31 KLONIDIN 0,15 MG TABLET TAB 6,000 Rp 184.00 Rp 1,104,000.00 PT.

Kimia Farma
32 KLORFENIRAMIN MALEAT 4 MG TABLET TAB 120,000 Rp 51.00 Rp 6,120,000.00 PT.Rama Emerald Multi Sukses
33 KOTRIMOKSAZOL SUSPENSI BTL 3,600 Rp 2,350.00 Rp 8,460,000.00 PT.Novapharin
34 KOTRIMOKSAZOL DEWASA TABLET TAB 12,000 Rp 152.00 Rp 1,824,000.00 PT.Holi Pharma
35 METFORMIN 500 MG TABLET TAB 6,000 Rp 112.50 Rp 675,000.00 PT.Bernofarm
36 METIL ERGOMETRIN MALEAT TABLET TAB 2,400 Rp 154.00 Rp 369,600.00 PT.Kimia Farma
37 METRONIDAZOL 250 MG TABLET TAB 12,000 Rp 110.00 Rp 1,320,000.00 PT.Phyto Kemo Agung Farma
38 METRONIDAZOL 500 MG TABLET TAB 18,000 Rp 160.00 Rp 2,880,000.00 PT.Phyto Kemo Agung Farma
39 METRONIDAZOL INFUS BTL 36 Rp 9,950.00 Rp 358,200.00 PT.Natura Laboratoria Prima
40 MIKONAZOL 2 % KRIM TUBE 864 Rp 3,000.00 Rp 2,592,000.00 PT.Kimia Farma
41 NATRIUM DIKLOFENAK 25 MG TABLET TAB 6,000 Rp 133.00 Rp 798,000.00 PT.Phapros TBK
42 NATRIUM DIKLOFENAK 50 MG TABLET TAB 6,000 Rp 200.00 Rp 1,200,000.00 PT.Novel Pharmaceutical Laboratiries
43 NATRIUM KLORIDA 0,9 % INFUS BTL 1,440 Rp 4,700.00 Rp 6,768,000.00 PT.Widatrabhakti
44 NIFEDIPIN TABLET TAB 3,600 Rp 100.00 Rp 360,000.00 PT.Dexa Medika
45 NISTATIN 100,000 IU TABLET VAGINA TAB 400 Rp 480.00 Rp 192,000.00 PT.Phapros TBK
46 NISTATIN 500,000 IU TABLET SALUT TAB 600 Rp 640.00 Rp 384,000.00 PT.Phapros TBK
47 PARASETAMOL 120 MG/ML SIRUP BTL 6,000 Rp 1,438.00 Rp 8,628,000.00 PT.Afi Farma
48 PARASETAMOL 500 MG TABLET TAB 240,000 Rp 89.00 Rp 21,360,000.00 PT.Infamind Farmasi Industri
49 PARASETAMOL DROPS BTL 1,200 Rp 5,200.00 Rp 6,240,000.00 PT.Indofarma
50 PIRIDOKSIN HCL 10 MG TABLET TAB 60,000 Rp 110.00 Rp 6,600,000.00 PT.Kimia Farma
51 POVIDOBNE IODIDA 10% BTL 90 Rp 2,163.00 Rp 194,670.00 PT.Afi Farma
52 PREDNISON 5 MG TABLET TAB 48,000 Rp 114.00 Rp 5,472,000.00 PT.Holi Pharma
53 RANITIDIN 150 MG TABLET TAB 2,400 Rp 120.00 Rp 288,000.00 PT.Dexa Farma
54 SALBUTAMOL 2 MG TABLET TAB 6,000 Rp 59.00 Rp 354,000.00 PT.Yarindo FarmaTama
55 SALEP 2-4 POT 864 Rp 2,000.00 Rp 1,728,000.00 PT.Marin Liza Farmasi
56 SALISIL 2 % BEDAK KTK 2,400 Rp 1,250.00 Rp 3,000,000.00 PT.Rama Emerald Multi Sukses
57 SIANOKOBALAMIN 500 MG/ML INJEKSI AMP 100 Rp 1,077.00 Rp 107,700.00 PT.Lucas Djaja
58 SIANOKOBALAMIN 50 MCG TABLET TAB 36,000 Rp 57.00 Rp 2,052,000.00 PT.Afi Farma
59 SIMVASTATIN TABLET TAB 3,600 Rp 169.00 Rp 608,400.00 PT.Natura Laboratoria Prima
60 TETRASIKLIN 500 MG KAPSUL KAPS 6,000 Rp 300.00 Rp 1,800,000.00 PT.Afi Farma
61 VITAMIN B KOMPLEK TABLET TAB 60,000 Rp 107.00 Rp 6,420,000.00 PT.Kimia Farma
62 Zink TAB 2400 Rp 473.00 Rp 1,135,200.00 PT.Kimia Farma
Rp 228,991,470.00
65 THIAMIN HCL INJEKSI AMP
66 THIAMIN 50 MG TABLET TAB 60,000
67 TRAMADOL INJEKSI AMP
68 TRAMADOL KAPSUL 50 MG KAPS 1,800
69 TRIHEKSIPHENIDIL HCL 2 MG TABLET TAB
70 VITAMIN K INVANT INJEKSI AMP
REAGENSIA
71 LARUTAN ASAM KLORIDA BTL 6
72 LARUTAN BENEDICT BTL 6

OBAT GIGI
73 ALBOTHYL CONCENTRAT BTL 60
74 DEVITALISASI PASTA BTL 4
75 ETIL KLORIDA SEMPROT BTL 160
76 EUGENOL CAIRAN BTL 6
77 GLASS IONOMER CEMENT SET 4
78 KALSIUM HIDROKSIDA PASTA BTL 2
79 LIDOKAIN KOMP INJEKSI AMP 1,080
80 MONOKLORKAMFER MENTHOL CAIRAN BTL 3
81 MUMMYFYING PASTA BTL 2
82 SEMEN SENG FOSFAT BTL
83 TEMPORARY STOPPING FLETCER BTL 12

ALAT KESEHATAN
84 ABOCATH NO 20 SET
85 ABOCATH NO 22 SET
86 ABOCATH NO 24 SET
87 ALAT SUNTIK DISPOSIBLE 2,5 ML SET
88 ALAT SUNTIK DISPOSIBLE 5 ML SET
89 CATGUT KTK
90 INFUSION SET ANAK SET
91 INFUSION SET DEWASA SET
92 KAPAS PEMBALUT 250 MG BKS
93 KASA HIDROFIL STERIL 16 X 16 ROL
94 KASA PEMBALUT 2 M X 80 CM ROL
 95 KASA PEMBALUT 4 M X 10 CM ROL
96 KASA PEMBALUT 4 M X 5 CM ROL
97 PLESTER ROL
98 SILK KTK
99 HANDSCOEN PASANG
100 MASKER UNIT
101 ADS 0,5 ML PCS
102 SAFETY BOX 5 LTR PCS
 RENCANA PENGADAAN OBAT 2015 NON KATALOG

PERKIRAAN HARGA JUMLAH

NO NAMA OBAT SATUAN
KEBUTUHAN 1 TAHUN SATUAN (Rp) HARGA (Rp)
1 ACYCLOVIR KRIM TUBE 300 Rp 2,997.00 Rp 899,100.00
2 ASAM ASKORBAT TABLET TAB 18,000 Rp 62.00 Rp 1,116,000.00
3 BISMECON JELLY / NEOCENTA GEL TUBE 144 Rp 11,880.00 Rp 1,710,720.00
4 CIMETIDIN 200 MG TABLET TAB 3,000 Rp 137.00 Rp 411,000.00
5 ANTI BATUK INFLUENSA SIRUP BTL 1,000 Rp 7,425.00 Rp 7,425,000.00
6 KLORAMFENIKOL 250 MG KAPSUL KAPS 7,200 Rp 288.00 Rp 2,073,600.00
7 KLORAMFENIKOL 125 MG/ML SIRUP BTL 1,080 Rp 4,449.00 Rp 4,804,920.00
8 KLORAMFENIKOL TETES TELINGA 3% BTL 400 Rp 5,600.00 Rp 2,240,000.00
9 LESDIAR TABLET antapulgit TAB 1,200 Rp 190.00 Rp 228,000.00
10 OBAT BATUK HITAM BTL 720 Rp 1,511.00 Rp 1,087,920.00
11 OKSITETRASIKLIN HCL 1 % SALEP MATA TUBE 400 Rp 2,207.00 Rp 882,800.00
12 OKSITETRASIKLIN SALEP KULIT TUBE 400 Rp 1,835.00 Rp 734,000.00
13 OMEGDIAR SIRUP BTL 400 Rp 7,150.00 Rp 2,860,000.00
14 OMEPRAZOLE 20 MG KAPSUL KAPS 400 Rp 581.00 Rp 232,400.00
15 PIROKSIKAM 20 MG TAB 3,000 Rp 111.00 Rp 333,000.00
16 TENSIGARD KAPS 600 Rp 2,234.00 Rp 1,340,400.00
17 THIAMPHENIKOL 500 MG KAPSUL KAPS 9,000 Rp 594.00 Rp 5,346,000.00
18 THIAMIN 50 MG TABLET TAB 12,000 Rp 38.00 Rp 456,000.00
19 ALBOTHYL CONCENTRAT BTL 12 Rp 30,360.00 Rp 364,320.00
20 ETIL KLORIDA SEMPROT BTL 60 Rp 110,616.00 Rp 6,636,960.00
21 DULCOLAK TAB 120 Rp 1,200.00 Rp 144,000.00
22 AMBROXOL SYR (HUFAXOL SYR) SYR 300 Rp 4,000.00 Rp 1,200,000.00
25 ANTALGIN TAB 12,000 Rp 160.00 Rp 1,920,000.00
Rp 61,704,610.00

Mengetahui
Kepala UPTD Puskesmas Balapulang
 dr. Jaka Suyatna
NIP : 19611103 198711 1 001
 RENCANA PENGADAAN OBAT 2015 E-KATALOG

PERKIRAAN HARGA JUMLAH

NO NAMA OBAT SATUAN NAMA PABRIKAN
KEBUTUHAN 1 TAHUN SATUAN (Rp) HARGA (Rp)
1 ACYCLOVIR 200 MG TABLET TAB 800 Rp 237.00 Rp 189,600.00 PT.Indofarma
2 ALLOPURINOL 100 MG TABLET TAB 800 Rp 86.00 Rp 68,800.00 PT. Pertiwi Agung
3 AMLODIPIN 5 MG TABLET TAB 1,500 Rp 187.00 Rp 280,500.00 PT. Pertiwi Agung
4 AMOKSISILLIN 500 MG TABLET TAB 72,000 Rp 272.00 Rp 19,584,000.00 PT.Bernofarm
5 AMOKSISILLIN SIRUP KERING 125 MG BTL 1,200 Rp 2,445.00 Rp 2,934,000.00 PT.Novapharin
6 ASAM MEFENAMAT 500 TABLET TAB 12,000 Rp 112.00 Rp 1,344,000.00 PT.Bernofarm
7 CIPROFLOKSASIN 500 MG TABLET TAB 2,000 Rp 255.00 Rp 510,000.00 PT.Bernofarm
8 DEXAMETHASONE 0,5MG TAB 30,000 Rp 67.50 Rp 2,025,000.00 PT.Bernofarm
9 DIAZEPAM 2 MG TABLET TAB 1,200 Rp 45.00 Rp 54,000.00 PT.Kimia Farma
10 DIMENHIDRINATE 10 MG TABLET TAB 2,400 Rp 104.00 Rp 249,600.00 PT.Kimia Farma
11 FITOMENADION 10 MG TABLET TAB 600 Rp 630.00 Rp 378,000.00 PT.Phapros TBK
12 FUROSEMID 40 MG TABLET TAB 600 Rp 85.00 Rp 51,000.00 PT.Indofarma
14 GENTAMISIN TETES MATA BTL 1,200 Rp 3,194.00 Rp 3,832,800.00 PT.Indofarma
15 GRISEOFULVIN 125 MG TABLET BTL 1,200 Rp 219.00 Rp 262,800.00 PT.Indofarma
18 KAPTOPRIL 25 MG TAB 2,000 Rp 84.00 Rp 168,000.00 PT.Errita Pharma
19 KLONIDIN 0,15 MG TABLET TAB 1,200 Rp 184.00 Rp 220,800.00 PT.Kimia Farma
20 KLORFENIRAMIN MALEAT 4 MG TABLET TAB 12,000 Rp 51.00 Rp 612,000.00 PT.Rama Emerald Multi Sukses
23 METFORMIN 500 MG TABLET TAB 4,000 Rp 112.50 Rp 450,000.00 PT.Bernofarm
24 METRONIDAZOL 500 MG TABLET TAB 4,000 Rp 160.00 Rp 640,000.00 PT.Phyto Kemo Agung Farma
25 METOKLOPRAMIDE 5 MG TAB 200 Rp 108.00 Rp 21,600.00 PT.Kimia Farma
26 MIKONAZOL 2 % KRIM TUBE 400 Rp 3,000.00 Rp 1,200,000.00 PT.Kimia Farma
27 NATRIUM DIKLOFENAK 25 MG TABLET TAB 1,200 Rp 133.00 Rp 159,600.00 PT.Phapros TBK
28 BETAMETASONE 0,1 % KRIM TUBE 400 Rp 1,520.00 Rp 608,000.00 PT.Kimia Farma
29 NIFEDIPIN TABLET TAB 800 Rp 100.00 Rp 80,000.00 PT.Dexa Medika
32 PARASETAMOL 120 MG/ML SIRUP BTL 1,500 Rp 1,438.00 Rp 2,157,000.00 PT.Afi Farma
33 PARASETAMOL 500 MG TABLET TAB 40,000 Rp 89.00 Rp 3,560,000.00 PT.Infamind Farmasi Industri
35 PIRIDOKSIN HCL 10 MG TABLET TAB 12,000 Rp 110.00 Rp 1,320,000.00 PT.Kimia Farma
36 PREDNISON 5 MG TABLET TAB 12,000 Rp 114.00 Rp 1,368,000.00 PT.Holi Pharma
38 SALBUTAMOL 2 MG TABLET TAB 1,200 Rp 59.00 Rp 70,800.00 PT.Yarindo FarmaTama
40 SALEP 24 POT 300 Rp 2,000.00 Rp 600,000.00 PT.Marin Liza Farmasi
41 SALISIL 2 % BEDAK KTK 600 Rp 1,250.00 Rp 750,000.00 PT.Rama Emerald Multi Sukses
42 SIANOKOBALAMIN 50 MCG TABLET TAB 20,000 Rp 57.00 Rp 1,140,000.00 PT.Afi Farma
43 SIMVASTATIN TABLET TAB 400 Rp 169.00 Rp 67,600.00 PT.Natura Laboratoria Prima
45 VITAMIN B KOMPLEK TABLET TAB 20,000 Rp 107.00 Rp 2,140,000.00 PT.Kimia Farma
46 Ceftriaxone Vial 700 Rp 3,000.00 Rp 2,100,000.00
47 Ampisilin Vial 200 Rp 5,100.00 Rp 1,020,000.00
48 Metronidazole inf Botol 12 Rp 9,950.00 Rp 119,400.00
49 Aminophyllin Ampul 40 Rp 3,823.00 Rp 152,920.00
50 Asam Traneksamat Ampul 60 Rp 2,950.00 Rp 177,000.00
51 Vit K Ampul 250 Rp 3,417.00 Rp 854,250.00
52 Dexamethasone Ampul 900 Rp 1,580.00 Rp 1,422,000.00
53 Diazepam Ampul 120 Rp 4,180.00 Rp 501,600.00
54 Epinefrin Ampul 30 Rp 8,100.00 Rp 243,000.00
55 Aquabidest 25ml Flabot 1,000 Rp 2,200.00 Rp 2,200,000.00
56 Oksitosin Ampul 1,500 Rp 2,200.00 Rp 3,300,000.00 PT Ethica Industri Farmasi
57 Lidokain Ampul 330 Rp 1,363.00 Rp 449,790.00 PT Indofarma
58 Chlorampenicol (Colsancetine) Vial 1,000 Rp 7,260.00 Rp 7,260,000.00 PT Sanbe Farma
59 Zink TABLET 20 MG TAB 3,000 Rp 473.00 Rp 1,419,000.00 PT.Kimia Farma
60 RL Flabot 2,400 Rp 5,200.00 Rp 12,480,000.00
61 NaCl Flabot 200 Rp 4,700.00 Rp 940,000.00
62 Glukosa 5% Flabot 120 Rp 5,200.00 Rp 624,000.00
Rp 108,928,460.00

Mengetahui
Kepala UPTD Puskesmas Balapulang

dr. Jaka Suyatna

NIP : 19611103 198711 1 001
 RENCANA PENGADAAN OBAT 2016 NON KATALOG

PERKIRAAN HARGA JUMLAH

NO NAMA OBAT SATUAN
KEBUTUHAN 1 TAHUN SATUAN (Rp) HARGA (Rp)
1 ACYCLOVIR KRIM TUBE 300 Rp 2,997.00 Rp 899,100.00
2 AMBROXOL TABLET TAB 1,200 Rp 114.00 Rp 136,800.00
5 ANTI HEMOROID SUPP SUPP 120 Rp 2,640.00 Rp 316,800.00
6 ASAM ASKORBAT TABLET TAB 24,000 Rp 62.00 Rp 1,488,000.00
7 BISMECON JELLY / NEOCENTA GEL TUBE 250 Rp 11,880.00 Rp 2,970,000.00
8 BROADAPEN 500 MG (AMPISILINA TRIHIDRAT) TAB 1,200 Rp 370.00 Rp 444,000.00
9 CIMETIDIN 200 MG TABLET TAB 6,000 Rp 137.00 Rp 822,000.00
11 DULCOLAX 5 MG TABLET TAB 200 Rp 1,067.00 Rp 213,400.00
12 ERPHAFLU TABLET TAB 12,000 Rp 261.00 Rp 3,132,000.00
13 ANTI BATUK INFLUENSA SIRUP BTL 3,000 Rp 7,425.00 Rp 22,275,000.00
15 GARAM ORALIT UNTUK 200 CC SACHET 1,500 Rp 288.00 Rp 432,000.00
16 GENTIAN VIOLET 1 % BTL 240 Rp 1,074.00 Rp 257,760.00
17 GLISERIL GUAIAKOLAT 100 MG TABLET TAB 60,000 Rp 115.00 Rp 6,900,000.00
18 HEMOROGARD KAPSUL KAPS 720 Rp 1,655.00 Rp 1,191,600.00
19 HEPAGARD KAPSUL KAPS 720 Rp 2,957.00 Rp 2,129,040.00
20 ICHTIYOL SALEP POT 360 Rp 4,752.00 Rp 1,710,720.00
21 KLORAMFENIKOL 250 MG KAPSUL KAPS 24,000 Rp 288.00 Rp 6,912,000.00
22 KLORAMFENIKOL 125 MG/ML SIRUP BTL 1,200 Rp 4,449.00 Rp 5,338,800.00
23 KLORAMFENIKOL TETES TELINGA 3% BTL 600 Rp 5,600.00 Rp 3,360,000.00
24 LESDIAR TABLET antapulgit TAB 3,600 Rp 190.00 Rp 684,000.00
25 LIVRON B PLEX TABLET TAB 18,000 Rp 269.00 Rp 4,842,000.00
27 OBAT BATUK HITAM BTL 2,500 Rp 1,511.00 Rp 3,777,500.00
28 OKSITETRASIKLIN HCL 1 % SALEP MATA TUBE 600 Rp 2,207.00 Rp 1,324,200.00
29 OKSITETRASIKLIN SALEP KULIT TUBE 2,400 Rp 1,835.00 Rp 4,404,000.00
30 OMEGDIAR SIRUP BTL 600 Rp 7,150.00 Rp 4,290,000.00
31 OMEPRAZOLE 20 MG KAPSUL KAPS 2,500 Rp 581.00 Rp 1,452,500.00
32 OBAT FLU SIRUP TAB 3,000 Rp 7,425.00 Rp 22,275,000.00
33 PIRANTEL PAMOAT TABLET TAB 1,200 Rp 251.00 Rp 301,200.00
34 PIROKSIKAM 20 MG TAB 3,000 Rp 111.00 Rp 333,000.00
35 TENSIGARD KAPS 1,800 Rp 2,234.00 Rp 4,021,200.00
36 THIAMPHENIKOL 500 MG KAPSUL KAPS 6,000 Rp 594.00 Rp 3,564,000.00
37 THIAMIN 50 MG TABLET TAB 48,000 Rp 38.00 Rp 1,824,000.00
38 TRAMADOL KAPSUL 50 MG KAPS 600 Rp 476.00 Rp 285,600.00
39 FENOBARBITAL TAB. 30 MG TAB 1,000 Rp 67.00 Rp 67,000.00
REAGENSIA
40 LARUTAN ASAM KLORIDA BTL 6 Rp 7,986.00 Rp 47,916.00
41 LARUTAN BENEDICT BTL 6 Rp 57,420.00 Rp 344,520.00

OBAT GIGI
42 ALBOTHYL CONCENTRAT BTL 60 Rp 30,360.00 Rp 1,821,600.00
43 DEVITALISASI PASTA BTL 6 Rp 468,000.00 Rp 2,808,000.00
44 ETIL KLORIDA SEMPROT BTL 240 Rp 110,616.00 Rp 26,547,840.00
45 EUGENOL CAIRAN BTL 6 Rp 3,814.00 Rp 22,884.00
46 GLASS IONOMER CEMENT SET 3 Rp 473,880.00 Rp 1,421,640.00
47 KALSIUM HIDROKSIDA PASTA BTL 2 Rp 290,400.00 Rp 580,800.00
48 MONOKLORKAMFER MENTHOL CAIRAN BTL 2 Rp 66,000.00 Rp 132,000.00
49 MUMMYFYING PASTA BTL 2 Rp 211,200.00 Rp 422,400.00
50 SEMEN SENG FOSFAT BTL 2 Rp 112,728.00 Rp 225,456.00
51 TEMPORARY STOPPING FLETCER BTL 6 Rp 40,889.00 Rp 245,334.00
Rp 148,994,610.00

Mengetahui
Kepala UPTD Puskesmas Balapulang

dr. Jaka Suyatna

NIP : 19611103 198711 1 001
 RENCANA PENGADAAN OBAT 2016 E-KATALOG

PERKIRAAN HARGA JUMLAH

NO NAMA OBAT SATUAN NAMA PABRIKAN
KEBUTUHAN 1 TAHUN SATUAN (Rp) HARGA (Rp)
1 ACYCLOVIR 200 MG TABLET TAB 2,400 Rp 237.00 Rp 568,800.00 PT.Indofarma
2 ALLOPURINOL 100 MG TABLET TAB 3,600 Rp 86.00 Rp 309,600.00 PT. Pertiwi Agung
3 AMLODIPIN 5 MG TABLET TAB 1,200 Rp 187.00 Rp 224,400.00 PT. Pertiwi Agung
4 AMOKSISILLIN 500 MG TABLET TAB 150,000 Rp 272.00 Rp 40,800,000.00 PT.Bernofarm
5 AMOKSISILLIN SIRUP KERING 125 MG BTL 3,500 Rp 2,445.00 Rp 8,557,500.00 PT.Novapharin
6 ASAM MEFENAMAT 500 TABLET TAB 55,000 Rp 112.00 Rp 6,160,000.00 PT.Bernofarm
8 CIPROFLOKSASIN 500 MG TABLET TAB 18,000 Rp 255.00 Rp 4,590,000.00 PT.Bernofarm
10 DIAZEPAM 2 MG TABLET TAB 3,600 Rp 45.00 Rp 162,000.00 PT.Kimia Farma
11 DIMENHIDRINATE 10 MG TABLET TAB 2,400 Rp 104.00 Rp 249,600.00 PT.Kimia Farma
12 FITOMENADION 10 MG TABLET TAB 1,200 Rp 630.00 Rp 756,000.00 PT.Phapros TBK
13 FUROSEMID 40 MG TABLET TAB 1,200 Rp 85.00 Rp 102,000.00 PT.Indofarma
14 GARAM ORALIT UNTUK 200 CC SACHET 6,000 Rp 288.00 Rp 1,728,000.00 PT.Phapros TBK
15 GENTAMISIN TETES MATA BTL 2,400 Rp 3,194.00 Rp 7,665,600.00 PT.Indofarma
16 GRISEOFULVIN 125 MG TABLET BTL 2,400 Rp 219.00 Rp 525,600.00 PT.Indofarma
17 IBUPROFEN 200 MG TABLET TAB 7,200 Rp 110.00 Rp 792,000.00 PT.Yarindo FarmaTama
18 ISOSORBID DINITRAT 5 MG TABLET TAB 600 Rp 88.00 Rp 52,800.00 PT.Indofarma
19 KALSIUM LAKTAT 500 MG TABLET TAB 30,000 Rp 70.00 Rp 2,100,000.00 PT.Afi farma
20 KLONIDIN 0,15 MG TABLET TAB 6,000 Rp 184.00 Rp 1,104,000.00 PT.Kimia Farma
21 KLORFENIRAMIN MALEAT 4 MG TABLET TAB 120,000 Rp 51.00 Rp 6,120,000.00 PT.Rama Emerald Multi Sukses
22 KOTRIMOKSAZOL SUSPENSI BTL 3,600 Rp 2,350.00 Rp 8,460,000.00 PT.Novapharin
23 KOTRIMOKSAZOL DEWASA TABLET TAB 12,000 Rp 152.00 Rp 1,824,000.00 PT.Holi Pharma
24 METFORMIN 500 MG TABLET TAB 6,000 Rp 112.50 Rp 675,000.00 PT.Bernofarm
25 METIL ERGOMETRIN MALEAT TABLET TAB 2,400 Rp 154.00 Rp 369,600.00 PT.Kimia Farma
26 METRONIDAZOL 500 MG TABLET TAB 20,000 Rp 160.00 Rp 3,200,000.00 PT.Phyto Kemo Agung Farma
27 METOKLOPRAMIDE 5 MG TAB 2,400 Rp 108.00 Rp 259,200.00 PT.Kimia Farma
28 MIKONAZOL 2 % KRIM TUBE 864 Rp 3,000.00 Rp 2,592,000.00 PT.Kimia Farma
29 NATRIUM DIKLOFENAK 25 MG TABLET TAB 6,000 Rp 133.00 Rp 798,000.00 PT.Phapros TBK
30 BETAMETASONE 0,1 % KRIM TUBE 2,400 Rp 1,520.00 Rp 3,648,000.00 PT.Kimia Farma
31 NIFEDIPIN TABLET TAB 3,600 Rp 100.00 Rp 360,000.00 PT.Dexa Medika
32 NISTATIN 100,000 IU TABLET VAGINA TAB 400 Rp 480.00 Rp 192,000.00 PT.Phapros TBK
33 NISTATIN 500,000 IU TABLET SALUT TAB 600 Rp 640.00 Rp 384,000.00 PT.Phapros TBK
34 PARASETAMOL 120 MG/ML SIRUP BTL 6,000 Rp 1,438.00 Rp 8,628,000.00 PT.Afi Farma
35 PARASETAMOL 500 MG TABLET TAB 240,000 Rp 89.00 Rp 21,360,000.00 PT.Infamind Farmasi Industri
36 PARASETAMOL DROPS BTL 1,200 Rp 5,200.00 Rp 6,240,000.00 PT.Indofarma
37 PIRIDOKSIN HCL 10 MG TABLET TAB 60,000 Rp 110.00 Rp 6,600,000.00 PT.Kimia Farma
38 PREDNISON 5 MG TABLET TAB 48,000 Rp 114.00 Rp 5,472,000.00 PT.Holi Pharma
39 RANITIDIN 150 MG TABLET TAB 2,400 Rp 120.00 Rp 288,000.00 PT.Dexa Farma
40 SALBUTAMOL 2 MG TABLET TAB 6,000 Rp 59.00 Rp 354,000.00 PT.Yarindo FarmaTama
41 SALEP 2-4 POT 864 Rp 2,000.00 Rp 1,728,000.00 PT.Marin Liza Farmasi
42 SALISIL 2 % BEDAK KTK 2,400 Rp 1,250.00 Rp 3,000,000.00 PT.Rama Emerald Multi Sukses
43 SIANOKOBALAMIN 50 MCG TABLET TAB 36,000 Rp 57.00 Rp 2,052,000.00 PT.Afi Farma
44 SIMVASTATIN TABLET TAB 3,600 Rp 169.00 Rp 608,400.00 PT.Natura Laboratoria Prima
45 TETRASIKLIN 500 MG KAPSUL KAPS 6,000 Rp 300.00 Rp 1,800,000.00 PT.Afi Farma
46 VITAMIN B KOMPLEK TABLET TAB 60,000 Rp 107.00 Rp 6,420,000.00 PT.Kimia Farma
47 Zink TAB 2400 Rp 473.00 Rp 1,135,200.00 PT.Kimia Farma
Rp 171,015,300.00

Mengetahui
Kepala UPTD Puskesmas Balapulang

dr. Jaka Suyatna

NIP : 19611103 198711 1 001