1.

Obat- Obatan dan Perbekalan Kesehatan

JUMLAH HARGA JUMLAH

NO. NAMA OBAT SATUAN KET
BARANG SATUAN HARGA
1 Acyclovir 200 mg Tablet 239

2 Acyclovir 400 mg Tablet 345

3 Acyclovir cream Tube 2,260

4 Air Raksa Dental Use Set

5 Alat Suntik 0.5 ML Set 2,850

6 Alat Suntik 0.05 ML Set 2,850

7 Alat Suntik 1ML Set 650

8 Alat Suntik 2.5 ML Set 957

9 Alat Suntik 5 ML Set 2,950

10 Albendazol tablet 400 MG Tablet 400

11 Alopurinol tablet 100 MG Tablet 88

12 Alprazolam Tablet 0,5 mg Tablet 214

13 Ambroxol 30 mg Tablet 87.43

14 Ambroxol Syrup 15 mg/ml Botol 2,598

15 Aminofilin Injeksi Ampul 4,014

16 Aminofilin tablet 200 MG Tablet 93

17 Amitriptilin HCl 25 mg Tablet 117

18 Amoksisilin Kaplet 500 mg Kaplet 270

19 Amoksisilin Kapsul 250 MG Kapsul 210

20 Amoksisilin Sirup Kering Botol 2,500

21 Ampisilln 500 mg Tablet

22 Antalgin tablet 500 MG Tablet 116

23 Antalgin Injeksi Ampul

24 Antasida Sirup Botol 2,200

25 Antasida DOEN Tablet 74

26 Anti TBC Kategori III/FDC Paket

27 Anti TBC Kategori II/ FDC Paket 1,259,990

28 Anti TBC Sisipan Paket 168,000

29 Anti TBC Kategori I/FDC Paket 377,900

30 Anti Bakteri DOEN Tube 2,641

31 Anti Fungi DOEN Kombinasi Pot 2,001.04

32 Anti Hemoroid DOEN Suppos 3,200

33 Anti Parkinson DOEN Tablet

34 Anti TBC Anak Paket 225,740

35 Aquadest Steril 500 ml Botol

36 Aquadest Steril 250 ml Botol

37 Aqua Pro injeksi Vial

38 Artemeter TABLET Tablet

39 Artesunate injeksi Vial

40 Asam Askorbat Tablet 50 MG Tablet 100

41 Asam Askorbat Tablet 250 MG Tablet

42 Asam Folat 1 mg Tablet 50

43 Asam Klorida 0.1 N Botol 50,000

44 Asam Mefenamat 500 mg Tablet 116

45 Asam Sulfasalisilat 20 % Botol

46 Asetosal tablet 500 MG Tablet 122

47 Atropin Sulfat Injeksi 0.25 mg Ampul 1,418

48 Atropin Sulfat Tablet 0.5 MG Tablet 77

49 Betahistin Mesilat Tablet 6 mg Tablet 924

50 Betametason Krem 0.1 % Tube 1,520

51 Bisoprolol Tablet 5 mg Tablet 669

52 Ca Glukonas Inj Ampul

53 Carbamazepin 200 mg Tablet 257

54 Captopril 12, 5 mg Tablet 62

55 Captopril 25 mg Tablet 89

56 Catgut/Benang Bedah Set 22,599

57 Cimetidin Tablet Tablet

58 Ciproflaksasin tablet 500 mg Tablet 260

59 Clobazam Tablet 10 mg Tablet 900

60 Dekstrometorfan HBR Sirup Botol 1,423.12

61 Dekstrometorfan HBR Tablet Tablet 97

62 Devitalisasi Pasta (Non Arsen) Botol

63 Dexametason Injeksi Ampul 1,659

64 Dexametason Tablet 0.5 MG Tablet 64

65 Diazepam injeksi Ampul 4,389

66 Diazepam Tablet 2 MG Tablet 45

67 Dietil Karbamazin 100 mg Tablet

68 Difenhidramin HCL Inj. Ampul 1,008

69 Digoksin Tablet 0.25 MG Tablet 100

70 Diltiazem Tablet Tablet 134

71 Dimenhidrinat Tablet 50 Mg Tablet

72 Doksissiklin Kapsul Tablet

73 Domperidon Tablet 10 mg Tablet 170

74 Efedrin Tablet 25 MG Tablet 173

75 Ekstrak Beladona Tbalet 10 MG Tablet 40

76 Epinefrin HCL/Bitartrat Inj. Ampul 8,505

77 Ergotamin Coffein Tablet

78 Eritromisin kapsul 250 mg Kapsul 497

79 Etakridin (Rivanol) 0.1 % Botol 2,283.19

80 Etanol 70 % Botol 2,575

81 Etil Klorida Semprot Botol 110,250

82 Eugenol cairan Botol 48,125

83 Famotidin Tablet 40 mg Tablet

84 Fenil Butason 200 mg Tablet 102

85 Fenobarbital Inj. Ampul 1,890

86 Fenobarbital Tablet 30 MG Tablet 142

87 Fenoksimetil Penisilin 250 MG Tablet

88 Fenol Gliserol TT 10% Botol 1,560

89 Fitomenadion Inj. Ampul 3,582

90 Fitomenadion Tablet 10 MG Tablet 660

91 Fluor Tablet 0.5 MG Tablet

92 Folley Catether Buah 12,300

93 Furosemid Tablet 40 mg Tablet 80

94 Gameksan Krem Tube

95 Gameksan Emulsi 1 % Botol

96 Garam Oralit untuk 200 ML Air Buah 303

97 Gentian Violet Larutan 1 % Botol 945

98 Gentamycin inj Ampul 3,259

99 Gentamycin Tetes Mata Botol 3,049

100 Gentamycin Salap Kulit Tube 1,943

101 Glass Lonomer Cement (GC IX) Set 414,750

102 Glibenklamid Tablet 5 MG Tablet 58

103 Gliseril Guayakolas 100 Mg Tablet 434

104 Glukosa Larutan Infus 5 % Botol 5,460

105 Glukosa Larutan Infus 10 % Botol 5,985

106 Griseofulvin Tablet 125 Mg Tablet 219

107 Haloperidol Tablet 1.5 MG Tablet 72

108 Haloperidol Tablet 5 MG Tablet 100

109 Hanschoon 7 Psg 7,560

110 Hanschoon 7,5 Psg 7,560

111 Hanschoon 8 Psg 7,560

112 Hidroklorotiazid (HCT) 25 MG Tablet 38

113 Hidrokortison Krim 2.5 % Tube 2,798

114 Ibuprofen Tablet 200 MG Tablet 116

115 Ibuprofen Tablet 400 MG Tablet 153

116 Imersi Oil Botol 500,000

117 Implan KB Set

118 Eter Alkohol Botol

119 Infusion Set Anak Set 17,391

120 Infusion Set Dewasa Set 17,391

121 Iodina Test Botol

122 Iodiol Kapsul Lunak Kapsul

123 Iodoform Pasta Botol

124 Isosorbid Dinitrat Tablet. 5 MG Tablet 93

125 IV Catheter no 18 Buah 14,575

126 IV Catheter no 20 Buah 14,575

127 IV Catheter no 22 Buah 14,575

128 IV Catheter no 24 Buah 15,180

129 Jarum Jahit (Bedah) 9 S/D 14 Lusin 18,000

130 Kalium Hidroksida Pasta Tube 254,000

131 Kalsium Laktat (Kalk) 500 MG Tablet 73

132 Kapas Adsorben 250 Gram Rol 3,454

133 Kasa Pembalut 2 M x 80 CM Rol 8,545

134 Kasa Hidrofil 4 M X 15 CM Rol 3,454

135 Kasa Pembalut 35 x 80 Cm Rol 118,181

136 Kasa Pembalut Steril 16 Cm Kotak

137 Ketokonazol 200 mg Tablet 310

138 Kloramfenikol Kapsul 250 MG Kapsul 262

139 Kloramfenikol TT 3 % Botol 3,500

140 Kloramfenikol TM 0,5% Botol 19,440

141 Kloramfenikol SM 1% Botol 1,600

142 Klorfeniramini Maleas (CTM) Tablet 53

143 Klorfenol Kanfer Mentol (CHKM) Botol 60,500

144 Klorokuin Fosfat Tablet 250 MG Tablet

145 Klorpromazin HCL Inj. Ampul 1,103

146 Klorpromazin HCL 100 mg Tablet 153

147 Klorpromazin HCL 25 mg Tablet

148 Klorpropamid Tablet 100 MG Tablet

149 Kodein HCL tablet 10 MG Tablet 525

150 Komb.Pirimetamin Sulfadoksin Tablet

151 Kotrimoksazol Suspensi Botol 2,222

152 Kotrimoksazol Dewasa tablet Tablet 145

153 Kotrimoksazol Pediatrik Tablet Tablet 75

154 Kuinin Dihidroklorida inj Ampul

155 Kuinin Sulfat Tablet Tablet

156 Larutan Benedict Botol 50,000

157 Larutan Eosin 2 % Botol 320,000

158 Larutan Etanol Asam Botol 90,000

159 Larutan Giemsa Stain Botol 415,000

160 Larutan Karbol Fuksin Botol

161 Larutan Metilen Biru Botol

162 Larutan Turk Botol 60,000

163 Larutan Ress Ecker 200 ml Botol

164 Larutan Nat Citrat 3.8 % 100 ml Botol

165 Larutan Asam Asetat 6 % Botol

166 Larutan BaCl 2 100 ml Botol 70,000

167 Larutan Fauchet 100 ml Botol

168 Larutan Buffer Fosfat PH 6,4 Botol

169 Larutan Schlisinger 500 ml Botol

170 Larutan Lugol 100 ml Botol

171 Larutan Hayem 100 ml Botol

172 Larutan EDTA 100 ml Botol

173 Larutan Xilol 100 ml Botol

174 Levothiroxin tab Tablet

175 Lidokain Kompositum Injeksi Ampul 1,431

176 Lincomycin 500mg Tablet

177 Lisol Botol 41,000

178 Loperamid Tablet 92

179 Magnesium Sulfat Inj.(IV) 20% Vial

180 Magnesium Sulfat Inj.(IV) 40% Vial 2,045

181 Masker Lembar 440

182 Mebendazol Tablet 100 MG Tablet

183 Metanol 500 ml Botol 55,000

184 Metformin HCl tablet 500mg Tablet 115

185 Metformin HCl tablet 850mg Tablet

186 Metil Ergometrin Maleat Injeksi Ampul 2,750

187 Metil Ergometrin Maleat Tablet Tablet 154
188 Metilprednisolon Tablet 210

189 Metronidazol Tablet 250 MG Tablet 113

190 Metronidazol Infus Botol

191 Mikonazol Krim Tube 3,000

192 Monoklorkamfer Mentol Cairan Botol

193 Mummifying Pasta Botol

194 Natrium Bikarbonat 500 MG Tablet 31

195 Natrium Diclofenac 25 mg Tablet 140

196 Natrium Diclofenac 50 mg Tablet 210

197 Natrium Fenitoin Kapsul 30 MG Tablet 116

198 Natrium Klorida Infus 0.9 % Botol 4,935

199 Nifedipin tab 10 mg Tablet 110

200 Nistatin 500.000 IU/G Tablet Tablet 672

201 Obat Batuk Hitam (OBH) cairan Botol 4,600

201 Oksitetrasiklin HCL SK 3 % Tube 2,200

203 Oksitetrasiklin HCL SM 1 % Tube 2,800

204 Oksitosin Injeksi 10 IU/ML-1 mL Vial 1,900

205 Omeprazol 20 mg Tablet 216

206 Papaverin tab 40 mg Tablet

207 Paraformaldehid Tablet 1 Gram Tablet

208 Parasetamol drops Botol 5,460

209 Parasetamol syrup 120 mg/5 ml Botol 1,496

210 Parasetamol Tablet 100 MG Tablet 32.96

211 Parasetamol Tablet 500 MG Tablet 84

212 Pehacain Injeksi Ampul

213 Pil KB Tablet

214 Pirantel Pamoat Tablet 365 MG Tablet 274

215 Piridoksin Tablet 10 MG Tablet 16

216 Piroksikam 10 mg Tablet 100

217 Piroksikam 20 mg Tablet

218 Plester 5 Yard X 2 Inch Rol 12,500

219 Prednison Tablet 5 MG Tablet 119

220 Primakuin Tablet 15 MG Tablet

221 Propanolol HCL Tablet 40 MG Tablet 110

222 Propiltiourasil Tablet 100 MG Tablet 335

223 Prokain Benzil Penisillin Vial 6,480

224 Rabies Imune Globulin Set

225 Ranitidin tab 150 mg Tablet 126

226 Ranitidin Inj Ampul 1,190

227 Rapid test Syphilis Set

228 Reserpin Tablet 0.25 MG Tablet

229 Retinol (Vit.A) 200.000 IU Kapsul 482

230 Retinol (Vit.A) 100.000 IU Kapsul 273

231 Ringer Laktas Infus Steril Ampul 5,460

232 Salbutamol Tablet 2 MG Tablet 74

233 Salbutamol Tablet 4 MG Tablet 89

234 Salep 2-4 Kombinasi Pot 2,100

235 Salisil Bedak 2 % Buah 1,250

236 Semen Seng Fosfat Set 98,175

227 Serum ABUr Polivalen Inj.5 ML. Vial 473,000

228 Serum ATS Inj.1.500 IU/Ampul Ampul 126,500

239 Sianokobalamin (Vit.B12) Inj. Ampul

240 Sianokobalamin (Vit.B12) Tab Tablet 60

241 Silk (Benang Bedah Sutera) Set 13,616

242 Silver Amalgam Serbuk Set

243 Simvastatin tablet 10 mg Tablet 174

244 Spons Gelatin Set 6,050

245 Spritus 1000 ml Botol

246 Stip Test PH Kotak

247 Sulfadimidin Tablet 500 MG Tablet

248 Sulfasetamid Natrium TM Botol 3,387

249 Suntik KB Vial

250 Tabung Oksigen besar Unit

251 Tablet Tambah Darah Tablet 43

252 Temporary Stopping Fletcher Buah 112,500

253 Test Golongan Darah A,B,AB Set

254 Tetrasiklin Kapsul 250 MG Kapsul 180

255 Tetrasiklin Kapsul 500 MG Kapsul 312

256 Tiamin HCL (Vit.B1) Inj. Ampul 700

257 Tiamin HCL Tablet 50 MG Tablet 26

258 Tramadol 50 mg Kapsul Kapsul 192.23

259 Triheksifenidil HCL Tablet 2 MG Tablet 320

260 Trikresol Formalin (TKF) Botol

261 Urine Bag Buah 5,005

262 Vitamin B.Komplek Tablet Tablet 110

263 Wing Nidle no 21 Buah

264 Wing Nidle no 23 Buah

265 Wing Nidle no 25 Buah

266 Yodium Povidon 10 % 1000 ML Botol 38,594

267 Yodium Povidon 10 % 300 ML Botol 14,771

268 Yodium Povidon 10 % 30 ML Botol 2,250

269 Zinc tab. 20 mg Tablet 497.00

270 Bioplacenton Tube 12,000

271 Dumin Rectal Suppos

272 Enthyrox Tablet

273 Hidrogen Peroksida Botol

274 Kaca Slide Ktk 18,000

275 Larutan Klorin Botol 170,000

276 Pot Sputum Buah 2,790

277 Stesolit Sufos Suppos 17,604

278 Sofratul Ktk

279 Topicana Gel Botol 61,875

280 Ziehl Nielsen Botol 189,350

281 Metoclopamida Tablet 108

282 Amlodipin 5 mg Tablet 192

283 Kotak slide Buah 75,000

284 Safety Box Buah 20,490

285 Botol 100 ml Buah 35,000

286 Kertas saring Lembar 10,000

287 Hanschoon S,M,L Pasang 6,930

288 Etanol 70% 1000 ml Botol 21,500

289 Vit K Infant Inj Ampul 3,582

290 Erytromicyn Sirup Botol 7,893

291 INH 100 mg Tablet 68

292 Asering Kolf 9,000

293 KA EN 1 B Kolf 9,000

294 Cetirizin Tablet 186

295 Loratadin Tablet 162

296 Haloperidol Inj Ampul 87,500

297 Amlodipin 10 mg Tablet 341