PEMERINTAH KABUPATEN PASER 1

DINAS KESEHATAN 0
UPTD PERBEKALAN OBAT DAN ALAT KESEHATAN 29-Jan-20
JL. YOS SUDARSO SENAKEN KEC. TANAH GROGOT KAB. PASER, KODE POS : 76211 TELP : (0543) 21285 1 Page
GFK-F-INHOUSE-17

PENERIMAAN BARANG PROGRAM 2021

Mar-21
HARGA SATUAN
(PPN+ONGKIR)
NO NAMA OBAT (GENERIK/LPLPO) NAMA OBAT (FAKTUR/SBBK) SATUAN NO BATCH E.D SUMBER
HARGA / SAT QTY
DASAR
1 MDT MB Dewasa MB DEWASA BLISTER B.JS9335 Nov-22 Rp 41,240.00 APBN 3
2 MDT MB Dewasa MB DEWASA BLISTER B.JX5414 Mar-23 Rp 41,240.00 APBN 3
3 Lamprene 100mg LAMPRENE 100 MG TABLET JK1871 Apr-23 Rp 1,683.52 APBN 2

4 RDT HIV (SD BIOLINE HIV 1/2 3.0) RAPID TEST HIV 1 (SD) TEST 03ADE029A Jun-21 Rp 11,975.00 APBN

5 RDT HIV (SD BIOLINE HIV 1/2 3.0) RAPID TEST HIV 1 (SD) TEST 03ADE055A Oct-21 Rp 11,975.00 APBN

6 RDT HIV (SD BIOLINE HIV 1/2 3.0) RAPID TEST HIV 1 (SD) TEST 03ADE059A Oct-21 Rp 11,975.00 APBN

7 RDT HIV (KHB Diagnostic Kit 1+2) RAPID TEST HIV 2 (KHB) TEST 401190912 May-21 Rp 12,500.00 APBN

RDT HIV (DIAGNOSTAR DS HIV

8 1/2) RAPID TEST HIV 3 (DIAGNOSTAR) TEST 1907099 Jul-21 Rp 12,527.00 APBN

RAPID TEST SIFILIS

9 RDT Syphilis (Trepocheck) (TERPOCHECK) TEST L19155 Dec-21 Rp 9,300.00 APBN

10 Kondom Laki-Laki (Sutra) KONDOM I PCS M36161207 Nov-21 Rp 358.00 SPIRITIA

11 Alkohol Swab (APBN) ALCOHOL SWAB PCS 6260513 Aug-21 Rp 128.00 SPIRITIA

12 Alat Suntik Sekali Pakai 1 mL ALAT SUNTIK TUBERKULIN PCS 161118D Oct-21 Rp 1,668.00 SPIRITIA
(Tuberkulin)
13 Apron APRON DISPOSIBLE PCS Rp 5,500.00 GF
14 Handscoun Latex M GLOVE/HANDSCOON PCS Rp 1,391.50 GF
15 Handsanitizer HANDSANITIZER BOTOL 5 105 Jun-22 Rp 12,760.00 GF
16 Masker Medis (Karet) MASKER HIJAB 3 PLY PCS FM200121142 Nov-25 Rp 1,452.00 GF
17 Safety Box 5 L SAFETY BOX Box Rp 9,018.00 APBN

18 Kantong Limbah Medis M KANTONG LIMBAH MEDIS UK. M PCS Rp 1,375.00 APBN

19 Kantong Limbah Medis L KANTONG LIMBAH MEDIS UK.L PCS Rp 2,937.00 APBN
 Apr-21
1 Abate 1 gr ABATE (SACHET 10 gr) SACHET 1901100005 Jul-21 Rp 4,500.00 APBD 1
2 Abate 1 gr ABATE (SACHET 10 gr) SACHET 190110006 Sep-21 Rp 4,500.00 APBD 1
3 Abate 1 gr ABATE (SACHET 10 gr) SACHET 1901100003 Sep-21 Rp 4,500.00 APBD 1

4 Blood Lancet (Prog. Prov) VACCINOSTLY/BLOOD LANCET PCS 171226 Jan-23 Rp 320.33 APBN

5 Blood Slide BLOOD SLIDE KOTAK Rp 41,065.00 GF

6 Box Slide SLIDE BOX BOX Rp 66,065.00 GF
7 Giemsa GIEMSA BOTOL GMS1138 Sep-23 Rp 875,065.00 GF
8 Immersion Oil IMMERSION OIL BOTOL IMR1034 Oct-23 Rp 1,123,065.00 GF
9 Laboratorium Kit LAB KIT PAKET Rp 1,016,565.00 GF
MASKER STUPAMED 3 PLY
10 Masker Medis (Stupamed 3 Ply) PCS 06191201 Dec-24 Rp 2,290.00 GF
EARLOOP SURGICAL FACE

11 RDT DBD NS 1 (Prog. Provinsi) SD DENGUE NS1 TEST CASSETE TEST DEGC9016 Aug-21 Rp 90,000.00 APBD 1

12 RDT HBsAg (Virocheck) VIROCHECK HBsAg TEST K20051 Oct-22 Rp 8,100.00 APBN
SIPERMETRIN 50 GRAM/LITER
13 Sipermetrin 50 gr/L (CYNOFF) LITER 7100048 Aug-21 Rp 290,000.00 APBD 1

May-21
1 Albendazole 400 mg ALBENDAZOL 400 MG TABLET J00553BJ Sep-22 Rp 463.00 APBN
2 Albendazole 400 mg ALBENDAZOL 400 MG TABLET J00554BJ Sep-22 Rp 463.00 APBN
3 Artesunate inj ARTESUNATE INJ VIAL LA201068 Sep-23 Rp 62,500.00 APBD 1
4 DHP / Obat Anti Malaria DHP TABLET TABLET 200521 May-22 Rp 1,900.00 APBN
5 Primaquine 15 mg PRIMAKUIN TABLET 15 MG TABLET 36386001-1 Aug-23 Rp 242.00 APBD 1
6
7
8
9
10
11
12
13
 PEMERINTAH KABUPATEN PASER 1

DINAS KESEHATAN 0
UPTD PERBEKALAN OBAT DAN ALAT KESEHATAN 29-Jan-20
JL. YOS SUDARSO SENAKEN KEC. TANAH GROGOT KAB. PASER, KODE POS : 76211 TELP : (0543) 21285 1 Page
GFK-F-INHOUSE-17

PENERIMAAN VAKSIN 2021

Jan-21
HARGA SATUAN
(PPN+ONGKIR)
NO NAMA OBAT (GENERIK/LPLPO) NAMA OBAT (FAKTUR/SBBK) SATUAN NO BATCH E.D SUMBER
HARGA / SAT QTY
DASAR
1 Vaksin BCG Dosis 20 VAKSIN BCG 20 ds VIAL 0379G143 Nov-21 Rp 66,154.00 APBN
2 Pelarut BCG Dosis 20 PELARUT BCG 20 ds VIAL Rp - APBN
3 Vaksin MR Inj. 10 DS VAKSIN MR 10 DS VIAL 0129N271 Jun-22 Rp 166,265.00 APBN
4 Pelarut Vaksin MR PELARUT MR 10 DS VIAL Rp - APBN
5 Vaksin DTP HB HIB VAKSIN DPT-HB-HIB 5 DS PCS 5010219 Jul-21 Rp 84,282.00 APBN
6 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3651620 Aug-22 Rp 25,597.00 APBN

Feb-21
1 Vaksin BCG Dosis 20 VAKSIN BCG 20 ds VIAL 0379G186 Jan-22 Rp 66,154.00 APBN
2 Pelarut BCG Dosis 20 PELARUT BCG 20 ds VIAL Rp - APBN
3 Vaksin MR Inj. 10 DS VAKSIN MR 10 DS VIAL 0129N271 Jun-22 Rp 166,265.00 APBN
4 Pelarut Vaksin MR PELARUT MR 10 DS VIAL Rp - APBN
5 Vaksin DTP HB HIB VAKSIN DPT-HB-HIB 5 DS PCS 5041919 Dec-21 Rp 84,282.00 APBN
6 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3652320 Sep-22 Rp 25,597.00 APBN
7 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3651620 Aug-22 Rp 25,597.00 APBN
 Mar-21
1 Vaksin Rabies VERORAB (RABIES VACCINE) BOX R1F571M Aug-21 Rp 165,000.00 APBN
Hepatitis B Imune Globulin HEPATITIS B IMUNE GLOBULIN
2 BOX H2MAR00033 May-23 Rp 1,325,000.00 APBN
(Human) (HUMAN)

Apr-21
1 Alat Suntik 0,05 ml ADS 0,05 ML PCS 20002 Apr-25 Rp 1,460.00 APBN
2 Alat Suntik 0,5 ml ADS 0,5 ML PCS 18111/4 Mar-23 Rp 1,240.00 APBN
3 Alat Suntik 5 ml ADS 5 ML PCS 1904401 Jul-24 Rp 1,500.00 APBN
4 Pelarut BCG Dosis 20 PELARUT BCG 20 ds VIAL Rp - APBN
5 Pelarut Vaksin MR PELARUT MR 10 DS VIAL Rp - APBN
6 Penetes Vaksin Polio bopv Dosis 1PIPET POLIO 10 DS PCS Rp - APBN
7 Vaksin BCG Dosis 20 VAKSIN BCG 20 ds VIAL 0379G216 Feb-22 Rp 66,154.00 APBN
8 Vaksin DTP HB HIB VAKSIN DPT HB HIB 5 DS VIAL 5041719 Nov-21 Rp 84,282.00 APBN
9 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3652320 Sep-22 Rp 25,597.00 APBN
10 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3652620 Sep-22 Rp 25,597.00 APBN
11 Vaksin MR Inj. 10 DS VAKSIN MR 10 DS VIAL 0129N271 Jun-22 Rp 166,265.00 APBN
12 Vaksin Polio bopv Dosis 10 VAKSIN POLIO BOPV DOSIS 10 VIAL 2050420 Dec-22 Rp 23,643.00 APBN
13 Vaksin Polio IPV Ds. 5 VAKSIN POLIO IPV DS.5 VIAL 2101619 Sep-22 Rp 158,994.00 APBN
14 Vaksin Rabies VERORAB (RABIES VACCINE) VIAL R1F571M Aug-21 Rp 165,000.00 APBN

May-21
1 Alat Suntik 0,5 ml ADS 0,5 ML PCS 18130 May-23 Rp 1,240.00 APBN
2 Pelarut BCG Dosis 20 PELARUT BCG 20 ds VIAL Rp - APBN
3 Pelarut Vaksin MR PELARUT MR 10 DS VIAL Rp - APBN
4 Penetes Vaksin Polio bopv Dosis 1PIPET POLIO 10 DS PCS Rp - APBN
5 Safety Box 2,5 L SAFETY BOX 2,5 LTR PCS 12788I19 Rp 12,500.00 APBN
6 Safety Box 5 L SAFETY BOX 5 LTR PCS Rp 26,746.97 APBN
7 Vaksin BCG Dosis 20 VAKSIN BCG 20 ds VIAL 0379G186 Jan-22 Rp 66,154.00 APBN
8 Vaksin DTP HB HIB VAKSIN DPT HB HIB 5 DS VIAL 5041719 Nov-21 Rp 84,282.00 APBN
9 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3652620 Nov-22 Rp 25,597.00 APBN
10 Vaksin MR Inj. 10 DS VAKSIN MR 10 DS VIAL 0129N271 Jun-22 Rp 166,265.00 APBN
11 Vaksin Polio bopv Dosis 10 VAKSIN POLIO BOPV DOSIS 10 VIAL 2050320 Dec-22 Rp 23,643.00 APBN
12 Vaksin Polio bopv Dosis 10 VAKSIN POLIO BOPV DOSIS 10 VIAL 2050321 Jan-23 Rp 23,643.00 APBN
13
14
 PEMERINTAH KABUPATEN PASER 1

DINAS KESEHATAN 0
UPTD PERBEKALAN OBAT DAN ALAT KESEHATAN 29-Jan-20
JL. YOS SUDARSO SENAKEN KEC. TANAH GROGOT KAB. PASER, KODE POS : 76211 TELP : (0543) 21285 1 Page
GFK-F-INHOUSE-17

PENERIMAAN BARANG BUFFER 2021

HARGA SATUAN
(PPN+ONGKIR)
NO NAMA OBAT SATUAN NO BATCH E.D SUMBER
HARGA / SAT QTY
DASAR
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
 PEMERINTAH KABUPATEN PASER
DINAS KESEHATAN
UPTD PERBEKALAN OBAT DAN ALAT KESEHATAN
JL. YOS SUDARSO SENAKEN KEC. TANAH GROGOT KAB. PASER, KODE POS : 76211 TELP : (0543) 21285

GFK-F-INHOUSE-17

PENERIMAAN BARANG DAK 2021

HARGA SATUAN
(PPN+ONGKIR)
NO NAMA OBAT (GENERIK/LPLPO) NAMA OBAT (FAKTUR/SBBK) SATUAN NO BATCH E.D SUMBER
HARGA / SAT QTY
DASAR
Apr-21
AMOXICILLIN TRIHYDRATE / 200
1 Amoxicillin 500 mg TABLET TAMXB12196 Mar-23 Rp 231.00 DAK
KAPLET
2 Asam Mefenamat 500 mg MEFENAMIC ACID 500 MG TABLET HTMECA12548 Mar-23 Rp 117.00 DAK
3 Asam Mefenamat 500 mg MEFENAMIC ACID 500 MG TABLET HTMECA12549 Mar-23 Rp 117.00 DAK
4 Chlorpromazine Inj 25 mg/Ml CEPEZET INJ AMPUL D90626 Sep-22 Rp 8,651.50 DAK
5 Haloperidol Inj. 5 mg/Ml LODOMER INJ 5MG/ML AMPUL D90716 Sep-22 Rp 13,775.83 DAK
6 Haloperidol Inj. 5 mg/Ml LODOMER INJ 5MG/ML AMPUL D90872 Sep-22 Rp 13,775.83 DAK

May-21
CATHETER 20GX1 1/4 / 2032-N-
1 Abbocat No. 20 G PCS 20F2506J May-25 Rp 5,179.35 DAK
PU
2 Abbocat No. 22 G I.V CATHETER 22GX1 /2225-N-PU PCS 21A2606J Dec-25 Rp 5,015.57 DAK

3 Abbocat No. 22 G I.V CATHETER 22GX1 /2225-N- PCS 21C3006J Feb-26 Rp 5,015.57 DAK
PU

4 Abbocat No. 24 G I.V CATHETER 24GX3/4 /2420-N- PCS 20H3006J Jul-25 Rp 5,081.43 DAK
PU

5 Abbocat No. 24 G I.V CATHETER 24GX3/4 /2420-N- PCS 20L2206J Nov-25 Rp 5,081.43 DAK
PU
6 Alat suntik sekali pakai 1 ml DISP. SYRINGE 1ML TB 26GX1/2 /2 PCS 20H0601J Jul-25 Rp 1,036.03 DAK

DISP. SYRINGE 3ML LUER LOCK

7 Alat suntik sekali pakai 3 ml PCS 20J1908J Sep-25 Rp 896.85 DAK
WITH NEEDLE 23GX1 1/4R

8 Alat suntik sekali pakai 3 ml DISP. SYRINGE 3ML LUER LOCK W PCS 20J2208J Sep-25 Rp 896.85 DAK

DISP. SYRINGE 3ML LUER LOCK

9 Alat suntik sekali pakai 3 ml WITH NEEDLE 23GX1 1/4R PCS 20K2302J Oct-25 Rp 896.85 DAK

10 Alat suntik sekali pakai 3 ml DISP. SYRINGE 3ML LUER LOCK W PCS 21A2108J Dec-25 Rp 896.85 DAK
11 Alat suntik sekali pakai 5 ml DISP. SYRINGE 5ML LUER LOCK W PCS 21A1303J Dec-25 Rp 1,049.47 DAK
Asam Traneksamat inj. 250 TRANEXAMIC ACID INJEKSI 5%
12 AMPUL 4701077 Jun-23 Rp 1,820.00 DAK
mg/ml 250MG / 5 ML
13 Desoximetasone Krim 0,25% DESOXIMETASON 0,25 CREAM TUBE 4310289 Feb-23 Rp 9,500.00 DAK
15G
14 Glukosa Infus 5 % GLUKOSA 5% OGB BOTOL 210218 Jan-23 Rp 6,627.00 DAK
15 Infus Set Dewasa NIPRO INFUSION SET PCS 20D20L1J Mar-25 Rp 7,662.60 DAK
16 Infus Set Dewasa NIPRO INFUSION SET PCS 20G03L1J Jun-25 Rp 7,662.60 DAK
17 Ringer Laktat RINGER LACTATE OGB BOTOL 310211 Jan-26 Rp 7,703.00 DAK
18 Risperidon 2 mg RISPERIDONE 2MG TABLET 51I0300 Sep-23 Rp 130.00 DAK
19 Risperidon 2 mg RISPERIDONE 2MG TABLET 51J0352 Sep-23 Rp 130.00 DAK
 PEMERINTAH KABUPATEN PASER 1

DINAS KESEHATAN 0
UPTD PERBEKALAN OBAT DAN ALAT KESEHATAN 29-Jan-20
JL. YOS SUDARSO SENAKEN KEC. TANAH GROGOT KAB. PASER, KODE POS : 76211 TELP : (0543) 21285 1 Page
GFK-F-INHOUSE-17

PENERIMAAN BARANG DAK PENUGASAN 2021

HARGA SATUAN
(PPN+ONGKIR)
NO NAMA OBAT (GENERIK/LPLPO) NAMA OBAT (FAKTUR/SBBK) SATUAN NO BATCH E.D SUMBER
HARGA / SAT QTY
DASAR
1 DAK PENUGASAN
2 DAK PENUGASAN
3 DAK PENUGASAN
4 DAK PENUGASAN
5 DAK PENUGASAN
6 DAK PENUGASAN
7 DAK PENUGASAN
8 DAK PENUGASAN
9 DAK PENUGASAN
10 DAK PENUGASAN
11 DAK PENUGASAN
12 DAK PENUGASAN
13 DAK PENUGASAN
14 DAK PENUGASAN
15 DAK PENUGASAN
16 DAK PENUGASAN
 PEMERINTAH KABUPATEN PASER
DINAS KESEHATAN
UPTD PERBEKALAN OBAT DAN ALAT KESEHATAN
JL. YOS SUDARSO SENAKEN KEC. TANAH GROGOT KAB. PASER, KODE POS : 76211 TELP : (0543) 21285

GFK-F-INHOUSE-17

PENERIMAAN BARANG APBD 2021

HARGA SATUAN
(PPN+ONGKIR)
NO NAMA OBAT (GENERIK/LPLPO) NAMA OBAT (FAKTUR/SBBK) SATUAN NO BATCH E.D SUMBER
HARGA / SAT QTY
DASAR
SELANG O2 DEWASA HIJAU
1 Kanula Hidung Dewasa PCS 31102088 Sep-24 Rp 11,000.00 APBD
BESMED

Apr-21
1 Antasida DOEN Tab ANTASIDA DOEN TABLET IFI TABLET 26905102 Feb-24 Rp 102.00 APBD
2 Asam Traneksamat NEXITRA 500MG IFARS TABLET 01428 Aug-22 Rp 1,775.00 APBD
3 Asam Traneksamat NEXITRA 500MG IFARS TABLET 01528 Aug-22 Rp 1,775.00 APBD

4 Cetirizine10 mg CETIRIZINE TAB SAMPHARINDO TABLET JB1971 Feb-23 Rp 96.00 APBD

5 Clozapine 25 mg CLOZAPINE TAB TABLET A80245 Feb-22 Rp 3,775.20 APBD

6 Clozapine 25 mg CLOZAPINE TAB TABLET A80245 Feb-22 Rp 3,775.20 APBD
Nystatin 100.000 IU/g Tab NISTATIN 100.000 IU TAB
7 TABLET 26372001 Feb-23 Rp 550.00 APBD
Vaginal VAGINAL
Nystatin 100.000 IU/g Tab NISTATIN 100.000 IU TAB
8 Vaginal VAGINAL TABLET 36372002 Mar-24 Rp 550.00 APBD

9 Pyrantel Pamoate 250 mg WORMETRIN 250MG KAPLET T.4355004 May-22 Rp 672.00 APBD
10 Pyrantel Pamoate 250 mg WORMETRIN 250MG KAPLET T.4355007 Aug-22 Rp 672.00 APBD
11 Serum Anti Bisa Ular 5 mg BIOSAVE ABU I VIAL 4700420 Sep-22 Rp 517,132.00 APBD
12 Vit C 50 mg CVITAMIN C 50 MG (MARIN) TABLET 21TB009 Feb-25 Rp 46.00 APBD
13 Zinc ZINC TAB HOLI TABLET 1102032 Feb-23 Rp 613.00 APBD
14 Zinc ZINC TAB HOLI TABLET 1102033 Feb-23 Rp 613.00 APBD
15 Zinc ZINC TAB HOLI TABLET 1102034 Feb-23 Rp 613.00 APBD

May-21
1 Furosemide inj FUROSEMIDE INJ 10MG AMPUL 4110081 Dec-22 Rp 969.00 APBD
2 Natrium Klorida Infus 0,9% SODIUM CHLORIDE 0,9% OGB BOTOL 310306 Feb-26 Rp 6,900.00 APBD

3 Ondansetron Inj. 4 mg/2ml ONDANSETRON INJ 4MG/2ML AMPUL 4901299 Nov-22 Rp 963.00 APBD

4 Ondansetron Inj. 4 mg/2ml ONDANSETRON INJ 4MG/2ML AMPUL 4110090 Jan-23 Rp 963.00 APBD

5 Prophylthiouracil 100 mg PROPYLTHIOURACIL 100 TABLET 51L0412 Dec-24 Rp 440.00 APBD

6
7
8
9
10
11
12
13
14
15
 PEMERINTAH KABUPATEN PASER
DINAS KESEHATAN
UPTD PERBEKALAN OBAT DAN ALAT KESEHATAN
JL. YOS SUDARSO SENAKEN KEC. TANAH GROGOT KAB. PASER, KODE POS : 76211 TELP : (0543) 21285

GFK-F-INHOUSE-17

PENERIMAAN BARANG PENGADAAN KABUPATEN 2021

HARGA SATUAN
(PPN+ONGKIR)
NO NAMA OBAT (GENERIK/LPLPO) NAMA OBAT (FAKTUR/SBBK) SATUAN NO BATCH E.D SUMBER
HARGA / SAT QTY
DASAR

1 Abbocat No. 20 G CATHETER 20GX1 1/4 / 2032-N- PCS 20F2506J May-25 Rp 5,179.35 DAK
PU
2 Abbocat No. 22 G I.V CATHETER 22GX1 /2225-N-PU PCS 21A2606J Dec-25 Rp 5,015.57 DAK
I.V CATHETER 22GX1 /2225-N-
3 Abbocat No. 22 G PCS 21C3006J Feb-26 Rp 5,015.57 DAK
PU
I.V CATHETER 24GX3/4 /2420-N-
4 Abbocat No. 24 G PCS 20H3006J Jul-25 Rp 5,081.43 DAK
PU
I.V CATHETER 24GX3/4 /2420-N-
5 Abbocat No. 24 G PCS 20L2206J Nov-25 Rp 5,081.43 DAK
PU
6 Alat suntik sekali pakai 1 ml DISP. SYRINGE 1ML TB 26GX1/2 /2 PCS 20H0601J Jul-25 Rp 1,036.03 DAK

7 Alat suntik sekali pakai 3 ml DISP. SYRINGE 3ML LUER LOCK PCS 20J1908J Sep-25 Rp 896.85 DAK
WITH NEEDLE 23GX1 1/4R

8 Alat suntik sekali pakai 3 ml DISP. SYRINGE 3ML LUER LOCK W PCS 20J2208J Sep-25 Rp 896.85 DAK

9 Alat suntik sekali pakai 3 ml DISP. SYRINGE 3ML LUER LOCK PCS 20K2302J Oct-25 Rp 896.85 DAK
WITH NEEDLE 23GX1 1/4R

10 Alat suntik sekali pakai 3 ml DISP. SYRINGE 3ML LUER LOCK W PCS 21A2108J Dec-25 Rp 896.85 DAK
11 Alat suntik sekali pakai 5 ml DISP. SYRINGE 5ML LUER LOCK W PCS 21A1303J Dec-25 Rp 1,049.47 DAK

12 Amoxicillin 500 mg AMOXICILLIN TRIHYDRATE / 200 TABLET TAMXB12196 Mar-23 Rp 231.00 DAK
KAPLET
13 Antasida DOEN Tab ANTASIDA DOEN TABLET IFI TABLET 26905102 Feb-24 Rp 102.00 APBD
14 Asam Mefenamat 500 mg MEFENAMIC ACID 500 MG TABLET HTMECA12548 Mar-23 Rp 117.00 DAK
15 Asam Mefenamat 500 mg MEFENAMIC ACID 500 MG TABLET HTMECA12549 Mar-23 Rp 117.00 DAK
16 Asam Traneksamat NEXITRA 500MG IFARS TABLET 01428 Aug-22 Rp 1,775.00 APBD
17 Asam Traneksamat NEXITRA 500MG IFARS TABLET 01528 Aug-22 Rp 1,775.00 APBD
Asam Traneksamat inj. 250 TRANEXAMIC ACID INJEKSI 5%
18 AMPUL 4701077 Jun-23 Rp 1,820.00 DAK
mg/ml 250MG / 5 ML

19 Cetirizine10 mg CETIRIZINE TAB SAMPHARINDO TABLET JB1971 Feb-23 Rp 96.00 APBD

20 Chlorpromazine Inj 25 mg/Ml CEPEZET INJ AMPUL D90626 Sep-22 Rp 8,651.50 DAK
21 Clozapine 25 mg CLOZAPINE TAB TABLET A80245 Feb-22 Rp 3,775.20 APBD
22 Clozapine 25 mg CLOZAPINE TAB TABLET A80245 Feb-22 Rp 3,775.20 APBD

23 Desoximetasone Krim 0,25% DESOXIMETASON 0,25 CREAM TUBE 4310289 Feb-23 Rp 9,500.00 DAK
15G
24 Furosemide inj FUROSEMIDE INJ 10MG AMPUL 4110081 Dec-22 Rp 969.00 APBD
25 Glukosa Infus 5 % GLUKOSA 5% OGB BOTOL 210218 Jan-23 Rp 6,627.00 DAK
26 Haloperidol Inj. 5 mg/Ml LODOMER INJ 5MG/ML AMPUL D90716 Sep-22 Rp 13,775.83 DAK
27 Haloperidol Inj. 5 mg/Ml LODOMER INJ 5MG/ML AMPUL D90872 Sep-22 Rp 13,775.83 DAK
28 Infus Set Dewasa NIPRO INFUSION SET PCS 20D20L1J Mar-25 Rp 7,662.60 DAK
29 Infus Set Dewasa NIPRO INFUSION SET PCS 20G03L1J Jun-25 Rp 7,662.60 DAK

30 Kanula Hidung Dewasa SELANG O2 DEWASA HIJAU PCS 31102088 Sep-24 Rp 11,000.00 APBD
BESMED
31 Natrium Klorida Infus 0,9% SODIUM CHLORIDE 0,9% OGB BOTOL 310306 Feb-26 Rp 6,900.00 APBD

32 Nystatin 100.000 IU/g Tab NISTATIN 100.000 IU TAB TABLET 26372001 Feb-23 Rp 550.00 APBD
Vaginal VAGINAL

33 Nystatin 100.000 IU/g Tab NISTATIN 100.000 IU TAB TABLET 36372002 Mar-24 Rp 550.00 APBD
Vaginal VAGINAL

34 Ondansetron Inj. 4 mg/2ml ONDANSETRON INJ 4MG/2ML AMPUL 4901299 Nov-22 Rp 963.00 APBD

35 Ondansetron Inj. 4 mg/2ml ONDANSETRON INJ 4MG/2ML AMPUL 4110090 Jan-23 Rp 963.00 APBD

36 Prophylthiouracil 100 mg PROPYLTHIOURACIL 100 TABLET 51L0412 Dec-24 Rp 440.00 APBD

37 Pyrantel Pamoate 250 mg WORMETRIN 250MG KAPLET T.4355004 May-22 Rp 672.00 APBD
38 Pyrantel Pamoate 250 mg WORMETRIN 250MG KAPLET T.4355007 Aug-22 Rp 672.00 APBD
39 Ringer Laktat RINGER LACTATE OGB BOTOL 310211 Jan-26 Rp 7,703.00 DAK
40 Risperidon 2 mg RISPERIDONE 2MG TABLET 51I0300 Sep-23 Rp 130.00 DAK

41 Risperidon 2 mg RISPERIDONE 2MG TABLET 51J0352 Sep-23 Rp 130.00 DAK

42 Serum Anti Bisa Ular 5 mg BIOSAVE ABU I VIAL 4700420 Sep-22 Rp 517,132.00 APBD

43 Vit C 50 mg CVITAMIN C 50 MG (MARIN) TABLET 21TB009 Feb-25 Rp 46.00 APBD

44 Zinc ZINC TAB HOLI TABLET 1102032 Feb-23 Rp 613.00 APBD
45 Zinc ZINC TAB HOLI TABLET 1102033 Feb-23 Rp 613.00 APBD
46 Zinc ZINC TAB HOLI TABLET 1102034 Feb-23 Rp 613.00 APBD
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 PEMERINTAH KABUPATEN PASER
DINAS KESEHATAN
UPTD PERBEKALAN OBAT DAN ALAT KESEHATAN
JL. YOS SUDARSO SENAKEN KEC. TANAH GROGOT KAB. PASER, KODE POS : 76211 TELP : (0543) 21285

GFK-F-INHOUSE-17

PENERIMAAN BARANG HIBAH PROVINSI 2021

HARGA SATUAN
(PPN+ONGKIR)
NO NAMA OBAT (GENERIK/LPLPO) NAMA OBAT (FAKTUR/SBBK) SATUAN NO BATCH E.D SUMBER
HARGA / SAT QTY
DASAR
1 Abate 1 gr ABATE (SACHET 10 gr) SACHET 1901100005 Jul-21 Rp 4,500.00 APBD 1
2 Abate 1 gr ABATE (SACHET 10 gr) SACHET 190110006 Sep-21 Rp 4,500.00 APBD 1
3 Abate 1 gr ABATE (SACHET 10 gr) SACHET 1901100003 Sep-21 Rp 4,500.00 APBD 1
4 Alat Suntik 0,05 ml ADS 0,05 ML PCS 20002 Apr-25 Rp 1,460.00 APBN
5 Alat Suntik 0,5 ml ADS 0,5 ML PCS 18111/4 Mar-23 Rp 1,240.00 APBN
6 Alat Suntik 0,5 ml ADS 0,5 ML PCS 18130 May-23 Rp 1,240.00 APBN
7 Alat Suntik 5 ml ADS 5 ML PCS 1904401 Jul-24 Rp 1,500.00 APBN
Alat Suntik Sekali Pakai 1 mL
8 ALAT SUNTIK TUBERKULIN PCS 161118D Oct-21 Rp 1,668.00 SPIRITIA
(Tuberkulin)
9 Albendazole 400 mg ALBENDAZOL 400 MG TABLET J00553BJ Sep-22 Rp 463.00 APBN
10 Albendazole 400 mg ALBENDAZOL 400 MG TABLET J00554BJ Sep-22 Rp 463.00 APBN
11 Alkohol Swab (APBN) ALCOHOL SWAB PCS 6260513 Aug-21 Rp 128.00 SPIRITIA
12 Apron APRON DISPOSIBLE PCS Rp 5,500.00 GF
13 Artesunate inj ARTESUNATE INJ VIAL LA201068 Sep-23 Rp 62,500.00 APBD 1

14 Blood Lancet (Prog. Prov) VACCINOSTLY/BLOOD LANCET PCS 171226 Jan-23 Rp 320.33 APBN

15 Blood Slide BLOOD SLIDE KOTAK Rp 41,065.00 GF

16 Box Slide SLIDE BOX BOX Rp 66,065.00 GF
17 DHP / Obat Anti Malaria DHP TABLET TABLET 200521 May-22 Rp 1,900.00 APBN
18 Giemsa GIEMSA BOTOL GMS1138 Sep-23 Rp 875,065.00 GF
19 Handsanitizer HANDSANITIZER BOTOL 5 105 Jun-22 Rp 12,760.00 GF
20 Handscoun Latex M GLOVE/HANDSCOON PCS Rp 1,391.50 GF
Hepatitis B Imune Globulin HEPATITIS B IMUNE GLOBULIN
21 BOX H2MAR00033 May-23 Rp 1,325,000.00 APBN
(Human) (HUMAN)
22 Immersion Oil IMMERSION OIL BOTOL IMR1034 Oct-23 Rp 1,123,065.00 GF

23 Kantong Limbah Medis L KANTONG LIMBAH MEDIS UK.L PCS Rp 2,937.00 APBN

24 Kantong Limbah Medis M KANTONG LIMBAH MEDIS UK. M PCS Rp 1,375.00 APBN

25 Kondom Laki-Laki (Sutra) KONDOM I PCS M36161207 Nov-21 Rp 358.00 SPIRITIA

26 Laboratorium Kit LAB KIT PAKET Rp 1,016,565.00 GF
27 Lamprene 100mg LAMPRENE 100 MG TABLET JK1871 Apr-23 Rp 1,683.52 APBN 2
28 Masker Medis (Karet) MASKER HIJAB 3 PLY PCS FM200121142 Nov-25 Rp 1,452.00 GF
MASKER STUPAMED 3 PLY
29 Masker Medis (Stupamed 3 Ply) PCS 06191201 Dec-24 Rp 2,290.00 GF
EARLOOP SURGICAL FACE
30 MDT MB Dewasa MB DEWASA BLISTER B.JS9335 Nov-22 Rp 41,240.00 APBN 3
31 MDT MB Dewasa MB DEWASA BLISTER B.JX5414 Mar-23 Rp 41,240.00 APBN 3
32 Pelarut BCG Dosis 20 PELARUT BCG 20 ds VIAL Rp - APBN
33 Pelarut Vaksin MR PELARUT MR 10 DS VIAL Rp - APBN
34 Penetes Vaksin Polio bopv Dosis PIPET POLIO 10 DS PCS Rp - APBN
35 Primaquine 15 mg PRIMAKUIN TABLET 15 MG TABLET 36386001-1 Aug-23 Rp 242.00 APBD 1

36 RDT DBD NS 1 (Prog. Provinsi) SD DENGUE NS1 TEST CASSETE TEST DEGC9016 Aug-21 Rp 90,000.00 APBD 1

37 RDT HBsAg (Virocheck) VIROCHECK HBsAg TEST K20051 Oct-22 Rp 8,100.00 APBN

38 RDT HIV (DIAGNOSTAR DS HIV RAPID TEST HIV 3 (DIAGNOSTAR) TEST 1907099 Jul-21 Rp 12,527.00 APBN
1/2)

39 RDT HIV (KHB Diagnostic Kit 1+2) RAPID TEST HIV 2 (KHB) TEST 401190912 May-21 Rp 12,500.00 APBN

40 RDT HIV (SD BIOLINE HIV 1/2 RAPID TEST HIV 1 (SD) TEST 03ADE029A Jun-21 Rp 11,975.00 APBN
3.0)

41 RDT HIV (SD BIOLINE HIV 1/2 RAPID TEST HIV 1 (SD) TEST 03ADE055A Oct-21 Rp 11,975.00 APBN
3.0)
RDT HIV (SD BIOLINE HIV 1/2
42 RAPID TEST HIV 1 (SD) TEST 03ADE059A Oct-21 Rp 11,975.00 APBN
3.0)
RAPID TEST SIFILIS
43 RDT Syphilis (Trepocheck) TEST L19155 Dec-21 Rp 9,300.00 APBN
(TERPOCHECK)
44 Safety Box 2,5 L SAFETY BOX 2,5 LTR PCS 12788I19 Rp 12,500.00 APBN
45 Safety Box 5 L SAFETY BOX Box Rp 9,018.00 APBN
46 Safety Box 5 L SAFETY BOX 5 LTR PCS Rp 26,746.97 APBN

47 Sipermetrin 50 gr/L SIPERMETRIN 50 GRAM/LITER LITER 7100048 Aug-21 Rp 290,000.00 APBD 1

(CYNOFF)
48 Vaksin BCG Dosis 20 VAKSIN BCG 20 ds VIAL 0379G143 Nov-21 Rp 66,154.00 APBN
49 Vaksin BCG Dosis 20 VAKSIN BCG 20 ds VIAL 0379G186 Jan-22 Rp 66,154.00 APBN

50 Vaksin BCG Dosis 20 VAKSIN BCG 20 ds VIAL Rp 66,154.00 APBN

0379G216 Feb-22
51 Vaksin DTP HB HIB VAKSIN DPT-HB-HIB 5 DS PCS 5010219 Jul-21 Rp 84,282.00 APBN
52 Vaksin DTP HB HIB VAKSIN DPT-HB-HIB 5 DS PCS 5041919 Dec-21 Rp 84,282.00 APBN
53 Vaksin DTP HB HIB VAKSIN DPT HB HIB 5 DS VIAL 5041719 Nov-21 Rp 84,282.00 APBN
54 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3651620 Aug-22 Rp 25,597.00 APBN
55 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3652320 Sep-22 Rp 25,597.00 APBN
56 Vaksin Hepatitis B0 / Uniject VAKSIN HB PID / UNIJECT 1 DS PCS 3652620 Sep-22 Rp 25,597.00 APBN
57 Vaksin MR Inj. 10 DS VAKSIN MR 10 DS VIAL 0129N271 Jun-22 Rp 166,265.00 APBN
58 Vaksin Polio bopv Dosis 10 VAKSIN POLIO BOPV DOSIS 10 VIAL 2050420 Dec-22 Rp 23,643.00 APBN
59 Vaksin Polio bopv Dosis 10 VAKSIN POLIO BOPV DOSIS 10 VIAL 2050320 Dec-22 Rp 23,643.00 APBN
60 Vaksin Polio bopv Dosis 10 VAKSIN POLIO BOPV DOSIS 10 VIAL 2050321 Jan-23 Rp 23,643.00 APBN
61 Vaksin Polio IPV Ds. 5 VAKSIN POLIO IPV DS.5 VIAL 2101619 Sep-22 Rp 158,994.00 APBN
62 Vaksin Rabies VERORAB (RABIES VACCINE) BOX R1F571M Aug-21 Rp 165,000.00 APBN
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