BILL OF QUANTITY (BOQ)

PENGADAAN OBAT NON E-CATALOG

DINAS KESEHATAN KOTA TERNATE
TAHUN 2021

Harga Satuan TOTAL HARGA

No Nama Obat Kemasan Jumlah
(Rp) (Rp)
1 Air untuk irigasi lar inf 1000 ml Botol 500
2 Albendazol tab 400 mg tab/kapsul/kaplet 10000
3 Ambroksol tablet 30 mg tab/kapsul/kaplet 25000
4 Ambroxol sirup 15 mg / 5 ml tab/kapsul/kaplet 1500
5 Aminofilin Tab 200 mg tab/kapsul/kaplet 5000
6 Amitriptilin tab sal 25 mg tab/kapsul/kaplet 15000
7 Amlodipin tab 10 mg tab/kapsul/kaplet 50000
8 Amoksisilin sir kering 125 mg/5 ml Botol 1000
Anestetik lokal gigi kombinasi : lidokain hcl 2% + epinefrin 1 : 80.000 inj
9 ampul/vial 2000
2 ml

10 Antibakteri, kombinasi : basitrasin 500 UI/g+ Polimiksin B 10.000 UI/g tube 1000

11 Artesunat serb inj 60 mg/ml (i.v./i.m.) ampul/vial 100

tablet sal
12 Asam asetilsalisilat (asetosal) tab 100 mg enterik/kaplet salut 1000
enterik
13 Asam askorbat (vitamin C) tab 250 mg tablet 50000
14 Asam mefenamat kaps 500 mg tab/kapsul/kaplet 10000
15 Asam traneksamat tab 500 mg ampul/vial 2000
 Harga Satuan TOTAL HARGA
No Nama Obat Kemasan Jumlah
(Rp) (Rp)
16 Asiklovir salep kulit tube 1000
17 Asiklovir tab 200 mg tab/kapsul/kaplet 10000
18 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) ampul 500
19 Bahan tumpatan sementara lar, serb Botol 20
20 Bedak salisil serb 2% Dus/Sachet/Plastik 1000
21 Betahistin tab 6 mg tab/kapsul/kaplet 2000
22 Betametason krim 0,1% tube 5 gram 2000
23 Bisakodil tab sal 5 mg tab/kapsul/kaplet 5000
24 Caviplex sirup botol @ 60 mL 5000
25 Clindamycin kapsul 300 mg tab/kapsul/kaplet 5000
26 Deksametason tab 0,5 mg tab/kapsul/kaplet 100000
27 Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL 500
28 Diazepam tab 2 mg tab/kapsul/kaplet 50000
29 Diltiazem tab 30 mg tab 2000
30 Doksisiklin kaps 100 mg tab/kapsul/kaplet 3000
31 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) ampul/vial 1000
32 Eritromisin sirup botol @ 60 mL 1500
33 Eritromisin tab 500 mg tab/kapsul/kaplet 20000
34 Etakridina (rivanol) larutan 0,1% 300ml Botol 300 ml 1500
35 Etanol 70% cairan 70% 1000 ML Botol 3000
36 Furosemid tab 40 mg tab/kapsul/kaplet 5000
37 Gentamisin salep kulit tube 3000
38 Glimepirid tab 1 mg tab/kapsul/kaplet 20000
39 Glimepirid tab 2 mg tab/kapsul/kaplet 50
 Harga Satuan TOTAL HARGA
No Nama Obat Kemasan Jumlah
(Rp) (Rp)
40 Gliseril guaiakolat tablet 100 mg tab/kapsul/kaplet 15000
41 Griseofulvin (micronized) tab 500 mg tab 5000
42 Gutta percha dan paper points 15 - 40 mm roll 50
43 Gutta percha dan paper points 45 - 80 mm roll 50
44 Haloperidol inj 50 mg/ml (i.m.) vial 200
45 Haloperidol tab 0,5 mg tab/kapsul/kaplet 20000
46 Haloperidol tab 1,5 mg tab/kapsul/kaplet 30000
47 Haloperidol tablet 5 mg tab/kapsul/kaplet 10000
48 Hiosina butilbromida inj 20 mg/ml ampul/vial 700
49 Hiosina butilbromida tab 10 mg tab/kapsul/kaplet 15000
50 Ibuprofen sir 200 mg/5 ml botol @ 60 ml 2000
51 Ibuprofen tab 200 mg tab/kapsul/kaplet 100000
52 Ibuprofen tab 400 mg tab/kapsul/kaplet 50000
53 Isosorbid dinitrat tab 5 mg tab/kapsul/kaplet 5000
54 Kalsium glukonat inj 100 mg/ml ampul/vial 100
55 Kalsium hidroksida bubuk, pasta Tube 50
56 Karbogliserin tts telinga 10 % Botol 500
57 Ketokonazol krim 2% tube 10 g 500
58 Ketokonazol tab 200 mg tab/kapsul/kaplet 20000
59 Ketoprofen sup 100 mg Suppositoria 1000
60 Klindamisin kaps 150 mg kaps 1000
61 Kloramfenikol salep mata 1% tube @ 5 gram 500
62 Kloramfenikol tetes telinga 3% Botol 1000
63 Klorfeniramin tab 4 mg tab/kapsul/kaplet 100000
 Harga Satuan TOTAL HARGA
No Nama Obat Kemasan Jumlah
(Rp) (Rp)
tablet salut
64 Klorpromazin tab sal 100 mg selaput/kaplet salut 50000
selaput
65 Kombinasi : ergotamin 1 mg+ kafein 50 mg tab/kapsul/kaplet 1000
Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 800 mg+
66 tab/kaptab 10000
trimetoprim 160 mg
67 Lansoprazol kaps 30 mg tab/kapsul/kaplet 20000
68 Loperamid 2 mg tablet tab/kapsul/kaplet 2500
69 Loperamid tab 2 mg tab 20000
70 Loratadin tab 10 mg tab/kapsul/kaplet 20000
71 Magnesium sulfat inj 20% ampul/vial @25 ml 200
72 Magnesium sulfat inj 40% ampul/vial @25 ml 200
73 Meloxicam tab 15 mg tab/kapsul/kaplet 10000
74 Metampiron (antalgin) tablet 500 mg tab/kapsul/kaplet 25000
75 Metilergometrin inj 0,2 mg/ml ampul/vial 1000
76 Metoklopramid inj 5 mg/ml ampul/vial 1000
77 Metronidazol tab 500 mg tab/kapsul/kaplet 20000
78 N-asetil sistein 300 mg tab/kapsul/kaplet 10000
tablet salut
79 Natrium diklofenak tab 50 mg enterik/kaplet salut 30000
enterik
80 Natrium fusidat krim 20 mg/g tube 1000
81 Nifedipin kaps 10 mg tab/kapsul/kaplet 2000
82 Nistatin susp 100.000 UI/ml botol/vial 500
 Harga Satuan TOTAL HARGA
No Nama Obat Kemasan Jumlah
(Rp) (Rp)
83 Obat batuk hitam sirup botol @ 60 mL 1500
84 Oksigen ih, gas dlm tabung botol 100
85 Oksitetrasiklin hcl salap kulit 3% tube 1000
86 Oksitosin inj 10 UI/ml ampul/vial 2000
87 Omeprazol kaps 20 mg tab/kapsul/kaplet 30000
88 Papaverin tablet 40 mg tab/kapsul/kaplet 10000
89 Parasetamol tab 500 mg tab/kapsul/kaplet 50000
90 Pasta pengisi saluran akar (pasta) tube 20
91 Perak sulfadiazin krim 1% tube 500
92 Permetrin krim 5 % tube 500
93 Pirantel pamoat susp 125 mg/5 ml botol 500
94 Pirantel pamoat tab scored 250 mg tab 2000
95 Piridoksin (vitamin B6) tab 10 mg tab/kapsul/kaplet 20000
96 Piroksikam tablet 10 mg tab/kapsul/kaplet 10000
97 Piroksikam tablet 20 mg tab/kapsul/kaplet 10000
98 Povidon iodin lar 100 mg/ml Botol 300 ml 1000
99 Povidon iodin lar 100 mg/ml botol @ 60 mL 1000
100 Prednison tab 5 mg tab/kapsul/kaplet 20000
101 Propiltiourasil tab 100 mg tab/kapsul/kaplet 1000
102 Ranitidin tab 150 mg tab/kapsul/kaplet 20000
103 Salbutamol tab 4 mg tab/kapsul/kaplet 20000
104 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang endap 4 % pot 30 gram 500
105 Sefadroksil kaps/tab 500 mg tab/kapsul/kaplet 10000
106 Sefadroksil sir kering 125 mg/5 ml botol @ 60 mL 1000
 Harga Satuan TOTAL HARGA
No Nama Obat Kemasan Jumlah
(Rp) (Rp)
107 Sefiksim tab 100 mg tab 2000
108 Serum antitetanus (A.T.S) inj 1500 UI/vial (i.m /i.v.) vial 30
109 Setirizin sir 5 mg/5 ml. botol @ 60 mL 1000
110 Setirizin tab 10 mg tab/kapsul/kaplet 50000
111 Sianokobalamin (vitamin B12) tab 50 mcg tab/kapsul/kaplet 50000
112 Simvastatin tab sal 10 mg tab/kapsul/kaplet 50000
113 Siprofloksasin tab scored 500 mg tab/kapsul/kaplet 20000
114 Tiamin (vitamin B1) tab 50 mg tab/kapsul/kaplet 50000
115 Triheksifenidile tab 2 mg tab/kapsul/kaplet 15000
116 Vitamin B kompleks tablet 50000
117 Zinc tab disp 20 mg tablet dispersible 10000