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KEPOLISIAN NEGARA REPUBLIK INDONESIA
DAERAH JAWA BARAT
BIDANG KEDOKTERAN DAN KESEHATAN
Pelayanan Kesehatan merupakan salah satu tugas fungsi Biddokkes Polda Jabar yang harus
diemban untuk mewujudkan derajat kesehatan masyarakat Polri yang setinggi-tingginya. Hal
tersebut diperjelas dalam Peraturan Kepala Kepolisian Negara Republik Indonesia Nomor : 03
Tahun 2024 tentang Susunan Organisasi dan Tata Kerja Pada Tingkat Kepolisian Daerah, yang
menyebutkan bahwa dalam melaksanakan tugasnya, Biddokkes menyelenggarakan pembinaan
kesehatan kesamaptaan, pelayanan kesehatan, dan materiil fasilitas kesehatan.
Dalam rangka pemenuhan bekal kesehatan khususnya obat-obatan dan Bahan habis Pakai
Tahap III untuk FKTP jajaran Polda Jabar Sumber Dana PNBP Ta. 2025 untuk mendukung upaya
atau kegiatan pelayanan kesehatan di FKTP Jajaran Polda Jabar TA. 2025, maka perlu diadakan
pengadaan obat-obatan dan Bahan Habis Pakai Tahap III Sumber dana PNBP T.A. 2025, dengan
Rincian Sebagai Berikut:
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
I ANALGETIK, ANTIPIRETIK
1 Asam Mefenamat 500 mg Tablet 13.300 BRANDED
2 Paracetamol Tablet 500 mg Tablet 19.600 BRANDED
3 Ibuprofen 200 mg, Paracetamol 350 mg Tablet 5.000 BRANDED
Paracetamol+Ibuprofen + Kafein(Tab BRANDED
4 Tablet 2.800
350+200mg+50 mg)
5 Paracetamol+BI+B2+B12 Tablet 1.400 BRANDED
Metamizol 500 mg, Thiamine 50 mg, Pyridoxin 100 BRANDED
6 Tablet 4.000
mg, Cyanocobalamine 100 mcg
7 Paracetamol 650 mg Tablet 5.100 BRANDED
8 Ibuprofen 400 mg Tablet 6.600 GENERIK
9 Ibuprofen 200 mg Tablet 4.700 GENERIK
10 Paracetamol Syrup 125 mg Botol 346 BRANDED
-
II ANTI INFLAMASI, ANTI RHEUMATOID
11 Potasium Diklofenak 50 mg Tablet 7.600 BRANDED
12 Natrium Diclofenak 50 mg Tablet 7.850 BRANDED
13 Piroksikam 10 mg Tablet 1.900 BRANDED
14 Piroksikam 20 mg Tablet 1.300 BRANDED
GENERIK
15 Meloksikam 7,5 mg Tablet 3.900
16 Meloksikam 15 mg Tablet 3.600 GENERIK
17 Antalgin Tablet 1.000 BRANDED
-
III ANTI GOUT
BRANDED
18 Allupurinol 100 mg Tablet 3.700
BRANDED
19 Allupurinol 300 mg Tablet 3.400
-
IV ANTI VERTIGO
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
20 Betahistin mesilat 6 mg Tablet 3.300 BRANDED
21 Flunarizine 10 mg Tablet 550 BRANDED
-
V ANTI INFLUENZA
Paracetamol 300 mg.Phenylpropanolamine HCI 15 BRANDED
22 Tablet 4.900
mg.Chlorpeheniramine maleate 2 mg.
BRANDED
Paracetamol 500 mg, Phenylpropanolamine HCI
23 12.5 mg, Chlorphenamine Maleate 2 mg dan Tablet 14.100
Dextromethorpan Hbr 15 mg
Paracetamol 120 mg, Phenylephrine HCl 2,5 mg, BRANDED
24 Dextromethorphan HBr 2,5 mg, Chlorphenamine Botol 344
Maleate 0,5 mg
BRANDED
25 Oxomemazine 1,65 mg dan Guaifenisin 33,30 mg. Botol 73
Paracetamol 120 Mg, Guafenesin 50 Mg, BRANDED
26 Botol 91
Chlorpheniramin Maleat 1 Mg
-
VI DEKONGESTAN
Paracetamol 500 mg, pseudoepedrin, 7.5, CTM 2 BRANDED
27 Tablet 5.600
mg
28 pseudoefedrin HCl 30mg, triprolidin HCl 2,5mg Tablet 4.600 BRANDED
Paracetamol 500mg, GG 50 mg, chlorpheniramine BRANDED
29 Tablet 9.400
maleat 2mg, Phenylpropanolamine hcl 15 mg,
-
VII DIURETIKA
30 Furosemide 40mg Tablet 1.000 BRANDED
-
VIII MUKOLITIK
31 Ambroxol 30 mg Tablet 7.000 BRANDED
32 Ambroxol 15 mg sirup Botol 171 BRANDED
33 Guaifenesin 100 mg Tablet 2.500 GENERIK
34 Acetylcysteine 200mg Kapsul 4.900 BRANDED
-
IX OBAT BATUK
Succus Glycyrrhizae 160 mg, Chloretum BRANDED
35 Ammonicum 100 mg, Solutio ammonia dan Botol 373
Sprituosa anisata 100 mg
-
X OBAT ASMA
36 Salbutamol 4 mg Tablet 2.800 BRANDED
37 Terbutalin Sulfat 2.5 mg Tablet 1.000 BRANDED
38 Terbutaline Sulphate 1.5 mg / 5 ml Botol 27 BRANDED
Ipratropium Br 0.52 mg, salbutamol sulphate 3.01 BRANDED
39 Ampul 110
mg
BRANDED
40 Salbutamol 2,5 mg Nebules Ampul 150
-
XI ANTASIDA
Alumunium Hidroksida 200 mg, Magnesium BRANDED
41 Tablet 8.400
Trisilikat 300 mg, Dimetilpolisiloksan 50 mg
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
Alumunium Hidroksida 300 mg, Magnesium BRANDED
42 Botol 190
Trisilikat 300 mg, Dimetilpolisiloksan 50 mg Syr
-
XII ANTI ULCER
43 Rhanitidine 150 mg Tablet 10.000 BRANDED
44 Omeprazol 20 mg Kapsul 8.600 BRANDED
45 Lansoprazole 30 mg Kapsul 4.300 BRANDED
46 Ranitidin HCl 75 mg Sirup Botol 31 BRANDED
47 Sucralfate 500mg/100 ml Botol 334 BRANDED
-
XIII ANTI DIARE
48 Attapulgite 600 mg Tablet 4.400 BRANDED
49 Kaolin 986 mg, Pektin 40 mg Botol 26 BRANDED
Zinc Sulfate Monohydrate 54.9 mg setara Zinc 20 BRANDED
50 Tablet 2.000
mg
51 Zinc 10mg/5 ml Botol 113 BRANDED
BRANDED
52 Lactobacillus Acidophillus,Vit.B1,Vit.B2,Vit.B6 Sachet 450
BRANDED
53 Karbon Aktif (Norit) Tablet 560
GENERIK
54 Na. bicarbonate, Glucose anhydrous, NaCl, CaCl2 Sachet 500
-
XIV LAKSANSIA
55 Bisacodyl 5 mg Tablet 1.300 GENERIK
-
XV SPASMOLITIKA
BRANDED
56 Hiosin N butilbromida 10 mg, Paracetamol 500 mg Tablet 4.900
BRANDED
57 Hiosin N butilbromida 10 mg, Tablet 700
-
XVI ANTI EMETIKA
58 Domperidon 10 mg Tablet 5.700 BRANDED
59 Domperidon 5mg/5cc Botol 126 BRANDED
60 Ondancetron 4 mg Tablet 2.430 BRANDED
61 Metoclopramide 10mg Tablet 600 BRANDED
62 Metoclopramide 10 mg Syrup Botol 2 BRANDED
-
XVII ANTI HIPERTENSI
63 Amlodipin 10 mg Tablet 13.500 GENERIK
64 Amlodipin 5 mg Tablet 14.200 GENERIK
65 Captropil 25 mg Tablet 700 BRANDED
GENERIK
66 Captopril 12,5 mg Tablet 800
-
XVIII ANTI HELMINTIKA
BRANDED
67 Pirantel Pamoat 250 mg Tablet 450
-
XIX ANTI DIABET
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
68 Glibenclamid 5 mg Tablet 2.900 BRANDED
69 Metformin 500 mg Tablet 8.400 BRANDED
70 Glimeferid 2 mg Tablet 950 BRANDED
71 Glimeferide 1 mg Tablet 400 BRANDED
72 Metformin 850 mg Tablet 800 BRANDED
-
XX ANTI HIPERLIPIDEMIA
73 Simvastatin 10 mg Tablet 3.800 BRANDED
74 Atorvastatin 20 mg Tablet 510 BRANDED
75 Fenofibrate 100 mg Tablet 540 BRANDED
76 Fenofibrate 300 mg Tablet 240 BRANDED
77 Atorvastatin 10 mg Tablet 90 BRANDED
-
XXI ANTI JAMUR TABLET
78 Ketokonazole 200 mg Tablet 1.400 BRANDED
-
XXII SALEP KULIT
79 Betametason 17-Valerat 0,1 % Tube 304 BRANDED
80 Gentamisin 0,1% Tube 385 BRANDED
81 Bacitracin Zinc 500 IU, Neomycin sulfate 5 mg Tube 145 BRANDED
82 Na-heparin 200 IU Tube 128 BRANDED
83 Hidrocortison asetat 2,5% Tube 114 BRANDED
84 Hidrocortison asetat 2,5%, Chloramphenicol 2% Tube 147 BRANDED
85 Chlorampenicol Salep Kulit Tube 63 BRANDED
86 Aciclovir 5% Tube 159 BRANDED
87 Na. Diklofenak 1% Gel Tube 141 BRANDED
Fluocinolone acetonide 0,025%, neomycin sulfate BRANDED
88 Tube 234
0,1%
89 Miconazole Cream Tube 158 BRANDED
90 Salep 2-4 Pot 47 GENERIK
91 Salicyl Talk Pot 65 GENERIK
92 Metilsalisilat 11%, menthol 6%, Eugenol 1,5% Tube 338 BRANDED
93 Triamcinolone acetonide oral base Tube 33 BRANDED
94 Clobetasol Propionat 0.05% Tube 36 BRANDED
-
XXIII MULTIVITAMIN DAN MINERAL
Curcuma 6 mg, Vitamin A 2000 IU, Vitamin D3 100 BRANDED
95 IU, Vitamin B1 3 mg, Vitamin B2 2 mg, Vitamin B6 5 Botol 357
mg dan Vitamin B12 5 mcg.
Curcuma xanthorrhiza Extract 20 mg (mengandung BRANDED
96 Tablet 1.600
Curcuminoid 15%)
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
BRANDED
Vitamin A 500.000 I.U 2,98 mg,Vitamin D 100.000
ui 1,33 mg,Vitamin B1 1,67 mg, Vitamin B6 0,33
mg,Vitamin B2 0,67 mg,Vitamin B12 1,64
mcg,Vitamin C 8,33 mg,Nikotinamida 3,33 mg,
Kolina Bitartrat 1 mg, Vitamin E 3,34 mg, Royal
97 Jelly 1,67 mg, Kalsium Pantotenat 0,33 mgm, Asam Tablet 9.300
Folat 0,09 mg, Besi (II) Sulfat 2,05 mg, Kalium
Iodida 0,11 mg, Tembaga (II)Sulfat 0,33 mg,
Mangan Sulfat 0,16 mg, Dikalsium Fosfat 33,64
mg,Magnesium Sulfat 0,04 mg, Seng Sulfat 0,018
mg, Ginseng 3,33 mg, Natrium Klorida 0,018 mg
BRANDED
Vitamin B1 15 Mg, Vitamin B2 15 Mg, Vitamin B6 20
Mg,Vitamin B12 12 Mcg, Asam Folat 400 Mcg,
98 Tablet 2.800
Vutamin C 750 Mg, Calcium Pantothenate 20 Mg,
Zinc Picolinat 22,5 Mg, Vitamin E 30 Mg
Vitamin B1 100 mg, vitamin B6 100 mg, vitamin B12 BRANDED
99 Ampul 410
5,000 mcg Injeksi
100 Natrium Bicarbonat 500 mg Tablet 300 GENERIK
101 Folic Acid 400 mcg Tablet 1.100 BRANDED
102 Vitamin B12 50 Mcg Tablet 800 GENERIK
103 Phytomenadione 10 mg Tab Tablet 500 GENERIK
104 Mecobalamin 500 mcg Tablet 4.200 BRANDED
BRANDED
105 Vitamin C 1000 injeksi ampul 140
Kalsium (CaCO3) 250 mg, Vitamin D 300IU, BRANDED
106 tablet 290
Vitamin C 1000mg, Vitamin B6 15 mg
-
XXIV ANTIKOAGULASI
107 Asam Tr aneksanat 500 mg Tablet 900 BRANDED
-
XXV ANTIFUNGI
108 Nystatin Fls 27 BRANDED
-
XXVI ANTIBIOTIK
109 Amoxicillin 500 mg Tablet 14.500 BRANDED
BRANDED
110 Amoxicillin 125 mg/5 cc Botol 276
111 Ciprofloxacin 500 mg Tablet 6.600 BRANDED
BRANDED
112 Levofloxacin 500 mg Tablet 550
113 Clindamicin 150 mg Tablet 1.400 GENERIK
114 Clindamycin Hydrochloride 300 mg Kapsul 50 BRANDED
115 Thiamphenicol 500 mg Tablet 1.400 BRANDED
116 Tetrasklin 250/500 mg Kapsul 100 BRANDED
117 Thiamphenicol 125 mg Sirup Botol 29 BRANDED
BRANDED
118 Cefixime 100 mg Tab Tablet 3.900
119 Cefixime 200 Tab Tablet 6.600 GENERIK
BRANDED
120 Cefixime 100mg/5ml Syrup Botol 228
BRANDED
121 Cefadroxil Monohydrate 500 mg Tablet 8.200
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
BRANDED
122 Cefadroxil Monohydrate Dry Syrup 125 mg/5 mL Botol 168
123 Cotrimoxazole 480 mg Tab Tablet 600 BRANDED
124 Cotrimoxazole 240 mg Sirup Botol 17 BRANDED
BRANDED
125 Metronidazole 500 mg Tablet 3.300
126 Metronidazole 125 mg Sirup Botol 20 BRANDED
BRANDED
127 Cloramphenicole 250 mg Tablet Tablet 100
BRANDED
128 Chloramphenicol Palmitate 125 mg susp Botol 15
129 Azitromicin 500 mg Tablet 192 BRANDED
BRANDED
130 Doxicicilin 100 mg Tablet 400
GENERIK
131 Amoxiclav 625 mg Tablet 210
-
XXVII ANTI VIRUS
132 Acyclovir 200 mg Tablet 900 BRANDED
133 Acyclovir 400 mg Tablet 780 BRANDED
-
XXVIII ANTI HISTAMIN
134 Citerizin HCl 10 mg Tablet 10.900 BRANDED
135 Loratadine 5 mg/5 ml Botol 58 BRANDED
BRANDED
136 CTM 4 mg Tab Tablet 4.000
137 Cetirizin 5 mg syrup Botol 207 BRANDED
BRANDED
138 Mebhidroline Tablet 200
-
XXIX KORTIKOSTEROID
BRANDED
139 Metilprednisolon 4 mg Tablet 11.900
BRANDED
140 Metilprednisolon 8 mg Tablet 5.300
141 Dexametason 0,75 mg Tablet 11.800 BRANDED
142 Prednison 5 mg Tablet 1.600 BRANDED
Betamethasone 0.25 mg dan Dexchlorpheniramine BRANDED
143 Botol 43
maleate 2 mg / 5 ml
BRANDED
144 Metilprednisolon 4 mg/5ml Botol 2
-
XXX ANTI HEMOROID
BRANDED
145 Diosmin 450 mg, Hesperidin 50 mg Tablet 480
-
XXXI ANTI TUBERKULOSIS
146 Pyrazinamid 500 mg Tablet 100 BRANDED
-
XXXII OBAT KARDIOVASKULER
GENERIK
147 Bisoprolol 2.5 mg Tablet 800
BRANDED
148 Bisoprolol 5 mg Tablet 800
149 Clopidogler 75 mg Tablet 1.000 GENERIK
BRANDED
150 Asam Asetilsalisilet 100 mg Tablet 1.300
151 Isosorbit dinitrat 5 mg Tablet 600 GENERIK
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
152 Digoxin 0.25 mg Tablet 200 BRANDED
-
XXXIII OBAT MATA
BRANDED
153 Chlorampenicol 10 mg Salep Mata Tube 109
154 Gentamisin 0,3% Salep Mata Tube 65 BRANDED
155 Chloramfenicol 0,5% mg TM Fls 117 BRANDED
Dexamethasone Sodium Phosphate 1mg, BRANDED
156 Neomycin Sulfate 3,5 mg, Polymixin B sulfate 6000 Fls 177
IU TM
BRANDED
157 Tetrahidrozoline HCl 0,5 mg TM Fls 220
158 Hypromellose, Dextran 70 TM Fls 6 BRANDED
-
XXXIV TETES TELINGA
BRANDED
159 Chloramfenicol 3% TT Fls 103
160 Phenol Gliyserol 10 % TT Fls 22 GENERIK
-
XXXV ANTI SEPTIK
161 Povidon Iodine 30 ml Botol 110 BMHP
BMHP
162 Povidon iodine 60 ml Botol 34
163 Povidon 1 Liter Botol 1 BMHP
164 Alkohol 70% 100 ml Botol 44 BMHP
BMHP
165 Alkohol 70% 1 Liter Botol 11
166 H202 Botol 13 BMHP
167 Ripanol Botol 21 BMHP
Chlorhexidine Glucc. Sol. 7,5& v/v dan Cetrimide BMHP
168 Botol 6
15% b/v
169 Handsanitizer 500 ml Botol 10 BMHP
170 Handsanitizer 100 ml Botol 16 BMHP
171 Minyak Kayu Putih 100 ml Fls 28 BMHP
-
XXXVI CAIRAN INFUS
172 Cairan Infus RL Kolf 195 GENERIK
173 Cairan Infus NaCl Kolf 285 GENERIK
174 Dextrose 5 % Kolf 3 GENERIK
BRANDED
175 NS / NACL Piggy back 100 ml Kolf 247
XXXVII OBAT INJEKSI -
176 Ranitidine 25 mg / ml Injection Ampul 280 GENERIK
177 Epineprin 1mg/ml Inj Ampul 90 GENERIK
GENERIK
178 Dexamethasone 5mg/mL Injection Ampul 90
179 Ketorolac 30 mg/ml Inj Ampul 180 GENERIK
GENERIK
180 Hiosin N butilbromida 20 mg/ml Inj Ampul 50
BRANDED
181 Lidocaine 20 mg dan Epinephrine 0.0125 mg/mL Ampul 260
Lidocaine Hydrochloride Monohydrate 20 mg/ml GENERIK
182 Ampul 100
Injection
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
BRANDED
183 Phytomenadione 2 mg/ mL Inj Ampul 5
184 Ondancentron 2mg inj Ampul 160 GENERIK
185 Aquadest 500 ml Btl 23 GENERIK
GENERIK
186 Omeprazole 40 mg Injeksi Vial 39
-
XXXVIII ANTI KONVULSAN
187 fenitoin natrium 100 mg Tablet 300 GENERIK
-
XXXIX BHP GIGI
BMHP
188 GC - Glass lonomer Fuji tipe 9 Pack 10
BMHP
189 Single Bond Universal Adesive Btl 3
BMHP
Etching Gel (3M EspeScotchbond Universal
190 Btl 5
Etchant)
BMHP
191 Endometason Pack 3
BMHP
192 Zinc phospat cement Pack 2
193 Caviton Pink Pot 8 BMHP
194 Endofrost Botol 2 BMHP
BMHP
195 Jarum citoject Box 6
BMHP
196 Bur fisur Pcs 8
BMHP
197 Bur round Pcs 21
BMHP
198 Composite Filtex 3M Z350XT No. 2 Syringe 5
BMHP
199 Composite Filtex 3M Z350XT No. 3 Syringe 8
BRANDED
200 Composite Filtex 3M Z350XT No. 3.5 Syringe 4
BMHP
201 Penol Botol 4
Bor low spite bundar, BMHP
202 Bor low spite fissure, Set 5
Bor low spite invertid
Box/50 BMHP
203 Xylestesin Citoject 3
Catridge
BMHP
204 Palfique LX5 Tokuyomo A3 Syringe 6
BMHP
205 Palfique LX5 Tokuyomo A2 Syringe 5
BMHP
206 Devit-ars Syringe 5
Box/50 BMHP
207 Scandonest 9
Catridge
-
XXXX REAGEN -
Reagen
208 Diluent dirui bcc-3600 1 kit Galon 2
Reagen
209 lyse dirui bcc-3600 1 kit Botol 3
JUMLAH
NO KOMPOSISI SATUAN TOTAL KET
KEBUTUHAN
Reagen
210 Cleanser bcc-3600 1 kit Botol 3
Reagen
211 Strip urine H-100 dirui 1 kit Box 1
Bandung, Oktober 2025
PEJABAT PEMBUAT KOMITMEN
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