DAFTAR PENGADAAN OBAT BERDASARKAN E- CATALOGUE OBAT

TAHUN 2016
E-CATALOGUE OBAT
VOLUME
NAMA OBAT,BENTUK
NO KEMASAN SATUAN KEBUTUHAN( HARGA SATUAN
SEDIAAN,KEKUATAN PENYEDIA
SATUAN) (RUPIAH)

1 SYRINGE 3 CC DUS DUS 700 Rp 101,475 Sapta Sari Farma

2 SYRINGE 5 CC DUS DUS 500 Rp 114,144 Sapta Sari Farma

3 INFUS SET PAED PCS PCS 4,200 Rp 6,273 Sapta Sari Farma

4 AXIMED FACE MASKER EAR LOOP DUS DUS 1,600 Rp 24,354 Sapta Sari Farma

5 INFUS SET A PCS PCS 200 Rp 5,904 Sapta Sari Farma

6 SYRINGE 10 CC DUS DUS 50 Rp 160,146 Sapta Sari Farma

7 NASAL OXYGEN UK. L PCS PCS 300 Rp 8,118 Sapta Sari Farma

8 NASAL OXYGEN UK. S PCS PCS 200 Rp 8,118 Sapta Sari Farma

9 NASAL OXYGEN UK. XS PCS PCS 200 Rp 8,118 Sapta Sari Farma

10 AXIMED EXAMINATION GLOVES L BOX BOX 500 Rp 56,826 Sapta Sari Farma

11 AXIMED EXAMINATION GLOVES M BOX BOX 500 Rp 56,826 Sapta Sari Farma

12 AXIMED EXAMINATION GLOVES S BOX BOX 500 Rp 56,826 Sapta Sari Farma

13 SYRINGE 1 CC DUS DUS 200 Rp 102,090 Sapta Sari Farma

14 AXIMED FOLLEY CATH.NO.12 PCS PCS 100 Rp 13,530 Sapta Sari Farma

15 AXIMED FOLLEY CATH.NO.16 PCS PCS 350 Rp 13,530 Sapta Sari Farma

16 AXIMED FOLLEY CATH.NO.18 PCS PCS 200 Rp 13,530 Sapta Sari Farma

17 STOMACH TUBE NO 16 PCS PCS 113 Rp 9,065 Sapta Sari Farma

18 IV CATH.NO.18 PCS PCS 2,700 Rp 8,610 Sapta Sari Farma

19 IV CATH.NO.20 PCS PCS 4,000 Rp 8,610 Sapta Sari Farma

20 IV CATH.NO.22 PCS PCS 5,000 Rp 8,610 Sapta Sari Farma

21 IV CATH.NO.24 PCS PCS 2,900 Rp 8,610 Sapta Sari Farma

22 IV CATH.NO.26 PCS PCS 2,000 Rp 10,086 Sapta Sari Farma

23 AXIMED CHIRURGIC GLOVES 6.5 PCS PCS 500 Rp 9,348 Sapta Sari Farma

24 AXIMED FACE MASKER TIES ON DUS DUS 2,000 Rp 29,520 Sapta Sari Farma

25 AMOKSILLIN SIRUP KERING KAPSUL KAPSUL 20,000 Rp 2,200 Sapta Sari Farma

26 BEDAK SALISIL KOTAK KOTAK 500 Rp 1,066 Sapta Sari Farma

27 BETAMETHASONE KRIM TUBE TUBE 4,000 Rp 1,435 Sapta Sari Farma

28 ERYTHROMICIN 500 MG CAP KAPLET KAPLET 8,000 Rp 766 Sapta Sari Farma

29 IBUPROFEN SUSP 100 mg/5 ml BOTOL BOTOL 5,000 Rp 2,560 Sapta Sari Farma

30 URINE BAG PCS PCS 180 Rp 6,765 Sapta Sari Farma

31 ANTI FUNGI DOEN SALEP UNIT UNIT 1,000 Rp 4,782 Sapta Sari Farma

32 SALEP 2-4 UNIT UNIT 8,000 Rp 2,797 Sapta Sari Farma

33 ASAM FOLAT 0.4 MG TAB TAB 7,500 Rp 68 Sapta Sari Farma

34 TETRASIKLIN 250 MG CAP KAP KAP 10,000 Rp 174 Sapta Sari Farma

35 KOTRIMOXAZOLE 480 MG TAB TAB TAB 106,000 Rp 158 Sapta Sari Farma

36 SEFADROXIL 500 MG KAP, cap cap 50,000 Rp 557 Sapta Sari Farma

37 KOTRIMOXAZOLE SUSP BOTOL BOTOL 15,000 Rp 2,225 Sapta Sari Farma

38 ALUPURINOL 100 MG TAB TAB 100,000 Rp 95 Sapta Sari Farma

39 ANTASIDA DOEN SUSP BOTOL BOTOL 30,000 Rp 2,106 Sapta Sari Farma

40 SEFOTAXIM SERBUK INJ 500 MG VIAL VIAL 400 Rp 6,485 Sapta Sari Farma

41 HALOPERIDOL TAB 0.5 MG TAB TAB 5,000 Rp 64 Sapta Sari Farma

42 LIDOCAIN INJ 2 % + EPINEFRIN 2 ML AMPUL AMPUL 30,000 Rp 2,122 Sapta Sari Farma

43 SIANOKOBALAMIN INJ 500 MG AMPUL AMPUL 4,500 Rp 1,226 Sapta Sari Farma

44 ATROVENT HFA CAN CAN 30 Rp 83,500 Tempo

45 COMBIVENT UDV VIAL VIAL 500 Rp 4,995 Tempo

46 ONDANCENTRON 2 MG INJ. AMPUL AMPUL 10,000 Rp 1,650 Parit Padang

47 RIFAMPICIN 450 MG KAP KAPSUL KAPSUL 4,500 Rp 1,031 Indo Farma

48 ZINC 20 MG TAB TAB TAB 20,000 Rp 592 Indo Farma

49 KAPTOPRIL 50 MG TAB TAB TAB 50,000 Rp 143 Indo Farma

50 PARACETAMOL DROP 100MG/ML BOTOL BOTOL 3,000 Rp 5,980 Indo Farma

51 AMOKSILLIN 250 MG KAPSUL KAPSUL 40,000 Rp 207 Indo Farma

52 CIPROFLOXACIN 500 MG TAB TAB 50,000 Rp 298 Indo Farma

53 DOMPERIDONE SUSP. BOTOL BOTOL 7,000 Rp 3,180 Indo Farma

54 IBUPROFEN 200 MG TAB TAB 10,000 Rp 111 Indo Farma

55 THIAMIN 50 MG TAB TAB 100,000 Rp 91 Indo Farma

56 TETRACIKLIN 500 MG KAPSUL KAPSUL 30,000 Rp 329 Indo Farma

57 LOPERAMID TAB 2 MG TAB TAB 50,000 Rp 90 Indo Farma

58 METOKLOPRAMIDE 10 MG TAB TAB TAB 20,000 Rp 100 Indo Farma

59 CITIRIZINE SIRUP BTL BTL 3,000 Rp 2,950 Indo Farma

60 GLUCOSE 10 % BTL BTL 500 Rp 7,500 Indo Farma

61 GLUCOSE 5 % BTL BTL 1,000 Rp 6,900 Indo Farma

62 RINGER LACTAT BOTOL BOTOL 5,000 Rp 7,150 Indo Farma

63 ASAM ASCORBAT (VIT C) 50 MG TAB TAB TAB 200,000 Rp 45 Indo Farma

64 GENTAMYCIN TETES MATA BOTOL BOTOL 3,000 Rp 4,600 Indo Farma

65 KLORFENIRAMINE MALEAT(ctm) 4 MG TAB TAB 200,000 Rp 45 Indo Farma

66 CONCOR 2.5 MG TAB TAB 2,500 Rp 650 AAM

E-CATALOGUE OBAT
VOLUME
NAMA OBAT,BENTUK
NO KEMASAN SATUAN KEBUTUHAN( HARGA SATUAN
SEDIAAN,KEKUATAN PENYEDIA
SATUAN) (RUPIAH)

67 METFORMIN 500 MG TAB TAB 50,000 Rp 108 AAM

68 NIFEDIPINE TAB TAB TAB 24,000 Rp 123 AAM

69 RANITIDINE 150 MG TAB TAB TAB 300,000 Rp 119 AAM

70 ASAM TRANEXAMAT INJ. AMP AMP 5,000 Rp 2,789 AAM

71 STREPTOMYCIN INJ. 1000 MG VIAL VIAL 1,120 Rp 5,750 Rajawali/Ahmadaris

72 GEMFIBROZIL 300 MG TAB TAB 5,000 Rp 436 Rajawali/Ahmadaris

73 NISTATIN tablet .500.000 IU TAB TAB 23,000 Rp 857 Rajawali/Ahmadaris

74 FDC KATAGORI II PAK PAK 20 Rp 1,379,984 Rajawali/Ahmadaris

75 KAPAS PEMBALUT HIDROFIL 250 G ROLL ROLL 2000 Rp 27,750 Rajawali/Ahmadaris

76 KASA HIDROFIL 36 X 80 CM ROLL ROLL 500 Rp 139,000 Rajawali/Ahmadaris

77 KASA HIDROFIL 2 X 80 CM ROLL ROLL 3000 Rp 10,128 Rajawali/Ahmadaris

78 KASA PEMBALUT 4 X 3 CM ROLL ROLL 3600 Rp 865 Rajawali/Ahmadaris

79 KASA PEMBALUT 4 X 15 CM ROLL ROLL 3000 Rp 4,000 Rajawali/Ahmadaris

80 KASA KOMPRES 40 X 40 CM ROLL ROLL 5000 Rp 1,913 Rajawali/Ahmadaris

81 KASA STERIL 16 X 16 KTK KTK 2000 Rp 8,491 Rajawali/Ahmadaris

82 POLIBAN 5 cm X 2.7 M roll roll 2,000 Rp 9,497 Rajawali/Ahmadaris

83 POLIFIX 5 cm X 5 cm Roll Roll 50 Rp 41,617 Rajawali/Ahmadaris

84 CAT GUT PLAIN 2/0 SACH SACH 108 Rp 41,185 Rajawali/Ahmadaris

85 CAT GUT PLAIN 3/0 SACH SACH 108 Rp 41,185 Rajawali/Ahmadaris

86 KETOROLAC INJ. 30 MG AMPUL AMPUL 9,996 Rp 1,383 Rajawali/Ahmadaris

87 AQUA GEL TUBE TUBE 150 Rp 46,368 Rajawali/Ahmadaris

88 SILK BLACK 3/0 SACH SACH 204 Rp 23,385 Rajawali/Ahmadaris

89 NA.DIKOLOFENAK 50 MG TAB TAB TAB 100,000 Rp 161 Rajawali/Ahmadaris

90 NA.DIKOLOFENAK 25 MG TAB TAB TAB 100,000 Rp 167 Rajawali/Ahmadaris

91 NISTATIN VAG.100.000 IU TAB TAB 2,000 Rp 602 Rajawali/Ahmadaris

92 RIFAMPICIN 600 MG KAPLET KAPLET 7,000 Rp 1,420 Metro Drug Ind

93 LORATADINE 10 MG KAPLET KAPLET 70,000 Rp 149 Metro Drug Ind

94 DEXAMETHASONE INJ. AMPUL AMPUL 10,000 Rp 1,745 Metro Drug Ind

95 ZINC DROPS botol botol 3,000 Rp 11,700 APL

96 SIMVASTATIN TAB 10 MG tablet tablet 300,000 Rp 135 Mensa Bina Sukses

97 AMLODIPIN 5 MG TAB TAB TAB 150,000 Rp 105 Kimia Farma

98 DEXAMETHASONE 0.5 MG TAB TAB TAB 300,000 Rp 48 Kimia Farma

99 METRONIDAZOLE 250 MG TAB TAB TAB 35,000 Rp 98 Kimia Farma

100 ERITROMICIN SIRUP KERING 200 MG/5 ML BOTOL BOTOL 2,000 Rp 7,039 Kimia Farma

101 AMLODIPIN 10 MG TAB TAB TAB 150,000 Rp 163 Kimia Farma

102 AMOKSICILLIN 500 MG CAP KAPLET KAPLET 753,000 Rp 233 Kimia Farma
103 IBUPROFEN 400 MG TAB TAB TAB 200,000 Rp 133 Kimia Farma

104 OMEPRAZOLE 20 MG CAP KAPSUL KAPSUL 20,010 Rp 164 Milenium Pharmacon

105 PARACETAMOL SIRUP 120MG/5 ML BOTOL BOTOL 25,000 Rp 1,119 Milenium Pharmacon

106 ASAM MEFENAMAT 500 MG KAP KAPLET KAPLET 500,000 Rp 113 Milenium Pharmacon

107 BRONSOLVAN/theopillin TAB TAB TAB 5,000 Rp 310 Enseval

JUMLAH

Sungai Raya, April 2016

Diusulkan Oleh Disusun Oleh
Kepala IFK Kubu Raya Pejabat Pembuat Komitmen (PPK)

Erlin Dwisafitri, S.Farm.,Apt H. Marijan, S.Pd. M. Kes

NIP.19830624 201001 2 007 NIP. 19660507 198912 1 002
OGUE OBAT

E OBAT
JUMLAH HARGA
DISTRIBUTOR (RUPIAH)

Sapta Sari Farma Rp 71,032,500

Sapta Sari Farma Rp 57,072,000
Sapta Sari Farma Rp 26,346,600
Sapta Sari Farma Rp 38,966,400
Sapta Sari Farma Rp 1,180,800
Sapta Sari Farma Rp 8,007,300
Sapta Sari Farma Rp 2,435,400
Sapta Sari Farma Rp 1,623,600
Sapta Sari Farma Rp 1,623,600
Sapta Sari Farma Rp 28,413,000
Sapta Sari Farma Rp 28,413,000
Sapta Sari Farma Rp 28,413,000
Sapta Sari Farma Rp 20,418,000
Sapta Sari Farma Rp 1,353,000
Sapta Sari Farma Rp 4,735,500
Sapta Sari Farma Rp 2,706,000
Sapta Sari Farma Rp 1,024,356
Sapta Sari Farma Rp 23,247,000
Sapta Sari Farma Rp 34,440,000
Sapta Sari Farma Rp 43,050,000
Sapta Sari Farma Rp 24,969,000
Sapta Sari Farma Rp 20,172,000
Sapta Sari Farma Rp 4,674,000
Sapta Sari Farma Rp 59,040,000
Sapta Sari Farma Rp 44,000,000
Sapta Sari Farma Rp 533,000
Sapta Sari Farma Rp 5,740,000
Sapta Sari Farma Rp 6,128,000
Sapta Sari Farma Rp 12,800,000
Sapta Sari Farma Rp 1,217,700
Sapta Sari Farma Rp 4,782,000
Sapta Sari Farma Rp 22,376,000
Sapta Sari Farma Rp 510,000
Sapta Sari Farma Rp 1,740,000
Sapta Sari Farma Rp 16,748,000
Sapta Sari Farma Rp 27,850,000
Sapta Sari Farma Rp 33,375,000
Sapta Sari Farma Rp 9,500,000
Sapta Sari Farma Rp 63,180,000
Sapta Sari Farma Rp 2,594,000
Sapta Sari Farma Rp 320,000
Sapta Sari Farma Rp 63,660,000
Sapta Sari Farma Rp 5,517,000
Tempo Rp 2,505,000
Tempo Rp 2,497,500
Parit Padang Rp 16,500,000
Indo Farma Rp 4,639,500
Indo Farma Rp 11,840,000
Indo Farma Rp 7,150,000
Indo Farma Rp 17,940,000
Indo Farma Rp 8,280,000
Indo Farma Rp 14,900,000
 Indo Farma Rp 22,260,000
Indo Farma Rp 1,110,000
Indo Farma Rp 9,100,000
Indo Farma Rp 9,870,000
Indo Farma Rp 4,500,000
Indo Farma Rp 2,000,000
Indo Farma Rp 8,850,000
Indo Farma Rp 3,750,000
Indo Farma Rp 6,900,000
Indo Farma Rp 35,750,000
Indo Farma Rp 9,000,000
Indo Farma Rp 13,800,000
Indo Farma Rp 9,000,000
AAM Rp 1,625,000

E OBAT
JUMLAH HARGA
DISTRIBUTOR (RUPIAH)

AAM Rp 5,400,000
AAM Rp 2,952,000
AAM Rp 35,700,000
AAM Rp 13,945,000
Rajawali/Ahmadaris Rp 6,440,000
Rajawali/Ahmadaris Rp 2,180,000
Rajawali/Ahmadaris Rp 19,711,000
Rajawali/Ahmadaris Rp 27,599,680
Rajawali/Ahmadaris Rp 55,500,000
Rajawali/Ahmadaris Rp 69,500,000
Rajawali/Ahmadaris Rp 30,382,500
Rajawali/Ahmadaris Rp 3,112,500
Rajawali/Ahmadaris Rp 12,000,000
Rajawali/Ahmadaris Rp 9,562,500
Rajawali/Ahmadaris Rp 16,982,000
Rajawali/Ahmadaris Rp 18,994,000
Rajawali/Ahmadaris Rp 2,080,850
Rajawali/Ahmadaris Rp 4,447,980
Rajawali/Ahmadaris Rp 4,447,980
Rajawali/Ahmadaris Rp 13,824,468
Rajawali/Ahmadaris Rp 6,955,200
Rajawali/Ahmadaris Rp 4,770,540
Rajawali/Ahmadaris Rp 16,100,000
Rajawali/Ahmadaris Rp 16,700,000
Rajawali/Ahmadaris Rp 1,204,000
Metro Drug Ind Rp 9,940,000
Metro Drug Ind Rp 10,430,000
Metro Drug Ind Rp 17,450,000
APL Rp 35,100,000
Mensa Bina Sukses Rp 40,500,000
Kimia Farma Rp 15,750,000
Kimia Farma Rp 14,400,000
Kimia Farma Rp 3,430,000
Kimia Farma Rp 14,078,000
Kimia Farma Rp 24,450,000
Kimia Farma Rp 175,449,000
 Kimia Farma Rp 26,600,000
Milenium Pharmacon Rp 3,281,640
Milenium Pharmacon Rp 27,975,000
Milenium Pharmacon Rp 56,500,000
Enseval Rp 1,550,000

Rp 1,957,069,594

April 2016
n Oleh
Komitmen (PPK)

.Pd. M. Kes
198912 1 002
 DAFTAR KEBUTUHAN OBAT YANG DIADAKAN TIDAK
BERDASARKAN E- CATALOGUE OBAT TAHUN 2016

VOLUME E-CATALOGUE OBAT

NAMA OBAT,BENTUK KEBUTUH
NO KEMASAN SATUAN AN(SATUA HARGA SATUAN PENYEDIA
SEDIAAN,KEKUATAN DISTRIBUTOR
(RUPIAH)
N)

1 KAMOLAS/ PARACETAMOL 500 MG box/100 tablet Tablet 385,900 Rp 185 Sapta Sari Farma Sapta Sari Farma

2 ETANOL 70 % BOTOL/60 Ml Botol 500 Rp 2,625 Sapta Sari Farma Sapta Sari Farma

3 RANITIDINE INJ.2 ML box/100 ampul ampul 20,000 Rp 6,000 Dos Ni Roha Dos Ni Roha

4 SAMCOBION box/100 tablet tablet 221,100 Rp 494 Kubu Raya Kubu Raya

5 INFUS SET A box/50 pcs pcs 7,000 Rp 4,756 Kapuas Permata Kapuas Permata

6 FOLLEY CATH 18 box/10 pcs pcs 1,000 Rp 9,200 Kapuas Permata Kapuas Permata

7 ETANOL 70 1 LTR BOTOL/ 1000 ml Botol 50 Rp 30,000 Apt.Sentarum Apt.Sentarum

8 ASAM MEFENAMAT 500 MG TAB box/ 100 tablet Tablet 3,000 Rp 165 Apt.Sentarum Apt.Sentarum

9 CAT GUT 2/0 box/10 pcs pcs 24 Rp 10,000 Apt.Sentarum Apt.Sentarum

10 CAT GUT 3/0 box/10 pcs pcs 288 Rp 10,000 Apt.Sentarum Apt.Sentarum

11 JARUM OTOT zak pcs 15 Rp 15,000 Apt.Sentarum Apt.Sentarum

12 PEHACAIN INJ box/20 ampul ampul 200 Rp 3,150 Apt.Sentarum Apt.Sentarum

JUMLAH

Sungai Raya, April 2016

Diusulkan Oleh Disusun Oleh
Kepala IFK Kubu Raya Pejabat Pembuat Komitmen (PPK)

Erlin Dwisafitri, S.Farm.,Apt H. Marijan, S.Pd. M. Kes

NIP.19830624 201001 2 007 NIP. 19660507 198912 1 002
 JUMLAH HARGA
(RUPIAH)

Rp 71,441,667
Rp 1,312,500
Rp 120,000,000
Rp 109,322,895
Rp 33,292,000
Rp 9,200,000
Rp 1,500,000
Rp 495,000
Rp 240,000
Rp 2,880,000
Rp 225,000
Rp 630,000

Rp 350,539,062

2016

en (PPK)

Kes
1 002