REKAP REALISASI PENGADAAN OBAT 2016

No Penyedia Total
1 PT. Bio Axion Healthindo 534,573,756
2 PT. Phapros Tbk 118,024,040
3 PT. Erela 22,650,000
4 PT. Yarindo Farmatama 9,490,000
5 PT. Rama emerald multi sukses 175,766,000
6 PT. Novapharin 74,520,000
7 PT. MARIN LIZA FARMASI 27,158,000
8 PT. Dexa Medica 57,997,000
9 PT. ACTAVIS INDONESIA 9,229,000
10 PT. Ethica Industri Farmasi 7,600,000
11 PT. Ahmadaris 197,039,500
12 PT. Widatra Bhakti 46,400,000
13 PT. SOHO Industri Pharmasi 16,500,000
14 PT. Bernofarm 37,820,000
15 PT. Combined Imperial Pharmaceuticals 35,100,000
16 PT. ERRITA PHARMA 87,756,640
17 PT. Graha Farma 2,000,000
18 PT. GUARDIAN PHARMATAMA 4,950,000
19 PT. Holi Pharma 49,252,000
20 PT. IFARS PHARMACEUTICAL LABORATORIES 4,500,000
21 PT. Imfarmind Farmasi Industri 9,000,000
22 PT. Indofarma (Persero) Tbk 41,569,500
23 PT. KALBE FARMA Tbk 1,550,000
24 PT. Kimia Farma (Persero) Tbk 229,704,000
25 PT. LUCAS DJAJA 75,920,000
26 PT. Merck Tbk 1,625,000
27 PT. Mersifarma Tirmaku Mercusana 68,860,000
28 PT. Natura Laboratoria Prima 16,000,000
29 PT. Pertiwi Agung 40,500,000
30 PT. PHARMA LABORATORIES 199,899,000
31 PT. Phyto Kemo Agung Farma 44,108,000
32 PT. PROMEDRAHARDJO FARMASI INDUSTRI 30,150,000
33 PT. Boehringer Ingelheim 5,002,500
34 PT. Sinaraya Nugraha Ahmadaris medika 21,074,850
35 PT. Rajawali Nusindo 20,621,700
JUMLAH 2,323,910,486
AT 2016
Realisasi Persentasi
534,573,756 100%
29,802,968 25%
8,850,000 39%
9,490,000 100%
69,201,000 39%
65,520,000 88%
- 0%
44,052,000 76%
- 0%
7,600,000 100%
197,039,500 100%
10,650,000 23%
16,500,000 100%
37,820,000 100%
35,100,000 100%
- 0%
2,000,000 100%
- 0%
- 0%
4,500,000 100%
- 0%
41,569,500 100%
- 0%
- 0%
- 0%
1,625,000 100%
6,120,000 9%
- 0%
40,500,000 100%
- 0%
- 0%
- 0%
5,002,500 100%
21,074,850 100%
8,895,960 43%
1,197,487,034 52%
sapta sari farma
PT. Bio Axion Healthindo
PT. Rama emerald multi sukses
PT. MARIN LIZA FARMASI
PT. Holi Pharma
PT. LUCAS DJAJA

IGM
PT. Mersifarma Tirmaku Mercusana
PT. Indofarma (Persero) Tbk
PT. Imfarmind Farmasi Industri
PT. IFARS PHARMACEUTICAL LABORATORIES
PT. Graha Farma
PT. Widatra Bhakti
PT. Novapharin
PT. Erela

RAJAWALI
PT. Sinaraya Nugraha Ahmadaris medika
PT. Ahmadaris
PT. Rajawali Nusindo
PT. Yarindo Farmatama
PT. Phapros Tbk

KF
PT. PROMEDRAHARDJO FARMASI INDUSTRI
PT. PHARMA LABORATORIES
PT. Phyto Kemo Agung Farma
PT. Kimia Farma (Persero) Tbk

AAM
PT. Merck Tbk
PT. ACTAVIS INDONESIA
PT. Dexa Medica
MDI
PT. Natura Laboratoria Prima
PT. Bernofarm

MPI
PT. ERRITA PHARMA
PT. GUARDIAN PHARMATAMA

PARIT PADANG
PT. SOHO Industri Pharmasi
PT. Ethica Industri Farmasi

APL
PT. Combined Imperial Pharmaceuticals

ENSEVAL
PT. KALBE FARMA Tbk

MBS
PT. Pertiwi Agung

TEMPO
PT. Boehringer Ingelheim
 Penyedia
PT. Bio Axion Healthindo

Harga Satuan
# Produk Kuantitas satuan (IDR)
1 AXIMED CHIRURGIC GLOVES, size 6.5 500 piece 7,600.00
2 AXIMED EXAMINATION GLOVES, size L 500 box 46,200.00
3 AXIMED EXAMINATION GLOVES, size M 500 box 46,200.00
4 AXIMED EXAMINATION GLOVES, size S 500 box 46,200.00
5 AXIMED FACE MASK EAR LOOP 1,600 dus 19,800.00
6 AXIMED FACE MASK TIES ON 2,000 dus 24,000.00
7 AXIMED FOLEYCATH, 2 way latex foley cath, no. 12 100 piece 11,000.00
8 AXIMED FOLEYCATH, 2 way latex foley cath, no. 16 350 piece 11,000.00
9 AXIMED FOLEYCATH, 2 way latex foley cath, no. 18 200 piece 11,000.00
10 AXIMED INFUSET 200 piece 4,800.00
11 AXIMED IV-CATH WP, with wings & port, no. 18 2,700 piece 7,000.00
12 AXIMED IV-CATH WP, with wings & port, no. 20 4,000 piece 7,000.00
13 AXIMED IV-CATH WP, with wings & port, no. 22 5,000 piece 7,000.00
14 AXIMED IV-CATH WP, with wings & port, no. 24 2,900 piece 7,000.00
15 AXIMED IV-CATH WP, with wings & port, no. 26 2,000 piece 8,200.00
16 AXIMED NASAL OXYGEN, O2 cannula, size L 300 piece 6,600.00
17 AXIMED NASAL OXYGEN, O2 cannula, size S 200 piece 6,600.00
18 AXIMED NASAL OXYGEN, O2 cannula, size XS 200 piece 6,600.00
19 AXIMED STOMACH TUBE, 85cm, no. 16 113 piece 7,370.00
20 AXIMED PEDIATRIC SET 4,200 piece 5,100.00
21 AXIMED Syringe 1 cc 200 dus 83,000.00
22 AXIMED Syringe 10 cc 50 dus 130,200.00
23 AXIMED Syringe 3 cc 700 dus 82,500.00
24 AXIMED Syringe 5 cc 500 dus 92,800.00
25 AXIMED URINE DRAINAGE BAG, T valve, with hanger 180 piece 5,500.00
TOTAL
Distributor/Pelaksana Pekerjaan
PT SAPTA SARI TAMA CABANG Pontianak

Ongkos Kirim Total Harga

(IDR) (IDR) Realisasi harga item Total Persentase
4,674,000.00 500 9,348.00 4,674,000.00 100%
874,000.00
28,413,000.00 500 56,826.00 28,413,000.00 100%
5,313,000.00
5,313,000.00 28,413,000.00 500 56,826.00 28,413,000.00 100%
28,413,000.00 500 56,826.00 28,413,000.00 100%
5,313,000.00
38,966,400.00 1600 24,354.00 38,966,400.00 100%
7,286,400.00
59,040,000.00 2000 29,520.00 59,040,000.00 100%
11,040,000.00
1,353,000.00 100 13,530.00 1,353,000.00 100%
253,000.00
4,735,500.00 350 13,530.00 4,735,500.00 100%
885,500.00
2,706,000.00 200 13,530.00 2,706,000.00 100%
506,000.00
220,800.00 1,180,800.00 200 5,904.00 1,180,800.00 100%
23,247,000.00 2700 8,610.00 23,247,000.00 100%
4,347,000.00
34,440,000.00 4000 8,610.00 34,440,000.00 100%
6,440,000.00
43,050,000.00 5000 8,610.00 43,050,000.00 100%
8,050,000.00
24,969,000.00 2900 8,610.00 24,969,000.00 100%
4,669,000.00
20,172,000.00 2000 10,086.00 20,172,000.00 100%
3,772,000.00
2,435,400.00 300 8,118.00 2,435,400.00 100%
455,400.00
1,623,600.00 200 8,118.00 1,623,600.00 100%
303,600.00
1,623,600.00 200 8,118.00 1,623,600.00 100%
303,600.00
1,024,356.00 113 9,065.10 1,024,356.00 100%
191,546.00
26,346,600.00 4200 6,273.00 26,346,600.00 100%
4,926,600.00
20,418,000.00 200 102,090.00 20,418,000.00 100%
3,818,000.00
8,007,300.00 50 160,146.00 8,007,300.00 100%
1,497,300.00
71,032,500.00 700 101,475.00 71,032,500.00 100%
13,282,500.00
10,672,000.00 57,072,000.00 500 114,144.00 57,072,000.00 100%
1,217,700.00 180 6,765.00 1,217,700.00 100%
227,700.00
534,573,756.00 ### 100%
 Penyedia
PT.Phapros Tbk

2 Produk jumlah
1 Natrium diklofenak tablet/kapsul/kaplet 50 mg 100,000
2 Natrium diklofenak tablet/kapsul/kaplet 25 mg 100,000
3 Kaptopril tablet/kaplet scored 12,5 mg 100,000
4 Nistatin vaginal tablet 100.000 IU/ g 2,000
5 Nistatin tablet/kaplet salut 500.000 IU/ g 23,000
6 STREPTOMISIN SERBUK INJ IV 1000 mg/ml 1,120
7 Obat Anti Tuberculosis FDC Kategori II 20
8 Ketorolak inj 30 mg/ml 10,000
9 Obat Anti Tuberculosis FDC Kategori Sisipan 40
10 Gemfibrozil tablet/kapsul/kaplet 300 mg 5,000
TOTAL
Distributor/Pelaksana Pekerjaan
PT Rajawali Nusindo Cabang Pontianak

Kuantitas Harga Satuan Total Harga

tablet 161.00 16,100,000.00
tablet 167.00 16,700,000.00
tablet 69.00 6,900,000.00
tablet 602.00 1,204,000.00
tablet 857.00 19,711,000.00
Vial 5,750.00 6,440,000.00
pack 1,379,984.00 27,599,680.00
Ampul 1,383.00 13,830,000.00
pack 183,984.00 7,359,360.00
tablet 436.00 2,180,000.00
118,024,040.00
realisasi Total Persentase
- 0%
- 0%
- 0%
- 0%
23000 19,711,000 100%
896 5,152,000 80%
2 2,759,968 10%
- 0%
- 0%
5000 2,180,000 100%
29,802,968 25%
 Penyedia
PT.ERELA

# Produk jumlah Satuan

1 Setirizin sirup 5 mg/5 ml 3,000 bottle
2 Gentamisin tetes mata 0,3% 3,000 bottle
TOTAL
Distributor/Pelaksana Pekerjaan
PT. Indofarma Global Medika Pontianak

Harga Satuan Total Harga realisasi

2,950 8,850,000 3000
4,600 13,800,000
22,650,000.00
Total Persentase
8,850,000 100%
- 0%
8,850,000 39%
 Penyedia
PT Yarindo Farmatama

# Produk jumlah Satuan

1 Issosorbid Dinitrat 5 mg 30,000 Tablet
2 Amitriptiline tablet 25 mg 20,000 Tablet
3 Salbutamol 2 mg (sebagai Sulfat) 50,000 Tablet
TOTAL
Distributor/Pelaksana Pekerjaan
PT. Rajawali Nusindo Cabang Pontianak

Harga Satuan Total Harga realisasi

93 2,790,000 30000
165 3,300,000 20000
68 3,400,000 50000
9,490,000.00
Total Persentase
2,790,000 100%
3,300,000 100%
3,400,000 100%
9,490,000 100%
 Penyedia
PT. RAMA EMERALD MULTI SUKSES

# Produk
1 Betametason krim0,1% (Sebagai Valerat)
2 Eritromisin kaplet 500mg
3 Bedak Salisil serbuk 2%
4 Ibuprofen Suspensi 100 mg/5 ml
6 Asam Folat tablet 0,4 mg
7 Alopurinol tablet 100 mg
8 Kotrimoksazol (Dewasa ) kombinasi tiap 5 ml
Suspensi :Sulfametoksazol 200 mg + Trimetoprim 40 mg
9 Amoksisilin sirup kering 125 mg/5 ml
10 Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg/5
ml, Magnesium Hidroksida 200 mg/ 5 ml.
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Sapta Sari Tama Cabang Pontianak

jumlah Kuantitas Harga Satuan

4,000 tube 1,435
8,000 kaplet 766
500 box 1,066
5,000 bottle 2,560
7,500 tablet 68
100,000 tablet 95
15,000 bottle 2,225

20,000 bottle 2,200

30,000 bottle 2,106
Total Harga realisasi Total Persentase
5,740,000.00 4,000 5,740,000 100%
6,128,000.00 8,000 6,128,000 100%
533,000.00 500 533,000 100%
12,800,000.00 5,000 12,800,000 100%
510,000.00 - 0%
9,500,000.00 - 0%
33,375,000.00 - 0%

44,000,000.00 20,000 44,000,000 100%

63,180,000.00 - 0%

175,766,000.00 69,201,000 39%

 Penyedia
PT NOVAPHARIN
# Produk
1 Ibuprofen tablet/kapsul/kaplet 200 mg
2 Tiamin (Vitamin B1) tablet/kapsul/kaplet 50 mg
3 (HCl/ Nitrat)kapsul/kaplet 250 mg
Amoksisilin
4 Domperidon suspensi/sirup 5 mg/5 ml
5 Klorfeniramina Maleat (CTM)
6 tablet/kapsul/kaplet 4 mg
Tetrasiklin tablet/kapsul/kaplet 500 mg
7 Siprofloksasin tab scored 500 mg
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. INDOFARMA GLOBAL MEDIKA - PONTIANAK
jumlah Kuantitas Harga Satuan
10,000 Tablet 111
100,000 Tablet 91
40,000 Capsule 207
7,000 Bottle 3,180
200,000 Tablet 45
30,000 Capsule 329
50,000 Tablet 298
ONTIANAK
Total Harga realisasi Total Persentase
1,110,000.00 10000 1,110,000 100%
9,100,000.00 100000 9,100,000 100%
8,280,000.00 40000 8,280,000 100%
22,260,000.00 7000 22,260,000 100%
9,000,000.00 - 0%
9,870,000.00 30000 9,870,000 100%
14,900,000.00 50000 14,900,000 100%
74,520,000.00 65,520,000 88%
 Penyedia
PT. MARIN LIZA FARMASI
# Produk jumlah Satuan
1 Antifungi DOEN Salep, Kombinasi: Asam 1,000 Unit
Benzoat 6% Asam Salisilat 3% (Whitfield)
2 Salep 2-4 , Kombinasi : Asam Salisilat 2% + 8,000 Unit
Belerang endap 4%
TOTAL
Distributor/Pelaksana Pekerjaan
PT. Sapta Sari Tama Cabang Pontianak [Baru]
Harga Satuan Total Harga realisasi
4,782 4,782,000

2,797 22,376,000

27,158,000.00
Total Persentase
- 0%

- 0%

- 0%
 Penyedia
P.T. Dexa Medica

# Produk jumlah
1 Metformin HCl tablet/kapsul/kaplet 500 mg 50,000
2 Asam traneksamat injeksi 100 mg/ml 5,000
3 Nifedipin tablet 10 mg 24,000
4 Ranitidin tablet 150 mg 300,000
TOTAL
 Distributor/Pelaksana Pekerjaan
Pt Anugrah Argon Medica Pontianak
Satuan Harga Satuan Total Harga
Tablet 108 5,400,000
Vial 2,789 13,945,000
Tablet 123 2,952,000
Tablet 119 35,700,000
57,997,000.00
realisasi Total Persentase
50000 5,400,000 100%
- 0%
24000 2,952,000 100%
300000 35,700,000 100%
44,052,000 76%
 Penyedia
PT ACTAVIS INDONESIA
# Produk jumlah
1 Diazepam larutan rektal 10 mg/2,5 mL 500
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. AAM Pontianak
Satuan Harga Satuan Total Harga
Tube 18,458 9,229,000
9,229,000.00
realisasi Total Persentase
- 0%
- 0%
 Penyedia
PT Ethica Industri Farmasi
# Produk jumlah
1 OXYTOCIN INJLQ 10 IU Oksitosin inj 10 UI/ml 4,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Parit Padang Global Pontianak

Satuan Harga Satuan Total Harga

Ampul 1900 7,600,000
7,600,000.00
realisasi Total Persentase
4000 7,600,000 100%
7,600,000 100%
 Penyedia
PT. Ahmadaris
# Produk jumlah
1 Ahmadaris Kapas pembalut hidrofil 250 gr 2,000
2 Ahmadaris Kasa hidrofil DRC 36m x 80 cm 500
3 Ahmadaris Kasa hidrofil DRC 2m x 80 cm 3,000
4 Ahmadaris Kasa Pembalut hidrofil DRC 4m x 3cm 3,600
5 Ahmadaris Kasa Pembalut hidrofil DRC 4m x 15cm 3,000
6 Ahmadaris Kasa kompres DRC 40cm x 40cm 5,000
7 Ahmadaris Kasa Steril DRc 16cm x 16cm 2,000
TOTAL
 Distributor/Pelaksana Pekerjaan Rajawali Nusindo Pontianak

Satuan Harga Satuan Ongkos kirim

Roll 24,000 7,500,000
Roll 130,000 4,500,000
Piece 9,400 2,182,500
Roll 800 232,500
Roll 3,800 600,000
Piece 1,800 562,500
Box 7,900 1,182,000
Total Harga realisasi harga item Total
55,500,000 2,000 27,750 55,500,000
69,500,000 500 139,000 69,500,000
30,382,500 3,000 10,128 30,382,500
3,112,500 3,600 865 3,112,500
12,000,000 3,000 4,000 12,000,000
9,562,500 5,000 1,913 9,562,500
16,982,000 2,000 8,491 16,982,000
197,039,500.00 197,039,500
Persentase
100%
100%
100%
100%
100%
100%
100%
100%
 Penyedia Widatra Bhakti

# Produk jumlah
1 Glukosa larutan infus 10% 500
2 Glukosa larutan infus 5 % steril 1,000
3 Ringer Laktat 5,000
TOTAL
Distributor/Pelaksana Pekerjaan
PT. Indofarma Global Medika Pontianak

Satuan Harga Satuan Total Harga

Bottle 7,500 3,750,000
Bottle 6,900 6,900,000
Bottle 7,150 35,750,000
46,400,000.00
realisasi Total Persentase
500 3,750,000 100%
1000 6,900,000 100%
- 0%
10,650,000 23%
 Penyedia
PT. SOHO Industri Pharmasi
# Produk jumlah
1 ONDANSETRON 4 MG INJ 2 ML Ondansetron Injeksi 2 mg/ 10,000
ml
TOTAL
(4 mg/ 2 ml)
 Distributor/Pelaksana Pekerjaan
PT. Parit Padang Global Pontianak

Satuan Harga Satuan Total Harga

ampul 1650 16,500,000
16,500,000.00
realisasi Total Persentase
10000 16,500,000 100%
16,500,000 100%
 Penyedia berno farm

# Produk jumlah
1 Rifampisin tablet/kapsul/kaplet 600 mg 7,000
2 Loratadin tablet/kapsul/kaplet 10 mg 70,000
3 Deksametason injeksi i.v./i.m. 5 mg/ml 10,000
TOTAL
Distributor/Pelaksana Pekerjaan
metro drug indonesia
Satuan Harga Satuan Total Harga
Kaplet 1,420 9,940,000
Kaplet 149 10,430,000
Ampul 1,745 17,450,000
37,820,000.00
realisasi Total Persentase
7000 9,940,000 100%
70000 10,430,000 100%
10000 17,450,000 100%
37,820,000 100%
 PT. Combined Imperial pharmaceutical

# Produk jumlah
1 Zinc Pro Drop - zinc elemental 10 mg / ml 3,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Anugrah Pharmindo Lestari Pontianak

Satuan Harga Satuan Total Harga

bottle 11700 35,100,000
35,100,000.00
realisasi Total Persentase
3000 35,100,000 100%
35,100,000 100%
 Penyedia
PT. ERRITA PHARMA
# Produk jumlah
1 Omeprazol kapsul 20 mg 20,010
2 Parasetamol sirup 120 mg/ 5ml 25,000
3 Asam Mefenamat kaplet 500 mg 500,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Millennium Pharmacon International, Tbk. (KALBAR -

Satuan Harga Satuan Total Harga

Capsule 164 3,281,640
Bottle 1,119 27,975,000
Kaplet Salut 113 56,500,000
87,756,640.00
realisasi Total Persentase
- 0%
- 0%
- 0%
- 0%
 Penyedia
PT. Graha Farma
# Produk jumlah
1 Metoklopramid 10 mg 20,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. INDOFARMA GLOBAL MEDIKA PONTIANAK
Satuan Harga Satuan Total Harga
Tablet 100 2,000,000
2,000,000.00
realisasi Total Persentase
20000 2,000,000 100%
2,000,000 100%
 Penyedia
PT. GUARDIAN PHARMATAMA
# Produk jumlah
1 Risperidon 2 mg 10,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. MILLENIUM PHARMACON INTERNATIONAL (Cab.
Satuan Harga Satuan Total Harga
Tablet 495 4,950,000
4,950,000.00
realisasi Total Persentase
- 0%
- 0%
 Penyedia
PT. Holi Pharma
# Produk jumlah
1 Tetrasiklin kapsul/kaplet 250 mg 10,000
2 Sefotaksim Serbuk Injeksi 500 mg 400
3 Kotrimoksazol DOEN I (dewasa) kombinasi : Sulfamet 106,000
4 Sefadroksil kapsul/kaplet 500 mg 50,000
5 Haloperidol Tablet 0,5 mg 5,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Sapta Sari Tama Cabang Pontianak
Satuan Harga Satuan Total Harga
Tablet 174 1,740,000
Vial 6,485 2,594,000
Tablet 158 16,748,000
Capsule 557 27,850,000
Tablet 64 320,000
49,252,000.00
realisasi Total Persentase
- 0%
- 0%
- 0%
- 0%
- 0%
- 0%
 Penyedia
PT. IFARS PHARMACEUTICAL LABORATORIES
# Produk jumlah
1 Loperamid tablet 2 mg 50,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Indofarma Global Medika Cabang Pontianak
Satuan Harga Satuan Total Harga
Tablet 90 4,500,000
4,500,000.00
realisasi Total Persentase
50000 4,500,000 100%
4,500,000 100%
 Penyedia
PT.Imfarmind Farmasi Industri
# Produk jumlah
1 Asam Askorbat (Vitamin C) tablet 50 mg 200,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT.Indofarma Global Medika - Pontianak
Satuan Harga Satuan Total Harga
Tablet 45 9,000,000
9,000,000.00
realisasi Total Persentase
- 0%
- 0%
 Penyedia
PT. Indofarma (Persero) Tbk
# Produk jumlah
1 Rifampisin tablet/kapsul/kaplet 450 mg 4,500
2 Kaptopril tablet/kapsul/kaplet 50 mg 50,000
3 Zinc tablet dispersible 20 mg 20,000
4 Parasetamol drop 100 mg/ml btl @15ml 3,000
(60mg/0,6ml) (G)
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Indofarma Global Medika Cabang Pontianak
Satuan Harga Satuan Total Harga
Capsule 1,031 4,639,500
Tablet 143 7,150,000
Tablet 592 11,840,000
Bottle 5,980 17,940,000
41,569,500.00
realisasi Total Persentase
4,500 4,639,500 100%
50,000 7,150,000 100%
20,000 11,840,000 100%
3,000 17,940,000 100%
41,569,500 100%
 Penyedia
PT KALBE FARMA Tbk
# Produk jumlah
1 Teofilin Tab 150 mg 5,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. ENSEVAL PUTERA MEGATRADING Cabang Pontianak
Satuan Harga Satuan Total Harga
Tablet 310 1,550,000
1,550,000.00
realisasi Total Persentase
- 0%
- 0%
 Penyedia
PT. Kimia Farma (Persero) Tbk
# Produk jumlah
1 Diltiazem HCl tablet 30 mg 3,000
2 Kloramfenikol salep mata 1 % 3,000
3 Ketokonazol krim 2% 3,000
4 hidroklorotiazid tab 25 mg 400,000
5 Vitamin B Kompleks tablet 500,000
6 Retinol (Vitamin A) 100.000 IU 125,000
7 Hidrokortison krim 2,5 % 15,000
TOTAL
 Distributor/Pelaksana Pekerjaan
KFTD PONTIANAK
Satuan Harga Satuan Total Harga
Tablet 128 384,000
Tube 1,850 5,550,000
Tube 2,605 7,815,000
Tablet 171 68,400,000
Tablet 132 66,000,000
Capsule 327 40,875,000
Tube 2,712 40,680,000
229,704,000.00
realisasi Total Persentase
- 0%
- 0%
- 0%
- 0%
- 0%
- 0%
- 0%
- 0%
 Penyedia
PT. LUCAS DJAJA
# Produk jumlah
1 Lidokain injeksi 2% (HCl) + Epinefrin 1: 80.000 - 30,000
2 2 mL
Sianokobalamin (vitamin B12) injeksi 500 mcg 10,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Sapta Sari Tama Cabang Pontianak [Baru]
Satuan Harga Satuan Total Harga
Ampul 2,122 63,660,000
Ampul 1,226 12,260,000
75,920,000.00
realisasi Total Persentase
- 0%
- 0%
- 0%
 Penyedia
PT. Merck Tbk
# Produk jumlah
1 CONCOR 2.5 - Bisoprolol tablet 2,5 mg 2,500
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. ANUGRAH ARGON MEDICA CABANG PONTIANAK
Satuan Harga Satuan Total Harga
Tablet 650 1,625,000
1,625,000.00
realisasi Total Persentase
2500 1,625,000 100%
1,625,000 100%
 Penyedia
PT. Mersifarma Tirmaku Mercusana
# Produk jumlah
1 ALPRAZOLAM TABLET 0,5 MG - Alprazolam tablet/kapsu 10,000
2 Kalsium Laktat (Kalk) tablet/kapsul/kaplet 500 mg 300,000
3 PARASETAMOL KAPLET 500 MG - Parasetamol tablet/ka 700,000
4 KARBAMAZEPIN KAPLET 200 MG - Karbamazepin tablet 20,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Indofarma Global Medika - Pontianak
Satuan Harga Satuan Total Harga
Tablet 144 1,440,000
Tablet 69 20,700,000
Tablet 58 40,600,000
Kaplet 306 6,120,000
68,860,000.00
realisasi Total Persentase
- 0%
- 0%
- 0%
20000 6,120,000 100%
6,120,000 9%
 Penyedia
PT. Natura Laboratoria Prima
# Produk jumlah
1 Ranitidin injeksi 25 mg/ml 10,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT METRO DRUG INDONESIA - Pontianak
Satuan Harga Satuan Total Harga
Ampul 1,600 16,000,000
16,000,000.00
realisasi Total Persentase
- 0%
- 0%
 Penyedia
Pertiwi
# Produk jumlah
1 Simvastatin scored tablet 10 mg 300,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT MBS - Pontianak
Satuan Harga Satuan Total Harga
Tablet 135 40,500,000
40,500,000.00
realisasi Total Persentase
300000 40,500,000 100%
40,500,000 100%
 Penyedia
PT. PHARMA LABORATORIES
# Produk jumlah
1 Amlodipin tablet 10 mg 150,000
2 Amoksisilin kapsul/kaplet/tablet scored 500 mg 753,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT. Kimia Farma Trading & Distribution (Pontianak)
Satuan Harga Satuan Total Harga
Tablet 163 24,450,000
Kaplet 233 175,449,000
199,899,000.00
realisasi Total Persentase
- 0%
- 0%
- 0%
 Penyedia
PT. Phyto
# Produk jumlah
1 Metronidazol tablet 250 mg 35,000
2 Ibuprofen 400 mg Tablet 200,000
3 Eritromisin sirup kering 200 mg/ 5 ml 2,000
TOTAL
 Distributor/Pelaksana Pekerjaan
KFTD PONTIANAK
Satuan Harga Satuan Total Harga
Tablet 98 3,430,000
Tablet 133 26,600,000
Bottle 7039 14,078,000
44,108,000.00
realisasi Total Persentase
- 0%
- 0%
- 0%
- 0%
 Penyedia
PT. PROMEDRAHARDJO FARMASI INDUSTRI
# Produk jumlah
1 Deksametason tablet 0,5 mg 300,000
2 Amlodipin tablet/kapsul/kaplet 5 mg 150,000
TOTAL
 Distributor/Pelaksana Pekerjaan
PT Kimia Farma T&D Cab Pontianak
Satuan Harga Satuan Total Harga
Tablet 48 14,400,000
Tablet 105 15,750,000
30,150,000.00
realisasi Total Persentase
- 0%
- 0%
- 0%
 Penyedia
PT. Boehringer Ingelheim
# Produk jumlah
1 COMBIVENT UDV - Kombinasi : Ipratropium bromida 500
0,5 mg
2 ATROVENT HFA - Ipratropium bromida anhidrous 30
Salbutamol
inhalasi 0.022,5
TOTAL mg cairan inhalasi
mg/dosis
 Distributor/Pelaksana Pekerjaan
PT. TEMPO CABANG PONTIANAK
Satuan Harga Satuan Total Harga
Vial 4995 2,497,500
can 83500 2,505,000
5,002,500.00
realisasi Total Persentase
500 2,497,500 100%
30 2,505,000 100%
5,002,500 100%
 PT. Rajawali Nusindo

# Produk jumlah
1 ECOLAB AQUAGEL STERILE JELY 82gr 150
2 SMI CATGUT PLAIN SMI 2/0 DS 24 MM 108
3 SMI CATGUT PLAIN SMI 3/0 DS 24 MM 108
4 SMI SILK BLACK 3/0 DS 24 MM 204
TOTAL
 Distributor : PT. Rajawali Nusindo

Satuan Harga Satuan Ongkos kirim

Tube 42,588 567,000
Sachet 40,200 106,380
Sachet 40,200 106,380
Sachet 22,400 200,940
Total Harga realisasi harga item Total
6,955,200 46,368 -
4,447,980 108 41,185 4,447,980
4,447,980 108 41,185 4,447,980
4,770,540 23,385 -
20,621,700.00 8,895,960
Persentase
0%
100%
100%
0%
43%
 PT. Sinaraya Nugraha Ahmadaris medika

# Produk jumlah
1 SNA MEDIKA Polifix 5cm x5cm 50
2 SNA MEDIKA Poliban 5cm x 2,7 m 2000
TOTAL
 Distributor : PT. Rajawali Nusindo

Satuan Harga Satuan Ongkos kirim

Roll 39,217 120,000
Roll 7,457 4,080,000
Total Harga realisasi harga item Total
2,080,850 50 41,617 2,080,850
18,994,000 2000 9,497 18,994,000
21,074,850.00 21,074,850
Persentase
100%
100%
100%