1.
NO.
Obat- Obatan dan Perbekalan Kesehatan
NAMA OBAT
SATUAN
JUMLAH
HARGA
JUMLAH
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 m g
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
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
35
Aquadest Steril 500 ml
Botol
36
Aquadest Steril 250 ml
Botol
116
225,740
KET
37
Aqua Pro injeksi
Vial
38
Artemeter TABLET
Tablet
39
Artesunate injeksi
Vial
40
Asam Askorbat Tablet 50 MG
Tablet
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 m g
Ampul
1,418
48
Atropin Sulfat Tablet 0.5 M G
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
100
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
119
Infusion Set Anak
Set
17,391
120
Infusion Set Dewasa
Set
17,391
121
Iodina Test
122
Iodiol Kapsul Lunak
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
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
Botol
Botol Kapsul
525
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
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
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
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
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
60,000
70,000
1,431
3,000
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
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
Set
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
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
275 276
3,387
Ktk
18,000
Larutan Klorin
Botol
170,000
Pot Sputum
Buah
2,790
277
Stesolit Sufos
Suppos
17,604
278
Sofratul
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
Ktk
