LAMPIRAN PENGADAAN BAHAN OBAT-OBATAN DAN BMHP TAHUN

Rencana
No Nama Obat Satuan Harga Satuan
Pembelian

1
2 abbocath no 26 AXIMED pcs Rp 7,700 500
3 Acetyl cysteine 200 mg capsule Rp 412 42900
4 Acyclovir Salep Tube Rp 4,000 5000
5 Albendazole tab bottle Rp 463 1500
6 Alkohol 70% 1 Liter bottle Rp 25,000 40
7 alkohol swab kotak Rp 12,300 160
8 alprazolam 0,5 mg. tablet Rp 88 5000
9 allopurinol 100 mg tab Tablet Rp 99 300000
10 alvogyl septodont kotak Rp 400,000 6
11 Ambroxol Syr Botol Rp 6,000 12500
12 Ambroxol tab tablet Rp 275 65000
13 aminofilin inj amp Rp 2,878 1020
amlodipine 5mg tab Kaplet Rp 74 250200
14 Amlodipine 10mg tab Kaplet Rp 95 150000
15 Amoksisilin 125mg/5ml sy bottle Rp 1,919 17500
16 Amoksisilin 500mg tab tablet Rp 248 300000
17 anestesi topikal topicaina topical tutti frutti pot Rp 125,000 6
18 Antalgin inj Ampul Rp 4,025 3500
19 Antalgin tablet tablet Rp 143 125000
20 Antasida DOEN sy bottle Rp 2,098 13000
21 Antasida DOEN tab Tablet Rp 56 550000
Anti Bakteri salep kombinasi: Basitrasin 500 IU/g +
22 Tube Rp 3,490 4500
Polimiksin 10.000 IU/g

23 Asam mefenamat 500mg tab kaplet salut selaput Rp 103 350000

24 Asering infus Botol Plastik Rp 9,646 200

25 Atropin inj Ampul Rp 1,815 200
26 atropin tab tab Rp 81 2000
27 bahan tambal sementara Caviton pot Rp 138,600 12
28 becom C tab box Rp 148,830 25
29 benang demetech chromic catgut 2 75cm + jarum kotak Rp 360,000 23
30 benang demetech chromic catgut 2/0 75cm + jarum kotak Rp 270,000 23

31 benang demetech plain catgut 3/0 70 cm + jarum kotak Rp 295,000

25
32 benang demetech silk 3/0 75Cm + jarum kotal Rp 180,000 23
33 benang demetech silk 4/0 45 cm + jarum kotak Rp 250,000 23
BEROTEC INHALASI BOTOL BTL Rp 130,190 30
34 Betametasone cr tube Rp 1,373 4000
35 bioplacenton tulle box Rp 104,000 45
36 bisolvon larutan 50 ml botol Rp 93,800 25
37 blood lancet 28 G kotak Rp 14,566 45
38 bubuk larvasida (abate) @25kg botol Rp 82,500 50
39 Bufacetine cr tube Rp 3,360 300
40 captopril 25 mg tab Tablet Rp 80 290000
CATAPRES INJ AMP Rp 33,900 200
41 Cefixime 100mg tab capsule Rp 923 27450
42 Ceftriaxon 1 gr Injeksi vial Rp 4,822 4000
43 Cetirizine sy btl Rp 2,993 3500
Tablet Salut Selaput
44 cetirizine tab Rp 97 45000
(Tablet)
45 ChKM botol Rp 70,000 12
46 Chloramphenicol Tetes Telinga Botol Rp 10,000 500
Botol@100 ml (Botol
47 Chlorethyl Spray------------- (Branded) Rp 115,000 150
Kaleng)
Tablet Salut Selaput
48 Ciprofloxacine tab Rp 281 50000
(Tablet)
49 colchicine 0,5 mg (Recolfar) box Rp 163,350 10
Combivent : Ipratropium bromida inhalasi 0,5 mg
50 Vial (e-cat) Rp 5,990 500
Salbutamol 2,5 mg ---------(Branded)
51 Concor 1,25 mg tab Tablet Rp 1,815 1000
52 Concor 10 mg tab Tablet Rp 2,950 1020
53 cresophene / cresodent @ 5ml btl Rp 175,000 6
54
55 Kloramfenikol salp mata tube Rp 1,925 480
56 Deksametason 0,5mg tab tab Rp 34 70000
57 Deksametason inj Ampul Rp 1,210 7500
58 Dektrose 40% inj 25ml flakon Rp 3,388 250
59 dentin conditioner kotak Rp 241,900 6
60 devitec @6gr kotak Rp 550,000 6
61 Diazepam 5mg tab Tablet Rp 109 5000
62 Diazepam inj amp Rp 1,913 750
63 difenhidramin inj Ampul Rp 1,262 3510
64 Dimenhidrinat tab Tablet Rp 121 7500
65 disclosing solution dental @200gr botol Rp 60,000 12

66

67 Domperidone syrup botol @ 60 ml Rp 2,862 5000

68 domperidone tab Tablet Rp 90 75000
69 Ecodin 1 L Bottle Rp 79,650 60
70 Epinefrin amp Ampul Rp 1,518 1000
71 Ergotamin + Cafein tab (btl@100) Rp 199 5000
72 Eritromisin 500mg Kaplet Rp 781 5000
73 eugenol botol Rp 21,648 20
74 Face Mask Ear Loop Dus Rp 19,800 250
75 Fe + asam folat tab Tablet Rp 409 40020
76 fenobarbital inj Ampul Rp 2,135 450
77 fenobarbital tab 30 mg tablet Rp 197 5000
78
79 folley catheter 12 pcs Rp 9,200 60
80 folley catheter 18 pcs Rp 9,200 160
81 folley catheter 6 pcs Rp 10,400 40
82 formocresol @10ml botol Rp 110,000 6
Fucilex krim natrium fusidat tube Rp 4,889 1000
83 Furosemide 40 mg Tablet Rp 79 25000
84 Furosemide inj amp Rp 1,555 600
85 Gavistal : Metoklopramid drop 2 mg/mL Bottle Rp 3,995 1000
86 Gentamisin inj Ampul Rp 4,036 1200
87 gentamisin tts mata bottle Rp 4,885 480
88 glass ionomer cement (GIC) Fuji VII kotak Rp 617,800 6
89 Glibenclamid 5 mg Tab tab Rp 137 40000
90 Gliseril Guaikolate tab tablet Rp 50 400000
91 Griseofulvin 125mg tab Tablet Rp 223 25000
92 H2O2 3% @800 ml btl Rp 21,000 100
93 Handschoen steril no 6 (sensosurge) pasang Rp 6,595 200
94 handschoen steril no 6,5 (sensosurge) pasang Rp 6,595 200
95 handschoen streril no 7 (sensosurge) pasang Rp 6,595 200
96 handschoen uk L kotak Rp 77,801 50
97 handschoen uk M kotak Rp 77,801 150
98 handschoen uk S kotak Rp 77,801 100
Hico / trombophob : Heparin sodium 20.000 I.U------
99 Tube Rp 15,500 250
(branded)
100 Hidrochlortiazide tab Tablet Rp 178 15000
101 Hidrocortisone cr tube Rp 2,533 11000
Tablet Salut Selaput
102 Ibuprofen 200mg tab Rp 112 35000
(Tablet)
103 Infus set anak pcs Rp 5,100 2500
104 Infus set dewasa pcs Rp 4,800 5000
105 irvask 300 MG tab box Rp 347,985 20
106 Isotic adretor tetes mata bottle Rp 11,275 100
107 Kalium Permanganat serbuk ---(Branded) pot Rp 2,500 250
108 Kalk tab Tablet Rp 59 225000
109 kalsium hidroksida Calcipex II kotak Rp 310,000 6
110 kapas pembalut absorben 1000gr rol Rp 52,000 75
111 Kasa hidrofil 40yd x 80 cm rol Rp 103,000 40
112 Kasa kompres steril 16x16 cm kotak Rp 5,500 750
113 Ketokonazole 200mg tab Tablet Rp 286 20000
114 Ketokonazole cr tube Rp 2,577 8000
115 Kloramfenikol sy bottle Rp 4,985 2500
116 kodein 10 mg Tablet Rp 657 2500
117 klorpromazine inj Ampul Rp 1,435 210
KOMPOLAX Kombinasi: parafin + gliserin +
118 Bottle Rp 5,555 1000
fenolftalein Susp
119 Komposit light curing nano hybrid A3 set Rp 200,000 6
120 Kotrimoksazole 480mg tab Tablet Rp 125 35000
121 Kotrimoksazole sy bottle Rp 2,052 7000
122
123 Levofloksasin kap kaplet salut selapuT Rp 449 10000
124 Lidokain epinefrin inj Ampul Rp 1,317 7500
125 Loperamide tab Tablet Rp 85 50000
126 Loratadine tab Kaplet Rp 127 75000
127 masker ties on kotak Rp 21,945 100
128 Meloxicam 7,5 mg Tab Rp 110 170000
129 Metilergometrin amp Ampul Rp 3,399 3500
130 Metilprednisolon 4 mg tab Tablet Rp 139 63000
Metilprednisolon 16 mg tab tablet Rp 548 20000
131 metoklopramide inj Ampul Rp 4,554 500
132 Metronidazole tab Tablet Rp 127 45000
133 MgSO4 20% flakon Rp 3,328 500
134 MgSO4 40% flakon Rp 3,796 500
135 Miconazole salep@10 g tube (dus@24 tube) Rp 3,926 4000
136 Mineral mix sachet Rp 2,920 5160
 Molakrim : Menthol 53.4 mg, eugenol 13.6 mg, methyl
137 Tube@30 gr Rp 14,000 750
salicylate 102 mg ------- (Branded)
138
139 Nacl 0,9% infus bottle Rp 6,410 5000
140 nasogastric tube no 16 pcs Rp 11,100 75
141 nasogastric tube no 18 pcs Rp 11,100 75
142 natrium diklofenak 25 mg tab Tablet Rp 142 175000
143 needle 24G x 25 mm pcs Rp 330 15000
144 needle 26G x 13 mm pcs Rp 330 15000
145 Neo Diagon tab Tablet Rp 237 10000
Neocenta / bioplacenton: Placenta extract 10% ,
146 Tube@ 20 gr Rp 14,500 500
Neomycin sulfate 0,5% ---- (branded)
147 Nonwoven Fixation/ 20 cm x 10 m Roll Rp 127,000 50
148 nystatin vaginal tab Tablet Rp 645 1000
149 Obat fogging @1 liter Mustang botol Rp 130,000 100
150 OBH sy botol Rp 3,740 5000
151 oksitetrasiklin salep Kulit tube Rp 4,138 4000
152 Oksitetrasiklin salep mata Tube Rp 2,600 7500
153 Oksitosin inj amp Rp 1,232 4500
154 Omeprazole 20mg tab capsule Rp 138 22980
155 Ondansetron inj 2 mg/ml amp Rp 1,198 3000
156 Ondansetron tab Tablet Rp 406 6480
Sachet (Saset, Sachet,
157 Oralit sachet Rp 263 45000
Sacet)
158 Otsu-WI air 25 ml amp Ampul Rp 2,860 3500
Ottopain tts telinga : Polymyxin B sulfate 10.000 IU,
Neomycin sulfate 5 mg, Fludrocortisone acetate 1 mg,
159 Botol@8 ml Rp 63,000 100
Lidocain HCl 40 mg -------- (Branded)

160 Papaverin 40 mg Tablet tab Rp 160 20000

Paracetamol 500 mg, Chlorpheniramine Maleate 2
161 mg, Phenylpropanolamine HCI 12,5 mg, botol Rp 17,600 450
Dextromethorphan HBr 15 mg----------- (Branded)
Paracetamol 125 mg, chlorpheniramine maleate 0,5
162 mg, guaiaphenesin 50 mg, phenylpropanolamine botol Rp 19,260 450
hidroklorida 3,125 mg -------- (Branded)
163 Paracetamol 125 mg/2.5 ml (Branded) Rectal tube Rp 13,780 700
164 Paracetamol 250 mg/2.5 ml (Branded) Rectal tube Rp 15,000 250
paracetamol 500 mg, phenylpropanolamine HCl 12.5
165 mg, chlorpheniramine maleate 2 mg--------- (Branded) tablet Rp 857 2500

166 Parasetamol drop botol Rp 7,646 2500

167 Parasetamol sy btl Rp 1,160 59000
168 Parasetamol tab Tablet Rp 60 800000
169 Petidin Injeksi 50mg/2 ml ampul (dus 10 Amp) Rp 15,920 300
170 phytomenadion inj Ampul Rp 4,236 2490
171 plester fescoplast 5cm x 4,5M rol Rp 15,175 120
PHENOL GLYCEROL TETES TELINGA 10%
172 Botol Plastik Rp 2,590
Karbogliserin tetes telinga 10% 1930
173 Prednison 5 mg Tablet Rp 74 11000
174 primakuin tab Tablet Rp 258 2500
175 Propituracil 100 mg tab (btl@100) Rp 299 2500
176 Ranitidine inj Ampul Rp 1,155 20000
Tablet Salut Selaput
177 Ranitidine tab Rp 110 300000
(Tablet)
178 RDT HIV CD4 strip Rp 350,000 125
179 RDT HIV R3 (INTEC products) strip Rp 13,100 6000
180 RDT HIV R2 (Biomereux vikia) strip Rp 487,500 100
181
182 RL infus bottle Rp 7,150 31500
183 rockles kotak Rp 500,000 6
184 salbutamol 4mg tab Tablet Rp 77 90000
185 Salbutamol sy bottle Rp 4,446 500
186 Salep 2-4 Pot Rp 3,017 500
187 Salisil bedak dus Rp 1,071 5000
188 sancorbin injeksi box Rp 145,000 10
189 Scabimite cr tube Rp 12,155 500
190 Sefadroksil 500mg tab capsule Rp 492 35000
191 Sefotaksim 1 gr inj Vial (Ampul) Rp 4,410 6000
192 selang oksigen bayi pcs Rp 6,400 40
193 selang oksigen dewasa pcs Rp 6,400 80
194 selang oksigen neonatus pcs Rp 7,300 40
Tablet Salut Selaput
195 Simvastatin 10 mg tab Rp 110 198000
(Tablet)
196 Simvastatin 20mg tab Tablet Rp 225 50000
197
198 spuit 10cc box Rp 130,200 50
199 spuit 1cc box Rp 83,000 100
200 spuit 3cc box Rp 82,500 200
201 spuit 50cc box Rp 120,300 2
202 spuit 5cc box Rp 92,800 100
203 stain remover OCO btl Rp 85,000 8
204 Stesolid 5 mg supp tube Rp 14,459 500
205 strip autocheck asam urat botol Rp 90,000 10
206 strip autocheck gula darah botol Rp 70,000 10
207 strip autocheck kolesterol botol Rp 140,000 30
208 Sukralfat sy bottle Rp 7,338 300
209 sungkup nebulizer anak pcs Rp 10,340 40
210 sungkup nebulizer dewasa pcs Rp 10,340 40
211 SUPRAFENID ketoprofen supositoria 100 mg Suppositoria Rp 2,380 550
212 surgical blade onemed no 11 box Rp 90,000 50
213 Taburia sachet Rp 300 3150
214 TERUMO SURFLO IV CATH SR+OX1832C3 pcs Rp 8,355 1250
215 TERUMO SURFLO IV CATH SR+OX2032C3 pcs Rp 8,355 3250
216 TERUMO SURFLO IV CATH SR+OX2225C3 pcs Rp 8,355 1500
217 TERUMO SURFLO IV CATH SR+OX2419C3 pcs Rp 8,355 2500
218 Tetrakain HCl tetes mata 0,5% --------- (Branded) Botol@5 ml (e-Cat) Rp 11,500 50
219 Tiamfenikol 500 mg Capsul Rp 1,809 4500
220 tiriz tab box Rp 130,680 20
221 tongue spatel kayu onemed kotak Rp 14,000 100
222 tramadol inj ampul Rp 1,764 3000
223 Tramadol Tablet Tab Rp 500 5000
224 tri kresol formalin (TKF) camex botol Rp 70,000 6
225 Triprolidine HCI 1,25 mg, pseudoephedrine HCI 30 mg - Tab Rp 1,025 10000
226 urine bag pcs Rp 3,000 220
Ventolin : Salbutamol cairan ih 0,1% ---------- Botol Plastik@2,5 ml (e-
227 Rp 7,260 500
(Branded) Cat)
228 PD crepe/Bandage 7,5 cm x 4,5 m rol Rp 28,800 50
229 Vit B complex tab Tablet Rp 135 300000
230 Tiamin (Vit B1) tab Tablet Rp 88 120000
231 Vit B6 (Piridoksin) tab Tablet Rp 141 150000
Vit B12 (sianokobalamin) tab Rp 49 250000
232 Vit C 50 mg tab Tablet Rp 120 250000
233 Zink tab Tablet Rp 604 49000
TOTAL BELANJA

TOTAL PAGU Rp 2,382,478,000 total pagu

KEKURANGAN Rp 51,289,612 obat
BMHP
DAN BMHP TAHUN 2018
Ongkos kirim Total Harga Pembelian

Rp 577,500 Rp 4,427,500 AXIMED

Rp 17,674,800 PT. Indofarma (persero) Tbk
Rp 20,000,000
Rp 694,500 PT. Kimia Farma (Persero) Tbk
Rp 250,000 Rp 1,200,000 jayamas
Rp 492,000 Rp 2,460,000 remedi
Rp 440,000 PT. Mersifarma Tirmaku Mercusana
Rp 29,700,000 PT. Mersifarma Tirmaku Mercusana
Rp 2,400,000 bahan gigi
Rp 75,000,000
Rp 17,875,000
Rp 2,935,560 PT. LUCAS DJAJA
Rp 18,514,800 PT Tempo Scan Pacific, Tbk
Rp 14,250,000 Pharma Laboratories
Rp 33,582,500 PT.Phyto Kemo Agung Farma
Rp 74,400,000
Rp 750,000 bahan gigi
Rp 14,087,500
Rp 17,875,000
Rp 27,274,000 PT. LUCAS DJAJA
Rp 30,800,000 PT. Mersifarma Tirmaku Mercusana
Rp 15,705,000 PT. Indofarma (persero) Tbk
Rp 36,050,000
PT. Mersifarma Tirmaku Mercusana
Rp 1,929,200 PT. Otsuka Indonesia
Rp 363,000
Rp 162,000
Rp 1,663,200 bahan gigi
Rp 3,720,750
Rp 450,000 Rp 8,730,000
Rp 337,500 Rp 6,547,500

Rp 7,743,750 demetech/enseval
Rp 368,750
Rp 225,000 Rp 4,365,000

Rp 312,500 Rp 6,062,500
Rp 3,905,700
Rp 5,492,000 PT. Kimia Farma (Persero) Tbk
Rp 521,111 Rp 5,201,111 eracita
Rp 2,345,000

Rp 109,245 Rp 753,790 jayamas

Rp 4,125,000
Rp 1,008,000 PT. BUFA ANEKA
Rp 23,200,000 PT PERTIWI AGUNG
Rp 6,780,000
Rp 25,336,350
 Rp 19,288,000
Rp 10,475,500 PT. RAMA EMERALD MULTI SUKSES
Rp 4,365,000

Rp 840,000 bahan gigi

Rp 5,000,000

Rp 17,250,000

Rp 14,050,000 PT NOVAPHARIN
Rp 1,633,500
Rp 2,912,000

Rp 1,815,000
PT. Merck Tbk
Rp 3,009,000
Rp 1,050,000 bahan gigi

Rp 924,000
Rp 2,380,000 PT NOVAPHARIN
Rp 9,075,000 PT. MEPROFARM
Rp 847,000
Rp 1,451,400 bahan gigi
Rp 3,300,000 bahan gigi
Rp 545,000 PT. Mersifarma Tirmaku Mercusana
Rp 1,434,750 PT. MEPROFARM
Rp 4,429,620 PT.Phapros Tbk
Rp 907,500 PT. Kimia Farma (Persero) Tbk
Rp 720,000 bahan gigi

Rp 14,310,000 PT NOVAPHARIN
Rp 6,750,000 PT. Yarindo Farmatama
Rp 1,354,050 Rp 5,734,800 jayamas
Rp 1,518,000 PT. Ethica Industri Farmasi
Rp 995,000 PT. Kimia Farma (Persero) Tbk
Rp 3,905,000 PT. Yarindo Farmatama
Rp 432,960 bahan gigi
Rp 742,500 Rp 5,692,500 Bio Axion
Rp 16,368,180 PT.Phapros Tbk
Rp 960,750 PT.Phapros Tbk
Rp 985,000 PT. Kimia Farma (Persero) Tbk

Rp 184,000 Rp 736,000

Rp 368,000 Rp 1,840,000

Rp 104,000 Rp 520,000 remedi

Rp 660,000 bahan gigi
Rp 4,889,000 molex ayus
Rp 1,975,000 PT. Kimia Farma (Persero) Tbk
Rp 933,000 PT. DEXA MEDICA
Rp 3,995,000 PT. MEPROFARM
Rp 4,843,200 PT. Indofarma (persero) Tbk
Rp 2,344,800 PT. ERELA
Rp 3,706,800 bahan gigi
 Rp 5,480,000 PT. Indofarma (persero) Tbk
Rp 20,000,000
Rp 5,575,000 PT NOVAPHARIN
Rp 2,100,000
Rp 1,319,000
Rp 1,319,000
Rp 1,319,000 troge/global dispo medica
Rp 778,025 Rp 4,668,056
Rp 2,334,050 Rp 14,004,167 unolab mitra persada
Rp 1,556,025 Rp 9,336,111

Rp 3,875,000

Rp 2,670,000 PT. Kimia Farma (Persero) Tbk

Rp 27,863,000 PT. Kimia Farma (Persero) Tbk
Rp 3,920,000 PT NOVAPHARIN
Rp 1,912,500 Rp 14,662,500

Rp 3,600,000 Rp 27,600,000 AXIMED

Rp 6,959,700
Rp 1,127,500
Rp 625,000
Rp 13,275,000
Rp 1,860,000 bahan gigi
Rp 795,000 Rp 4,695,000
Rp 800,000 Rp 4,920,000 busana utama
Rp 850,000 Rp 4,975,000
Rp 5,720,000 PT NOVAPHARIN
Rp 20,616,000 PT. Kimia Farma (Persero) Tbk
Rp 12,462,500 PT NOVAPHARIN
Rp 1,642,500 PT. Kimia Farma (Persero) Tbk
Rp 301,350 PT.Phapros Tbk
Rp 5,555,000 PT. IFARS PHARMACEUTICAL LABORATORIES
Rp 1,200,000 bahan gigi
Rp 4,375,000 PT. Mersifarma Tirmaku Mercusana
Rp 14,364,000 PT. Mersifarma Tirmaku Mercusana

Rp 4,490,000 PT. PROMEDRAHARDJO FARMASI INDUSTRI

Rp 9,877,500 PT.Phapros Tbk
Rp 4,250,000
Rp 9,525,000

Rp 868,358 Rp 3,062,858 beauty kasatama

Rp 18,700,000
Rp 11,896,500 PT. Ethica Industri Farmasi
Rp 8,757,000 PT. Molex Ayus
Rp 10,960,000
Rp 2,277,000
Rp 5,715,000 PT.Phyto Kemo Agung Farma
Rp 1,664,000
PT. Otsuka Indonesia
Rp 1,898,000
Rp 15,704,000 PT. Kimia Farma (Persero) Tbk
Rp 15,067,200 gizi
 Rp 10,500,000

Rp 32,050,000 PT Widatra Bhakti

Rp 208,125 Rp 1,040,625
Rp 208,125 Rp 1,040,625 steril medical
Rp 24,850,000 PT.Phapros Tbk
Rp 5,692,500
Rp 5,692,500 terumo indonesia
Rp 2,370,000 PT. HARSEN LABAROTORIES
Rp 7,250,000

Rp 952,500 Rp 7,302,500
Rp 645,000 PT.Phapros Tbk
Rp 13,000,000
Rp 18,700,000
Rp 16,552,000
Rp 19,500,000 PT. Kimia Farma (Persero) Tbk
Rp 5,544,000 PT. Ethica Industri Farmasi
Rp 3,171,240 PT NOVAPHARIN
Rp 3,594,000 PT. DEXA MEDICA
Rp 2,630,880 PT. Novell Pharmaceutical Laboratories
Rp 11,835,000

Rp 10,010,000 PT. Otsuka Indonesia

Rp 6,300,000

Rp 3,200,000

Rp 7,920,000

Rp 8,667,000

Rp 9,646,000
Rp 3,750,000

Rp 2,142,500

Rp 19,115,000 PT. Indofarma (persero) Tbk

Rp 68,440,000 PT. AFIFARMA
Rp 48,000,000 PT. Mersifarma Tirmaku Mercusana
Rp 4,776,000
Rp 10,547,640
Rp 683,000 Rp 2,504,000 fesco indonesia
Rp 4,998,700 PT. LUCAS DJAJA
Rp 814,000 PT. Holi Farma
Rp 645,000
Rp 747,500
Rp 23,100,000 PT. SOHO Industri Pharmasi
Rp 33,000,000

Rp 43,750,000

Rp 5,089,000 Rp 83,689,000 Mitra samaya sejati

 Rp 48,750,000 enseval

Rp 225,225,000 PT Widatra Bhakti

Rp 3,000,000 bahan gigi
Rp 6,930,000 PT. Graha Farma
Rp 2,223,000 PT. Indofarma (persero) Tbk
Rp 1,508,500 PT. Marin Liza Farmasi
Rp 5,355,000

Rp 1,450,000
Rp 6,077,500
Rp 17,220,000 PT. OTTO Pharmaceutical Industries
Rp 26,460,000 PT. RAMA EMERALD MULTI SUKSES
Rp 64,000 Rp 320,000

Rp 128,000 Rp 640,000
Rp 73,000 Rp 365,000 remedi
Rp 21,780,000 PT. Yarindo Farmatama
Rp 11,250,000 PT Tempo Scan Pacific, Tbk

Rp 976,500 Rp 7,486,500
Rp 1,245,000 Rp 9,545,000

Rp 2,475,000 Rp 18,975,000

Rp 36,090 Rp 276,690

Rp 1,392,000 Rp 10,672,000 AXIMED

Rp 680,000 bahan gigi
Rp 7,229,500 PT ACTAVIS INDONESIA
Rp 900,000
Rp 700,000
Rp 4,200,000
Rp 2,201,400 PT. MEPROFARM
Rp 103,400 Rp 517,000

Rp 103,400 Rp 517,000 remedi

Rp 1,309,000 PT. MEPROFARM
Rp 4,500,000 onemed
Rp 945,000 gizi
Rp 27,500 Rp 10,471,250
Rp 71,500 Rp 27,225,250
PT. Terumo Indonesia
Rp 33,000 Rp 12,565,500
Rp 55,000 Rp 20,942,500
Rp 575,000
Rp 8,140,500

Rp 2,613,600
Rp 1,400,000 onemed
Rp 5,292,000 PT. Mersifarma Tirmaku Mercusana
Rp 2,500,000
Rp 420,000 bahan gigi
Rp 10,250,000
Rp 112,500 Rp 759,000 Jaya Mas
Rp 3,630,000

Rp 1,440,000 antar mitra sambada

Rp 40,500,000 PT. Kimia Farma (Persero) Tbk
Rp 10,560,000 PT. Kimia Farma (Persero) Tbk
Rp 21,150,000 PT. Kimia Farma (Persero) Tbk
Rp 12,250,000 PT. Kimia Farma (Persero) Tbk
Rp 30,000,000 PT. Kimia Farma (Persero) Tbk
Rp 29,596,000 PT. Kimia Farma (Persero) Tbk
Rp 2,433,767,612

Rp 2,382,478,000
Rp 1,856,818,825
Rp 525,659,175
bio axion

AMS

Mensa samarinda

enseval
PT. Kimia Farma (Persero) Tbk

AMS
 axion

ABORATORIES

ASI INDUSTRI

enseval

PT. Indofarma (persero) Tbk

 AMS

bioaxion

AMS

KMS
 LAMPIRAN PENGADAAN OBAT-OBATAN E-KATALOG TAHUN 2018
Rencana
No Nama Obat Satuan Harga Satuan Total Harga Pembelian Penyedia
Pembelian

1 Acetyl cysteine 200 mg capsule Rp 412 42900 Rp 17,674,800 PT. Indofarma (persero) Tbk
2 Albendazole tab bottle Rp 463 1500 Rp 694,500 PT. Kimia Farma (Persero) Tbk
3 alprazolam 0,5 mg. tablet Rp 88 5000 Rp 440,000 PT. Mersifarma Tirmaku Mercusana
4 allopurinol 100 mg tab Tablet Rp 99 300000 Rp 29,700,000 PT. Mersifarma Tirmaku Mercusana
5 aminofilin inj amp Rp 2,878 1020 Rp 2,935,560 PT. LUCAS DJAJA
6 amlodipine 5mg tab Kaplet Rp 74 250200 Rp 18,514,800 PT Tempo Scan Pacific, Tbk
7 Amlodipine 10mg tab Kaplet Rp 95 150000 Rp 14,250,000 Pharma Laboratories
8 Amoksisilin 125mg/5ml sy bottle Rp 1,919 17500 Rp 33,582,500 PT.Phyto Kemo Agung Farma
9 Amoksisilin 500mg tab tablet Rp 248 300000 Rp 74,400,000 Hexpharm
10 Antalgin inj Ampul Rp 4,025 3500 Rp 14,087,500 Bernofarm
11 Antasida DOEN sy bottle Rp 2,098 13000 Rp 27,274,000 PT. LUCAS DJAJA
12 Antasida DOEN tab Tablet Rp 56 550000 Rp 30,800,000 PT. Mersifarma Tirmaku Mercusana
Anti Bakteri salep kombinasi: Basitrasin 500 IU/g +
13 Tube Rp 3,490 4500 Rp 15,705,000
Polimiksin 10.000 IU/g PT. Indofarma (persero) Tbk
kaplet salut
14 Asam mefenamat 500mg tab Rp 103 350000 Rp 36,050,000
selaput PT. Mersifarma Tirmaku Mercusana
15 Asering infus Botol Plastik Rp 9,646 200 Rp 1,929,200 PT. Otsuka Indonesia
16 Atropin inj Ampul Rp 1,815 200 Rp 363,000 ethica
17 BEROTEC INHALASI BTL Rp 130,190 30 Rp 3,905,700 BOEHRINGER
18 Betametasone cr tube Rp 1,373 4000 Rp 5,492,000 PT. Kimia Farma (Persero) Tbk
19 Bufacetine cr tube Rp 3,360 300 Rp 1,008,000 PT. BUFA ANEKA
20 captopril 25 mg tab Tablet Rp 80 290000 Rp 23,200,000 PT PERTIWI AGUNG
21 CATAPRES INJ AMP Rp 33,900 200 Rp 6,780,000 BOEHRINGER
22 Cefixime 100mg tab capsule Rp 923 27450 Rp 25,336,350 kimia farma
23 Ceftriaxon 1 gr Injeksi vial Rp 4,822 4000 Rp 19,288,000
24 Cetirizine sy btl Rp 2,993 3500 Rp 10,475,500 PT. RAMA EMERALD MULTI
SUKSES
Tablet Salut
25 cetirizine tab Rp 97 45000 Rp 4,365,000
Selaput (Tablet)
Tablet Salut
26 Ciprofloxacine tab Rp 281 50000 Rp 14,050,000
Selaput (Tablet) PT NOVAPHARIN
Combivent : Ipratropium bromida inhalasi 0,5 mg
27 Vial (e-cat) Rp 4,550 640 Rp 2,912,000
Salbutamol 2,5 mg ---------(Branded) BOEHRINGER
28 Concor 1,25 mg tab Tablet Rp 1,815 1000 Rp 1,815,000
PT. Merck Tbk
29 Concor 10 mg tab Tablet Rp 2,950 1020 Rp 3,009,000
30 Kloramfenikol salp mata tube Rp 1,925 480 Rp 924,000 kimia farma
31 Deksametason 0,5mg tab tab Rp 34 70000 Rp 2,380,000 PT NOVAPHARIN
32 Deksametason inj Ampul Rp 1,210 7500 Rp 9,075,000 PT. MEPROFARM
33 Diazepam 5mg tab Tablet Rp 109 5000 Rp 545,000 PT. Mersifarma Tirmaku Mercusana
34 Diazepam inj amp Rp 1,913 750 Rp 1,434,750 PT. MEPROFARM
35 difenhidramin inj Ampul Rp 1,262 3510 Rp 4,429,620 PT.Phapros Tbk
36 Dimenhidrinat tab Tablet Rp 121 7500 Rp 907,500 PT. Kimia Farma (Persero) Tbk
37 Domperidone syrup botol @ 60 ml Rp 2,862 5000 Rp 14,310,000 PT NOVAPHARIN
38 domperidone tab Tablet Rp 90 75000 Rp 6,750,000 PT. Yarindo Farmatama
39 Epinefrin amp Ampul Rp 1,518 1000 Rp 1,518,000 PT. Ethica Industri Farmasi
40 Ergotamin + Cafein tab (btl@100) Rp 199 5000 Rp 995,000 PT. Kimia Farma (Persero) Tbk
41 Eritromisin 500mg Kaplet Rp 781 5000 Rp 3,905,000 PT. Yarindo Farmatama
42 eugenol botol Rp 21,648 20 Rp 432,960 kimia farma
43 Fe + asam folat tab Tablet Rp 409 40020 Rp 16,368,180 PT.Phapros Tbk
44 fenobarbital inj Ampul Rp 2,135 450 Rp 960,750 PT.Phapros Tbk
45 fenobarbital tab 30 mg tablet Rp 197 5000 Rp 985,000 PT. Kimia Farma (Persero) Tbk
46 Fucilex krim natrium fusidat tube Rp 4,889 1000 Rp 4,889,000 molex ayus
47 Furosemide 40 mg Tablet Rp 79 25000 Rp 1,975,000 PT. Kimia Farma (Persero) Tbk
48 Furosemide inj amp Rp 1,555 600 Rp 933,000 PT. DEXA MEDICA
49 Gavistal : Metoklopramid drop 2 mg/mL Bottle Rp 3,995 1000 Rp 3,995,000 PT. MEPROFARM
50 Gentamisin inj Ampul Rp 4,036 1200 Rp 4,843,200 PT. Indofarma (persero) Tbk
51 gentamisin tts mata bottle Rp 4,885 480 Rp 2,344,800 PT. ERELA
52 Glibenclamid 5 mg Tab tab Rp 137 40000 Rp 5,480,000 PT. Indofarma (persero) Tbk
53 Griseofulvin 125mg tab Tablet Rp 223 25000 Rp 5,575,000 PT NOVAPHARIN
54 Hidrochlortiazide tab Tablet Rp 178 15000 Rp 2,670,000 PT. Kimia Farma (Persero) Tbk
55 Hidrocortisone cr tube Rp 2,533 11000 Rp 27,863,000 PT. Kimia Farma (Persero) Tbk
Tablet Salut
56 Ibuprofen 200mg tab Rp 112 35000 Rp 3,920,000
Selaput (Tablet) PT NOVAPHARIN
57 Isotic adretor tetes mata 0,5% bottle Rp 11,275 100 Rp 1,127,500 PRATAPA NIRMALA
58 Kalk tab Tablet Rp 59 225000 Rp 13,275,000 mersifarma
59 Ketokonazole 200mg tab Tablet Rp 286 20000 Rp 5,720,000 PT NOVAPHARIN
60 Ketokonazole cr tube Rp 2,577 8000 Rp 20,616,000 PT. Kimia Farma (Persero) Tbk
61 Kloramfenikol sy bottle Rp 4,985 2500 Rp 12,462,500 PT NOVAPHARIN
62 kodein 10 mg Tablet Rp 657 2500 Rp 1,642,500 PT. Kimia Farma (Persero) Tbk
63 klorpromazine inj Ampul Rp 1,435 210 Rp 301,350 PT.Phapros Tbk
KOMPOLAX Kombinasi: parafin + gliserin + fenolftalein
64 Bottle Rp 5,555 1000 Rp 5,555,000 PT. IFARS PHARMACEUTICAL
Susp LABORATORIES
65 Kotrimoksazole 480mg tab Tablet Rp 125 35000 Rp 4,375,000 PT. Mersifarma Tirmaku Mercusana
66 Kotrimoksazole sy bottle Rp 2,052 7000 Rp 14,364,000 PT. Mersifarma Tirmaku Mercusana
kaplet salut
67 Levofloksasin kap Rp 449 10000 Rp 4,490,000 PT. PROMEDRAHARDJO FARMASI
selapuT INDUSTRI
68 Lidokain epinefrin inj Ampul Rp 1,317 7500 Rp 9,877,500 PT.Phapros Tbk
69 Loratadine tab Kaplet Rp 127 75000 Rp 9,525,000 Hexpharm
70 Metilergometrin amp Ampul Rp 3,399 3500 Rp 11,896,500 PT. Ethica Industri Farmasi
71 Metilprednisolon 4 mg tab Tablet Rp 139 63000 Rp 8,757,000 PT. Molex Ayus
72 Metilprednisolon 16 mg tab tablet Rp 548 20000 Rp 10,960,000 dexa medica
73 metoklopramide inj Ampul Rp 4,554 500 Rp 2,277,000 bernofarm
74 Metronidazole tab Tablet Rp 127 45000 Rp 5,715,000 PT.Phyto Kemo Agung Farma
75 MgSO4 20% flakon Rp 3,328 500 Rp 1,664,000
PT. Otsuka Indonesia
76 MgSO4 40% flakon Rp 3,796 500 Rp 1,898,000
tube (dus@24
77 Miconazole salep@10 g Rp 3,926 4000 Rp 15,704,000
tube) PT. Kimia Farma (Persero) Tbk
78 Mineral mix sachet Rp 2,920 5160 Rp 15,067,200 indofarma
79 Nacl 0,9% infus bottle Rp 6,410 5000 Rp 32,050,000 PT Widatra Bhakti
80 natrium diklofenak 25 mg tab Tablet Rp 142 175000 Rp 24,850,000 PT.Phapros Tbk
81 Neo Diagon tab Tablet Rp 237 10000 Rp 2,370,000 PT. HARSEN LABAROTORIES
82 nystatin vaginal tab Tablet Rp 645 1000 Rp 645,000 PT.Phapros Tbk
83 Oksitetrasiklin salep mata Tube Rp 2,600 7500 Rp 19,500,000 PT. Kimia Farma (Persero) Tbk
84 Oksitosin inj amp Rp 1,232 4500 Rp 5,544,000 PT. Ethica Industri Farmasi
85 Omeprazole 20mg tab capsule Rp 138 22980 Rp 3,171,240 PT NOVAPHARIN
86 Ondansetron inj 2 mg/ml amp Rp 1,198 3000 Rp 3,594,000 PT. DEXA MEDICA

87 Ondansetron tab Tablet Rp 406 6480 Rp 2,630,880 PT. Novell Pharmaceutical

Laboratories
Sachet (Saset,
88 Oralit sachet Rp 263 45000 Rp 11,835,000
Sachet, Sacet) kimia farma
89 Otsu-WI air 25 ml amp Ampul Rp 2,860 3500 Rp 10,010,000 PT. Otsuka Indonesia
90 Parasetamol drop botol Rp 7,646 2500 Rp 19,115,000 PT. Indofarma (persero) Tbk
91 Parasetamol sy btl Rp 1,160 59000 Rp 68,440,000 PT. AFIFARMA
92 Parasetamol tab Tablet Rp 60 800000 Rp 48,000,000 PT. Mersifarma Tirmaku Mercusana
93 phytomenadion inj Ampul Rp 4,236 2490 Rp 10,547,640 phapros
PHENOL GLYCEROL TETES TELINGA 10%
94 Botol Plastik Rp 2,590 Rp 4,998,700
Karbogliserin tetes telinga 10% 1930 PT. LUCAS DJAJA
95 Prednison 5 mg Tablet Rp 74 11000 Rp 814,000 PT. Holi Farma
96 Ranitidine inj Ampul Rp 1,155 20000 Rp 23,100,000 PT. SOHO Industri Pharmasi
97 RL infus bottle Rp 7,150 31500 Rp 225,225,000 PT Widatra Bhakti
98 salbutamol 4mg tab Tablet Rp 77 90000 Rp 6,930,000 PT. Graha Farma
99 Salbutamol sy bottle Rp 4,446 500 Rp 2,223,000 PT. Indofarma (persero) Tbk
100 Salep 2-4 Pot Rp 3,017 500 Rp 1,508,500 PT. Marin Liza Farmasi
101 Sefadroksil 500mg tab capsule Rp 492 35000 Rp 17,220,000 PT. OTTO Pharmaceutical Industries

102 Sefotaksim 1 gr inj Vial (Ampul) Rp 4,410 6000 Rp 26,460,000 PT. RAMA EMERALD MULTI
SUKSES
Tablet Salut
103 Simvastatin 10 mg tab Rp 110 198000 Rp 21,780,000 PT. Yarindo Farmatama
Selaput (Tablet)
104 Simvastatin 20mg tab Tablet Rp 225 50000 Rp 11,250,000 PT Tempo Scan Pacific, Tbk
105 Stesolid 5 mg supp tube Rp 14,459 500 Rp 7,229,500 PT ACTAVIS INDONESIA
106 Sukralfat sy bottle Rp 7,338 300 Rp 2,201,400 PT. MEPROFARM
107 SUPRAFENID ketoprofen supositoria 100 mg Suppositoria Rp 2,380 550 Rp 1,309,000 PT. MEPROFARM
108 tramadol inj ampul Rp 1,764 3000 Rp 5,292,000 PT. Mersifarma Tirmaku Mercusana
109 Vit B complex tab Tablet Rp 135 300000 Rp 40,500,000 PT. Kimia Farma (Persero) Tbk
110 Tiamin (Vit B1) tab Tablet Rp 88 120000 Rp 10,560,000 PT. Kimia Farma (Persero) Tbk
111 Vit B6 (Piridoksin) tab Tablet Rp 141 150000 Rp 21,150,000 PT. Kimia Farma (Persero) Tbk
112 Vit B12 (sianokobalamin) tab Rp 49 250000 Rp 12,250,000 PT. Kimia Farma (Persero) Tbk
113 Vit C 50 mg tab Tablet Rp 120 250000 Rp 30,000,000 PT. Kimia Farma (Persero) Tbk
114 Zink tab Tablet Rp 604 49000 Rp 29,596,000 PT. Kimia Farma (Persero) Tbk

TOTAL BELANJA Rp 1,511,616,080

total pagu Rp 2,382,478,000

SISA PAGU untuk OBAT non e-cat Rp 345,202,745 obat Rp 1,856,818,825
BMHP Rp 525,659,175
 LAMPIRAN PENGADAAN BMHP E-KATALOG TAHUN 2018
Rencana Total Harga
No Nama Obat Satuan Harga Satuan Ongkos kirim Penyedia Distributor
Pembelian Pembelian

1 abbocath aximed no 26 pcs Rp 7,700 500 Rp 577,500 Rp 4,427,500 AXIMED bio axion
abbocath TERUMO SURFLO IV CATH
2 pcs Rp 8,355 1250 Rp 27,500 Rp 10,471,250
SR+OX1832C3
abbocath TERUMO SURFLO IV CATH
3 pcs Rp 8,355 3250 Rp 71,500 Rp 27,225,250
SR+OX2032C3 PT. Terumo
abbocath TERUMO SURFLO IV CATH Indonesia
4 pcs Rp 8,355 1500 Rp 33,000 Rp 12,565,500
SR+OX2225C3
abbocath TERUMO SURFLO IV CATH
5 pcs Rp 8,355 2500 Rp 55,000 Rp 20,942,500
SR+OX2419C3
6 Alkohol 70% 1 Liter bottle Rp 25,000 40 Rp 200,000 Rp 1,200,000 jayamas
7 alkohol swab kotak Rp 12,300 160 Rp 492,000 Rp 2,460,000 remedi AMS
8 benang demetech chromic catgut 2 75cm + jarum kotak Rp 360,000 23 Rp 450,000 Rp 8,730,000
benang demetech chromic catgut 2/0 75cm +
9 kotak Rp 270,000 23 Rp 337,500 Rp 6,547,500
jarum demetech/
10 benang demetech plain catgut 3/0 70 cm + jarum kotak Rp 295,000 25 Rp 368,750 Rp 7,743,750 enseval
11 benang demetech silk 3/0 75Cm + jarum kotal Rp 180,000 23 Rp 225,000 Rp 4,365,000
12 benang demetech silk 4/0 45 cm + jarum kotak Rp 250,000 23 Rp 312,500 Rp 6,062,500
13 bioplacenton tulle box Rp 104,000 45 Rp 521,111 Rp 5,201,111 eracita enseval
14 blood lancet 28 G kotak Rp 14,566 45 Rp 98,320 Rp 753,790 jayamas
15 Ecodin 1 L Bottle Rp 79,650 60 Rp 955,800 Rp 5,734,800 jayamas
16 folley catheter 12 pcs Rp 9,200 60 Rp 184,000 Rp 736,000
17 folley catheter 18 pcs Rp 9,200 160 Rp 368,000 Rp 1,840,000 remedi AMS
18 folley catheter 6 pcs Rp 10,400 40 Rp 104,000 Rp 520,000
19 Handschoen steril no 6 (sensosurge) pasang Rp 6,595 200 Rp 1,319,000
troge/global
20 handschoen steril no 6,5 (sensosurge) pasang Rp 6,595 200 Rp 1,319,000
dispo medica
21 handschoen streril no 7 (sensosurge) pasang Rp 6,595 200 Rp 1,319,000
22 handschoen uk L kotak Rp 77,801 50 Rp 778,000 Rp 4,668,056
unolab mitra
23 handschoen uk M kotak Rp 77,801 150 Rp 2,334,000 Rp 14,004,167
persada
24 handschoen uk S kotak Rp 77,801 100 Rp 1,556,000 Rp 9,336,111
25 Infus set anak pcs Rp 5,100 2500 Rp 1,912,500 Rp 14,662,500
AXIMED axion
26 Infus set dewasa pcs Rp 4,800 5000 Rp 3,600,000 Rp 27,600,000
27 kapas pembalut absorben 1000gr rol Rp 52,000 75 Rp 795,000 Rp 4,695,000
28 Kasa hidrofil 40yd x 80 cm rol Rp 103,000 40 Rp 800,000 Rp 4,920,000 busana utama
29 Kasa kompres steril 16x16 cm kotak Rp 5,500 750 Rp 850,000 Rp 4,975,000
30 Masker Ear Loop Dus Rp 19,800 250 Rp 742,500 Rp 5,692,500 Bio Axion
beauty
31 masker ties on kotak Rp 21,945 100 Rp 868,358 Rp 3,062,858 enseval
kasatama
32 nasogastric tube no 16 pcs Rp 11,100 75 Rp 208,125 Rp 1,040,625
steril medical
33 nasogastric tube no 18 pcs Rp 11,100 75 Rp 208,125 Rp 1,040,625
34 needle 24G x 25 mm pcs Rp 330 15000 Rp 742,500 Rp 5,692,500 terumo
35 needle 26G x 13 mm pcs Rp 330 15000 Rp 742,500 Rp 5,692,500 indonesia

36 Nonwoven Fixation/ 20cmx10m Roll Rp 127,000 50 Rp 952,500 Rp 7,302,500 AXIMED

antar mitra
37 PD crepe/Bandage 7,5 cmx4,5 m rol Rp 28,800 50 Rp 1,440,000
sambada
38 plester fescoplast 5cm x 4,5M rol Rp 15,175 120 Rp 683,000 Rp 2,504,000 fesco indonesia
Mitra samaya
39 RDT HIV R3 (INTEC products) strip Rp 13,100 6000 Rp 5,089,000 Rp 83,689,000
sejati
40 RDT HIV R2 (Biomereux vikia) strip Rp 487,500 100 Rp 48,750,000 enseval
41 selang oksigen bayi pcs Rp 6,400 40 Rp 64,000 Rp 320,000
42 selang oksigen dewasa pcs Rp 6,400 80 Rp 128,000 Rp 640,000 remedi AMS
43 selang oksigen neonatus pcs Rp 7,300 40 Rp 73,000 Rp 365,000
44 spuit 10cc box Rp 130,200 50 Rp 976,500 Rp 7,486,500
45 spuit 1cc box Rp 83,000 100 Rp 1,245,000 Rp 9,545,000
46 spuit 3cc box Rp 82,500 200 Rp 2,475,000 Rp 18,975,000 AXIMED bioaxion
47 spuit 50cc box Rp 120,300 2 Rp 36,090 Rp 276,690
48 spuit 5cc box Rp 92,800 100 Rp 1,392,000 Rp 10,672,000
49 sungkup nebulizer anak pcs Rp 10,340 40 Rp 103,400 Rp 517,000
remedi AMS
50 sungkup nebulizer dewasa pcs Rp 10,340 40 Rp 103,400 Rp 517,000
51 urine bag pcs Rp 3,000 220 Rp 99,000 Rp 759,000 Jaya Mas KMS
TOTAL BELANJA Rp 432,324,582

total pagu Rp 2,382,478,000

obat Rp 1,856,818,825
SISA PAGU untuk BMHP non e-cat Rp 93,334,593 BMHP Rp 525,659,175
 LAMPIRAN PENGADAAN OBAT-OBATAN NON E-KATALOG TAHUN 2018
Rencana
No Nama Obat Satuan Harga Satuan Total Harga Pembelian Keterangan
Pembelian

1 Acyclovir Salep Tube Rp 4,000 4000 Rp 16,000,000

2 Ambroxol Syr Botol Rp 6,000 10000 Rp 60,000,000
3 Ambroxol tab tablet Rp 275 65500 Rp 18,012,500
4 Antalgin tablet tablet Rp 143 100000 Rp 14,300,000
5 atropin tab tab Rp 81 2000 Rp 162,000
6 becom C tab tab Rp 1,488.3 2500 Rp 3,720,750 setkab
7 bisolvon larutan 50 ml botol Rp 93,800 25 Rp 2,345,000
8 Chloramphenicol Tetes Telinga Botol Rp 10,000 500 Rp 5,000,000
Botol@100 ml
9 Chlorethyl Spray------------- (Branded) Rp 115,000 150 Rp 17,250,000
(Botol Kaleng)
10 colchicine 0,5 mg (Recolfar) tab Rp 1,633.5 1000 Rp 1,633,500 setkab
11 Dektrose 40% inj 25ml flakon Rp 3,388 250 Rp 847,000
12 Gliseril Guaikolate tab tablet Rp 50 400000 Rp 20,000,000
Hico / trombophob : Heparin sodium 20.000 I.U------
13 Tube Rp 15,500 250 Rp 3,875,000
(branded)
14 irvask 300 MG tab tab Rp 11,599.5 600 Rp 6,959,700 setkab
15 Kalium Permanganat serbuk ---(Branded) pot Rp 2,500 250 Rp 625,000

16 Loperamide tab Tablet Rp 85 50000 Rp 4,250,000

17 Meloxicam 7,5 mg Tab Rp 110 120000 Rp 13,200,000

Molakrim : Menthol 53.4 mg, eugenol 13.6 mg, methyl

18 Tube@30 gr Rp 14,000 750 Rp 10,500,000
salicylate 102 mg ------- (Branded)

Neocenta / bioplacenton: Placenta extract 10% ,

19 Tube@ 20 gr Rp 14,500 500 Rp 7,250,000
Neomycin sulfate 0,5% ---- (branded)

20 OBH sy botol Rp 3,740 5000 Rp 18,700,000

21 oksitetrasiklin salep Kulit tube Rp 4,138 2500 Rp 10,345,000

Ottopain tts telinga : Polymyxin B sulfate 10.000 IU,

Neomycin sulfate 5 mg, Fludrocortisone acetate 1 mg,
22 Botol@8 ml Rp 63,000 100 Rp 6,300,000
Lidocain HCl 40 mg -------- (Branded)

23 Papaverin 40 mg Tablet tab Rp 160 20000 Rp 3,200,000

 Paracetamol 125 mg, chlorpheniramine maleate 0,5 mg,
25 guaiaphenesin 50 mg, phenylpropanolamine hidroklorida botol Rp 19,260 750 Rp 14,445,000
3,125 mg -------- (Branded)

26 Paracetamol 125 mg/2.5 ml (Branded) Rectal tube Rp 13,780 700 Rp 9,646,000

27 Paracetamol 250 mg/2.5 ml (Branded) Rectal tube Rp 15,000 250 Rp 3,750,000

28 paracetamol 500 mg, phenylpropanolamine HCl 12.5 mg, tablet Rp 857 10000 Rp 8,570,000
chlorpheniramine maleate 2 mg--------- (Branded)

ampul (dus 10
29 Petidin Injeksi 50mg/2 ml Rp 15,920 300 Rp 4,776,000
Amp)
31 Propituracil 100 mg tab (btl@100) Rp 299 2500 Rp 747,500
Tablet Salut
32 Ranitidine tab Rp 110 250000 Rp 27,500,000
Selaput (Tablet)
33 Salisil bedak dus Rp 1,071 5000 Rp 5,355,000
34 sancorbin injeksi amp Rp 29,000 50 Rp 1,450,000 setkab
35 Scabimite cr tube Rp 12,155 500 Rp 6,077,500
36 Taburia sachet Rp 300 3150 Rp 945,000
Botol@5 ml (e-
37 Tetrakain HCl tetes mata 0,5% --------- (Branded) Rp 11,500 50 Rp 575,000
Cat)
38 Tiamfenikol 500 mg Capsul Rp 1,809 4500 Rp 8,140,500
39 tiriz tab tab Rp 4,356 600 Rp 2,613,600 setkab
40 Tramadol Tablet Tab Rp 500 5000 Rp 2,500,000

Botol Plastik@2,5
42 Ventolin : Salbutamol cairan ih 0,1% ----------(Branded) Rp 7,260 500 Rp 3,630,000
ml (e- Cat)

TOTAL BELANJA Rp 345,196,550

PAGU OBAT NON E-KAT Rp 345,202,745

BELANJA Rp 345,196,550
SISA Rp 6,195
 LAMPIRAN PENGADAAN BAHAN BMHP NON E-KATALOG TAHUN 2018
Rencana
No Nama Obat Satuan Harga Satuan Ongkos kirim Total Harga Pembelian Keterangan
Pembelian

1 alvogyl septodont kotak Rp 400,000 6 Rp 2,400,000 bahan gigi

2 anestesi topikal topicaina topical tutti frutti pot Rp 125,000 Rp 750,000

6 bahan gigi
3 bahan tambal sementara Caviton pot Rp 138,600 10 Rp 1,386,000 bahan gigi
4 bubuk larvasida (abate) @25kg botol Rp 82,500 50 Rp 4,125,000 P2M
5 ChKM botol Rp 70,000 10 Rp 700,000 bahan gigi
6 cresophene / cresodent @ 5ml btl Rp 175,000 6 Rp 1,050,000 bahan gigi
7 dentin conditioner kotak Rp 241,900 6 Rp 1,451,400 bahan gigi
8 devitec @6gr kotak Rp 550,000 6 Rp 3,300,000 bahan gigi
9 disclosing solution dental @200gr botol Rp 60,000 10 Rp 600,000 bahan gigi
10 formocresol @10ml botol Rp 110,000 6 Rp 660,000 bahan gigi
11 glass ionomer cement (GIC) Fuji VII kotak Rp 617,800 6 Rp 3,706,800 bahan gigi
12 H2O2 3% @800 ml btl Rp 21,000 100 Rp 2,100,000 PKD
13 kalsium hidroksida Calcipex II kotak Rp 310,000 6 Rp 1,860,000 bahan gigi
14 Komposit light curing nano hybrid A3 set Rp 200,000 6 Rp 1,200,000 bahan gigi
15 Obat fogging @1 liter Mustang botol Rp 130,000 100 Rp 13,000,000 P2M
16 RDT HIV CD4 strip Rp 350,000 110 Rp 38,500,000 HIV
17 rockles kotak Rp 500,000 6 Rp 3,000,000 bahan gigi
18 stain remover OCO btl Rp 85,000 6 Rp 510,000 bahan gigi
19 strip autocheck asam urat botol Rp 90,000 10 Rp 900,000 KORPRI
20 strip autocheck gula darah botol Rp 70,000 10 Rp 700,000 KORPRI
21 strip autocheck kolesterol botol Rp 140,000 30 Rp 4,200,000 KORPRI
22 surgical blade onemed no 11 box Rp 90,000 60 Rp 5,400,000 PKD
23 tongue spatel kayu onemed kotak Rp 14,000 100 Rp 1,400,000 PKD
24 tri kresol formalin (TKF) camex botol Rp 70,000 6 Rp 420,000 bahan gigi

TOTAL BELANJA Rp 93,319,200

PAGU BMHP NON E-KAT Rp 93,334,593

BELANJA Rp 93,319,200
SISA Rp 15,393