28 OBAT DINKES

Standarisasi Harga Obat dan Alat Kesehatan

XX. STANDARISASI HARGA OBAT DAN ALAT KESEHATAN

NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)

KETERANGAN (Merk, Tipe, Kualitas, Ukuran, dsb) (5)

A.

OBAT NON GENERIK Anti Vertigo

1 2 3

Antimo Bellapen Mertigo

Strip 10 's Btl 500 's Box 10 X 10

Rp Rp Rp

3,000 620,550 57,750

Vitamin , Anti Anemia, Roboransia 1 2 3 4 5 6 7 8 9 Amarapo Amarapo Beceport Beceport Beceport Syrup Bio ATP Bioneuron Bioneuron Bioneuron Ds. 10 X 10 's Btl. 30 's Ds. 10 X 10 's Btl. 250 's Btl. 60 's Ds. 10 X 10 's Btl. 400 's Ds. 10 X 10 's Ds, 5 Amp Btl. 30 's Ds. 10 X 10 's Btl 350 's Ds. 10 X 10 's Btl. 100 's Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp 91,875 24,523 85,050 170,100 8,505 170,100 233,888 70,875 13,466 38,063 56,700 177,188 18,428 17,294

10 Gena Vita 11 Hemafort 12 Hemafort 13 Livron B Plex 14 Livron B Plex

Standar Satuan Harga Barang / Jasa dan Belanja Pegawai Pemerintah Kabupaten Nunukan

163


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


15 Livron B Plex 16 Optalvit 17 Optalvit 18 Pehalmin 19 Pehavral 20 Pehavral 21 Supra Livron 22 Supra Livron

Btl. 800 's Btl. 30 's Ds. 10 X 10 's Btl. 600 's Ds. 10 X 10 's Btl. 350 's Ds. 10 X 10 's Btl. 400 's

Rp Rp Rp Rp Rp Rp Rp Rp

101,372 25,090 102,697 79,931 53,288 148,838 42,630 112,691

Antihistaminika, Kortikosteroid 1 2 3 4 5 6 7 8 9 Corsona Corsona Corsona Inj Dextamine Dextamine Syrup Pehaclort Pehaclort Pehatifen Syrup Pehatifen tablet Btl. 300 's Ds. 10 X 10 's Ds. 5 Amp Ds. 10 X 30 's Btl. 60 ml Btl. 1500 's Btl. 1500 's Btl. 60 ml Ds. 5 X 10 's Rp Rp Rp Rp Rp Rp Rp Rp Rp 43,376 16,160 22,964 251,213 16,301 80,089 219,713 11,340 25,121

Antitusiva, Expektoransia, Anti Influenza 1 2 Dexatrofen Caps Dexatrofen Syrup Btl. 60 's Btl. 60 ml Rp Rp 35,779 10,124


164


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


3 4 5 6 7

Hustab Hustab P Hustab P. Syrup Niriton Syrup Noza

Ds. 30 X 10 's Ds. 30 X 10 's Btl. 60 ml Btl. 60 ml Ds. 5 X 6 's

Rp Rp Rp Rp Rp

92,138 88,305 6,379 9,896 21,263

Analgetika, Anti Piretika, Anti Inflamasi, Anti Rheumatik 1 2 3 4 5 6 7 8 9 Dolsic 50 Mg Dolsic Inj Febrinex Ped. Susp Metabiioneuron Metaneuron Pehason Forte Pehastan 250 Pehastan 500 Pehazon Ds. 5 X 10 's Ds. 5 Amp 2 ml Btl. 60 ml Btl. 350 's Ds. 30 X 10 's Btl 300 's Ds. 10 X 10 's Ds. 10 X 10 's Btl. 200's Rp Rp Rp Rp Rp Rp Rp Rp Rp 120,488 63,788 8,505 148,838 198,450 283,500 50,321 8,505 99,225

Anestetik Lokal 1 Pehacain Injeksi Ds. 20 Amp Rp 30,336

Anti Spasmodika, Anti Tukak Lambung 1 2 Cimet Managel Ds. 5 X 10 's Ds. 50 X 2 's Rp Rp 49,613 23,898


165


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


3 4 5

Neogastrolet Neogastrolet Pehaspas

Ds. 2 X 10 's Btl. 250 's Btl. 100 's

Rp Rp Rp

6,851 63,788 39,123

Anti Mikroba 1 2 3 4 5 6 7 8 9 Eros Grivin Grivin Forte Oksitroid Pehadoxin Pehadoxin Forte Pehamoxil Forte Pehatrim dewasa Pehatrim Forte Ds. 5 X 10 's Ds. 30 X 10 's Ds. 10 X 10 's Ds. 5 X 10 's Btl. 1500 's Btl. 100 's Ds. 5 X 10 's Ds. 10 X 10 's Ds. 10 X 10 's Ds. 5 X 10 's Ds. 5 X 10 's Ds. 5 X 10 's Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp 43,848 228,926 282,083 91,350 190,313 137,025 134,663 77,963 127,575 70,875 246,645 466,358

10 Phapin 11 Phaproxin 250 Mg 12 Phaproxin 500 Mg

Obat Kardiovaskuler 1 2 Cortab Pro Infark Inj Btl. 100 's Ds. 1 Amp / 10 ml Rp Rp 25,578 28,350


166


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


3 4 5

Pro Infark Inj Vapril 25 Mg Vapril 12,5 Mg

Ds. 5 Amp - 10 ml Ds. 10 X 10 's Ds. 10 X 10 's

Rp Rp Rp

134,663 173,648 102,769

Dermatologi 1 2 Fluocort N Cream NB Topical Tube. 5 Gr Tube. 5 Gr Rp Rp 8,505 4,948

Lain - Lain 1 2 3 4 Kolkatriol Lovium 2 Mg Lovium 5 Mg Spirolaction Btl. 30 's Btl 300 's Ds. 30 X 10 's Ds. 10 X 10 's Rp Rp Rp Rp 167,475 21,924 38,273 65,363

B

DAFTAR HARGA OGB

1 2 3 4 5 6 7

Albendazol Tablet 400 Mg Ambroxol Syrup Ambroxol Tablet Amoksisilin Kaplet 500 Mg Amoksisilin Kapsul 250 Mg Amoksisilin Syrup Kering 125 Mg/5 ml Ampisilin Kaplet 500 Gr

Ktk. 5 X 6 Tablet Btl. 60 ml 10 X 10 's Strip. 10 X 10 Kapsul Strip. 10 X 20 Kapsul Btl. 60 ml Strip. 10 X 10 Kaplet

Rp Rp Rp Rp Rp Rp Rp

12,832 11,209 15,939 37,274 31,559 9,522 57,667


167


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


8 9

Ampisilin Syrup Kering 125 Mg / 5 ml Ansiklovir Cream 5 %

Btl. 60 ml Tube 5 Gr Ktk. 30 Amp / 2 ml Btl. 1000 Tablet Ktk. 100 Tablet Btl. 1000 Tablet Btl. 100 Tablet Strip. 10 X 10 Kaplet Strip. 10 X 10 Kapsul Ktk. 100 Tablet Ktk. 100 Tablet Ktk. 50 Tablet Ktk. 50 Tablet 10 Vial / 20 ml 10 Vial / 20 ml Ktk. 120 Kapsul Ktk. 100 Amp / 1 ml Btl. 1000 Tablet Btl 60 ml Btl 1000 tablet Btl. 500 Tablet Ktk 30 Amp / 1 ml Ktk 30 Amp / 1 ml

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

4,022 3,365 13,830 74,100 116,767 18,855 27,669 21,177 8,616 14,430 44,375 77,702 20,742 123,513 11,281 2,978 14,692 11,760 19,361 11,761

10 Antalgin Injeksi 250 Mg/ml 11 Antalgin Tablet 500 Mg 12 Anti Parkison DOEN Tablet Kombinasi 13 Asam Askorbat ( Vit. C ) Tablet 50 Gr 14 Asam Folat Tablet 1 Mg 15 Asam Mefenamat Kaplet 500 Mg 16 Asam Mefenamat Kapsul 250 Mg 17 Asetasol Tablet 100 Mg 18 Asetasol Tablet 500 Mg 19 Asiklovir Tablet 200 Mg 20 Asiklovir Tablet 400 Mg 21 Bensatin Benszil Penisilin 1,5 Juta IU / Vial 22 Bensatin Benzil Penisilin 2,4 juta IU / Vial 23 Cimetidin Tablet 200 Mg 24 Deksametason Injeksi 5 Mg / ml 25 Deksametason Tablet 0,5 Mg 26 Destrometafon Syrup 10 Mg/ 5 ml 27 Diazepam 2 mg tablet 28 Diazepam 5 mg tablet 29 Difenhidramin inj 10 mg/5 mg 30 Epinefrin inj 0,1 %


168


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


31 Extrak belladon tablet 10 mg 32 Fenibutazon tablet salut 200 Mg 33 Fenobarbital Injeksi 50 Mg/ml 34 Fenosimetil Penisilin tablet 250 Mg 35 Fenosmetil Penisilin Tablet 500 Mg 36 Ferro Sulfat 300 Mg 37 Fitomenadion (Vit. K) tablet salut 10 Mg 38 Fitomenadion Injeksi 10 Mg/ml 39 Flour Tablet 0,5 Mg 40 Garam Oralit 200 ml 41 Genatasimin Sulfat Salep 42 Gentamisin Injeksi 80 Mg/2ml 43 Gentamisin Tetes Mata 0,3 % / 5 ml 44 Griseofulvin Tablet Micrinizet 125 Mg 45 Ibuprofen Tablet 200 Mg 46 Ibuprofen Tablet 400 Mg 47 Isoniazid Tablet 100 Mg 48 Kalsium laktat 500 Mg 49 Katropil Tablet 25 Mg 50 Katropril Tablet 12,5 Mg 51 klopormazin Injeksi 5 Mg/ml 52 Klopormazin Tablet Salut 25 Mg 53 Klopormazin Tablet Salut100 Gr

Btl 1000 tablet Btl. 1000 Tablet Ktk 30 Amp / 2 ml Strip. 10 X 10 Kaplet Strip. 10 X 10 Kaplet Btl. 1000 Btl. 100 Tablet Ktk. 100 Amp/ 1 ml Btl. 100 Tablet Dos. 25 Sachet Ktk. 10 Tube / 5 Gr 1 Vial / Ktk Ktk. 10 Btl Btl. 100 Tablet Btl. 100 Tablet Strip. 10 X 10 Tablet Btl. 1000 tablet Btl. 1000 tablet Strip. 10 X 10 's Strip. 10 X 10 Tablet Ktk. 30 Amp / 2 ml Btl. 1000 tablet Btl. 1000 tablet


40,411 265,650 22,266 15,372 33,066 26,565 23,909 126,809 5,098 10,626 22,523 4,331 35,490 21,252 11,743 24,325 27,032 44,728 23,649 23,100 12,816 33,402 116,906


169


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


54 Kloramfenikol 250 Mg 55 Kloramfenikol Malaet Tablet 4 Mg 56 klorpromazin HCl Tablet Salut 100 Mg 57 Klorpromazin HCl Tablet Salut 25 Mg 58 Kotrimoksazol 120 Mg Tablet Pediatrik 59 Kotrimoksazol 480 Mg Tablet Kombinasi 60 Kotrimoksazol Suspensi 61 Larutan Benedict 62 Larutan Eosin 2 % 63 Larutan Etanol Asam 64 Larutan Giemsa Stain 65 Larutan Karbol Fuksin 66 Larutan Matilen Biru 67 Larutan Turk 68 Lidokain Injeksi 2 % 69 Lisol, Mengandung Kresol tersabun 50 % 70 Magnesium Sulfat Injeksi (IV) 20 %-25 ml 71 Magnesium Sulfat Injeksi (IV) 40 %-25 ml 72 Magnesium Sulfat Serbuk 30 Mg 73 Mebendazol Tablet 100 Mg 74 Mengendazol Sirup 100 Mg / 5 ml

Btl 1000 Tablet Ktk. 30 Amp / 2 ml 250 Tablet / Btl 1000 Tablet / Btl Strip. 10 X 10 Tablet Strip. 10 X 10 Tablet Btl. 60 ml Botol 100 ml Botol 100 ml Botol 100 ml Botol 100 ml Botol 100 ml Botol 100 ml Botol 100 ml Ktk. 100 Amp/ 2 ml Botol 100 ml 10 Vial / Ktk 10 Vial / Ktk 10 Sase/ 30 Gr Ktk 30 Tablet Btl 30 ml

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

26,985 20,500 30,990 35,417 7,875 20,228 4,183 33,744 98,603 95,500 57,899 29,271 17,799 15,869 63,998 73,125 17,057 21,578 11,264 6,372 2,659


170


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


75 Metanol 76 Metilergometrin Meleat Injeksi 0,200 Mg/1 ml 77 Metilergometrin Meleat Tablet Salut 0,125 Mg 78 Metochlorpropamid 10 Mg 79 Metrodinazol Tablet 500 Mg 80 Metronidasol 250 Mg Tablet 81 Metronidasol 500 Mg Tablet 82 Metronidazol Tablet 250 Mg 83 Natrium Bikarbonat Tablet 500 Mg 84 Natrium Diklofenak Tablet 25 Mg 85 Natrium Diklofenak Tablet 50 Mg 86 Natrium Fluresein Tetes Mata 2 % 87 Natrium Tiosulfat Injeksi 25 % - 10 ml 88 Natrium Tiosulfat Injeksi 25 %/ 10 ml 89 Nifedipine Tab 10 Mg 90 Nisatin Tablet salut 500.000 IU 91 Nisatin Tablet Vaginal 100.000 IU/Gr 92 Nistatin Dragee 93 Nistatin Vagina Tablet 94 Obat Anti Tuberkolosis 1 95 Obat Anti Tuberkolosis 2 96 Obat Anti Tuberkolosis 3 97 Obat Anti Tuberkolosis Sisipan

Btl 100 ml 30 Amp/Ktk 100 Tablet /Ktk 10 X 10 Box Btl. 100 Tablet 100 Tablet/Btl 10 X 10 Strip / Ktk Strip. 10 X 10 Tablet 1000 Tablet / Btl Ktk. 50 Tablet Ktk. 50 Tablet 24 Btl/ 5 ml/ Ktk Ktk. 10 Amp / 10 ml 10 Amp/Ktk Strip. 10 X 10 100 Tablet/Ktk 100 Tablet/Ktk Strip. 10 X 10 Dragee Strip. 10 X 10 Dragee Paket Paket Paket Paket


28,100 49,358 14,553 25,358 18,753 12,804 21,135 12,247 13,084 12,600 17,851 137,765 17,189 14,947 31,500 87,782 41,816 66,783 41,816 -


171


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


98 Obat Batuk Hitam (OBH) 99 Oksitetrasiklin Hcl Salep Mata 1 % 100 Oksitetrasiklin Inj. 50 Mg/ml-10ml 101 Oksitetrasiklin Salep 31 % 102 Papaverin Inj 40 Mg Injeksi 103 Parafomaldehid Tablet 1 Gr 104 Parasetamol Syrup 120 Mg 105 Parasetamol Syrup 120 Mg/5 ml 106 Parasetamol Tablet 100 Mg 107 Parasetamol Tablet 500 Mg 108 Parasetamol Tablet 500 Mg 109 Penisilin Procain 1 Gr 110 Perfenazin HCl Tablet 16 Mg 111 Perfenazin Hcl Tablet 4 Mg 112 Pilokarpin Hci / Nitrat Tetes Mata 2 % 113 Pirantel Tablet 125 Mg 114 Piridoksin HCl (Vit. B6) Tablet 10 Mg 115 Polikresulen Sulfonat dan 360 Mg/Gr 116 Polipeptida Kombinsai Doen Larutan Infus Steril 117 Povidon Lodida 10 % 118 Povidon Lodida 10 % 119 Prazikuantel Tablet 500 Mg 120 Prednison Tablet 5 Mg

Btl. 100 ml 25 Tube/3,5 gr /Ktk 10 Vial / Ktk 25 Tube/ 5 Gr/Ktk Ktk. 100 100 Tablet/Btl Btl. 60 ml Btl Plastik 60 ml 100 Tablet/Box Btl. 1000 tablet Strip. 10 X 10 Tablet 1 Vial 100 Tablet /Btl 100 Tablet /Btl 24 Btl/ 5 ml / Ktk Strip. 30 X 2 Tablet 1000 Tablet / Btl Btl 10 ml Btl 500 ml Btl 30 ml Btl 300 ml Strip. 10 X 10 Tablet Btl. 1000 Tablet


3,990 37,251 52,182 29,971 37,800 8,256 2,494 3,215 8,924 54,920 8,925 13,650 13,806 5,248 169,407 22,733 19,667 21,166 2,371 17,190 213,612 99,236


172


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


121 Primakuin Tablet 15 Mg 122 Prokain Benzil Penisilin Injeksi 3 Juta IU/Vial 123 Prometazil Tablet 12,5 Mg 124 Prometazil Tablet 25 Mg 125 Propanolol HCl Tablet 40 Mg 126 Propiltiourasil Tablet 100 Mg 127 Ranitidine Tablet 150 Mg 128 Reserpin Tablet 0,10 Mg 129 Reserpin Tablet 0,25 Mg 130 Rifampisin Kaplet 450 Mg 131 Rifampisin Kapsul 300 Mg 132 Rifampisin Kapsul 600 Mg 133 Salbutanol Tablet 2 Mg 134 Salep 2-4 Komb ; Asam Salisilat 2 % + Belerang Endap 4 % 135 Salisil Bedak 2 % 136 Salisil Spritus 10 % 137 sianokobalamin (Vit. B 12) Injeksi 500 Mg/ml- 1 ml 138 Sipreptomisin Sulfat Injeksi 1500 Mg/ml 139 Siproploksasin Tablet 250 Mg 140 Siproploksasin Tablet 500 Mg 141 Sulfadimidin Tablet 500 Mg 142 Sulfasetamida Batrium Tetes Mata 15 % 143 Tetrakain HCl Tetes mata 0,5 %

Btl. 1000 Tablet 1 Vial Btl. 30 Tablet Btl. 30 Tablet 100 Tablet/ Btl 100 Tablet/ Btl Btl. 30 Tablet 250 Tablet / Btl 1000 Tablet / Btl Strip. 10 X 10 Tablet Strip. 10 X 10 Tablet Strip. 10 X 10 Tablet 100 Tablet / Ktk 24 Pot/30 Gr/Ktk 50 Gr/ Ktk 10 Btl / 25 ml / Kotak 100 Amp/ ktk Strip. 5 X 10 Tablet Strip. 10 X 10 Tablet Strip. 5 X 10 Tablet 1000 Tablet / Btl 24 Botol / 5 ml/ Kkt 24 Botol / 5 ml/ Kkt


93,049 10,290 16,632 35,616 54,338 14,438 89,720 93,441 73,213 116,837 11,635 28,674 1,285 16,298 76,840 10,395 30,074 52,166 131,861 120,906 119,192


173


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


144 Tetraksiklin HCl Kapsul 250 Mg 145 Tetraksiklin Hcl Kapsul 500 Mg 146 Tetrasiklin Kapsul 250 Mg 147 Tetresiklin Kapsul 500 Mg 148 Tiamfenikol Kapsul 250 Mg 149 Tiamfenikol Kapsul 500 Mg 150 Tiamin Hcl (Vit. B1) Inj 100 Mg/ml-1 ml 151 Tiamin Hcl / Mononitrat ( Vit. B1) Tablet 50 Mg 152 Tiamin HCL / Mononitrat (Vit. B1) Injeksi 153 Tramadol Injeksi 154 Triheksifenidil Hidroklorida Tablet 2 Mg 155 Vitamin B Kaompleks Tablet

1000 Kapsul / Btl 100 kapsul /Ktk Btl. 1000 Strip. 10 X 10 Kapsul Strip. 10 X 10 Kapsul Strip. 10 X 10 Kapsul 30 Amp / Ktk 1000 Tablet / Btl Ktk. 30 Amp / 1 ml Ktk. 25 Amp 100 Tablet / Ktk 1000 Tablet / Btl

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

147,878 27,452 123,877 27,452 57,750 83,161 16,570 37,500 17,514 116,222 7,450 24,604

Obat Gigi 156 Eugenol Cairan 157 Flour Tablet 0,5 Mg 12 Botol / 10 ml / Ktk 100 Tablet / Botol Rp Rp 55,755 4,248

Alat Kesehatan 158 Kapas Berlemak 500 Mg 159 Kapas Pembalut / Absorben 250 Gr 160 Kasa Kompas 40/40 Steril 40 Cm X 40 Cm 161 Kasa Pembalut 2 gr X 80 Cm 162 Kasa Pembalut Hidrofil 4 M X 15 Cm Bungkus Bungkus Bungkus Rol Rol Rp Rp Rp Rp Rp 19,988 16,512 3,759 7,039 2,850


174


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


163 Pembalut Gips 164 Plester 5 Yards X 2 Inchi

Rol Rol

Rp Rp

8,783 13,180

MAKANAN TAMBAHAN UNTUK IBU HAMIL/MENYUSUI 165 Lactamil Ibu Hamil 166 Lactamil Ibu Menyusui 167 Prenagen185 Gram 185 Gram

Rp Rp Rp

8,190 8,348 29,820

400 Gram

MAKANAN TAMBAHAN UNTUK BALITA 168 Dancow I 169 Dancow II 170 Dancow III 400 Gram 400 Gram 400 Gram Rp Rp Rp 32,000 32,000 32,000

C

OBAT GENERIK

I. 1 2 3 4 5 6 7

Obat Sangat Esensial Albendazol tablet 400 mg amoksisilin kaplet 500 mg Amoksisilin kapsul 250 mg Amosisilin sirup kering 125 mg / 5 ml Ampisilina sirup kering 125 mg / 5 ml Besi Sirup Deksametason injeksi 5 mg / ml -1 ml 30 tablet / strip / bisper,kotakRp 100 kapsul / strip / blister,kotak Rp 120 kapsul / strip / blister,kotak Rp Botol 60 ml Botol 60 ml Botol 150 ml 100 ampul / kotak Rp Rp Rp Rp 12,832 37,274 31,559 4,272 4,022 5,521 123,534


175


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


8 9

Diasepam injeksi 5 mg / ml - 2 ml Difenhidramin HCI inj 10 mg / ml -1 ml

100 ampul / kotak 30 ampul / kotak

Rp Rp Rp

91,287 19,361 12,937 10,626 9,497 9,497 8,079 102,900 122,063 226,173 181,172 92,209 92,209 39,858 7,875 20,228 4,183 267,485 166,858 63,998 8,224 74,574

10 Efinefrina HCI / Bitatrat ( Epinefrina / adrelina ) Injeksi 0,1 % - 1 30 ampul / kotak ml 11 Garam oralit untuk 200 ml air 12 Glukosa larutan infus 10 % steril 13 Glukosa larutan infus 40 % steril 14 Glukosa larutan infus 5 % steril 15 Insulin Reguler inj 40 IU / ml - 10 ml (Human) 16 Iodial kapsul lunak 17 Ketamin injeksi 10 mg / ml 18 kloramfenikol kapsul 250 mg 19 Klorokuin tablet 150 mg 20 Kodein fosfat tablet 10 mg 21 Kombinasi Pirimetamin 25 mg + Sulfadoxin 500 mg

100 kantong / kotak tahan lembap Rp Botol / Plastik 500 ml Rp

10 amp @ 25 ml, kotak Rp Botol / Plastik 500 ml 1 Vial @ 10 ml, kotak 100 kapsul / botol10 Vial @ 20 ml, kotak 1000 kapsul / botol

Rp Rp Rp Rp Rp Rp Rp Rp Rp

1000 kapsul / botol 250 kapsul / botol 100 kapsul / botol

100 tablet 22 Kotrimoksazol tablet komb : Sulfametoksazol 400 mg + Trimetoprim 80 mg / box

23 Kotrimoksazol tablet pediatrik komb : Sulfametoksazol 100 mg +100 tablet / botol mg Rp Trimetropim 20 24 Kotrimuksazol suspensi komb : Sulfametoksazol 200 mg + Trimetropim 40 mg / ml Botol 60 ml 25 Kuinin (kina) tablet 222 mg 26 Kuinin Dihidroklorida injeksi 25 % - 2 ml 27 Lidokain komb. Injeksi : Lidokain HCI 12 % 28 Natrium klorida larutan infus 0,9 % steril 29 Oksitosin injeksi 10 IU / ml - 1 ml 30 Obat Gigi 1000 tablet / botol 100 Amp/ kotak 100 Amp/ kotak Botol / plastik 500 ml 30 Ampul / kotak Rp Rp Rp Rp Rp Rp


176


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


- Air raksa dental use - Devitalisasi pasta (non arsen) - Etil klorida semprot - Formokresol (pengganti (TFK) - Glass ionomer cement (GC IX) - Kalsium hidroksida pasta - Klorfenol kamfer menthol (CHKM) - Mummifying pasta - Semen seng fostat serbuk dan cairan - Silver amalgam serbuk 65 - 75 % - Spons gelatin cubicles 1 X 1 X 1 cm

1000 gram / botol Botol / kotak Botol 100 ml Botol 10 ml Set / Botol 2 Tube / kotak Botol 10 ml Botol / Kotak Set @ 30 gram / kotak 1 oz / botol 24 Buah / kotak

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

149,958 563,408 119,013 67,549 796,604 296,519 71,301 151,259 116,823 329,231 289,645 7,601 54,920 22,733 213,612 99,236 93,049 42,035 8,917 783,927 29,891,490 2,143,172 167,517

- Temporary stopping fletcher (fletcher) serbuk dan cairan Set @ 100 gram / botol Rp 31 Parasetamol tablet 500 mg 32 Pirantel tablet 125 mg 33 Prazikuantel tablet 600 mg 34 Prednison tablet 5 mg 35 Primakuin tablet 15 mg 36 Rabies immune Globulin (human) 150 IU / ml 37 Ringer laktat larutan infus steril 38 Serum anti bisa ular polivalen injeksi 5 ml (ABU I) 39 Serum anti bisa ular polivalen injeksi 50 ml (ABU I) 40 Serum anti difteri injeksi 20.000 IU/Vial (A.D.S) 41 Serum anti tetanus injeksi 1.500 IU/ampul (A.T.S) 1000 tablet / botol Rp

60 tablet / strip / blister, kotakRp100 tablet / strip / blister, kotak

Rp Rp Rp Rp Rp Rp Rp Rp Rp

1000 tablet / botol 1000 tablet / botol1 Vial @ 2 ml / kotak

Botol / plastik 500 ml 10 Vial / kotak 1 Vial / kotak 10 Vial / kotak 10 ampul / kotak


177


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


42 Serum anti tetanus injeksi 20.000 IU/vial (A.T.S) 43 Suspensi seng insulin inj.40 IU/ml - 10 ml (Human) 44 Tiopental natrium serb inj 1000 mg.amp 45 Vaksin Rabies vero

10 Vial / kotak 1 Vial @ 10 ml / kotakAmpul @ 10 ml

Rp Rp Rp Rp

1,163,021 115,516 93,242 450,373

1 kuur / set

D. 1 2 3 4 5 6 7 8 9

Obat sangat Esensial dan Esensial Alopurinol tablet 100 mg Aminofilin tablet 200 mg Aminofilin injeksi 24 mg / ml - 10 ml Amitriptilin HCI tablet salut 25 ml Antalgin injeksi 250 mg / ml - 2 ml Antalgin (Metampiron) tablet 500 mg 100 tablet / strip / blister, kotak Rp 1000 tablet / botol30 Ampul / kotak

19,989 52,454 38,358 13,946 114,713 74,100 59,512 63,686 15,155 40,121 16,397 116,767 1,596 5,119 18,855 13,939 34,311

Rp Rp

100 tablet / strip / blister, kotak Rp 30 Ampul / kotak 1000 tablet / botol Rp Rp Rp Rp Rp Rp Rp

Antasida DOEN tab, kombinasi : Mg Hidroksida 200 mg + Al. Hidroksida 200botol 1000 tablet / mg Anti bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiskin 1000 IU/g 25 Tube @ 5 g/kotak Anti Hemoroid DOEN kombinasi 10 supp/kotak

24 pot 10 Antifungi DOEN kombinasi : Asam Benzoat 6 % + Asam Salisilat 3 % @ 30g/kotak 11 Antimigren DOEN kombinasi : Ergotamin Tartrat 1 mg + kofein 50 mg 100 tablet / botol

12 Antiparkison DOEN tablet kombinasi : karbidopa 25 mg + levodopa /250 mg 100 tablet strip / blister / kotak Rp 13 Aqua pro injeksi steril, bebas pirogen 14 Aquadest steril 1 Vial @ 25 cc Botol 500 ml Rp Rp Rp Rp Rp

1000 mg 15 Asam askorbat (Vit C) tablet 50 mg Asam askorbat (Vit C) tablet 250 tablet / botol 16 Asam Klorida 0,1 N 17 Asam sulfosasilat 20 % Botol 100 ml Botol 1000 ml


178


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


18 Asetosal tablet 100 mg Asetosal tablet 500 mg 19 Atropin sulfat tablet 0,5 mg 20 Atropin sulfat tetes mata 0,5 mg 21 Atropin sulfat injeksi 0,25 mg / ml - 1 ml 22 Betametason krim 0,1 % 23 Deksametason tablet 0,5 mg 24 Dekstran 70 - larutan infus 6 % steril in 5 % dekstrose 25 Dekstrometorfan sirup 10 mg / 5 ml 26 Dekstrometorfan tablet 15 mg 27 Diazepam tablet 2 mg 28 Diazepam tablet 5 mg 29 Digoksin tablet 0,25 mg 30 Efedrin HCI tablet 25 mg 31 Ekstrak Belladon tablet 10 mg 32 Etakridin (Rivanol) larutan 0,1 % 33 Etanol 70 % 34 Eter anestetik 35 Fenitoin Natrium injeksi 50 mg / ml 36 Fenitoin Natrium kapsul 30 mg 37 Fenitoin Natrium kapsul 100 mg 38 Fenobarbital injeksi 50 mg / ml - 2 ml 39 Fenobarbital tablet 30 mg 40 Fenobarbital tablet 100 mg

100 tablet / strip / blister / kotak Rp 500 tablet / botol Rp

8,616 18,598 74,459 38,640 2,757 35,574 63,300 2,978 69,563 15,359 13,524 11,877 47,125 40,411 25,914 20,713 27,342 12,413 23,192 47,775 16,275 20,326 16,559

24 botol @ 5 ml / kotak Rp 30 ampul / kotak 1 Tube @ 5 g 1000 tablet / botol Botol 500 ml Botol 60 ml 1000 tablet / botol 1000 tablet / botol 500 tablet / botol 100 tablet / botol 1000 tablet / botol 1000 tablet / botol Botol 300 ml Botol 1000 mlBotol 140 ml

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

Ampul @ 2 ml / kotak 250 kapsul / botol 250 kapsul / botol30 ampul / kotak 1000 tablet / botol

250 tablet / botol


179


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


41 Fneoksimetil Penisilina tablet 250 mg 42 Fneoksimetil Penisilina tablet 500 mg 43 Fenol Gliderol tetes telinga 10 % 44 Fitomenadion (Vit K 1) injeksi 10 mg / ml - ml 45 Fitomenadion (Vit K 1) tablet salut gula 10 mg 46 Furosemid tanlet 40 mg 47 Gameksan emulsi 1 % 48 Gentian Violet larutan 1 % 49 Glibenklamid tablet 5 mg 50 Gliseril Guayakolat tablet 100 mg 51 Gliserin 52 Griseofulvin tablet 125 mg, micronized 53 Haloperidol tablet 5 mg 54 Haloperidol tablet 1,5 mg 55 Hidroklorotiazed (HCT) tablet 25 mg 56 Hidrokortiso krim 2,5 % 57 Ibuprofen tablet 200 mg 58 Ibuprofen tablet 400 mg 59 Ipeka sirup 0,14% 60 Isosorbit Dinitrat tablet sublingual 5 mg 61 Kalium Permanganat serbuk 62 Kalsium Laktat (kalk) tablet 500 mg 63 Karbamazepin tablet 200 mg

100 tablet / botol 100 tablet / botol

Rp Rp

15,372 33,066 57,308 126,788 22,869 23,835 9,584 3,217 20,159 33,162 6,111 18,480 17,168 11,151 19,803 71,191 11,743 24,325 5,704 13,456 9,049 51,436 45,722

24 botol @ 5 ml / kotak Rp 100 ampul / kotak 500 tablet / botol 100 tablet / kotak Botol 100 mlBotol 10 ml

Rp Rp Rp Rp Rp

100 tablet / strip / blister, kotak Rp 1000 tablet / botol Botol 100 ml 100 tablet / box Rp Rp Rp

100 tablet / strip / blister, kotak Rp 100 tablet / strip / blister, kotak Rp 1000 tablet / botol 24 tube @ 5 g / kotak 100 tablet / botol 100 tablet / botol Botol 30 ml 100 tablet / botol 20 botol @ 5 g / kotak 1000 tablet / botol Rp Rp Rp Rp Rp Rp Rp Rp

100 tablet / strip / blister, kotak Rp


180


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


64 Klofazimin kapsul 100 mg micronize 65 Kloramfenikol salep mata 1 % 66 Kloramfenikol tetes telinga 3 % 67 Klorfeniramin maleat (CTM) tablet 4 mg 68 Klorpromazin HCI injeksi 5 mg / ml - 2 ml 69 Klorpromazin HCI injeksi 25 mg / ml - 1 ml 70 Klorpromazin HCl Tablet Salut 25 Mg 71 klorpromazin HCl Tablet Salut 100 Mg 72 Metochlorpropamid 10 Mg 73 Larutan Benedict 74 Larutan Eosin 2 % 75 Larutan Etanol Asam 76 Larutan Giemsa Stain 77 Larutan Karbol Fuksin 78 Larutan Matilen Biru 79 Larutan Turk 80 Lisol, Mengandung Kresol tersabun 50 % 81 Magnesium Sulfat Injeksi (IV) 20 %-25 Ml 82 Magnesium Sulfat Injeksi (IV) 40 %-25 Ml 83 Magnesium Sulfat Serbuk 30 Mg 84 Mengendazol Sirup 100 Mg / 5 Ml 85 Mebendazol Tablet 100 Mg 86 Metanol

100 kapsul / botol 24 tube @ 5 g / kotak 24 tube @ 5 ml / kotak 1000 tablet / botol 30 ampul / kotak 30 ampul / kotak 1000 Tablet / Btl 250 Tablet / Btl 10 X 10 Box Botol 100 Ml Botol 100 Ml Botol 100 Ml Botol 100 Ml Botol 100 Ml Botol 100 Ml Botol 100 Ml Botol 100 Ml 10 Vial / Ktk 10 Vial / Ktk 10 Sase/ 30 Gr Ktk Btl 30 Ml 30 Tablet Btl 100 Ml


34,623 2,828 20,500 12,816 12,816 35,417 30,990 25,358 33,744 98,603 95,500 57,899 29,271 17,799 15,869 73,125 17,057 21,578 11,264 2,659 6,372 28,100


181


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


87 Metilergometrin Meleat Injeksi 0,200 Mg/1 Ml 88 Metilergometrin Meleat Tablet Salut 0,125 Mg 89 Metronidasol 250 Mg Tablet 90 Metronidasol 500 Mg Tablet 91 Natrium Bikarbonat Tablet 500 Mg 92 Natrium Fluresein Tetes Mata 2 % 93 Natrium Tiosulfat Injeksi 25 %/ 10 Ml 94 Nisatin Tablet Vaginal 100.000 IU/Gr 95 Nisatin Tablet salut 500.000 IU 96 Obat Batuk Hitam (OBH) 97 Oksitetrasiklin Hcl Salep Mata 1 % 98 Oksitetrasiklin Inj. 50 Mg/Ml-10Ml 99 Oksitetrasiklin Salep 31 % 100 Parafomaldehid Tablet 1 Gr 101 Parasetamol Syrup 120 Mg/5 Ml 102 Parasetamol Tablet 100 Mg 103 Perfenazin Hcl Tablet 4 Mg 104 Perfenazin HCl Tablet 16 Mg 105 Pilokarpin Hci / Nitrat Tetes Mata 2 % 106 Piridoksin HCl (Vit. B6) Tablet 10 Mg 107 Polikresulen Sulfonat dan 360 Mg/Gr 108 Polipeptida Kombinsai Doen Larutan Infus Steril 109 Povidon Lodida 10 %

30 Amp/Ktk 100 Tablet /Ktk 100 Tablet/Btl 10 X 10 Strip / Ktk 1000 Tablet / Btl 24 Btl/ 5 Ml/ Ktk 10 Amp/Ktk 100 Tablet/Ktk 100 Tablet/Ktk Btl. 100 Ml 25 Tube/3,5 gr /Ktk 10 Vial / Ktk 25 Tube/ 5 Gr/Ktk 100 Tablet/Btl Btl Plastik 60 Ml 100 Tablet/Box 100 Tablet /Btl 100 Tablet /Btl 24 Btl/ 5 Ml / Ktk 1000 Tablet / Btl Btl 10 Ml Btl 500 Ml Btl 30 Ml


49,358 14,553 12,804 21,135 13,084 137,765 14,947 41,816 87,782 3,990 37,251 52,182 29,971 8,256 3,215 8,924 5,248 13,806 169,407 19,667 21,166 2,371


182


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


110 Povidon Lodida 10 % 111 Propiltiourasil Tablet 100 Mg 112 Propanolol HCl Tablet 40 Mg 113 Reserpin Tablet 0,10 Mg 114 Reserpin Tablet 0,25 Mg 115 Salbutanol Tablet 2 Mg 116 Salep 2-4 Komb ; Asam Salisilat 2 % + Belerang Endap 4 % 117 Salisil Bedak 2 % 118 Salisil Spritus 10 % 119 Sianokobalamin (Vit. B 12) Injeksi 500 Mg/Ml- 1 Ml 120 Sulfadimidin Tablet 500 Mg 121 Sulfasetamida Batrium Tetes Mata 15 % 122 Tetrakain HCl Tetes mata 0,5 % 123 Tetraksiklin HCl Kapsul 250 Mg 124 Tetraksiklin Hcl Kapsul 500 Mg 125 Tiamin Hcl (Vit. B1) Inj 100 Mg/Ml-1 Ml 126 Tiamin Hcl / Mononitrat ( Vit. B1) Tablet 50 Mg 127 Triheksifenidil Hidroklorida Tablet 2 Mg 128 Vitamin B Kaompleks Tablet

Btl 300 Ml 100 Tablet/ Btl 100 Tablet/ Btl 250 Tablet / Btl 1000 Tablet / Btl 100 Tablet / Ktk 24 Pot/30 Gr/Ktk 50 Gr/ Ktk 10 Btl / 25 Ml / Kotak 100 Amp/ ktk 1000 Tablet / Btl 24 Botol / 5 Ml/ Kkt 24 Botol / 5 Ml/ Kkt 1000 Kapsul / Btl 100 kapsul /Ktk 30 Amp / Ktk 1000 Tablet / Btl 100 Tablet / Ktk 1000 Tablet / Btl

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

17,190 35,616 16,632 14,438 89,720 11,635 28,674 1,285 16,298 76,840 131,861 120,906 119,192 147,878 27,452 16,570 37,500 7,450 24,604

E. 1

OBAT GENERIK LAINNYA Aclovir 400 MG Tablet Box. Rp 85,102 50 Tab


183


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


2 3 4 5 6 7 8 9

Aclovir Cream Albendazole 400 MG Tablet Allopurinol 100 MG Tablet Amoxicilin Kapsul 250 MG Amoxicilin Kapsul 500 MG Amoxicilin Syirup 125 MG / ml Ampicilin 250 MG Caplet Ampicilin 500 MG Caplet

Tube. DS. Str. Str. Str. FL. Str. Str. FL. Str. Btl. FL. Btl. DS. Str. Btl. DS. Btl. Str. Str. Str. Btl. Tub.


5,000 14,054 21,893 34,564 40,824 4,679 33,027 63,159 4,405 13,369 81,157 4,208 65,180 16,598 30,304 20,651 42,320 48,988 15,180 22,424 166,290 198,427 37,917

5 Gr 5X6 10 X 10 10 X 12 10 X 10 60 ml 10 X 10 10 X 10 60 ml 10 X 10 1000 60 ml 1000 10 Suppo 10 X 10 1000 100 X 1 ml 1000 6 X 10 6 X 10 5 X 10 1000 5 GR / 24 Tube / Kotak

10 Ampicilin Syirup 125 MG / ml 11 Antalgin 500 MG Tablet 12 Antalgin 500 MG Tablet 13 Antasida Doen Suspensi 14 Antasida Doen Tablet 15 Anti Haermoroid Supp 16 Asam Mefenamat 500 MG 17 Ascorbig Acid Tab 50 MG 18 Atropin Inj 0,25 Mg / ml 19 Calcium Lactate 500 MG 20 Captropil 12.5 MG 21 Captropil 25 MG 22 Cefadroxil Cap 500 MG 23 Chloramphenicol Capsul 250 MG 24 Chloramphenicol Salep Mata 1 %


184


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


25 Chloramphenicol Susp 125 MG / 5 ml 26 Chloramphenicol TTS Telinga 3 % 27 Chloroquine 250 MG Tablet 28 Chlorpheniramine (CTM) 4 MG 29 Cholorpom Azine 25 MG Tablet 30 Cholorpom Azine tablet Sal 100 MG 31 Cimitidine 200 MG Tablet 32 Ciprofloxacin 250 MG 33 Ciprofloxacin 500 MG 34 Clonidine 0,15 ml Tablet 35 Contrimoxazol 480 MG-400 MG Tablet 36 Contrimoxazol PED - 120 M Tablet 37 Contrimoxazol SYR 60 ml 38 Cyanocobalamin Inj 500 MG / ml 39 Dexamatason Tablet 0,5 MG 40 Dexamatason Tablet 0,5 MG 41 Dextromethorphan SYR 10 ml / 5 ml 42 Dextromethorphan Tablet 15 MG 43 Diltiazem 30 MG Tablet Salut 44 Dimenhydrinate Tablet 50 MG 45 Doxycycline 100 MG Capsul 46 Efedrine 25 MG Tablet 47 Ergotamine Coffeine 1 MG 50 G

Btl. Btl. Btl. Btl. Fls. Btl. Str. Str. Str. Str. Str. Str. Fls. DS. Str. Btl. Fls. Btl. Str. Fl. Str. Btl. Fl.


6,372 3,097 106,260 22,453 38,790 33,947 22,723 32,731 57,134 25,933 8,625 22,155 4,582 84,158 10,744 35,420 3,261 76,188 32,890 12,244 36,132 54,306 15,436

60 ml 5 ml 1000 1000 1000 1000 10 X 10 5 X 10 5 X 10 10 X 10 10 X 10 10 X 10 60 100 X 1 ml 10 X 10 1000 60 ml 1000 10 X 10 100 10 X 10 1000 100


185


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


48 Erythromycin Kap 250 MG 49 Erythromycin Kap 500 MG 50 Erythromycin Syr 200 MG / 5 ml 51 Ethambutol 250 MG Tablet 52 Ethambutol 500 MG Tablet 53 Ferrosus Sulfathe Tab 300 MG 54 Furesemude 40 MG Tablet 55 Glibenclamid 5 MG Tablet 56 Glyceril Guajacolat Tablet 100 MG 57 Griseofulvin 125 MG Tablet 58 H.C.T 25 MG Tablet 59 Hydrocortisone Cream 2,5 % 60 I.N.H 100 MG Tablet 61 I.N.H 300 MG Tablet 62 Iodine Povidon Lar 10 % 63 Iodine Povidon Lar 10 % 64 Iodine Povidon Lar 10 % 65 Iodine Povidon Lar 10 % 66 Mebendazol 100 MG Tablet 67 Methylergometrin M.A.L 0,125 MG 68 Metoclopramid 10 MG 69 Metronidazole 250 MG Tablet 70 Metronidazole 500 MG Tablet

Str. Str. Fl. Str. Str. Btl. Str. Str. Btl. Str. Btl. Tube. Btl. Btl. Btl. Btl. Btl. Btl. Str. Str. Str. Str. Str.


67,327 139,150 8,886 49,219 49,197 27,830 23,403 22,079 36,320 20,240 21,689 3,249 34,047 95,031 3,968 48,300 18,010 2,484 25,405 15,364 21,821 14,023 23,858

10 X 10 10 X 10 60 ml 20 X 10 10 X 10 1000 20 X 10 10 X 10 1000 10 X 10 1000 5 GR 1000 1000 60 ml 1000 ml 300 ml 30 ml 10 X 10 10 X 10 10 X 10 10 X 10 10 X 10


186


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


71 Miconacol Krim 2 % 72 Miconacol Serbuk 2 % 73 Natrium Diklofenak 25 MG 74 Natrium Diklofenak 50 MG 75 Nifedipin 10 MG 76 Oralit / Oral Serbuk U / 1 Ltr 77 Oralit / Oral Serbuk U / 200 ml 78 Oxitetracycline 3 % / Salep Kit 79 Oxytetracycline Salep Mata 1 % 80 Papaverine 40 MG Tablet 81 Papaverine Inj 40 MG / ml 82 Paracetamol 500 MG Tablet 83 Paracetamol 500 MG Tablet 84 Paracetamol Syirup 120 MG / 5 ml 85 Perphenazine Tablet 4 MG 86 Piroksikam Tablet 10 MG 87 Piroksikam Tablet 20 MG 88 Prenidsone 5 MG Tablet 89 Primaquine 15 MG Tablet 90 Propanolol 40 MG Tablet 91 Pyrantel 125 MG Base Tablet 92 Pyrdoxine 10 MG Tablet / Vit B.6 93 Pyrzinamide 500 MG Tablet

Tub. Zak Str. Str. Str. Zak Zak Tub. Tube. Btl. DS. Str. Btl. Btl. Btl. Str. Str. Btl. Btl. Str. DS. Btl. Str.


4,497 4,497 15,180 21,506 34,500 17,825 11,132 32,826 40,799 68,270 47,610 11,241 60,151 2,731 5,748 17,193 26,120 108,687 101,911 18,216 24,898 22,519 61,100

10 GR 20 Gr 5 X 10 5 X 10 10 X 10

5 GR 3,5 GR 1000 100 X 1 ml 10 X 10 1000 ml 60 ml 100 10 X 12 10 X 12 1000 1000 10 X 10 25 X 4 1000 10 X 10


187


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


94 Pythomenadion (Vit K) 95 Quinine Inj 25 % 96 Quinine Tablet Salut 222 MG 97 Ranitidin Tablet 98 Retinol (Vit A Tablet 50.000 IU) 99 Rifampicin Caplet 300 MG 100 Rifampicin Caplet 600 MG 101 Rifampicin Kapsul Salut 450 MG 102 Salbutamol 2 MG 103 Salbutamol 4 MG 104 Sufadoxine Pyrimethmine 25 MG 105 Tetracylin Kapsul 250 MG 106 Tetracylin Kapsul 500 MG 107 Thiamine 50 MG Tablet / Vit B1 50 MG 108 Trisulfa Tablet 500 MG 109 Verapamil 80 MG Tablet 110 Vitamin B Complex Tablet

Btl. DS. Btl. Str. Btl. Str. Str. Str. Str. Str. Str. Btl. Str. Btl. Btl. Str. Btl.

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

26,186 182,749 292,960 59,513 11,270 85,601 158,657 117,690 12,743 14,427 56,868 141,841 30,067 39,034 140,098 60,372 28,291

500 100 X 2 ml 1000 10 X 10 1000 10 X 10 10 X 10 10 X 10 10 X 10 10 X 10 10 X 10 1000 10 X 10 1000 1000 10 X 10 1000

F. 1 2 3 4

OBAT - OBATAN PATEN NARKOTIKA Codein 10 MG Codein 15 MG Codein 20 MG Codipront Cap Btl. Btl. Btl. Box. Rp Rp Rp Rp 112,148 432,831 250 Tab 250 Tab 250 Tab 100 Cap


188


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


5 6 7 8 9

Codipront Cap Codipront Cum Expect Cap Codipront Cum Expect Syirup Codipront Syirup Coditam

Box. Box. Fls. Fls. Box. Btl. Btl. Btl. Btl. Flac. Box. Box. Box. Box. Str. Btl. Btl. Box.

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

43,376 51,491 29,268 27,107 22,634 72,968 95,220 102,350 55,502 18,136 22,289 125,373

10 Cap 10 Cap 60 ml 60 ml 10 X 10 1000 Tab 1000 Tab 1000 Tab 1000 Tab 10 ml 100 60 Tab 60 Tab 10 Amp 10 X 10 250 Tab 1000 Tab 10 Amp

10 Diazepam 2 MG 11 Doveri 100 MG 12 Doveri 150 MG 13 Doveri 200 MG 14 Fentanyl Citrat Inj 15 Hedix 16 Morphine Continus 10 MG (MST) 17 Morphine Continus 15 MG (MST) 18 Morphine HCL 10 MG Inj 19 Neorodial 20 Phenobarbital 100 MG 21 Phenobarbital 30 MG 22 Phethidine HCL 50 MG / ml

G. OBAT PATEN PAKAI HABIS


189


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


1 2 3 4 5 6 7 8 9

Acran 150 mg tablet Acran inj Actifed Cough Syr Actifed Plus expectoran Actrafid HM 100 IU/ml x 3 ml Actrafid HM 40 IU/ml x 10 ml Adona AC 17 inj 5 ml Alco oral drops Alco plus DMP syrup

Box 30 "s" Box 5 ampul Btl 60 ml Btl 60 ml box box box Btl 1 Btl 100 ml Box 150 "s" Btl 15 ml Btl 60 ml box 100 Box 10 vial Btl 60 ml Btl 60 ml Btl Box 100 "s" Box 5 ampul Box 30 "s"


143,000 19,067 21,000 21,000 75,500 146,500 103,000 28,000 17,800 43,500 12,000 6,500 363,000 25,000 24,000 35,500 25,000 110,000 78,000 247,500 87,000 24,063 22,000

10 Alpara caplet 11 Alphamol Drop 12 Alphamol syrup 13 Amoksan 500 mg tablet 14 Amoksan inj 1 gr 15 Amoxsan Dry Syrup 16 Amoxsan Dry Syrup forte 17 Amoxsan Paediatrix Drop 18 Analsik kaplet 19 Anesfar inj 20 Angioten 50 mg 21 Anore 3 x 10 22 Apyalis Drop 23 Apyalis Syrup

Btl Btl

Rp Rp


190


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


24 Aspar K 25 Aspilet chew tablet 26 ATP Dankos inj 27 ATP Dankos tablet 28 Avogin Kaplet 29 Baquinor Forte Kaplet 30 Baquinor Infus 100 ml 31 Becom C tablet 32 Becomzet tablet 33 Bellacid chew tablet 34 Bevalex cream 35 Biocef 1 gram inj 36 Biosanbe tablet 37 Biostrum syrup 38 Biothicol 500 mg 39 Bioxon 1 gram inj 40 Brainact inj 500 mg 41 Brainact tablet 500 mg 42 Braxidin tablet 43 Broadced inj 1 gr Hospital pack 44 Bufect Suspensi 100 ml 45 Bufect Forte suspensi 46 Buscopan tablet

Box 100 tablet Box 100 tablet Box 10 amp/2 ml Box 100 "s" Box 30 "s" Box 20 "s" Btl box 100 box 100 box 100 tablet Tube 5 gram 1 box 1 vial box 100 Btl Box 100 "s" 1 box 1vial Box 5 amp/4 ml Box 30 "s" Box 100 "s" Box 1 vial Btl Btl Box 100 tablet


148,500 32,000 357,500 110,000 82,500 261,067 220,000 121,000 168,667 115,000 8,000 93,500 90,993 38,500 352,000 132,000 242,000 264,000 79,200 151,800 20,533 20,533 250,000


191


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


47 Caldece tablet eff 48 Captensin 12,5 mg 49 Captensin 25 mg 50 Cefat 250 mg tablet 51 Cefat 500 mg Kapsul 52 Cefat Dry syrup 60 ml 53 Cerini tablet 54 Cetazum inj 1 gr 55 Cholestat 10 mg 56 Cholestat 20 mg 57 Cinolon cream 10 gram 58 Claneksi 1 gr injeksi 59 Claneksi caplet 60 Claneksi Dry Syrup btl 60 ml 61 Clatax 1 gr inj 62 Clavamox inj 1 gr 63 Colistine 1,5 Juta IU 64 Colme eye drop 65 Colsancetine 250 mg kapsul 66 Colsancetine inj 67 Colsancetine Syrup 68 Comtusi capsul 69 Cortidex inj

Tube 10 tablet Box 100 "s" Box 100 "s" Box 100 "s" Box 100 "s" Btl Box 20 "s" Box 1 vial Box 30 "s" Box 30 "s" Tube Box 6 Vial Box 30 "s" Btl Box 1 vial Box 1 vial Btl 100 tablet Btl 8 ml Box 100 "s" Box 10 vial Btl 60 ml Box 30 "s" Box 10 ampul


21,560 45,000 65,000 528,000 1,026,000 42,533 67,467 148,500 35,000 45,000 16,133 88,000 347,600 49,867 96,000 67,100 150,000 15,000 58,667 110,000 11,000 33,000 10,267


192


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


70 Cortidex tablet 71 Cravit 500 mg tablet 72 Curcuma Tablet 73 Curmunos syrup 74 Curvit CL Emulsion 75 Damaben tablet 76 Daxet tablet 77 Dextral Forte capsul 78 Dextral capsul 79 Diabex 500 mg 80 Dialac sachet 81 Digenta Cream 82 Dobutamin inj 83 Duphaston Inj. 84 Duvadilan Inj. 85 Duvadilan Tablet 86 Ekinase Syrup 60 ml 87 Ekinase Tablet 88 Elkana Syrup Btl 60 ml 89 Elkana tablet 90 Elpicef 1 gr inj 91 Epexol 30 mg tablet

Box 100 "s" Box 10 tablet Box 10 Strip Btl 60 ml Btl 175 ml Box 100 "s" Btl 15 "s" Box 100 "s" Box 150 "s" Box 100 "s" Box 20 sachet Tube 1 Box 5 amp

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

25,667 297,000 50,600 75,000 38,000 42,000 126,000 45,000 38,000 98,000 77,000 35,000 541,750 321,500 55,000 98,000 12,000 33,000 19,067 66,000 144,000 80,667

Box 5 Amp. Box 30 Tablet Btl 60 ml Box 100 Tablet Btl Box 100 "s" Box 1 vial Box 100 "s"

Rp Rp Rp Rp Rp Rp Rp Rp


193


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


92 Epexol Syrup btl 60 ml 93 Erysanbe 200 mg tablet 94 Erysanbe Dry syrup 60 ml 95 Famocid 20 mg tablet 96 Famocid 40 mg tablet 97 Farbion 5000 inj 98 Farbion tablet 99 Farmacrol F Syrup 100 Farmacrol F Syrup 101 Farmacrol F tablet 102 Farmavon Syrup 103 Farmavon tablet 8 mg 104 Farmin 100 ml 105 Farmin 50 ml 106 Farnat Infusion 107 Farsix inj 108 Fartolin tablet 2 mg 109 Fexazol cream 110 Fexazol tablet 200 mg

btl Box 100 "s" Btl Box 30 "s" Box 30 "s" Box 5 vial Box 100 "s" Btl 100 ml Btl 200 ml Box 100 "s" Btl 125 ml Box 100 "s" Btl 100 ml Btl 50 ml Btl 100 ml Box 5 vial Box 100 "s" Tube 5 gram Box 30 "s"


16,687 154,000 22,169 110,000 167,200 25,000 82,000 30,000 45,000 65,000 25,000 32,000 1,350,000 655,000 65,000 30,000 72,000 10,000 95,000


194


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


111 Flamar 25 mg tablet 112 Flamar 50 mg tablet 113 Flavin kaplet 114 Flucoral 150 mg 115 Folavit 400 mg tablet 116 Frego 10 mg tablet 117 Frego 5 mg tablet 118 Gastrul tablet 119 Glostrum syrup 120 Gludepatic 500 tablet 121 Hepachol kaplet 122 Hepatin kaplet 123 Heptasan 4 mg tablet 124 Hexilon 8 mg tablet 125 Hexilon 4 mg tablet 126 Histapan 50 mg tablet 127 Imboost Force Syrup 128 Imboost Force Tablet 129 Imunos syrup 130 Imunos tablet 131 Indop 200 inj 132 Induksin inj 1 ml 133 Infantrim Forte tablet

Box 100 "s" Box 100 "s" Box 100 "s" Box 10 Tablet Box 100 "s" Box 50 "s" Box 50 "s" Box 30 "s" Btl 60 ml Box 100 "s" Box 50 "s" Box 30 "s" Box 100 "s" Box 30 "s" Box 50 "s" Box 100 "s" Btl 60 ml Box 30 Kaplet Btl Box 20 "s" Box 1 vial/ 40 mg/ml Box 10 ampul Box 100 "s"


80,667 176,000 176,000 542,000 73,333 214,500 154,000 285,000 21,500 54,000 99,000 144,375 22,000 88,000 93,500 61,600 35,000 125,500 57,750 115,500 30,000 57,200 65,000


195


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


134 Infantrim Syrup 135 Infantrim tablet 136 Infusan D5 137 Infusan D5 + 1/2 NS 138 Infusan D5 + 1/4 NS 139 Infusan NS 140 Infusan R + D 141 Infusan Ring As 142 Infusan RI 143 Inotrop inj 144 Inpepsa 100 ml Syrup 145 Inpepsa 200 ml Syrup 146 Interhistin tablet 147 Interpec Syr 15 ml 148 Interpec Syr 30 ml 149 Interpec tablet 30 mg 150 Intifen Tablet 151 Inviclot inj 152 Isotic Neolysin 153 Isotic Renator 154 kalmoxilin inj 1 gr 155 Kalmoxilin tablet 500 mg 156 Kalnex inj 250 mg

Btl 60 ml Box 100 "s" Btl Btl Btl Btl Btl Btl Btl Box 1 vial Btl 100 ml Btl 200 ml Box 100 "s" Btl 60 ml Btl 60 ml Box 100 "s" Box 100 Tablet Box 1 vial Btl 5 ml Btl 5 ml Vial Box 100 tablet Box 10 ampul


9,500 35,000 13,090 13,310 13,310 12,600 13,500 14,410 12,900 96,000 38,000 65,000 49,500 13,500 19,000 75,000 151,800 36,000 18,000 23,500 19,250 100,000 62,700


196


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


157 Kalnex inj 500 mg 158 Kalnex tablet 250 mg 159 Kalnex tablet 500 mg 160 Kaltrofen 100 mg 161 Kaltrofen 50 mg 162 Kaltrofen inj 100 163 Kaltrofen Suppositoria 164 Kenalog in Orabase 165 Ketamin 500 mg 166 Ketopain Inj. 10 mg 167 Ketopain Inj. 30 mg 168 Kolivit Syrup 60 ml 169 Lacbon Tablet 170 Lanaginkola 171 Lanakeloid cream 172 Lanaprost tablet 173 Lanaven kapsul 174 Lanaven plus 175 Lantiflam 100 mg tablet 176 Lantiflam 50 mg tablet 177 Lantiflam inj

Box 10 ampul Box 100 "s" Box 100 "s" Box 30 "s" Box 30 "s" Box 5 amp/2 ml Box 10 suppo Tube 1 Box 10 vial Box 5 Amp Box 5 Amp Btl 60 ml Box 100 Box 50 "s" Tube 10 gr Box 100 Box 100 Box 60 Box 30 "s" Box 30 "s" Box 5 amp/2 ml


89,100 113,300 201,300 102,300 56,320 75,350 77,715 45,000 770,000 96,250 151,250 22,000 60,000 247,000 30,800 187,000 308,000 270,600 82,500 44,550 13,200


197


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


178 Lapraz capsul 179 Lesichol 300 tablet 180 Lesipar kapsul 181 Lexadium tablet 182 Lexahist tablet 183 Lexapram Syrup 184 Lexapram tablet 185 Lipitor 10 mg 186 Lodia 2 mg tablet 187 Longatin Capsul 188 Lycalvit Syrup 189 Mefinal 500 mg kaplet 190 Mexpharm 15 mg tablet 191 Mexpharm 7,5 mg tablet 192 Midazolam inj 5 mg/1ml 193 Molacort 0,5 mg tablet 194 Molacort 0,75 mg tablet 195 Molapect tablet 196 Molasic 500 mg tablet 197 Molason Cream 198 Molexflu caplet 199 Mucohexin 8 mg Kapsul 200 Nasaflam inj

Box 20 "s" Box 60 "s" Box 100 "s" Box 60 "s" Box 200 "s" Btl 60 ml Box 100 "s" Box 30 Box 60 "s" Box 100 Btl 60 ml Box 100 "s" Box 20 "s" Box 20 "s" Box 5 ampul Box 100 "s" Box 200 "s" Box 100 "s" Box 100 "s" Tube 5 gram Box 100 "s" 4 x 25 Strip Box 5 ampul


220,000 363,000 343,750 45,000 42,500 7,500 43,500 388,000 58,000 133,000 12,650 121,000 121,000 47,250 66,000 15,000 35,000 55,000 57,000 6,500 35,000 44,000 78,000


198


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


201 Nasaflam tab 100 mg 202 Nasaflam tab 50 mg 203 Neo kaolana Syr 120 ml 204 Neprovit Fe tablet 205 Neurosanbe 5000 tablet 206 Neurosanbe injeksi 207 Neurosanbe plus kaplet 208 Neurosanbe tablet 209 Neurotam 12 gr/60 ml 210 Neurotam 1200 mg tablet 211 Neurotam 3 gr inj 212 Neurotam 400 mg tablet 213 Neurotam 800 mg tablet 214 neurotam inj 1 gr 215 New Kenacomb 216 Nokoba inj 217 Norvask 5 mg @30 Tab 218 Novalgin Inj. 219 Nymiko Suspensi Drop 220 Oscal 0,5 mg 30 kapsul 221 Oscal kapsul 222 Oste Forte Tablet 223 Ostelox 15 mg tablet

Box 100 "s" Box 100 "s" Btl Box 100 "s" Box 100 "s" Box 10 vial Box 100 "s" Box 100 "s" Btl 60 ml Box 50 "s" Box 4 ampul Box 100 "s" Box 50 "s" Box 10 ampul Tube Box 5 ampul Box 30 "s" Box 5 Amp. Btl Btl 30 kapsul Btl 30 kapsul Box 30 Tablet Box 20 "s"


245,000 130,000 12,000 245,000 212,000 48,000 96,800 99,000 143,000 192,500 154,000 143,000 121,000 115,500 47,000 300,000 321,500 47,000 32,000 247,500 148,500 155,000 184,000


199


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


224 Ostelox 7,5 mg tablet 225 Osteofar 226 Ostriol 227 Otopain ear drop 228 Pamol Syrup 229 Pavulon 2 mg x 2 ml @ 10 230 Plasminex inj 231 Plasminex tablet 232 Pospargin 0,125 mg tablet 233 Pospargin 2mg/ml inj 234 Pralax Syrup 235 Preabor tablet 236 Pregvomit tablet 237 Premaston 5 mg 238 Prenamia kapsul 239 Prenatin Df 240 Pritacort tablet 241 Pritagesic caplet 242 Pritalinc 500 mg 243 Pritamox Dry syrup 244 Pritavit caplet 245 Profertil 50 mg 246 Profungal 200 mg Tablet

Box 20 "s" Box 30 "s" Box 30 "s" Btl 8 ml Btl 60 ml Box 10 Box 10 ampul Box 100 "s" Box 100 "s" Box 10 ampul Btl 100 ml Box 30 "s" Box 100 "s" Box 30 "s" Box 4 x 25 60 Kapsul Box 150 "s" Box 100 "s" Box 60 "s" Btl 60 ml Box 100 "s" Box 10 tablet Box 50


114,000 225,000 155,000 23,000 8,050 318,700 118,000 264,000 192,500 61,600 40,000 94,600 65,000 85,470 102,000 99,000 75,000 45,000 185,000 12,500 55,000 95,288 190,600


200


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


247 Profungal 5 gr cream 248 Propyretic suppo 160 mg 249 Prostacom tablet 250 Pumpitor Kapsul 251 Qidrox 500 mg 252 Rantin 150 mg 253 Rantin inj 254 Recolfar 255 Renabetic 5 mg tablet 256 Renagas tablet 257 Renalyte 258 Renapar tablet 259 Sagestam cream 10 gram 260 Sagestam Eye Drop 5 ml 261 Sagestam injeksi 262 San B plek Drop 263 Sanadryl expectoran 60 ml 264 Sanadryl Plus Dmp 265 Sanmag Suspensi 120 ml 266 Sanmag tablet 267 Sanmol Drop 15 ml

Tube 5 gr Box 12 suppo Box 30 "s" Box 20 "s" Box 30 Tablet Box 100 tablet Box 5 amp/2 ml Box 30 "s" Box 100 "s" Box 100 "s" Btl 200 ml Box 100 "s" Tube Btl Box 5 ampul Btl 15 ml Btl 60 ml Btl 60 ml Btl 120 ml Box 100 Btl


12,100 59,500 210,000 256,500 258,000 363,000 66,000 55,000 55,000 45,000 10,000 135,000 12,540 21,560 9,863 16,000 9,500 10,000 23,467 58,000 14,500


201


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


268 Sanmol syrup btl 60 ml 269 Sanmol tablet 270 Sanpicilin inj 271 Sanprima Forte Kaplet 272 Sanprima Syrup 273 Sanprima tablet 274 Sedrofen 500 mg kapsul 275 Sedrofen Kapsul 500 mg 276 Sedrofen Syrup 277 Siclidon 100 mg kapsul 278 Sinova 10 mg 279 Somerol 4 mg 280 Sopirom Inj. 1 gr. 281 Sotatic inj 282 Stolax suppo 283 Taxegram inj 1 gr 284 Teosal Tablet 285 Terfacef inj 1 gr 286 Thiamfilex 500 mg 287 Thyamicin 1000 mg kapsul 288 Thyamicin 250 mg kapsul 289 Thyamicin 500 mg kapsul 290 Thyamicin syr Forte

Btl Box 25 x 4 Box 10 vial Box 100 "s" Btl 60 ml Box 100 "s" Box 30 "s" Box 30 Kapsul Btl 60 ml Box 20 "s" Box 20 "s" Box 50 Kapsul Box 1 Vial Box 5 vial Box 6 suppo Box 1 vial Box 100 Box 1 vial Box 100 "s" Box 50 "s" Box 100 "s" Box 100 "s" Btl 60 ml


11,000 25,000 160,000 190,000 25,000 90,500 241,500 253,000 33,350 102,000 165,000 82,500 220,000 30,000 39,600 130,500 87,000 198,000 168,000 258,000 145,000 282,000 19,000


202


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


291 Thyrax 100 mcg 292 Tilidon syrup 60 ml 293 Timact 80 mg inj 294 Tivilac tablet 295 Torasic inj 10 mg 296 Torasic inj 30 mg 297 Trazep tube Rectal 298 Tremenza tablet 299 Tricodazol 500 mg tablet 300 Tricodazol Infus 301 Trifed tablet 302 Tuzalos tablet 303 Uplores 150 mg kapsul 304 Urdahex 305 Vagistin Ovula 306 Valisanbe 2 mg tablet 307 Valisanbe 5 mg tablet 308 Vblock 25 mg 309 Vical suspensi 310 Vosedon Suspension 311 Vosedon tablet 312 X Flam 50 mg 313 Zantadin 30 mg

Box 100 Tablet Btl 60 ml Box 5 vial/2 ml Btl 30 "s" Box 6 ampul Box 6 ampul Box 5 Tube Box 100 "s" Box 100 "s" Btl Box 50 "s" Box 4 x 25 Box 30 "s" Box 30 "s" Box 10 "s" Box 100 "s" Box 100 "s" Box 30 "s" Btl 60 ml Btl 60 ml Box 100 "s" Box 30 "s" Box 30 Tablet


145,000 23,000 55,000 21,000 99,000 148,000 75,000 96,800 167,000 88,000 41,500 65,000 154,000 181,500 98,000 14,500 24,200 156,750 8,000 28,000 225,000 43,500 118,000


203


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


314 Zantadin Inj. 2 ml 315 Zomerol Inj. 2 ml 316 Zomerol Inj. 2 ml 317 Zypras 0,25 mg 318 Zypras 0,5 mg 319 Zypras 1 mg

Box 5 Amp. 2 ml Box 1 Amp. Box 50 Tablet Box 50 "s" Box 50 "s" Box 50 "s"

Rp Rp Rp Rp Rp Rp

66,500 53,000 94,900 46,750 72,600 115,500

H.

ALAT KESEHATAN

1 2 3 4 5 6 7 8 9

01-34 Micro Drip Elasty Ball 20 % Magnesium Sufate 40 % Magnesium Sulfate 6 % Dextran 70 IN 0,9 % Sod Cloride 6 % Dextran 70 IN 5 % Dextrose Abbocath 20 Abbocath 21 Abbocath 22 Abbocath 24

Pieces Amp 25 CC Amp 25 CC Btl 500 CC Btl 500 CC Pcs Pcs Pcs Pcs Fles Btl 100 Gr Buah 100 Set / Ktk 100 Set / Ktk

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

14,548 3,041 4,053 83,714 79,728 24,933 24,933 24,933 24,933 15,209 188,876 144,869 108,350

10 Adelysin Drops 10 ml 11 Air Raksa Dental Use 12 Alat Hitung Manual 13 Alat Suntik Sekali Pakai 1 ml 14 Alat Suntik Sekali Pakai 2,5 ml


204


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


15 Alat Suntik Sekali Pakai 5 ml 16 Alkohol 70 % 17 Aminophylin Inj 18 Ampicillin Inj 19 Artiflek 3" 20 Artiflek 4" 21 Artiflek 6" 22 Asntropometrik Alat Ukur 23 Atropin Inj 24 Atropin Inj 25 Autoclave Oven 26 Bangku Harvad 27 Bed Screen 2 Panel 28 Bed Side Cabinet 29 Befalex Crem 30 Bein Lurus Besar 31 Bein Lurus Kecil 32 Bingkai Kaca Mata 33 Blood Transfusion Set 34 Bor Gigi Mikro Kec. 20000 - 40000 RPM 35 Bor Intan Kontra Agel ( Kec. Rendah )

100 Set / Ktk Btl 1 Liter 25 Amp/Ktk Ktk / 10's' Rol Rol Rol Buah Ktk / 100 Amp Ktk / 30 Amp Memmert - UM 400 Buah Tesena - TSN 0258 Tesena - TSN 002 A Tube 5 Gr Buah Buah Buah Pieces Buah Buah


135,637 34,500 86,250 59,591 16,730 20,367 29,823 3,345,925 36,800 36,800 16,445,000 1,035,000 3,024,500 5,601 195,227 141,839 22,549 24,730,750 284,840


205


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


36 Bor Intan Kontra Agel ( Kec. Tinggi ) 37 Bumiser Kecil 38 Buniser Besar 39 Cairan Untuk Memeriksa Dental Plak 40 Cat Gut Chromic No 0 (75 M) 41 Cat Gut Chromic No 1 ( 75 M ) 42 Cat Gut Chromic No 2 ( 50 M ) 43 Cat Gut Chromic No 2/0 (100 M ) 44 Cat Gut Chromic No 3 ( 40 M ) 45 Cat Gut Chromic No 3/0 ( 100 M ) 46 Cat Gut Chromic No 4 ( 25 M ) 47 Cat Gut Chromic No 4/0 ( 100 M ) 48 Cat Gut Plain No 0 ( 75 M ) 49 Cat Gut Plain No 1 ( 75 M ) 50 Cat Gut Plain No 2 ( 50 M ) 51 Cat Gut Plain No 2/0 ( 100 M ) 52 Cat Gut Plain No 3 ( 40 M ) 53 Cat Gut Plain No 3/0 ( 100 M ) 54 Cat Gut Plain No 4 ( 25 M ) 55 Cat Gut Plain No 4/0 ( 100 M ) 56 Cateter 57 Catgut chromic 0 75 m 58 Catgut chromic 2/0 100 m

Buah Buah Buah Buah Casette Casette Casette Casette Casette Casette Casette Casette Casette Casette Casette Casette Casette Casette Casette Casette Buah Casette Casette


178,207 67,646 67,646 899,300 961,458 833,175 965,425 879,463 938,975 727,375 925,750 899,300 961,458 833,175 965,425 879,463 938,975 727,375 925,750 20,948 919,500 923,500


206


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


59 Catgut chromic 3/0 100 m 60 Catgut chromic 4/0 100 m 61 Chromic 1 W115 62 Chromic 1-0 W114 63 Chromic 2`W116 64 Chromic 2-0 W113 65 Chromic 3-0 W2212 66 Chromic 4-0 W2251 67 Daryantulle 68 Devitalisasi Pasta (Non Arsen) 69 Diagnostik Sel Lengkap 70 Doppler Digital 71 EKg ( Daerah Perkotaan ) 72 Excavator Berujung Dua ( Besar ) 73 Excavator Berujung Dua ( Kecil ) 74 Feeding Tube FR 8 75 Gunting Operasi Gusi 12 Cm 76 Gynecological Tablet - Steel 77 Gynoxa Ovula 78 Gypsona BSN 3 79 Gypsona BSN 4 80 Gypsona BSN 6 81 Hanscand

Casette Casette Bx Bx Bx Bx Bx Bx Box 10 Btl / Ktk Buah Hadeco Buah Buah Buah Set Buah Tesena - TSN 005 C


898,500 885,500 221,500 202,500 240,000 189,500 174,000 171,000 105,800 709,626 12,937,500 35,204,950 67,646 67,646 10,402 91,649 3,944,500 104,500 21,821 30,550 35,000 12,903

Rol Rol Roll Pcs

Rp Rp Rp Rp


207


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


82 Hanscond L 83 Hospital Bed Hi-Low 3 Crank + Matras 84 Infant Incubator Manual Control 85 Infusion Set 01 - 24 86 Infusion Stand - Steel 87 Jarum Semprit Air 88 K. Berlemak DRC 1000 Gr 89 Kac Mulut Datar 22 M 90 Kaca Kepala 91 Kaca Pembesar 92 Kain Handuk Hidrofil Warna DRC 93 Kain Hnaduk Hidrofil Putih DRC 94 Kantong air Panas 95 Kantong Air Panas Beruang 96 Kantong Air Panas Serie Anjing 97 Kantong Air Panas Serie Kucing 98 Kartu Tes Penglihatan Dekat 99 Kasa Hydrofil DRC 40y X 80 CM 100 Kasa Steril DRC 16 Cm X 18 CM 101 Kursi Gigi Lapangan 102 KursI Gigi Modle Tidur Naik Turun 103 Lempengan Kaca P. Semen 10 X 7 X 1 Cm 104 Lensa Pemeriksaan Virus

Buah

Rp

14,838 16,261,000 28,451,000 9,820 506,000 39,278 29,458 584,083 104,015 218,359 205,557 252,670 252,670 252,670 252,670 132,250 113,471 5,819 80,011,250 38,405 23,130,525

Tesena - TSN 001 KCLHL Rp Tesena - TS 87 Pieces Tesena - TSN 017 A Buah Rol Buah Buah Buah Rol Rol Zak @ 0 Zak @ 0 Zak @ 0 Zak @ 0 Buah Rol Box Buah Buah Buah Buah Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp


208


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


105 Leukocrepe 3" 106 Leukocrepe 4" 107 Leukocrepe 6" 108 Leukodur 3" 109 Leukodur 4" 110 Leukodur 6 111 Manset Anak Pengait Valero Ibu 112 Meja Ginekologi 113 Meteran 114 Metochlorpropamid Inj 5 mg 115 Minor Set 116 Motyl Ergometri Inj 117 Oksitosin Inj 118 Over Bed Table 119 Palu Pengukur Reflek 120 Partus Set 121 Pelvimeter Obstetrik Ukur Panggul 122 Pembalut Gips 123 Pembalut Katun DRC 4y X 5 Cm 124 Pengukur Panjang Batu 125 Pengukur Tinggi Badan 126 Pengukur Waktu 127 Pengukur Waktu (Stopwacth)

Rol Rol Rol Rol Rol Roll Buah Buah Buah 10 Amp EPOS - Germany

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

40,674 54,990 82,921 21,123 28,368 55,600 115,216 9,310,400 33,063 25,300 17,179,965 546,250 1,426,000 246,435 7,787,340 684,896 11,076 2,691 141,839 147,221 218,213 396,750

Ktk / 100 Amp Tesena - TSN 002 B Buah EPOS - Germany Buah Rol Rol Buah Buah Buah Buah

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp


209


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


128 Phototerapy unit Blue Light - Stan 129 Plester 5 yard x 2 " 130 Poliban 10 cm x 2,7 MT 131 Poliban 15 cm x 2,7 MT 132 Poliban 7,5 cm x 2,7 MT 133 Polifix 10 cm x 5 MT 134 Polifix 15 cm x 5 MT 135 Polifix 20 cm x 5 MT 136 Polifix 5 cm x 5 MT 137 Poligyp 10 cm x 2,7 MT 138 Poligyp 15 cm x 2,7 MT 139 Poligyp 7,5 cm x 2,7 MT 140 Pompa Susu 141 Pulsa (Alat Ukur Nadi) 142 Ranitidin Inj 143 Silk Benang Bedah Suter No 3/0 144 Silk Black PFR No 0 100 M 145 Silk Black PFR No 1 100 M 146 Silk Black PFR No 2 50 M 147 Silk Black PFR No 2/0 100 M 148 Silk Black PFR No 3 50 M 149 Silk Black PFR No 3/0 100 M 150 Silk Black PFR No 4/0 100 M

Tesena - TLC IH Rol Rol Rol Rol Box/Pcs Box/Pcs Box/Pcs Box/Pcs Box/24's Box/24's Box/24's Box @ 0 Buah Ktk/25 amp 12x3x7 cm/Ktk Cassette Cassette Cassette Cassette Cassette Cassette Cassette


11,914,000 16,600 18,912 26,186 14,548 66,919 82,921 112,016 35,205 733,194 960,135 523,710 163,013 5,993,570 94,875 374,573 488,003 502,550 443,038 447,005 465,520 420,325 396,750


210


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


151 Silk Black PFR No 5/0 100 M 152 Silver Amalgam Serbuk 65-7% 153 Snellen Pemeriksa Vius 154 Softban Biru 3 155 Softban Biru 4 156 Softban Biru 6 157 Spekulum Hidung (Lempert) 158 Spekulum Telinga 159 Spekulum Vagina (SIMS) 160 Spekulum Vagina (Welss) 161 Spekulum Vagina Besar 162 Spekulum Vagina Kecil 163 Spekulum Vagina Sedang 164 Spons Gelatin Cubicies 1x1x1 cm 165 Stetoscope 166 Stetoscope 167 Stetoscope Janin 168 Suction 169 Sudip Lidah 12 cm 170 Sudip Lidah 16.5 cm 171 Tabung Oxigen 1500L + Trolley 172 Tempat Tidur Periksa dan perlengkapan 173 Temporary Stopping Flecher S & C

Cassette 1 Oz/Btl Buah Rol Rol Rol Buah Buah Buah Buah Buah Buah Buah 24 bh/Ktk Buah Litmann Buah Tesena - TSN 505 Buah Buah Tesena - TSN 019 M Buah Set 100 Gr/Btl

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

383,525 414,674 26,695 16,730 21,094 29,095 354,596 121,617 1,056,149 354,698 544,077 512,072 528,074 481,556 218,213 1,725,000 37,824 21,321,000 354,596 35,460 5,439,500 5,951,250


211


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


174 Tenometer Ukur Teknologi Bola Mata 175 Tensicap 12.5 MG Tabl 176 Tensicap 25 MG Tabl 177 Tensimeter Air Raksa 178 Tensimeter Air Raksa 179 Tensimeter Tanpa Air Raksa 180 Tensocrepe 6 181 Tensocrepe FL 3 182 Tensocrepe FL 4 183 Tensocrepe FL 6 184 Tensoplast STK Adult 185 Tensoplast STK Child 186 Termometer Klinis 187 Tes Buta Warna Ishihara 188 THT Set 189 Timbangan Bayi 190 Timbangan Dacing 191 Timbangan dewasa 192 Triofix 10 M x 4 cm 193 Triofix 10 M x 6 cm 194 Triofix 10 M x 8 cm 195 Uniflex 3" 196 Uniflex 4"

Buah 5x10 Strip 5x10 Strip Buah Riester - Germany Buah Rol Rol Rol Rol Box Box Buah Buah Hillbrow Buah Buah Buah Rol Rol Rol Rol Rol


2,116,000 87,285 176,025 1,745,700 1,380,000 1,040,146 50,500 36,835 44,341 57,696 101,251 73,669 49,608 661,250 13,416,667 3,054,975 793,500 1,891,175 59,645 83,794 104,451 31,772 36,835


212


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


197 Uniflex 6" 198 Vacuum Partus 199 Venflon 18 200 Venflon 20 201 Venflon 22 202 Venflon 24 203 Wheel Chair

Rol Menex Pcs Pcs Pcs Pcs Tesena - TSN 021 B

Rp Rp Rp Rp Rp Rp Rp

46,739 9,487,500 26,000 26,000 26,000 32,900 2,679,500

I 1 2 3 4 5 6 7 8 9

ALAT PUSKESMAS - NON RAWAT INAP SET POLI UMUM Trial Frames Diagnostik set ECG 3 channel W/display Ziegler head mirror 90 mm Kaca Pembesar Snellen Chart Trial Lens Set Manset anak dengan velcro Manset dengan pengait unit unit unit pieces buah lembar unit buah buah buah unit buah unit pieces Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp 7,472,000 5,952,000 76,180,000 1,746,000 59,000 70,000 34,059,000 70,000 88,000 9,000 253,000 195,000 7,778,000 3,692,000

10 Meteran 11 Reflex 12 Stopwats 13 Snellen Chart Eletric 14 Weis Eye Spec adult Plain


213


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


15 Weis Eye Spec Child Plain 16 Double Lightweight stethoscope adult

pieces unit

Rp Rp

3,692,000 1,006,000


214


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


17 tongue depressor 14 cm 18 Examination Table 19 Mercury Sphygmomanometer Desk 20 Clinical Thermometer 21 Buku Ishihara 14 Plate 22 Timbangan Berat Badan Dewasa 23 Pengukur tekanan Bola mata 24 Gelas Ukur 500 ml 25 Bowman probe cyl Size 3 + 4 AG 26 Alat mengeluarkan Benda Asing ujung tumpul 27 Calgut Plain 2/0 1,5 m 28 Silk Caset 29 Surg SCS CVD SH / SH 14,5 cm 30 Surg SCS CVD SH/BL 14,5 cm 31 Surg SCS CVD BL/BL 14,5 cm 32 Surg SCS STR SH/SH 14,5 cm 33 Surg SCS STR SH/BL 14, 5 cm 34 Surg SCS STR BL/BL 14,5 cm 35 Gunting Mayo Untuk mata 11, 5 36 Lister Bandage SCS 14, 5 cm 37 Jarum Hecting Otot 1/2 lingkaran 38 Jarum Hecting Kulit 1/2 Lingkaran 39 Jarum Hecting Otot 3/8 lingkaran

pieces unit unit unit buah unit pieces buah pieces pieces box roll pieces pieces pieces pieces pieces pieces pieces pieces lusin lusin lusin


593,000 8,176,000 2,381,000 382,000 622,000 177,000 11,360,000 506,000 1,081,000 2,151,000 106,000 735,000 1,075,000 1,075,000 1,034,000 1,034,000 1,034,000 1,034,000 1,217,000 1,258,000 62,000 62,000 62,000


215


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


40 Jarum Hecting Kulit 3/8 Lingkaran 41 Jarum Suntik Hypodrmis No 02 42 Jarum Suntik Hypodrmis No 12 43 Jarum Suntik Hypodrmis No 14 44 Jarum Suntik Hypodrmis No 18 45 Jarum Suntik Hypodrmis No 20 46 Nelaton Cetheter No 10 47 Nelaton Cetheter No 12 48 Nelaton Cetheter No 14 49 Famale Cetheter 12 FR 50 Michel Skin Clips 14 x 3 per 100 51 Kelly Art FCPS STR 14 cm 52 Mayo Hegar NH 18, 5 cm 53 Barraq NH STR W Cath 13, 5 54 Matheieu Needle Holder 14 cm 55 Foester SP FCPS STR 18 cm 56 Kuret membersihkan hordeolum meyhoefer 1,8 57 Thumb Dress FCPS 14,5 cm 58 Thumb Drees FCPS 18 cm 59 Tissue Forceps 14,5 cm 1 x 2 T 60 Tissue FCPS 18 cm 1x2T 61 Beer cilia Forceps 9 cm 62 Desmarres Chai FCPS 9 cm 20 mm

lusin lusin lusin lusin lusin lusin pieces pieces pieces pieces pieces pieces pieces pieces pieces pieces pieces pieces pieces pieces pieces pieces pieces


62,000 36,000 36,000 36,000 36,000 36,000 26,000 26,000 26,000 636,000 211,000 1,176,000 1,867,000 10,468,000 3,205,000 1,867,000 1,907,000 467,000 609,000 507,000 670,000 487,000 2,434,000


216


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


63 Desmarres Lid Retr 13 x 18 mm 64 Slang karet untuk anus No 20 65 Glycerine Spuit 66 Semprit Hipodemik Type Record 1 cc 67 Semprit Hipodemik Type Record 10 cc 68 Semprit Hipodemik Type Record 2 cc 69 Semprit Hipodemik Type Record 5 cc 70 Semprit Karet untuk mengeringkan telinga 71 Reiner Alexand Ear Syr 50 cc 72 Hand Brush 73 Surgical Blade No 10 74 Scapel Handle No 3 75 Grooved Director 14,5 cm 76 Strelisator (pemanas alkohol) 77 Duk Bolong 60 x 90 cm 78 Sarung tangan Steril Size 6,5

pieces buah buah unit buah unit buah pieces pieces buah box pieces pieces buah buah pasang

Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp Rp

1,299,000 26,000 195,000 74,000 115,000 82,000 131,000 4,118,000 5,285,000 37,000 187,000 324,000 284,000 796,000 133,000 22,000


217


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)


79 Sarung tangan steril Size 7 80 Sarung tangan Steril Size 7, 5 81 Instrument tray with cover 300x360x40 mm 82 Penligh (white) 83 Instrument cabinet 84 iodine cup 90 mm 85 Instrumen trolley 86 Forcep jar dia 50 mm H 170 mm 87 Single Bowl Stand 88 Tromol Kapas / Kasa Steril 14 cm 89 Torniquet adult 90 Tromol Steril dia 240 mm H 185 mm 91 Nierbekken 23 cm SS 92 Waskom Cekung 320 mm x 100 mm 93 Waskom cuci 40 cm 94 Cyto Transforter 95 Examination HIV 96 Ultrasonografhy 97 Nebulizer W / Portable Suction 98 Oxygen Concentrator 99 Minor Surgery Set

pasang pasang unit unit unit buah unit buah unit unit unit unit unit unit unit buah buah unit unit unit set


22,000 22,000 562,000 228,000 11,048,000 51,000 5,104,000 401,000 2,032,000 377,000 486,000 1,331,000 97,000 213,000 440,000 54,000 295,000 336,458,000 23,611,000 56,505,000 78,725,000


218


NO (1)

JENIS BARANG (2)

SATUAN (3)

HARGA (4)



219

28 OBAT DINKES

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Transcript of 28 OBAT DINKES