no. jenis barang spesifikasi satuan harga 1 2 3 4 5 alat dan bahan... · 31 ampisilin sirup...

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NO. JENIS BARANG SPESIFIKASI SATUAN HARGA

1 2 3 4 5

KESEHATAN

DAFTAR OBAT-OBATAN

1ACT (Artesunate tablet 50 mg +

Amodiaquine anhydrida tablet 200 mg)

2 blister @

12 tablet / kotakTABLET 36,300

2ACT (Artesunate tablet 50 mg +

Amodiaquine anhydrida tablet 200 mg)

3 blister @

8 tablet / kotakTABLET 36,300

3 Albendazol suspensi 200 mg/5 ml ktk 10 btl @ 10 ml ML 4,235

4Albendazol tablet/tablet kunyah 400

mgktk 5 x 6 tablet TABLET 13,420

5 Alopurinol tablet 100 mg ktk 10 x 10 tablet TABLET 14,520

6 Alopurinol tablet 300 mg ktk 3 x 10 tablet TABLET 8,085

7 Alprazolam tablet 0,25 mg ktk 10 x 10 tablet TABLET 53,240

8 Alprazolam tablet 0,5 mg ktk 10 x 10 tablet TABLET 64,350

9 Alprazolam tablet 1 mg ktk 10 x 10 tablet TABLET 99,000

10 Ambroxol sirup 15 mg/ml btl 60 ml ML 3,630

11 Ambroxol tablet 30 mg ktk 10 x 10 tablet TABLET 13,758

12 Amilorida tablet 5 mg (HCl) ktk 10 x 10 tablet TABLET 9,701

13 Aminofilin injeksi 24 mg/ml ktk 30 ampul @ 10 ml ML 99,000

14 Aminofilin tablet 150 mg btl 1000 tablet TABLET 47,876

15 Aminofilin tablet 200 mg btl 100 tablet TABLET 12,463

16 Amitriptilin tablet salut 25 mg (HCl) ktk 10 x 10 tablet salut TABLET 13,201

17 Amlodipin tablet 5 mg ktk 3 x 10 tablet TABLET 31,680

18 Amlodipin tablet 5 mg ktk 5 x 10 tablet TABLET 52,800

19 Amlodipin tablet 10 mg ktk 3 x 10 tablet TABLET 55,880

20 Amlodipin tablet 10 mg ktk 5 x 10 tablet TABLET 93,104

21Amoksisilin + As. Klavulanat 625 mg

tabletktk 5 x 6 tablet TABLET 166,835

22 Amoksisilin kapsul 250 mg ktk 10 x 10 kapsul KAPSUL 31,614

23 Amoksisilin kapsul 250 mg ktk 12 x 10 kapsul KAPSUL 38,115

24 Amoksisilin kaplet 500 mg ktk 10 x 10 kaplet KAPSUL 40,700

25 Amoksisilin serbuk injeksi 1000 mg ktk 10 vial VIAL 82,500

26 Amoksisilin sirup kering 125 mg/ 5 ml btl 60 ml ML 4,070

27 Ampisilin kaplet 250 mg ktk 10 x 10 kaplet KAPLET 29,590

28 Ampisilin kaplet 500 mg ktk 10 x 10 kaplet KAPLET 41,910

29Ampisilin serbuk injeksi i.m./i.v.

1000 mg/vialktk 10 vial VIAL 59,048

OBAT-OBATAN, ALAT DAN BAHAN KESEHATAN, PERTANIAN, PERKEBUNAN DAN

PETERNAKAN

STANDARISASI HARGA BARANG DAN JASA PEMERINTAH PROVINSI SULAWESI UTARA TAHUN 2013

NO. JENIS BARANG SPESIFIKASI SATUAN HARGA

1 2 3 4 5

30Ampisilin serbuk injeksi i.m./i.v.

500 mg/vialktk 10 vial VIAL 33,000

31 Ampisilin sirup kering 125 mg/5 ml btl 60 ml ML 4,840

32

Antasida DOEN I tablet kunyah,

kombinasi :

Aluminium Hidroksida 200 mg

Magnesium Hidroksida 200 mg

ktk 10 x 10 tablet kunyah TABLET 17,820

33

Antasida DOEN II suspensi, kombinasi :

Aluminium Hidroksida 200 mg/5 ml

Magnesium Hidroksida 200 mg/5 ml

btl 60 ml ML 4,235

34

Anti Bakteri DOEN salep kombinasi:

Basitrasin 500 IU/g + Polimiksin 10.000

IU/g

ktk 25 tube @ 5 gram TUBE 69,212

35Antifungi DOEN Kombinasi:

Asam Benzoat 6% + Asam Salisilat 3%ktk 24 pot @ 30 gram POT 45,375

36

Antihemoroid DOEN kombinasi :

Bismut subgalat 150 mg

Heksaklorofen 2,5 mg

ktk 10 supp SUPP 22,000

37

Antimalaria DOEN kombinasi :

Pirimetamin 25 mg

Sulfadoksin 500 mg

ktk 10 x 10 tablet TABLET 53,075

38Antimigren:

Ergotamin Tartrat 1 mg + Kofein 50 mgbtl 100 tablet TABLET 13,563

39

Antiparkinson DOEN tablet kombinasi:

Karbidopa 25 mg

Levodopa 250 mg

ktk 10 x 10 tablet TABLET 139,711

40 Aqua pro Injeksi steril, bebas pirogen ktk 10 vial @ 20 ml VIAL 60,500

41 Artemether injeksi 80 mg/ml ktk 6 ampul AMPUL 146,300

42 Artesunate injeksi, vial 60 mg ktk 8 vial VIAL 220,550

43Asam Asetilsalisilat tablet 100 mg

(Asetosal)ktk 10 x 10 tablet TABLET 10,560

44Asam Asetilsalisilat tablet 500 mg

(Asetosal)ktk 10 x 10 tablet TABLET 17,138

45Asam Askorbat (Vitamin C) tablet

250 mgbtl 250 tablet TABLET 35,200

46Asam Askorbat (Vitamin C) tablet

100 mgbtl 500 tablet TABLET 23,692

47 Asam Askorbat (Vitamin C) tablet 50 mg btl 1000 tablet TABLET 35,200

48 Asam Folat tablet 1 mg btl 100 tablet TABLET 7,480

49 Asam Folat tablet 5 mg btl 1000 tablet TABLET 51,700

50 Asam Mefenamat kapsul 250 mg ktk 10 x 10 kapsul KAPSUL 13,552

51 Asam Mefenamat kaplet 500 mg ktk 10 x 10 kaplet KAPLET 19,360

52 Asetazolamid tablet 250 mg btl 100 tablet TABLET 19,538

53 Asiklovir krim 5% tube 5 gram TUBE 3,465

54 Asiklovir krim 5% ktk 25 tube @ 5 gram TUBE 82,500

55 Asiklovir tablet 200 mg ktk 3 x 10 tablet TABLET 16,005

56 Asiklovir tablet 200 mg ktk 5 x 10 tablet TABLET 29,343

STANDARISASI HARGA BARANG DAN JASA PEMERINTAH PROVINSI SULAWESI UTARA TAHUN 2013

NO. JENIS BARANG SPESIFIKASI SATUAN HARGA

1 2 3 4 5

57 Asiklovir tablet 200 mg ktk 10 x 10 tablet TABLET 42,700

58 Asiklovir tablet 400 mg ktk 3 x 10 tablet TABLET 24,008

59 Asiklovir tablet 400 mg ktk 5 x 10 tablet TABLET 34,678

60 Asiklovir tablet 400 mg ktk 10 x 10 tablet TABLET 62,846

61 Atenolol tablet 100 mg ktk 5 x 10 tablet TABLET 28,046

62 Atenolol tablet 50 mg ktk 10 x 10 tablet TABLET 29,677

63Atropin injeksi i.m./i.v./s.k. 0,25 mg/ml

(Sulfat)ktk 30 ampul @ 1 ml AMPUL 41,745

64 Atropin Sulfat tablet 0,5 mg btl 100 tablet TABLET 6,600

65 Atropin Sulfat tablet 0,5 mg btl 500 tablet TABLET 38,720

66 Atropin Sulfat tetes mata 0,5% ktk 24 btl @ 5 ml BOTOL 73,938

67 Atropin Sulfat tetes mata 0,5 % btl 5 ml BOTOL 3,328

68 Azatioprin tablet 50 mg ktk 10 x 10 tablet TABLET 23,043

69Benzatin Benzil Penisilin 1,2 juta

IU/ vialktk 10 vial @ 20 ml VIAL 90,200

70Benzatin Benzil Penisilin 2,4 juta

IU/vialktk 10 vial @ 20 ml VIAL 125,400

71Besi (II) sulfat 7 H2O tablet salut

300 mgbtl 1000 tablet salut TABLET 28,855

72

Besi (II) Sulfat 200 mg + Asam Folat

0,25 mg tablet (tablet tambah darah

kombinasi )

1 bungkus @ 30 tablet TABLET 2,200

73 Betahistin Mesilat tablet 6 mg ktk 3 x 10 tablet TABLET 30,492

74 Betametason krim 0,1 % (sebagai Valerat) tube 5 gram TUBE 2,229

75 Betametason krim 0.1 % (sebagai Valerat) ktk 25 tube @ 5 gram TUBE 51,315

76 Betametason tablet 0,5 mg ktk 10 x 10 tablet TABLET 7,697

77 Bisoprolol tablet 5 mg ktk 3 x 10 tablet TABLET 76,615

78 Bromheksin tablet 8 mg ktk 10 x 10 tablet TABLET 4,237

79 Cetirizin sirup 5 mg/5 ml btl 60 ml BOTOL 11,495

80 Cetirizine tablet 10 mg ktk 3 x 10 tablet TABLET 10,890

81 Cetirizine tablet 10 mg ktk 5 x 10 tablet TABLET 17,243

82 Cisapride tablet 10 mg ktk 10 x 10 tablet TABLET 149,435

83 Cisapride tablet 5 mg ktk 10 x 10 tablet TABLET 86,213

84 Clobazam tablet 10 mg ktk 10 x 10 tablet TABLET 104,500

85 Clobetasol krim 0,05% tube 10 gram TUBE 12,874

86 Dapson tablet 100 mg btl 1000 tablet TABLET 34,650

87 Deksametason injeksi i.v. 5 mg/ml ktk 100 ampul @ 1 ml AMPUL 220,220

88 Deksametason tablet 0,5 mg ktk 10 x 10 tablet TABLET 9,570

STANDARISASI HARGA BARANG DAN JASA PEMERINTAH PROVINSI SULAWESI UTARA TAHUN 2013

NO. JENIS BARANG SPESIFIKASI SATUAN HARGA

1 2 3 4 5

89 Dekstran 70 larutan infus 6% steril btl 500 ml BOTOL 39,079

90Dekstrometorfan sirup 10 mg/5 ml

(HBr)btl 60 ml BOTOL 3,152

91 Dekstrometorfan tablet 15 mg (HBr) ktk 10 x 10 tablet TABLET 12,100

92 Diazepam injeksi 5 mg/ml ktk 30 ampul @ 2 ml AMPUL 78,147

93 Diazepam tablet 2 mg btl 100 tablet TABLET 3,509

94 Diazepam tablet 2 mg ktk 10 x 10 tablet TABLET 4,400

95 Diazepam tablet 5 mg btl 250 tablet TABLET 13,200

96 Diazepam tablet 5 mg btl 100 tablet TABLET 5,280

97 Diazepam tablet 5 mg ktk 10 x 10 tablet TABLET 7,260

98 Dietilkarbamazin Sitrat tablet 100mg ktk 10 x 10 tablet TABLET 10,725

99Difenhidramin injeksi i.m. 1