NO BAGIAN JUMLAH HARGA JASA

1 Dokter (Ketua) 1 IDR 1,000,000

2 Dokter 4 IDR 600,000
3 Farmasi 1 IDR 250,000
4 pengukuran dan penimbangan BB tensi 2 IDR 250,000
5 Lab sederhana 1 IDR 250,000
Snack 250
TOTAL

NO NAMA OBAT KEMASAN HARGA

ANTIBIOTIK
1 Amoksisilin kaplet 500 mg ktk 10 x 10 kaplet Rp 30,000
2 Amoksisilin sirup 250 mg/ 5 ml btl 60 ml Rp 5,000
3 Ketokonazol tablet 200 mg ktk 5 x 10 tablet Rp 20,000
4 Kotrimoksazol 480 mg ktk 10 x 10 tablet Rp 40,000
5 Kotrimoksazol Sirup btl 60 ml Rp 4,000
6 Metronidazol tablet 500 mg ktk 10 x 10 tablet Rp 20,000
7 Siprofloksasin tablet 500 mg ktk 10 x 10 tablet Rp 30,000
8 Tiamfenikol kapsul 500 mg ktk 10 x 10 kapsul Rp 180,000
9 Acyclovir 400 mg 5 blister x 10 tablet Rp 35,000
10 Clindamycin 300 mg 5 blister x 10 tablet Rp 60,000
11 Pirantel Pamoat Tablet 125mg satuan terkecil Rp 15,000
TOTAL
ANALGETIK-ANTIPIRETIK-ANTIINFLAMASI
1 Asam Mefenamat kaplet 500 mg ktk 10 x 10 kaplet Rp 18,500
2 Ibuprofen tablet 400 mg ktk 10 x 10 kaplet Rp 25,000
3 Betahistin 6 mg ktk 3 x 10 tablet Rp 17,000
4 Natrium Diklofenak tablet 50 mg ktk 5 x 10 kaplet Rp 15,000
5 Parasetamol tablet 500 mg ktk 10 x 10 tablet Rp 12,000
6 Parasetamol sirup 120 mg / 5 ml btl 60 ml Rp 3,500
7 Thrombo aspilet 80 mg 5 blister x 30 tablet Rp 150,000
8 Piroksikam tablet 20 mg ktk 10 x 10 tablet Rp 25,000
9 Antalgin 500 mg ktk 10 x 10 tablet Rp 40,000
TOTAL
ANTIALERGI-STEROID
1 Klorfeniramina Maleat (CTM) tablet 4 mg btl 100 tablet Rp 11,000
2 Metilprednisolon 4 mg ktk 10 x 10 tablet Rp 27,500
3 Cetirizine 10 mg ktk 5 x 10 tablet Rp 15,000
4 Deksametason tablet 0,5 mg ktk 10 x 10 tablet Rp 6,000
5 Prednison tablet 5 mg ktk 10 x 10 tablet Rp 25,000
TOTAL
ANTIHIPERTENSI-CARDIOVASKULAR
1 Kaptopril tablet 12,5 mg ktk 10 x 10 tablet Rp 15,000
2 Kaptopril tablet 25 mg ktk 10 x 10 tablet Rp 12,000
3 Furosemid tablet 40 mg ktk 10 x 10 tablet Rp 15,000
4 ISDN 5 mg ktk 10 x 10 tablet Rp 15,000
5 Hidroklorotiazida tablet 25 mg ktk 10 x 10 tablet Rp 25,000
6 Amlodipin tablet 5 mg ktk 10 x 10 tablet Rp 24,000
7 Amlodipin tablet 10 mg ktk 10 x 10 tablet Rp 44,000
TOTAL
OBAT GASTROINTESTINAL
1 Antasida tablet kunyah ktk 10 x 10 tablet Rp 10,000
2 Antasida sirup btl 60 ml Rp 7,000
3 Ranitidin tablet 150 mg ktk 10 x 10 tablet Rp 15,000
4 Loperamide HCL 2 mg ktk 10 x 10 kaplet Rp 21,500
5 Domperidone 10 mg ktk 5 x 10 tablet Rp 19,000
6 Metoklopramide tablet 10 mg ktk 10 x 10 tablet Rp 15,000
7 Omeprazol kapsul 20 mg ktk 3 x 10 kapsul Rp 11,000
8 Garam Oralit I serbuk ktk 100 bungkus Rp 53,000
9 Spasminal ktk 10 x 10 tablet Rp 50,000
10 Neo Diaform btl 500 tablet Rp 17,500
11 Dulcolax/Bisacodyl satuan terkecil Rp 1,500
12 Vitazym ktk 10 x 10 tablet Rp 45,000
TOTAL
OBAT ASMA
1 Salbutamol tablet 4 mg ktk 10 x 10 tablet Rp 15,000
2 Salbutamol tablet 2 mg ktk 10 x 10 tablet Rp 12,000
3 Aminofilin tablet 200 mg btl 1000 tablet Rp 126,000
4 Teosal ktk 10 x 10 tablet Rp 16,500
TOTAL
OBAT FLU-BATUK
1 Bromhexin tablet 30 mg ktk 10 x 10 tablet Rp 13,500
2 Obat Batuk Hitam ( O.B.H. ) cairan btl 200 ml Rp 5,000
3 Demacolin ktk 10 x 10 tablet Rp 42,500
4 Flutrop ktk 10 x 10 tablet Rp 110,000
5 Intunal F satuan terkecil Rp 62,500
6 Baby cought syrup 60 ml Rp 4,500
TOTAL
ROBORANTIA
1 Vitamin B comp btl 250 tab Rp 12,000
2 Vitamin C tablet 100 mg 500 tablet Rp 31,000
3 Calcium lactat btl 250 tab Rp 20,000
4 Neuromec/Zecaneuron ktk 10 x 10 kaplet Rp 37,500
5 Univit/Caviplex syrup 60 ml Rp 4,500
TOTAL
OBAT LUAR
1 Salep 2-4 box isi 24 Rp 95,000
2 Ketokonazol krim 2% ktk isi 12 Rp 55,000
3 Hidrokortison krim 2,5 % ktk 24 tube 5 gram Rp 85,000
4 Betametason krim 0.1 % tube 5 gram Rp 20,000
5 Gentamisin salep kulit 0.1% tube Rp 2,500
6 Erlamycetin tetes mata tube Rp 11,000
7 Erlamycetin tetes telinga tube Rp 6,000
8 Scabicid tube Rp 12,000
9 Bioplacenton tube Rp 13,500
TOTAL
LAIN LAIN
1 Alopurinol tablet 300 mg ktk 3 x 10 tablet Rp 80,000
2 Alopurinol tablet 100 mg ktk 10 x 10 tablet Rp 40,000
3 Glibenklamida tablet 5 mg ktk 10 x 10 tablet Rp 30,000
4 Metformin HCl tablet 500 mg ktk 10 x 10 tablet Rp 30,000
5 Simvastatin tablet 10 mg ktk 3 x 10 tablet Rp 21,000
TOTAL

TOTAL HARGA OBAT

TOTAL KESELURUHAN
 TOTAL
IDR 1,000,000
IDR 2,400,000
IDR 250,000
IDR 500,000
IDR 250,000
IDR 2,500,000
IDR 6,900,000

JUMLAH TOTAL

20 Rp 600,000
100 Rp 500,000
6 Rp 120,000
10 Rp 400,000
20 Rp 80,000
6 Rp 120,000
10 Rp 300,000
10 Rp 1,800,000
6 Rp 210,000
8 Rp 480,000
40 Rp 600,000
Rp 5,210,000
LAMASI
7 Rp 129,500
7 Rp 175,000
10 Rp 170,000
10 Rp 150,000
10 Rp 120,000
50 Rp 175,000
4 Rp 600,000
6 Rp 150,000
8 Rp 320,000
Rp 1,989,500

8 Rp 88,000
6 Rp 165,000
12 Rp 180,000
6 Rp 36,000
5 Rp 125,000
Rp 594,000
LAR
5 Rp 75,000
5 Rp 60,000
 2 Rp 30,000
5 Rp 75,000
3 Rp 75,000
3 Rp 72,000
3 Rp 132,000
Rp 519,000

10 Rp 100,000
50 Rp 350,000
15 Rp 225,000
5 Rp 107,500
5 Rp 95,000
5 Rp 75,000
15 Rp 165,000
3 Rp 159,000
8 Rp 400,000
2 Rp 35,000
100 Rp 150,000
5 Rp 225,000
Rp 2,086,500

5 Rp 75,000
5 Rp 60,000
1 Rp 126,000
2 Rp 33,000
Rp 294,000

7 Rp 94,500
80 Rp 400,000
5 Rp 212,500
4 Rp 440,000
20 Rp 1,250,000
25 Rp 112,500
Rp 2,509,500

3 Rp 36,000
2 Rp 62,000
3 Rp 60,000
20 Rp 750,000
25 Rp 112,500
Rp 1,020,500

2 Rp 190,000
3 Rp 165,000
2 Rp 170,000
30 Rp 600,000
30 Rp 75,000
50 Rp 550,000
50 Rp 300,000
20 Rp 240,000
20 Rp 270,000
Rp 2,290,000

3 Rp 240,000
4 Rp 160,000
4 Rp 120,000
6 Rp 180,000
5 Rp 105,000
Rp 805,000

Rp 17,318,000

IDR 24,218,000
NO NAMA OBAT KEMASAN HARGA

ANTIBIOTIK
1 Amoksisilin kaplet 500 mg ktk 10 x 10 kaplet Rp 55,000
2 Amoksisilin sirup 250 mg/ 5 ml btl 60 ml Rp 8,000
3 Ketokonazol tablet 200 mg ktk 5 x 10 tablet Rp 30,000
5 Kotrimoksazol 480 mg ktk 10 x 10 tablet Rp 25,000
6 Kotrimoksazol Sirup btl 60 ml Rp 7,000
7 Metronidazol tablet 500 mg ktk 10 x 10 tablet Rp 33,000
8 Siprofloksasin tablet 500 mg ktk 10 x 10 tablet Rp 42,000
9 Tiamfenikol kapsul 500 mg ktk 10 x 10 kapsul Rp 85,000
10 Pirantel Pamoat Tablet 125mg satuan terkecil Rp 9,000
TOTAL
ANALGETIK-ANTIPIRETIK-ANTIINFLAMASI
1 Asam Mefenamat kaplet 500 mg ktk 10 x 10 kaplet Rp 26,000
2 Ibuprofen tablet 400 mg ktk 10 x 10 kaplet Rp 30,000
3 Natrium Diklofenak tablet 50 mg ktk 5 x 10 kaplet Rp 16,000
5 Parasetamol tablet 500 mg btl 1000 tablet Rp 70,000
6 Parasetamol sirup 120 mg / 5 ml btl 60 ml Rp 5,000
7 Piroksikam tablet 10 mg ktk 10 x 10 tablet Rp 14,000
9 Antalgin 500 mg satuan terkecil Rp 250
TOTAL
ANTIALERGI-STEROID
1 Klorfeniramina Maleat (CTM) tablet 4 mg btl 1000 tablet Rp 35,000
2 Deksametason tablet 0,5 mg btl 1000 tablet Rp 78,000
3 Prednison tablet 5 mg btl 1000 tablet Rp 87,000
4 Cyproheptadine ktk 10 x 10 tablet Rp 25,000
TOTAL
ANTIHIPERTENSI-CARDIOVASKULAR
1 Kaptopril tablet 12,5 mg ktk 10 x 10 tablet Rp 15,000
2 Kaptopril tablet 25 mg ktk 10 x 10 tablet Rp 21,000
3 Furosemid tablet 40 mg btl 250 tablet Rp 27,000
4 Hidroklorotiazida tablet 25 mg btl 1000 tablet Rp 52,000
5 Asam Asetilsalisilat tablet 500 mg (Asetosal) ktk 10 x 10 tablet Rp 23,000
6 Nifedipin tablet 10 mg ktk 10 x 10 tablet Rp 20,000
TOTAL
OBAT GASTROINTESTINAL
1 Antasida tablet kunyah ktk 10 x 10 tablet Rp 23,000
2 Antasida sirup btl 60 ml Rp 7,000
4 Ranitidin tablet 150 mg ktk 10 x 10 tablet Rp 32,000
5 Metoklopramide tablet 10 mg ktk 10 x 10 tablet Rp 16,000
7 Omeprazol kapsul 20 mg ktk 3 x 10 kapsul Rp 18,000
8 Garam Oralit I serbuk ktk 100 bungkus Rp 53,000
9 Spasminal ktk 10 x 10 tablet Rp 72,000
10 Neo Diaform btl 1000 tablet Rp 135,000
11 Dulcolax/Bisacodyl satuan terkecil Rp 1,500
12 Vitazym ktk 10 x 10 tablet Rp 45,000
TOTAL
OBAT ASMA
1 Salbutamol tablet 4 mg ktk 10 x 10 tablet Rp 15,000
2 Salbutamol tablet 2 mg ktk 10 x 10 tablet Rp 13,000
3 Aminofilin tablet 200 mg btl 1000 tablet Rp 126,000
4 Teosal ktk 10 x 10 tablet Rp 25,000
TOTAL
OBAT FLU-BATUK
2 Ambroxol tablet 30 mg ktk 10 x 10 tablet Rp 18,000
4 Obat Batuk Hitam ( O.B.H. ) cairan btl 200 ml Rp 5,000
5 Demacolin ktk 10 x 10 tablet Rp 47,000
6 Alpara/Paratusin/Intunal F satuan terkecil Rp 4,000
8 Baby cought syrup 60 ml Rp 4,500
TOTAL
ROBORANTIA
1 Sianokobalamin (vitamin B12) tablet btl 1000 tablet Rp 20,000
2 Vitamin C tablet 100 mg 500 tablet Rp 31,000
3 Calcium lactat satuan terkecil Rp 300
5 Neuromec/Zecaneuron ktk 10 x 10 kaplet Rp 5,500
6 Univit/Caviplex syrup 60 ml Rp 6,000
TOTAL
OBAT LUAR
1 Salep 2-4 ktk 24 pot 30 gram Rp 42,000
2 Mikonazol krim/salep 2 % tube 10 gram Rp 5,000
3 Ketokonazol krim 2% tube 15 gram Rp 11,000
4 Hidrokortison krim 2,5 % ktk 24 tube 5 gram Rp 100,000
5 Betametason krim 0.1 % ktk 25 tube 5 gram Rp 65,000
6 Gentamisin salep kulit 0.1% ktk 25 tube 5 gram Rp 64,000
7 Erlamycetin tetes mata tube Rp 10,000
8 Erlamycetin tetes telinga tube Rp 5,000
9 Scabicid tube Rp 12,000
10 Acyclovir tube Rp 13,000
11 Bioplacenton tube Rp 18,000
TOTAL
LAIN LAIN
1 Alopurinol tablet 300 mg ktk 3 x 10 tablet Rp 12,000
2 Alopurinol tablet 100 mg ktk 10 x 10 tablet Rp 19,000
3 Glibenklamida tablet 5 mg ktk 10 x 10 tablet Rp 12,000
4 Metformin HCl tablet 500 mg ktk 10 x 10 tablet Rp 37,000
5 Simvastatin tablet 5 mg ktk 3 x 10 tablet Rp 12,000
TOTAL
TOTAL KESELURUHAN Rp 8,861,500
 JUMLAH TOTAL

5 Rp 275,000
50 Rp 400,000
2 Rp 60,000
3 Rp 75,000
20 Rp 140,000
2 Rp 66,000
2 Rp 84,000
2 Rp 170,000
50 Rp 450,000
Rp 1,720,000
AMASI
5 Rp 130,000
10 Rp 300,000
5 Rp 80,000
10 Rp 700,000
50 Rp 250,000
2 Rp 28,000
200 Rp 50,000
Rp 1,538,000

1 Rp 35,000
1 Rp 78,000
1 Rp 87,000
2 Rp 50,000
Rp 250,000
AR
5 Rp 75,000
5 Rp 105,000
1 Rp 27,000
1 Rp 52,000
2 Rp 46,000
3 Rp 60,000
Rp 365,000

5 Rp 115,000
50 Rp 350,000
2 Rp 64,000
2 Rp 32,000
5 Rp 90,000
3 Rp 159,000
2 Rp 144,000
 1 Rp 135,000
200 Rp 300,000
2 Rp 90,000
Rp 1,479,000

5 Rp 75,000
5 Rp 65,000
1 Rp 126,000
2 Rp 50,000
Rp 316,000

5 Rp 90,000
50 Rp 250,000
4 Rp 188,000
30 Rp 120,000
25 Rp 112,500
Rp 760,500

1 Rp 20,000
2 Rp 62,000
200 Rp 60,000
20 Rp 110,000
25 Rp 150,000
Rp 402,000

2 Rp 84,000
20 Rp 100,000
30 Rp 330,000
2 Rp 200,000
2 Rp 130,000
2 Rp 128,000
25 Rp 250,000
25 Rp 125,000
20 Rp 240,000
20 Rp 260,000 \
20 Rp 360,000
Rp 1,847,000

2 Rp 24,000
2 Rp 38,000
2 Rp 24,000
2 Rp 74,000
2 Rp 24,000
Rp 184,000
No Alat Medis Jumlah Harga Satuan
1 Timbangan bayi 1
2 Timbangan dewasa 1
3 Tensimeter 2
4 termometer 2
5 otoskopi 2
6 Stetoskop 2
7 spatel tongue kayu 100 pieces
8 handscoen non steril 1 box
9 senter kecil 4 buah