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DAFTAR PERENCANAAN OBAT E-KAT

PERIODE JANUARI - DESEMBER 2

VOLUME HARGA SATUAN


NO NAMA OBAT, BENTUK, KEKUATAN, SEDIAAN KEMASAN SATUAN
KEBUTUHAN
HNA
OBAT
1 Akarbose tablet 50 mg Dus, 10 strip @ 10tablet Tab 17,300 Rp 657.00
2 Alopurinol 100 mg Dus, 10 strip @ 10 Tablet Tab 5,000 Rp 90.00
3 Amlodipin tablet 5 mg Dus, 3 Strip @ 10 tablet Tab 45,000 Rp 105.00
4 Amlodipine10 mg Dus, 3 Strip @ 10 tablet Tab 30,510 Rp 148.00
5 Amoksisilin kaplet 500 mg Dus, 10 strip @ 10 kaplet Kapl 10,000 Rp 232.00
Antihemoroid, kombinasi: bismut subgalat 150 mg
6 heksaklorofen 2,5 mg lidokain 10 mg seng oksida 120 DUS, 10 SUPP Supp 200 Rp 3,045.00
mg
7 Asam asetilsalisilat (asetosal) Dus 10 strip @ 10 tablet Tab 10,000 Rp 130.00

Tab 10,000 Rp 39.00


8 Asam Askorbat (Vitamin C) tablet 50 mg Botol plastik @ 100 tablet
9 Asam Mefenamat tablet 500 mg dus, 10 strip @ 10 tablet Tab 35,000 Rp 106.00
10 Asam Pipemidat 400 mg BOX, 10 strip @ 10 capsule kaps 3,000 Rp 1,485.00
11 Attapulgite 600 mg tablet Box isi 10 Strip @ 10 Tablet Tab 1,000 Rp 145.00
12 Azitromisin tablet 500 mg ktk 2x10 tablet Tab 100 Rp 1,900.00
13 Betahistine tablet 6mg KOTAK @ 3 x 10 Tablet Tab 2,010 Rp 149.00

14 Bisakodil suppositoria 10mg Box, 50 Supp Supp 300 Rp 5,800.00

15 Bisakodil suppositoria 5 mg Dus, 1 strip @ 6 suppositoria Supp 102 Rp 5,670.00

16 Bisoprolol tablet 2,5 mg Kotak @ 10 x 10 tab Tab 40,000 Rp 650.00


17 Bisoprolol tablet 5 mg Dus, 10 Blister @ 10 Tablet Tab 20,000 Rp 330.00
18 Budesonide - Formoterol 160/4.5 mcg 60 Dosis BOX ISI 1 CAN Botol 20 Rp 121,000.00

19 Budesonide 0.25 mg/ml BOX ISI 20 Nebule Neb 1,000 Rp 9,725.00

20 Deksametason tablet 0,5 mg Dus, 10 strip @ 10 tablet Tab 4,000 Rp 44.00


21 Digoksin 0,25 mg Box 10 Strip @ 10 tablet Tab 16,000 Rp 105.00
22 Diltiazem HCl tablet 30 mg Ktk 10X10 TAB Tab 4,500 Rp 127.00
23 Doksisiklin kapsul 100 mg Dus, 10 Strip @ 10 Kapsul Kaps 500 Rp 269.00
24 Domperidon suspensi/sirup 5 mg/5 ml Dus, botol @ 60 mL Botol 200 Rp 3,000.00
25 Domperidon tablet 10 mg Dus, Blister 10@10 Tablet Tab 1,500 Rp 118.00
26 Domperidon tetes 5 mg/mL Dus, 10 botol @ 10 ml Botol 100 Rp 15,559.00
27 Eritromisin sirup kering 200 mg/ 5 ml Botol @60 ml Botol 20 Rp 6,700.00
28 Fenitoin Kapsul/Kaplet 100 mg Botol 100 Capsul Kaps 1,000 Rp 154.00
29 Fenoterol HBr aerosol 100 mcg/dosis Dus, canister @ 200 dosis Dus 500 Rp 80,000.00
30 Fenofibrat kaps 100 mg Dus, 3 strip @ 10 kapsul Kapsul 1,500 Rp 1,073.00
31 Fitomenadion (Vit.K1) kaplet salut gula 10 mg Dus, 10 str x 10's Tab 2,000 Rp 695.00
32 Flukonazol kapsul 150 mg ktk 1 x 10 kapsul Kaps 50 Rp 18,000.00
33 Furosemid tablet 40 mg Dus, 10 strip @ 10 tablet Tab 10,000 Rp 78.00
34 Gemfibrozil kap 600 mg Botol 100 Capsul Kaps 2,000 Rp 742.00
35 Gemfibrozil kapsul 300 mg Botol 100 Capsul Kaps 7,300 Rp 380.00
36 Glimepiride tablet 1 mg Dus, 10 blister @ 10 tablet Tab 23,000 Rp 218.00
37 Glimepiride tablet 2 mg Dus, 5 strip @ 10 tablet Tab 3,000 Rp 289.00
38 Gliseril trinitrat kaps SR 2,5 mg Dus 10x10 tab 3,000 Rp 1,500.00
39 hidroklorotiazid tab 25 mg dus, 10 strip @ 10 tablet Tab 2,000 Rp 149.00
40 Ibuprofen Suspensi 100 mg/5 ml Dus, botol @ 60 mL Botol 100 Rp 2,475.00
41 Irbesartan tablet 150 mg Box, 3 strip @ 10 tablet Tab 11,000 Rp 708.00
42 Kalium Klorida tablet SR 600 mg Dus 10 strip @ 10 tablet Tab 5,000 Rp 1,700.00
43 Kalsium Laktat (Kalk) tablet 500 mg dus, 10 strip @ 10 tablet Tab 6,000 Rp 63.00
44 Kaptopril tablet/kaplet scored 25 mg Dus, 10 Strip @ 10 Tablet Tab 15,000 Rp 68.00
45 Klindamisin kapsul 300 mg dus, 5 strip @ 10 kapsul Kaps 4,000 Rp 603.00
46 Klopidogrel tablet 75 mg Dus, 5 strip@6tablet salut selaput Tab 2,490 Rp 2,000.00
47 Kloramfenikol kapsul 500 mg Dus, 10 strip @ 10 kapsul Kaps 200 Rp 798.00
48 Kloramfenikol salep mata 1 % Tube 5 gr Tube 250 Rp 1,798.00
49 Klorpromazin tablet salut 100 mg (HCl) Kotak @ 10 x 10 tab Tab 1,000 Rp 162.00
50 Kolkisin tablet 500 mcg Dus, 3 strip @ 10 tablet Tab 150 Rp 3,845.00
Antasida DOEN I tablet kunyah, kombinasi :
Aluminium Hidroksida 200 mg Magnesium Hidroksida Dus, 10 Strip @ 10 Tablet Tab 4,000 Rp 62.00
51 200 mg
Kombinasi : Ipratropium bromida 0,5 mg Salbutamol
Box, 20 vials 2.5ml Vial 6,600 Rp 4,995.00
52 2,5 mg cairan inhalasi

Kombinasi: Salmeterol 50 mcg; Flutikason propionat


Dus, Botol 60 Dosis Botol 200 Rp 113,333.00
250 mcg
53

Kotrimoksazol (dewasa) kombinasi : sulfametoksazol dus 10X10 tablet Tab 9,000 Rp 151.00
54 400 mg+ trimetoprim 80 mg
55 Lanzoprazol kapsul/kaplet 30 mg Dus, 2 Strip @ 10 Kapsul Kaps 45,000 Rp 319.00
56 Levofloksasin tablet/kapsul/kaplet 500 mg Dus, 10 blister @ 10 tablet salut selaput Tab 2,000 Rp 495.00
57 Levotiroksin tablet/kapsul/kapsul 100 mcg Dus, 10 Strip @ 10 tablet salut selaput Tab 1,000 Rp 944.00
58 Loperamid tablet 2 mg Dus, 10 blister @ 10 tablet salut selaput Tab 2,000 Rp 85.00
59 Loratadin tablet/kapsul/kaplet 10 mg Dus, 10 blister @ 10 kaptab Tab 3,000 Rp 134.00
60 Maprotilin HCl tab 50 mg KOTAK @ 5 x 10 TAB Tab 2,000 Rp 2,428.00
61 Metildopa tablet salut 250 mg Dus, 10 Strip @ 10 tablet salut selaput Tab 6,500 Rp 869.00
62 Metilprednisolon Kaplet 16 mg Dus, 3 Strip @ 10 Kaptab Tab 1,020 Rp 637.00
63 Metilprednisolon tablet/kapsul/kaplet 4 mg Dus, 10 Blister @ 10 Tablet Tab 6,500 Rp 194.00
64 Metoklopramid 10 mg Dus, 10 Strip x 10 Tablet Tab 3,000 Rp 90.00
65 Metronidazol kaptab 500 mg Dus, 10 blister @ 10 tablet salut selaput Tab 3,000 Rp 133.00
66 Metronidazole sirup 125mg/ 5ml Dus, botol @ 60 mL Botol 100 Rp 3,800.00
67 Metronidazole sirup 125mg/ 5ml Botol @ 60 ml Botol 100 Rp 3,800.00
68 Omeprazol kapsul/kaplet 20 mg Dus, strip 3X10 kapsul Kaps 21,000 Rp 160.00
69 Ondansetron tablet/kapsul/kaplet 8 mg Dus, 2 Strip @ 6 Tablet Tab 1,200 Rp 299.00
70 Parasetamol kaplet 500 mg KOTAK, 10 blister @ 10 tablet Tab 100,000 Rp 56.00
71 Pirazinamid tablet 500 mg Dus, 10 str x 10's Tab 7,000 Rp 237.00
72 Piridoksin (Vitamin B6) tablet 10 mg Botol plastik @ 100 tablet Tab 20,000 Rp 45.00
73 Propanolol tablet 10 mg Dus, 10 strip @ 10 tablet Tab 8,500 Rp 60.00
74 Propiltiourasil tablet/kapsul/kaplet 100 mg Botol 100 Tablet Tab 15,000 Rp 279.00
75 Ranitidin tablet 150 mg Dus, 10 Strip @ 10 tablet salut selaput Tab 65,000 Rp 105.00
76 Rifampisin tablet/kapsul/kaplet 300 mg Dus, 10 strip @ 10 kapsul Kaps 2,000 Rp 683.00
77 Rifampisin tablet/kapsul/kaplet 450 mg Dus, 10 Strip @ 10 tablet salut selaput Tab 2,000 Rp 897.00
78 Rifampisin tablet/kapsul/kaplet 600 mg Dus, 10 Strip @ 10 tablet salut selaput Tab 1,000 Rp 1,114.00
79 Risperidon 2 mg Box 5 Blister @ 10 Tablet Tab 2,000 Rp 495.00
80 Salbutamol 2 mg Box 10 Strip @ 10 tablet Tab 30,000 Rp 66.00
81 Salbutamol sirup botol @ 100 ml Botol 200 Rp 4,750.00
82 Salbutamol tablet 4 mg Box 10 Strip @ 10 tablet Tab 30,000 Rp 83.00
83 Sefadroksil Sirup Kering 125 mg/5ml Dus, botol @ 60 mL Botol 300 Rp 4,485.00
84 Sefadroksil Sirup Kering 250 mg/5 ml Dus, botol @ 60 mL Botol 100 Rp 5,585.00
85 Sefadroksil tablet/kapsul/kaplet 500 mg Dus, Strip@100 Tablet Kaps 35,000 Rp 510.00
86 Sefiksim kapsul/kaplet 100 mg Dus, 5 strip @ 10 kapsul kaps 25,000 Rp 590.00
87 Sefiksim sirup kering 100 mg/5 ml Dus, botol @ 30 ml Botol 900 Rp 7,490.00
88 Setirizin kapsul 10 mg Box, 10 strips @ 10 capsules Kaps 1,000 Rp 143.00
89 Setirizin sirup 5 mg/5 ml Dus, botol @ 60 mL Botol 600 Rp 2,850.00
90 Siprofloksasin tab scored 500 mg dus 10X10 tablet Tab 22,000 Rp 281.00
91 spironolactone 100mg Dus 10 Strip @10 tablet Tab 10,000 Rp 876.00
92 Sukralfat susp 500 mg / 5 m Botol, 100 ml Botol 10,000 Rp 9,578.00
93 Sukralfat tab 500 mg dus 10 blister @ 10 tablet Tab 3,000 Rp 368.00
94 TAMSULOSIN HCI 0,2 mg DUS, 2 BLISTER @ 14 TABLET DISPERSIB Tab 2,016 Rp 7,100.00
95 TAMSULOSIN HCI 0,4 mg DUS, 3 BLISTER @ 10 TABLET PELEPASAN LAMBA 510 Rp 6,479.00
96 Telmisartan tab 80 mg Box, 2 alu-blisters @10 tablets Tab 23,100 Rp 6,500.00
97 Terazosin HCl tablet 2 mg Dus, Blister 10 @ 10 Tablet (1 Dus,100 Table Tab 5,000 Rp 1,399.00
98 Tiamazol tab 10 mg dus 10 blister @ 10 tablet Tab 1,000 Rp 1,195.00
99 Tiamazol tab 5 mg dus 10 blister @ 10 tablet Tab 3,000 Rp 610.00
100 URSODEOXYCHOLIC ACID 250 MG Dus, 3 Strip @10 kapsul Kaps 300 Rp 3,600.00
101 URSODEOXYCHOLIC ACID 250 MG Dus, 3 Strip @10 kapsul kaps 200 Rp 3,600.00
102 Valsartan tab 80 mg Dus, 5 strip @ 6 tablet salut selaput Tab 1,500 Rp 1,800.00
103 Vitamin B Kompleks tablet Botol plastik @ 100 tablet Tab 30,000 Rp 43.00
104 Warfarin tablet 2 mg Dus 10 Strip @10 tablet Tab 1,000 Rp 950.00
105 Zinc sir 20 mg/5 Ml Dus, botol 60 ml Botol 500 Rp 6,290.00

CAIRAN
1 Asetat Ringer Plastic bottle of 500 mL Botol 2,500 Rp 9,275.00
2 Glukosa larutan infus 10% Botol plastik 500 ml Botol 1,000 Rp 7,500.00

Larutan Karbohidrat+elektrolit(NaCl 1,75 , KCL 1,5, Na


3 Plastic bottle of 500 mL Botol 1,500 Rp 10,050.00
Laktat 2,24,Deskstrosa 27 gram)

Larutan mengandung Asam Amino (Asam Amino 5%


4 botol 500 ml Botol 200 Rp 81,750.00
dengan BCAA 50%, L-Ornithine L Aspartate 10 gr/L,
Sorbito 50 gr/L, Xylitol 50 gr/L)

Larutan mengandung Asam Amino (Asam Amino 6%,


5 mengandung Taurine 0,24 gr/l, tidak mengandung botol Botol 200 Rp 43,450.00
Elektrolit)

Larutan mengandung Asam Amino (Kombinasi Asam


6 botol 250 ml Botol 15 Rp 52,000.00
amino 50 g/L, Vitamin dan elektrolit)

7 Larutan mengandung Elektrolit Plastic bottle of 500 mL Botol 3,000 Rp 9,273.00


8 Larutan mengandung Karbohidrat Botol plastik 500 ml Botol 50 Rp 31,100.00
Larutan mengandung karbohidrat (Glukosa 5g/100
9 Softbag 100 ml Softbag 200 Rp 11,450.00
ml)
Larutan mengandung Karbohidrat + Elektrolit
(Larutan nutrisi kombinasi infus per L: Na. 100mEQ, K
10 softbag 500ml Softbag 8,100 Rp 39,325.00
18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl 90mEQ, Asetat
38mEQ, Sorbitol 50g)

11 Larutan mengandung Karbohidrat+Elektrolit Plastic bottle of 500 mL Botol 50 Rp 9,600.00


12 Levofloksasin inf 5 mg/mL Botol @ 100 ml Botol 400 Rp 27,999.00
13 Manitol lar infus 20% Botol plastik 500 ml Botol 100 Rp 44,000.00
14 Nacl 0,9% Botol plastik 500 ml Botol 5,000 Rp 6,410.00
15 Ringer Laktat Botol plastik 500 ml Botol 15,000 Rp 7,150.00
16 Siprofloksasin infus 2% Botol 100 ml Botol 2,000 Rp 11,489.00

INJEKSI
Albumin Serum Normal (Human Albumin) Inj 20% 50
1 Dus, Vial @ 50ml Vial 100 Rp 409,200.00
m
2 Aminofilin inj 24 mg/ml dus @30 Ampul Amp 2,000 Rp 3,345.00
Analog insulin long acting inj 100 UI/ml, (flexpen @
3 1 box isi 5 flexpen disposible Flexpen 200 Rp 85,000.00
3ml)
Analog insulin long acting inj 100 UI/ml, vial/cartridge
4 disposible/penfill cartridge (Insulin glargine 100 Prefilled pen
DUS, 5 SOLOSTAR PEN @ CARTRIDGE 3 m 300 Rp 85,000.00
IU/ml)

Analog insulin mix acting inj 100 UI/ml (Premix 30%


5 1 box isi 5 flexpen disposible Flexpen 500 Rp 110,000.00
Insulin Aspart + 70% Protaminated Insulin Aspart)

6 Analog Insulin Mix Insulin Inj 100 UI/ml Dus, 5 prefilled pen @ 3 ml Prefilled pen 900 Rp 110,000.00

7 Analog Insulin Rapid Acting Inj 100 UI/ml Dus, 5 prefilled pen @ 3 ml Prefilled pen 200 Rp 87,000.00

Analog insulin rapid acting inj 100 UI/ml,


8 vial/cartridge disposible/penfill cartridge (Insulin 2 box isi 5 flexpen disposible Flexpen 800 Rp 87,000.00
Aspart)
9 Analog insulin rapid actinginj 100 UI/ml DUS, 5 SOLOSTAR PEN @ CARTRIDGE 3 m Flexpen 100 Rp 87,000.00
10 Asam traneksamat injeksi 100 mg/ml Box, 10 Amp@5 ml Amp 2,000 Rp 2,489.00
11 Deksametason injeksi i.v./i.m. 5 mg/ml dus @100 Ampul Amp 1,000 Rp 1,500.00
12 Digoksin injeksi 0,25 mg/ml Box 5 ampul@2mL Amp 300 Rp 24,095.00

Diltiazem Injeksi 25 mg/5mL Dus, Vial@5mL Vial 200 Rp 55,000.00


13
14 Dopamin Inj 40mg/ml Ampul@5 ml Amp 500 Rp 7,480.00
15 Efedrin Inj 50mg/ml Dus, 10 Ampul@1 ml Amp 100 Rp 10,989.00
Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml
dus @30 Ampul Amp 5,000 Rp 2,204.00
16 (0,1%)
17 Fenitoin injeksi 50 mg/ml (100 mg/2 ml) Dus, 10 ampul @ 2 ml Amp 20 Rp 7,980.00
18 Gentamisin injeksi 40 mg/ ml Dus, 5 ampul @ 2 ml Amp 600 Rp 3,083.00

19 Human tetanus imunoglobulinn injeksi i.m. 250 UI Dus, 1 prefilled syringe @ 1 ml syringe 20 Rp 170,000.00

20 Kalsium Glukonat Injeksi i.v 10% (100mg/ml) Dus,24 ampul@10mL Amp 150 Rp 9,955.00
21 Ketorolak inj 30 mg/ml Dus, 12 ampul @ 1 ml Amp 9,000 Rp 1,290.00
22 Lansoprazol Inj 30 mg/ml Box 1 Vial @30mg Vial 700 Rp 88,500.00
23 Lidokain injeksi 2% (HCL) Dus, 100 ampul @ 2 ml Amp 3,500 Rp 860.00
24 Meropenem serb inj 1000 mg Dus, 1 vial @ 0.5 g Vial 200 Rp 44,490.00
25 Meropenem serb inj 500 mg/vial Dus, 1 vial @ 0.5 g Vial 600 Rp 31,456.00
26 Metilergometrin inj 0,2 mg/ml Dus, 100 ampul@1 ml Amp 1,000 Rp 2,684.00

Metilprednisolon inj 125 mg/mL Dus.1 vial 125 mg+1 ampul pelarut @ 2 ml Amp 100 Rp 14,486.00
27
28 Natrium Bikarbonat Injeksi i.v 8,4% ampul @ 25 mL Amp 50 Rp 6,200.00

29 Neostigmine-hameln 0,5 mg/ml Dus, 5 ampul @ 1 ml Amp 150 Rp 8,800.00

30 Oksitosin inj 10 UI/ml Dus,100 ampul@1 mL Amp 2,000 Rp 1,900.00

1 Box @1 Vial serbuk kering injeksi 40mg


Omeprazole Injeksi 40mg / 10ml Vial 900 Rp 16,997.00
dan 1 ampul @10 ml Pelarut
31
32 Ondansetron Injeksi 2 mg/ ml (4 mg/ 2 ml) Dus, 5 Ampul @ 2 ml Amp 11,000 Rp 1,650.00
33 Ranitidin injeksi 25 mg/ml Dus, 10 Ampul @ 2 ml Amp 20,000 Rp 1,390.00
34 Sefotaksim serb inj 1.000 mg Dus, 10 Vial @ 1 g Vial 2,600 Rp 4,000.00
35 Tramadol injeksi 50 mg/ml KOTAK, 5 ampul @ 2 mL Amp 1,000 Rp 1,800.00
36 Triamsinolon inj 10 mg/mL Dus,1 vial@ 5ml Vial 100 Rp 71,450.00
PERENCANAAN OBAT E-KATALOG
DE JANUARI - DESEMBER 2017

NAMA DAGANG PENYEDIA DISTRIBUTOR TOTAL

P.T. Dexa Medica PT Anugrah Argon Medica Rp 11,366,100


PT. Sampharindo Perdana PT.Indofarma Global Medika Bandung Rp 450,000
PT. PROMEDRAHARDJO FARMAPT Kimia Farma T&D Cab Bandung Rp 4,725,000
PT. NUFARINDO PT Mensa Binasukses Cabang Bandung Rp 4,515,480
PT. PHARMA LABORATORIES PT. Kimia Farma Trading & Distribution (Bandung) Rp 2,320,000

PT. Kimia Farma (Persero) Tbk PT Kimia Farma T&D Cab Bandung Rp 609,000

PT. MARIN LIZA FARMASI PT. Prima Anugerah Mandiri Cabang Jabar RS Rp 1,300,000

PT.Imfarmind Farmasi IndustriPT.Indofarma Global Medika - Bandung Rp 390,000

PT. Mersifarma Tirmaku Merc PT. Merapi Utama Pharma - Bandung Rp 3,710,000
PT. Interbat PT Mensa Binasukses Cabang Bandung Rp 4,455,000
New Antides PT. TROPICA MAS PHARMACEPT.Indofarma Global Medika - Bandung Rp 145,000
PT. Kimia Farma (Persero) Tbk PT Kimia Farma T&D Cab Bandung Rp 190,000
PT. Mersifarma Tirmaku Merc PT. Merapi Utama Pharma - Bandung Rp 299,490
Dulcolax supp adult
10mg
PT Boehringer Ingelheim IndonPT Tempo Scan Pacific Rp 1,740,000

Dulcolax supp anak 5


mg
PT Boehringer Ingelheim IndonPT Tempo Scan Pacific Rp 578,340

Concor 2.5 PT. Merck Tbk PT Anugrah Argon Medica Rp 26,000,000


PT. NOVELL PHARMACEUTICAPT Rajawali Nusindo Cabang Bandung Rp 6,600,000
Symbicort Turbuhaler
160/4.5 mcg
PT AstraZeneca Indonesia PT. Parit Padang Global Bandung Rp 2,420,000

Pulmicort Respules PT AstraZeneca Indonesia PT. Parit Padang Global Bandung Rp 9,725,000

PT. PROMEDRAHARDJO FARMA PT Kimia Farma T&D Cab Bandung Rp 176,000


PT Yarindo Farmatama PT. Parit Padang Global Bandung Rp 1,680,000
PT. Kimia Farma (Persero) Tbk PT Kimia Farma T&D Cab Bandung Rp 571,500
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 134,500
PT NOVAPHARIN PT.Indofarma Global Medika - Bandung Rp 600,000
P.T. Dexa Medica PT Anugrah Argon Medica Rp 177,000
PT.Bernofarm PT. Tri Sapta Jaya - Bandung Rp 1,555,900
PT.Phyto Kemo Agung Farma PT Kimia Farma T&D Cab Bandung Rp 134,000
PT Ikapharmindo Putramas PT Kimia Farma T&D Cab Bandung Rp 154,000
Berotec MDI PT Boehringer Ingelheim IndonPT. TEMPO CABANG BANDUNG .1 Rp 40,000,000
PT. Hexpharm Jaya Laboratori PT. ENSEVAL PUTERA MEGATRADING Cabang Bandu Rp 1,609,500
PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 1,390,000
PT. Kimia Farma (Persero) Tbk PT Kimia Farma T&D Cab Bandung Rp 900,000
PT. Sampharindo Perdana PT.Indofarma Global Medika - Bandung Rp 780,000
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 1,484,000
PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 2,774,000
PT.Bernofarm PT. Tri Sapta Jaya - Bandung Rp 5,014,000
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 867,000
Nitrokaf Retard PT. Kimia Farma (Persero) Tbk PT Kimia Farma T&D Cab Bandung Rp 4,500,000
PT. Kimia Farma (Persero) Tbk PT Kimia Farma T&D Cab Bandung Rp 298,000
PT. RAMA EMERALD MULTI S PT Rajawali Nusindo Cabang Bandung Rp 247,500
PT PERTIWI AGUNG PT Mensa Binasukses Cabang Bandung Rp 7,788,000
KSR PT. Merck Tbk PT Anugrah Argon Medica Rp 8,500,000
PT. Mersifarma Tirmaku Merc PT. Merapi Utama Pharma - Bandung Rp 378,000
PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 1,020,000
PT. Mersifarma Tirmaku Merc PT. Merapi Utama Pharma - Bandung Rp 2,412,000
PT Tempo Scan Pacific, Tbk PT Tempo Scan Pacific Rp 4,980,000
Chloramex PT ACTAVIS INDONESIA PT Mensa Binasukses Cabang Bandung Rp 159,600
PT. Kimia Farma (Persero) Tbk PT Kimia Farma T&D Cab Bandung Rp 449,500
PT. Mersifarma Tirmaku Merc PT. Merapi Utama Pharma - Bandung Rp 162,000
PT Pratapa Nirmala PT. Parit Padang Global Bandung Rp 576,750

PT.ERELA PT Rajawali Nusindo Cabang Bandung Rp 248,000

Combivent UDV PT Boehringer Ingelheim IndonPT Tempo Scan Pacific Rp 32,967,000

Seretide Discus
PT Glaxo Wellcome Indonesia PT. Anugerah Pharmindo Lestari Cabang Bandung Rp 22,666,600
250mcg

PT NOVAPHARIN PT.Indofarma Global Medika - Bandung Rp 1,359,000

PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 14,355,000


PT.Bernofarm PT. Tri Sapta Jaya - Bandung Rp 990,000
Euthyrox 100 mg PT. Merck Tbk PT Anugrah Argon Medica Rp 944,000
PT. IFARS PHARMACEUTICAL PT.Indofarma Global Medika - Bandung Rp 170,000
PT.Bernofarm PT. Tri Sapta Jaya - Bandung Rp 402,000
Sandepril PT. Mersifarma Tirmaku Merc PT. Merapi Utama Pharma - Bandung Rp 4,856,000
DOPAMET PT ACTAVIS INDONESIA PT Mensa Binasukses Cabang Bandung Rp 5,648,500
PT. IFARS PHARMACEUTICAL PT.Indofarma Global Medika - Bandung Rp 649,740
PT. Natura Laboratoria Prima PT. DOS NI ROHA - BANDUNG Rp 1,261,000
PT. Graha Farma PT. INDOFARMA GLOBAL MEDIKA BANDUNG Rp 270,000
PT.ERELA PT Rajawali Nusindo Cabang Bandung Rp 399,000
PT. MEPROFARM PT Sapta Sari Tama Cabang Bandung Rp 380,000
PT. MEPROFARM PT Sapta Sari Tama Cabang Bandung Rp 380,000
PT NOVAPHARIN PT.Indofarma Global Medika - Bandung Rp 3,360,000
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 358,800
PT. Mersifarma Tirmaku Merc PT. Merapi Utama Pharma - Bandung Rp 5,600,000
PT. Holi Pharma PT Sapta Sari Tama Cabang Bandung Rp 1,659,000
PT.Imfarmind Farmasi IndustriPT.Indofarma Global Medika - Bandung Rp 900,000
PT. Holi Pharma PT Sapta Sari Tama Cabang Bandung Rp 510,000
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 4,185,000
P.T. Dexa Medica PT Anugrah Argon Medica Rp 6,825,000
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 1,366,000
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 1,794,000
PT.Bernofarm PT. Tri Sapta Jaya - Bandung Rp 1,114,000
PT. GUARDIAN PHARMATAMA PT. MILLENNIUM PHARMACON INTERNATIONAL (Cab Rp 990,000
PT Yarindo Farmatama PT. Parit Padang Global Bandung Rp 1,980,000
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 950,000
PT. Kimia Farma (Persero) Tbk PT Kimia Farma T&D Cab Bandung Rp 2,490,000
PT. IFARS PHARMACEUTICAL PT.Indofarma Global Medika - Bandung Rp 1,345,500
PT. IFARS PHARMACEUTICAL PT.Indofarma Global Medika - Bandung Rp 558,500
P.T. Dexa Medica PT Anugrah Argon Medica Rp 17,850,000
PT. PHARMA LABORATORIES PT Kimia Farma T&D Cab Bandung Rp 14,750,000
PT. PHARMA LABORATORIES PT Kimia Farma T&D Cab Bandung Rp 6,741,000
PT PERTIWI AGUNG PT Mensa Binasukses Cabang Bandung Rp 143,000
PT.ERELA PT Rajawali Nusindo Cabang Bandung Rp 1,710,000
PT NOVAPHARIN PT.Indofarma Global Medika - Bandung Rp 6,182,000
PT. OTTO Pharmaceutical Indus PT Mensa Binasukses Cabang Bandung Rp 8,760,000
PT. COMBINED IMPERIAL PH PT. Anugerah Pharmindo Lestari Cabang Bandung Rp 95,780,000
Ulsidex P.T. Dexa Medica PT Anugrah Argon Medica Rp 1,104,000
Harnal D PT. COMBINED IMPERIAL PH PT. Anugerah Pharmindo Lestari Cabang Bandung Rp 14,313,600
Harnal OCAS PT. COMBINED IMPERIAL PH PT. Anugerah Pharmindo Lestari Cabang Bandung Rp 3,304,290
Micardis 80 mg PT Boehringer Ingelheim IndonPT. TEMPO CABANG BANDUNG .1 Rp 150,150,000
P.T. Dexa Medica PT Anugrah Argon Medica Rp 6,995,000
Thyrozol 10 mg PT. Merck Tbk PT Anugrah Argon Medica Rp 1,195,000
Thyrozol 5 mg PT. Merck Tbk PT Anugrah Argon Medica Rp 1,830,000
PT. ETERCON PHARMA PT Rajawali Nusindo Cabang Bandung Rp 1,080,000
PT. ETERCON PHARMA PT Rajawali Nusindo Cabang Bandung Rp 720,000
P.T. Dexa Medica PT Anugrah Argon Medica Rp 2,700,000
PT.Imfarmind Farmasi IndustriPT.Indofarma Global Medika - Bandung Rp 1,290,000
Simarc 2 PT Pratapa Nirmala PT. Parit Padang Global Bandung Rp 950,000
Zircum Kid PT. MEPROFARM PT Sapta Sari Tama Cabang Bandung Rp 3,145,000
Rp 637,635,690

Asering PT. Otsuka Indonesia PT. Anugerah Pharmindo Lestari - Bandung Rp 23,187,500
PT Widatra Bhakti PT. Indofarma Global Medika Bdg Rp 7,500,000

KAEN 3B PT. Otsuka Indonesia PT. Anugerah Pharmindo Lestari - Bandung Rp 15,075,000

Comafusin Hepar PT. FINUSOLPRIMA FARMA INPT. ENSEVAL PUTERA MEGATRADING Cabang BanduRp 16,350,000

Aminosteril Infant 6% PT. Fresenius Kabi CombipharPT. Anugerah Pharmindo Lestari Cabang Bandung Rp 8,690,000

Aminofusin Paed PT KALBE FARMA Tbk PT. ENSEVAL PUTERA MEGATRADING Cabang BanduRp 780,000

KAEN 1B PT. Otsuka Indonesia PT. Anugerah Pharmindo Lestari - Bandung Rp 27,819,000
Martos PT. Otsuka Indonesia PT. Anugerah Pharmindo Lestari - Bandung Rp 1,555,000

Infusan D5 (100 ml) PT SANBE FARMA PT. Bina San Prima Rp 2,290,000
Futrolit PT SANBE FARMA PT. Bina San Prima Rp 318,532,500

KAEN MG3 PT. Otsuka Indonesia PT. Anugerah Pharmindo Lestari - Bandung Rp 480,000
PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 11,199,600
PT. FINUSOLPRIMA FARMA IN PT. ENSEVAL PUTERA MEGATRADING Cabang Bandu Rp 4,400,000
PT Widatra Bhakti PT. Indofarma Global Medika Bdg Rp 32,050,000
PT Widatra Bhakti PT. Indofarma Global Medika Bdg Rp 107,250,000
P.T. Dexa Medica PT Anugrah Argon Medica Rp 22,978,000
Rp 600,136,600

Albuman 50 ml PT. Graha Farma PT. INDOFARMA GLOBAL MEDIKA BANDUNG Rp 40,920,000

PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 6,690,000

Levemir Flexpen PT Ferron Par PharmaceuticalsPT.Anugrah Argon Medica Bandung Rp 17,000,000

Lantus Solostar
100IU/ml
PT Aventis Pharma PT. Anugerah Pharmindo Lestari Rp 25,500,000

Novomix Flexpen PT Ferron Par PharmaceuticalsPT.Anugrah Argon Medica Bandung Rp 55,000,000

Humalog Mix 25
Kwikpen
PT Bayer Indonesia PT Anugrah Argon Medica Rp 99,000,000

Humalog Kwikpen PT Bayer Indonesia PT Anugrah Argon Medica Rp 17,400,000

Novorapid Flexpen PT Ferron Par PharmaceuticalsPT.Anugrah Argon Medica Bandung Rp 69,600,000

Apidra Solostar PT Aventis Pharma PT. Anugerah Pharmindo Lestari Rp 8,700,000


P.T. Dexa Medica PT Anugrah Argon Medica Rp 4,978,000
PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 1,500,000
Fargoxin PT Pratapa Nirmala PT. Parit Padang Global Bandung Rp 7,228,500
Farmabes Injeksi 25
mg
PT Pratapa Nirmala PT. Parit Padang Global Bandung Rp 11,000,000

Cetadop PT Ethica Industri Farmasi PT. Parit Padang Global Bandung Rp 3,740,000
PT Ethica Industri Farmasi PT. Parit Padang Global Bandung Rp 1,098,900

PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 11,020,000

PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 159,600


PT.Indofarma Global Medika - PT.Indofarma Global Medika - Bandung Rp 1,849,800

P.T. Dexa Medica PT Anugrah Argon Medica Rp 3,400,000

Ca Gluconas 10 PT Ethica Industri Farmasi PT. Parit Padang Global Bandung Rp 1,493,250
PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 11,610,000
Prosogan PT.Takeda Indonesia PT. United Dico Citas cabang Bandung Rp 61,950,000
PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 3,010,000
PT.Bernofarm PT. Tri Sapta Jaya - Bandung Rp 8,898,000
P.T. Dexa Medica PT Anugrah Argon Medica Rp 18,873,600
PT Ethica Industri Farmasi PT. Parit Padang Global Bandung Rp 2,684,000

PT.Phapros Tbk PT Rajawali Nusindo Cabang Bandung Rp 1,448,600

Meylon PT. Otsuka Indonesia PT. Anugerah Pharmindo Lestari - Bandung Rp 310,000

Neostigmin Hameln inj PT Pharma Health Care PT. Anugerah Pharmindo Lestari - Bandung Rp 1,320,000

Oxytocin Injlq 10 IU PT Ethica Industri Farmasi PT. Parit Padang Global Bandung Rp 3,800,000

PT. OTTO Pharmaceutical Indus


PT Mensa Binasukses Cabang Bandung Rp 15,297,300

PT. SOHO Industri Pharmasi PT. Parit Padang Global Bandung Rp 18,150,000
PT. Natura Laboratoria Prima PT. DOS NI ROHA - BANDUNG Rp 27,800,000
P.T. Dexa Medica PT Anugrah Argon Medica Rp 10,400,000
PT. Mersifarma Tirmaku Merc PT. Merapi Utama Pharma - Bandung Rp 1,800,000
Flamicort P.T. Dexa Medica PT Anugrah Argon Medica Rp 7,145,000
Rp 581,774,550

TOTAL Rp 1,819,546,840
DAFTAR PERENCANAAN OBAT NON E-KATALOG
PERIODE JANUARI - DESEMBER 2017

VOL
NAMA OBAT, BENTUK, KEBUTUH
HARGA SATUAN
NO KEMASAN SATUAN AN
KEKUATAN, SEDIAAN
HNA
OBAT
700
Allopurinol 300 mg 7,000
Ambroxol 30 mg Tab 17,000
Ambroxol Syr 700
Aminophyllin 200 mg Tab 4,000
Antalgin 500 mg 3,000
200
Asam Traneksamat Tab 4,000
6,000
Atorvastatin 20 mg 800
100
100
200
Cefadroxyl 250 mg 5,000
150
250
6,500
700
Clindamicin 150 mg 3,000
13,000
50
5,000
10,000
Flunarizin 1,500
1,600
120
Gliseril Guaicolat 100 Mg 5,000
Glucosamin
500mg,Chondroitin
400mg,Vit C 50mg 15,000
Asam Valproat Syr 130
ISDN 11,100
Amiodaron Tab 400
Ketorolak Tab 10 mg 3,200
60
6,400
20
200
Mecobalamin 1,500
Meloksikam 15 mg 22,000
Metil Ergometrin Tab 5,000
3,000
6,000
35,000
Misoprostol 2,000
500
55
300
600
700
500
Parasetamol Syr 1,000
600
50
500
3,700
100
1,000
10
230
50
5,000
100
50
3,000
700
30
13
30
CAIRAN
350
3,000
300
5,000
20
650
800

INJEKSI
Ampicillin Inj 1 g 2,000
100
200
50
Ceftriaxon 1 g 8,000
Citicolin Inj 720
Amiodaron Inj 50
120
Dobutamin Inj 600
400
10
5,000
250
220
Ketorolak 10 mg/ml 100
350
550
1,300
20
150
20
800
Phytomenadion 10 Mg ( Vit K Inj ) 1,800
Piracetam 1 gr 200
1,500
350
2,000
120
1,500
50
2,000
50
OBAT NON E-KATALOG
- DESEMBER 2017

NAMA DAGANG PENYEDIA DISTRIBUTOR TOTAL

Alinamin-F Tab

Apialys Drop

Aspilet

Betadine Gargle
Bisolvon Solution
Burnazin Cream

Centabio Cream
Cetirizin Drop
Ciflon
Citicolin Tab

Curcuma Tab
Dicynone Tab
Ethambutol Tab
Ferro sulfat

Gastrul Tab
Gentamycin SK
GG

Ketrisin Cream
L-Bio
Lacophen Syr
Laxadine Syr

Myonal
Neo-Diaform
Neurodex

Norelut
Nystin Drop
OBH Syr
Oralit
Pamol 125 mg Supp
Pamol 250 mg Supp

Pronalges Supp
Ranyvel Syr
Regumen Tab
Rifastar
Sibro
Spasminal
Symbicort
Tantum Verde
Thrombopob Gel
Tramadol Tab
Tramal Supp
Trichodazol Plus Ovula
Velutin Neb
Vitacur Syr
Isoflurane
Sevorane
Sibro 20 Gr

Enerton Inf
Metronidazole Inf
NaCl 0,9% 100 ml
NaCl 0,9% 1000 ml
Nacl 3%
Parasetamol Inf
Sanbe Hes
Antalgidon
Alinamin-F Inj
ATP inj

Dycinon Inj

Duvadilan Inj
Epidosin Inj
Furosemid Inj
Hyoscine Inj
Valamin

Marcain
Neo-K
Neurosanbe Inj
Norepinephrin
Norsec Inj
Novalgin
Pehacain Inj

Piralen Inj
Proanes
Santocyn Inj
S.A.B.U
ATS 1500 IU
Sohobal Inj
Topazol Inj
Tramus
NAMA OBAT, BENTUK, STOK
NO KEMASAN SATUAN
KEKUATAN, SEDIAAN
2015
EKATALOG
Alprazolam tablet 0,5 mg KOTAK @ 10 x 10 Tablet Tab
Lorazepam tablet 1 mg Dus, 10 Strip @ 10 tablet Tab
Klobazam tab 10 mg Dus, 10 Strip @ 10 tablet Tab
Kodein tablet 20 mg ktk 10x10 tablet Tab
Fentanil patch 12,5 mcg/jam Dus @ 5 patch Patch
Fentanil injeksi i.m/i.v 0,05 mg/ml, Dus 5 ampul@ 2ml Amp
Sertralin tablet/kapsul/kaplet 50 mg dus, 3 strip @ 10 tablet Tab
Haloperidol Tablet 0,5 mg Dus, 10 strip @ 10 tablet Tab
Haloperidol tablet/kapsul/kaplet 5 mKOTAK @ 10 x 10 Tablet Tab
Fluoksetin kapsul 20 mg Tab
Olanzapin tablet salut 10 mg Dus, 4 Blister @ 7 tablet salut selapuTab
Diazepam larutan rektal 10 mg/2,5 Dus, 5 alubag @ 1 tube @ 2,5ml tube
Diazepam larutan rektal 5 mg/2,5 mDus, 5 alubag @ 1 tube @ 2,5ml tube

NON EKATALOG
Diazepam 2 mg
Analsik

Lorazepam 0,5 mg
Phetidin
Phenobarbital Kaps
DAFTAR PERENCANAAN OBAT NARKOTIKA - PSIKOTROPIKA BPJS
PERIODE JANUARI - DESEMBER 2017

VOL
KEBUTUHA HARGA SATUAN
N NAMA DAGANG

HNA

10,000 Rp 126.00
500 Rp 1,000.00 Ativan 1 mg
200 Rp 970.00
11,500 Rp 1,210.00
200 Rp 97,725.00 Durogesic 12,5 MU Matrix
500 Rp 40,000.00
420 Rp 2,340.00 Fridep 50 mg
3,000 Rp 58.00
2,000 Rp 75.00
700 Rp 250.00 Prestin
2,000 Rp 6,996.00 Onzapin
30 Rp 16,742.00 Stesolid Rect 10 mg
160 Rp 11,517.00 Stesolid Rect 5 mg

8,000
11,000
500 Stesolid Inj
1,500
400
200
AT NARKOTIKA - PSIKOTROPIKA BPJS
UARI - DESEMBER 2017

PENYEDIA

PT. Mersifarma Tirmaku Mercusana


PT SUNTHI SEPURI
P.T. Dexa Medica
PT. Kimia Farma (Persero) Tbk
PT. Kimia Farma (Persero) Tbk
PT. Kimia Farma (Persero) Tbk
PT. Mersifarma Tirmaku Mercusana
PT. Holi Pharma
PT. Mersifarma Tirmaku Mercusana
PT. PROMEDRAHARDJO FARMASI INDUSTRI
PT ACTAVIS INDONESIA
PT ACTAVIS INDONESIA
PT ACTAVIS INDONESIA
DISTRIBUTOR TOTAL

PT. Merapi Utama Pharma - Bandung Rp 1,260,000.00


PT Mensa Bina Sukses Cab. Bandung Rp 500,000.00
PT Anugrah Argon Medica Rp 194,000.00
PT Kimia Farma T&D Cab Bandung Rp 13,915,000.00
PT Kimia Farma T&D Cab Bandung Rp 19,545,000.00
PT Kimia Farma T&D Cab Bandung Rp 20,000,000.00
PT. Merapi Utama Pharma - Bandung Rp 982,800.00
PT. Sapta Sari Tama Cabang Bandung Rp 174,000.00
PT. Merapi Utama Pharma - Bandung Rp 150,000.00
PT Kimia Farma T&D Cab Bandung Rp 175,000.00
PT Mensa Bina Sukses Cab. Bandung Rp 13,992,000.00
PT Mensa Bina Sukses Cab. Bandung Rp 502,260.00
PT Mensa Bina Sukses Cab. Bandung Rp 1,842,720.00
Rp 73,232,780.00

Rp -
NO NAMA OBAT, BENTUK, KEKUATAN, SEDIAAN

1 AUTOCLAVE INDICATOR TAPE UK. 25 MM x 50 M

2 Comy Bag ( Colostomy Bag )


3 COROLENE 0, 3/8 RC 26mm, 75cm single armed

4 COROLENE 4/0, 3/8 RC 19mm, 75cm single armed

5 Cuticell Classic 10 cm x 10 cm

6 Cutimed Gel 15 gr

7 Cutimed Siltec Super Absorbent Silicone 10 X 10 Cm

8 Cutimed Sorbact Swap 7 x 9 cm

9 E-CARE ALCOHOL SWAB CHG + 0.5% (EMPAC)


10 E-CARE ANTISEPTIK HAND RUB 10 BTL @ 500 ml

11 Guedel Airway 100 mm Disp. Steril


12 Guedel Airway 110 mm Disp. Steril
13 Guedel Airway 40 mm Disp. Steril
14 Guedel Airway 60 mm Disp. Steril
15 Guedel Airway 70 mm Disp. Steril
16 Guedel Airway 80 mm Disp. Steril
17 Guedel Airway 90 mm Disp. Steril
18 Guedel Airway size 000
19 Kasa Hydrofil Steril 16x16 cm
20 Kondom Natural Male Latex
21 MICROPORE 1 INCH

22 MICROPORE 1/2 INCH

23 MICROPORE 2 INCH

24
NASAL OXYGEN, O2 cannula, size L
25
NASAL OXYGEN, O2 cannula, size M
26
NASAL OXYGEN, O2 cannula, size S
27
NASAL OXYGEN, O2 cannula, size XS
28 Perfusor Tubing, White, 150 cm

29 Polyglycolic Acid (PGA) Multifilament 1, 1/2 TP 48mm,


90cm
30 Polyglycolic Acid (PGA) Multifilament 2/0, 1/2 TP
36mm, 75cm
31 Sarung Tangan Obgyn Steril ( Obgyn glove )
32 Surgical Mask Tie On
33 THREE WAY STOP COCK

34 UMBILICAL CORD CLAMP

35 Underpad
36 VASOFIX IV G16 X 50 MM GREY
37 VASOFIX IV G18 X 33 MM GREEN

38 VASOFIX IV G20 X 33 MM PINK


39 VASOFIX IV G22 X 25 MM BLUE

40 VASOFIX IV G24 X 0,75"


DAFTAR PERENCAN
PERIODE JANUARI

VOLUME
SPESIFIKASI KEMASAN SATUAN KEBUTUHAN

AUTOCLAVE INDICATOR TAPE Roll Roll 5


UK. 25 MM x 50 M

With faeces drainage, Pcs Pcs 30


Polypropylene Monofilament 0, 3/8 50
RC 26mm, 75cm single armed

Polypropylene Monofilament 4/0, Pcs Pcs 70


3/8 RC 19mm, 75cm single armed

Gauze steril ukuran 10 cm x 10 Box'10 Pcs Pcs 5,500


cm, Low adherent dressing
dilimpregnasi dengan soft paraffin

Hidro gel yang mengandung Tube 15 gr Tube 15 gr 80


gliserin & carbomer 940, tanpa
bahan pengawet

Super Absorbent Silicone Foam Box'10 Pcs Pcs 100


Dressing ukuran 10 X 10 Cm,
Polyurethane foam dressing yang
mengandung partikel penyerap dng
kemampuan super maksimal

Swab dressing ukuran 7 cm x 9 Box'10 Pcs Pcs 60


cm, Terbuat dari bahan khusus
dilapisi DACC
(Dialkylcarbamoylchloride);
turunan asam lemak.

ABSORBENT TIPPED Box'100 Box'100 500


APPLICATOR, ISOPROPYL
ALCOHOL 70% & CHG 0,5%
LIQUIDE CHEMICAL Box'10 Btl Btl 500 ml 850
STERILANTS/HIGH LEVEL
DISINFECTANTS, MENGANDUNG
ETHANOL 70% DAN CHG 0,5%
W/V

Sterile, Single use only Pcs Pcs 40


Sterile, Single use only Pcs Pcs 13
Sterile, Single use only Pcs Pcs 13
Sterile, Single use only Pcs Pcs 20
Sterile, Single use only Pcs Pcs 13
Sterile, Single use only Pcs Pcs 40
Sterile, Single use only Pcs Pcs 100
Sterile, Single use only Pcs Pcs 13
16x16 (isi 16 lembar) Box'16 Box'16 1,500
Alat Kontrasepsi Pria/ Natural Mal Box'144 Box'144 1
Plester Hypoallergenic berbahan Box'12 Box'12 17
kertas berpori kecil (micro-pore)
ukuran 1 inch x 10 yds

Plester Hypoallergenic berbahan Box'24 Box'24 11


kertas berpori kecil (micro-pore)
ukuran 1/2 inch x 10 yds

Plester Hypoallergenic berbahan Box'6 Box'6 28


kertas berpori kecil (micro-pore)
ukuran 2 inch x 10 yds

2,300
Nasal Oxygen Cannula Pcs Pcs
550
Nasal Oxygen Cannula Pcs Pcs
250
Nasal Oxygen Cannula Pcs Pcs
300
Nasal Oxygen Cannula Pcs Pcs
Perfusor Tubing, White, 150 Pcs pcs 500
cmFungsi: set untuk pemberian
therapy melalui syringe
pumpBahan terbuat dari PVC
(DEHP free), sambungan Luer Lock
sehingga tidak mudah terlepas dari
sambungan. Diameter 0.9mm dan
panjang 150 cm

Pcs Pcs 100

Pcs Pcs 100

Obgyn / Latex Pasang Pasang 300


Tie On Box'50 Box'50 820
MMP POLYMED-POLYWAY-PRO Pcs Pcs 600
THREE WAY STOP COCK

Dimensi : Panjang 62mm, Lebar A Pcs Pcs 850


= 5,0mm, Lebar B = 9,2 mm ,
Warna putih

60 x 90 Lembar Lembar 2,050


FITUR : Injection Port with Wings, Pcs 200
Universal bevel, Kateter transparan
dengan garis radioopaque, Double
flasback, Bahan FEP / PUR
BENEFIT : Untuk penambahan
obat dan ciran serta mencegah
needle stick injury karena tidak
menggunakan jarum pada saat
penambahan obat.Mempermudah
fiksasi dan menjaga kestabilan
dalam fiksasi.Jarum yang tajam
dengan "Triple faceted back cut
bevel" sehingga mengurangi rasa
sakit pasien.Dapat diidentifikasi
secara radiologi.Memudahkan
penandaan kesusksesan dalam
penusukan ke pembuluh darah
pasien.Lebih aman dan tahan
lama.
FITUR : Injection Port with Wings, Pcs 3,000
Universal bevel, Kateter transparan
dengan garis radioopaque, Double
flasback, Bahan FEP / PUR
BENEFIT : Untuk penambahan
obat dan ciran serta mencegah
needle stick injury karena tidak
menggunakan jarum pada saat
penambahan obat.Mempermudah
fiksasi dan menjaga kestabilan
dalam fiksasi.Jarum yang tajam
dengan "Triple faceted back cut
bevel" sehingga mengurangi rasa
sakit pasien.Dapat diidentifikasi
secara radiologi.Memudahkan
penandaan kesusksesan dalam
penusukan ke pembuluh darah
pasien.Lebih aman dan tahan
lama.

FITUR : Injection Port with Wings, 6,000


Universal bevel, Kateter transparan
dengan garis radioopaque, Double
flasback, Bahan FEP / PUR
BENEFIT : Untuk penambahan
obat dan ciran serta mencegah
needle stick injury karena tidak
menggunakan jarum pada saat
penambahan obat.Mempermudah
fiksasi dan menjaga kestabilan
dalam fiksasi.Jarum yang tajam
dengan "Triple faceted back cut
bevel" sehingga mengurangi rasa
sakit pasien.Dapat diidentifikasi
secara radiologi.Memudahkan
penandaan kesusksesan dalam
penusukan ke pembuluh darah
pasien.Lebih aman dan tahan
lama.
FITUR : Injection Port with Wings, 3,000
Universal bevel, Kateter transparan
dengan garis radioopaque, Double
flasback, Bahan FEP / PUR
BENEFIT : Untuk penambahan
obat dan ciran serta mencegah
needle stick injury karena tidak
menggunakan jarum pada saat
penambahan obat.Mempermudah
fiksasi dan menjaga kestabilan
dalam fiksasi.Jarum yang tajam
dengan "Triple faceted back cut
bevel" sehingga mengurangi rasa
sakit pasien.Dapat diidentifikasi
secara radiologi.Memudahkan
penandaan kesusksesan dalam
penusukan ke pembuluh darah
pasien.Lebih aman dan tahan
lama.

FITUR : Injection Port with Wings, 3,000


Universal bevel, Kateter transparan
dengan garis radioopaque, Double
flasback, Bahan FEP / PUR
BENEFIT : Untuk penambahan
obat dan ciran serta mencegah
needle stick injury karena tidak
menggunakan jarum pada saat
penambahan obat.Mempermudah
fiksasi dan menjaga kestabilan
dalam fiksasi.Jarum yang tajam
dengan "Triple faceted back cut
bevel" sehingga mengurangi rasa
sakit pasien.Dapat diidentifikasi
secara radiologi.Memudahkan
penandaan kesusksesan dalam
penusukan ke pembuluh darah
pasien.Lebih aman dan tahan
lama.
FTAR PERENCANAAN BHP E-KATALOG
ERIODE JANUARI - DESEMBER 2017

HARGA SATUAN
NAMA DAGANG PENYEDIA
HNA
Rp 51,547.00 PT. ANUGERAH SINERGI
SOLUSTAMA

Rp 24,200.00 PT. Jayamas Medica


Rp 57,697.00 PT.GLOBAL DISPO MEDIKA

Rp 83,473.00 PT.GLOBAL DISPO MEDIKA

Rp 5,198.00 PT BSN MEDICAL INDONESIA

Rp 45,591.00 PT BSN MEDICAL INDONESIA

Rp 31,756.00 PT BSN MEDICAL INDONESIA

Rp 30,503.00 PT BSN MEDICAL INDONESIA

Rp 19,680.00 PT Enseval Medika Prima


Rp 60,800.00 PT Enseval Medika Prima

Rp 12,574.39 PT. Jayamas Medica


Rp 12,574.39 PT. Jayamas Medica
Rp 12,574.39 PT. Jayamas Medica
Rp 12,574.39 PT. Jayamas Medica
Rp 12,574.39 PT. Jayamas Medica
Rp 12,574.39 PT. Jayamas Medica
Rp 12,574.39 PT. Jayamas Medica
Rp 14,200.00 PT Steril Medical Indonesia
Rp 5,950.00 PT. KASA HUSADA WIRA JATIM
Rp 96,000.00 PT. Mitra Rajawali Banjaran
Rp 217,028.00 PT.MENSA BINASUKSES

Rp 262,874.00 PT.MENSA BINASUKSES

Rp 197,606.00 PT.MENSA BINASUKSES

Rp 6,600.00 PT. Bio Axion Healthindo

Rp 6,600.00 PT. Bio Axion Healthindo

Rp 6,600.00 PT. Bio Axion Healthindo

Rp 6,600.00 PT. Bio Axion Healthindo


Rp 35,000.00 PT. B Braun Medical Indonesia

Rp 78,961.00 OPTIME 1, 1/2 TP 48mm, PT.GLOBAL DISPO MEDIKA


90cm
Rp 67,681.00 OPTIME 2/0, 1/2 TP PT.GLOBAL DISPO MEDIKA
36mm, 75cm
Rp 19,360.00 PT. Jayamas Medica
Rp 16,500.00 PT. Jayamas Medica
Rp 14,025.00 PT. MEGAH MEDIKA PHARMA

Rp 2,750.00 PT. Sentra Asia Gemilang

Rp 4,620.00 PT. Sentra Asia Gemilang


Rp 8,750.00 PT. B Braun Medical Indonesia
Rp 8,750.00 PT. B Braun Medical Indonesia

Rp 8,750.00 PT. B Braun Medical Indonesia


Rp 8,750.00 PT. B Braun Medical Indonesia

Rp 8,750.00 PT. B Braun Medical Indonesia


DISTRIBUTOR

PT. Indofarma Global Medika Cabang Bandung

PT.INTISUMBER HASIL SEMPURNA (Bandung)


PT. MILLENNIUM PHARMACON INTERNATIONAL Tbk. -
BDG

PT. MILLENNIUM PHARMACON INTERNATIONAL Tbk. -


BDG

PT Anugrah Argon Medica (PT AAM)

PT Anugrah Argon Medica (PT AAM)

PT Anugrah Argon Medica (PT AAM)

PT Anugrah Argon Medica (PT AAM)

PT Enseval Medika Prima


PT Enseval Medika Prima

PT.INTISUMBER HASIL SEMPURNA (Bandung)


PT.INTISUMBER HASIL SEMPURNA (Bandung)
PT.INTISUMBER HASIL SEMPURNA (Bandung)
PT.INTISUMBER HASIL SEMPURNA (Bandung)
PT.INTISUMBER HASIL SEMPURNA (Bandung)
PT.INTISUMBER HASIL SEMPURNA (Bandung)
PT.INTISUMBER HASIL SEMPURNA (Bandung)
PT. Millennium Pharmacon International,Tbk Cabang Band
PT. Indofarma Global Medika Cabang Bandung
PT. Rajawali Nusindo Cab. Bandung
PT.MENSA BINASUKSES

PT.MENSA BINASUKSES

PT.MENSA BINASUKSES

PT KIMIA FARMA TRADING AND DISTRIBUTION CABANG


BANDUNG
PT KIMIA FARMA TRADING AND DISTRIBUTION CABANG
BANDUNG
PT KIMIA FARMA TRADING AND DISTRIBUTION CABANG
BANDUNG
PT KIMIA FARMA TRADING AND DISTRIBUTION CABANG
BANDUNG
PT. Parit Padang Global Cabang Bandung

PT. MILLENNIUM PHARMACON INTERNATIONAL Tbk. -


BDG
PT. MILLENNIUM PHARMACON INTERNATIONAL Tbk. -
BDG
PT.INTISUMBER HASIL SEMPURNA (Bandung)
PT.INTISUMBER HASIL SEMPURNA (Bandung)
PT. MEGAH MEDIKA PHARMA (Cabang BANDUNG 1)

PT. Sentra Asia Gemilang - Bandung

PT. Sentra Asia Gemilang - Bandung


PT. Parit Padang Global Cabang Bandung
PT. Parit Padang Global Cabang Bandung

PT. Parit Padang Global Cabang Bandung


PT. Parit Padang Global Cabang Bandung

PT. Parit Padang Global Cabang Bandung


TOTAL

Rp 257,735.00

Rp 726,000.00
Rp 2,884,850.00

Rp 5,843,110.00

Rp 28,589,000.00

Rp 3,647,280.00

Rp 3,175,600.00

Rp 1,830,180.00

Rp 9,840,000.00
Rp 51,680,000.00

Rp 502,975.60
Rp 163,467.07
Rp 163,467.07
Rp 251,487.80
Rp 163,467.07
Rp 502,975.60
Rp 1,257,439.00
Rp 184,600.00
Rp 8,925,000.00
Rp 96,000.00
Rp 3,689,476.00

Rp 2,891,614.00

Rp 5,532,968.00

Rp 15,180,000.00

Rp 3,630,000.00

Rp 1,650,000.00

Rp 1,980,000.00
Rp 17,500,000.00

Rp 7,896,100.00

Rp 6,768,100.00

Rp 5,808,000.00
Rp 13,530,000.00
Rp 8,415,000.00

Rp 2,337,500.00

Rp 9,471,000.00
Rp 1,750,000.00
Rp 26,250,000.00

Rp 52,500,000.00
Rp 26,250,000.00

Rp 26,250,000.00

Rp 359,964,392.21
DAFTAR PERENC
PERIODE JA

NO NAMA OBAT, BENTUK, KEKUATAN, SEDIAAN KEMASAN

Glutaraldehide 0,17%
Mono Enzymatic Protease Surfactant
Apron Film White Surgilab
Bed Liner Care 50 X 60 Cm
Bed Liner Care 75 X 160 Cm

Benang Advantime 3/0 (Mid Term Absorbable Syntetic


Monofilament Made Of Glyconate No.3/0) CT 24

Benang Advantime 3/0 (Mid Term Absorbable Syntetic


Monofilament Made Of Glyconate No.3/0) RC 24
Benang Bedah Silk 1 RC 40
Benang Bedah Silk 2/0 TP 25
Bisturi No.15
Bisturi No.23
Benang Cat Gut Chromic No.1 TP 40
Benang Cat Gut Chromic 2/0 TP 35(TP 40)
Benang Cat Gut Chromic 3/0 (CAT 26-3)
Benang Cat Gut Chromic Apex No. 2/0 (CAT 37L-2)
Benang Cat Gut Chromic No. 3/0 (CAC 26-3)
Benang Cat Gut Chromic No. 4/0 (CAT 17-4)
Benang Cat Gut Plain No 1 TP 40
Cathejell 12,5 Gr
Cervical Collar Support L
Cervical Collar Support M
Chest Tub No. 28
Chest Tub No. 32
Benang COROLENE NO. 3/0 RC 19
Coverplast Transparent 19x40mm
Cutimed Cavity 10x10 Cm
Cutimed Sorbach Dressing Pad
Demelene Teper No 1 100 C 40M R
Demelene Teper No 2/0 75C 26M R
Elektroda Jantung
Endotracheal Tube Kinking No.6
Endotracheal Tube Kinking No.7
Endotracheal Tube Kinking No.7,5
Face Mask Anak
Face Mask Bayi
Face Mask Dewasa
Face Mask Non Rebreathing
Face Mask Non Rebreathing Pediatric
Folley Catheter 2 Way No.10
Folley Catheter 2 Way No.12
Folley Catheter 2 Way No.14
Folley Catheter 2 Way No.16
Folley Catheter 2 Way No.18
Folley Catheter 2 Way No.20
Folley Catheter 2 Way No.8
Folley Catheter 3 Way No.24
Folley Catheter 2 Way No.22
Gipsona 4 Inc (3,5 M X 10 Cm)
Gliserin 50ml
Handscoon Non Steril M
Heparin Cap
Hypafix 10 Cm X 5 M
Hypafix 5 Cm X 5 M
I. Vena Catheter No. 26
Infuset Anak/ Buret 100cc
Infuset Makro
Infuset Mikro
IV Dressing
Jarum Spinal No.25
Jarum Spinal No.26
Ky Jelly 50 Gr
Laminaria M
Leukomed T Plus 10" (10 X 25 Cm)
Leukomed T Plus 3 "( 7,2 X 5 Cm)
Leukomed T Plus 4" ( 8x 10 Cm)
Leukomed T Plus 6"( 8 X 15 Cm)
Lina Pen Disposible, Single Use 516
Micromist Nebulizer Bayi
Micromize Nebulizer Adult
Micromize Nebulizer Pediatrik (Anak)
Benang Monolon 2/0 (BNC 30-2)
Benang Monolon 3/0 (BNC 26L-3)
Benang Monolon 4/0 (BNC19L-4)
Needle Micro Fine
Needle No.23
Needle No.24
Needle No.25
Needle No.27
Sarung Tangan Steril No. 6,5
Sarung Tangan Steril No. 8
Sarung Tangan Steril No.7
Sarung Tangan Steril No.7,5
Sarung Tangan Steril Tanpa Bubuk No.6,5
Sarung Tangan Steril Tanpa Bubuk No.7
Sarung Tangan Steril Tanpa Bubuk No.7,5
Sarung Tangan Steril Tanpa Bubuk No.8
Softban 4 Inc (10 cm x 2,75 m)
Spalk Anak
Spalk Bayi
Spalk Kaki Triple 7X85
Spalk Tangan Triple Spalk 5x30
Spuit 1 Ml
Spuit 10 Ml
Spuit 20 ml
Spuit 3 Ml
Spuit 5 Ml
Spuit 50 Cc Catheter Tip
Spuit 50 Ml
Stomach Tube No 10
Stomach Tube No.16
Stomach Tube No.18
Stomach Tube No.5
Stomach Tube No.6
Stomach Tube No.8
Suction Catheter No.10 With Tumb Control
Suction Catheter No.16 With Tumb Control
Suction Catheter No.8 With Tumb Control
Benang Surgion Apex 1 (PGC 40L-1B)
Benang SURGION 1 (PGT 50L-1B)
Benang Surgion Apex PGC 3/0 26-3
Tensocrafe 3 Inc (7,5 Cm X 4,55 M)
Tensocrafe 4 Inc (10 Cm X 4,55 M)
Tensocrafe 6 Inc (15 Cm X 4,55 M)
Transfer Set / Transofix
Transfusi Set
Umbilical Catheter No 5
Umbilical Catheter No 6
Urine Bag
Wings Needle No. 25G
Wings Needle No. 27G
Wundres B 10 X 10
Benang Cat Gut Chromic Apex 1 CAT 40-1B
Benang Cat Gut Chromic C2/0 90C 37M R(DEMETEC)

Benang Monolon 5/0 (BNC16-5)


Big Gauze Polos 35 Cm X 35 Cm
Big Gauze X-Ray 35 Cm X 50 Cm
Bio Conector
Bisturi No 20
Bisturi No. 11
Chlor Ethyl
Elastomull Haft 8 Cm X 4 M
Endotracheal Tube Non Kinking No.2,5
Endotracheal Tube Kinking No.5
Endotracheal Tube Non Kinking No.6
Endotracheal Tube Non Kinking No.7
Face Mask Anastesi Small (1280)
Face Mask Anastesi Adult (1281)
Face Mask Anastesi L-ADL(1282)
Face Mask Anastesi Paed (1279)
Formalin Cair
Hand Towel 38x60 Cm
Handscoon Non Steril S
Handscoon Non Steril XS
Indicator Strip Steam
Jarum Kulit No 9
Jarum Otot No 9
Jarum Spinal No.27
Jelly Usg
Kassa Dapper Kecil 3 Cm X 3 Cm
Kassa Gold 10cm X 10cm
Kassa Lipat Gold 10 Cm X 5 Cm
Kassa Lipat Silver Plus 5 Cm X 10 Cm
Kassa Lipat Silver Plus 5 Cm X 5 Cm
Kassa Lipat X-Ray Plus 10 Cm X 10 Cm
Kertas CTG
Kertas EKG 110 X 30m
Kertas EKG 30 X 50
Kertas EKG 30 X 63
Kertas USG 110 HG 110 mm x 18 m
Leukoplast 1625H(3x5)
Medical Duk 120 Cm X 100 Cm
Plester Coklat 4,5 M X 7,50 Cm
Pouches Stericlim Flat, 20 Cm/200 M
Pouches Stericlin Flat, 15 Cm/200 M
Pouches Stericlin Gussette,15x5 Cm (100 M)
Pouches Stericlin Gussette,20X5 Cm (100M)
Povidone Iodine 1 L
Softaman
Spongostan Besar 80x50x10cm
Spongostan Kecil 10x10x10
Stabimed (Cocopropilendiamine 20 G)
Stomach Tube No 3,5
Stomach Tube No.12
Suction Catheter No.14 With Tumb Control
Suction Connection Tube Size 1/4 Lengt 180cm
Surgical & Nurse Cup
Wash Bensin
DAFTAR PERENCANAAN BHP NON E-KATALOG
PERIODE JANUARI - DESEMBER 2017

VOLUME HARGA SATUAN


SATUAN NAMA DAGANG
KEBUTUHAN
HNA
2 Alkacide
2 Alkazime
1,700
450
800

30

100
55
130
400
500
100
330
240
510
170
120
50
360
15
30
15
15
450
22,700
70
160
60
70
2,200
13
55
15
50
16
170
200
40
30
50
100
900
200
100
50
10
50
15
150
177,000
300
250
220
1,500
300
7,000
200
5,500
60
170
400
13
300
700
500
500
900
13
30
13
300
700
300
1,200
1,700
1,200
2,400
2,500
400
300
1,600
800
1,000
1,300
1,400
1,200
20
200
2,000
100
50
6,800
7,000
600
65,000
23,000
800
800
110
70
600
60
150
1,000
120
50
1,000
200
100
100
100
90
50
50
2,600
30
30
2,700
250
200
60

120
250
100
50
150
40
170
300
50
40
15
15
15
15
15
15
15
15
15
1,600
11,500
1,500
2,000
5
5
100
5
150
1,000
2,700
3,500
3,100
550
15
15
15
120
20
200
120
100
5
5

5
13
200
5
30
13
60
55
13
50
40
3,000
10
PENYEDIA DISTRIBUTOR TOTAL

Ada rekomendasi drPPI


DAFTAR PERENCA
PERIODE JANUARI

NAMA OBAT, BENTUK,


NO KEMASAN SATUAN
KEKUATAN, SEDIAAN
OBAT
1 Ranitidine 150mg Box'30 Tab Tablet
2 Alprazolam 0,5mg Box'40 Tab Tablet
3 Glimepirid 1mg box'50tab Tablet
4
5
6
7
8
9

10
11
12
13
14
15
16
17
Ceterizin drop Botol botol
18
19
Cairan elektrolit Botol botol
20
ambroxol drop botol botol
21
22
23
PCT 500mg, dektrometrofan 15mg, box'100tab Tablet
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
Cefadroxil 500 Box'50 Kaps Kapsul
Amoxicillin 500 mg Box'100tab Tablet
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95

INJEKSI
1 Ranitidine Inj box'5amp@2ml Ampul
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18

CAIRAN
DAFTAR PERENCANAAN OBAT UMUM
PERIODE JANUARI - DESEMBER 2017

VOLUME HARGA SATUAN


NAMA DAGANG PENYEDIA
KEBUTUHAN
HNA

3,000 Rp 3,648 Acran Tab Sanbe


120 Rp 1,945 Alganax 0,5 mg Guardian
200 Rp 1,913 Amadiab 1 mg Lapi
50 Amoxsan Drop Sanbe
700 Amoxsan 500 mg Kaps Sanbe
20 Amoxsan Syr Sanbe
1,100 Analtram Tab Lapi
100 Anbacim Tab Sanbe
700 Atofar 20 mg Fahrenheit
700 Atofar 10 mg Fahrenheit
600 Baquinor Forte Sanbe
400 Braxidin Sanbe
20 Bufect Forte Sanbe
40 Bufect Syr Sanbe
250 Cefat 500 mg Sanbe
50 Cefat Syr Sanbe
150 Cefila Syr Lapi
30 Cerini Syr Sanbe
Rp 45,600 Cerini Drop Sanbe
550 Ciflos Tab Guardian
500 Cravox 500 mg Lapi
Rp 11,200 Dehidralite Novell
30 Epexol Syr Sanbe
Rp 27,200 Epexol Drop Sanbe
200 Ericaf Tab
350 Fendex Tab Fahrenheit
2,500 Folamil Genio
Rp 638 fluzep Otto
200 Goflex Guardian
600 HI-Bone Otto
50 Immucea Tab
50 Imunos Kap Lapi
50 Imunos Plus Syr Lapi
30 Imunos Syr Lapi
250 Inpepsa Susp Fahrenheit
300 Keto-G Guardian
2,000 Lanfix 100 mg Landson
750 Lanfix 200 mg Landson
45 Lanfix Syr Landson
230 Lansiclav 500 mg Landson
50 Lapicef Tab Lapi
10 Lapifed EXP Syr Lapi
20 Lapifed Syr Lapi
150 Lapistan Tab Lapi
10 Laprosin Syr Lapi
250 Lasal Exp Syr Lapi
10 Lasal Syr Lapi
800 Lasgan Kaps Lapi
100 Lefos Tab Guardian
150 Lexa Kap Landson
1,000 Mefinal Sanbe
140 Mucera drop Otto
20 Mucos Drop
50 Musin Syr Otto
500 N-Ace Fahrenheit
300 Natto 10 Lapi
1,500 Neurosanbe 5000 Sanbe
220 Nucral Syr Guardian
5 Opicef Syr Otto
200 Rp 7,650 Opicef 500 mg Otto
200 Rp 1,870 Opimox 500 mg Otto
200 Orbumin Forpharm
800 Piralen Tab Otto
1,000 Prazotec Tab Fahrenheit
100 Preabor Sanbe
200 Provital Plus Sanbe
900 Pumpitor Kaps Sanbe
300 Puricemia Kaps Sanbe
15 Q-Cef Syr Guardian
200 Q-Cef Tab Guardian
55 Ryvel Syr Novell
250 Sanmol Drop Sanbe
500 Sanmol Syr Sanbe
4,200 Sanmol Tab Sanbe
600 Similac Neosure
1,300 Smecta
300 Sporetik 100 mg Sanbe
70 Sporetik DS Sanbe
150 Sysmuco Fahrenheit
100 Tequinol Sanbe
750 Teranol Tab Guardian
120 Tiriz Drop Lapi
2,700 Tofedex Tab Lapi
500 Tramifen Otto
15 Tremenza Syr Sanbe
700 Tremenza Tab Sanbe
300 Trombufit Novell
120 Trovensis Tab Sanbe
600 Tuzalos Sanbe
100 Urotractin Sanbe
50 Unalium Guardian
600 Utrogestan 100 mg Lapi
300 Utrogestan 200 mg Lapi
5 Vectrin Syr
50 Vostrin DS Novell
400 Wiacid 150 Landson
1,600 Wiaflox Landson
100 Zamel Drop Novell
50 Zamel Syr Novell
20 Zibramax Syr Guardian
50 Zibramax Kaps Guardian
50 Zollocid Kaps Landson

120 Rp 15,456 Acran Inj Sanbe


50 Cefxon Inj Lapi
40 Cephaflox Inj Guardian
160 Cetazum Inj Landson
50 Getidine Inj Guardian
250 Lantipain Inj Landson
10 Lapixime Inj Lapi
100 Ondane Inj Guardian
55 Ottozol Inj Otto
80 Rocer Inj Otto
40 Sanpicillin Inj Sanbe
10 Taxegram Inj Sanbe
10 Tetagam Inj
10 Teranol Inj Guardian
50 Triject Inj Landson
100 Trovensis Inj Sanbe
100 Wiacid Inj Landson
50 Zollocid Inj Landson
50 Cravox Inf Lapi
10 Lefos 500 mg Inf Guardian
5 Lefos 750 mg Inf Guardian
1,200 Sanmol Inf Sanbe
DISTRIBUTOR TOTAL

BSP Rp 10,944,000
PENTA VALENT Rp 233,400
MPI Rp 382,500
BSP Rp -
BSP Rp -
BSP Rp -
MPI Rp -
BSP Rp -
PARIT PADANG Rp -
PARIT PADANG Rp -
BSP Rp -
BSP Rp -
BSP Rp -
BSP Rp -
BSP Rp -
BSP Rp -
MPI Rp -
BSP Rp -
BSP
PENTA VALENT Rp -
MPI Rp -
AMS
Sanbe Rp -
Sanbe
Rp -
PARIT PADANG Rp -
Rp -
MBS
PENTA VALENT Rp -
MBS Rp -
Rp -
MPI Rp -
MPI Rp -
MPI Rp -
PARIT PADANG Rp -
PENTA VALENT Rp -
MBS Rp -
MBS Rp -
MBS Rp -
MBS Rp -
MPI Rp -
MPI Rp -
MPI Rp -
MPI Rp -
MPI Rp -
MPI Rp -
MPI Rp -
MPI Rp -
PENTA VALENT Rp -
MBS Rp -
BSP Rp -
MBS Rp -
Rp -
MBS Rp -
PARIT PADANG Rp -
MPI Rp -
BSP Rp -
PENTA VALENT Rp -
MBS Rp -
MBS
MBS
Parit Padang Rp -
MBS Rp -
PARIT PADANG Rp -
BSP Rp -
BSP Rp -
BSP Rp -
BSP Rp -
PENTA VALENT Rp -
PENTA VALENT Rp -
AMS Rp -
BSP Rp -
BSP Rp -
BSP Rp -
Rp -
Rp -
BSP Rp -
BSP Rp -
PARIT PADANG Rp -
BSP Rp -
PENTA VALENT Rp -
MPI Rp -
MPI Rp -
MBS Rp -
BSP Rp -
BSP Rp -
AMS Rp -
BSP Rp -
BSP Rp -
BSP Rp -
PENTA VALENT Rp -
MPI Rp -
MPI Rp -
Rp -
AMS Rp -
MBS Rp -
MBS Rp -
AMS Rp -
AMS Rp -
PENTA VALENT Rp -
PENTA VALENT Rp -
MBS Rp -

BSP Rp 1,854,720
MPI Rp -
PENTA VALENT Rp -
MBS Rp -
PENTA VALENT Rp -
MBS Rp -
MPI Rp -
PENTA VALENT Rp -
MBS Rp -
MBS Rp -
BSP Rp -
BSP Rp -
Rp -
PENTA VALENT Rp -
MBS Rp -
BSP Rp -
MBS Rp -
MBS Rp -
MPI Rp -
PENTA VALENT Rp -
PENTA VALENT Rp -
BSP Rp -
Rp -
DAFTAR PERENCAN
PERIODE JANUARI -

NAMA OBAT, BENTUK, KEKUATAN,


NO KEMASAN SATUAN
SEDIAAN
Antiseptik/fenol-Dexamethason
Glass Ionomer (Fuji IX ART)
Ultracal (Calsium Hidroksid Pasta)
DAFTAR PERENCANAAN BAHAN GIGI
PERIODE JANUARI - DESEMBER 2017

VOLUME HARGA SATUAN


NAMA DAGANG PENYEDIA
KEBUTUHAN
HNA
4
2

3
DISTRIBUTOR TOTAL