#VALUE! #VALUE! 366.505 349.052 235,648 7/1/2018
313,778 355,615 350.988 334.274 218,405 7/1/2018
132,001 149,601 155.931 155.931 88 9/6/2016
133,716 151,545 144.745 137.852 847 7/1/2018
443,916 503,105 518.76 494.057 2,915 5/31/2019
673,201 762,961 643.114 612.489 4,488 4/16/2020
25,815 29,257 23.959 23.959 1,843 2/20/2014
23,379 26,497 26.974 25.689 16,941 7/1/2018
447,181 506,805 371.243 353.656 29,812 8/6/2018
10,709 12,137 37.679 35.885 6,954 11/13/2018
#VALUE! #VALUE! 44.121 44.121 198 4/26/2017
346,501 392,701 390.949 372.332 231 7/1/2018
360 408 525 500 61 7/1/2018
32,700 37,060 52.793 50.279 21,615 11/25/2019
159,226 180,456 178.528 170.027 93,412 7/1/2018
138,878 157,395 156.872 149.402 924 7/1/2018
154,553 175,160 176.278 167.884 107,479 7/1/2018
#VALUE! #VALUE! 32.192 32.192 12,887 4/26/2017
152,078 172,355 173.562 165.297 105,754 7/1/2018
#VALUE! #VALUE! 302.674 288.261 13,068 7/1/2018
72,666 82,355 174.764 166.442 88 4/16/2020
128,153 145,240 155.56 148.152 8,525 4/24/2019
#VALUE! #VALUE! 3,306,611 3,306,611 2,870,670 12/11/2019
641,916 727,505 548.689 522.561 427,735 7/1/2018
168,578 191,055 201.386 191.796 12,342 7/1/2018
#VALUE! #VALUE! 49.824 49.824 17,903 4/26/2017
33,443 37,902 47.596 45.329 2,211 11/25/2019
#VALUE! #VALUE! 17.203 17.203 1,144 4/26/2017
#VALUE! #VALUE! 408.467 389.016 259,624 1/9/2020
3,059,166 3,467,055 2,345,591 2,345,591 2,035,000 12/11/2019
#VALUE! #VALUE! 31.71 30.2 8,422 7/1/2018
#VALUE! #VALUE! 1,002,193 1,002,193 770,918 2/20/2014
179,916 203,905 223.609 212.961 121 6/24/2019
#VALUE! #VALUE! 10.714 10.204 6,389 7/1/2018
295,416 334,805 330.866 315.11 1,925 7/1/2018
130,133 147,484 192.725 183.548 8,657 2/13/2020
#VALUE! #VALUE! 48.558 48.558 1,683 4/26/2017
#VALUE! #VALUE! 34.911 34.911 23,274 1/2/2015
567,666 643,355 511.169 511.169 374 12/11/2019
36,366 41,215 100.378 95.598 198 5/11/2020
#VALUE! #VALUE! 316.62 301.543 19,602 7/1/2018
297,066 336,675 267.629 267.629 1,936 12/11/2019
422,301 478,608 430.998 410.475 27,709 2/13/2020
#VALUE! #VALUE! 150.153 143.003 9,515 7/1/2018
133,515 151,317 140.198 133.522 88,825 4/24/2019
29,436 33,361 35.725 34.024 19,745 9/16/2019
#VALUE! #VALUE! 327.6 327.6 252 3/2/2018
15,453 17,513 14.388 13.703 10,293 5/13/2019
30,051 34,058 27.376 26.073 19,812 4/28/2020
271,803 308,043 248.944 237.09 181,913 4/18/2019
17,820 20,196 13.807 13.149 10,098 5/9/2019
907,833 1,028,878 827.938 788.512 605 7/29/2019
1,073,167 1,216,255 2,274,555 2,274,555 1,815,000 12/12/2019
7,260 8,228 11.136 10.606 814 8/28/2019
36,386 41,237 51.833 47.386 2,343 7/1/2018
43,791 49,630 51.45 49 2,409 1/17/2019
112,761 127,796 109.468 104.256 7,073 8/23/2019
44,781 50,752 55.514 52.87 2,541 2/13/2020
77,451 87,778 83.529 79.552 4,719 4/16/2020
105,666 119,755 109.802 99.231 6,171 7/1/2018
89,166 101,055 98.239 93.561 55 7/1/2018
70,191 79,550 82.836 74.871 39,598 7/1/2018
80,916 91,705 92.142 87.755 495 4/16/2020
93,456 105,917 98.348 93.665 5,786 10/26/2018
44,616 50,565 53.55 51 253 1/17/2019
39,666 44,955 40.613 38.679 22 11/13/2018
25,971 29,434 30.45 29 1,254 1/17/2019
61,776 70,013 64.865 61.776 3,674 7/1/2018
36,366 41,215 48.031 45.744 20,691 7/1/2018
44,616 50,565 54.745 52.138 253 3/5/2019
51,216 58,045 56.7 54 297 1/17/2019
97,416 110,405 116.38 110.838 605 10/5/2018
128,931 146,122 140.585 133.89 8,151 11/25/2019
94,116 106,665 108.3 103.143 5,698 3/5/2019
122,826 139,203 129.212 123.059 737 7/1/2018
98,324 111,433 126.447 120.426 61,105 7/1/2018
91,064 103,205 116.468 110.922 90 3/19/2019
43,296 49,069 52.611 48.126 2,442 2/27/2020
89,166 101,055 94.327 89.835 484 7/1/2018
89,166 101,055 106.108 101.055 55 7/1/2018
23,001 26,068 24.905 23.719 1,089 2/13/2020
37,356 42,337 37.853 36.05 2,046 2/27/2020
32,571 36,914 40.13 36 1,727 1/30/2020
144,359 163,606 152.25 145 8,954 1/17/2019
40,491 45,890 39.917 38.016 209 7/1/2018
68,541 77,680 75.6 72 428 11/20/2019
51,216 58,045 60.165 57.3 297 1/17/2019
134,046 151,919 144.618 137.732 8,492 3/13/2019
41,316 46,825 38.324 36.499 231 4/16/2020
106,161 120,316 118.812 113.154 6,633 5/31/2019
67,386 76,371 68.85 65.571 3,927 7/1/2018
15,329 17,372 20.605 19.624 63 3/5/2019
12,786 14,491 15.215 14.491 408 7/1/2018
19,041 21,580 31.686 31.686 21,124 1/2/2015
26,466 29,995 32.053 30.526 132 12/26/2019
33,231 37,662 36.838 35.083 1,771 5/31/2019
56,166 63,655 60.561 52.967 363 7/1/2018
97,416 110,405 103.284 98.365 605 1/24/2020
66,066 74,875 68.116 64.872 396 4/16/2020
61,116 69,265 77.196 73.52 363 4/24/2019
16,088 18,233 20.265 19.3 6,909 7/1/2018
94,116 106,665 113.619 108.208 583 1/24/2020
72,666 82,355 74.854 71.29 44 11/25/2019
40,697 46,124 58.6 55.81 3,025 4/16/2020
80,916 91,705 99.501 94.763 495 4/17/2020
100,716 114,145 96.086 91.51 766 3/5/2019
79,266 89,835 91.552 87.193 62 7/26/2018
125,466 142,195 132.29 125.991 792 4/24/2019
#VALUE! #VALUE! 86.694 82.566 506 7/1/2018
92,730 105,094 111.961 106.63 66,642 7/1/2018
89,100 100,980 99.077 94.359 594 8/16/2019
103,950 117,810 144.4 137.524 693 4/24/2019
137,017 155,286 170.903 162.765 913 7/1/2018
163,350 185,130 168.731 168.731 1,012 4/26/2017
265,221 300,584 282.825 269.357 17,237 7/1/2018
72,666 82,355 76.886 73.225 44 7/11/2019
25,744 29,176 40.925 36.656 17,118 7/1/2018
49,567 56,176 66.838 63.655 33 7/1/2018
#VALUE! #VALUE! 58.392 55.611 33 7/1/2018
#VALUE! #VALUE! 93.065 88.634 56,942 2/20/2020
#VALUE! #VALUE! 99.318 94.589 67,857 2/13/2020
33,891 38,410 42.684 38.41 1,815 7/1/2018
#VALUE! #VALUE! 77.522 73.831 43,913 4/17/2020
#VALUE! #VALUE! 177.543 169.089 108,282 7/1/2018
#VALUE! #VALUE! 117.293 111.707 6,655 3/19/2020
80,916 91,705 75.181 71.601 495 4/21/2020
59,533 67,471 67.986 63 396 1/17/2019
72,501 82,168 74.703 66.652 46,827 7/1/2018
45,376 51,426 61.702 58.764 3,025 4/17/2020
69,367 78,616 79.405 75.624 462 10/9/2018
41,361 46,876 59.794 56.947 275 7/1/2018
68,541 77,680 78.65 74.904 4,125 11/25/2019
24,816 28,125 24.851 23.668 121 9/17/2018
28,116 31,865 32.357 30.817 1,573 9/12/2018
119,758 135,726 134.868 128.446 7,975 7/1/2018
83,391 94,510 87.561 83.391 5,115 7/1/2018
113,302 128,409 114.32 108.876 67,705 5/13/2019
28,116 31,865 32.357 30.817 1,573 9/12/2018
28,116 31,865 35.594 33.899 183 9/25/2018
97,416 110,405 102.287 97.416 605 7/1/2018
42,910 48,631 68.843 65.565 286 11/25/2019
32,010 36,278 53.524 50.975 2,189 7/1/2018
#VALUE! #VALUE! 21.873 20.832 781 7/1/2018
633,666 718,155 719.712 685.44 418 11/13/2018
133,783 151,621 127.688 121.607 891 7/1/2018
59,466 67,395 74.547 70.997 352 11/25/2019
20,031 22,702 23.837 22.702 891 7/1/2018
122,166 138,455 122.74 116.895 77 7/1/2018
61,116 69,265 64.172 61.116 363 7/1/2018
16,500 18,700 28.387 27.035 11 7/1/2018
88,551 100,358 97.277 92.645 605 7/1/2018
189,816 215,125 237.859 226.532 1,221 8/16/2019
45,745 51,845 36.418 36.418 30,348 12/1/2015
41,472 47,002 38.87 38.87 275 4/26/2017
84,464 95,726 85.482 81.411 5,115 3/5/2019
234,021 265,224 214.227 204.025 15,157 4/16/2020
184,951 209,611 174.642 166.326 123,299 12/3/2018
1 1 147.931 140.886 10,373 4/9/2019
15,661 17,749 19.984 19.032 1,044 5/7/2019
125,466 142,195 114.447 108.997 792 6/25/2019
19,223 21,786 19.369 18.446 14,097 6/24/2019
19,223 21,786 19.369 18.446 14,097 6/24/2019
#VALUE! #VALUE! 37.201 35.43 2,706 8/7/2019
159,291 180,530 145.228 138.312 10,175 9/16/2019
18,216 20,645 10.722 10.211 77 9/16/2019
68,541 77,680 65.055 61.957 4,125 12/12/2019
83,167 94,255 84.545 80.519 55 12/12/2019
73,492 83,291 80.896 77.044 588 3/16/2020
112,266 127,235 102.435 97.557 704 3/27/2020
51,596 58,475 70.191 63.385 37,812 7/1/2018
61,942 70,201 61.027 58.121 4,125 10/26/2018
#VALUE! #VALUE! 57.679 53.402 31,158 7/1/2018
47,587 53,932 81.17 77.305 3,168 1/17/2020
44,963 50,958 56.243 52.663 30,665 7/1/2018
24,404 27,658 43.649 43.649 29,099 1/2/2015
29,500 33,434 46.124 46.124 30,749 1/2/2015
36,094 40,906 47.137 42.76 24,063 7/1/2018
42,760 48,461 46.245 44.043 313 1/4/2019
#VALUE! #VALUE! 30.04 28.609 14,628 7/1/2018
38,156 43,244 44.26 42.152 27,981 7/1/2018
50,366 57,082 66.204 62.068 36,935 7/1/2018
84,010 95,212 95.14 90.61 55,963 7/1/2018
59,260 67,162 87.681 83.505 513 3/5/2019
96,195 109,021 97.686 85.041 5,225 7/1/2018
37,332 42,310 48.407 44.855 2,546 7/1/2018
50,532 57,269 62.734 59.747 37,057 7/1/2018
104,061 117,936 123.261 123.261 82,174 1/2/2015
47,644 53,996 63.209 59.073 34,938 7/1/2018
63,246 71,679 79.894 76.09 46,283 7/1/2018
132,004 149,604 165.322 157.449 88 2/13/2020
21,863 24,778 46.114 43.918 14,911 7/1/2018
40,220 45,583 53.941 51.372 29,493 7/1/2018
30,525 34,595 52.328 49.836 22,385 7/1/2018
28,875 32,725 50.595 48.186 21,175 7/1/2018
113,883 129,068 130.885 124.652 77,646 7/1/2018
100,733 114,164 112.619 107.256 67,155 7/1/2018
37,192 42,151 48.196 44.646 2,532 7/1/2018
58,988 66,853 79.742 75.944 40,229 7/1/2018
57,610 65,292 69.16 65.533 39,245 7/1/2018
47,710 54,072 66.953 59.073 34,938 7/1/2018
27,679 31,369 36.062 34.345 18,453 7/1/2018
78,789 89,294 97.999 93.332 57,778 7/1/2018
60,639 68,724 83.946 79.949 44,468 7/1/2018
33,124 37,540 49.424 49.424 32,949 1/2/2015
33,644 38,130 42.256 40.244 22,385 7/1/2018
#VALUE! #VALUE! 91.859 87.485 51,123 7/1/2018
20,032 22,703 39.334 37.461 1,331 7/1/2018
48,804 55,311 58.215 55.443 32,518 7/1/2018
37,977 43,040 71.034 67.651 38,363 1/22/2019
94,051 106,591 100.21 95.438 6,897 7/1/2018
77,781 88,152 100.492 95.707 51,854 7/1/2018
#VALUE! #VALUE! 41.933 39.936 15,125 7/1/2018
126,291 143,130 124.637 118.702 7,975 1/10/2020
105,394 119,446 126.734 112.06 70,263 7/1/2018
#VALUE! #VALUE! 100.21 95.438 5,159 7/1/2018
25,575 28,985 47.13 44.886 18,755 7/1/2018
31,350 35,530 50.661 46.638 2,299 7/1/2018
#VALUE! #VALUE! 55.064 52.442 26,404 7/1/2018
22,073 25,016 41.283 39.317 14,671 7/1/2018
34,939 39,597 53.628 51.074 23,293 7/1/2018
54,104 61,318 86.062 74.922 39,628 7/1/2018
#VALUE! #VALUE! 68.202 64.066 38,267 7/1/2018
#VALUE! #VALUE! 63.437 59.301 3,509 7/1/2018
59,194 67,087 75.914 65.86 39,463 7/1/2018
#VALUE! #VALUE! 48.917 44.781 2,541 7/1/2018
43,379 49,163 58.445 54.31 31,763 7/1/2018
32,794 37,166 50.859 48.437 24,048 7/1/2018
#VALUE! #VALUE! 45.303 41.379 23,142 7/1/2018
50,598 57,344 67.097 63.902 37,057 7/1/2018
60,241 68,273 59.8 59.8 46 3/4/2015
#VALUE! #VALUE! 85.689 81.609 5,082 7/1/2018
63,741 72,240 81.816 77.92 42,405 1/24/2020
148,917 168,773 141.849 135.095 99,275 3/21/2019
63,179 71,603 60.735 60.735 42,075 10/21/2019
86,626 98,177 81.112 81.112 5,775 10/21/2019
#DIV/0! #DIV/0! 69.811 69.811 41,745 7/12/2016
31,587 35,798 34.958 33.293 1,914 7/1/2018
15,571 17,647 18.741 17.849 135 3/5/2019
29,820 33,797 38.325 36.5 19,302 1/17/2019
36,998 41,931 39.475 37.595 24,657 8/16/2019
29,886 33,871 40.757 38.816 19,922 2/13/2020
180,396 204,449 205.377 195.597 120,175 4/17/2020
197,661 224,016 220.012 209.536 131,769 11/25/2019
214,237 242,802 221.53 210.981 14,278 10/8/2019
395,828 448,605 367.49 349.99 263,882 4/16/2020
732,101 829,715 664.96 664.96 487,919 12/11/2019
285,865 323,980 290.585 266.541 195,219 1/9/2020
13,200 14,960 12.329 11.742 88 11/15/2019
132,007 149,608 126.459 120.437 88 3/12/2020
#VALUE! #VALUE! 5.931 5.931 4,562 8/1/2013
70,950 80,410 77.087 73.416 5,203 7/1/2018
#VALUE! #VALUE! 1.05 1 605 7/1/2018
2,679,666 3,036,955 2,293,384 2,184,175 1,782,000 5/31/2019
#VALUE! #VALUE! 1,702,198 1,621,141 1,061,775 7/1/2018
171,336 194,181 160.19 145.608 998 6/6/2020
53,460 60,588 62.976 59.977 33,323 7/1/2018
115,515 130,917 114.92 105.247 7,701 4/21/2020
94,941 107,600 97.53 92.885 5,885 10/8/2019
26,622 30,172 38.563 37.669 176 9/13/2019
37,191 42,150 46.351 41 2,035 1/30/2020
86,998 98,598 96.59 96.59 743 8/21/2017
5,659 6,413 6.8 6.476 3,625 10/5/2018
52,042 58,981 67.03 63.839 38,115 7/1/2018
58,905 66,759 72.111 66.697 43,197 7/1/2018
34,716 39,345 39.926 38.025 187 2/13/2020
66,001 74,801 80.642 76.802 44 7/1/2018
5,706 6,466 8.748 8.331 4,911 8/16/2019
19,800 22,440 31.269 29.78 132 1/24/2020
5,474 6,203 14.392 13.706 45 3/5/2019
81,897 92,817 105.743 100.708 697 9/25/2018
92,466 104,795 110.397 105.14 572 8/16/2019
122,271 138,573 162.568 154.827 86,631 7/1/2018
117,152 132,773 135.222 128.782 781 11/25/2019
162,361 184,010 169.05 161 10,824 1/17/2019
117,483 133,148 111.337 106.035 781 2/13/2020
158,467 179,596 152.151 144.906 1,056 1/10/2020
107,283 121,588 110.949 105.666 66 7/1/2018
216,932 245,856 208.551 198.62 13,765 3/5/2019
61,117 69,266 75.445 71.852 40,293 7/1/2018
131,508 149,043 137.852 137.852 847 4/26/2017
7,429 8,420 12.823 12.212 495 7/1/2018
89,102 100,983 109.91 104.676 6,534 7/1/2018
47,857 54,238 62.749 59.761 319 8/16/2019
160,710 182,138 174.156 165.863 10,714 3/5/2019
10,723 12,153 13.031 12.411 693 7/1/2018
280,567 317,976 306.211 291.629 187 1/22/2019
151,635 171,853 164.322 156.497 111,199 7/1/2018
4,408 4,995 5.836 5.558 3,641 3/13/2019
74,316 84,225 78.48 74.316 451 7/1/2018
35,937 40,729 58.152 55.383 307 7/26/2018
52,181 59,139 83.559 79.58 34,788 2/20/2020
52,182 59,140 83.252 79.288 34,788 4/17/2020
54,507 61,775 70.172 66.83 39,809 7/1/2018
149,490 169,422 168.562 160.535 9,966 8/23/2019
23,843 27,022 40.93 37.278 17,485 7/1/2018
127,057 143,998 170.729 162.599 7,865 7/1/2018
260,561 295,303 243.026 231.453 173,485 4/21/2020
66,000 74,800 126.011 120.01 44 5/31/2019
46,019 52,155 61.056 61.056 30,635 4/26/2017
363,067 411,476 336.396 320.377 242 7/1/2018
37,785 42,823 53.698 51.141 2,519 5/13/2019
#VALUE! #VALUE! 43.469 41.399 2,035 2/13/2020
103,950 117,810 132.012 125.726 693 7/1/2018
117,975 133,705 149.549 131.248 83,054 7/1/2018
#VALUE! #VALUE! 60.374 57.499 33 4/24/2019
#VALUE! #VALUE! 29.059 27.675 1,353 11/25/2019
#VALUE! #VALUE! 110.693 105.422 7,645 2/27/2019
91,467 103,663 85.881 81.791 6,556 4/15/2019
91,483 103,681 98.966 94.253 6,083 4/16/2020
#VALUE! #VALUE! 37 35.238 3,175 6/17/2019
82,544 93,550 75.329 71.741 55 8/23/2019
66,177 75,000 60.83 57.934 4,411 9/10/2019
#VALUE! #VALUE! 39.959 38.056 2,882 9/10/2019
107,997 122,397 98.893 94.184 71,995 9/10/2019
70,347 79,727 64.433 61.365 4,675 9/10/2019
37,842 42,888 34.854 33.194 2,508 9/10/2019
84,867 96,183 77.647 73.949 5,643 9/10/2019
233,541 264,680 243.078 231.503 15,125 3/19/2020
34,045 38,584 42.749 40.713 2,306 7/1/2018
20,053 22,727 38.883 37.031 13,969 7/1/2018
30,938 35,063 44.748 42.617 20,625 7/1/2018
25,592 29,004 43.726 41.644 1,551 4/24/2019
35,756 40,523 51.665 49.205 2,167 4/24/2019
39,231 44,461 52.506 50.006 2,875 7/1/2018
12,375 14,025 16.322 15.545 8,168 7/1/2018
18,480 20,944 25.191 23.991 1,232 1/10/2020
22,275 25,245 28.851 27.477 1,485 1/10/2020
24,750 28,050 30.046 28.615 165 4/17/2020
23,767 26,935 35.236 33.558 154 4/17/2020
11,687 13,245 15.512 14.773 7,792 2/13/2020
14,305 16,212 18.694 17.804 9,167 5/11/2020
10,868 12,317 14.916 14.205 7,242 2/13/2020
58,819 66,662 69.321 66.02 43,124 7/1/2018
#VALUE! #VALUE! 29.316 27.92 16,335 7/1/2018
24,422 27,679 31.35 29.857 16,266 7/11/2019
7,822 8,865 11.471 10.925 4,834 7/1/2018
#VALUE! #VALUE! 25.768 24.541 13,695 7/1/2018
34,487 39,086 48.856 46.53 2,255 10/26/2018
460,967 522,429 585.831 557.934 338,038 7/1/2018
305 345 233 222 28 11/28/2018
9,862 11,176 33.92 32.304 6,426 4/17/2020
20,790 23,562 30.309 30.309 20,206 1/2/2015
57,883 65,601 68.87 68.87 385 12/21/2017
107,317 121,626 132.889 126.561 7,865 7/1/2018
172 194 210 200 110 7/1/2018
3,025 3,429 10.511 10.01 3,025 1/24/2020
23,102 26,183 42.411 42.411 28,274 1/2/2015
150,000 170,000 1.476 1.476 952 1/2/2015
199 225 210 200 109 7/1/2018
106 120 117.249 111.665 70 7/1/2018
#VALUE! #VALUE! 1.545 1.545 110 4/26/2017
1,994 2,260 3.034 2.889 1,329 7/1/2018
160,875 182,325 190.315 181.253 10,725 10/26/2018
3,246 3,679 22.199 22.199 14,799 1/2/2015
33,000 37,400 50.882 48.459 2,035 7/1/2018
476,933 540,524 457.613 435.822 317,955 5/11/2020
#VALUE! #VALUE! 18.566 18.566 11,978 1/2/2015
136,125 154,275 154.273 146.927 99,825 7/1/2018
127 144 1.837 1.837 85 6/9/2020
#VALUE! #VALUE! 1.968 1.968 407 4/26/2017
1,155 1,309 1.057 1.007 770 6/14/2019
#VALUE! #VALUE! 10.843 10.843 28 4/26/2017
#VALUE! #VALUE! 95.406 90.863 49,005 7/1/2018
4,399 4,985 15.206 14.482 7 7/23/2018
64,461 73,056 85.416 81.349 429 1/24/2020
7,866 8,915 25.416 25.416 52 4/26/2017
36,275 41,111 67.399 64.189 24,035 4/24/2019
248 281 525 500 163 7/1/2018
35,971 40,767 58.793 55.993 2,398 3/13/2019
#VALUE! #VALUE! 44.171 44.171 22,528 4/26/2017
353 400 525 500 259 7/1/2018
26,813 30,388 25.408 24.198 17,875 3/19/2020
#DIV/0! #DIV/0! 24.707 23.53 181 1/15/2020
1,073 1,216 950 905 650 6/24/2019
2,145 2,431 2.686 2.558 1,416 7/1/2018
1,162 1,317 1.26 1.2 700 6/24/2019
3,630 4,114 4.435 4.224 2,396 7/1/2018
#VALUE! #VALUE! 1.239 1.18 605 7/1/2018
1,568 1,777 1.423 1.355 708 7/1/2018
1,980 2,244 2.75 2.619 1,452 7/1/2018
#VALUE! #VALUE! 6.09 5.8 44 1/17/2019
5,635 6,387 3.01 3.01 1,597 7/1/2018
7,499 8,499 8.61 8.2 5 1/17/2019
#VALUE! #VALUE! 10.954 10.432 473 12/12/2019
299,210 339,105 276.45 276.45 199,473 3/26/2018
#VALUE! #VALUE! 105 100 73 7/1/2018
#VALUE! #VALUE! 4 4 3 7/28/2015
76 86 107 102 41 7/1/2018
76 86 108 103 42 7/1/2018
76 86 109 104 45 7/1/2018
83 94 146 139 51 5/11/2020
125 142 148 141 79 5/11/2020
0 0 8.317 7.921 6 4/15/2019
#DIV/0! #DIV/0! 350 350 - 2/20/2015
#VALUE! #VALUE! 600 600 - 2/7/2014
6,666 7,555
#REF!
67 76
6,666 7,555
6,666 7,555
6,666 7,555
444 504
- -
6,666 7,555
#DIV/0! #DIV/0!
#DIV/0! #DIV/0!
DATE: 09/06/2020 RUMAH SAK PAGE: 1
rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

GROUP : 51 PHARMACY

TYPE : 5101 TABLET

LACTO B sach - Lactobac51010001 9.228 8.789 0 5.227 7/1/2018


ASCARDIA 80mg tab - Ace 51010004 1.748 1.665 0 935 7/1/2018
NEW DIATABS tab - Acti 51010005 1.106 1.054 0 675 1/4/2019
EPEXOL 30mg tab - Amb51010007 2.195 2.09 0 913 ###
CLINOVIR 200 mg tab - A51010016 9.524 9.07 0 4.73 7/1/2018
CLINOVIR 400 mg tab - A51010017 14.35 13.365 0 7.714 7/1/2018
CAPTOPRIL 12,5 mg Tab 51010024 1.363 1.298 0 146 ###
CAPTOPRIL 25 mg Tab 51010025 1.315 1.252 0 181 ###
OZEN 10 mg tab - Cetriz 51010028 5.912 5.912 0 4.548 ###
RYVELL 10 mg tab - Cetr 51010029 5.715 5.715 0 4.397 ###
ZEUFOR 500 mg tab - Cit51010036 18.722 18.722 0 11.165 ###
PLAVIX 75 mg Tab - Clop51010038 43.244 41.185 0 27.2 7/1/2018
SANPRIMA tab - Co-trimo51010042 2.331 2.22 0 843 7/1/2018
ELKANA tab - Dibasic C 51010045 2.321 2.211 0 924 ###
DIGOXIN 0,25 mg tab 51010046 2.191 2.191 0 1.096 1/2/2015
PRORENAL tab - DL-3-me51010048 12.029 11.456 0 6.6 7/1/2018
VOMETA FT 10 mg tab - 51010049 9.682 9.221 0 4.4 ###
PROFIBRAT 300 mg tab -51010052 17.969 17.113 0 11.102 7/1/2018
LASIX 40 mg Tab - Furo 51010057 9.1 8.667 0 5.938 ###
BUSCOPAN 10 mg tab Hy51010062 7.475 7.119 0 3.436 ###
DUVADILAN 20 mg tab - 51010067 15.119 14.399 0 5.042 7/1/2018
ISORBID 5 mg tab - Isorb51010068 1.045 1.045 0 550 ###
CEDOCARD 10 mg - Isoso51010069 4.503 4.289 0 1.769 ###
CEDOCARD 5 mg TAB- Iso51010070 3.626 3.453 0 1.192 ###
CATAFLAM 50 mg tab- Ka51010072 11.607 11.054 0 6.243 ###
Q-TEN 100 mg soft gel 51010073 17.703 16.86 0 8.47 7/1/2018
IMODIUM 2mg tab - Lo 51010081 13.154 12.528 0 8.025 ###
MEFINAL 500mg capl - 51010083 2.696 2.567 0 1.469 ###
PRIMPERAN 10 MG TAB 51010087 2.623 2.623 0 2.018 ###
ZEPRASOL 20mg caps - 51010092 11.83 11.83 0 9.1 8/1/2013
PANTOZOL 40 mg tab - 51010096 34.29 32.657 0 20.743 7/1/2018
PANTOZOL 20 mg tab - 51010098 27.525 26.214 0 17.977 7/1/2018
PANADOL 500mg tab 51010099 1.327 1.264 0 699 7/1/2018
SANMOL 500 mg tab 51010100 653 621 0 319 ###
RHINOFED cap - Pseudo 51010108 6.83 6.505 0 2.2 ###
VENTOLIN 2 mg tab - Sa 51010112 5.53 5.267 0 2.668 ###
ZITANID 2 mg tab - Tiza 51010113 11.07 10.543 0 7.386 1/4/2019
TRAMAL RETARD tab - T 51010114 11.203 11.203 0 8.618 ###
ZALDIAR tab - Tramadol 51010115 23.081 21.982 0 10.291 7/1/2018
THERAGRAN M tab - Vit 51010117 9.501 9.049 0 4.983 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 2


rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
MOLOCO+B12 tab - Vit 51010118 7.106 6.768 0 3.52 3/5/2019
LAPRAZ caps 30 mg - La 51010119 23.683 22.555 0 13.178 ###
LEVOCIN Tab 500 mg - L 51010120 68.918 65.636 0 40.59 ###
METVELL 0,125 mg tab 51010122 4.666 4.444 0 2.396 7/1/2018
NEUROSANBE tab - vit 51010123 4.048 3.855 0 1.315 ###
PHENYTOIN 100 mg Kap51010129 1.598 1.522 0 666 7/1/2018
PROLIC Cap 150 mg - Cl 51010133 7.447 7.092 0 3.795 ###
PROLIC Cap 300 mg - Cl 51010134 15.451 14.715 0 7.904 ###
RIFAMTIBI caps 600 mg -51010137 12.699 12.095 0 6.32 ###
RIFAMTIBI tab 450 mg - 51010138 8.933 8.507 0 4.741 ###
SANPRIMA FORTE Kapl -51010141 4.761 4.534 0 2.14 ###
SPORETIK 100 mg Kaps -51010143 36.607 34.864 0 21.747 ###
SPORETIK 50 mg Kaps - 51010144 13.428 13.428 0 8.712 ###
TRADOSIK 50 mg Kaps - 51010145 8.82 8.4 0 4.18 ###
TREMENZA Tab - pseudo51010147 3.99 3.8 0 1.524 ###
TRICHODAZOL 500mg Ta51010148 5.67 5.4 0 1.782 ###
TROVENSIS tab 8 mg - 51010149 34.44 32.8 0 18.942 ###
TUZALOS Kaplet - dmp 151010150 1.785 1.7 0 957 ###
ZELAVEL tab 400 mg - Of51010160 17.733 17.733 0 13.641 ###
BAQUINOR FORTE cap - C51010167 26.904 25.623 0 9.951 ###
CEFAT Kapsul 500 mg - C51010170 19.508 18.579 0 10.885 7/1/2018
CLANEKSI 500 mg Kapl - 51010171 22.05 21 0 12.925 ###
CODEIN 10MG TAB 51010174 1.368 1.303 0 685 7/1/2018
CODEIN 15MG TAB 51010175 2.773 2.641 0 1.234 7/1/2018
CODIPRONT CAP 51010176 17.491 16.658 0 7.938 7/1/2018
CODIPRONT CUM EXPE 51010177 19.541 18.61 0 10.503 7/1/2018
ERYSANBE kaps 500 mg 51010184 6.95 6.619 0 2.849 ###
FOLAVIT tab 400 mcg - F51010187 1.856 1.768 0 985 ###
ZERLIN 50 mg tab - Setr 51010202 15.422 15.422 0 11.863 ###
ACYCLOVIR 200MG TAB 51010204 1.255 1.195 0 587 ###
ACYCLOVIR 400MG TAB 51010205 2.058 1.96 0 966 ###
AMBROXOL 30MG TAB 51010209 630 600 0 300 3/5/2019
AMOXSAN 500MG -amoxi 51010213 7.233 6.889 0 3.52 ###
CALCIUM LACTATE 500 51010223 449 428 0 170 ###
CEFADROXIL 500MG T 51010225 2.395 2.281 0 714 7/1/2018
CELESTAMIN tab 51010227 6.983 6.65 0 3.881 3/5/2019
CETIRIZINE 10MG TAB 51010228 979 932 0 313 ###
CLINDAMYCIN 150MG K51010230 1.47 1.47 0 702 ###
CLINDAMYCIN 300MG K51010231 5.77 5.495 0 1.375 ###
CO-AMOXICLAV 625MG 51010232 10.296 9.806 0 6.389 7/1/2018
DEXAMETHASON 0.5MG51010234 539 513 0 140 ###
DILTIAZEM 30MG TAB 51010237 1.155 1.1 0 203 ###
DOMPERIDONE TAB 51010238 1.103 1.05 0 484 ###
DOXYCYCLINE 100MG T 51010239 1.68 1.6 0 880 ###
FUROSEMIDE 40MG TA 51010246 630 600 0 242 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 3


rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
GLUCOPHAGE 500mg ta51010248 3.939 3.751 0 1.874 ###
ISONIAZIDE (INH) 300M 51010254 1.023 975 0 262 ###
KETOCONAZOLE 200MG51010255 1.363 1.298 0 451 7/1/2018
LANZOPRAZOLE 30MG 51010256 3.15 3 0 649 7/1/2018
LEVOFLOXACIN 500MG 51010257 2.546 2.424 0 1.328 ###
LORATADINE 10MG TAB51010259 1.47 1.4 0 333 ###
MELOXICAM 15MG TAB 51010261 1.289 1.228 0 863 ###
MELOXICAM 7.5MG TA 51010262 1.328 1.265 0 656 ###
METHYLPREDNISOLONE 51010264 1.552 1.478 0 825 7/1/2018
MUCOPECT 30mg tab 51010267 7.001 6.668 0 3.742 ###
NATRIUM DIKLOFENAK 51010268 611 611 0 151 ###
NATRIUM DIKLOFENAK 51010269 998 950 0 341 ###
NEUROBION 1000 tab 51010271 3.707 3.531 0 1.769 ###
NEUROBION 5000 tab 51010272 6.283 5.984 0 3.257 ###
NEUROSANBE 5000 TAB 51010273 6.244 5.947 0 2.811 ###
NIFEDIPINE TAB 51010274 1.05 1 0 193 7/1/2018
PIRACETAM 1200MG T 51010280 2.111 2.011 0 1.138 7/1/2018
PROPYLTHIOURACYL (P 51010286 1.082 1.03 0 496 ###
PYRAZINAMIDE 500MG 51010287 1.094 1.042 0 376 ###
RIFAMPICIN 300MG TA 51010290 2.289 2.18 0 1.403 ###
SALBUTAMOL 2MG TAB 51010298 575 547 0 92 7/1/2018
SALBUTAMOL 4MG TAB 51010299 561 534 0 107 ###
SANGOBION tab 51010302 2.466 2.349 0 1.287 ###
VITAMIN B COMPLEK T 51010311 525 500 0 158 7/1/2018
VITAMIN B12 50MCG T 51010312 1.314 1.251 0 110 ###
VITAMIN C 50MG TAB 51010313 546 520 0 350 4/1/2020
VITAMIN K TAB 51010314 178 178 0 89 1/2/2015
ZOLACAP cap 51010315 28.297 28.297 0 21.767 ###
CORTIDEX tab 51010319 2.205 2.1 0 308 ###
DAMABEN TAB (methocl51010321 1.295 1.234 0 479 ###
GLIQUIDONE 30MG TAB51010324 2.844 2.708 0 1.325 ###
BRAXIDIN tab 51010325 3.842 3.659 0 1.161 3/5/2019
FUNDAMIN E tab 51010327 2.575 2.453 0 938 ###
ANALSIK tab -methampy51010330 3.255 3.1 0 1.595 ###
CARDIO ASPIRIN tab 51010333 2.905 2.767 0 1.556 ###
OCUSON tab 51010334 3.944 3.756 0 1.43 ###
KETOPROFEN 100mg ta 51010335 3.807 3.626 0 1.35 ###
CATAFLAM 25mg tab 51010341 6.011 5.725 0 3.271 ###
LAMESON 4mg tab 51010345 6.513 6.203 0 3.74 ###
PURECEMIA TAB 51010346 7.968 7.588 0 3.102 ###
MERISLON tab 51010351 5.805 8.1 0 5.849 7/1/2018
UROTRACTIN cap 51010353 9.688 9.226 0 3.586 ###
PREABOR TAB (Allylestr 51010355 7.182 6.84 0 4.031 7/1/2018
BIOTHICOL 500mg cap 51010360 8.103 7.717 0 4.015 ###
KETOROLAC 10mg tab 51010361 5.77 5.77 0 2.53 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 4


rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
HP PRO cap 51010364 13.809 13.151 0 5.867 ###
RHINOS SR CAP (Larotad51010367 11.477 10.931 0 6.05 ###
URISPAS 200mg tab 51010370 9.584 9.128 0 4.62 ###
ALLORIS tab 51010371 9.87 9.4 0 4.923 ###
IMBOOST FORCE tab 51010379 11.391 10.848 0 6.233 7/1/2018
ADALAT OROS 30mg tab51010384 24.508 23.341 0 11.586 ###
CEFILA 100mg tab 51010395 30.718 29.255 0 21.45 7/1/2018
LIPITOR 10mg tab 51010399 35.825 34.024 0 20.533 ###
LIPITOR 20mg tab 51010400 33.526 31.93 0 21.12 ###
LIPITOR 40mg tab 51010401 30.447 28.997 0 22.151 ###
NOLIPO 500mg cap 51010406 10.256 9.767 0 5.225 ###
CRAVOX 500mg tab 51010407 67.694 64.47 0 41.25 ###
CYCLO-PROGYNOVA 21 51010411 258.112 245.821 0 167.539 ###
GLIBENCLAMIDE 5mg ta 51010414 835 795 0 239 ###
Becom C Tab 51010429 3.635 3.462 0 1.65 ###
Bisolvon 8mg Tab 51010434 5.364 5.108 0 2.091 ###
BRAIN ACT 500MG TAB 51010437 24.819 23.638 0 13.75 ###
Buscopan Plus Tab 51010438 8.415 8.015 0 4.666 ###
Cal-95 Kaplet 51010439 10.497 9.997 0 5.72 ###
Celebrex 100mg Tab 51010447 19.467 18.54 0 11.33 ###
CTM 4mg Tab 51010451 649 618 0 135 1/4/2019
Diabetasol Vanilla 180g 51010454 67.285 64.081 0 36.135 ###
Dopamet 250mg Tab 51010459 4.406 4.196 0 2.263 7/1/2018
Dulcolax 5mg Tab 51010460 3.375 3.214 0 1.888 ###
Enervon-C Tab 51010462 2.398 2.284 0 1.066 ###
ESILGAN 1MG TAB 51010467 8.085 7.7 0 4.517 ###
ESILGAN 2MG TAB 51010468 10.972 10.45 0 6.914 ###
FG Throches 120 Tab 51010472 2.595 2.472 0 1.281 ###
Fluimucil 200mg Kap 51010474 16.612 15.821 0 6.362 ###
Folamil Genio Soft Cap 51010476 8.715 8.3 0 4.18 ###
Forres 50mg Tab 51010477 9.976 9.501 0 5.5 7/1/2018
Frego 5mg Tab 51010478 11.94 11.371 0 6.6 7/1/2018
Glurenorm 30mg Tab 51010484 6.01 6.01 0 3.935 ###
Glyceril Guaicolat 100 51010485 1.386 1.32 0 235 ###
Imunos Tab 51010493 14.848 14.141 0 5.39 ###
Isosorbide Dinitrate 5m 51010500 561 534 0 123 7/1/2018
Kalmethasone Tab 51010502 525 500 0 121 7/1/2018
Ketesse Tab 51010503 15.996 15.234 0 8.8 7/1/2018
KSR Tab 51010505 8.567 8.159 0 3.48 7/1/2018
Lasgan 30mg Kaps 51010507 29.526 28.12 0 15.4 7/1/2018
Lipantyl 200M Tab 51010512 29.051 27.668 0 21.134 7/1/2018
Lipantyl Supra Tab 51010513 39.588 37.703 0 21.761 ###
Losartan 50mg Tab 51010515 9.35 8.905 0 3.303 7/1/2018
Lutenyl Cap 51010517 26.189 24.942 0 15.666 ###
Medixon 16mg Tab 51010520 14.766 14.063 0 6.875 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 5


rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999
I/P O/P Compan y Cost Eff
Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Medixon 4mg Tab 51010521 6.069 5.78 0 2.53 7/1/2018
Medixon 8mg Tab 51010522 8.4 8 0 4.4 7/1/2018
Mertigo Tab 51010525 6.282 5.983 0 3.245 7/1/2018
Mucosta Tab 51010531 9.66 9.2 0 4.948 ###
Nephrisol Vanilla 180g 51010536 102.197 97.33 0 61.6 ###
Nimotop Tab 51010544 22.086 21.034 0 8.262 8/6/2018
Peptisol Vanilla 180g 51010556 118.884 113.223 0 61.71 3/5/2019
Pletaal 100mg Tab 51010562 22.986 21.891 0 13.442 7/1/2018
Pletaal 50mg Tab 51010563 13.722 13.069 0 9.315 7/1/2018
Prednison 5mg Tab kf 51010566 505 481 0 88 7/1/2018
Primolut N 5mg Tab 51010568 13.57 12.923 0 5.753 ###
Pumpitor Cap 51010572 26.847 25.568 0 14.85 ###
Pyridoxine (Vit B6 ) 10 51010573 525 500 0 163 7/1/2018
SIMVASTATIN 20MG TA 51010576 1.89 1.8 0 936 7/1/2018
Spasminal Tab 51010579 1.221 1.163 0 638 ###
Strocain P Tab 51010580 4.919 4.684 0 3 ###
Theophyllin 1gram 51010583 1.078 1.026 0 680 7/1/2018
Urdafalk Tab 51010596 18.297 17.426 0 11 ###
Valisanbe 2mg Tab 51010597 683 650 0 242 ###
Valisanbe 5mg Tab 51010598 1.155 1.1 0 407 ###
Zicho 500mg Tab 51010611 26.933 26.933 0 20.718 ###
Zolesco Kap 51010612 15.493 15.493 0 11.918 ###
ARCOXIA 120MG TAB 51010617 29.335 27.938 0 17.796 3/5/2019
ARICEPT 5MG TAB @ 3051010618 40.363 38.441 0 25.345 7/1/2018
ASPILET CHEWABLE TAB51010619 1.44 1.372 0 611 ###
ASPILET TROMBO TAB 51010620 3.756 3.577 0 862 ###
BETASERC 24MG TAB 51010623 26.298 25.046 0 11 ###
CEFSPAN 100MG TAB 51010630 38.52 36.686 0 24.2 ###
CEFSPAN 200MG TAB 51010631 61.878 58.931 0 38.5 8/6/2018
CELEBREX 200MG TAB 51010632 25.956 24.72 0 15.934 ###
CORDARONE TAB 51010639 16.33 15.553 0 8.033 ###
CPG TAB 51010640 27.786 26.463 0 18.7 ###
CRAVIT 500MG TAB 51010641 66.705 63.529 0 42.532 7/1/2018
CURCUMA TAB 51010642 1.817 1.73 0 974 7/1/2018
DIVASK 10MG TAB 51010648 20.881 19.887 0 11.55 7/1/2018
DIVASK 5MG TAB 51010649 12.754 12.147 0 6.6 7/1/2018
DOLO NEUROBION 100 51010650 3.957 3.769 0 1.717 ###
EUPHYLLIN RETARD TAB51010653 6.342 6.04 0 3.134 7/1/2018
FREGO 10MG TAB 51010658 14.689 13.989 0 8.14 7/1/2018
GLUCOPHAGE XR 500M 51010663 5.363 5.108 0 2.696 7/1/2018
HCT 25MG TAB OGB KF 51010664 525 500 0 141 7/1/2018
HEMOBION TAB 51010665 6.746 6.424 0 2.032 3/5/2019
HEPAMAX CAP 51010666 16.253 15.479 0 9.607 ###
HEPATOSOL VANILLA 51010668 177.662 169.202 0 110.352 7/1/2018
IMBOOST TAB 51010671 6.929 6.599 0 3.41 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 6


rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
ISOPRINOSINE TAB 51010673 22.636 21.558 0 13.293 7/1/2018
LAPIBAL 500MCG CAP 51010677 5 4.761 0 2.475 ###
METHYCOBAL 500MG C 51010680 7.478 7.122 0 4.056 7/1/2018
OSCAL 0.5MG CAP 51010681 19.735 18.796 0 12.382 7/1/2018
STARCEF 100MG CAP 51010685 33.328 31.741 0 20.35 ###
STARCEF 200MG CAP 51010686 46.2 44 0 33 ###
VECTRIN 300MG CAP 51010687 10.471 9.973 0 5.5 ###
KALNEX 250MG TAB 51010694 5.159 4.913 0 2.145 ###
KALNEX 500MG TAB 51010695 9.236 8.796 0 3.685 ###
KALTROFEN 100MG TAB51010696 9.436 8.987 0 4.95 7/1/2018
KALTROFEN 50MG TAB 51010697 6.405 6.1 0 2.75 7/1/2018
KALXETIN 20MG TAB 51010699 10.966 10.444 0 6.514 7/1/2018
KETOPROFEN 50MG TA 51010700 1.737 1.654 0 704 7/1/2018
LAMESON 8MG TAB 51010702 11.522 10.973 0 6.05 ###
MYONAL TAB 51010716 12.563 11.965 0 7.857 7/1/2018
NEUROTAM 1200MG TA51010718 9.892 9.421 0 5.772 7/1/2018
OMZ CAP @ 30 51010727 22.285 21.224 0 12.833 7/1/2018
PEHADOXIN FRTE TAB @51010733 2.27 2.162 0 660 7/1/2018
Profertil Tab 51010735 33.27 31.685 0 18.15 ###
Propanolol 10mg Tab O 51010736 541 515 0 89 ###
Propanolol 40mg Tab O 51010737 1.103 1.05 0 139 7/4/2019
Proris Kaplet 51010738 1.902 1.811 0 968 7/1/2018
Sirdalud Tab 51010744 13.399 13.399 0 8.408 ###
Sistenol Cap @ 60 51010745 3.986 3.986 0 1.65 ###
Sulcolon Tab 51010751 16.719 15.923 0 8.47 7/1/2018
Urdahex Tab 51010763 17.507 16.673 0 10.633 ###
V-Bloc 25mg Tab 51010767 14.152 13.478 0 7.81 ###
V-Bloc 6.25mg Tab 51010768 8.09 7.705 0 3.153 ###
Voltaren 25mg Tab 51010772 7.805 7.434 0 3.943 ###
Voltaren 50mg Tab 51010773 11.986 11.415 0 6.869 ###
Voltaren SR 75mg Tab 51010774 14.06 13.39 0 9.135 ###
Vomitas FDT Tab 51010776 9.407 8.959 0 4.51 ###
Zilop 600mg Tab 51010779 5.34 5.34 0 4.108 ###
BICNAT TAB 51010801 655 624 0 58 ###
LODIA 2MG TAB 51010805 3.446 3.282 0 1.1 ###
CODEIN 20MG TAB 51010808 3.594 3.423 0 1.331 7/1/2018
FORMUNO TAB 51010813 14.885 14.176 0 7.48 ###
OMEPRAZOLE 20MG CAP51010831 2.922 2.783 0 660 ###
SIMARC 2 TAB 51010834 4.757 4.757 0 1.93 ###
ARCOXIA 90MG TAB 51010835 29.545 28.138 0 16.204 3/5/2019
ALINAMIN F TAB 51010840 4.243 4.041 0 1.32 ###
COBAZIM 1000 TAB 51010843 8.987 8.559 0 4.455 ###
GLUTROP TAB 51010844 25.879 24.647 0 18.15 ###
LAMESON 16MG TAB 51010845 14.041 13.373 0 9.24 ###
COLISTINE 250.000 TAB 51010850 3.453 3.289 0 1.392 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 7


rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
L-BIO SACH 51010851 14.904 14.194 0 7.7 ###
ALDISA SR TAB 51010856 10.703 10.194 0 5.907 ###
PRONALGES 100MG TA 51010859 8.336 8.336 0 4.675 ###
PROFIBRAT 200M TAB 51010861 21.341 20.325 0 13.31 7/1/2018
CRESTOR 10MG TAB 51010862 36.874 35.118 0 22.63 ###
ALLOPURINOL 300MG 51010868 1.736 1.654 0 495 3/5/2019
ETHAMBUTOL 500MG T 51010869 3.35 3.19 0 880 ###
RIFAMPICIN 450MG TA 51010871 2.819 2.685 0 1.87 ###
RIFAMPICIN 600MG TA 51010872 3.807 3.626 0 2.59 ###
AMOXICILLIN 500MG T 51010876 3.501 3.334 0 462 ###
CEFIXIME 200MG TAB 51010877 6.871 6.544 0 4.214 7/1/2018
METRONIDAZOLE 500M51010878 886 844 0 286 ###
RANITIDIN 150MG TAB 51010879 472 450 0 220 7/1/2018
BETASERC 8MG TAB 51010882 7.76 7.39 0 4.239 7/1/2018
GLUCOPHAGE 850MG T 51010891 5.209 4.961 0 2.4 9/5/2018
LAPICEF 500MG CAP 51010893 18.189 17.323 0 10.45 7/1/2018
DEPAKOTE 250MG TAB 51010896 17.108 16.293 0 10.072 7/1/2018
DEXTAMIN TAB 51010898 4.319 4.113 0 1.766 7/1/2018
ASAM MEFENAMAT 50051010900 1.05 1 0 217 7/1/2018
IMDUR 60MG TAB 51010901 9.904 9.904 0 6.603 1/2/2015
CEFIXIME 100MG TAB 51010911 8.113 7.727 0 1.673 7/1/2018
ZEGAVIT CAP 51010914 7.085 6.748 0 3.52 ###
LESIPAR 300MG CAP 51010919 11.648 11.094 0 5.005 3/5/2019
SESDEN 30MG CAP 51010923 4.579 4.361 0 2.225 7/1/2018
GLUCOVANCE 500MG/251010927 9.132 8.697 0 4.327 ###
GLUCOVANCE 500MG/551010928 8.902 8.478 0 5.254 7/1/2018
MEPTIN 0.05MG TAB 51010931 8.063 7.679 0 4.822 ###
THEOBRON CAP 51010932 3.859 3.676 0 2.585 ###
NEULIN PS TAB 51010944 23.826 22.692 0 13.2 7/1/2018
SUMAGESIC TAB 51010945 1.298 1.236 0 495 ###
TELFAST HD 180MG TA 51010946 18.522 17.64 0 9.811 ###
HYPERIL 5MG TAB 51010947 15.84 15.086 0 8.8 7/1/2018
GEMFIBROZIL 300MG T 51010952 1.614 1.537 0 546 ###
CIPROFLOXACIN 500MG51010953 1.431 1.363 0 667 ###
METFORMIN 500MG TA51010954 632 602 0 100 7/1/2018
AMLODIPINE 5MG TAB 51010955 3.582 3.411 0 207 ###
ALLOPURINOL 100MG 51010957 1.082 1.03 0 220 ###
TRIATEC 5MG TAB 51010959 21.429 20.408 0 14.432 ###
FARSORBID 5MG TAB 51010961 1.215 1.157 0 259 ###
CONCOR 2.5MG TAB 51010971 11.799 11.237 0 6.55 ###
OSTE FORTE TAB 51010988 15.75 15 0 7.478 7/1/2018
TRIATEC 10MG TAB 51010997 23.837 23.837 0 15.892 1/2/2015
ASAM TRANEKSAMAT 5 51011000 4.223 4.022 0 1.782 ###
ONDANSETRON 8MG TA51011001 5.291 5.039 0 2.816 7/1/2018
SIMVASTATIN 10MG T 51011003 3.652 3.652 0 643 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 8


rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
FLUNARIZINE 5MG TAB 51011004 3.99 3.8 0 983 ###
GLIMEPIRIDE 2MG TAB 51011005 2.638 2.512 0 1.433 7/1/2018
ITRACONAZOLE 100MG 51011006 9.004 8.575 0 4.84 7/1/2018
METFORMIN 850MG TA51011007 1.753 1.669 0 429 ###
HALOPERIDOL 0.5MG TA51011009 269 269 0 180 1/2/2015
HALOPERIDOL 1.5MG TA51011010 525 500 0 113 7/1/2018
HALOPERIDOL 5MG TAB51011011 525 500 0 147 7/1/2018
LINCOMYCIN 500MG CA51011012 1.699 1.699 0 649 ###
TRUVAS 20MG TAB 51011013 25.949 24.713 0 17.6 ###
VESTEIN 300MG CAP 51011014 9.642 9.183 0 5.06 ###
SANTA E 200MG TAB 51011015 5.25 5 0 2.079 ###
CONCOR 5MG TAB 51011016 13.937 13.273 0 9.033 ###
CAVIT D3 TAB 51011018 4.306 4.101 0 2.068 3/5/2019
METHYLPREDNISOLON 51011021 578 551 0 279 7/1/2018
ZYLORIC 100MG TAB 51011022 5.769 5.494 0 2.432 7/1/2018
CRESTOR 20MG TAB 51011023 41.571 39.591 0 26.037 ###
PARACETAMOL 500MG 51011027 1.195 1.138 0 177 ###
METHYLPREDNISOLON 51011028 2.522 2.402 0 462 ###
BECOM-ZET CAP 51011031 5.234 4.985 0 2.2 ###
FLUIMUCIL GRANULE 2 51011032 11.328 10.788 0 6.472 ###
ZINKID 20MG TAB 51011033 5.965 5.681 0 3.025 7/1/2018
BIOSANBE CAP 51011035 1.945 1.852 0 1.045 7/1/2018
NEUROSANBE PLUS TAB51011036 2.415 2.3 0 1.128 ###
TRUVAS 10MG TAB 51011040 25.643 25.643 0 16.133 7/1/2018
MEPTIN MINI 0.025MG 51011041 5.843 5.565 0 2.83 ###
ZYLORIC 300MG TAB 51011043 10.194 9.709 0 5.874 7/1/2018
RECOLFAR 0.5MG TAB 51011045 10.067 9.587 0 5.5 ###
DIOVAN 80MG TAB 51011046 20.666 20.666 0 12.432 ###
ASPAR K TAB 51011050 5.865 5.586 0 2.721 ###
ZESTRIL 5MG TAB 51011055 10.226 10.226 0 7.866 ###
AVODART CAP 51011056 18.415 17.538 0 10.395 7/1/2018
EXFORGE 5/80MG TAB 51011062 25.792 24.564 0 18.73 ###
NEUROVIT E TAB 51011065 2.215 2.11 0 1.167 7/1/2018
SANTIBI 500 TAB 51011070 2.917 2.917 0 1.945 1/2/2015
HERBESSER CD 100 CAP 51011075 23.74 22.61 0 8.593 ###
FORNEURO TAB 51011076 13.96 13.295 0 5.583 7/1/2018
OSCAL 0.25MG TAB 51011081 12.149 12.149 0 6.966 ###
ACPULSIF 5MG TAB 51011083 8.327 7.93 0 3.85 7/1/2018
BIO ATP TAB 51011084 5.09 5.09 0 3.394 1/2/2015
XARELTO TAB 51011088 59.254 56.432 0 34.757 ###
EXFORGE 5/160 TAB 51011101 25.961 25.961 0 17.05 ###
CORALAN 5MG TAB 51011104 21.915 20.871 0 9.62 7/1/2018
KETRICIN TAB 51011111 7.122 6.782 0 4.72 1/4/2019
NAN 1 PROBIOTIK 400G 51011112 258.028 258.028 0 164.817 ###
PROVERA 10MG TAB 51011113 20.53 19.552 0 11.515 3/5/2019

DATE: 09/06/2020 RUMAH SAK PAGE: 9


rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
THROMBOLES CAP 51011115 14.412 13.726 0 8.37 ###
DUPHASTON TAB 51011117 34.987 33.321 0 19.378 7/1/2018
GLIMEPIRIDE 3MG TAB 51011155 3.465 3.3 0 1.075 ###
GLIMEPIRIDE 1MG TAB 51011156 2.067 1.969 0 627 7/1/2018
LIPROQY CAP 51011164 14.779 14.075 0 7.26 7/1/2018
HEPAMERTZ GRANUL 51011166 60.501 57.62 0 39.93 7/1/2018
DORNER 20 MCG TAB 51011168 17.015 17.015 0 9.566 ###
TEBOKAN TAB 51011171 8.258 8.258 0 6.352 8/1/2013
SPORACID 100MG TAB 51011174 37.459 35.675 0 21.453 7/1/2018
DIFLUCAN 150MG TAB 51011175 195.522 186.212 0 128.563 ###
STOBLED CAP 51011179 13.667 13.016 0 8.099 7/1/2018
NEURODEX TAB 51011180 1.646 1.568 0 605 7/1/2018
LAPIFLOX 500MG TAB 51011199 22.932 21.84 0 14.3 ###
ERICAF TAB 51011200 11.529 10.98 0 5.908 ###
DUROGESIC 25 51011209 321.271 321.271 0 237.05 ###
FARSORBID 10MG TAB 51011214 903 860 0 361 7/1/2018
GRISEOVULFIN 500MG 51011216 2.602 2.478 0 1.859 ###
ENTRAMIX VANILLA 18051011219 97.401 92.763 0 49.5 7/1/2018
NODROF F TAB 51011222 1.446 1.377 0 708 7/1/2018
GLIMEPIRIDE 4MG TAB 51011235 6.316 6.015 0 1.693 ###
DIGOXIN 0,25MG TAB I 51011242 535 500 0 143 7/1/2018
LIPANTHYL PENTA 145 51011254 38.978 37.122 0 21.688 7/1/2018
CILOSTAZOL 100MG TA 51011260 16.572 15.783 0 8.047 7/1/2018
CIFLON TAB 51011261 16.878 16.074 0 9.35 ###
POSTOVIT TAB 51011262 6.312 6.011 0 2.97 7/1/2018
ECLID 100MG TAB 51011264 5.625 5.357 0 2.64 ###
HERBESER CD 200MG C 51011269 25.084 23.89 0 13.717 ###
THYROZOL 10MG TAB 51011270 3.988 3.988 0 2.659 1/2/2015
AZOMAX 500MG TAB 51011271 60.9 58 0 36.3 ###
GLUCOSAMIN 500MG T 51011273 3.368 3.208 0 1.843 7/1/2018
CRESTOR 40MG TAB 51011274 50.454 48.051 0 31.413 ###
CANDERIN 8MG TAB 51011275 11.668 11.112 0 7.26 7/1/2018
VALTREX TAB 51011278 29.071 27.687 0 18.04 7/1/2018
NATTO 10 TAB 51011280 17.759 16.914 0 9.801 7/1/2018
AB VASK 5MG TAB 51011281 11.35 10.81 0 6.435 ###
FLUIMUCIL 600MG EFF 51011283 20.625 19.643 0 13.613 7/1/2018
VIPALBUMIN CAP 51011285 11.603 11.05 0 6.6 7/1/2018
MOZUKU TAB 51011287 19.747 18.807 0 9.9 3/5/2019
TANAKAN 40MG TAB 51011289 12.008 12.008 0 8.8 ###
KALITAKE SACH 51011299 32.748 31.188 0 24.877 9/5/2018
RENALOF CAP 51011300 21.253 20.241 0 12.217 ###
PLASMIN DUS CAP 51011310 26.565 25.3 0 16.5 ###
ARTRODAR 50MG CAP 51011316 17.968 17.112 0 10.23 ###
AZITHROMYCIN 500MG 51011317 17.936 17.082 0 9.9 7/1/2018
BRILINTA 90MG TAB (T 51011318 31.482 29.983 0 17.153 ###
DATE: 09/06/2020 RUMAH SAK PAGE: 10
rptchgpr.p CHARGE PRICE LI TIME: 12:15:52
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
LIPANTYL 100 TAB 51011321 16.46 15.676 0 8.433 7/1/2018
SAMSCA 15MG TAB 51011322 284.05 284.05 0 218.5 ###
MEXTRIL TABLET 51011323 1.05 1 0 484 7/1/2018
RISPERIDON 2 MG TAB
51011325 5,46 8 5 0.208 0 2 ,565 15/09 2 18
SANAZET 500MG TAB 51011328 3.36 3.2 0 1.364 ###
PARIET 20MG TAB 51011329 41.42 39.448 0 20.498 7/1/2018
PROSTAM TAB 51011330 14.414 14.414 0 9.61 1/2/2015
PROBIOKIDS SACHET 51011331 27.785 26.462 0 15.065 ###
PANTOPRAZOLE 20MG 51011332 13.695 13.043 0 8.8 7/1/2018
PANTOPRAZOLE 40MG 51011333 21.15 20.143 0 11 7/1/2018
ONDANSETRON 4MG TA51011334 3.017 2.873 0 1.767 7/1/2018
GLAUSETA 250 TAB 51011335 7.837 7.464 0 6.321 6/4/2019
BETAHISTIN 6MG TAB 51011340 2.901 2.763 0 1.694 7/1/2018
LISINOPRIL 10MG TAB 51011341 9.45 9 0 2.743 7/1/2018
LISINOPRIL 5MG TAB 51011342 3.514 3.347 0 1.613 7/1/2018
MECOBALAMIN 500MG 51011343 3.351 3.192 0 880 ###
TRIAMCINOLONE 4MG 51011344 1.502 1.43 0 797 7/1/2018
CITICHOLIN 500MG TAB 51011345 14.524 13.833 0 7.333 ###
ACETYLCYSTEIN 200 CA 51011346 3.563 3.394 0 1.833 ###
VIPALBUMIN SACHET 51011350 109.627 104.407 0 85.8 3/5/2019
ALPRAZOLAM 0.25MG T51011351 1.123 1.069 0 584 7/1/2018
ALPRAZOLAM 0.5MG TA51011352 1.397 1.33 0 738 7/1/2018
ALPRAZOLAM 1MG TAB 51011353 2.11 2.009 0 1.137 7/1/2018
ACARBOSE 50MG TAB 51011355 2.196 2.091 0 1.186 7/1/2018
CISAPRIDE 5MG TAB 51011356 1.428 1.36 0 756 7/1/2018
CLOBAZAM 10MG TAB 51011357 1.945 1.852 0 1.045 7/1/2018
GABAPENTIN 300 CAP 51011358 12.574 11.975 0 5.5 ###
RAMIPRIL 5MG TAB 51011360 1.213 1.155 0 635 7/1/2018
SPIRONOLACTONE 100 51011361 1.944 1.851 0 1.044 7/1/2018
SPIRONOLACTONE 25M 51011362 1.05 1 0 346 7/1/2018
ACARBOSE 100MG TAB 51011363 3.286 3.13 0 1.912 7/1/2018
ARKINE 2MG TAB
51011367 1.962 1.869 0 762 1 1 /05/2020
ATORVASTATIN 20MG T51011368 8.118 7.732 0 4.4 7/5/2018
NUTRIFLAM TAB 51011370 19.831 18.887 0 6.93 3/5/2019
LAPROSIN TAB 51011374 15.724 14.975 0 9.801 7/1/2018
VISANNE 2 MG TAB
51011380 662, 123 6 62.123 0 4 85,817 11/ 2 /2019
ISONIAZID 100MG TAB 51011382 849 809 0 157 7/1/2018
RESPIRA TAB 51011384 47.009 44.771 0 33 3/5/2019
EPERISONE TAB 51011385 3.465 3.3 0 1.694 7/4/2019
REBAMIPIDE TAB 51011386 3.773 3.593 0 2.069 7/1/2018
URSODEOXYCHOLIC ACI 51011387 8.511 8.106 0 4.62 7/1/2018
GALVUSMET 50/500MG 51011388 11.622 11.622 0 6.875 ###
PREGABALIN 75MG TAB 51011389 16.863 16.06 0 7.15 ###
DEXTRAL CAPSUL 51011392 1.157 1.102 0 557 ###
ARDIUM 500 TAB 51011393 15.368 14.636 0 8.126 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 11


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
AMLODIPIN 10MG TAB 51011394 1.66 1.581 0 272 ###
MADOPAR TAB 51011402 11.165 11.165 0 8.151 ###
INFATRINI SUSU CAIR 1 51011403 53.361 53.361 0 29.091 ###
DISOLF TAB 51011405 19.559 18.628 0 7.15 7/1/2018
PRO TB4 TABLET 51011408 10.939 10.418 0 5.969 7/1/2018
RICOVIR 300MG 51011409 33.129 33.129 0 25.08 ###
BICROLID 500MG TABLE51011411 39.959 38.056 0 27.027 ###
TRAJENTA 5 MG TAB 51011412 28.228 26.884 0 18.355 ###
FORMALIN TABLET
51011413 1.318 1.318 0 892 12 / Jan-17
INBUMIN TABLET 51011415 9.555 9.1 0 6.417 ###
NEURO AID CAPSUL 51011416 58.562 55.773 0 43.884 3/5/2019
VELACOM PLUS 1 MG/2 51011417 3.277 3.121 0 1.27 7/1/2018
VELACOM PLUS 2 MG/500 MG
51011418 4,607 4.388 0 2.65 ###
TRIZEDON MR TABLET 51011422 6.009 5.723 0 4.6 9/5/2018
CORMEGA BLISTER 51011424 18.659 17.771 0 13.383 ###
ANALTRAM TAB 51011425 15.847 15.093 0 9.9 ###
SPORETIK 200 MG KAPS 51011432 47.361 45.106 0 31.405 ###
UTROGESTAN 100 MG 51011434 18.392 17.517 0 13.2 ###
UTROGESTAN 200 MG
51011435 33,7 72 3 2.164 0 2 4,200 25/1 / 2019
CEFILA 200 MG CAPSUL 51011436 40.261 40.261 0 30.25 2/1/2018
MONURIL 3 GR 51011437 314.496 299.52 0 198 ###
FOSRENOL TABLET
51011438 4 4.584 42.461 0 23,100 13 / Sep-19
GABEXAL 100 MG CAPS 51011439 5.582 5.582 0 4.054 ###
TELMISARTAN 40 MG
51011440 6,8 30 6.505 0 3,678 01/0 / 2018
TELMISARTAN 80 MG 51011441 9.337 8.892 0 4.792 7/1/2018
CEFIXIM 100 MG OBG D 51011442 3.116 3.116 0 2.395 ###
CEFIXIM 200 MG OBG D 51011443 5.337 5.337 0 4.034 ###
TEGRETOL 200 MG TAB
51011444 7,45 3 7 0.098 0 5 ,634 19/11 2 18
TOFEDEX TAB 25MG 51011446 10.27 9.781 0 7.26 ###
HEXIMER 2MG 51011447 649 618 0 424 ###
CEPEZET 100MG 51011448 739 704 0 495 ###
RICLONA 2MG 51011449 11.06 10.534 0 8.052 5/8/2020
NOPRENIA TAB 2MG 51011452 10.422 9.925 0 7.48 9/7/2018
XIETY TAB 10MG
51011454 6.069 5.78 0 4,400 18 / Sep-18
XEPAZYM TAB 51011456 5.255 5.005 0 3.025 ###
CODIPRONT KAPSUL ISI 51011457 12.984 12.365 0 9.048 ###
NOPROSOL TAB 51011459 14.932 14.221 0 10.846 ###
S-OMEVELL 20 TAB 51011460 18.98 18.076 0 13.75 ###
S-OMEVELL 40 TAB 51011461 25.437 24.226 0 18.48 ###
DEPRAM 10MG TAB 51011462 16.728 15.932 0 12.1 ###
DEPRAM 30MG TAB 51011463 33.245 31.662 0 24.2 ###
MIRZAP 30MG TAB 51011464 18.98 18.077 0 13.75 ###
RETIVIT PLUS TABLET 51011465 10.523 10.022 0 7.662 ###
GLUCOPHAGE XR 750M 51011466 3.733 3.555 0 2.696 4/1/2019
FENOFIBRAT 200 MG 51011467 9.551 9.096 0 6.765 4/1/2019

DATE: 09/06/2020 RUMAH SAK PAGE: 12


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
LESICHOL 600 MG 51011468 36.728 34.979 0 26.752 4/8/2019
IBERET FOLIC TABLET 51011469 6.37 6.066 0 4.62 4/8/2019
DISFLATYL TABLET 51011470 822 783 0 556 ###
L-BIO KAPSUL 51011471 10.722 10.212 0 7.7 ###
OSTEOKOM TABLET 51011472 9.22 8.781 0 6.6 ###
CIVELL MR 1000 TAB 51011473 38.171 36.353 0 27.5 ###
XEROLAC 10MG TAB 51011474 9.326 8.882 0 6.6 ###
PARIET 10MG TAB 51011475 28.624 27.261 0 20.97 ###
BUDENOFALK CAP 3MG 51011476 43.606 41.53 0 31.946 ###
RENVELA 800 MG TABL 51011478 26.698 25.426 0 19.404 8/9/2019
NEPRISOL D 51011479 96.429 91.837 0 66 ###
AMADIAB 4 MG TABLET 51011480 10.337 9.845 0 7.48 ###
NORVASK 5 MG TABLET 51011481 12.09 11.514 0 8.696 ###
TONICARD KAPSUL 51011482 26.954 25.67 0 19.7 9/5/2019
SELOXY TABLET 51011483 7.719 7.351 0 55 ###
ANTIMO TABLET 51011484 778 741 0 570 ###
LUTERON 5MG TAB 51011485 5.967 5.682 0 4.216 ###
PROHELIC TAB 51011486 8.47 8.066 0 6.05 ###
MEFOZ 4MG TAB 51011487 19.403 18.479 0 13.75 ###
SANDIMMUN NEORAL 51011488 44.296 42.187 0 32.359 ###
OSCIFIC TABLET 51011489 2.33 2.219 0 1.661 ###
OSTGEN TABLET 51011490 13.294 12.661 0 9.57 ###
MEDIGREL TABLET 51011491 19.13 18.22 0 13.86 ###
FIBRAMET 300 MG 51011492 17.479 16.647 0 12.65 ###
FORXIGA 10 MG TABLET51011493 30.749 29.285 0 20.979 ###
FEBURIC 300MG TAB 51011494 30.239 28.799 0 22 ###
SULFASALAZINE TABLET 51011495 3.066 2.92 0 2.2 ###
CARDISMO TABLET 51011497 3.885 3.7 0 2.8 ###
THEORAL TABLET 51011498 3.624 3.452 0 2.5 ###
RYMONT SACHET 51011499 9.921 9.449 0 6.833 ###
CLOZAPIN 5 MG TABLET 51011511 4.481 4.268 0 3.19 ###
KINA TABLET 51011519 1.874 1.785 0 1.357 ###
AMITRIPTYLLIN 25 MG 51011521 326 311 0 193 ###
EZETROL 10 MG 30'S TA 51011522 26.878 25.598 0 19.536 ###
ATORVASTATIN 40 MG-IS51011523 4.956 4.72 0 3.476 ###
METHYSOPRINOL 500MG51011524 4.631 4.411 0 3.3 ###
INLACIN 100MG TABLET51011525 7.719 7.351 0 5.5 ###
EUTHYROX 50 MG TABL 51011526 2.111 2.01 0 1.5 5/4/2020
INVITEC TABLET 51011527 19.856 18.91 0 14.5 5/4/2020
VALSARTAN 160 MG 51011528 6.217 5.921 0 4.4 ###
HYOLOQUIN 51011529 24.88 23.696 0 18.15 ###
NEOSTIGMIN HAMELN 051020445 46.591 44.373 0 17.6 ###
INFUSAN D5 500ML DP 51030394 47.596 45.329 0 22.11 ###
CLINOLEIQ 20% 100 ML 51030421 267.629 267.629 0 193.6 ###
ZINKID SYR 100ML 51040421 36.418 36.418 0 30.348 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 13


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999
I/P O/P Compan y Cost Eff
Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
ELKANA CL SYRUP 51044104 85.482 81.411 0 51.15 3/5/2019
VIVITY R-HIDRATE JERU 51044114 19.369 18.446 0 14.097 ###
MONARIN TAB 10MG 51044182 10.722 10.211 0 7.7 ###
SYMBICORT 160 MG/4,5 MCG 120 DOSIS
51180346 682,699 650,189 0 487,919 13/03/2019
DISCOUNT (PHARMACY)51999998
OTHERS (PHARMACY) 51999999

DATE: 09/06/2020 RUMAH SAK PAGE: 14


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5102 INJECTION

CLONIDIN 0.15MG TAB 51011073 765 728 0 266 ###


AMINOPHYLLIN 24 mg/ 51020002 13.349 12.713 0 6.497 ###
ATROPIN SULFAT 0,25 mg 51020003 6.349 6.047 0 2.75 ###
DOPAMINE GIULINI 20 m51020016 124.407 118.483 0 78.1 7/1/2018
EPINEPHRINE Base 1 mg 51020017 18.986 18.082 0 9.5 7/1/2018
INVICLOT 5.000 UI/ml in51020020 117.117 111.54 0 72.6 ###
BUSCOPAN 20ml/ ml inj 51020021 68.361 65.105 0 37.705 ###
REMOPAIN 30 mg inj/ml51020025 75.146 71.568 0 46.2 7/1/2018
VITAMIN K3 10 mg/ml in51020029 9.624 9.165 0 5.243 7/1/2018
PANTOZOL 40 mg inj - P 51020040 271.899 258.951 0 168.19 7/1/2018
TRAMAL 50 MG INJ 51020050 40.934 40.934 0 23.98 ###
CORTIDEX Vial - Dexam 51020070 14.7 14 0 6.699 ###
METHYCOBAL 500MG IN51020086 54.584 51.985 0 33.831 7/1/2018
METVELL 0,2 mg/ml inj 51020087 18.488 17.608 0 9.488 7/1/2018
MORPHIN 10MG/ML INJ51020088 51.649 49.189 0 37.455 ###
OXYLA 10IU/ML INJ 51020092 20.624 19.642 0 12.65 7/1/2018
PELASTIN inj 1 g - Imip 51020093 491.567 491.567 0 359.48 ###
PETHIDIN HCL inj - Pethi 51020094 29.793 28.374 0 19.481 ###
PHENYTOIN 200 mg Am 51020095 99.75 95 0 75.606 ###
SAGESTAM inj 2 ml - Ge 51020099 23.911 22.772 0 10.714 ###
SYNTOCINON 1 ml Amp-51020101 28.112 26.774 0 15.305 7/1/2018
TERFACEF Vial 1 gr - sef 51020103 412.65 393 0 226.38 ###
BISOLVON 4mg/2ml inj 51020120 89.622 85.355 0 58.234 ###
CORDARONE INJ- amiod51020126 68.39 65.133 0 44.083 ###
DICYNONE 250 mg/2 ml 5i 1020128 73.5 70 0 45.467 7/1/2018
EXTRACE 1000 mg/5mL in 51020131 51.66 51.66 0 33 ###
EXTRACE 500mg/5ml inj51020132 39.655 37.766 0 24.2 ###
KALMETHASON 5MG INJ51020134 14.864 14.864 0 7.15 ###
KETALAR inj 100 mg 51020136 504.713 504.713 0 340.877 ###
LASIX inj - Furosemid 51020137 33.524 33.524 0 15.148 ###
NEO-K INJ- 51020140 25.274 24.07 0 13.64 7/1/2018
NEUROBION 5000 inj 51020141 13.23 12.6 0 8.178 7/1/2018
PREVENAR (pneumococca 51020144 1,010,380 962.267 0 735.422 ###
TETAGAM P 250IU x 1m 51020148 364.508 347.15 0 220 ###
NEEDLE NOVOFINE 51020152 5.767 5.492 0 3.007 7/1/2018
DAMABEN INJ (methoclo51020158 21.518 20.494 0 10.12 ###
CA GLUCONAS 10% inj 51020160 37.8 36 0 17.967 ###
PROSTIGMIN 0.5mg am 51020162 47.294 45.042 0 26.356 ###
KETOROLAC 30mg inj 51020163 18.976 18.976 0 13.365 ###
VAKSIN DIFTERI TETANUS 51020173 129.834 123.651 0 77.99 7/1/2018
VAKSIN TETANUS (TT) 5m 51020174 166.337 158.416 0 93.5 ###
DECAIN 4ml inj 51020175 78.413 78.413 0 60.318 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 15


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
VAKSIN CAMPAK 10 DS v51020179 245.71 234.009 0 139.736 ###
HIPNOZ 5MG/5ML INJ 51020181 29.714 29.714 0 19.809 1/2/2015
PPD 0.3 ML 51020182 170.202 170.202 0 117.381 1/2/2015
SERUM ANTI TETANUS 1.5 51020183 292.862 278.916 0 181.5 7/1/2018
RECOFOL 10mg/ml inj 2 51020185 166.982 159.03 0 104.5 7/1/2018
RAIVAS inj 4ml 51020187 170.1 162 0 104.5 ###
CEFXON 1g inj 51020195 395.546 376.71 0 231 7/1/2018
SERUM ANTI BISA ULAR 51020198 1,007,037 1,007,037 0 770 ###
ACTRAPID HM 100IU/ml51020201 479.985 479.985 0 350.9 ###
PPD 1.5ml vial 51020203 1,159,094 1,103,899 0 844.078 ###
SERUM ANTI DIFTERI 20.51020204 811.347 811.347 0 624.113 8/1/2013
ISORANE 250ML 51020205 12.991 12.372 0 7.26 7/1/2018
EPHEDRIN HCL INJ 51020207 39.174 37.309 0 27.225 7/1/2018
BRAIN ACT 500MG INJ 51020215 119.341 113.658 0 73.26 7/1/2018
Catapres 0.15mg/ml Inj 51020217 140.131 133.458 0 100.995 ###
Cepraz 1g Inj 51020225 158.76 151.2 0 103.95 ###
CERVARIX INJ 51020226 929.567 885.302 0 641.3 7/1/2018
Engerix B 0.5 ml Inj 51020234 143.874 137.023 0 93.336 ###
Engerix B 20mcg Inj 51020235 227.617 216.778 0 107.907 ###
Extrace 200mg Inj 51020236 23.053 21.955 0 12.1 ###
FENTANYL 2MG INJ 51020237 87.572 83.402 0 48.4 7/1/2018
Flamicort 10mg/ml IAD 51020238 223.65 213 0 137.5 ###
Flamicort 40mg/ml IM I 51020239 223.616 212.967 0 132 ###
Havrix 720 Junior 51020244 410.993 391.422 0 284.834 ###
Herbesser 50mg Inj 51020246 446.552 425.288 0 326.7 7/1/2018
Ketesse Inj 51020249 115.745 110.233 0 72.6 7/1/2018
Lapixime 1g Inj 51020250 249.626 237.739 0 165 3/5/2019
Medixon 125mg Inj 51020251 134.552 134.552 0 82.5 ###
Merosan 1g Inj 51020252 939.61 894.867 0 591.965 ###
Merotik Inj 51020253 685.287 685.287 0 522.5 ###
Neurotam 3g Inj 51020258 97.017 92.397 0 53.24 7/1/2018
Primperan Inj 51020267 23.213 22.108 0 11.367 7/1/2018
STESOLID 10MG/2ML IN51020276 24.984 23.794 0 12.584 7/1/2018
Streptomycin 1g Inj 51020277 28.246 26.901 0 9.703 ###
Vaksin BCG 51020285 354.092 337.23 0 234.995 ###
Varilrix Inj 51020286 563.144 563.144 0 412.5 ###
VERORAB INJ 51020287 340.254 324.051 0 234.08 ###
ARIXTRA 2,5 MG INJ @ 51020300 492.978 492.978 0 360.525 ###
BROADCED 1G INJ 51020301 349.602 332.954 0 200.558 7/1/2018
CEFTUM 1G INJ 51020306 370.824 353.166 0 207.995 7/1/2018
CERNEVIT INJ 51020309 340.191 323.992 0 236.5 5/4/2020
FUROSEMIDE 10MG/ML51020321 11.271 11.15 0 3.542 ###
Lantus Solostar Pen @ 551020329 313.637 298.702 0 207.995 ###
Levemir Pen Inj 51020330 266.752 266.752 0 189.097 ###
Meropenem 1g Inj 51020332 366.777 349.311 0 84.7 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 16


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Neurosanbe 5000mg Inj 51020336 11.55 11 0 5.467 ###
Novorapid Flexpen @ 5 51020338 270.21 257.342 0 176.492 ###
OMZ Inj 51020339 227.378 216.55 0 130.9 7/1/2018
Pehacain Inj 51020340 7.29 6.943 0 3.082 7/1/2018
Ceftazidime 1g Inj @ 1 51020358 142.769 135.971 0 45.65 ###
Infanrix 51020363 382.311 382.311 0 254.874 1/2/2015
Infanrix HIB 51020364 534.111 534.111 0 356.074 1/2/2015
Lapibal 500 Inj 51020367 48.444 46.137 0 24.2 7/1/2018
LOVENOX 40MG INJ 51020371 304.347 289.855 0 173.549 ###
LOVENOX 60MG INJ 51020372 357.109 340.104 0 260.68 ###
SANKORBIN 1000MG IN 51020374 49.675 47.31 0 29.568 ###
BACTESYN 1.5G INJ 51020375 244.536 244.536 0 163.024 1/2/2015
CEFTRIAXONE 1G INJ 51020376 60.842 57.945 0 10.01 7/1/2018
PIRACETAM 3G INJ OG 51020377 40.407 38.483 0 20.526 ###
ONDANSETRON 8MG IN51020386 19.273 18.356 0 8.8 8/6/2018
RANITIDIN INJ NOVEL 51020392 6.157 5.864 0 3.465 7/1/2018
LAMESON 125MG INJ 51020393 183.269 174.542 0 104.5 ###
FLUIMUCIL AMPUL 300 51020395 101.274 96.452 0 57.2 ###
ISORBID INJ 51020396 120.19 114.467 0 75.867 7/1/2018
CEFOTAXIME 1G INJ O 51020399 22.949 21.856 0 6.93 ###
NOVOMIX 30 FLEXPEN 51020400 307.241 292.611 0 176.492 ###
ROBUMIN 20% 100 ML 51020410 2,994,262 2,851,679 0 1,896,675 7/1/2018
TRAMADOL 100MG INJ 51020411 26.179 24.932 0 5.5 7/1/2018
VAXIGRIP 0.25MG 51020412 146.811 146.811 0 97.874 1/2/2015
ASAM TRANEKSAMAT 5 51020416 34.532 32.887 0 6.93 ###
ONDANSETRON 4MG IN51020418 11.192 10.659 0 3.19 7/1/2018
METHYLPREDNISOLON 51020421 157.81 150.295 0 27.225 ###
VAXIGRIP 0.5MG INJ 51020426 195.962 195.962 0 139.973 1/2/2015
GENTAMICIN 40MG/ML 5I 1020428 11.558 11.008 0 1.078 7/1/2018
SNMC ( STRONGER NEO 51020429 206.85 197 0 115.5 ###
IKADRYL INJ 51020434 24.075 22.929 0 8.894 7/1/2018
CARDIOPLEDIC SOL 3 IN 51020442 483.557 460.53 0 195.999 ###
PROTAMIN INJ 51020443 285.879 272.265 0 176.04 ###
BRAIN ACT 250MG INJ 51020448 72.259 72.259 0 38.031 1/2/2015
NEULIN 500MG INJ 51020451 131.178 124.931 0 72.6 7/1/2018
SYNFLORIX VAKSIN 51020452 665.684 665.684 0 488.455 ###
TROVENSIS 4MG/2ML IN51020482 120.546 114.806 0 75.614 ###
TROVENSIS 2MG/2ML IN51020483 66.15 63 0 36.3 ###
CEFOPERAZONE + SULB 51020485 212.667 202.54 0 110 ###
PANTOPRAZOLE 40MG 51020491 88.631 84.41 0 40.7 8/6/2018
VOMIZOLE 40MG INJ 51020495 258.089 245.799 0 159.5 ###
PROANES INJ 51020497 144.615 137.729 0 88.935 ###
ECRON 10MG INJ 51020501 430.5 410 0 231 ###
PUMPITOR INJ 51020505 260.4 248 0 158.84 ###
FARGOXIN INJ 51020507 81.469 77.59 0 44 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 17


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
DEXAMETHASONE INJEK51020508 4.065 3.871 0 2.196 ###
MECOBALAMIN 500MG 51020509 17.472 16.64 0 8.8 7/1/2018
N-EPI INJ 51020513 158.193 150.66 0 81.675 7/1/2018
PROTERINE INJ 51020515 29.162 27.774 0 20.9 ###
INOVAD INJ 51020517 423.316 423.316 0 325.682 ###
TYPIM VI O.5 ML 51020530 306.451 291.858 0 219.863 ###
LIDOCAIN INJEKSI 51020532 8.4 8 0 1.76 ###
RANITIDIN INJEKSI BE 51020533 11.587 11.036 0 2.6 ###
ACRAN INJEKSI 51020535 42 40 0 22.352 ###
VAKSIN POLIO 10 DS 51020537 115.239 109.752 0 71.499 ###
SANDOSTATIN INJ 51020545 420.881 420.881 0 307.12 ###
FOSULAR INJEKSI 51020546 291.561 291.561 0 194.374 1/2/2015
ROTARIX VAKSIN 51020547 397.31 397.31 0 289.66 ###
OKAVAK VAKSIN ( CACAR51020548 473.061 473.061 0 315.374 1/2/2015
LODOMER INJ 51020549 31.686 30.177 0 13.776 7/1/2018
REGIVEL INEJEKSI 51020558 122.675 116.833 0 77 7/1/2018
DOBUTAMIN 50MG INJ 51020566 87.557 83.388 0 40.81 7/1/2018
NICARDIPINE HCL 1MG I51020567 226.625 215.833 0 143 7/1/2018
NOTRIXUM 25MG INJ 51020568 67.957 67.957 0 49.5 ###
NOTRIXUM 50MG INJ 51020569 131.337 125.083 0 82.5 7/1/2018
NTG INJEKSI 51020571 113.312 107.917 0 71.5 7/1/2018
TOPAZOL INJ 51020573 296.567 282.445 0 161.7 7/1/2018
PUMPICEL INJ 51020574 277.748 264.521 0 162.855 ###
CEFORIM INJ 51020575 462.61 462.61 0 338.03 ###
NICARDEX INJEKSI 51020577 281.994 268.656 0 205.7 7/1/2018
MILOZ 15MG/3ML INJEK51020578 67.469 67.469 0 49.5 ###
MILOZ 5 MG / ML INJ 51020579 35.003 33.337 0 21.78 7/1/2018
CARBAZOCHROME 50MG51020585 21.351 20.335 0 13.112 7/1/2018
DEXKETOPROFEN 50MG 51020586 36.009 36.009 0 27.699 ###
ZYFORT INJEKSI 51020587 12.816 12.205 0 6.958 7/1/2018
CHROME INJ 50 MG 51020589 35.35 33.667 0 22 7/1/2018
VAKSIN PENTABIO 51020593 255.864 243.68 0 159.044 ###
URESIX INJ 51020594 23.724 22.595 0 9.196 ###
CEFOPERAZONE INJ 1 G 51020597 127.304 121.242 0 44 ###
PLASMINEX 500MG INJ 51020598 23.064 21.966 0 13.332 3/5/2019
OMEPRAZOLE INJ MBF 51020602 70.209 66.865 0 34.98 ###
FARTISON INJ 51020604 160.1 152.931 0 104.5 ###
FURAMIN INJEKSI 51020606 19.638 18.703 0 12.1 8/6/2018
VAKSIN TD (DIFTERI TETANUS) DEWASA
51020607 82,340 82,340 0 81,62 0 21/12/2017
SALTICIN 80 MG INJ (GE 51020610 36.896 35.139 0 25.3 ###
VENODENOL INK FAHRENHEIT
51020611 86,840 86.84 0 66.8 ###
FIBRION INJEKSI
51020612 4,81 2,341 4 ,812,341 0 4 ,180,000 1 / Dec-19
TOFEDEX INJ 2MLM 51020674 69.674 66.356 0 49.5 ###
INFANRIX HEXA
51020675 904.579 861.504 0 646.866 1 2/3/2020
INFANRIX IPV + HIB
51020676 681,7 12 68 1.712 0 51 9,750 11/1 / 2019

DATE: 09/06/2020 RUMAH SAK PAGE: 18


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
ESOLA INJEKSI 51020677 270.9 258 0 181.5 ###
DIVITI INJEKSI
51020678 4 34.851 414.144 0 316,250 1 3 /08/2018
GRANISETRON 3 MG INJ51020679 76.343 72.707 0 55 ###
CITICOLIN 500MG INJ 51020680 60.694 57.804 0 44 ###
UMARON INJ
51020681 269.1 2 256,28 7 0 192,5 0 0 08/09/2018
VITAMIN K1 INJEKSI BE 51020683 9.698 9.236 0 7.04 ###
DIPHENHYDRAMINE INJ 51020684 11.144 10.614 0 7.7 ###
LANSOPRAZOLE INJ 51020685 141.474 134.737 0 99 ###
NOREPINEPHRIN INJ 51020686 91.358 87.007 0 66 ###
SANSULIN LOG G 51020688 253.67 241.59 0 184.91 ###
VAKSIN MR (MEASLES R 51020689 606.939 578.037 0 440 ###
DUALVIS INJEKSI 51020690 2,258,589 2,151,037 0 1,650,000 ###
ETHANYL INJEKSI 51020691 56.823 54.117 0 40.7 ###
VALISANBE INJ 51020692 27.678 26.36 0 19.789 ###
INDOP INJEKSI (DOPAMI51020693 50.429 48.027 0 36.3 ###
NOSORBID INJEKSI 51020694 57.804 57.804 0 44 ###
OMEPRAZOLE INJ DEXA 51020695 102.19 97.324 0 74.8 ###
HEPATITIS B RECOMBI 51020698 119.552 113.859 0 87.12 ###
GRANISETRON 1 MG INJ51020701 40.706 38.768 0 27.5 ###
AZITROMYCIN INJEKSI 51020703 201.534 191.937 0 143 ###
VASCON INJEKSI 51020704 166.598 158.665 0 121.121 ###
HEPAGUSAN INJEKSI 51020705 60.697 57.807 0 44.002 6/9/2020

DATE: 09/06/2020 RUMAH SAK PAGE: 19


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5103 INFUSION

OTSU D40 infus 25 ml - 51030001 63.041 60.039 0 10.461 7/1/2018


OTSU KCL 7,46 mg infus 51030005 31.527 30.026 0 9.541 7/1/2018
STERIL WATER 1 L OTSUK51030006 46.2 44 0 30.69 ###
OTSU D5 1/4 NS infus 5 51030007 47.539 45.275 0 15.67 7/1/2018
OTSU D10,1/5NS 500ML51030008 36.561 36.561 0 13.2 ###
OTSU D5 RUBBER 500M 51030012 34.326 34.326 0 13.2 ###
OTSU MANITOL 20% infu51030018 142.223 135.45 0 65.459 ###
OTSU MANITOL 20% inf51030019 141.617 134.873 0 88.2 ###
OTSU MgSO4 20 infus 2 51030020 31.117 29.635 0 10.01 7/1/2018
OTSU MgSO4 40 infus 2 51030022 38.268 36.446 0 10.01 ###
OTSU NS 100ML PIGGY 51030031 34.552 34.552 0 12.1 ###
PEDIALYTE sol 500 ml- 51030032 44.001 44.001 0 31.429 1/2/2015
KA-EN 1B infus 500 ml- 51030034 50.059 47.675 0 24.2 ###
KA-EN 3B infus 500 ml- 51030035 55.74 53.086 0 24.2 7/1/2018
MEYLON 8.4% inf 25 ml 51030041 38.11 36.295 0 15.18 7/1/2018
OTSU SALIN/NS 3% 500 51030043 71.663 68.25 0 39.435 ###
OTSU RL RUBBER 500ML51030044 31.884 31.884 0 22.774 1/2/2015
OTSU WATER INJ 25ML 51030050 45.15 43 0 6.954 ###
INFUSAN D5 100 ml 51030054 49.926 47.548 0 19.14 ###
INFUSAN D5+1/4NS SP 51030058 44.49 42.371 0 15.128 7/1/2018
FUTROLIT infus 51030059 160.81 153.152 0 40.15 ###
LEVOCIN Infus - Levoflo 51030063 443.602 443.602 0 323.95 ###
INFUSAN NS 100 ml 51030066 51.005 48.576 0 18.7 ###
INFUSAN RING AS DP 2451030070 60.774 57.88 0 24.31 ###
TRICHODAZOL Infusion -51030074 168 160 0 95.81 ###
TRIDEX 27 A infus 51030076 48.434 48.434 0 32.289 1/2/2015
TRIDEX 27 B infus 51030077 56.506 53.815 0 23.705 ###
OTSU D10 500ML infus 51030081 54.963 52.346 0 17.71 7/4/2019
INFUSAN D5 500ML SP 51030082 17.251 17.251 0 13.077 ###
INFUSAN NS 500ML SA 51030084 57.442 54.707 0 21.12 ###
OTSU-RD5 500ML INF- N51030087 25.371 24.163 0 17.71 ###
METRONIDAZOLE INFU 51030093 78.391 74.658 0 39.82 ###
TUTOFUSIN OPS 51030094 111.575 106.262 0 62.92 ###
CIPROFLOXACIN INFUS 51030096 255.452 243.288 0 53.295 7/1/2018
AMINOFUSIN HEPAR 51030102 366.505 349.052 0 235.648 7/1/2018
AMINOFLUID 1000ml 51030108 350.988 334.274 0 218.405 7/1/2018
MARTOS 10 infus 500ml51030109 155.931 155.931 0 88 9/6/2016
TRIOFUSIN 500ml 51030111 144.745 137.852 0 84.7 7/1/2018
Cravox Inf 100ml 51030116 518.76 494.057 0 291.5 ###
Hidonac 20% Inf 51030119 643.114 612.489 0 448.8 ###
Infusan D5+ 1/2NS DP 2 51030122 23.959 23.959 0 18.43 ###
Infusan D5+ 1/2NS SP 2 51030123 26.974 25.689 0 16.941 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 20


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Nimotop Infus 50ml 51030130 371.243 353.656 0 298.12 8/6/2018
OTSU NS 25 ML 51030134 37.679 35.885 0 6.954 ###
OTSU NS 1000ML 51030137 44.121 44.121 0 19.8 ###
COMAFUSIN HEPAR 50 51030139 390.949 372.332 0 231 7/1/2018
HYDROGEN PEROKSIDA 51030141 525 500 0 61 7/1/2018
INFUSAN RL DP 24 51030142 52.793 50.279 0 21.615 ###
Renxamin Infus 51030148 178.528 170.027 0 93.412 7/1/2018
Triofusin 1000 Inf 51030149 156.872 149.402 0 92.4 7/1/2018
Triofusin E 1000 51030150 176.278 167.884 0 107.479 7/1/2018
Wida WI Twist Off 1 L 51030152 32.192 32.192 0 12.887 ###
Aminofusin Paed 250ml 51030153 173.562 165.297 0 105.754 7/1/2018
FIMA HES 200 51030154 302.674 288.261 0 130.68 7/1/2018
LEVOFLOXACIN INF OG 51030373 174.764 166.442 0 88 ###
AMINOSTERIL 6% INFA 51030380 155.56 148.152 0 85.25 ###
INTEGRILIN 100ML INF 51030381 3,306,611 3,306,611 0 2,870,670 ###
CLINIMIX N9G15E INF 51030382 548.689 522.561 0 427.735 7/1/2018
TRIOFUSIN 1600 INF 51030384 201.386 191.796 0 123.42 7/1/2018
INFUSAN NS 0.9 % 1000 51030393 49.824 49.824 0 17.903 ###
SOJOURN 250 ML 51030395 17.203 17.203 0 11.44 ###
BAQUINOR INFUS SOFT 51030396 408.467 389.016 0 259.624 1/9/2020
ALBUMINAR 25% 100 M51030397 2,345,591 2,345,591 0 2,035,000 ###
DEXTRAL 60 ML 51030398 31.71 30.2 0 8.422 7/1/2018
ROBUMIN 20% 50 ML I 51030399 1,002,193 1,002,193 0 770.918 ###
FLUCONAZOLE INFUS 51030408 223.609 212.961 0 121 ###
AERANE 250 ML 51030411 10.714 10.204 0 6.389 7/1/2018
GELAFUSAL INFUS 51030413 330.866 315.11 0 192.5 7/1/2018
ENERTON INFUS 51030415 192.725 183.548 0 86.57 ###
OTSU D5 1/2 NS 500ML 51030416 48.558 48.558 0 16.83 ###
OTSU D5,NS 500ML 51030417 34.911 34.911 0 23.274 1/2/2015
CRAVOX 750 INF 51030418 511.169 511.169 0 374 ###
PARACETAMOL INFUS 51030419 100.378 95.598 0 19.8 ###
IMIPENEM + CILASTATI 51030420 316.62 301.543 0 196.02 7/1/2018
RENOSAN INFUS 51030422 430.998 410.475 0 277.09 ###
INFUMAL DP 10% 500 51030423 150.153 143.003 0 95.15 7/1/2018
INFUSAN M20 500ML 51030426 140.198 133.522 0 88.825 ###
SANBE STERIL WATER 1 51030427 35.725 34.024 0 19.745 ###
GARENA INFUS
51030431 310.129 295.361 0 220 7/1/2018
NIMODIPIN INFUS 51030433 327.6 327.6 0 252 3/2/2018
WIDA BES ( ASERING 50051030434 14.388 13.703 0 10.293 ###
WIDA KDN1 500 MG (3B51030436 27.376 26.073 0 19.812 ###
WIDAHES 130 500 ML 51030437 248.944 237.09 0 181.913 ###
SEVODEX 250ML 51030438 13.807 13.149 0 10.098 5/9/2019
KABIVEN PERIHERAL 14 51030439 827.938 788.512 0 605 ###
GRIFOLS 20% 100ML 51030440 2,274,555 2,274,555 0 1,815,000 ###
SEVOFLURANT 250 ML 51030441 11.136 10.606 0 8.14 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 21


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5104 SYRUP

AMOXSAN 100MG/ML 51040003 51.833 47.386 0 23.43 7/1/2018


AMOXSAN 125MG/5ML 51040004 51.45 49 0 24.09 ###
CELESTAMINE syr 60 ml 51040005 109.468 104.256 0 70.73 ###
ELKANA syr 60 ml - Ca 51040006 55.514 52.87 0 25.41 ###
CEFAT 125mg/5ml dry sy51040007 83.529 79.552 0 47.19 ###
OZEN 10 mg/ml drop 12 51040010
m 109.802 99.231 0 61.71 7/1/2018
OZEN 5 mg/ml syr 60 ml51040011 98.239 93.561 0 55 7/1/2018
VISTRUM syr 100 ml - C 51040012 82.836 74.871 0 39.598 7/1/2018
VOMETA 5mg/ml drop 151040015 92.142 87.755 0 49.5 ###
COMTUSI syr 100ml - Gl 51040018 98.348 93.665 0 57.86 ###
PRORIS 100mg/5ml susp51040019 53.55 51 0 25.3 ###
POLYSILANE susp 100ml 51040020 40.613 38.679 0 22 ###
SANMOL 120mg/ 5ml syr51040023 30.45 29 0 12.54 ###
TEMPRA 160mg/ 5ml syr51040024 64.865 61.776 0 36.74 7/1/2018
PRAXION 100mg/ml drop51040026 48.031 45.744 0 20.691 7/1/2018
PRAXION 120mg/5ml sus51040027 54.745 52.138 0 25.3 3/5/2019
PRAXION FORTE 250 mg/51040028 56.7 54 0 29.7 ###
INPEPSA 100 ml susp- S 51040032 116.38 110.838 0 60.5 ###
CEFAT Dry Syr - Cefadro 51040037 140.585 133.89 0 81.51 ###
CLANEKSI Dry Syr 125 m51040038 108.3 103.143 0 56.98 3/5/2019
CLANEKSI FORTE Dry Syr51040039 129.212 123.059 0 73.7 7/1/2018
CODIPRONT CUM EXPEC51040040 126.447 120.426 0 61.105 7/1/2018
CODIPRONT SYR 60ML 51040041 116.468 110.922 0 90 ###
ERYSANBE Dry Syr - ery 51040044 52.611 48.126 0 24.42 ###
RYVELL 10mg/mL drop 30 51040048 94.327 89.835 0 48.4 7/1/2018
RYVELL syr 60 ml - Citiri 51040049 106.108 101.055 0 55 7/1/2018
SANADRYL EXP Syr - di 51040050 24.905 23.719 0 10.89 ###
SAN-B-PLEX baby drops 151040051 37.853 36.05 0 20.46 ###
SANMOL drop - paracet 51040052 40.13 36 0 17.27 ###
SPORETIK Dry Syr - sefi 51040054 152.25 145 0 89.54 ###
TREMENZA Syr 60 ml - 51040055 39.917 38.016 0 20.9 7/1/2018
ZAMEL syr 60 ml - Vita 51040056 75.6 72 0 42.8 ###
PRORIS FORTE syr 50ml 51040057 60.165 57.3 0 29.7 ###
BISOLVON 10 mg/5 ml S 51040062 144.618 137.732 0 84.92 ###
DEXTROSIN SYR- dmp 1551040063 38.324 36.499 0 23.1 ###
NIFURAL syp 60 ml 51040069 118.812 113.154 0 66.33 ###
TEMPRA FORTE 250mg/5m 51040072 68.85 65.571 0 39.27 7/1/2018
PARACETAMOL syr 51040074 20.605 19.624 0 6.3 3/5/2019
AMBROXOL syr 51040075 15.215 14.491 0 4.08 7/1/2018
VERMIC drop 51040087 31.686 31.686 0 21.124 1/2/2015
SANADARYL DMP 51040089 32.053 30.526 0 13.2 ###
RENALYT syr 51040090 36.838 35.083 0 17.71 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 22


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
FERRIZ drop 51040099 60.561 52.967 0 36.3 7/1/2018
ALCO PLUS syr 51040106 103.284 98.365 0 60.5 ###
RHINOS JUNIOR syr 51040107 68.116 64.872 0 39.6 ###
APYALIS 100ml syr 51040109 77.196 73.52 0 36.3 ###
ZIN PRO syr 51040110 20.265 19.3 0 6.909 7/1/2018
SILEX syr 51040113 113.619 108.208 0 58.3 ###
LAXADIN syr 51040116 74.854 71.29 0 44 ###
CEFIXIME SYR BERNOF 51040123 58.6 55.81 0 30.25 ###
VECTRIN syr 51040129 99.501 94.763 0 49.5 ###
FLUIMUCIL DS 75ml 51040131 96.086 91.51 0 76.6 3/5/2019
LACTULAX syr 60ml 51040132 91.552 87.193 0 62 ###
ALCO drop 51040133 132.29 125.991 0 79.2 ###
LAPICEF 125mg syr 51040134 86.694 82.566 0 50.6 7/1/2018
DULCOLACTOL syr 51040141 111.961 106.63 0 66.642 7/1/2018
MYCOSTATIN DROP 12 51040149 99.077 94.359 0 59.4 ###
IMUNOS SYR 60ML 51040152 144.4 137.524 0 69.3 ###
CEFILA DS drop 30ml 51040157 170.903 162.765 0 91.3 7/1/2018
CEFSPAN syr 51040163 168.731 168.731 0 101.2 ###
DEPAKEN syr 51040166 282.825 269.357 0 172.37 7/1/2018
Apialys Drop 10ml 51040182 76.886 73.225 0 44 ###
Enervon C Syr 120ml 51040193 40.925 36.656 0 17.118 7/1/2018
Ferriz 100ml Syr 51040195 66.838 63.655 0 33 7/1/2018
Magtral Forte Dry Syr 1 51040202 58.392 55.611 0 33 7/1/2018
Mucopect 15mg/5ml Sy 51040206 93.065 88.634 0 56.942 ###
Mucopect 30mg/5ml Sy 51040207 99.318 94.589 0 67.857 ###
POLYCROL SYR 100ML 51040219 42.684 38.41 0 18.15 7/1/2018
BATUGIN ELIXIR 300ML 51040301 77.522 73.831 0 43.913 ###
ISOPRINOSINE SYR 51040305 177.543 169.089 0 108.282 7/1/2018
Osteocare Syr 100ml 51040315 117.293 111.707 0 66.55 ###
Vometa Syr 60ml 51040320 75.181 71.601 0 49.5 ###
CANDISTIN DROP 51040321 67.986 63 0 39.6 ###
Tempra Drop 51040322 74.703 66.652 0 46.827 7/1/2018
Rhinofed Syr 51040324 61.702 58.764 0 30.25 ###
Vomitas Syr 60ml 51040325 79.405 75.624 0 46.2 ###
POLYCROL FORTE SYR 1 51040339 59.794 56.947 0 27.5 7/1/2018
LASAL EXPECTORANT S 51040346 78.65 74.904 0 41.25 ###
OBH IKA 100ML 51040353 24.851 23.668 0 12.1 ###
SIRPLUS SIRUP RASA JE 51040356 32.357 30.817 0 15.73 ###
LAPICEF FORTE 250MG/ 51040358 134.868 128.446 0 79.75 7/1/2018
CURVIT CL EMULSION 1 51040359 87.561 83.391 0 51.15 7/1/2018
MUCOPECT DROP 51040361 114.32 108.876 0 67.705 ###
SIRPLUS SIRUP RASA A 51040363 32.357 30.817 0 15.73 ###
SIRPLUS SIRUP RASA S 51040364 35.594 33.899 0 18.3 ###
RANIVEL SIRUP 60 ML 51040371 102.287 97.416 0 60.5 7/1/2018
LASAL SYR 51040395 68.843 65.565 0 28.6 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 23


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
BIOTHICOL DRY SYR 51040397 53.524 50.975 0 21.89 7/1/2018
CEFADROXIL SYR BERN 51040399 21.873 20.832 0 7.81 7/1/2018
TRACETATE SUSPENSI O 51040400 719.712 685.44 0 418 ###
IMBOOST FORCE SYR 1 51040403 127.688 121.607 0 89.1 7/1/2018
AMOXSAN FORTE DRY S 51040407 74.547 70.997 0 35.2 ###
AMBROXOL 30MG SYR 51040412 23.837 22.702 0 8.91 7/1/2018
LAPROSIN SYR 60ML 51040415 122.74 116.895 0 77 7/1/2018
L-ZINC SYR 51040416 64.172 61.116 0 36.3 7/1/2018
MEXTRIL SYR 51040417 28.387 27.035 0 11 7/1/2018
BIOTHICOL FORTE DRY 51040418 97.277 92.645 0 60.5 7/1/2018
MYCOSTATIN SYR 30ML 51040419 237.859 226.532 0 122.1 ###
VIPALBUMIN DRY SYRU 51040423 38.87 38.87 0 27.5 ###
FRISIO MOM 400 GR
51044106 131, 626 1 31.626 0 94,050 27/ 3 /2018
ZYTHROMAX SYRUP
51044107 19 8.062 188.63 0 145,100 30/ Oct-18
FRISOLAC GOLD 1 400G 51044108 214.227 204.025 0 151.57 ###
FRISOLAC GOLD 2 400G 51044109 174.642 166.326 0 123.299 ###
LACTULAC SYR 120 ML 51044110 147.931 140.886 0 103.73 4/9/2019
CETIRIZINE SYRUP 51044111 19.984 19.032 0 10.44 5/7/2019
PEPTIFAT 200ML 51044112 114.447 108.997 0 79.2 ###
VIVIT R-HIDRATE APEL 51044113 19.369 18.446 0 14.097 ###
SANADRYL DMP 120 ML51044115 37.201 35.43 0 27.06 8/7/2019
AZOMAX DRY SYRUP 2 51044116 145.228 138.312 0 101.75 ###
VOSTRIN DS SYR 60 ML 51044183 65.055 61.957 0 41.25 ###
DESTAVELL SRY 60 ML 51044184 84.545 80.519 0 55 ###
ALCO DMP SYR 51044188 80.896 77.044 0 58.8 ###
AZITHROMICIN SYR 51044189 102.435 97.557 0 70.4 ###
LIFREE POPOK PEREKAT 52040218 11.604 11.051 0 6.953 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 24


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5106 EAR ,EYE & NOSE DROP

BAQUINOR TETES MATA51060001 70.191 63.385 0 37.812 7/1/2018


BREATHY tetes hidung 51060002 61.027 58.121 0 41.25 ###
FENICOL 1% 5ml Eye Dr 51060003 57.679 53.402 0 31.158 7/1/2018
SAGESTAM ear drops 5 51060004 81.17 77.305 0 31.68 ###
XITROL Eye Drop 5 ml - 51060005 56.243 52.663 0 30.665 7/1/2018
VASACON A MINI DOSE 51060007 43.649 43.649 0 29.099 1/2/2015
VASACON EYE DROP 51060008 46.124 46.124 0 30.749 1/2/2015
FENICOL 0.25% 5ml Eye 51060011 47.137 42.76 0 24.063 7/1/2018
FENICOL EYE OINT 3.5g 51060012 46.245 44.043 0 31.3 1/4/2019
CONVER Eye Drop 51060013 30.04 28.609 0 14.628 7/1/2018
EYEFRESH MINI DOSE 51060015 44.26 42.152 0 27.981 7/1/2018
FLOXA Eye Drop 51060017 66.204 62.068 0 36.935 7/1/2018
TOBROSON Eye Drop 51060018 95.14 90.61 0 55.963 7/1/2018
PROTAGENTA A MINI D 51060020 87.681 83.505 0 51.3 3/5/2019
TARIVID OPTH 5ML EYE 51060022 97.686 85.041 0 52.25 7/1/2018
CATARLENT 5ML EYE D 51060023 48.407 44.855 0 25.46 7/1/2018
Fenicol 0.5 % 5ml Eye D 51060027 62.734 59.747 0 37.057 7/1/2018
Hialid Eye Drop 5ml 51060030 123.261 123.261 0 82.174 1/2/2015
Mydriatyl 0.5% 5ml 51060034 63.209 59.073 0 34.938 7/1/2018
Mydriatyl 1% 5ml 51060035 79.894 76.09 0 46.283 7/1/2018
Tarivid Otic 51060036 165.322 157.449 0 88 ###
Pantocain 2% 5ml Eye D 51060037 46.114 43.918 0 14.911 7/1/2018
XITROL MINI DOSES 51060038 53.941 51.372 0 29.493 7/1/2018
POLYGRAN EYE OINT 3. 51060039 52.328 49.836 0 22.385 7/1/2018
POLYGRAN 0.6ML MINI 51060040 50.595 48.186 0 21.175 7/1/2018
LFX MINIDOSE 51060041 130.885 124.652 0 77.646 7/1/2018
OCULOTECT GEL 10 G 51060044 112.619 107.256 0 67.155 7/1/2018
LYTEERS 15ML EYE DRO 51060045 48.196 44.646 0 25.32 7/1/2018
POLYDEX 5ML EYE DRO 51060046 79.742 75.944 0 40.229 7/1/2018
CENFRESH EYE DROP 5 51060048 69.16 65.533 0 39.245 7/1/2018
EYEFRESH EYE DROP 5M51060049 66.953 59.073 0 34.938 7/1/2018
EFRISEL EYE DROP 5ML 51060050 36.062 34.345 0 18.453 7/1/2018
TIMOL EYE DROP 5ML 51060051 97.999 93.332 0 57.778 7/1/2018
HERVIS EYE OINT 3.5G 51060052 83.946 79.949 0 44.468 7/1/2018
STATROL EYE DROP 5M 51060053 49.424 49.424 0 32.949 1/2/2015
VERNACEL EYE DROP 5 51060054 42.256 40.244 0 22.385 7/1/2018
NONCORT MINI DOSE 51060055 91.859 87.485 0 51.123 7/1/2018
OPTHALGON EYE DROP 51060056 39.334 37.461 0 13.31 7/1/2018
POLYNEL 5ML EYE DROP51060058 58.215 55.443 0 32.518 7/1/2018
CENFRESH 0.6 MINI DO 51060059 71.034 67.651 0 38.363 ###
HYALUB MD 51060060 100.21 95.438 0 68.97 7/1/2018
AFRIN NASAL SPRAY 15 51060061 100.492 95.707 0 51.854 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 25


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
TROPIN 1% ED 5ML 51060062 41.933 39.936 0 15.125 7/1/2018
OTOPAIN EAR DROP 8M51060063 124.637 118.702 0 79.75 ###
OCULENTA EYE OINT 3. 51060064 126.734 112.06 0 70.263 7/1/2018
ILIADIN NASAL DROP 0. 51060066 100.21 95.438 0 51.59 7/1/2018
CARPINE 1% ED 5ML 51060068 47.13 44.886 0 18.755 7/1/2018
CARPINE 2% ED 5ML 51060069 50.661 46.638 0 22.99 7/1/2018
CARPINE 4% ED 5ML 51060070 55.064 52.442 0 26.404 7/1/2018
PANTOCAIN 0.5 ED 5ML 51060071 41.283 39.317 0 14.671 7/1/2018
AUGENTONIC ED 5ML 51060072 53.628 51.074 0 23.293 7/1/2018
VITROLENTA ED 5ML 51060074 86.062 74.922 0 39.628 7/1/2018
POLYGRAN ED 5ML 51060075 68.202 64.066 0 38.267 7/1/2018
TOBROSON 0.6ML MD 51060076 63.437 59.301 0 35.09 7/1/2018
XITROL EYE OINT 51060082 75.914 65.86 0 39.463 7/1/2018
ASTHENOF EYE DROP 51060083 48.917 44.781 0 25.41 7/1/2018
MYCOS EYE OINT 51060084 58.445 54.31 0 31.763 7/1/2018
MYCOS EYE DROP 51060085 50.859 48.437 0 24.048 7/1/2018
TOBRO MINI DOSES 51060086 45.303 41.379 0 23.142 7/1/2018
CATARLENT 15ML EYE 51060087 67.097 63.902 0 37.057 7/1/2018
CENDO GENTAMYCIN S 51060088 59.8 59.8 0 46 3/4/2015
PROTAGENTA 5 ML 51060090 85.689 81.609 0 50.82 7/1/2018
OTILON EAR DROP 51060091 81.816 77.92 0 42.405 ###
CENDO GALUPEN MINID51060093 141.849 135.095 0 99.275 ###
CENDO P-PRED MINIDO 51060094 60.735 60.735 0 42.075 ###
CENDO POSOP MINIDO 51060095 81.112 81.112 0 57.75 ###
BLECIDEX EYE/EAR DRO 51062092 69.811 69.811 0 41.745 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 26


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5107 INHALATIONS

FLIXOTIDE 0,5mg/ 2ml ne51070001 34.958 33.293 0 19.14 7/1/2018


VENTOLIN 2,5 mg nebulis51070003 18.741 17.849 0 13.5 3/5/2019
PULMICORT 0.25 mg res51070007 38.325 36.5 0 19.302 ###
PULMICORT 0.5 mg resp51070008 39.475 37.595 0 24.657 ###
COMBIVENT 2.5ML UDV51070011 40.757 38.816 0 19.922 ###
Ventolin Inhaler 51070014 205.377 195.597 0 120.175 ###
STERIMAR ORIGINAL 5 51070016 220.012 209.536 0 131.769 ###
STERIMAR BABY 50ML 51070017 221.53 210.981 0 142.78 ###
SERETIDE DISCUS 250 I 51070019 367.49 349.99 0 263.882 ###
SYMBICORT TURB 160 D51070022 664.96 664.96 0 487.919 ###
AVAMYS NASAL SP 51070023 290.585 266.541 0 195.219 1/9/2020
LASAL NEBU (SALBUTA 51070030 12.329 11.742 0 8.8 ###
BREATHY NASAL SPRAY 51070031 126.459 120.437 0 88 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 27


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5108 SOLUTION

VAKSIN BCG 1 DS 51080005 5.931 5.931 0 4.562 8/1/2013


VAKSIN POLIO 10 DS via 51080006 77.087 73.416 0 52.03 7/1/2018
FORMALIN 1ML 51080007 1.05 1 0 605 7/1/2018
SEMAX 0.1 % SOLUTION51080009 2,293,384 2,184,175 0 1,782,000 ###
GUARDIX SOL 5G 51080012 1,702,198 1,621,141 0 1,061,775 7/1/2018
VAKSIN FLUBIO 51080021 160.19 145.608 0 99.8 6/6/2020

DATE: 09/06/2020 RUMAH SAK PAGE: 28


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5109 CREAMS

CLINOVIR 5 g cream - As51090001 62.976 59.977 0 33.323 7/1/2018


VOLTAREN emulgel 20 g-51090004 114.92 105.247 0 77.01 ###
BURNAZIN 10 mg/g cream 51090010 97.53 92.885 0 58.85 ###
CINOLON cream 10 g - Fl51090011 38.563 37.669 0 17.6 ###
CINOLON N cream 10 g -51090012 46.351 41 0 20.35 ###
EMLA cream 5 g - Lidoca51090013 96.59 96.59 0 74.3 ###
ACYCLOVIR 5% CREAM 51090015 6.8 6.476 0 3.625 ###
APOLAR CREAM 10G - 51090016 67.03 63.839 0 38.115 7/1/2018
APOLAR-N CREAM 10G 51090017 72.111 66.697 0 43.197 7/1/2018
BIOPLACENTON GEL (neo51090018 39.926 38.025 0 18.7 ###
FUSYCOM 5gr cream - Fu 51090021 80.642 76.802 0 44 7/1/2018
HYDROCORTISONNE 2. 51090024 8.748 8.331 0 4.911 ###
KALMICETINE DERMATO51090025 31.269 29.78 0 13.2 ###
MICONAZOLE 2% CREA 51090028 14.392 13.706 0 4.5 3/5/2019
THROMBOPHOB gel 51090029 105.743 100.708 0 69.7 ###
KENALOG IN ORABASE 551090037 110.397 105.14 0 57.2 ###
FELDENE gel 0.5% 15g 51090039 162.568 154.827 0 86.631 7/1/2018
MYCO-Z 10g oint 51090040 135.222 128.782 0 78.1 ###
FAKTU ointment 20 G - P51090043 169.05 161 0 108.24 ###
Boraginol N Oint 15g 51090049 111.337 106.035 0 78.1 ###
Boraginol S Oint 15g 51090050 152.151 144.906 0 105.6 ###
Dermovel Cream 10g 51090053 110.949 105.666 0 66 7/1/2018
Esperson 0.25% Cream 51090056 208.551 198.62 0 137.65 3/5/2019
Forderm 10g Cream 51090057 75.445 71.852 0 40.293 7/1/2018
Mebo Oint 15g 51090064 137.852 137.852 0 84.7 ###
Salep Ichtyol 15g 51090066 12.823 12.212 0 4.95 7/1/2018
BACTODERM 10G OINT 51090069 109.91 104.676 0 65.34 7/1/2018
CARMED CREAM 40G 51090072 62.749 59.761 0 31.9 ###
ELOCON CREAM 10G 51090077 174.156 165.863 0 107.14 3/5/2019
Ketoconazole 2% Cream51090081 13.031 12.411 0 6.93 7/1/2018
Mederma Topikal Tube 51090082 306.211 291.629 0 187 ###
ELOCON OINT 10G 51090090 164.322 156.497 0 111.199 7/1/2018
GENTAMICIN 0.1 % SALE51090091 5.836 5.558 0 3.641 ###
BACTODERM 5G CREAM51090094 78.48 74.316 0 45.1 7/1/2018
DECUBAL CREAM 20G 51090098 58.152 55.383 0 30.7 ###
KLODERMA CREAM 10G51090099 83.559 79.58 0 34.788 ###
KLODERMA OINT 10G 51090100 83.252 79.288 0 34.788 ###
COUNTERPAIN CREAM 51090105 70.172 66.83 0 39.809 7/1/2018
DIPROGENTA CREAM 1 51090106 168.562 160.535 0 99.66 ###
BETADINE OINT 10G 51090111 40.93 37.278 0 17.485 7/1/2018
ALOCLAIR GELL 8ML 51090116 170.729 162.599 0 78.65 7/1/2018
VOLTAREN EMULGEL 5051090123 243.026 231.453 0 173.485 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 29


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
SCABIMATE 10G CREAM51090124 126.011 120.01 0 44 ###
VITACID CREAM 0.05% 51090128 61.056 61.056 0 30.635 ###
NOVELL SMOOTHING CR51090134 336.396 320.377 0 242 7/1/2018
MEDIKLIN CREAM 51090138 53.698 51.141 0 25.19 ###
FORMYCO CREAM 51090146 43.469 41.399 0 20.35 ###
INSTILLAGEL ALMED 10 51090147 132.012 125.726 0 69.3 7/1/2018
DECUBAL CREAM 40GR
51090149 76,1 79 7 2.551 0 4 3,923 01/0 / 2018
SCABIMITE 30 GR 51090150 149.549 131.248 0 83.054 7/1/2018
MUPIROCYN CREAM 10 51090151 60.374 57.499 0 33 ###
SAGESTAM CREAM 10G 51090153 29.059 27.675 0 13.53 ###
ERYMED CREAM 20 GR
51090155 62,4 07 5 9.435 0 3 1,570 13/0 / 2019
OCTENIC GEL
51090156 88.922 84.687 0 60.5 0 8/6/2018
KLODERMA LOTION 30 51090157 110.693 105.422 0 76.45 ###
PIROTOP CREAM 10GR 51090158 85.881 81.791 0 65.56 ###
MEDICORT CREAM 10 G 51090159 98.966 94.253 0 60.83 ###
ERYMED GEL 51090160 37 35.238 0 31.75 ###
MOMETASON CREAM 1 51090161 75.329 71.741 0 55 ###
KETOMED SS 60ML 51090163 60.83 57.934 0 44.11 ###
KETOMED CREAM 15GR 51090164 39.959 38.056 0 28.82 ###
MEDSCAB CREAM 30GR 51090165 98.893 94.184 0 71.995 ###
REFAQUIN CREAM 10 51090166 64.433 61.365 0 46.75 ###
DESOLEX CREAM 10 GR 51090167 34.854 33.194 0 25.08 ###
PARASOL FC SPF 33 20 51090168 77.647 73.949 0 56.43 ###
TOPICARE CREAM 100 51090169 243.078 231.503 0 151.25 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 30


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999
I/P O/P Compan y Cost Eff
Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5110 SUPPOSITORY/PESSARY/ENEMA

DULCOLAX 10 mg adult s51100001 42.749 40.713 0 23.06 7/1/2018


PROFENID 100 mg supp 51100004 38.883 37.031 0 13.969 7/1/2018
MICROLAX enema 5ml -51100008 44.748 42.617 0 20.625 7/1/2018
DUMIN RECATAL 125MG51100014 43.726 41.644 0 15.51 ###
DUMIN RECTAL 250MG S51100015 51.665 49.205 0 21.67 ###
STESOLID 5 MG RECTAL 51100016 52.506 50.006 0 28.75 7/1/2018
FAKTU supp- Policresule51100017 16.322 15.545 0 8.168 7/1/2018
Boraginol N Suppo 51100019 25.191 23.991 0 12.32 ###
Boraginol S Suppo 51100020 28.851 27.477 0 14.85 ###
Fladystin Ovula 51100022 30.046 28.615 0 16.5 ###
Pronalges Suppo 1G 51100023 35.236 33.558 0 15.4 ###
Propyretic 160mg Supp 51100024 15.512 14.773 0 7.792 ###
Propyretic 240mg Supp 51100025 18.694 17.804 0 9.167 ###
Propyretic 80mg Suppo 51100026 14.916 14.205 0 7.242 ###
STESOLID 10MG RECTAL51100027 69.321 66.02 0 43.124 7/1/2018
TRAMAL 100MG SUPPO 51100028 29.316 27.92 0 16.335 7/1/2018
DULCOLAX 5MG CHILD 51100029 31.35 29.857 0 16.266 ###
Proris Suppositoria 51100032 11.471 10.925 0 4.834 7/1/2018
TRICHODAZOLE PLUS V 51101137 25.768 24.541 0 13.695 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 31


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5112 EXTERNAL PREPARATIONS

LACTACYD LIQUID BABY 561120001 48.856 46.53 0 22.55 ###


XYLOCAIN 50 ml spray - 51120002 585.831 557.934 0 338.038 7/1/2018
ALKOHOL 70% 1 L ( BR 51120005 233 222 0 28 ###
SALICYL TALK 51120006 33.92 32.304 0 6.426 ###
SALICYL TALK MENTHOL 51120007 30.309 30.309 0 20.206 1/2/2015
ALBOTHYL CONC 10 ml -51120008 68.87 68.87 0 38.5 ###
OXOFERIN SOL 30ml - Te51120009 132.889 126.561 0 78.65 7/1/2018
GARAM INGGRIS 1G 51120022 210 200 0 110 7/1/2018
BORAX GLISERIN 8ml 51120023 10.511 10.01 0 3.025 ###
ISODINE GARGLE 190ml 51120025 42.411 42.411 0 28.274 1/2/2015
GARAM INGGRIS 1kg 51120029 1.476 1.476 0 952 1/2/2015
Acid Salicylk 1kg 51120032 210 200 0 109 7/1/2018
ALKOHOL 96% 1L ( BRAT51120033 117.249 111.665 0 70 7/1/2018
Camphora 500g 51120037 1.545 1.545 0 110 ###
Condom Sutra @ 12 51120040 3.034 2.889 0 1.329 7/1/2018
Fleet Enema 51120041 190.315 181.253 0 107.25 ###
Gentian Violet 1% 10ml 51120042 22.199 22.199 0 14.799 1/2/2015
Nebacetin Powder 5g 51120045 50.882 48.459 0 20.35 7/1/2018
Nova T 51120047 457.613 435.822 0 317.955 ###
Wash Bensin 1 ml 51120051 18.566 18.566 0 11.978 1/2/2015
ALOCLAIR ORAL RINSE 51120055 154.273 146.927 0 99.825 7/1/2018
CALCII CARBONAT ( CAC51120056 1.837 1.837 0 85 6/9/2020
COFFEINUM 500G 51120057 1.968 1.968 0 407 ###
Natrium Chlorida PH 1 51120062 1.057 1.007 0 770 ###
Sulfur 1 mg 51120063 10.843 10.843 0 28 ###
BETADINE VAGINAL DO 51120074 95.406 90.863 0 49.005 7/1/2018
PK KRISTAL 5G 51120076 15.206 14.482 0 7 ###
MINOSEP OBAT KUMUR51120082 85.416 81.349 0 42.9 ###
ALKOHOL 70% 100ML 51120083 25.416 25.416 0 5.2 ###
BETADINE OBAT KUMU 51120090 67.399 64.189 0 24.035 ###
STARDINE 1 ML 51120091 525 500 0 163 7/1/2018
LACTACYD PINK 60 ML 51120092 58.793 55.993 0 23.98 ###
SOFRA-TULLE 10 X 10 51120096 44.171 44.171 0 22.528 ###
SACCARUM LACTIS ( LA 51120098 525 500 0 259 7/1/2018
LOMATUELL 10X10CM 51120102 25.408 24.198 0 17.875 ###
COMBANTRIN JERUK 10 51120105 24.707 23.53 0 18.1 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 32


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5115 CONTAINERS & STICKERS

POT PLASTIK 10CC 51150007 950 905 0 650 ###


POT PLASTIK 100cc 51150008 2.686 2.558 0 1.416 7/1/2018
POT PLASTIK 20CC 51150009 1.26 1.2 0 700 ###
POT PLASTIK 200cc 51150010 4.435 4.224 0 2.396 7/1/2018
POT PLASTIK 30CC 51150011 1.239 1.18 0 605 7/1/2018
POT PLASTIK 50CC 51150012 1.423 1.355 0 708 7/1/2018
POT PLASTIK 75cc 51150013 2.75 2.619 0 1.452 7/1/2018
BOTOL COKLAT 100 cc 51150015 6.09 5.8 0 4.4 ###
BOTOL COKLAT 200 cc 51150016 3.01 3.01 0 1.597 7/1/2018
BOTOL BELING 150 mL 51150019 8.61 8.2 0 5 ###
UNDERPAD SENSI PADS 51150040 10.954 10.432 0 4.73 ###
LOPROX NAIL LACQUER 51150044 276.45 276.45 0 199.473 ###
KERTAS PUYER BERLOG 51150045 105 100 0 73 7/1/2018
KERTAS PERKAMEN 51150046 4 4 0 3 ###
KAPSUL NO 3 51150047 107 102 0 41 7/1/2018
KAPSUL NO 2 51150048 108 103 0 42 7/1/2018
KAPSUL NO 1 51150049 109 104 0 45 7/1/2018
KAPSUL NO 0 51150050 146 139 0 51 ###
KAPSUL NO 00 51150051 148 141 0 79 ###
BOTOL 30 CC + PIPET 51150052 8.317 7.921 0 6 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 33


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5199 Special Medicine

STESOLID 5MG TAB 51011190 2.607 2.483 0 1.863 ###


TENSIVASK 10MG 51011501 18.544 17.661 0 13.585 ###
LODOZ 5MG TABLET 51011502 13.475 12.833 0 9.717 ###
EXFORGE 10/160 MG TA51011503 19.681 18.744 0 14.252 ###
UBI Q KAPSUL 51011504 20.259 19.294 0 14.687 ###
UPERIO 50MG TABLET 51011505 22.749 21.666 0 16.5 ###
UPERIO 100MG TABLET 51011506 28.396 27.043 0 20.637 ###
ARCALION 200MG TABL 51011507 8.847 8.426 0 6.404 ###
XARELTO 200 MG TABLE51011508 45.411 43.248 0 33.102 ###
TWYNSTA 80/5 TABLET 51011510 34.844 33.185 0 25.361 ###
SIBITAL INJEKASI 51020697 14.147 13.474 0 9.9 ###
CONSUMABLE I 51160001 350 350 0 0 ###
CONSUMABLE II 51160002 600 600 0 0 2/7/2014
AMLODIPINE 10MG TAB51180009 799 761 0 104 7/1/2018
AMLODIPINE 5MG TAB 51180010 822 783 0 85 7/1/2018
LANTUS INJ BPJS 51180014 119.527 113.835 0 83.95 7/1/2018
NOVOMIX FLEXPEN ( BPJ51180015 157.192 149.707 0 110.968 7/1/2018
NOVORAPID FLEXPEN ( B51180016 127.889 121.799 0 87 7/1/2018
ASERING 500ML ( BPJS ) 51180035 33.6 32 0 9.646 ###
FUTROLIT INFUS BPJS 51180048 139.338 132.703 0 40.259 ###
DEPAKOTE 250 ER BPJS 51180066 7.133 6.793 0 2.954 7/1/2018
SPIRIVA HANDIHALER B 51180070 388.52 370.019 0 167 7/1/2018
HARNAL OCAS TAB ( BPJ51180074 10.529 10.027 0 5.115 ###
HARNAL 0.2MG TAB ( BP51180075 11.329 10.789 0 7.788 ###
SIMVASTATIN 20MG TAB51180081 2.169 2.169 0 1.231 ###
CEFADROXIL 250 FORTE 5S1180090 17.025 17.025 0 5.895 ###
PROPANOLOL 10MG TAB51180100 224 224 0 77 ###
MEROPENEM 1G INJ BP 51180113 73.71 70.2 0 44 7/1/2018
MICONAZOLE CREAM 1051180124 13.587 13.587 0 3.251 ###
IBUPROFEN 400MG TAB51180143 987 940 0 528 ###
ISOSORBID DINITRATE 551180148 525 500 0 97 7/1/2018
KSR TAB BPJS 51180149 2.61 2.485 0 1.842 ###
KANDESARTAN 16MG TA51180151 9.832 9.832 0 7.15 ###
KANDESARTAN 8MG TAB51180152 7.273 7.273 0 4.95 ###
KLOBAZAM TAB BPJS 51180161 1.26 1.26 0 900 ###
KETOROLAC 30MG INJ B51180163 16.916 16.916 0 11.572 ###
SERETTIDE DISKUS 250 51180172 190.599 181.523 0 122.521 ###
EPINEFRIN INJ BPJS 51180180 10.531 10.531 0 8.1 ###
RECORMON 2000 INJ BP51180184 239.755 228.339 0 133.576 7/1/2018
FLUCONAZOLE CAP ( BPJ51180198 33.132 31.555 0 20.592 7/1/2018
FLIXOTIDE NEB BPJS 51180199 21.813 20.775 0 15.675 ###
ARIXTRA INJ BPJS 51180200 328.306 328.306 0 248.84 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 34


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
FUROSEMID INJ BPJS 51180201 4.226 4.025 0 3.41 ###
GEMFIBROSIL 300 CAP B51180204 888 888 0 380 ###
GENTAMYCIN INJ BPJS 51180205 25.607 24.388 0 5.06 ###
NITROKAF RETARD CAP 51180213 2.864 2.728 0 1.56 7/1/2018
ACTRAPID HM 10 INJ BP51180224 258.3 246 0 144.762 ###
DOMPERIDONE SYR ( BPJ51180232 27.641 26.325 0 15.18 ###
AVODART TAB BPJS 51180235 12.44 11.847 0 7.75 7/1/2018
LOVENOX 0.4 INJ BPJS 51180236 303.17 288.733 0 90.704 ###
LOVENOX 0.6 INJ BPJS 51180237 188.973 179.974 0 125.385 ###
STARFOLAT 0.4MG TAB (51180242 525 500 0 130 7/1/2018
ULSAFATE SYR ( BPJS ) 51180256 31.5 30 0 13.97 7/1/2018
VENTOLIN NEBULIZER B 51180260 9.702 9.24 0 4 7/1/2018
LEVEMIR INJ (BPJS) 51180265 119.334 113.651 0 83.95 7/1/2018
ASAM FOLAT TABLET 51180266 525 500 0 135 7/1/2018
THYROZOL 10MG TAB B 51180273 2.14 2.038 0 1.314 7/1/2018
BETAMETASON CREAM 51180284 21.633 20.603 0 2.56 ###
METFORMIN 500MG TAB51180285 576 549 0 154 ###
COMBIVENT UDV BPJS 51180287 10.571 10.068 0 5.7 7/1/2018
MINI ASPI TAB BPJS 51180288 541 515 0 105 ###
SIMARC 2MG TAB BPJS 51180291 4.162 3.964 0 1.54 ###
SYMBICORT 80/ 4.5 MC 51180296 216.632 206.316 0 133.1 7/1/2018
SIFROL 0.375 TAB BPJS 51180303 13.081 12.458 0 8 7/1/2018
AKILEN EAR DROP 51180309 124.431 118.505 0 66.77 ###
FORUMEN EAR DROP 51180311 51.937 49.463 0 27.39 ###
BRILINTA TAB (BPSJ) 51180317 22.86 21.772 0 17.153 ###
ECOSOL RL 500 (BPJS) 51180318 22.505 21.433 0 7.63 ###
CLOPIDOGREL TAB 75ML51180321 3.599 3.428 0 1.451 7/1/2018
ECOSOL NACL 1000 (BPJ51180322 23.7 23.7 0 16.5 ###
ECOSOL NACL 100ML (B 51180323 31.019 29.542 0 10.45 ###
ARICEPT 10MG BPJS 51180327 24.068 22.922 0 13.734 ###
AVAMYS NASAL SP (BPJS51180330 179.749 171.189 0 112.476 ###
POVIDONE IODINE INTIS51180332 123 123 0 73 ###
POVIDONE IODINE 30 M51180333 6.94 6.609 0 4.62 ###
BISOPROLOL 5MG "BPJS51180334 711 677 0 260 7/1/2018
ECOSOL NACL 500ML (B 51180335 17.9 17.048 0 6.921 7/1/2018
EPODIUON 2000 BPJS 51180336 116.627 111.073 0 84.7 7/1/2018
INFUSAN RING AS 500 M51180337 18.299 17.428 0 10.573 ###
INFUSAN RL 500 ML SP 51180338 13.218 12.589 0 7.677 ###
INFUSAN NS SP 500 ML 51180339 13.923 13.26 0 7.121 ###
INFUSAN D5 1/4 NS SP 500 ML BPJS
51180340 27,230 25,934 0 19, 525 13/03 19
INFUSAN D5 1/2 NS SP 500 ML BPJS
51180341 29,670 28,257 0 19, 635 13/03 19
SANMOL INFUS BPJS 51180343 49.35 47 0 37.224 ###
NEFROFER INJ BPJS 51180344 125.274 119.308 0 78.65 7/1/2018
SALBULIN INHAELER BPJS
51180345 61,821 58.878 0 31.372 ###
V-BLOC 6,25 MG TABLET BPJS
51180347 2,636 2.511 0 1,665 13 /05/2019

DATE: 09/06/2020 RUMAH SAK PAGE: 35


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
POVIDONE IODINE 60 51180348 10.143 9.66 0 7.194 1/9/2020
EZELIN INSULIN 51180349 120.931 115.172 0 83.95 ###
ONBREZ 150 MCG INHA 51180352 28.437 27.083 0 20.66 ###
EPODION INJ DAEWOO 51180353 84.722 84.722 0 73.48 ###
DIAMICRON MR TAB BP 51180355 4.215 4.015 0 2.933 ###
PARACETAMOL BERN SY51190001 5.459 5.199 0 4 ###
PARACETAMOL BERN TA51190002 177 169 0 130 ###
ANTALGIN BERN TAB 5 51190003 210 200 0 154 ###
KETOROLAC BERN TAB 51190004 2.072 1.973 0 1.518 ###
ASAM MEFENAMAT BER51190005 243 231 0 178 ###
SIMVASTATIN BERN TA 51190006 646 615 0 473 ###
METHYLPREDNISOLON B51190007 410 390 0 300 ###
METHYLPREDNISOLON B51190008 642 611 0 470 ###
DEKSAMETHASONE BERN 51190009 126 120 0 92 ###
METFORMIN BERN TAB 51190010 410 390 0 300 ###
METFORMIN BERN TAB 51190011 205 195 0 150 ###
RIFAMPICIN BERN TAB 51190012 3.041 2.896 0 2.228 ###
RIFAMPICIN BERN TAB 51190013 2.048 1.95 0 1.5 ###
CEFADROXIL BERN KAPS51190014 826 787 0 605 ###
CIPROFLOXACIN BERN 51190015 614 585 0 450 ###
AMOKSISILLIN BERN TA 51190016 475 450 0 346 ###
LORATADINE 10 BERN T 51190017 273 260 0 200 ###
ALLOPURINOL 300MG T 51190018 450 429 0 330 ###
NATRIUM DIKLOFENAK 51190019 218 208 0 160 ###
EPERISONE HCI 50MG N51190020 2.312 2.202 0 1.694 ###
AMBROXOL 30MG NOVE51190021 288 275 0 211 ###
URSODEOXYCHOLIC ACI 51190022 5.045 4.805 0 3.696 ###
OMEPRAZOLE 20MG NO51190023 557 531 0 408 ###
LANSOPRAZOLE 30MG N51190024 1.845 1.757 0 1.351 8/1/2019
ATORVASTATIN 20MG N51190025 3.685 3.51 0 2.7 ###
VALSARTAN 160MG NOV51190026 9.76 9.295 0 7.15 ###
VALSARTAN 80MG NOVE51190027 6.006 5.72 0 4.4 ###
CANDESARTAN 16MG N 51190028 9.76 9.295 0 7.15 8/1/2019
CANDESARTAN 8MG NO51190029 6.757 6.435 0 4.95 8/1/2019
BISOPROLOL 5 MG INH 51190030 944 899 0 692 ###
RAMIPRIL 10 MG TAB I 51190031 1.45 1.381 0 1.062 ###
METHYLPREDNISOLONE 51190033 1.413 1.346 0 1.035 ###
CLONIDIN 0,15MG INH 51190034 251 239 0 184 ###
GLIMEPIRID 4 MG KIFA 51190035 1.215 1.157 0 890 ###
GLIMEPIRID 3MG KIFA 51190036 887 845 0 650 ###
GLIMEPIRID 2MG KIFA 51190037 601 572 0 440 ###
GLIMEPIRID 1MG KIFA 51190038 386 368 0 283 ###
PYRAZINAMID 500MG KI51190039 478 455 0 350 4/3/2020
ISONIAZID 300MG KIFA 51190040 273 260 0 200 4/3/2020
VITAMIN C 100MG KIFA 51190041 151 144 0 110 4/3/2020

DATE: 09/06/2020 RUMAH SAK PAGE: 36


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
SALBUTAMOL 4MG KIFA51190042 117 112 0 86 2/3/2020
SIMVASTATIN TAB 10MG51190043 259 247 0 190 4/3/2020
FUROSEMID 40MG KIFA 51190044 150 143 0 110 ###
ALLOPURINOL 100MG I 51190045 212 202 0 155 ###
NATRIUM DIKLOFENAK 251190046 444 423 0 325 ###
BETAHISTINE 6MG NOVE51190057 1.261 1.201 0 924 ###
CEFIXIME 200MG NOVE 51190058 3.441 3.277 0 2.521 ###
CLINDAMYCIN 150MG N51190059 1.087 1.035 0 796 ###
AZITHROMYCIN 500MG 51190061 13.514 12.87 0 9.9 ###
PREGABALIN 75MG NOV51190062 7.132 6.793 0 5.225 4/3/2020
GABAPENTIN 300MG NO51190063 6.622 6.306 0 4.851 ###
CETIRIZINE 10MG NOVE 51190064 526 501 0 385 ###
MELOXICAM 15MG NOVE 51190065 1.637 1.559 0 1.199 ###
MELOXICAM 7,5MG NOV51190066 944 899 0 692 ###
LEVOFLOXACIN NOVE T 51190067 1.575 1.5 0 1.154 8/1/2019
CLOPIDOGREL IKAP TAB 51190069 4.092 3.897 0 2.998 ###
ONDANSENTRON 4MG I51190071 7.508 7.15 0 5.5 ###
NOREPINEPHRINE BERN 51190072 72.072 68.64 0 52.8 ###
IMIPENEM CILASTATIN B51190073 238.875 227.5 0 175 ###
CEFTRIAXONE 1G INJ BE 51190075 15.766 15.015 0 11.55 ###
MEROPENEM 1G BERN 51190078 95.823 91.26 0 70.2 ###
PROSOGAN TAKE 30MG 51190081 163.8 156 0 120 ###
ESOFER 40MG FERR INH51190082 121.486 115.701 0 89.001 ###
ACARBOSE TAB 100MG 51190087 2.413 2.298 0 1.768 ###
SIMARC TAB 2MG PRAT 51190088 1.577 1.502 0 1.155 ###
INVICLOT INH 51190089 94.595 90.09 0 69.3 ###
RECOLFAR TAB INH 51190090 7.057 6.721 0 5.17 ###
ASERING OTSU KOMB I 51190091 25.901 24.668 0 18.975 ###
OTSU NS 500ML 0,9% I 51190092 15.015 14.3 0 11 ###
OTSU D5 500ML 5% GL 51190093 15.015 14.3 0 11 ###
OTSU RL 500ML INH 51190094 13.514 12.87 0 9.9 ###
OTSU MANITOL 20% 5051190095 86.863 82.727 0 63.636 ###
OTSU MANITOL 20% 25 51190096 54.601 52.001 0 40 ###
PANTOPRAZOL INJ 40M 51190097 40.268 38.35 0 29.5 ###
OMEPRAZOLE INJ 40MG51190098 30.03 28.6 0 22 ###
METILPREDNISOLON INJ51190099 27.3 26 0 20 ###
PANTOPRAZOLE TAB 40 51190100 10.92 10.4 0 8 ###
KALNEX INJ 100MG/ML 51190101 12.012 11.44 0 8.8 ###
NEVOX XR TAB 500MG K51190103 1.722 1.687 0 1.298 ###
NEPATIC KAPS 300MG 51190104 5.051 4.81 0 3.7 ###
V-BLOC TAB 6,25MG IN 51190105 2.729 2.599 0 1.999 ###
V-BLOC TAB 25MG INH 51190106 6.823 6.499 0 4.999 ###
KALNEX TAB 500MG KAL51190107 2.593 2.47 0 1.9 ###
VEISTEIN 175MG/5ML 6 51190108 36.171 34.449 0 26.499 ###
VEISTEIN 200MG KAPS 51190109 3.754 3.575 0 2.75 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 37


rptchgpr.p CHARGE PRICE LI TIME: 12:15:53
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
PROVELYN KAPS 75MG 51190110 9.487 9.035 0 6.95 ###
PROVELYN KAPS 150MG51190111 12.899 12.285 0 9.45 ###
FUROSEMIDE 10MG INJ 51190112 2.809 2.675 0 2.058 ###
GENTAMICIN INJ 40MG/51190113 4.635 4.414 0 3.396 ###
ACETYLCYSTEIN TAB 20 51190119 1.04 990 0 825 ###
ONDANSENTRON TAB 8M 51190120 1.691 1.611 0 1.239 4/3/2020
ONDANSENTRON TAB 4M 51190121 1.051 1.001 0 770 4/3/2020
CAPTOPRIL TAB 12,5MG51190124 137 131 0 109 ###
ISOSORBIDE DINITRAT 51190125 225 215 0 165 ###
PARACETAMOL 120MG/51190129 4.204 4.004 0 3.08 ###
SERETIDE DISKUS 500M 51190131 241.666 230.159 0 177.045 ###
SERETIDE DISKUS 250M 51190132 222.431 211.839 0 162.953 ###
FLIXOTIDE NEBULES 0, 51190133 25.603 24.384 0 18.757 ###
AVAMYS 27,5MCG GLAX51190134 185.405 176.576 0 135.828 ###
SYMBICORT TURB 80 A 51190135 207.48 197.6 0 152 ###
SYMBICORT TURB 160 51190136 286.65 273 0 210 ###
PULMICORT RESP 0,5M 51190137 21.84 20.8 0 16 ###
PULMICORT RESP 0,25 51190138 15.698 14.95 0 11.5 ###
CRESTOR TAB 20MG AS 51190139 10.92 10.4 0 8 ###
CRESTOR TAB 10MG AS 51190140 9.555 9.1 0 7 ###
BRILINTA TAB 90MG IN 51190141 19.11 18.2 0 14 ###
DORNER TAB 20MCG IN 51190143 7.371 7.02 0 5.4 ###
HARNAL OCAS TAB 0,4M51190144 15.425 14.69 0 11.3 ###
MALTOFER CHEW TAB 51190145 3.661 3.487 0 2.682 ###
DEPAKOTE ER TAB 500 51190146 11.252 10.716 0 8.243 ###
BETASERC TAB 8MG ABB51190147 4.558 4.341 0 3.339 ###
HARNAL D TAB 0,2MG A51190148 15.015 14.3 0 11 ###
BETASER TAB 24MG ABB51190149 11.592 11.04 0 8.492 ###
ULSAFATE 500MG/5ML 51190152 62.763 59.774 0 45.98 ###
NEW DIATABS 600MG T 51190154 648 618 0 475 9/4/2019
ASPILETS CHEWABLE TA 51190155 601 572 0 440 ###
CEDOCARD TAB 10MG I 51190156 1.979 1.885 0 1.45 ###
GRISEOFULVIN TAB 50 51190157 1.911 1.82 0 1.4 ###
AMLODIPIN BESYLAT 5M51190162 240 229 0 176 ###
KSR 600MG TAB MERC 51190166 3.877 3.692 0 2.84 ###
NOVORAPID FLEXPEN 1 51190175 240.911 229.439 0 176.492 6/9/2020
CORDARONE 150MG INJ51190179 35.354 33.67 0 25.9 ###
LOVENOX 40MG AVEN I 51190181 158.34 150.8 0 116 ###
LOVENOX 60MG AVEN I 51190182 221.13 210.6 0 162 ###
BRICASMA INJ 0,5MG/M51190183 23.205 22.1 0 17 ###
DIAMICRON MR 60MG T51190184 8.514 8.109 0 6.237 ###
FUTROLIT INH 51190188 61.686 58.749 0 45 ###
SAGESTAM 40MG/ML IN51190189 13.65 13 0 10 ###
SANMOL INFUS 10MG/M51190191 61.221 58.306 0 44 ###
ELKANA KOMB SYRUP I 51190192 36.309 34.58 0 22 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 38


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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
TREMENZA TAB SANB I 51190203 1.351 1.287 0 990 ###
LEVOFLOXACIN 500MG/ 51190206 60.06 57.2 0 44 ###
DEXKETOPROFEN 50MG 51190208 27.628 26.312 0 20.24 4/3/2020
STARFOLAT 0,4MG TAB 51190217 240 229 0 176 ###
RHINOS SR DEXA INH 51190239 5.321 5.068 0 5.068 ###
DUVADILAN TAB 20MG K51190242 6.142 5.85 0 4.5 ###
CHLORAMPHENICOL SAL51190243 4.369 4.161 0 3.201 ###
DIAZINK 20MG TAB INH 51190244 655 624 0 480 ###
HIDROKORTISON ASETAT51190246 4.505 4.29 0 3.3 ###
BETASON 0,1% INH 51190247 3.821 3.639 0 2.8 ###
BETAMETASON 0,1% IN 51190248 2.73 2.6 0 2 ###
MICONAZOL 2% KIFA IN 51190249 4.66 4.438 0 3.414 ###
PROPRANOLOL 40MG KI51190250 362 345 0 265 ###
DILTIAZEM 30MG TAB I 51190251 238 226 0 174 ###
HIDROKLOROTIAZID 25M51190253 203 194 0 149 ###
ASIKLOVIR 400MG TAB K51190255 901 858 0 660 ###
PIROXICAM 10MG TAB K51190256 150 143 0 110 ###
PIROXICAM 20MG TAB K51190257 162 155 0 119 ###
ACARBOSE 50MG TAB P 51190259 1.446 1.377 0 1.059 ###
CILOSTAZOL 100MG TAB51190260 10.699 10.189 0 7.838 ###
ETHAMBUTOL 500MG TA51190265 751 715 0 550 ###
CEFADROXIL 250MG/5M51190266 16.892 16.088 0 12.375 ###
CEFIXIME 100MG CAP H51190269 1.091 1.039 0 799 ###
RANITIDINE HCI 150MG 51190270 218 208 0 160 ###
DOMPERIDONE 5ML (SY51190271 10.21 9.724 0 7.48 ###
FENOFIBRATE 100MG H51190273 1.829 1.742 0 1.34 ###
CEFIXIME TRIHYDRATE 51190274 15.423 14.689 0 11.299 ###
BINTAMOX 500MG HEXP51190275 573 546 0 420 ###
DICLOFENAC POTASSIU 51190276 368 350 0 270 7/8/2019
DAPYRIN 500MG TAB HE51190277 246 234 0 180 ###
DAPYRIN 125MG/5ML (S51190278 6.279 5.98 0 4.6 ###
BINTAMOX 125MG/5ML51190279 8.191 7.801 0 6.001 ###
METHYLPREDNISOLON I 51190281 105.105 100.1 0 77 ###
KETOROLAC BERN 10MG51190282 6.143 5.85 0 4.5 ###
ONDANSENTRON 2MG/251190283 4.505 4.29 0 3.3 ###
RANITIDINE INJ HEXP 51190285 1.952 1.859 0 1.43 ###
CLANEKSI 500MG KAPL 51190286 9.419 8.97 0 6.9 9/9/2019
NEUROSANBE INJ INH 51190287 7.267 6.921 0 5.324 9/9/2019
BISACODYL 5MG TAB IN 51190289 412 412 0 317 ###
ATORVASTATIN 40MG T51190290 5.005 5.005 0 3.85 ###
DOMPERIDONE TABLET 51190291 244 233 0 179 ###
PLANTACID FORTE SYR 51190292 38.711 36.868 0 23.76 ###
LANTUS SOLOSTAR PEN 51190293 1,419,601 1,352,001 0 1,040,001 ###
METRONIDAZOL INFUS 51190294 11.261 10.725 0 8.25 ###
EZELIN INH 51190295 122.85 117 0 90 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 39


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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
VENTOLIN NEBU INH 51190296 13.104 12.48 0 9.6 ###
MUCOSTA TAB INH 51190297 4.845 4.615 0 3.55 ###
ETORVEL TABLET 120MG51190300 9.968 9.493 0 7.302 2/5/2020
ETORVEL TABLET 90MG 51190301 6.826 6.5 0 5 2/5/2020
RAMIPRIL 5MG TAB INH 51190302 841 801 0 570 ###
EPODION 2000IU INH 51190303 133.081 126.744 0 97.495 2/5/2020
SANMOL TAB INH 51190307 358 341 0 262 ###
OTSU NS 100ML INH 51190308 11.55 11 0 11 ###
ELKANA TAB INH 51190309 971 924 0 711 ###
NEUROSANBE TAB INH 51190310 1.302 1.24 0 954 ###
BREATHY NASAL SPRAY 51190311 75.075 71.5 0 55 3/6/2020
EPODION 3000IU INH 51190312 143.325 136.5 0 105 ###
ALBUMINAR 25% 100ML51190313 2,777,775 2,645,500 0 2,035,000 ###
FLUCONAZOL IV INH 51190314 78.829 75.075 0 57.75 4/3/2020
MIKAJECT INJ 250MG/2 51190315 74.324 70.785 0 54.45 4/1/2020
MIKACIN INJ 500MG/2M51190316 124.215 118.3 0 91 4/8/2020
OTSU WATER 25ML INH 51190317 8.108 7.722 0 5.94 ###
DEPAKENE 250MG/ML S51190318 136.105 129.624 0 99.711 4/8/2020
FLUIMUCIL INJ INH 51190319 32.883 31.317 0 24.09 ###
CALOS KAPSUL 500MG 51190320 1.315 1.252 0 963 ###
ARICEF 5MG INJ INH 51190321 15.015 14.3 0 11 6/5/2020
AMLODIPIN 10MG TAB 51190322 403 384 0 295 6/5/2020
LMA SUPREME SU SIZE 352373162 794.627 756.787 0 577.5 9/6/2019
LMA SUPREME SU SIZE 252373169 794.627 756.787 0 577.5 ###
PAKET PCI FEMORAL BMS TANPA BALON & WIRE BPJS(MM)
52910241 19,749,543 19, 180,000 0 4/6/2016
GUDEL SOFT CLEAR 4 90MM (BPJS)
52910298 46,427 7 0 28 ,512 21/05 18

DATE: 09/06/2020 RUMAH SAK PAGE: 40


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5412 MEDICAL EQUIPMENT

SEWA ALAT CABG - OC 54120046 10,000,00010,000,000 0 0 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 41


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

GROUP : 52 SURGICAL / MEDICAL SUPPLIES

TYPE :

Kodak DVB Film 8x10 In 52720004 37.377 35.597 0 22.176 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 42


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5201 NURSING ITEM

DISCOUNT (MEDICAL SU52999998 1.388 1.388 0 918 3/1/2014


OTHERS (MEDICAL SUPP52999999 1.388 1.388 0 918 3/1/2014
Set Basic 56010010 173 173 0 0 7/1/2018
Set SC 56010011 219 219 0 0 7/1/2018
Set Laparatomi 56010012 230 230 0 0 7/1/2018
Set Appendic 56010013 196 196 0 0 7/1/2018
Set Neuro Surgery 56010014 230 230 0 0 7/1/2018
Set Laminectomi 56010015 242 242 0 0 7/1/2018
Set Jas Operasi 56010016 230 230 0 0 7/1/2018
Set Gaal Bleder 56010017 53 53 0 0 7/1/2018
Set THT 56010018 173 173 0 0 7/1/2018
Set Orthopedy 56010019 242 242 0 0 7/1/2018
Set Wire 56010020 53 53 0 0 7/1/2018
Set Amputasi orthoped 56010021 173 173 0 0 7/1/2018
Set Pembuka K.Nail 56010022 53 53 0 0 7/1/2018
Set Thorax Cardio 56010023 230 230 0 0 7/1/2018
Set Tympanoplasty 56010024 53 53 0 0 7/1/2018
Set Pemasang K.Nail 56010025 53 53 0 0 7/1/2018
Set VP Shunt 56010026 230 230 0 0 7/1/2018
Set Hak Thorax 56010027 53 53 0 0 7/1/2018
Set Basic Thorax 56010028 230 230 0 0 7/1/2018
Set Pemasang Angular P56010029 53 53 0 0 7/1/2018
Set Curet 56010030 173 173 0 0 7/1/2018
Set Pemasang Plate Scre56010031 41 41 0 0 7/1/2018
Set TUR 56010032 32 32 0 0 7/1/2018
Set Exterpatie 56010033 32 32 0 0 7/1/2018
Set Tonsil 56010034 32 32 0 0 7/1/2018
Set K. Nail 56010035 32 32 0 0 7/1/2018
Set Staped Motor 56010036 42 42 0 0 7/1/2018
Set Histerctomi 56010037 173 173 0 0 7/1/2018
Set Macam-macam hak 56010038 42 42 0 0 7/1/2018
Set Leyla Head Frame 56010039 42 42 0 0 7/1/2018
Set Tambahan Orthope 56010040 32 32 0 0 7/1/2018
Set Plate B / K 56010041 173 173 0 0 7/1/2018
Set HD + kasa 6 56010042 32 32 0 0 7/1/2018
Set Spinal + kasa 5 56010043 22 22 0 0 7/1/2018
SET CATHETER+KASA 5 56010044 22 22 0 0 7/1/2018
Set CVP + kasa 5 56010045 22 22 0 0 7/1/2018
Set Umbilical + kasa 5 56010046 22 22 0 0 7/1/2018
Set GV / Set Aff Jahit 56010047 22 22 0 0 7/1/2018
Set Hecting + kasa 5 56010048 22 22 0 0 7/1/2018
Set Partus + kasa 5 56010049 173 173 0 0 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 43


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TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Set Tali Pusat + kasa 5 56010050 22 22 0 0 7/1/2018
Set Jas Mata 56010051 32 32 0 0 7/1/2018
Set Vena Sectio 56010052 173 173 0 0 7/1/2018
Set Cimino 56010053 173 173 0 0 7/1/2018
Macam-macam Chisel 56010054 173 173 0 0 7/1/2018
Set Bedah Minor + kas 56010055 173 173 0 0 7/1/2018
Set HSG 56010056 173 173 0 0 7/1/2018
ICU-DRESSING SET PER 56010057 173 173 0 0 7/1/2018
ICU-VENA SECTI SET PE 56010058 173 173 0 0 7/1/2018
ICU-CVP SET PER HARI 56010059 173 173 0 0 7/1/2018
ICU-WSD SET PER HARI 56010060 173 173 0 0 7/1/2018
SET JAS CATH LAB 56010061 350 350 0 0 7/1/2018
SET INSTRUMEN CATH 56010062 173 173 0 0 7/1/2018
SET PPM 56010063 529 529 0 0 7/1/2018
SET MATA 56010064 173 173 0 0 7/1/2018
Jas Packing 56020010 16 16 0 0 7/1/2018
Duk Bawah / Atas 56020011 16 16 0 0 7/1/2018
Perlak Orthopedy 56020012 16 16 0 0 7/1/2018
Selang / Sirkuit Ventila 56020013 16 16 0 0 7/1/2018
Blashak 56020014 11 11 0 0 7/1/2018
Bone Klem 56020015 11 11 0 0 7/1/2018
Canul Suction 56020016 11 11 0 0 7/1/2018
Chisel / Raspatorium 56020017 11 11 0 0 7/1/2018
Clow Hak 56020018 11 11 0 0 7/1/2018
Sendok Curet 56020019 11 11 0 0 7/1/2018
Curet Uterus 56020020 11 11 0 0 7/1/2018
Double Hak 56020021 11 11 0 0 7/1/2018
Dressing Forcep 56020022 11 11 0 0 7/1/2018
Elis Klem 56020023 11 11 0 0 7/1/2018
Forcep Kebidanan 56020024 11 11 0 0 7/1/2018
Guide Ligature Needle 56020025 11 11 0 0 7/1/2018
Gunting 56020026 11 11 0 0 7/1/2018
L. Hak 56020027 11 11 0 0 7/1/2018
Hak Gigi 56020028 11 11 0 0 7/1/2018
Spatula 56020029 11 11 0 0 7/1/2018
Hammer 56020030 11 11 0 0 7/1/2018
Handle Bar 56020031 11 11 0 0 7/1/2018
Hernia Tang 56020032 11 11 0 0 7/1/2018
Hidrotubasi 56020033 11 11 0 0 7/1/2018
Kabel Microtone 56020034 11 11 0 0 7/1/2018
Kerizone 56020035 11 11 0 0 7/1/2018
Klem uterus 56020036 11 11 0 0 7/1/2018
Klip Bedah syaraf 56020037 11 11 0 0 7/1/2018
Kocher 56020038 11 11 0 0 7/1/2018
Langen Back 56020039 11 11 0 0 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 44


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TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Lever Hak 56020040 11 11 0 0 7/1/2018
Mandrein 56020041 11 11 0 0 7/1/2018
Mouth Gouge 56020042 11 11 0 0 7/1/2018
Nald Holder 56020043 11 11 0 0 7/1/2018
Otomatis Hak 56020044 11 11 0 0 7/1/2018
Pemotong Cincin 56020045 11 11 0 0 7/1/2018
Pemotong Iga 56020046 11 11 0 0 7/1/2018
Pin Head Frame 56020047 11 11 0 0 7/1/2018
Pinset Bipolar 56020048 11 11 0 0 7/1/2018
Pinset Bipolar Irigation 56020049 11 11 0 0 7/1/2018
Pinset Chirurgis / Anat 56020050 11 11 0 0 7/1/2018
Reduction Klem 56020051 11 11 0 0 7/1/2018
Ring Klem / Penster Kle 56020052 11 11 0 0 7/1/2018
Roux Hak 56020053 11 11 0 0 7/1/2018
Screw driver 56020054 11 11 0 0 7/1/2018
Sean Miller 56020055 11 11 0 0 7/1/2018
Septum Tang 56020056 11 11 0 0 7/1/2018
Silk Cup 56020057 11 11 0 0 7/1/2018
Slip Sonde 56020058 11 11 0 0 7/1/2018
Sonde Uterus 56020059 11 11 0 0 7/1/2018
Speculum Anus 56020060 11 11 0 0 7/1/2018
Rectal Speculum 56020061 11 11 0 0 7/1/2018
Speculum Vagina 56020062 11 11 0 0 7/1/2018
Speculum Sim 56020063 11 11 0 0 7/1/2018
Sprider B / K 56020064 11 11 0 0 7/1/2018
Suction Laparascopy 56020065 11 11 0 0 7/1/2018
Suction Micro Neuro 56020066 11 11 0 0 7/1/2018
Tang Orthopedy 56020067 11 11 0 0 7/1/2018
Tapal Kuda 56020068 11 11 0 0 7/1/2018
Tenakulum 56020069 11 11 0 0 7/1/2018
Tracheostomi metal 56020070 11 11 0 0 7/1/2018
Trocart 56020071 11 11 0 0 7/1/2018
Cutting Wire 56020072 11 11 0 0 7/1/2018
Pinset Tumor 56020073 11 11 0 0 7/1/2018
Pinset Bayonet 56020074 11 11 0 0 7/1/2018
Scaple 56020075 11 11 0 0 7/1/2018
Micro Scissor 56020076 11 11 0 0 7/1/2018
Micro Disector 56020077 11 11 0 0 7/1/2018
Head Frame 56020078 11 11 0 0 7/1/2018
Chuck 56020079 11 11 0 0 7/1/2018
SkinGraf 56020080 11 11 0 0 7/1/2018
Bor Kepala 56020081 11 11 0 0 7/1/2018
Bor Tangan 56020082 11 11 0 0 7/1/2018
Bender 56020083 11 11 0 0 7/1/2018
Knable tang 56020084 11 11 0 0 7/1/2018
DATE: 09/06/2020 RUMAH SAK PAGE: 45
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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Sarung Kursi 56020085 11 11 0 0 7/1/2018
Bougi 56020086 11 11 0 0 7/1/2018
Timah Tangan 56020087 11 11 0 0 7/1/2018
Mata Cauter 56020088 11 11 0 0 7/1/2018
Pegangan Microskop 56020089 11 11 0 0 7/1/2018
Kabel Motor 56020090 11 11 0 0 7/1/2018
Meja mayo 56020091 11 11 0 0 7/1/2018
Pegangan Lampu 56020092 11 11 0 0 7/1/2018
Korentang 56020093 11 11 0 0 7/1/2018
Kom tutup 56020094 11 11 0 0 7/1/2018
Sikat 56020095 11 11 0 0 7/1/2018
Galipot 56020096 11 11 0 0 7/1/2018
Kom Besar 56020097 11 11 0 0 7/1/2018
Kabel Diathermi 56020098 11 11 0 0 7/1/2018
Blade 56020099 11 11 0 0 7/1/2018
Duk Sedang 56020100 11 11 0 0 7/1/2018
Handuk Packing 56020101 11 11 0 0 7/1/2018
Sarung Mayo 56020102 11 11 0 0 7/1/2018
Kantong Suction 56020103 11 11 0 0 7/1/2018
Tali Pengikat 56020104 11 11 0 0 7/1/2018
Duk lubang 56020105 11 11 0 0 7/1/2018
Waslap 56020106 11 11 0 0 7/1/2018
Selang Suction 56020107 11 11 0 0 7/1/2018
Tampon Tang 56020108 11 11 0 0 7/1/2018
Steinman pin 56020109 11 11 0 0 7/1/2018
Drill 56020110 11 11 0 0 7/1/2018
Pot Sputum 56020111 11 11 0 0 7/1/2018
Alat mata 56020112 11 11 0 0 7/1/2018
Selang Phaco / Selang 56020113 11 11 0 0 7/1/2018
Pisau Phaco 56020114 11 11 0 0 7/1/2018
Hand Piece Diathermi 56020115 11 11 0 0 7/1/2018
Needle 56020116 11 11 0 0 7/1/2018
Irigasi needle 56020117 11 11 0 0 7/1/2018
Wire 56020118 11 11 0 0 7/1/2018
Selang drain 56020119 11 11 0 0 7/1/2018
Suture Wire 56020120 11 11 0 0 7/1/2018
Temporary Clip 56020121 11 11 0 0 7/1/2018
Beban Speculum 56020122 11 11 0 0 7/1/2018
Buldog 56020123 11 11 0 0 7/1/2018
Titanium Clip 56020124 11 11 0 0 7/1/2018
Striping Set 56020125 11 11 0 0 7/1/2018
Screw / Plate Packing 56020126 11 11 0 0 7/1/2018
Alat THT 56020127 11 11 0 0 7/1/2018
Botol PA 56020128 11 11 0 0 7/1/2018
Khulner 56020129 11 11 0 0 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 46


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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Gigli 56020130 11 11 0 0 7/1/2018
Aproximator 56020131 11 11 0 0 7/1/2018
Hak Kelly 56020132 11 11 0 0 7/1/2018
Yodern Tang 56020133 11 11 0 0 7/1/2018
Pengukur 56020134 11 11 0 0 7/1/2018
Pembuka Perban 56020135 11 11 0 0 7/1/2018
Mosquito Lurus / Bengk 56020136 11 11 0 0 7/1/2018
Klem Lurus / Bengkok 56020137 11 11 0 0 7/1/2018
Kabel phaco 56020138 11 11 0 0 7/1/2018
Kabel Bipolar 56020139 11 11 0 0 7/1/2018
Pisau Skingraf 56020140 11 11 0 0 7/1/2018
Selang laparascopy 56020141 11 11 0 0 7/1/2018
Hak Speculum 56020142 11 11 0 0 7/1/2018
Duk Klem 56020143 11 11 0 0 7/1/2018
Over Hole 56020144 11 11 0 0 7/1/2018
Knop Sonde 56020145 11 11 0 0 7/1/2018
Bak Spuit / Bak instrum 56020146 11 11 0 0 7/1/2018
Busi 56020147 11 11 0 0 7/1/2018
Handle Coupling 56020148 11 11 0 0 7/1/2018
Humidifier 56020149 11 11 0 0 7/1/2018
Nasapharing 56020150 11 11 0 0 7/1/2018
Gudel 56020151 11 11 0 0 7/1/2018
Ekstrasi komedo 56020152 11 11 0 0 7/1/2018
╜ Kocher 56020153 11 11 0 0 7/1/2018
Speculum Hidung 56020154 11 5.5 0 0 7/1/2018
Elbow 56020155 11 11 0 0 7/1/2018
Curet THT 56020156 11 11 0 0 7/1/2018
Pengait IUD 56020157 11 11 0 0 7/1/2018
Kawat Gigi 56020158 11 11 0 0 7/1/2018
Nierbeken ( Bengkok ) 56020159 11 11 0 0 7/1/2018
Servo Respirator 56020160 11 11 0 0 7/1/2018
Set Gigi 56020161 11 11 0 0 7/1/2018
Tang Gigi 56020162 11 11 0 0 7/1/2018
Selang Vakum 56020163 11 11 0 0 7/1/2018
Catheter Logam 56020164 11 11 0 0 7/1/2018
Abortus Tang 56020165 11 11 0 0 7/1/2018
Palu Gigi 56020166 11 11 0 0 7/1/2018
Pinset Epilator 56020167 11 11 0 0 7/1/2018
Bein 56020168 11 11 0 0 7/1/2018
Tang Biopsi 56020169 11 11 0 0 7/1/2018
Ring Kebidanan 56020170 11 11 0 0 7/1/2018
Curet Gigi 56020171 11 11 0 0 7/1/2018
Margil Forcep 56020172 11 11 0 0 7/1/2018
Spuit Gliserin 56020173 11 11 0 0 7/1/2018
Bone File 56020174 11 11 0 0 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 47


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Ilusi Hak 56020175 11 11 0 0 7/1/2018
Tang Kulit 56020176 11 11 0 0 7/1/2018
Jarum Anel 56020177 11 11 0 0 7/1/2018
Penahan Lidah 56020178 11 11 0 0 7/1/2018
Mata Bor 56020179 7 7 0 0 7/1/2018
VEIN STRIPPER SET 56020181 350 350 0 0 ###
Patties 56030010 11 11 0 0 7/1/2018
Tensocrep 56030011 11 11 0 0 7/1/2018
Velband 56030012 11 11 0 0 7/1/2018
Handscoen ( sarung tan 56030013 6.6 6.6 0 0 7/1/2018
Cordclem 56030014 6.6 6.6 0 0 7/1/2018
Silet 56030015 6.6 6.6 0 0 7/1/2018
Cottonbud 56030016 6.6 6.6 0 0 7/1/2018
Depper 56030017 8.3 8.3 0 0 7/1/2018
Kapas lidi 56030018 8.3 8.3 0 0 7/1/2018
Kasa X- Ray 10 x 10 ( isi 56030019 53 53 0 0 7/1/2018
Kasa x-ray 7,5 x 7,5 ( isi 56030020 37 37 0 0 7/1/2018
Kasa 6 x 6 56030021 11 11 0 0 7/1/2018
Tampon Hidung 56030022 8.6 8.6 0 0 7/1/2018
Rol Gaas 56030023 8.6 8.6 0 0 7/1/2018
Tampon Vagina 56030024 8.6 8.6 0 0 7/1/2018
KAPAS LIDE STERIL PER 56030025 1 1 0 0 7/1/2018
DISCOUNT (STERILE SUP56999998

DATE: 09/06/2020 RUMAH SAK PAGE: 48


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5204 HOSPITAL SUNDRIES

KAPAS PEMBALUT HID D52040017 65.856 62.72 0 32.45 7/1/2018


PEMPERS ADULT L 52040030 19.6 18.667 0 5.839 7/1/2018
PEMPERS ADULT M 52040031 15.969 15.209 0 5.109 7/1/2018
PEMPERS ADULT XL 52040033 19.316 18.396 0 6.812 7/1/2018
SPATEL LIDAH 52040053 2.159 2.056 0 407 7/1/2018
SPATEL OBGYN 9 52040054 4.103 3.908 0 1.725 7/1/2018
THERMOMETER DIGITA 52040057 73.5 73.5 0 25.3 7/1/2018
ASEPTANIOS TERMINAL 52040070 3,617,592 3,445,326 0 2,632,795 7/1/2018
DERMANIOS SCRUB CHL52040072 1,941,994 1,849,518 0 1,410,750 7/1/2018
CHLORAETYL SPRAY 10 52040075 146.378 138.455 0 77 7/1/2018
KARTU GOLONGAN DARA 52040076 17.216 17.216 0 406 ###
THERMOVENT O2 52040078 478.281 455.506 0 263.501 7/1/2018
THERMOVENT T 52040079 292.64 278.705 0 159.5 7/1/2018
XYLOCAIN JELLY 10GR 52040080 92.758 88.341 0 54.45 7/1/2018
ANIOSYME DDI 5 LTR 52040082 2,792,218 2,659,255 0 2,033,625 7/1/2018
KACAMATA POSEY 52040086 75
ANIOS DDSH 52040087 482.462 459.488 0 316.25 7/1/2018
KAPAS LIDI 52040088 867 826 0 342 7/1/2018
PRESEPT 2.5GR "J&J 52040091 8.85 8.429 0 4.25 7/1/2018
ANIOSGEL 85,500ML 52040112 290.547 276.711 0 171.6 7/1/2018
STERANIOS 2% (382.03452040117 895.705 853.052 0 651.75 7/1/2018
THERMAL PAPER FOR D 52040118 474.774 252.166 0 297 7/1/2018
ANIOSGEL 85, 5 LT 52040121 1,521,294 1,448,851 0 1,052,700 7/1/2018
MAMY POKO NB28+2 ( 52040123 4.695 4.471 0 2.162 7/1/2018
CUTTON BUDS FLUFFY 52040200 138 131 0 55 7/1/2018
AQUAPAK 340ML 52040213 113.036 113.036 0 79.75 6/7/2018
LIFREE POPOK PEREKAT 52040219 14.242 13.563 0 8.111 ###
LIFREE POPOK PEREKAT 52040220 9.206 8.767 0 5.583 1/8/2020

DATE: 09/06/2020 RUMAH SAK PAGE: 49


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5206 CATHETERS & TUBING

IV CATHETER 14G X2 " 52060001 72.001 68.572 0 29.7 7/1/2018


IV CATHETER 16G "ABB 52060002 82.073 78.165 0 59.994 5/4/2020
IV CATHETER 18G "ABB 52060003 34.783 33.127 0 19.397 7/1/2018
CONDOM CATHETER L 52060008 12.28 11.695 0 6.435 7/1/2018
CONDOM CATHETER M 52060009 12.28 11.695 0 6.435 7/1/2018
CONDOM CATHETER S 52060010 12.28 11.695 0 6.435 7/1/2018
FEEDING TUBE 5 40 CM 52060015 35.28 33.6 0 18.513 7/1/2018
FEEDING TUBE 8 120 C 52060017 33.165 31.586 0 18.491 7/1/2018
FOL CATH 3 WAY 24 "R 52060035 121.925 116.119 0 21.78 7/1/2018
FOL CATH SILICON 2 WA52060036 210 200 0 96.8 7/1/2018
GUEDEL AIRWAIYS 0 "P 52060037 118.203 112.574 0 61.776 7/1/2018
GUEDEL AIRWAIYS 00 " 52060038 237.862 226.535 0 58.834 7/1/2018
GUEDEL AIRWAIYS 000 52060039 250.575 238.643 0 58.834 7/1/2018
GUEDEL AIRWAIYS 1 "P 52060040 237.862 226.535 0 58.834 7/1/2018
GUEDEL AIRWAIYS 2 "P 52060041 125.743 119.755 0 66 7/1/2018
GUEDEL AIRWAIYS 3 "P 52060042 136.937 130.416 0 82.5 7/1/2018
NASAL OXYGEN CANULA52060061 68.801 65.525 0 34.1 7/1/2018
STOMACH TUBE 12 "T 52060067 35.502 33.811 0 19.8 7/1/2018
STOMACH TUBE 14 "T 52060068 94.344 89.851 0 36.96 7/1/2018
STOMACH TUBE 16 "T 52060069 66.132 62.983 0 36.96 7/1/2018
STOMACH TUBE 18 "T 52060070 66.132 62.983 0 36.96 7/1/2018
SUCTION CATH 6 "HOSP 52060072 36.105 34.386 0 19.25 7/1/2018
SUCTION CATH 8 "REME52060073 21.096 20.091 0 7.15 7/1/2018
SUCTION CATH 10 "REM52060074 21.096 20.091 0 7.15 7/1/2018
IV CATH PORT 18 "TER 52060081 54.203 51.622 0 32.12 7/1/2018
IV CATH PORT 20 "TER 52060082 55.898 53.236 0 32.12 7/1/2018
IV CATH PORT 22 "TER 52060083 56.377 53.692 0 32.12 7/1/2018
IV CATH PORT 24 "TER 52060084 58.185 55.414 0 33.44 7/1/2018
IV CATH PORT 26 "TER 52060085 80.577 76.74 0 46.365 7/1/2018
THORACIC TROCAR/CAN52060091 979.477 932.835 0 544.282 7/1/2018
THORACIC TROCAR/CAN52060092 936.023 891.45 0 357.5 7/1/2018
FOL CATH 2 WAY 16 "R 52060099 44.646 44.646 0 29.518 3/1/2014
FEEDING TUBE 8 40CM 52060100 35.499 33.809 0 18.513 7/1/2018
THORACIC TROCAR/CAN52060107 570.062 542.916 0 357.5 7/1/2018
CONECTOR TUBING 60" 52060108 132.882 126.554 0 70 7/1/2018
FEEDING TUBE 5 100C 52060109 40.546 38.615 0 18.513 7/1/2018
FEEDING TUBE 8 100C 52060110 40.546 38.615 0 16.83 7/1/2018
FOL CATH 2 WAY GOLD 52060117 38.23 38.23 0 21.78 ###
TUBE CIT GH 4.5 "BD 52060131 8.874 8.451 0 3.113 7/1/2018
TUBE MICRO 0.5ML "BD52060136 10.562 10.059 0 5.72 7/1/2018
TUBE SST 3.5ML "BD" 52060137 7.069 6.732 0 2.882 7/1/2018
TUBE SST 5.0ML "BD" 52060138 7.312 6.964 0 3.553 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 50


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
Y ADAPTOR TUBING DU 52060139 442.283 421.222 0 246.4 7/1/2018
ENDOTRACHEAL KK 2 " 52060140 143.798 143.798 0 89.874 1/2/2015
ENDOTRACHEAL KK 7 " 52060141 150.988 143.798 0 52.25 7/1/2018
ENDOTRACHEAL KK 8 " 52060142 150.988 143.798 0 86.515 7/1/2018
ENDOTRACHEAL KK 8,5 52060143 162.362 154.63 0 86.515 7/1/2018
ENDOTRACHEAL NKK 3. 52060144 850.628 810.122 0 498.883 7/1/2018
ENDOTRACHEAL NKK 4 52060145 898.87 856.067 0 499.125 7/1/2018
ENDOTRACHEAL NKK 4. 52060146 898.87 856.067 0 499.125 7/1/2018
ENDOTRACHEAL NKK 5 52060147 898.87 856.067 0 499.125 7/1/2018
ENDOTRACHEAL NKK 5. 52060148 898.87 856.067 0 499.125 7/1/2018
ENDOTRACHEAL NKK 6 52060149 898.87 856.067 0 499.125 7/1/2018
ENDOTRACHEAL NKK 6. 52060150 898.871 856.067 0 499.125 7/1/2018
ENDOTRACHEAL NKK 8. 52060151 898.87 856.067 0 499.125 7/1/2018
EPIDURAL MINIPACK 16 52060152 489.087 465.797 0 179.74 7/1/2018
EPIDURAL MINIPACK 18 52060153 489.087 465.797 0 188.727 7/1/2018
FOL CATH 2 WAY GOLD 52060154 42.356 42.356 0 31.35 ###
FOL CATH 2 WAY GOLD 52060155 38.201 36.382 0 22.688 7/1/2018
GUEDEL AIRWAIYS 4 "P 52060156 136.937 130.416 0 82.5 7/1/2018
THORACIC CATH 16 "PO 52060157 596.405 596.405 0 329.677 7/1/2018
THORACIC CATH 20 "PO 52060158 596.405 568.005 0 329.677 7/1/2018
THORACIC CATH 24 "PO 52060159 625.828 596.027 0 346.16 7/1/2018
THORACIC CATH 28 "PO 52060160 625.828 596.027 0 346.16 7/1/2018
ENDOTRACHEAL NKK 7 52060162 817.877 778.93 0 453.75 7/1/2018
ENDOTRACHEAL NKK 7. 52060163 817.877 778.93 0 453.75 7/1/2018
FEEDING TUBE 12 52060164 40.546 38.615 0 18.513 7/1/2018
FEEDING TUBE 18 52060167 40.546 38.615 0 18.513 7/1/2018
FEEDING TUBE 3.5 100 52060168 40.546 38.615 0 18.513 7/1/2018
FOL CATH 2 WAY GOLD 52060170 37.007 35.245 0 21.78 7/1/2018
FOL CATH 2 WAY GOLD 52060171 52.266 52.266 0 33 ###
GUEDEL AIRWAIYS 8 "R 52060173 120.726 120.726 0 86.233 1/2/2015
GUEDEL AIRWAIYS 9 "R 52060174 120.726 120.726 0 86.233 1/2/2015
RECTAL TUBE 28 FG "T 52060176 27.773 26.45 0 8.219 7/1/2018
THORACIC TROCAR/CAN52060180 1,025,740 976.895 0 570.2 7/1/2018
VENOCATH 12 52060181 110.821 105.544 0 65.919 7/1/2018
Syringe Multipak Optist 52060185 530.224 504.975 0 292.6 7/1/2018
GAUZE PAD NON XRAY 152060192 4.948 4.712 0 2.486 3/5/2019
ENDOTRACHEAL NKK 8 52060208 720.789 686.466 0 453.2 7/1/2018
FEMALE CATHETER 14G 52060213 37.974 36.166 0 16.83 7/1/2018
Syringe w/handifill 200 52060214 437.553 416.717 0 240.24 ###
FOL CATH 2 WAY GOLD 52060219 121.109 115.342 0 76.45 7/1/2018
LEFT HEART VENT CATH 52060221 1,407,628 1,340,598 0 825 7/1/2018
NELATHON CATHETER 1 52060222 43.508 41.436 0 13.2 7/1/2018
SUCTION CATH 16 "REM52060225 24.11 22.962 0 7.15 7/1/2018
FOL CATH 3 WAY 22 "R 52060226 173.587 165.315 0 96.8 7/1/2018
SUCTION CATH 12 "REM52060228 24.11 22.962 0 7.15 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 51


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
SUCTION CATH 14 "REM52060229 24.11 22.962 0 7.15 7/1/2018
ENDOTRACHEAL NKK 7 52060232 983.296 936.472 0 577.5 7/1/2018
ENDOTRACHEAL NKK 7,552060235 960.23 914.505 0 533.5 7/1/2018
OXYGEN TUBING " SALT 52060237 28.834 27.461 0 8.47 7/1/2018
FOL CATH 3 WAY GOLD 52060238 145.847 138.902 0 77 7/1/2018
IV CATHETER 18G X2" 52060239 43.748 41.665 0 24.42 7/1/2018
FOL CATH 3 WAY GOLD 52060244 145.847 138.902 0 77 7/1/2018
STOMATH TUBE NO. 16 52060246 425.17 404.924 0 404.924 ###
KERT T. TUBE NO 4 "R 52060247 356.62 339.638 0 212.214 7/1/2018
NELATON CATETER NO. 52060250 29.531 28.125 0 12.1 7/1/2018
NELATON CATETHER NO.52060251 29.531 28.125 0 12.1 7/1/2018
FOL CATH 2 WAY 12 RU 52060252 43.472 43.472 0 21.78 ###
ENDOTRACHEAL NKK NO.52060254 916.562 872.916 0 577.5 7/1/2018
ENDOTRACHEAL NKK NO52060255 916.562 872.916 0 577.5 7/1/2018
FEEDING TUBE NO 5 JMS
52060257 52,827 50.3 12 0 37,9 50 28/04/2 2 0
FEEDING TUBE NO 8 JMS
52060258 35,937 35.9 37 0 27,5 00 15/11/2 1 7
FEEDING TUBE NO 3 JM 52060259 45.745 43.567 0 28.6 7/1/2018
CYSTOFIX CH 10 12CM 52060260 802.134 763.937 0 583 ###
CASE DUAL PACK W/ CH52060261 1,098,339 1,046,038 0 800 ###
TRACHEOSTOMY MASKE52060262 49.97 47.59 0 36.608 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 52


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5207 LABORATORY

POT URINE STERIL 52070081 7.571 7.21 0 5.5 ###


FAECES CONTAENER 30 52070083 21.627 20.597 0 3.3 7/1/2018
NEEDLE FLASHBACK 22X52070090 5.097 4.854 0 2.662 7/1/2018
MEDISAFE FINE TOUCH 52070091 4.642 4.421 0 1.796 7/1/2018
MEDISAFE TEST SRIP 52070092 16.627 15.835 0 9.166 7/1/2018
CELLCLEAN 52070120 2,032,559 1,935,770 0 1,197,900 7/1/2018
E CHECK 52070121 4,460,831 4,248,410 0 2,643,300 7/1/2018
HELICOTEC UT PLUS (IR 52070135 209.061 209.061 0 126.5 ###
SYRINGE ASTRUP 3 ML 52070150 44.007 41.911 0 16.5 7/1/2018
OPTIUM XCEED KETONES52070160 68.625 65.357 0 38.001 7/1/2018
CARDIACT PROBNP 52070178 3,340,598 3,340,598 0 2,454,100 ###
ACCUCHECK PERFORMA GLUCOSE
52070214 12,912 12.912 0 9,614 02 /01/2017
ACCU CHECK SAFE T- P 52070215 2.339 2.228 0 1.463 7/1/2018
RAPID TES 52070317 190 190 0 120 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 53


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999
I/P O/P Compan y Cost Eff
Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5210 CATHLAB

INTRODUCER SHEATH 6F52100001 167.382 167.382 0 104.614 1/2/2015


THREE WAY ROTATING 52100003 98.334 93.651 0 55 7/1/2018
NICHIBAND 52100004 141.458 134.722 0 77 7/1/2018
GUIDE WIRE FLOPPY G 52100005 2,301,558 2,301,558 0 1,425,600 ###
GUIDE WIRE INTERMED 52100006 2,111,478 2,111,478 0 1,319,674 1/2/2015
GUIDE WIRE STANDARD52100007 2,271,303 2,162,886 0 1,437,480 7/1/2018
GUIDE WIRE CROSS IT 52100008 2,111,478 2,111,478 0 1,319,674 1/2/2015
GUIDE WIRE EXTRA SP 52100009 2,301,558 2,301,558 0 1,425,600 ###
GUIDE WIRE BALANCE 52100010 2,870,330 2,870,330 0 1,782,000 ###
GUIDE WIRE WHISPER 52100011 2,765,908 2,634,198 0 1,633,500 7/1/2018
GUIDE WIRE PILOT "ABB52100012 2,634,198 2,634,198 0 1,633,500 ###
DOC EXTENSION WIRE 52100013 2,217,052 2,111,478 0 1,436,600 7/1/2018
GUIDING CATHETER "ABB 52100014 2,732,222 2,602,116 0 1,730,300 7/1/2018
INDEFLATOR 20/30 "AB 52100015 2,664,268 2,537,398 0 1,573,000 7/1/2018
GUIDE WIRE ACCESSORI52100016 833.718 833.718 0 508.2 ###
COPILOT BLEEDBACK C 52100017 761.676 725.406 0 479.16 7/1/2018
INTRODUCER SHEATH "T52100027 520.938 520.938 0 325.586 1/2/2015
GUIDE WIRE "TERUMO" 5( 2100028 816.268 777.398 0 473 7/1/2018
YASHIRO CATHETER "T 52100029 916.579 916.579 0 572.862 1/2/2015
TORANOMON CATHETER52100030 711.208 711.208 0 444.505 1/2/2015
GUIDING CATHETER HEAR 52100032 3,551,694 3,382,566 0 2,250,600 7/1/2018
RUNTHROUGH NS FLOP 52100033 3,542,233 3,373,555 0 1,980,000 7/1/2018
MASLA JUST BALLON "AS52100041 8,582,874 8,174,166 0 5,445,000 7/1/2018
MANIFOLD 3GMF "BIOS 52100044 252.628 240.598 0 151.25 7/1/2018
MEDEX INFLATION DEVI 52100045 2,793,628 2,660,598 0 1,650,000 7/1/2018
NEO ASAHI WIRE ROUTE52100046 2,660,598 2,660,598 0 1,650,000 ###
FIELDER/FIELDER FC "AS52100047 3,717,628 3,540,598 0 2,200,000 7/1/2018
FIELDER XT "ASAHI INTE 52100048 3,532,828 3,364,598 0 2,200,000 7/1/2018
CTO WIRE MIRACLE & C 52100049 4,771,374 4,544,166 0 3,025,000 7/1/2018
MICROCATHETER - STRID52100051 7,861,933 7,487,555 0 4,400,000 7/1/2018
GUIDING CATHETER - G 52100052 2,608,828 2,484,598 0 1,650,000 7/1/2018
MICROGUIDE - STREAMI52100053 3,437,349 3,273,666 0 2,178,000 7/1/2018
OPTITORQUE "TERUMO"52100055 1,191,182 1,134,459 0 561 ###
TRANDUCER HAEMODIN52100058 258.99 258.99 0 161.869 1/2/2015
NEEDLE ONE WALL 18G 52100059 184.272 175.497 0 71.5 ###
INTRODUCER SHEATH 1 52100060 66.786 66.786 0 51.374 1/2/2015
INTRODUCER SHEATH 1 52100062 406.673 387.308 0 297 ###
INTRODUCER SHEATH R 52100063 616.92 587.543 0 385 7/1/2018
MANIFOLD "MERIT" M 52100064 201.917 192.302 0 121 7/1/2018
MONITORING LINE 12I 52100065 106.108 101.055 0 55 7/1/2018
MONITORING LINE 60I 52100066 106.108 101.055 0 55 7/1/2018
INDEFLATOR "MEDISEN 52100067 2,239,228 2,132,598 0 1,320,000 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 54


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
HIGH PRESSURE FLEX T 52100069 450.93 429.457 0 330 ###
HIGH PRESSURE FLEX T 52100070 382.485 364.272 0 209 ###
ANGIOPLASTY PACK (Y 52100071 695.158 662.055 0 385 7/1/2018
BASIC INDEFLATOR IN 4 52100072 2,829,247 2,694,521 0 1,485,000 7/1/2018
JIVE "MICROPORT" (RE 52100074 7,280,598 7,280,598 0 4,537,500 ###
GUIDE WIRE 0.035" 15 52100078 350.598 350.598 0 181.5 ###
PERFORMA CATH. "MERIT 52100080 960.032 914.316 0 440 ###
NEEDLE ONE WALL (REK52100086 93.695 89.233 0 59.4 7/1/2018
BASIC INDEFLATOR IN 52100088 2,734,100 2,603,905 0 1,188,000 7/1/2018
BASIC INDEFLATOR IN 4 52100089 2,516,428 2,396,598 0 1,188,000 7/1/2018
BIPOLAR TEMPORARY L 52100094 4,239,393 4,037,518 0 2,750,000 ###
ANGIOSEAL 8F "ST JUDE52100095 6,644,493 6,328,088 0 2,970,000 ###
ACCESS GUIDING CATH. 5( 2100097 2,798,923 2,665,641 0 1,772,650 7/1/2018
HUNTER HYDROPHILIC E52100099 9,261,628 8,820,598 0 5,500,000 7/1/2018
INTRODUCER SHEATH L 52100100 391.228 372.598 0 220 7/1/2018
INTRODUCER SHEATH L 52100101 788.357 750.816 0 496.1 7/1/2018
DIAGNOSTIC CATHETER 52100102 400.633 381.555 0 220 7/1/2018
GUIDE WIRE "MEDTRONIC 52100103 280.348 266.998 0 154 7/1/2018
LAUNCHER GUIDING CA 52100104 2,793,628 2,660,598 0 1,650,000 7/1/2018
INDEFLATOR EVEREST 52100105 2,793,628 2,660,598 0 1,650,000 7/1/2018
COUGAR PTCA WIRE 0. 52100106 2,953,183 2,812,555 0 1,650,000 7/1/2018
MULLINS TRANSEPTAL 52100109 7,413,628 7,060,598 0 4,400,000 7/1/2018
CRUISER GUIDE WIRE PT52100116 2,364,133 2,251,555 0 1,320,000 7/1/2018
CONCIERGE GUIDING CAT 52100117 2,424,028 2,308,598 0 1,100,000 7/1/2018
FINALE COMPRESSION 52100121 426.857 406.531 0 297 ###
INTRODUCER SHEATH F 52100122 455.618 433.922 0 264 7/1/2018
INTRODUCER SHEATH 6 52100124 788.548 750.998 0 385 7/1/2018
INTRODUCER SHEATH 8 52100125 797.886 759.891 0 502.15 7/1/2018
BALLON DILATION CATH52100132 6,180,598 6,180,598 0 3,862,874 1/2/2015
CATHETER PIG 4F (5384 52100133 751.588 715.798 0 434.5 7/1/2018
CATHETER MPA 2 5F (5352100134 751.588 715.798 0 434.5 7/1/2018
CRANIAL PERFORATOR 52100135 5,826,196 5,548,758 0 1,485,000 7/1/2018
HI LINE XS CRANIOTOME52100136 2,481,078 2,481,078 0 1,550,674 1/2/2015
HI LINE XS DIAMOND BU52100137 1,623,078 1,623,078 0 1,014,424 1/2/2015
CONCIERGE GUIDING CAT52100138 2,516,428 2,396,598 0 1,485,000 7/1/2018
NEXGAN BMW -COBALT 52100141 14,099,13014,099,130 0 8,811,956 1/2/2015
MOZEC (RX PTCA BALLON DILATATION CATH)
52100143 5,514,653 0 4,235,000 /09/2017
AMAZONIA CROCO STE 52100146 11,809,79011,809,790 0 8,250,000 ###
YANGTZE U BALLON 52100147 8,322,999 7,926,666 0 5,280,000 7/1/2018
AMAZONIA PAX STENT 52100148 25,180,29025,180,290 0 17,600,000 ###
INDEFLATOR KIT (MINV 52100149 2,371,790 2,371,790 0 1,650,000 ###
GUIDE WIRE 0,035 15 52100150 665.349 633.666 0 418 7/1/2018
GUIDE WIRE 0,035 18 52100151 699.999 666.666 0 440 7/1/2018
ASAP 100 (REKA) 52100152 11,027,02911,027,029 0 8,470,000 ###
DANUBIO MINFASIF 52100153 15,406,91414,673,251 0 11,275,000 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 55


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
AMAZONIA SIR 52100154 27,043,53925,755,751 0 19,800,000 7/1/2018
CATHETER DOUBLE LUMEN EMBOLECTOMY
52100155 2,011,361 2,011,361 0 1,540,0 00 05/12/ 7
SYRINGE ILLUMENA W/ 52100156 384.717 366.397 0 277.2 8/6/2018
ANGIOLATE DES "IVASC 52100157 20,276,58919,311,037 0 14,850,000 ###
MERIT GUIDING CATH 552100158 2,403,668 2,289,207 0 1,760,000 ###
FIELDER XT A "ASAHI IN 52100159 4,055,318 3,862,207 0 2,970,000 ###
STENT DES "BIOFREED 52100160 20,276,58919,311,037 0 14,850,000 1/6/2020
COMBO PLUS (DUAL THE52100161 22,221,71421,163,537 0 16,275,000 1/6/2020
BALLON SAPPHIRE II " 52100162 5,323,014 5,069,537 0 3,895,000 1/6/2020
BALLON SCOREFLEX "O 52100163 6,217,089 5,921,037 0 4,550,000 1/6/2020
STENT XIENCE PRO A 52100164 14,338,83913,656,037 0 10,500,000 1/8/2020
ANGIOSEAL ALL SIZE " 52100165 4,135,464 3,938,537 0 3,025,000 2/6/2020
GUIDE WIRE 0.035, 15 52100166 315.632 300.602 0 231 ###
GUIDE WIRE 0.038, 15 52100167 315.632 300.602 0 231 ###
PAKET PCI COROFLEX D 52100168 17,751,06616,905,777 0 13,000,000 3/3/2020
GUIDE WIRE 0,0038 "ME52300085 298.828 284.598 0 165 7/1/2018
IOPAMIRO 370/30ML 52740001 403.412 384.202 0 232.925 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 56


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5211 IMPLANT

PLATES COMPR, BROAD 52110062 2,639,984 2,514,270 0 1,671,736 7/1/2018


PLATES COMPR, BROAD 52110063 2,788,823 2,656,022 0 1,766,237 7/1/2018
MONO PLATE 140 52110064 4,252,058 4,049,579 0 2,695,275 7/1/2018
HOLE STRAIGHT PLATE 52110066 2,156,068 2,053,398 0 1,270,500 7/1/2018
HOLE STRAIGHT PLATE 52110067 3,200,237 3,047,845 0 1,892,029 7/1/2018
AUTO DRIVE SCREW 1.6 52110068 704.649 671.094 0 406.56 7/1/2018
SCREW 2.0X10MM "OST52110069 668.035 636.224 0 384.766 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 57


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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5212 DRESSING

GYPSONA 3 INC (3.5mx752120003 58.497 55.711 0 28.327 7/1/2018


GYPSONA 4 INC (3.5mx 52120004 71.336 67.939 0 42.02 1/9/2020
GYPSONA 6 INC (3.5mx 52120005 92.465 88.062 0 54.086 ###
CUTICEL CLASSIC 10CM 52120008 29.007 27.626 0 8.278 7/1/2018
HANSAPLAST JUMBO 52120010 3.735 3.557 0 584 7/1/2018
LAKMUS RED PAPER 52120011 2.5 2.381 0 1.26 7/1/2018
LAPARATOMY SPONGES 52120015 1 1 0 0 7/2/2013
MICROPORE TAPE 1 INC 52120025 46.762 44.535 0 25.827 7/1/2018
MICROPORE TAPE 1/2 IN52120026 23.009 21.913 0 12.705 7/1/2018
OPSITE POST OP 25 X 1 52120028 75.406 71.815 0 41.8 7/1/2018
SOFFBAND 3 INC 52120029 51.45 49 0 25.599 1/9/2020
SOFFBAND 4 INC 52120030 56.784 54.08 0 31.002 ###
SOFFBAND 6 INC 52120031 69.456 66.149 0 44.132 1/9/2020
TEGADERM GEN IV 6X7 52120040 15.75 15 0 7.322 7/1/2018
TEGADERM 10X25CM ( 52120041 79.8 76 0 44.468 ###
VELBAND 3" (7.5CM) 52120047 46.274 44.07 0 23.1 7/1/2018
VELBAND 4" (10CM) 52120048 56.166 53.491 0 26.565 ###
MICROPORE TAPE 2 INC 52120051 93.522 89.069 0 51.653 7/1/2018
TEGADERM PLUS 7X8.5 52120052 20.038 19.084 0 10.89 7/1/2018
IOBAN 6650 52120053 518.146 493.472 0 307.7 7/1/2018
TEGADERM PAED (1610 52120054 33.459 31.866 0 18.7 7/1/2018
TEGADERM PAED 3591 52120055 102.419 97.542 0 57.2 7/1/2018
TEGADERM PAED 3590 52120056 66.122 66.122 0 41.326 1/2/2015
CUTIMED SORBACT DRE52120058 162.374 154.642 0 86.522 7/1/2018
CUTISORB STERILE 10X1 52120059 28.748 28.748 0 22.114 1/2/2015
DURAPREP SURGICAL 2652120060 176.108 167.722 0 97.625 7/1/2018
GAUZE PAD XRAY 10X1 52120061 5.232 4.983 0 2.706 7/1/2018
GAUZE PAD NON XRAY 52120062 3.065 2.919 0 1.067 7/1/2018
IOBAN ANTIMICROBIAL 52120065 794.614 756.775 0 577.5 ###
LAPARATOMY SPONGES52120066 30.118 30.118 0 19.866 3/5/2019
STERI DRAPE ARTHRO 52120067 1,044,661 994.915 0 580.8 7/1/2018
STERI DRAPE ISOLATIO 52120068 828.676 789.215 0 459.8 7/1/2018
STERI DRAPE ORTHO "3M 52120069 1,773,504 1,689,049 0 1,124,922 7/1/2018
STERI DRAPE U 120X13 52120070 598.843 570.327 0 346.5 ###
STOCKINET 2"X25YDS ' 52120071 852.238 811.655 0 473 7/1/2018
STOCKINET 3"X25YDS ' 52120072 1,136,945 1,082,805 0 632.5 7/1/2018
STOCKINET 4"X25YDS ' 52120073 1,696,543 1,615,755 0 946 7/1/2018
STOCKINET 5"X25YDS ' 52120074 1,912,749 1,821,666 0 1,210,000 7/1/2018
TEGADERM 10X12CM ( 52120075 35.7 34 0 17.325 ###
TEGADERM GEN IV 8.5X 52120076 44.436 42.35 0 24.805 7/1/2018
TENSOCREPE 3" (7.5CM 52120077 118.968 113.303 0 63.694 1/9/2020
TENSOCREPE 4" (10CMX52120078 140.317 133.635 0 76.85 1/9/2020

DATE: 09/06/2020 RUMAH SAK PAGE: 58


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
TENSOCREPE 6" (15CMX52120079 178.482 169.983 0 100.874 1/9/2020
VELBAND 6" (15CM) 52120080 70.669 67.304 0 42.816 1/9/2020
CURASPON STANDARD 52120081 114.719 109.256 0 60.5 7/1/2018
CELL PACK 52120083 2,424,241 2,308,801 0 1,768,800 7/1/2018
MICROPORE 2" (SUDAH 52120084 73.102 73.102 0 56.232 1/2/2015
STROMATOLYSER 4DL 52120085 4,967,734 4,731,175 0 2,778,600 7/1/2018
STROMATOLYSER 4DS 52120086 4,575,034 4,357,175 0 2,558,600 7/1/2018
SULFOLYSER 52120087 1,221,376 1,163,215 0 679.8 7/1/2018
TEGADERM PAD 3586 52120088 49.813 47.441 0 25.981 7/1/2018
DELTA DRY 3" (7,5CMX 52120089 245.306 233.625 0 102.336 ###
TENSOPLAST STK CHILD 52120091 142.324 135.547 0 71.843 7/1/2018
CAST PADDING SYNTHET52120092 47.481 47.481 0 36.524 1/2/2015
CAST PADDING SYNTHET52120093 63.211 63.211 0 48.624 1/2/2015
CAST PADDING SYNTHET52120094 78.226 78.226 0 60.174 1/2/2015
DEPPER BALL SMALL 52120095 1.996 1.901 0 246 7/1/2018
DELTA LITE 4" 52120098 351.825 335.071 0 211.754 ###
CUTIMED SORBAC CURT52120100 98.7 94 0 67.564 1/9/2020
CARDIOVASCULAR SET "52120104 1,444,520 1,302,658 0 806.96 7/1/2018
DELTA LITE CONFORMAB52120105 331.8 316 0 181.06 ###
INTRASITE GEL 15G/1X1 52120108 167.539 159.561 0 99 7/1/2018
DURAPORE 1 INC "3M" 52120111 83.129 79.17 0 46.2 7/1/2018
GURITA BIDADARI 52120112 52.486 52.486 0 40.374 1/2/2015
IOBAN "3M" (TM 6657) 52120113 382.391 364.182 0 225.5 7/1/2018
REM POLYHESIVE II 52120116 219.241 208.801 0 110 7/1/2018
TRYPAN BLUE 1% 1ML 52120118 115.925 110.405 0 60.5 7/1/2018
CARBACHOL 1% 1ML 52120119 108.409 103.247 0 60.5 7/1/2018
CERATOME 2,8 ML "JM-J52120121 206.428 196.598 0 110 7/1/2018
LANCE TIP STRAIGHT 15'52120122 206.428 196.598 0 110 7/1/2018
OPTEM "ARRON/ BOUVI52120123 483.628 460.598 0 187 7/1/2018
MQA TANGKAI " EYE SP 52120124 160.228 152.598 0 82.5 7/1/2018
HPMC 2ML 52120125 194.465 185.205 0 104.5 7/1/2018
HEALON GV 0.85 ML 52120126 945.628 900.598 0 550 7/1/2018
SURVISC (SODIUM HYA 52120127 622.228 592.598 0 330 7/1/2018
CRESCENT JE-2 52120128 204.283 194.555 0 110 7/1/2018
OPTIMA 553 (PMMA) AL52120129 206.428 196.598 0 99 7/1/2018
OPTIMA FOLD "ASPHERIC52120130 1,222,828 1,164,598 0 660 7/1/2018
OCUSOL 500 ML (BSS) 52120131 371.18 353.505 0 203.5 7/1/2018
DEPPER BALL MEDIUM 52120132 5.143 4.898 0 2.024 7/1/2018
SURGICAL GOWN UK L 52120135 169.399 169.399 0 104.28 ###
SURGICAL GOWN UK M52120136 192.054 182.908 0 101.75 ###
ELEKTROSURGICAL PENCI52120137 171.87 163.686 0 77 7/1/2018
INFANT REM POLYHESIVE 52120138 382.539 364.323 0 278.3 ###
ANGIO DRAPE (AG-010352120139 331.321 315.544 0 181.17 7/1/2018
SLIT ANGLED 2,75MM K 52120140 314.729 299.742 0 171.875 7/1/2018
STRAIGHT 15 KNIFE "MA52120141 314.729 299.742 0 171.875 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 59


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
LAMINARIA M "KTK"
52120142 115, 783 1 15.783 0 89,064 10/ 3 /2015
LAMINARIA L KTK
52120143 115 0.783 115.783 0 89,064 10/ 0 Mar-15
BONGROS- HA 52120144 3,540,598 3,540,598 0 2,212,874 1/2/2015
ADULT POLYHESIVE II-W52120145 133.886 127.511 0 66 7/1/2018
DELTA LITE 5" 52120146 425.959 405.676 0 243.1 ###
ELASTOMUL HAFT 10X4 52120147 82.95 79 0 51.944 1/9/2020
SURGICAL GOWN XL 52120149 173.331 165.077 0 75.092 7/1/2018
ANGIO DRAPE (AG-020252120150 648.819 617.923 0 359.04 7/1/2018
CUTISORB SORBACT RI 52120152 253.406 253.406 0 168.937 1/2/2015
CUTISORB SORBACT RI 52120153 131.676 131.676 0 87.784 1/2/2015
CUTIMED CAVITY 15X2 52120155 108.219 108.219 0 77.299 1/2/2015
CUTICELL EPIGRAFT 10X 52120156 320.003 304.765 0 227.234 7/1/2018
CUTIMED SILTEC 10X10 52120157 151.218 144.017 0 91.567 7/1/2018
CUTIMED GEL 15 GR 52120158 129.15 123 0 77 ###
CUTIMED HYDRO B 10X 52120159 68.141 64.896 0 29.416 7/1/2018
DELTA DRY 4" (10CMX 252120160 174.368 166.065 0 127.373 1/9/2020
CRESCENT (MANI/KAI/F 52120161 440.124 419.166 0 275 7/1/2018
BVI SLIT 2,75MM DB SA 52120162 317.13 302.029 0 220 7/1/2018
BVI STAB 15 SAFETY (3057406)
52120163 302,029 0.029 0 232,330 22 Jan-15
VISITEC LASIK PVA SPEA 52120165 52.675 50.167 0 33 7/1/2018
CONFORMING BANDAGE52120166 9.988 9.512 0 5.225 7/1/2018
CONFORMING BANDAGE52120167 17.043 16.231 0 10.45 7/1/2018
EYE DRAPE PLAIN (MED 52120168 89.944 85.661 0 49.5 7/1/2018
DOP MATA STERIL (MED52120169 31.5 30 0 11 7/1/2018
HPMC AEROVISC (MEDE52120170 136.937 130.416 0 82.5 7/1/2018
SURVISC VISCO SUPREM52120173 483.437 460.416 0 302.5 7/1/2018
AQUACEL SILVER 10X10 52120174 307.469 292.828 0 224.532 7/1/2018
W CARE AH B3 52120175 86.186 82.082 0 53.24 7/1/2018
SS EXTENDED BLADE ELECTRODE (E15516)
52120176 173,051 0 121 ###
APPENDECTOMY DRAPE52120177 275.419 275.419 0 204.82 ###
MAYO STAND COVER FI 52120178 97.956 97.956 0 68.31 ###
LEUKOMED IV FILM 6X 52120181 4.198 4.198 0 3.086 ###
LEUCOPLAST ROL UK 1"
52120182 10,140 10 140 0 7, 800 26/04/ 0 18
CANNOFIX PU
52120183 9.736 9.736 0 7.454 ###
PD PLATE M1 MONOPOLAR PRODEVICE
52120184 62,645 2 0 41 ,250 20/08 18
CURAVAC M 52120186 1,447,779 1,378,837 0 1,056,000 ###
CANISTER 600ML 52120187 636.969 606.637 0 462 ###
FLUORESCEIN SODIUM 52120188 6.82 6.495 0 4.95 ###
ORTHOPEDIC SET ORS 2 52120189 1,829,160 1,742,057 0 1,335,400 2/7/2019
LEUKOMED SORBACT 5X52120190 19.646 18.711 0 14.3 ###
LEUKOMED SORBACT 8X52120191 32.86 31.295 0 23.98 ###
CURAPORT TRANSPARA 52120192 49.116 46.777 0 35.75 ###
ORTHOPEDIC SET (TKR) 52120193 1,227,109 1,168,675 0 897.82 ###
ORTHOPEDIC SET (THR) 52120194 1,418,400 1,350,857 0 1,037,960 ###
JASLAB DISPOSABLE 52120197 25.108 23.912 0 13.75 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 60


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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
BAJU ASTRONOT COVID 52120199 896.406 853.72 0 650 ###
GOWN WITH MASK & 2T52120200 153.937 146.606 0 108.13 ###
APD JH 52120202 21.109 20.104 0 15 ###
BAJU ASTRONOT COVID 52120203 252.039 240.037 0 180 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 61


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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5220 CARDIAC OT

AUTOCLAVE TAPE 1/2 I 52200001 184.864 176.061 0 90.2 7/1/2018


AUTOCLAVE TAPE 1/4 I 52200002 168.94 160.895 0 90.2 7/1/2018
LINA PEN SINGLE 52200003 202.167 192.54 0 123.916 7/1/2018
BISTURI AESCULAP 10 52200004 6.774 6.451 0 3.74 7/1/2018
BISTURI AESCULAP 11 52200005 6.404 6.099 0 3 7/1/2018
BISTURI AESCULAP 15 52200006 6.404 6.099 0 3.74 7/1/2018
BISTURI AESCULAP 20 52200007 6.404 6.099 0 3 7/1/2018
BISTURI AESCULAP 21 52200008 4.081 3.887 0 2.242 7/1/2018
SANDAL KAMAR OPERAS52200009 29.341 27.944 0 9.483 7/1/2018
SANDAL PASIEN RS.MB 52200010 27.633 26.317 0 8.47 7/1/2018
TRACHEAOSTOMY BLUE 52200012
F 1,527,141 1,454,420 0 1,322,200 ###
BOWIE DICK TEST 52200020 3,328,611 3,170,106 0 102.666 7/1/2018
AUTOCLAVE TAPE 3/4 I 52200063 264.866 252.253 0 132 7/1/2018
CELITE ACT REAGENT T 52200080 34.138 32.512 0 21.23 7/1/2018
VITAL OXYGENATOR 52200081 10,218,1339,731,555 0 5,720,000 7/1/2018
PERCUTANEOUS INTROD52200084 1,519,828 1,447,455 0 847 7/1/2018
CVC VANTEX TRIPLE LU 52200085 1,472,308 1,402,198 0 863.5 7/1/2018
HAEMOCONCENTRATOR52200086
A 3,775,565 3,595,776 0 2,750,000 ###
SLS CLIP SMALL 52200087 202.861 193.201 0 146.667 ###
SLS CLIP MEDIUM 52200088 188.182 179.221 0 100.98 7/1/2018
ANTEGRADE ANTEPLEGI52200089 1,053,366 1,053,366 0 645.48 ###
SWAN GANZ COMBO 52200091 5,724,249 5,451,666 0 2,630,000 7/1/2018
MANOMETER LINE PT 8 52200092 125.949 119.951 0 60.5 ###
Y CONNECTOR 3/8X3/8X52200093 96.29 91.705 0 49.5 7/1/2018
CURVED TIP ARTERIAL 52200094 1,501,535 1,430,034 0 836 ###
VENOUS CANNULA 28 52200095 1,676,908 1,597,055 0 935 7/1/2018
CHEST DRAIN PLEUR EV 52200097 1,651,564 1,572,918 0 970.2 7/1/2018
BLOWER 52200099 2,821,846 2,687,473 0 1,650,000 ###
TIP CLEANER 52200100 107.388 102.274 0 55 7/1/2018
NELATHON CATHETER N52200101 29.585 28.176 0 12.1 7/1/2018
MONITORING KIT DOUBL52200104 1,036,807 987.435 0 576.4 7/1/2018
MONITORING KIT TRIPLE52200105 1,546,515 1,472,872 0 1,100,000 ###
CARDIOLPLEGIA INFUSI 52200106 1,074,838 1,074,838 0 671.774 1/2/2015
RETROGRADE CARDIOPL52200107 1,808,799 1,722,666 0 1,144,000 7/1/2018
TWO STAGE VC2 VENOU52200108 1,775,549 1,690,999 0 990 ###
THERMODILUTION CATH52200109 4,595,428 4,376,598 0 2,475,000 7/1/2018
PERCUTANEOUS INTRO 52200110 1,342,948 1,278,998 0 715 7/1/2018
CVC SET 3 LUMEN 7FR- 52200111 1,379,908 1,314,198 0 726 7/1/2018
CARDIOTOMIE RESERVOI52200115 2,818,998 2,818,998 0 1,761,874 1/2/2015
VENOUS CANNULA 31 52200116 1,676,908 1,597,055 0 935 7/1/2018
VASCULAR TOURNIQUET52200119 31.036 31.036 0 23.874 1/2/2015
MEDICAL TUBING 1/4 (L 52200120 187.948 178.998 0 99 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 62


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
STRAIGHT CONNECTOR 152200121 81.086 81.086 0 62.374 1/2/2015
CVC SET 2 LUMEN 7F " 52200125 1,037,340 987.943 0 748 7/1/2018
VITAL OXYGENATOR "M 52200127 14,270,58913,591,037 0 10,450,000 ###
AORTIC PUNCH 4.0 MM 52200128 1,689,153 1,608,718 0 1,078,000 ###
AORTIC ROOT CANNULA52200129 1,340,598 1,340,598 0 837.874 1/2/2015
CARDIOPLEGIA SET ADUL52200131 2,914,535 2,775,748 0 2,200,000 ###
SKIN STAPLER 35 STAP 52200134 492.197 468.759 0 275 7/1/2018
SKIN STAPLER EXTRACT 52200135 253.37 241.305 0 137.5 7/1/2018
ARGOTRANDUCER (041552200139 1,224,122 1,165,830 0 715.77 7/1/2018
LIGASUR MAX (LS 3092) 52200140 1,193,415 1,136,586 0 753.28 7/1/2018
CVC 14GA SINGLE LUM 52200144 525.398 525.398 0 328.374 1/2/2015
Y ADAPTER -10005 (PBA 52200147 749.308 713.627 0 544.5 7/1/2018
Y ADAPTER -10003 (PBA 52200148 926.858 882.722 0 544.5 7/1/2018
IAB CATHETER 7,5 FR 4052200158 27,033,33925,746,037 0 19,800,000 ###
OCTOBASE SUTURE HOL52200159 2,709,039 2,580,037 0 1,980,000 ###
MACRO SUCKER SUCTION 52200160 1,221,537 1,221,537 0 935 ###
THORAMETRIC DRAIN 1 52200163 907.239 864.037 0 660 ###
BLUE RHENO/PDT 52200164 7,975,108 7,595,341 0 6,600,000 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 63


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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5230 CONSIGNMENT

GLO-TIP ERCP CATHETE 52300004 2,608,828 2,484,598 0 1,540,000 7/1/2018


GLO-TIP II DOUBLE LU 52300005 2,405,548 2,290,998 0 1,144,000 7/1/2018
HUIBREGTSE-KATON ERC52300006 1,971,433 1,877,555 0 1,100,000 7/1/2018
SIDE ARM ADAPTER,ROTA52300007 1,389,148 1,322,998 0 814 7/1/2018
HIWIRE HYDROPHILIC WI52300008 1,912,749 1,821,666 0 1,210,000 7/1/2018
ROADRUNNER PC WIRE G 52300009 1,971,433 1,877,555 0 1,100,000 7/1/2018
TMD WIRE GUIDE STRAI 52300010 5,839,528 5,561,455 0 3,267,000 7/1/2018
TMD WIRE GUIDE STRAI 52300011 5,741,353 5,467,955 0 3,212,000 7/1/2018
TMD WIRE GUIDE STRAIG52300012 5,741,353 5,467,955 0 3,212,000 7/1/2018
STANDART WIRE GUIDE 52300013 3,169,168 3,018,255 0 1,771,000 7/1/2018
TRI TOME PC PROTECTO52300014 5,909,331 5,627,934 0 3,740,000 7/1/2018
COTTON CANNULATOME52300015 6,114,418 5,823,255 0 3,421,000 7/1/2018
HUIBREGTSE SINGLE LU 52300016 5,639,548 5,370,998 0 3,344,000 7/1/2018
QUANTUM TTC BILIARY 52300017 7,228,828 6,884,598 0 4,290,000 7/1/2018
QUANTUM TTC BILIARY 52300018 7,228,828 6,884,598 0 4,290,000 7/1/2018
QUANTUM TTC BULIARY52300019 7,228,828 6,884,598 0 4,290,000 7/1/2018
COTTON GRADUATED DIL 52300020 2,619,388 2,494,655 0 1,463,000 7/1/2018
COTTON GRADUATED DIL 52300021 2,619,388 2,494,655 0 1,463,000 7/1/2018
GREENEN GRADUATED D52300022 2,479,468 2,361,398 0 1,463,000 7/1/2018
SPHERE INFLATION DEVIC52300023 2,265,958 2,158,055 0 1,265,000 7/1/2018
CYTOMAX II DOUBLE LU 52300024 3,403,468 3,241,398 0 2,013,000 7/1/2018
THE WEB EXTRACTION B52300026 7,312,153 6,963,955 0 4,092,000 7/1/2018
THE WEB EXTRACTION B52300027 7,312,153 6,963,955 0 4,092,000 7/1/2018
THE WEB II DOUBLE LU 52300028 7,312,153 6,963,955 0 4,092,000 7/1/2018
MEMORY BASKET EIGHT52300029 14,537,83313,845,555 0 8,140,000 7/1/2018
MEMORY BASKET EIGHT52300030 14,537,83313,845,555 0 8,140,000 7/1/2018
SOEHENDRA LITHOTRIP 52300031 17,090,38316,276,555 0 9,570,000 7/1/2018
SOEHENDRA LITHOTRIPT52300032 6,192,958 5,898,055 0 3,465,000 7/1/2018
LIGUORY NASAL BILIARY52300033 4,974,268 4,737,398 0 2,948,000 7/1/2018
STENT INTRODUCER, 5 F52300034 1,421,653 1,353,955 0 792 7/1/2018
COTTON LEUNG PLASTIC52300035 2,462,308 2,345,055 0 1,375,000 7/1/2018
COTTON LEUNG PLASTIC52300036 2,403,403 2,288,955 0 1,342,000 7/1/2018
COTTON LEUNG PLASTIC52300037 2,403,403 2,288,955 0 1,342,000 7/1/2018
GREENEN PLASTIC PANCR 52300038 2,479,468 2,361,398 0 1,463,000 7/1/2018
ZIMMON PANCREAATIC 5S2300039 2,479,468 2,361,398 0 1,463,000 7/1/2018
ST-20 SOEHENDRA TANN52300040 2,403,403 2,288,955 0 1,342,000 7/1/2018
ZIMMON BILIARY STENT52300041 2,331,628 2,220,598 0 1,375,000 7/1/2018
SOLUS DOUBLE PIGTAIL 52300042 5,976,973 5,692,355 0 3,344,000 7/1/2018
FUSION WIRE GUIDE LOC52300044 557.548 530.998 0 319 7/1/2018
FUSION WIRE GUIDE LO 52300045 557.548 530.998 0 319 7/1/2018
FUSION OASIS FOR 10 FR52300046 3,743,706 3,565,434 0 2,365,000 7/1/2018
FUSION BILIARY DILATI 52300047 6,563,548 6,250,998 0 3,894,000 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 64


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
MAXUM REUSABLE GAST52300048 12,440,18811,847,798 0 7,392,000 7/1/2018
MAXUM REUSABLE COL52300049 12,440,18811,847,798 0 7,392,000 7/1/2018
MAXUM REUSABLE GRAS52300050 12,440,18811,847,798 0 7,392,000 7/1/2018
CAPTURE DISPOSABLE H52300051 1,270,198 1,270,198 0 793.874 1/2/2015
CAESAR GRASPING FORC52300052 4,666,998 4,666,998 0 2,916,874 1/2/2015
SONNET SHORT THROW 52300053 1,284,208 1,223,055 0 715 7/1/2018
GERCULES 3 STAGE WIR 52300054 13,801,39813,801,398 0 1,694,000 ###
HERCULES 3 STAGE WIR 52300055 14,491,46813,801,398 0 8,613,000 7/1/2018
HERCULES 3 STAGE WIR 52300056 14,491,46813,801,398 0 8,613,000 7/1/2018
HERCULES 3 STAGE WIR 52300057 14,491,46813,801,398 0 8,613,000 7/1/2018
HERCULES 3 STAGE WIR 52300058 14,491,46813,801,398 0 8,613,000 7/1/2018
DILATION SYRINGE 52300059 1,869,628 1,780,598 0 1,100,000 7/1/2018
INJECTAFLOW VARIABLE52300063 1,637,638 1,559,655 0 913 7/1/2018
ECHOTIP ULTRA ENDOS 52300064 11,435,50310,890,955 0 6,402,000 7/1/2018
ECHOTIP ULTRA CELIAC 52300065 15,676,66314,930,155 0 8,778,000 7/1/2018
SSS HEMORRHOIDAL MU52300068 1,559,098 1,484,855 0 869 7/1/2018
TRICLIP ENDOSCOPIC CL52300069 2,324,863 2,214,155 0 1,298,000 7/1/2018
QUICKSILVER BIPOLAR P52300070 9,002,908 8,574,198 0 5,346,000 7/1/2018
PEG 24 FR FULL TYPE (P 52300071 3,866,210 3,682,105 0 2,161,500 7/1/2018
FLOW 20 FR PULL TYPE 52300072 3,478,998 3,478,998 0 2,174,374 1/2/2015
BALLON REPLACEMENT 52300073 1,278,268 1,217,398 0 710.575 7/1/2018
BRONCHOSCOPY DISPOS52300076 680.598 680.598 0 425.374 1/2/2015
GENIUS MAGIC (COBALT52300078 20,820,59820,820,598 0 13,012,874 1/2/2015
GENIUS MEGAFLEX (BMS52300079 10,817,38010,817,380 0 8,012,874 ###
AMADEUS SUPERCROSS-R 52300080 9,893,991 9,422,849 0 4,954,950 7/1/2018
DIOR (DEB- PACLITAXEL 52300081 24,020,59824,020,598 0 15,012,874 1/2/2015
AQUA SEAL CHEST DRAI 52300082 2,630,534 2,505,270 0 2,025,700 ###
HPF 200E "MERIT" (MM 52300083 317.308 302.198 0 176 7/1/2018
HPF 480 E "MERIT" (MM52300084 317.308 302.198 0 176 7/1/2018
BALLON SEQUENT PLEA52300097 6,951,628 6,620,598 0 4,087,833 7/1/2018
BALLON SEQUENT PLEAS52300098 6,321,628 6,020,598 0 3,520,000 7/1/2018
BALLON SEQUENT PLEAS52300099 6,321,628 6,020,598 0 3,520,000 7/1/2018
PERFORMA PIGTAIL 6 F 52300100 596.983 568.555 0 308 7/1/2018
PERFORMA MPA 2-6F (752300101 479.173 456.355 0 264 7/1/2018
PERFORMA MPA 1 6F (752300102 518.443 493.755 0 286 7/1/2018
GUIDE WIRE M 0,035" 52300106 816.268 777.398 0 364.21 7/1/2018
CHATETER NIH WOVEN 52300107 2,331,628 2,220,598 0 1,375,000 7/1/2018
CATHETER NIH WOVEN 52300108 2,331,628 2,220,598 0 1,375,000 7/1/2018
AMPLATZER SIZING BALL52300111 5,103,628 4,860,598 0 3,025,000 7/1/2018
AMPLATZER GUIDE WIR 52300116 1,546,228 1,472,598 0 907.5 7/1/2018
STOPCOCK "MARQUIS SE52300118 106.108 101.055 0 55 7/1/2018
BASIX INFLATION SYRIN 52300124 2,364,133 2,251,555 0 1,320,000 7/1/2018
BASIC INDEFLATOR IN 52300128 2,267,917 2,159,921 0 1,188,000 7/1/2018
GUIDE WIRE SION BLUE 52300129 2,793,628 2,660,598 0 1,650,000 7/1/2018
PRESSURE MONITORING52300130
K 557.713 531.155 0 308 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 65


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
HI TORQUE PROGRESS, A52300131 2,667,628 2,540,598 0 2,200,000 7/1/2018
HI TORQUE BMW ELITE 52300132 2,516,428 2,396,598 0 1,485,000 7/1/2018
PERFORMA CATHETER " 52300139 596.983 568.555 0 330 7/1/2018
INTRODUCER SHEATH 2352300159 733.398 733.398 0 458.374 1/2/2015
INTRODUCER SHEATH T 52300160 996.184 948.747 0 726 ###
GUIDE WIRE 038 260CM52300161 574.998 574.998 0 359.374 1/2/2015
GUIDING CATHETER ZEN52300170 3,181,708 3,030,198 0 1,881,000 7/1/2018
INFLATION DEVICE (BTS 52300177 1,428,598 1,428,598 0 892.874 1/2/2015
CLICK Y WITH EXTENTIO 52300178 474.264 451.68 0 261.25 7/1/2018
GUIDEWIRE 150CM, 0.35" 52300179 273.429 273.429 0 198 ###
GUIDEWIRE 150CM, 0.038 52300180 225.561 225.561 0 150.374 1/2/2015
HIGH PRESSURE TUBING52300191 204.283 194.555 0 110 7/1/2018
IINTRODUCER SET 6F (B 52300192 371.18 353.505 0 203.5 7/1/2018
INTRODUCER NEEDLE 1852300193 81.086 81.086 0 62.374 1/2/2015
DISP TRANSDUCER SINGL52300194 548.308 522.198 0 313.5 7/1/2018
SLS CLIP SMALL HORISO 52300195 175.052 166.716 0 106.7 7/1/2018
SLS CLIP MEDIUM HORI 52300196 214.1 203.905 0 115.5 7/1/2018
AORTIC PUNCH DP 36 " 52300197 988.598 988.598 0 617.874 1/2/2015
AORTIC PUNCH DP 40 " 52300198 988.598 988.598 0 617.874 1/2/2015
CHEST DRAIN A8000 "TE52300199 1,319,478 1,319,478 0 811.8 ###
AORTIC ROOT CANNULA52300200 1,067,798 1,067,798 0 667.374 1/2/2015
AORTIC ROOT CANNULA52300201 1,067,798 1,067,798 0 667.374 1/2/2015
THORACIC CHATETER F 52300202 184.311 184.311 0 122.874 1/2/2015
THORACIC CHATETER F 52300203 231.564 220.537 0 165 ###
THORACIC CHATETER F 52300204 243.553 231.955 0 165 ###
THORACIC CHATETER F 52300205 243.553 231.955 0 165 ###
TWO STAGE VENOUS CA52300206 1,173,398 1,173,398 0 733.374 1/2/2015
TWO STAGE VENOUS CA52300207 1,412,758 1,412,758 0 882.974 1/2/2015
IMPRESS CATHETER ULTI52300209 720.172 685.878 0 415.8 7/1/2018
SHUNT FLOW AXIUS C 52300212 2,837,038 2,701,941 0 1,796,850 7/1/2018
SHUNT FLOW AXIUS C 52300213 2,942,038 2,801,941 0 1,796,850 7/1/2018
SHUNT FLOW AXIUS C 52300214 2,837,038 2,701,941 0 1,796,850 7/1/2018
3 GANG MANIFOLD RHT 52300215 184.648 175.855 0 99 7/1/2018
FAST CATH LONG SHEA 52300223 940.595 895.805 0 522.5 7/1/2018
PAKET DIAGNOSTIK FEM52300224 2,275,775 2,167,405 0 1,270,500 7/1/2018
PAKET DIAGNOSTIK TRA 52300225 2,318,692 2,208,278 0 1,367,300 7/1/2018
ROTATING ADAPTOR 52300226 122.793 122.793 0 94.456 1/2/2015
FINECROSS 1,8FR 130C 52300227 11,538,69310,989,231 0 7,321,710 7/1/2018
BALLON RYUJIN 1,50M 52300228 9,119,105 8,684,862 0 6,667,100 7/1/2018
MICRO CATHETER ALL SI52300229 8,124,930 7,738,029 0 5,720,000 7/1/2018
PAKET TINDAKAN DIAG 52300230 2,562,437 2,440,416 0 1,622,500 7/1/2018
PAKET TINDAKAN DIAGN52300231 2,484,474 2,366,166 0 1,573,000 7/1/2018
PAKET TINDAKAN PCI F 52300232 35,684,02133,984,782 0 24,270,400 7/1/2018
PAKET TINDAKAN PCI RA52300233 34,620,87032,972,257 0 24,419,450 7/1/2018
PAKET TINDAKAN PCI F 52300234 17,982,54917,982,549 0 13,832,730 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 66


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
PAKET TINDAKAN PCI RA52300235 18,031,45518,031,455 0 13,870,350 ###
ORSIRO BIOLUTE SIROL 52300236 29,419,14129,419,141 0 21,780,000 ###
PRO KINETIC ENERGY C 52300237 15,599,49914,856,666 0 9,900,000 7/1/2018
CONCIERGE GUIDING C 52300238 1,946,043 1,946,043 0 1,485,000 7/6/2015
GUIDEWIRE CONQUEST P52300239 4,338,249 4,131,666 0 2,750,000 7/1/2018
DLP SUCTION TUBE 20 F52300240 2,265,821 2,157,925 0 1,650,000 7/1/2018
ATS MITRAL SIZE 25 PB
52300241 28,612,925 28,612,9 25 0 22,000,000 31/08/2 1 5
DLP CORONARY OSTIAL 52300242 2,641,196 2,515,425 0 1,925,000 7/1/2018
GUIDE WIRE M 0.035 2 52300243 1,315,037 1,252,416 0 830.5 7/1/2018
APPROACH HYDRO ST MICROWIRE (HMW 14 300ST)
52300244 6,093,043 0 4,68 6,956 17/1 2015
CANTATA MICROCATHETER (MCS 2.5-NT-150-15-HP)
52300245 5,378,043 5,3 4,136, 956 17/11 15
SAGITA GUIDE WIRE (TPMG16.180.SAG.HC)
52300246 2,575,243 0 1,980,956 ###
BEACON TIP TORCON (HNBR5.0.38.125PNSVERT
52300247 1,088,043 0 836,956 17 Jan-15
BEACON TIP TORCON (HNBR53880PNSMIK)
52300248 1,088,043 0 836.956 ###
TORNADO EMBOLIZATION COIL (AL SIZE)
52300249 3,333,143 0 2,563,956 ###
INTRODUCER KIT 5FR 10CM (P17A50K1)
52300251 538,253 538,253 0 0 04/08/2017
INTRODUCER KIT 6FR 10CM (P17A60K1)
52300252 538,253 538,253 0 0 04/08/2017
G WIRE 0,032, 180CM ANGLED TIP (P17A3218)
52300253 581,153 0 4 40,000 04/ /2017
CATHETER VETEBERAL 1.5FR
52300254 695,553 695.553 0 528 8/4/2017
GUIDE WIRE 0,032, 260CM TERUMO
52300255 1,089,011 11 0 83 0,500 20/0 2018
GUIDE WIRE SION ASAHI52300256 2,258,589 2,151,037 0 1,650,000 ###
GUIDE WIRE GAIA 3ND 52300257 4,060,389 3,867,037 0 2,970,000 ###
GUIDE WIRE GAIA 2ND 52300258 4,060,389 3,867,037 0 2,970,000 ###
HEETY INTRODUCER SHEA
52300259 676.943 644.707 0 495 ###
EXPERIENCE BALLON " 52300260 6,012,339 5,726,037 0 4,400,000 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 67


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5237 MEDICAL DISPOSAL

GUIDE WIRE 0.038" 15 52100057 350.598 350.598 0 181.5 ###


AMPLATZER GUIDE WIR 52300110 1,546,228 1,472,598 0 907.5 7/1/2018
SOFT SEAL LARYNGEAL 52370003 421.38 401.314 0 227.7 7/1/2018
SOFT SEAL LARYNGEAL 52370004 421.38 401.314 0 227.7 7/1/2018
AMBICOR PEMB. TALI 52370008 5.242 4.993 0 1.719 7/1/2018
BABY HALER 52370009 353.788 336.941 0 217.485 7/1/2018
BLOOD ADM TRANSFUSI52370010 55.902 53.24 0 33 ###
CERVICAL COLLAR L 52370025 464.858 442.722 0 269.5 7/1/2018
CERVICAL COLLAR SUP 52370026 464.858 442.722 0 275 7/1/2018
CERVICAL COLLAR S 52370027 358.662 341.583 0 159.72 7/1/2018
COLOSTOMY BAG F1 52370028 113.548 108.141 0 67.65 7/1/2018
CTG PAPER (FETAL MO 52370029 284.968 271.398 0 137.5 7/1/2018
CYTOBRUSH 52370039 6.917 6.588 0 1.32 7/1/2018
DISPOSIBLE SUCTION B 52370041 124.297 118.378 0 69.19 7/1/2018
DISPOSIBLE SUCTION B 52370042 131.806 125.53 0 73.37 3/5/2019
ELEKTRODA BLUE SENS 52370047 11.206 10.672 0 5.61 7/1/2018
ENDOTRACHEAL NKK 2052370049 568.243 541.184 0 356.345 7/1/2018
ENDOTRACHEAL NKK 2252370050 529.515 504.3 0 292.203 7/1/2018
ENDOTRACHEAL NKK 2452370051 445.621 445.621 0 278.513 1/2/2015
ENDOTRACHEAL NKK 2652370052 529.515 504.3 0 292.203 7/1/2018
ENDOTRACHEAL NKK 2852370053 604.871 576.068 0 379.601 7/1/2018
ENDOTRACHEAL NKK 3052370054 604.871 576.068 0 379.601 7/1/2018
ENDOTRACHEAL NKK 2052370055 529.515 504.3 0 292.203 7/1/2018
ENDOTRACHEAL KK 2,5 52370056 123.538 123.538 0 81.04 ###
ENDOTRACHEAL KK 3 " 52370057 123.538 123.538 0 81.04 ###
ENDOTRACHEAL KK 3,5 52370058 121.166 121.166 0 86.547 1/2/2015
ENDOTRACHEAL KK 4 " 52370059 121.166 121.166 0 86.547 1/2/2015
ENDOTRACHEAL KK 4,5 52370060 121.166 121.166 0 86.547 1/2/2015
ENDOTRACHEAL KK 5 " 52370061 134.637 128.266 0 81.04 7/1/2018
ENDOTRACHEAL KK 5,5 52370062 127.224 121.166 0 52.25 7/1/2018
ENDOTRACHEAL KK 6 " 52370063 127.224 121.166 0 52.25 7/1/2018
ENDOTRACHEAL KK 6,5 52370064 127.224 121.166 0 52.25 7/1/2018
ENDOTRACHEAL KK 7,5 52370065 127.224 121.166 0 52.25 7/1/2018
ENDOTRACHEAL 2 "POR 52370066 104.35 99.381 0 61.81 7/1/2018
ENDOTRACHEAL 2,5 "P 52370067 114.598 109.141 0 68.317 7/1/2018
ENDOTRACHEAL 3 "POR 52370068 114.179 108.742 0 68.05 7/1/2018
ENDOTRACHEAL 3,5 "P 52370069 136.937 130.416 0 82.5 7/1/2018
ENDOTRACHEAL 4 "POR 52370070 148.352 141.288 0 89.748 7/1/2018
ENDOTRACHEAL 4.5 "P 52370071 133.551 127.191 0 64.625 7/1/2018
ENDOTRACHEAL 5 "POR 52370072 172.059 163.865 0 104.5 ###
ENDOTRACHEAL 5,5 "P 52370073 172.059 163.865 0 104.5 ###
ENDOTRACHEAL 6 "POR 52370074 182.684 173.985 0 97.9 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 68


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
ENDOTRACHEAL 6,5 "P 52370075 171.587 163.416 0 104.5 7/1/2018
ENDOTRACHEAL 7 "POR 52370076 171.587 163.416 0 104.5 7/1/2018
ENDOTRACHEAL 7,5 "P 52370077 171.587 163.416 0 104.5 7/1/2018
ENDOTRACHEAL 8 "POR 52370078 154.626 146.916 0 93.5 7/1/2018
ENDOTRACHEAL 8,5 "P 52370079 164.894 157.042 0 100.251 7/1/2018
ID BRACELETT INFANT 52370091 3.694 3.518 0 1.32 7/1/2018
ID BRACELETT INFANT P 52370092 5.447 5.187 0 1.1 ###
ID BRACELETT ADULT B 52370093 3.813 3.631 0 1.32 7/1/2018
ID BRACELETT ADULT PI 52370094 5.447 5.187 0 1.1 ###
ID BRACELETT RED 52370095 3.694 3.518 0 1.32 7/1/2018
HAND SCOON STERIL 6 52370096 29.87 28.448 0 17.6 7/1/2018
HAND SCOON STERIL 6, 52370097 32.743 31.184 0 11.22 7/1/2018
HAND SCOON STERIL 7 52370098 24.485 23.319 0 11.22 7/1/2018
HAND SCOON STERIL 8 52370100 40.674 38.737 0 22 ###
INFUSION SET MICRODR52370119 137.534 130.985 0 95.7 ###
INFUSION SOL. ADM SET52370122 31.666 31.666 0 19.791 1/2/2015
KASA GULUNG 4Y X 10 52370127 6.511 6.511 0 2.42 ###
KASA GULUNG 4Y X 5 C 52370128 5.326 5.072 0 2.09 7/1/2018
KASA GULUNG 4Y X 7,5 52370129 9.921 9.449 0 6.38 7/1/2018
MASKER AEROSOL ADU 52370138 51.307 48.864 0 16.5 7/1/2018
MASKER AEROSOL PEDI 52370139 60.723 57.831 0 18.92 7/1/2018
MASKER HIJAU TIE ON 52370141 4.422 4.211 0 1.65 7/1/2018
MASKER NEBULIZER AD 52370146 68.608 65.341 0 36.96 ###
MASKER NEBULIZER PE 52370147 82.546 78.615 0 41.8 7/1/2018
MASKER REBREATHING 52370150 55.149 52.523 0 29.04 7/1/2018
MASKER REBREATHING P52370151 246.084 234.366 0 151.8 7/1/2018
NASAL OXYGEN CANULA52370153 31.837 30.321 0 12.65 7/1/2018
EEG PAPER 52370159 5,203,798 5,203,798 0 3,252,374 1/2/2015
TREADMIL PAPER 52370161 997.372 949.878 0 440 7/1/2018
NURSE CAP WOMAN "HO 52370188 2.874 2.737 0 908 7/1/2018
URINE COLECTOR PED 1 52370194 83.86 79.867 0 52.8 7/1/2018
WASHLAP PUTIH LOGO R52370197 21.026 20.025 0 4.4 7/1/2018
N/A - HYPAFIX 5 X 5 M 52370199 16.736 16.736 0 12.874 1/2/2015
BABY WIPES "PIGEON" 252370215 16.736 16.736 0 12.874 1/2/2015
THICK WIPES CUSSONS 52370216 16.736 16.736 0 12.874 1/2/2015
EL-MED INFUS SPALK SI 52370225 24.536 24.536 0 18.874 1/2/2015
ANIOZYNE 52370237 16.173 16.173 0 12.441 1/2/2015
ELEKTRODA 52372011 16.736 16.736 0 12.874 1/2/2015
HAND SCOON STERIL 8 52372029 16.811 16.811 0 10.507 1/2/2015
INFUSION SET "BBRAUN"52372033 58.985 56.176 0 33 7/1/2018
MEDIFIX LINE 90CM WIT52372034 214.744 204.518 0 104.5 7/1/2018
MEDIFIX MANOMETER S52372035 367.204 349.718 0 187 7/1/2018
APRON FILM WHITE "HOS 52372037 7.641 7.277 0 3.421 7/1/2018
CLIP CARTRIDGE "MASL 52372038 750.242 714.516 0 471.9 7/1/2018
ESPOCAN "BBRAUN" 52372040 891.508 849.055 0 495 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 69


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
HYPAFIX 5 X 5 M "BSN" 52372041 123.9 118 0 63.8 ###
HYPAFIX 10 X 5 M "BSN 52372042 300.3 286 0 121 ###
HYPAFIX 15 X 5 M "BSN 52372043 499.8 476 0 170.5 ###
STERISTRIP ISI 50 "3M" 52372049 11.406 10.683 0 5.095 7/1/2018
TONGUE SPATULA ISI 1 52372050 18.137 17.273 0 454 7/1/2018
INTUBATION STYLET 2 (100-120-200) 4MM "PORTEX"
52372051 228,771 21 138.05 0 01/07/2018
INTUBATION STYLET 3 (100-120-300) 5MM "PORTEX"
52372052 238,318 22 148.5 0 15/11/2018
UROGARD PLUS 52372053 168.184 160.175 0 81.4 7/1/2018
ARM SLING L 52372054 56.611 53.916 0 23.1 7/1/2018
ARM SLING M 52372055 56.611 53.916 0 23.1 7/1/2018
INTUBATION STYLET NO.52372056 249.122 249.122 0 148.5 ###
MITELA 52372057 52.486 52.486 0 40.374 1/2/2015
OXYGEN MASK 0 52372059 873.318 873.318 0 545.824 1/2/2015
OXYGEN MASK 1 52372060 873.318 873.318 0 545.824 1/2/2015
OXYGEN MASK 2 52372061 943.542 943.542 0 589.714 1/2/2015
OXYGEN MASK 3 52372062 943.542 943.542 0 589.714 1/2/2015
OXYGEN MASK 4 52372063 943.542 943.542 0 589.714 1/2/2015
OXYGEN MASK 5 52372064 943.542 943.542 0 589.714 1/2/2015
NASAL OXYGEN CANULA52372067 113.52 108.114 0 64.35 7/1/2018
PISAU CUKUR "GILLETE"52372068 18.261 17.391 0 7.15 7/1/2018
SARUNG TANGAN PANJA52372069 39.759 39.759 0 30.584 1/2/2015
STERISTRIP ISI 50 "3M" 52372071 22.707 21.626 0 11.924 7/1/2018
SUCTION PRO DUEL LUM52372073 455.037 455.037 0 284.398 1/2/2015
TRANSOFIX "BBRAUN" 52372077 13.707 13.054 0 7.59 7/1/2018
HANDSCHOON WRP STER 52372081 46.296 44.091 0 23.65 7/1/2018
BAROVAC PS 400ML M 52372084 1,011,760 963.581 0 502.838 7/1/2018
OPSITE POST OP 6,5X5 52372092 31.747 30.235 0 9.9 7/1/2018
OPSITE POST OP 9,5X8, 52372093 40.276 38.358 0 19.8 7/1/2018
MATHERNITY NAPKINS 52372094 6.639 6.323 0 2.75 7/1/2018
SOFT SEAL LARYNGEAL 52372104 414.377 394.645 0 227.7 7/1/2018
WASHLAP POLOS 52373000 19.596 19.596 0 15.074 1/2/2015
ANAESTHESI MASK SIZE 52373008 265.142 252.516 0 163.9 7/1/2018
ANAESTHESI MASK SIZE 52373009 265.142 252.516 0 153.9 7/1/2018
ANAESTHESI SIZE 3 (112 52373010 249.549 237.666 0 154 7/1/2018
ANAESTHESI MASK SIZE 52373011 249.549 237.666 0 154 7/1/2018
ANAESTHESI MASK SIZE 52373012 249.549 237.666 0 154 7/1/2018
T SCRUB BRUSH 52373014 35.845 34.139 0 12.1 8/6/2018
HAND SCOON SIZE M R 52373015 3.443 3.279 0 1.133 7/1/2018
HAND SCOON NON STER52373018 2.292 2.183 0 495 7/1/2018
HAND SCOON NON STER52373019 2.521 2.401 0 935 ###
CANULA FOR VACUM CU52373020 156.86 156.86 0 104.573 1/2/2015
NASOPHARYNGEAL AIRW52373026 314.53 299.552 0 192.5 7/1/2018
NASOPHARYNGEAL AIRW52373027 314.53 299.552 0 192.5 7/1/2018
NASOPHARYNGEAL AIRW52373028 309.332 294.602 0 192.5 7/1/2018
OBJECT GLASS 52373031 361 361 0 278 3/2/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 70


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
INTRODUCER SHEATH FE52373039 433.922 433.922 0 264 ###
MANIFOLD "MERIT" 52373040 298.348 284.141 0 148.5 ###
MOUTHPIECES 52373042 15.75 15.75 0 3.85 7/1/2018
SUCTION CONECTING T 52373044 165.9 158 0 29.591 ###
SIMPLE MASK ADULT "S 52373049 44.726 42.596 0 25.874 1/9/2020
TOURNIQUET 52373053 45.114 42.966 0 24.2 7/1/2018
SPALEK TANGAN KECIL 52373058 31.335 29.843 0 11 7/1/2018
MASKER NON REBREATH52373061 68.016 64.777 0 33.66 7/1/2018
MASKER NON REBREATHI 52373062 124.116 118.206 0 74.36 7/1/2018
BREATHING SYSTEM "INT52373063 708.482 708.482 0 435.6 ###
CLIP POUCH 52373067 45.73 43.552 0 21.175 7/1/2018
MUCUS EXTRACTOR "SA52373070 40.095 38.186 0 16.5 7/1/2018
SURGEON CAP "HOSPIL 52373071 3.351 3.191 0 1.067 7/1/2018
PRISMAFLEX M60 PRE SE52373072 11,264,67810,728,265 0 6,306,300 7/1/2018
HEMOSOL BO (109124) 52373073 1,014,004 965.718 0 590.7 7/1/2018
BIOPSY FORCEPS, OVAL 52373075 1,098,088 1,045,798 0 640.75 7/1/2018
CODMAN SURGICAL MAR 52373076 106.108 101.055 0 55 7/1/2018
SPALK ANAK UK 15 X5 " 52373087 24.398 23.236 0 4.95 7/1/2018
HEMODIALYSIS CATH SE52373089 2,079,798 2,079,798 0 1,287,000 ###
NEBULIZER KIT W/TEE 52373094 61.757 58.816 0 29.7 ###
DISPOSABLE MANUAL R 52373096 606.966 578.063 0 440.22 7/1/2018
FACE MASK NON INVASI52373097 1,211,766 1,211,766 0 757.354 1/2/2015
URINAL PLASTIK 52373100 33.339 31.751 0 11.22 7/1/2018
TRACHEOSTOMY FILTER 52373101 80.631 76.791 0 46.75 7/1/2018
CLOSED SUCTION NO 1452373103 639.882 609.411 0 401.83 7/1/2018
CLOSED SUCTION NO 1252373104 725.199 690.666 0 401.83 7/1/2018
SPALK TANGAN DEWASA52373106 35.318 33.636 0 14.3 7/1/2018
SPALK KAKI 65X10CM 52373107 40.344 38.423 0 17.6 7/1/2018
SPALK KAKI 90X10CM 52373108 41.846 39.853 0 18.7 7/1/2018
MASKER N95 3M 52373110 179.234 170.699 0 130 ###
ALERT SNAPS RED (ALL 52373111 3.72 3.542 0 2.332 7/1/2018
ALERT SNAPS YELLOW (A52373112 3.903 3.717 0 2.701 ###
ALERT SNAPS PURPLE ( 52373113 3.72 3.542 0 2.332 7/1/2018
ALERT SNAPS GREEN (N 52373114 3.72 3.542 0 2.332 7/1/2018
DOUBEL J 4,5 SURGIMED52373116 501.411 477.534 0 362.89 7/1/2018
DISP SPO2 SENSO MEDK52373117 279.083 265.793 0 192.5 7/1/2018
SKIN TRACTION ADULT 52373119 195.842 186.516 0 105.271 7/1/2018
SKIN TRACTION ADULT 52373120 195.253 185.955 0 104.941 7/1/2018
PIGTAIL DRAINAGE CATH TIP 12 FR
52373121 1,231,043 3 0 935 ,000 09/06 16
VISION URETER CATH 5F52373122 290.818 290.818 0 211.75 ###
VISION URETER CATH 5F52373123 290.818 290.818 0 211.75 ###
PNCL LUNDERQUEST G 52373124 866.393 866.393 0 654.5 ###
AMPLATZ SHEAT ALL SIZ52373125 866.393 866.393 0 654.5 ###
PUNCTURE NEEDLE 52373126 866.393 866.393 0 654.5 ###
DILATORS DOR DRAINAG52373127 866.393 866.393 0 654.5 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 71


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
CERTOFIX TRIO V122O 52373128 1,593,114 1,517,251 0 1,155,000 7/1/2018
STENT BIORESORBABLE 52373129 42,915,75142,915,751 0 33,000,000 ###
HD CATH SILICONE STRAIGHT DOUBLE LUMEN 12.5FR X28
52373130 5,943,861 5,9 65,000 05 /05/2017
GIGLI WIRE SAW OLIV 52373132 491.624 468.213 0 355.52 ###
INTUBATION STYLET (5552373134 119.471 119.471 0 84.7 ###
OCTENIC HAIR WASH 52373138 39.858 37.96 0 19.36 7/1/2018
BREATING ALTERA 1121 52373139 270.336 270.336 0 200.75 ###
INTUBATION STYLET (550 0001 1) 2.5-4.5MM
52373140 119,471 0 84,700 14/ May-18
ELEKTRODE SOLID HYDRO GEL ADULT (HR-OP55)
52373141 4,434 0 3,267 04/0 /2018
ARM SLING S 52373142 39.391 39.391 0 23.1 ###
RADIOLOGI KIT
52373143 1,3 32.762 1,332,762 0 1,018,001 0 /04/2018
ELVES ENDOVENOUS LASER ABLATION
52373144 17,559,361 1 0 13,500 ,000 04/05 18
SPALK FIRST AID KAYU ONEMED
52373145 90,423 6.117 0 61,600 13/ Jul-18
HANDSCOON NON STERIL MYGUARD UK M
52373147 1,178 1,122 0 7 70 05/09/ 8
HANDSCOON NON STERIL MYGUARD UK S
52373148 1,178 1,122 0 7 70 05/09/ 8
AUTOMATIC RESUSITATOR (VORTRAN)
52373149 757,707 5 0 600 ,710 21/08 18
KASA STERIL 16X16 C 52373150 1.7 1.619 0 781 ###
CERTOFIX TRIO V720 BBRAUN (CVC)
52373152 2,027,025 0 0 1,485 ,000 03/12 18
UNIVERSAL DRAPE TITA 52373154 1,117,165 1,063,967 0 0 2/8/2019
TRIPLE DISPOSABLE PR 52373156 1,379,606 1,313,910 0 1,006,500 5/2/2019
TRIPLE DISPOSABLE PR 52373157 1,379,606 1,313,910 0 0 5/2/2019
SINGLE HEATED WIRE C 52373159 571.053 543.86 0 413.71 ###
HAND SCOON STERIL 7. 52373160 18.145 17.281 0 13.2 7/8/2019
URINAL PLASTIK PLUS 52373161 45.679 43.504 0 33 ###
LMA SUPREME SU SIZE 52373163 794.627 756.787 0 577.5 9/6/2019
LMA SUPREME SU SIZE 552373164 794.627 756.787 0 577.5 9/6/2019
UNIVERSAL DRAPE SOLI 52373165 835.437 835.437 0 638 ###
BREATHING CIRCUIT BU 52373166 2,258,589 2,151,037 0 1,650,000 ###
TALI PENGIKAT PASIEN 52373167 41.584 39.604 0 30 ###
HD CATHETER KIT 2L 12 52373170 952.284 906.937 0 693 ###
BREATHING CIRCUIT INT52373171 276.609 263.437 0 198 2/7/2020
BAKTERIAL FILTER FLEX 52373172 63.997 90.949 0 42.24 ###
HD CATHETER 2L 12FR 52373173 948.189 903.038 0 690 ###
SURGICAL HAT 52373174 1.965 1.871 0 1.346 ###
MASKER KN 95 52373175 44.31 42.2 0 32.229 ###
SET C SECTION WITH 3 52373176 1,180,262 1,124,059 0 863.5 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 72


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5242 SYRINGES & NEEDLE

DISP NEEDLE 18 G "TE 52420001 5.739 5.466 0 1.98 7/1/2018


DISP NEEDLE 20 G "TE 52420002 3.776 3.596 0 1.98 7/1/2018
DISP NEEDLE 21 G "TE 52420003 3.614 3.442 0 1.98 7/1/2018
DISP NEEDLE 22 G "TE 52420004 3.614 3.442 0 1.98 7/1/2018
DISP NEEDLE 23 G "TE 52420005 4.2 4 0 1.98 7/1/2018
DISP NEEDLE 24 G "TE 52420006 3.614 3.442 0 1.98 7/1/2018
DISP NEEDLE 25 G "TE 52420007 5.913 5.631 0 1.98 7/1/2018
DISP NEEDLE 26 G "TE 52420008 5.295 5.043 0 1.98 7/1/2018
SYRINGE 1 CC INSULIN 852420020 10.486 9.987 0 5.83 7/1/2018
SYRINGE 1 CC TUBERCU 52420021 14.583 13.889 0 7.04 7/1/2018
SYRINGE 10 CC "TERUM 52420024 14.413 13.727 0 8.03 7/1/2018
SYRINGE 20 CC "TERUM 52420030 23.711 22.582 0 10.12 7/1/2018
SYRINGE 3 CC "TERUMO52420032 9.112 8.678 0 5.06 7/1/2018
SYRINGE 5 CC "TERUMO52420036 12.377 11.788 0 6.16 7/1/2018
SYRINGE 50 CC "TERUM 52420038 42.023 40.022 0 23.32 7/1/2018
SYRINGE 50 CC CAT. TI 52420039 78.937 75.178 0 44 7/1/2018
WING NEEDLE 21 52420041 22.15 21.095 0 12.32 7/1/2018
WING NEEDLE 23 52420042 22.15 21.095 0 12.32 7/1/2018
WING NEEDLE 25 52420043 22.15 21.095 0 12.32 7/1/2018
WING NEEDLE 27 52420044 36.483 34.746 0 20.35 7/1/2018
SPINAL NEEDLE 25G "B 52420049 78.857 75.102 0 44 7/1/2018
SPINAL NEEDLE 26G "B 52420050 78.857 75.102 0 44 7/1/2018
SPINAL NEEDLE 27G "B 52420051 87.34 83.181 0 44 7/1/2018
SPINAL NEEDLE 29G "B 52420052 87.34 83.181 0 44 7/1/2018
IV CATHETER 18G "BBR 52420053 61.08 58.171 0 17.303 7/1/2018
IV CATHETER 20G "BBR 52420054 61.08 58.171 0 25.96 7/1/2018
IV CATHETER 22G "BBR 52420055 61.08 58.171 0 25.96 7/1/2018
IV CATHETER 24G "BBR 52420056 61.08 58.171 0 35.2 7/1/2018
VENOCATH 16 52420057 240.887 229.416 0 148.5 7/1/2018
VENOCATH 18 52420058 240.887 229.416 0 148.5 7/1/2018
VENTILATOR ADAPTOR 52420059 523.034 498.128 0 327.642 7/1/2018
INTROCAN SAFETY 23G 52420063 48.491 48.491 0 30.307 1/2/2015
DISP NEEDLE 27 G "TE 52420065 3.614 3.442 0 1.98 7/1/2018
SPINAL NEEDLE 23 "TE 52420066 59.219 59.219 0 42.299 1/2/2015
SPINAL NEEDLE 23G "B 52420068 53.274 53.274 0 33.296 1/2/2015
SPINAL NEEDLE 27 "BD" 52420069 70.702 70.702 0 44.189 1/2/2015
WING NEEDLE 19 52420071 19.597 18.664 0 10.89 7/1/2018
WINGSET 23X75 "BD"
52420073 15,2 02 1 5.202 0 1 1,550 22/0 / 2018
SURFLO FLASH IV CAT. 52420076 42.859 42.859 0 26.787 1/2/2015
SPINAL NEEDLE WHITAC52420079 104.662 99.678 0 58.19 7/1/2018
SPINAL NEEDLE WHITAC52420080 91.114 86.775 0 50.6 7/1/2018
SPINAL PAJUNK 27GX31/52420081 163.049 155.285 0 86.9 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 73


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
SPINAL PAJUNK 25GX 3 52420083 154.262 146.916 0 93.5 7/1/2018
CUTTING LOOP HAWK (N6110)
52420084 1,081,653 1 81.653 0 825,000 0 ###
SPINAL NEEDLE 22G "B 52420085 82.836 78.891 0 60.5 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 74


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5250 HAEMODIALYSIS

STERIL GENERAL HD SET52373155 44.1 42 0 29.7 ###


BLOOD LINE ARTERIAL 52500006 231.642 220.611 0 134.2 7/1/2018
DIACAN ARTERIAL G16 52500007 32.438 30.893 0 10.89 7/1/2018
DIACAP LOPS 15; PS-D 52500008 488.99 465.705 0 269.5 7/1/2018
AV FISTULA 1 1/4 52500011 21.589 20.561 0 11.66 ###
SOL CART B (494/496) 52500014 239.626 228.215 0 129.8 7/1/2018
ELISIO (720354101D) 52500015 265.33 265.33 0 253 ###
ALKALINE HD 5% 10L 52500016 184.783 184.783 0 141.756 ###
HD CONC ACIDIC HDM 52500017 27 27 0 19 ###
STERIL ATANDART HD S 52500021 42.075 40.071 0 26.18 ###
DIALYSER F-7 52500022 281.114 267.727 0 201.3 ###
BI BAG 5008 52500024 120.003 114.288 0 83.27 ###
BLOODLINE TUBBING S 52500025 143.726 136.882 0 100.65 ###
HD SOLUTION 52500026 136.219 129.732 0 95.15 ###
FISTULA NEEDLE 52500027 22.255 21.195 0 11.66 ###
SAS-MA 300 ACID CON 52500028 123.297 123.297 0 90.2 ###
SYRINGE 1CC ONEMED (52910010 3.198 3.046 0 781 ###
SYRINGE 10CC ONEMED 52910013 4.907 4.673 0 1.21 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 75


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5257 PHYSIOTHERAPY

KNEE SUPORT 1022 XL 52570002 460.598 460.598 0 114.95 ###


KRUK KETIAK "POLICARE52570003 316.92 301.829 0 159.72 7/1/2018
STOCKING UK S "SIGVAR52570004 510.422 486.116 0 281.507 7/1/2018
STOCKING UK M "SIGVA 52570005 1,089,812 1,037,916 0 687.5 7/1/2018
STOCKING UK L "SIGVAR52570006 224.255 213.576 0 137.94 7/1/2018
LUMBAL CORSET 2060 52570010 520.298 495.522 0 302.5 7/1/2018
LUMBAL CORSET 2064 52570011 16.736 16.736 0 12.874 1/2/2015
LUMBAL CORSET 2164 52570012 936.098 891.522 0 550 7/1/2018
LUMBAL CORSET OPPO 52570013 17.573 16.736 0 0 7/1/2018
CANADIAN KRUCK "POL 52570016 632.102 602.002 0 369.05 7/1/2018
CORRUGATED TUBE "B 52570017 41.596 39.616 0 20.9 7/1/2018
KRUCK"POLICARE" 52570020 849.341 808.896 0 534.82 7/1/2018
TLSO 52570023 1,087,858 1,036,055 0 605 7/1/2018
QUADRIPOD 52570024 494.038 494.038 0 308.774 1/2/2015
WALKER "POLICARE' 52570025 1,489,590 1,418,657 0 830.06 7/1/2018
ADJUSTABLE ANKLE SUPP52570030 182.684 173.985 0 97.9 7/1/2018
COMPRESSION STOCKI 52570038 520.406 495.625 0 287.1 7/1/2018
SPIRO BALL 52570039 498.808 475.055 0 275 7/1/2018
SIGVARIS STOCKING C 52570040 1,180,828 1,124,598 0 319 7/1/2018
LUMBAL CORSET 2068
52570044 588,0 29 58 8.029 0 45 2,330 10/0 / 2015
TENNIS ELBOW BRACE 52570045 1,133,124 1,079,166 0 715 7/1/2018
LUMBAL CORSET (OXY S 52570046 613.374 584.166 0 385 7/1/2018
HOT/COLD PACK (OXY M52570047 51.501 51.501 0 27.5 ###
AIR STIRR UP ANKLE 52570048 2,154,361 2,154,361 0 1,650,000 ###
STOCKING VENOSAN UK52570049 802.134 763.937 0 583 9/6/2019
CERVICAL COLLAR FOA 52570050 163.997 156.187 0 115.5 ###
LUMBAL CORSET GLOBAL52570052 3,227,057 3,073,387 0 2,359,500 ###
TLSO BRACE XL 52572243 2,657,934 2,657,934 0 1,771,956 1/2/2015

DATE: 09/06/2020 RUMAH SAK PAGE: 76


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5262 CATGUT & SUTURES

N/A - SURGIPRO 7-0 52620073 111.35 106.048 0 71.583 ###


N/A - VICRYL 5/0 9105 52620086 111.51 111.51 0 79.65 1/2/2015
BIOSYN 3/0 "USSDG" (S 52620101 216.878 206.55 0 137.5 7/1/2018
CHROMIC GUT 0 "ETHIC 52620106 97.908 93.246 0 59.772 7/1/2018
CHROMIC GUT 0 "USSDG52620107 102.205 97.339 0 62.92 7/1/2018
CHROMIC GUT 1 "USSDG 52620108 102.467 97.588 0 57.75 7/1/2018
CHROMIC GUT 1 "ETHIC 52620109 142.359 135.58 0 103.675 ###
CHROMIC GUT 2/0 "ETH52620110 97.908 93.246 0 59.772 7/1/2018
CHROMIC GUT 2/0 "SYN52620111 112.977 107.598 0 64.9 7/1/2018
CHROMIC GUT 3/0 "USS52620112 92.896 88.473 0 56.1 7/1/2018
MERSILK BLACK 2/0 "ET 52620113 100.359 95.58 0 56.1 7/1/2018
MERSILK BLACK 3/0 "ET 52620114 92.225 87.833 0 51.296 7/1/2018
MONOCRYL 3.0 "ETHICO52620115 183.12 174.4 0 102.465 7/1/2018
POLYSORB 1 "USSDG" ( 52620124 186.753 177.86 0 104.5 7/1/2018
POLYSORB 2/0 "USSDG" 52620125 179.078 170.55 0 100.1 7/1/2018
POLYSORB 2/0 "USSDG" 52620126 155.698 148.284 0 86.9 7/1/2018
POLYSORB 3/0 "USSDG" 52620127 176.936 168.51 0 99 7/1/2018
POLYSORB 3/0 "USSDG" 52620128 169.979 161.885 0 107.8 7/1/2018
POLYSORB 4/0 "USSDG"52620129 215.024 204.785 0 136.4 7/1/2018
PROLENE 1 "ETHICON" 52620130 188.56 179.581 0 119.35 7/1/2018
PROLENE 2/0 "ETHICON"52620131 196.047 186.711 0 109.706 7/1/2018
PROLENE 3/0 "ETHICON 52620132 226.236 215.463 0 126.317 ###
PROLENE 4/0 "ETHICON 52620133 196.619 187.256 0 109.78 7/1/2018
PROLENE 5/0 "ETHICON 52620134 162.918 155.16 0 88.366 7/1/2018
SURGIPRO 1 "USSDG" ( 52620144 192.502 183.335 0 122.1 7/1/2018
SURGIPRO 2/0 "USSDG" 52620145 171.712 163.535 0 108.9 7/1/2018
SURGIPRO 3/0 "USSDG" 52620146 184.763 175.965 0 99 7/1/2018
SURGIPRO 4/0 "USSDG" 52620147 194.607 185.34 0 108.9 7/1/2018
SURGIPRO 5/0 "USSDG" 52620148 186.779 177.885 0 93.5 7/1/2018
SURGIPRO MESH 15x15 52620149 355.538 355.538 0 253.956 1/2/2015
VICRYL 0 "ETHICON" (W 52620150 149.298 142.189 0 83.27 7/1/2018
VICRYL 1 "ETHICON" (J3 52620151 217.973 207.593 0 121.99 7/1/2018
VICRYL 2/0 "ETHICON" 52620152 195.048 185.76 0 108.9 7/1/2018
VICRYL 2/0 "ETHICON" 52620153 145.409 138.485 0 81.277 7/1/2018
VICRYL 3/0 "ETHICON" 52620154 195.048 185.76 0 108.9 7/1/2018
VICRYL 3/0 "ETHICON" 52620155 122.265 116.443 0 77.259 7/1/2018
VICRYL 4/0 "ETHICON" 52620156 123.938 118.036 0 78.32 7/1/2018
BLACK SILK 3/0 "BBRAU 52620157 105.034 105.034 0 75.024 1/2/2015
BLACK SILK 4/0 "BBRAU 52620158 74.651 74.651 0 57.424 1/2/2015
DAFILON BLUE 4/0 "BB 52620160 123.116 117.253 0 68.849 7/1/2018
PREMILENE BLUE 6/0 " 52620164 238.225 226.881 0 68.849 7/1/2018
SILK 3/0 75CM "VIGILEN52620166 78.416 74.682 0 43.56 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 77


rptchgpr.p CHARGE PRICE LI TIME: 12:15:54
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
SILK 3/0 75CM "VIGILEN52620167 98.934 94.233 0 55.055 7/1/2018
SILK 2/0 75CM "VIGILEN52620168 71.937 68.511 0 39.93 7/1/2018
SURGICEL ABSORBABLE 52620171 207.284 197.413 0 115.94 7/1/2018
BONEWAX 2.5GR "ETHI 52620172 144.758 137.864 0 104.5 ###
SOFSILK 3-0 GS 832 52620173 97.214 92.585 0 61.6 7/1/2018
SOFSILK 2-0 GS-833 52620174 104.144 99.185 0 66 7/1/2018
SAFIL 1 HR 40s "BBRAU 52620175 160.791 160.791 0 107.194 1/2/2015
ETHILON 10/0 "ETHICON52620176 339.288 323.131 0 215.05 7/1/2018
SILK BLACK (SILKAM) 4 52620177 78.941 78.941 0 60.724 1/2/2015
SOFSILK 3/0 "SYNETURE"52620178 131.775 125.5 0 73.7 7/1/2018
SOFSILK 4/0 "SYNETURE"52620179 108.213 103.06 0 60.5 7/1/2018
BONE WAX 2.5G "BBRAU52620183 99.898 99.898 0 59.4 ###
LYOSTYPT 5X8CM (1069 52620184 286.165 272.538 0 206.8 ###
NNS SILKAM 3/0 13X60 52620185 105.034 105.034 0 75.024 1/2/2015
PREMICRON 2/0 2XHRT 52620186 268.511 255.725 0 193.875 ###
PREMICRON 3/0 2XHR 252620187 218.403 208.003 0 193.875 ###
PREMICRON 4/0 2XHRT 52620188 172.926 172.926 0 115.284 1/2/2015
PREMILENE 5/0 2XHRT 52620189 292.107 278.197 0 208.67 ###
PREMILENE 6/0 2XDRC 52620190 593.265 565.015 0 302.907 ###
PREMILENE 7/0 2XDRC 52620191 364.477 364.477 0 227.798 1/2/2015
PREMILENE 8/0 2XDRM 52620192 398.998 398.998 0 249.374 1/2/2015
SAFIL 2/0 HRT 37 "BBR 52620193 199.624 190.118 0 130.769 ###
SAFIL QUICK 4/0 DS 19 52620194 153.619 146.304 0 85.58 7/1/2018
SILKAM 0 DS 30 "BBRAU52620195 179.878 171.312 0 110.594 ###
SILKAM 1 HR 35 "BBRAU52620196 107.231 102.125 0 59.95 7/1/2018
SILKAM 3/0 HR 26 "BBR 52620197 126.745 120.709 0 78.771 ###
STAINLESS STEEL 3/0 H 52620198 836.046 796.234 0 468.246 ###
STAINLESS STEEL 5 HRS 52620199 796.148 758.236 0 468.246 ###
SOFSILK 0 "SYNETURE" 52620200 118.449 112.809 0 63.8 7/1/2018
PLAIN GUT 0 "SYNETURE52620201 98.425 93.738 0 55 7/1/2018
SOFSILK 2-0 "SYNETURE"52620202 133.739 127.37 0 74.8 7/1/2018
BIOSYN 4/0 "SYNETURE"52620203 204.153 194.431 0 129.25 7/1/2018
PLEDJET 3X7MM "SYNET52620204 527.54 502.419 0 294.8 7/1/2018
SURGIPRO 7/0 "SYNETUR52620206 332.493 316.66 0 185.9 7/1/2018
TICRON 2/0 "SYNETURE"52620207 224.908 214.198 0 121 7/1/2018
SILKAM 3/0 13 X60CM 52620208 148.141 141.086 0 82.5 ###
SILKAM 1 13X60CM "BB 52620211 163.946 156.139 0 89.1 ###
ETHILOOP 52620212 247.676 235.882 0 138.631 7/1/2018
PROLENE 4/0 "ETHICON 52620214 278.987 265.702 0 155.925 7/1/2018
NYLON TAPE "ETHICON"52620215 70.725 67.357 0 39.251 7/1/2018
MERSILK 2/0 "ETHICON"52620216 217.508 207.15 0 121.483 7/1/2018
PREMICRON 2/0 6X3 "B 52620217 1,847,692 1,759,707 0 1,030,678 7/1/2018
PREMICRON 2/0 3X3 "B 52620218 2,035,394 1,938,470 0 936.98 7/1/2018
SOFSILK 1 "SYNETURE" (52620220 114.104 108.67 0 63.8 7/1/2018
MERSILK 2/0 "ETHICON"52620221 157.349 149.856 0 87.78 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 78


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999
I/P O/P Compan y Cost Eff
Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
ETHIBON ROUND BODIED 52620222 383.184 363.937 0 214.299 7/1/2018
JARUM OTOT "TRITON" 52620224 4.751 4.525 0 2.291 7/1/2018
VICRYL 1/0 "ETHICON" 52620226 185.836 176.987 0 103.986 7/1/2018
SAFIL 3/0 DS 24 "BBRA 52620227 162.688 154.941 0 82.014 7/1/2018
SAFIL 4/0 DS 24 "BBRA 52620228 164.016 164.016 0 109.344 1/2/2015
VICRYL RAPIDE 2/0 "ET 52620229 147.056 140.053 0 82.014 7/1/2018
VICRYL 2/0 "ETHICON" 52620230 205.519 195.732 0 114.766 7/1/2018
SURGIGUT CHROMIC 4- 52620231 127.848 121.76 0 71.5 7/1/2018
SOFSILK 0 (SS-678) 52620232 128.073 121.974 0 66 7/1/2018
BENANG UV SUTURE 10 52620234 193.527 184.311 0 99 7/1/2018
PLAIN GUT 3.0 (GG-322 52620235 104.727 99.74 0 58.3 7/1/2018
POLYSORB 5.0 (SL-5687 52620236 186.753 177.86 0 104.5 7/1/2018
CATGUT PLAIN 3.0,75 C 52620237 81.162 77.297 0 46.585 7/1/2018
CATGUT PLAIN 2.0, 90 52620238 81.162 77.297 0 46.585 7/1/2018
CHROMIC 2-0 (CG-811) 52620239 130.132 123.935 0 82.5 7/1/2018
ASSUCRYL 1 "HRG 50" ( 52620241 167.019 159.066 0 93.17 7/1/2018
MERSILK 4.0 75 CM (W552620242 78.527 74.788 0 43.623 7/1/2018
MERSILK 3.0 75CM (W5 52620243 90.983 86.65 0 50.6 7/1/2018
COROLONE 4-0 CIRCLE 52620244 217.311 217.311 0 144.874 1/2/2015
COROLONE 3-0 CIRCLE 52620245 207.411 207.411 0 138.274 1/2/2015
COROLONE 3-0 CIRCLE 52620246 183.131 174.411 0 99 7/1/2018
COROLONE 2-0 CIRCLE 52620247 183.131 174.411 0 99 7/1/2018
FILAPEAU 3/0 (REF 873052620248 106.691 101.61 0 59.4 7/1/2018
FILAPEAU 4/0 (REF 870052620249 106.691 101.61 0 59.4 7/1/2018
COROLENE 6-0 3/8 TP, ( 52620250 245.501 233.811 0 143 7/1/2018
COROLENE 7-0 3/8 TP, ( 52620251 354.267 337.398 0 204.6 7/1/2018
PROLENE MESH 8X15CM52620252 1,007,354 959.385 0 559.9 7/1/2018
PLAIN GUT 4.0 (KOREA) 52620253 63.842 60.802 0 30.8 7/1/2018
PLAIN GUT 3.0 (CINA) 52620254 26.882 25.602 0 8.8 7/1/2018
SURGIPRO II 5-0 (VP-55652620255 231.914 220.87 0 129.8 7/1/2018
SURGIPRO VP-557X 4-0 52620256 275.111 262.01 0 154 7/1/2018
ACIER-2 (31763) A6010 52620257 714.793 680.755 0 396 7/1/2018
COROLENE 5/0 CS10H ( 52620260 243.553 231.955 0 132 7/1/2018
SURGIPRO 6-0 (VP-703X 52620261 308.49 293.8 0 172.7 7/1/2018
TICRON 3-0 (3256-41) 52620262 177.377 168.93 0 99 7/1/2018
TICRON 3-0 (3167-41) 52620263 206.829 196.98 0 115.5 7/1/2018
FLEXON 3-0 (2586-43) 52620264 548.598 548.598 0 330 ###
ASSUCRYL 2/0 HRG 50 ( 52620265 167.019 159.066 0 93.17 7/1/2018
POLYSORB 2-0 CL 923 52620266 177.762 169.297 0 99 7/1/2018
CATGUT PLAIN 3-0 76 52620267 71.076 71.076 0 41.8 ###
COROLENE 6-0 3/8 TP ( 52620268 337.398 337.398 0 210.874 1/2/2015
CHROMIC GUT 3/0 SG 6 52620270 108.668 103.494 0 61.05 7/1/2018
CHROMIC GUT 2-0 GG1 52620272 148.03 140.981 0 93.5 7/1/2018
CATGUT CHROMIC 3-0 T52620273 79.908 76.103 0 51.244 7/1/2018
VICRYL 2.0 J602H URG 52620274 213.751 203.572 0 119.625 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 79


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
SURGICAL STAINLESS S 52620275 1,997,958 1,997,958 0 1,248,724 1/2/2015
CHROMIC 3-0 GG122 "S 52620276 125.392 119.421 0 78.1 7/1/2018
SOFSILK 2-0 SS 679 CU 52620277 136.143 129.66 0 75.9 4/1/2019
PDS 6.0 (W9858T) "ETH 52620278 293.874 279.88 0 164.45 7/1/2018
PDS 5.0 (W9098H/Z101 52620279 193.8 184.571 0 108.386 7/1/2018
CHROMIC 4-0 UG203 CO52620280 130.521 124.306 0 82.5 7/1/2018
NYLON SINUSPOINT 850052620281 320.23 304.981 0 202.95 7/1/2018
SURGIPRO 6-0 VP 776X 52620282 294.719 280.685 0 187 7/1/2018
BENANG MERSILK 2-0 52620283 84.397 84.397 0 64.55 ###
COROLENE 5-0 (20S10H 52620284 193.105 193.105 0 138.6 ###
ACIER 6 (31764) 52620285 1,219,749 1,161,666 0 770 7/1/2018
FILASILK 3.0 (SLK30088 52620286 106.042 106.042 0 80.651 ###
SURGIPRO 2.0 VP-523 TAPPER
52620287 208,040 8.04 0 159,500 08/03/2017
SURGIPRO 4.0 VP 557X 52620288 258.09 258.09 0 198 3/8/2017
CATGUT CHROMIC 3/0 752620289 101.451 96.62 0 73.7 7/1/2018
ECOLANE 2.0 (R20RH26 52620290 180.685 172.081 0 132 7/1/2018
CATGUT CHROMIC 2/0 (C27RH370) VIGILENZ
52620291 93,714 0 71,500 13 /10/2017
SILK 2/0 S26-P150 PRE 52620292 66.56 66.56 0 50.6 ###
CATGUT CHROMIC 2/0 GR 37S 75CM BBRAUN
52620293 114,504 0 87,780 1 ###
ECOLANE 4.0 CUTTING ( 52620294 147.457 140.435 0 93.5 7/1/2018
ECOSYN 3.0 (Y37CD240)52620295 172.101 163.906 0 108.9 7/1/2018
T BOND ROUND BODIED52620296 112.778 112.778 0 86.152 1/8/2018
OPTIME 4/0 18S15E TAPER
52620297 110,604 110.604 0 84.48 ###
CHROMIC SUTURE 3/0 SMARTCARE
52620298 18,655 0.655 0 13,750 06/ Jul-18
FILASILK 3-0 (SLK305028) CUTTING
52620300 108,636 103,463 0 79, 200 06/08 18
FILASILK 2-0 (SLK200685) CUTTING
52620301 68,096 64,853 0 49, 500 06/08 18
CHROMIC 3/0 75CM O 52620302 7.909 7.533 0 5.601 ###
POLYSORB 4/0 GL-181 52620303 153.329 146.028 0 112.2 ###
PREMICRON 2/0 2XHRT 52620304 4,893,722 4,660,687 0 3,580,500 ###
PREMILENE 7/0 2X75CM52620305 1,765,496 1,681,425 0 1,288,760 ###
BENANG FSSB PGA 8/0 (52620306 450.978 429.503 0 330 ###
SILKAM 2/0 HR 26 "BBR 52620307 97.645 92.996 0 71.148 ###
SILKAM 3/0 DS 24 " BB 52620308 90.356 86.054 0 66.066 ###
PROLENE BLU 60CM 7.0 52620309 406.266 406.266 0 312.125 ###
POLYSORB 1-0 CL 905 52620310 195.369 186.066 0 143 ###
POLYSORB 5/0 UL 202 ( 52620311 165.341 157.468 0 121 2/7/2020

DATE: 09/06/2020 RUMAH SAK PAGE: 80


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5272 X-RAY FILMS & CHEMICALS

KODAK DVB FILM 8X10 I52720001 37.353 35.574 0 22.176 7/1/2018


KODAK DVB FILM 11X14 52720002 69.286 65.987 0 41.184 7/1/2018
KODAK DVB FILM 14X17 52720003 101.219 96.399 0 60.192 7/1/2018
Kodak DVB Film 14 x17 i 52720006 101.243 96.422 0 60.192 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 81


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5274 RADIOLOGY

IOPAMIRO 370/50ML 52740002 550.156 523.958 0 314.6 7/1/2018


IOPAMIRO 370/100ML 52740003 1,136,144 1,082,042 0 669.075 7/1/2018
IOMERON 400/100ML 52740004 1,036,180 986.838 0 603.9 7/1/2018
Microbar Powder 52740005 80.162 80.162 0 42.9 ###
OMNIPAQUE 300MGI/2 52740006 160.09 152.467 0 101.2 7/1/2018
OMNIPAQUE 300MGI/5 52740007 439.023 418.117 0 278.3 7/1/2018
OMNIPAQUE 350MGI/1 52740008 1,026,722 977.83 0 574.75 7/1/2018
OMNISCAN 0.5MMOL/152740009 658.613 627.25 0 621.259 7/5/2019
VISIPAQUE 320MGI/50 52740010 826.025 786.69 0 484 7/1/2018
IOPAMIRO 300/50ML 52740013 469.48 447.124 0 262.57 7/1/2018
IOPAMIRO 300/100 ML 52740014 855.71 814.962 0 502.15 7/1/2018
MULTIHANCE 10ML 52740016 621.938 592.322 0 363 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 82


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5299 Special Medical Supplies

SANIFRESH 52040204 57.02 54.305 0 27.5 7/1/2018


SOAPY CHLOROSCRUB 452040205 51.501 51.501 0 27.5 ###
DES XIENCE V "ABBOTH"52100018 37,752,09935,954,380 0 26,620,000 7/1/2018
DES XIENCE PRIME LL "A52100019 37,752,09935,954,380 0 26,620,000 7/1/2018
CS MULTILINK ULTRA "A52100020 20,160,30619,200,291 0 12,795,750 7/1/2018
CS MULTILINK MINI VIS 52100021 22,399,56221,332,916 0 14,217,500 7/1/2018
CS MULTILINK VISION "A52100022 23,079,05821,980,055 0 12,925,000 7/1/2018
BALLON VOYAGER "ABBO 52100023 8,732,598 8,732,598 0 5,445,000 ###
OTW VOYAGER "ABBOTH" 52100024 9,440,462 8,990,916 0 5,989,500 7/1/2018
BALLON POWERSAIL "ABB 52100025 9,169,228 8,732,598 0 5,989,500 7/1/2018
BALLON VOYAGER NC "A52100026 8,732,598 8,732,598 0 5,457,874 1/2/2015
SIROLIMUS ELUTING C 52100031 30,325,74928,881,666 0 19,250,000 7/1/2018
PROGREAT MICRO CATH52100034 11,460,59811,460,598 0 7,162,874 1/2/2015
RYUJIN OXYGENATOR S 52100035 13,220,59813,220,598 0 8,262,874 1/2/2015
TSUNAMI STENT "TERU 52100036 23,334,31322,223,155 0 13,068,000 7/1/2018
DES NOBORI STENT "T 52100037 32,762,49931,202,380 0 22,869,000 7/1/2018
GAZELLE STENT "BIOSEN52100038 15,729,62814,980,598 0 9,350,000 7/1/2018
DES BIOMATRIX A9 "BIO52100039 38,999,49937,142,380 0 27,500,000 7/1/2018
POWER LINE BALLON "BI52100040 9,261,628 8,820,598 0 5,500,000 7/1/2018
OTTIMMO BALLON "KANE 52100042 11,109,62810,580,598 0 6,600,000 7/1/2018
FORTIS HIGH PRESSURE 52100043 10,401,9999,906,666 0 6,600,000 7/1/2018
TORNUS CATHETER "ASA52100050 9,261,628 8,820,598 0 5,500,000 7/1/2018
THROMBUSTER "KANEK 52100054 16,697,68315,902,555 0 9,350,000 7/1/2018
ELECT CORONARY BALL 52100068 7,413,628 7,060,598 0 4,400,000 7/1/2018
BRIO BALLON PEGASSO 52100073 6,936,300 6,606,000 0 4,400,000 7/1/2018
MUSTANG "MICROPORT" 52100075 14,436,02813,748,598 0 8,580,000 7/1/2018
TANGO "MICROPORT" ( 52100076 22,470,37321,400,355 0 12,584,000 7/1/2018
FIRE BIRD 2 STENT "MI 52100077 31,396,59629,901,520 0 22,136,400 7/1/2018
DES JANUS OPTIMA "SO52100079 36,981,62835,220,598 0 22,000,000 7/1/2018
CHRONO COBALT CROME 52100092 18,501,62817,620,598 0 11,000,000 7/1/2018
PRO HP BALLON "SORIN52100093 8,337,628 7,940,598 0 4,950,000 7/1/2018
BALLON NC SPRINTER 52100107 10,401,9999,906,666 0 6,600,000 7/1/2018
MICRO/DRIVER STENT 52100108 19,827,26618,883,110 0 11,797,500 7/1/2018
DES ENDEAVOR RESOLU52100110 40,558,74938,627,380 0 31,460,000 7/1/2018
EXPORT ASPIRATION C 52100111 12,033,62811,460,598 0 7,150,000 7/1/2018
AGGRASTAT TIROFIBAN 52100112 9,825,433 9,357,555 0 5,500,000 7/1/2018
BROCKENBROUGH CURV52100113 8,820,598 8,820,598 0 5,512,874 1/2/2015
SENSIA SSI "MEDTRONI 52100118 30,308,42428,865,166 0 19,239,000 7/1/2018
SENSIA SR (SESR01) "M 52100119 39,854,49937,956,666 0 25,300,000 7/1/2018
INTRODUCER SHEATH 5 52100123 797.498 759.522 0 467.5 7/1/2018
DES GENOUS BIO ENGI 52100126 34,321,74932,687,380 0 25,300,000 7/1/2018
BMS BLAZER "ORBUSNE 52100127 14,100,59814,100,598 0 9,900,000 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 83


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
BALLON SAPPHIRE "OR 52100128 8,669,499 8,256,666 0 5,500,000 7/1/2018
BALLON SAPPHIRE NC " 52100129 12,033,62811,460,598 0 6,050,000 7/1/2018
BARE METAL CORONARY52100130 14,100,59814,100,598 0 8,000,000 ###
BIOMIME DES- COBALT 52100139 35,219,13035,219,130 0 22,011,956 1/2/2015
MEDTRONIC OFF PUMP 52200114 45,282,53345,282,533 0 43,126,222 7/1/2018
IAB CATHETER 8FR 30C 52200137 24,054,86822,909,398 0 14,305,500 7/1/2018
IAB CATHETER 8 FR, 40C52200138 24,054,86822,909,398 0 14,305,500 7/1/2018
KATUB MECHANICAL MI52200142 27,259,22427,259,224 0 17,303,000 7/1/2018
CARPENTIER EDWARD B52200143 34,540,56632,895,777 0 25,300,000 7/1/2018
ARTERIAL FILT 125 X 52300002 2,185,468 2,081,398 0 1,416,800 7/1/2018
TRILLIUM OXYGENATOR52300003 14,560,35013,867,000 0 9,900,000 ###
ZILFER BILIARY SELF 52300043 31,203,24929,717,380 0 22,000,000 7/1/2018
EVOLUTION CONTROLLE52300061 31,203,24929,717,380 0 22,000,000 7/1/2018
EVOLUTION CONTROLLE52300062 31,203,24929,717,380 0 22,000,000 7/1/2018
CAPTURA DISPOSABLE 52300075 29,806,48029,806,480 0 22,078,874 ###
GENIUS TAXCOR I (DES P52300077 31,067,38031,067,380 0 23,012,874 ###
STENT DES COROFLEX P 52300089 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX P 52300090 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX P 52300091 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX P 52300092 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX P 52300093 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX 3 52300094 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX P 52300096 35,122,60933,450,104 0 22,295,625 7/1/2018
AMPLATZER DELIVERY SY52300112 10,185,6289,700,598 0 6,050,000 7/1/2018
ASO (ALL SIZE) 52300113 42,897,62440,854,880 0 30,250,000 7/1/2018
AMPLATZER PDA OCCLUD 52300115 25,431,62824,220,598 0 15,125,000 7/1/2018
AMPLATZER DELIVERY SY52300117 10,185,6289,700,598 0 6,050,000 7/1/2018
STENT DES COROFLEX P 52300119 31,994,88031,994,880 0 23,662,874 ###
STENT DES COROFLEX P 52300120 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX P 52300121 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX P 52300122 35,122,60933,450,104 0 22,295,625 7/1/2018
STENT DES COROFLEX P 52300123 35,122,60933,450,104 0 22,295,625 7/1/2018
PANTERA BALLON (ALL 52300125 9,261,628 8,820,598 0 3,850,000 7/1/2018
BALLON RX MINI TREK (A52300126 8,582,874 8,174,166 0 5,445,000 7/1/2018
BALLON RX TREK (ALL SI 52300127 8,582,874 8,174,166 0 5,445,000 7/1/2018
DIDECO HAEMOCONCENT 52300133 3,196,751 3,044,525 0 2,332,000 7/1/2018
DIDECO COMPACTFLO E52300134 9,594,268 9,137,398 0 5,698,000 7/1/2018
BICARBON MITRAL MECH 52300135 27,705,39827,705,398 0 17,315,874 1/2/2015
DES CRE8 "CID" 52300137 33,594,62431,994,880 0 23,650,000 7/1/2018
BMS AVANGARDE "CID" 52300138 18,501,62817,620,598 0 11,000,000 7/1/2018
TISSUE HEART VALVE B 52300176 30,820,59830,820,598 0 19,262,874 1/2/2015
PAKET APOLLO REKA (A 52300208 18,501,62817,620,598 0 11,000,000 7/1/2018
FLUYDO BALLON (REKA) 52300210 7,060,598 7,060,598 0 4,400,000 ###
FLUYDO BALLON (REKA) 52300211 6,620,598 6,620,598 0 4,137,874 1/2/2015
DES "PROLIMUS" 52300216 31,203,24929,717,380 0 22,000,000 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 84


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
BMS "PRECISION" 52300217 12,033,62811,460,598 0 7,150,000 7/1/2018
PACLITAXEL DRUG ELUT 52300220 27,741,62826,420,598 0 16,500,000 7/1/2018
BALLON TAZUNA (ASKES52300221 10,420,59810,420,598 0 6,512,874 1/2/2015
BALLON TAZUNA (REGU 52300222 12,020,59812,020,598 0 7,512,874 1/2/2015
PANTERA LUX DEB (ALL 52300250 24,031,46624,031,466 0 14,300,000 7/1/2018
NEPHORSTOMY CATHETER SET
52373135 2,261,611 ,261,611 0 1,732,500 ###
RENOVISION NEPHROSTOMY PIGTAIL CATH KIT
52373136 1,120,861 0 855,000 27 Feb-17
ENDOTRACHEAL TUBE KK52900012 76.655 73.005 0 38.5 7/1/2018
ENDOTRACHEAL TUBE KK52900013 66.786 66.786 0 51.374 1/2/2015
INFUSION SET "STARDE 52900017 15.064 14.347 0 7.81 7/1/2018
NASAL CANULE ADULT 52900022 28.083 26.746 0 5.5 7/1/2018
NASAL CANULE PEADIAT52900023 28.083 26.746 0 5.5 7/1/2018
ENDOTRACHEAL TUBE KK52900030 66.786 66.786 0 51.374 1/2/2015
ENDOTRACHEAL TUBE KK52900031 66.786 66.786 0 51.374 1/2/2015
ENDOTRACHEAL TUBE NK 52900033 372.748 354.998 0 180.62 7/1/2018
ENDOTRACHEAL TUBE NK 52900038 408.034 388.604 0 180.62 7/1/2018
ENDOTRACHEAL TUBE NK 52900039 372.748 354.998 0 180.62 7/1/2018
Bisturi No 17 " Aescula 52900054 4.785 4.785 0 2.991 1/2/2015
Bisturi No 19 " Aescula 52900056 4.785 4.785 0 2.991 1/2/2015
STOMACH TUBE NO. 14 52900079 36.567 34.826 0 12.65 7/1/2018
STOMACH TUBE NO. 16 52900080 36.567 34.826 0 12.65 7/1/2018
STOMACH TUBE NO. 18 52900081 36.567 34.826 0 12.65 7/1/2018
HAND SCOON STERIL NO52900097 11.629 11.629 0 6.111 ###
THORACIC TROCAR 20CH52900565 368.431 350.887 0 201.96 7/1/2018
THORACIC TROCAR 24CH52900566 368.431 350.887 0 201.96 7/1/2018
THORACIC TROCAR 28CH52900567 368.431 350.887 0 201.96 7/1/2018
THORACIC TROCAR NO. 352900568 368.431 350.887 0 201.96 7/1/2018
ALKOHOL SWAB REMEDI52910000 1.617 1.54 0 220 ###
BLOOD SET REMEDI (BPJ52910001 16.959 16.152 0 12.672 ###
MASKER 3 PLY GREEN CO52910002 5.189 4.942 0 3.601 ###
SYRINGE 3CC ONEMED (52910011 2.468 2.35 0 770 7/1/2018
SYRINGE 5CC ONEMED (52910012 2.917 2.778 0 825 ###
URINE BAG REMEDI (BPJ52910014 15.371 14.639 0 4.95 7/1/2018
UNDERPAD TOP (BPJS) 52910020 9.323 8.879 0 3.245 7/1/2018
NACAL CANNULA NEONA52910021 46.968 44.731 0 24.75 7/1/2018
NASAL CANNULA PAEDIA52910023 21.122 20.116 0 7.7 7/1/2018
IV SET THERAPY NO. 18 52910024 40.114 38.204 0 19.877 7/1/2018
IV SET THERAPY NO. 20 52910025 40.114 38.204 0 16.625 7/1/2018
IV SET THERAPY NO. 22 52910026 41.669 39.685 0 16.625 7/1/2018
IV SET THERAPY NO. 24 52910027 40.114 38.204 0 19.877 7/1/2018
IV SET TERAPY NO. 26 POLYMED (BPJS)
52910028 41,597 0 20.042 ###
HANDSCOON STERIL NO.52910029 13.067 12.445 0 6.138 7/1/2018
HANDSCOON STERIL NO.52910030 13.067 12.445 0 5.5 7/1/2018
HANDSCOON STERIL 7.0 52910031 13.72 13.067 0 5.5 7/1/2018
HANDSCOON STERIL NO.52910032 15.125 14.405 0 5.5 7/1/2018

DATE: 09/06/2020 RUMAH SAK PAGE: 85


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
HANDSCOON STERIL NO.52910033 14.346 13.663 0 9.02 7/1/2018
MASKER NEBULIZER PEAD 52910038 51.13 48.695 0 24.2 7/1/2018
MASKER NON REBREATIN 52910039 45.114 42.966 0 24.2 7/1/2018
MASKER NON REBEATING 52910040 38.766 38.766 0 35.242 1/2/2015
SUCTION CATHETER 8 BI52910041 22.253 21.193 0 6.71 7/1/2018
SUCTION CATHETER 10 B52910042 20.936 19.939 0 6.05 7/1/2018
SUCTION CATHETER 12 52910043 22.253 21.193 0 6.71 7/1/2018
SUCTION CATHETER 14 B52910044 25.698 24.474 0 6.71 7/1/2018
SUCTION CATHETER 16 B52910045 22.253 21.193 0 6.71 7/1/2018
BREATHING CIRCUIT LIM52910050 272.592 259.611 0 192.5 7/1/2018
CATHETER MOUNT ALTEC 52910051 57.873 55.117 0 36.3 7/1/2018
THERMOVENT HEPA AL-52910052 72.461 69.01 0 40.15 7/1/2018
TRACHEOSTOMY FILTER 52910053 60.115 60.115 0 46.242 1/2/2015
ENDOTRACHEAL TUBE KK52910057 76.655 73.005 0 38.5 7/1/2018
ENDOTRACHEAL TUBE KK52910058 76.655 73.005 0 38.5 7/1/2018
ENDOTRACHEAL TUBE KK52910059 76.655 73.005 0 38.5 7/1/2018
ENDOTRACHEAL TUBE KK52910060 76.655 73.005 0 38.5 7/1/2018
ENDOTRACHEAL TUBE NK 52910061 291.476 277.596 0 180.62 7/1/2018
ENDOTRACHEAL TUBE NKK 52910062 291.476 277.596 0 180.62 7/1/2018
GUDEL AIRWAY SIZE 3 52910067 58.984 56.175 0 28.6 7/1/2018
GUDEL AIRWAY SIZE 4 52910068 58.984 56.175 0 28.6 7/1/2018
RECTAL TUBE NO. 20 BI 52910074 22.229 21.17 0 7.7 7/1/2018
RECTAL TUBE NO. 22 BI 52910075 22.229 21.17 0 7.7 7/1/2018
STOMACT TUBE NO. 14 B52910078 30.513 29.06 0 12.65 7/1/2018
STOMACT TUBE NO. 16 B52910079 30.513 29.06 0 12.65 7/1/2018
STOMACT TUBE NO. 18 B52910080 30.513 29.06 0 12.65 7/1/2018
SYRINGE 20CC ONEMED 52910081 8.418 8.018 0 1.892 ###
SYRINGE 50CC ONEMED 52910082 13.077 12.454 0 4.62 7/1/2018
DISP SUCTION BAG GREE52910092 109.685 104.462 0 69.19 ###
DISP SUCTION BAG WHIT52910093 108.115 102.967 0 68.2 7/1/2018
UMBILICAL CORD CLAMP52910116 3.15 3 0 1.452 7/1/2018
WOUND DRAIN 400ML M 52910128 236.413 225.155 0 132 7/1/2018
CUTICELL CLASSIC 10X1 52910136 22.622 22.622 0 18.852 1/2/2015
SYRINGE 50CC WITH CA 52910147 18.578 17.693 0 10.23 7/1/2018
AMAZONIA CRONO STEN52910149 9,548,195 9,093,519 0 0 7/1/2018
YANGTZE U BALLON (BPJ52910150 7,469,233 7,113,555 0 4,180,000 7/1/2018
AMAZONIA PAX STENT D52910151 16,529,40815,742,293 0 0 7/1/2018
OPTIME 1 18S40G (GDM52910152 187.587 178.654 0 104.72 7/1/2018
OPTIME 3/0 18S20K (G 52910153 135.376 135.376 0 96.697 ###
CHROMIC 1 C07358 (G 52910154 122.318 122.318 0 87.37 ###
CHROMIC 3/0 C07202 ( 52910155 103.685 103.685 0 74.061 ###
CHROMIC 2/0 C7250 (G 52910156 137.567 137.567 0 98.262 ###
OPTIME 2/0 18S30G (GD52910157 144.726 137.869 0 91.542 7/1/2018
OPTIME R 2/0 12S30AL 52910158 147.531 140.506 0 82.28 7/1/2018
ADVANTIME 3/0 15D20 52910159 184.156 184.156 0 131.54 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 86


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code
Price Price Pric e Price Date
------------------------------- --------
----------- ----------- ---------- - ----------- ----------
SILK 2/0 S25339 (GDM) 52910160 92.868 88.446 0 50.82 7/1/2018
COROLENE 4/0 20S15K 52910161 198.582 189.126 0 110.88 7/1/2018
OPTIME 0 18S35G (GDM52910162 161.472 153.783 0 90.09 7/1/2018
CAESAREAN SET (OB-21 52910163 240.603 240.603 0 171.859 ###
FOL CATH 3 WAY 20 REM52910165 71.479 68.075 0 39.6 7/1/2018
IV CATH PORT NO 18 PO52910167 20.93 19.933 0 13.2 7/1/2018
IV CATH PORT NO 20 PO52910168 20.93 19.933 0 13.2 7/1/2018
IV CATH PORT NO 22 PO52910169 20.93 19.933 0 13.2 7/1/2018
IV CATH PORT NO 24 PO52910170 20.93 19.933 0 13.2 7/1/2018
OMNIPAQUE 300/50ML 52910171 497.558 473.865 0 278.3 7/1/2018
OMNIPAQUE 350/100ML (BPJS)
52910172 872,643 31.088 0 638,000 21/11/2019
WASH GLOVE "EASY CARE 52910173 12.366 11.777 0 5.088 7/1/2018
GUDEL AIRWAY SIZE 2 L 52910174 58.984 56.175 0 28.6 7/1/2018
NASAL CANUL ADULT (B52910175 14.145 13.471 0 7.48 7/1/2018
XLIMUS DES (BPJS) 52910177 26,293,08025,041,029 0 19,250,000 7/1/2018
THREE WAY STOP COCK 52910178 28.256 26.911 0 15.73 ###
THREE WAY STOP COCK 52910179 28.237 26.892 0 15.73 7/1/2018
NASAL CANUL PEDIATRIK (BPJS)
52910183 11,325 0.325 0 7,480 22/0 Aug-16
MASKER NEBULIZER ADU52910184 51.13 48.695 0 24.2 7/1/2018
FOL CATH 2 WAY NO. 1652910186 25.828 24.598 0 14.025 7/1/2018
IV CATH PORT NO.26 PO52910187 25.885 24.652 0 16.346 7/1/2018
FOL CATH 2 WAY NO 14 52910189 25.828 24.598 0 14.025 7/1/2018
FOL CATH 2 WAY NO 18 52910190 25.828 24.598 0 14.025 7/1/2018
PAKET DIAGNOSTIK FEM52910191 1,667,876 1,588,453 0 990 7/1/2018
PAKET DIAGNOSTIK RAD52910192 1,667,970 1,588,543 0 990 7/1/2018
PAKET PCI FEMORAL 1 52910193 25,091,37023,896,543 0 18,370,000 7/1/2018
PAKET PCI RADIAL 1 BM 52910194 23,579,61622,456,777 0 17,270,000 7/1/2018
PAKET PCI FEMORAL 1D 52910195 33,647,17132,044,925 0 24,640,000 7/1/2018
PAKET PCI RADIAL 1 DES52910196 33,647,17132,044,925 0 24,640,000 7/1/2018
STOMACT TUBE NO. 16 (52910197 20.34 19.371 0 8.47 7/1/2018
STOMACT TUBE NO. 14 (52910198 23.036 21.939 0 8.47 7/1/2018
ELEKTROSURGICAL PENCI52910199 121.816 116.015 0 63.8 7/1/2018
ALPHAMED MONO GROUN 52910200 110.949 105.666 0 66 7/1/2018
MONO GROUNDING PAD52910201 249.549 237.666 0 154 7/1/2018
SKIN MARKER FINE TIP 52910203 98.968 94.255 0 55 7/1/2018
SUCTION CATHETER NO.52910204 20.936 19.939 0 6.05 7/1/2018
PRO KINETIC ENERGY C 52910205 10,524,07110,022,925 0 7,700,000 7/1/2018
LENSA AURO FLEX SPHERI52910206 613.374 584.166 0 385 7/1/2018
PANTERA CORONARY BA52910207 6,151,716 5,858,777 0 4,180,000 7/1/2018
CONCIERGE GUIDING C 52910208 1,739,499 1,656,666 0 1,100,000 7/1/2018
BASIC INFLATIN SYRING 52910209 1,635,191 1,557,325 0 1,188,000 7/1/2018
FOL CATH 2 WAY N0 12 CHROMA ( BPJS )
52910210 19,527 0 14.025 ###
LENSA AUROLENS PMMA52910212 162.924 155.166 0 99 7/1/2018
FOL CATH 3 WAY NO. 22 CHROMA (BPJS)
52910214 62,114 0 47,780 2 ###
FOL CATH 3 WAY NO. 24 CHROMA (BPJS)
52910215 62,114 0 47,780 2 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 87


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
PARTNER SIROLIMUS ST 52910216 13,168,92513,168,925 0 10,129,942 ###
HOPER PTCA BALLON (B 52910217 5,518,425 5,518,425 0 4,244,942 ###
PAKET BMS ALPHACARE (BPJS)
52910218 15,742,925 42.925 0 1 2,109,942 /11/2015
PAKET DES ALPHACARE (BPJS)
52910219 28,612,925 12.925 0 2 2,009,942 /11/2015
IOPAMIRO 370/100 (BPJ52910220 581.875 554.167 0 369.001 7/1/2018
HAND CONTROL ELEKTRO 52910221 162.924 155.166 0 99 7/1/2018
MONOPOLAR WIRELESS 52910222 P 163.425 155.643 0 77 7/1/2018
PAKET PCI FEMORAL TA 52910223 32,151,00030,620,000 0 23,540,000 7/1/2018
PAKET PCI RADIAL TAN 52910224 34,610,33332,962,222 0 23,540,000 7/1/2018
NASAL CANUL NEONATE52910225 23.402 22.288 0 16.5 ###
APRON FILM (BPJS) 52910226 3.455 3.455 0 2.658 ###
PAKET DIAGNOSTIK FEM52910227 2,228,284 2,122,175 0 1,622,500 7/1/2018
PAKET DIAGNOSTIK RADI52910228 2,735,687 2,605,416 0 1,732,500 7/1/2018
PAKET PCI FEMORAL DES52910229 27,926,45826,596,627 0 20,454,500 7/1/2018
PAKET PCI RADIAL DES B52910230 28,231,26126,886,915 0 20,672,300 7/1/2018
PAKET PCI FEMORAL BMS 52910231 24,859,71223,675,916 0 15,779,500 7/1/2018
PAKET PCI RADIAL BMS 52910232 20,823,71520,823,715 0 16,018,242 ###
STENT BIOMATRIX "BIOS52910233 21,034,57120,032,925 0 8,800,000 7/1/2018
ADMIRAL EXTREME BALL52910235 5,031,249 4,791,666 0 3,190,000 7/1/2018
CARBACHOL (MEDEQ)
52910236 87, 43 87.043 0 55,000 13/ 6 /2016
PTCA STENT BMS (BPJS) 52910237 10,401,9999,906,666 0 6,600,000 7/1/2018
PANTERA LEO NC (BPJS 52910238 5,711,766 5,439,777 0 4,180,000 7/1/2018
PAKET PCI FEMORAL DES TANPA BALLON & WIRE BP
52910239 27,900,543 27,
2,145, 000 06/04 16
PAKET PCI RADIAL DES TANPA BALLON & WIRE BP
52910240 27,900,543 0 21,450 ,000 06/04 16
PAKET PCI RADIAL BMS TANPA BALON & WIRE BPJS (MM)
52910242 19,749,543 19,
180,000 0 4/7/2016
HD CATH KIT DUAL LUMEN SORT TERM BIOTEQ
52910243 1,185,099 0 748,000 01 Jul-18
PAKET PCI FEMORAL BM52910244 25,994,49924,756,666 0 16,500,000 7/1/2018
MONOPOLAR PLATE WITH 52910245 156.216 148.777 0 110 7/1/2018
XOLMETRAS 350/100 ML52910246 794.595 756.757 0 561 7/1/2018
AMAZONIA SIR (BPJS)
52910247 16,460,54 3 16,460 0.543 0 12,650 ,000 09/06 2 16
YANGTZE NC BALLON (BPJS)
52910248 5,592,543 ,592,543 0 4,290,000 6/9/2016
PAKET AMAZONIA SIR+Y52910249 15,012,61114,309,153 0 8,800,000 7/1/2018
ENDOTRACHEAL TUBE NKK NO 6.5 BICAKCILAR
52910251 244,167 0 180,620 18 May-17
ULTRAVIST 370 100 JKN (84234257)
52910252 443,575 443,575 0 340, 000 26/09 16
XOLMETROS 300/50 ML 52910253 414.566 394.825 0 302.5 7/1/2018
PAKET DIAGNOSTIK RADI52910254 1,657,716 1,578,777 0 1,210,000 7/1/2018
PAKET DIAGNOSTIK FEM52910255 1,445,751 1,445,751 0 1,100,000 ###
FOL CATH 2 WAY NO. 10 CHROMA (BPJS)
52910256 55,289 0 0 ###
FOL CATH 2 WAY NO 8 52910257 68.824 65.546 0 45.76 ###
ACROSS CTO 52910258 3,948,043 3,948,043 0 3,025,000 ###
FEMALE CATHETER NO 16 (BPJS)
52910259 14,183 0.183 0 9,900 21/1 Jan-16
FEMALE CATHETER NO 14 (BPJS)
52910260 14,183 0.183 0 9,900 21/1 Jan-16
LUMBAL CORSET (OXY SP52910261 500.762 476.916 0 313.5 7/1/2018
PENCIL COUNTER MEID LINKET (BPJS)
52910263 123,001 123,001 0 82,5 00 24/01/ 7
WASH GLOVE PRO PROD52910264 9.539 9.539 0 4.813 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 88


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
BALLON MOZEC (BPJS) 52910265 3,426,699 3,263,523 0 2,500,300 7/1/2018
PAKET TINDAKAN PCI D 52910266 13,866,99913,206,666 0 8,800,000 7/1/2018
PAKET TINDAKAN PCI B 52910267 10,735,64810,735,648 0 8,250,990 ###
ETT NO. 6.0 CANACK (BPJS)
52910268 46,080 46.08 0 25,344 0 3/8/2017
ETT NO. 6.5 CANACK (BP52910269 46.08 46.08 0 25.344 3/8/2017
ETT NKK NO 6.0 CANACK (BPJS)
52910270 228,348 0.348 0 165,550 08 Mar-17
ETT NKK NO 6.5 CANACK (BPJS)
52910271 228,348 0.348 0 165,550 08 Mar-17
GUDEL SOFT CLEAR 2 70MM (BPJS)
52910272 50,198 98 0 2 8,512 08/0 2017
GUDEL SOFT CLEAR 3 80MM (BPJS)
52910273 46,427 7 0 28 ,512 16/05 18
EXTENTION TUBE 150CM52910274 17.423 17.423 0 13.2 3/8/2017
WOUND DRAIN 200ML NO 52910275 187.81 178.867 0 118.8 7/1/2018
BIOMIME (DES COBALT CR) BPJS
52910276 9,766,921 0.921 0 7, 500,900 04 Apr-17
THORACIC CATH WITH TROCAR 24FG SURU (BPJS)
52910277 345,411 0 25 8,500 28/0 2017
THORACIC CATH WITH TROCAR 28FG SURU (BPJS)
52910278 345,411 0 25 8,500 28/0 2017
DOUBLE LUMENT LONG TERM (CASCADE) BPJS
52910279 4,862,337 0 2,795,650 /01/2019
DOUBLE LUMENT LONG TERM (TAURUS) BPJS
52910280 6,137,944 0 3,730,650 1/5/2019
PAKET PCI DES ANGIOLITE (BPJS)
52910281 14,309,361 61 0 11,00 0,000 18/0 2017
PAKET PCI BMS ARCHITE52910282 10,409,36110,409,361 0 8,000,000 ###
DOUBLE LUMEN PALINDROME 23/40KIT 14.5 FR
52910283 5,229,934 0 4, 015,825 12 Jun-17
OCTENIC BODY WASH (B52910284 9.45 9 0 4.813 ###
FOL CATH 2 WAY NO 14 GEA (BPJS)
52910286 11,640 00 8 ,250 13/10 17
FOL CATH 2 WAY NO.16 GEA (BPJS)
52910287 11,640 00 8 ,250 13/10 17
FOL CATH 2 WAY NO 18 GEA (BPJS)
52910288 11,640 00 8 ,250 13/10 17
PAKET PCI EUCATECH (BPJS)
52910289 10,805,653 805.653 0 8,305,000 ###
EUCA LIMUS STENT DES (BPJS)
52910290 11,449,361 9.361 0 8 ,800,000 0 Dec-17
ENDOTRACHEAL TUBE NKK 4.5 BICAKCILAR BPJS
52910291 244,167 0 1 80,620 03/ /2018
ENDOTRACHEAL TUBE NKK 5.0 BICAKCILAR BPJS
52910292 244,167 0 1 80,620 26/ /2018
BALLON CATHETER EUCA52910294 4,514,329 4,299,361 0 3,300,000 7/1/2018
LAUNCHER GUIDING CATH. "MEDTRONIC" BPJS
52910295 1,926,861 0 1, 475,000 23 Feb-18
ENDOTRACHEAL TUBE KK 5.5 BICAKCILAR (BPJS)
52910296 58,892 0 3 8,500 30/0 2018
ENDOTRACHEAL TUBE NKK 52910297 252.885 240.843 0 180.62 ###
BALLON CATHETER ARMADA (ALL SIZE)
52910299 6,444,361 6,444,361 0 4,950,0 0 07/06/2018
BASIC INFLATION DEVICE KITS ANESMED
52910300 1,367,861 0 1,045,000 7/4/2018
BIOMIME MORPH- LONG STENT DES (BPJS)
52910301 14,956,687 0 11,500,500 ###
MUSTANG BALLON ALL SIZE
52910302 5,712,039 5,440,037 0 4,180,000 ###
PAKET PCI BIOMETRIX DES (BPJS)
52910303 10,731,037 37 0 8,25 0,000 06/0 2018
PAKET PCI IVASCULER (BPJS)
52910304 9,465,789 15.037 0 6,930,000 /09/2018
STENT BIOMATRIX ALPHA 52910305 9,015,339 8,586,037 0 6,600,000 ###
BALLON CATHETER FORTREK ALL SIZE (BPJS)
52910306 5,712,039 0 4 ,180,000 2 Oct-18
BALLON CAHTEHER EVERCROS ALL SIZE (BPJS)
52910307 5,712,039 0 4, 180,000 220/2018
HANDSCOON STERIL PD 52910308 12.139 11.561 0 8.8 ###
HANDSCOON STERIL PD 52910309 12.139 11.561 0 8.8 ###
HANDSCOON STERIL PD 52910310 12.139 11.561 0 8.8 ###
DOUBLE LUMEN POLIND52910311 5,229,934 5,229,934 0 4,015,825 ###
UNIVERSAL DRAPE TARAF 52910312 855.437 814.702 0 622.05 2/8/2019

DATE: 09/06/2020 RUMAH SAK PAGE: 89


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
HD CATH CURVE SORTT 52910313 1,057,389 1,007,037 0 770 2/1/2019
DOUBLE LUMEN POLIND52910314 5,490,397 5,228,950 0 4,015,825 ###
DOUBLE LUMEN POLIND52910315 5,487,940 5,226,610 0 4,015,825 ###
PENCIL CUTTER CARELU 52910316 81.414 77.537 0 55 ###
PENCIL HARUM PEN (XY 52910317 75.392 71.802 0 55 ###
EXPERIENCE BALLON " I 52910318 2,258,589 2,151,037 0 1,650,000 ###
ENVIROS DES STENT "IV 52910319 8,264,589 7,871,037 0 6,050,000 ###
ELEKTROSURGERY PENC52910320 67.884 64.652 0 49.5 ###
PAKET INDEFLATOR BB 52910321 1,473,714 1,403,537 0 1,075,000 ###
PAKET CAG (DIAGNOSTI 52910322 1,492,824 1,421,737 0 1,089,000 ###
PAKET CAG (DIAGNOSTIK52910323 1,492,824 1,421,737 0 1,089,000 ###
BALLON "POWERLINE" ( 52910325 3,009,339 2,866,037 0 2,200,000 ###
STENT GENOSS DES "GE 52910326 11,567,88911,017,037 0 8,470,000 ###
BALLON GENOSS/ GENO52910327 2,483,814 2,365,537 0 1,815,000 ###
PAKET PCI COROFLEX DE52910328 11,335,83910,796,037 0 8,300,000 3/3/2020
STENT COROFLEX ALL SIZ52910329 9,561,339 9,106,037 0 7,000,000 3/3/2020
BALLON SEQUENT NEO A 52910330 3,009,339 2,866,037 0 2,200,000 3/3/2020

DATE: 09/06/2020 RUMAH SAK PAGE: 90


rptchgpr.p CHARGE PRICE LI TIME: 12:15:55
GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5301 NURSING CARE

BUBBLE C-PAP / HARI 53010050 900 900 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : PKG PACKAGE DEAL

APD 1 (CATHLAB) 52100169 992.638 992.638 0 0 ###


APD 2 (CATHLAB) 52100170 444.665 444.665 0 0 ###
PAKET APD 3 (HMD) 52120198 1,367,554 1,367,554 0 0 ###
APD ODP 52373177 10.006 10.006 0 0 ###
APD PDP 52373178 425 425 0 0 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 92


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

GROUP : 53 SERVICES CHARGE

TYPE : 5301 NURSING CARE

KOMPRES HANGAT DIN 53010010 10 10 0 0 ###


MEMANDIKAN BAYI 53010011 20 20 0 0 ###
BANDAGING & ARM SLI 53010012 10 10 0 0 ###
MEMANDIKAN PASIEN 53010013 15 15 0 0 ###
MEMANDIKAN PASIEN D53010014 10 10 0 0 ###
MEMANDIKAN PASIEN K53010015 20 20 0 0 ###
BREAST CARE - PER DAY 53010016 15 15 0 0 ###
BREAST FEEDING COUNS53010017 15 15 0 0 ###
CATHETER CARE - PER 53010031 15 15 0 0 ###
CHEST PHYSIO - PER DA 53010032 20 20 0 0 ###
COLOSTOMY CARE - PER53010033 35 35 0 0 ###
PERAWATAN TALI PUSAT53010034 15 15 0 0 ###
PERAWATAN TELINGA - 53010036 15 15 0 0 ###
GASTROSTOMY FEEDING53010037 10 10 0 0 ###
HAIR WASH - PER DAY 53010039 30 30 0 0 ###
MOUTH TOILET - PER D 53010040 10 10 0 0 ###
NGT FEEDING - PER DAY53010041 10 10 0 0 ###
Vulva Hygienes 53010043 10 10 0 0 ###
MIRING KANAN - MIRING53010044 10 10 0 0 ###
POST NATAL CARE - 8 53010045 10 10 0 0 ###
VITAL SIGNS/TTV 53010048 15 15 0 0 ###
VULVAL SWABBING - PER53010049 15 15 0 0 ###
JASA DOKTER PAKET M 53020152 30.834 30.834 0 0 ###
ASISTEN DOKTER 53020153
JASA DOKTER PA (EKST 53020154
JASA DOKTER 53020155
DISCOUNT (NURSING P 53999998
MISCELLANEOUS (NURS 53999999 11 11 0 0 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 93


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5302 NURSING PROCEDURE

IRIGASI SALURAN KENC 53020013 15 15 0 0 ###


PASANG TRANSFUSI DA 53020015 30 30 0 0 ###
PERAWATAN LUKA BAKA53020016 50 50 0 0 ###
PERAWATAN LUKA BAKA53020017 25 25 0 0 ###
PEMASANGAN INFUS 53020019 25 25 0 0 ###
PEMASANGAN CATHETE53020020 25 25 0 0 ###
CODE BLUE / RESUSITA 53020022 100 100 0 0 ###
COLLAR & CUFF 53020023 18 18 0 0 ###
GANTI VERBAND BESAR 53020028 25 25 0 0 ###
GANTI VERBAND KECIL 53020029 20 20 0 0 ###
EYE IRRIGATION / SPOO 53020032 10 10 0 0 ###
PERAWATAN MATA 53020033 10 10 0 0 ###
PASANG RECTAL TUBE 53020034 20 20 0 0 ###
BILAS LAMBUNG DEWA 53020035 20 20 0 0 ###
BILAS LAMBUNG ANAK 53020036 30 30 0 0 ###
JASA SUNTIK PERAWAT 53020037 25 25 0 0 ###
JASA VAKSINASI 53020038 25 25 0 0 ###
PEMSANGAN NGT 53020039 30 30 0 0 ###
INSETION OF CHEMO P 53020040 30 30 0 0 ###
MEMBANTU BAB 53020041 20 20 0 0 ###
IRIGASI HIDUNG 53020042 20 20 0 0 ###
JASA INHALASI RAWAT 53020043 25 25 0 0 ###
INHALASI - R.JALAN 53020044 20 20 0 0 ###
CABUT TAMPON HIDUN53020046 10 10 0 0 ###
CABUT ARTERIAL LINE 53020048 30 30 0 0 ###
CABUT CVP LINE 53020049 30 30 0 0 ###
JASA PERAWAT AFF DRA53020050 25 25 0 0 ###
JASA PERAWAT AFF FEM53020051 30 30 0 0 ###
JASA PERAWAT PASAN 53020052 30 30 0 0 ###
JASA PERAWAT CABUT 53020053 20 20 0 0 ###
JASA CUKUR 53020054 25 25 0 0 ###
SHORTENING OF DRAIN 53020055 10 10 0 0 ###
INHALATIONS UAP / A 53020059 20 20 0 0 ###
STOMACH WASHOUT (A53020060 20 20 0 0 ###
STOMACH WASHOUT (P53020061 25 25 0 0 ###
SUCTION (CLEAN) 53020062 20 20 0 0 ###
SUCTION (STERILE) - 8 H53020063 25 25 0 0 ###
URINE TAMPUNG 24 JA 53020066 15 15 0 0 ###
VAGINAL EXAMINATION53020067 25 25 0 0 ###
GANTI PERBAN 53020068 35 35 0 0 ###
SERVICES CHARGE - KLS 53020069 100 100 0 0 4/1/2013
SERVICES CHARGE - KLS 53020070 200 200 0 0 4/1/2013

DATE: 09/06/2020 RUMAH SAK PAGE: 94


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
SERVICES CHARGE - KLS 53020071 300 300 0 0 4/1/2013
SERVICES CHARGE - VIP 53020072 400 400 0 0 4/1/2013
SERVICES CHARGE - SVI 53020073 500 500 0 0 4/1/2013
ICU-PERASAT PER HARI 53020075 40 40 0 0 ###
NURSING PROCEDURE 53020076
NURSE PROCEDURE-NIC53020077 50 50 0 0 ###
PERAWATAN GASTROST53020078 20 20 0 0 ###
JASA PERAWAT TINDAK 53020079 20 20 0 0 ###
JASA PERAWAT TINDAK 53020080 35 35 0 0 ###
JASA PERAWAT TINDAK 53020081 20 20 0 0 ###
JASA PERAWAT TINDAK 53020082 30 30 0 0 ###
JASA PERAWAT TINDAK 53020083 30 30 0 0 ###
JASA PERAWAT TINDAK 53020084 15 15 0 0 ###
JASA PERAWAT TINDAK 53020085 15 15 0 0 ###
JASA PERAWAT TINDAK 53020086 150 150 0 0 ###
JASA PERAWAT TINDAK 53020087 35 35 0 0 ###
JASA PERAWAT TINDAK 53020088 15 15 0 0 ###
JASA PERAWAT TINDAK 53020089 15 15 0 0 ###
JASA PERAWAT TINDAKA53020090 15 15 0 0 ###
JASA PERAWAT TINDAKA53020091 15 15 0 0 ###
JASA PERAWAT TINDAK 53020092 20 20 0 0 ###
JASA PERAWAT ASS PA 53020093 20 20 0 0 ###
JASA PERAWAT OBS PAS53020094 100 100 0 0 ###
JASA PERAWAT OBS IAB 53020095 15 15 0 0 1/2/2012
JASA PERAWAT TINDAK 53020096 15 15 0 0 ###
JASA PERAWAT ASS PA 53020097 15 15 0 0 ###
JASA PERAWATAN CDL 53020098 25 25 0 0 ###
JASA PERAWATAN PEM 53020099 250 250 0 0 1/1/2012
JASA PERAWATAN PEMA53020100 250 250 0 0 1/1/2012
JASA PERAWAT PEMAS 53020101 250 250 0 0 1/1/2012
JASA PERAWAT PEMAS 53020102 250 250 0 0 1/1/2012
JASA PERAWAT PEMAS 53020103 250 250 0 0 1/1/2012
JASA PERAWAT PEMAS 53020104 20 20 0 0 ###
JASA PERAWAT ASISTE 53020105 20 20 0 0 ###
JASA PERAWAT ASISTEN53020106 20 20 0 0 ###
JASA PERAWAT ELEKTRO53020107 20 20 0 0 ###
JASA PERAWAT CARDIO 53020108 20 20 0 0 ###
JASA PERAWAT ASS PAS 53020109 20 20 0 0 ###
JASA PERAWAT PASANG53020110 20 20 0 0 ###
JASA PERAWAT SETTING53020111 100 100 0 0 ###
JASA PERAWAT ASS HEC53020112 25 25 0 0 ###
JASA PERAWAT ASS HEC53020113 20 20 0 0 ###
NURSING PROSEDUR UG53020114 10 10 0 0 ###
NURSING PROSEDUR UG53020115 20 20 0 0 ###
NURSING PROSEDUR UG53020116 30 30 0 0 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 95


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
JASA PERAWAT ASS BE 53020117 20 20 0 0 ###
JASA PERAWAT REVER P53020118 25 25 0 0 ###
JASA EKG HOLTER 53020119 40 40 0 0 ###
JASA GDS 53020120 10 10 0 0 ###
JASA PENKESPOS KATA 53020122 10 10 0 0 ###
JASA DENTAL X-RAY 53020123 35 35 0 0 ###
JASA SKIN TEST A B STR 53020124 20 20 0 0 ###
JASA ASSISTEN BEDAH 53020125 50 50 0 0 ###
JASA PERAWAT AFF CA 53020126 25 25 0 0 ###
JASA PERAWAT AFF INF 53020127 25 25 0 0 ###
JASA ASS.NS.POLI I 53020128 20 20 0 0 1/1/2012
JASA ASS.NS.POLI II 53020129 35 35 0 0 1/1/2012
JASA ASS.NS.POLI III 53020130 50 50 0 0 1/1/2012
Asisten Angiografi Coro 53020131 150 150 0 0 2/1/2012
Asisten Angiografi Carot53020132 150 150 0 0 2/1/2012
ASISTEN TPM 53020133 250 250 0 0 2/1/2012
ASISTEN PEMASANGAN 53020134 250 250 0 0 2/1/2012
JASA BIDAN ASISTEN D 53020135 100 100 0 0 7/1/2012
JASA MENOLONG BUANG 53020136 7.5 7.5 0 0 2/3/2012
JASA ASISTEN DOKTER 53020137 20 20 0 0 2/3/2012
Asisten Penyadapan 53020138 150 150 0 0 2/1/2012
JASA ASISTEN DOKTER R53020139 25 25 0 0 2/3/2012
JASA RESUSITASI BBL 53020140 40 40 0 0 2/3/2012
JASA BIDAN DOPLER 53020141 50 50 0 0 2/3/2012
Jasa Monitoring perawat53020142 50 50 0 0 2/3/2012
JASA PERAWAT DIALYSIS53020143 50 50 0 0 2/3/2012
JASA BIDAN CTG GEMEL53020144 75 75 0 0 2/3/2012
Jasa Monitoring perawat53020145 80 80 0 0 2/3/2012
JASA BIDAN PERSALIN 53020146 100 100 0 0 2/3/2012
JASA PERAWAT DIALYSIS53020147 100 100 0 0 2/3/2012
SPECIAL PROCEDURE 53020148 150 150 0 0 9/1/2012
KONSELING ASI 53020149 25 25 0 0 ###
ASISTEN CATHLAB DIAG 53020150
ASISTEN CATHLAB THER 53020151
SERVICE CHARGE SVIP ( 53020156 300 300 0 0 ###
SERVICE CHARGE VIP (I 53020157 300 300 0 0 ###
SERVICE CHARGE ICU (I 53020158 300 300 0 0 ###
SERVICE CHARGE KELAS 53020159 150 150 0 0 ###
SERVICE CHARGE KELAS 53020160 150 150 0 0 ###
SERVICE CHARGE KELAS 53020161 150 150 0 0 ###
SERVICE CHARGE-VIP BP53020162 300 300 0 0 ###
SERVICE CHARGE ISOLAS53020163 100 100 0 0 ###
SERVICE CHARGE ISOLAS53020164 100 100 0 0 ###
SERVICE CHARGE ISOLAS53020165 100 100 0 0 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 96


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5303 NURSING SERVICE

TINDIK 53030001 60 60 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5305 ASSIST DR'S PROCEDURE

ASISTEN ENDOSCOPY 1 53050001 240 240 0 0 ###


ASISTEN ENDOSCOPY 2 53050002 200 200 0 0 ###
ENDOSCOPY THT RIGID 53050003 150 150 0 0 ###
ENDOSCOPY FLEXIBEL T 53050004 150 150 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

GROUP : 54 MEDICAL EQUIPMENT

TYPE : 5401 NEURO

DISCOUNT (MEDICAL E 54999998

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5403 OPTHAMOLOGY

AUTOREFRAKTOMETRI 54030001 100 100 0 0 7/1/2018


TONOMETRI NON CONT54030002 125 125 0 0 2/6/2019
SLIT LAMP 54030003 110 110 0 0 2/6/2019
PHACO MACHINE 54030004 2,562,500 2,500,000 0 0 ###
MICROSCOPE MATA 54030005 2,562,500 2,500,000 0 0 ###
ISIHARA / BUTA WARNA54030006 60 60 0 0 ###
KOREKSI VISUS MATA 54030007 85 85 0 0 ###
FLORESIN TEST 54030008 85 85 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5406 PLASTIC

LINEN RUANGAN I 54060001 30 30 0 0 ###


LINEN RUANGAN II 54060002 75 75 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5410 UROLOGY

TUR-P 54100001 2,500,000 2,500,000 0 0 ###


URS 54100002 2,500,000 2,500,000 0 0 ###
SACHSE 54100003 1,025,000 1,025,000 0 0 ###
LITHOTRIPSI/LITHOCLAS54100004 2,500,000 2,500,000 0 0 ###
CYTOSCOPY 54100005 2,500,000 2,500,000 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5412 MEDICAL EQUIPMENT

SEWA ALAT DOKTER IN 54120001


SEWA ALAT DOKTER EX 54120002
ALAT DOKTER INTERNAL54120005
ALAT DOKTER EXTERNA 54120006
INSTRUMENT OPERATI 54120007
EEG 54120008 1,000,000 1,000,000 0 0 4/6/2017
SEWA ALAT ENDOSCOPY54120009 1,600,000 1,600,000 0 0 ###
SEWA ALAT ENDOSCOPY54120010 2,050,000 2,050,000 0 0 ###
C-ARM 54120012 666.25 650 0 0 ###
HIGH SPEED DRILL 54120013 1,097,263 1,070,500 0 0 ###
ELECTRO SURGICAL CAU54120014 307.5 300 0 0 ###
STERNAL SAW 54120015 1,665,625 1,625,000 0 0 ###
TEMPORARY PACE MAK 54120016 307.5 300 0 0 ###
ICU - VENA SECTI SET P 54120017 46.92 46.92 0 0 7/1/2018
ICU - WSD SET PER HARI54120018 110.4 110.4 0 0 7/1/2018
ICU - INTRA ARTERIAL 54120019 207 207 0 0 7/1/2018
ICU - DEFIBRILATOR PER54120020 862.5 862.5 0 0 7/1/2018
ICU - DRESSING SET PER 54120021 28.98 28.98 0 0 7/1/2018
ICU - BLOOD WARMER 54120022 85.56 85.56 0 0 7/1/2018
ICU - VIGILANT / CCO 54120023
ICU - WARMER 54120024 207 207 0 0 7/1/2018
SYRING PUMP - NICU / 54120025 73.288 71.5 0 0 ###
INFUS PUMP - NICU / H 54120026 73.288 71.5 0 0 ###
MONITOR - NICU / HARI54120027 51.25 50 0 0 ###
VENTILATOR - NICU / H 54120028 719.55 702 0 0 ###
BIBLE C PAP - NICU / HA 54120029 1,025,000 1,000,000 0 0 ###
INKUBATOR - NICU / HA 54120030 492 480 0 0 ###
OKSIGEN - NICU / HARI 54120031 307.5 300 0 0 ###
NEBULEZER - NICU / HA 54120032 66.625 65 0 0 ###
SARUNG 54120033 43.05 42 0 0 ###
SEWA CAUTER RS 54120034 56.375 55 0 0 ###
SEWA SIRKUMSISI SET 54120035 25 25 0 0 ###
SEWA MESIN PHACO 54120036 1,947,500 1,900,000 0 0 ###
SEWA MESIN MICROSC 54120037 1,640,000 1,600,000 0 0 ###
SEWA SET TONSIL 54120038 26.384 25.74 0 0 ###
SEWA ALAT UROLOGI 54120039 2,000,000 2,000,000 0 0 ###
SEWA BED EXTRA 54120040 150 150 0 0 ###
SEWA MATRAS EXTRA 54120041 50 50 0 0 ###
SEWA ALAT PHACO EXT 54120042 1,100,000 1,100,000 0 0 ###
SEWA VENTILATOR MOBI54120043 750 363
ELEKTRO SURGICAL CAU54120044 4,375,000 4,375,000 0 0 ###
ELEKTRO SURGICAL CAUT54120045

DATE: 09/06/2020 RUMAH SAK PAGE: 103


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
SEWA ALAT ENDOSCOPY54120047 500 500 0 0 ###
SEWA ALAT GASTROSCO54120048 400 400 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5413 MONITORING EQUIPMENT

ICU- MONITOR 54130001 207 207 0 0 7/1/2018

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5414 PUMPS

ICU- SYRING PUMP PER 54140001 98.67 98.67 0 0 7/1/2018


ICU-INFUS PUMP PER H 54140002 98.67 98.67 0 0 7/1/2018
ICU-NEBULIZER PER HAR54140003 89.7 89.7 0 0 7/1/2018
ICU-SUCTION PUMP PER54140004 44.16 44.16 0 0 7/1/2018
SYRING PUMP PER HARI 54140005 60.568 59.091 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5415 HEATER/WARMER

INKUBATOR 54150001 256.25 250 0 0 ###


FASILITAS KAMAR BERS 54150002 71.75 70 0 0 ###
SINGLE BLUE LIGHT 54150003 102.5 100 0 0 ###
DOUBLE BLUE LIGHT 54150004 307.5 300 0 0 ###
GELAS ASI (PINJAM PAK 54150005 10.25 10 0 0 ###
GELAS ASI (BAWA PULA 54150006 25.625 25 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5416 THERAPY


CPM 54160001 125 125 0 0 ###
CRYOTHERAPY 54160002 95 95 0 0 ###
STATIC BICYCLE 54160003 95 95 0 0 ###
ICU - CRRT PRISMA 54160004 10,212,00010,212,000 0 0 7/1/2018

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5417 SUPPORT EQUIPMENT

ICU - KASUR DECUBITUS54170001 115.23 115.23 0 0 7/1/2018


DIALISER LOPS 15 54170002 160.515 156.6 0 0 ###
AV FISTULA 54170004 6.919 6.75 0 0 ###
LARUTAN DIALISA HDM 54170005 66.728 65.1 0 0 ###
LARUTAN DIALISA BICA 54170006 76.629 74.76 0 0 ###
SEWA ALAT BUBEL C-PA 54170008
SEWA ALAT C-PAP 54170009 410 400 0 0 ###
SEWA HEAD MASK C-PA 54170010 2,050,000 2,000,000 0 0 ###
SEWA INKUBATOR 54170011 492 480 0 0 ###
SEWA VACUM 54170012 102.5 100 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5419 MEDICAL GAS

OXYGEN PER HOUR 54190002 5.125 5 0 0 ###


ICU- VENTILATOR PER H 54190003 968.76 968.76 0 0 7/1/2018
ICU-OXYGEN PER HARI 54190004 570 570 0 0 7/1/2018
OKSIGEN INPATIEN /24 54190005 112.91 112.91 0 0 7/1/2018
NITROGEN (N20) PER J 54190006 46.23 46.23 0 0 7/1/2018
AIR BREATHING GAS 54190007 28.98 28.98 0 0 7/1/2018
CO2/LITER 54190009 17.25 17.25 0 0 7/1/2018
ICU - PEMAKAIAN OKSI 54190010 23.115 23.115 0 0 7/1/2018
GAS CO2 (CHOLESISTE 54190011 15 15 0 0 7/1/2013

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5420 CARDIAC EQUIPMENT

ICU-EKG PER HARI 54200001 103.5 103.5 0 0 7/1/2018


INTRA AORTIC BALLOON54200002 2,070,000 2,070,000 0 0 7/1/2018
HEART LUNG MECHINE 54200003 2,562,500 2,500,000 0 0 ###
EKG HOLTER 54200004 410 400 0 0 ###
CARDIAC OUTPUT MONIT54200005 1,785,550 1,742,000 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5421 CATHERIZATION LABORATORY

CARDIAC INSTRUMENT 54210001 2,050,000 2,000,000 0 0 ###


ANIOGRAFI 54210002

DATE: 09/06/2020 RUMAH SAK PAGE: 112


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

GROUP : 55 SPECIAL DIAGNOSTIC

TYPE : 5501 CARDIOLOGY

DISCOUNT (SPECIAL DI 55999998

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5511 ENDOSCOPY SERVICES

BRONCHOSCOPY 55110001 1,100,000 1,100,000 0 0 5/1/2011


GASTROSCOPY - PROF J 55110002 1,100,000 1,100,000 0 0 5/1/2011
GASROSCOPY THERAPEUT 55110003 1,750,000 1,750,000 0 0 5/1/2011
ERCP 55110004 2,500,000 2,500,000 0 0 5/1/2011
ERCP THERAPEUTIC 55110005 5,000,000 5,000,000 0 0 5/1/2011
COLONOSCOPY - PROF J 55110006 1,500,000 1,500,000 0 0 5/1/2011
COLONOSCOPY THERAPEU 55110007 1,800,000 1,800,000 0 0 5/1/2011
RECTO-SIGMOIDESCOPY55110008 1,000,000 1,000,000 0 0 5/1/2011
BIOPSI HATI & ASPIRASI 55110009 1,800,000 1,800,000 0 0 5/1/2011
PUNGSI ASITES IP 55110010 1,000,000 1,000,000 0 0 5/1/2011
TINDAKAN ENDOSCOPY 55110011 500 500 0 0 5/1/2011
ANASTHESI UPPER TRAC55110012 400 400 0 0 5/1/2011
ANASTHESI LOWER TRAC55110013 400 400 0 0 5/1/2011
ANASTHESI UPPER AND 55110014 700 700 0 0 5/1/2011
ANASTHESI ERCP 55110015 1,000,000 1,000,000 0 0 5/1/2011
GASTROSCOPY - DR HAI 55110016 1,100,000 1,100,000 0 0 ###
COLONOSCOPY THERAPE55110017 1,800,000 1,800,000 0 0 ###
COLONOSCOPY - DR HA 55110018 1,500,000 1,500,000 0 0 ###
GASTROSCOPY THERAPEU 55110019 1,750,000 1,750,000 0 0 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 114


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TYPE FROM 5100 TO 5999
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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

GROUP : 56 STERILE SUPPLIES

TYPE : 5601 CSSD SETS

INSTRUMEN STERIL RA 56010065 80 80 0 0 ###

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : 5602 CSSD SUPP. INST

KABEL TPM 56020180 2,504,700 2,504,700 0 1,800,000 ###

DATE: 09/06/2020 RUMAH SAK PAGE: 116


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TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

GROUP : 58 OPERATION THEATRE

TYPE : 5801 MAJOR OPERATION

DOKTER BEDAH OPERASI58010111 1,363,637 1,363,637 0 0 1/1/2010


DOKTER ANESTESI OPERA
58010112 545.455 545.455 0 0 1/1/2010
KAMAR OPERASI SEDANG58010113 800 800 0 0 6/1/2011
DOKTER BEDAH OPERASI58010114 1,500,000 1,500,000 0 0 1/1/2010
DOKTER ANESTESI OPERA
58010115 600 600 0 0 1/1/2010
KAMAR OPERASI SEDANG 58010116 1,050,000 1,050,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010117 1,750,000 1,750,000 0 0 1/1/2010
DOKTER ANESTESI OPERA58010118 700 700 0 0 1/1/2010
KAMAR OPERASI SEDANG 58010119 1,300,000 1,300,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010120 2,153,847 2,153,847 0 0 1/1/2010
DOKTER ANESTESI OPERA58010121 861.539 861.539 0 0 ###
KAMAR OPERASI SEDANG 58010122 1,550,000 1,550,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010123 2,500,000 2,500,000 0 0 1/1/2010
DOKTER ANESTESI OPERA58010124 1,000,000 1,000,000 0 0 1/1/2010
KAMAR OPERASI SEDANG 58010125 1,800,000 1,800,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010126 868.182 868.182 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010127 347.273 347.273 0 0 1/1/2010
KAMAR OPERASI KECIL -58010128 600 600 0 0 6/1/2011
DOKTER BEDAH OPERASI58010129 1,000,000 1,000,000 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010130 400 400 0 0 1/1/2010
KAMAR OPERASI KECIL -58010131 850 850 0 0 6/1/2011
DOKTER BEDAH OPERASI58010132 1,125,000 1,125,000 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010133 450 450 0 0 1/1/2010
KAMAR OPERASI KECIL -58010134 900 900 0 0 6/1/2011
DOKTER BEDAH OPERASI58010135 1,346,154 1,346,154 0 0 1/1/2010
DOKTER ANESTESI OPERA58010136 538.462 538.462 0 0 1/1/2010
KAMAR OPERASI KECIL -58010137 1,350,000 1,350,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010138 1,500,000 1,500,000 0 0 1/1/2010
DOKTER ANESTESI OPERA58010139 600 600 0 0 1/1/2010
KAMAR OPERASI KECIL -58010140 1,600,000 1,600,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010141 1,681,819 1,681,819 0 0 1/1/2010
DOKTER ANESTESI OPERA58010142 672.728 672.728 0 0 1/1/2010
KAMAR OPERASI BESAR 5- 8010143 1,000,000 1,000,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010144 1,916,667 1,916,667 0 0 1/1/2010
DOKTER ANESTESI OPERA58010145 766.667 766.667 0 0 1/1/2010
KAMAR OPERASI BESAR 5- 8010146 1,250,000 1,250,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010147 2,333,334 2,333,334 0 0 1/1/2010
DOKTER ANESTESI OPERA58010148 933.334 933.334 0 0 ###
KAMAR OPERASI BESAR 5- 8010149 1,500,000 1,500,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010150 2,692,308 2,692,308 0 0 1/1/2010

DATE: 09/06/2020 RUMAH SAK PAGE: 117


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TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
DOKTER ANESTESI OPERA58010151 1,076,923 1,076,923 0 0 ###
KAMAR OPERASI BESAR 5- 8010152 1,750,000 1,750,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010153 3,000,000 3,000,000 0 0 1/1/2010
DOKTER ANESTESI OPERA58010154 1,200,000 1,200,000 0 0 01/01/0210
KAMAR OPERASI BESAR 5- 8010155 2,000,000 2,000,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010156 2,272,728 2,272,728 0 0 1/1/2010
DOKTER ANESTESI OPERA58010157 909.091 909.091 0 0 1/1/2010
KAMAR OPERASI KHUSUS 58010158 1,500,000 1,500,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010159 2,500,000 2,500,000 0 0 1/1/2010
DOKTER ANESTESI OPERA58010160 1,000,000 1,000,000 0 0 1/1/2010
KAMAR OPERASI KHUSUS 58010161 1,750,000 1,750,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010162 2,916,667 2,916,667 0 0 1/1/2010
DOKTER ANESTESI OPERA58010163 1,666,667 1,666,667 0 0 1/1/2010
KAMAR OPERASI KHUSUS 58010164 2,000,000 2,000,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010165 3,346,154 3,346,154 0 0 1/1/2010
DOKTER ANESTESI OPERA58010166 1,338,462 1,338,462 0 0 1/1/2010
KAMAR OPERASI KHUSUS 58010167 2,250,000 2,250,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010168 3,928,572 3,928,572 0 0 1/1/2010
DOKTER ANESTESI OPERA58010169 1,571,429 1,571,429 0 0 1/1/2010
KAMAR OPERASI KHUSUS 58010170 2,500,000 2,500,000 0 0 6/1/2011
DOKTER BEDAH OPERASI58010171 454.546 454.546 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010172 181.819 181.819 0 0 1/1/2010
KAMAR OPERASI KECIL L58010173 550 550 0 0 ###
DOKTER BEDAH OPERASI58010174 625 625 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010175 250 250 0 0 1/1/2010
KAMAR OPERASI KECIL L58010176 550 550 0 0 ###
DOKTER BEDAH OPERASI58010177 833.334 833.334 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010178 333.334 333.334 0 0 1/1/2010
KAMAR OPERASI KECIL L58010179 550 550 0 0 ###
DOKTER BEDAH OPERASI58010180 1,153,847 1,153,847 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010181 461.539 461.539 0 0 1/1/2010
KAMAR OPERASI KECIL LA
58010182 550 550 0 0 ###
DOKTER BEDAH OPERASI58010183
K 1,250,000 1,250,000 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010184 500 500 0 0 1/1/2010
KAMAR OPERASI KECIL LA
58010185 550 550 0 0 ###
DOKTER BEDAH OPERASI58010186 1,090,909 1,090,909 0 0 1/1/2010
DOKTER BEDAH OPERASI58010189 1,125,000 1,125,000 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010190 450 450 0 0 1/1/2010
KAMAR OPERASI KECIL LA
58010191 550 550 0 0 ###
DOKTER BEDAH OPERASI58010192 1,250,000 1,250,000 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010193 500 500 0 0 1/1/2010
KAMAR OPERASI KECIL LA
58010194 550 550 0 0 ###
DOKTER BEDAH OPERASI58010195 1,384,616 1,384,616 0 0 1/1/2010
DOKTER ANESTESI OPERAS
58010196 553.847 553.847 0 0 1/1/2010
KAMAR OPERASI KECIL LA
58010197 550 550 0 0 ###
DATE: 09/06/2020 RUMAH SAK PAGE: 118
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GROUP FROM 51 TO 59
TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
DOKTER BEDAH OPERASI58010198 K 1,500,000 1,500,000 0 0 1/1/2010
DOKTER ANESTESI OPERAS 58010199 600 600 0 0 1/1/2010
KAMAR OPERASI KECIL LA 58010200 550 550 0 0 ###
DOKTER BEDAH OPERASI58010202 1,950,000 1,950,000 0 0 1/1/2010
KAMAR OPERASI SEDANG 58010203 1,516,667 1,516,667 0 0 1/1/2010
DOKTER BEDAH OPERASI58010204 1,300,000 1,300,000 0 0 1/1/2010
KAMAR OPERASI SEDANG 58010205 1,300,000 1,300,000 0 0 1/1/2010
DOKTER BEDAH OPERASI58010206 2,275,000 2,275,000 0 0 1/1/2010
KAMAR OPERASI SEDANG 58010207 4,755,000 4,755,000 0 0 1/1/2010
DOKTER BEDAH OPERASI58010208 2,800,000 2,800,000 0 0 1/1/2010
KAMAR OPERASI SEDANG 58010209 2,000,000 2,000,000 0 0 1/1/2010
DOKTER BEDAH OPERASI58010210 3,250,000 3,250,000 0 0 1/1/2010
KAMAR OPERASI SEDANG 58010211 2,228,572 2,228,572 0 0 1/1/2010
DOKTER ANESTESI OPERA 58010212
DOKTER BEDAH SARAF O58010213 15,909,09115,909,091 0 0 ###
DOKTER ANESTHESI SAR58010214 6,363,636 6,363,636 0 0 ###
KAMAR OPERASI SARAF 58010215 1,200,000 1,200,000 0 0 ###
DOKTER BEDAH SARAF O58010216 13,636,36413,636,364 0 0 ###
DOKTER ANESTHESI SAR58010217 5,454,545 5,454,545 0 0 ###
KAMAR OPERASI SARAF 58010218 1,200,000 1,200,000 0 0 ###
DOKTER BEDAH SARAF O58010219 10,909,09110,909,091 0 0 ###
DOKTER ANESTHESI SARA 58010220 4,363,636 4,363,636 0 0 ###
KAMAR OPERASI SARAF 58010221 1,200,000 1,200,000 0 0 ###
DOKTER BEDAH SARAF O58010222 8,181,818 8,181,818 0 0 ###
DOKTER ANESTHESI SARA 58010223 3,272,727 3,272,727 0 0 ###
KAMAR OPERASI SARAF 58010224 1,200,000 1,200,000 0 0 ###
DOKTER BEDAH SARAF O58010225 6,818,182 6,818,182 0 0 ###
DOKTER ANESTHESI SARA 58010226 2,727,273 2,727,273 0 0 ###
KAMAR OPERASI SARAF 58010227 1,200,000 1,200,000 0 0 ###
DOKTER BEDAH SARAF O58010228 13,636,36413,636,364 0 0 ###
DOKTER ANESTHESI SARA 58010229 5,454,545 5,454,545 0 0 ###
KAMAR OPERASI SARAF 5O8010230 1,000,000 1,000,000 0 0 ###
DOKTER BEDAH SARAF O58010231 10,909,09110,909,091 0 0 ###
DOKTER ANESTHESI SARA 58010232 4,363,636 4,363,636 0 0 ###
KAMAR OPERASI SARAF 5O8010233 1,000,000 1,000,000 0 0 ###
DOKTER BEDAH SARAF OP
58010234 9,090,909 9,090,909 0 0 ###
DOKTER ANESTHESI SARA
58010235 3,636,364 3,636,364 0 0 ###
KAMAR OPERASI SARAF 5O8010236 1,200,000 1,200,000 0 0 ###
DOKTER BEDAH SARAF OP
58010237 7,272,727 7,272,727 0 0 ###
DOKTER ANESTHESI SARA
58010238 2,909,091 2,909,091 0 0 ###
KAMAR OPERASI SARAF 5O8010239 1,000,000 1,000,000 0 0 ###
DOKTER BEDAH SARAF OP
58010240 5,454,545 5,454,545 0 0 ###
DOKTER ANESTHESI SARA
58010241 2,181,818 2,181,818 0 0 ###
KAMAR OPERASI SARAF 5O8010242 1,000,000 1,000,000 0 0 ###
OPERASI OBGYN SEDERH58010243 1,785,714 1,785,714 0 0 4/5/2010

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TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
OPERASI OBGYN SEDERH58010244 1,538,462 1,538,462 0 0 4/5/2010
OPERASI OBGYN SEDERH58010245 1,500,000 1,500,000 0 0 4/5/2010
OPERASI OBGYN SEDERH58010246 1,250,000 1,250,000 0 0 4/5/2010
OPERASI OBGYN SEDERH58010247 909.091 909.091 0 0 4/5/2010
OPERASI OBGYN GOL.1 -58010248 2,500,000 2,500,000 0 0 4/5/2010
OPERASI OBGYN GOL.1 -58010249 2,307,692 2,307,692 0 0 4/5/2010
OPERASI OBGYN GOL.1 -58010250 1,666,667 1,666,667 0 0 4/5/2010
OPERASI OBGYN GOL.1 -58010251 1,666,667 1,666,667 0 0 4/5/2010
OPERASI OBGYN GOL.1 -58010252 1,363,636 1,363,636 0 0 4/5/2010
OPERASI OBGYN GOL.2 -58010253 2,857,143 2,857,143 0 0 4/5/2010
OPERASI OBGYN GOL.2 -58010254 2,692,308 2,692,308 0 0 4/5/2010
OPERASI OBGYN GOL.2 -58010255 2,500,000 2,500,000 0 0 4/5/2010
OPERASI OBGYN GOL.2 -58010256 2,083,333 2,083,333 0 0 4/5/2010
OPERASI OBGYN GOL.2 -58010257 1,818,182 1,818,182 0 0 4/5/2010
OPERASI OBGYN GOL.3 -58010258 3,571,429 3,571,429 0 0 4/5/2010
OPERASI OBGYN GOL.3 -58010259 3,461,538 3,461,538 0 0 4/5/2010
OPERASI OBGYN GOL.3 -58010260 3,333,333 3,333,333 0 0 4/5/2010
OPERASI OBGYN GOL.3 -58010261 2,666,667 2,666,667 0 0 4/5/2010
OPERASI OBGYN GOL.3 -58010262 2,545,455 2,545,455 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010263 4,285,714 4,285,714 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010264 3,846,154 3,846,154 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010265 3,750,000 3,750,000 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010266 3,333,333 3,333,333 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010267 3,181,818 3,181,818 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010268 10,000,00010,000,000 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010269 9,230,769 9,230,769 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010270 8,333,333 8,333,333 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010271 7,500,000 7,500,000 0 0 4/5/2010
OPERASI OBGYN KHUSUS. 58010272 7,272,727 7,272,727 0 0 4/5/2010
KAMAR OPERASI 58010273
Dokter Bedah Orthopedi58010274 6,454,545 6,454,545 0 0 ###
Dokter Bedah Orthopedi58010275 6,750,000 6,750,000 0 0 ###
Dokter Bedah Orthopedi58010276 9,083,333 9,083,333 0 0 ###
Dokter Bedah Orthopedi58010277 10,076,92310,076,923 0 0 ###
Dokter Bedah Orthopedi58010278 11,500,00011,500,000 0 0 ###
Dokter Anesthesi Ortho 58010279 2,581,818 2,581,818 0 0 ###
Dokter Anesthesi Ortho 58010280 2,700,000 2,700,000 0 0 ###
Dokter Anesthesi Ortho 58010281 3,633,333 3,633,333 0 0 ###
Dokter Anesthesi Ortho 58010282 4,030,769 4,030,769 0 0 ###
Dokter Anesthesi Ortho 58010283 4,600,000 4,600,000 0 0 ###
Kamar Operasi Orthoped58010284 1,200,000 1,200,000 0 0 ###
Kamar Operasi Orthoped58010285 1,200,000 1,200,000 0 0 ###
Kamar Operasi Orthoped58010286 1,200,000 1,200,000 0 0 ###
Kamar Operasi Orthoped58010287 1,200,000 1,200,000 0 0 ###
Kamar Operasi Orthoped58010288 1,200,000 1,200,000 0 0 ###

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TYPE FROM 5100 TO 5999

I/P O/P Compan y Cost Eff


Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------
KAMAR OPERASI BEDAH58010289 6,500,000 6,500,000 0 6,500,000 9/1/2015
KAMAR OPERASI BEDAH58010290 6,500,000 6,500,000 0 0 9/1/2015
KAMAR OPERASI BEDAH58010291 6,500,000 6,500,000 0 0 9/1/2015
KAMAR OPERASI BEDAH58010292 6,500,000 6,500,000 0 0 9/1/2015
KAMAR OPERASI BEDAH58010293 6,500,000 6,500,000 0 0 9/1/2015
KAMAR OPERASI BEDAH58010294 6,500,000 6,500,000 0 0 9/1/2015
KAMAR OPERASI TKR 58010295 2,000,000 2,000,000 0 0 ###
KAMAR OPERASI KECIL 58010296 1,600,000 1,600,000 0 0 ###
KAMAR OPERASI SEDA 58010297 2,700,000 2,700,000 0 0 ###
KAMAR OPERASI BESAR 58010298 4,000,000 4,000,000 0 0 ###
KAMAR OPERASI KHUSU58010299 5,000,000 5,000,000 0 0 ###
KAMAR OPERASI ORTHO58010300 2,500,000 2,500,000 0 0 ###
KAMAR OPERASI ORTH 58010301 3,500,000 3,500,000 0 0 ###
KAMAR OPERASI ORTHO58010302 4,600,000 4,600,000 0 0 ###
KAMAR OPERASI ORTH 58010303 5,500,000 5,500,000 0 0 ###
KAMAR OPERASI CDL 58010304 1,000,000 1,000,000 0 0 ###
KAMAR OPERASI MATA 58010305 1,500,000 1,500,000 0 0 ###
KAMAR OPERASI THT 58010306 1,500,000 1,500,000 0 0 ###
DISCOUNT (OT TIME) 58999998

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TYPE FROM 5100 TO 5999

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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

GROUP : 59 HEAMODIALYSIS

TYPE : 5900 DIALYSIS

DISCOUNT (DIALYSIS) 59999998


OTHERS (DIALYSIS) 59999999

DATE: 09/06/2020 RUMAH SAK PAGE: 122


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Description Code Price Price Pric e Price Date
------------------------------- -------- ----------- ----------- ---------- - ----------- ----------

TYPE : pkg PACKAGE DEAL

HAEMODIALISA SINGLE 59000001 982.649 982.649 0 0 ###


PAKET HD I SINGLE US 59000016 974.814 974.814 0 0 ###
PAKET HD II REUSE UM 59000017 715.444 715.444 0 0 ###
PAKET HD III SINGLE U 59000018 950.501 950.501 0 0 ###
PAKET MCU PT. ROTARY59000019 2,458,000 2,458,000 0 0 ###
PAKET HD IV REUSE AL 59000020 682.994 682.994 0 0 ###
PAKET HD I SINGLE USE 59000021 780.806 780.806 0 0 ###
PAKET HD II REUSE - SO 59000022 619.106 619.106 0 0 ###
PAKET HD III SINGLE US 59000023 780.806 780.806 0 0 ###
PAKET HD IV REUSE ALK 59000024 619.106 619.106 0 0 ###
PAKET HD FRESENIUS BP59000025 801.405 801.405 0 0 9/2/2019
PAKET HD FRESENIUS BP59000026 643.586 643.586 0 0 9/2/2019
PAKET HD FRESENIUS - 59000027 894.779 894.779 0 0 9/2/2019

DATE: 09/06/2020 RUMAH SAK PAGE: 123


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TYPE FROM 5100 TO 5999

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