Rab Obat Dak - 2024

RENCANA ANGGARAN BIAYA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP)
TAHUN 2024
SATUAN KERJA : PUSKESMAS MALEBER
NO NAMA OBAT SATUAN RENCANA HARGA JUMLAH LINK REFERENSI HARGA

PENGADAAN DAK SATUAN HARGA
TAHUN 2024 (Rp) (Rp)
(b) (c) (d) = (b) x (c) (e)

OBAT
1 Air untuk injeksi ampul/vial/botol 10 mL - -
2 Air untuk injeksi Botol 100 ml - -
3 Air untuk injeksi Botol 250 ml - -
4 Air untuk injeksi amp 20 ml ampul/vial/botol - -
5 Air untuk injeksi amp 25 ml ampul/vial/botol 25 mL - 2.955 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49208001?lang=id&type=province&location_id=12
6 Albendazol susp 200 mg/5 ml Botol - 5.100 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48086079?lang=id&type=province&location_id=12
7 Albendazol tab 400 mg tablet/kapsul/kaplet - -
8 Alopurinol tab 100 mg Tab - 170 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49092643?lang=id&type=province&location_id=12
9 Alopurinol tab 300 mg tablet/kapsul/kaplet - 382 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49161059?lang=id&type=province&location_id=12
10 Aminofilin inj 24 mg/ml ampul/vial 10 ml - 12.595 - https://e-katalog.lkpp.go.id/katalog/produk/detail/55369708?lang=id&type=province&location_id=12
11 Aminofilin tab 150 mg tablet/kapsul/kaplet - -
12 Aminofilin Tab 200 mg tablet/kapsul/kaplet - 270 - https://e-katalog.lkpp.go.id/katalog/produk/detail/44899614?lang=id&type=province&location_id=12
13 Amitriptilin tab sal 25 mg tablet/kapsul/kaplet - 205 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48164529?lang=id&type=province&location_id=12
14 Amlodipin tab 10 mg tablet/kapsul/kaplet - 132 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45454173?lang=id&type=province&location_id=12
15 Amlodipin tab 5 mg tablet/kapsul/kaplet - 113 - https://e-katalog.lkpp.go.id/katalog/produk/detail/55508638?lang=id&type=province&location_id=12
16 Amoksisilin drops 100 mg/ml Botol @10 ml - -
19 Amoksisilin sir forte 250 mg/5 ml botol 60 ml - 6.069 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47691102?lang=id&type=province&location_id=12
20 Amoksisilin sir kering 125 mg/5 ml Botol - 3.480 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48594935?lang=id&type=province&location_id=12
21 Amoksisilin tab 250 mg tablet/kapsul/kaplet - 395 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49431245?lang=id&type=province&location_id=12
22 Amoksisilin tab 500 mg tablet/kapsul/kaplet - 494 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49414753?lang=id&type=province&location_id=12
23 Ampisilin serb inj 1000 mg/vial ampul/vial - 9.040 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49587940?lang=id&type=province&location_id=12
24 Ampisilin serb inj 250 mg/vial Vial - -
25 Anestetik lokal gigi kombinasi : lidokain hcl ampul/vial - 1.848 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47798670?lang=id&type=province&location_id=12
2% + epinefrin 1 : 80.000 inj 2 ml
26 Antasida, kombinasi : aluminium hidroksida botol 60 ml - 2.675 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48810825?lang=id&type=province&location_id=12
200 mg + magnesium hidroksida 200 mg
27 Antasida, kombinasi : aluminium hidroksida tablet/kapsul/kaplet - 106 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47585154?lang=id&type=province&location_id=12

200 mg + magnesium hidroksida 200 mg
28 Antibakteri kombinasi : Basitrasin 500 UI/g + Tube - 4.444 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48218779?lang=id&type=province&location_id=12

Polimiksin B 10.000 UI/g
29 Antifungi salep, kombinasi : asam benzoat pot 30 g - 5.500 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49444012?lang=id&type=province&location_id=12
6%+ asam salisilat 3%
30 Antihemoroid, kombinasi: bismut subgalat Suppositoria - 3.250 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45966316?lang=id&type=province&location_id=12
150 mg + heksaklorofen 2,5 mg + lidokain
lidokain 10 mg+ seng oksida 120 mg + sup ad
2g
31 Aquadest cairan 500 ml Botol 500 ml - -
32 Articulating paper kertas warna penanda Kertas warna penanda - -
oklusi oklusi
33 Asam asetat tetes telinga 2% Botol - -
(b) (c) (d) = (b) x (c) (e)

34 Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/kaplet - 216 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48732016?lang=id&type=province&location_id=12
35 Asam askorbat (vitamin C) tab 250 mg Tab - 220 - https://e-katalog.lkpp.go.id/katalog/produk/detail/74736877?lang=id&type=province&location_id=12

36 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/kaplet - 72 - https://e-katalog.lkpp.go.id/katalog/produk/detail/56991895?lang=id&type=province&location_id=12
37 Asam folat tab 0,4 mg tablet/kapsul/kaplet - -
38 Asam folat tab 1 mg tablet/kapsul/kaplet - 200 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47801605?lang=id&type=province&location_id=12
39 Asam folat tab 5 mg Tab - -
40 Asam mefenamat kaps 250 mg tablet/kapsul/kaplet - -
41 Asam mefenamat kaps 500 mg tablet/kapsul/kaplet/kaptab - 180 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49462471?lang=id&type=province&location_id=12
42 Asam retinoat krim 0,05% Tube/pot - -

43 Asam salisilat salep 10% Tube - -
46 Asetazolamid tab 250 mg tablet/kapsul/kaplet - -
47 Asiklovir tab 200 mg tablet/kapsul/kaplet - 550 - https://e-katalog.lkpp.go.id/katalog/produk/detail/56991233?lang=id&type=province&location_id=12
48 Asiklovir tab 400 mg tablet/kapsul/kaplet - 988 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48347338?lang=id&type=province&location_id=12
49 Atapulgit 600 mg tablet/kapsul/kaplet - 300,630 - https://e-katalog.lkpp.go.id/katalog/produk/detail/74592272?lang=id&type=province&location_id=12
50 Atapulgit tab 630 mg tablet/kapsul/kaplet - 304 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47603995?lang=id&type=province&location_id=12
51 Atapulgit tablet 650 mg tablet/kapsul/kaplet - -
52 Atapulgit tablet 750 mg Tab - -
53 Atenolol tab 100 mg tablet/kapsul/kaplet - -
54 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul - 3.778 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49730928?lang=id&type=province&location_id=12
55 Atropin tab 0,5 mg Tab - -
56 Bahan tumpatan sementara lar, serb Botol - -
57 Bedak salisil serb 2% Dus/Sachet/Plastik - 6.285 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47183353?lang=id&type=province&location_id=12
58 Benzatin benzilpenisilin inj 1,2 juta UI/ml Vial - -
(i.m.)
59 Benzatin benzilpenisilin inj 2,4 juta UI/ml Vial - 66.600 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47801968?lang=id&type=province&location_id=12
(i.m.)
60 Betahistin tab 6 mg tablet/kapsul/kaplet - 555 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47581635?lang=id&type=province&location_id=12
61 Betametason krim 0,1% tube 5 gram - 3.100 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48156201?lang=id&type=province&location_id=12
62 Betametason krim 0,5 mg/g Tube - -
63 Bisakodil sup 10 mg Suppositoria - -
64 Bisakodil sup 5 mg Suppositoria - 184 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48276448?lang=id&type=province&location_id=12
65 Bisakodil tab sal 5 mg tablet/kapsul/kaplet - -
66 Bisoprolol tab 2,5 mg tablet/kapsul/kaplet - 2.664 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47681810?lang=id&type=province&location_id=12
67 Budesonid cairan ih 0,25mg/ml Botol @ 4 ml - 11.600 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46009493?lang=id&type=province&location_id=12
68 Budesonid cairan ih 0,25mg/ml, respoules 2 respoules - -
ml
69 Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml - -
70 Budesonid cairan ih 0,5 mg/ml, respoules 2 respoules - 15.795 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46010279?lang=id&type=province&location_id=12
ml
71 Budesonid serb ih 200 mcg/dosis 100 dosis - -
72 Budesonid serb ih 200 mcg/dosis 200 dosis - -
73 Dapson tab 100 mg Tab - -
74 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial - 1.776 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47804736?lang=id&type=province&location_id=12
75 Diazepam enema 10 mg/2,5 ml tube @ 2,5 mL - 19.872 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48172052?lang=id&type=province&location_id=12
76 Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL - 13.669 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48171323?lang=id&type=province&location_id=12
77 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial - 1.545 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46051947?lang=id&type=province&location_id=12
78 Diazepam tab 2 mg tablet/kapsul/kaplet - 127 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45967217?lang=id&type=province&location_id=12
(b) (c) (d) = (b) x (c) (e)

79 Diazepam tab 5 mg tablet/kapsul/kaplet - 216 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47951470?lang=id&type=province&location_id=12
80 Dietilkarbamazin tab 100 mg tablet/kapsul/kaplet - -
81 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial - 2.220 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48069447?lang=id&type=province&location_id=12
82 Dimenhidrinat tab 50 mg tablet/kapsul/kaplet - 151 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45968441?lang=id&type=province&location_id=12
83 Doksisiklin kaps 100 mg tablet/kapsul/kaplet - -
84 Domperidon susp 5 mg/5 ml botol @60 ml - 4.728 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47711213?lang=id&type=province&location_id=12
85 Domperidon tab 10 mg tablet/kapsul/kaplet - 355 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47688568?lang=id&type=province&location_id=12
86 Ekstrak Herba meniran (Phyllanthi niruri Botol - -
herba)
87 Ekstrak Herba meniran (Phyllanthi niruri Kapsul - -
herba)
88 Epinefrin (adrenalin) inj 1 mg/ml Ampul - 3.885 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48069604?lang=id&type=province&location_id=12
89 Ergotamin tab 1 mg Tablet/kapsul/kaplet - 6.260 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49759846?lang=id&type=province&location_id=12
90 Eritromisin kaps 250 mg tablet/kapsul/kaplet - -
91 Eritromisin sir 200 mg/5 ml Botol @ 60 ml - -
92 Eritromisin tab 500 mg tablet/kapsul/kaplet - -
93 Etambutol tab 400 mg tablet/kapsul/kaplet - -
94 Etanol 70% cairan 70% Botol - -
95 Etil klorida semprot 100 ml Botol - 187.550 - https://e-katalog.lkpp.go.id/katalog/produk/detail/54133879?lang=id&type=province&location_id=12
96 Etonogestrel implan 68 mg Set - -
97 Eugenol Botol - 20.150 - https://e-katalog.lkpp.go.id/katalog/produk/detail/66320459?lang=id&type=province&location_id=12
98 Fenitoin Na inj 50 mg/ml (100 mg/ 2 mL) ampul @ 2 ml - -
99 Fenitoin Na kaps 100 mg Kaps - 179 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45449335?lang=id&type=province&location_id=12

100 Fenitoin Na kaps 30 mg Kaps - -
101 Fenobarbital inj 50 mg/ml Ampul - 3.885 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48069604?lang=id&type=province&location_id=12
102 Fenobarbital tab 100 mg Tab - -
103 Fenobarbital tab 30 mg tablet/kapsul/kaplet - 182 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45968771?lang=id&type=province&location_id=12
104 Fenoksimetil penisilin (penisilin V) tab 250 Tab - -
mg
105 Fenoksimetil penisilin (penisilin V) tab 500 Tab - -
mg
106 Ferrakrilum cairan 1% Botol - -
107 Ferro Sulfat sir 150 mg/5 ml botol - -
108 Ferro Sulfat tab sal selaput 300 mg tablet salut selaput - -
109 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) ampul/vial - 1.386 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46062024?lang=id&type=province&location_id=12
110 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal - 759 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49445816?lang=id&type=province&location_id=12
111 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) tablet salut gula/kaplet salut - -
gula
112 Flufenazin Dekanoat inj 25 mg/ml (i.m) Vial - -
113 Fluoksetin kaps 10 mg tablet/kapsul/kaplet - -
114 Fluoksetin kaps 20 mg tablet/kapsul/kaplet - -
115 Fluor kapl 1 mg Kaplet - -
116 Fluor sediaan topikal Tube - -
117 Flutikason propionat cairan ih 0,5 mg/dosis Botol - -
118 Formokresol Botol - -

(b) (c) (d) = (b) x (c) (e)

119 Fraksi dari ekstrak campuran Daun bungur Kapsul - -
(Lagerstroemiae speciosae folium) dan Kulit
kayu manis (Cinnamomi burmannii cortex)
120 Fraksi dari ekstrak Kulit kayu manis Kaplet - -

(Cinnamomi burmannii cortex)
121 Framisetin Sulfat Tulle 1% Patch - -
122 Furosemid inj 10 mg/ml (i.v./i.m.) ampul/vial - -
123 Furosemid tab 40 mg tablet/kapsul/kaplet - 263 - https://e-katalog.lkpp.go.id/katalog/produk/detail/57025064?lang=id&type=province&location_id=12
124 Galactose microparticle 200-400 mg Vial - -
micropart/ml
125 Garam oralit kombinasi : natrium klorida 0,52 sachet - 739 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48072178?lang=id&type=province&location_id=12
g + kalium klorida 0,30 g + trinatrium sitrat
0,58 g + glukosa anhidrat 2,7 g
126 Gentamisin salep mata 0,3% Tube - -

127 Gentamisin tts mata 0,3% Botol - -
128 Glibenklamid tab 2,5 mg tablet/kapsul/kaplet - -
129 Glibenklamid tab 5 mg tablet/kapsul/kaplet - 172 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48175500?lang=id&type=province&location_id=12
130 Glimepirid tab 1 mg tablet/kapsul/kaplet - -
131 Glimepirid tab 2 mg tablet/kapsul/kaplet - 180 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49199218?lang=id&type=province&location_id=12
134 Glipizid tab 10 mg tablet/kapsul/kaplet - -
135 Glipizid tab 5 mg tablet/kapsul/kaplet - -
136 Gliseril trinitrat tab 0,5 mg tablet/kapsul/kaplet - -
137 Gliserol obat luar 100 ml Botol - -
138 Glukosa Larutan Infus 10% steril 100 ml Botol - -
140 Glukosa Larutan Infus 10% steril 500 ml Botol - 8.350 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49262997?lang=id&type=province&location_id=12
141 Glukosa Larutan Infus 40% Ampul @25 ml - -
144 Glukosa Larutan Infus 5% steril 500 ml Botol - 7.686 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49350914?lang=id&type=province&location_id=12
145 Griseofulvin (micronized) tab 125 mg tablet/kapsul/kaplet - 310 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49537870?lang=id&type=province&location_id=12
146 Griseofulvin (micronized) tab scored 250 mg tablet/kapsul/kaplet - -
147 Griseofulvin tab 500 mg Tablet/kapsul/kaplet - 1.310 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49873036?lang=id&type=province&location_id=12

148 Haloperidol Dekanoat inj 50 mg/ml Vial - 109.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/50121809?lang=id&type=province&location_id=12
149 Haloperidol inj 5 mg/ml (i.m.) Vial - -
150 Haloperidol tab 0,5 mg tablet/kapsul/kaplet - 152 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47733252?lang=id&type=province&location_id=12
151 Haloperidol tab 1,5 mg tablet/kapsul/kaplet - 200 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47747803?lang=id&type=province&location_id=12
152 Haloperidol tab 2 mg tablet/kapsul/kaplet - -
153 Haloperidol tab 5 mg tablet/kapsul/kaplet - 218 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48747876?lang=id&type=province&location_id=12
154 Haloperidol tts 2 mg/ml botol - -
155 Hepatitis B imunoglobulin (human) inj 110 IU Ampul - -
156 Hepatitis B imunoglobulin (human) inj 200 IU Ampul - 1.389.500 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45942752?lang=id&type=province&location_id=12
157 Hepatitis B imunoglobulin (human) Inj 220 IU Ampul - -

(b) (c) (d) = (b) x (c) (e)

158 Hidrogen peroksida cairan 3% Botol - -
159 Hidroklorotiazid tab 25 mg tablet/kapsul/kaplet - 148 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46133998?lang=id&type=province&location_id=12
160 Hidrokortison krim 1% tube @ 5 g - 3.800 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49523469?lang=id&type=province&location_id=12
161 Hidrokortison krim 2,5% tube @ 5 g - 2.800 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46134101?lang=id&type=province&location_id=12
162 Hidrokortison serb inj 100 mg Vial - -
163 Hiosina butilbromida tab 10 mg tablet/kapsul/kaplet - -
164 Human tetanus imunoglobulin inj 250 UI Ampul - 177.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49730903?lang=id&type=province&location_id=12
(i.m.)
165 Human tetanus imunoglobulin inj 500 UI Ampul - -
(i.m.)
166 Ibuprofen sir 100 mg/5 ml botol @ 60 ml - 4.350 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47752414?lang=id&type=province&location_id=12
167 Ibuprofen sir 200 mg/5 ml botol @ 60 ml - -
168 Ibuprofen tab 200 mg tablet/kapsul/kaplet - 146 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47713610?lang=id&type=province&location_id=12
169 Ibuprofen tab 400 mg tablet/kapsul/kaplet - 300 - https://e-katalog.lkpp.go.id/katalog/produk/detail/74917614?lang=id&type=province&location_id=12
170 Ipratropium bromida aerosol 20 Botol - -
mcg/semprot
171 Ipratropium bromida cairan ih 0,025% Botol - -
172 Isoniazid tab 100 mg Tablet/kapsul/kaplet - 278 - https://e-katalog.lkpp.go.id/katalog/produk/detail/71410748?lang=id&type=province&location_id=12
173 Isoniazid tab 300 mg Tablet/kapsul/kaplet - 485 - https://e-katalog.lkpp.go.id/katalog/produk/detail/71411578?lang=id&type=province&location_id=12
174 Isosorbid dinitrat tab 5 mg tablet/kapsul/kaplet - -
175 Kalamin Tube - 14.825 - https://e-katalog.lkpp.go.id/katalog/produk/detail/76725485?lang=id&type=province&location_id=12
176 Kalium Klorida tab lepas lambat 600 mg tab - -
177 Kalsium glukonat inj 100 mg/ml ampul/vial - 11.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49910652?lang=id&type=province&location_id=12
178 Kalsium hidroksida bubuk, pasta Tube - -
179 Kalsium hipoklorit serb Sachet - -
180 Kalsium karbonat tab 500 mg tablet/kapsul/kaplet - -
181 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/kaplet - 165 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46134241?lang=id&type=province&location_id=12
182 Kaptopril tab 12,5 mg tablet/kaplet - 139 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48072722?lang=id&type=province&location_id=12
183 Kaptopril tab 25 mg tablet/kaplet - 200 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48072798?lang=id&type=province&location_id=12
184 Karbamazepin sir 100 mg/5 ml Botol - -
185 Karbamazepin Tab 200 mg Tablet/kapsul/kaplet - 706 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48761200?lang=id&type=province&location_id=12
186 Karbogliserin tts telinga 10 % Botol - -
187 Ketokonazol krim 2% Tube 10 g - 4.844 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49765375?lang=id&type=province&location_id=12
188 Ketokonazol scalp sol 2% botol - -
189 Ketokonazol tab 200 mg tablet/kapsul/kaplet - 400 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49209682?lang=id&type=province&location_id=12
190 Klindamisin kaps 150 mg Tablet/kapsul/kaplet - -
191 Klindamisin kaps 300 mg tablet/kapsul/kaplet - 1.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48602848?lang=id&type=province&location_id=12
192 Klofazimin, micronized kaps 50 mg Kapsul - -
193 Klofazimin, micronizedkaps 100 mg kapsul - -
194 Kloramfenikol kaps 250 mg tablet/kapsul/kaplet - 556 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47708035?lang=id&type=province&location_id=12
195 Kloramfenikol salep mata 1% tube @ 5 gram - 7.475 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45966004?lang=id&type=province&location_id=12
196 Kloramfenikol serb inj 1.000 mg/ml vial/ampul - -
197 Kloramfenikol susp 125 mg/5 ml botol 60 ml - -
198 Kloramfenikol tetes telinga 3% Botol - 8.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49738084?lang=id&type=province&location_id=12
199 Kloramfenikol tts mata 0,5% botol - 9.300 - https://e-katalog.lkpp.go.id/katalog/produk/detail/60281610?lang=id&type=province&location_id=12
200 Kloramfenikol tts mata 1% Botol - 9.300 - https://e-katalog.lkpp.go.id/katalog/produk/detail/60281610?lang=id&type=province&location_id=12
201 Klorfeniramin tab 4 mg tablet/kapsul/kaplet 5.000 74 370.000 https://e-katalog.lkpp.go.id/katalog/produk/detail/46626801?lang=id&type=province&location_id=12
202 Klorfenol kamfer mentol (CHKM) Botol - -
203 Klorheksidin lar 0,2% Botol - -
204 Klorheksidin lar 15% Botol - -
205 Klorpromazin inj 25 mg/ml (i.m.) ampul/vial - -
(b) (c) (d) = (b) x (c) (e)

206 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial - -
207 Klorpromazin tab sal 100 mg tablet salut selaput/kaplet - 888 - https://e-katalog.lkpp.go.id/katalog/produk/detail/72107079?lang=id&type=province&location_id=12
salut selaput
208 Klorpromazin tab sal 25 mg Tab sal 300 463 138.900 https://e-katalog.lkpp.go.id/katalog/produk/detail/47803885?lang=id&type=province&location_id=12
209 Kodein tab 10 mg tablet/kapsul/kaplet - -
212 Kolkisin tab 500 mcg Tablet/kapsul/kaplet - -
213 Komb: Deksametason 0,1% Thymol 5% Botol - -
Paraklorphenol 30
214 Kombinasi (DHP) : dihidroartemisin 20 mg + tablet dispersible - -
Piperakuin 160 mg tab dispersible
215 Kombinasi : artemether 20 mg + lumefantrin tablet/kapsul/kaplet - -
120 mg
216 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/kaplet - 6.260 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49759846?lang=id&type=province&location_id=12
217 Kombinasi : levonorgestrel 150 mcg + tab salut gula - -

etinilestradiol 30 mcg
218 Kombinasi : triamsinolon asetonoid + dimetil- Pasta tube - -
klortetrasiklin pasta
219 Kombinasi ekstrak Herba seledri (Apii Kapsul - -
graveolentis herba) dan ekstrak Daun kumis
kucing (Orthosiphonis staminei folium)
220 Kombinasi ekstrak Ikan gabus (Ophiocephali Sachet - -

striati), ekstrak Buah jeruk (Citri sinensidis
fructus), dan ekstrak Rimpang kunyit
(Curcumae longae rhizoma)
221 Kombinasi: Ipratropium bromida 0,5 mg + Ampul/vial - 4.238 - https://e-katalog.lkpp.go.id/katalog/produk/detail/71180181?lang=id&type=province&location_id=12

Salbutamol 2,5 mg, cairan ih
222 Kombinasi: kaolin 550 mg + pektin 20 mg Tab - 250 - https://e-katalog.lkpp.go.id/katalog/produk/detail/70897150?lang=id&type=province&location_id=12
223 Kombinasi: lidokain + medisinal creosote Botol - -

phenol + eugenol + benzil alkohol, cairan
224 Komposit resin Set - -

225 Kotrimoksazol (dewasa) kombinasi : tab/kaptab - 260 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47705953?lang=id&type=province&location_id=12
sulfametoksazol 400 mg+ trimetoprim 80 mg
226 Kotrimoksazol (dewasa) kombinasi : tab/kaptab - 575 - https://e-katalog.lkpp.go.id/katalog/produk/detail/70665373?lang=id&type=province&location_id=12

sulfametoksazol 800 mg+ trimetoprim 160
mg
227 Kotrimoksazol kombinasi tiap 5 ml suspensi : botol 60 mL - 8.880 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45966091?lang=id&type=province&location_id=12
sulfametoksazol 200 mg + trimetoprim 40 mg
228 Kuinin tab 200 mg tablet/kapsul/kaplet - -

229 Laktulosa sir 3,335 g/5 ml botol @ 60 mL - -
(b) (c) (d) = (b) x (c) (e)

230 Larutan mengandung elektrolit (CaCl2H2O Botol plastik @500 ml - -
0,165 gr, KCl 0,15 gr, NaCl 4,3 gr)
231 Larutan mengandung Elektrolit (Kalium Botol - -

Klorida)
232 Larutan mengandung Elektrolit (KCl 0,15%, Botol - -
NaCL 0,9%) (KN1)
233 Larutan mengandung Elektrolit (KCl Botol - -
0,3%,NaCl 0,9%) (KN2)
234 Larutan mengandung Elektrolit (Na 130 mEq, Botol plastik @ 500 ml - -
K 4 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28
mEq) Ringer Asetat
235 Larutan mengandung Elektrolit (Na 130 mEq, Softbag @ 500 ml - -
K 4 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28
mEq) Ringer Asetat
236 Larutan mengandung Elektrolit (Sodium Botol - -
Lactate sol (50%) 113 gr/L, Potassium
Chloride 0.3 gr/L, Calcium Chloride 0.2 gr/L,
elektrolit)
237 Larutan mengandung Elektrolit (Tiap 1000 ml Botol - -
mengandung electrolit: Sodium 145 mmol/l,
Potassium 4.0 mmol/l, Calcium 2.5 mmol/l,
Magnesium 1.0 mmol/l, Chloride 118 mmol/l,
Acetate 24 mmol/l, Malate 5.0 mmol/l)
238 Larutan mengandung Karbohidrat (Fructose Botol - -

120 g, glucose 66 g, Xylitol 60 g/ L)
239 Larutan mengandung Karbohidrat (Fructose softbag - -

15 mg, glucose monohydrate 30 mg, xylitol
15 mg)

242 Larutan mengandung Karbohidrat (Maltose Botol - -

10%)
243 Larutan mengandung Karbohidrat + Elektrolit Botol plastik @500 ml - -
(25.00g dextrose anhidrat, 3.00 g sodium
chloride, 0.15 g potassium chloride, 0.10 g
calcium chloride dihydrate dan 1.55 g sodium
lactate)
244 Larutan mengandung Karbohidrat + Elektrolit Botol plastik @500 ml - -

(25.00g maltose, 3.00 g sodium chloride, 0.15
g potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate)
(b) (c) (d) = (b) x (c) (e)

245 Larutan mengandung Karbohidrat + Elektrolit Botol - -
(Acetate, Na, K, Cl, Ca, Mg, Sorbitol 50 gr/L)

(Dextrose 5%, NaCL 0,45%, KCl) (HSD)

(Fructose 120 g, glucose 66 g, Xylitol 60 g/ L +
elektrolit)
(Glukosa 25 g, NaCl 2,0 g, KCl 1,3 g, Natrium
Laktat 3,1 g, air untuk injeksi ad 1000 ml)

(Glukosa 55 g ; Natrium Chloride 9 g, air
untuk injeksi ad 1000 ml) (D5-NS)
250 Larutan mengandung Karbohidrat + Elektrolit botol/softbag - -

(Glukosa: 110.0 g; NaCl: 1.80 g) (D10-1/5NS)

(Glukosa: 25,0 g; NaCl: 4,5 g)
252 Larutan mengandung Karbohidrat + Elektrolit botol/softbag @ 100 mL - -
253 Larutan mengandung Karbohidrat + Elektrolit botol/softbag @ 500 mL - -



(Larutan nutrisi kombinasi infus per L: Na.
100mEQ, K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl
90mEQ, Asetat 38mEQ, Sorbitol 50g)

(Larutan Ringer & Glukosa 5%)

(NaCl 1.125 gr, Dekstrosa 18.75 gr) (KA EN 1B)

(NaCl 1.75 g, KCL 1.5g, Glukosa 100 gr)

(NaCl 1.75 g, KCL 1.5g, Na Lactate 2.24 g,
Glukosa 100 gr)
(b) (c) (d) = (b) x (c) (e)

260 Larutan mengandung Karbohidrat + Elektrolit Botol - 12.770 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49194971?lang=id&type=province&location_id=12
(Nacl 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr,
Dekstrosa 27 gr) (KA EN 3B)

(Nacl 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr
Dekstrosa 27 gr) (KA EN 3A)
262 Levonorgestrel implan 2 rods, 75 mg (3-4 pack/ sachet/ set - -

tahun)
263 Lidokain gel 2% syringe/syringe plastik - -
264 Lidokain inj 2% (infiltr/p.v.) ampul/vial - 2.498 - https://e-katalog.lkpp.go.id/katalog/produk/detail/69240778?lang=id&type=province&location_id=12
265 Lidokain salep 5% Tube - -
266 Lidokain spray topikal 10% botol - -
267 Linestrenol tab 0,5 mg tablet/kapsul/kaplet - -
268 Liquor carbonis detergens lar 5% Botol - -
269 Lisinopril tab 10 mg tablet/kapsul/kaplet - -
270 Lisinopril tab 5 mg tablet/kapsul/kaplet - -
271 Loratadin tab 10 mg tablet/kapsul/kaplet - 199 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48226979?lang=id&type=province&location_id=12
272 Lorazepam tab 0,5 mg tablet/kapsul/kaplet - -
273 Lorazepam tab 1 mg tablet/kapsul/kaplet - -
274 Lorazepam tab sal 2 mg Tab sal - -
275 Magnesium sulfat inj 20% ampul/vial - 4.973 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48245542?lang=id&type=province&location_id=12
276 Magnesium sulfat inj 20% ampul/vial @25 ml - 4.973 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48245542?lang=id&type=province&location_id=12
277 Magnesium sulfat inj 40% ampul/vial - 5.661 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48246053?lang=id&type=province&location_id=12
278 Magnesium sulfat inj 40% ampul/vial @25 ml - 5.661 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48246053?lang=id&type=province&location_id=12
279 Magnesium sulfat serb, ktg 30 g Sachet - -
280 Manitol lar infus 20% Botol @ 100 ml - -
283 Mebendazol sir 100 mg/5 ml Botol - -
284 Mebendazol tab 100 mg Tablet/kapsul/kaplet - -
285 Mebendazol tab 500 mg tablet/kapsul/kaplet - -
286 Medroksi progesteron asetat inj 150 mg/ml ampul/vial - -
287 Metadon sir 50 mg/5 ml Botol 1000 ml - -

288 Metenamin mandelat (heksamin mandelat) Tab salut - -
tab salut enterik 500 mg
289 Metformin tab 500 mg tablet/kapsul/kaplet - 170 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49768499?lang=id&type=province&location_id=12
290 Metformin tab 850 mg tablet/kapsul/kaplet - 215 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49769739?lang=id&type=province&location_id=12
291 Metildopa tab 250 mg tablet/kapsul/kaplet - 1.832 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48170650?lang=id&type=province&location_id=12
292 Metilergometrin inj 0,2 mg/ml ampul/vial - 2.050 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49947124?lang=id&type=province&location_id=12
293 Metilergometrin tab salut 0,125 mg tablet/kaplet salut selaput - 298 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46644583?lang=id&type=province&location_id=12
294 Metilprednisolon inj 125 mg ampul/vial - -

295 Metoklopramid inj 5 mg/ml ampul/vial - -
296 Metoklopramid tab 10 mg tablet/kapsul/kaplet - 112 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46626532?lang=id&type=province&location_id=12
297 Metoklopramid tab 5 mg tablet/kapsul/kaplet - -
298 Metronidazol susp 125 mg/5 ml Botol @ 100 ml - -
299 Metronidazol susp 125 mg/5 ml Botol @ 60 ml - 6.001 - https://e-katalog.lkpp.go.id/katalog/produk/detail/72167657?lang=id&type=province&location_id=12
300 Metronidazol tab 250 mg tablet/kapsul/kaplet - -
(b) (c) (d) = (b) x (c) (e)

301 Metronidazol tab 500 mg tablet/kapsul/kaplet - 297 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47964382?lang=id&type=province&location_id=12
302 Mikonazol krim 2% tube - 3.917 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46624633?lang=id&type=province&location_id=12
303 Mikonazol serb 2% botol / sachet - -
304 Mometason furoat krim 0,1% tube 10 gram - -
305 Mometason furoat krim 0,1% Tube 5 gram - -
306 N-asetil sistein kaps 200 mg tablet/kapsul/kaplet - 373 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49620361?lang=id&type=province&location_id=12
307 N-asetil Sistein sir 100 mg/5ml botol - -
308 NaCl 0,9% Larutan Ampul/botol @ 10 mL - -
309 NaCl 0,9% Larutan Botol @1.000 mL - -
310 NaCl 0,9% Larutan Botol @100 ml - -
313 NaCl 0,9% Larutan Botol @500 ml - 7.673 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49328524?lang=id&type=province&location_id=12
314 NaCl 3% Larutan Botol plastik @500 ml - -
315 Natrium bikarbonat tab 500 mg tablet/kapsul/kaplet - 77 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47180779?lang=id&type=province&location_id=12
316 Natrium diklofenak tab 25 mg tablet salut enterik/kaplet - 244 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47805885?lang=id&type=province&location_id=12
salut enterik
317 Natrium diklofenak tab 50 mg tablet salut enterik/kaplet - 119 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49948334?lang=id&type=province&location_id=12

salut enterik
318 Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL - -
319 Natrium fluoresein tetes mata 2% Botol - -

320 Natrium hipoklorit cairan konsentrat 5% Botol - -
321 Natrium tiosulfat inj 25% (i.v.) Ampul - -

322 Nistatin susp 100.000 UI/ml botol/vial - 13.100 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49532199?lang=id&type=province&location_id=12
323 Nistatin tab salut 500.000 UI tablet salut gula/kaplet salut - 1.238 - https://e-katalog.lkpp.go.id/katalog/produk/detail/58087872?lang=id&type=province&location_id=12
gula
324 Nistatin tab vaginal 100.000 UI tablet/kaplet - 1.610 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47801605?lang=id&type=province&location_id=12
325 Oksigen ih, gas dlm tabung Botol - -
326 Oksimetazolin tts hidung 0,025% botol @ 10 mL - -
327 Oksimetazolin tts hidung 0,050% botol @ 10 mL - -
328 Oksitetrasiklin 1% Salep Mata tube - 5.934 - https://e-katalog.lkpp.go.id/katalog/produk/detail/62350815?lang=id&type=province&location_id=12
329 Oksitosin inj 10 UI/ml ampul/vial - 3.297 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48074222?lang=id&type=province&location_id=12
330 Olopatadin tts mata 0,1% Botol - -
331 Omeprazol inj 40 mg ampul/vial - 6.250 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49946367?lang=id&type=province&location_id=12
332 Omeprazol kaps 20 mg tablet/kapsul/kaplet - -
333 Parasetamol sir 120 mg/5 ml botol @ 60 mL - 2.999 - https://e-katalog.lkpp.go.id/katalog/produk/detail/74567947?lang=id&type=province&location_id=12
334 Parasetamol tab 500 mg tablet/kapsul/kaplet 20.000 278 5.550.000 https://e-katalog.lkpp.go.id/katalog/produk/detail/48254612?lang=id&type=province&location_id=12
335 Parasetamol tts 60 mg/0,6 ml botol @ 15 mL - 6.125 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49613566?lang=id&type=province&location_id=12
336 Pasta devitalisasi (non arsen) Tube - 255.300 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1407716?lang=id&type=general
337 Pasta pengisi saluran akar (pasta) Tube - 205.350 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1407198?lang=id&type=general
338 Perak sulfadiazin krim 1% Tube - 21.934 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49857121?lang=id&type=province&location_id=12
339 Permetrin krim 5 % Tube 10 g - 8.436 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49764262?lang=id&type=province&location_id=12
340 Permetrin krim 5 % Tube 15 g - -
341 Permetrin krim 5 % Tube 30 g - 12.765 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49729185?lang=id&type=province&location_id=12
342 Pilokarpin tetes mata 2% Botol 5 ml - -
343 Pilokarpin tetes mata 2% Catchcover, botol 0,6 ml - -
344 Pirantel pamoat susp 125 mg/5 ml Botol - -
(b) (c) (d) = (b) x (c) (e)

345 Pirantel pamoat tab scored 125 mg tablet/kapsul/kaplet - -
346 Pirantel pamoat tab scored 250 mg Tab - -
347 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl - 114 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46630395?lang=id&type=province&location_id=12
348 Piridoksin (vitamin B6) tab 25 mg tablet/kapsul/kaplet - -
349 Povidon iodin lar 100 mg/ml botol 30 mL - -
350 Povidon iodin lar 100 mg/ml Botol 300 ml - 33.156 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1932762?lang=id&type=general
351 Povidon iodin lar 100 mg/ml botol @ 1.000 mL - -
352 Povidon iodin lar 100 mg/ml botol @ 60 mL - -
353 Povidon iodin lar obat kumur 1% Botol - -
354 Povidon iodin tts mata 2,5% botol/strip - -
355 Prazikuantel tab scored 600 mg Tab - -
356 Prednison tab 5 mg tablet/kapsul/kaplet - 103 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47891692?lang=id&type=province&location_id=12
357 Probenesid tab 500 mg tablet/kapsul/kaplet - -
358 Prokain benzilpenisilin serb inj 3 juta UI/vial ampul/vial - -
(i.m.)
359 Propranolol tab 10 mg tablet/kapsul/kaplet - 70 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49933701?lang=id&type=province&location_id=12
360 Ranitidin tab 150 mg tablet/kapsul/kaplet - 170 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49439772?lang=id&type=province&location_id=12
361 Rifampisin kaps 300 mg tablet/kapsul/kaplet - -
362 Ringer Laktat Larutan Botol - 8.498 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49325224?lang=id&type=province&location_id=12
363 Risperidon tab sal 2 mg tablet/kapsul/kaplet - 210 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49921978?lang=id&type=province&location_id=12
364 Salbutamol cairan ih 1 mg/mL ampul/vial/botol - -
365 Salbutamol tab 2 mg tablet/kapsul/kaplet - 86 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46135307?lang=id&type=province&location_id=12
366 Salep 2-4, kombinasi : asam salisilat 2 %+ pot 15 gram - 4.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47920582?lang=id&type=province&location_id=12
belerang endap 4 %
367 Salep 2-4, kombinasi : asam salisilat 2 %+ pot 30 gram - 4.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48541789?lang=id&type=province&location_id=12
belerang endap 4 %
368 Sefadroksil drops 150 mg/ml botol - -
369 Sefadroksil kaps 250 mg tablet/kapsul/kaplet - -
370 Sefadroksil kaps/tab 500 mg tablet/kapsul/kaplet - 1.149 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47483556?lang=id&type=province&location_id=12
371 Sefadroksil sir kering 125 mg/5 ml botol @ 60 mL - 5.600 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49519004?lang=id&type=province&location_id=12
372 Sefadroksil sir kering 250 mg/5 ml botol @ 60 mL - -
373 Serum anti bisa ular : A.B.U. I (khusus ular Vial - 688.189 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47990264?lang=id&type=province&location_id=12
dari luar Papua) inj (i.m./i.v.)
374 Serum anti bisa ular :A.B.U.II (khusus ular dari Vial - -
Papua) inj (i.m./i.v.)
375 Serum antirabies inj 100 UI/ml Vial - -
376 Serum antirabies inj 200 UI/ml Vial - -
377 Serum antitetanus (A.T.S) (i.m.) Inj 10.000 Vial - -
UI/vial (i.m /i.v.)
378 Serum antitetanus (A.T.S) inj 1500 UI/amp Ampul - -
(i.m.)
379 Serum antitetanus (A.T.S) inj 20.000 UI/vial Vial - -
(i.m /i.v.)
380 Serum antitetanus (A.T.S) inj 5.000 IU/mL Ampul/vial - -
(i.m)
381 Setirizin sir 5 mg/5 ml. botol @ 60 mL - -
382 Setirizin tab 10 mg tablet/kapsul/kaplet - 99 - https://e-katalog.lkpp.go.id/katalog/produk/detail/73172985?lang=id&type=province&location_id=12
383 Sianokobalamin (vitamin B12) inj 500 mcg/ml ampul/vial - 2.129 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49219998?lang=id&type=province&location_id=12
384 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kaplet - 46 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47710163?lang=id&type=province&location_id=12

(b) (c) (d) = (b) x (c) (e)

385 Simvastatin tab sal 10 mg tablet/kapsul/kaplet/tablet - 300 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48197181?lang=id&type=province&location_id=12
salut selaput/kaplet salut
selaput
386 Simvastatin tab sal 20 mg tablet/kapsul/kaplet/tablet - 555 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48203025?lang=id&type=province&location_id=12
salut selaput/kaplet salut
selaput
387 Simvastatin tab sal selaput 40 mg Tab salut selaput - -
388 Siprofloksasin tab scored 500 mg tablet salut selaput/kaplet - 396 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49186487?lang=id&type=province&location_id=12
salut selaput
389 Spironolakton tab 25 mg tablet/kapsul/kaplet - 250 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49908965?lang=id&type=province&location_id=12

390 Streptomisin serb inj 1.000 mg/vial ampul/vial - -
391 Surgical ginggival pack Tube - -
392 Terbutalin cairan ih 2,5 mg/ml Botol - -
393 Terbutalin inj 0,5 mg/ml ampul/vial - -
394 Tetanus toxoid inj Ampul - -
395 Tetrakain tts mata 0,5% Botol - -
396 Tetrasiklin kaps 250 mg tablet/kapsul/kaplet - -
397 Tetrasiklin kaps 500 mg tablet/kapsul/kaplet - -
398 Tiamin (vitamin B1) tab 50 mg tablet/kapsul/kaplet - 225 - https://e-katalog.lkpp.go.id/katalog/produk/detail/46629336?lang=id&type=province&location_id=12
399 Timolol tts mata 0,25% botol @ 5 mL - -
400 Timolol tts mata 0,5% botol @ 5 mL - -
401 Triheksifenidil tab 2 mg tablet/kapsul/kaplet - 126 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48585408?lang=id&type=province&location_id=12
402 Tropikamid tts mata 0,5% Botol @ 5 ml - -
403 Tropikamid tts mata 0,5% Catchcover, botol 0,6 ml - -
404 Tropikamid tts mata 1% Botol @ 0,6 ml - -
405 Tropikamid tts mata 1% Botol @ 5 ml - -
406 Urea krim 10 % Tube/pot - -
407 Urea krim 20 % Tube/pot - -
408 Vaksin bivalen OPV (b-OPV) drops 10 dosis Vial - -
409 Vaksin rabies, untuk manusia serb Inj 2,5 IU Vial - -
410 Valproat sir 250 mg/5 ml botol @ 120 ml - -

411 Valproat tab lepas lambat 250 mg tabet lepas lambat/kaplet - -
lepas lambat
412 Valproat tab lepas lambat 500 mg tabet lepas lambat/kaplet - -

lepas lambat
413 Valproat tab sal enterik 250 mg tablet salut enterik/ kaplet - -
salut enterik
414 Vitamin B kompleks tablet - 121 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45970577?lang=id&type=province&location_id=12
415 Zinc drops 10 mg/ml Botol - -
416 Zinc sir 20 mg/5 ml botol - 4.350 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47926754?lang=id&type=province&location_id=12
417 Zinc tab disp 20 mg tablet dispersible - 175 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48031785?lang=id&type=province&location_id=12
OBAT TAMBAHAN - -
1 Acyclovir Cream tube - -
2 Ambroxol Tablet 30 mg tablet - -
3 Ambroxol Syrup botol - -
4 Antitusif Syrup boto; - -
(b) (c) (d) = (b) x (c) (e)

5 Bromhexin Hcl tablet - -
6 Clozapine 25 mg tablet - -
7 Clozapine100 mg tablet - -
8 Obat Batuk Herbal botol - -
9 Obat Batuk Hitam botol - -
10 Multivitamin Syrup botol - -
11 Multivitamin Tablet dan Mineral (PEHAVRAL) tablet - -
12 Vitamin Neurotropik tablet - -

13 Guafenesin Tablet tablet - -
14 Metamizole Tablet 500 mg tablet - -
15 Salbutamol 4 mg tablet - -
16 Methylprednisolone 4 mg tablet - -
17 Pehacain Injeksi vial - -
18 Meloxicam 7,5 mg tablet - -
19 Meloxicam 15 mg tablet - -
20 Piroxicam 20 mg tablet - -
21 Neo Diaform tablet - -
22 Kalium Diklofenak tablet - -
23 Novagrip Tablet tablet - -
24 Lansoprazole kapsul - -
25 Klorampenikol Salep kulit tube - -
26 Gentamisin salep Kulit tube - -
27 Asam Askorbat 500 mg tablet - -
BMHP - -
1 Alat Suntik Sekali Pakai/Auto Disable Syringe Pcs - 1.899,54 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1259663?lang=id&type=general
0,05 ml
2 Alat Suntik Sekali Pakai/Auto Disable Syringe Pcs - 1.332 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1256315?lang=id&type=general
0,5 ml
3 Alat Suntik Sekali Pakai/Auto Disable Syringe Pcs - 1.750 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1259994?lang=id&type=general
5 ml
4 Alkohol 70% Botol 1 L - 26.418 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1932857?lang=id&type=general
5 Benang Chromic Catgut Pcs, No. 2/0 - 67.932 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1374247?lang=id&type=general
6 Benang Silk Pcs, No. 3/0 - 45.510 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1376612?lang=id&type=general
7 Bisturi No. 10 Pcs - 850 - https://e-katalog.lkpp.go.id/katalog/produk/detail/77265012?lang=id&type=general
8 Bisturi No. 11 Pcs - 850 - https://e-katalog.lkpp.go.id/katalog/produk/detail/76205726?lang=id&type=general
9 Cairan Antiseptik/Antimikroba Klorheksidin Botol 500 ml - 65.934 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1255217?lang=id&type=general
Glukonat 2-4%
10 Cairan Desinfektan Ruangan Galon 5 L - 759.240 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1267116?lang=id&type=general
11 Cairan Desinfektan Tangan/Handrubs Botol 500 ml - 55.500 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1255670?lang=id&type=general
12 Disposable Syringe 1 ml Pcs - 1.322 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1514370?lang=id&type=general
13 Disposable Syringe 2,5 ml Pcs - 1.221 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1514375?lang=id&type=general
16 Disposable Syringe 20 ml Pcs - -
17 Disposable Syringe 50 ml Pcs - -
18 Endotracheal Tube (ETT) Tanpa Cuff 2,5 Pcs - -
19 Endotracheal Tube (ETT) Tanpa Cuff 3 Pcs - -
20 Endotracheal Tube (ETT) Tanpa Cuff 3,5 Pcs - -
(b) (c) (d) = (b) x (c) (e)

25 Extension Tube Pcs - -
26 Feeding Tube/Orogastric Tube Pcs - -
27 Folley Catheter Pcs , No. 14 - 9.990 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1253343?lang=id&type=general
28 Goggle Pcs - 50.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/40067966?lang=id&type=general
29 Infus Set Anak Pcs - 9.663 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1245036?lang=id&type=general
30 Infus Set Dewasa Pcs - 9.324 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1245269?lang=id&type=general
31 Jarum Jahit Pcs - -
32 Jarum Jahit Untuk Operasi Mata, 1/2 Pcs - -
Lingkaran
33 Jarum Jahit, Lengkung, 1/2 Lingkaran, Pcs - -
Penampang Bulat
34 Jarum Jahit, Lengkung, 1/2 Lingkaran, Pcs - -
Penampang Segitiga
35 Jarum Jahit, Lengkung, 3/8 Lingkaran Pcs - -
Penampang Bulat
36 Jarum Jahit, Lengkung, 3/8 Lingkaran Pcs - -
Penampang Segitiga
37 Jarum Lancet Box isi 100 - 18.900 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1248798?lang=id&type=general
38 Jarum Suntik Intra Ligamen Pcs - -
39 Kaca Penutup (Dek Glass) Pcs - -
40 Kaca Sediaan Frosted End untuk Pemeriksaan Box isi 72 - 16.500 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1377805?lang=id&type=general
Tb
41 Kain Balut Segitiga Pcs - -
42 Kain Steril Pcs - -
43 Kantong Urin Pcs - 7.100 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1248692?lang=id&type=general
44 Kassa Hidrofil Steril Uk 16 cmx16 cm Box - 7.114 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1260942?lang=id&type=general
45 Kassa Non Steril Pak isi 50, ''4 m x 15 cm - 141.900 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1245546?lang=id&type=general
46 Kassa Steril Pcs, 40 cm x 40 cm - 1.554 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246462?lang=id&type=general
47 Kateter Intravena 16 G Pcs - -
48 Kateter Intravena 18 G Pcs 100 5.900 590.000 https://e-katalog.lkpp.go.id/katalog/produk/detail/1246768?lang=id&type=general
49 Kateter Intravena 20 G Pcs - 5.900 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246704?lang=id&type=general
50 Kateter Intravena 23 G Pcs - -
53 Kateter Karet No. 10 (Nelaton) Pcs - -
56 Kateter Nasal dengan Canule Pcs - 12.900 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1248701?lang=id&type=general
57 Kateter Penghisap Lendir Dewasa 10 Pcs - -
58 Kateter Penghisap Lendir Dewasa 8 Pcs - -
59 Kertas Golongan Darah Lembar, Box 100 pcs - 60.480 - https://e-katalog.lkpp.go.id/katalog/produk/detail/53092728?lang=id&type=general
60 Kertas Lakmus Pcs - -
61 Kertas Perkamen Pcs - 2.442.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/50730988?type=general
62 Kertas Saring Pcs - -
63 Laringeal Mask Airway (LMA) Pcs - -
64 Larutan Klorin 0,5% Botol - -
65 Larutan Povidon Iodin Botol, 30 ml 15 4.551 68.265 https://e-katalog.lkpp.go.id/katalog/produk/detail/1932742?lang=id&type=general
66 Lubricant Gel Botol - 29.550 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246353?lang=id&type=general
67 Masker Pcs - 1.100 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1497863?lang=id&type=general
(b) (c) (d) = (b) x (c) (e)

68 Micropore Surgical Tape Pcs - 45.360 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1434309?lang=id&type=general
69 Mixing Pad Pcs - -
70 Nasal Pronge Pcs - -
71 Nasogastric Tube (NGT) No. 3 Pcs - -
74 Pelilit kapas/Cotton applicator Pcs - -
75 Penghisap Karet (Aspirator) Pcs - -
76 Pengikat/Penjepit Tali Pusat Steril 'Box isi 50 pcs - 89.910 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246201?lang=id&type=general
77 Plester Pcs (5 cm x 5 m) - 47.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246559?lang=id&type=general
78 Pot Spesimen Dahak Pcs - 2.500 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1248717?lang=id&type=general
79 Pot Spesimen Urine Pcs - 2.230 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1248491?lang=id&type=general
80 Reagen Fluoresen Kornea Pcs - -
81 Reagen Pemeriksaan Kimia Klinik Botol 500 ml, Lyse - 1.332.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/71253771?lang=id&type=general
82 Reagen Ziehl Nielsen Untuk Pemeriksaan Tb Box 1 set 5 botol - 225.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1245559?lang=id&type=general
83 Reagen untuk Pemeriksaan Hepatitis Pcs - -

84 Rivanol Botol 300 ml - 8.665 - https://e-katalog.lkpp.go.id/katalog/produk/detail/2237931?lang=id&type=general
85 Sarung Tangan Non Steril Pcs, Ukuran S - 833 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1261441?lang=id&type=general
86 Sarung Tangan Steril Pcs, No. 6,5 - 450.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/57730468?lang=id&type=general
87 Semen Glass Ionomer Pcs - 460.872 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1439952?lang=id&type=general
88 Skalpel, Mata Pisau Bedah Pcs - -
89 Spatula Ayre Pcs - -
90 Specimen Transport Tube (EDTA) Box isi 100 - 168.210 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1393210?lang=id&type=general
91 Spuit Irigasi Liang Telinga Pcs - 150.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/56802944?lang=id&type=general
92 Strip Tes Kehamilan Box isi 50 pcs - 108.780 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246209?lang=id&type=general
93 Suction Catheter No. 10 Pcs - 4.345 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246396?lang=id&type=general
96 Sudip Lidah Pcs - 18.648 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1244195?lang=id&type=general
97 Tabung Kapiler Mikrohematokrit Pcs - -
98 Three-Way Stopcock Pcs - -
99 Tip Pipet Pcs - -
100 Ultrasonic Gel Pcs, 250 ml - 13.860 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1250036?lang=id&type=general
101 Underpad Pcs, 60 x 90 cm - 35.520 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1373128?lang=id&type=general
102 Verban Elastic Pcs, 10 cm x 4,55 m - 39.900 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1244546?lang=id&type=general
103 Wing Needle Box isi 100 - 130.980 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1245934?lang=id&type=general
104 Benang Chromic Catgut Pcs, No. 3/0 - 60.717 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1373285?lang=id&type=general
105 Benang Plain Catgut Pcs, No. 2/0 - 62.604 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1372651?lang=id&type=general
106 Benang Plain Catgut Pcs, No. 3/0 - 62.604 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1377150?lang=id&type=general
107 Folley Catheter Pcs, No. 16 - 9.990 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246893?lang=id&type=general
108 Folley Catheter Pcs, No. 18 - 9.990 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1246893?lang=id&type=general
109 Sarung Tangan Steril Pcs, No. 7 - 450.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/57733144?lang=id&type=general
110 Sarung Tangan Steril Pcs, No. 7,5 - 450.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/57736492?lang=id&type=general
111 Sarung Tangan Steril Pcs, Obgyn - 40.700 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1724324?lang=id&type=general
112 Sarung Tangan Non Steril Pcs, Ukuran M - 833 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1261457?lang=id&type=general
113 Sarung Tangan Non Steril Pcs, Ukuran L - 833 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1261474?lang=id&type=general
114 Larutan Povidon Iodin Botol, 60 ml - 6.420 - https://e-katalog.lkpp.go.id/katalog/produk/detail/63708446?lang=id&type=general
115 Larutan Povidon Iodin Botol, 300 ml - 32.190 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1932762?lang=id&type=general
117 Verban Elastic Pcs, 15 cm x 4,55 m - 49.900 - https://e-katalog.lkpp.go.id/katalog/produk/detail/1244663?lang=id&type=general
(b) (c) (d) = (b) x (c) (e)

118 Reagen Pemeriksaan Kimia Klinik Botol, 10 L, Diluent - 888.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/71178699?lang=id&type=general
119 Reagen Pemeriksaan Kimia Klinik Botol, 5 L, Detergent - 888.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/71252331?lang=id&type=general
120 Reagen Pemeriksaan Kimia Klinik Botol, 500 ml, Cleanser - 1.332.000 - https://e-katalog.lkpp.go.id/katalog/produk/detail/71250723?lang=id&type=general
BMHP TAMBAHAN - -
1 Reagen Goldar anti A Pcs - -
2 Reagen Goldar anti B Pcs - -
3 Reagen Goldar anti AB Pcs - -
4 Reagen Goldar anti D Pcs - -
5 Plester 5 x 7 cm anti air Pak - -
6 Nebulizer Set Anak Pcs - -
7 Nebulizer Set Dewasa Pcs - -
8 Blood Transfusion Set Pcs - -
9 Nasal Kanul Bayi Pcs - -
10 Nasal Kanul Anak Pcs - -
11 Nasal Kanul Dewasa Pcs - -
12 Stik pemeriksaan gula darah test - 6.838 - https://e-katalog.lkpp.go.id/katalog/produk/detail/54603460?lang=id&type=general
13 stik pemeriksaan asam urat test - 5.600 - https://e-katalog.lkpp.go.id/katalog/produk/detail/58702321?lang=id&type=general
14 stik pemeriksaan kolestrol test 800 25.000 20.000.000 https://e-katalog.lkpp.go.id/katalog/produk/detail/1369848?lang=id&type=general
15 stik pemeriksaan hemoglobin test - -
16 Urine Bag Pcs - -
TOTAL 6.058.900
Mengetahui Kuningan, 24 Maret 2024

Kepala UPTD Puskesmas Maleber Apoteker Puskesmas
MELI VERNIANA SISKA,S.STr.Keb Apt.SHEILA JULLYAN,S.Farm

NIP. 19830705 200312 2 001 SIPA. 446/KPTS.077-SIPA/DPMPTSP/XII/2023

Rab Obat Dak - 2024

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Rab Obat Dak - 2024

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RENCANA ANGGARAN BIAYA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP)

SATUAN KERJA : PUSKESMAS MALEBER

NO NAMA OBAT SATUAN RENCANA HARGA JUMLAH LINK REFERENSI HARGA

(b) (c) (d) = (b) x (c) (e)

27 Antasida, kombinasi : aluminium hidroksida tablet/kapsul/kaplet - 106 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47585154?lang=id&type=province&location_id=12

28 Antibakteri kombinasi : Basitrasin 500 UI/g + Tube - 4.444 - https://e-katalog.lkpp.go.id/katalog/produk/detail/48218779?lang=id&type=province&location_id=12

(b) (c) (d) = (b) x (c) (e)

35 Asam askorbat (vitamin C) tab 250 mg Tab - 220 - https://e-katalog.lkpp.go.id/katalog/produk/detail/74736877?lang=id&type=province&location_id=12

42 Asam retinoat krim 0,05% Tube/pot - -

(b) (c) (d) = (b) x (c) (e)

99 Fenitoin Na kaps 100 mg Kaps - 179 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45449335?lang=id&type=province&location_id=12

110 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal - 759 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49445816?lang=id&type=province&location_id=12

118 Formokresol Botol - -

(b) (c) (d) = (b) x (c) (e)

120 Fraksi dari ekstrak Kulit kayu manis Kaplet - -

126 Gentamisin salep mata 0,3% Tube - -

147 Griseofulvin tab 500 mg Tablet/kapsul/kaplet - 1.310 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49873036?lang=id&type=province&location_id=12

156 Hepatitis B imunoglobulin (human) inj 200 IU Ampul - 1.389.500 - https://e-katalog.lkpp.go.id/katalog/produk/detail/45942752?lang=id&type=province&location_id=12

157 Hepatitis B imunoglobulin (human) Inj 220 IU Ampul - -

(b) (c) (d) = (b) x (c) (e)

(b) (c) (d) = (b) x (c) (e)

217 Kombinasi : levonorgestrel 150 mcg + tab salut gula - -

220 Kombinasi ekstrak Ikan gabus (Ophiocephali Sachet - -

221 Kombinasi: Ipratropium bromida 0,5 mg + Ampul/vial - 4.238 - https://e-katalog.lkpp.go.id/katalog/produk/detail/71180181?lang=id&type=province&location_id=12

223 Kombinasi: lidokain + medisinal creosote Botol - -

224 Komposit resin Set - -

226 Kotrimoksazol (dewasa) kombinasi : tab/kaptab - 575 - https://e-katalog.lkpp.go.id/katalog/produk/detail/70665373?lang=id&type=province&location_id=12

228 Kuinin tab 200 mg tablet/kapsul/kaplet - -

(b) (c) (d) = (b) x (c) (e)

231 Larutan mengandung Elektrolit (Kalium Botol - -

238 Larutan mengandung Karbohidrat (Fructose Botol - -

239 Larutan mengandung Karbohidrat (Fructose softbag - -

241 Larutan mengandung Karbohidrat (Fructose Botol - -

242 Larutan mengandung Karbohidrat (Maltose Botol - -

244 Larutan mengandung Karbohidrat + Elektrolit Botol plastik @500 ml - -

(b) (c) (d) = (b) x (c) (e)

246 Larutan mengandung Karbohidrat + Elektrolit Botol - -

247 Larutan mengandung Karbohidrat + Elektrolit Botol - -

249 Larutan mengandung Karbohidrat + Elektrolit Botol - -

250 Larutan mengandung Karbohidrat + Elektrolit botol/softbag - -

251 Larutan mengandung Karbohidrat + Elektrolit Botol - -

253 Larutan mengandung Karbohidrat + Elektrolit botol/softbag @ 500 mL - -

254 Larutan mengandung Karbohidrat + Elektrolit Botol - -

255 Larutan mengandung Karbohidrat + Elektrolit Botol - -

256 Larutan mengandung Karbohidrat + Elektrolit Botol - -

257 Larutan mengandung Karbohidrat + Elektrolit Botol - -

258 Larutan mengandung Karbohidrat + Elektrolit Botol - -

259 Larutan mengandung Karbohidrat + Elektrolit Botol - -

(b) (c) (d) = (b) x (c) (e)

261 Larutan mengandung Karbohidrat + Elektrolit Botol - -

262 Levonorgestrel implan 2 rods, 75 mg (3-4 pack/ sachet/ set - -

287 Metadon sir 50 mg/5 ml Botol 1000 ml - -

294 Metilprednisolon inj 125 mg ampul/vial - -

(b) (c) (d) = (b) x (c) (e)

317 Natrium diklofenak tab 50 mg tablet salut enterik/kaplet - 119 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49948334?lang=id&type=province&location_id=12

318 Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL - -

319 Natrium fluoresein tetes mata 2% Botol - -

321 Natrium tiosulfat inj 25% (i.v.) Ampul - -

(b) (c) (d) = (b) x (c) (e)

384 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kaplet - 46 - https://e-katalog.lkpp.go.id/katalog/produk/detail/47710163?lang=id&type=province&location_id=12

(b) (c) (d) = (b) x (c) (e)

389 Spironolakton tab 25 mg tablet/kapsul/kaplet - 250 - https://e-katalog.lkpp.go.id/katalog/produk/detail/49908965?lang=id&type=province&location_id=12

409 Vaksin rabies, untuk manusia serb Inj 2,5 IU Vial - -