SPESIFIKASI TEKNIS
14
SPESIFIKASI OBAT-OBATAN PELAYANAN KESEHATAN DASAR NO. NAMA OBAT SATUAN KEMASAN KEMASAN PABRIKAN 1 2 3 4 5 OBAT GENERIK ( E-KATALOG) PAKET I 1 Albendazol tablet 400 mg 30 tablet Kotak Holi Pharma 2 Alopurinol tablet 100 mg 100 tablet Kotak Pertiwi Agung 3 Alprazolam tablet 0,5 mg 100 tablet Kotak Kimia Farma 4 Aminofilin tablet scored 200 mg 100 tablet Botol Erela 5 Aminofilina injeksi 24 mg / ml - 10 ml 30 amp @ 10 ml Kotak Lucas Djaya 6 Amitriptilin tablet salut 25 mg ( HCl ) 100 tablet Kotak Indofarma 7 Amlodipin tablet 5 mg 30 tab Kotak Pertiwi Agung 8 Amoksisilin sirup kering 125 mg / 5 ml 60 ml Botol Novapharin 9 Amoksisilin kaplet scored 500 mg 100 kaplet Kotak 10 Amoksisilin kapsul 250 mg 100 kapsul Kotak Novapharin 11 Antasida DOEN I tablet 100 tablet Kotak Erela 12 Antasida DOEN II sirup 60 ml Botol Erela 13 Asam Askorbat ( Vitamin C ) tablet 50 mg 100 tablet Botol Kimia Farma 14 Asam Mefenamat kaplet 500 mg 100 kaplet Kotak Bernofarm 15 Asiklovir tablet 400 mg 50 tablet Kotak 16 Azitromisin tablet 500 mg 20 tablet Kotak Kimia Farma 17 Bedak salisil serbuk 2 % 50 gr Kotak 18 Betametason krim 0.1% ( sebagai Valerat ) 25 tube @ 5 g Kotak Kimia Farma 19 Deksametason injeksi 5 mg / ml - 1 ml 100 amp. @ 1 ml Kotak Indofarma 20 Deksametason tablet 0,5 mg 100 tablet Kotak 21 Desoksimetason krim 0,25 % tube @ 15 gr Tube Dexa Medica 22 Difenhidramin HCl injeksi 10 mg / ml -1 ml 30 amp. @ 1 ml Kotak Phapros Tbk 23 Digoksin tablet 0,25 mg 100 tablet Kotak 24 Dimenhidrinat tablet 50 mg 100 tablet Botol Kimia Farma 25 Domperidone Suspensi 5 mg/5ml 60 ml Botol Novapharin 26 Domperidone tablet 10 mg 100 tablet Kotak Novapharin 27 Epinefrina HCl (Adrenalin) injeksi 0,1 % 30 amp. @ 1 ml Kotak Phapros Tbk 28 Eritromisin kapsul 500 mg 100 kapsul Kotak Indofarma 29 Eritromisin sirup 200 mg / 5 ml 60 ml Botol 30 Furosemid tablet 40 mg 100 tablet Kotak Indofarma 31 Gentamisin tetes mata 0,3 % 5 ml Botol Indofarma 32 Glibenklamid tablet 5 mg 100 tablet kotak Indofarma 33 Glimipiride tablet 2 mg 50 tablet Kotak Kimia Farma 34 Glukosa 5% 1/2 NS ( Wida D5-1/2 NS ) 500 ml Botol Widrata Bhakti 35 Glukosa 5% 1/4 NS ( Wida D5-1/4NS ) 500 ml Botol Widrata Bhakti 36 Glukosa larutan infus 5 % steril 500 ml Botol Widrata Bhakti 37 Griseofulvin tablet 125 mg, Micronized 100 tablet Kotak Phapros Tbk 38 Haloperidol tablet 0,5 mg 100 tablet Kotak Indofarma 39 Haloperidol tablet 1,5 mg 100 tablet Kotak Indofarma 40 Haloperidol tablet 5 mg 100 tablet Kotak Indofarma 41 Ibuprofen sirup 100 mg / 5ml 60 ml Botol Indofarma 42 Ibuprofen tablet 400 mg 100 tablet Kotak Novapharin 43 Isosorbid Dinitrat tablet sublingual 5 mg 100 tablet Kotak Indofarma 44 Kaptopril tablet 12,5 mg 100 tablet Kotak Indofarma Mersifarma Tirmaku Sampharindo Perdana Rama Emerald Multi Sukses Promedrahardjo Farmasi Industri Yarindo Farmatama Kemo Agung Farma
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Transcript of SPESIFIKASI TEKNIS
SPESIFIKASI OBAT-OBATAN PELAYANAN KESEHATAN DASAR
NO. NAMA OBAT KEMASAN PABRIKAN KUANTUM
1 2 3 4 5 6
OBAT GENERIK ( E-KATALOG) PAKET I
1 Albendazol tablet 400 mg 30 tablet Kotak Holi Pharma 1,500
2 Alopurinol tablet 100 mg 100 tablet Kotak Pertiwi Agung 1,727
3 Alprazolam tablet 0,5 mg 100 tablet Kotak Kimia Farma 100
4 Aminofilin tablet scored 200 mg 100 tablet Botol Erela 50
5 Aminofilina injeksi 24 mg / ml - 10 ml 30 amp @ 10 ml Kotak Lucas Djaya 13
6 Amitriptilin tablet salut 25 mg ( HCl ) 100 tablet Kotak Indofarma 52
7 Amlodipin tablet 5 mg 30 tab Kotak Pertiwi Agung 1,000
8 Amoksisilin sirup kering 125 mg / 5 ml 60 ml Botol Novapharin 9,451
9 Amoksisilin kaplet scored 500 mg 100 kaplet Kotak 7,318
10 Amoksisilin kapsul 250 mg 100 kapsul Kotak Novapharin 254
11 Antasida DOEN I tablet 100 tablet Kotak Erela 2,361
12 Antasida DOEN II sirup 60 ml Botol Erela 15,759
13 Asam Askorbat ( Vitamin C ) tablet 50 mg 100 tablet Botol Kimia Farma 1,294
14 Asam Mefenamat kaplet 500 mg 100 kaplet Kotak Bernofarm 4,311
15 Asiklovir tablet 400 mg 50 tablet Kotak 764
16 Azitromisin tablet 500 mg 20 tablet Kotak Kimia Farma 139
17 Bedak salisil serbuk 2 % 50 gr Kotak 5,674
18 Betametason krim 0.1% ( sebagai Valerat ) 25 tube @ 5 g Kotak Kimia Farma 233
19 Deksametason injeksi 5 mg / ml - 1 ml 100 amp. @ 1 ml Kotak Indofarma 86
20 Deksametason tablet 0,5 mg 100 tablet Kotak 2,148
21 Desoksimetason krim 0,25 % tube @ 15 gr Tube Dexa Medica 680
22 Difenhidramin HCl injeksi 10 mg / ml -1 ml 30 amp. @ 1 ml Kotak Phapros Tbk 203
23 Digoksin tablet 0,25 mg 100 tablet Kotak 226
24 Dimenhidrinat tablet 50 mg 100 tablet Botol Kimia Farma 433
25 Domperidone Suspensi 5 mg/5ml 60 ml Botol Novapharin 500
26 Domperidone tablet 10 mg 100 tablet Kotak Novapharin 60
27 Epinefrina HCl (Adrenalin) injeksi 0,1 % 30 amp. @ 1 ml Kotak Phapros Tbk 89
28 Eritromisin kapsul 500 mg 100 kapsul Kotak Indofarma 198
29 Eritromisin sirup 200 mg / 5 ml 60 ml Botol 1,320
30 Furosemid tablet 40 mg 100 tablet Kotak Indofarma 236
31 Gentamisin tetes mata 0,3 % 5 ml Botol Indofarma 364
32 Glibenklamid tablet 5 mg 100 tablet kotak Indofarma 1,301
33 Glimipiride tablet 2 mg 50 tablet Kotak Kimia Farma 800
34 Glukosa 5% 1/2 NS ( Wida D5-1/2 NS ) 500 ml Botol Widrata Bhakti 1,000
35 Glukosa 5% 1/4 NS ( Wida D5-1/4NS ) 500 ml Botol Widrata Bhakti 1,500
36 Glukosa larutan infus 5 % steril 500 ml Botol Widrata Bhakti 9,110
37 Griseofulvin tablet 125 mg, Micronized 100 tablet Kotak Phapros Tbk 261
38 Haloperidol tablet 0,5 mg 100 tablet Kotak Indofarma 74
39 Haloperidol tablet 1,5 mg 100 tablet Kotak Indofarma 122
40 Haloperidol tablet 5 mg 100 tablet Kotak Indofarma 120
41 Ibuprofen sirup 100 mg / 5ml 60 ml Botol Indofarma 4,610
42 Ibuprofen tablet 400 mg 100 tablet Kotak Novapharin 2,471
43 Isosorbid Dinitrat tablet sublingual 5 mg 100 tablet Kotak Indofarma 156
44 Kaptopril tablet 12,5 mg 100 tablet Kotak Indofarma 1,149
SATUAN KEMASAN
Mersifarma Tirmaku
Sampharindo Perdana
Rama Emerald Multi Sukses
Promedrahardjo Farmasi Industri
Yarindo Farmatama
Kemo Agung Farma
NO. NAMA OBAT KEMASAN PABRIKAN KUANTUM
1 2 3 4 5 6
SATUAN KEMASAN
45 Karbamazepin tablet 200 mg 100 tablet Kotak Indofarma 468
46 Ketokonazol tablet 200 mg 50 tablet Kotak Dexa Medica 1,000
47 Klindamisin kapsul 150 mg 50 kapsul Kotak Indofarma 611
48 Kloramfenikol salep mata 1 % Tube @ 5 g Tube Kimia Farma 432
49 Kodein HCl tablet 10 mg 100 tablet Kotak Kimia Farma 44
50 Kotrimoksazol Dewasa tablet 100 tablet Kotak 725
51 Kotrimoksazol suspensi 60 ml Botol 4,387
52 Lanzoprazol kapsul 30 mg 20 kapsul Kotak Indofarma 1,044
53 Lidokain injeksi 2% (HCl) + Epinefrin 1:80.000-2ml 30 amp. @ 2 ml Kotak Indofarma 541
54 Loperamida - HCl tablet 2 mg 100 tablet Kotak 477
55 100 tablet Kotak Kimia Farma 149
56 Metronidazol tablet 250 mg 100 tablet Kotak 533
57 Miconazol krim Tube @ 10 g Tube Kimia Farma 3,981
58 Nifedipin tablet 10 mg 100 tablet Kotak Dexa Medica 1,270
59 Nistatin tablet salut 500.000 IU / g 100 tablet Kotak Phapros Tbk 28
60 Noretisteron tablet 5 mg ( Primolut N ) 100 tablet Kotak Bayer Indonesia 200
61 OAT - FDC Kategori 1 PAKET Paket Paket Kimia Farma 160
62 OAT - FDC Kategori 2 PAKET Paket Paket Indofarma 10
63 OAT - FDC Kategori Anak PAKET Paket Paket Phapros Tbk 50
64 Ofloxaxin tablet 200 mg 50 tablet Kotak 79
65 Omeprazol kapsul 20 mg 100 kapsul Kotak Novapharin 300
66 Parasetamol sirup 120 mg / 5 ml 60 ml Botol Afifarma 17,532
67 Pirantel tablet score (base) 125 mg 100 tablet Kotak Holi Pharma 255
68 Povidon Iodida 10% 30 ml 30 ml Botol Afifarma 548
69 Povidon Iodida 10% 300 ml 300 ml Botol Afifarma 274
70 Ranitidin injeksi 25 mg / 2ml 10 ampul Kotak 686
71 Retinol ( Vitamin A ) 100.000 IU Kapsul 50 kapsul lunak Botol Kimia Farma 500
72 Ringer Laktat larutan infus steril 500 ml Botol Widrata Bhakti 41,936
73 Risperidon tablet 1 mg 50 tab Kotak Dexa Medica 224
74 Sefadroksil kapsul 500 mg 100 kapsul Kotak Bernofarm 756
75 Sefadroksil sirup kering 125 mg / 5 ml 60 ml Botol Holi Pharma 6,781
76 Sefiksim kapsul 100 mg 100 kapsul Kotak Bernofarm 297
77 Sefotaksim serbuk injeksi 1 gr 10 vial Kotak 1,026
78 Seftriakson injeksi 1 g 10 vial Kotak 138
79 Sianokobalamin ( Vitamin B12 ) injeksi 500 mcg 100 ampul Kotak Lucas Djaya 83
80 Simvastatin Scored tablet 10 mg 30 tablet Kotak 4,911
81 Trifluoperazin tablet 5 mg 100 tablet Kotak Darya Varia 540
82 Zink tablet dispersible 20 mg 100 tablet Kotak Indofarma 500
Gresik, 25 Maret 2014
Mengetahui, Menetapkan,
KEPALA DINAS KESEHATAN PEJABAT PEMBUAT KOMITMEN
KABUPATEN GRESIK PENGADAAN OBAT PKD
dr. SOEGENG WIDODO Drg. HARI TUTIK RAHAYU
Pembina Utama Muda Pembina
Promedrahardjo Farmasi Industri
Sampharindo Perdana
Ifars Pharmaceutical
Metilergometrin Maleat ( Metilergometrin ) tablet salut 0,125 mg
Phyto Kemo Agung Farma
Novel Pharmaceutical
Natura Laboratoria Farma
Natura Laboratoria Farma
Natura Laboratoria Farma
Natura Laboratoria Farma
NO. NAMA OBAT KEMASAN PABRIKAN KUANTUM
1 2 3 4 5 6
SATUAN KEMASAN
NIP. 19560315 198511 1 001 NIP. 19620424 198910 2 001
Lampiran : Berita Acara Penyusunan HPS / OE Pengadaan Obat-Obatan Pelayanan Kesehatan Dasar.
Nomor : 027 / 389.1 / 437.52 / 2014
PAGU ANGGARAN : Rp. 4.637.556.000,00
Harga Perkiraan Sendiri (HPS) / OE : Rp. 1.490.887.458,00
NO. NAMA OBAT KEMASAN PABRIKAN KUANTUM JUMLAH HARGA
1 2 3 4 5 6 7 8 9
OBAT GENERIK ( E-KATALOG) PAKET I
1 Albendazol tablet 400 mg 30 tablet Kotak Holi Pharma 344 10,320.00 1,500 15,480,000.00
2 Alopurinol tablet 100 mg 100 tablet Kotak Pertiwi Agung 86 8,600.00 1,727 14,852,200.00
3 Alprazolam tablet 0,5 mg 100 tablet Kotak Kimia Farma 214 21,400.00 100 2,140,000.00
4 Aminofilin tablet scored 200 mg 100 tablet Botol Erela 80 8,000.00 50 400,000.00
5 Aminofilina injeksi 24 mg / ml - 10 ml 30 amp @ 10 ml Kotak Lucas Djaya 3,822 114,660.00 13 1,490,580.00
6 Amitriptilin tablet salut 25 mg ( HCl ) 100 tablet Kotak Indofarma 112 11,200.00 52 582,400.00
7 Amlodipin tablet 5 mg 30 tab Kotak Pertiwi Agung 187 5,610.00 1,000 5,610,000.00
8 Amoksisilin sirup kering 125 mg / 5 ml 60 ml Botol Novapharin 2,445 2,445.00 9,451 23,107,695.00
9 Amoksisilin kaplet scored 500 mg 100 kaplet Kotak 261 26,100.00 7,318 190,999,800.00
10 Amoksisilin kapsul 250 mg 100 kapsul Kotak Novapharin 211 21,100.00 254 5,359,400.00
11 Antasida DOEN I tablet 100 tablet Kotak Erela 72 7,200.00 2,361 16,999,200.00
12 Antasida DOEN II sirup 60 ml Botol Erela 2,160 2,160.00 15,759 34,039,440.00
13 Asam Askorbat ( Vitamin C ) tablet 50 mg 100 tablet Botol Kimia Farma 95 32,000.00 1,294 41,408,000.00
14 Asam Mefenamat kaplet 500 mg 100 kaplet Kotak Bernofarm 112 11,200.00 4,311 48,283,200.00
15 Asiklovir tablet 400 mg 100 tablet Kotak 336 33,600.00 382 12,835,200.00
16 Azitromisin tablet 500 mg 20 tablet Kotak Kimia Farma 4,500 220,000.00 139 30,580,000.00
17 Bedak salisil serbuk 2 % 50 gr Kotak 1,250 1,120.00 5,674 6,354,880.00
18 Betametason krim 0.1% ( sebagai Valerat ) 25 tube @ 5 g Kotak Kimia Farma 1,520 38,000.00 233 8,854,000.00
19 Deksametason injeksi 5 mg / ml - 1 ml 100 amp. @ 1 ml Kotak Indofarma 1,580 158,000.00 86 13,588,000.00
20 Deksametason tablet 0,5 mg 100 tablet Kotak 62 6,200.00 2,148 13,317,600.00
SATUAN KEMASAN
HARGA SATUAN TERKECIL ( Rp. )
E-CATALOGUE TAHUN 2014
HARGA SATUAN PER KEMASAN
(Rp.) E.CATALOGUE TAHUN 2014
Mersifarma Tirmaku
Sampharindo Perdana
Rama Emerald Multi Sukses
Promedrahardjo Farmasi Industri
NO. NAMA OBAT KEMASAN PABRIKAN KUANTUM JUMLAH HARGA
1 2 3 4 5 6 7 8 9
SATUAN KEMASAN
HARGA SATUAN TERKECIL ( Rp. )
E-CATALOGUE TAHUN 2014
HARGA SATUAN PER KEMASAN
(Rp.) E.CATALOGUE TAHUN 2014
21 Desoksimetason krim 0,25 % tube @ 15 gr Tube Dexa Medica 9,983 9,983.00 680 6,788,440.00
22 Difenhidramin HCl injeksi 10 mg / ml -1 ml 30 amp. @ 1 ml Kotak Phapros Tbk 1,050 31,500.00 203 6,394,500.00
23 Digoksin tablet 0,25 mg 100 tablet Kotak 97 9,700.00 226 2,192,200.00
24 Dimenhidrinat tablet 50 mg 100 tablet Botol Kimia Farma 104 10,400.00 433 4,503,200.00
25 Domperidone Suspensi 5 mg/5ml 60 ml Botol Novapharin 3,333 3,333.00 500 1,666,500.00
26 Domperidone tablet 10 mg 100 tablet Kotak Novapharin 167 16,700.00 60 1,002,000.00
27 Epinefrina HCl (Adrenalin) injeksi 0,1 % 30 amp. @ 1 ml Kotak Phapros Tbk 8,100 243,000.00 89 21,627,000.00
28 Eritromisin kapsul 500 mg 100 kapsul Kotak Indofarma 930 93,000.00 198 18,414,000.00
29 Eritromisin sirup 200 mg / 5 ml 60 ml Botol 7,700 7,700.00 1,320 10,164,000.00
30 Furosemid tablet 40 mg 100 tablet Kotak Indofarma 85 8,500.00 236 2,006,000.00
31 Gentamisin tetes mata 0,3 % 5 ml Botol Indofarma 3,194 3,194.00 364 1,162,616.00
32 Glibenklamid tablet 5 mg 100 tablet kotak Indofarma 56 5,600.00 1,301 7,285,600.00
33 Glimipiride tablet 2 mg 50 tablet Kotak Kimia Farma 436 21,800.00 800 17,440,000.00
34 Glukosa 5% 1/2 NS ( Wida D5-1/2 NS ) 500 ml Botol Widrata Bhakti 7,700 7,700.00 1,500 11,550,000.00
35 Glukosa 5% 1/4 NS ( Wida D5-1/4NS ) 500 ml Botol Widrata Bhakti 7,700 7,700.00 1,000 7,700,000.00
36 Glukosa larutan infus 5 % steril 500 ml Botol Widrata Bhakti 5,200 5,200.00 9,110 47,372,000.00
37 Griseofulvin tablet 125 mg, Micronized 100 tablet Kotak Phapros Tbk 209 20,900.00 261 5,454,900.00
38 Haloperidol tablet 0,5 mg 100 tablet Kotak Indofarma 59 5,900.00 74 436,600.00
39 Haloperidol tablet 1,5 mg 100 tablet Kotak Indofarma 69 6,900.00 122 841,800.00
40 Haloperidol tablet 5 mg 100 tablet Kotak Indofarma 96 9,600.00 120 1,152,000.00
41 Ibuprofen sirup 100 mg / 5ml 60 ml Botol Indofarma 3,499 3,499.00 4,610 16,130,390.00
42 Ibuprofen tablet 400 mg 100 tablet Kotak Novapharin 150 15,000.00 2,471 37,065,000.00
43 Isosorbid Dinitrat tablet sublingual 5 mg 100 tablet Kotak Indofarma 88 8,800.00 156 1,372,800.00
44 Kaptopril tablet 12,5 mg 100 tablet Kotak Indofarma 62 6,200.00 1,149 7,123,800.00
45 Karbamazepin tablet 200 mg 100 tablet Kotak Indofarma 245 24,500.00 468 11,466,000.00
Yarindo Farmatama
Kemo Agung Farma
NO. NAMA OBAT KEMASAN PABRIKAN KUANTUM JUMLAH HARGA
1 2 3 4 5 6 7 8 9
SATUAN KEMASAN
HARGA SATUAN TERKECIL ( Rp. )
E-CATALOGUE TAHUN 2014
HARGA SATUAN PER KEMASAN
(Rp.) E.CATALOGUE TAHUN 2014
46 Ketokonazol tablet 200 mg 50 tablet Kotak Dexa Medica 300 15,000.00 1,000 15,000,000.00
47 Klindamisin kapsul 150 mg 50 kapsul Kotak Indofarma 361 18,050.00 611 11,028,550.00
48 Kloramfenikol salep mata 1 % Tube @ 5 g Tube Kimia Farma 1,600 1,600.00 432 691,200.00
49 Kodein HCl tablet 10 mg 100 tablet Kotak Kimia Farma 500 50,000.00 44 2,200,000.00
50 Kotrimoksazol Dewasa tablet 100 tablet Kotak 138 13,800.00 725 10,005,000.00
51 Kotrimoksazol suspensi 60 ml Botol 2,167 2,167.00 4,387 9,506,629.00
52 Lanzoprazol kapsul 30 mg 20 kapsul Kotak Indofarma 473 9,460.00 1,044 9,876,240.00
53 Lidokain injeksi 2% (HCl) + Epinefrin 1:80.000-2ml 30 amp. @ 2 ml Kotak Indofarma 1,363 40,890.00 541 22,121,490.00
54 Loperamida - HCl tablet 2 mg 100 tablet Kotak 89 8,900.00 477 4,245,300.00
55 Metilergometrin Maleat ( Metilergometrin ) tablet salut 0,125 mg 100 tablet Kotak Kimia Farma 154 15,400.00 149 2,294,600.00
56 Metronidazol tablet 250 mg 100 tablet Kotak 110 11,000.00 533 5,863,000.00
57 Miconazol krim Tube @ 10 g Tube Kimia Farma 3,000 3,000.00 3,981 11,943,000.00
58 Nifedipin tablet 10 mg 100 tablet Kotak Dexa Medica 110 11,000.00 1,270 13,970,000.00
59 Nistatin tablet salut 500.000 IU / g 100 tablet Kotak Phapros Tbk 640 64,000.00 28 1,792,000.00
60 Noretisteron tablet 5 mg ( Primolut N ) 30 tablet Kotak Bayer Indonesia 2,618 261,800.00 200 52,360,000.00
61 OAT - FDC Kategori 1 PAKET Paket Paket Kimia Farma 359,990 359,990.00 160 57,598,400.00
62 OAT - FDC Kategori 2 PAKET Paket Paket Indofarma 1,199,990 1,199,990.00 10 11,999,900.00
63 OAT - FDC Kategori Anak PAKET Paket Paket Phapros Tbk 214,900 214,900.00 50 10,745,000.00
64 Ofloxaxin tablet 200 mg 50 tablet Kotak 400 20,000.00 79 1,580,000.00
65 Omeprazol kapsul 20 mg 100 kapsul Kotak Novapharin 211 21,100.00 300 6,330,000.00
66 Parasetamol sirup 120 mg / 5 ml 60 ml Botol Afifarma 1,438 1,438.00 17,532 25,211,016.00
67 Pirantel tablet score (base) 125 mg 100 tablet Kotak Holi Pharma 298 29,800.00 255 7,599,000.00
68 Povidon Iodida 10% 30 ml 30 ml Botol Afifarma 2,163 2,163.00 548 1,185,324.00
69 Povidon Iodida 10% 300 ml 300 ml Botol Afifarma 14,203 14,203.00 274 3,891,622.00
Promedrahardjo Farmasi Industri
Sampharindo Perdana
Ifars Pharmaceutical
Phyto Kemo Agung Farma
Novel Pharmaceutical
NO. NAMA OBAT KEMASAN PABRIKAN KUANTUM JUMLAH HARGA
1 2 3 4 5 6 7 8 9
SATUAN KEMASAN
HARGA SATUAN TERKECIL ( Rp. )
E-CATALOGUE TAHUN 2014
HARGA SATUAN PER KEMASAN
(Rp.) E.CATALOGUE TAHUN 2014
70 Ranitidin injeksi 25 mg / 2ml 10 ampul Kotak 1,140 11,400.00 686 7,820,400.00
71 Retinol ( Vitamin A ) 100.000 IU Kapsul 50 kapsul lunak Botol Kimia Farma 260 13,000.00 500 6,500,000.00
72 Ringer Laktat larutan infus steril 500 ml Botol Widrata Bhakti 5,200 5,200.00 41,936 218,067,200.00
73 Risperidon tablet 1 mg 50 tab Kotak Dexa Medica 1,200 60,000.00 224 13,440,000.00
74 Sefadroksil kapsul 500 mg 100 kapsul Kotak Bernofarm 509 50,900.00 756 38,480,400.00
75 Sefadroksil sirup kering 125 mg / 5 ml 60 ml Botol Holi Pharma 4,896 4,896.00 6,781 33,199,776.00
76 Sefiksim kapsul 100 mg 100 kapsul Kotak Bernofarm 859 85,900.00 297 25,512,300.00
77 Sefotaksim serbuk injeksi 1 gr 10 vial Kotak 2,950 29,500.00 1,026 30,267,000.00
78 Seftriakson injeksi 1 g 10 vial Kotak 3,300 33,000.00 138 4,554,000.00
79 Sianokobalamin ( Vitamin B12 ) injeksi 500 mcg 100 ampul Kotak Lucas Djaya 1,078 107,800.00 83 8,947,400.00
80 Simvastatin Scored tablet 10 mg 30 tablet Kotak 169 5,070.00 4,911 24,898,770.00
81 Trifluoperazin tablet 5 mg 100 tablet Kotak Darya Varia 405 40,500.00 540 21,870,000.00
82 Zink tablet dispersible 20 mg 100 tablet Kotak Indofarma 474 47,400.00 500 23,700,000.00
Terbilang : Satu milyar empat ratus sembilan puluh juta delapan ratus delapan puluh tujuh ribu empat ratus lima puluh delapan rupiah 1,490,887,458.00
Gresik, 25 Maret 2014
Mengetahui, Menetapkan,
KEPALA DINAS KESEHATAN PEJABAT PEMBUAT KOMITMEN
KABUPATEN GRESIK PENGADAAN OBAT PKD
dr. SOEGENG WIDODO drg. HARI TUTIK RAHAYU
Pembina Utama Muda Pembina
NIP. 19560315 198511 1 001 NIP. 19620424 198910 2 001
Natura Laboratoria Farma
Natura Laboratoria Farma
Natura Laboratoria Farma
Natura Laboratoria Farma
