DINAS KESEHATAN KABUPATEN PANDEGL UPT GUDANG FARMASI PANDEGLANG Jl. Raya Serang KM. 3 Telp. ( 0!3 " 00#$ Pan%eglang &!'
DAFTAR HARGA BAT DLL TAHUN 0') 0') NO
NAMA OBAT
KODE
SATUAN
1
2
3
4
1 Albendazol Tablet 400 mg
Tablet
3 Ambroxol tablet 30 mg
Tablet
4 Ambroxol sr!"
Botol
# Amno$lna n%e&s 24 mg 'ml ( 10 ml
Am"!l
) Amtr"*ln +,- Tablet 2# mg
Tablet
. Amo&ssln #00 mg tablet
Tablet
/ Amo&sslln Sr!" Kerng 12# mg '# ml
Botol
10 Amo&ssln orte sr!" &erng 2#0mg
Botol
12 Amlod"n # mg
Tablet
13 Amlod"n 10 mg
Tablet
14 Analog ns!ln -ong A*ng
en
1# Analog ns!ln Mx A*ng
en
1. Antasda DOEN s!s"ens
Botol
1/ ANTASDA DOEN Tablet
Tablet
20 An*"ar&nson Tablet -e5o"ar 6
Tablet
21 An* Se"*& +and 7!b
Botol
22 An* Se"*& S!rg&al +and Sr!b
Botol
28 A9!a ro n%e&s
:al
2) Aserng Aserng
Botol Botol
2. Asam As&orbat tablet #0 mg
Tablet
2/ Asam !sdat ,ream
T!be
30 Asam Trane&samat n% #;
Am"!l
31 Asam Me
Tablet
32 Asam olat 1 mg
Tablet
33 Artes!nate n%e&s 80 mg 'ml
5al
34 Artermet=er n%e&s
:al
3) Asam Ase*l Sallat 100 mg tablet
Tablet
3/ As&lo5r tablet 200 mg
Tablet
40 As&lo5r tablet 400 mg
Tablet
41 As&lo5r ,ream #;
T!be
42 Atro"n S!l
# mg
Tablet
48 Bsa&odl S!""ostora 4) Bso"rolol 2>#M?
s!"" Tablet
4. ,aran embers= rote&tor 6
Botol
4/ ,a"to"rl Tablet 2# mg
Tablet
#0 ,a"to"rl Tablet 12># mg
Tablet
#1 ,arbamaze"n 200 mg tablet
Tablet
#2 ,e
,a"s!l
#3 ,e$xme ,a"s!l 100 mg
,a"s!l
#4 ,e$xme Sr!"
Botol
## ,e
:al
#8 ,e*rzne sr!" # mg'# ml
Botol
#/ ,lobazam 10 mg Tablet
Tablet
80 ,loza"ne 2# mg Tablet
Tablet
81 D(Arte"" tablet
Tablet
82 De&sametason tablet 0># mg
Tablet
83 De&sametason n%e&s 1 ml
Am"!l
84 Dox@ln #00mg
a"s!l
8) Daze"am 7e&tal 0># mg
s!""
8. Daze"am tablet 2 mg
Tablet
8/ Daze"am n%e&s 2 ml
Am"!l
)1 D
Am"!l
)2 Dgo&sn tablet 0>2# mg
Tablet
)3 E
Tablet
)4 Dom"erdon 10mg Tablet
Tablet
)8 E"ne
Am"!l
.1 Er@tromn sr!" 12# mg
Botol
.3 E*l Klorda Sem"rot
Botol
.4 enton Natr!m &a"s!l 30 mg
Ka"s!l
.# enobarbtal n%e&s #0 mg'ml ( 2 ml
Am"!l
.8 enobarbtal Tablet 30 mg
Tablet
/0 tomenadon :tK16 n%e&s 10 mg'ml(1 ml
Am"!l
/1 tomenadon :tK16 tab sal!t g!la 10 mg
Tablet
/4 ?lme"rde 2 mg
Tablet
/# ?aram Oralt
Sa=et
/8 ?lbenlamd tablet # mg
Tablet
/) ?entamn Sale" K!lt
T!be
/. ?entamn Sale" mata
T!be
// ?lern ?!aaolat ?? 6 100 mg
Tablet
100 ?rseo
Tablet
101 ?rseo
Tablet
102 +dro&loro*azd +,T6 tab 2# mg
Tablet
103 ?em$brozl
Tablet
10. ?l&azd .0 mg Tablet
Tablet
10/ +alo"erdol # mg Tablet
Tablet
110 +alo"erdol 2 mg tablet
Tablet
111 +dro&or*son &rm 2>#;
T!be
112 b!"ro
Tablet
113 sonazd tablet 300 mg
Tablet
118 b!"ro
Tablet
11/ m!nomod!lator sr!" STMUNO6
Botol
120 Kals!m -a&tat Kal&6 tablet #00 mg
Tablet
122 Ketorola n%
Am"!l
123 Kals!m ?l!&onas n%e&s
Am"!l
124 Kloram"=enol #00 mg
a"s!l
12# Kaen 3 B aran n
Botol
12. Klor
Tablet
131 Keto&onazol Kream
T!be
133 Klor"romazn +,- tablet sal!t 2# mg
Tablet
134 Klor"romazn +,- tablet sal!t 100 mg
Tablet
13/ Kotrmo&sazol Deasa Tablet 4.0 M?
Tablet
140 K!nn D=dro&lorda n%e&s 2#; ( 2 ml
Botol
141 -atobal!s serb!&
Sa=et
142 -doan n%e&s 2 ml
Am"!l
143 -doan 2;Ce$ne
Am"!l
144 -sno"rl # mg tablet
Tablet
14# -sno"rl 10 mg tablet
Tablet
148 -o"eramd 2 mg tablet
Tablet
14. Magnes!m S!l
Blster
1#0 MDT MB Ana& Tablet
Blster
1#1 MDT MB Deasa Tablet
Tablet
1#2 MDT B Deasa Tablet
Tablet
1#4 Metam"ron tablet #00 mg
Tablet
1## Meormn #00 mg Tablet
Tablet
1#8 Me*lergometrn Maleat Me*lergometrn6 n%e&s 1 ml
Am"!l
1#) Me*lergometrn tablet
Tablet
180 Metrondazol #00 mg
Tablet
181 Metrondazol s!s"ens
Botol
182 Met=l"rednsolon tablet . mg
Tablet
183 Meto&lo"ramd S!s"ens
Botol
184 Meto&lo"ramd tablet
Tablet
18# M&onazol &ream
T!be
188 M!l*5tamn Ana& Sanbe Kds 6
Botol
18) M!l*5tamn Deasa An*o&sdan Beom 6
Tablet
18. M!l*5tamn Deasa an5ton 6
Tablet
18/ Natr!m Klorda ,aran n
Botol
1)1 Natr!m D&lo
Tablet
1)4 N
Tablet
1)8 Obat An* Dare Tablet A&ta ' Molagt 6
Tablet
1)) Obat An*t!ber&!loss &ategor 2
a&et
1). Obat An*t!ber&!loss &ategor 1
a&et
1)/ Obat An*t!ber&!loss Kategor Ana&
a&et
1.0 Obat Bat!& l! Ka"s!l
Ka"s!l
1.2 Obat Bat!& Sr!" +erbal +erbao" 6
Botol
1.3 Ooxsan Tetes Telnga
T!be
1.4 O&stosn n%e&s 10 U'ml ( 1 ml
Am"!l
1.8 Ome"razol n%e&s
Am"!l
1.) Ome"razol Ka"s!l 20 mg
a"s!l
1.. Ondanentron Tablet 4 mg
Tablet
1./ Ondanentron n%e&s 4 mg
Am"!l
1/0 ara$n Dresng Bo"laenton T!ll 6
"s
1/2 arasetamol tablet #00 mg
Tablet
1/3 araetamol Sr!" 120 mg'# ml
Botol
1/4 araetamol Dro"
Botol
1/# ermetrn Krm # ;
T!be
1/8 rantel Sr!"
Botol
1/) rantel tablet 2# mg
Tablet
200 "rdo&sn +,- :T B86 tablet 10mg
Botol
201 ro&s&am tablet 10 mg
Tablet
203 "o5don lodda 10; 300 ml
Botol
204 "o5don lodda 10; 80 ml
Tablet
20# OT Da=a& Sterl
ot
208 rednson Tablet # mg
Tablet
20) OT Da=a& Non Sterl
ot
20. rma&!n
Tablet
20/ ro"anolol +,- tablet 10 mg
Tablet
210 robenesd #00 mg tablet
Tablet
211 7es"erdone 2 mg tablet
Tablet
213 7an*dn n%e&s
Am"!l
214 7an*dn tablet
Tablet
21# 7eagen Fe=l Neelsen
Kt
218 7e*nol :tamn A6 &a"s!l 200000 U
a"s!l
21) 7e*nol :tamn A6 &a"s!l 100000 U
a"s!l
21. 7nger -a&tat aran n
Botol
21/ Salb!tamol tablet 4mg
Tablet
220 Salb!tamol Tablet 2 mg
Tablet
221 Salb!tamol Neb!lzer :entoln 6
:al
223 Sale" &ombnas ream Berloson 6
T!be
224 Se*rzn Tablet 10 mg
Tablet
22# Sale" 2(4
T!be
228 Ser!m An* Bsa Ular n% #ml
:al
22) Ser!m An* Tetan!s n% 1#00 U
:al
22. S!&ral
Tablet
230 Tablet enamba= Dara=
Tablet
231 Sm5asta*n 20 mg tablet
Tablet
232 Sano&obalamn n%e&s
Am"!l
234 Tablet Tamba= Dara=
Sa=et
23) Tetras&ln 2#0 mg a"s!l
a"s!l
23. Tetras&ln #00 mg a"s!l
a"s!l
23/ Tr=e&sl
Tablet
240 Under"ad
-embar
241 Urne Bag
B%
242 :tamn B &om"le&
Tablet
243 Fn& sr!"
Botol
NAMA BAHAN MEDIS HABIS PAKAI (BMHP )
24) Alat s!n*& 10 ml
s
24. Alat s!n*& 20 ml
s
24/ Alat s!n*& 1 ml
s
2#0 Alat s!n*& 2># ml
s
2#1 Alat s!n*& 3 ml
s
2#2 Alat s!n*& # ml
"s
2#3 Al&o=ol sab
Sa=et
2## ,at ?!t no 2'0
Sa=et
2#8 ,at ?!t no 3'0
Sa=et
2#) ,at=eGer Hell@
B%
2#. Demete= Sl& 3'0
Set
2#/ E ,are : Dresng
-embar
280 oll@ No 14 ,atet=er
"s
281 oll@ No 18 ,atet=er
"s
282 : ,at=eGer No 20
Set
283 : ,at=eGer No 22
Set
284 : ,at=eGer No 24
Set
28# n
Set
288 : ,at=eGer No 28
Set
28) n
Set
28. n
Set
28/ Har!m ns!ln
Tablet
2)0 Ka"as Berlema& 2#0 gr
B!ng&!s
2)2 Kasa 4 m x 10 m
7ol
2)3 Kasa +dro$l 38 x .0 m
7ol
2)4 Kasa Sterl 18 x 18 m
Kota&
2)# Mas&er tal E ,are S!rgal Mas& Te On6
T!be
2)8 Mas&er &aret
Sa=et
2). lester 1I
7ol
2)/ Sar!ng tangan M Non Sterl6 Axmed
asang
2.0 Sar!ng tangan no 8># ,osmo
asang
2.1 Sar!ng tangan no 8># Sterl
asang
2.2 Sar!ng tangan no )>0 Sterl
asang
NAMA OBAT REAGEN
2.# ,=&!ng!n@a gM 7eagen6
Kota&
2.8 Deng!e gM ' gM 7eagen 6
Kota&
2.) -e"tos"ra gM 7eagen6
Kota&
2.. NS1 An*gen Test 7eagen6
Kota& Pelaksana Opname Fisik Pers
S@l5an* T Ma=aran> M+> A"t 6 N 1/.80)082010012 010
J!la* 6 N 1/810/031/.)032 003
Mengeta=! Ke"ala UT ?!dang arma Kab!"aten andeglang
Didiek Hendro Baono!SK
N 1/8804301//2031 00
NG
+A7?A SATUAN #
408 18/ )>4// 3>34# 143 232 2>44# 3>/.4 10# 330 42#>000 ##0>000 2>140 81 1>#00 80>.00 )4>000 2>)#0 />2)# /# #>#08 24>44/ 108 83 14>2#0 1>000 130 23) 34. 8>4/0 1>8)2 #>8)0 8#0 22>000 8.
82 28/ #18 #/0 )>4/0 #>#00 2>.4/ /8/ 1>#4. 1>000 44 1>#.0 28/ 11>#18 4# 4>1.0 1>1)8 10# #1 11. 2>204 8) 132>000 1#4 1>/8/ 18# 3>##0 8/# 2.. 3.0 1). 2>.2/ 2>800 #1 2>200 21/ 14/ 3.0 23# /8 128 2>8#0 104 /) 3>4// 20>8.0 82 1>2/0
/>/## 1>00) 10>0#0 42 2>#4# 14. 14/ 1#0 8>200 12>)00 .80 1>.4# 3)# 44. .# 3>200 21>)#0 30>#/# />))0 3.0 100 2>8.4 1#4 133 3>)// 30/ 2>34# /1 3>2#0 3#>000 1>320 1>318 8>410 14# 10. 4#0 1>1//>//0 3#/>81/ 180>000 388 12>210 4#>/./ 1>/00 18>//) 180 4)1 1>8#0 10>400
1// 1>43. #>1// 12>1## .>380 2/1 4# 143 14>203 8>##0 #>./0 114 1>)#0 224 80 1>).0 1>00. 1>140 10# 2)8>800 4#/ 2.4 )>1#0 .3 88 110 11>100 143 2>42/ #01>0#0 13)>#00 38. 400 2#2 1>0/. 1>)40 183 300 .. )>/#8 )>038 43 8>2/0
1>08) 2>8#0 )))
84/ .2# .#8 1/) #2>000 44>/#3 41>800 20>.33 2>200 18>810 12>038 4>)/4 12>342 4>)/4 )>/20 13>484 #>100 4>1.2 2>0.3 12>2#0 1>440 12)>800 #>#00 ##3 )40 .>18) /24 1>01. 4>#00 4>#00 2>)#0>000 1>#.4>000 2>0/0>000 2>200>000
diaan
s
M
4