KERANGKA ACUAN KERJA

KEGIATAN KEFARMASIAN

TAHUN ANGGARAN 2 0 2 4
SUB KEGIATAN PENGADAAN PERBEKALAN FARMASI E-
KATALOG DAN NON E KATALOG
A. LATAR BELAKANG
Rumah sakit adalah tempat untuk menyelenggarakan upaya kesehatan (health
service). Standar pelayanan rumah sakit berkaitan dengan kemampuan rumah sakit
memberikan layanan kesehatan sesuai dengan kualifikasinya. Konsekuensinya, wajib bagi
rumah sakit untuk memberikan pelayanan kesehatan dengan sebaik-baiknya sesuai dengan
hak pasien. Keberhasilan upaya pelayanan kesehatan tergantung pada ketersediaan sumber
daya kesehatan berupa tenaga, sarana, dan prasarana dalam jumlah dan mutu yang
memadai.
Dalam upaya memberikan pelayanan kesehatan bagi masyarakat, Rumah sakit wajib
menyediakan sarana dan prasarana kefarmasian untuk menunjang pelayanan kesehatan.
Dalam Undang-Undang Nomor 44 Tahun 2009 tentang Rumah Sakit dinyatakan
bahwa Rumah Sakit harus memenuhi persyaratan lokasi, bangunan, prasarana, sumber daya
manusia, kefarmasian, dan peralatan. Persyaratan kefarmasian harus menjamin ketersediaan
Sediaan Farmasi, Alat Kesehatan, dan Bahan Medis Habis Pakai yang bermutu, bermanfaat,
aman, dan terjangkau.
Seiring dengan meningkatnya pemahaman masyarakat akan kebutuhan kesehatan
yang berpengaruh pada meningkatnya pelayanan kesehatan di RSUD Tamiang Layang
Kabupaten Barito Timur perlu dimbangi dengan cukup tersedianya perbekalan kefarmasian di
rumah sakit. Perbekalan kefarmasian wajib memenuhi Standar Pelayanan Minimal (SPM)
sesuai dengan standar akreditasi rumah sakit. Sehingga perlu menjaga mutu didalam
pengadaan perbekalan kefarmasian untuk menjamin kualitas perbekalan mutu yang baik.
Pelaksanaan kegiatan penyediaan Perbekalan Farmasi di RSUD Tamiang Layang
tahun 2024, dilaksanakan mulai januari 2024 sampai dengan desember 2024 oleh Tim
Pengadaan Perbekalan Farmasi disesuaikan dengan anggaran yang tersedia. Pengadaan
Perbekalan Farmasi ini meliputi :
1. Obat E Katalog dan Non E Katalog
2. BMKHP E Katalog TKDN dan Non E Katalog
3. Reagen Laboratorium E Katalog dan Non E Katalog
4. Reagen dan BMKHP Radiologi E Katalog dan Non E Katalog

B. DASAR HUKUM
1. Undang – Undang Nomor 36 tahun 2009 tentang Kesehatan;
2. Undang – Undang Nomor 44 tahun 2009 tentang Rumah Sakit;
3. Permenkes RI Nomor 72 tahun 2016 tentang Standar Pelayanan
Kefarmasian Di rumah Sakit;
4. Peraturan Pemerintah Republik Indonesia Nomor 55 tahun 2005 tentang Dana
Perimbangan;

5. Peraturan Pemerintah Republik Indonesia Nomor 74 tahun 2012 tentang Perubahan Atas
Peraturan Pemerintah Nomor 23 Tahun 2005 Tentang Pengelolaan Keuangan Badan
Layanan Umum;
6. Keputusan Menteri Kesehatan RI Nomor 129/Menkes/SK/II/2008 tentang Standar
Pelayanan Minimal Rumah Sakit.

C. TUJUAN
1. Tujuan Umum
Untuk meningkatkan mutu layanan rumah sakit dan fasilitas pelayanan kesehatan lainnya
yang dilaksanakan oleh semua instansi / unit di rumah sakit dan fasilitas pelayanan
kesehatan lainnya meliputi kualitas pelayanan, manajemen pelayanan serta kesehatan
dan keselamatan kerja.
2. Tujuan Khusus
 Tersediannya Perbekalan Farmasi di RSUD Tamiang Layang

D. PENERIMA MANFAAT
Penerima manfaat dari kegiatan ini adalah bagian farmasi terkait guna mendukung
pelayanan kefarmasian di Rumah Sakit berjalan dengan lancar.

E. OUTPUT/OUTCOME/IMPACT

Output : Terpenuhinya Obat E Katalog

Outcome : Terpenuhinya Obat E Katalog yang

terstandarisasi di Unit Farmasi

Impact : Meningkatnya Mutu Pelayanan Medis dan Pelayanan

Penunjang Medis

F. INDIKASI KEBUTUHAN PENGADAAN P E R B E K A L A N F A R M A S I

1. OBAT E KATALOG Dan NON E KATALOG
VOL. HARGA
NO NAMA OBAT KEBUTUHAN SATUAN SATUAN TOTAL HARGA

1 Acarbose 100 mg 300 tab 950.00 285,000.01

2 Acyclovir cream 5% 50 tube 4,031.81 201,590.43

3 Akilen tetes telinga 72 btl 50,738.10 3,653,143.20

4 Allopurinol 100 mg 2000 tab 249.75 499,500.00

5 Allopurinol 300 mg 1000 tab 419.58 419,580.00

6 Alprazolam 0,5 mg 2000 tab 291.38 582,750.00

7 Alprazolam 1 mg 2000 tab 518.93 1,037,850.00

8 Ambroxol 15 mg Elixir 100 btl 5,994.00 599,400.00

9 Ambroxol 30 mg 2000 tab 310.80 621,600.00

10 Ambroxol 30 mg sirup 50 btl 8,991.00 449,550.00

11 Aminofilin 200 mg 3000 tab 366.30 1,098,900.00

12 Amitriptilin 25 mg 1000 tab 288.60 288,600.00

13 Amlodipin 10 mg 5000 tab 266.40 1,332,000.00

14 Amlodipine 5 mg 5000 tab 239.76 1,198,800.00

15 Amoxicilin 125 mg DS 30 btl 5,994.00 179,820.00

16 Amoxicillin 500 mg 1000 tab 582.75 582,750.00

Ampicilin + Sodium Sulbactam
17 inj 100 vial 23,999.98 2,399,997.60

18 Ampicilin 1 g inj 100 vial 11,988.00 1,198,800.00

19 Ampicilin sulbactam inj 750 mg 100 vial 27,750.00 2,775,000.00

20 Anadium 900 tab 6,993.00 6,293,700.00

21 Analtram 1200 tab 9,490.50 11,388,600.00

22 Antasida DOEN suspensi 200 btl 4,766.34 953,268.00

23 Antihemaroid supp 30 supp 3,663.00 109,890.00

24 Apetic drop 200 btl 27,417.00 5,483,400.00

25 Apetic Forte 300 btl 37,962.00 11,388,600.00

26 Apetic suspensi 200 btl 31,635.00 6,327,000.00

27 Apialys drop 200 btl 47,452.50 9,490,500.00

29 Apialys sirup 100 btl 40,071.00 4,007,100.00

30 Arkine 1000 tab 865.80 865,800.00

31 Asam folat 400 mcg 2000 tab 61.00 122,000.00

32 Asam mefenamat 500 mg 5000 tab 284.04 1,420,210.26

Asam traneksamat 250 mg
33 injeksi 1000 amp 6,993.00 6,993,000.00
Asam traneksamat 500 mg
34 injeksi 1000 amp 9,990.00 9,990,000.00

35 Asam Valproat 250 mg/5 ml 50 btl 15,500.00 775,000.05

36 Ascorbid Acid Inj 1000 mg 300 amp 10,656.00 3,196,800.00

37 Asering infus 40 btl 8,750.13 350,005.20

38 Asi M 1200 kap 3,058.05 3,669,660.00

39 Aspar K 300 tab 3,320.01 996,003.00

40 Atopin inj 200 amp 1,718.00 343,600.50

41 Atorvastatin 10 mg 3000 tab 1,265.40 3,796,200.00

42 Atorvastatin 20 mg 3000 tab 2,886.00 8,658,000.00

43 Axtan 300 tab 9,753.33 2,926,000.00

44 Betadine obat kumur 100 mg 50 btl 23,199.00 1,159,950.00

45 Betahistine 6 mg 3000 tab 839.16 2,517,480.00

46 Betason N cream 100 tube 14,957.25 1,495,725.00

47 Biocombine 5000 mg inj 1000 amp 5,272.50 5,272,500.00

48 Bioplacenton 30 tube 20,757.00 622,710.00

49 Biosan 300 tab 15,817.50 4,745,250.00

50 Biosave ABU 5 vial 688,819.38 3,444,096.90

51 Bisacodyl 5 mg 300 tab 339.66 101,898.00

52 Bisoprolol 2,5 mg 3000 tab 503.66 1,510,987.50

53 Bisoprolol 5 mg 3000 tab 699.30 2,097,900.00

54 Bupivacain inj 500 amp 65,712.00 32,856,000.00

55 Burnazin cream 50 tube 68,745.63 3,437,281.50

56 Cal-95 600 tab 5,799.75 3,479,850.00

57 Calcii Gluconas inj 240 amp 26,455.00 6,349,200.00

58 Candesartan 16 mg 2000 tab 6,493.50 12,987,000.00

59 Candesartan 8 mg 5000 tab 4,995.00 24,975,000.00

60 Carbamazepin 200 mg 500 tab 2,112.00 1,056,000.00

61 Cavicur 2000 tab 695.97 1,391,940.00

62 Cefadroxil 125 mg DS 100 btl
893,605.50
 8,936.06

63 Cefadroxil 250 mg DS 50 btl 14,985.00 749,250.00

64 Cefadroxil 500 mg 2000 kap 1,037.85 2,075,700.00

65 Cefixime 100 mg 5000 kap 2,174.72 10,873,615.50

66 Cefixime 100 mg DS 200 btl 9,262.00 1,852,399.08

67 Cefixime 200 mg 3000 kap 2,397.60 7,192,800.00

68 Cefotaxime 1 g inj 500 vial 7,770.00 3,885,000.00

69 Ceftriaxon 1 g inj 3000 vial 9,435.00 28,305,000.00

70 Cefxon inj 360 vial 258,352.50 93,006,900.00

71 Cetirizine 10 mg 5000 tab 316.04 1,580,196.00

72 Cetirizine 10 mg kapsul 5000 kap 316.04 1,580,196.00

73 Cetirizine sirup 100 btl 3,330.00 333,000.00

74 Chlorpeniramin maleat 500 tab 77.04 38,519.49

75 Cilostazol 100 mg 200 tab 8,436.00 1,687,200.00

76 Ciprofloxacin HCl 500 mg kaplet 1000 tab 662.84 662,843.44

77 Ciprofloxacin Infus 300 btl 8,174.00 2,452,200.01

78 Citicolin 250 mg inj 1000 amp 13,597.50 13,597,500.00

79 Citicolin 500 mg 3000 tab 4,162.50 12,487,500.00

80 Citicolin 500 mg inj 1000 amp 16,952.74 16,952,741.40

81 Clanexi 1200 tab 14,097.00 16,916,400.00

82 Clindamycin 150 mg 1000 kap 799.20 799,200.00

83 Clindamycin 300 mg 2000 kap 1,816.36 3,632,723.64

84 Clopidogrel 75 mg 3000 tab 2,747.25 8,241,750.00

85 Codein 10 mg 3000 tab 720.00 2,160,004.50

86 Cotrimoxazole 480 mg 2000 tab 240.00 480,000.00

87 Cotrimoxazole sirup 100 btl 3,078.03 307,803.00

88 Criax inj 200 vial 200,355.00 40,071,000.00

89 D40 % 360 amp 7,063.64 2,542,910.50

90 D5 1/2NS 100 btl 12,551.88 1,255,188.00

91 D5 1/4NS 100 btl 12,486.39 1,248,639.00

92 DC2 1200 tab 7,908.75 9,490,500.00

93 Desolex N 30 tube 34,809.60 1,044,288.00

94 Devit 1000 1200 tab 2,799.42 3,359,304.00

95 Dexametason 0,5 mg 3000 tab 79.92 239,760.00

96 Dexamethason 5 mg inj 1500 amp 2,181.82 3,272,724.00

97 Dexketoprofen 25 mg 1200 tab 2,952.60 3,543,120.00

98 Dextamin 500 tab 2,014.65 1,007,325.00

99 Diagit 3000 tab 2,885.17 8,655,502.50
10
0 Diazepam inj 5 mg/ml 200 amp 1,545.01 309,001.80
10
1 Diazepam Rectal 5 mg 40 tube 13,546.00 541,840.02
10
2 Diclofenac Potasium 50 mg 3000 tab 643.02 1,929,049.02
10
3 Digoxin 0,25 3000 tab 155.40 466,200.00
10
4 Diklofenak Sodium 50 mg 3000 tab 309.69 929,070.00
10
5 Diltiazem 500 tab 167.00 83,499.95
10
6 Diphenhidramin 10 mg 300 tab 901.99 270,595.80
10
7 Diphenhydramin 10 mg inj 1000 amp 1,332.00 1,332,000.00
10
8 Dobutamine 250 mg/5 ml inj 200 amp 24,864.00 4,972,800.00
10
9 Domperidon 10 mg 1000 tab 439.87 439,869.69
11
0 Domperidon 5 mg/5 ml sirup 100 btl 12,254.40 1,225,440.00
11
1 Dopamet 1000 tab 1,832.00 1,831,999.94
11
2 Dopamin injeksi 300 amp 7,272.72 2,181,816.00
11
3 Doxycycline 100 mg 300 kap 738.15 221,445.00
11
4 Dulcolax 10 mg supp 100 supp 27,109.97 2,710,997.40
11
5 Dumin Rectal 125 mg 100 tube 19,884.76 1,988,476.20
11
6 Dumin Rectal 250 mg 100 tube 27,024.50 2,702,450.40
11
7 Elomep krim 20 tube 52,725.00 1,054,500.00
11
8 Eperison HCl 50 mg 1500 tab 1,538.46 2,307,690.00
11
9 Epinephrine 0.1% injeksi 300 amp 2,930.40 879,120.00
12
0 Erlamycetin SM 50 tube 10,545.00 527,250.00
12
1 Erphafillin 200 mg 3000 tab 186.92 560,764.46
12
2 Esola 20 1000 kap 10,545.00 10,545,000.00
12
3 Ethambutol 500 mg 1000 tab 793.30 793,300.35
12
4 Fenofibrate 100 mg 1000 kap 1,665.00 1,665,000.00
12
5 Fenofibrate 300 mg 500 kap 2,442.00 1,221,000.00
12
6 Fentanex 0,05 mg injeksi 500 amp 29,768.20 14,884,101.00
12
7 FG Troches 1000 tab 1,480.00 1,480,000.00
12
8 Floragyn 1200 tab 13,919.40 16,703,280.00
12
9 Fluconazole 150 mg 200 tab 18,890.20 3,778,040.40
13
0 Flunarizine 10 mg 2000 tab 3,178.64 6,357,276.36
13
1 Flunarizine 5 mg 3000 tab 1,998.00 5,994,000.00
13
2 Folavit 400 mcg 2000 tab 1,054.50 2,109,000.00
13
3 Forbetes 500 XR 2000 tab 1,437.45 2,874,900.00
13
4 Formical-B 600 tab 4,440.00 2,664,000.00
13 Forumen ear drop 10 btl
5 25,946.25 259,462.50
13
6 Fudan 1000 tab 17,020.00 17,020,000.00
13
7 Furamin inj 50 amp 13,708.50 685,425.00
13
8 Furosemide inj 1000 amp 3,960.00 3,960,002.70
13
9 Futrolit infus 2400 softbag 40,460.67 97,105,597.20
14
0 Gabapentin 100 mg 5000 kap 499.50 2,497,500.00
14
1 Gabapentin 300 mg 1200 kap 7,992.00 9,590,400.00
14
2 Gabapentin 300 mg 3000 kap 5,328.00 15,984,000.00
14
3 Gemfibrozil 300 mg 500 kap 345.00 172,499.55
14
4 Genoint Eye Ointment 200 tube 8,348.39 1,669,678.71
14
5 Gentamycin SK 200 tube 2,963.70 592,740.00
14
6 Gitas Plus 1500 kap 7,443.94 11,165,906.25
14
7 Glibenclamide 5 mg 500 tab 224.83 112,415.25
14
8 Glicazide 80 mg 500 tab 375.00 187,499.98
14
9 Glimepiride 2 mg 3000 tab 220.00 660,000.01
15
0 Glimepiride 4 mg 2000 tab 434.50 868,999.91
15
1 Gliquidone 30 mg 2000 tab 1,100.00 2,200,000.02
15
2 Glucosamin MPL 500 500 tab 1,315.51 657,756.17
15
3 Glucose 10% 180 btl 7,199.46 1,295,902.80
15
4 Glucose 5% infus 1000 btl 7,685.64 7,685,640.00
15
5 Gracef inj 1 g 120 vial 226,107.00 27,132,840.00
15
6 Graphalac sirup 120 ml 120 btl 58,275.00 6,993,000.00
15
7 Guaifenesin 100 mg 5000 tab 109.98 549,890.06
15
8 Hepa Q 1000 kap 4,662.00 4,662,000.00
15
9 Heparmin 2000 kap 6,290.59 12,581,180.00
16
0 Hepatin 2000 kap 6,063.38 12,126,750.00
16
1 Human Albumin 20% 100 ml 10 botol 913,226.97 9,132,269.70
16
2 Human Albumin 20% 50 ml 30 btl 445,000.11 13,350,003.30
16
3 Hydrocortisone 2,5% krim 100 tube 4,955.41 495,541.00
16
4 Hydromal infus 240 sofbag 49,119.52 11,788,684.85
16
5 Hyocine Butylbromide 10 mg 2000 tab 1,059.55 2,119,101.00
16
6 Hyoscine bromide injeksi 1000 amp 8,991.00 8,991,000.00
16
7 Ibuprofen 200 mg sirup 200 btl 3,519.81 703,962.00
16
8 Ibuprofen 400 mg 2000 tab 204.00 407,991.60
16
9 Ibuprofen sirup 200 btl 9,990.00 1,998,000.00
17
0 Imunos 600 tab 9,279.60 5,567,760.00
17
1 Imunos sirup 100 btl 73,815.00 7,381,500.00
17
2 Isoflurane 250 ml 10 btl 1,420,800.00 14,208,000.00
17
3 Isoniazid 100 mg 2000 tab 170.75 341,506.00
17
4 Isosorbid dinitrat 10 mg 1000 tab 249.75 249,750.00
17
5 Isosorbid dinitrat 5 mg 2000 tab 113.22 226,440.00
17
6 Kanamycin inj 30 vial 16,650.00 499,500.00
17
7 KCl inj 120 amp 3,789.54 454,744.80
17
8 Ketocid 1000 tab 10,178.70 10,178,700.00
17
9 Ketoconazole 200 mg 500 tab 487.87 243,936.65
18
0 Ketoconazole cream 2% 100 tube 6,604.50 660,450.00
18
1 Ketoprofen 100 mg 1000 tab 1,332.00 1,332,000.00
18
2 Ketorolac 30 mg inj 3000 amp 4,773.00 14,319,000.00
18
3 KingVit 120 kap 7,557.25 906,870.00
18
4 KN-3B 20 btl 11,499.60 229,992.00
18
5 KTM injeksi 5 vial 143,190.00 715,950.00
18
6 Kutoin inj 20 amp 88,800.00 1,776,000.00
18
7 Lactasin 2000 kap 3,776.22 7,552,440.00
18
8 Lanfix 100 1000 kap 15,512.25 15,512,250.00
18
9 Lanfix 200 1000 kap 25,252.50 25,252,500.00
19
0 Lansoprazole 30 mg 3000 kap 618.83 1,856,475.00
19
1 Lansoprazole inj 600 vial 105,450.00 63,270,000.00
19
2 Lapifed 600 tab 3,427.13 2,056,275.00
19
3 Lapifed sirup 30 btl 30,580.50 917,415.00
19
4 Lasal 4 mg 1000 kap 1,898.10 1,898,100.00
19
5 Lasal expectorant syrup 600 btl 44,816.25 26,889,750.00
19
6 Lasal nebu 1000 amp 11,599.50 11,599,500.00
19
7 Lasal syrup 2 mg 180 btl 33,744.00 6,073,920.00
19
8 Lasalcom inj 600 amp 14,763.00 8,857,800.00
19
9 L-Bio capsul 1200 kap 8,172.38 9,806,850.00
20
0 L-Bio sachet 2000 sach 8,963.25 17,926,500.00
20
1 Levemir Flexpen 100 pen 89,809.00 8,980,899.89
20
2 Levofloxacin 500 mg 1000 tab 722.61 722,610.00
20
3 Levofloxacin infus 300 btl 23,100.00 6,929,999.73
20
4 Lidocain 2% inj 500 amp 2,553.00 1,276,500.00
20
5 Lisinopril 10 mg 300 tab 610.50 183,150.00
20
6 Loperamid 2 mg 1000 tab 85.00 85,003.80
20
7 Loratadine 10 mg 500 tab 193.55 96,774.68
20
8 L-Zinc syrup 240 btl 42,180.00 10,123,200.00
20
9 Manitol 20% 80 amp 43,894.95 3,511,596.00
21
0 Mecobalamin 500 mcg injeksi 500 amp 7,992.00 3,996,000.00
21
1 Mecobalamin 500 mcg kapsul 2000 kap 699.30 1,398,600.00
21
2 Mefinal 500 mg 1000 tab 1,554.00 1,554,000.00
21
3 Megazing 3000 tab 6,025.08 18,075,240.00
21
4 Meloxicam 15 mg 1000 tab 302.40 302,399.70
21
5 Meloxicam 7,5 mg 2000 tab 488.73 977,466.00
21
6 Meprolar N Krim 30 tube 36,907.50 1,107,225.00
21
7 Meropenem inj 120 vial 159,285.00 19,114,200.00
21
8 Metamizole 250 mg inj 300 amp 2,331.00 699,300.00
21
9 Metamizole 500 mg 3000 tab 264.74 794,205.00
22
0 Metamizole injeksi 2000 amp 3,784.09 7,568,174.25
22
1 Metformin HCl 500 mg 5000 tab 284.16 1,420,800.00
22
2 Metil Ergometrin 0,125mg 1000 tab 369.08 369,075.00
22
3 Metil Ergometrin inj 300 amp 3,310.96 993,289.05
22
4 Metil prednisolon 125 mg inj 600 vial 17,760.00 10,656,000.00
22
5 Metil prednisolon 16 mg 1000 tab 932.40 932,400.00
22
6 Metil Prednisolon 4 mg 4000 tab 247.99 991,940.40
22
7 Metil Prednisolon 8 mg 2000 tab 490.00 979,999.02
22
8 Metronidazole infus 500 btl 17,871.00 8,935,500.00
22
9 Meylon 8,4% 25 ml 120 amp 6,749.91 809,989.20
23
0 MgSO4 20% 78 amp 4,300.14 335,410.92
23
1 MgSO4 20% 240 amp 4,972.80 1,193,472.00
23
2 MgSO4 40% 240 amp 4,944.55 1,186,692.12
23
3 Miconazole 2% cream 50 tube 4,309.02 215,451.00
23
4 Microgest 100 mg 600 tab 12,654.00 7,592,400.00
23
5 Microlax enema 100 tube 17,149.50 1,714,950.00
23
6 Midazolam 5 mg inj 500 amp 22,200.00 11,100,000.00
23
7 Misoprostol 3000 tab 11,188.80 33,566,400.00
23
8 Modexa Nasal spray 10 btl 175,824.00 1,758,240.00
23
9 Mometason krim 50 tube 11,388.60 569,430.18
24
0 Monarin FC 300 tab 7,492.50 2,247,750.00
24
1 Morfina 10 mg/ml injeksi 10 amp 34,049.95 340,499.50
24
2 Moxifloxacin infus 200 botol 38,400.00 7,680,000.00
24
3 MST Continus 10 mg 600 tab 15,762.00 9,457,200.00
24
4 NaCl 0,9% 100 ml 400 botol 10,450.00 4,180,000.00
24
5 NaCl 0,9% 1000 ml 2000 btl 27,866.55 55,733,100.00
24
6 NaCl 0,9% 500 ml 5000 btl 6,899.76 34,498,800.00
24
7 Naloxone inj 20 amp 81,189.62 1,623,792.36
24
8 Neostigmin inj 100 amp 7,050.05 705,005.40
24
9 Neurosanbe 5000 tab 1,387.50 6,937,500.00
25
0 Nicardipine HCl injeksi 50 vial 119,880.00 5,994,000.00
25
1 Nifedipine 10 mg 1000 tab 164.00 164,000.06
25
2 Norages sirup 20 btl 33,744.00 674,880.00
25
3 Norepinephrin inj 100 amp 59,940.00 5,994,000.00
25
4 Norphagen 200 amp 99,900.00 19,980,000.00
25
5 Novomix flexpen 100 pen 113,018.00 11,301,800.00
25
6 Novorapid flexpen 500 pen 95,326.00 47,663,000.40
25
7 Nulacta 1200 kap 4,639.80 5,567,760.00
25
8 Nystatin drop 30 btl 20,424.00 612,720.00
25
9 Obdhamin 1200 kap 4,616.60 5,539,921.20
26
0 Omeprazole 20 mg 3000 kap 231.99 695,970.00
26
1 Omeprazole 40 mg inj 1000 vial 7,215.00 7,215,000.00
26
2 Ondancetron 4 mg 3000 tab 240.87 722,610.00
26
3 Ondancetron 4mg/2 ml inj 5000 amp 2,575.20 12,876,000.00
26
4 Ondancetron 8 mg 1000 tab 261.96 261,960.00
26
5 Oralit 1000 sachet 749.25 749,250.00
26
6 Orinox 90 mg 1200 tab 8,791.20 10,549,440.00
26
7 Otilon TT 30 btl 39,155.25 1,174,657.50
26
8 Otsu Water inj 25 ml 3600 amp 2,954.82 10,637,352.00
26
9 Oxytocin inj 500 amp 3,296.70 1,648,350.00
27
0 Pantoprazole 40 mg inj 500 vial 29,970.00 14,985,000.00
27
1 Paracetamol 500 mg 10000 tab 207.00 2,069,972.40
27
2 Paracetamol infus 1000 btl 13,875.00 13,875,000.00
27
3 Pehacain inj 300 amp 3,150.87 945,259.63
27
4 Peinlos inj 200 vial 57,997.50 11,599,500.00
27
5 Penagon 500 mg kaplet 5000 tab 1,423.58 7,117,875.00
27
6 Pethidina injeksi 100 amp 19,658.10 1,965,810.00
27
7 Phenobarbital 30 mg 1000 tab 184.66 184,659.60
27
8 Phytomenadion 10 mg 1000 tab 912.00 911,998.20
27
9 Phytomenadion 10 mg inj 200 amp 4,107.00 821,400.00
28
0 Phytomenadion inj 2ml 500 amp 3,818.40 1,909,200.00
28
1 Pipemidat acid 1000 tab 6,089.74 6,089,737.50
28 Piracetam 1 g/5 ml 300 amp
2 5,328.00 1,598,400.00
28
3 Piracetam 1200 mg 1000 tab 1,044.29 1,044,288.00
28
4 Piracetam 3 g injeksi 500 amp 18,641.34 9,320,670.00
28
5 Piracetam 800 mg 1000 tab 777.89 777,888.00
28
6 Prednison 5 mg 1000 tab 78.00 77,999.70
28
7 Prenamia 1000 tab 1,387.50 1,387,500.00
28
8 Promavit 1200 tab 4,218.00 5,061,600.00
28
9 Propanolol 10 mg 1000 tab 77.00 77,000.09
29
0 Propanolol 40 mg 1000 tab 127.83 127,827.60
29
1 Prophylthiouracil 100 mg 1000 tab 495.00 495,000.06
29
2 Propofol inj 100 amp 84,360.00 8,436,000.00
29
3 Protofen supp 300 supp 10,531.13 3,159,337.50
29
4 Provagin Ovula 300 ovula 14,235.75 4,270,725.00
29
5 Pyrazinamide 500 mg 1000 tab 495.28 495,282.00
29
6 QueenVit 600 kap 7,557.25 4,534,350.00
29
7 Ranitidin 150 mg 2000 tab 213.92 427,843.73
29
8 Ranitidin inj 5000 amp 2,390.11 11,950,537.50
29
9 Renalyte 500 btl 20,668.20 10,334,100.00
30
0 Renax 1000 kap 10,228.65 10,228,650.00
30
1 Renosan 500 ml 120 btl 76,701.13 9,204,135.98
30
2 Rhelafen 100 mg susp 500 btl 23,726.25 11,863,125.00
30
3 Rhelafen Forte 200 500 btl 27,944.25 13,972,125.00
30
4 Rifampicin 450 mg 1000 kap 2,113.44 2,113,440.00
30
5 Rifampicin 600 mg 500 tab 1,429.88 714,939.90
30
6 Ringer Lactat infus 12000 btl 8,498.16 101,977,920.00
30
7 Rinvell injeksi 100 amp 35,520.00 3,552,000.00
30
8 Salbutamol 2 mg 5000 tab 179.82 899,100.00
30
9 Salbutamol 4 mg 5000 tab 132.99 664,974.64
31
0 Sanbe Hes infus 240 softbag 238,705.50 57,289,320.00
31
1 Sanbreth nasal drops 5 btl 38,850.00 194,250.00
31
2 Sanmag suspensi 50 btl 29,137.50 1,456,875.00
31
3 Sanmol 2000 tab 466.20 932,400.00
31
4 Sanvita B Plus 1000 tab 4,856.25 4,856,250.00
31
5 Scobutrin 10 mg 3000 tab 2,447.55 7,342,650.00
31
6 Seretide diskus 250 mcg 500 can 132,692.73 66,346,365.00
31
7 Seretide diskus 500 mcg 200 can 146,442.30 29,288,460.00
31
8 Sevoflurane 250 ml 10 btl 2,397,600.00 23,976,000.00
31 Simextam injeksi 120 vial
9 210,900.00 25,308,000.00
32
0 Simvastatin 10 mg 5000 tab 559.07 2,795,351.85
32
1 Simvastatin 20 mg 2000 tab 1,118.16 2,236,321.44
32
2 Sirplus rasa jeruk 40 btl 14,763.00 590,520.00
32
3 Sirplus tablet 20 g 3 btl 44,289.00 132,867.00
32
4 Sodermix krim 15 g 30 tube 89,632.50 2,688,975.00
32
5 Solafexone 1g inj 80 vial 194,250.00 15,540,000.00
32
6 Spironolacton 100 mg 1000 tab 850.00 850,000.04
32
7 Spironolacton 25 mg 2000 tab 275.00 550,000.12
32
8 Stolax Supp 5 mg 100 supp 7,659.00 765,900.00
32
9 Sukralfat 500 mg 2000 tab 2,003.55 4,007,100.00
33
0 Sukralfat suspensi 1000 btl 7,788.87 7,788,870.00
33
1 Suprafenid supp 500 supp 2,379.95 1,189,975.50
33
2 Supramox drop 10 btl 22,144.50 221,445.00
33
3 Suprasma HFA 100 can 30,000.00 3,000,000.33
33
4 symbicort turb 100 can 150,094.20 15,009,420.00
33
5 Tablet tambah darah 5000 tab 224.22 1,121,100.00
33
6 TB Vit 1000 tab 790.88 790,875.00
33
7 Tetagam inj 100 amp 177,000.00 17,700,000.05
33
8 Tramadol 50 mg 1000 kap 5,790.04 5,790,037.50
33
9 Tramadol inj 100 mg/2 ml 200 amp 4,522.14 904,428.00
34
0 Tranexamic Acid 500 mg 2000 tab 1,577.31 3,154,620.00
34
1 Tranexamic Acid 500 mg/5ml inj 1000 amp 9,990.00 9,990,000.00
34
2 Ulvice injeksi 300 amp 25,946.25 7,783,875.00
34
3 Ursodeoxycholic Acid 5000 kap 2,808.30 14,041,500.22
34
4 Valamin Infus 500 btl 48,396.18 24,198,088.80
34
5 Vasola inj 100 vial 249,750.00 24,975,000.00
34
6 Velutine 2,5 mg nebulizer 500 amp 8,205.12 4,102,560.00
34
7 Ventolin Inhaler 100 can 86,929.65 8,692,965.00
34
8 Ventolin Nebulizer 2,5 mg 1000 amp 4,799.97 4,799,973.00
34
9 Vip Albumin 5000 kap 6,290.50 31,452,500.00
35
0 Vip albumin plus 1200 sach 62,900.00 75,480,000.00
35
1 Vitacur sirup 180 btl 47,452.50 8,541,450.00
35
2 Vitamin B komplex + B12 5000 tab 664.34 3,321,675.00
35
3 Vitamin B1 50 mg 1000 tab 108.00 108,003.00
35
4 Vitamin B12 50 mg 5000 tab 74.00 370,018.50
35
5 Vitamin B6 10 mg 1000 tab 99.00 99,000.90
35
6 Vitamin C 50 mg 1000 tab 50.45 50,449.50
35
7 Vitamin C 500 mg 1000 tab 549.45 549,450.00
35
8 Vitamin E 100 mg 3000 tab 1,576.20 4,728,600.00
35
9 Vomilas 1000 kap 5,061.60 5,061,600.00
36
0 Warfarin 2 mg 500 tab 749.25 374,625.00
36
1 Water inj 1000 ml 100 btl 16,527.90 1,652,790.00
36
2 Xepavit 2000 tab 2,636.25 5,272,500.00
36
3 Xepazym 500 kap 3,163.50 1,581,750.00
36
4 Xiety 500 tab 5,272.50 2,636,250.00
36
5 Xylocain top pump spray 10% 2 btl 206,092.01 412,184.01
36
6 Zinc Sulfat 20 mg 1000 tab 333.00 333,000.00
36
7 Zinc sulfat 20 mg sirup 50 btl 8,491.50 424,575.00

TOTAL 2,455,963,566.63
2. PENGADAAN BMKHP E KATALOG Dan NON E KATALOG
VOL. HARGA
NO NAMA OBAT KEBUTUHAN SATUAN SATUAN TOTAL HARGA

1 Alkohol 70% 1L 150 btl 55,500.00 8,325,000.00

2 Alkohol 95% 1L 10 btl 69,930.00 699,300.00

3 Alkohol swab 15000 pcs 164.28 2,464,200.00

4 Apron 10000 pcs 3,663.00 36,630,000.00

5 Aquasonic 250 cc 100 tube 91,575.00 9,157,500.00

6 Aquasonic gel refill 2 ltr 226,440.00 452,880.00

7 Arm sling L 10 pcs 44,400.00 444,000.00

8 Arm sling M 10 pcs 44,400.00 444,000.00

9 Arm Sling S 10 pcs 44,400.00 444,000.00

10 Aseptan 500 ml 120 ltr 65,268.00 7,832,160.00

11 Aseptan 5L 50 galon 453,412.80 22,670,640.00

12 BD Venflon IV 22 200 pcs 33,300.00 6,660,000.00

13 BD Venflon IV 24 100 pcs 44,400.00 4,440,000.00

14 Blood Lancet 200 pcs 333.00 66,600.00

15 Blood transfusi set 200 pcs 19,980.00 3,996,000.00

16 Calsium hidroksite 3 pcs 488,400.00 1,465,200.00

17 Caviton White GC 1 pcs 471,750.00 471,750.00

18 Cervical Colar CC-01 10 pcs 359,640.00 3,596,400.00

19 Cervical Collar Hard L 5 pcs 181,500.00 907,500.00

20 Cervical Collar Hard M 5 pcs 181,500.00 907,500.00

21 Cervical Collar Soft L 5 pcs 82,500.00 412,500.00

22 Cervical Collar Soft M 5 pcs 82,500.00 412,500.00

23 Chloroethyl 100 ml 10 pcs
 277,500.00 2,775,000.00

24 Composite 3M A2 1 pcs 532,800.00 532,800.00

25 Composite 3M A3 1 pcs 532,800.00 532,800.00

26 Cuticell 10 x 10 200 pcs 8,650.00 1,729,999.38

27 Dermafix 10x25 200 pcs 23,310.00 4,662,000.00

28 Duckbill Mask 5000 pcs 3,996.00 19,980,000.00

29 ECG 210x140x180 30 roll 330,800.00 9,924,000.00

30 ECG 80mm x 20m 20 roll 164,280.00 3,285,600.00

31 ECG Electrode dewasa 500 pcs 122,100.00 61,050,000.00

32 Endo 58x20 10 roll 66,600.00 666,000.00

Endotracheal Tube Plan with
33 cuffed no.3 5 pcs 24,831.81 124,159.05
Endotracheal Tube with cuffed
34 3,5 5 pcs 21,090.00 105,450.00
Endotracheal Tube with cuffed
35 4 5 pcs 21,090.00 105,450.00
Endotracheal Tube with cuffed
36 4,5 5 pcs 21,090.00 105,450.00
Endotracheal Tube with cuffed
37 5 10 pcs 21,090.00 210,900.00
Endotracheal Tube with cuffed
38 5,5 10 pcs 21,090.00 210,900.00
Endotracheal Tube with cuffed
39 6,5 10 pcs 21,090.00 210,900.00

40 Etsa 9ml 3M 1 pcs 666,000.00 666,000.00

41 ETT no.2,5 cuffed 5 pcs 36,075.00 180,375.00

42 ETT No.6 NKK 5 pcs 471,750.00 2,358,750.00

43 ETT No.7 NKK 5 pcs 471,750.00 2,358,750.00

44 ETT no.7,5 cuffed 10 pcs 36,075.00 360,750.00

45 FC 2 way No.16 500 pcs 12,210.00 6,105,000.00

46 FC 2 way No.22 20 pcs 11,550.00 231,000.00

47 FC 2 way No.24 20 pcs 15,400.00 308,000.00

48 FC 2way No.10 20 pcs 15,762.00 315,240.00

49 Folley catheter 2way 8Fr 20 pcs 18,381.60 367,632.00

50 Folley catheter 2way no.18 200 pcs 12,210.00 2,442,000.00

51 Folley catheter No.12 50 pcs 19,499.99 974,999.58

52 Folley catheter No.14 50 pcs 19,499.99 974,999.58

53 Formalin 37% 1 L 10 btl 222,000.00 2,220,000.00

54 Gamex No.6,5 500 pair 22,000.00 11,000,000.00

55 Gamex No.7 500 pair 26,640.00 13,320,000.00

56 Gamex No.7,5 500 pair 26,640.00 13,320,000.00

57 Glove Latex L 15000 pcs 843.60 12,654,000.00

58 Glove latex M 30000 pcs 843.60 25,308,000.00

59 Glove latex S 30000 pcs 843.60 25,308,000.00

60 Glove Nitril Examination M 5000 pcs 999.00 4,995,000.00

61 Glove Nitril Examination S 5000 pcs 999.00 4,995,000.00

62 Grounding Plate Bipolar 30 pcs 37,518.00 1,125,540.00

63 Gudel No.0 5 pcs 26,640.00 133,200.00

64 Gudel No.00 5 pcs 26,640.00 133,200.00

65 Gudel No.1 5 pcs 26,640.00 133,200.00

66 Gudel No.2 5 pcs 26,640.00 133,200.00

67 Guedel no.3 5 pcs 26,640.00 133,200.00

68 Guedel no.4 5 pcs 26,640.00 133,200.00

69 Gynaecological Steril Uk.M 100 pcs 72,150.00 7,215,000.00

70 Gypsona 4" 36 roll 28,000.00 1,007,999.99

71 H2O3 3% 800 ml 3 btl 49,950.00 149,850.00

72 Hypafix 10x5 m 500 roll 133,016.85 66,508,425.00

73 ID band anak blue 500 pcs 1,332.00 666,000.00

74 ID Band anak pink 500 pcs 1,332.00 666,000.00

75 ID Band dewasa blue 3000 pcs 1,332.00 3,996,000.00

76 ID Band dewasa pink 3000 pcs 1,332.00 3,996,000.00

77 ID Band NLX 1 blue 3000 pcs 610,500.00 1,831,500,000.00

78 ID Band NLX 2 pink 3000 pcs 610,500.00 1,831,500,000.00

79 Intrafix Primeline 50 pcs 24,420.00 1,221,000.00

80 Intrafix SafeSet 100 pcs 48,840.00 4,884,000.00

81 Iodine Povidone 10% 1L 100 btl 88,800.00 8,880,000.00

82 Iodine Povidone 10% 300 ml 30 btl 69,930.00 2,097,900.00

83 Jackson Rees Infant 5 pcs 1,439,999.00 7,199,995.00

84 Jackson ress 1L 10 pcs 1,332,000.00 13,320,000.00

85 Jackson ress dewasa 10 pcs 471,750.00 4,717,500.00

86 Jepit tali pusat 1000 pcs 2,046.00 2,046,000.00

87 Kapas 500 g 10 roll 52,170.00 521,700.00

88 Kapsul kosong No. 1 3000 pcs 99.90 299,700.00

89 Kapsul kosong No. 2 2000 pcs 81.03 162,060.00

90 Kapsul kosong No.0 5000 pcs 88.80 444,000.00

91 Kapsul kosong No.00 5000 pcs 138.75 693,750.00

92 Kasa 40x80 200 roll 194,250.00 38,850,000.00

93 Kasa steril 16x16 1000 kotak 6,660.00 6,660,000.00

94 Kertas perkamen 10000 pcs 571.65 5,716,500.00

95 Kertas puyer berlem 5000 pcs 1,554.00 7,770,000.00

96 Kit Gown Disposible 200 pcs 54,000.39 10,800,078.00

97 K-Y Jelly 100g 50 tube 93,240.00 4,662,000.00

98 Leukoplast 7,5cm x 4,5 100 roll 55,500.00 5,550,000.00

99 LMA no.1 5 pcs 260,850.00 1,304,250.00

100 LMA no.2 5 pcs 260,850.00 1,304,250.00

101 LMA No.3 5 pcs 277,500.00 1,387,500.00

102 LMA No.4 5 pcs 277,500.00 1,387,500.00

103 Mask O2 + kantong anak 50 pcs 33,300.00 1,665,000.00

104 Mask O2 + kantong dewasa 200 pcs 44,955.00 8,991,000.00

105 Mask O2 Bayi 50 pcs 25,960.00 1,298,000.00

106 Mask O2 dewasa 200 pcs 33,300.00 6,660,000.00

107 Mask O2 anak 100 pcs 33,300.00 3,330,000.00

108 Masker earloop 50000 pcs 799.20 39,960,000.00

109 Masker Headloop 20000 pcs 1,252.08 25,041,600.00

110 Masker KN95 5000 pcs 8,436.00 42,180,000.00

111 Masker Nebo Anak 500 pcs 38,850.00 19,425,000.00

112 Masker Nebo bayi 200 pcs 42,180.00 8,436,000.00

113 Masker Nebo dewasa 1000 pcs 38,850.00 38,850,000.00

114 Masterbond biodinamica 1 pcs 566,100.00 566,100.00

115 Mess No. 22 500 pcs 5,272.50 2,636,250.00

116 Mess No. 23 500 pcs 5,272.50 2,636,250.00

117 Mess No.11 200 pcs 4,995.00 999,000.00

118 Mess No.15 200 pcs 4,995.00 999,000.00

119 Mess no.20 300 pcs 5,272.50 1,581,750.00

120 Mess no.21 300 pcs 5,272.50 1,581,750.00

121 Mess no.24 500 pcs 4,995.00 2,497,500.00

122 Microdrip 500 pcs 9,662.55 4,831,275.00

123 Multizym E-5L 10 galon 1,831,500.00 18,315,000.00

124 Nasal O2 Anak 500 pcs 11,100.00 5,550,000.00

125 Nasal O2 Bayi 200 pcs 11,100.00 2,220,000.00

126 Nasal O2 Neonatus 100 pcs 11,100.00 1,110,000.00

127 Nasal Oxygen Canul Adult 2000 pcs 17,812.17 35,624,340.00

128 Needle 18G 500 pcs 1,032.30 516,150.00

129 Needle 23G 500 pcs 1,554.00 777,000.00

130 Needle 24G 500 pcs 1,380.50 690,250.00

131 Needle 26G 500 psc 1,380.50 690,250.00

132 Needle Agani No.25G 500 pcs 888.00 444,000.00

133 Needle No.27G 500 pcs 1,332.00 666,000.00

134 Neo Tee Infant T-Piece 5 pcs 3,496,500.00 17,482,500.00

135 NGT 8/100 cm 800 pcs 42,735.00 34,188,000.00

136 NGT No.10 200 pcs 55,500.00 11,100,000.00

137 NGT no.12 500 pcs 42,735.00 21,367,500.00

138 NGT No.14 200 pcs 42,735.00 8,547,000.00

139 NGT no.16 800 pcs 42,735.00 34,188,000.00

140 NGT No.18 400 pcs 42,735.00 17,094,000.00

141 NGT no.3,5 200 pcs 42,735.00 8,547,000.00

142 NGT no.5 200 pcs 42,735.00 8,547,000.00

143 Novofine 32G 4mm 1000 pcs 2,100.93 2,100,929.97

144 Nurse cap 40000 pcs 671.55 26,862,000.00

145 Onescrub 5L 20 galon 838,050.00 16,761,000.00

146 Otsu Y adaptor 15000 pcs 9,435.00 141,525,000.00

147 Perfusor tube 150cm 300 pcs 73,260.00 21,978,000.00

148 Pulp-X Devitalizer 1 pcs 1,221,000.00 1,221,000.00

149 Romovac No.14 10 pcs 119,340.54 1,193,405.40

150 Romovac No.16 10 pcs 119,340.54 1,193,405.40

151 Safety Box 12,5Lt 1000 pcs 33,300.00 33,300,000.00

152 Safety box 5L 1000 pcs 17,760.00 17,760,000.00

153 Sendok obat 5000 pcs 2,220.00 11,100,000.00

154 Sikat Operasi 500 pcs 14,430.00 7,215,000.00

155 Sodalime 5L 5 galon 2,081,250.00 10,406,250.00

156 Soffban 4" 100 roll 32,800.50 3,280,050.00

157 Spinocan 25G 100 pcs 67,710.00 6,771,000.00

158 Spinocan 26G 500 pcs 74,925.00 37,462,500.00

159 Spuit 1 cc 10000 pcs 4,162.50 41,625,000.00

160 Spuit 10cc 30000 pcs 1,609.50 48,285,000.00

161 Spuit 20 cc 10000 pcs 2,553.00 25,530,000.00

162 Spuit 3 cc 50000 pcs 1,132.20 56,610,000.00

163 Spuit 5 cc 50000 pcs 1,254.30 62,715,000.00

164 Spuit 50 cc Luer Lock 1000 pcs 8,325.00 8,325,000.00

165 ST. Steril 6,5 50000 pair 8,880.00 444,000,000.00

166 ST. Steril 7 50000 pair 8,880.00 444,000,000.00

167 ST. Steril 7,5 50000 pair 8,880.00 444,000,000.00

168 ST. Steril no.8 30000 pair 8,800.00 264,000,000.00

169 Stopcock 3way 1000 pcs 29,082.00 29,082,000.00

170 Stopcock 3way + Slang 2000 pcs 8,880.00 17,760,000.00

171 Suct Cath. No.14 100 pcs 13,320.00 1,332,000.00

172 Suct. Cath No.6 100 pcs 13,320.00 1,332,000.00

173 Suct. Cath No.8 100 pcs 13,320.00 1,332,000.00

174 Suction cath No.10 100 pcs 13,200.00 1,320,000.00

175 Suction cath. No.12 100 pcs 6,120.40 612,040.00

176 Surflo IV 16 200 pcs 18,870.00 3,774,000.00

177 Surflo IV 18 1000 pcs 18,870.00 18,870,000.00

178 Surflo IV 20 1000 pcs 18,870.00 18,870,000.00

179 Surflo IV 22 3000 pcs 18,870.00 56,610,000.00

180 Surflo IV 24 2000 pcs 18,870.00 37,740,000.00

181 Surflo IV 26 100 pcs 15,540.00 1,554,000.00

182 T-Chromic 2-0 round bodied 120 pcs 62,715.00 7,525,800.00

183 T-Chromic 2-0 Tapercut 120 pcs 64,000.00 7,680,000.00

184 T-Chromic 3-0 round bodied 120 pcs 67,488.00 8,098,560.00

185 Tensocrepe 4" 10 x 4,55cm 200 pcs 132,000.00 26,400,000.00

186 T-Hemocel 60 pcs 75,177.00 4,510,620.00

187 T-Hemovine 8x5 60 pcs 75,682.00 4,540,920.00

188 Thermal Paper 57x50mm 50 roll 55,500.00 2,775,000.00

189 T-Hernia mesh Heavy 36 pcs 136,086.00 4,899,096.00

190 T-Hernia mesh Medium 36 pcs 106,893.00 3,848,148.00

191 T-Lene 2-0 Cutting 240 pcs 81,141.00 19,473,840.00

192 T-Lene 3-0 cutting 240 pcs 80,919.00 19,420,560.00

193 T-Lene 4-0 cutting 240 pcs 77,145.00 18,514,800.00

194 T-Lene 5-0 Cutting 240 pcs 77,145.00 18,514,800.00

195 Torniquet 50 pcs 30,525.00 1,526,250.00

196 T-Plain 1 Round bodied 240 pcs 60,606.00 14,545,440.00

197 T-Plain 2-0 round bodied 240 pcs 56,166.00 13,479,840.00

198 T-Plain 2-0 tapercut 240 pcs 64,824.00 15,557,760.00

199 T-Plain 3-0 round bodied 240 pcs 59,829.00 14,358,960.00

200 Transofix 500 pcs 11,211.00 5,605,500.00

201 T-Silk 1 round bodied 120 pcs 55,389.00 6,646,680.00

202 T-Silk 2-0 cutting 120 pcs 40,737.00 4,888,440.00

203 T-Silk 3-0 cutting 120 pcs 45,510.00 5,461,200.00

204 T-Vio 1 tapercut 360 pcs 81,918.00 29,490,480.00

205 T-Vio 2 round bodied 360 pcs 91,797.00 33,046,920.00

206 T-Vio 2-0 round bodied 360 pcs 79,365.00 28,571,400.00

207 T-Vio 2-0 tapercut 360 pcs 84,915.00 30,569,400.00

208 T-Vio 3-0 cutting 360 pcs 84,360.00 30,369,600.00

209 T-Vio 3-0 round bodied 360 pcs 77,478.00 27,892,080.00

210 T-Vio 4-0 cutting 360 pcs 70,707.00 25,454,520.00

211 T-Vio 4-0 Round Bodied 360 pcs 81,696.00 29,410,560.00

212 Underpad SP 10000 pcs 6,105.00 61,050,000.00

213 Urine bag 500 pcs 8,325.00 4,162,500.00

214 USG Paper 110 x 18 120 roll 321,900.00 38,628,000.00

TOTAL 7,609,038,952.35
3. PENGADAAN REAGEN E KATALOG DAN NON E KATALOG
VOL.
KEBUTUHA HARGA
NO NAMA OBAT N SATUAN SATUAN TOTAL HARGA
12,000,000
1 HBsAg 30 box 400,000.00 .00
7,750,000
2 HIV 1/2 Triline 10 box 775,000.00 .00
14,000,000
3 Shipylis Dev 20 box 700,000.00 .00
21,000,000
4 HCV Dev 30 box 700,000.00 .00
15,000,000
5 Malaria Dev 10 box 1,500,000.00 .00
1,350,000
6 Gol. Darah A 10 vial 135,000.00 .00
1,350,000
7 Gol. Darah B 10 vial 135,000.00 .00
1,800,000
8 Gol. Darah D 10 vial 180,000.00 .00
6,750,000
9 Hb Stik 30 box 225,000.00 .00
8,750,000
10 Lyse Waplab 5 botol 1,750,000.00 .00
20,000,000
11 Cassete with Lids Whitebox 5 vial 4,000,000.00 .00
38,462,000
12 NB Formalin 10% 20 pak 1,923,100.00 .00
6,600,000
13 Dengue NS1 2 box 3,300,000.00 .00
48,000,000
14 Bloodbag double 500 pcs 96,000.00 .00
710,00
15 Widal AO 5 vial 142,000.00 0.00
450,00
16 Bovine Albumin 3 vial 150,000.00 0.00
875,00
17 Anti Human Globulin 5 galon 175,000.00 0.00
15,000,000
18 Diluent WapLAb 5 vial 3,000,000.00 .00
9,500,000
19 Cleanser WapLab 5 botol 1,900,000.00 .00
14,000,000
20 Instan Eosin 2 kit 7,000,000.00 .00
13,000,000
21 Instan Hematoxyline 2 kit 6,500,000.00 .00
14,400,000
22 HbSAb 30 box 480,000.00 .00
2,300,000
23 Urinalysis stik 10 box 230,000.00 .00
6,750,000
24 Strip Hb 30 box 225,000.00 .00
710,00
25 Widal O 5 vial 142,000.00 0.00
710,00
26 Widal BO 5 vial 142,000.00 0.00
2,240,000
27 Alat 2 kit 1,120,000.00 .00
3,200,000
28 Urea 2 kit 1,600,000.00 .00
7,770,000
29 HIV 10 box 777,000.00 .00
30 Pedriatric bloodbag 50 pcs 30,250,000
 605,000.00 .00
7,950,000
31 Larutan Extran Netral 5 botol 1,590,000.00 .00
332,627,000.
TOTAL 00
4. PENGADAAN RADIOLOGI E KATALOG DAN NON E KATALOG
VOL.
NO NAMA OBAT KEBUTUHAN SATUAN HARGA SATUAN TOTAL HARGA
7,836,600.
1 Fujira Film FHR 24x30 400 lbr 19,591.50 00
16,317,000.0
2 Fujira Film FHR 30x40 500 lbr 32,634.00 0
19,980,000.0
3 Fujira Film FHR 35x35 600 lbr 33,300.00 0
44,133,600.0
TOTAL 0

G. METODE PELAKSANAAN
1. Tahap Pelaksanaan
Metode Pelaksanaan kegiatan pengadaan prasarana dan pendukung fasilitas pelayanan
kesehatan dilakukan dengan pengadaan langsung.

2. Tahap Pelaksanaan
Rencana Pengadaan Perbekaln Farmasi pelaksanaan dilaksanakan pada tahun anggaran
2024. Tahapan Pelaksanaan kegiatan tersebut diatur dengan tahapan sebagai berikut :

Tahapan Bulan Ke
No.
Kegiatan 1 2 3 4 5 6 7 8 9 10 11 12
Pengadaan Perbekalan Farmasi

1 Perencanaan

2 Pelaksanaan

4 Pencatatan dan
Pelaporan
5 Monitoring dan
Evaluasi

H. SUMBER BIAYA
Sub Kegiatan Pengadaan Perbekalan Farmasi Belanja Obat adalah dana BLUD tahun 2024

Tamiang Layang, Januari 2024

Kepala Instalasi Farmasi
RSUD Tamaing Layang

Sri Romiati, S.Farm.,Apt

NIP.19810716 201001 2017