DAFTAR HARGA OBAT PKD ( PROPINSI / APBD I ) DAN OBAT HIBAH

TOTAL
KET. TOTAL
NO NAMA OBAT HARGA PENGELUA
EXPIRE NTR SKD HJM BRY TSN BJR KRA TJB TJS TJA KTB MM TLJ WS SDM CDP WP KLD WU RBS PLS BMD SRG PNG KTP BKH KLSN PENGELUA KEMAS
SATUAN SATUAN (Rp) RAN
DATE RAN IFK AN
kemasan

APBD I ( PROPINSI )
SUB OBAT -OBATAN

1 Albendazol Tablet Kunyah 400 mg Tablet 402.00 juni-24 - 100 -

9 Amoksisilin Kaplet 500 mg Kaplet 402.00 okt-23 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 4,000 200 20

11 Amlodipin Tab 5 mg Kaplet 53.00 juli-23 600 600 300 300 600 600 600 600 300 300 600 300 600 300 600 300 300 300 300 300 300 600 300 600 600 600 300 12,000 300 40
Ampisilin Serbuk Injeksi im/iv. 1000
12 vial 8,591.00 Jan-25 20 20 10 10 20 20 20 20 10 10 20 10 20 10 20 10 10 10 10 10 10 20 10 20 20 20 10 400 10 40
mg/vial
Antasida DOEN Tablet Kunyah,
13 Tablet 54.00 okt-24 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 1,000 1,000 1,000 500 15,000 100 150
Kombinasi : AlOH 200 mg +
14 Antifungi Salep Kombinasi pot 3,477.00 okt-24 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 400 200 200 400 200 200 200 400 200 200 200 200 6,000 200 30

18 Artesunate Injeksi vial 60 mg Vial 57,585.00 juli-24 - - - - - - - - - - - - - - - - - - - 10 - - - - - - - 10 10 1

Asam Askorbat (Vitamin C) Tablet
21 Tablet 42.00 Sep-23 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 500 1,000 1,000 1,000 500 500 500 500 15,000 100 150
50mg
22 Asam Mefenamat Kapsul 500 mg Tablet 111.00 maret-24 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 - 2,500 100 25
28 Betahistin Tablet 24 mg Tablet 4,945.00 juni-23 30 30 30 30 30 30 30 60 30 30 60 30 30 30 30 30 30 30 30 30 30 30 30 30 30 60 30 900 30 30
29 Betamethason Krim Tube 1,534.00 okt-23 25 25 25 25 25 25 25 25 25 25 25 25 - - - - - - - - - - - - - - - 300 25 12

Besi (II) Sulfat 200 mg + Asam Folat

31 0,25mg Tablet (tablet tambah darah Tablet 226.00 ags-24 8,000 8,000 7,900 7,900 8,000 8,000 8,000 8,000 7,900 7,900 8,000 7,900 8,000 7,900 8,000 7,900 7,900 7,900 8,000 8,000 7,900 8,000 8,000 8,000 8,000 8,000 8,000 215,000 100 2,150
kombinasi)
Besi (II) Sulfat 200 mg + Asam Folat feb-
32 0,25mg Tablet (tablet tambah darah Tablet 226.00 23,sept- - 30 -
kombinasi) 23
33 Calsium Glukonas Inj Ampul 5,723.00 1 1 1 1 1 1 1 1 1 - 1 1 1 - 1 1 - 1 1 1 1 1 1 1 1 1 1 24 1 24
34 Cetrizin Tablet 10 mg Tablet 44.66 - - 100 100 200 200 - 200 100 100 200 200 - - 200 200 - - - - - 200 200 - 200 - 100 2,500 100 25
37 Diazepan Inj Ampul 1,545.00 maret-24 10 10 10 10 10 10 10 10 10 10 10 10 20 10 10 10 10 10 20 10 10 10 240 10 24
Amp
43 Fenobarbital Injeksi i.m./i.v. 50 mg/ml 1,700.00 des-25 30 30 30 60 30 60 30 30 60 30 60 30 60 60 30 30 30 690 30 23
1ml
44 Fenobarbital tablet 30 mg tablet 177.00 Apr-23 1 1 100 0
46 Fitomenadion (Vit K ) Injeksi Ampul 1,386.00 Apr-24 90 120 90 90 120 120 120 120 120 90 120 90 120 90 120 90 90 90 120 120 120 90 120 120 120 120 90 2,910 30 97
48 Garam Oralit sachet 280.00 maret-26 2,400 2,400 2,400 2,400 2,400 2,400 2,500 2,400 2,400 2,400 2,500 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 2,400 65,000 100 650
49 Garam Oralit sachet 280.00 Nov-23 100 - - 100 100 - 100 100 100 100 100 100 100 100 100 1,200 100 12
50 Gentamisin Injeksi 40 mg/ml Ampul 3,355.00 10 20 10 10 20 20 20 20 10 10 20 10 15 10 20 10 10 10 10 10 10 20 20 20 20 20 10 395 5 79
55 Hidrokortison krim Tube 2,475.00 24 24 24 24 24 24 24 24 24 24 24 264 24 11
60 Kaptopril tab 12,5 mg Tablet 65.00 Jan-24 100 200 100 100 200 200 200 200 100 100 200 100 200 100 200 100 100 100 100 100 100 200 200 200 200 200 100 4,000 100 40
68 Levotoroksin ( Ethyrox 50 mg ) Tablet 656.36 mei-24 100 100 100 1
69 Lidocain Compositum Injeksi Tablet 2,676.67 agst-25 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 90 60 2,400 30 80
70 Loperamid tablet 2 mg Tablet 77.00 Apr-25 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 200 4,000 100 40
71 Magnesium Sulfat Injeksi (IV)20% Ampul 3,580.00 mei-23 2 2 1 1 2 2 2 2 1 1 2 1 2 1 2 1 1 1 1 2 2 2 2 2 2 2 1 43 1 43
72 Magnesium Sulfat Injeksi (IV)40% vial 4,090.00 okt-23 2 2 2 2 2 2 2 3 2 2 3 2 3 2 3 2 2 2 3 3 3 3 3 3 3 3 2 66 1 66
73 Metformin Tablet 500 mg Tablet 38.50 Nov-23 400 400 200 200 400 400 400 400 200 400 400 400 400 400 400 400 400 400 400 400 400 400 400 400 400 400 200 10,000 200 50
74 Metil Ergometrin Malet Inj Ampul 1,023.00 mei-24 25 25 25 75 25 3
75 Metil prednisolon 8 mg Tablet 206.31 juni-25 100 100 100 100 100 100 100 100 100 100 100 100 100 100 200 100 100 100 100 100 100 100 200 100 100 200 100 3,000 100 30
76 Metoklorperamide Tab Tablet 120.00 - - 1 1 2 2 - 2 1 2 2 2 - - 2 2 - - - - - 2 2 - 2 - 25 100 0
77 Metronidazol Inj botol 5,885.00 maret-24 3 3 3 3 3 3 3 3 2 2 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 3 2 78 1 78
79 Natrium Clorida (NaCl Larutan Infus) Botol 6,800.00 juni-26 20 20 20 - 20 20 20 20 20 20 20 20 20 20 20 20 300 20 15
87 Obat Anti Tuberkulosis FDC Kategori 1 Paket 418,971.00 - 1 -
Obat Anti Tuberkulosis FDC Kategori 1
88 Paket 409,461.00 juli-23 - 1 -
dosis
Obat harian
Anti Tuberkulosis FDC Kategori
94 Paket 248,710.00 - 1 -
Anak
104 Obat HIV Atripla Tablet ( Tenolam E ) Tablet 6,800.00 - 30 -
105 Obat HIV (Efavirenz) Tablet Tablet 6,375.00 - 30 -
107 Obat HIV (Duviral) Tablet Tablet 3,700.00 juni-24 - 60 -
109 Obat HIV (Nevirapine) Tablet Tablet 2,800.00 mei-23 - 60 -

Obat HIV TDF

110 Tablet 2,544.33 agst-23 - 30 -
(300)/3TC(300)/DTG(50) ( Acriptega)

112 Oksitosin Injeksi 10 IU/ml-1ml Ampul 1,126.00 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 100 2,700 100 27
113 Omeprazol Kapsul kapsul 129.00 maret-24 200 200 200 200 200 200 1,200 200 6
 TOTAL
KET. TOTAL
NO NAMA OBAT HARGA PENGELUA
EXPIRE NTR SKD HJM BRY TSN BJR KRA TJB TJS TJA KTB MM TLJ WS SDM CDP WP KLD WU RBS PLS BMD SRG PNG KTP BKH KLSN PENGELUA KEMAS
SATUAN SATUAN (Rp) RAN
DATE RAN IFK AN
kemasan
119 Oxytetrasiklin salep mata 1 % tube 3,500.00 mei-25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 25 50 25 50 25 25 50 25 750 25 30
125 Primakuin Tablet Tablet 235.00 - 100 -
Retinol (Vitamin A) 100.000 IU Kapsul
131 Kapsul 305.00 mei-25 1,550 750 850 1,100 850 650 2,350 1,100 800 850 950 950 350 600 1,550 1,450 450 850 1,500 - - 19,500 50 390
Lunak
Retinol (Vitamin A) 100.000 IU Kapsul
132 Kapsul 305.00 600 900 600 900 1,000 1,300 650 900 6,850 50 137
Lunak
Retinol (Vitamin A) 200.000 IU Kapsul
133 Kapsul 553.00 maret-25 13,650 6,050 7,100 9,650 7,050 5,250 21,650 9,650 6,400 6,900 8,200 7,900 2,600 4,750 13,750 12,950 3,350 7,250 13,200 4,700 7,800 4,750 7,500 8,450 8,150 208,650 50 4,173
Lunak
Retinol (Vitamin A) 200.000 IU Kapsul
134 Kapsul 553.00 Sep-24 - - 3,550 4,950 7,550 16,050 50 321
Lunak Botol
135 Ringer Laktat Larutan Infus 7,630.00 juni-25 100 100 100 100 100 100 600 20 30
500 ml
136 Salbutamol Tablet 2 mg Tablet 67.00 agst-24 100 100 100 100 100 100 100 100 800 100 8
144 Zinc Tablet Tablet 216.00 okt-23 1,700 1,800 1,700 1,700 1,800 1,800 1,800 1,800 1,700 1,700 1,700 1,700 1,700 1,700 1,800 1,700 1,700 1,700 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,800 1,700 47,300 100 473
PERBEKALAN KESEHATAN - -
8 Alkohol Swab pcs 152.25 juni-24 1 1 2 200 0
10 Apron pcs 3,700.00 - - - - - - - - - - - - - - - - - - - - -
chlodine hand rub botol 5 L 395,000.00 okt-23 1 1 1 1 1 1 6 1 6
15 Handscone non Steril pasang 9,229.00 juli-24 1 1 50 0
Handscone steril ukuran #7 pasang 9,427.00 juli-24 1 1 50 0
Handscone Steril # 7 ( Troge) pasang 13,563.00 juli-24 1 1 1 1 4 50 0
Handscone Steril # 7,5 ( Troge) pasang 13,563.00 juli-24 1 1 1 1 4 50 0
Kapas Pembalut Roll 7,205.00 mei-24 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 20 1 20
32 Masker pcs 869.66 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 150 100 4,000 50 80
44 RDT MALARIA TES 4,830.00 - 25 -
45 Swab Dacron pcs 17,000.00 - 50 -
30 Paket Alat Pelindung Diri ( APD) paket 1,500,000.00

6 HIBAH - -
sub obat-
1 RDT- Ag pcs 96,000.00 obat 725 725 725 725 725 725 750 750 725 725 725 725 750 725 750 725 725 725 725 725 725 750 750 750 750 750 725 19,800 25 792
hibah

perlengk
2 Masker KN 95 pcs 10,000.00 apan 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 1,000 500 500 1,000 1,000 1,000 500 1,000 1,000 1,000 1,000 1,000 500 25,000 25 1,000
dinas

SUM JUMLAH APBN

- -

TOTAL

Stok Opname IFK- 12-4-2022 2