Kepada Yth.

Bapak Direktur RSUD Rantauprapat

c/q PPK Obat dan BMHP

Daftar Usulan Kebutuhan Obat

JLH REFERENSI CATATAN /
NO NAMA OBAT SPESIFIKASI SATUAN
PESAN PENYEDIA ONLINE / OFFLINE KETERANGAN
1 Chloramphenicol SM 1% 1% Tube 250 PT. Erela https://e-katalog.lkpp.go.id/katalog/produk/detail/7684
2 Furosemide Tablet 40 mg Tablet 50.000 PT. Yarindo https://e-katalog.lkpp.go.id/katalog/produk/detail/5702
3 Amlodipin 5 mg 5 mg Tablet 25.000 PT. Bernofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/4748
4 Haloperidol 5 mg 5 mg Tablet 2.000 PT. Holi Pharma https://e-katalog.lkpp.go.id/katalog/produk/detail/4836
5 Manitol 20% 20% Botol 50 PT. Finusolprima https://e-katalog.lkpp.go.id/katalog/produk/detail/4966
6 Gentamisin Salep Mata 0,3 % 0,30% Tube 400 PT. Erela https://e-katalog.lkpp.go.id/katalog/produk/detail/4966
7 Gentamisin Salep Kulit 1 mg 0,10% Tube 600 CV. Bima Jaya Medika https://e-katalog.lkpp.go.id/katalog/produk/detail/7650
8 Fluvoxamine Maleat Tablet 50 mg, @ 60 Tablet 3.600 PT. Abbot Indonesia https://e-katalog.lkpp.go.id/katalog/produk/detail/4942
9 Paracetamol Tablet 500 mg Tablet 50.000 PT. Bernofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/4796
10 Loperamide Tablet 2 mg Tablet 2.000 PT. Ifars https://e-katalog.lkpp.go.id/katalog/produk/detail/4952
11 Neostigmine hameln 0.5 mg/ml Ampul 200 PT. Pratapa Nirmala https://e-katalog.lkpp.go.id/katalog/produk/detail/4898
12 Ryzodeg 100 IU/ml Pen 200 PT. Ferron https://e-katalog.lkpp.go.id/katalog/produk/detail/4959
13 Lansoprazol Inj 30 mg Vial 2.500 PT. Pratapa Nirmala https://e-katalog.lkpp.go.id/katalog/produk/detail/4888
14 Sevoflurane Inhalasi 250 ml Botol 18 PT. Yarindo https://e-katalog.lkpp.go.id/katalog/produk/detail/5452
15 Pletaal (Silostazol) Tablet 100 mg, @ Tablet 6.000 PT. Otsuka Indonesia https://e-katalog.lkpp.go.id/katalog/produk/detail/4979
16 Lansoprazol Kapsul 30 mg, @ 50 Kapsul 30.000 PT. Hexpharm Jaya https://e-katalog.lkpp.go.id/katalog/produk/detail/4921
17 Glimepirid 2 mg 2 mg Tablet 6.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4998
18 Novorapid Flexpen 100 IU/ml Pen 250 PT. Beta Pharmacon https://e-katalog.lkpp.go.id/katalog/produk/detail/4940
19 Permetrin Krim 5 % 5% Tube 250 PT. Combiphar https://e-katalog.lkpp.go.id/katalog/produk/detail/4970
20 Fleet Enema 133 ml Botol 40 PT. Combiphar https://e-katalog.lkpp.go.id/katalog/produk/detail/4969
21 NTG inj 1 mg/ml Amp 100 PT. Ferron https://e-katalog.lkpp.go.id/katalog/produk/detail/6928
22 Levemir Flexpen 100 IU/ml Pen 100 PT. Beta Pharmacon https://e-katalog.lkpp.go.id/katalog/produk/detail/4905
23 Sansulin Log-G 100 IU/ml Pen 100 PT. Sanbe Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4848
24 Fenofibrate 100 100 mg Tablet 2.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4998
25 Midazolam 1 mg/ml Ampul 100 PT. Kalbe Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4913
26 Hemafo 3000 IU Syringe 150 PT. Kalbe Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4913
27 Herbesser CD (Diltiazem) Tab 100 mg Tablet 1.000 PT. Mitshubishi https://e-katalog.lkpp.go.id/katalog/produk/detail/4947
28 Infimycin 500 mg Inj 500 mg Vial 150 PT. Infion https://e-katalog.lkpp.go.id/katalog/produk/detail/5046
Ref Harga : 83.250
29 Ketamin Injeksi 50 mg/ml Vial 50 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4998
30 Kompolax Sirup 60 ml Botol 200 PT. Ifars https://e-katalog.lkpp.go.id/katalog/produk/detail/7489
31 Lactulose Sirup 3,335 g/5 mL Botol 150 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4999
32 Lacyvir Krim 5% 5% Tube 50 PT. Sampharindo https://e-katalog.lkpp.go.id/katalog/produk/detail/7662
33 Larutan D5-1/2 NS Infus 500 ml D5-1/2 NS Botol 20 PT. Otsuka Indonesia https://e-katalog.lkpp.go.id/katalog/produk/detail/4923
34 Larutan D5-1/4 NS Infus 500 ml D5-1/4 NS Botol 40 PT. Otsuka Indonesia https://e-katalog.lkpp.go.id/katalog/produk/detail/4924
35 Levopar 100/25 Tablet 7.000 PT. Meprofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/4596
36 Metoclopramide Inj 10mg/2ml Ampul 2.500 PT. Meprofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/4606
37 Metronidazol Tablet 500 mg Tablet 10.000 PT. Holi Pharma https://e-katalog.lkpp.go.id/katalog/produk/detail/4788
38 Meylon (Sodium Bicarbonat) 8.4% Fls 240 PT. Otsuka Indonesia https://e-katalog.lkpp.go.id/katalog/produk/detail/4914
39 Natrium Diklofenak tab 50 mg Tablet 40.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4994
40 Nifedipin 10 mg Tablet 600 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4994
41 Norepinephrine 1 mg/ml Injeksi 4 ml, @ 5 Ampul 400 PT. Hexpharm Jaya https://e-katalog.lkpp.go.id/katalog/produk/detail/4927
42 Nystatin Drop 100.000 IU Botol 300 PT. Bernofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/4986
43 Octalbin 25 50 ml, 25% Botol 100 PT. Kalbe Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4908
44 Olanzapin 5 mg 5 mg, @30 Tablet 1.200 PT. Amarox Pharma https://e-katalog.lkpp.go.id/katalog/produk/detail/4852
45 Omeprazol Kapsul 20 mg Kapsul 15.000 PT. Hexpharm Jaya https://e-katalog.lkpp.go.id/katalog/produk/detail/4927
46 Ondansetron Inj 4mg/2ml Ampul 6.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4994
47 Oxytocin 10 IU Ampul 1.000 PT. Ethica Industri https://e-katalog.lkpp.go.id/katalog/produk/detail/4807
48 Propylthiouracil Tablet 100 mg, Tablet 6.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4993
49 Revatio Tablet @100
20 mg, @ 90 Tablet 1.800 PT. Pfizer Indonesia https://e-katalog.lkpp.go.id/katalog/produk/detail/4847
 50 Risperidon 2 mg 2 mg Tablet 30.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4992
51 Simvastatin 20 mg 20 mg Tablet 20.000 PT. Hexpharm Jaya https://e-katalog.lkpp.go.id/katalog/produk/detail/4945
52 Stalevo Tablet 3.000 PT. Imedco Djaya https://e-katalog.lkpp.go.id/katalog/produk/detail/4608
53 (Levodopa+Carbidopa+Entacapon
Tenofovir tablet 300 mg, @ Tablet 900 PT. Kimia Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4596
54 Tramadol Inj 30 mg/ml
50 Ampul 1.800 PT. Bernofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/4958
55 Uperio 24,3/25,7 Tablet 50 mg, @ 28 Tablet 8.400 PT. Novartis https://e-katalog.lkpp.go.id/katalog/produk/detail/4941
56 Ursodeoxycholic Acid 250 mg Kapsul 4.500 PT. Meprofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/4604
57 Valproic Acid Sirup 250 mg/5ml Botol 250 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4990
58 Valsartan 80 mg @ 30 80 mg Tab 2.400 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4989
59 Benzatin Benzil Penisilin 2,4 jt UI/ml Vial 20 PT. Phapros https://e-katalog.lkpp.go.id/katalog/produk/detail/4780
60 Aspilet 80 mg Tab 40.000 PT. Darya Varia https://e-katalog.lkpp.go.id/katalog/produk/detail/7499
61 Cendo Floxa (Ofloxacin) 0,3 % 0,6 ml Strip 800 https://e-katalog.lkpp.go.id/katalog/produk/detail/7584
PT. Prima Mulia Mandiri
62 Cendo Noncort TM 0,6 ml Strip 500 https://e-katalog.lkpp.go.id/katalog/produk/detail/7425
PT. Prima Mulia Mandiri
63 Cendo Pantocaine TM 2% 5 ml Btl 50 https://e-katalog.lkpp.go.id/katalog/produk/detail/7421
PT. Prima Mulia Mandiri
64 Diazepam Rectal Tube 5 mg/2,5 Tube 40 PT. Actavis https://e-katalog.lkpp.go.id/katalog/produk/detail/4817
65 ml
Dextrose 10 % 0,1 Botol 300 PT. Otsuka https://e-katalog.lkpp.go.id/katalog/produk/detail/4926
66 Allopurinol 100 100 mg Tablet 6.000 PT. Kimia Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4596
67 Asering infus/Ringer Asetat Botol 400 PT. Otsuka https://e-katalog.lkpp.go.id/katalog/produk/detail/4925
68 Vitamin B Kompleks Tablet 30.000 PT. Kimia Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4597
69 Betahistin 6 mg 6 mg Tablet 6.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4990
70 Betametasone krim 0,1 % Tube 500 PT. Kimia Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4596
71 Bisoprolol 2,5 2,5 mg Tablet 60.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4991
72 Ticaglelor 90 mg Tablet 3.000 PT. Dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/7554
73 Bucain (Bupivacaine) Spinal Ampul 400 PT. Bernofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/5989
74 Calcium Carbonat/ Calren 500 mg Tablet 2.100 PT. Infion https://e-katalog.lkpp.go.id/katalog/produk/detail/5263
75 Ca Gluconas 24 Ampul / Ampul 96 PT. Dexa medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4991
76 Captopril 25 mg Box
25mg Tablet 5.000 PT. dexa Medica https://e-katalog.lkpp.go.id/katalog/produk/detail/4991
77 Cefixime 100 100 mg Tablet 20.000 PT. Hexpharm https://e-katalog.lkpp.go.id/katalog/produk/detail/4917
78 Ceftriaxone 1000 mg Vial 9.000 PT. Hexpharm https://e-katalog.lkpp.go.id/katalog/produk/detail/4917
79 Cendo Vitrolenta Eye Drop Botol 600 https://e-katalog.lkpp.go.id/katalog/produk/detail/7584
PT. Prima Mulia Mandiri
80 Cetirizin Tablet 10 mg Tablet 15.000 PT. Hexpharm https://e-katalog.lkpp.go.id/katalog/produk/detail/4917
81 Clopidogrel 75 75 mg, @ 30 Tablet 30.000 PT. Kimia Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/4596
82 Sodium Bicarbonat 500 mg Tablet 20.000 PT. Balatif https://e-katalog.lkpp.go.id/katalog/produk/detail/7454
Tidak Aktif
83 Isoniazid 100 mg 100 mg Tablet 2.000 PT. Kimia Farma https://e-katalog.lkpp.go.id/katalog/produk/detail/7141
Stok Tidak Cukup
84 Rifampicin 450 450 mg Tablet 3.000 PT. Bernofarm Tidak Aktif
https://e-katalog.lkpp.go.id/katalog/produk/detail/4797
85 Sandepril (Maprotiline) 50 mg Tablet 1.000 PT. Mersifarma https://e-katalog.lkpp.go.id/katalog/produk/detail/4851
Tidak Aktif
86 Bisacodyl Tablet 5 mg Tablet 1.000 PT. Harsen https://e-katalog.lkpp.go.id/katalog/produk/detail/4827
Stok Tidak Cukup
87 Colsancetine Inj 1 gr Vial 250 PT. Sanbe OFFLINE Tidak Ada di E Katalog
88 Dulcolax Supp 5 mg Supp 400 PT. Boehringer OFFLINE Tidak Ada di E Katalog
89 Rifampicin 600 600 mg Tablet 5.000 PT. Bernofarm https://e-katalog.lkpp.go.id/katalog/produk/detail/4797
Stok Tidak Cukup

Disetujui Oleh, Rantauprapat, 05 Februari 2024

Pejabat Pembuat Komitmen Kepala Instalasi Farmasi

Abner Sitanggang, S.T Deddy Kurniawan Nst, S.Si., Apt

NIP. 19740504 200502 1 001 NIP. 19800318 201101 1 006

Diketahui Oleh,
Direktur RSUD Rantauprapat

Dr. Syafril Rahmadi Maulana, SpB

NIP. 19650616 200012 1 001