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DAFTAR PESANAN OBAT DANA JKN

DISTRIBUTOR : PT. INDOFARMA GLOBAL MEDIKA

NO NAMA PRODUK BENTUK SEDIAAN KEKUATAN SEDIAAN JUMLAH SATUAN HARGA TOTAL HARGA
1 Acyclovir krim 5% 24 tube 5 gram 4,200 100,800
2 Amoksisilin sirup 125 mg/cth 120 botol 3,500 420,000
3 Ampisilin serbuk injeksi 1 gram/vial 1 box @10 vial 90,000 90,000
4 Bedak salisil serbuk 2% 10 box@12pcs 16,000 160,000
5 Betahistine mesylate Tablet 6 mg 10 Box @30 tab 30,000 300,000
6 Captopril tablet 25 mg 24 box@100 tab 28,800 691,200
7 Ciprofloxacin tablet 500 mg 5 box@100 tab 42,000 210,000
8 Domperidon tablet 10 mg 10 Box @100 tab 36,000 360,000
9 Domperidon sirup 10 mg/cth 120 botol 3,500 420,000
10 Ibuprofen tablet 400 mg 10 Box @100 tab 46,800 468,000
11 Kloramfenikol kapsul 250 mg 6 box@100 tab 72,000 432,000
12 Kloramfenikol sirup 125 mg/cth 50 botol 3,500 175,000
13 Loratadin tablet 10 mg 1 box @50 tab 23,200 23,200
14 Metilprednisolon tablet 4 mg 5 box@100 tab 74,000 370,000
15 Metronidazol tablet 500 mg 10 Box @100 tab 26,800 268,000
16 Omepazol serbuk injeksi 40 mg 1 box@10 vial 120,000 120,000
17 Parasetamol sirup 120 mg/cth 300 botol 3,000 900,000
18 Permethrin (SCABIMITE) krim 5% 10 Tube 10 gram 58,000 580,000
19 Sefadroksil kapsul 500 mg 10 box@100 tab 92,000 920,000
TOTAL HARGA 7,008,200

Bonto Perak, 12 November 2019


Apoteker Penanggungjawab,

Permana Juliansyah, S. Farm., Apt.


SIPA No. 430-09/018/SIPA/V/2019
DAFTAR PESANAN ALKES & BMHP DANA JKN

DISTRIBUTOR :

TOTAL
NO NAMA PRODUK JUMLAH SATUAN HARGA
HARGA
1 Sarung tangan nonsteril ukuran S 2 box@100psg 49,500 99,000
2 Sarung tangan nonsteril ukuran M 5 box@100psg 49,500 247,500
3 Sarung tangan nonsteril ukuran L 2 box@100psg 49,500 99,000
4 Catgut 3/0 3 box@24 pcs 171,504 514,512
5 Catgut 4/0 1 box@24 pcs 171,504 171,504
6 Penjepit tali pusat 1 box@100pcs 150,000 150,000
7 Hypafix 5 cm 5 roll 91,000 455,000
8 Hypafix 15 cm 1 roll 241,000 241,000
9 Kasa steril 16cm x 16cm 60 bungkus 7,414 444,840
10 Kertas perkamen 10 bungkus 36,000 360,000
11 Kapas 250 gram 10 bungkus 8,212 82,120
TOTAL HARGA 2,864,476

Bonto Perak, 12 November 2019


Apoteker Penanggungjawab,

Permana Juliansyah, S. Farm., Apt.


SIPA No. 430-09/018/SIPA/V/2019

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