Anda di halaman 1dari 12

DINAS KESEHATAN KABUPATEN PANDEGLANG

UPT GUDANG FARMASI PANDEGLANG


Jl. Raya Serang KM. 3 Telp. ( 0253 ) 202089 Pandeglang 42251

DAFTAR HARGA OBAT DLL


TAHUN 2017

NO NAMA OBAT KODE SATUAN

1 2 3 4
1 Albendazol Tablet 400 mg Tablet
3 Ambroxol tablet 30 mg Tablet
4 Ambroxol sirup Botol
5 Aminofilina injeksi 24 mg/ml - 10 ml Ampul
7 Amitriptilin HCL Tablet 25 mg Tablet
8 Amoksisilin 500 mg tablet Tablet
9 Amoksisillin Sirup Kering 125 mg/5 ml Botol
10 Amoksisilin Forte sirup kering 250mg Botol
12 Amlodipin 5 mg Tablet
13 Amlodipin 10 mg Tablet
14 Analog insulin Long Acting Pen
15 Analog insulin Mix Acting Pen
18 Antasida DOEN suspensi Botol
19 ANTASIDA DOEN Tablet Tablet
20 Antiparkinson Tablet ( Levopar ) Tablet
21 Anti Septik Hand Rub Botol
22 Anti Septik Surgikal Hand Scrub Botol
26 Aqua Pro Injeksi Vial
27 Asering Botol
28 Asam Askorbat tablet 50 mg Tablet
29 Asam Fusidat Cream Tube
30 Asam Traneksamat Inj 5% Ampul
31 Asam Mefenamat 500 mg Tablet
32 Asam Folat 1 mg Tablet
33 Artesunate injeksi 60 mg/ml vial
34 Artermether injeksi Vial
37 Asam Asetil Salicilat 100 mg tablet Tablet
39 Asiklovir tablet 200 mg Tablet
40 Asiklovir tablet 400 mg Tablet
41 Asiklovir Cream 5% Tube
42 Atropin Sulfat tablet 0,5 mg Tablet
46 Bisakodil Suppositoria supp
47 Bisoprolol 2,5MG Tablet
48 Cairan Pembersih ( Protektor ) Botol
49 Captopril Tablet 25 mg Tablet
50 Captopril Tablet 12,5 mg Tablet
51 Carbamazepin 200 mg tablet Tablet
52 Cefadroxil Capsul 500 mg Capsul
53 Cefixime Capsul 100 mg Capsul
54 Cefixime Sirup Botol
55 Cefotaksime 1 gr Injeksi Vial
56 Cetirizine sirup 5 mg/5 ml Botol
59 Clobazam 10 mg Tablet Tablet
60 Clozapine 25 mg Tablet Tablet
61 D-Artepp tablet Tablet
62 Deksametason tablet 0,5 mg Tablet
63 Deksametason injeksi 1 ml Ampul
64 Doxicyclin 500mg capsul
67 Diazepam Rektal 0,5 mg supp
68 Diazepam tablet 2 mg Tablet
69 Diazepam injeksi 2 ml Ampul
71 Difenhidramin HCL injeksi 10 mg/ml - 1ml Ampul
72 Digoksin tablet 0,25 mg Tablet
73 Efedrin HCL tablet 25 mg Tablet
74 Domperidon 10mg Tablet Tablet
76 Epinefrina HCL/Bitartrat Injeksi Ampul
81 Erytromicin sirup 125 mg Botol
83 Etil Klorida Semprot Botol
84 Fenitoin Natrium kapsul 30 mg Kapsul
85 Fenobarbital injeksi 50 mg/ml - 2 ml Ampul
86 Fenobarbital Tablet 30 mg Tablet
90 Fitomenadion (Vit.K1) Injeksi 10 mg/ml-1 ml Ampul
91 Fitomenadion (Vit.K1) tab salut gula 10 mg Tablet
94 Glimepiride 2 mg Tablet
95 Garam Oralit Sachet
96 Glibenclamid tablet 5 mg Tablet
97 Gentamicin Salep Kulit Tube
98 Gentamicin Salep mata Tube
99 Glicerin Guaiacolat ( GG ) 100 mg Tablet
100 Griseofulvin tablet 500 mg, Tablet
101 Griseofulvin tablet 125 mg, Tablet
102 Hidroklorotiazid (HCT) tab. 25 mg Tablet
103 Gemfibrozil Tablet
108 Glikazid 80 mg Tablet Tablet
109 Haloperidol 5 mg Tablet Tablet
110 Haloperidol 2 mg tablet Tablet
111 Hidrokortison krim 2,5% Tube
112 Ibuprofen tablet 200 mg Tablet
113 Isoniazid tablet 300 mg Tablet
116 Ibuprofen Suspensi Tablet
119 Imunomodulator sirup( STIMUNO) Botol
120 Kalsium Laktat (Kalk) tablet 500 mg Tablet
122 Ketorolac inj Ampul
123 Kalsium Glukonas Injeksi Ampul
124 Kloramphenicol 500 mg capsul
125 Kaen 3 B cairan infus Botol
128 Klorfeniramin Maleat (CTM) tablet 4 mg Tablet
131 Ketokonazol Kream Tube
133 Klorpromazin HCL tablet salut 25 mg Tablet
134 Klorpromazin HCL tablet salut 100 mg Tablet
139 Kotrimoksazol Dewasa Tablet 480 MG Tablet
140 Kuinin Dihidroklorida injeksi 25% - 2 ml Botol
141 Lactobacilus serbuk Sachet
142 Lidocain injeksi 2 ml Ampul
143 Lidocain 2%+efinefrin injeksi Ampul
144 Lisinopril 5 mg tablet Tablet
145 Lisinopril 10 mg tablet Tablet
146 Loperamid 2 mg tablet Tablet
148 Magnesium Sulfat injeksi 25 ml Blister
150 MDT MB Anak Tablet Blister
151 MDT MB Dewasa Tablet Tablet
152 MDT PB Dewasa Tablet Tablet
154 Metampiron tablet 500 mg Tablet
155 Metformin 500 mg Tablet Tablet
156 Metilergometrin Maleat (Metilergometrin) injeksi 1 ml Ampul
157 Metilergometrin tablet Tablet
160 Metronidazol 500 mg Tablet
161 Metronidazol suspensi Botol
162 Methilprednisolon tablet 8 mg Tablet
163 Metoklopramid Suspensi Botol
164 Metoklopramid tablet Tablet
165 Mikonazol kream Tube
166 Multivitamin Anak ( Sanbe Kids ) Botol
167 Multivitamin Dewasa Antioksidan ( Becom c ) Tablet
168 Multivitamin Dewasa ( Panviton ) Tablet
169 Natrium Klorida Cairan Infus ( NaCl ) Botol
171 Natrium Diklofenak 25 mg Tablet
174 Nifedipine Tablet 10 mg Tablet
176 Obat Anti Diare Tablet (Akita / Molagit ) Tablet
177 Obat Antituberkulosis kategori 2 Paket
178 Obat Antituberkulosis kategori 1 Paket
179 Obat Antituberkulosis Kategori Anak Paket
180 Obat Batuk Flu Kapsul Kapsul
182 Obat Batuk Sirup Herbal ( Herbacop ) Botol
183 Ofloxsacin Tetes Telinga Tube
184 Oksitosin injeksi 10 IU/ml - 1 ml Ampul
186 Omeprazol injeksi Ampul
187 Omeprazol Kapsul 20 mg capsul
188 Ondancentron Tablet 4 mg Tablet
189 Ondancentron injeksi 4 mg Ampul
190 Parafin Dresing ( Bioplacenton Tull ) pcs
192 Parasetamol tablet 500 mg Tablet
193 Paracetamol Sirup 120 mg/5 ml Botol
194 Paracetamol Drop Botol
195 Permetrin Krim 5 % Tube
196 Pirantel Sirup Botol
197 Pirantel tablet 25 mg Tablet
200 piridoksin HCL (VIT B6) tablet 10mg Botol
201 Piroksikam tablet 10 mg Tablet
203 povidon lodida 10% 300 ml Botol
204 povidon lodida 10% 60 ml Tablet
205 POT Dahak Steril Pot
206 Prednison Tablet 5 mg Tablet
207 POT Dahak Non Steril Pot
208 Primakuin Tablet
209 Propanolol HCL tablet 10 mg Tablet
210 Probenesid 500 mg tablet Tablet
211 Resperidone 2 mg tablet Tablet
213 Ranitidin injeksi Ampul
214 Ranitidin tablet Tablet
215 Reagen Ziehl Neelsen Kit
216 Retinol (Vitamin A) kapsul 200.000 IU capsul
217 Retinol (Vitamin A) kapsul 100.000 IU capsul
218 Ringer Laktat cairan infus Botol
219 Salbutamol tablet 4mg Tablet
220 Salbutamol Tablet 2 mg Tablet
221 Salbutamol Nebulizer ( Ventolin ) Vial
223 Salep kombinasi cream ( Berloson ) Tube
224 Setirizin Tablet 10 mg Tablet
225 Salep 2-4 Tube
226 Serum Anti Bisa Ular Inj. 5ml Vial
227 Serum Anti Tetanus inj 1500 IU Vial
228 Sukralfat tablet 500 mg Tablet
230 Tablet Penambah Darah Tablet
231 Simvastatin 20 mg tablet Tablet
232 Sianokobalamin Injeksi Ampul
234 Tablet Tambah Darah Sachet
237 Tetrasiklin 250 mg capsul capsul
238 Tetrasiklin 500 mg capsul capsul
239 Triheksilfenidil Hcl 2 mg tablet Tablet
240 Underpad Lembar
241 Urine Bag Biji
242 Vitamin B komplek Tablet
243 Zink sirup Botol

NAMA BAHAN MEDIS HABIS PAKAI (BMHP )


247 Alat suntik 10 ml Pcs
248 Alat suntik 20 ml Pcs
249 Alat suntik 1 ml Pcs
250 Alat suntik 2,5 ml Pcs
251 Alat suntik 3 ml Pcs
252 Alat suntik 5 ml pcs
253 Alkohol swab Sachet
255 Cat Gut no 2/0 Sachet
256 Cat Gut no 3/0 Sachet
257 Cathetter Jelly Biji
258 Demetech Silk 3/0 Set
259 E Care I.V Dresing Lembar
260 Folly No 14 Catether pcs
261 Folly No 16 Catether pcs
262 I.V Cathetter No. 20 Set
263 I.V Cathetter No. 22 Set
264 I.V Cathetter No. 24 Set
265 Infuset Dewasa ( Otsuka ) Set
266 I.V Cathetter No. 26 Set
267 Infuset Anak Set
268 Infuset Dewasa Set
269 Jarum Insulin Tablet
270 Kapas Berlemak 250 gr Bungkus
272 Kasa 4 m x 10 cm Rol
273 Kasa Hidrofil 36 x 80 cm Rol
274 Kasa Steril 16 x 16 cm Kotak
275 Masker tali (E Care Surgical Mask Tie On) Tube
276 Masker karet Sachet
278 Plester 1" Rol
279 Sarung tangan M (Non Steril) Aximed Pasang
280 Sarung tangan no 6,5 Cosmo Pasang
281 Sarung tangan no 6,5 Steril Pasang
282 Sarung tangan no 7,0 Steril Pasang
NAMA OBAT REAGEN
285 Chikungunya IgM (Reagen) Kotak
286 Dengue IgM / IgM ( Reagen ) Kotak
287 Leptospira IgM (Reagen) Kotak
288 NS1 Antigen Test (Reagen) Kotak

Pelaksana Opname Fisik Persediaan

( Sylvianti T Maharani, MPH., Apt )


NIP. 198607062010012 010

( Yuliati )
NIP. 196109031987032 003
Mengetahui
Kepala UPT Gudang Farmasi
Kabupaten Pandeglang

Didiek Hendro Bawono.SKM


NIP. 196604301992031 004
DEGLANG
ANG

HARGA
SATUAN
5
406
169
7,499
3,345
143
232
2,445
3,984
105
330
425,000
550,000
2,140
61
1,500
60,800
74,000
2,750
9,275
95
5,506
24,449
106
63
14,250
1,000
130
237
348
6,490
1,672
5,670
650
22,000
68
62
269
516
590
7,490
5,500
2,849
969
1,548
1,000
44
1,580
269
11,516
45
4,180
1,176
105
51
118
2,204
67
132,000
154
1,969
165
3,550
695
288
380
178
2,829
2,600
51
2,200
219
149
380
235
96
126
2,650
104
97
3,499
20,680
62
1,290
9,955
1,007
10,050
42
2,545
148
149
150
6,200
12,700
860
1,845
375
448
85
3,200
21,750
30,595
9,770
380
100
2,684
154
133
3,799
309
2,345
91
3,250
35,000
1,320
1,316
6,410
145
108
450
1,199,990
359,619
160,000
366
12,210
45,989
1,900
16,997
160
471
1,650
10,400
199
1,438
5,199
12,155
8,360
291
45
143
14,203
6,550
5,890
114
1,750
224
60
1,780
1,008
1,140
105
276,600
459
284
7,150
83
66
110
11,100
143
2,429
501,050
137,500
368
400
252
1,098
1,740
163
300
88
7,956
7,036
43
6,290

1,067
2,650
777
649
825
856
197
52,000
44,953
41,600
20,833
2,200
16,610
12,036
4,794
12,342
4,794
7,920
13,464
5,100
4,182
2,083
12,250
1,440
127,600
5,500
553
740
8,167
924
1,018
4,500
4,500

2,750,000
1,584,000
2,090,000
2,200,000

e Fisik Persediaan
tahui
dang Farmasi
Pandeglang

Bawono.SKM
1992031 004

Anda mungkin juga menyukai