OWNER ESTIMATE (OE)

Keg : Pengadaan Obat Dan Perbekalan Kesehatan Pelayanan Kesehatan Dasar KLB Kab. Tolikara
Lokasi : Karubaga
Sumber : DAK+DAU
TA 2014
HARGA
NO NAMA BARANG SATUAN VOLUME
SATUAN (Rp)
1 2 3 4 5
1 Alopurinol tablet 100 mg ktk 10 x 10 tablet 200 32,500.00
2 Ambroxol tablet 30 mg ktk 10x 10 tablet 500 31,200.00
3 Aminofilin injeksi 24 mg/ ml ktk 30 ampul @10 ml 50 144,780.00
4 Aminofilin tablet 200 mg botol 100 tablet 200 31,100.00
5 Amitriptilin tablet salut 25 mg (Hcl) ktk 10 x 10 tablet 100 34,600.00
6 Amlodipin tablet 10mg ktk 3 x 10 tablet 50 24,900.00
7 Amoksisilin + As.Klavulanat 625 mg tablet ktk 5 x 6 tablet 200 227,550.00
8 Amoksisilin kapsul 250 mg ktk 10 x 10 kapsul 250 49,100.00
9 Amoksisilin kapsul 500 mg ktk 10 x 10 tablet 800 49,100.00
10 Antasida DOEN I tablet kunyah, kombinasi : Al.Hidroksida 200 mg+ Mg.Hi ktk 10 x 10 tablet 400 29,400.00
11 Antifungi DOEN kombinasi : As. Benzoat 6% +As. Salisilat 3% ktk 24 pot@ 30 gram 50 74,856.00
12 Antimigren:Ergotamin tartrat 1 mg + Kofein 50 mg botol 100 tablet 50 37,000.00
13 Artemeter injeksi 80 mg/ml ktk 6 ampul 500 206,166.00
14 Asetosal tablet 500 mg ktk 10 x 10 tablet 150 28,815.00
15 Asam Askorbat (Vitamin C) tablet 250 mg ktk 10 x 10 tab 750 37,100.00
16 Asam mefenamat kapsul 500 mg ktk10x10 kaplet 600 33,800.00
17 Atropin injeksi i.m/i.v/s.k 0,25 mg/ml (sulfat) ktk 30 ampul @1 ml 50 62,310.00
18 Besi II Sulfat 200 mg + Asam Folat 0,25 mg tablet (tablet tambah darah ko 1 sase @ 30 tablet 1,500 7,260.00
19 Betametason krim 0,1% (Sebagai valerat) ktk 25 tube @ 5 gram 500 66,500.00
20 Bromheksin tablet 8 mg ktk 10 x 10 tablet 300 24,600.00
21 Deksametasone injeksi i.v 5 mg/ml ktk 100 ampul 300 306,600.00
22 Deksametasone tablet 0,5 mg ktk 10 x 10 tablet 300 27,900.00
23 Diazepam tablet 2 mg ktk 10 x 10 tablet 100 21,900.00
24 Doksisiklin kapsul 100mg ktk 10 x 10 tablet 150 50,400.00
25 Domperidon tablet 10 mg ktk 10 x 10 tablet 150 45,100.00
26 Efedrin HCl tablet 25 mg botol 1000 tablet 200 94,325.00
27 Eritromisin kapsul 250 mg ktk 12 x 10 kapsul 300 112,680.00
28 Eritromisin kaplet 500 mg ktk 10 x 10 kaplet 300 159,900.00
29 Captopril 25 mg ktk 10 x 10 tablet 15,910.00
100
30 Cefotaxim injeksi 1 gr ktk 2 vial 1,000 7,530.00
31 Ceftriakson injeksi 1 g ktk 2 vial 1,000 7,980.00
32 Epinefrina HCl ( Adrenalina ) Inj 0,1% - 1 ml ktk 30 ampul @ 1 ml 10 74,790.00
33 Fenol Gliserol tetes telinga 10% ktk 24 botol @ 5 ml 30 41,616.00
34 Fitomenadion (vit. K1) tablet salut gula 10 mg ktk 10 x 10 tablet 100 95,700.00
35 Fitomenadion (vit. K1) injeksi 10 mg/ml kotak 30 ampul 50 77,850.00
36 Gameksan lotion 1% btl 30 ml 498 4,069.00
37 Garam Oralit untuk 200 ml air ktk 100 bungkus 250 63,100.00
38 Gentamisin injeksi 40mg/ml ktk 5 ampul 150 24,835.00
39 Gentamisin salep kulit 0,1% kotak 10 tube @ 5 mg 500 23,380.00
40 Gliseril Guayakolat tablet 100 mg btl 1000 tablet 700 51,601.00
41 Hidrokortison krim 2,5% ktk 24 tube @ 5 gram 300 92,184.00
42 Ibuprofen 200 mg btl 100 tablet 1,000 32,200.00
43 Ibuprofen 400mg ktk 10 x 10 tablet 500 40,600.000
44 Ichtyol salep pot 500 455.00
45 Kalium diklofenat 50mg ktk 5 x 10 tablet 300 40,400.00
46 Kalsium Laktat tablet 500 mg ktk 10 x 10 tablet 300 25,200.00
47 Klindamizin kapsul 150 mg ktk 5 x 10 kapsul 100 38,500.00
48 Klindamizin kapsul 300mg ktk 5 x 10 kapsul 100 49,600.00
49 Kloramfenikol kapsul 250 mg ktk 12 x 10 kapsul 500 53,000.00
50 Kloramfenikol tetes mata 0,5 % btl 5 ml 500 4,624.00
51 Kloramfenikol tetes telinga 3 % btl 5 ml 300 4,266.00
52 Klorfeniramin Maleat (CTM) tablet 4 mg ktk 10 x 10 tablet 1,500 21,200.00
53 Kodein tablet 10 mg ktk 10 x 10 tablet 200 90,500.00
54 Kotrimoksazol 480 mg tablet ktk 10 x 10 tablet 700 38,800.00
55 Kuinin tablet 222 mg ktk 60 tablet 500 64,733.00
56 Loratadin 10 mg ktk5x10kapsul 500 20,800.00
57 Mebendasol tablet 100 mg ktk 3 x 10 tablet 350 15,810.00
58 Meloksikam tablet 7,5 mg ktk 5 x 10 tablet 100 24,050.00
59 Metampiron tablet 500 mg ktk 10 x 10 tablet 1,000 36,600.00
60 Metformin 500 mg ktk 10 x 10 tablet 50 33,500.00
61 Metilergometrin maleat injeksi0,200mg-1ml ktk 30 ampul 100 82,673.00
62 Metilergometrin maleat tablet salut 0,125mg ktk 10 x 10 tablet 50 22,379.00
63 Metilprednisolon tablet 8 mg ktk10x10 100 75,800.00
64 Metoklopramide tablet 10mg ktk10x10 tablet 200 30,600.00
65 Metoklopramide injeksi 5 mg/ml ktk 5 ampul @ 2ml 100 8,480.00
66 Metronidazol tablet 250 mg ktk 10 x 10 tablet 500 35,900.00
67 Miconazol krim/ salep 2% tube 10 gram 1,000 5,526.00
68 Natrium diklofenak tablet 50mg ktk 5 x 10 tablet 500 22,900.00
69 Nistatin tablet salut 500.000 IU/gram ktk 10 x 10 tablet salut 100 116,700.00
70 Nistatin vaginal tablet 100.000 IU/gram ktk 10 x 10 vaginal 50 80,700.00
71 Oksitetrasiklin salep kulit 3% ktk 25 tube @ 5 gram 400 60,250.00
72 Oksitetrasiklin salep mata 1% ktk 25 tube @ 3,5 gram 200 61,050.00
73 Oksitosin injeksi ktk 30 ampul 50 87,900.00
74 Omeprazol kapsul 20mg ktk 3 x 10 tablet 300 17,160.00
75 Papaverine tablet 40 mg ktk 10 x 10 tablet 100 35,200.00
76 Parasetamol tablet 500 mg ktk 10 x 10 tablet 500 29,300.00
77 Piracetam tablet 400mg ktk 5 x 10 tablet 50 23,350.00
78 Pirantel tablet 125 mg ktk 25 x 4 tablet 300 56,700.00
79 Piridoksin (vit. B6) tablet 10 mg btl 1000 tablet 100 32,181.00
80 Pirosikam kapsul 20mg ktk10x10tablet 500 30,500.00
81 Prednison tablet 5mg ktk 10 x 10 tablet 800 26,000.00
82 Primakuin tablet 15 mg ktk 10 x 10 tablet 500 35,600.00
83 Ranitidin tablet 150mg ktk 10 x 10 tablet 200 35,600.00
84 Retinol Vit A biru 100000 IU btl 50 kapsul lunak 50 26,100.00
85 Retinol Vit A merah 200000 IU btl 50 kapsul lunak 50 36,700.00
86 Salep 2-4 kombinasi ktk 24 pot@ 30 gram 200 131,424.00
87 Salicyl Bedak 2% ktk 50 gram 900 1,786.00
88 Sefadroksil 250mg KTK10X10 250 87,300.00
89 Sefadroksil 500 mg ktk 10 x 10 300 95,000.00
90 Sefiksim 100mg ktk 5 x 10 kapsul 200 205,800.00
91 Sianokobalamin (Vit.B 12 ) injeksi ktk 100 ampul 150 167,600.00
92 Simvastin tablet 20 mg ktk 5 x 10 tablet 100 44,150.00
93 Siprofloksaksin 500 mg ktk 10 x 10 tablet 300 53,600.00
94 Tetrasiklin 500 mg ktk 10 x 10 kapsul 500 55,300.00
95 Tetrasiklin 250mg ktk 10 x 10 kapsul 500 37,800.00
96 Tiamin (vitamin B1) 100 mg ktk 10 x 10 tablet 100 29,400.00
97 Tiamin injeksi 100mg/ml ktk 30 ampul @1 ml 100 40,110.00
98 Tramadol injeksi 50mg/ml ktk 5 ampul 200 45,875.00
99 Tramadol tablet 50mg ktk 5 x 10 kapsul 400 23,500.00
100 Vitamin B komplek botol 1000 tablet 500 41,059.00
101 Zinc Dispersible ktk 10 x 10 tablet 250 90,000.00
102 Arterakine paket 300 58,313.00

Dibulatkan :
JUMLAH HARGA
(Rp)
6
6,500,000.00
15,600,000.00
7,239,000.00
6,220,000.00
3,460,000.00
1,245,000.00
45,510,000.00
12,275,000.00
39,280,000.00
11,760,000.00
3,742,800.00
1,850,000.00
103,083,000.00
4,322,250.00
27,825,000.00
20,280,000.00
3,115,500.00
10,890,000.00
33,250,000.00
7,380,000.00
91,980,000.00
8,370,000.00
2,190,000.00
7,560,000.00
6,765,000.00
18,865,000.00
33,804,000.00
47,970,000.00
1,591,000.00
7,530,000.00
7,980,000.00
747,900.00
1,248,480.00
9,570,000.00
3,892,500.00
2,026,362.00
15,775,000.00
3,725,250.00
11,690,000.00
36,120,700.00
27,655,200.00
32,200,000.00
20,300,000.00
227,500.00
12,120,000.00
7,560,000.00
3,850,000.00
4,960,000.00
26,500,000.00
2,312,000.00
1,279,800.00
31,800,000.00
18,100,000.00
27,160,000.00
32,366,500.00
10,400,000.00
5,533,500.00
2,405,000.00
36,600,000.00
1,675,000.00
8,267,300.00
1,118,950.00
7,580,000.00
6,120,000.00
848,000.00
17,950,000.00
5,526,000.00
11,450,000.00
11,670,000.00
4,035,000.00
24,100,000.00
12,210,000.00
4,395,000.00
5,148,000.00
3,520,000.00
14,650,000.00
1,167,500.00
17,010,000.00
3,218,100.00
15,250,000.00
20,800,000.00
17,800,000.00
7,120,000.00
1,305,000.00
1,835,000.00
26,284,800.00
1,607,400.00
21,825,000.00
28,500,000.00
41,160,000.00
25,140,000.00
 4,415,000.00
16,080,000.00
27,650,000.00
18,900,000.00
2,940,000.00
4,011,000.00
9,175,000.00
9,400,000.00
20,529,500.00
22,500,000.00
17,493,900.00
1,510,938,692.00
1,510,940,000.00
 OWNER ESTIMATE (OE)
Keg : Pengadaan Obat Pelayanan Kesehatan Dasar untuk KLB Kab. Tolikara
Lokasi : Karubaga
SumberOTSUS
TA : 2014

NO NAMA BARANG SATUAN VOLUME

1 2 3 4
1 Abocat 18 pcs 500
2 Abocat 20 pcs 500
3 Abocat 22 pcs 500
4 Abocat 24 pcs 500
5 Abocat 26 pcs 500
6 Alkohol swab kotak 100 pcs 1,000
7 Alat suntik 1 ml 100 set/kotak 500
8 Alat suntik 2,5 ml 100 set/kotak 500
9 Alat suntik 5 ml 100 set/kotak 500
10 Bisturi surgical blades pcs 2,000
11 Blood lancet ktk 200 pcs 500
12 Infusion set anak 25 pcs/kantong 300
13 Infusion set dewasa 25 pcs/ kantong 400
14 Kapas Pembalut / Absorben 250 gram bungkus 800
15 Kasa hydrofil 2 m x 80 cm rol 1,000
16 Kasa Pembalut Hidrofil 4 m x 15 cm elastic rol 3,000
17 Kasa kompres steril 40x40 cm bungkus 5,000
18 Kertas puyer 500
19 Masker kotak 50 buah 200
20 Plester 5 yards x 2 inch rol 600
21 Silk (Benang Bedah Sutera) No. 3/0 dng jarum 12 x 3 x 75 cm / kotak 330
22 Sarung Tangan Steril 7,5 pasang 3,000
23 Test Malaria Pf + Pv Combo /Parascreen ktk 25 set 500
24 urine analyzer test strip ktk100 100
25 Nesco cholesterol strip tube 100
26 Nesco uric acid strip tube 300
27 Nesco Glucose strip tube 100
28 Mission strip ktk 100
29 lancet device unit
30 widal test kit
31 HCG kehamilan box 50
32 sarung tangan Gynekologi pairs 600
33 Gypsona roll 300
34 sputum pot pcs 1000
35 sarung tangan biasa ktk 100
36 Glukosa larutan infus 5% botol 500 ml 1000
37 Natrium klorida larutan infus 0,9 % botol 500 ml 5000
38 Ringer laktat larutan infus botol 500 ml 5000
39 Metronidazol infus 500MG/100ML botol 100 ml 1,000
40 Aqua pro injeksi steril, bebas pirogen kotak 10 vial @ 20 ml 500
2 Ambroxol sirup 15 mg/ml btl 60 ml 2,000
10 Amoksisilin sirup kering 125 mg/5ml btl 60 ml 1,500
11 Antasida DOEN II suspensi, kombinasi : Al.Hidroksida 200 mg/ 5 ml + Mg.Hidroksida 200 mbtl 60 ml 350
21 Cetirizin sirup 5mg/5ml botol 60 ml 700
29 Eritromisin sirup 200 mg/5ml btl 60 ml 1,000
29 Etakridin larutan 0,1% btl 300 ml 200
44 Ibuprofen suspensi 100mg/5ml btl 60 ml 1,500
50 Klorampenikol suspensi125mg/5ml btl 60 ml 500
54 Kotrimoksazol 240 mg/5 ml sirup btl 60 ml 500
59 Mebendasol sirup 100 mg/5ml botol 30 ml 500
71 Obat Batuk Hitam ( O.B.H. ) cairan botol 100 ml 1,500
76 Parasetamol drop botol 15 ml 500
77 Parasetamol sirup 120 mg/5 ml Botol 60 ml 2,000
81 Povidon iodium 10% Botol 60 ml 800
82 Povidon iodium 10% botol 1000 ml 100
90 Sefadroksil sirup Botol 60 ml 700
91 Sefiksim sirup botol 30 ml 500
41
42
43
44
45
HARGA SATUAN (Rp.) JUMLAH HARGA (Rp.)
5 6
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 -
-
-
-
-
-
-
-
-
9,993.00 9,993,000.00
9,358.00 46,790,000.00
9,818.00 49,090,000.00
17,058.00 17,058,000.00
76,430.00 38,215,000.00
5,475.00 10,950,000.00
5,213.00 7,819,500.00
4,597.00 1,608,950.00
17,752.00 12,426,400.00
12,005.00 12,005,000.00
5,034.00 1,006,800.00
7,143.00 10,714,500.00
7,595.00 3,797,500.00
4,899.00 2,449,500.00
7,250.00 3,625,000.00
3,640.00 5,460,000.00
8,240.00 4,120,000.00
2,108.00 4,216,000.00
6,747.00 5,397,600.00
47,371.00 4,737,100.00
9,555.00 6,688,500.00
17,446.00 8,723,000.00
-
-
-
266,891,356.00
 TIME SHCEDULLE
PEKERJAAN #REF!
LOKASI #REF!
TAHUN ANGGARAN #REF!

BULAN I BULAN II
NO URAIAN PEKERJAAN BOBOT (%) MINGGU
1 2 3 4 5

1 PERSIAPAN 10.000 10.00

2 PEMBELIAN 30.000 15.00 15.00

3 PENGEPAKAN/PENGIRIMAN 50.000 10.00 10.00 10.00

4 PEMERIKSAAN DAN PENYERAHAN 10.000

100.00

FISIK
RENCANA PERMINGGU 15.00 25.00 10.00 10.00
KOMULATIF 10.00 25.00 50.00 60.00 70.00

Wamena, 10 April 2013

dibuat oleh
CV. SANDY

SENDI M. RUMAWAK
Direktris
ME SHCEDULLE

BULAN II
MINGGU KET
6 7 8

10.00 10.00

10.00

10.00 10.00 10.00

80.00 90.00 100.00

Wamena, 10 April 2013

dibuat oleh
CV. SANDY

SENDI M. RUMAWAK
Direktris