POLRI DAERAH JAWA TIMUR

BIDANG KEDOKTERAN DAN KESEHATAN

RS BHAYANGKARA TK IV WAHYU TUTUKO BOJONEGORO

RENCANA KEBUTUHAN OBAT MATKES SATKER :RSB TK IV. WAHYU TUTUKO BOJONEGORO
DALAM 1 TAHUN ANGGARAN :DPK PUSDOKKES
TAHUN :2012

HARGA
NO NAMA OBAT SATUAN JUMLAH
SATUAN JUMLAH
1 2 3 4 5 6
1 OBAT KESEHATAN UMUM
A OBAT SUSUNAN SYARAF

1 ANALGETIKA, ANTI PIRETIKA

1 Methampiron Tab Tablet 500 Rp 600 Rp 300,000
2 Sanmol Tab / Tamanopan Tab Tablet 2,000 Rp 200 Rp 400,000
3 Sanmol sirup / Tamanopan sirup Botol 500 Rp 2,500 Rp 1,250,000
4 Asam mefenamat 500 mg/ mefinal Tablet 2,500 Rp 600 Rp 1,500,000
5 Analsik Tab Tablet 1,000 Rp 800 Rp 800,000
6 Tramadol / Tradosik Tablet 500 Rp 700 Rp 350,000
7 Antalgin inj / benodon Vial 25 Rp 3,500 Rp 87,500
8 Methamizol inj / Antrain inj Ampul 500 Rp 7,000 Rp 3,500,000
9 Lidocain inj Ampul 500 Rp 2,500 Rp 1,250,000
10 Ketoprofen Sup Sup 200 Rp 7,500 Rp 1,500,000
11 Tramadol inj / Tradosik inj Ampul 500 Rp 6,000 Rp 3,000,000

2 ANTI INFLAMASI
1 Natrium dic / Voltadex Tablet 1,000 Rp 500 Rp 500,000
2 Piroxicam 10mg / 20 mg Tablet 1,000 Rp 300 Rp 300,000
3 Meloxicam 15 mg Tablet 1,000 Rp 2,000 Rp 2,000,000
4 Allupurinol 100 mg Tablet 500 Rp 500 Rp 250,000
5 Allupurinol 300 mg Tablet 1,000 Rp 600 Rp 600,000
6 Kalium Diclofenac /Nonflamin Tablet 1,000 Rp 500 Rp 500,000

3 ANTI INFLUENZA
1 Paratusin / silabat / Flugan Tablet 300 Rp 400 Rp 120,000
2 Dextral Tablet 300 Rp 500 Rp 150,000
3 Tuzalos tab Tablet 300 Rp 600 Rp 180,000
4 Dextral Forte Tablet 1,000 Rp 600 Rp 600,000

B. OBAT PSIKOFARMA
1 HIPNOTIK, SEDATIF
1 Phenobarbital 30 mg Tablet 100 Rp 300 Rp 30,000
2 Diazepam Tab Tablet 200 Rp 300 Rp 60,000
3 Diazepam inj Tablet 30 Rp 10,000 Rp 300,000
4 Codein 10 mg Tablet 250 Rp 500 Rp 125,000

2 ANTI DEPRESAN

C OBAT CARDIOVASKULER
1 ANTI ANGINA
1 Isosorbid dinitrat 5 mg Tablet 300 Rp 500 Rp 150,000
2 Kalium losartan / Angioten Tablet 300 Rp 3,000 Rp 900,000
3 Clopidogrel Tablet 300 Rp 3,000 Rp 900,000

2 ANTI HYPERTENSI
1 HCT 25 mg Tablet 1,000 Rp 100 Rp 100,000
2 Captropil 25 mg / Fapril 25 Tablet 2,000 Rp 500 Rp 1,000,000
3 Captropil 12,5 mg / Fapril 12,5 Tablet 2,000 Rp 300 Rp 600,000
4 Furosemid Tab Tablet 1,000 Rp 300 Rp 300,000

3 VASODILATOR
1 Dopamin inj Ampul 25 Rp 40,000 Rp 1,000,000

4 GLIKOSIDA JANTUNG
1 Digoxin 0,25 mg Tablet 300 Rp 200 Rp 60,000
5 HAEMOSTATIK
1 Tranexamin Acid Tablet 300 Rp 800 Rp 240,000
2 Tranexamin Acid inj Ampul 50 Rp 8,000 Rp 400,000
3 Carbazocrom natrium sulfonat / Crome Ampul 100 Rp 8,500 Rp 850,000
4 Adona Tablet 500 Rp 2,000 Rp 1,000,000
5 Adona inj Ampul 50 Rp 10,000 Rp 500,000

D OBAT SALURAN PERNAFASAN

1 ANTUSIF / EXPECTORAN
1 Dextrometropan tab Tablet 1,000 Rp 100 Rp 100,000
2 Dextrocin Tablet 500 Rp 500 Rp 250,000
4 OBH lapifol Botol 100 Rp 4,500 Rp 450,000
5 Alphadryl / Poladryl sirup Botol 50 Rp 4,500 Rp 225,000
6 Bromhexin 8 mg Tablet 1,000 Rp 300 Rp 300,000
7 Bromhexin sirup Botol 50 Rp 4,500 Rp 225,000
8 Ambroxol Tablet 1,000 Rp 300 Rp 300,000
9 Gliserin Guaicolat Tablet 1,000 Rp 50 Rp 50,000

2 ANTI ASMA
1 Pseudoephedrin + triprolidyn / Trifed Tablet 1,000 Rp 1,000 Rp 1,000,000
2 Aminophilin 150 / 200 Mg Tablet 1,000 Rp 50 Rp 50,000
3 Aminophilin 240 mg / 10 ml inj Ampul 200 Rp 1,500 Rp 300,000
4 Terbutalin Sulfat inj / Nairet inj Ampul 200 Rp 5,000 Rp 1,000,000
5 Asmadex / Sakasma Tablet 500 Rp 400 Rp 200,000
6 Salbutamol 4 Mg Tablet 500 Rp 300 Rp 150,000
7 Ephedrin HCL inj Ampul 100 Rp 15,000 Rp 1,500,000

E OBAT SALURAN CERNA

1 ANTASIDA
1 Antasida Doen Tablet 500 Rp 200 Rp 100,000
2 Buscopan Tab Tablet 1,000 Rp 700 Rp 700,000
3 Kombinasi dengan anti flutulen Tablet 500 Rp 700 Rp 350,000
4 Ranitidine / Acran tab Tablet 800 Rp 300 Rp 240,000
5 Omeperazole / Redusec Tablet 300 Rp 1,500 Rp 450,000
6 Ranitidine inj / Acran inj Ampul 200 Rp 4,500 Rp 900,000
7 Antasida Doen sirup Botol 100 Rp 2,000 Rp 200,000
8 Asam Sukrafat sirup / Profat sirup Botol 100 Rp 12,500 Rp 1,250,000

2 ENZYM

3 ANTI EMETIKUM
1 Metocloperamid / meperamide tab Tablet 500 Rp 400 Rp 200,000
2 Metocloperamid inj / Tomit inj Ampul 200 Rp 7,000 Rp 1,400,000
3 Domperidon / Dom Tab Tablet 500 Rp 400 Rp 200,000
4 Ondancetron inj / Ondane inj Ampul 200 Rp 8,000 Rp 1,600,000
5 Domperidon sirup / Vosedon Botol 50 Rp 4,500 Rp 225,000

4 ANTI SPASMODIK
1 Papaverin inj Ampul 20 Rp 1,500 Rp 30,000
2 Atropin sulfas inj Ampul 200 Rp 1,500 Rp 300,000
3 Systabon / buscopan inj Ampul 100 Rp 8,500 Rp 850,000
4 Spasmacyl / Untecol / Procolic Tablet 1,000 Rp 500 Rp 500,000

5 ANTI DIARE
1 Loperamid HCL 2 mg / Inamid Tab Tablet 500 Rp 400 Rp 200,000
2 Active Attapul gite Tablet 500 Rp 400 Rp 200,000
3 Kombinasi kaolimec + pectin Tablet 500 Rp 500 Rp 250,000
4 Kombinasi kaolimec + pectin Sirup Botol 100 Rp 3,500 Rp 350,000

6 OBAT HEPATITIS
1 Methionine Tab / Methidol / Lipagent Tablet 300 Rp 1,000 Rp 300,000
2 Lesihcol / Sensicol Tablet 300 Rp 3,500 Rp 1,050,000
3 Hepabion Tablet 500 Rp 1,500 Rp 750,000

F ANTI ALERGI
1 ANTI HISTAMIN
1 CTM Tablet 1,000 Rp 50 Rp 50,000
2 Dipenhidramin Hcl inj 10mg Vial 50 Rp 2,500 Rp 125,000
 3 Mebhidrolin Napadisilate / Zolin Tablet 300 Rp 1,000 Rp 300,000
4 Loratadine / Pylor Tablet 300 Rp 800 Rp 240,000

2 CORTICOSTEROID
1 Dexamethason 0,5 mg / Cortidex Tablet 1,000 Rp 400 Rp 400,000
2 Dexamethason inj / Cortidex inj Ampul 300 Rp 2,500 Rp 750,000
3 Omegtamin / Dextamin ( sejenis ) Tablet 500 Rp 500 Rp 250,000
4 Methilprednisolon Tab / Flason tab Tablet 200 Rp 700 Rp 140,000

G ANTI DIABETIK
1 Glibenclamid 5 mg Tablet 2,000 Rp 200 Rp 400,000
2 Glikasid 80 mg Tablet 500 Rp 1,000 Rp 500,000
3 Methoformin HCL 500 mg / Glikos tab Tablet 2,000 Rp 800 Rp 1,600,000
4 Homolin N Vial 10 Rp 100,000 Rp 1,000,000
5 Glimepirid 1 mg Tablet 2,000 Rp 500 Rp 1,000,000

H VITAMIN
1 Vitamin Bcomplex Tablet 1,000 Rp 100 Rp 100,000
2 Vitamin K 10 mg Ampul 200 Rp 2,000 Rp 400,000
3 Vitamin C 100 Mg Tablet 2,000 Rp 100 Rp 200,000
4 Kalsium lactat Tablet 1,000 Rp 200 Rp 200,000
5 Ferro sulfat Tablet 1,000 Rp 200 Rp 200,000
6 Livron B plex Tablet 500 Rp 500 Rp 250,000
7 Becom C ( sejenis ) Tablet 500 Rp 500 Rp 250,000
8 Neurobion sejenis Tablet 500 Rp 700 Rp 350,000
9 Multivitamin dan mineral ( sejenis ) Tablet 500 Rp 700 Rp 350,000
10 Multivitamin Sirup Botol 100 Rp 4,500 Rp 450,000
11 Vit.B complex inj Ampul 20 Rp 4,000 Rp 80,000
12 Neurobion inj 5000 inj Ampul 50 Rp 7,000 Rp 350,000
13 Nulacta DHA Tablet 500 Rp 3,000 Rp 1,500,000

I ANTI INFEKSI
ANTI BAKTERI SISTEMIK
1 Chlorampenicol 500 mg Tablet 500 Rp 500 Rp 250,000
2 Chlorampenicol Sirup Botol 50 Rp 4,500 Rp 225,000
3 Amoxcycilin 500 mg Tablet 3,000 Rp 400 Rp 1,200,000
4 Amoxcycilin Sirup Botol 250 Rp 3,500 Rp 875,000
5 Spiramycin Tablet 500 Rp 1,000 Rp 500,000
6 Clindamicyn 150 mg Tablet 1,000 Rp 1,000 Rp 1,000,000
7 Clindamicyn 300 mg Tablet 1,000 Rp 1,500 Rp 1,500,000
8 Erytromicin 500 mg Tablet 1,000 Rp 400 Rp 400,000
9 Metronidazole 500 mg Tablet 1,000 Rp 500 Rp 500,000
10 Kotrimoxazole Tab Tablet 200 Rp 300 Rp 60,000
11 Ciprofloxacin 500 mg Tablet 1,000 Rp 800 Rp 800,000
12 Lincomycin Tablet 1,000 Rp 1,500 Rp 1,500,000
13 Cefadroxil 500 mg Tablet 2,000 Rp 1,000 Rp 2,000,000
14 Metronidazole infus Botol 100 Rp 18,000 Rp 1,800,000
15 Cefotaxime 1gr inj Vial 200 Rp 11,000 Rp 2,200,000
16 Ceftriaxone 1gr inj Vial 200 Rp 12,000 Rp 2,400,000
17 Gentamicin inj Ampul 100 Rp 9,000 Rp 900,000
18 Cefixim Tab Tablet 1,000 Rp 5,000 Rp 5,000,000
19 Ciprofloxacin infus Fls 25 Rp 70,000 Rp 1,750,000

J ANTI TBC

K ANTELMINTIK

L ANTI MALARIA

M ANTI FUNGI
1 Griseopulvin 125 / 250 mg Tablet 500 Rp 600 Rp 300,000
2 Ketoconazole Tablet 500 Rp 500 Rp 250,000

N SALEP / OBAT TETES / INFUS

1 Chlorampenicol SM Tube 25 Rp 2,000 Rp 50,000
2 Chlorampenicol SK Tube 25 Rp 2,500 Rp 62,500
3 Chlorampenicol + Hydrocorison SK Tube 25 Rp 3,000 Rp 75,000
4 Chlorampenicol + Hydrocorison SM Tube 25 Rp 3,500 Rp 87,500
 5 Chlorampenicol TT Tube 50 Rp 3,500 Rp 175,000
6 Chlorampenicol TM Tube 50 Rp 3,500 Rp 175,000
7 Gentamycin SK Tube 50 Rp 3,500 Rp 175,000
8 Gentamycin TM Tube 50 Rp 4,500 Rp 225,000
9 Cendo xytol TM Botol 50 Rp 28,500 Rp 1,425,000
10 Rotho TM Botol 50 Rp 4,500 Rp 225,000
11 Bethadine Sol ( sejenis ) Botol 25 Rp 8,500 Rp 212,500
12 Bethadine Gar ( sejenis ) Botol 25 Rp 8,500 Rp 212,500
13 Bio placenton jell Tube 50 Rp 9,000 Rp 450,000
14 Pain killa cream Tube 100 Rp 12,000 Rp 1,200,000
15 Aciclovir Cream Tube 100 Rp 2,500 Rp 250,000

O CAIRAN INFUS
1 Cairan Rl Flas 500 Rp 5,000 Rp 2,500,000
2 Cairan NACL 0,9 % Flas 300 Rp 5,000 Rp 1,500,000
3 Cairan D5% Flas 300 Rp 5,000 Rp 1,500,000
4 Cairan D 10% Flas 100 Rp 5,000 Rp 500,000
5 Cairan NACL 1 liter Flas 100 Rp 10,000 Rp 1,000,000
6 Cairan RD5% Flas 100 Rp 9,500 Rp 950,000

P ANTI VERTIGO
1 Dymenhidrinat 50mg Tablet 300 Rp 300 Rp 90,000
2 Betahistine / Merislon Tablet 250 Rp 3,000 Rp 750,000
3 Flunarizine / Unalium Tablet 250 Rp 3,500 Rp 875,000

Q ANTI LIPID
1 Gemfibrozil Tablet 300 Rp 1,000 Rp 300,000
2 Simvastatin Tablet 500 Rp 500 Rp 250,000
3 Fenofibrate tab Tablet 500 Rp 1,500 Rp 750,000

H ALKES HABIS PAKAI

A FILM RONGEN
1 Film RO UK 24 x 30 Cm Box 2 Rp 1,000,000 Rp 2,000,000
2 Film UK 30 x 40 Cm Box 2 Rp 1,250,000 Rp 2,500,000
3 Film UK 35 x 35 Cm Box 2 Rp 1,400,000 Rp 2,800,000
4 Developer Box 2 Rp 450,000 Rp 900,000
5 Developer Automatic Box 2 Rp 450,000 Rp 900,000
6 Fixer Box 2 Rp 450,000 Rp 900,000
7 Fixer Automatic Box 2 Rp 450,000 Rp 900,000

B KAPAS / VERBAND
1 Kapas 250 gr Roll 10 Rp 8,000 Rp 80,000
2 Kapas 500 gr Roll 15 Rp 15,000 Rp 225,000
3 Kapas 1000 gr Roll 15 Rp 25,000 Rp 375,000
4 Verband 4x5 cm Roll 100 Rp 1,500 Rp 150,000
5 Verband 4x10 cm Roll 100 Rp 2,500 Rp 250,000
6 Plester 2,5 x 4,5 cm Roll 10 Rp 11,000 Rp 110,000
7 Plester 5 x 4,5 cm Roll 10 Rp 20,000 Rp 200,000
8 Plester 7,5 x 4,5 cm Roll 20 Rp 26,000 Rp 520,000
9 Tensocrape 3 inci Roll 20 Rp 36,000 Rp 720,000
10 Tensocrape 4 inci Roll 20 Rp 44,000 Rp 880,000
11 Tensocrape 6 inci Roll 20 Rp 57,000 Rp 1,140,000
12 Poliband natural 3 inci Roll 30 Rp 10,000 Rp 300,000
13 Poliband natural 4 inci Roll 30 Rp 13,000 Rp 390,000
14 Poliband natural 6 inci Roll 30 Rp 18,000 Rp 540,000
15 Polygips 3 inci Roll 25 Rp 15,000 Rp 375,000
16 Polygips 4 inci Roll 25 Rp 20,000 Rp 500,000
17 Polygips 6 inci Roll 25 Rp 25,000 Rp 625,000
18 Bactigras / Supratule Dos 20 Rp 95,000 Rp 1,900,000
19 Kasa steril 5 x 4 Y Roll 100 Rp 2,500 Rp 250,000
20 Kasa steril 10 x 4 Y Roll 100 Rp 5,000 Rp 500,000
21 Kasa steril 16 x 16 Dos 50 Rp 7,000 Rp 350,000
22 Kasa Hidrofil 40 x 30 YRD Roll 50 Rp 120,000 Rp 6,000,000
23 Tensoplast ( Sejenis ) Dos 50 Rp 20,000 Rp 1,000,000
24 Kapas Alkohol Box 100 Rp 500 Rp 50,000
25 Masker Box 20 Rp 40,000 Rp 800,000
 26 Sarung Tanggan Steril ( uk 7,5 ) Pasang 1,000 Rp 7,500 Rp 7,500,000
27 Sarung Tanggan non steril Pasang 1,000 Rp 1,500 Rp 1,500,000
28 Kertas ECG 50 x 30 MM Roll 20 Rp 41,500 Rp 830,000
29 Kertas ECG 60 x 30 MM Roll 20 Rp 64,500 Rp 1,290,000
30 Jelly USG Sak 20 Rp 9,500 Rp 190,000
31 Colostomy Bag Buah 20 Rp 10,000 Rp 200,000
32 Under Pad dewasa Pcs 500 Rp 6,500 Rp 3,250,000
33 Dermafix besar Box 10 Rp 120,000 Rp 1,200,000
34 Mucus Extraktor Pcs 100 Rp 8,000 Rp 800,000
35 Under pad bayi Pcs 400 Rp 5,000 Rp 2,000,000
36 Jepit tali pusat Pcs 300 Rp 2,000 Rp 600,000

C ALAT INJEKSI / ALAT INFUS / BENANG

1 Disposible Syringe 1 CC ( Terumo ) Buah 300 Rp 3,000 Rp 900,000
2 Disposible Syringe 3 CC ( Terumo ) Buah 1,000 Rp 3,000 Rp 3,000,000
3 Disposible Syringe 5 CC ( Terumo ) Buah 1,000 Rp 3,500 Rp 3,500,000
4 Disposible Syringe 10 CC ( Terumo ) Buah 500 Rp 5,000 Rp 2,500,000
5 Infuset set ( Terumo ) Buah 500 Rp 11,500 Rp 5,750,000
6 Blood Set ( Terumo ) Buah 500 Rp 13,500 Rp 6,750,000
7 Surflo 18,20,22,24 Buah 200 Rp 15,000 Rp 3,000,000
8 Cat Gut chromic 2/0 Roll 3 Rp 700,000 Rp 2,100,000
9 Cat Gut chromic 3/0 Roll 1 Rp 700,000 Rp 700,000
10 Cat Gut plain 2/0 Roll 1 Rp 700,000 Rp 700,000
11 Cat Gut Plain 3/0 Roll 1 Rp 700,000 Rp 700,000
12 Cat Gut Chrome no 2 Roll 1 Rp 700,000 Rp 700,000
13 Silk Black Roll 1 Rp 700,000 Rp 700,000
14 Spinocan no 25 Pcs 100 Rp 25,000 Rp 2,500,000
15 Selang O2 dewasa Pcs 20 Rp 20,000 Rp 400,000
16 Masker O2 dewasa Pcs 20 Rp 20,000 Rp 400,000
17 Selang O2 Bayi Pcs 10 Rp 15,000 Rp 150,000
18 Masker O2 Bayi Pcs 10 Rp 15,000 Rp 150,000
19 Venflon Pcs 25 Rp 15,000 Rp 375,000

D LAIN - LAIN
1 Thermometer Buah 10 Rp 11,000 Rp 110,000
2 Spatel Disposible. Buah 100 Rp 1,500 Rp 150,000
3 Bidai Buah 0 Rp - Rp -
4 Pisau operasi Buah 100 Rp 11,000 Rp 1,100,000
5 Urine Bag Buah 50 Rp 4,500 Rp 225,000
6 Blood Buah 0 Rp - Rp -
7 Folley Cateter ( No 16 dan No 18 ) Buah 100 Rp 8,500 Rp 850,000
8 Jarum kulit / Otot Lusin 5 Rp 15,000 Rp 75,000
9 ETT no 7.0 Buah 20 Rp 55,000 Rp 1,100,000
10 ETT no 7.5 Buah 20 Rp 55,000 Rp 1,100,000
11 Korentang + Tempat Set 1 Rp 150,000 Rp 150,000
12 Reflex Hamer Buah 1 Rp 50,000 Rp 50,000
13 Gunting Buah 2 Rp 35,000 Rp 70,000
14 guedel Buah 0 Rp - Rp -
17 Alkohol 70% 1 liter Botol 30 Rp 25,000 Rp 750,000
18 Betadine 1 Liter Botol 30 Rp 30,000 Rp 900,000

111 OBAT KESEHATAN GIGI

A TAMBALAN TETAP
1 Amalgam 1 oz Botol 1 Rp 150,000 Rp 150,000
2 DenTal Mercury 100 gr Botol 1 Rp 100,000 Rp 100,000
3 Composite resin Set 2 Rp 600,000 Rp 1,200,000
4 Glass ionomer Set 2 Rp 300,000 Rp 600,000
5 Cement Phospart Set 1 Rp 200,000 Rp 200,000

B TAMBALAN SEMENTARA
1 Fletcer ( Powder + Liq ) Set 1 Rp 100,000 Rp 100,000
2 Cavit / Dentorit / Carvitos ( Sejenis ) Set 2 Rp 100,000 Rp 200,000

C BAHAN ENDODONTRIK
1 Arsen ( sejanis ) Set 1 Rp 100,000 Rp 100,000
2 Putri domors Botol 1 Rp 100,000 Rp 100,000
3 Oxpara ( Oxsypara ) Botol 1 Rp 100,000 Rp 100,000
4 Cresopene ( Sejenis ) Botol 1 Rp 100,000 Rp 100,000
 5 Endomethaspone Botol 1 Rp 100,000 Rp 100,000
6 CHKM Botol 2 Rp 100,000 Rp 200,000
7 TKF ( Sejanis ) Botol 2 Rp 100,000 Rp 200,000
8 Eugenol Botol 2 Rp 100,000 Rp 200,000
9 Putrex / Mumiflying / Paste Pot 1 Rp 100,000 Rp 100,000

D BAHAN HYPERSENSITIF DENTIN

1 Dycal Set 2 Rp 250,000 Rp 500,000

E BAHAN CETAK
1 Alginate Zak 1 Rp 100,000 Rp 100,000
2 Doible impresion Set 1 Rp 300,000 Rp 300,000

F ACRYLIC
1 Liq tin foil ( CMS ) 250 gr Botol 1 Rp 400,000 Rp 400,000
2 Acrylic teeth frontal atas 6 'S Set 1 Rp 100,000 Rp 100,000

G OBAT ANASTHESI / EXTRAKSI

1 Pehacain inj @20 mg Dos 5 Rp 50,000 Rp 250,000
2 Chlorethyl Botol 3 Rp 100,000 Rp 300,000
3 Xylonor / Xylestesin / Spray Botol 2 Rp 200,000 Rp 400,000
4 Xylonor / Xylestesin Capsul Botol 2 Rp 400,000 Rp 800,000
5 Spongostan Dos 1 Rp 100,000 Rp 100,000
6 Alvogil / Post pengha Pot 1 Rp 100,000 Rp 100,000
7 Bethadine Sol ( Sejenis ) Botol 1 Rp 85,000 Rp 85,000
8 Dental needle untuk cito jet Dos 2 Rp 100,000 Rp 200,000

1V ALKES GIGI HABIS PAKAI

A ALAT ENDODONTIK
1 Headstroam files no 15/40 Box 1 Rp 100,000 Rp 100,000
2 Headstroam files no 45/80 Box 1 Rp 100,000 Rp 100,000
3 K.Files no 15/40 Box 1 Rp 100,000 Rp 100,000
4 K.Files no 45/80 Box 1 Rp 100,000 Rp 100,000
5 Jarum Exterpasi Box 1 Rp 100,000 Rp 100,000
6 Jarum lentulo Box 1 Rp 100,000 Rp 100,000
7 Jarum miller Box 1 Rp 100,000 Rp 100,000
8 Paper poin 15/40 Box 1 Rp 100,000 Rp 100,000
9 Paper poin 45/80 Box 1 Rp 100,000 Rp 100,000
10 Gutta percha point 15/40 Box 1 Rp 100,000 Rp 100,000
11 Gutta percha point 45/80 Box 1 Rp 100,000 Rp 100,000
12 Diamond burs higth speed Box 1 Rp 100,000 Rp 100,000
13 Fussure burs panjang 502 Box 1 Rp 100,000 Rp 100,000
14 Dental film RO Box 1 Rp 100,000 Rp 100,000
15 Articulating paper Buah 1 Rp 100,000 Rp 100,000
16 Celluloit strip Dos 1 Rp 100,000 Rp 100,000

B ALAT LAIN / BAHAN LABORATORIUM GIGI

1 Stone Buah 1 Rp 50,000 Rp 50,000
2 Stone putih Buah 1 Rp 25,000 Rp 25,000
3 Wax merah Dos 1 Rp 50,000 Rp 50,000
4 Air turbin HP spray Kaleng 1 Rp 150,000 Rp 150,000

C LABORATORIUM
1 Reagen SGOT Botol 6 Rp 165,000 Rp 990,000
2 Reagen SGPT Botol 6 Rp 165,000 Rp 990,000
3 Reagen BUN Botol 3 Rp 900,000 Rp 2,700,000
4 Reagen Serum kreatinin R1+R2 Botol 3 Rp 743,800 Rp 2,231,400
5 Reagen Uric Acid Botol 5 Rp 430,500 Rp 2,152,500
6 Reagen Cholesterol Botol 3 Rp 1,282,500 Rp 3,847,500
7 Reagen Trigeserida Botol 3 Rp 1,282,500 Rp 3,847,500
8 Reagen HDL Precipitate Botol 1 Rp 540,000 Rp 540,000
9 Reagen Albumin Botol 2 Rp 620,000 Rp 1,240,000
10 Reagen Total Protein Botol 2 Rp 250,000 Rp 500,000
11 Reagen Bilirubin Direct Botol 2 Rp 250,000 Rp 500,000
12 Reagen Bilirubin Total Botol 2 Rp 250,000 Rp 500,000
13 Reagen Salmonella Thypi O Vial 5 Rp 625,000 Rp 3,125,000
14 Reagen Salmonella Thypi H Vial 5 Rp 625,000 Rp 3,125,000
15 Reagen Salmonella Thypi A Vial 5 Rp 625,000 Rp 3,125,000
16 Reagen Salmonella Thypi B Vial 5 Rp 625,000 Rp 3,125,000
17 Reagen Golongan Darah A Vial 2 Rp 200,000 Rp 400,000
18 Reagen Golongan Darah B Vial 2 Rp 200,000 Rp 400,000
19 Reagen Golongan Darah AB Vial 2 Rp 200,000 Rp 400,000
20 Reagen UL Vial 10 Rp 150,000 Rp 1,500,000
21 Reagen DL 20 Liter Botol 1 Rp 1,200,000 Rp 1,200,000

TOTAL Rp 234,951,400

Bojonegoro, April 2012

KARUMKIT BHAYANGKARA WAHYU TUTUKO BOJONEGORO

Dr. BAYU DHARMA SHANTI, Sp.PD

AJUN KOMISARIS POLISI NRP 75081283
 POLRI DAERAH JAWA TIMUR
BIDANG KEDOKTERAN DAN KESEHATAN
RS BHAYANGKARA TK IV WAHYU TUTUKO BOJONEGORO

RENCANA KEBUTUHAN OBAT MATKES SATKER :RSB TK IV. WAHYU TUTUKO BOJONEGORO
DALAM 1 TAHUN ANGGARAN :APBN PUSDOKKES
TAHUN :2012

HARGA
NO NAMA OBAT SATUAN JUMLAH
SATUAN JUMLAH
1 2 3 4 5 6
1 OBAT KESEHATAN UMUM
A OBAT PRODUKSI BIDFIPOL
1 Fiproxil 500 mg Tablet 1000 Rp 500 Rp 500,000
2 Fiflox 400 mg Tablet 0 Rp - Rp -
3 Fiflu Tablet 0 Rp - Rp -
4 Ficold Tablet 0 Rp - Rp -
5 Politusin Tablet 1000 Rp 500 Rp 500,000
6 Finalgren Tablet 500 Rp 600 Rp 300,000
7 Fenamic 500 mg Tablet 1000 Rp 500 Rp 500,000
8 Fineuron Tablet 500 Rp 300 Rp 150,000
9 Fineuron 5000 Tablet 500 Rp 600 Rp 300,000
10 Fineural Tablet 500 Rp 400 Rp 200,000
11 Fimag Tablet 600 Rp 300 Rp 180,000
12 Finalgin Tablet 500 Rp 400 Rp 200,000
13 Spasfinal Tablet 500 Rp 1,000 Rp 500,000
14 OBH lafipol 110 Ml Botol 100 Rp 5,500 Rp 550,000
15 OBH Sachet Tablet 0 Rp - Rp -
16 Fibroxol 15 mg / 5 ml sirup Botol 0 Rp - Rp -
17 Fibroxol 30 mg / 5 ml sirup Botol 100 Rp 4,000 Rp 400,000
18 Fimicetin SK 2 % Tube 0 Rp - Rp -
19 Fizoral 2% cream Tube 50 Rp 3,000 Rp 150,000
20 Diphenhidramin 2% cream Tube 50 Rp 3,000 Rp 150,000
21 Thiamficol 500 mg Kapsul 0 Rp - Rp -
22 Gesixpol Tab Tablet 1000 Rp 1,000 Rp 1,000,000

1 OBAT KESEHATAN UMUM

A OBAT SUSUNAN SYARAF

1 ANALGETIKA, ANTI PIRETIKA

1 Methampiron / Antalgin 500 mg Tablet 200 Rp 600 Rp 120,000
2 Paracetamol 500 mg Tablet 1,000 Rp 200 Rp 200,000
3 Paracetamol Syr Botol 200 Rp 2,500 Rp 500,000
4 Asam mefenamat 250 mg Tablet 500 Rp 300 Rp 150,000
5 Asam mefenamat 500 mg Tablet 1,000 Rp 600 Rp 600,000
6 Analsik / Neurogen / Proneuron Tablet 1,000 Rp 800 Rp 800,000
7 Tramadol Tablet 500 Rp 700 Rp 350,000
8 Antalgin inj / benodon Vial 50 Rp 4,000 Rp 200,000
9 Methamizol inj Ampul 500 Rp 7,000 Rp 3,500,000
10 Ketorolax inj Ampul 200 Rp 8,000 Rp 1,600,000
11 Lidocain inj Ampul 500 Rp 2,500 Rp 1,250,000
12 Ketoprofen Sup Sup 200 Rp 7,500 Rp 1,500,000

2 ANTI INFLAMASI
1 Natrium diclofenac Tablet 500 Rp 500 Rp 250,000
2 Piroxicam 10mg / 20 mg Tablet 1,000 Rp 300 Rp 300,000
3 Meloxicam 15 mg Tablet 1,000 Rp 2,000 Rp 2,000,000
4 Dancera / Nonflamin Tablet 300 Rp 2,000 Rp 600,000
5 Allupurinol 100 mg Tablet 1,000 Rp 250 Rp 250,000
6 Allupurinol 300 mg Tablet 1,000 Rp 400 Rp 400,000

3 ANTI INFLUENZA
1 Paratusin / silabat / Flugan Tablet 200 Rp 400 Rp 80,000
2 Paranomin / deconal Tablet 200 Rp 500 Rp 100,000
3 Suprafl / Naflu / Megaflu Tablet 200 Rp 500 Rp 100,000
4 Flupol / Flidexin / Tuzalos Tablet 200 Rp 600 Rp 120,000
5 Nalgestam Tablet 300 Rp 300 Rp 90,000
6 Gunacold Tablet 0 Rp -
7 Dextral Forte Tablet 1,000 Rp 600 Rp 600,000
B. OBAT PSIKOFARMA
1 HIPNOTIK, SEDATIF
1 Phenobarbital 30 mg Tablet 100 Rp 300 Rp 30,000
2 Diazepam Tab Tablet 200 Rp 300 Rp 60,000
3 Diazepam inj Tablet 20 Rp 10,000 Rp 200,000
4 Ketamin inj Vial 10 Rp 90,000 Rp 900,000

2 ANTI DEPRESAN
1 Chlorpromazin Tablet 0 Rp - Rp -
2 Trifluoperazin 5mg Tablet 0 Rp - Rp -
3 Trihexyphenidil 2 mg Tablet 0 Rp - Rp -

C OBAT CARDIOVASKULER
1 ANTI ANGINA
1 Nitrogliserino sublingal 0,1 mg Tablet 0 Rp - Rp -
2 Isosorbid dinitrat 5 mg Tablet 200 Rp 500 Rp 100,000
3 Diltiazem Tablet 200 Rp 600 Rp 120,000

2 ANTI HYPERTENSI
1 HCT 25 mg Tablet 1,000 Rp 100 Rp 100,000
2 Propanolol 10 mg Tablet 500 Rp 300 Rp 150,000
3 Captropil 25 mg Tablet 1,000 Rp 500 Rp 500,000
4 Captropil 12,5 mg Tablet 500 Rp 300 Rp 150,000
5 Atenolol Tablet 0 Rp - Rp -
6 Methyldopa Tablet 0 Rp - Rp -
7 Furosemid Tab Tablet 500 Rp 200 Rp 100,000
8 Lisinopril 5 mg Tablet 200 Rp 1,000 Rp 200,000

3 VASODILATOR
1 Dipiridamol 25 mg Tablet 0 Rp - Rp -
2 Nifedipin 10 mg Tablet 500 Rp 400 Rp 200,000
3 Dopamin inj Ampul 25 Rp 30,000 Rp 750,000

4 GLIKOSIDA JANTUNG
1 Digoxin 0,25 mg Tablet 300 Rp 200 Rp 60,000

5 HAEMOSTATIK
1 Tranexamin Acid Tablet 200 Rp 800 Rp 160,000
2 Tranexamin Acid inj Ampul 50 Rp 8,000 Rp 400,000
3 Carbazocrom natrium sulfonat Tablet 50 Rp 8,500 Rp 425,000
4 Adona Tablet 500 Rp 2,000 Rp 1,000,000
5 Adona inj Ampul 50 Rp 10,000 Rp 500,000

D OBAT SALURAN PERNAFASAN

1 ANTUSIF / EXPECTORAN
1 Dextrometropan tab Tablet 1,000 Rp - Rp -
2 Dextrometropan Sirup Botol 0 Rp - Rp -
3 Dextrocin Tablet 500 Rp 500 Rp 250,000
4 OBH lapifol Botol 0 Rp - Rp -
5 Alphadryl / Poladryl sirup Botol 50 Rp 4,500 Rp 225,000
6 Bromhexin 8 mg Tablet 500 Rp 300 Rp 150,000
7 Bromhexin sirup Botol 0 Rp - Rp -
8 Ambroxol Tablet 1,000 Rp 300 Rp 300,000
9 Gliserin Guaicolat Tablet 1,000 Rp 50 Rp 50,000
10 Carbosysteine Tablet 0 Rp - Rp -

2 ANTI ASMA
1 Ephedrin HCL 25 MG Tablet 0 Rp - Rp -
2 Aminophilin 150 / 200 Mg Tablet 0 Rp - Rp -
3 Aminophilin 240 mg / 10 ml inj Ampul 200 Rp 1,500 Rp 300,000
4 Terbutalin Sulfat inj Ampul 200 Rp 7,000 Rp 1,400,000
5 Asmadex / Sakasma Tablet 0 Rp - Rp -
6 Salbutamol 4 Mg Tablet 500 Rp 300 Rp 150,000
7 Ephedrin HCL inj Ampul 500 Rp 10,000 Rp 5,000,000

E OBAT SALURAN CERNA

1 ANTASIDA
1 Antasida Doen Tablet 500 Rp 200 Rp 100,000
2 Kombinasi dengan anti spasmodik Tablet 500 Rp 700 Rp 350,000
3 Kombinasi dengan anti flutulen Tablet 0 Rp - Rp -
 4 Cimetidin Tablet 300 Rp 200 Rp 60,000
5 Dexanta Tablet 500 Rp 400 Rp 200,000
6 Ranitidine / Famotidin Tablet 500 Rp 300 Rp 150,000
7 Cimetidine / Famotidin Tablet 0 Rp - Rp -
8 Omeperazole Tablet 300 Rp 1,500 Rp 450,000
9 Oxethazin Tablet 0 Rp - Rp -
10 Ranitidine inj Ampul 100 Rp 4,500 Rp 450,000
11 Antasida Doen sirup Botol 100 Rp 2,000 Rp 200,000
12 Asam Sukrafat sirup Botol 50 Rp 12,500 Rp 625,000

2 ENZYM
1 Vitazym / Enzymfort ( sejenis ) Tablet 500 Rp 600 Rp 300,000
2 Excelase ( Sejenis ) Tablet 0 Rp - Rp -

3 ANTI EMETIKUM
1 Metocloperamid Tablet 500 Rp 400 Rp 200,000
2 Metocloperamid inj Ampul 200 Rp 7,000 Rp 1,400,000
3 Domperidon Tablet 500 Rp 400 Rp 200,000
4 Ondancetron inj Ampul 200 Rp 8,000 Rp 1,600,000
5 Domperidon sirup Botol 50 Rp 4,500 Rp 225,000

4 ANTI SPASMODIK
1 Papaverin 40 mg Tablet 100 Rp 100 Rp 10,000
2 Papaverin inj Ampul 100 Rp 1,500 Rp 150,000
3 Extrac belladon Tablet 0 Rp - Rp -
4 Atropin sulfas inj Ampul 200 Rp 1,500 Rp 300,000
5 Systabon / buscopan inj Ampul 100 Rp 8,500 Rp 850,000
6 Spasmacyl / Untecol / Procolic Tablet 500 Rp 500 Rp 250,000

5 ANTI DIARE
1 Garam oralit Zak 0 Rp - Rp -
2 Loperamid HCL 2 mg Tablet 300 Rp 400 Rp 120,000
3 Active Attapul gite Tablet 500 Rp 400 Rp 200,000
4 Kombinasi kaolimec + pectin Tablet 500 Rp 500 Rp 250,000
5 Entrograd Tablet 0 Rp - Rp -
6 Kombinasi kaolimec + pectin Sirup Botol 100 Rp 3,500 Rp 350,000

6 OBAT HEPATITIS
1 Methionine Tab / Methidol / Lipagent Tablet 300 Rp 1,000 Rp 300,000
2 Lesihcol / Sensicol Tablet 300 Rp 3,500 Rp 1,050,000
3 Hepabion Tablet 500 Rp 1,500 Rp 750,000

F ANTI ALERGI
1 ANTI HISTAMIN
1 CTM Tablet 500 Rp 50 Rp 25,000
2 Dipenhidramin Hcl inj 10mg Vial 50 Rp 2,500 Rp 125,000
3 Mebhidrolin Napadisilate / Zolin Tablet 500 Rp 800 Rp 400,000
4 Homochlorcycline / Homoclomin Tablet 0 Rp - Rp -
5 Astemizole /Lapihis Tablet 300 Rp 400 Rp 120,000
6 Loratadine / Pylor Tablet 300 Rp 800 Rp 240,000

2 CORTICOSTEROID
1 Prednison 5 mg Tablet 0 Rp - Rp -
2 Dexamethason 0,5 mg Tablet 1,000 Rp 400 Rp 400,000
3 Cortison acetat inj 10cc Vial 0 Rp - Rp -
4 Dexamethason inj Ampul 200 Rp 2,500 Rp 500,000
5 Omegtamin / Dextamin ( sejenis ) Tablet 500 Rp 500 Rp 250,000

G ANTI DIABETIK
1 Glibenclamid 5 mg Tablet 2,000 Rp 200 Rp 400,000
2 Glikasid 80 mg Tablet 500 Rp 1,000 Rp 500,000
3 Methoformin HCL 500 mg Tablet 2,000 Rp 800 Rp 1,600,000
4 Actrapid inj Vial 10 Rp 100,000 Rp 1,000,000
5 Glimepirid 2 mg Tablet 2,000 Rp 500 Rp 1,000,000

H VITAMIN
1 Vitamin A 50.000 UI Tablet 0 Rp - Rp -
2 Vitamin B1 50 mg Tablet 0 Rp - Rp -
3 Vitamin B12 100 mcg Tablet 500 Rp 200 Rp 100,000
4 Vitamin Bcomplex Tablet 1,000 Rp 100 Rp 100,000
 5 Vitamin B6 10 mg Tablet 0 Rp - Rp -
6 Vitamin K 10 mg Tablet 0 Rp - Rp -
7 Vitamin C 100 Mg Tablet 0 Rp 300 Rp -
8 Kalsium lactat Tablet 1,000 Rp 200 Rp 200,000
9 Ferro sulfat Tablet 1,000 Rp 200 Rp 200,000
10 Livron B plex Tablet 500 Rp 500 Rp 250,000
11 Becom C ( sejenis ) Tablet 500 Rp 500 Rp 250,000
12 Neurobion sejenis Tablet 500 Rp 700 Rp 350,000
13 Multivitamin dan mineral ( sejenis ) Tablet 500 Rp 700 Rp 350,000
14 Multivitamin Sirup Botol 100 Rp 4,500 Rp 450,000
15 Vit.B12 100 MCG / Ml inj Vial 0 Rp - Rp -
16 Vit.B complex inj Ampul 20 Rp 4,000 Rp 80,000
17 Neurobion inj 5000 inj Ampul 50 Rp 7,000 Rp 350,000

I ANTI INFEKSI
ANTI BAKTERI SISTEMIK
1 Acylovir Tablet Tablet 500 Rp 500 Rp 250,000
2 Amoxcycilin 250 mg Tablet 0 Rp - Rp -
3 Amoxcycilin 500 mg Tablet 500 Rp 400 Rp 200,000
4 Amoxcycilin Sirup Botol 200 Rp 3,500 Rp 700,000
5 Ampicilin 250 mg Tablet 0 Rp - Rp -
6 Ampicilin 500 mg Tablet 0 Rp - Rp -
7 Ampicilin inj 1gr Vial 0 Rp 8,000 Rp -
8 Ampicilin sirup Botol 0 Rp - Rp -
9 Cefadroxil 500 mg Tablet 1,000 Rp 1,000 Rp 1,000,000
10 Cefixim Tab Tablet 1,000 Rp 5,000 Rp 5,000,000
11 Cefotaxime 1gr inj Vial 100 Rp 11,000 Rp 1,100,000
12 Ceftriaxone 1gr inj Vial 100 Rp 12,000 Rp 1,200,000
13 Chlorampenicol 250 mg Tablet 0 Rp - Rp -
14 Chlorampenicol 500 mg Tablet 500 Rp 400 Rp 200,000
15 Chlorampenicol inj Vial 0 Rp - Rp -
16 Chlorampenicol Sirup Botol 100 Rp 4,500 Rp 450,000
17 Ciprofloxacin 250 mg Tablet 0 Rp - Rp -
18 Ciprofloxacin 500 mg Tablet 1,000 Rp 800 Rp 800,000
19 Clindamicyn 150 mg Tablet 500 Rp 1,000 Rp 500,000
20 Clindamicyn 300 mg Tablet 500 Rp 1,500 Rp 750,000
21 Erytromicin 500 mg Tablet 1,000 Rp 1,000 Rp 1,000,000
22 Erytromicin Sirup Tablet 100 Rp 4,500 Rp 450,000
23 Gentamicin inj Ampul 25 Rp 9,000 Rp 225,000
24 Kotrimoxazole Sirup Botol 100 Rp 3,500 Rp 350,000
25 Kotrimoxazole Tab Tablet 200 Rp 300 Rp 60,000
26 Lincomycin Tablet 500 Rp 1,000 Rp 500,000
27 Metronidazole 500 mg Tablet 1,000 Rp 500 Rp 500,000
28 Metronidazole infus Botol 50 Rp 18,000 Rp 900,000
29 Spiramycin Tablet 500 Rp 1,000 Rp 500,000
30 Tetracyklin 250 mg Tablet 0 Rp - Rp -
31 Tetracyklin 500 mg Tablet 0 Rp - Rp -
32 Thiampenicol 250 mg Tablet 0 Rp - Rp -
33 Thiampenicol 500 mg Tablet 0 Rp - Rp -

J ANTI TBC
1 INH 100 mg Tablet 0 Rp - Rp -
2 INH 300 mg Tablet 0 Rp - Rp -
3 Ethambutol 500 mg Tablet 0 Rp - Rp -
4 Pirazinamid 500 mg Tablet 0 Rp - Rp -
5 Rifamicin 300 mg Tablet 0 Rp - Rp -
6 Rifamicin 450 mg Tablet 0 Rp - Rp -
7 Rifampicin 650 mg Tablet 0 Rp - Rp -

K ANTELMINTIK
1 Pirantel palmoat 125 mg Tablet 0 Rp - Rp -
2 Mebendazole Tablet 0 Rp - Rp -

L ANTI MALARIA
1 Chloroquin 250 mg Tablet 0 Rp - Rp -
2 Primaquin 125 mg Tablet 0 Rp - Rp -
3 Artesunat kombinasi Tablet 0 Rp - Rp -
4 Suldox sejenis Tablet 0 Rp - Rp -

M ANTI FUNGI
 1 Griseopulvin 125 / 250 mg Tablet 300 Rp 600 Rp 180,000
2 Ketoconazole Tablet 500 Rp 500 Rp 250,000

N SALEP / OBAT TETES / INFUS

1 Chlorampenicol SM Tube 25 Rp 2,000 Rp 50,000
2 Chlorampenicol SK Tube 25 Rp 2,500 Rp 62,500
3 Chlorampenicol + Hydrocorison SK Tube 25 Rp 3,000 Rp 75,000
4 Chlorampenicol + Hydrocorison SM Tube 25 Rp 3,000 Rp 75,000
5 Chlorampenicol TT Tube 25 Rp 3,500 Rp 87,500
6 Chlorampenicol TM Tube 25 Rp 3,500 Rp 87,500
7 Gentamycin SK Tube 25 Rp 3,500 Rp 87,500
8 Gentamycin TM Tube 30 Rp 4,500 Rp 135,000
9 Cendom xytol TM Botol 50 Rp 28,500 Rp 1,425,000
10 Rotho TM Botol 50 Rp 4,500 Rp 225,000
11 Bethadine Sol ( sejenis ) Botol 25 Rp 8,500 Rp 212,500
12 Bethadine Gar ( sejenis ) Botol 25 Rp 8,500 Rp 212,500
13 Bio placenton jell Tube 50 Rp 9,000 Rp 450,000
14 Pain killa cream Tube 50 Rp 11,000 Rp 550,000
15 Aciclovir Cream Tube 100 Rp 2,500 Rp 250,000

O CAIRAN INFUS
1 Cairan Rl Flas 200 Rp 5,000 Rp 1,000,000
2 Cairan NACL 0,9 % Flas 100 Rp 5,000 Rp 500,000
3 Cairan D5% Flas 100 Rp 5,000 Rp 500,000
4 Cairan D 10% Flas 100 Rp 5,000 Rp 500,000
5 Cairan NACL 1 liter Flas 100 Rp 10,000 Rp 1,000,000
6 Cairan RD5% Flas 100 Rp 9,500 Rp 950,000

P ANTI VERTIGO
1 Dymenhidrinat 50mg Tablet 300 Rp 300 Rp 90,000
2 Betahistine / Merislon Tablet 250 Rp 3,000 Rp 750,000
3 Flunarizine Tablet 250 Rp 3,500 Rp 875,000

Q ANTI LIPID
1 Pravastatin Tablet 0 Rp - Rp -
2 Gemfibrozil Tablet 300 Rp 1,000 Rp 300,000
3 Simvastatin Tablet 500 Rp 500 Rp 250,000

H ALKES HABIS PAKAI

A FILM RONGEN
1 Film UK 24 x 30 Cm Box 2 Rp 1,000,000 Rp 2,000,000
2 Film UK 30 x 40 Cm Box 2 Rp 1,250,000 Rp 2,500,000
3 Film UK 35 x 35 Cm Box 2 Rp 1,400,000 Rp 2,800,000
4 Developer Box 2 Rp 450,000 Rp 900,000
5 Developer Automatic Box 2 Rp 450,000 Rp 900,000
6 Fixer Box 2 Rp 450,000 Rp 900,000
7 Fixer Automatic Box 2 Rp 450,000 Rp 900,000

B KAPAS / VERBAND
1 Kapas 250 gr Roll 10 Rp 8,000 Rp 80,000
2 Kapas 500 gr Roll 15 Rp 15,000 Rp 225,000
3 Kapas 1000 gr Roll 15 Rp 25,000 Rp 375,000
4 Verband 4x5 cm Roll 100 Rp 1,500 Rp 150,000
5 Verband 4x10 cm Roll 100 Rp 2,500 Rp 250,000
6 Plester 2,5 x 4,5 cm Roll 10 Rp 11,000 Rp 110,000
7 Plester 5 x 4,5 cm Roll 10 Rp 20,000 Rp 200,000
8 Plester 7,5 x 4,5 cm Roll 20 Rp 26,000 Rp 520,000
9 Elastic Verband 3 inci Roll 20 Rp 36,000 Rp 720,000
10 Elastic Verband 4 inci Roll 20 Rp 44,000 Rp 880,000
11 Elastic Verband 6 inci Roll 20 Rp 57,000 Rp 1,140,000
12 Soft Band 3 inci ( Natural ) Roll 20 Rp 10,000 Rp 200,000
13 Soft Band 4 inci ( Natural ) Roll 20 Rp 13,000 Rp 260,000
14 Soft band 6 inci ( Natural ) Roll 20 Rp 18,000 Rp 360,000
15 Gips 3 inci Roll 25 Rp 15,000 Rp 375,000
16 Gips 4 inci Roll 25 Rp 20,000 Rp 500,000
17 Gips 6 inci Roll 25 Rp 25,000 Rp 625,000
18 Bactigras / Supratule Dos 20 Rp 95,000 Rp 1,900,000
19 Kasa steril 5 x 4 Y Roll 100 Rp 2,500 Rp 250,000
20 Kasa steril 10 x 4 Y Roll 100 Rp 5,000 Rp 500,000
21 Kasa steril 16 x 16 Dos 50 Rp 7,000 Rp 350,000
 22 Kasa Hidrofil 40 x 30 YRD Roll 25 Rp 120,000 Rp 3,000,000
23 Tensoplast ( Sejenis ) Dos 50 Rp 20,000 Rp 1,000,000
24 Kapas Alkohol Box 0 Rp - Rp -
25 Masker Box 20 Rp 40,000 Rp 800,000
26 Sarung Tanggan Steril Pasang 1,000 Rp 7,500 Rp 7,500,000
27 Sarung Tanggan non steril Pasang 1,000 Rp 1,500 Rp 1,500,000
28 Kertas ECG 50 x 30 MM Roll 20 Rp 41,500 Rp 830,000
29 Kertas ECG 60 x 30 MM Roll 20 Rp 64,500 Rp 1,290,000
30 Jelly USG Sak 20 Rp 9,500 Rp 190,000
31 Colostomy Bag Buah 30 Rp 3,000 Rp 90,000
32 Apron Plastik Buah 0 Rp - Rp -
33 Dermafix besar Box 10 Rp 120,000 Rp 1,200,000

C ALAT INJEKSI / ALAT INFUS / BENANG

1 Disposible Syringe 1 CC Buah 300 Rp 3,000 Rp 900,000
2 Disposible Syringe 3 CC Buah 1,000 Rp 3,000 Rp 3,000,000
3 Disposible Syringe 5 CC Buah 1,000 Rp 3,500 Rp 3,500,000
4 Disposible Syringe 10 CC Buah 500 Rp 5,000 Rp 2,500,000
5 Infuset set Buah 500 Rp 11,500 Rp 5,750,000
6 Blood Set Buah 500 Rp 13,500 Rp 6,750,000
7 IV Catheter Buah 200 Rp 15,000 Rp 3,000,000
8 Wing Needle no 21 Buah 0 Rp - Rp -
9 Wing Needle no 23 Buah 0 Rp - Rp -
10 Wing Needle no 25 Buah 0 Rp - Rp -
11 Cat Gut chromic 2/0 Roll 3 Rp 480,000 Rp 1,440,000
12 Cat Gut chromic 3/0 Roll 1 Rp 450,000 Rp 450,000
13 Cat Gut plain 2/0 Roll 1 Rp 450,000 Rp 450,000
14 Cat Gut Plain 3/0 Roll 1 Rp 450,000 Rp 450,000
15 Silk Black Roll 1 Rp 450,000 Rp 450,000
16 Benang Athraumatic + Jarum Sachet 0 Rp - Rp -
17 Nall Heating Lusin 0 Rp - Rp -
18 Spinocan no 25 Pcs 100 Rp 25,000 Rp 2,500,000

D LAIN - LAIN
1 Thermometer Buah 10 Rp 11,000 Rp 110,000
2 Spatel Disposible Buah 100 Rp 1,500 Rp 150,000
3 Bidai Buah 0 Rp - Rp -
4 Pisau operasi Buah 0 Rp - Rp -
5 Urine Bag Buah 50 Rp 4,500 Rp 225,000
6 Blood Buah 0 Rp - Rp -
7 Folley Cateter ( No 16 Dan No 18 ) Buah 100 Rp 8,500 Rp 850,000
8 Jarum kulit / Otot Lusin 5 Rp 15,000 Rp 75,000
9 ETT no 7.0 Buah 20 Rp 55,000 Rp 1,100,000
10 ETT no 7.5 Buah 20 Rp 55,000 Rp 1,100,000
11 Korentang + Tempat Set 1 Rp 150,000 Rp 150,000
12 Reflex Hamer Buah 1 Rp 50,000 Rp 50,000
13 Gunting Buah 2 Rp 35,000 Rp 70,000
14 guedel Buah 0 Rp - Rp -
15 Mucus Extractor Pcs 100 Rp 13,000 Rp 1,300,000
16 Under pad Box 20 Rp 30,000 Rp 600,000
17 Alkohol 70% 1 liter Botol 20 Rp 25,000 Rp 500,000
18 Betadine 1 Liter Botol 20 Rp 30,000 Rp 600,000
19 Umbilical cosa Pcs 500 Rp 1,500 Rp 750,000

111 OBAT KESEHATAN GIGI

A TAMBALAN TETAP
1 Amalgam 1 oz Botol 1 Rp 150,000 Rp 150,000
2 DenTal Mercury 100 gr Botol 1 Rp 100,000 Rp 100,000
3 Composite resin Set 1 Rp 600,000 Rp 600,000
4 Glass ionomer Set 1 Rp 300,000 Rp 300,000
5 Cement Phospart Set 1 Rp 200,000 Rp 200,000

B TAMBALAN SEMENTARA
1 Fletcer ( Powder + Liq ) Set 1 Rp 100,000 Rp 100,000
2 Cavit / Dentorit / Carvitos ( Sejenis ) Set 1 Rp 100,000 Rp 100,000

C BAHAN ENDODONTRIK
1 Arsen ( sejanis ) Set 1 Rp 100,000 Rp 100,000
2 Putri domors Botol 1 Rp 100,000 Rp 100,000
3 Oxpara ( Oxsypara ) Botol 1 Rp 100,000 Rp 100,000
 4 Cresopene ( Sejenis ) Botol 1 Rp 100,000 Rp 100,000
5 Endomethaspone Botol 1 Rp 100,000 Rp 100,000
6 CHKM Botol 1 Rp 100,000 Rp 100,000
7 TKF ( Sejanis ) Botol 1 Rp 100,000 Rp 100,000
8 Eugenol Botol 1 Rp 100,000 Rp 100,000
9 Putrex / Mumiflying / Paste Pot 1 Rp 100,000 Rp 100,000

D BAHAN HYPERSENSITIF DENTIN

1 Duraphat ( Sejenis ) Botol 0 Rp - Rp -
2 Tresiolan Botol 0 Rp - Rp -
3 Anasthopulfae Pot 0 Rp - Rp -
4 Dycal Set 1 Rp 250,000 Rp 250,000

E BAHAN CETAK
1 Alginate Zak 1 Rp 100,000 Rp 100,000
2 Doible impresion Set 1 Rp 300,000 Rp 300,000

F ACRYLIC
1 Heat Curing Acrylic ( p+l) Set 0 Rp - Rp -
2 Cold Curing Acrylic putih ( p + L ) Set 0 Rp - Rp -
3 Cold Curing Acrylic pink ( p + L ) Set 0 Rp - Rp -
4 Liq tin foil ( CMS ) 250 gr Botol 1 Rp 400,000 Rp 400,000
5 Acrylic teeth frontal atas 6 'S Set 1 Rp 100,000 Rp 100,000
6 Acrylic teeth frontal bawah 6 'S Set 0 Rp - Rp -
7 Acrylic teeth frontal atas 8 'S Set 0 Rp - Rp -
8 Acrylic teeth frontal bawah 8 'S Set 0 Rp - Rp -
9 Acrylic teeth 28'S Set 0 Rp - Rp -

G OBAT ANASTHESI / EXTRAKSI

1 Pehacain inj @20 mg Dos 5 Rp 50,000 Rp 250,000
2 Chlorethyl Botol 3 Rp 100,000 Rp 300,000
3 Xylonor / Xylestesin / Spray Botol 1 Rp 200,000 Rp 200,000
4 Xylonor / Xylestesin Capsul Botol 1 Rp 400,000 Rp 400,000
5 Gelatamp Botol 0 Rp -
6 Spongostan Dos 1 Rp 100,000 Rp 100,000
7 Alvogil / Post pengha Pot 1 Rp 100,000 Rp 100,000
8 Periodontal pack Tube 0 Rp -
9 Bethadine Sol ( Sejenis ) Botol 1 Rp 85,000 Rp 85,000
10 Bethadine Gargle ( Sejenis ) Botol 0 Rp - Rp -
11 Marbalet Botol 0 Rp - Rp -
12 Dental needle untuk cito jet Dos 1 Rp 100,000 Rp 100,000
13 Disposyble Syringe 3 CC Buah 200 Rp 3,000 Rp 600,000

1V ALKES GIGI HABIS PAKAI

A ALAT ENDODONTIK
1 Reamer no 15/40 Box 0 Rp - Rp -
2 Reamer no 45/80 Box 0 Rp - Rp -
3 Headstroam files no 15/40 Box 1 Rp 100,000 Rp 100,000
4 Headstroam files no 45/80 Box 1 Rp 100,000 Rp 100,000
5 K.Files no 15/40 Box 1 Rp 100,000 Rp 100,000
6 K.Files no 45/80 Box 1 Rp 100,000 Rp 100,000
7 Jarum Exterpasi Box 1 Rp 100,000 Rp 100,000
8 Jarum lentulo Box 1 Rp 100,000 Rp 100,000
9 Jarum miller Box 1 Rp 100,000 Rp 100,000
10 Paper poin 15/40 Box 1 Rp 100,000 Rp 100,000
11 Paper poin 45/80 Box 1 Rp 100,000 Rp 100,000
12 Gutta percha point 15/40 Box 1 Rp 100,000 Rp 100,000
13 Gutta percha point 45/80 Box 1 Rp 100,000 Rp 100,000
14 Diamond burs higth speed Box 1 Rp 100,000 Rp 100,000
15 Fussure burs panjang 502 Box 1 Rp 100,000 Rp 100,000
16 Dental film RO Box 1 Rp 100,000 Rp 100,000
17 Articulating paper Buah 1 Rp 100,000 Rp 100,000
18 Celluloit strip Dos 1 Rp 100,000 Rp 100,000

B ALAT LAIN / BAHAN LABORATORIUM GIGI

1 Acrylic trimmer Buah 0 Rp - Rp -
2 Stone Buah 1 Rp 50,000 Rp 50,000
3 Stone putih Buah 1 Rp 25,000 Rp 25,000
4 Polishing rubber wheel / cup / brush Buah 0 Rp - Rp -
5 Gips putih KG 0 Rp - Rp -
 6 Moldamo ( Sejenis ) Buah 0 Rp - Rp -
7 Wax merah Dos 1 Rp 50,000 Rp 50,000
8 Expantie screw rahang atas Buah 0 Rp - Rp -
9 Expantie screw rahang bawah Buah 0 Rp - Rp -
10 Wire 0,6 @ 1 M Roll 0 Rp - Rp -
11 Wire 0,7 @ 1 M Roll 0 Rp - Rp -
12 Wire 0,8 @ 1 M Roll 0 Rp - Rp -
13 Air turbin HP spray Kaleng 1 Rp 150,000 Rp 150,000

C LABORATORIUM
1 Lancet 23 G Box 1 Rp 45,000 Rp 45,000
2 Gluko Stik Box 1 Rp 450,000 Rp 450,000
3 Vacuntainer ( Merah ) Box 50 Rp 210,000 Rp 10,500,000
4 Vacuntainer ( Ungu ) Box 50 Rp 210,000 Rp 10,500,000
5 Vacuntainer ( Biru ) Box 50 Rp 210,000 Rp 10,500,000
6 Reagen Dilluent M 18 CFL Liter 3 Rp 1,870,000 Rp 5,610,000
7 Reagen Lyse M 18 CFL Liter 3 Rp 1,200,000 Rp 3,600,000
8 Reagen Probe Cleanser 50 P Botol 3 Rp 400,000 Rp 1,200,000
9 Reagen EZ Cleanzer M 23 E Botol 10 Rp 500,000 Rp 5,000,000
10 HCG Box 1 Rp 225,000 Rp 225,000
11 HBS - AG Box 1 Rp 200,000 Rp 200,000
12 HBS - AB Box 1 Rp 200,000 Rp 200,000
13 HIV Box 1 Rp 200,000 Rp 200,000
14 Yello Tip Pack 20 Rp 125,000 Rp 2,500,000
15 Blue Tip Pack 10 Rp 135,000 Rp 1,350,000
16 Reagen Rinse Botol 2 Rp 1,187,000 Rp 2,374,000

TOTAL Rp 222,369,000

Bojonegoro, April 2012

KARUMKIT BHAYANGKARA WAHYU TUTUKO BOJONEGORO

Dr. BAYU DHARMA SHANTI, Sp.PD

AJUN KOMISARIS POLISI NRP 75081283
 POLRI DAERAH JAWA TIMUR
BIDANG KEDOKTERAN DAN KESEHATAN
RS BHAYANGKARA TK IV WAHYU TUTUKO BOJONEGORO

RENCANA KEBUTUHAN ALAT KESEHATAN SATKER :RSB TK IV. WAHYU TUTUKO BOJONEGORO
JANUARI S/D FEBRUARI ANGGARAN :APBN PUSDOKKES
TAHUN :2012

NO NAMA OBAT SATUAN JUMLAH

1 2 3 4
1 ALAT KESEHATAN :
1 UV LAMP UNIT 1

Bojonegoro, Februari 2012

KARUMKIT BHAYANGKARA WAHYU TUTUKO BOJONEGORO

Dr.BAYU DHARMA SHANTI,Sp.PD

AJUN KOMISARIS POLISI NRP 75081283
 POLRI DAERAH JAWA TIMUR
BIDANG KEDOKTERAN DAN KESEHATAN
RS BHAYANGKARA TK IV WAHYU TUTUKO BOJONEGORO

RENCANA KEBUTUHAN ALAT KESEHATAN SATKER :RSB TK IV. WAHYU TUTUKO BOJONEGORO
JANUARI S/D FEBRUARI ANGGARAN :APBN PUSDOKKES
TAHUN :2012

NO NAMA OBAT SATUAN JUMLAH

1 2 3 4
1 ALAT KESEHATAN :
1 UV LAMP UNIT 1

Bojonegoro, Mei 2012

KARUMKIT BHAYANGKARA WAHYU TUTUKO BOJONEGORO

Dr.BAYU DHARMA SHANTI,Sp.PD

AJUN KOMISARIS POLISI NRP 75081283