Form Rko Pkm 2016 Dinas

RENCANA KEBUTUHAN BMHP PADA FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP) TAHUN 2015

PUSKESMAS : BANJARAN DTP

NO NAMA BARANG SATUAN

(a)

1 Alat suntik sekali pakai 1 ml + jarum pcs 294

2 Alat suntik sekali pakai 3 ml + jarum pcs 666

3 Alat suntik sekali pakai 10 cc + jarum pcs 260

4 Alat Suntik sekali pakai 20 cc tanpa jarum pcs -

5 Alat Suntik sekali pakai 50 cc tanpa jarum pcs -

6 IV catheter no 18 G pcs -



9 IV catheter no 24 G pcs 98

10 Infusion set dewasa pcs 177

11 blood tranfusion set pcs -

12 Urine bag steril pcs -

13 nelathon Catheter (12 Fr) pcs -

14 Sarung tangan periksa No. 7 pasang -

15 Sarung tangan periksa No. 7.5 pasang -

16 Sarung tangan bedah steril No. 7 pasang -

17 Sarung tangan bedah steril No. 7.5 pasang -

18 Kapas pembalut / absorben 250 gr pcs 18

19 Kasa Steril 16 x 16 dus 115

20 Plester (adhesive tape) roll 19

21 Catgut Chromic/benang bedah no. 3/0 + jarum pcs 24

22 Silk (benang bedah sutera) no. 3/0 + jarum pcs 58

23 Hecting needle (tanpa benang) untuk kulit pcs -

24 Hecting needle (tanpa benang) untuk otot pcs -

25 masker 3 Ply non woven ear loop pcs 45

26 Alkohol 70% 1000ml Botol -

27 Temporary Stopping Fletcher serbuk Pcs -

28 Temporary Stopping Fletcher cairan Pcs -

29 Mucus extractor (penyedot lendir bayi baru lahir) Pcs 60

30 Under pad (perlak sekali pakai) Pcs 40

31 Folley Catheter No.18 Pcs -

SISA STOK PER 31 DESEMBER

2014

32 Dopler jelly 250ml Botol -

33 IV.Catheter No.26 Pcs -

34 Umbilikal klem Pcs 87

35 Tip kuning 1000s Pak -

36 Stilet 4.3 Pcs -

37 Spiritus 1ltr Botol -

38 Pipa orogastrik 5F Pcs -

39 Pipa endotrakeal No.2.5 Pcs -




43 Kertas lakmus Pak -

44 Kertas EKG 50/30 Roll -

45 Kertas saring Pcs -

46 Catheter penghisap 10F Pcs -







53 Kertas USG Roll -

54 Plastik klip obat K Kg -

55 PLastik klip obat B Kg -

56 Sendok obat Pcs -

57 Aqua Galon -

58 Kertas perkamen Pak -

59 Kertas Kantong puyer Dus -

60 Masker N 95 Pcs -

61 Objek glass Box -

62 Lancet 100s Box -

63 Deck glass box -

64 Bisturi Pcs -

65 Kassa gulung besar 40/80cm Roll -

66 Canula anak Pcs -

JUMLAH


HARGA SATUAN

(b) (c) = (b) x 12 (d) = (c) - (a) (e)

Rp 1,540.00 280 3,360 2,400

Rp 957.00 683 8,196 6,000

Rp 1,790.00 42 504 244

Rp 3,080.00 - - 50

Rp 680.00 - - 2

Rp 8,355.00 35 420 420

Rp 8,355.00 36 432 432

Rp 11,000.00 35 420 420

Rp 11,000.00 27 324 226

Rp 4,975.00 58 696 519

Rp 13,976.00 - - 10

Rp 3,000.00 2 24 24

Rp 6,400.00 - - 5

Rp 5,940.00 200 2,400 2,400

Rp 5,940.00 260 3,120 3,120

Rp 6,600.00 20 240 240

Rp 6,600.00 101 1,212 1,212

Rp 15,070.00 13 65 47

Rp 8,250.00 106 848 733

Rp 80,000.00 10 120 101

Rp 50,967.00 18 216 192

Rp 28,875.00 34 408 350

Rp 50,000.00 - - 26

Rp 50,000.00 - - 2

Rp 21,945.00 60 600 555

Rp 41,500.00 5 90 ###

Rp 900,000.00 - - 6

Rp 900,000.00 - - 6

Rp 10,450.00 10 90 30

Rp 6,270.00 37 444 404

Rp 18,000.00 - - 50

PEMAKAIAN RATA-RATA PER BULAN SELAMA

2014

JUMLAH KEBUTUHAN TAHUN 2015

RENCANA KEBUTUHAN TAHUN 2015

RENCANA PENGADAAN TAHUN 2015

Rp 15,000.00 - - 60

Rp 20,000.00 20 240 240

Rp 10,000.00 17 119 32

Rp 500,000.00 - - 2

Rp 312,000.00 - - 1

Rp 20,000.00 - - 5

Rp 15,000.00 - - 1

Rp 105,000.00 - - 1

Rp 60,000.00 - - 1

Rp 60,000.00 - - 1

Rp 60,000.00 - - 1

Rp 60,000.00 - - 1

Rp 90,000.00 - - 2

Rp 15,000.00 - - 10

Rp 25,000.00 - - 1

Rp 25,000.00 - - 1

Rp 25,000.00 - - 1

Rp 25,000.00 - - 1

Rp 25,000.00 - - 1

Rp 25,000.00 - - 1

Rp 25,000.00 - - 1

Rp 175,000.00 - - 2

Rp 50,000.00 - - 72

Rp 50,000.00 2 - 36

Rp 500.00 - - 1,000

Rp 18,000.00 1 - 12

Rp 20,000.00 - - 5

Rp 210,000.00 - - 2

Rp 30,000.00 - - 30

Rp 30,000.00 - - 20

Rp 35,000.00 - - 12

Rp 30,000.00 - - 32

Rp 11,520.00 - - 100

Rp 96,000.00 - - 16

Rp 8,100.00 - - 50

Arjasari, 9 Mei 2015


JUMLAH HARGA SpesifikasiMerk

(f)

Rp 3,696,000 BBRAUN

Rp 5,742,000 BBRAUN

Rp 436,760 BBRAUN

Rp 154,000 BBRAUN

Rp 1,360 BBRAUN

Rp 3,509,100 BBRAUN

Rp 3,609,360 BBRAUN

Rp 4,620,000 BBRAUN

Rp 2,486,000 BBRAUN

Rp 2,582,025 Nipro/sinar RU

Rp 139,760 Terumo

Rp 72,000 Onemed/jayamas


Rp 14,256,000

Rp 18,532,800

Rp 1,584,000 Global dismedika

Rp 7,999,200 Global dismedika

Rp 708,290

Rp 6,047,250

Rp 8,080,000

Rp 9,785,664 BBRAUN

Rp 10,106,250 Silkam

Rp 1,300,000 uk.10,11,12

Rp 100,000 uk.10,11,12

Rp 12,179,475

Rp 3,735,000

Rp 5,400,000 Phapros

Rp 5,400,000 Phapros

Rp 313,500

Rp 2,533,080

Rp 900,000

Rp 900,000

Rp 4,800,000 Polymed


Rp 1,000,000

Rp 312,000

Rp 100,000

Rp 15,000

Rp 105,000

Rp 60,000

Rp 60,000

Rp 60,000

Rp 60,000

Rp 180,000

Rp 150,000

Rp 25,000

Rp 25,000

Rp 25,000

Rp 25,000

Rp 25,000

Rp 25,000

Rp 25,000

Rp 350,000

Rp 3,600,000

Rp 1,800,000

Rp 500,000

Rp 216,000

Rp 100,000

Rp 420,000

Rp 900,000

Rp 600,000

Rp 420,000

Rp 960,000

Rp 1,152,000 BBRAUN uk.11

Rp 1,536,000

Rp 405,000

Rp 157,296,874

RENCANA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP) TAHUN 2015


NO NAMA OBAT SATUAN

1 Air untuk injeksi amp 25 ml Ampul

2 Alopurinol tab 100 mg Tab

3 Aminofilin tab 200 mg Tab

4 Amlodipin tab 10 mg Tab

5 Amlodipin tab 5 mg Tab

6 Amoksisilin sir kering 125 mg/5 ml Botol

7 Amoksisilin tab 250 mg Tab

8 Amoksisilin tab 500 mg Tab

9 Ampisilin serb inj 1000 mg/vial Vial

10 Vial

11 Tab kunyah

12 Botol

13 Tube

14 sup

15 Articulating paper kertas warna penanda oklusi

16 Asam asetilsalisilat (asetosal) tab 100 mg Tab

17 Asam folat tab 1 mg Tab

18 Asam mefenamat kaps 500 mg Kaps

Anestetik lokal gigi kombinasi : lidokain hcl 2% + epinefrin 1 : 80.000 inj 2 ml Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium hidroksida 200 mg Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium hidroksida 200 mg Antifungi salep, kombinasi : asam benzoat 6%+ asam salisilat 3%

Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng oksida 120 mg + sup ad 2 g

Kertas warna penanda

oklusi

NO NAMA OBAT SATUAN

19 Asiklovir tab 400 mg Tab

20 Atapulgit Tab

21 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul

22 Atropin tab 0,5 mg Tab

23 Bedak salisil serb 2% Botol

24 Betametason krim 0,1% Tube

25 Bisakodil sup 10 mg Botol

26 Bisakodil tab sal 5 mg Tab sal

27 Deksametason tab 0,5 mg Tab

28 Deksametason inj 5 mg/ml (i.v./i.m.) Vial

29 Diazepam lar rektal 10 mg/2,5 ml Botol

30 Digoksin tab 0,25 mg Tab

31 Domperidon tab 10 mg Tab

32 Eritromisin tab 500 mg Tab

33 Etil klorida semprot 100 ml Botol

34 Eugenol Botol

35 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) Vial

36 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal

37 Furosemid tab 40 mg Tab

38 Sachet

39 Gemfibrozil kaps 300 mg Kaps

40 Gentamisin tts mata 0,3% Botol

41 Sachet

42 Botol

Garam oralit kombinasi : natrium klorida 0,52 g + kalium klorida 0,30 g + trinatrium sitrat 0,58 g + glukosa anhidrat 2,7 g Glass ionomer ART (Atraumatic Restorative Treatment) cocoa butter 5 gGlass ionomer ART (Atraumatic Restorative Treatment) lar

NO NAMA OBAT SATUAN

43 Vial

44 Botol

45 Haloperidol tab 0,5 mg Tab

46 Haloperidol tab 1,5 mg Tab

47 Hidrogen peroksida cairan 3% Botol

48 Hidrokortison krim 2,5% Tube

49 Hiosina butilbromida tab 10 mg Tab

50 Ibuprofen tab 200 mg Tab

51 Ibuprofen tab 400 mg Tab

52 Kalamin Tube

53 Kaptopril tab 12,5 mg Tab

54 Kaptopril tab 25 mg Tab

55 Karbo adsorben tab 0,5 g Tab

56 Karbogliserin tts telinga 10 % Botol

57 Ketokonazol tab 200 mg Tab

58 Ketoprofen sup 100 mg Botol

59 Klindamisin kaps 300 mg Kaps

60 Kloramfenikol tts mata 1% Botol

61 Kloramfenikol salep kulit 2% Tube

62 Kloramfenikol salep mata 1% Tube

63 Klorfeniramin tab 4 mg Tab

64 Klorheksidin lar 0,2% Botol

65 Kodein tab 10 mg Tab

66 Kombinasi : ergotamin 1 mg+ kafein 50 mg Tab

Glass ionomer ART (Atraumatic Restorative Treatment) serb

Gliserin tts 100 mg/ml

NO NAMA OBAT SATUAN

67 Tab sal

68 Tab

69 Botol

70 Ringer Laktat Larutan Botol

71 Glukosa Larutan Infus 10% steril Botol

72 Lidokain gel 2% Tube

73 Loratadin tab 10 mg Tab

74 Metformin tab 500 mg Tab

75 Metildopa tab sal 250 mg Tab

76 Metilergometrin inj 0,2 mg/ml Ampul

77 Metilprednisolon tab 4 mg Tab

78 Metoklopramid inj 5 mg/ml Vial

79 Metoklopramid tab 10 mg Tab

80 Metronidazol lar inf 5 mg/ml Botol

81 Metronidazol ovula 500 mg Supp

82 Metronidazol tab 500 mg Tab

83 Mikonazol krim 2% Tube

84 Natrium diklofenak tab 50 mg Tab

85 Nifedipin kaps 10 mg Kaps

86 Nistatin susp 100.000 UI/ml Botol

87 Nistatin tab vaginal 100.000 UI Tab

88 Oksitosin inj 10 UI/ml Ampul

89 Omeprazol kaps 20 mg Kaps

90 Ondansetron inj 2 mg/ml Vial

Kombinasi : ferro sulfat 200 mg+ as. Folat 0,25 mg Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+ trimetoprim 80 mg

Kotrimoksazol (dewasa) kombinasi tiap 5 ml suspensi : sulfametoksazol 200 mg + trimetoprim 40 mg

NO NAMA OBAT SATUAN

91 Parasetamol sir 120 mg/5 ml Botol

92 Parasetamol tab 500 mg Tab

93 Parasetamol tts 60 mg/0,6 ml Botol

94 Perak sulfadiazin krim 1% Tube

95 Permetrin krim 5 % Tube

96 Polikresulen Botol

97 Povidon iodin lar 100 mg/ml Botol 300 ml

98 Prednison tab 5 mg Tab

99 Ranitidin inj 25 mg/ml Ampul

100 Ranitidin tab 150 mg Tab

101 Salbutamol tab 2 mg Tab

102 Sefadroksil kaps/tab 500 mg Tab

103 Sefadroksil sir kering 125 mg/5 ml Botol

104 Sefotaksim serb inj 1.000 mg/vial Vial

105 Seftriakson serb inj 1.000 mg/vial Vial

106 Setirizin sir 5 mg/5 ml. Botol

107 Sianokobalamin (vitamin B12) inj 500 mcg/ml Vial

108 Sianokobalamin (vitamin B12) tab 50 mcg Tab

109 Simvastatin tab sal 10 mg Tab sal

110 Siprofloksasin tab scored 500 mg Tab

111 Tetrasiklin kaps 500 mg Kaps

112 Tiamin (vitamin B1) tab 50 mg Tab

113 Zinc tab disp 20 mg Tab

114 Vitamin B kompleks Tab

NO NAMA OBAT SATUAN

115 Ambroxol tab 30mg Tab

116 Ambroxol sir Botol

117 Amoxycillin injeksi Ampul

118 Antalgin tab 500mg Tab

119 Acyclovir salep kulit 5gr Tube

120 Gentamicin salep kulit 5gr Tube

121 Glyceril guaiacolas tab 100mg Tab

122 Kloramfenicol tetes telinga Botol

123 Meloxicam tab 15mg Tab

124 Multivitamin syrup 60ml Botol

125 Multivitamin dewasa kap Kap

126 Obat batuk pilek syr 60ml Botol

127 Obat batuk pilek tab Tab

128 Thiamphenicol kap 500mg Kap

129 Thiamphenicol syr 125mg/60ml Botol

130 Misoprostol tab 200mg Tab

131 OBH 100ml syr Botol

132 Sulfacetamide Tetes mata Botol

133 Betahistin Tab

134 Obat bahan gigi kombinasi (Cresophen ) Botol

135 Obat bahan gigi kombinasi (Alvogil ) Botol

136 Cresopate Botol

137 Devitasol Botol

138 Bahan tambalan sementara (Caviton ) Botol

NO NAMA OBAT SATUAN

139 Glucosamin 500mg Tab

140 Oxytetra salep kulit Tube

141 Oxytetra salep mata Tube

142 Rockles Botol

143 Etakridin (rivanol) 0.1% Botol

JUMLAH

Mengetahui :Kepala Puskesmas

Banjaran DTP

dr. Wiji HartonoNIP. 19730512 201001 1

012



HARGA SATUAN

(a) (b) 80 Rp 2,030.00 58 1,556 Rp 86.00 1,183 1,414 Rp 90.00 322 758 Rp 330.00 1,500 - Rp 187.00 - 407 Rp 2,445.00 392 22,664 Rp 211.00 3,500 9,495 Rp 272.00 10,000 60 Rp 5,100.00 50 260 Rp 1,363.00 300 10,416 Rp 75.00 6,000 112 Rp 2,100.00 350 16 Rp 1,904.40 16 - Rp 3,300.00 -

### Rp 130,000.00 - 112 Rp 116.00 99 - Rp 48.00 - 2,506 Rp 112.00 3,320

SISA STOK PER 31

DESEMBER 2014


2014

HARGA SATUAN

SISA STOK PER 31

DESEMBER 2014


2014

426 Rp 345.00 208 1,103 Rp 190.00 750 8 Rp 1,230.00 5 - Rp 74.00 - 106 Rp 1,250.00 100 63 Rp 1,520.00 150 - Rp 6,045.00 -

### Rp 4,990.00 - 4,664 Rp 68.00 6,000 10 Rp 1,580.00 22 - Rp 16,748.00 - 75 Rp 97.00 30 629 Rp 167.00 200 - Rp 930.00 300 1 Rp 104,500.00 3 - Rp 16,667.00 - 28 Rp 3,417.00 47 227 Rp 634.00 138 147 Rp 85.00 86 762 Rp 285.00 658 - Rp 289.00 - 6 Rp 3,194.00 16 - Rp 547,800.00 1 - Rp 547,800.00 1

HARGA SATUAN

SISA STOK PER 31

DESEMBER 2014


2014

- Rp 547,800.00 1 2 Rp 5,333.00 5 67 Rp 59.00 50 620 Rp 69.00 67 - Rp 2,400.00 - 36 Rp 2,798.00 144 - Rp 300.00 300 1,064 Rp 110.00 1,000 399 Rp 149.00 3,500 - Rp 16,000.00 - 2,403 Rp 62.00 1,500 2,545 Rp 80.00 2,500 - Rp 300.00 -

### Rp 2,042.00 - 420 Rp 300.00 76 - Rp 2,722.00 50 - Rp 553.00 -

### Rp 5,000.00 - ### Rp 7,150.00 -

50 Rp 1,600.00 44 7,744 Rp 26.00 8,407 4 Rp 79,800.00 6 - Rp 500.00 - 94 Rp 170.00 6

HARGA SATUAN

SISA STOK PER 31

DESEMBER 2014


2014

44,430 Rp 50.00 6,173 1,902 Rp 149.00 1,675 237 Rp 2,145.00 191 334 Rp 5,200.00 500 - Rp 5,700.00 -

### Rp 40,000.00 - ### Rp 154.00 500

- Rp 112.50 - ### Rp 800.00 -

139 Rp 2,750.00 12 780 Rp 205.00 300 208 Rp 860.00 50 1,061 Rp 108.00 600 - Rp 9,950.00 -

### Rp 3,850.00 - 1,638 Rp 160.00 768 27 Rp 3,000.00 30 1,875 Rp 200.00 562 635 Rp 100.00 206 - Rp 39,000.00 - 113 Rp 480.00 24 60 Rp 2,200.00 61 291 Rp 211.00 200 - Rp 2,400.00 -

HARGA SATUAN

SISA STOK PER 31

DESEMBER 2014


2014

176 Rp 1,438.00 500 14,502 Rp 89.00 19,000 62 Rp 5,200.00 35 - Rp 11,500.00 -

### Rp 11,475.00 - 11 Rp 25,000.00 4 35 Rp 14,203.00 15 2,163 Rp 98.00 2,279 201 Rp 1,140.00 200 1,789 Rp 120.00 3,000 220 Rp 59.00 800 707 Rp 509.00 500 90 Rp 4,746.00 50 20 Rp 2,950.00 100

### Rp 3,300.00 100 - Rp 7,999.00 - 186 Rp 1,078.00 129 - Rp 57.00 618 569 Rp 169.00 265 1,975 Rp 255.00 1,590 315 Rp 300.00 200 8,982 Rp 36.00 6,623 1,400 Rp 473.00 775 10,718 Rp 107.00 9,000

HARGA SATUAN

SISA STOK PER 31

DESEMBER 2014


2014

2,299 Rp 123.00 2,024 - Rp 2,822.00 292 60 Rp 7,396.00 40 165 Rp 352.00 635 107 Rp 3,374.00 30 - Rp 1,350.00 44 14,065 Rp 39.00 3,000 - Rp 1,599.00 57 - Rp 1,100.00 300 379 Rp 7,150.00 250 1,139 Rp 440.00 3,000 61 Rp 6,996.00 200 - Rp 574.00 1,000 47 Rp 431.00 1,500 - Rp 22,300.00 -

### Rp 15,000.00 - 298 Rp 3,850.00 300 68 Rp 3,300.00 120 - Rp 500.00 -

### Rp 595,320.00 1 - Rp 374,000.00 1 - Rp 595,320.00 1 - Rp 360,000.00 1 - Rp 165,000.00 1

HARGA SATUAN

SISA STOK PER 31

DESEMBER 2014


2014

- Rp 2,000.00 - 130 Rp 2,090.00 115 179 Rp 1,600.00 50 - Rp 490,000.00 1 54 Rp 2,212.00 15



(c) = (b) x 12 (d) = (c) - (a) (e) 696 616 8,281 6,725 3,864 2,450 6,000 6,000 - 5,000 2,352 2,352 14,000 14,000 50,000 50,000 600 540 1,800 1,540 72,000 61,584 350 1,000 192 176 1,000 1,000 3 3 495 383 1,000 1,000 23,240 23,000


RENCANA KEBUTUHAN TAHUN

2015




2015


2,080 1,654 9,000 7,897 60 52 100 100 1,200 1,094 1,800 1,737 100 100 100 100 54,000 50,000 264 254 10 10 360 285 2,400 1,771 3,600 3,600 36 35 3 3 329 301 1,104 877 774 627 3,948 3,948 200 200 192 186 12 12 12 12



2015


12 12 45 43 150 200 536 300 10 10 1,152 1,116 3,600 3,600 12,000 10,936 42,000 41,601 100 100 7,500 5,097 15,000 12,455 1,000 1,000 200 200 304 300 600 600 1,000 1,000 600 600 200 200 528 478 75,663 67,919 72 68 500 500 - 100



2015


61,730 17,300 15,075 13,173 191 300 6,000 5,666 5 5 5 5 6,000 6,000 2,000 2,000 300 300 144 200 3,600 2,820 400 392 7,200 6,139 12 12 50 50 1,536 2,000 210 183 6,744 4,869 618 400 100 100 48 300 732 672 1,800 1,509 200 200



2015


4,000 4,000 114,000 114,000 420 358 240 240 240 240 48 30 135 100 13,674 11,511 1,600 1,600 24,000 24,000 3,200 2,980 6,000 5,293 600 510 1,200 1,180 1,200 1,100 100 100 645 459 7,416 7,416 1,325 2,611 19,080 17,105 2,200 1,885 26,492 20,000 9,300 7,900 27,000 18,000



2015


8,096 5,797 2,336 2,336 480 420 5,080 4,915 210 103 528 528 36,000 21,935 684 684 3,600 3,600 3,000 2,621 36,000 34,861 2,400 2,339 12,000 12,000 18,000 17,953 300 300 300 300 3,600 3,302 1,440 1,372 300 300 12 12 7 10 12 12 12 12 12 12



2015


1,000 1,000 1,380 1,250 600 421 12 12 180 126


Pengelola Obat,

Sunsun Sumirah, Amd. FarmNIP. 19730125 199603 2 003


JUMLAH HARGA KET

(f) Rp 1,250,480

Rp 578,350

Rp 220,500

Rp 1,980,000

Rp 935,000

Rp 5,750,640

Rp 2,954,000

Rp 13,600,000

Rp 2,754,000

Rp 2,099,020

Rp 4,618,800

Rp 2,100,000

Rp 335,174

Rp 3,300,000

Rp 390,000

Rp 44,428

Rp 48,000

Rp 2,576,000

JUMLAH HARGA KET

Rp 570,630

Rp 1,500,430

Rp 63,960

Rp 7,400

Rp 1,367,500

Rp 2,640,240

Rp 604,500

Rp 499,000

Rp 3,400,000

Rp 401,320

Rp 167,480

Rp 27,645

Rp 295,757

Rp 3,348,000

Rp 3,657,500

Rp 50,001

Rp 1,028,517

Rp 556,018

Rp 53,295

Rp 1,125,180

Rp 57,800

Rp 594,084

Rp 6,573,600

Rp 6,573,600

JUMLAH HARGA KET

Rp 6,573,600

Rp 229,319

Rp 11,800

Rp 20,700

Rp 24,000

Rp 3,122,568

Rp 1,080,000

Rp 1,202,960

Rp 6,198,549

Rp 1,600,000

Rp 316,014

Rp 996,400

Rp 300,000

Rp 408,400

Rp 90,000

Rp 1,633,200

Rp 553,000

Rp 3,000,000

Rp 1,430,000

Rp 764,800

Rp 1,765,894

Rp 5,426,400

Rp 250,000

Rp 17,000

JUMLAH HARGA KET

Rp 865,000

Rp 1,962,777

Rp 643,500

Rp 29,463,200

Rp 28,500

Rp 200,000

Rp 924,000

Rp 225,000

Rp 240,000

Rp 550,000

Rp 578,100

Rp 337,120

Rp 663,012

Rp 119,400

Rp 192,500

Rp 320,000

Rp 549,000

Rp 973,800

Rp 40,000

Rp 3,900,000

Rp 144,000

Rp 1,478,400

Rp 318,399

Rp 480,000

JUMLAH HARGA KET

Rp 5,752,000

Rp 10,146,000

Rp 1,861,600

Rp 2,760,000

Rp 2,754,000

Rp 750,000

Rp 1,420,300

Rp 1,128,078

Rp 1,824,000

Rp 2,880,000

Rp 175,820

Rp 2,694,137

Rp 2,420,460

Rp 3,481,000

Rp 3,630,000

Rp 799,900

Rp 494,802

Rp 422,712

Rp 441,259

Rp 4,361,775

Rp 565,500

Rp 720,000

Rp 3,736,700

Rp 1,926,000

JUMLAH HARGA KET

Rp 713,031

Rp 6,592,192

Rp 3,106,320

Rp 1,730,080

Rp 347,522

Rp 712,800

Rp 855,465

Rp 1,093,716

Rp 3,960,000

Rp 18,740,150

Rp 15,338,840

Rp 16,363,644

Rp 6,888,000

Rp 7,737,743

Rp 6,690,000

Rp 4,500,000

Rp 12,712,700

Rp 4,527,600

Rp 150,000

Rp 7,143,840

Rp 3,740,000

Rp 7,143,840

Rp 4,320,000

Rp 1,980,000

JUMLAH HARGA KET

Rp 2,000,000

Rp 2,612,500

Rp 673,600

Rp 5,880,000

Rp 278,712

Rp 220,054,204


Pengelola Obat,


PEMERINTAH KABUPATEN BANDUNG

LAPORAN RENCANA KEBUTUHAN OBAT TRIWULAN 2 TAHUN 2015

NAMA SKPD : DINAS KESEHATANNAMA PUSKESMAS : UPTD YANKES KEC.ARJASARI

NO NAMA OBAT SATUAN HARGA SATUAN RENCANA KEBUTUHAN TAHUN 2015

Arjasari

1Air untuk injeksi amp 25 ml Ampul Rp 2,030.00 -

2Aminofilin tab 200 mg Tab Rp 90.00 -

3Aminofilin tab 150mg Tab Rp 80.00 120

4Amlodipin tab 5 mg Tab Rp 187.00 1,000

5Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium hidroksida 200 mg

Tab kunyah Rp 75.00 39,936

6Asam folat tab 1 mg Tab Rp 48.00 -


7Asiklovir tab 200 mg Tab Rp 237.00 800

8Asiklovir tab 400 mg Tab Rp 345.00 2,520

9Atapulgit Tab Rp 190.00 1,200

10Atropin tab 0,5 mg Tab Rp 74.00 -

11Bedak salisil serb 2% Botol Rp 1,250.00 270

12Betametason krim 0,1% Tube Rp 1,520.00 1,716

13Bisakodil sup 5 mg Botol Rp 4,990.00 40

14Bisakodil sup 10 mg Botol Rp 6,045.00 40

15Deksametason tab 0,5 mg Tab Rp 68.00 -

16Deksametason inj 5 mg/ml (i.v./i.m.) Vial Rp 1,580.00 -

17Diazepam lar rektal 10 mg/2,5 ml Botol Rp 16,748.00 -

18Digoksin tab 0,25 mg Tab Rp 97.00 -

19Domperidon tab 10 mg Tab Rp 167.00 667

20Eritromisin tab 500 mg Tab Rp 930.00 -


21Eugenol Botol Rp 16,667.00 -

22Gemfibrozil kaps 300 mg Kaps Rp 289.00 -

23Gentamisin tts mata 0,3% Botol Rp 3,194.00 -

24 Botol Rp 5,333.00 -

25Haloperidol 5 mg Tab Rp 96.00 240

26Ibuprofen tab 400 mg Tab Rp 149.00 3,600

27Karbogliserin tts telinga 10 % Botol Rp 2,042.00 100

28Ketoprofen sup 100 mg Botol Rp 2,722.00 -

29Ketokonazole krim 2% Tube Rp 2,850.00 100

30Klindamisin kaps 300 mg Kaps Rp 553.00 1,000

31Kloramfenikol salep mata 1% Tube Rp 1,600.00 -

32Kodein tab 10 mg Tab Rp 500.00 -

33

Tab Rp 149.00 -

Gliserin tts 100 mg/ml

Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+ trimetoprim 80 mg


34Ringer Laktat Larutan Botol Rp 5,200.00 -

35Glukosa Larutan Infus 10% steril Botol Rp 5,700.00 -

36Lidokain gel 2% Tube Rp 40,000.00 -

37Loratadin tab 10 mg Tab Rp 154.00 4,800

38Metformin tab 500 mg Tab Rp 112.50 1,667

39Metilprednisolon tab 4 mg Tab Rp 205.00 -

40Metronidazol lar inf 5 mg/ml Botol Rp 9,950.00 -

41Metronidazol ovula 500 mg Supp Rp 3,850.00 -

42Natrium diklofenak tab 50 mg Tab Rp 200.00 4,488

43Oksitosin inj 10 UI/ml Ampul Rp 2,200.00 -

44Omeprazol kaps 20 mg Kaps Rp 211.00 -

45Ondansetron inj 2 mg/ml Vial Rp 2,400.00 -

46Parasetamol sir 120 mg/5 ml Botol Rp 1,438.00 -

47Parasetamol tts 60 mg/0,6 ml Botol Rp 5,200.00 600


48Perak sulfadiazin krim 1% Tube Rp 11,500.00 40

49Permetrin krim 5 % Tube Rp 11,475.00 40

50Polikresulen Botol Rp 25,000.00 30

51Povidon iodin lar 100 mg/ml Botol 300 ml Rp 14,203.00 -

52Ranitidin inj 25 mg/ml Ampul Rp 1,140.00 -

53Ranitidin tab 150 mg Tab Rp 120.00 -

54Ramipril tab 10 mg Tab Rp 1,013.00 333

55Ramipril tab 5 mg Tab Rp 580.00 333

56Sefadroksil kaps/tab 500 mg Tab Rp 509.00 1,200

57Sefadroksil sir kering 125 mg/5 ml Botol Rp 4,746.00 33

58Sefotaksim serb inj 1.000 mg/vial Vial Rp 2,950.00 -

59Seftriakson serb inj 1.000 mg/vial Vial Rp 3,300.00 -

60Setirizin sir 5 mg/5 ml. Botol Rp 7,999.00 80

61Setirizin tab 10 mg Tab Rp 181.00 333


62Sianokobalamin (vitamin B12) tab 50 mcg Tab Rp 57.00 -

63Siprofloksasin tab scored 500 mg Tab Rp 255.00 3,320

64Tetracyclin kaps 500 mg Kaps Rp 300.00 317

65Zinc tab disp 20 mg Tab Rp 473.00 4,000

66Ampisilin serb inj 1000 mg/vial Vial Rp 5,100.00 -

67Tube Rp 1,904.40 -

68

sup Rp 3,300.00 -

69

Articulating paper kertas warna penanda oklusi Rp 130,000.00 -

70Ambroxol sir Botol Rp 2,822.00 -

71Bisakodil tab sal 5 mg Tab sal Rp 4,990.00 80

72Betahistin Tab Rp 500.00 -

73Bahan tambalan sementara (Caviton ) Botol Rp 165,000.00 -

Antifungi salep, kombinasi : asam benzoat 6%+ asam salisilat 3%

Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng oksida 120 mg + sup ad 2 g

Kertas warna penanda oklusi


74Cresopate Botol Rp 595,320.00 -

75Co Amoxiclave Tab Rp 9,700.00 333

76Devitasol Botol Rp 360,000.00 -

77Etil klorida semprot 100 ml Botol Rp 104,500.00 4

78Etakridin (rivanol) 0.1% Botol Rp 2,212.00 -

79Furosemid tab 40 mg Tab Rp 85.00 -

80Sachet Rp 547,800.00 -

81 Botol Rp 547,800.00 -

82 Vial Rp 547,800.00 -

83Gentian Violet Botol Rp 895.00 33

84Gentamicin salep kulit 5gr Tube Rp 1,350.00 387

85Glyceril guaiacolas tab 100mg Tab Rp 39.00 19,415

86Glucosamin 500mg Tab Rp 2,000.00 -

Glass ionomer ART (Atraumatic Restorative Treatment) cocoa butter 5 g

Glass ionomer ART (Atraumatic Restorative Treatment) lar



87Hidrogen peroksida cairan 3% Botol Rp 2,400.00 -

88Hiosina butilbromida tab 10 mg Tab Rp 300.00 667

89Kloramfenicol tetes telinga Botol Rp 1,599.00 100

90Kloramfenikol tts mata 1% Botol Rp 5,000.00 -

91Kloramfenikol salep kulit 2% Tube Rp 7,150.00 -

92Kalamin Tube Rp 16,000.00 40

93Karbo adsorben tab 0,5 g Tab Rp 300.00 100

94Klorfeniramin tab 4 mg Tab Rp 26.00 60,048

95Klorheksidin lar 0,2% Botol Rp 79,800.00 8

96Kombinasi;NaCl + KCl( tetes mata) Botol Rp 36,000.00 200

97 Tab sal Rp 50.00 -

98Laktulose sirup Botol Rp 40,000.00 80

99Meloxicam tab 15mg Tab Rp 1,100.00 -

100Multivitamin syrup 60ml Botol Rp 7,150.00 844

Kombinasi : ferro sulfat 200 mg+ as. Folat 0,25 mg


101Multivitamin dewasa kap Kap Rp 440.00 4,000

102Misoprostol tab 200mg Tab Rp 15,000.00 -

103Metildopa tab sal 250 mg Tab Rp 800.00 -

104Metilergometrin inj 0,2 mg/ml Ampul Rp 2,750.00 -

105Metoklopramid tab 10 mg Tab Rp 108.00 -

106Nistatin susp 100.000 UI/ml Botol Rp 39,000.00 -

107Piroxicam 20 mg Kaps Rp 105.00 4,488

108Oxytetra salep kulit Tube Rp 2,090.00 778

109Oxytetra salep mata Tube Rp 1,600.00 462

110OBH 100ml syr Botol Rp 3,850.00 1,992

111Obat bahan gigi kombinasi (Cresophen ) Botol Rp 595,320.00 -

112Obat batuk pilek syr 60ml Botol Rp 6,996.00 1,200

113 Obat batuk pilek tab Tab Rp 574.00 9,000

114Thiamphenicol kap 500mg Kap Rp 431.00 -


115Thiamphenicol syr 125mg/60ml Botol Rp 22,300.00 -

116Rockles Botol Rp 490,000.00 -

117Sulfacetamide Tetes mata Botol Rp 3,300.00 525

118

Salep luka bakar ( ekstra placenta +neomycin )

Tube Rp 11,500.00 23

JUMLAH

Menyetujui,Kepala UPTD Yankes Kec. Arjasari

dr. Hj. Iis Aisjah

NIP. 19711119 200212 2 003

PEMERINTAH KABUPATEN BANDUNG

LAPORAN RENCANA KEBUTUHAN OBAT TRIWULAN 2 TAHUN 2015

NAMA SKPD : DINAS KESEHATANNAMA PUSKESMAS : UPTD YANKES KEC.ARJASARI

RENCANA KEBUTUHAN TAHUN 2015 JUMLAH TOTAL JUMLAH HARGA SPESIFIKASI

Banjaran DTP

(f)

152 152 Rp 308,560 PT. Ikapharmindo

500 500 Rp 45,000 PT. Marin Liza Farmasi

- 120 Rp 9,600 PT. Erela

1,500 2,500 Rp 467,500 PT. Pertiwi Agung

24,000 63,936 Rp 4,795,200 PT. Promedrahardjo Farmasi Industri

300 300 Rp 14,400 PT. Marin Liza Farmasi


- 800 Rp 189,600 PT. Indofarma

400 2,920 Rp 1,007,400 PT. Kimia Farma

1,897 3,097 Rp 588,430 PT. Zenith Pharmaceuticals

100 100 Rp 7,400 PT. Indofarma

294 564 Rp 705,000 PT. Rama Emerald Multi Sukses

537 2,253 Rp 3,424,560 PT. Kimia Farma

- 40 Rp 199,600 PT. Boehringer Ingelheim

30 70 Rp 423,150 PT. Sanbe Farma

6,000 6,000 Rp 408,000 PT. Indofarma


2 2 Rp 33,496 PT. Actavis Indonesia

200 200 Rp 19,400 PT. Yarindo Farmatama

200 867 Rp 144,789 PT. Novapharin

1,200 1,200 Rp 1,116,000 PT. Indofarma


1 1 Rp 16,667 PT. Kimia Farma



3 3 Rp 15,999 PT. Lucas Djaja

- 240 Rp 23,040 PT. Indofarma

13,600 17,200 Rp 2,562,800 PT. Holi Pharma

50 150 Rp 306,300 PT. Lucas Djaja


- 100 Rp 285,000 PT. Hexpharm Jaya Laboratories

300 1,300 Rp 718,900 PT. Indofarma

126 126 Rp 201,600 PT. Erela


3,000 3,000 Rp 447,000 PT. Holi Pharma


2,000 2,000 Rp 10,400,000 PT. Widatra Bhakti

2 2 Rp 11,400 PT. Widatra Bhakti

2 2 Rp 80,000 PT. AstraZeneca indonesia

2,000 6,800 Rp 1,047,200 PT. Promedrahardjo Farmasi Industri

500 2,167 Rp 243,788 PT. Bernofarm

300 300 Rp 61,500 PT. Natura Laboratoria Prima



1,500 5,988 Rp 1,197,600 PT. Novell Pharmaeutical Laboratories

200 200 Rp 440,000 PT. Ethica Industri Farmasi

200 200 Rp 42,200 PT. Novapharin


1,000 1,000 Rp 1,438,000 PT. Afifarma

70 670 Rp 3,484,000 PT. Ifars Pharmaceutical Laboratories


60 100 Rp 1,150,000 PT. Darya Varia

60 100 Rp 1,147,500 PT. Galenium Pharmasia Laboratories

12 42 Rp 1,050,000 PT. Pratapa Nirmala

15 15 Rp 213,045 PT. Afifarma


3,000 3,000 Rp 360,000 PT. Dexa Medica

- 333 Rp 337,329 PT. Novell Pharmaeutical Laboratories

- 333 Rp 193,140 PT. Dexa Medica

1,500 2,700 Rp 1,374,300 PT. Holi Pharma

200 233 Rp 1,105,818 PT. Holi Pharma

400 400 Rp 1,180,000 PT. Natura Laboratoria Prima

400 400 Rp 1,320,000 PT. Natura Laboratoria Prima


- 333 Rp 60,273 PT. Pertiwi Agung


2,472 2,472 Rp 140,904 PT. Afifarma

6,000 9,320 Rp 2,376,600 PT. Bernofarm

- 317 Rp 95,100 PT. Afifarma

2,000 6,000 Rp 2,838,000 PT. Kimia Farma

140 140 Rp 714,000 NON Ekatalog









4 4 Rp 2,381,280 NON Ekatalog

- 333 Rp 3,230,100 NON Ekatalog








- 33 Rp 29,535 NON Ekatalog


12,000 31,415 Rp 1,225,185 NON Ekatalog




1,200 1,867 Rp 560,100 NON Ekatalog






16,000 76,048 Rp 1,977,248 NON Ekatalog



10,000 10,000 Rp 500,000 NON Ekatalog


1,200 1,200 Rp 1,320,000 NON Ekatalog

1,000 1,844 Rp 13,184,600 NON Ekatalog


6,000 10,000 Rp 4,400,000 NON Ekatalog

100 100 Rp 1,500,000 NON Ekatalog



2,000 2,000 Rp 216,000 NON Ekatalog


- 4,488 Rp 471,240 NON Ekatalog

460 1,238 Rp 2,587,420 NON Ekatalog


1,200 3,192 Rp 12,289,200 NON Ekatalog


800 2,000 Rp 13,992,000 NON Ekatalog

4,000 13,000 Rp 7,462,000 NON Ekatalog

6,000 6,000 Rp 2,586,000 NON Ekatalog




480 1,005 Rp 3,316,500 NON Ekatalog


Rp 164,359,446


Koordinasi Obat UPTD Yankes Kec.Arjasari



UPTD Yankes Kec.Arjasari

NO NAMA OBAT SATUANPEMAKAIAN BULANAN

HARGA SATUAN

Nambo Arjasari Nambo

1 Air untuk vial amp 25 mL ampul 50 0 50 Rp 2,200.0 500

2 Alopurinol tab 100 mg tablet 884 768 1,652 Rp 86.0 11,309

3 Alopurinol tab 300 mg tablet 200 0 200 Rp 199.5 3,000

4 Aminofilin tab 200 mg tablet 190 100 290 Rp 90.0 1,413

5 Aminofilin inj 24 mg/mL vial 4 0 4 Rp 3,822.0 58

6 tablet 800 360 1,160 Rp 187.0 7,313

7 tablet 1500 900 2,400 Rp 330.0 3,920

8 Amoksisilin tab 500 mg tablet 8610 9130 17,740 Rp 272.0 35,972

9 Amoksisilin sir forte 250 mg/5 mL botol 100 50 150 Rp 4,045.0 1,500

JML TOTAL PEMAKAIAN


Amlodipin tab 5 mg

Amlodipin tab 10 mg


HARGA SATUANJML TOTAL PEMAKAIAN


10 vial 300 5 305 Rp 1,363.0 4,480

11tablet kunyah 3278 3166 6,444 Rp 75.0 44,816

12Antasida, kombinasi :aluminium hidroksida 200 mg + magnesium hidroksida 200 mg botol 406 336 742 Rp 2,100.0 5,895

13supp 37 42 79 Rp 3,045.0 550

14 Articulating paper 2 0 2 Rp 130,000.0 3

15 Asam asetilsalisilat (asetosal) tab 100 mg Tab 46 0 46 Rp 116.0 635

16 Asam asetilsalisilat (asetosal) tab 80 mg tablet 0 20 20 Rp 148.0 -

17Asam askorbat (vitamin C) tab 50 mg tablet 2427 2657 5,084 Rp 95.0 33,530

18 Asam folat tab 1 mg tablet 81 0 81 Rp 48.0 1,000

19 Asam mefenamat kaps 500 mg kapsul 2900 2892 5,792 Rp 112.0 43,500

20 Asiklovir tab 200 mg tablet 6 50 56 Rp 237.0 1,000

21 Asiklovir tab 400 mg tablet 237 300 537 Rp 345.0 2,975

22 Atapulgit tablet 750 300 1,050 Rp 190.0 4,718

23 Atropin tab 0,5 mg tablet 0 0 - Rp 74.0 200

Anestetik lokal gigi kombinasi : lidokain HCl 2% + epinefrin 1 : 80.000 inj 2 mL Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium hidroksida 200 mg

Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 mg + lidokain 10 mg + seng oksida 120 mg, sup ad 2 g kertas warna

penanda oklusi




24 Atropin inj 0,25 mg/mL (i.v./i.m./s.k.) vial 0 0 - Rp 1,230.0 20

25 Bedak salisil serb 2% serbuk 61 50 111 Rp 1,250.0 915

26 Betametason krim 0,5 mg/g krim 78 124 202 Rp 1,520.0 1,106

27 Bisakodil tab salut 5 mg tab salut 20 20 40 Rp 645.0 300

28 Bisakodil sup 10 mg supp 20 10 30 Rp 6,045.0 300

29 Deksametason inj 5 mg/mL (i.v./i.m.) vial 50 5 55 Rp 1,580.0 590

30 Deksametason tab 0,5 mg tablet 4733 3948 8,681 Rp 68.0 13,658

31Diazepam lar rektal 5 mg/2,5 mL lar rektal 5 3 8 Rp 11,525.0 57

32Diazepam lar rektal 10 mg/2,5 mL lar rektal 0 0 - Rp 16,748.0 10

33Diazepam tab 2 mg tablet 124 130 254 Rp 45.0 1,821

34Difenhidramin inj 10 mg/mL (i.v./i.m.) vial 23 0 23 Rp 1,054.0 77

35 Digoksin tab 0,25 mg tablet 35 30 65 Rp 97.0 525

36 Dimenhidrinat tab 50 mg tablet 79 0 79 Rp 104.0 909

37 Doksisiklin kaps 100 mg kapsul 3 20 23 Rp 270.0 -




38 Domperidon tab 10 mg tablet 500 100 600 Rp 167.0 5,738

39 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) ampul 4 0 4 Rp 1,500.0 30

40 Ergotamin tab 1 mg tablet 18 0 18 Rp 135.0 100

41 Eritromisin kaps 250 mg kapsul 356 300 656 Rp 497.0 4,450

42 Eritromisin sir 200 mg/5 mL botol 17 5 22 Rp 7,700.0 208

43 Etanol botol 70% 1 L botol 10 10 20 Rp 2,500.0 87

44 Etil klorida semprot 100 mL botol 0 1 1 Rp 104,500.0 20

45 Eugenol botol 0 0 - Rp 35,000.0 12

46 Fenobarbital tab 30 mg tablet 43 360 403 Rp 144.0 498

47 Fitomenadion (vitamin K 1) tab sal 10 mg tab. Salut 124 90 214 Rp 634.0 1,017

48 Fitomenadion (vitamin K 1) inj 2 mg/mL (i.m.) vial 38 0 38 Rp 3,417.0 522

49 Furosemid tab 40 mg tablet 62 120 182 Rp 85.0 930

50 sachet 461 500 961 Rp 285.0 6,285

51 paket 1 0 1 Rp 968,000.0 15

52 Glibenklamid tab 5 mg tablet 136 120 256 Rp 54.0 -

Garam oralit kombinasi : natrium klorida 0,52 g + kalium klorida 0,30 g + trinatrium sitrat dihidrat 0,58 g+ glukosa anhidrat 2,7 g serbuk untuk 200 ml air

Glass ionomer ART (Atraumatic Restorative Treatment)




53 botol 2 5 7 Rp 5,333.0 0

54 tablet 10 180 190 Rp 228.0 0

55 Haloperidol tab 0,5 mg tablet 42 90 132 Rp 59.0 493

56 Haloperidol tab 1,5 mg tablet 90 300 390 Rp 69.0 995

57Haloperidol tab 5 mg tablet 2 60 62 Rp 96.0 300

58 Hidrogen peroksida botol 3% botol 0 0 - Rp 2,400.0 100

59Hidroklorotiazid tab 25 mg tablet 555 420 975 Rp 33.0 6061

60 Hidrokortison krim 2,5% krim 139 224 363 Rp 2,798.0 1960

61 Hiosina butilbromida tab 10 mg tablet 0 0 - Rp 300.0 2000

62 Ibuprofen tab 400 mg tablet 3500 2500 6,000 Rp 149.0 21618

63 Ibuprofen sir 100 mg/5 mL botol 0 20 20 Rp 3,499.0 300

64 Ibuprofen sir 200 mg/5 mL botol 0 0 - Rp 3,499.0 300

65 Ipratropium bromida nebulizer 0,025% botol 0 10 10 Rp 90,000.0 0

66 Isosorbid dinitrat tab 5 mg tablet 29 20 49 Rp 92.0 234

67 Kalamin botol 0 0 - Rp 16,000.0 100

Gliserin tts 100 mg/mL Griseofulvin (micronized) tab 125 mg




68 Kalsium laktat (kalk) tab 500 mg tablet 2295 2290 4,585 Rp 70.0 32587

69 Kaptopril tab 12,5 mg tablet 1244 600 1,844 Rp 62.0 2686

70 Kaptopril tab 25 mg tablet 1467 2714 4,181 Rp 80.0 21564

71 Karbamazepin tab 200 mg tablet 90 80 170 Rp 245.0 1220

72 Karbo adsorben tab 0,5 g tablet 0 0 - Rp 300.0 2000

73 Karbogliserin tts telinga 10 % botol 18 20 38 Rp 2,042.0 200

74 Ketokonazol tab 200 mg tablet 116 600 716 Rp 300.0 1000

75 Kloramfenikol kaps 250 mg kapsul 1647 600 2,247 Rp 275.0 24469

76 Kloramfenikol susp 125 mg/5 mL botol 10 10 Rp 3,680.0 300

77 Kloramfenikol salep kulit 2% pot 0 5 5 Rp 3,524.0 100

78 Kloramfenikol tts mata 0,5% botol 0 30 30 Rp 5,000.0 300

79 Kloramfenikol salep mata 1% pot 8 40 48 Rp 1,600.0 50

80 Klorfeniramin maleat tab 4 mg tablet 5678 9380 15,058 Rp 51.0 80566

81 Klorfenol kamfer mentol (CHKM) botol 0 0 - Rp 80,000.0 3

82 Klorheksidin lar 15% botol 4 0 4 Rp 79,800.0 60




83 Klorpromazin tab sal 25 mg tablet salut 6 120 126 Rp 38.0 250

84 Tablet salut 5250 5000 10,250 Rp 50.0 68820

85Paket 8 3 11 Rp 214,900.0 106

86

Paket 8 8 16 Rp 359,900.0 120

87 Kotrimoksazol 240 mg : sulfametoksazol 200 mg + trimetoprim 40 mg botol 152 116 268 Rp 2,145.0 2162

88tablet 1222 740 1,962 Rp 149.0 17092

89Lidokain inj 2% (infiltr/p.v.) ampul 0 12 12 Rp 1,363.0 0

90 Lidokain gel 2% gel 0 0 - Rp 80,000.0 10

91Lidokain semprot 15% (HCl) botol 0 0 - Rp 142,000.0 5

92Loratadin tab 10 mg tablet 0 0 - Rp 154.0 2000

93Magnesium sulfat inj 40% ampul 8 0 8 Rp 2,629.0 105

94 Metformin tab 500 mg tablet 0 0 - Rp 112.5 3000

95 Metildopa tab sal 250 mg Tab 0 0 - Rp 800.0 300

kombinasi : tablet salut ferro sulfat 200 mg + asam folat 0,25 mg

Kombinasi untuk anak : Paduan dalam bentuk dosis tetap (KDT/FDC) Rifampisin kaplet 75 mg + isoniazid tablet 50 mg + pirazinamid tablet 150 mg

kombinasi untuk dewasa: Paduan dalam bentuk dosis tetap (KDT/FDC) Rifampisin kaplet 150 mg + isoniazid tablet 75 mg + pirazinamid tablet 400 mg + etambutol tablet 275 mg

Kotrimoksazol (dewasa) 480 mg : sulfametoksazol 400 mg + trimetoprim 80 mg




96 Metilergometrin tab salut 0,125 mg tablet 49 60 109 Rp 154.0 685

97 Metilergometrin inj 0,2 mg/Ml ampul 17 0 17 Rp 4,620.0 215

98 Metilprednisolon tab 4 mg Tab 500 166 666 Rp 370.0 4866

99 Metoklopramid tab 10 mg tablet 0 0 - Rp 300.0 10000

100 Metronidazol tab 500 mg tablet 1014 500 1,514 Rp 160.0 14745

101 Metronidazol sir 125 mg/5 mL botol 0 0 - Rp 4,100.0 300

102 Metronidazol lar inf 5 mg/mL botol 0 0 - Rp 9,950.0 30

103 Mikonazol serb 2% dus 0 66 66 Rp - 0

104 Mikonazol krim 2% krim 32 94 126 Rp 3,000.0 451

105 Natrium bikarbonat tab 500 mg tablet 994 760 1,754 Rp 14.0 13637

106 Natrium diklofenak tab 50 mg tab 50 mg 840 1658 2,498 Rp 200.0 8787

107 Nifedipin kaps 10 mg kapsul 146 400 546 Rp 100.0 604

108 Nistatin tab salut 500.000 UI tablet salut 0 30 30 Rp 640.0 300

109 Nistatin susp 100.000 UI/mL botol 0 10 10 Rp 39,000.0 200

110 Nistatin tab vaginal 100.000 UI/tab supp 28 60 88 Rp 480.0 347




111 Oksitosin inj 10 UI/mL ampul 43 0 43 Rp 2,200.0 597

112 Omeprazol kaps 20 mg kapsul 500 140 640 Rp 211.0 5498

113 Parasetamol tab 500 mg tablet 17394 12406 29,800 Rp 89.0 250132

114 Parasetamol sir 120 mg/5 mL botol 382 508 890 Rp 1,438.0 5011

115 Parasetamol tts 60 mg/0,6 mL botol 42 80 122 Rp 6,540.0 400

116 Perak sulfadiazin krim 1% pot 0 0 - Rp 23,000.0 150

117 Permetrin krim 5 % pot 4 15 19 Rp 11,475.0 50

118 Pirantel pamoat 125 mg tablet 4 0 4 Rp 153.0 200

119 Pirantel pamoat susp 125 mg/5 mL botol 0 0 - Rp 8,360.0 100

120 Pirazinamid tab 500 mg tablet 33 0 33 Rp 206.0 455

121 Piridoksin (vitamin B6) tab 10 mg tablet 3715 3018 6,733 Rp 34.1 54423

122 Prednison 5 mg tablet 2212 1109 3,321 Rp 183.0 27559

123 Ranitidin 150 mg tablet 2856 2822 5,678 Rp 120.0 11827

124 Retinol (vitamin A) kaps lunak 100.000 UI kapsul lunak 0 60 60 Rp 260.0 12000

125 Retinol (vitamin A) kaps lunak 200.000 UI kaps lunak 0 500 500 Rp 259.0 10000




126 Risperidon tab sal 1 mg Tab sal 0 0 - Rp 1,400.0 100

127 Salbutamol 2 mg tablet 484 442 926 Rp 59.0 6253

128 Salbutamol 4 mg tablet 0 200 200 Rp 89.0 0

129 Salbutamol lar ih 0,5 % botol 37 0 37 Rp 6,600.0 505

130 Salep 2-4, kombinasi : asam salisilat 2% + belerang endap 4% tube 32 51 83 Rp 2,000.0 250

131 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) ampul 1 0 1 Rp - 15

132 Setirizin 5 mg/5 mL botol 0 0 - Rp 7,999.0 200

133 Sianokobalamin (vitamin B12) 50 mcg tablet 0 0 - Rp 57.0 5000

134 Sianokobalamin (vitamin B12) 500 mcg/mL ampul 110 0 110 Rp 1,078.0 780

135 Simvastatin 10 mg tablet salut 338 210 548 Rp 169.0 4354

136 Siprofloksasin 500 mg 993 650 1,643 Rp 550.0 14895

137 Tetrasiklin 250 mg kapsul 136 300 436 Rp 148.0 0

138 Tetrasiklin 500 mg kapsul 33 50 83 Rp 300.0 495

139Tiamin (vitamin B1) 50 mg tablet 5769 2792 8,561 Rp 74.4 45778

140Triheksifenidil 2 mg tablet 60 380 440 Rp 275.0 515

tablet scored




141Vaksin BCG vial 30 30 60 Rp - 450

142Vaksin campak vial 50 25 75 Rp - 750

143Vaksin jerap difteri tetanus pertusis (DTP) vial 80 0 80 Rp - 1200

144Vaksin jerap difteri tetanus (DT) vial 15 0 15 Rp - 225

145vial 40 30 70 Rp - 600

146Vaksin kombinasi DPT + hepatitis B vial 100 0 100 Rp - 1500

147Vaksin polio botol 60 60 120 Rp - 900

148Vitamin B kompleks tablet 6423 4544 10,967 Rp 107.0 88707

149Zinc 10 mg/mL botol 0 30 30 Rp - 0

150Zinc 20 mg tablet disp 519 710 1,229 Rp 292.0 7017

151Zinc 20 mg/5 mL botol 47 0 47 Rp 7,400.0 587

152Zinc 10 mg sachet 0 0 - Rp - 0

Vaksin jerap tetanus (tetanus adsorbed toxoid)




Daftar Usulan Obat Tambahan


JUMLAH HARGA SPESIFIKASI PABRIK

Arjasari

0 500 Rp 1,100,000

11520 22,829 Rp 1,963,294

0 3,000 Rp 598,500

1500 2,913 Rp 262,170

0 58 Rp 221,676

5400 12,713 Rp 2,377,331

13500 17,420 Rp 5,748,600

136950 172,922 Rp 47,034,784

750 2,250 Rp 9,101,250

JUMLAH KEBUTUHAN TAHUN 2015 JML TOTAL

KEBUTUHAN

JUMLAH HARGA SPESIFIKASI PABRIKJUMLAH KEBUTUHAN TAHUN 2015 JML TOTAL

KEBUTUHAN

75 4,555 Rp 6,208,465

47490 92,306 Rp 6,922,950

5040 10,935 Rp 22,963,500

630 1,180 Rp 3,593,100

0 3 Rp 390,000

0 635 Rp 73,660

300 300 Rp 44,400

39855 73,385 Rp 6,971,575

0 1,000 Rp 48,000

43380 86,880 Rp 9,730,560

750 1,750 Rp 414,750

4500 7,475 Rp 2,578,875

4500 9,218 Rp 1,751,420

0 200 Rp 14,800


KEBUTUHAN

0 20 Rp 24,600

750 1,665 Rp 2,081,250

1860 2,966 Rp 4,508,320

300 600 Rp 387,000

150 450 Rp 2,720,250

75 665 Rp 1,050,700

59220 72,878 Rp 4,955,704

45 102 Rp 1,175,550

0 10 Rp 167,480

1950 3,771 Rp 169,695

0 77 Rp 81,158

450 975 Rp 94,575

0 909 Rp 94,536

300 300 Rp 81,000


KEBUTUHAN

1500 7,238 Rp 1,208,746

0 30 Rp 45,000

0 100 Rp 13,500

4500 8,950 Rp 4,448,150

75 283 Rp 2,179,100

150 237 Rp 592,500

15 35 Rp 3,657,500

0 12 Rp 420,000

5400 5,898 Rp 849,312

1350 2,367 Rp 1,500,678

0 522 Rp 1,783,674

1800 2,730 Rp 232,050

7500 13,785 Rp 3,928,725

0 15 Rp 14,520,000

1800 1,800 Rp 97,200


KEBUTUHAN

75 75 Rp 399,975

2700 2,700 Rp 615,600

1350 1,843 Rp 108,737

4500 5,495 Rp 379,155

900 1,200 Rp 115,200

0 100 Rp 240,000

6300 12,361 Rp 407,913

3360 5,320 Rp 14,885,360

0 2,000 Rp 600,000

37500 59,118 Rp 8,808,582

300 600 Rp 2,099,400

0 300 Rp 1,049,700

150 150 Rp 13,500,000

300 534 Rp 49,128

0 100 Rp 1,600,000


KEBUTUHAN

34350 66,937 Rp 4,685,590

9000 11,686 Rp 724,532

40710 62,274 Rp 4,981,920

1200 2,420 Rp 592,900

0 2,000 Rp 600,000

300 500 Rp 1,021,000

9000 10,000 Rp 3,000,000

9000 33,469 Rp 9,203,975

150 450 Rp 1,656,000

75 175 Rp 616,700

450 750 Rp 3,750,000

600 650 Rp 1,040,000

140700 221,266 Rp 11,284,566

0 3 Rp 240,000

0 60 Rp 4,788,000


KEBUTUHAN

1800 2,050 Rp 77,900

75000 143,820 Rp 7,191,000

45 151 Rp 32,449,900

120 240 Rp 86,376,000

1740 3,902 Rp 8,369,790

11100 28,192 Rp 4,200,608

180 180 Rp 245,340

0 10 Rp 800,000

0 5 Rp 710,000

0 2,000 Rp 308,000

0 105 Rp 276,045

0 3,000 Rp 337,500

0 300 Rp 240,000


KEBUTUHAN

900 1,585 Rp 244,090

0 215 Rp 993,300

2490 7,356 Rp 2,721,720

0 10,000 Rp 3,000,000

7500 22,245 Rp 3,559,200

0 300 Rp 1,230,000

0 30 Rp 298,500

990 990 Rp -

1410 1,861 Rp 5,583,000

11400 25,037 Rp 350,518

24870 33,657 Rp 6,731,400

6000 6,604 Rp 660,400

450 750 Rp 480,000

150 350 Rp 13,650,000

900 1,247 Rp 598,560


KEBUTUHAN

0 597 Rp 1,313,400

2100 7,598 Rp 1,603,178

186090 436,222 Rp 38,823,758

7620 12,631 Rp 18,163,378

1200 1,600 Rp 10,464,000

0 150 Rp 3,450,000

225 275 Rp 3,155,625

200 400 Rp 61,200

0 100 Rp 836,000

0 455 Rp 93,730

45270 99,693 Rp 3,399,531

16635 44,194 Rp 8,087,502

42330 54,157 Rp 6,498,840

900 12,900 Rp 3,354,000

7500 17,500 Rp 4,532,500


KEBUTUHAN

0 100 Rp 140,000

6630 12,883 Rp 760,097

3000 3,000 Rp 267,000

0 505 Rp 3,333,000

765 1,015 Rp 2,030,000

0 15 Rp -

0 200 Rp 1,599,800

0 5,000 Rp 285,000

0 780 Rp 840,840

3150 7,504 Rp 1,268,176

9750 24,645 Rp 13,554,750

4500 4,500 Rp 666,000

750 1,245 Rp 373,500

41880 87,658 Rp 6,521,755

5700 6,215 Rp 1,709,125


KEBUTUHAN

450 900 Rp -

375 1,125 Rp -

0 1,200 Rp -

0 225 Rp -

450 1,050 Rp -

0 1,500 Rp -

900 1,800 Rp -

68160 156,867 Rp 16,784,769

450 450 Rp -

10650 17,667 Rp 5,158,764

0 587 Rp 4,343,800

0 - Rp -


KEBUTUHAN



NO NAMA OBAT

1Air untuk injeksi amp 25 ml

2Alopurinol tab 100 mg

4Amlodipin tab 10 mg

5Amlodipin tab 5 mg

3Aminofilin tab 200 mg

17Asam folat tab 1 mg

36Fitomenadion (vitamin K 1) tab sal 10 mg

6Amoksisilin sir kering 125 mg/5 ml

7Amoksisilin tab 250 mg

31Domperidon tab 10 mg

89Omeprazol kaps 20 mg

8Amoksisilin tab 500 mg

9Ampisilin serb inj 1000 mg/vial

18Asam mefenamat kaps 500 mg

74Metformin tab 500 mg

110Siprofloksasin tab scored 500 mg

10

22Atropin tab 0,5 mg

27Deksametason tab 0,5 mg

28Deksametason inj 5 mg/ml (i.v./i.m.)

32Eritromisin tab 500 mg

39Gemfibrozil kaps 300 mg

40Gentamisin tts mata 0,3%

45Haloperidol tab 0,5 mg

Anestetik lokal gigi kombinasi : lidokain hcl 2% + epinefrin 1 : 80.000 inj 2 ml

NO NAMA OBAT

46Haloperidol tab 1,5 mg

53Kaptopril tab 12,5 mg

59Klindamisin kaps 300 mg

90Ondansetron inj 2 mg/ml

106Setirizin sir 5 mg/5 ml.

37Furosemid tab 40 mg


73Loratadin tab 10 mg


38

16Asam asetilsalisilat (asetosal) tab 100 mg

35Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.)

87Nistatin tab vaginal 100.000 UI

19Asiklovir tab 400 mg

24Betametason krim 0,1%

34Eugenol

58Ketoprofen sup 100 mg

65Kodein tab 10 mg

67

81Metronidazol ovula 500 mg

83Mikonazol krim 2%

113Zinc tab disp 20 mg

114Vitamin B kompleks

20Atapulgit

23Bedak salisil serb 2%

25Bisakodil sup 10 mg

29Diazepam lar rektal 10 mg/2,5 ml

75Metildopa tab sal 250 mg

30Digoksin tab 0,25 mg

50Ibuprofen tab 200 mg

Garam oralit kombinasi : natrium klorida 0,52 g + kalium klorida 0,30 g + trinatrium sitrat 0,58 g + glukosa anhidrat 2,7 g

Kombinasi : ferro sulfat 200 mg+ as. Folat 0,25 mg

NO NAMA OBAT

101Salbutamol tab 2 mg

44

69

51Ibuprofen tab 400 mg

68

102Sefadroksil kaps/tab 500 mg

103Sefadroksil sir kering 125 mg/5 ml

54Kaptopril tab 25 mg

57Ketokonazol tab 200 mg

85Nifedipin kaps 10 mg

100Ranitidin tab 150 mg

62Kloramfenikol salep mata 1%

70Ringer Laktat Larutan

71Glukosa Larutan Infus 10% steril

72Lidokain gel 2%

76Metilergometrin inj 0,2 mg/ml

88Oksitosin inj 10 UI/ml

77Metilprednisolon tab 4 mg

80Metronidazol lar inf 5 mg/ml

99Ranitidin inj 25 mg/ml

104Sefotaksim serb inj 1.000 mg/vial

105Seftriakson serb inj 1.000 mg/vial

109Simvastatin tab sal 10 mg

82Metronidazol tab 500 mg

84Natrium diklofenak tab 50 mg

91Parasetamol sir 120 mg/5 ml

97Povidon iodin lar 100 mg/ml

108Sianokobalamin (vitamin B12) tab 50 mcg

111Tetrasiklin kaps 500 mg

92Parasetamol tab 500 mg

Gliserin tts 100 mg/ml Kotrimoksazol (dewasa) kombinasi tiap 5 ml suspensi : sulfametoksazol 200 mg + trimetoprim 40 mg

Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+ trimetoprim 80 mg

NO NAMA OBAT

93Parasetamol tts 60 mg/0,6 ml

94Perak sulfadiazin krim 1%

95Permetrin krim 5 %

96Polikresulen

115Ambroxol tab 30mg

116Ambroxol sir

13

14

15 Articulating paper kertas warna penanda oklusi

118Antalgin tab 500mg

119Acyclovir salep kulit 5gr

21Atropin inj 0,25 mg/ml (i.m./i.v./s.k)

26Bisakodil tab sal 5 mg

133Betahistin

138Bahan tambalan sementara (Caviton )

136Cresopate

137Devitasol

33Etil klorida semprot 100 ml

143Etakridin (rivanol) 0.1%

139Glucosamin 500mg

41

42

43

120Gentamicin salep kulit 5gr

121Glyceril guaiacolas tab 100mg

Hidrogen peroksida cairan 3%

49Hiosina butilbromida tab 10 mg

52Kalamin

55Karbo adsorben tab 0,5 g

60Kloramfenikol tts mata 1%

Antifungi salep, kombinasi : asam benzoat 6%+ asam salisilat 3% Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng oksida 120 mg + sup ad 2 g

Glass ionomer ART (Atraumatic Restorative Treatment) cocoa butter 5 g

Glass ionomer ART (Atraumatic Restorative Treatment) lar


NO NAMA OBAT

61Kloramfenikol salep kulit 2%

63Klorfeniramin tab 4 mg

64Klorheksidin lar 0,2%

122Kloramfenicol tetes telinga

123Meloxicam tab 15mg

124Multivitamin syrup 60ml

125Multivitamin dewasa kap

78Metoklopramid inj 5 mg/ml

79Metoklopramid tab 10 mg

86Nistatin susp 100.000 UI/ml

126Obat batuk pilek syr 60ml

127 Obat batuk pilek tab

131OBH 100ml syr

134Obat bahan gigi kombinasi (Cresophen )

135Obat bahan gigi kombinasi (Alvogil )

140Oxytetra salep kulit

141Oxytetra salep mata

98Prednison tab 5 mg

112Tiamin (vitamin B1) tab 50 mg

128Thiamphenicol kap 500mg

129Thiamphenicol syr 125mg/60ml

130Misoprostol tab 200mg

142Rockles

132Sulfacetamide Tetes mata

JUMLAH


Banjaran DTP


012

NO NAMA OBAT


Banjaran DTP


012



SATUAN HARGA SATUAN JUMLAH HARGA

Ampul 58 Rp 2,030.00 616 Rp 1,250,480

Tab 1,183 Rp 86.00 7,098 Rp 610,428

Tab 1,500 Rp 330.00 6,000 Rp 1,980,000

Tab - Rp 187.00 5,000 Rp 935,000

Tab 322 Rp 90.00 2,898 Rp 260,820

Tab - Rp 48.00 1,000 Rp 48,000

Tab sal 138 Rp 634.00 966 Rp 612,444

Botol 392 Rp 2,445.00 1,960 Rp 4,792,200

Tab 3,500 Rp 211.00 10,500 Rp 2,215,500

Tab 200 Rp 167.00 1,800 Rp 300,600

Kaps 200 Rp 211.00 1,800 Rp 379,800

Tab 10,000 Rp 272.00 40,000 Rp 10,880,000

Vial 50 Rp 5,100.00 450 Rp 2,295,000

Kaps 3,320 Rp 112.00 23,000 Rp 2,576,000

Tab - Rp 112.50 2,000 Rp 225,000

Tab 1,590 Rp 255.00 14,310 Rp 3,649,050

Vial 300 Rp 1,363.00 1,500 Rp 2,044,500

Tab - Rp 74.00 100 Rp 7,400

Tab 6,000 Rp 68.00 54,000 Rp 3,672,000

Vial 22 Rp 1,580.00 198 Rp 312,840

Tab 300 Rp 930.00 2,700 Rp 2,511,000

Kaps - Rp 289.00 200 Rp 57,800

Botol 16 Rp 3,194.00 144 Rp 459,936

Tab 50 Rp 59.00 200 Rp 11,800

PEMAKAI -AN BULANAN


SATUAN HARGA SATUAN JUMLAH HARGAPEMAKAI -AN

BULANAN


Tab 67 Rp 69.00 469 Rp 32,361

Tab 1,500 Rp 62.00 5,097 Rp 316,014

Kaps - Rp 553.00 1,000 Rp 553,000

Vial - Rp 2,400.00 200 Rp 480,000

Botol - Rp 7,999.00 100 Rp 799,900

Tab 86 Rp 85.00 774 Rp 65,790

Tab kunyah 6,000 Rp 75.00 60,000 Rp 4,500,000

Tab 500 Rp 154.00 4,500 Rp 693,000

Botol 350 Rp 2,100.00 1,000 Rp 2,100,000

Sachet 658 Rp 285.00 3,948 Rp 1,125,180

Tab 99 Rp 116.00 396 Rp 45,936

Vial 47 Rp 3,417.00 301 Rp 1,028,517

Tab 24 Rp 480.00 100 Rp 48,000

Tab 208 Rp 345.00 1,872 Rp 645,840

Tube 150 Rp 1,520.00 1,350 Rp 2,052,000

Botol - Rp 16,667.00 2 Rp 33,334

Botol - Rp 2,722.00 200 Rp 544,400

Tab - Rp 500.00 500 Rp 250,000

Tab sal 6,173 Rp 50.00 55,557 Rp 2,777,850

Supp - Rp 3,850.00 50 Rp 192,500

Tube 30 Rp 3,000.00 270 Rp 810,000

Tab 775 Rp 473.00 6,975 Rp 3,299,175

Tab 9,000 Rp 107.00 18,000 Rp 1,926,000

Tab 750 Rp 190.00 6,750 Rp 1,282,500

Botol 100 Rp 1,250.00 900 Rp 1,125,000

Botol - Rp 6,045.00 100 Rp 604,500

Botol - Rp 16,748.00 10 Rp 167,480

Tab - Rp 800.00 300 Rp 240,000

Tab 30 Rp 97.00 270 Rp 26,190

Tab 1,000 Rp 110.00 9,000 Rp 990,000


BULANAN


Tab 800 Rp 59.00 2,400 Rp 141,600

Botol 5 Rp 5,333.00 45 Rp 239,985

Botol 191 Rp 2,145.00 300 Rp 643,500

Tab 3,500 Rp 149.00 31,500 Rp 4,693,500

Tab 1,675 Rp 149.00 15,075 Rp 2,246,175

Tab 500 Rp 509.00 5,293 Rp 2,694,137

Botol 50 Rp 4,746.00 450 Rp 2,135,700

Tab 2,500 Rp 80.00 12,455 Rp 996,400

Tab 76 Rp 300.00 300 Rp 90,000

Kaps 206 Rp 100.00 618 Rp 61,800

Tab 3,000 Rp 120.00 27,000 Rp 3,240,000

Tube 44 Rp 1,600.00 396 Rp 633,600

Botol 500 Rp 5,200.00 4,500 Rp 23,400,000

Botol - Rp 5,700.00 5 Rp 28,500

Tube - Rp 40,000.00 5 Rp 200,000

Ampul 12 Rp 2,750.00 150 Rp 412,500

Ampul 61 Rp 2,200.00 600 Rp 1,320,000

Tab 300 Rp 205.00 2,700 Rp 553,500

Botol - Rp 9,950.00 12 Rp 119,400

Ampul 200 Rp 1,140.00 1,800 Rp 2,052,000

Vial 100 Rp 2,950.00 900 Rp 2,655,000

Vial 100 Rp 3,300.00 900 Rp 2,970,000

Tab sal 265 Rp 169.00 1,325 Rp 223,925

Tab 768 Rp 160.00 2,000 Rp 320,000

Tab 562 Rp 200.00 5,058 Rp 1,011,600

Botol 500 Rp 1,438.00 4,500 Rp 6,471,000

Botol 300 ml 15 Rp 14,203.00 135 Rp 1,917,405

Tab 618 Rp 57.00 6,000 Rp 342,000

Kaps 200 Rp 300.00 1,000 Rp 300,000

Tab 19,000 Rp 89.00 171,000 Rp 15,219,000


BULANAN


Botol 35 Rp 5,200.00 315 Rp 1,638,000

Tube - Rp 11,500.00 150 Rp 1,725,000

Tube - Rp 11,475.00 200 Rp 2,295,000

Botol 4 Rp 25,000.00 36 Rp 900,000

Tab 2,024 Rp 123.00 6,072 Rp 746,856

Botol 292 Rp 2,822.00 2,628 Rp 7,416,216

Tube 16 Rp 1,904.40 144 Rp 274,234

sup - Rp 3,300.00 500 Rp 1,650,000

- Rp 130,000.00 3 Rp 390,000

Tab 635 Rp 352.00 5,715 Rp 2,011,680

Tube 30 Rp 3,374.00 180 Rp 607,320

Ampul 5 Rp 1,230.00 30 Rp 36,900

Tab sal - Rp 4,990.00 100 Rp 499,000

Tab - Rp 500.00 200 Rp 100,000

Botol 1 Rp 165,000.00 12 Rp 1,980,000

Botol 1 Rp 595,320.00 2 Rp 1,190,640

Botol 1 Rp 360,000.00 6 Rp 2,160,000

Botol 3 Rp 104,500.00 35 Rp 3,657,500

Botol 15 Rp 2,212.00 126 Rp 278,712

Tab - Rp 2,000.00 1,000 Rp 2,000,000

Sachet 1 Rp 547,800.00 8 Rp 4,382,400

Botol 1 Rp 547,800.00 8 Rp 4,382,400

Vial 1 Rp 547,800.00 8 Rp 4,382,400

Tube 44 Rp 1,350.00 396 Rp 534,600

Tab 3,000 Rp 39.00 27,000 Rp 1,053,000

Botol - Rp 2,400.00 10 Rp 24,000

Tab 300 Rp 300.00 3,600 Rp 1,080,000

Tube - Rp 16,000.00 100 Rp 1,600,000

Tab - Rp 300.00 1,000 Rp 300,000

Botol - Rp 5,000.00 600 Rp 3,000,000

Kertas warna penanda oklusi


BULANAN


Tube - Rp 7,150.00 200 Rp 1,430,000

Tab 8,407 Rp 26.00 75,663 Rp 1,967,238

Botol 6 Rp 79,800.00 68 Rp 5,426,400

Botol 57 Rp 1,599.00 513 Rp 820,287

Tab 300 Rp 1,100.00 3,600 Rp 3,960,000

Botol 250 Rp 7,150.00 2,250 Rp 16,087,500

Kap 3,000 Rp 440.00 30,000 Rp 13,200,000

Vial 50 Rp 860.00 450 Rp 387,000

Tab 600 Rp 108.00 6,139 Rp 663,012

Botol - Rp 39,000.00 100 Rp 3,900,000

Botol 200 Rp 6,996.00 2,000 Rp 13,992,000

Tab 1,000 Rp 574.00 12,000 Rp 6,888,000

Botol 300 Rp 3,850.00 3,302 Rp 12,712,700

Botol 1 Rp 595,320.00 4 Rp 2,381,280

Botol 1 Rp 374,000.00 8 Rp 2,992,000

Tube 115 Rp 2,090.00 1,035 Rp 2,163,150

Tube 50 Rp 1,600.00 150 Rp 240,000

Tab 2,279 Rp 98.00 11,395 Rp 1,116,710

Tab 6,623 Rp 36.00 20,000 Rp 720,000

Kap 1,500 Rp 431.00 13,500 Rp 5,818,500

Botol - Rp 22,300.00 300 Rp 6,690,000

Tab - Rp 15,000.00 300 Rp 4,500,000

Botol 1 Rp 490,000.00 4 Rp 1,960,000

Botol 120 Rp 3,300.00 1,080 Rp 3,564,000

Rp 314,049,927


Pengelola Obat,

Sunsun Sumirah, Amd. Farm

NIP. 19730125 199603 2 003


BULANAN


Pengelola Obat,

Sunsun Sumirah, Amd. Farm

NIP. 19730125 199603 2 003


SPESIFIKASI PABRIK

PT.Ikapharmindo

PT. Pertiwi Agung

PT. Pertiwi Agung

PT. Marin Liza Farmasi


PT. Novapharin

PT. Novapharin

PT. Bernofarm

PT. Indofarma

PT. Indofarma

PT. Indofarma

PT. Indofarma

PT. Indofarma

PT. Indofarma

PT. Pertiwi Agung


PT. Novapharin

PT. Novapharin

PT. Bernofarm

PT. Bernofarm

PT. Bernofarm

PT. Bernofarm

PT. Indofarma

PT. Indofarma

https://katalog-buku.lkpp.go.id/e-katalog-obat/index.php/katalog/info_penyedia/49










SPESIFIKASI PABRIK

PT. Indofarma

PT. Indofarma

PT. Indofarma

PT. Promedrahardjo Farmasi Industri

PT. Promedrahardjo Farmasi Industri

PT. Kimia Farma

PT. Kimia Farma

PT. Kimia Farma

PT. Kimia Farma

PT. Kimia Farma

PT. Kimia Farma

PT. Kimia Farma

PT. Zenith Pharmaceuticals

PT. Rama Emerald Multi Sukses

PT. Sanbe Farma

PT. Actavis Indonesia

PT. Yarindo Farmatama

PT. Indofarma

PT. Indofarma

PT. Indofarma



PT. Phapros, Tbk

PT. Phapros, Tbk

PT. Phapros, Tbk

PT. Kimia Farma

PT. Kimia Farma

PT. Kimia Farma

PT. Actavis Indonesia















SPESIFIKASI PABRIK

PT. Lucas Djaja

PT. Holi Pharma

PT. Holi Pharma

PT. Holi Pharma

PT. Holi Pharma

PT. Dexa Medica

PT. Erela

PT. Widatra Bhakti

PT. Widatra Bhakti

PT. AstraZeneca indonesia

PT. Ethica Industri Farmasi

PT. Natura Laboratoria Prima





PT. Novell Pharmaeutical Laboratories

PT. Afifarma

PT. Afifarma

PT. Afifarma

PT. Afifarma


PT. Lucas Djaja

PT. Errita Pharma

PT. Dexa Medica

PT. Dexa Medica

PT. Ethica Industri Farmasi


PT. Phyto Kemo Agung Farma

PT. Imfarmind Farmasi industri










SPESIFIKASI PABRIK

PT. Ifars Pharmaceutical Laboratories

PT. Darya Varia

PT. Galenium Pharmasia Laboratories

PT. Pratapa Nirmala

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

SPESIFIKASI PABRIK

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

Non E-katalog

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Non E-katalog

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SPESIFIKASI PABRIK

Form Rko Pkm 2016 Dinas

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Transcript of Form Rko Pkm 2016 Dinas