RPK Ukm

PERENCANAAN OBAT PUSKESMAS NGLETIH KOTA KEDIRI
TAHUN 2019
PENGELUARAN KEKOSO SISA KEBUTU PEREN

NO KODE NAMA OBAT SATUAN 1 TH (th 2017 NGAN DES ED HAN CANAA
BARANG OBAT 2017 2018 2018 N 2019
RESEP ED (bln)
I. OBAT
1 Albendazol tablet 400 mg Tablet 40 130 60 50
2 AA006 Alkohol Swab Kotak 88 3 132 500
3 OA004 Alopurinol tablet 100 mg Tablet 294 50 441 500
4 OA005 Alopurinol tablet 300 mg Tablet 371 135 557 500
5 OA007 Ambroksol sirup Botol 51 84 77 0
6 OA008 Ambroksol tablet 30 mg Tablet 6,009 742 9,014 0
7 OA009 Aminofilin injeksi 24 mg/ml-10 ml Ampul 10 38 15 50
8 OA010 Aminofilin tablet 200 mg Tablet 10 60 15 100
9 OA011 Amitriptilin HCL tablet salut 25 mg Tablet 429 187 644 1,000
10 OA012 Amlodipin tablet 10 mg Tablet 33,879 6,394 50,819 50,000
11 OA013 Amlodipin tablet 5 mg Tablet 12,399 7,591 18,599 10,000
12 OA015 Amoksisilin kapsul/kaplet 250 mg Kapsul 3,823 457 5,735 5,000
13 OA016 Amoksisilin kapsul/kaplet 500 mg Kaplet 35,373 5,739 53,060 50,000
14 OA017 Amoksisilin sirup kering 125 mg/5 ml Botol 487 133 731 1,500
15 OA018 Amoksisilin sirup kering forte 250 mg/5 ml Botol 447 78 671 300
16 OA014 Amoksisilin drop 100 mg/ml Botol 53 20 80 100
17 OA020 Ampisilin serbuk injeksi i.m/i.v. 500 mg Ampul 1,501 250 2,252 2,000
18 OA021 Ampisilin Serbuk injeksi i.m/i.v.1000 mg Ampul 1,504 320 2,256 2,000
19 OA025 Antasida Doen I tablet kunyah kombinasi Tablet 48,744 7,340 73,116 75,000
20 OA026 Antasida Doen II suspensi Botol 27 10 473 243 2,500
21 OA027 Antibakteri Doen Salep Kombinasi Tube 63 10 39 567 600
22 Antidiare tablet (kaolin+pektin) Tablet 0 0 0 0
23 OA028 Antifungi Doen kombinasi Pot 0 0 0 0
24 OA029 Antihemoroid Doen kombinasi Supp 241 17 362 500
25 OA030 Antimigrain Doen kombinasi Tablet 197 0 296 300
26 Antrain injeksi Ampul 0 0 0 0
27 OA033 Aqua Pro Injeksi steril, bebas pirogen Vial 1,018 273 1,527 1,500
28 Aquadest steril Botol 0 0 0 0
29 OA035 Aquasonic Gell Botol 10 7 15 10
30 OA036 Asam Asetilsalisilat tablet 100 mg
Tablet 0 0 0 0
(Asetosal)

Tablet 0
(Asetosal) 0 0 0

Tablet 347
(Asetosal) 167 521 1,000
33 OA039 Asam Askorbat (Vitamin C) tablet 250 mg Tablet 954 9 5,855 5,724 10,000
34 OA040 Asam Askorbat (Vitamin C) tablet 50 mg Tablet 4,313 5 436 11,091 10,000
35 OA041 Asam Folat tablet 1 mg Tablet 2,263 5 0 5,819 6,000
36 OA042 Asam Mefenamat kapsul/kaplet 500 mg Kaplet 7,513 2 11,673 13,523 30,000
37 OA044 Asiklovir krim 5% Tube 99 56 149 200
38 OA045 Asiklovir tablet 200 mg Tablet 166 113 249 200
39 OA046 Asiklovir tablet 400 mg Tablet 1,147 483 1,721 2,000
40 Aspilet tablet 80 mg Tablet 0 0 0 0
41 OA048 Atapulgit tablet 630 mg Tablet 3,398 618 5,097 5,000
42 OA049 Atenolol tablet 50 mg Tablet 72 72 0 108 0
43 OA050 Atropin Sulfat injeksi 0,25 mg/ml-1 ml Ampul 10 7 20 36 0
44 OB008 Betametason krim 0,1 % (sebagai valerat) Tube 835 165 1,253 1,000
45 OB010 Bisakodil Supositoria 10 mg Supp 8 12 12 60
46 OB011 Bisakodil tablet 5 mg Tablet 223 134 335 200
PENGELUARAN KEKOSO SISA
NO KODE NAMA OBAT SATUAN 1 TH (th 2017 NGAN ED KEBUTU PEREN
BARANG OBAT DES 2018 HAN CANAA
(bln) 2017 2018 N 2019
RESEP ED
47 OB001 Bisolvon sol Botol 1 3 2 1
48 OB014 Budesonid cairan inhalasi 0,25 mg/ml Ampul 6 24 9 0
49 OB015 Budesonid inhaler 200 mcg/puff Botol 5 2 8 6
50 OC001 Cairan Infus Dextrose 5%/0,225% Nacl Botol 1,205 307 1,808 1,500
51 OC002 Cairan Infus Dextrose 5%/0,45% Nacl Botol 724 273 1,086 1,000
52 OC003 Calsium AD Tablet Tablet 0 0 0 0
53 OC006 Cendo Lyteers Botol 10 0 15 15
54 OC011 Combantrin tablet Tablet 0 0 0 0
55 Corobion tablet Tablet 0 0 0 0
56 OD002 Dasabion tablet ( multivitamin + Fe tablet ) Tablet 0 0 0 0
57 OD003 Deksametason injeksi i.v. 5 mg/ml- 1 ml Ampul 268 33 402 400
58 OD004 Deksametason tablet 0,5 mg Tablet 5,422 1,578 8,133 8,000
59 OD009 Diazepam injeksi 5 mg/ml- 2 ml Ampul 18 6 49 54 10
60 OD010 Diazepam tablet 2 mg Tablet 1,068 540 1,602 1,500
61 OD014 Difenhidramin HCL injeksi i.m. 10 mg/ml-
Ampul 0 15 0 0
1 ml
62 OD015 Digoksin tablet 0,25 mg Tablet 764 188 1,146 1,000
63 OD016 Diltiazem HCL tablet 30 mg Tablet 40 231 60 0
64 OD017 Dimenhidrinat tablet 50 mg Tablet 3,407 947 5,111 4,000
65 OD018 Doksisiklin kapsul 100 mg Kapsul 0 0 0 0
66 OD019 Domperidon suspensi 5 mg/5ml Botol 46 9 69 60
67 OD020 Domperidon tablet 10 mg Tablet 1,812 222 2,718 2,500
68 OE003 Efedrin HCL tablet 25 mg Tablet 377 332 0 566 0
69 OE004 Ekstrak Belladon tablet 10 mg Tablet 235 2 65 423 350
70 OE006 Epinefrine (Adrenalin) injeksi 0,1%
Ampul 3 12 5 0
(sebagai HCl)
71 Eritromisin kapsul/kaplet 500 mg Tablet 9 91 14 0
72 OE008 Eritromisin kapsul/kaplet 500 mg Tablet 202 0 303 500
73 OE009 Eritromisin sirup 200 mg/5ml Botol 35 0 53 60
74 OE011 Etakridin (Rivanol) Larutan 0,1 % 300 ml Botol 0 0 0 0
75 OE013 Etanol 70 % Botol 3 2 5 5
76 OE014 Etanol 70 % 100 ml 258 147 387 250
77 OE015 Etanol 95% 1 liter Botol 5 2 8 5
78 OE018 Etil Klorida Semprot Botol 20 11 30 20
79 OF004 Fenitoin Natrium kapsul/kaplet 100 mg Kapsul 0 0 0 0
80 OF005 Fenitoin Natrium kapsul/kaplet 30 mg Kapsul 0 0 0 0
81 OF009 Fenobarbital tablet 30 mg Tablet 0 0 0 0
82 OF011 Fenoksimetil Penicilina tablet 500 mg Tablet 0 0 0 0
83 OF013 Fenol Gliserol tetes telinga 10% Botol 0 10 24 0 60
84 OF015 Fitomenadion(Vit K1) injeksi 10 %/ml-1 ml Ampul 76 74 114 40
85 OF016 Fitomenadion(Vit K1) tablet salut gula 10
Tablet 493 175 740 600
mg
86 OF021 Furosemid tablet 40 mg Tablet 2,802 591 4,203 4,000
87 OG001 Garam Oralit untuk 200 ml air Sak 4,150 494 6,225 6,000
88 OG002 Gentamisin Inj. 80 mg/ml (Sulfat) Ampul 0 200 0 0
89 OG003 Gentamisin salep kulit 0,1% Tube 295 66 443 400
90 OG004 Gentian Violet larutan 1 % Botol 197 50 296 300
91 OG007 Glibenklamid tablet 5 mg Tablet 8,037 2,147 12,056 10,000
92 OG008 Glimepirid tablet 1 mg Tablet 16,766 1,863 25,149 5,000
93 OG009 Glimepirid tablet 2 mg Tablet 9,043 4 7,328 20,347 15,000
94 OG011 Gliseril Guayakolat tablet 100 mg Tablet 50,453 8,597 75,680 65,000
95 OG014 Glukose larutan infus 40% steril Botol 4 50 6 0
96 OG015 Glukose larutan infus 5 % Steril Botol 277 58 416 400
97 OG016 Griseofulvin forte tablet 500 mg Tablet 471 259 707 1,000
(bln) 2017 2018 N 2019
RESEP ED
98 OG017 Griseofulvin tablet 125 mg micronized Tablet 409 260 614 500
99 OG018 Grotavit sirup Botol 0 0 0 0
100 OG019 Guanistrep suspensi Botol 112 19 168 150
101 OH001 Haloperidol tablet 0,5 mg Tablet 4,158 587 6,237 6,000
102 OH003 Haloperidol tablet 5 mg Tablet 1,003 354 1,505 1,200
103 Hand Wash (Sabun Cuci
Botol 95 49 143 150
Tangan)/klorhexidin 4%/hydrex 0,5 ml
104 OH008 Hidroklortiazid (HCT) tablet 25 mg Tablet 9,598 800 14,397 15,000
105 OH009 Hidrokortison krim 2,5 % Tube 332 60 498 500
106 OH010 Hiosin-N-butilbromida injeksi Ampul 56 5 0 144 150
107 OH011 Hiosin-N-butilbromida tablet Tablet 999 321 1,499 1,200
108 OI001 Ibuprofen suspensi 100 mg/5 ml Botol 31 2 0 56 60
109 OI002 Ibuprofen tablet 200 mg Tablet 6,823 1,432 10,235 10,000
110 OI003 Ibuprofen tablet 400 mg Tablet 86,518 6,856 129,777 50,000
111 OI010 Ipratrium Br 0,5 m, salbutamol 2,5 mg/ 2,5
Ampul 0 0 0 0
ml Neb.
112 OI013 Isosorbid dinitrat tablet sublingual 5 mg Tablet 1,214 315 1,821 2,000
113 OK002 Kalsium Glukonat Injeksi Ampul 0 135 0 0
114 OK004 Kalsium Laktat (Kalk) tablet 500 mg Tablet 2,602 5 4,383 6,691 3,000
115 OK005 Kaptopril tablet 12,5 mg Tablet 22,480 1,664 33,720 20,000
116 OK006 Kaptopril tablet 25 mg Tablet 21,561 4 13,327 48,512 40,000
117 OK007 Kaptopril tablet 50 mg Tablet 3,000 0 4,500 5,000
118 OK008 Karbamazepin tablet 200 mg Tablet 16 34 24 0
119 OK011 Ketokonazol krim 2% 15 gr Tube 0 0 0 0
120 Ketokonazol krim 2% 5 gr Tube 0 0 0 0
121 OK013 Ketokonazol tablet 200 mg Tablet 0 0 0 0
122 OK014 Klindamisin kapsul 150 mg Kapsul 304 80 456 1,000
123 Kloramfenikol injeksi 1 gr (Chlorbiotic inj) Vial 0 0 0 0
124 OK019 Kloramfenikol Kapsul/kaplet 250 mg Kapsul 3,410 2,016 5,115 5,000
125 OK020 Kloramfenikol Salep Mata 1 % Tube 0 0 0 0
126 OK021 Kloramfenikol suspensi 125 mg/5 ml Botol 33 70 50 0
127 OK022 Kloramfenikol Tetes Mata Botol 192 3 78 384 300
128 OK023 Kloramfenikol Tetes Telinga 3 % Botol 59 5 41 152 200
129 OK024 Klorfeniramin Maleat ( CTM ) tablet 4 mg Tablet 72,702 24,122 109,053 85,000
130 OK028 Klorpromazin HCL tablet salut 100 mg Tablet 1,053 6 0 3,159 3,000
131 OK029 Klorpromazin HCL tablet salut 25 mg Tablet 7,217 4 2,683 16,238 3,000
132 OK031 Kodein Fosfat tablet 10 mg Tablet 1,678 252 2,517 2,500
133 OK038 Kontrasepsi oral Linesterol tablet 0,5 mg Tablet 46 8 69 60
134 OK039 Kotrimoksazol Doen I (dewasa) tablet Tablet 556 225 834 700
135 OK040 Kotrimoksazol Forte tablet Kaplet 298 148 447 500
136 OK041 Kotrimoksazol suspensi kombinasi Botol 59 2 21 106 100
137 OL001 Lactulax sirup Botol 2 6 0 6 10
138 OL001 Laktulose sirup Botol 0 0 0 0
139 OL010 Lidokain HCl 2% injeksi Ampul 0 0 0 0
140 OL011 Lidokain injeksi 2% (HCl) + Epineprin
Ampul 0 60 0 0
1:80.000-2 ml
141 OLO12 Loperamide tablet 2 mg Tablet 113 167 170 3
142 OL013 Loratadin tablet 10 mg Tablet 1,414 854 2,121 1,500
143 OL014 Lotion kombinasi Difenhidramin 2% -
Botol 10 7 15 24
Kalamin 5% - Zinc 10% - Gliserin 5%
144 OM002 Magnesium Sulfat injeksi (IV) 20%-25 ml Vial 0 0 0 0
145 OM003 Magnesium Sulfat injeksi (IV) 40%-25 ml Vial 243 230 62 365 20
146 OM006 Metamizol injeksi 500 mg/ml Ampul 78 31 117 100
147 OM007 Metampiron tablet 500 mg Tablet 990 0 1,485 0
148 OM008 Metformin HCl tablet 500 mg Tablet 56,125 14,583 84,188 70,000
149 OM009 Metformin HCl tablet 850 mg Tablet 554 753 831 0
150 OM010 Metilergometrin maleat injeksi 0,200 mg Ampul 13 86 20 0
(bln) 2017 2018 N 2019
RESEP ED
151 OM011 Metilergometrin maleat tablet salut 0,125
Tablet 0 0 0 0
mg
152 OM012 Metilprednisolon tablet 4 mg Tablet 849 5 0 2,183 2,500
153 OM013 Metoklopramid Injeksi 5mg/ml Ampul 110 39 165 150
154 OM014 Metoklopramid tablet 10 mg Tablet 201 172 302 130
155 OM015 Metronidazol ovula 500 mg Supp 7 59 11 0
156 OM016 Metronidazol tablet 250 mg Tablet 578 5 0 1,486 1,500
157 OM017 Metronidazol tablet 500 mg Tablet 1,428 371 2,142 2,000
158 OM018 Mikonazol krim/salep 2% (nitrat) Tube 326 105 489 400
159 OM021 Multivitamin komb (antianemia) tablet
Kapsul 9,534 1,895 14,301 10,000
(novabion)
Multivitamin komb (neurotropik) tablet
160 OM022 Tablet 4,049 9 0 24,294 25,000
(Neurodex)
161 ON002 N-asetisistein kapsul 20 mg Kapsul 320 120 480 1,000
162 ON003 Natrium Bikarbonat tablet 500 mg Tablet 0 0 0 0
163 ON004 Natrium Diklofenak tablet 25 mg Tablet 2,333 193 3,500 3,500
164 ON005 Natrium Diklofenak tablet 50 mg Tablet 2,580 2 464 4,644 5,000
165 ON007 Natrium Klorida larutan infus 0,9% steril Botol 419 167 629 500
166 Neo Kaominal sirup Botol 0 0 0 0
167 Neurovit E tablet Kaplet 0 0 0 0
168 ON017 Nifedipin tablet 10 mg Tablet 6,043 744 9,065 8,500
169 Nifedipin tablet oros 30 mg Tablet 90 5 0 231 0
170 ON018 Nistatin 100.000 UI/ml drop Botol 47 55 71 50
171 ON019 Nistatin tablet salut 500.000 IU/g Tablet 0 0 0 0
172 ON020 Nistatin tablet vaginal 100.000 IU/g Tablet 17 123 26 0
173 OO009 Obat Flu komb Sirup (Fludane) Botol 108 29 162 200
174 OO010 Obat Flu komb Tablet(Fludane) Tablet 895 9 0 5,370 6,000
175 OO008 Obat Batuk Hitam (OBH) cairan 100 ml Botol 963 231 1,445 1,500
176 OO012 Oksitetrasiklin HCL Salep kulit 3 % Tube 325 53 488 435
177 OO013 Oksitetrasiklin HCL salep mata 1% Tube 149 7 0 536 500
178 OO014 Oksitosin injeksi 10 IU/ ml- 1 ml Ampul 136 132 204 72
179 OO015 Omegdiar tablet Tablet 0 0 0 0
180 OO016 Omeprazol injeksi 20 mg 40mg/10 ml Vial 0 0 0 0
181 OO017 Omeprazol kapsul/kaplet 20 mg Kapsul 1,482 450 2,223 1,500
182 OP002 Parasetamol drop 100 mg/ml Botol 87 21 131 150
183 OP003 Parasetamol sirup 120 mg/ 5 ml Botol 3,399 707 5,099 5,000
184 OP005 Parasetamol tablet 500 mg Tablet 32,687 5 16,800 84,052 120,000
185 OP006 Pehacain inj Ampul 797 39 1,196 1,200
186 OP007 Perak Sulfadiazin krim 1% Tube 4 8 6 10
187 OP010 Permetrin Krim 5% (Scabimite) Tube 87 77 131 100
188 OP013 Pirantel Pamoat tablet 125 mg Tablet 0 0 0 0
189 OP014 Piridoksin HCL tablet 10 mg Tablet 21,397 3,370 32,096 30,000
190 OP015 Piroksikam kapsul/kaplet/tablet 20 mg Kapsul 238 69 357 300
191 OP018 Povidon Iodida Larutan 10% 1000 ml Botol 3 2 5 3
194 OP022 Prednison tablet 5 mg Tablet 1,020 809 0 1,530 500
195 OP027 Propanolol HCL tablet 40 mg Tablet 170 140 255 150
196 OP028 Propiltiourasil tablet Tablet 0 0 0 0
197 OP029 Pseudoefedrin+tripolidin tablet Tablet 500 9 0 3,000 3,000
198 OR002 Ranitidin Injeksi 25 mg/ ml Ampul 0 0 0 0
199 Ranitidin Injeksi 50 mg/2 ml Ampul 496 5 104 1,275 1,200
200 OR003 Ranitidin tablet 150 mg Tablet 12,370 1,765 18,555 18,000
201 OR018 Ringer Laktat larutan Infus steril Botol 2,520 481 3,780 3,500
202 OS011 SABU injeksi 5 ml Vial 0 0 0 0
203 OS001 Salbutamol tablet 2 mg (sebagai sulfat) Tablet 5,821 1,179 8,732 8,000
(bln) 2017 2018 N 2019
RESEP ED
204 OS002 Salbutamol tablet 4 mg (sebagai sulfat) Tablet 0 0 0 0
205 OS003 Salep 2-4 kombinasi Pot 48 38 72 50
206 OS004 Salisil Bedak 2 % Kotak 358 133 537 500
207 OS004 Scabicid krim Tube 0 0 0 0
208 OS007 Sefotaksim Injeksi 1 g Vial 291 3 62 582 500
209 OS008 Seftriakson Injeksi 1 gr Vial 114 38 171 120
210 OS013 Serum Anti Tetanus inj. 1500 UI/vial amp
Ampul 0 2 0 0
(ATS)
211 OS015 Setirizine sirup 5 mg/5ml Botol 22 15 33 50
212 OS016 Setirizine tablet 10 mg Tablet 290 248 435 300
213 OS017 Sianokobalamin (vit. B12) tablet 50 mcg Tablet 2,483 1,233 3,725 3,000
214 OS021 Simetidin tablet 200 mg Tablet 1,215 2 104 2,187 2,000
215 OS022 Simvastatin tablet 10 mg Tablet 457 3 0 914 1,000
216 OS023 Simvastatin tablet 20 mg Tablet 211 51 317 200
217 OS024 Siprofloksasin tablet 500 mg (sebagai
Tablet 2,086 233 3,129 3,000
HCl)
218 OS025 Siprofloksasin tetes mata Botol 15 4 23 30
219 Spironolakton tablet 100 mg Tablet 0 0 0 0
220 OS027 Spironolakton tablet 25 mg Tablet 245 114 0 368 500
221 OS028 Stesolid Rectal supp 5 mg Supp 25 12 38 30
222 OS032 Sulfasetamid Natrium tetes mata 15 % Botol 6 11 0 108 0
223 OT001 Tablet Tambah Darah Kombinasi Sachet 28,267 1,025 42,401 3,000
224 OT008 Terbutalin sulfat 0,5 mg - spray 100 dosis Botol 2 0 3 3
225 OT009 Terbutalin sulfat 2,5 mg/ml respules Ampul 1 19 2 0
226 OT010 Tetrakain Tetes Mata 0,5% Botol 2 0 3 3
227 OT012 Tetrasiklin HCL Kapsul/kaplet 250 mg Kapsul 0 0 0 0
228 Thrombo Aspilet tablet 80 mg Tablet 0 0 0 0
229 Tiamin HCL (Vit B1) Inj. 100 mg/ml-1 ml Ampul 0 0 0 0
230 OT016 Tiamin HCL Mononitrat (Vitamin B1)
Tablet 11,678 2,888 17,517 15,000
Tablet 100 mg
231 OT019 Trifluoperazin tablet 5 mg Tablet 1,469 236 2,204 2,000
232 OT020 Triheksifenidil Hidroklorida tablet 2 mg Tablet 3,087 256 4,631 4,000
233 OV012 Ventolin Nebulizer Ampul 729 70 1,094 1,200
234 Vit K Infant / Neo - K injeksi Ampul 0 0 0 0
235 OV015 Vitamin B Komplek Tablet Tablet 105,260 22,558 157,890 135,000
236 OY001 Y-Rins cuci mata Botol 0 0 0 0
237 OZ003 Zinc Drop 10mg/ml Botol 0 0 0 0
238 OZ004 Zinc sirup 20 mg/5 ml Botol 25 7 38 50
239 OZ005 Zinc tablet 20 mg Tablet 2,580 888 3,870 5,000
II. OBAT PROGRAM

1 OB006 Benzatin Benzil Penisilin injeksi Vial 10 0 0
2 OF017 Flukonazol kapsul 150 mg kapsul 0 0 0 0
3 OH004 Haloperidol inj 5mg/ml (Lodomer) Ampul 0 0 0 0
4 OK016 Klobazam tablet 10 mg (obat program
Tablet 0 100 0 0
jiwa)
5 OK030 Klozapin tablet 25 mg (obat program jiwa) Tablet 158 158 0 237 0
6 OK032 Kombipak azitrhromycin-cefixim Paket 42 19 0 63 63
7 OM019 Mineral Mix, kombinasi Pirimitamin tab 25
Sachet 0 0 0 0
mg Sulfadoksin tablet 500 mg
8 OO003 Obat Antituberkulosis FDC Kategori Anak Paket 0 0 0 0
9 OO004 Obat Antituberkulosis FDC Kategori I Paket 19 3 29 26
10 OO005 Obat Antituberkulosis FDC Kategori II Paket 3 1 5 4
(bln) 2017 2018 N 2019
RESEP ED
11 OP026 Procain Benzil Penisillin 3 juta IU/vial inj Vial 1 224 2 0
12 OR014 Retinol (Vitamin A) 100.000 IU kapsul
Kapsul 300 0 450 500
lunak
Retinol (Vitamin A) 200.000 IU kapsul
13 OR015 Kapsul 2,350 0 3,525 3,500
lunak
Risperidon tablet 2 mg (obat program
14 OR019 Tablet 65 95 98 0
jiwa)
15 Speculum Vagina Biji 0 0 0 0
III. ALKES
1 AA002 Alat suntik sekali pakai 1 ml Biji 378 359 567 200
2 AA003 Alat suntik sekali pakai 10 ml Biji 412 194 618 400
3 AA004 Alat suntik sekali pakai 2,5 ml Biji 0 0 0 0
4 AA004 Alat suntik sekali pakai 3 ml Biji 4,893 2,303 7,340 10,000
5 AA005 Alat suntik sekali pakai 5 ml Biji 1,998 361 2,997 2,500
6 AB002 Benang Cat Gut Chromic 2/0 Sachet 58 4 87 96
7 AB003 Benang Cat Gut Chromic 3/0 Sachet 47 37 71 36
8 AB004 Benang Cat Gut Plain 2/0 Sachet 0 0 0 0
9 AB005 Benang Cat Gut Plain 3/0 Sachet 65 64 98 60
10 AB006 Benang Silk/Side 2/0 Sachet 0 0 0 0
11 AB007 Benang Silk/Side 3/0 Sachet 28 22 42 20
12 AB009 Blood Set Biji 85 23 128 100
13 AF001 Foley Catheter no. 14 Biji 20 0 30 30
14 AF002 Foley Catheter no. 16 Biji 20 0 30 30
15 AH001 Handscun Panjang Biji 83 115 125 50
16 AH003 Handscun non steril L Biji 1,291 4 200 2,905 5,000
17 AH004 Handscun non steril M Biji 9,915 4,285 14,873 15,000
18 AH005 Handscun non steril S Biji 200 0 300 0
19 AH007 Handscun steril 7 Pasang 1,221 2 1,832 3,000
20 AH006 Handscun steril 6,5 Pasang 1,283 570 1,925 1,000
21 AH008 Handscun steril 7,5 Pasang 400 0 600 1,500
22 AH011 Handscun steril 8 Pasang 515 185 773 0
23 AH010 Hansaplast Biji 3,783 885 5,675 5,000
24 AI001 Infusion set anak Set 342 137 513 500
25 AI002 Infusion set dewasa Set 975 233 1,463 1,200
26 AI004 IV Chateter 18 (Surflo 18) Biji 117 5 0 301 200
27 AIOO5 IV Chateter 20 (Surflo 20) Biji 182 55 273 500
28 AIOO6 IV Chateter 22 (Surflo 22) Biji 738 266 1,107 1,000
29 AI007 IV Chateter 24 (Surflo 24) Biji 611 215 917 1,000
30 AI008 IV Chateter 26 (Surflo 26) Biji 183 70 275 200
31 AJ002 Jarum suntik 23 G Biji 219 100 329 100
32 AK003 Kapas Pembalut/ Adsorben 250 mg Biji 22 14 33 19
33 AK004 Kasa Hidrofil gulung Rol 0 0 0 0
34 AK005 Kasa Husada Steril 16x16 Kit 4 11 6 10
35 AK007 Kasa Pembalut 2 x 80 cm Biji 0 0 0 0
36 AK008 Kasa Pembalut Hidrofil 4 m x 15 cm Biji 1,791 214 2,687 2,473
37 Masker Kain Biji 0 0 0 0
38 AM004 Masker O2 anak Buah 3 13 5 0
39 AM005 Masker O2 bayi Buah 10 12 15 20
40 AM006 Masker O2 dewasa Buah 18 10 27 40
41 AM002 Masker N95 Biji 0 0 0 10
42 AM003 Masker Tissue Biji 5,905 2,848 8,858 20,000
43 AN002 Nasal O2 ukuran M Biji 6 4 9 100
44 AN003 Nasal O2 ukuran S Biji 6 14 9 50
45 AP004 Plester 5 yard x 2 inch Rol 270 80 405 350
46 Silk (Benang Bedah Sutera) No. 3/0 Kotak 0 0 0 0
47 AS001 Scafel Handle Biji 1 0 2 2
48 AS004 Slim Suiqer Biji 21 79 32 10
(bln) 2017 2018 N 2019
RESEP ED
49 AS010 Surgical Blade Biji 218 100 327 300
50 AS011 Surgical Needle Sak 4 0 6 6
51 AU001 Urin bag Biji 31 0 47 47
Mengetahui
Kepala Puskesmas Perawatan Ngletih Pengelola Obat,
dr. Susana Dewi Hanik Mariana Dewi, S. Farm. M. Farm. Klin., Apt
NIP. 19700827 200212 2 009 NIP. 19811107 201001 2 016
TAHUN 2019
PENGELUAR KEKOSON
AN 1 TH GAN SISA DES ED
NO NAMA OBAT SATUAN OBAT 2016 2017
RESEP ED (bln)
1 OA002 Air Raksa dental Botol 0

2 OA006 Alvogyl pasta Pot 0
3 AA007 Articulaying Paper Paket 0
4 OB012 Bonding Botol 0
5 OB013 Bonding Aplikator Kotak 0
6 OC004 Calsium Hidroxyd tube 0
7 AC005 Cotton Roll Gigi Dos 0
8 OD008 Devitalisasi Pasta (non Arsen) Botol 0
9 OE016 Etching Botol 0
10 OE019 Eugenol Cairan Botol 0
11 OG006 Glass Ionomer Cement (GC IX) Set 0
12 AI003 Instrumen Gigi Set Paket 0
13 OI001 Iodoform Botol 0
14 AK001 Kaca Mulut Buah 0
15 Kalsium Hidroksida (CaOH2) tube 0
16 OK033 Komposit Resin Anterior A2 tube 0
17 OK034 Komposit Resin Anterior A3 tube 0
18 OK035 Komposit Resin Anterior A3.5 tube 0
19 OK036 Komposit Resin Posterior

tube
QA3,5/A3 0
20 AM007 Mata Boor Kotak 0
21 AM008 Mata Boor Frisure Besar Biji 0
22 AM009 Mata Boor Frisure Kecil Biji 0
23 AM010 Mata Boor Frisure Sedang Biji 0
24 Mata Boor Inverted Biji 0
25 AM009 Mata Boor Inverted Kecil Biji 0
26 AM013 Mata Boor Inverted Sedang Biji 0
27 AM014 Mata Boor Round Besar Biji 0
28 AM016 Mata Boor Round Sedang Biji 0
29 Mata Boor Tapper Besar Biji 0
30 AM017 Mata Boor Tapper Kecil Biji 0
31 AM018 Mata Boor Tapper Sedang Biji 0
32 OM020 Monoklorkamfer Mentol cairan
Botol 0
(CHKM)
33 OM024 Mumifying pasta Botol 0
34 OP016 Polikresulen 10 ml (Albothyl) Botol 0
35 AP005 Polising Amalgam Restoration Set 0
36 OR020 Root Canal Filling Buah 0
37 AS002 Selleloid strip Sachet 0
38 OS009 Semen Seng Fosfat serbuk dan
Set 0
cairan
39 OS020 Silver Amalgam Serbuk 65-75 % Botol 0
40 AS005 Spongostan Kotak 0
41 AS010 Surgical Blade / Mess no 11 Biji 0
42 Temporary Stopping Fletcher Cair Set 0
43 OT003 Temporary Stopping Fletcher
Set
Serbuk dan cairan
44 OT021 Trikresol Formalin (TKF) Cairan Botol
45 OT023 TSR Botol
46 OT024 Tumpatan sementara Botol
Mengetahui
Kepala Puskesmas Perawatan Ngletih Pengelola Obat,
dr. Susana Dewi Hanik Mariana Dewi, S.Farm. M. Farm. Klin.,Apt

NIP. 19700827 200212 2 009 NIP. 19811107 201001 2 016
DIRI
KEBUTU PEREN HARGA

HAN CANAAN PERKIRAAN BIAYA
SATUAN
2019 2019
0 550,000 0
1 170,934 170934
0 165,000 0
0 242,000 0
0 99,000 0
0 60,500 0
1 66,000 66000
0 330,000 0
0 332,200 0
3 78,100 234300
13 770,000 10010000
0 1,555,000 0
1 214,352 214352
9 0
2 0
4 374,000 1496000
0 374,000 0
4 374,000 1496000
374,000
2 748000
1 163,350 163350
2 27,500 55000
3 27,500 82500
2 27,500 55000
5 0
5 27,500 137500
1 27,500 27500
3 0
3 0
5 0
5 27,500 137500
5 27,500 137500
0 66,550 0
1 66,000 66000
42,350 0
126,493 0
126,500 0
165,000 0
201,300 0
440,000 0
1 93,500 93500
10 2,645 26450
0 0
2 0
0 77,000 0
0 144,648 0
7 159,478 1116346
Rp16,533,732
S.Farm. M. Farm. Klin.,Apt

01001 2 016
TAHUN 2019
PENGELUAR KEKOSO
AN 1 TH SISA PEREN
NO NAMA OBAT SATUAN NGAN DES ED KEBUTUH CANAAN
RESE ED OBAT 2017 AN 2019
(bln) 2017 2019
P
1 Alat Pemeriksaan Gula Darah Kit 0 0
2 Bilirubin Kit 0 0
3 LB002 Blood Lancet Kotak 0 24
4 AB010 Blue Tip Sak 0 1
5 AC006 Cover glass Kotak 0 1
6 LD001 Darah Kontrol Ampul 0 12
7 LD003 Diluent 20 ltr Galon 0 6
8 LE001 EDTA Cair 10% 100 mL Botol 0 0
9 LE003 ETA cair 10% 100ml Botol 0 0
10 LG001 Glucosa Enzimatik Trinder Kit 0 6
11 LG002 Gol. Darah A Vial 0 6
12 LG003 Gol. Darah AB Vial 0 6
13 LG004 Gol. Darah B Vial 0 6
14 LG005 Gol. Darah Rhesus Vial 0 6
15 LH001 H2O2 3% Botol 0 0
16 LH003 Hb-Cyanmet 1 liter Botol 0 6
17 KLK001 Kartu Golongan Darah Kotak 0 6
18 AK010 Kertas Lensa Buah 0 12
19 Kotak slide Buah 0 2
20 OL003 Larutan Zheil Nielson/BTA 100 ml Botol 0 12
21 OL004 Larutan Emersi Oil Botol 0 4
22 OL005 Larutan Eter alkohol Botol 0 0
23 OK006 Larutan Klorin / NaClO 5,25% (bayclin) Botol 0 12
24 OL007 Larutan KOH 10% Botol 0 2
25 OL008 Larutan Metilen Biru Botol 0 0
26 OL009 Larutan NaCl 0,9% 100 ml Botol 0 4
27 Larutan VDRL 10 ml Botol 0 0
28 LM001 M-18 E-cfd lyse 500ml Botol 0 6
29 LM002 M-18 E-Z cleaner Botol 0 6
30 LM003 M-18 R rinse Botol 0 6
31 LM004 M-18P probe cleanser Botol 0 6
32 Methilen Blue 0,3% Botol 0 0
33 LO001 Obyek Glass 72 Dos 0 24
34 Ose Buah 0 2
35 AP001 PH Paper Vagina Kotak 0 0
36 Pot Dahak Buah 0 500
37 LR004 Reagen Asam Urat Kit 0 6
38 LR006 Reagen Drabkin 1000ml Botol 0 6
39 LR008 Reagen Gula Darah Vial 0 7
40 LR010 Reagen Hbs Ag Kotak 0 12
41 OR012 Ragen HIV/intec/II Sachet 0 0
42 OR013 Reagen HIV / oncoprobe / I Sachet 0 0
43 OR015 Reagen HIV / vikia / III Sachet 0 0
44 LR012 Reagen Kolesterol HDL Kit 0 1
45 LR013 Reagen Kolesterol LDL Kit 0 1
46 LR014 Reagen Kolesterol Total Vial 0 6
47 LR015 Reagen Kreatinin Kit 0 0
48 LR019 Reagen Thypoid IgG/IgM+B383 Kotak 0 0
49 LR021 Reagen Trigliserida Kit 0 4
50 LR022 Reagen Urea Kit 0 0
51 LR023 Reagent SGOT 4x20 UV Kinetik
Kit 0 3
(IFCC)
Reagent SGPT 4x20 UV Kinetik
52 LR024 Kit 0 3
(IFCC)
53 OR008 Reagen Shipilis / VDRL test (Syphillis Kotak 0 0
device)
54 LR017 Reagent Standart Trucal U Vial 0 6
55 LR018 Reagent Standart Trulab N Vial 0 0
56 AS002 Selleloid strip Sachet 0 0
57 LS001 Serum Kontrol Vial 0 12
PENGELUAR KEKOSO
AN 1 TH SISA PEREN
NO NAMA OBAT SATUAN NGAN DES ED KEBUTUH CANAAN
RESE ED OBAT 2017 AN 2019
2017 2019
P (bln)
58 Slide Object Glass Kotak 0 0
59 LS002 Spiritus Botol 0 6
60 LS003 Strip Gula Darah Kotak 0 120
61 LT001 Tabung centrifuge 15 TP Buah 0 0
62 LT009 Tabung Vacuntainer EDTA (tutup
Kotak 0 24
merah)
63 LT010 Tabung Vacuntainer EDTA (tutup ungu) Kotak 0 24
64 LT011 Tes Kehamilan Buah 0 0
65 LT012 Thermal Paper Rol 0 12
66 Uric Acid Trinder 4x30 ml Botol 0 0
67 LU002 Urinalisis Strip 10 Parameter Tube 0 6
68 LU003 Urinalisis Strip 2 Parameter Tube 0 12
69 Uro Paper/ Urine 10 pm Botol 0 0
70 LW001 Widal AO Vial 0 6
71 LW002 Widal BO Vial 0 6
72 LW003 Widal H Vial 0 6
73 LW004 Widal O Vial 0 6
74 LY001 Yellow Tip Sak 0 2
STOK HARGA
NO NAMA OBAT SATUAN HARGA MASUK KEL SISA
AWAL PERSEDIAAN
I. OBAT
1 Albendazol tablet 400 mg Tablet 170 378 0 40 130 0
2 AA006 Alkohol Swab Kotak 4 20,812 87 88 3 1,810,644
3 OA004 Alopurinol tablet 100 mg Tablet 244 99 100 294 50 9,900
4 OA005 Alopurinol tablet 300 mg Tablet 106 220 400 371 135 88,000
5 OA007 Ambroksol sirup Botol 39 3,497 96 51 84 335,712
6 OA008 Ambroksol tablet 30 mg Tablet 1,351 248 5,400 6,009 742 1,339,200
7 OA009 Aminofilin injeksi 24 mg/ml-10 ml Ampul 13 3,298 35 10 38 115,430
8 OA010 Aminofilin tablet 200 mg Tablet 70 100 0 10 60 0
9 OA011 Amitriptilin HCL tablet salut 25 mg Tablet 157 400 429 187 62,800
216
10 OA012 Amlodipin tablet 10 mg Tablet 8,593 160 31,680 33,879 6,394 5,068,800
11 OA013 Amlodipin tablet 5 mg Tablet 4,270 116 15,720 12,399 7,591 1,823,520
12 OA015 Amoksisilin kapsul/kaplet 250 mg Kapsul 215 3,300 3,823 457 709,500
980
13 OA016 Amoksisilin kapsul/kaplet 500 mg Kaplet 209 34,312 35,373 5,739 7,171,208
6,800
14 OA017 Amoksisilin sirup kering 125 mg/5 450 487 133 931,050
Botol 2,069
ml 170
15 OA018 Amoksisilin sirup kering forte 250 501 447 78 2,195,382

Botol 4,382
mg/5 ml 24
16 OA014 Amoksisilin drop 100 mg/ml Botol 52 53 20 0

21
17 OA020 Ampisilin serbuk injeksi i.m/i.v. 500 1,600 1,501 250 8,800,000
Ampul 5,500
mg 151
18 OA021 Ampisilin Serbuk injeksi 1,700 1,504 320 9,537,000

Ampul 5,610
i.m/i.v.1000 mg 124
19 OA025 Antasida Doen I tablet kunyah 10,884 45,200 48,744 7,340 2,892,800
Tablet 64
kombinasi
20 OA026 Antasida Doen II suspensi Botol 2,115 500 27 473 1,057,500

0
21 OA027 Antibakteri Doen Salep Kombinasi Tube 52 3,216 50 63 39 160,800
22 Antidiare tablet (kaolin+pektin) Tablet 0 0 0 0

0
23 OA028 Antifungi Doen kombinasi Pot 4,574 0 0 0 0

0
24 OA029 Antihemoroid Doen kombinasi Supp 4,180 220 241 17 919,600

38
25 OA030 Antimigrain Doen kombinasi Tablet 97 149 100 197 0 14,900
26 Antrain injeksi Ampul 0 0 0 0

0
27 OA033 Aqua Pro Injeksi steril, bebas 1,233 1,018 273 3,729,825
Vial 58 3,025
pirogen
28 Aquadest steril Botol 0 0 0 0 0
29 OA035 Aquasonic Gell Botol 5 46,850 12 10 7 562,200
30 OA036 Asam Asetilsalisilat tablet 100 mg 0 0 0 0
Tablet 0 178
(Asetosal)
31 OA037 Asam Asetilsalisilat tablet 500 mg 0 0 0 0
Tablet 0 275
(Asetosal)
32 OA038 Asam Asetilsalisilat tablet 80 mg 300 347 167 30,300
Tablet 101
(Asetosal) 214
33 OA039 Asam Askorbat (Vitamin C) tablet 6,800 954 5,855 850,000
Tablet 9 125
250 mg
34 OA040 Asam Askorbat (Vitamin C) tablet 3,200 4,313 436 364,800
Tablet 1,549 114
50 mg
35 OA041 Asam Folat tablet 1 mg Tablet 53 1,700 2,263 0 90,100
563
36 OA042 Asam Mefenamat kapsul/kaplet 17,300 7,513 11,673 1,903,000

Kaplet 110
500 mg 1,886
37 OA044 Asiklovir krim 5% Tube 3,795 99 99 56 375,705

56
38 OA045 Asiklovir tablet 200 mg Tablet 261 200 166 113 52,200
79
39 OA046 Asiklovir tablet 400 mg Tablet 370 1,350 1,147 483 499,500
280
40 Aspilet tablet 80 mg Tablet 0 0 0 0 0
41 OA048 Atapulgit tablet 630 mg Tablet 156 3,200 3,398 618 499,200
816
STOK HARGA
AWAL PERSEDIAAN
42 OA049 Atenolol tablet 50 mg Tablet 72 856 0 72 0 0
43 OA050 Atropin Sulfat injeksi 0,25 mg/ml-1 30 10 20 50,820
Ampul 0 1,694
ml
44 OB008 Betametason krim 0,1 % (sebagai 850 835 165 1,290,300
Tube 150 1,518
valerat)
45 OB010 Bisakodil Supositoria 10 mg Supp 0 6,380 20 8 12 127,600
46 OB011 Bisakodil tablet 5 mg Tablet 57 330 300 223 134 99,000
47 OB001 Bisolvon sol Botol 2 96,800 2 1 3 193,600
48 OB014 Budesonid cairan inhalasi 0,25 10 6 24 106,980

Ampul 10,698
mg/ml 20
49 OB015 Budesonid inhaler 200 mcg/puff Botol 116,600 4 5 2 466,400

3
50 OC001 Cairan Infus Dextrose 5%/0,225% 1,320 1,205 307 13,576,200
Botol 192 10,285
Nacl
51 OC002 Cairan Infus Dextrose 5%/0,45% 740 724 273 7,651,600
Botol 257 10,340
Nacl
52 OC003 Calsium AD Tablet Tablet 0 0 0 0 0
53 OC006 Cendo Lyteers Botol 21,038 10 10 0 210,380

0
54 OC011 Combantrin tablet Tablet 0 0 0 0 0
55 Corobion tablet Tablet 0 0 0 0

0
56 OD002 Dasabion tablet ( multivitamin + 0 0 0 0

Tablet
Fe tablet ) 0
57 OD003 Deksametason injeksi i.v. 5 mg/ml- 200 268 33 347,600
Ampul 101 1,738
1 ml
58 OD004 Deksametason tablet 0,5 mg Tablet 400 48 6,600 5,422 1,578 316,800
59 OD009 Diazepam injeksi 5 mg/ml- 2 ml Ampul 17 2,385 50 18 49 119,250
60 OD010 Diazepam tablet 2 mg Tablet 1,122 1,500 1,068 540 1,683,000

108
61 OD014 Difenhidramin HCL injeksi i.m. 10 15 0 15 17,325

Ampul 1,155
mg/ml- 1 ml 0
62 OD015 Digoksin tablet 0,25 mg Tablet 252 116 700 764 188 81,200
63 OD016 Diltiazem HCL tablet 30 mg Tablet 271 147 0 40 231 0
64 OD017 Dimenhidrinat tablet 50 mg Tablet 954 109 3,400 3,407 947 370,600
65 OD018 Doksisiklin kapsul 100 mg Kapsul 0 0 0 0

0
66 OD019 Domperidon suspensi 5 mg/5ml Botol 36 3,300 19 46 9 62,700
67 OD020 Domperidon tablet 10 mg Tablet 934 105 1,100 1,812 222 115,500
68 OE003 Efedrin HCL tablet 25 mg Tablet 377 75 0 377 0 0
69 OE004 Ekstrak Belladon tablet 10 mg Tablet 0 110 300 235 65 33,000
70 OE006 Epinefrine (Adrenalin) injeksi 15 3 12 9,345
Ampul 0 623
0,1% (sebagai HCl)
71 Eritromisin kapsul/kaplet 500 mg Tablet 0 100 9 91 0
72 OE008 Eritromisin kapsul/kaplet 500 mg Tablet 202 803 0 202 0 0
73 OE009 Eritromisin sirup 200 mg/5ml Botol 35 6,765 0 35 0 0
74 OE011 Etakridin (Rivanol) Larutan 0,1 % 0 0 0 0

Botol 6,381
300 ml 0
75 OE013 Etanol 70 % Botol 4 39,567 1 3 2 39,567
76 OE014 Etanol 70 % 100 ml 104 2,750 301 258 147 827,750
77 OE015 Etanol 95% 1 liter Botol 42,834 0 5 2 0

7
78 OE018 Etil Klorida Semprot Botol 11 94,562 20 20 11 1,891,240
79 OF004 Fenitoin Natrium kapsul/kaplet 100 0 0 0 0
Kapsul 0 146
mg
80 OF005 Fenitoin Natrium kapsul/kaplet 30 0 0 0 0
Kapsul 0 121
mg
81 OF009 Fenobarbital tablet 30 mg Tablet 0 149 0 0 0 0
82 OF011 Fenoksimetil Penicilina tablet 500 0 0 0 0

Tablet 512
mg 0
83 OF013 Fenol Gliserol tetes telinga 10% Botol 2,750 24 0 24 66,000

0
84 OF015 Fitomenadion(Vit K1) injeksi 10 135 76 74 408,375
Ampul 15 3,025
%/ml-1 ml
85 OF016 Fitomenadion(Vit K1) tablet salut 500 493 175 377,500
Tablet 755
gula 10 mg 168
86 OF021 Furosemid tablet 40 mg Tablet 1,093 86 2,300 2,802 591 197,800
87 OG001 Garam Oralit untuk 200 ml air Sak 317 4,100 4,150 494 1,299,700
544
88 OG002 Gentamisin Inj. 80 mg/ml (Sulfat) Ampul 0 0 200 0

200
89 OG003 Gentamisin salep kulit 0,1% Tube 41 2,239 320 295 66 716,480
STOK HARGA
AWAL PERSEDIAAN
90 OG004 Gentian Violet larutan 1 % Botol 61 3,850 186 197 50 716,100
91 OG007 Glibenklamid tablet 5 mg Tablet 1,484 62 8,700 8,037 2,147 539,400
92 OG008 Glimepirid tablet 1 mg Tablet 329 292 18,300 16,766 1,863 5,343,600
93 OG009 Glimepirid tablet 2 mg Tablet 2,671 318 13,700 9,043 7,328 4,356,600
94 OG011 Gliseril Guayakolat tablet 100 mg Tablet 8,050 110 51,000 50,453 8,597 5,610,000
95 OG014 Glukose larutan infus 40% steril Botol 54 4,950 0 4 50 0
96 OG015 Glukose larutan infus 5 % Steril Botol 95 7,590 240 277 58 1,821,600
97 OG016 Griseofulvin forte tablet 500 mg Tablet 825 400 471 259 330,000
330
98 OG017 Griseofulvin tablet 125 mg 500 409 260 135,000
Tablet 169 270
micronized
99 OG018 Grotavit sirup Botol 0 0 0 0 0
100 OG019 Guanistrep suspensi Botol 27 6,380 104 112 19 663,520
101 OH001 Haloperidol tablet 0,5 mg Tablet 62 4,500 4,158 587 279,000
245
102 OH003 Haloperidol tablet 5 mg Tablet 157 76 1,200 1,003 354 91,200
Hand Wash (Sabun Cuci
103 Tangan)/klorhexidin 4%/hydrex 0,5 Botol 14 110,000 130 95 49 14,300,000
ml
104 OH008 Hidroklortiazid (HCT) tablet 25 mg Tablet 2,898 164 7,500 9,598 800 1,230,000
105 OH009 Hidrokortison krim 2,5 % Tube 56 2,904 336 332 60 975,744
106 OH010 Hiosin-N-butilbromida injeksi Ampul 14,850 0 56 0 0

56
107 OH011 Hiosin-N-butilbromida tablet Tablet 2,750 1,100 999 321 3,025,000
220
108 OI001 Ibuprofen suspensi 100 mg/5 ml Botol 11 4,949 20 31 0 98,980
109 OI002 Ibuprofen tablet 200 mg Tablet 2,755 116 5,500 6,823 1,432 638,000
110 OI003 Ibuprofen tablet 400 mg Tablet 5,574 165 87,800 86,518 6,856 14,487,000
111 OI010 Ipratrium Br 0,5 m, salbutamol 2,5 0 0 0 0
Ampul 0
mg/ 2,5 ml Neb.
112 OI013 Isosorbid dinitrat tablet sublingual 1,300 1,214 315 128,700
Tablet 229 99
5 mg
113 OK002 Kalsium Glukonat Injeksi Ampul 135 0 0 135 0
114 OK004 Kalsium Laktat (Kalk) tablet 500 6,900 2,602 4,383 427,800
Tablet 62
mg 85
115 OK005 Kaptopril tablet 12,5 mg Tablet 68 23,200 22,480 1,664 1,577,600
944
116 OK006 Kaptopril tablet 25 mg Tablet 6,388 75 28,500 21,561 13,327 2,137,500
117 OK007 Kaptopril tablet 50 mg Tablet 154 3,000 3,000 0 462,000

0
118 OK008 Karbamazepin tablet 200 mg Tablet 50 251 0 16 34 0
119 OK011 Ketokonazol krim 2% 15 gr Tube 0 2,856 0 0 0 0
120 Ketokonazol krim 2% 5 gr Tube 0 0 0 0 0
121 OK013 Ketokonazol tablet 200 mg Tablet 0 308 0 0 0 0
122 OK014 Klindamisin kapsul 150 mg Kapsul 184 605 200 304 80 121,000
123 Kloramfenikol injeksi 1 gr 0 0 0 0
Vial 0
(Chlorbiotic inj)
124 OK019 Kloramfenikol Kapsul/kaplet 250 4,700 3,410 2,016 3,102,000
Kapsul 726 660
mg
125 OK020 Kloramfenikol Salep Mata 1 % Tube 0 1,991 0 0 0 0
126 OK021 Kloramfenikol suspensi 125 mg/5 53 50 33 70 217,550

Botol 4,351
ml
127 OK022 Kloramfenikol Tetes Mata Botol 3,575 260 192 78 929,500
10
128 OK023 Kloramfenikol Tetes Telinga 3 % Botol 0 8,030 100 59 41 803,000
129 OK024 Klorfeniramin Maleat ( CTM ) 83,200 72,702 24,122 3,827,200

Tablet 46
tablet 4 mg 13,624
130 OK028 Klorpromazin HCL tablet salut 100 700 1,053 0 110,600
Tablet 353 158
mg
131 OK029 Klorpromazin HCL tablet salut 25 9,900 7,217 2,683 742,500
Tablet 0 75
mg
132 OK031 Kodein Fosfat tablet 10 mg Tablet 550 900 1,678 252 495,000
1,030
133 OK038 Kontrasepsi oral Linesterol tablet 30 46 8 528,000

Tablet 17,600
0,5 mg 24
134 OK039 Kotrimoksazol Doen I (dewasa) 400 556 225 60,800

Tablet 152
tablet 381
135 OK040 Kotrimoksazol Forte tablet Kaplet 346 339 100 298 148 33,900
136 OK041 Kotrimoksazol suspensi kombinasi Botol 2,515 74 59 21 186,110

6
STOK HARGA
AWAL PERSEDIAAN
137 OL001 Lactulax sirup Botol 0 2 0 0

2
138 OL001 Laktulose sirup Botol 0 0 0 0
0
139 OL010 Lidokain HCl 2% injeksi Ampul 0 1,775 0 0 0 0
140 OL011 Lidokain injeksi 2% (HCl) + 2,030 60 0 60 121,800
Ampul 0
Epineprin 1:80.000-2 ml
141 OLO12 Loperamide tablet 2 mg Tablet 280 98 0 113 167 0
142 OL013 Loratadin tablet 10 mg Tablet 135 2,000 1,414 854 270,000
268
Lotion kombinasi Difenhidramin
143 OL014 2% - Kalamin 5% - Zinc 10% - Botol 17 15,400 0 10 7 0
Gliserin
Magnesium5% Sulfat injeksi (IV)
144 OM002 Vial 0 0 0 0 0
20%-25 ml
145 OM003 Magnesium Sulfat injeksi (IV) 0 243 62 0

Vial
40%-25 ml
305
146 OM006 Metamizol injeksi 500 mg/ml Ampul 11,550 80 78 31 924,000

29
147 OM007 Metampiron tablet 500 mg Tablet 281 0 990 0 0

990
148 OM008 Metformin HCl tablet 500 mg Tablet 10,708 103 60,000 56,125 14,583 6,180,000
149 OM009 Metformin HCl tablet 850 mg Tablet 7 172 1,300 554 753 223,600
150 OM010 Metilergometrin maleat injeksi 0 13 86 0
Ampul 99 2,952
0,200 mg
151 OM011 Metilergometrin maleat tablet salut 0 0 0 0
Tablet 0 169
0,125 mg
152 OM012 Metilprednisolon tablet 4 mg Tablet 194 0 849 0 0

849
153 OM013 Metoklopramid Injeksi 5mg/ml Ampul 13,750 30 110 39 412,500

119
154 OM014 Metoklopramid tablet 10 mg Tablet 173 99 200 201 172 19,800
155 OM015 Metronidazol ovula 500 mg Supp 66 4,510 0 7 59 0
156 OM016 Metronidazol tablet 250 mg Tablet 578 180 0 578 0 0
157 OM017 Metronidazol tablet 500 mg Tablet 299 4,510 1,500 1,428 371 6,765,000
158 OM018 Mikonazol krim/salep 2% (nitrat) Tube 71 4,400 360 326 105 1,584,000
159 OM021 Multivitamin komb (antianemia) 9,400 9,534 1,895 7,275,600
Kapsul 2,029 774
tablet (novabion)
160 OM022 Multivitamin komb (neurotropik) 1,600 4,049 0 1,936,000
Tablet 2,449 1,210
tablet (Neurodex)
161 ON002 N-asetisistein kapsul 20 mg Kapsul 469 120 320 120 56,280
320
162 ON003 Natrium Bikarbonat tablet 500 mg Tablet 24 0 0 0 0

0
163 ON004 Natrium Diklofenak tablet 25 mg Tablet 126 160 2,400 2,333 193 384,000
164 ON005 Natrium Diklofenak tablet 50 mg Tablet 134 1,900 2,580 464 254,600
1,144
165 ON007 Natrium Klorida larutan infus 0,9% 540 419 167 3,807,540
Botol 46 7,051
steril
166 Neo Kaominal sirup Botol 0 0 0 0 0
167 Neurovit E tablet Kaplet 0 0 0 0

0
168 ON017 Nifedipin tablet 10 mg Tablet 5,287 109 1,500 6,043 744 163,500
169 Nifedipin tablet oros 30 mg Tablet 90 0 90 0 0
170 ON018 Nistatin 100.000 UI/ml drop Botol 20 44,000 82 47 55 3,608,000
171 ON019 Nistatin tablet salut 500.000 IU/g Tablet 0 0 0 0 0
172 ON020 Nistatin tablet vaginal 100.000 0 17 123 0
Tablet 140 575
IU/g
173 OO009 Obat Flu komb Sirup (Fludane) Botol 45 14,738 92 108 29 1,355,896
174 OO010 Obat Flu komb Tablet(Fludane) Tablet 823 500 895 0 411,500
395
175 OO008 Obat Batuk Hitam (OBH) cairan 936 963 231 4,530,240
Botol 258 4,840
100 ml
176 OO012 Oksitetrasiklin HCL Salep kulit 3 % Tube 28 2,448 350 325 53 856,800
177 OO013 Oksitetrasiklin HCL salep mata 1% Tube 2,299 100 149 0 229,900
49
178 OO014 Oksitosin injeksi 10 IU/ ml- 1 ml Ampul 2,090 200 136 132 418,000
68
179 OO015 Omegdiar tablet Tablet 0 0 0 0

0
180 OO016 Omeprazol injeksi 20 mg 40mg/10 0 0 0 0
Vial 0
ml
181 OO017 Omeprazol kapsul/kaplet 20 mg Kapsul 342 154 1,590 1,482 450 244,860
STOK HARGA
AWAL PERSEDIAAN
182 OP002 Parasetamol drop 100 mg/ml Botol 8,140 86 87 21 700,040

22
183 OP003 Parasetamol sirup 120 mg/ 5 ml Botol 586 1,111 3,520 3,399 707 3,910,720
184 OP005 Parasetamol tablet 500 mg Tablet 21,687 54 27,800 32,687 16,800 1,501,200
185 OP006 Pehacain inj Ampul 136 4,180 700 797 39 2,926,000
186 OP007 Perak Sulfadiazin krim 1% Tube 1 22,772 11 4 8 250,492
187 OP010 Permetrin Krim 5% (Scabimite) Tube 24 13,371 140 87 77 1,871,940
188 OP013 Pirantel Pamoat tablet 125 mg Tablet 0 0 0 0 0
189 OP014 Piridoksin HCL tablet 10 mg Tablet 4,767 130 20,000 21,397 3,370 2,600,000
190 OP015 Piroksikam kapsul/kaplet/tablet 20 100 238 69 12,100
Kapsul 207 121
mg
191 OP018 Povidon Iodida Larutan 10% 1000 1 3 2 40,820
Botol 40,820
ml 4
192 OP019 Povidon Iodida Larutan 10% 30 ml Botol 3,190 34 25 16 108,460
7
193 OP020 Povidon Iodida Larutan 10% 300 24 0 24 475,200

Botol 19,800
ml 0
194 OP022 Prednison tablet 5 mg Tablet 84 0 1,020 0 0

1,020
195 OP027 Propanolol HCL tablet 40 mg Tablet 310 118 0 170 140 0
196 OP028 Propiltiourasil tablet Tablet 0 429 0 0 0 0
197 OP029 Pseudoefedrin+tripolidin tablet Tablet 500 1,053 0 500 0 0
198 OR002 Ranitidin Injeksi 25 mg/ ml Ampul 0 1,604 0 0 0 0
199 Ranitidin Injeksi 50 mg/2 ml Ampul 0 600 496 104 0
200 OR003 Ranitidin tablet 150 mg Tablet 2,335 108 11,800 12,370 1,765 1,274,400
201 OR018 Ringer Laktat larutan Infus steril Botol 501 12,128 2,500 2,520 481 30,320,000
202 OS011 SABU injeksi 5 ml Vial 0 331,430 0 0 0 0
203 OS001 Salbutamol tablet 2 mg (sebagai 6,000 5,821 1,179 390,000

Tablet 65
sulfat) 1,000
204 OS002 Salbutamol tablet 4 mg (sebagai 0 0 0 0

Tablet 88
sulfat) 0
205 OS003 Salep 2-4 kombinasi Pot 14 3,336 72 48 38 240,192
206 OS004 Salisil Bedak 2 % Kotak 151 1,122 340 358 133 381,480
207 OS004 Scabicid krim Tube 0 0 0 0 0
208 OS007 Sefotaksim Injeksi 1 g Vial 193 4,710 160 291 62 753,600
209 OS008 Seftriakson Injeksi 1 gr Vial 66 8,800 86 114 38 756,800
210 OS013 Serum Anti Tetanus inj. 1500 0 0 2 0

Ampul 143,000
UI/vial amp (ATS) 2
211 OS015 Setirizine sirup 5 mg/5ml Botol 12 7,420 25 22 15 185,500
212 OS016 Setirizine tablet 10 mg Tablet 538 106 0 290 248 0
213 OS017 Sianokobalamin (vit. B12) tablet 2,900 2,483 1,233 182,700
Tablet 63
50 mcg 816
214 OS021 Simetidin tablet 200 mg Tablet 209 1,110 1,215 104 0
215 OS022 Simvastatin tablet 10 mg Tablet 357 186 100 457 0 18,600
216 OS023 Simvastatin tablet 20 mg Tablet 62 277 200 211 51 55,400
217 OS024 Siprofloksasin tablet 500 mg 1,200 2,086 233 370,800

Tablet 309
(sebagai HCl) 1,119
218 OS025 Siprofloksasin tetes mata Botol 9 7,700 10 15 4 77,000
219 Spironolakton tablet 100 mg Tablet 0 0 0 0 0
220 OS027 Spironolakton tablet 25 mg Tablet 245 347 0 245 0 0
221 OS028 Stesolid Rectal supp 5 mg Supp 7 13,299 30 25 12 398,970
222 OS032 Sulfasetamid Natrium tetes mata 0 6 0 0

Botol
15 % 6
223 OT001 Tablet Tambah Darah Kombinasi Sachet 7,092 391 22,200 28,267 1,025 8,680,200
224 OT008 Terbutalin sulfat 0,5 mg - spray 0 2 0 0

Botol 62,769
100 dosis 2
225 OT009 Terbutalin sulfat 2,5 mg/ml 0 1 19 0
Ampul 20 7,535
respules
226 OT010 Tetrakain Tetes Mata 0,5% Botol 2 12,650 0 2 0 0
227 OT012 Tetrasiklin HCL Kapsul/kaplet 250 0 0 0 0

Kapsul 183
mg 0
228 Thrombo Aspilet tablet 80 mg Tablet 0 0 0 0 0
229 Tiamin HCL (Vit B1) Inj. 100 502 0 0 0 0

Ampul
mg/ml-1 ml 0
STOK HARGA
AWAL PERSEDIAAN
230 OT016 Tiamin HCL Mononitrat (Vitamin 11,000 11,678 2,888 1,815,000
Tablet 165
B1) Tablet 100 mg 3,566
231 OT019 Trifluoperazin tablet 5 mg Tablet 205 550 1,500 1,469 236 825,000
232 OT020 Triheksifenidil Hidroklorida tablet 2 3,000 3,087 256 264,000

Tablet 88
mg 343
233 OV012 Ventolin Nebulizer Ampul 79 4,400 720 729 70 3,168,000
234 Vit K Infant / Neo - K injeksi Ampul 0 0 0 0 0
235 OV015 Vitamin B Komplek Tablet Tablet 15,618 127 112,200 105,260 22,558 14,249,400
236 OY001 Y-Rins cuci mata Botol 0 0 0 0 0
237 OZ003 Zinc Drop 10mg/ml Botol 0 11,879 0 0 0 0
238 OZ004 Zinc sirup 20 mg/5 ml Botol 8 5,268 24 25 7 126,432
239 OZ005 Zinc tablet 20 mg Tablet 2,768 564 700 2,580 888 394,800
0 278,644,354
II. OBAT PROGRAM 0
1 Benzatin benzil penisilin 2,4 ui/ml Vial 10 15,950 0 10 0 0
2 Flukonazol kapsul 150 mg kapsul 39 0 0 39 0

3 Haloperidol inj 5mg/ml (Lodomer) Ampul 5 91,665 0 0 5 0
4 Klobazam tablet 10 mg (obat 80 0 0 80 0

Tablet 1,067
program jiwa)
5 Klozapin tablet 25 mg (obat 158 0 158 0 0

Tablet 2,475
program jiwa)
6 Kombipak azitrhromycin-cefixim Paket 0 0 42 0 0
Mineral Mix, kombinasi Pirimitamin
7 tab 25 mg Sulfadoksin tablet 500 Sachet 0 2,450 0 0 0 0
mg
8 Obat Antituberkulosis FDC 0 0 0 0 0
Paket 223,585
Kategori Anak
9 Obat Antituberkulosis FDC 0 20 19 1 7,919,680
Paket 395,984
Kategori I
10 Obat Antituberkulosis FDC 1 1,319,989 3 3 1 3,959,967

Paket
Kategori II
11 Procain Benzil Penisillin 3 juta 0 0 1 -1 0

Vial 7,190
IU/vial inj
12 Retinol (Vitamin A) 100.000 IU 0 300 300 0 78,000

Kapsul 260
kapsul lunak
13 Retinol (Vitamin A) 200.000 IU 0 2,350 2,350 0 1,078,650

Kapsul 459
kapsul lunak
14 Risperidon tablet 2 mg (obat 16 0 65 0 0

Tablet 495
program jiwa)
15 Speculum Vagina Biji 0 0 0 0 0
0 13,036,297
III. ALKES 0
1 AA002 Alat suntik sekali pakai 1 ml Biji 18 1,600 719 378 359 1,150,400
2 AA003 Alat suntik sekali pakai 10 ml Biji 306 1,790 300 412 194 537,000
3 AA004 Alat suntik sekali pakai 2,5 ml Biji 0 1,500 0 0 0 0
4 AA004 Alat suntik sekali pakai 3 ml Biji 996 6,200 4,893 2,303 0
5 AA005 Alat suntik sekali pakai 5 ml Biji 268 1,500 2,091 1,998 361 3,136,500
6 AB002 Benang Cat Gut Chromic 2/0 Sachet 38 36,080 24 58 4 865,920
7 AB003 Benang Cat Gut Chromic 3/0 Sachet 36 36,080 48 47 37 1,731,840
8 AB004 Benang Cat Gut Plain 2/0 Sachet 0 37,730 0 0 0 0
9 AB005 Benang Cat Gut Plain 3/0 Sachet 17 37,730 112 65 64 4,225,760
10 AB006 Benang Silk/Side 2/0 Sachet 0 22,330 0 0 0 0
11 AB007 Benang Silk/Side 3/0 Sachet 26 24,640 24 28 22 591,360
12 AB009 Blood Set Biji 58 8,470 50 85 23 423,500
13 AF001 Foley Catheter no. 14 Biji 7 10,230 13 20 0 132,990
14 AF002 Foley Catheter no. 16 Biji 1 10,230 19 20 0 194,370
15 AH001 Handscun Panjang Biji 198 38,000 0 83 115 0
16 AH003 Handscun non steril L Biji 200 600 1,291 1,291 200 774,600
17 AH004 Handscun non steril M Biji 200 600 14,000 9,915 4,285 8,400,000
18 AH005 Handscun non steril S Biji 200 550 0 200 0 0
19 AH007 Handscun steril 7 Pasang 423 9,000 800 1,221 2 7,200,000
20 AH006 Handscun steril 6,5 Pasang 53 9,000 1,800 1,283 570 16,200,000
21 AH008 Handscun steril 7,5 Pasang 400 9,000 0 400 0 0
STOK HARGA
AWAL PERSEDIAAN
22 AH011 Handscun steril 8 Pasang 400 300 515
22 AH010 Hansaplast Biji 377 375 4,291 3,783 885 1,609,125
23 AI001 Infusion set anak Set 79 11,447 400 342 137 4,578,800
24 AI002 Infusion set dewasa Set 158 7,500 1,050 975 233 7,875,000
25 AI004 IV Chateter 18 (Surflo 18) Biji 71 9,400 46 117 0 432,400
26 AIOO5 IV Chateter 20 (Surflo 20) Biji 137 9,500 100 182 950,000
27 AIOO6 IV Chateter 22 (Surflo 22) Biji 194 9,500 810 738 7,695,000
28 AI007 IV Chateter 24 (Surflo 24) Biji 176 13,500 650 611 215 8,775,000
29 AI008 IV Chateter 26 (Surflo 26) Biji 153 18,500 100 183 70 1,850,000
30 AJ002 Jarum suntik 23 G Biji 0 2,000 319 219 100 638,000
31 AK003 Kapas Pembalut/ Adsorben 250 31 22 14 341,000

Biji 11,000
mg 5
32 AK004 Kasa Hidrofil gulung Rol 0 143,000 0 0 0 0
33 AK005 Kasa Husada Steril 16x16 Kit 0 9,500 15 4 11 142,500
34 AK007 Kasa Pembalut 2 x 80 cm Biji 0 10,500 0 0 0 0
35 AK008 Kasa Pembalut Hidrofil 4 m x 15 1,700 1,791 214 7,650,000

Biji 4,500
cm 305
36 Masker Kain Biji 0 0 0 0 0
37 AM004 Masker O2 anak Buah 6 10,500 10 3 13 105,000
38 AM005 Masker O2 bayi Buah 12 10,500 10 10 12 105,000
39 AM006 Masker O2 dewasa Buah 7 10,500 21 18 10 220,500
40 AM002 Masker N95 Biji 0 25,025 0 0 0 0
41 AM003 Masker Tissue Biji 453 350 8,300 5,905 2,848 2,905,000
42 AN002 Nasal O2 ukuran M Biji 10 7,500 0 6 4 0
43 AN003 Nasal O2 ukuran S Biji 10 7,500 10 6 14 75,000
44 AP004 Plester 5 yard x 2 inch Rol 16 30,250 334 270 80 10,103,500
45 Silk (Benang Bedah Sutera) No. 0 0 0 0

Kotak
3/0 0
46 AS001 Scafel Handle Biji 1 0 1 0 0
47 AS004 Slim Suiqer Biji 0 6,900 100 21 79 690,000
48 AS010 Surgical Blade Biji 118 2,404 200 218 100 480,874
49 AS011 Surgical Needle Sak 4 130,000 0 4 0 0
50 AU001 Urin bag Biji 0 4,400 31 31 0 136,400
102,922,339
IV. OBAT GIGI
1 OA002 Air Raksa dental Botol 1 550,000 0 1 0 0
2 OA006 Alvogyl pasta Pot 0 170,934 2 2 0 341,868
3 AA007 Articulaying Paper Paket 2 165,000 2 4 0 330,000
4 OB013 Bonding Botol 1 242,000 3 4 0 726,000
5 OB013 Bonding Aplikator Kotak 0 99,000 1 1 0 99,000
6 AC004 Calsium Hidroxyd tube 1 60,500 0 1 0 0
7 AC005 Cotton Roll Gigi Dos 1 66,000 4 5 0 264,000
8 OD008 Devitalisasi Pasta (non Arsen) Botol 3 330,000 3 6 0 990,000
9 OE016 Etching Botol 1 332,200 3 4 0 996,600
10 OE019 Eugenol Cairan Botol 0 78,100 5 5 0 390,500
11 OG006 Glass Ionomer Cement (GC IX) Set 3 770,000 9 12 0 6,930,000
12 AI003 Instrumen Gigi Set Paket 0 1,555,000 1 1 0 1,555,000
13 AI001 Iodoform Botol 1 214,352 0 1 0 0
14 AK001 Kaca Mulut Buah 1 0 1 0 0
15 Kalsium Hidroksida (CaOH2) tube 0 0 0 0 0
16 OK033 Komposit Resin Anterior A2 tube 374,000 2 2 748,000

0
17 OK034 Komposit Resin Anterior A3 tube 0 374,000 2 2 748,000
18 OK035 Komposit Resin Anterior A3.5 tube 0 374,000 0 0 0 0
19 OK036 Komposit Resin Posterior 2 2 0 748,000

tube 0 374,000
QA3,5/A3
20 AM007 Mata Boor Kotak 1 163,350 0 1 0 0
21 AM008 Mata Boor Frisure Besar Biji 3 27,500 0 3 0 0
22 AM009 Mata Boor Frisure Kecil Biji 2 27,500 0 2 0 0
STOK HARGA
AWAL PERSEDIAAN
23 AM010 Mata Boor Frisure Sedang Biji 3 27,500 0 3 0 0
24 Mata Boor Inverted Biji 0 0 0 0 0
25 AM009 Mata Boor Inverted Kecil Biji 2 27,500 0 2 0 0
26 AM013 Mata Boor Inverted Sedang Biji 4 27,500 0 4 0 0
27 AM014 Mata Boor Round Besar Biji 2 0 2 0 0
28 AM016 Mata Boor Round Sedang Biji 2 0 2 0 0
29 Mata Boor Tapper Besar Biji 0 0 0 0

0
30 AM017 Mata Boor Tapper Kecil Biji 0 27,500 0 0 0 0
31 AM018 Mata Boor Tapper Sedang Biji 0 27,500 0 0 0 0
32 OM020 Monoklorkamfer Mentol cairan 3 5 0 199,650

Botol 66,550
(CHKM) 2
33 OM024 Mumifying pasta Botol 1 66,000 1 2 0 66,000
34 OP016 Polikresulen 10 ml (Albothyl) Botol 42,350 4 6 0 169,400

2
35 AP005 Polising Amalgam Restoration Set 1 126,493 0 1 0 0
36 OR020 Root Canal Filling Buah 0 126,500 0 0 0 0
37 AS002 Selleloid strip Sachet 0 165,000 2 2 0 330,000
38 OS009 Semen Seng Fosfat serbuk dan 3 3 0 603,900

Set 201,300
cairan 0
39 OS020 Silver Amalgam Serbuk 65-75 % Botol 440,000 0 1 0 0

1
40 AS005 Spongostan Kotak 0 93,500 2 2 0 187,000
41 AS010 Surgical Blade / Mess no 11 Biji 0 2,645 0 0 0 0
42 Temporary Stopping Fletcher Cair Set 0 0 0 0

0
43 Temporary Stopping Fletcher 0 0 0 0

Set
Serbuk dan cairan 0
44 OT021 Trikresol Formalin (TKF) Cairan Botol 3 77,000 3 6 0 231,000
45 OT023 TSR Botol 0 144,648 2 2 0 289,296
46 OT024 Tumpatan sementara Botol 1 159,478 10 11 0 1,594,780
18,537,994
V. LABORATORIUM
1 Alat Pemeriksaan Gula Darah Kit 0 0 0 0 0
2 Bilirubin Kit 0 0 0 0 0
3 LB002 Blood Lancet Kotak 0 19,250 2 2 0 38,500
4 AB010 Blue Tip Sak 0 249,810 0 0 0 0
5 AC006 Cover glass Kotak 0 33,000 0 0 0 0
6 LD001 Darah Kontrol Ampul 0 814,000 4 4 0 3,256,000
7 LD003 Diluent 20 ltr Galon 0 1,892,000 0 0 0 0
8 LE001 EDTA Cair 10% 100 mL Botol 0 0 0 0 0
9 LE003 ETA cair 10% 100ml Botol 0 0 0 0 0
10 LG001 Glucosa Enzimatik Trinder Kit 0 0 0 0 0
11 LG002 Gol. Darah A Vial 0 80,520 2 2 0 161,040
12 LG003 Gol. Darah AB Vial 0 107,261 2 2 0 214,522
13 LG004 Gol. Darah B Vial 0 80,520 2 2 0 161,040
14 LG005 Gol. Darah Rhesus Vial 0 130,977 2 2 0 261,954
15 LH001 H2O2 3% Botol 3 55,000 3 6 0 165,000
16 LH002 Hb-Cyanmet 1 liter Botol 0 192,000 0 0 0 0
17 Kartu Golongan Darah Kotak 0 175,000 2 2 0 350,000
18 K010 Kertas Lensa Buah 0 33,274 0 0 0 0
19 Kotak slide Buah 0 0 0 0 0
20 OL003 Larutan Zheil Nielson/BTA 100 ml Botol 0 0 0 0 0
21 OL004 Larutan Emersi Oil Botol 0 0 0 0 0
22 OL005 Larutan Eter alkohol Botol 0 0 0 0 0
23 OK006 Larutan Klorin / NaClO 5,25% 0 2 0 0
Botol 2
(bayclin)
24 OL007 Larutan KOH 10% Botol 0 0 0 0 0
25 OL008 Larutan Metilen Biru Botol 0 0 0 0 0
26 OL009 Larutan NaCl 0,9% 100 ml Botol 0 0 0 0 0
STOK HARGA
AWAL PERSEDIAAN
27 Larutan VDRL 10 ml Botol 0 0 0 0 0
28 LM001 M-18 E-cfd lyse 500ml Botol 0 1,925,000 3 3 0 5,775,000
29 LM002 M-18 E-Z cleaner Botol 0 1,210,000 2 2 0 2,420,000
30 LM003 M-18 R rinse Botol 0 1,892,000 0 0 0 0
31 LM004 M-18P probe cleanser Botol 0 192,500 2 2 0 385,000
32 Methilen Blue 0,3% Botol 0 66,000 0 0 0 0
33 LO001 Obyek Glass 72 Dos 0 55,000 0 0 0 0
34 Ose Buah 0 0 0 0 0
35 AP001 PH Paper Vagina Kotak 0 0 0 0 0
36 Pot Dahak Buah 0 0 0 0 0
37 LR004 Reagen Asam Urat Kit 0 825,000 0 0 0 0
38 LR006 Reagen Drabkin 1000ml Botol 0 0 0 0 0
39 LR008 Reagen Gula Darah Vial 0 440,000 0 0 0 0
40 LR010 Reagen Hbs Ag Kotak 0 874,500 4 4 0 3,498,000
41 OR012 Ragen HIV/intec/II Sachet 0 2,468,400 1 1 0 2,468,400
42 OR013 Reagen HIV / oncoprobe / I Sachet 0 25,725 1 1 0 25,725
43 OR015 Reagen HIV / vikia / III Sachet 0 21,823 0 0 0 0
44 LR012 Reagen Kolesterol HDL Kit 0 1,230,000 0 0 0 0
45 LR013 Reagen Kolesterol LDL Kit 0 5,400,000 0 0 0 0
46 LR014 Reagen Kolesterol Total Vial 0 1,700,000 0 0 0 0
47 LR015 Reagen Kreatinin Kit 0 1,400,000 0 0 0 0
48 LR019 Reagen Thypoid IgG/IgM+B383 Kotak 0 1,900,000 0 0 0 0
49 LR021 Reagen Trigliserida Kit 0 1,720,000 0 0 0 0
50 LR022 Reagen Urea Kit 0 1,250,254 0 0 0 0
51 LR023 Reagent SGOT 4x20 UV Kinetik 0 0 0 0

Kit 875,000
(IFCC) 0
52 LR024 Reagent SGPT 4x20 UV Kinetik 0 0 0 0

Kit 900,000
(IFCC) 0
53 OR008 Reagen Shipilis / VDRL test 0 0 0 0
Kotak 0 29,338
(Syphillis device)
54 LR017 Reagent Standart Trucal U Vial 0 0 0 0 0
55 LR018 Reagent Standart Trulab N Vial 0 0 0 0 0
56 AS002 Selleloid strip Sachet 0 165,000 0 0 0 0
57 LS001 Serum Kontrol Vial 0 385,000 2 2 0 770,000
58 Slide Object Glass Kotak 0 0 0 0 0
59 LS002 Spiritus Botol 0 0 0 0 0
60 LS003 Strip Gula Darah Kotak 0 25 25 0 0
61 LT001 Tabung centrifuge 15 TP Buah 0 0 0 0 0
62 LT009 Tabung Vacuntainer EDTA (tutup 91 91 0 36,036,000
Kotak 0 396,000
merah)
63 LT010 Tabung Vacuntainer EDTA (tutup 410 410 0 175,890,000
Kotak 0 429,000
ungu)
64 LT011 Tes Kehamilan Buah 0 78,650 2 2 0 157,300
65 LT012 Thermal Paper Rol 0 0 0 0 0
66 Uric Acid Trinder 4x30 ml Botol 0 0 0 0 0
67 LU002 Urinalisis Strip 10 Parameter Tube 0 256520 0 0 0 0
68 LU003 Urinalisis Strip 2 Parameter Tube 0 198000 0 0 0 0
69 Uro Paper/ Urine 10 pm Botol 0 0 0 0 0
70 LW001 Widal AO Vial 0 82317 0 0 0 0
71 LW002 Widal BO Vial 0 82317 0 0 0 0
72 LW003 Widal H Vial 0 82317 0 0 0 0
73 LW004 Widal O Vial 0 82317 0 0 0 0
74 LY001 Yellow Tip Sak 0 193270 0 0 0 0
HARGA SISA
STOK
49,140
62,436
4,950
29,700
293,748
184,016
125,324
6,000
29,359
1,023,040
880,556
98,255
1,199,451
275,177
341,796
1,375,000
1,795,200
469,760
1,000,395
125,424
71,060
825,825
0
327,950
0
0
16,867
731,875
49,704
1,284,030
212,520
29,493
178,710
96,408
HARGA SISA
STOK
0
33,880
250,470
76,560
44,220
290,400
256,752
233,200
3,157,495
2,822,820
0
57,354
75,744
116,865
605,880
17,325
21,808
33,957
103,223
29,700
23,310
0
7,150 90,000.00
7,476
0
0
0
79,134
404,250
85,668
1,040,182
0
0
0
66,000
223,850
132,125
50,826
156,598
147,774
HARGA SISA
STOK
192,500
133,114 405,504.00
543,996 191,250.00
2,330,304
945,670
247,500
440,220 566.00
213,675
70,200
0
121,220
36,394
26,904
5,390,000
131,200
174,240
1,980.00
882,750
0
166,112
1,131,240
0
31,185
0
271,746
20,065.06
113,152
999,525
8,534
0
0
0
48,400
0
1,330,560
0
7,500.00
304,570
278,850
329,230
1,109,612
0
201,225
138,600
140,800
34,200
50,172
52,815
HARGA SISA
STOK
0 83,332.00
121,800
16,366
115,290
107,800
0
358,050
1,502,049
129,516
253,872
0
536,250
17,028
266,090
0
1,673,210
462,000
1,466,730
0 1,450,000.00
31,650.00
56,280
30,880
62,176
1,177,517
0
81,096
0
2,420,000 1,400.00
0 1,400.00
70,725 1,400.00
427,402
1,118,040
129,744
275,880
0
69,300
HARGA SISA
STOK
170,940
785,477
907,200
163,020
182,176
1,029,567
0
438,100
8,349
81,640
51,040
475,200
16,520
0
0
0
0
190,620 0.00
5,833,568
0
340,000.00
76,635
126,768
149,226
0
292,020
334,400
84,000.00
286,000
111,300
26,288
77,679
0
0
14,127
71,997
30,800
0
0
159,588
400,775
143,165
0
0
HARGA SISA
STOK
476,520
129,800
22,528
308,000
0
2,864,866
0
0
36,876
500,832
72,384,278
0
0
458,325
85,360
0
395,984
1,319,989
-7,190
0
0
0
574,400
347,260
0
0
541,500
144,320
1,334,960
0 500,000.00
2,414,720
0
542,080
194,810
0
0
4,370,000
120,000
2,571,000
0
18,000 1,650,000.00
5,130,000
0
HARGA SISA
STOK
0
331,875
1,568,239
1,747,500 1,200,000.00
0
0
0
2,902,500 2,181,500.00
1,295,000
200,000
154,000
0
104,500
0
963,000
0
136,500
126,000
105,000
0
996,800
30,000
105,000
2,420,000
0
545,100
240,437
0
0
0
0
0
0
0
0
0
0 916.00
0 0.00
0
0
0
0
0
0
0
0
0
0
0
0
0
HARGA SISA
STOK
0
0
0 366,300.00
0 421,620.00
0 243,000.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 94,980.00
0 205,740.00
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
HARGA SISA
STOK
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
PEMASUKAN DAN PENGELUARAN PUSKESMAS NGLETIH KOTA KEDIRI
TAHUN 2017
Januari Pebruari Maret April Mei Juni Juli Agustus September Oktober Nopember Desember Total Total
NO NAMA OBAT SATUAN STOK Penerim Pengelu
kode barang AWAL masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa aan aran
I. OBAT
1 Albendazol tablet 400 mg Tablet 170 1 169 169 12 157 9 148 148 148 2 146 9 137 1 136 136 6 130 130 0 40
2 AA006 Alkohol Swab Kotak 4 12 4 12 10 22 20 12 30 8 38 20 2 56 6 50 11 39 12 7 44 19 25 5 6 24 14 10 7 3 87 88
3 OA004 Alopurinol tablet 100 mg Tablet 244 244 20 224 90 134 100 56 178 50 128 10 118 20 98 20 78 20 58 8 50 50 50 100 294
4 OA005 Alopurinol tablet 300 mg Tablet 106 58 48 200 44 204 111 93 200 55 238 49 189 189 17 172 20 152 7 145 3 142 142 7 135 400 371
5 OA007 Ambroksol sirup Botol 39 1 38 3 35 4 31 1 30 5 25 5 20 96 15 101 1 100 1 99 3 96 2 94 10 84 96 51
6 OA008 Ambroksol tablet 30 mg Tablet 1,351 557 794 900 377 1,317 483 834 500 400 934 100 492 542 700 517 725 2,500 822 2,403 564 1,839 748 1,091 700 614 1,177 186 991 249 742 5,400 6,009
7 OA009 Aminofilin injeksi 24 mg/ml-10 ml Ampul 13 13 13 13 13 13 13 13 13 3 10 10 5 1 14 30 6 38 35 10
8 OA010 Aminofilin tablet 200 mg Tablet 70 70 10 60 60 60 60 60 60 60 60 60 60 60 0 10
9 OA011 Amitriptilin HCL tablet salut 25 mg Tablet 216 54 162 44 118 10 108 28 80 40 40 100 26 114 200 17 297 15 282 24 258 52 206 100 85 221 34 187 400 429
10 OA012 Amlodipin tablet 10 mg Tablet 8,593 3,003 5,590 7,920 2,355 11,155 2,200 8,955 1,993 6,962 2,648 4,314 7,920 3,480 8,754 15,840 3,348 21,246 2,991 18,255 2,987 15,268 3,050 12,218 2,995 9,223 2,829 6,394 31,680 33,879
11 OA013 Amlodipin tablet 5 mg Tablet 4,270 496 3,774 610 3,164 896 2,268 1,670 598 7,200 1,921 5,877 821 5,056 674 4,382 1,012 3,370 1,077 2,293 210 1,082 1,421 1,110 1,172 1,359 7,200 968 7,591 15,720 12,399
12 OA015 Amoksisilin kapsul/kaplet 250 mg Kapsul 980 596 384 1,400 472 1,312 362 950 100 392 658 500 335 823 100 188 735 400 278 857 242 615 320 295 500 308 487 300 200 587 130 457 3,300 3,823
13 OA016 Amoksisilin kapsul/kaplet 500 mg Kaplet 6,800 9,600 4,312 12,088 900 3,633 9,355 600 3,354 6,601 2,200 3,555 5,246 10,000 3,395 11,851 2,325 9,526 10,000 2,818 16,708 12 2,870 13,850 2,862 10,988 2,424 8,564 1,000 2,020 7,544 1,805 5,739 34,312 35,373
14 OA017 Amoksisilin sirup kering 125 mg/5 60 85 145 120 105 160 120 109 171 66 105 67 38 5 33 6 27 8 19 150 12 157 5 152 7 145 12 133
Botol 170 450 487
ml
15 OA018 Amoksisilin sirup kering forte 250 3 4 23 9 14 50 6 58 100 8 150 10 140 29 111 100 58 153 2 86 65 150 77 138 50 63 125 50 56 119 41 78
Botol 24 501 447
mg/5 ml
16 OA014 Amoksisilin drop 100 mg/ml Botol 21 1 20 2 18 7 11 7 1 17 2 15 4 11 24 7 28 9 19 9 10 11 5 16 10 1 25 5 20 52 53
17 OA020 Ampisilin serbuk injeksi i.m/i.v. 500 100 167 84 300 194 190 400 188 402 207 195 400 132 463 69 394 300 84 610 108 502 62 440 108 332 100 77 355 105 250
Ampul 151 1,600 1,501
mg
18 OA021 Ampisilin Serbuk injeksi 200 167 157 300 211 246 400 154 492 169 323 100 117 306 69 237 400 98 539 67 472 28 444 107 337 100 166 271 200 151 320
Ampul 124 1,700 1,504
i.m/i.v.1000 mg
19 OA025 Antasida Doen I tablet kunyah 10,884 4,564 6,320 7,000 3,923 9,397 2,000 4,460 6,937 5,000 4,871 7,066 8,000 4,780 10,286 2,000 3,774 8,512 3,676 4,836 4,000 4,462 4,374 5,000 3,038 6,336 8,200 3,534 11,002 4,000 3,938 11,064 3,724 7,340
Tablet 45,200 48,744
kombinasi
20 OA026 Antasida Doen II suspensi Botol 0 0 0 0 0 0 0 0 0 0 0 500 500 27 473 500 27
21 OA027 Antibakteri Doen Salep Kombinasi Tube 37 15 4 11 3 8 4 4 4 4 1 3 3 1 2 50 2 50 5 45 6 39 50 63

52
22 Antidiare tablet (kaolin+pektin) Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 OA028 Antifungi Doen kombinasi Pot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 OA029 Antihemoroid Doen kombinasi Supp 38 100 33 105 105 31 74 10 46 38 50 9 79 5 74 30 12 92 31 61 20 8 73 12 61 18 43 10 36 17 220 241
25 OA030 Antimigrain Doen kombinasi Tablet 97 40 57 16 41 100 50 91 20 71 20 51 51 0 0 0 0 0 0 0 100 197
26 Antrain injeksi Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 OA033 Aqua Pro Injeksi steril, bebas 453 71 440 94 346 108 238 127 111 200 88 223 66 157 220 70 307 87 220 22 198 101 97 120 104 113 240 80 273
Vial 58 1,233 1,018
pirogen
28 Aquadest steril Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
29 OA035 Aquasonic Gell Botol 5 2 3 3 0 0 0 0 5 1 4 2 1 5 2 3 5 8 1 7 7 7 12 10
30 OA036 Asam Asetilsalisilat tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0

Tablet 0 0 0
(Asetosal)
31 OA037 Asam Asetilsalisilat tablet 500 mg 0 0 0 0 0 0 0 0 0 0 0 0
Tablet 0 0 0
(Asetosal)
32 OA038 Asam Asetilsalisilat tablet 80 mg 117 97 300 397 397 40 357 17 340 36 304 34 270 270 270 270 33 237 70 167
Tablet 214 300 347
(Asetosal)
33 OA039 Asam Askorbat (Vitamin C) tablet 9 9 0 0 0 0 0 0 0 6,800 25 6,775 288 6,487 317 6,170 315 5,855
Tablet 9 6,800 954
250 mg
34 OA040 Asam Askorbat (Vitamin C) tablet
50 mg
Tablet 1,549 1,000 1,367 1,182 1,000 897 1,285 1,144 141 82 59 42 17 10 7 7 0 0 1,000 148 852 288 564 200 201 563 127 436 3,200 4,313
35 OA041 Asam Folat tablet 1 mg Tablet 563 500 333 730 300 300 730 100 397 433 600 377 656 200 366 490 333 157 157 0 0 0 0 0 0 1,700 2,263
36 OA042 Asam Mefenamat kapsul/kaplet 1,786 100 1,000 118 982 500 716 766 1,200 438 1,528 995 533 533 0 0 2,000 100 1,900 262 1,638 697 941 1,000 878 1,063 11,600 990 11,673
Kaplet 1,886 17,300 7,513
500 mg
37 OA044 Asiklovir krim 5% Tube 56 8 48 13 35 8 27 11 16 25 5 36 5 31 25 10 46 1 9 36 3 33 1 32 10 22 50 16 56 99 99
38 OA045 Asiklovir tablet 200 mg Tablet 79 79 79 24 55 30 25 100 125 125 12 113 100 213 25 188 188 15 173 60 113 200 166
39 OA046 Asiklovir tablet 400 mg Tablet 280 60 220 101 119 200 10 309 94 215 50 104 161 100 46 215 100 75 240 200 145 295 100 120 275 134 141 300 106 335 300 152 483 1,350 1,147
40 Aspilet tablet 80 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
41 OA048 Atapulgit tablet 630 mg Tablet 816 282 534 300 259 575 200 256 519 200 274 445 300 357 388 700 283 805 1,000 268 1,537 280 1,257 254 1,003 204 799 252 547 500 429 618 3,200 3,398
42 OA049 Atenolol tablet 50 mg Tablet 72 72 72 72 72 72 72 72 72 72 72 72 72 0 0 72
43 OA050 Atropin Sulfat injeksi 0,25 mg/ml-1 0 0 0 0 0 0 0 20 20 20 20 10 10 20 20
Ampul 0 30 10
ml
44 OB008 Betametason krim 0,1 % (sebagai 50 88 112 150 69 193 71 122 50 84 88 125 79 134 75 57 152 200 73 279 46 233 46 187 77 110 100 84 126 100 61 165
Tube 150 850 835
valerat)
45 OB010 Bisakodil Supositoria 10 mg Supp 0 0 0 0 0 0 10 1 9 9 2 7 5 2 10 12 12 12 20 8
46 OB011 Bisakodil tablet 5 mg Tablet 57 100 39 118 4 114 15 99 16 83 6 77 6 71 45 26 100 22 104 30 74 28 46 100 146 12 134 300 223
47 OB001 Bisolvon sol Botol 2 1 1 2 3 3 3 3 3 3 3 3 3 3 3 2 1
48 OB014 Budesonid cairan inhalasi 0,25 20 20 1 19 19 19 4 15 10 25 25 1 24 24 24 24

Ampul 20 10 6
mg/ml
49 OB015 Budesonid inhaler 200 mcg/puff Botol 3 3 3 3 3 2 1 3 4 1 3 3 3 1 2 1 1 2 4 5
3
50 OC001 Cairan Infus Dextrose 5%/0,225% 90 102 180 135 147 240 95 292 102 190 80 118 152 140 58 234 120 82 272 61 211 121 90 300 119 271 60 143 188 200 81 307
Botol 1,320 1,205
Nacl 192
51 OC002 Cairan Infus Dextrose 5%/0,45% 125 132 87 45 43 2 2 0 0 160 18 142 100 28 214 40 81 173 80 33 220 127 93 200 123 170 160 57 273
Botol 740 724
Nacl 257
52 OC003 Calsium AD Tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 OC006 Cendo Lyteers Botol 0 0 0 10 10 10 4 6 6 0 0 0 0 0 0 0 10 10
54 OC011 Combantrin tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
55 Corobion tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 OD002 Dasabion tablet ( multivitamin + 0 0 0 0 0 0 0 0 0 0 0 0

Tablet 0 0 0
Fe tablet )
57 OD003 Deksametason injeksi i.v. 5 mg/ml- 24 77 16 61 24 37 100 17 120 120 25 95 12 83 12 71 48 23 100 25 98 27 71 38 33
1 ml
Ampul 101 200 268
58 OD004 Deksametason tablet 0,5 mg Tablet 400 700 182 918 440 478 1,000 263 1,215 393 822 200 468 554 700 296 958 1,000 577 1,381 563 818 600 531 887 400 614 673 1,000 591 1,082 1,000 504 1,578 6,600 5,422
59 OD009 Diazepam injeksi 5 mg/ml- 2 ml Ampul 17 17 2 15 15 15 15 0 0 0 0 0 0 50 50 1 49 50 18
60 OD010 Diazepam tablet 2 mg Tablet 108 45 63 100 114 49 400 156 293 87 206 173 33 33 0 500 6 494 500 90 904 105 799 133 666 42 624 84 540 1,500 1,068
61 OD014 Difenhidramin HCL injeksi i.m. 10 0 0 0 0 0 0 0 10 10 10 10 5 15 15

Ampul 0 15 0
mg/ml- 1 ml
62 OD015 Digoksin tablet 0,25 mg Tablet 252 118 134 200 91 243 61 182 182 0 400 17 383 383 28 355 21 334 92 242 42 200 100 77 223 35 188 700 764
63 OD016 Diltiazem HCL tablet 30 mg Tablet 271 271 271 271 271 271 271 271 271 40 231 231 231 231 0 40
64 OD017 Dimenhidrinat tablet 50 mg Tablet 954 100 329 725 300 418 607 600 280 927 402 525 600 265 860 197 663 600 370 893 241 652 226 426 100 194 332 200 315 217 900 170 947 3,400 3,407
65 OD018 Doksisiklin kapsul 100 mg Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 OD019 Domperidon suspensi 5 mg/5ml Botol 36 4 32 5 27 27 1 26 1 25 4 21 4 17 6 11 4 5 10 5 5 10 10 6 14 5 9 19 46
67 OD020 Domperidon tablet 10 mg Tablet 934 175 759 152 607 213 394 200 149 445 166 279 200 75 404 100 198 306 100 126 280 100 138 242 100 179 163 300 96 367 145 222 1,100 1,812
68 OE003 Efedrin HCL tablet 25 mg Tablet 377 377 377 20 357 10 347 15 332 332 0 0 0 0 0 0 0 0 377
69 OE004 Ekstrak Belladon tablet 10 mg Tablet 0 0 0 200 200 200 62 138 30 108 49 59 38 21 21 0 100 100 10 90 25 65 300 235
70 OE006 Epinefrine (Adrenalin) injeksi 5 5 5 5 5 5 10 15 15 15 15 15 3 12 12

Ampul 0 15 3
0,1% (sebagai HCl)
71 Eritromisin kapsul/kaplet 500 mg Tablet 0 100 100 100 100 100 100 100 100 100 100 9 91 91 100 9
0
72 OE008 Eritromisin kapsul/kaplet 500 mg Tablet 72 130 60 70 22 48 34 14 6 8 8 8 8 8 0 0 0 0 0 202

202
73 OE009 Eritromisin sirup 200 mg/5ml Botol 35 2 33 10 23 6 17 1 16 4 12 12 2 10 10 10 10 10 0 0 0 35
74 OE011 Etakridin (Rivanol) Larutan 0,1 % 0 0 0 0 0 0 0 0 0 0 0 0

Botol 0 0
300 ml 0
75 OE013 Etanol 70 % Botol 4 1 3 1 2 1 1 2 2 2 2 2 2 2 2 2 2 1 3
76 OE014 Etanol 70 % 100 ml 104 48 56 100 11 145 28 117 1 12 106 7 99 18 81 100 13 168 33 135 4 131 26 105 51 54 100 7 147 301 258
77 OE015 Etanol 95% 1 liter Botol 7 7 7 1 6 6 1 5 1 4 4 4 4 4 4 2 2 0 5
78 OE018 Etil Klorida Semprot Botol 11 11 11 3 8 2 6 1 5 4 1 20 21 3 18 2 16 16 3 13 2 11 20 20
79 OF004 Fenitoin Natrium kapsul/kaplet 100 0 0 0 0 0 0 0 0 0 0 0 0

Kapsul 0 0
mg 0
80 OF005 Fenitoin Natrium kapsul/kaplet 30 0 0 0 0 0 0 0 0 0 0 0 0
Kapsul 0 0
mg 0
81 OF009 Fenobarbital tablet 30 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
82 OF011 Fenoksimetil Penicilina tablet 500 0 0 0 0 0 0 0 0 0 0 0 0

Tablet 0 0 0
mg
83 OF013 Fenol Gliserol tetes telinga 10% Botol 0 0 0 0 0 0 0 0 0 0 0 0 24 24 24 0
84 OF015 Fitomenadion(Vit K1) injeksi 10 3 12 4 8 30 8 30 9 21 7 14 5 4 15 9 6 100 1 105 20 85 5 80 6 74 74

Ampul 135 76
%/ml-1 ml 15
85 OF016 Fitomenadion(Vit K1) tablet salut 20 148 36 112 50 62 62 0 100 56 44 44 0 100 5 95 74 21 200 10 211 62 149 58 91 100 16 175
Tablet 500 493
gula 10 mg 168
86 OF021 Furosemid tablet 40 mg Tablet 1,093 486 607 900 484 1,023 300 347 976 292 684 100 412 372 700 186 886 300 116 1,070 121 949 74 875 102 773 116 657 66 591 2,300 2,802
87 OG001 Garam Oralit untuk 200 ml air Sak 544 200 331 413 600 289 724 100 214 610 309 301 500 359 442 500 239 703 330 373 100 385 88 900 374 614 614 0 1,200 185 1,015 521 494 4,100 4,150
88 OG002 Gentamisin Inj. 80 mg/ml (Sulfat) Ampul 200 200 200 200 200 200 200 200 200 200 200 200 200 0 0
89 OG003 Gentamisin salep kulit 0,1% Tube 41 50 24 67 10 30 47 40 33 54 30 21 63 26 37 30 14 53 30 16 67 50 17 100 23 94 21 73 22 51 30 15 66 320 295
90 OG004 Gentian Violet larutan 1 % Botol 61 24 20 65 70 16 119 21 98 13 85 17 68 21 47 15 32 19 13 68 16 65 23 42 24 7 59 9 50 186 197
91 OG007 Glibenklamid tablet 5 mg Tablet 1,484 1,000 835 1,649 900 633 1,916 799 1,117 1,000 735 1,382 500 804 1,078 1,000 574 1,504 2,000 604 2,900 630 2,270 464 1,806 598 1,208 300 725 783 2,000 636 2,147 8,700 8,037
92 OG008 Glimepirid tablet 1 mg Tablet 329 150 156 323 150 248 225 500 215 510 6,500 203 6,807 952 5,855 2,123 3,732 11,000 2,501 12,231 3,231 9,000 2,658 6,342 2,982 3,360 1,048 2,312 449 1,863 18,300 16,766
93 OG009 Glimepirid tablet 2 mg Tablet 2,671 1,250 1,337 2,584 1,450 1,273 2,761 1,250 1,478 2,533 1,406 1,127 1,127 0 0 0 0 0 5,000 5,000 2,250 1,078 6,172 2,500 1,344 7,328 13,700 9,043
94 OG011 Gliseril Guayakolat tablet 100 mg Tablet 8,050 2,000 5,066 4,984 10,000 5,747 9,237 7,000 5,266 10,971 4,000 4,000 10,971 3,894 7,077 3,000 2,140 7,937 5,000 3,137 9,800 3,525 6,275 3,000 4,004 5,271 4,000 4,954 4,317 8,000 4,811 7,506 5,000 3,909 8,597 51,000 50,453
95 OG014 Glukose larutan infus 40% steril Botol 54 54 54 54 54 54 54 54 54 54 2 52 2 50 50 0 4
96 OG015 Glukose larutan infus 5 % Steril Botol 95 40 36 99 20 17 102 12 90 28 62 15 47 12 35 80 20 95 56 39 60 15 84 17 67 27 40 40 22 58 240 277
97 OG016 Griseofulvin forte tablet 500 mg Tablet 330 35 295 28 267 21 246 26 220 58 162 31 131 100 41 190 18 172 200 36 336 66 270 100 65 305 46 259 400 471
98 OG017 Griseofulvin tablet 125 mg 300 54 415 30 385 24 361 10 351 58 293 20 273 74 199 72 127 12 115 25 90 200 30 260 260
micronized
Tablet 169 500 409
99 OG018 Grotavit sirup Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 OG019 Guanistrep suspensi Botol 27 11 16 17 9 24 10 14 12 10 16 10 14 12 25 6 31 5 7 29 7 22 17 5 35 4 36 4 32 13 19 104 112
101 OH001 Haloperidol tablet 0,5 mg Tablet 245 132 113 600 300 413 400 405 408 700 342 766 100 528 338 1,500 315 1,523 400 388 1,535 342 1,193 359 834 468 366 800 216 950 363 587 4,500 4,158
102 OH003 Haloperidol tablet 5 mg Tablet 157 200 129 228 200 87 341 341 70 271 84 187 100 132 155 700 90 765 120 645 645 56 589 70 519 165 354 1,200 1,003
103 OH006 Tangan)/klorhexidin 4%/hydrex 0,5 Botol 10 2 22 1 21 11 10 20 5 25 20 7 38 20 14 44 40 2 82 10 72 17 55 3 52 10 20 42 10 3 49 130 95
ml 14
104 OH008 Hidroklortiazid (HCT) tablet 25 mg Tablet 2,898 800 1,389 2,309 1,900 1,161 3,048 960 2,088 700 1,006 1,782 800 957 1,625 800 465 1,960 1,000 750 2,210 746 1,464 400 750 1,114 700 485 1,329 491 838 400 438 800 7,500 9,598
105 OH009 Hidrokortison krim 2,5 % Tube 56 24 19 61 18 43 24 21 46 24 36 34 72 27 79 17 62 48 26 84 32 52 72 31 93 34 59 48 34 73 24 37 60 336 332
106 OH010 Hiosin-N-butilbromida injeksi Ampul 56 2 54 2 52 4 48 1 47 1 46 1 45 45 0 0 0 0 0 0 0 56
107 OH011 Hiosin-N-butilbromida tablet Tablet 220 300 210 310 300 90 520 190 330 200 110 420 150 270 100 74 296 200 30 466 26 440 44 396 40 356 10 346 25 321 1,100 999
108 OI001 Ibuprofen suspensi 100 mg/5 ml Botol 11 1 10 10 6 4 10 14 14 14 6 8 10 3 15 2 13 13 0 0 0 20 31
109 OI002 Ibuprofen tablet 200 mg Tablet 2,755 711 2,044 100 568 1,576 1,007 569 2,100 609 2,060 520 1,540 310 1,230 700 341 1,589 478 1,111 478 633 500 514 619 600 752 467 1,500 535 1,432 5,500 6,823
110 OI003 Ibuprofen tablet 400 mg Tablet 5,574 2,000 3,338 4,236 5,000 2,963 6,273 5,000 6,418 4,855 15,000 8,575 11,280 15,000 7,717 18,563 6,287 12,276 30,000 8,234 34,042 8,093 25,949 8,062 17,887 800 9,420 9,267 15,000 9,614 14,653 7,797 6,856 87,800 86,518
111 OI010 Ipratrium Br 0,5 m, salbutamol 2,5 0 0 0 0 0 0 0 0 0 0 0 0

Ampul 0 0
mg/ 2,5 ml Neb. 0
112 OI013 Isosorbid dinitrat tablet sublingual 300 134 395 96 299 146 153 200 149 204 200 164 240 200 108 332 400 99 633 85 548 84 464 56 408 40 368 53 315
Tablet 1,300 1,214
5 mg 229
113 OK002 Kalsium Glukonat Injeksi Ampul 135 135 135 135 135 135 135 135 135 135 135 135 135 0 0
114 OK004 Kalsium Laktat (Kalk) tablet 500 29 56 500 226 330 330 0 0 0 0 0 0 6,400 314 6,086 615 5,471 547 4,924 541 4,383
mg
Tablet 85 6,900 2,602
115 OK005 Kaptopril tablet 12,5 mg Tablet 944 8,000 344 8,600 8,000 6,004 10,596 4,000 8,249 6,347 5,204 1,143 592 551 1,000 253 1,298 387 911 356 555 2,200 237 2,518 229 2,289 223 2,066 402 1,664 23,200 22,480
116 OK006 Kaptopril tablet 25 mg Tablet 6,388 4,626 1,762 1,224 538 256 282 102 180 10,000 90 10,090 198 9,892 5,000 2,562 12,330 2,558 9,772 2,370 7,402 3,155 4,247 3,500 2,374 5,373 10,000 2,046 13,327 28,500 21,561
117 OK007 Kaptopril tablet 50 mg Tablet 0 0 0 0 3,000 210 2,790 1,390 1,400 1,154 246 246 0 0 0 0 0 0 3,000 3,000
118 OK008 Karbamazepin tablet 200 mg Tablet 50 50 16 34 34 34 34 34 34 34 34 34 34 34 0 16
119 OK011 Ketokonazol krim 2% 15 gr Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
120 OK012 Ketokonazol krim 2% 5 gr Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 OK013 Ketokonazol tablet 200 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
122 OK014 Klindamisin kapsul 150 mg Kapsul 184 50 134 10 124 44 80 100 42 138 12 126 126 126 126 126 44 82 100 34 148 68 80 200 304
123 Kloramfenikol injeksi 1 gr 0 0 0 0 0 0 0 0 0 0 0 0

Vial 0 0
(Chlorbiotic inj) 0
124 OK019 Kloramfenikol Kapsul/kaplet 250 202 524 100 358 266 700 220 746 379 367 600 312 655 200 92 763 100 207 656 319 337 500 88 749 341 408 500 575 333 2,000 317 2,016
mg
Kapsul 726 4,700 3,410
125 OK020 Kloramfenikol Salep Mata 1 % Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
126 OK021 Kloramfenikol suspensi 125 mg/5 53 53 3 50 2 48 2 46 2 44 44 2 42 1 41 41 8 33 11 22 50 2 70

Botol 50 33
ml
127 OK022 Kloramfenikol Tetes Mata Botol 10 5 5 5 0 0 0 0 100 8 92 28 64 35 29 60 38 51 40 29 62 30 28 64 30 16 78 260 192
128 OK023 Kloramfenikol Tetes Telinga 3 % Botol 0 0 0 0 0 0 100 3 97 12 85 5 80 11 69 10 59 9 50 9 41 100 59
129 OK024 Klorfeniramin Maleat ( CTM ) 3,000 8,242 8,382 16,400 8,274 16,508 10,000 7,014 19,494 5,996 13,498 2,000 6,207 9,291 10,000 3,462 15,829 10,000 4,879 20,950 4,715 16,235 6,271 9,964 4,500 6,556 7,908 7,500 5,985 9,423 19,800 5,101 24,122
Tablet 83,200 72,702
tablet 4 mg 13,624
130 OK028 Klorpromazin HCL tablet salut 100 100 200 253 400 227 426 200 205 421 238 183 183 0 0 0 0 0 0 0 0
Tablet 700 1,053
mg 353
131 OK029 Klorpromazin HCL tablet salut 25 0 0 0 0 1,000 396 604 900 1,218 286 8,000 1,108 7,178 1,116 6,062 570 5,492 950 4,542 724 3,818 1,135 2,683
Tablet 9,900 7,217
mg 0
132 OK031 Kodein Fosfat tablet 10 mg Tablet 1,030 270 760 100 288 572 200 240 532 100 270 362 400 140 622 70 552 90 462 60 402 80 322 40 282 90 192 100 40 252 900 1,678
133 OK038 Kontrasepsi oral Linesterol tablet 5 19 9 10 30 40 4 36 3 33 3 30 4 26 6 20 3 17 5 12 2 10 2 8

Tablet 30 46
0,5 mg 24
134 OK039 Kotrimoksazol Doen I (dewasa) 189 192 400 39 553 9 544 56 488 88 400 32 368 21 347 36 311 52 259 15 244 3 241 16 225
Tablet 381 400 556
tablet
135 OK040 Kotrimoksazol Forte tablet Kaplet 346 12 334 40 294 29 265 49 216 45 171 43 128 100 19 209 10 199 20 179 6 173 25 148 148 100 298
136 OK041 Kotrimoksazol suspensi kombinasi Botol 50 3 53 25 28 17 11 5 6 6 6 6 6 6 0 0 0 24 3 21 74 59

6
137 Lactulax sirup Botol 2 2 2 2 2 1 1 1 0 0 0 0 0 0 0 0 2
138 OL001 Laktulose sirup Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 OL010 Lidokain HCl 2% injeksi Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
140 OL011 Lidokain injeksi 2% (HCl) + 0 0 0 0 0 0 0 0 0 60 60 60 60

Ampul 60 0
0
141 OLO12 Loperamide tablet 2 mg Tablet 280 28 252 252 252 252 28 224 224 224 5 219 4 215 9 206 23 183 16 167 0 113
142 OL013 Loratadin tablet 10 mg Tablet 268 100 155 213 500 138 575 151 424 238 186 500 112 574 118 456 300 35 721 130 591 45 546 500 180 866 100 49 917 63 854 2,000 1,414
143 OL014 2% - Kalamin 5% - Zinc 10% - Botol 1 16 2 14 1 13 3 10 10 2 8 8 8 1 7 7 7 7 0 10
17
Gliserin 5%
144 OM002 Magnesium Sulfat injeksi (IV) 0 0 0 0 0 0 0 0 0 0 0 0
Vial 0 0
20%-25 ml 0
145 OM003 Magnesium Sulfat injeksi (IV) 305 305 305 305 305 8 297 297 235 62 62 62 62 62
Vial 305 0 243
40%-25 ml
146 OM006 Metamizol injeksi 500 mg/ml Ampul 29 2 27 9 18 10 28 3 25 25 2 23 3 20 20 10 10 20 11 19 50 18 51 20 31 80 78
147 OM007 Metampiron tablet 500 mg Tablet 990 40 950 641 309 309 0 0 0 0 0 0 0 0 0 0 0 990
148 OM008 Metformin HCl tablet 500 mg Tablet 2,400 4,587 8,521 5,000 4,759 8,762 6,900 4,996 10,666 6,900 4,468 13,098 5,404 7,694 6,800 3,132 11,362 10,000 4,391 16,971 10,000 5,699 21,272 3,839 17,433 4,794 12,639 2,000 5,202 9,437 10,000 4,854 14,583 60,000 56,125
10,708
149 OM009 Metformin HCl tablet 850 mg Tablet 7 7 7 7 7 7 500 183 324 800 84 1,040 56 984 148 836 53 783 30 753 753 1,300 554
150 OM010 Metilergometrin maleat injeksi 99 2 97 2 95 95 1 94 1 93 1 92 92 2 90 3 87 1 86 86

Ampul 99 0 13
0,200 mg
151 OM011 Metilergometrin maleat tablet salut 0 0 0 0 0 0 0 0 0 0 0 0

Tablet 0 0
0,125 mg 0
152 OM012 Metilprednisolon tablet 4 mg Tablet 849 185 664 115 549 156 393 78 315 58 257 151 106 106 0 0 0 0 0 0 0 849
153 OM013 Metoklopramid Injeksi 5mg/ml Ampul 119 2 117 6 111 27 84 6 78 78 2 76 19 57 8 49 9 40 13 27 10 16 21 20 2 39 30 110
154 OM014 Metoklopramid tablet 10 mg Tablet 173 173 173 21 152 49 103 10 93 14 79 22 57 30 27 100 50 77 100 3 174 174 2 172 200 201
155 OM015 Metronidazol ovula 500 mg Supp 66 66 66 7 59 59 59 59 59 59 59 59 59 59 0 7
156 OM016 Metronidazol tablet 250 mg Tablet 578 100 478 206 272 124 148 40 108 108 108 108 0 0 0 0 0 0 0 578
157 OM017 Metronidazol tablet 500 mg Tablet 299 300 152 447 43 404 100 79 425 99 326 142 184 200 119 265 500 102 663 219 444 100 131 413 203 210 300 64 446 75 371 1,500 1,428
158 OM018 Mikonazol krim/salep 2% (nitrat) Tube 71 24 38 57 48 16 89 27 62 28 34 48 31 51 48 10 89 18 71 35 36 96 26 106 40 66 48 34 80 48 23 105 360 326
159 OM021 Multivitamin komb (antianemia)

tablet (novabion)
Kapsul 2,029 1,000 874 2,155 500 949 1,706 1,000 1,027 1,679 1,000 430 2,249 500 462 2,287 696 1,591 2,600 789 3,402 917 2,485 842 1,643 300 1,024 919 1,500 943 1,476 1,000 581 1,895 9,400 9,534
160 OM022 Multivitamin komb (neurotropik) 1,008 1,441 1,600 949 2,092 2,092 0 0 0 0 0 0 0 0 0 0
Tablet 2,449 1,600 4,049
tablet (Neurodex)
161 ON002 N-asetisistein kapsul 20 mg Kapsul 320 320 320 10 310 310 120 190 190 0 120 120 120 120 120 120 120 120 320
162 ON003 Natrium Bikarbonat tablet 500 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0

0
163 ON004 Natrium Diklofenak tablet 25 mg Tablet 126 50 20 156 36 120 10 110 82 28 1,000 288 740 186 554 600 262 892 600 324 1,168 150 258 1,060 373 687 294 393 200 193 2,400 2,333
164 ON005 Natrium Diklofenak tablet 50 mg Tablet 1,144 426 718 600 355 963 354 609 300 505 404 283 121 121 120 1 1 0 0 1,000 100 900 142 758 294 464 1,900 2,580
165 ON007 Natrium Klorida larutan infus 0,9% 100 41 105 20 8 117 9 108 26 82 25 57 20 8 69 100 52 117 32 85 60 57 88 40 30 98 62 36 200 69 167
Botol 540 419
steril 46
166 Neo Kaominal sirup Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
167 Neurovit E tablet Kaplet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
168 ON017 Nifedipin tablet 10 mg Tablet 5,287 1,048 4,239 765 3,474 675 2,799 633 2,166 618 1,548 489 1,059 527 532 1,000 319 1,213 217 996 258 738 352 386 500 142 744 1,500 6,043
169 Nifedipin tablet oros 30 mg Tablet 90 85 5 5 5 5 5 5 5 0 0 0 0 0 0 0 90
170 ON018 Nistatin 100.000 UI/ml drop Botol 20 3 17 4 13 7 6 12 1 17 3 14 14 4 10 2 8 10 5 13 6 7 10 4 13 50 8 55 82 47
171 ON019 Nistatin tablet salut 500.000 IU/g Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
172 ON020 Nistatin tablet vaginal 100.000 140 140 3 137 137 137 137 137 14 123 123 123 123 123
Tablet 140 0 17
IU/g
173 OO009 Obat Flu komb Sirup (Fludane) Botol 45 6 39 15 24 72 23 73 9 64 8 56 2 54 7 47 6 41 20 3 58 1 57 17 40 11 29 92 108
174 OO010 Obat Flu komb Tablet(Fludane) Tablet 395 500 135 760 354 406 406 0 0 0 0 0 0 0 0 0 0 500 895
175 OO008 Obat Batuk Hitam (OBH) cairan 91 167 192 123 236 96 92 240 92 148 96 60 184 51 133 192 60 265 60 63 262 61 201 65 136 60 115 81 240 90 231
Botol 258 936 963
100 ml
176 OO012 Oksitetrasiklin HCL Salep kulit 3 % Tube 50 14 64 24 40 25 20 45 25 28 42 50 58 34 100 18 116 23 93 36 57 50 32 75 24 51 25 27 49 25 21 53 350 325
28
177 OO013 Oksitetrasiklin HCL salep mata 1% Tube 50 33 66 19 47 50 21 76 37 39 39 0 0 0 0 0 0 0 0 100 149

49
178 OO014 Oksitosin injeksi 10 IU/ ml- 1 ml Ampul 68 5 63 10 53 23 30 100 5 125 14 111 9 102 11 91 22 69 17 52 13 39 100 7 132 132 200 136
179 OO015 Omegdiar tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
180 OO016 Omeprazol injeksi 20 mg 40mg/10 0 0 0 0 0 0 0 0 0 0 0 0

Vial 0 0 0
ml
181 OO017 Omeprazol kapsul/kaplet 20 mg Kapsul 342 283 59 810 154 715 143 572 104 468 143 325 30 84 271 145 126 600 144 582 116 466 87 379 150 22 507 57 450 1,590 1,482
182 OP002 Parasetamol drop 100 mg/ml Botol 22 5 17 10 7 30 12 25 11 14 12 2 2 2 56 2 56 14 42 7 35 8 27 6 21 86 87
183 OP003 Parasetamol sirup 120 mg/ 5 ml Botol 586 261 325 300 255 370 350 292 428 350 247 531 100 240 391 200 178 413 500 258 655 255 400 250 308 342 350 421 271 1,120 389 1,002 295 707 3,520 3,399
184 OP005 Parasetamol tablet 500 mg Tablet 21,687 11,500 10,187 4,000 11,004 3,183 2,000 4,929 254 5,000 215 5,039 2,319 2,720 2,008 712 712 0 0 0 0 0 16,800 16,800 27,800 32,687
185 OP006 Pehacain inj Ampul 136 40 85 91 160 34 217 70 147 40 92 95 200 34 261 73 188 260 106 342 83 259 96 163 34 129 75 54 15 39 700 797
186 OP007 Perak Sulfadiazin krim 1% Tube 1 4 5 5 5 5 5 1 4 2 6 6 6 2 4 5 1 8 8 11 4
187 OP010 Permetrin Krim 5% (Scabimite) Tube 24 24 3 21 4 17 17 3 14 2 12 4 8 60 10 58 6 52 60 16 96 31 65 20 8 77 140 87
188 OP013 Pirantel Pamoat tablet 125 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

189 OP014 Piridoksin HCL tablet 10 mg Tablet 4,767 2,000 2,598 4,169 4,000 2,178 5,991 2,358 3,633 3,000 2,105 4,528 2,000 2,115 4,413 1,000 1,574 3,839 6,000 1,304 8,535 1,352 7,183 1,402 5,781 1,581 4,200 1,000 1,652 3,548 1,000 1,178 3,370 20,000 21,397
190 OP015 Piroksikam kapsul/kaplet/tablet 20 11 196 29 167 6 161 43 118 33 85 6 79 20 59 5 54 25 29 100 6 123 34 89 20 69
Kapsul 207 100 238
mg
191 OP018 Povidon Iodida Larutan 10% 1000 4 4 1 3 3 3 3 1 1 3 1 2 2 2 2 2

Botol 1 3
ml 4
192 OP019 Povidon Iodida Larutan 10% 30 ml Botol 10 17 1 16 2 14 14 24 38 5 33 2 31 7 24 4 20 2 18 1 17 1 16 34 25
7
193 OP020 Povidon Iodida Larutan 10% 300 0 0 0 0 0 0 0 0 24 24 24 24 24
Botol 0 24 0
ml
194 OP022 Prednison tablet 5 mg Tablet 1,020 20 1,000 31 969 20 949 949 949 949 10 939 46 893 893 71 822 13 809 809 0 0 1,020
195 OP027 Propanolol HCL tablet 40 mg Tablet 310 25 285 126 159 159 159 19 140 140 140 140 140 140 140 140 0 170
196 OP028 Propiltiourasil tablet Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
197 OP029 Pseudoefedrin+tripolidin tablet Tablet 500 82 418 90 328 328 0 0 0 0 0 0 0 0 0 0 0 500
198 OR002 Ranitidin Injeksi 25 mg/ ml Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Ranitidin Injeksi 50 mg/2 ml Ampul 0 0 0 0 0 0 100 6 94 200 97 197 300 112 385 85 300 58 242 59 183 79 104 600 496
200 OR003 Ranitidin tablet 150 mg Tablet 2,335 1,000 1,357 1,978 2,100 1,267 2,811 500 1,301 2,010 2,010 0 500 139 361 2,000 651 1,710 2,200 870 3,040 699 2,341 993 1,348 1,000 992 1,356 1,000 1,038 1,318 1,500 1,053 1,765 11,800 12,370
201 OR018 Ringer Laktat larutan Infus steril Botol 501 680 438 743 580 347 976 313 663 160 221 602 249 353 280 54 579 141 438 100 145 393 164 229 160 126 263 40 224 79 500 98 481 2,500 2,520
202 OS011 SABU injeksi 5 ml Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 OS001 Salbutamol tablet 2 mg (sebagai 459 541 800 567 774 800 565 1,009 420 589 500 613 476 1,100 625 951 2,800 530 3,221 248 2,973 545 2,428 499 1,929 393 1,536 357 1,179
Tablet 1,000 6,000 5,821
sulfat)
204 OS002 Salbutamol tablet 4 mg (sebagai 0 0 0 0 0 0 0 0 0 0 0 0

Tablet 0 0
sulfat) 0
205 OS003 Salep 2-4 kombinasi Pot 4 10 24 2 32 2 30 5 25 6 19 3 16 24 6 34 7 27 2 25 25 11 14 24 38 72 48
14
206 OS004 Salisil Bedak 2 % Kotak 151 43 108 20 25 103 35 68 100 28 140 32 108 25 83 100 21 162 18 144 35 109 35 74 20 31 63 100 30 133 340 358
207 OS004 Scabicid krim Tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
208 OS007 Sefotaksim Injeksi 1 g Vial 193 91 102 102 0 0 0 0 30 30 100 7 123 15 108 108 14 94 34 60 30 28 62 160 291
209 OS008 Seftriakson Injeksi 1 gr Vial 66 38 28 86 18 96 37 59 59 2 57 13 44 44 6 38 38 38 38 38 86 114
210 OS013 Serum Anti Tetanus inj. 1500 2 2 2 2 2 2 2 2 2 2 2 2

Ampul 0 0
UI/vial amp (ATS) 2
211 OS015 Setirizine sirup 5 mg/5ml Botol 12 3 9 1 8 1 7 7 2 5 2 3 20 4 19 2 17 17 3 14 5 3 16 1 15 25 22
212 OS016 Setirizine tablet 10 mg Tablet 538 30 508 10 498 10 488 488 1 487 487 105 382 59 323 20 303 18 285 31 254 6 248 0 290
213 OS017 Sianokobalamin (vit. B12) tablet 816 28 788 5 783 389 394 600 528 466 1,000 384 1,082 1,300 206 2,176 277 1,899 192 1,707 168 1,539 143 1,396 163 1,233
Tablet 816 2,900 2,483
50 mcg
214 OS021 Simetidin tablet 200 mg Tablet 209 86 123 200 96 227 74 153 76 77 800 877 0 0 0 110 110 110 110 6 104 104 1,110 1,215
215 OS022 Simvastatin tablet 10 mg Tablet 357 79 278 100 64 314 42 272 61 211 22 189 57 132 21 111 46 65 65 0 0 0 0 100 457
216 OS023 Simvastatin tablet 20 mg Tablet 62 30 32 10 22 15 7 7 7 7 100 107 100 45 162 162 26 136 32 104 53 51 200 211
217 OS024 Siprofloksasin tablet 500 mg 363 756 400 140 1,016 334 682 200 172 710 206 504 139 365 500 100 765 184 581 116 465 84 381 131 250 100 117 233
Tablet 1,200 2,086
(sebagai HCl) 1,119
218 OS025 Siprofloksasin tetes mata Botol 9 9 3 6 10 1 15 3 12 12 3 9 1 8 1 7 7 1 6 6 2 4 10 15
219 Spironolakton tablet 100 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
220 OS027 Spironolakton tablet 25 mg Tablet 245 48 197 83 114 114 0 0 0 0 0 0 0 0 0 0 0 245
221 OS028 Stesolid Rectal supp 5 mg Supp 7 7 3 4 5 1 8 2 6 6 1 5 5 10 10 2 8 5 9 4 15 7 12 12 30 25

222 OS032 Sulfasetamid Natrium tetes mata 6 0 0 0 0 0 0 0 0 0 0 0 0

Botol 6 0 6
15 %
223 OT001 Tablet Tambah Darah Kombinasi Sachet 7,092 327 6,765 287 6,478 353 6,125 2,198 3,927 3,927 0 3,000 3,000 120 2,880 250 2,630 260 2,370 360 2,010 19,200 19,640 1,570 545 1,025 22,200 28,267
224 OT008 Terbutalin sulfat 0,5 mg - spray 2 2 2 2 2 0 0 0 0 0 0 0 0
Botol 2 0 2
100 dosis
225 OT009 Terbutalin sulfat 2,5 mg/ml 20 20 20 20 1 19 19 19 19 19 19 19 19
Ampul 20 0 1
respules
226 OT010 Tetrakain Tetes Mata 0,5% Botol 2 2 2 2 2 2 2 2 2 2 2 2 2 0 0 2
227 OT012 Tetrasiklin HCL Kapsul/kaplet 250 0 0 0 0 0 0 0 0 0 0 0 0

Kapsul 0 0 0
mg
228 Thrombo Aspilet tablet 80 mg Tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 Tiamin HCL (Vit B1) Inj. 100 0 0 0 0 0 0 0 0 0 0 0 0

Ampul 0 0
mg/ml-1 ml 0
230 OT016 Tiamin HCL Mononitrat (Vitamin 1,310 2,256 5,000 746 6,510 863 5,647 1,807 3,840 1,000 1,418 3,422 717 2,705 2,000 983 3,722 1,123 2,599 3,000 1,045 4,554 677 3,877 345 3,532 644 2,888
Tablet 3,566 11,000 11,678
B1) Tablet 100 mg
231 OT019 Trifluoperazin tablet 5 mg Tablet 205 400 132 473 185 288 200 90 398 150 248 200 90 358 150 208 700 90 818 150 668 90 578 150 428 90 338 102 236 1,500 1,469
232 OT020 Triheksifenidil Hidroklorida tablet 2 1,000 174 1,169 276 893 195 698 276 422 1,000 258 1,164 357 807 1,000 270 1,537 324 1,213 174 1,039 246 793 132 661 405 256
Tablet 343 3,000 3,087
mg
233 OV012 Ventolin Nebulizer Ampul 79 80 116 43 100 52 91 60 44 107 52 55 80 40 95 20 53 62 260 39 283 30 253 76 177 77 100 80 69 111 40 81 70 720 729
234 Vit K Infant / Neo - K injeksi Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 OV015 Vitamin B Komplek Tablet Tablet 15,618 6,800 9,119 13,299 13,600 8,006 18,893 3,000 7,640 14,253 6,800 8,374 12,679 13,600 7,790 18,489 6,381 12,108 18,800 9,724 21,184 12,000 9,542 23,642 9,890 13,752 9,400 10,783 12,369 9,400 9,689 12,080 18,800 8,322 22,558 112,200 105,260
236 OY001 Y-Rins cuci mata Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
237 OZ003 Zinc Drop 10mg/ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 OZ004 Zinc sirup 20 mg/5 ml Botol 8 2 6 3 3 5 8 1 7 1 6 6 6 4 2 10 4 8 5 5 8 4 1 11 4 7 24 25
239 OZ005 Zinc tablet 20 mg Tablet 2,768 290 2,478 234 2,244 185 2,059 221 1,838 306 1,532 97 1,435 211 1,224 324 900 486 414 700 127 987 69 918 30 888 700 2,580
II. OBAT PROGRAM

1 OB006 Benzatin Benzil Penisilin injeksi Vial 10 10 10 10 10 10 10 10 10 10 10 0 0 0 0 10
2 OF017 Flukonazol kapsul 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 OH004 Haloperidol inj 5mg/ml (Lodomer) Ampul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 OK016 Klobazam tablet 10 mg (obat 100 100 100 100 100 100 100 100 100 100 100 100
Tablet 0 0
program jiwa) 100
5 OK030 Klozapin tablet 25 mg (obat 158 158 158 158 158 158 158 158 158 0 0 0 0
program jiwa)
Tablet 158 0 158
6 OK032 Kombipak azitrhromycin-cefixim Paket 42 1 41 2 39 7 32 6 26 7 19 19 19 0 0 0 0 0 0 0 42

7 OM019 tab 25 mg Sulfadoksin tablet 500 Sachet 0 0 0 0 0 0 0 0 0 0 0 0 0 0
mg 0
8 OO003 Obat Antituberkulosis FDC 0 0 0 0 0 0 0 0 0 0 0 0
Paket 0 0
Kategori Anak 0
9 OO004 Obat Antituberkulosis FDC 2 4 0 7 4 3 4 1 6 6 3 3 3 2 4 4 1 7 1 6 1 5 5 1 4 1 3
Paket 20 19
Kategori I 2
10 OO005 Obat Antituberkulosis FDC 1 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1
Paket 3 3
Kategori II 1
11 OP026 Procain Benzil Penisillin 3 juta 225 225 225 1 224 224 224 224 224 224 224 224 224
Vial 225 0 1
IU/vial inj
12 OR014 Retinol (Vitamin A) 100.000 IU 150 150 150 0 0 0 0 0 150 150 0 0 0 0 0 0
Kapsul 0 300 300
kapsul lunak
13 OR015 Retinol (Vitamin A) 200.000 IU 1,100 1,100 1,100 0 0 0 0 0 1,250 1,250 0 0 0 0 0 0
Kapsul 0 2,350 2,350
kapsul lunak
14 OR019 Risperidon tablet 2 mg (obat 160 30 130 130 14 116 21 95 95 95 95 95 95 95 95
Tablet 160 0 65
program jiwa)
15 Speculum Vagina Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
III. ALKES
1 AA002 Alat suntik sekali pakai 1 ml Biji 18 4 14 7 7 7 0 0 19 19 0 400 100 300 300 100 500 8 492 9 483 5 478 111 367 8 359 719 378
2 AA003 Alat suntik sekali pakai 10 ml Biji 306 306 113 193 200 190 203 100 303 303 303 303 3 300 1 299 2 297 3 294 100 194 300 412
3 AA004 Alat suntik sekali pakai 2,5 ml Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 AA004 Alat suntik sekali pakai 3 ml Biji 996 500 444 1,052 300 221 1,131 532 599 800 235 1,164 235 929 320 609 1,400 229 1,780 339 1,441 539 902 400 639 663 1,000 740 923 1,800 420 2,303 6,200 4,893
5 AA005 Alat suntik sekali pakai 5 ml Biji 268 400 174 494 205 289 291 163 417 136 281 100 2 379 191 188 1,000 2 1,186 103 1,083 104 979 206 773 306 467 300 406 361 2,091 1,998
6 AB002 Benang Cat Gut Chromic 2/0 Sachet 38 2 36 8 28 28 8 20 10 10 24 4 30 6 24 8 16 1 15 9 6 2 4 4 24 58
7 AB003 Benang Cat Gut Chromic 3/0 Sachet 36 4 32 6 26 8 18 18 18 18 4 14 4 10 12 10 12 12 24 11 13 24 37 48 47
8 AB004 Benang Cat Gut Plain 2/0 Sachet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 AB005 Benang Cat Gut Plain 3/0 Sachet 17 12 1 28 28 21 7 28 35 35 15 20 72 8 84 2 82 8 74 74 74 10 64 112 65
10 AB006 Benang Silk/Side 2/0 Sachet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 AB007 Benang Silk/Side 3/0 Sachet 26 1 25 4 21 5 16 16 16 5 11 24 35 35 6 29 29 5 24 2 22 24 28
12 AB009 Blood Set Biji 58 1 57 57 57 0 0 0 50 50 50 8 42 10 32 5 27 4 23 23 50 85
13 AF001 Foley Catheter no. 14 Biji 7 2 5 1 4 4 5 1 8 1 7 7 5 12 2 10 4 6 3 9 9 9 0 13 20
14 AF002 Foley Catheter no. 16 Biji 1 4 5 5 0 0 5 5 1 4 5 1 8 5 3 10 2 8 1 7 7 2 5 5 0 19 20
15 AH001 Handscun Panjang Biji 198 198 2 196 56 140 25 115 115 115 115 115 115 115 115 115 0 83
16 AH003 Handscun non steril L Biji 200 100 100 100 0 91 91 0 0 0 0 0 300 300 300 0 700 200 500 400 100 200 100 200 1,291 1,291
17 AH004 Handscun non steril M Biji 200 100 300 200 100 500 600 0 0 1,000 400 600 1,000 900 700 5,000 700 5,000 400 950 4,450 2,504 1,946 2,000 1,022 2,924 1,000 1,615 2,309 3,000 1,024 4,285 14,000 9,915
18 AH005 Handscun non steril S Biji 200 200 200 200 100 100 100 0 0 0 0 0 0 0 0 0 200
19 AH007 Handscun steril 7 Pasang 423 213 210 400 208 402 243 159 400 350 209 131 78 10 68 6 62 62 54 8 4 4 2 2 2 800 1,221
20 AH006 Handscun steril 6,5 Pasang 53 400 453 150 303 200 103 75 28 12 16 400 113 303 400 100 603 150 453 108 345 200 155 390 200 100 490 200 120 570 1,800 1,283
21 AH008 Handscun steril 7,5 Pasang 400 310 90 50 40 40 0 0 0 0 0 0 0 0 0 0 0 400
22 AH011 Handscun steril 8 Pasang 400 310 90 50 40 40 0 0 0 300 50 250 250 37 213 28 185 185 185 185 300 515
23 AH010 Hansaplast Biji 377 400 502 275 1,000 205 1,070 91 501 660 700 105 1,255 103 1,152 266 886 1,000 372 1,514 218 1,296 249 1,047 325 722 100 717 105 1,000 220 885 4,291 3,783
24 AI001 Infusion set anak Set 79 39 40 50 49 41 100 29 112 17 95 17 78 11 67 22 45 100 20 125 39 86 30 56 100 47 109 50 22 137 400 342
25 AI002 Infusion set dewasa Set 158 100 103 155 100 83 172 50 83 139 100 61 178 64 114 50 101 63 600 57 606 69 537 156 381 81 300 85 215 50 32 233 1,050 975
26 AI004 IV Chateter 18 (Surflo 18) Biji 71 9 62 8 54 16 38 46 13 71 3 68 6 62 62 0 0 0 0 0 0 46 117
27 AIOO5 IV Chateter 20 (Surflo 20) Biji 137 30 107 3 104 10 94 50 15 129 129 2 127 5 122 3 119 10 109 92 17 50 7 60 5 55 100 182
28 AIOO6 IV Chateter 22 (Surflo 22) Biji 194 60 109 145 200 78 267 60 207 43 164 57 107 50 25 132 50 52 130 100 45 185 60 125 50 59 116 200 107 209 100 43 266 810 738
29 AI007 IV Chateter 24 (Surflo 24) Biji 176 77 99 150 66 183 49 134 29 105 48 57 100 26 131 50 32 149 100 42 207 52 155 103 52 200 66 186 50 21 215 650 611
30 AI008 IV Chateter 26 (Surflo 26) Biji 153 8 145 9 136 24 112 11 101 6 95 3 92 3 89 3 86 13 73 25 48 50 36 62 50 42 70 100 183
31 AJ002 Jarum suntik 23 G Biji 0 100 100 0 100 100 100 100 19 119 0 100 100 100 100 100 100 100 100 319 219
32 AK003 Kapas Pembalut/ Adsorben 250 3 2 6 1 5 3 2 6 8 8 4 4 20 3 21 21 7 14 2 16 1 15 1 14
mg
Biji 5 31 22
33 AK004 Kasa Hidrofil gulung Rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 AK005 Kasa Husada Steril 16x16 Kit 0 0 10 10 1 9 9 9 2 7 5 12 1 11 11 11 11 11 15 4
35 AK007 Kasa Pembalut 2 x 80 cm Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 AK008 Kasa Pembalut Hidrofil 4 m x 15 50 172 183 500 126 557 212 345 200 120 425 101 324 117 207 500 192 515 120 395 178 217 200 246 171 200 116 255 50 91 214
cm
Biji 305 1,700 1,791
37 Masker Kain Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 AM004 Masker O2 anak Buah 6 6 1 5 5 5 5 5 5 1 4 4 4 10 14 1 13 10 3
39 AM005 Masker O2 bayi Buah 12 12 1 11 11 1 10 10 10 10 1 9 2 7 7 10 17 5 12 10 10
40 AM006 Masker O2 dewasa Buah 7 5 12 2 10 10 10 10 2 8 4 2 10 2 8 3 5 2 7 10 4 13 3 10 21 18
41 AM002 Masker N95 Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 AM003 Masker Tissue Biji 453 500 238 715 500 430 785 400 664 521 1,200 217 1,504 610 894 2,500 559 2,835 700 160 3,375 640 2,735 501 2,234 377 1,857 500 1,235 1,122 2,000 274 2,848 8,300 5,905
43 AN002 Nasal O2 ukuran M Biji 10 10 3 7 7 7 7 1 6 6 6 2 4 4 4 4 0 6
44 AN003 Nasal O2 ukuran S Biji 10 10 1 9 1 8 8 8 8 8 1 7 2 5 5 10 1 14 14 10 6
45 AP004 Plester 5 yard x 2 inch Rol 16 48 25 39 36 36 39 48 30 57 11 46 15 31 10 22 19 144 18 145 19 126 23 103 24 79 48 26 101 21 80 334 270
46 Silk (Benang Bedah Sutera) No. 0 0 0 0 0 0 0 0 0 0 0 0

Kotak 0 0
3/0 0
47 AS001 Scafel Handle Biji 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 1
48 AS004 Slim Suiqer Biji 0 0 0 0 0 0 0 100 100 4 96 9 87 6 81 2 79 79 100 21
49 AS010 Surgical Blade Biji 118 18 100 100 100 0 0 0 0 0 0 0 0 0 200 100 100 200 218
50 AS011 Surgical Needle Sak 4 4 4 4 4 4 2 2 1 1 1 1 1 1 1 0 0 4
51 AU001 Urin bag Biji 0 10 10 0 10 10 10 0 0 0 0 10 10 10 1 9 1 2 8 1 7 7 0 31 31
IV. OBAT GIGI

1 OA002 Air Raksa dental Botol 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 1
2 OA006 Alvogyl pasta Pot 0 0 0 0 0 0 0 2 2 1 1 1 0 0 0 0 2 2
3 AA007 Articulaying Paper Paket 2 2 2 2 2 2 2 2 2 4 4 0 0 0 0 2 4
4 OB013 Bonding Botol 1 1 1 1 1 1 1 3 4 4 4 0 0 0 0 3 4
5 OB013 Bonding Aplikator Kotak 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 1 1
6 AC004 Calsium Hidroxyd tube 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 1
7 AC005 Cotton Roll Gigi Dos 1 1 0 1 1 1 1 1 1 3 4 1 3 3 0 0 0 0 4 5
8 OD008 Devitalisasi Pasta (non Arsen) Botol 3 3 3 1 2 2 2 2 3 5 5 5 0 0 0 0 3 6
9 OE016 Etching Botol 1 1 1 1 1 1 1 3 4 2 2 2 0 0 0 0 3 4
10 OE019 Eugenol Cairan Botol 0 0 0 0 0 0 0 3 3 2 5 5 0 0 0 0 5 5
11 OG006 Glass Ionomer Cement (GC IX) Set 3 1 2 2 1 1 1 0 1 1 1 0 8 8 2 6 6 0 0 0 0 9 12
12 AI003 Instrumen Gigi Set Paket 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1
13 AI001 Iodoform Botol 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 1
14 AK001 Kaca Mulut Buah 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1
15 Kalsium Hidroksida (CaOH2) tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 OK033 Komposit Resin Anterior A2 tube 0 0 0 0 0 0 0 2 2 2 2 0 0 0 0 2 2
17 OK034 Komposit Resin Anterior A3 tube 0 0 0 0 0 0 0 2 2 1 1 1 0 0 0 0 2 2
18 OK035 Komposit Resin Anterior A3.5 tube 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 OK036 Komposit Resin Posterior 0 0 0 0 0 0 2 2 2 2 0 0 0 0

tube 2 2
QA3,5/A3 0
20 AM007 Mata Boor Kotak 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
21 AM008 Mata Boor Frisure Besar Biji 3 3 3 3 3 3 3 3 3 0 0 0 0 0 0 3
22 AM009 Mata Boor Frisure Kecil Biji 2 2 2 2 2 2 2 2 2 2 0 0 0 0 0 2
23 AM010 Mata Boor Frisure Sedang Biji 3 3 3 3 3 3 3 3 3 3 0 0 0 0 0 3

24 Mata Boor Inverted Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 AM009 Mata Boor Inverted Kecil Biji 2 2 2 2 2 2 2 2 2 2 0 0 0 0 0 2
26 AM013 Mata Boor Inverted Sedang Biji 4 4 4 4 4 4 4 4 4 4 0 0 0 0 0 4
27 AM014 Mata Boor Round Besar Biji 2 2 2 2 2 2 2 2 2 2 0 0 0 0 0 2
28 AM016 Mata Boor Round Sedang Biji 2 2 2 2 2 2 2 2 2 2 0 0 0 0 0 2
29 Mata Boor Tapper Besar Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 AM017 Mata Boor Tapper Kecil Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 AM018 Mata Boor Tapper Sedang Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 OM020 Monoklorkamfer Mentol cairan 1 1 1 1 1 1 1 3 4 4 4 0 0 0 0

Botol 3 5
(CHKM) 2
33 OM024 Mumifying pasta Botol 1 1 1 1 1 1 1 1 2 2 2 0 0 0 0 1 2
34 OP016 Polikresulen 10 ml (Albothyl) Botol 2 1 1 2 3 3 1 2 2 2 2 4 4 4 0 0 0 0 4 6
35 AP005 Polising Amalgam Restoration Set 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 1

36 OR020 Root Canal Filling Buah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 AS002 Selleloid strip Sachet 0 0 0 0 0 0 0 2 2 2 2 0 0 0 0 2 2
38 OS009 Semen Seng Fosfat serbuk dan 0 0 0 0 0 0 3 3 1 2 2 0 0 0 0
Set 0 3 3
cairan
39 OS020 Silver Amalgam Serbuk 65-75 % Botol 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 1
40 AS005 Spongostan Kotak 0 0 0 0 0 0 0 2 2 1 1 1 0 0 0 0 2 2
41 AS010 Surgical Blade / Mess no 11 Biji 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Temporary Stopping Fletcher Cair Set 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
43 Temporary Stopping Fletcher 0 0 0 0 0 0 0 0 0 0 0 0

Set 0 0 0
Serbuk dan cairan
44 OT021 Trikresol Formalin (TKF) Cairan Botol 3 3 3 1 2 2 2 2 3 5 5 5 0 0 0 0 3 6
45 OT023 TSR Botol 0 0 0 0 0 0 0 2 2 2 2 0 0 0 0 2 2
46 OT024 Tumpatan sementara Botol 1 1 1 1 1 1 1 10 11 2 9 9 0 0 0 0 10 11
V. LABORATORIUM
1 Alat Pemeriksaan Gula Darah Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 Bilirubin Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 LB002 Blood Lancet Kotak 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 2 2
4 AB010 Blue Tip Sak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 AC006 Cover glass Kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 LD001 Darah Kontrol Ampul 0 0 0 0 1 1 0 0 2 2 0 0 0 0 0 1 1 0 0 4 4
7 LD003 Diluent 20 ltr Galon 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
8 LE001 EDTA Cair 10% 100 mL Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 LE003 ETA cair 10% 100ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 LG001 Glucosa Enzimatik Trinder Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 LG002 Gol. Darah A Vial 0 0 0 0 0 0 0 0 2 2 2 0 0 0 0 2 2
12 LG003 Gol. Darah AB Vial 0 0 0 0 0 0 0 0 2 2 2 0 0 0 0 2 2
13 LG004 Gol. Darah B Vial 0 0 0 0 0 0 0 0 2 2 2 0 0 0 0 2 2
14 LG005 Gol. Darah Rhesus Vial 0 0 0 0 0 0 0 0 2 2 2 0 0 0 0 2 2
15 LH001 H2O2 3% Botol 3 3 2 3 2 1 1 2 1 1 1 1 0 0 0 0 0 0 0 3 6
16 LH002 Hb-Cyanmet 1 liter Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Kartu Golongan Darah Kotak 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 2 2
18 K010 Kertas Lensa Buah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Kotak slide Buah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 OL003 Larutan Zheil Nielson/BTA 100 ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 OL004 Larutan Emersi Oil Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 OL005 Larutan Eter alkohol Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 OK006 Larutan Klorin / NaClO 5,25% 2 2 2 2 2 2 2 2 2 0 0 0 0
Botol 2 0 2
(bayclin)
24 OL007 Larutan KOH 10% Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 OL008 Larutan Metilen Biru Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
26 OL009 Larutan NaCl 0,9% 100 ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Larutan VDRL 10 ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
28 LM001 M-18 E-cfd lyse 500ml Botol 0 0 0 2 2 0 0 0 0 0 1 1 1 0 0 0 0 3 3
29 LM002 M-18 E-Z cleaner Botol 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 2 2
30 LM003 M-18 R rinse Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 LM004 M-18P probe cleanser Botol 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 2 2
32 Methilen Blue 0,3% Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 LO001 Obyek Glass 72 Dos 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Ose Buah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
35 AP001 PH Paper Vagina Kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 Pot Dahak Buah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 LR004 Reagen Asam Urat Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 LR006 Reagen Drabkin 1000ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 LR008 Reagen Gula Darah Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 LR010 Reagen Hbs Ag Kotak 0 0 0 0 0 0 0 0 4 4 4 0 0 0 0 4 4
41 OR012 Ragen HIV/intec/II Sachet 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1
42 OR013 Reagen HIV / oncoprobe / I Sachet 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1
43 OR015 Reagen HIV / vikia / III Sachet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
44 LR012 Reagen Kolesterol HDL Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

45 LR013 Reagen Kolesterol LDL Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 LR014 Reagen Kolesterol Total Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 LR015 Reagen Kreatinin Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 LR019 Reagen Thypoid IgG/IgM+B383 Kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 LR021 Reagen Trigliserida Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 LR022 Reagen Urea Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 LR023 Reagent SGOT 4x20 UV Kinetik 0 0 0 0 0 0 0 0 0 0 0 0
Kit 0 0 0
(IFCC)
Reagent SGPT 4x20 UV Kinetik
52 LR024 Kit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(IFCC)
53 OR008 Reagen Shipilis / VDRL test 0 0 0 0 0 0 0 0 0 0 0 0
Kotak 0 0 0
(Syphillis device)
54 LR017 Reagent Standart Trucal U Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
55 LR018 Reagent Standart Trulab N Vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 AS002 Selleloid strip Sachet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 LS001 Serum Kontrol Vial 0 0 0 0 0 0 2 2 0 0 0 0 0 0 0 2 2
58 Slide Object Glass Kotak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 LS002 Spiritus Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
60 LS003 Strip Gula Darah Kotak 0 0 0 15 15 0 0 0 0 0 10 10 10 0 0 0 0 25 25
61 LT001 Tabung centrifuge 15 TP Buah 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Tabung Vacuntainer EDTA (tutup
62 LT009 Kotak 0 0 0 91 91 0 0 0 0 0 0 0 0 0 0 91 91
merah)
63 LT010 Tabung Vacuntainer EDTA (tutup 400 400 0 0 10 10 0 0 0 0 0 0 0 0 0 0
Kotak 0 410 410
ungu)
64 LT011 Tes Kehamilan Buah 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 2 2
65 LT012 Thermal Paper Rol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Uric Acid Trinder 4x30 ml Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 LU002 Urinalisis Strip 10 Parameter Tube 0 0 0 5 5 0 0 0 0 0 2 2 2 0 0 0 0 7 7
68 LU003 Urinalisis Strip 2 Parameter Tube 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1
69 Uro Paper/ Urine 10 pm Botol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 LW001 Widal AO Vial 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1
71 LW002 Widal BO Vial 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1
72 LW003 Widal H Vial 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1
73 LW004 Widal O Vial 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 1 1
74 LY001 Yellow Tip Sak 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
VI. VAKSIN
1 OV001 Vaksin BCG + Pelarut Vial 0 0 0 5 5 0 20 20 5 11 14 4 10 10 10 9 11 5 6 10 6 4 10 1 13 3 10 55 45
2 OV002 Vaksin Campak + Pelarut Vial 0 0 0 5 5 0 20 20 10 16 14 6 8 5 13 8 5 5 0 0 0 0 40 40
3 788 Vaksin Campak 10 DS (MR) Vial 0 0 0 0 0 0 0 155 155 277 340 92 106 112 86 7 79 8 71 7 64 538 474
4 OV003 Vaksin DPT-HB-Hib (Penta Valent) Vial 0 0 15 15 0 70 70 30 75 25 16 9 30 39 10 42 7 30 14 23 20 22 21 30 24 27 22 5 235 230

0
PERSEDIAAN OBAT 1 JANUARI 2018
PUSKESMAS PERAWATAN NGLETIH
NO NAMA OBAT SATUAN JUMLAH
I. OBAT
1 Albendazol tablet 400 mg Tablet 130
2 Alopurinol tablet 100 mg Tablet 50
3 Alopurinol tablet 300 mg Tablet 135
4 Ambroksol sirup Botol 84
5 Ambroksol tablet 30 mg Tablet 742
6 Aminofilin injeksi 24 mg/ml-10 ml Ampul 38
7 Aminofilin tablet 200 mg Tablet 60
8 Amitriptilin HCL tablet salut 25 mg Tablet 187
9 Amlodipin tablet 10 mg Tablet 6394
10 Amlodipin tablet 5 mg Tablet 7591
11 Amoksisilin kapsul/kaplet 250 mg Kapsul 457
12 Amoksisilin kapsul/kaplet 500 mg Kaplet 5739
13 Amoksisilin sirup kering 125 mg/5 ml Botol 133
14 Amoksisilin sirup kering forte 250 mg/5 ml Botol 78
15 Amoksisilin drop 100 mg/ml Botol 20
16 Ampisilin serbuk injeksi i.m/i.v. 500 mg Ampul 250
17 Ampisilin Serbuk injeksi i.m/i.v.1000 mg Ampul 320
18 Antasida Doen I tablet kunyah kombinasi Tablet 7340
19 Antasida Doen II suspensi Botol 473
20 Antibakteri Doen Salep Kombinasi Tube 39
21 Antidiare tablet (kaolin+pektin) Tablet 0
22 Antifungi Doen kombinasi Pot 0
23 Antihemoroid Doen kombinasi Supp 17
24 Antimigrain Doen kombinasi Tablet 0
25 Antrain injeksi Ampul 0
26 Aqua Pro Injeksi steril, bebas pirogen Vial 273
27 Aquadest steril Botol 0
28 Aquasonic Gell Botol 7
29 Asam Asetilsalisilat tablet 100 mg (Asetosal) Tablet 0
32 Asam Askorbat (Vitamin C) tablet 250 mg Tablet 5855
33 Asam Askorbat (Vitamin C) tablet 50 mg Tablet 436
34 Asam Folat tablet 1 mg Tablet 0
35 Asam Mefenamat kapsul/kaplet 500 mg Kaplet 11673
36 Asiklovir krim 5% Tube 56
37 Asiklovir tablet 200 mg Tablet 113
38 Asiklovir tablet 400 mg Tablet 483
39 Aspilet tablet 80 mg Tablet 0
40 Atapulgit tablet 630 mg Tablet 618
41 Atenolol tablet 50 mg Tablet 0
42 Atropin Sulfat injeksi 0,25 mg/ml-1 ml Ampul 20
43 Betametason krim 0,1 % (sebagai valerat) Tube 165
44 Bisakodil Supositoria 10 mg Supp 12
45 Bisakodil tablet 5 mg Tablet 134
46 Bisolvon sol Botol 3
47 Budesonid cairan inhalasi 0,25 mg/ml Ampul 24

48 Budesonid inhaler 200 mcg/puff Botol 2
49 Cairan Infus Dextrose 5%/0,225% Nacl Botol 307
50 Cairan Infus Dextrose 5%/0,45% Nacl Botol 273
51 Calsium AD Tablet Tablet 0
52 Combantrin tablet Tablet 0
53 Corobion tablet Tablet 0
54 Dasabion tablet ( multivitamin + Fe tablet ) Tablet 0
55 Deksametason injeksi i.v. 5 mg/ml- 1 ml Ampul 0
56 Deksametason tablet 0,5 mg Tablet 33
57 Diazepam injeksi 5 mg/ml- 2 ml Ampul 1578
58 Diazepam tablet 2 mg Tablet 49
59 Difenhidramin HCL injeksi i.m. 10 mg/ml- 1 ml Ampul 540
60 Digoksin tablet 0,25 mg Tablet 15
61 Diltiazem HCL tablet 30 mg Tablet 188
62 Dimenhidrinat tablet 50 mg Tablet 231
63 Doksisiklin kapsul 100 mg Kapsul 947
64 Domperidon suspensi 5 mg/5ml Botol 0
65 Domperidon tablet 10 mg Tablet 9
66 Efedrin HCL tablet 25 mg Tablet 222
67 Ekstrak Belladon tablet 10 mg Tablet 0
68 Epinefrine (Adrenalin) injeksi 0,1% (sebagai
Ampul 65
HCl)
69 Eritromisin kapsul/kaplet 500 mg Tablet 12
70 Eritromisin sirup 200 mg/5ml Botol 91
71 Etakridin (Rivanol) Larutan 0,1 % 300 ml Botol 0
72 Etanol 70 % Botol 0
73 Etanol 70 % 100 ml 0
74 Etanol 95% 1 liter Botol 2
75 Etil Klorida Semprot Botol 147
76 Fenitoin Natrium kapsul/kaplet 100 mg Kapsul 2
77 Fenitoin Natrium kapsul/kaplet 30 mg Kapsul 11
78 Fenobarbital tablet 30 mg Tablet 0
79 Fenoksimetil Penicilina tablet 500 mg Tablet 0
80 Fenol Gliserol tetes telinga 10% Botol 0
81 Fitomenadion(Vit K1) injeksi 10 %/ml-1 ml Ampul 0
82 Fitomenadion(Vit K1) tablet salut gula 10 mg Tablet 24
83 Furosemid tablet 40 mg Tablet 74
84 Garam Oralit untuk 200 ml air Sak 175
85 Gentamisin Inj. 80 mg/ml (Sulfat) Ampul 591
86 Gentamisin salep kulit 0,1% Tube 494
87 Gentian Violet larutan 1 % Botol 200
88 Glibenklamid tablet 5 mg Tablet 66
89 Glimepirid tablet 1 mg Tablet 50
90 Glimepirid tablet 2 mg Tablet 2147
91 Gliseril Guayakolat tablet 100 mg Tablet 1863
92 Glukose larutan infus 40% steril Botol 7328
93 Glukose larutan infus 5 % Steril Botol 8597
94 Griseofulvin forte tablet 500 mg Tablet 50
95 Griseofulvin tablet 125 mg micronized Tablet 58
96 Grotavit sirup Botol 259

97 Guanistrep suspensi Botol 260
98 Haloperidol tablet 0,5 mg Tablet 0
99 Haloperidol tablet 5 mg Tablet 19
100 Hand Wash (Sabun Cuci Tangan)/klorhexidin
Botol 587
4%/hydrex 0,5 ml
101 Hidroklortiazid (HCT) tablet 25 mg Tablet 354
102 Hidrokortison krim 2,5 % Tube 49
103 Hiosin-N-butilbromida injeksi Ampul 800
104 Hiosin-N-butilbromida tablet Tablet 60
105 Ibuprofen suspensi 200 mg/5 ml Botol 0
106 Ibuprofen tablet 200 mg Tablet 321
107 Ibuprofen tablet 400 mg Tablet 0
108 Ipratrium Br 0,5 m, salbutamol 2,5 mg/ 2,5 ml
Ampul 1432
Neb.
109 Isosorbid dinitrat tablet sublingual 5 mg Tablet 6856
110 Kalsium Glukonat Injeksi Ampul 0
111 Kalsium Laktat (Kalk) tablet 500 mg Tablet 315
112 Kaptopril tablet 12,5 mg Tablet 135
113 Kaptopril tablet 25 mg Tablet 4383
114 Kaptopril tablet 50 mg Tablet 1664
115 Karbamazepin tablet 200 mg Tablet 13327
116 Ketokonazol krim 2% 15 gr Tube 0
117 Ketokonazol krim 2% 5 gr Tube 34
118 Ketokonazol tablet 200 mg Tablet 0
119 Klindamisin kapsul 150 mg Kapsul 0
120 Kloramfenikol injeksi 1 gr (Chlorbiotic inj) Vial 0
121 Kloramfenikol Kapsul/kaplet 250 mg Kapsul 80
122 Kloramfenikol Salep Mata 1 % Tube 0
123 Kloramfenikol suspensi 125 mg/5 ml Botol 2016
124 Kloramfenikol Tetes Mata Botol 0
125 Kloramfenikol Tetes Telinga 3 % Botol 70
126 Klorfeniramin Maleat ( CTM ) tablet 4 mg Tablet 78
127 Klorpromazin HCL tablet salut 100 mg Tablet 41
128 Klorpromazin HCL tablet salut 25 mg Tablet 24122
129 Kodein Fosfat tablet 10 mg Tablet 0
130 Kontrasepsi oral Linesterol tablet 0,5 mg Tablet 2683
131 Kotrimoksazol Doen I (dewasa) tablet Tablet 252
132 Kotrimoksazol suspensi kombinasi Botol 8
133 Lactulax sirup Botol 225
134 Laktulose sirup Botol 148
135 Lidokain HCl 2% injeksi Ampul 21
136 Lidokain injeksi 2% (HCl) + Epineprin 1:80.000-
Ampul 0
2 ml
137 Loperamide tablet 2 mg Tablet 0
138 Loratadin tablet 10 mg Tablet 0
139 Lotion kombinasi Difenhidramin 2% - Kalamin
Botol 60
5% - Zinc 10% - Gliserin 5%
140 Magnesium Sulfat injeksi (IV) 20%-25 ml Vial 167
141 Magnesium Sulfat injeksi (IV) 40%-25 ml Vial 854
142 Metamizol injeksi 500 mg/ml Ampul 7
143 Metampiron tablet 500 mg Tablet 0
144 Metformin HCl tablet 500 mg Tablet 62

145 Metformin HCl tablet 850 mg Tablet 31
146 Metilergometrin maleat injeksi 0,200 mg Ampul 0
147 Metilergometrin maleat tablet salut 0,125 mg Tablet 14583
148 Metilprednisolon tablet 4 mg Tablet 753
149 Metoklopramid Injeksi 5mg/ml Ampul 86
150 Metoklopramid tablet 10 mg Tablet 0
151 Metronidazol ovula 500 mg Supp 0
152 Metronidazol tablet 250 mg Tablet 39
153 Metronidazol tablet 500 mg Tablet 172
154 Mikonazol krim/salep 2% (nitrat) Tube 59
155 Multivitamin komb (antianemia) tablet
Kapsul 0
(novabion)
156 Multivitamin komb (neurotropik) tablet
Tablet 371
(Neurodex)
157 N-asetisistein kapsul 20 mg Kapsul 105
158 Natrium Bikarbonat tablet 500 mg Tablet 1895
159 Natrium Diklofenak tablet 25 mg Tablet 0
160 Natrium Diklofenak tablet 50 mg Tablet 120
161 Natrium Klorida larutan infus 0,9% steril Botol 0
162 Neo Kaominal sirup Botol 193
163 Neurovit E tablet Kaplet 464
164 Nifedipin tablet 10 mg Tablet 167
165 Nifedipin tablet oros 30 mg Tablet 0
166 Nistatin 100.000 UI/ml drop Botol 0
167 Nistatin tablet salut 500.000 IU/g Tablet 744
168 Nistatin tablet vaginal 100.000 IU/g Tablet 0
169 Obat Flu komb Sirup (Fludane) Botol 55
170 Obat Flu komb Tablet(Fludane) Tablet 0
171 Obat Batuk Hitam (OBH) cairan 100 ml Botol 123
172 Oksitetrasiklin HCL Salep kulit 3 % Tube 29
173 Oksitetrasiklin HCL salep mata 1% Tube 0
174 Oksitosin injeksi 10 IU/ ml- 1 ml Ampul 231
175 Omegdiar tablet Tablet 53
176 Omeprazol injeksi 20 mg 40mg/10 ml Vial 0
177 Omeprazol kapsul/kaplet 20 mg Kapsul 132
178 Parasetamol drop 100 mg/ml Botol 0
179 Parasetamol sirup 120 mg/ 5 ml Botol 0
180 Parasetamol tablet 500 mg Tablet 450
181 Perak Sulfadiazin krim 1% Tube 21
182 Permetrin Krim 5% (Scabimite) Tube 707
183 Pirantel Pamoat tablet 125 mg Tablet 16800
184 Piridoksin HCL tablet 10 mg Tablet 39
185 Piroksikam kapsul/kaplet/tablet 20 mg Kapsul 8
186 Povidon Iodida Larutan 10% 1000 ml Botol 77
189 Prednison tablet 5 mg Tablet 69
190 Propanolol HCL tablet 40 mg Tablet 2
191 Propiltiourasil tablet Tablet 16
192 Pseudoefedrin+tripolidin tablet Tablet 24
193 Ranitidin Injeksi 25 mg/2 ml Ampul 0

194 Ranitidin tablet 150 mg Tablet 140
195 Ringer Laktat larutan Infus steril Botol 0
196 SABU injeksi 5 ml Vial 0
197 Salbutamol tablet 2 mg (sebagai sulfat) Tablet 0
198 Salbutamol tablet 4 mg (sebagai sulfat) Tablet 104
199 Salep 2-4 kombinasi Pot 1765
200 Salisil Bedak 2 % Kotak 481
201 Scabicid krim Tube 0
202 Sefotaksim Injeksi 1 g Vial 1179
203 Seftriakson Injeksi 1 gr Vial 0
204 Serum Anti Tetanus inj. 1500 UI/vial amp (ATS) Ampul 38
205 Setirizine sirup 5 mg/5ml Botol 133
206 Setirizine tablet 10 mg Tablet 0
207 Sianokobalamin (vit. B12) tablet 50 mcg Tablet 62
208 Simetidin tablet 200 mg Tablet 38
209 Simvastatin tablet 10 mg Tablet 2
210 Simvastatin tablet 20 mg Tablet 15
211 Siprofloksasin tablet 500 mg (sebagai HCl) Tablet 248
212 Siprofloksasin tetes mata Botol 1233
213 Spironolakton tablet 100 mg Tablet 104
214 Spironolakton tablet 25 mg Tablet 0
215 Stesolid Rectal supp 5 mg Supp 51
216 Sulfasetamid Natrium tetes mata 15 % Botol 233
217 Tablet Tambah Darah Kombinasi Sachet 4
218 Terbutalin sulfat 0,5 mg - spray 100 dosis Botol 0
219 Terbutalin sulfat 2,5 mg/ml respules Ampul 0
220 Tetrakain Tetes Mata 0,5% Botol 12
221 Tetrasiklin HCL Kapsul/kaplet 250 mg Kapsul 0
222 Thrombo Aspilet tablet 80 mg Tablet 1025
223 Tiamin HCL (Vit B1) Inj. 100 mg/ml-1 ml Ampul 0
224 Tiamin HCL Mononitrat (Vitamin B1) Tablet 100
Tablet 19
mg
225 Trifluoperazin tablet 5 mg Tablet 0
226 Triheksifenidil Hidroklorida tablet 2 mg Tablet 0
227 Ventolin Nebulizer Ampul 0
228 Vit K Infant / Neo - K injeksi Ampul 0
229 Vitamin B Komplek Tablet Tablet 2888
230 Y-Rins cuci mata Botol 236
231 Zinc Drop 10mg/ml Botol 256
232 Zinc sirup 20 mg/5 ml Botol 70
233 Zinc tablet 20 mg Tablet 0
II. OBAT PROGRAM

1 Benzatin Benzil Penisilin injeksi Vial 0
2 Flukonazol kapsul 150 mg kapsul 7
3 Haloperidol inj 5mg/ml (Lodomer) Ampul 888
4 Klobazam tablet 10 mg (obat program jiwa) Tablet 0
5 Klozapin tablet 25 mg (obat program jiwa) Tablet 0
6 Kombipak azitrhromycin-cefixim Paket 0
7 Kotrimoksazol Forte tablet Kaplet 0

8 Larutan Zheil Nielson/BTA 100 ml Botol 0
9 Larutan Emersi Oil Botol 100
10 Larutan Eter alkohol Botol 0
11 Larutan Klorin / NaClO 5,25% (bayclin) Botol 0
12 Larutan KOH 10% Botol 0
13 Larutan Metilen Biru Botol 0
14 Larutan NaCl 0,9% 100 ml Botol 3
15 Larutan VDRL 10 ml Botol 1
Mineral Mix, kombinasi Pirimitamin tab 25 mg
16 Sachet 224
Sulfadoksin tablet 500 mg
17 Obat Antituberkulosis FDC Kategori Anak Paket 0
18 Obat Antituberkulosis FDC Kategori I Paket 0
19 Obat Antituberkulosis FDC Kategori II Paket 95
20 Procain Benzil Penisillin 3 juta IU/vial inj Vial 0
21 Ragen HIV/intec/II Sachet 0
22 Reagen HIV / oncoprobe / I Sachet 0
23 Reagen HIV / vikia / III Sachet 359
24 Reagen Shipilis / VDRL test (Syphillis device) Kotak 194
25 Retinol (Vitamin A) 100.000 IU kapsul lunak Kapsul 0
26 Retinol (Vitamin A) 200.000 IU kapsul lunak Kapsul 2303
27 Risperidon tablet 2 mg (obat program jiwa) Tablet 361
28 Speculum Vagina Biji 3
III. ALKES
1 Alat suntik sekali pakai 1 ml Biji 0
3 Alat suntik sekali pakai 2,5 ml Biji 0
6 Benang Cat Gut Chromic 2/0 Sachet 0
7 Benang Cat Gut Chromic 3/0 Sachet 0
8 Benang Cat Gut Plain 2/0 Sachet 115
9 Benang Cat Gut Plain 3/0 Sachet 200
10 Benang Silk/Side 2/0 Sachet 4285
11 Benang Silk/Side 3/0 Sachet 0
12 Blood Set Biji 2
13 Foley Catheter no. 14 Biji 570
14 Foley Catheter no. 16 Biji 0
15 Handscun Panjang Biji 185
16 Handscun non steril L Biji 885
17 Handscun non steril M Biji 137
18 Handscun non steril S Biji 233
19 Handscun steril 7 Pasang 0
20 Handscun steril 6,5 Pasang 55
21 Handscun steril 7,5 Pasang 266
22 Hansaplast Biji 215
23 Infusion set anak Set 70
24 Infusion set dewasa Set 100
25 IV Chateter 18 (Surflo 18) Biji 14

30 Jarum suntik 23 G Biji 0
31 Kapas Pembalut/ Adsorben 250 mg Biji 13
32 Kasa Hidrofil gulung Rol 12
33 Kasa Husada Steril 16x16 Kit 10
34 Kasa Pembalut 2 x 80 cm Biji 0
35 Kasa Pembalut Hidrofil 4 m x 15 cm Biji 2848
36 Masker Kain Biji 4
37 Masker O2 anak Buah 14
38 Masker O2 bayi Buah 80
39 Masker O2 dewasa Buah 0
40 Masker N95 Biji 0
41 Masker Tissue Biji 79
42 Nasal O2 ukuran M Biji 100
43 Nasal O2 ukuran S Biji 0
44 Plester 5 yard x 2 inch Rol 0
45 Silk (Benang Bedah Sutera) No. 3/0 Kotak 0
46 Scafel Handle Biji 0
47 Slim Suiqer Biji 0
48 Surgical Blade Biji 0
49 Surgical Needle Sak 0
50 Urin bag Biji 0
IV. OBAT GIGI

1 Air Raksa dental Botol 0
2 Alvogyl pasta Pot 0
3 Articulaying Paper Paket 0
4 Bonding Botol 0
5 Calsium Hidroxyd tube 0
6 Cotton Roll Gigi Dos 0
7 Devitalisasi Pasta (non Arsen) Botol 0
8 Etching Botol 0
9 Eugenol Cairan Botol 0
10 Glass Ionomer Cement (GC IX) Set 0
11 Iodoform Botol 0
12 Kaca Mulut Buah 0
13 Kalsium Hidroksida (CaOH2) tube 0
14 Komposit Resin Anterior A2 tube 0
15 Komposit Resin Anterior A3.5 tube 0
16 Komposit Resin Posterior QA3,5/A3 tube 0
17 Mata Boor Kotak 0
18 Mata Boor Frisure Besar Biji 0
19 Mata Boor Frisure Kecil Biji 0
20 Mata Boor Frisure Sedang Biji 0
21 Mata Boor Inverted Biji 0
22 Mata Boor Inverted Kecil Biji 0
23 Mata Boor Inverted Sedang Biji 0
24 Mata Boor Round Besar Biji 0

25 Mata Boor Round Sedang Biji 0
26 Mata Boor Tapper Besar Biji 0
27 Mata Boor Tapper Kecil Biji 0
28 Mata Boor Tapper Sedang Biji 0
29 Monoklorkamfer Mentol cairan (CHKM) Botol 0
30 Mumifying pasta Botol 0
31 Polikresulen 10 ml (Albothyl) Botol 0
32 Polising Amalgam Restoration Set 0
33 Root Canal Filling Buah 0
34 Semen Seng Fosfat serbuk dan cairan Set 0
35 Silver Amalgam Serbuk 65-75 % Botol 0
36 Spongostan Kotak 0
37 Surgical Blade / Mess no 11 Biji 0
38 Temporary Stopping Fletcher Cair Set 0
39 Temporary Stopping Fletcher Serbuk dan cairan Set 0
40 Trikresol Formalin (TKF) Cairan Botol 0
41 TSR Botol 0
42 Tumpatan sementara Botol 0
V. LABORATORIUM
1 Alkohol Swab Kotak 0
2 Alat Pemeriksaan Gula Darah Kit 0
3 Bilirubin Kit 0
4 Blood Lancet Kotak 0
5 Blue Tip Sak 0
6 Cover glass Kotak 0
7 Darah Kontrol Ampul 0
8 Diluent 20 ltr Galon 0
9 EDTA Cair 10% 100 mL Botol 0
10 ETA cair 10% 100ml Botol 0
11 Glucosa Enzimatik Trinder Kit 0
12 Gol. Darah A Vial 0
13 Gol. Darah AB Vial 0
14 Gol. Darah B Vial 0
15 Gol. Darah Rhesus Vial 0
16 H2O2 3% Botol 0
17 Hb-Cyanmet 1 liter Botol 0
18 Kartu Golongan Darah Kotak 0
19 Kertas Lensa Buah 0
20 Kotak slide Buah 0
21 M-18 E-cfd lyse 500ml Botol 0
22 M-18 E-Z cleaner Botol 0
23 M-18 R rinse Botol 0
24 M-18P probe cleanser Botol 0
25 Methilen Blue 0,3% Botol 0
26 Obyek Glass 72 Dos 0
27 Ose Buah 0
28 PH Paper Vagina Kotak 0
29 Pot Dahak Buah 0
30 Reagen Asam Urat Kit 0

31 Reagen Drabkin 1000ml Botol 0
32 Reagen Gula Darah Vial 0
33 Reagen Hbs Ag Kotak 0
34 Reagen Kolesterol HDL Kit 0
35 Reagen Kolesterol LDL Kit 0
36 Reagen Kolesterol Total Vial 0
37 Reagen Kreatinin Kit 0
38 Reagen Thypoid IgG/IgM+B383 Kotak 0
39 Reagen Trigliserida Kit 0
40 Reagen Urea Kit 0
Tahun 2017
NAMA OBAT JUMLAH
1 Parasetamol tablet 500 mg 105,591
Klorfeniramin Maleat ( CTM ) 180
2 tablet 4 mg 87,302
3 Vitamin B Komplek Tablet 64,350 126

Gliseril Guayakolat tablet 100
4 mg 46,396 228
Amoksisilin kapsul/kaplet 500 91
5 mg 43,971
Antasida Doen I tablet kunyah 12
6 kombinasi 42,543
7 Kaptopril tablet 25 mg 40,915 144

Tiamin HCL Mononitrat (Vitamin 113
8 B1) Tablet 100 mg 30,906
9 Amlodipin tablet 10 mg 22,983 18

10 Ibuprofen tablet 400 mg 22,725 107
Asam Mefenamat kapsul/kaplet
11 500 mg 19,546 184
Kalsium Laktat (Kalk) tablet 500 35
12 mg 19,240
13 Piridoksin HCL tablet 10 mg 18,685 111
14 Ibuprofen tablet 200 mg 16,656 223

15 Deksametason tablet 0,5 mg 15,536 9
16 Furosemid tablet 40 mg 13,981 101

17 Metformin HCl tablet 500 mg 11,676 10
Ranitidin tablet 150 mg 10,723 156

18
19 Glimepirid tablet 2 mg 10,094 90
Asam Askorbat (Vitamin C) 194
20 tablet 250 mg 8,816
21 Glibenklamid tablet 5 mg 8,425 216

Salbutamol tablet 2 mg 106
22 (sebagai sulfat) 7,895
23 Amlodipin tablet 5 mg 6,474 5
Tablet Tambah Darah 155
6,428
Kombinasi
24
25 Kaptopril tablet 12,5 mg 5,615 88
26 Metformin HCl tablet 850 mg 5,350 56

Siprofloksasin tablet 500 mg 164
27 (sebagai HCl) 4,531
28 Atapulgit tablet 630 mg 4,471 32

29 Calsium AD Tablet 4,230 165
Amoksisilin kapsul/kaplet 250 112
30 mg 4,164
Sianokobalamin (vit. B12) tablet 197
31 50 mcg 3,901
Kotrimoksazol Doen I (dewasa) 11

32 tablet 3,853
Kloramfenikol Kapsul/kaplet 40
33 250 mg 3,751
Natrium Diklofenak tablet 50
34 mg 3,507 84
Asam Askorbat (Vitamin C) 33
35 tablet 50 mg 3,262
36 Ringer Laktat larutan Infus steril 3,260 160
37 Asam Folat tablet 1 mg 3,245 62
Hidroklortiazid (HCT) tablet 25 121
38 mg 3,063
Multivitamin komb (antianemia) 195
39 tablet (novabion) 3,015
40 Trifluoperazin tablet 5 mg 2,985 179

41 Dimenhidrinat tablet 50 mg 2,929 34
42 Garam Oralit untuk 200 ml air 2,811 83
Multivitamin komb (neurotropik) 145
2,779
tablet (Neurodex)
43
Klorpromazin HCL tablet salut 129
44 100 mg 2,626
45 Ekstrak Belladon tablet 10 mg 2,587 131
46 Parasetamol sirup 120 mg/ 5 ml 2,546 95
47 Digoksin tablet 0,25 mg 2,380 225

48 Simvastatin tablet 10 mg 2,236 224
Griseofulvin tablet 125 mg 127
49 2,017
micronized
50 Zinc tablet 20 mg 1964 232
51 Ambroksol tablet 30 mg 1,896 153
52 Metoklopramid tablet 10 mg 1,891 89
53 Haloperidol tablet 0,5 mg 1,850 67

Isosorbid dinitrat tablet 211
54 sublingual 5 mg 1,827
55 Ranitidin Injeksi 25 mg/2 ml 1,672 109

56 Simetidin tablet 200 mg 1,672 193
57 Omeprazol kapsul/kaplet 20 mg 1,477 98

58 Metronidazol tablet 500 mg 1,418 202
59 Nifedipin tablet 10 mg 1,292 60
60 Asiklovir tablet 400 mg 1,139 206
61 Alopurinol tablet 300 mg 1,126 171

Amoksisilin sirup kering 125 177
62 mg/5 ml 1,125
63 Kodein Fosfat tablet 10 mg 1,120 128

Amitriptilin HCL tablet salut 25 170
64 mg 1,113
Obat Batuk Hitam (OBH) cairan 148
65 100 ml 900
66 Metronidazol tablet 250 mg 877 65
Eritromisin kapsul/kaplet 500 19
67 mg 875
68 Prednison tablet 5 mg 867 13

69 Alopurinol tablet 100 mg 833 209
70 mg 830 38
Ampisilin serbuk injeksi i.m/i.v. 150
71 500 mg 756
72 Diazepam tablet 2 mg 727 31

73 Antasida Doen II suspensi 704 213
Asam Asetilsalisilat tablet 100 189
74 mg (Asetosal) 695
Klorpromazin HCL tablet salut 99

75 25 mg 693
76 Loratadin tablet 10 mg 678 50
77 Glimepirid tablet 1 mg 645 152
78 Haloperidol tablet 5 mg 631 8

Salbutamol tablet 4 mg 192
79 (sebagai sulfat) 612
Aqua Pro Injeksi steril, bebas
80 pirogen 572 2
Piroksikam kapsul/kaplet/tablet 26
81 20 mg 548
82 Ventolin Nebulizer 515 208
Ampisilin Serbuk injeksi 159
83 i.m/i.v.1000 mg 510
Dasabion tablet ( multivitamin + 43
84 Fe tablet ) 500
Betametason krim 0,1 % 49

85 (sebagai valerat) 495
86 Sefotaksim Injeksi 1 g 491 161
87 Simvastatin tablet 20 mg 474 69

88 Setirizine tablet 10 mg 470 7
Kotrimoksazol suspensi 158
89 kombinasi 446
90 Spironolakton tablet 25 mg 434 58
Triheksifenidil Hidroklorida 20
91 tablet 2 mg 415
Deksametason injeksi i.v. 5 82

92 mg/ml- 1 ml 406
93 Diltiazem HCL tablet 30 mg 389 207

94 Hidrokortison krim 2,5 % 388 226
95 Asiklovir tablet 200 mg 348 73
96 Aminofilin tablet 200 mg 343 138
Fitomenadion(Vit K1) tablet 132
97 salut gula 10 mg 337
98 Glukose larutan infus 5 % Steril 315 51

99 Salisil Bedak 2 % 309 3
Lidokain injeksi 2% (HCl) + 200
100 Epineprin 1:80.000-2 ml 303
101 Metoklopramid Injeksi 5mg/ml 301 198
102 Mikonazol krim/salep 2% (nitrat) 266 55

Cairan Infus Dextrose
103 5%/0,225% Nacl 252 93
Pseudoefedrin+tripolidin tablet 102
104 Alfered) 252
Kloramfenikol injeksi 1 gr 185
105 (Chlorbiotic inj) 231
Antibakteri Doen Salep 137
106 Kombinasi 230
Cairan Infus Dextrose 157

107 5%/0,45% Nacl 212
108 Domperidon tablet 10 mg 200 135
Natrium Klorida larutan infus 215
109 0,9% steril 192
110 Antrain injeksi 186 87
111 Efedrin HCL tablet 25 mg 174 154

Sulfasetamid Natrium tetes 110
112 mata 15 % 156
113 Gentian Violet larutan 1 % 148 29

Obat Batuk Flu komb 149
114 Tablet(Fludane) 144
Amoksisilin sirup kering forte 86
115 250 mg/5 ml 140
116 Grotavit sirup 133 140

117 Nifedipin tablet oros 30 mg 124 210
118 Oksitosin injeksi 10 IU/ ml- 1 ml 120 37
119 Asiklovir krim 5% 119 142
120 Gentamisin salep kulit 0,1% 119 120
121 Albendazol tablet 400 mg 105 115

122 Antihemoroid Doen kombinasi 103 45
123 Kloramfenikol Tetes Telinga 3 % 95 174
124 Guanistrep suspensi 94 23

125 Salep 2-4 kombinasi 88 36
Oksitetrasiklin HCL salep mata 97
126 1% 84
127 Metamizol injeksi 500 mg/ml 82 173
128 Parasetamol drop 100 mg/ml 79 136

Oksitetrasiklin HCL Salep kulit 3 147
129 % 77
130 Eritromisin sirup 200 mg/5ml 73 94

131 Ketokonazol krim 2% 5 gr 70 119
Fitomenadion(Vit K1) injeksi 10 169
132 %/ml-1 ml 64
133 Lidokain HCl 2% injeksi 63 199
134 Bisakodil tablet 5 mg 62 178
135 Hiosin-N-butilbromida injeksi 61 168

Aminofilin injeksi 24 mg/ml-10 125
136 ml 60
137 mg (Asetosal) 55
138 Kloramfenikol Salep Mata 1 % 45 70

Kloramfenikol suspensi 125 14
139 mg/5 ml 45
140 Etanol 70 % 37 1
141 Domperidon suspensi 5 mg/5ml 36 124

142 Kloramfenikol Tetes Mata 34 104
Natrium Bikarbonat tablet 500
143 mg 31 166
144 Stesolid Rectal supp 5 mg 31 66
Etanol 70 % 100 ml 30 100

145
146 Metronidazol ovula 500 mg 27 172

147 Bisakodil supp 5 mg 23 4
148 Permetrin Krim 5% (Scabimite) 20 6

149 Zinc sirup 20 mg/5 ml 20 117
Metilergometrin maleat injeksi 44
150 0,200 mg 19
Obat Batuk Flu komb Sirup 203

151 (Fludane) 17
152 Omegdiar tablet 17 64

Povidon Iodida Larutan 10% 30 103
153 ml 16
154 Nistatin drop 15 81
155 Antimigrain Doen kombinasi 12 123
156 Propanolol HCL tablet 40 mg 12 182

157 Setirizine sirup 5 mg/5ml 12 151
158 Zinc Drop 10mg/ml 10 231
159 Aquasonic Gell 9 61
160 Etil Klorida Semprot 9 122
161 Perak Sulfadiazin krim 1% 9 187

162 Y-Rins cuci mata 9 75
163 Ambroksol sirup 8 214
Ibuprofen suspensi 200 mg/5 230
164 ml 8
Epinefrine (Adrenalin) injeksi 105
165 0,1% (sebagai HCl) 7

Tangan)/klorhexidin 4%/hydrex 6 205
166 0,5 ml
Magnesium Sulfat injeksi (IV) 146
167 40%-25 ml 6
168 Diazepam injeksi 5 mg/ml- 2 ml 5 130
Povidon Iodida Larutan 10% 139

5
300 ml
169
170 Lactulax sirup 4 143
Magnesium Sulfat injeksi (IV) 28
171 20%-25 ml 4
172 Bisolvon sol 3 141
173 Tetrakain Tetes Mata 0,5% 3 57

Omeprazol injeksi 20 mg 133
174 40mg/10 ml 2
Povidon Iodida Larutan 10% 16

175 1000 ml 1
176 Scabicid krim 1 176
177 Antidiare tablet (kaolin+pektin) 0 42
178 Antifungi Doen kombinasi 0 186

179 Aquadest steril 0 72
180 mg (Asetosal) 0
181 Aspilet tablet 80 mg 0 181
182 Atenolol tablet 50 mg 0 15
Atropin Sulfat injeksi 0,25 24
183 mg/ml-1 ml 0
184 Combantrin tablet 0 46
185 Corobion tablet 0 68

Difenhidramin HCL injeksi i.m. 92
186 10 mg/ml- 1 ml 0
187 Doksisiklin kapsul 100 mg 0
Etakridin (Rivanol) Larutan 0,1
188 % 300 ml 0 21
189 Etanol 95% 1 liter 0 22
Fenitoin Natrium kapsul/kaplet 25
190 100 mg 0
Fenitoin Natrium kapsul/kaplet 27
191 30 mg 0
192 Fenobarbital tablet 30 mg 0 30

Fenoksimetil Penicilina tablet 39
193 500 mg 0
194 Fenol Gliserol tetes telinga 10% 0 41

Gentamisin Inj. 80 mg/ml 47
195 (Sulfat) 0
196 Glukose larutan infus 40% steril 0 48
Ipratrium Br 0,5 m, salbutamol 52

0
2,5 mg/ 2,5 ml Neb.
197
198 Kalsium Glukonat Injeksi 0 53
199 Kaptopril tablet 50 mg 0 54
200 Karbamazepin tablet 200 mg 0 59

201 Ketokonazol krim 2% 15 gr 0 63
202 Ketokonazol tablet 200 mg 0 71
203 Laktulose sirup 0 76
204 Metampiron tablet 500 mg 0 77

Metilergometrin maleat tablet
205 salut 0,125 mg 0 78
206 Neo Kaominal sirup 0 79
207 Neurovit E tablet 0 80

Nistatin tablet salut 500.000 85
208 IU/g 0
Nistatin tablet vaginal 100.000 96

209 IU/g 0
Pirantel Pamoat tablet 125 mg 0 108

210
211 Propiltiourasil tablet 0 114
212 SABU injeksi 5 ml 0 116
213 Seftriakson Injeksi 1 gr 0 118
214 Spironolakton tablet 100 mg 0 134
Tetrasiklin HCL Kapsul/kaplet 162
215 0
250 mg
216 Thrombo Aspilet tablet 80 mg 0 163
Tiamin HCL (Vit B1) Inj. 100 167
217 0
mg/ml-1 ml
218 Vit K Infant / Neo - K injeksi 0 175
183
188
190
191
196
201
204
212
217
218
219
220
221
222
227
229
Tahun 2017
Nama Obat Jumlah

Parasetamol tablet 500 mg 32687
Klorfeniramin Maleat ( CTM )
tablet 4 mg 72702
Vitamin B Komplek Tablet 105260
Gliseril Guayakolat tablet 100
mg 16766
Amoksisilin kapsul/kaplet 500
mg 35373
Metformin HCl tablet 500 mg 243
Kaptopril tablet 25 mg 2602
Antasida Doen I tablet
kunyah kombinasi 48744
Ibuprofen tablet 400 mg 31
Piridoksin HCL tablet 10 mg 797
Asam Mefenamat PEMAKAIAN OBAT TERBANYAK TAHUN
kapsul/kaplet 500 mg 7513
Kalsium Laktat (Kalk) tablet
500 mg 1214 150000
Tiamin HCL Mononitrat 100000
(Vitamin B1) Tablet 100 mg 1 50000
Amlodipin tablet 10 mg 33879 0
Hidroklortiazid (HCT) tablet
25 mg 1003 Jum
Amlodipin tablet 5 mg 12399

Multivitamin komb
(neurotropik) tablet
(Neurodex) 1428
Glimepirid tablet 2 mg 8037
Ranitidin tablet 150 mg 170
Tablet Tambah Darah
Kombinasi 15
Ibuprofen tablet 200 mg 999
Ambroksol tablet 30 mg 6009
Multivitamin komb
(antianemia) tablet
(novabion) 578
Glibenklamid tablet 5 mg 295
Deksametason tablet 0,5 mg 268
Nifedipin tablet 10 mg 419
Asam Askorbat (Vitamin C)
tablet 250 mg 954
Nifedipin tablet oros 30 mg 0
Kaptopril tablet 12,5 mg 0
Salbutamol tablet 2 mg
(sebagai sulfat) 0
Amoksisilin kapsul/kaplet 250
mg 3823
Atapulgit tablet 630 mg 3398
Garam Oralit untuk 200 ml air 493
Asam Askorbat (Vitamin C)
tablet 50 mg 4313
mg 320
Dimenhidrinat tablet 50 mg 40
Kloramfenikol Kapsul/kaplet
250 mg 304
Ringer Laktat larutan Infus
steril 0
Parasetamol sirup 120 mg/ 5
ml 0
Asam Folat tablet 1 mg 2263
Furosemid tablet 40 mg 76
Metformin HCl tablet 850 mg

78
Kodein Fosfat tablet 10 mg 1053
Kotrimoksazol Doen I
(dewasa) tablet 1678
Griseofulvin tablet 125 mg
micronized 277
Triheksifenidil Hidroklorida
tablet 2 mg 0
Trifluoperazin tablet 5 mg 2
Klorpromazin HCL tablet
salut 100 mg 59
Zinc tablet 20 mg 0
Metronidazol tablet 500 mg 201
Glimepirid tablet 1 mg 197
Ekstrak Belladon tablet 10
mg 377
Siprofloksasin tablet 500 mg
(sebagai HCl) 290
Isosorbid dinitrat tablet
sublingual 5 mg 86518
Ranitidin Injeksi 25 mg/2 ml 1020
Haloperidol tablet 0,5 mg 0
Sefotaksim Injeksi 1 g 5821
Digoksin tablet 0,25 mg 0
Setirizine tablet 10 mg 0
Obat Batuk Hitam (OBH)
cairan 100 ml 17
Omeprazol kapsul/kaplet 20
mg 136
Klorpromazin HCL tablet
salut 25 mg 72702
Obat Flu komb
Tablet(Fludane) 0
Metilprednisolon tablet 4 mg 554
Domperidon tablet 10 mg 46
Antasida Doen II suspensi 27
Amoksisilin sirup kering 125
mg/5 ml 487
Simvastatin tablet 10 mg 0
Asiklovir tablet 400 mg 1147
Metoklopramid tablet 10 mg 0
Asam Asetilsalisilat tablet 80
mg (Asetosal) 347
Spironolakton tablet 25 mg 457
Prednison tablet 5 mg 238
Haloperidol tablet 5 mg 112
5%/0,45% Nacl 724
Metronidazol tablet 250 mg 110
Amitriptilin HCL tablet salut
25 mg 429
Pseudoefedrin+tripolidin
tablet 0
Alopurinol tablet 100 mg 294
Aqua Pro Injeksi steril, bebas
pirogen 1018
Simetidin tablet 200 mg 114
mg 4049
Betametason krim 0,1 %
(sebagai valerat) 835
5%/0,225% Nacl 1205
Natrium Klorida larutan infus
0,9% steril 0
Eritromisin kapsul/kaplet 500
mg 3
Aminofilin tablet 200 mg 10
Natrium Bikarbonat tablet
500 mg 9534
Diazepam tablet 2 mg 18
Antibakteri Doen Salep
Kombinasi 63
Fitomenadion(Vit K1) tablet
salut gula 10 mg 0
Sianokobalamin (vit. B12)
tablet 50 mcg 291
Ventolin Nebulizer 0
Etanol 70 % 100 ml 0
Loratadin tablet 10 mg 0
Kotrimoksazol suspensi
kombinasi 46
Calsium AD Tablet 0
Alopurinol tablet 300 mg 371
Salisil Bedak 2 % 2520
Salbutamol tablet 4 mg
(sebagai sulfat) 496
Deksametason injeksi i.v. 5
mg/ml- 1 ml 0
Glukose larutan infus 5 %
Steril 50453
Hidrokortison krim 2,5 % 95
Piroksikam
kapsul/kaplet/tablet 20 mg 4
Loperamide tablet 2 mg 0
N-asetisistein kapsul 20 mg 326
Lidokain HCl 2% injeksi 59
Sulfasetamid Natrium tetes
mata 15 % 2086
Gentian Violet larutan 1 % 0
Mikonazol krim/salep 2%
(nitrat) 7
Kalsium Glukonat Injeksi 0
mg (Asetosal) 0
Metoklopramid Injeksi
5mg/ml 13
Gentamisin salep kulit 0,1% 4150
Magnesium Sulfat injeksi (IV)
20%-25 ml 113
Simvastatin tablet 20 mg 22
Asiklovir tablet 200 mg 166
Metamizol injeksi 500 mg/ml 10
Kloramfenikol injeksi 1 gr
(Chlorbiotic inj) 0
Karbamazepin tablet 200 mg 21561
Bisakodil tablet 5 mg 223
Oksitosin injeksi 10 IU/ ml- 1
ml 963
Antihemoroid Doen
kombinasi 241
Asiklovir krim 5% 99
Guanistrep suspensi 409
Oksitetrasiklin HCL salep
mata 1% 895
Lidokain injeksi 2% (HCl) +
Epineprin 1:80.000-2 ml 2
Metilergometrin maleat tablet
salut 0,125 mg 56125
Griseofulvin forte tablet 500
mg 4
Klindamisin kapsul 150 mg 0
Obat Flu komb Sirup
(Fludane) 47
Salep 2-4 kombinasi 12370
Parasetamol drop 100 mg/ml 0
Nistatin tablet vaginal
100.000 IU/g 90
Kloramfenikol Tetes Telinga 3
% 33
Ampisilin Serbuk injeksi
i.m/i.v.1000 mg 1504
Eritromisin sirup 200 mg/5ml 9
Amoksisilin sirup kering forte
250 mg/5 ml 447
Albendazol tablet 400 mg 40
Kloramfenikol Tetes Mata 0
Hiosin-N-butilbromida tablet 332
Nistatin 100.000 UI/ml drop 0
Efedrin HCL tablet 25 mg 1812
Tangan)/klorhexidin
4%/hydrex 0,5 ml 4158
Oksitetrasiklin HCL Salep
kulit 3 % 108
Ambroksol sirup 51
Aminofilin injeksi 24 mg/ml-
10 ml 10
Ketokonazol krim 2% 5 gr 16
Bisakodil supp 5 mg 8
Seftriakson Injeksi 1 gr 0
Domperidon suspensi 5
mg/5ml 0
Hiosin-N-butilbromida injeksi 9598
Fitomenadion(Vit K1) injeksi
10 %/ml-1 ml 0
Kloramfenikol suspensi 125
mg/5 ml 3410
Permetrin Krim 5%
(Scabimite) 3399
Metronidazol ovula 500 mg 849
Zinc sirup 20 mg/5 ml 729
Diltiazem HCL tablet 30 mg 764
Kloramfenikol Salep Mata 1
% 0
Povidon Iodida Larutan 10%
30 ml 0
Etil Klorida Semprot 258
Stesolid Rectal supp 5 mg 211
Zinc Drop 10mg/ml 3087
Ibuprofen suspensi 200 mg/5
ml 56
Setirizine sirup 5 mg/5ml

358
Metilergometrin maleat
injeksi 0,200 mg 990
Kontrasepsi oral Linesterol
tablet 0,5 mg 7217
Lotion kombinasi
Difenhidramin 2% - Kalamin
5% - Zinc 10% - Gliserin 5%
0
Metampiron tablet 500 mg 0
Aquasonic Gell 10
Magnesium Sulfat injeksi (IV)
40%-25 ml 1414
Diazepam injeksi 5 mg/ml- 2
ml 5422
Lactulax sirup 556
Ampisilin serbuk injeksi
i.m/i.v. 500 mg 1501
Omeprazol injeksi 20 mg
40mg/10 ml 149
Atropin Sulfat injeksi 0,25
mg/ml-1 ml 10
1000 ml 87
Etanol 70 % 35
Etanol 95% 1 liter 3
Perak Sulfadiazin krim 1% 87
Amoksisilin drop 100 mg/ml 53
Antimigrain Doen kombinasi 197
Bisolvon sol 1
Epinefrine (Adrenalin) injeksi
0,1% (sebagai HCl) 235
Glukose larutan infus 40%
steril 9043
Siprofloksasin tetes mata 2483
Antidiare tablet
(kaolin+pektin) 0
Antifungi Doen kombinasi 0
Antrain injeksi 0
Aquadest steril 0
mg (Asetosal) 0
Aspilet tablet 80 mg 0
Atenolol tablet 50 mg 72
Budesonid cairan inhalasi
0,25 mg/ml 6
Budesonid inhaler 200
mcg/puff 5
Combantrin tablet
10
Corobion tablet 0
Dasabion tablet ( multivitamin
+ Fe tablet ) 0
Difenhidramin HCL injeksi
i.m. 10 mg/ml- 1 ml 1068
Doksisiklin kapsul 100 mg 3407
Etakridin (Rivanol) Larutan
0,1 % 300 ml 202
Fenitoin Natrium
Fenitoin Natrium
Fenobarbital tablet 30 mg 0
Fenoksimetil Penicilina tablet
500 mg 0
Fenol Gliserol tetes telinga
10% 0
Gentamisin Inj. 80 mg/ml
(Sulfat) 2802
Grotavit sirup 471
Ipratrium Br 0,5 m,
salbutamol 2,5 mg/ 2,5 ml
Neb. 6823
Kaptopril tablet 50 mg 22480
Ketokonazol krim 2% 15 gr 3000
Ketokonazol tablet 200 mg 0
Laktulose sirup 298
Neo Kaominal sirup 2333
Neurovit E tablet 2580
Nistatin tablet salut 500.000
IU/g 6043
Omegdiar tablet 325
Pirantel Pamoat tablet 125
mg 32687
300 ml 21397
Propanolol HCL tablet 40 mg 3
Propiltiourasil tablet 25
SABU injeksi 5 ml 500
Scabicid krim 0
Serum Anti Tetanus inj. 1500
UI/vial amp (ATS) 48
Spironolakton tablet 100 mg 1215
Terbutalin sulfat 0,5 mg -
spray 100 dosis 0
Terbutalin sulfat 2,5 mg/ml
respules 245
Tetrakain Tetes Mata 0,5% 25
Tetrasiklin HCL Kapsul/kaplet
250 mg 6
Thrombo Aspilet tablet 80 mg 28267
Tiamin HCL (Vit B1) Inj. 100
mg/ml-1 ml 2
Vit K Infant / Neo - K injeksi 0
Y-Rins cuci mata 1469
ERBANYAK TAHUN 2016
Jumlah
USULAN FARMASI
Belanja Obat 35,859,500.00

Antasida Doen II suspensi 300 Botol 2,160.00 648,000.00
Kalsium Laktat (Kalk) tablet 500 mg 5000 Tablet 70.00 350,000.00
Kloramfenikol injeksi 1 gr (Chlorbiotic inj) 2000 Vial 9,050.00 18,100,000.00
Kloramfenikol Tetes Mata 100 Botol 8,998.00 899,800.00
Kloramfenikol Tetes Telinga 3 % 200 Botol 1,837.00 367,400.00
Ranitidin Injeksi 25 mg/2 ml 2500 Ampul 1,140.00 2,850,000.00
Sefotaksim Injeksi 1 g 2500 Vial 4,898.00 12,245,000.00
Sulfasetamid Natrium tetes mata 15 % 100 Botol 3,993.00 399,300.00
Obat Gigi 1,821,690.00

Temporary Stopping Fletcher Serbuk 4 Set 79,420.00 317,680.00
Temporary Stopping Fletcher cairan 4 Set 86,630.00 346,520.00
Devitalisasi Pasta (non Arsen) 2 Botol 448,800.00 897,600.00
Eugenol Cairan 3 Botol 86,630.00 259,890.00
Belanja Bahan Laboratorium 28,422,000.00

Gol. Darah A 3 Vial 100,000.00 300,000.00
Gol. Darah AB 3 Vial 102,000.00 306,000.00
Gol. Darah B 3 Vial 100,000.00 300,000.00
Gol. Darah Rhesus 3 Vial 126,000.00 378,000.00
Reagen Kolesterol HDL 3 Kit 1,230,000.00 3,690,000.00
Reagen Thypoid IgG/IgM+B383 6 Kotak 1,900,000.00 11,400,000.00
Reagen Trigliserida 2 Kit 1,720,000.00 3,440,000.00
Reagent SGOT 4x20 UV Kinetik (IFCC) 2 Kit 875,000.00 1,750,000.00
Reagent SGPT 4x20 UV Kinetik (IFCC) 2 Kit 900,000.00 1,800,000.00
Serum Kontrol 3 Vial 600,000.00 1,800,000.00
Tabung Vacuntainer EDTA (tutup merah) 12 Kotak 165,000.00 1,980,000.00
Urinalisis Strip 2 Parameter 5 Tube 150,000.00 750,000.00
Yellow Tip 2 Sak 264,000.00 528,000.00
Belanja Penunjang alkes 2,400,000.00

Masker untuk Nebulizer anak 10 Buah 70,000.00 700,000.00
Masker untuk Nebulizer dewasa 20 Buah 85,000.00 1,700,000.00
Januari Pebruari
STOK
NO NAMA OBAT SATUAN AWAL
masuk keluar sisa masuk keluar sisa
I. OBAT
1 Albendazol tablet 400 mg Tablet 170 1 169 169
2 Alopurinol tablet 100 mg Tablet 244 244 20 224
3 Alopurinol tablet 300 mg Tablet 106 58 48 200 44 204
4 Ambroksol sirup Botol 39 1 38 3 35
5 Ambroksol tablet 30 mg Tablet 1,351 557 794 900 377 1,317
6 Aminofilin injeksi 24 mg/ml-10 ml Ampul 13 13 13
7 Aminofilin tablet 200 mg Tablet 70 70 10 60
8 Amitriptilin HCL tablet salut 25 mg Tablet 216 54 162 44 118
9 Amlodipin tablet 10 mg Tablet 8,593 3,003 5,590 7,920 2,355 11,155
10 Amlodipin tablet 5 mg Tablet 4,270 496 3,774 610 3,164
11 Amoksisilin kapsul/kaplet 250 mg Kapsul 980 596 384 1,400 472 1,312
12 Amoksisilin kapsul/kaplet 500 mg Kaplet 6,800 9,600 4,312 12,088 900 3,633 9,355
13 Amoksisilin sirup kering 125 mg/5 Botol 170 60 85 145 120 105 160
ml
14 Amoksisilin sirup kering forte 250 3 4 23 9 14
Botol 24
mg/5 ml
15 Amoksisilin drop 100 mg/ml Botol 21 1 20 2 18
16 Ampisilin serbuk injeksi i.m/i.v. 500 100 167 84 300 194 190
Ampul 151
mg
17 Ampisilin Serbuk injeksi 200 167 157 300 211 246
Ampul 124
i.m/i.v.1000 mg
18 Antasida Doen I tablet kunyah 4,564 6,320 7,000 3,923 9,397
Tablet 10,884
kombinasi
19 Antasida Doen II suspensi Botol 0 0 0
20 Antibakteri Doen Salep Kombinasi Tube 52 37 15 4 11
21 Antidiare tablet (kaolin+pektin) Tablet 0 0 0
22 Antifungi Doen kombinasi Pot 0 0 0
23 Antihemoroid Doen kombinasi Supp 38 100 33 105 105
24 Antimigrain Doen kombinasi Tablet 97 40 57 16 41
25 Antrain injeksi Ampul 0 0 0
26 Aqua Pro Injeksi steril, bebas 453 71 440 94 346
Vial 58
pirogen
27 Aquadest steril Botol 0 0 0
28 Aquasonic Gell Botol 5 2 3 3 0
29 Asam Asetilsalisilat tablet 100 mg 0 0
Tablet 0
(Asetosal)
30 Asam Asetilsalisilat tablet 500 mg Tablet 0 0 0
(Asetosal)
31 Asam Asetilsalisilat tablet 80 mg 117 97 300 397
Tablet 214
(Asetosal)
32 Asam Askorbat (Vitamin C) tablet 9 9 0
Tablet 9
250 mg
33 Asam Askorbat (Vitamin C) tablet
50 mg
Tablet 1,549 1,000 1,367 1,182 1,000 897 1,285
34 Asam Folat tablet 1 mg Tablet 563 500 333 730 300 300 730
35 Asam Mefenamat kapsul/kaplet 1,786 100 1,000 118 982
Kaplet 1,886
500 mg
36 Asiklovir krim 5% Tube 56 8 48 13 35
37 Asiklovir tablet 200 mg Tablet 79 79 79
38 Asiklovir tablet 400 mg Tablet 280 60 220 101 119
39 Aspilet tablet 80 mg Tablet 0 0 0
40 Atapulgit tablet 630 mg Tablet 816 282 534 300 259 575
41 Atenolol tablet 50 mg Tablet 72 72 72
42 Atropin Sulfat injeksi 0,25 mg/ml-1 0 0
Ampul 0
ml
43 Betametason krim 0,1 % (sebagai 50 88 112 150 69 193
Tube 150
valerat)
44 Bisakodil Supositoria 10 mg Supp 0 0 0
45 Bisakodil tablet 5 mg Tablet 57 100 39 118 4 114
46 Bisolvon sol Botol 2 1 1 2 3
47 Budesonid cairan inhalasi 0,25 20 20
Ampul 20
mg/ml
48 Budesonid inhaler 200 mcg/puff Botol 3 3 3
49 Cairan Infus Dextrose 5%/0,225% 90 102 180 135 147
Botol 192
Nacl
50 Cairan Infus Dextrose 5%/0,45% 125 132 87 45
Botol 257
Nacl
51 Calsium AD Tablet Tablet 0 0 0
52 Cendo Lyteers Botol 0 0 0
53 Combantrin tablet Tablet 0 0 0
54 Corobion tablet Tablet 0 0 0
55 Dasabion tablet ( multivitamin + 0 0
Tablet 0
Fe tablet )
Deksametason injeksi i.v. 5 mg/ml-
56 Ampul 101 24 77 16 61
1 ml
57 Deksametason tablet 0,5 mg Tablet 400 700 182 918 440 478
58 Diazepam injeksi 5 mg/ml- 2 ml Ampul 17 17 2 15
59 Diazepam tablet 2 mg Tablet 108 45 63 100 114 49
Difenhidramin HCL injeksi i.m. 10
60 Ampul 0 0 0
mg/ml- 1 ml
61 Digoksin tablet 0,25 mg Tablet 252 118 134 200 91 243
62 Diltiazem HCL tablet 30 mg Tablet 271 271 271
63 Dimenhidrinat tablet 50 mg Tablet 954 100 329 725 300 418 607
64 Doksisiklin kapsul 100 mg Kapsul 0 0 0
65 Domperidon suspensi 5 mg/5ml Botol 36 4 32 5 27
66 Domperidon tablet 10 mg Tablet 934 175 759 152 607
67 Efedrin HCL tablet 25 mg Tablet 377 377 377
68 Ekstrak Belladon tablet 10 mg Tablet 0 0 0
69 Epinefrine (Adrenalin) injeksi Ampul 0 5 5 5
0,1% (sebagai HCl)
70 Eritromisin kapsul/kaplet 500 mg Tablet 0 0 100 100
71 Eritromisin kapsul/kaplet 500 mg Tablet 202 72 130 60 70

72 Eritromisin sirup 200 mg/5ml Botol 35 2 33 10 23
73 Etakridin (Rivanol) Larutan 0,1 % Botol 0 0 0
300 ml
74 Etanol 70 % Botol 4 1 3 1 2
75 Etanol 70 % 100 ml 104 48 56 100 11 145
76 Etanol 95% 1 liter Botol 7 7 7
77 Etil Klorida Semprot Botol 11 11 11
78 Fenitoin Natrium kapsul/kaplet 100 0 0
Kapsul 0
mg
79 Fenitoin Natrium kapsul/kaplet 30 0 0
Kapsul 0
mg
80 Fenobarbital tablet 30 mg Tablet 0 0 0
81 Fenoksimetil Penicilina tablet 500 0 0
Tablet 0
mg
82 Fenol Gliserol tetes telinga 10% Botol 0 0 0
83 Fitomenadion(Vit K1) injeksi 10 3 12 4 8
Ampul 15
%/ml-1 ml
84 Fitomenadion(Vit K1) tablet salut 20 148 36 112
Tablet 168
gula 10 mg
85 Furosemid tablet 40 mg Tablet 1,093 486 607 900 484 1,023
86 Garam Oralit untuk 200 ml air Sak 544 200 331 413 600 289 724
87 Gentamisin Inj. 80 mg/ml (Sulfat) Ampul 200 200 200
88 Gentamisin salep kulit 0,1% Tube 41 50 24 67 10 30 47
89 Gentian Violet larutan 1 % Botol 61 24 20 65 70 16 119
90 Glibenklamid tablet 5 mg Tablet 1,484 1,000 835 1,649 900 633 1,916
91 Glimepirid tablet 1 mg Tablet 329 150 156 323 150 248 225
92 Glimepirid tablet 2 mg Tablet 2,671 1,250 1,337 2,584 1,450 1,273 2,761
93 Gliseril Guayakolat tablet 100 mg Tablet 8,050 2,000 5,066 4,984 10,000 5,747 9,237
94 Glukose larutan infus 40% steril Botol 54 54 54
95 Glukose larutan infus 5 % Steril Botol 95 40 36 99 20 17 102
96 Griseofulvin forte tablet 500 mg Tablet 330 35 295 28 267
97 Griseofulvin tablet 125 mg Tablet 169 300 54 415 30 385
micronized
98 Grotavit sirup Botol 0 0 0
99 Guanistrep suspensi Botol 27 11 16 17 9 24
100 Haloperidol tablet 0,5 mg Tablet 245 132 113 600 300 413
101 Haloperidol tablet 5 mg Tablet 157 200 129 228 200 87 341
102 Tangan)/klorhexidin 4%/hydrex 0,5 Botol 10 2 22 1 21
ml 14
103 Hidroklortiazid (HCT) tablet 25 mg Tablet 2,898 800 1,389 2,309 1,900 1,161 3,048
104 Hidrokortison krim 2,5 % Tube 56 24 19 61 18 43
105 Hiosin-N-butilbromida injeksi Ampul 56 2 54 2 52
106 Hiosin-N-butilbromida tablet Tablet 220 300 210 310 300 90 520
107 Ibuprofen suspensi 100 mg/5 ml Botol 11 1 10 10
108 Ibuprofen tablet 200 mg Tablet 2,755 711 2,044 100 568 1,576
109 Ibuprofen tablet 400 mg Tablet 5,574 2,000 3,338 4,236 5,000 2,963 6,273
110 Ipratrium Br 0,5 m, salbutamol 2,5 0 0
Ampul 0
mg/ 2,5 ml Neb.
111 Isosorbid dinitrat tablet sublingual 300 134 395 96 299
Tablet 229
5 mg
112 Kalsium Glukonat Injeksi Ampul 135 135 135
Kalsium Laktat (Kalk) tablet 500
113 Tablet 85 29 56 500 226 330
mg
114 Kaptopril tablet 12,5 mg Tablet 944 8,000 344 8,600 8,000 6,004 10,596
115 Kaptopril tablet 25 mg Tablet 6,388 4,626 1,762 1,224 538
116 Kaptopril tablet 50 mg Tablet 0 0 0
117 Karbamazepin tablet 200 mg Tablet 50 50 16 34
118 Ketokonazol krim 2% 15 gr Tube 0 0 0
119 Ketokonazol krim 2% 5 gr Tube 0 0 0
120 Ketokonazol tablet 200 mg Tablet 0 0 0
121 Klindamisin kapsul 150 mg Kapsul 184 50 134 10 124
122 Kloramfenikol injeksi 1 gr 0 0
Vial 0
(Chlorbiotic inj)
Kloramfenikol Kapsul/kaplet 250
123 Kapsul 726 202 524 100 358 266
mg
124 Kloramfenikol Salep Mata 1 % Tube 0 0 0
125 Kloramfenikol suspensi 125 mg/5 53 3 50
Botol 53
ml
126 Kloramfenikol Tetes Mata Botol 10 5 5 5 0
127 Kloramfenikol Tetes Telinga 3 % Botol 0 0 0
128 Klorfeniramin Maleat ( CTM )
tablet 4 mg
Tablet 13,624 3,000 8,242 8,382 16,400 8,274 16,508
129 Klorpromazin HCL tablet salut 100 100 200 253 400 227 426
Tablet 353
mg
130 Klorpromazin HCL tablet salut 25 0 0
Tablet 0
mg
131 Kodein Fosfat tablet 10 mg Tablet 1,030 270 760 100 288 572
Kontrasepsi oral Linesterol tablet
132 Tablet 24 5 19 9 10
0,5 mg
133 Kotrimoksazol Doen I (dewasa) 189 192 400 39 553
Tablet 381
tablet
134 Kotrimoksazol Forte tablet Kaplet 346 12 334 40 294
135 Kotrimoksazol suspensi kombinasi Botol 6 50 3 53 25 28
136 Lactulax sirup Botol 2 2 2
137 Laktulose sirup Botol 0 0 0
138 Lidokain HCl 2% injeksi Ampul 0 0 0
139 Lidokain injeksi 2% (HCl) + Ampul 0 0 0
140 Loperamide tablet 2 mg Tablet 280 28 252 252
141 Loratadin tablet 10 mg Tablet 268 100 155 213 500 138 575
142 2% - Kalamin 5% - Zinc 10% - Botol 1 16 2 14
Gliserin 5% 17
143 Magnesium Sulfat injeksi (IV) Vial 0 0 0
20%-25 ml
144 Magnesium Sulfat injeksi (IV) 305 305
Vial 305
40%-25 ml
145 Metamizol injeksi 500 mg/ml Ampul 29 2 27 9 18
146 Metampiron tablet 500 mg Tablet 990 40 950 641 309
147 Metformin HCl tablet 500 mg Tablet 10,708 2,400 4,587 8,521 5,000 4,759 8,762
148 Metformin HCl tablet 850 mg Tablet 7 7 7
149 Metilergometrin maleat injeksi 99 2 97
Ampul 99
0,200 mg
Metilergometrin maleat tablet salut
150 Tablet 0 0 0
0,125 mg
151 Metilprednisolon tablet 4 mg Tablet 849 185 664 115 549
152 Metoklopramid Injeksi 5mg/ml Ampul 119 2 117 6 111
153 Metoklopramid tablet 10 mg Tablet 173 173 173
154 Metronidazol ovula 500 mg Supp 66 66 66
155 Metronidazol tablet 250 mg Tablet 578 100 478 206 272
156 Metronidazol tablet 500 mg Tablet 299 300 152 447 43 404
157 Mikonazol krim/salep 2% (nitrat) Tube 71 24 38 57 48 16 89
158 Multivitamin komb (antianemia)
tablet (novabion)
Kapsul 2,029 1,000 874 2,155 500 949 1,706
159 Multivitamin komb (neurotropik) 1,008 1,441 1,600 949 2,092

Tablet 2,449
tablet (Neurodex)
160 N-asetisistein kapsul 20 mg Kapsul 320 320 320
161 Natrium Bikarbonat tablet 500 mg Tablet 0 0 0
162 Natrium Diklofenak tablet 25 mg Tablet 126 50 20 156 36 120
163 Natrium Diklofenak tablet 50 mg Tablet 1,144 426 718 600 355 963
164 Natrium Klorida larutan infus 0,9% Botol 46 100 41 105 20 8 117
steril
165 Neo Kaominal sirup Botol 0 0 0
166 Neurovit E tablet Kaplet 0 0 0
167 Nifedipin tablet 10 mg Tablet 5,287 1,048 4,239 765 3,474
168 Nifedipin tablet oros 30 mg Tablet 90 85 5 5
169 Nistatin 100.000 UI/ml drop Botol 20 3 17 4 13
170 Nistatin tablet salut 500.000 IU/g Tablet 0 0 0
171 Nistatin tablet vaginal 100.000 140 140
Tablet 140
IU/g
172 Obat Flu komb Sirup (Fludane) Botol 45 6 39 15 24
173 Obat Flu komb Tablet(Fludane) Tablet 395 500 135 760 354 406
174 Obat Batuk Hitam (OBH) cairan 91 167 192 123 236
Botol 258
100 ml
175 Oksitetrasiklin HCL Salep kulit 3 % Tube 28 50 14 64 24 40
176 Oksitetrasiklin HCL salep mata 1% Tube 49 50 33 66 19 47

177 Oksitosin injeksi 10 IU/ ml- 1 ml Ampul 68 5 63 10 53
178 Omegdiar tablet Tablet 0 0 0
179 Omeprazol injeksi 20 mg 40mg/10 Vial 0 0 0
ml
180 Omeprazol kapsul/kaplet 20 mg Kapsul 342 283 59 810 154 715
181 Parasetamol drop 100 mg/ml Botol 22 5 17 10 7
182 Parasetamol sirup 120 mg/ 5 ml Botol 586 261 325 300 255 370
183 Parasetamol tablet 500 mg Tablet 21,687 11,500 10,187 4,000 11,004 3,183
184 Pehacain inj Ampul 136 40 85 91 160 34 217
185 Perak Sulfadiazin krim 1% Tube 1 4 5 5
186 Permetrin Krim 5% (Scabimite) Tube 24 24 3 21
187 Pirantel Pamoat tablet 125 mg Tablet 0 0 0
188 Piridoksin HCL tablet 10 mg Tablet 4,767 2,000 2,598 4,169 4,000 2,178 5,991
189 Piroksikam kapsul/kaplet/tablet 20 11 196 29 167
Kapsul 207
mg
190 Povidon Iodida Larutan 10% 1000 4 4
Botol 4
ml
191 Povidon Iodida Larutan 10% 30 ml Botol 7 10 17 1 16
192 Povidon Iodida Larutan 10% 300 Botol 0 0 0

ml
193 Prednison tablet 5 mg Tablet 1,020 20 1,000 31 969
194 Propanolol HCL tablet 40 mg Tablet 310 25 285 126 159
195 Propiltiourasil tablet Tablet 0 0 0
196 Pseudoefedrin+tripolidin tablet Tablet 500 82 418 90 328
197 Ranitidin Injeksi 25 mg/ ml Ampul 0 0 0
198 Ranitidin Injeksi 50 mg/2 ml Ampul 0 0 0
199 Ranitidin tablet 150 mg Tablet 2,335 1,000 1,357 1,978 2,100 1,267 2,811
200 Ringer Laktat larutan Infus steril Botol 501 680 438 743 580 347 976
201 SABU injeksi 5 ml Vial 0 0 0
202 Salbutamol tablet 2 mg (sebagai 459 541 800 567 774
Tablet 1,000
sulfat)
203 Salbutamol tablet 4 mg (sebagai 0 0
Tablet 0
sulfat)
204 Salep 2-4 kombinasi Pot 14 4 10 24 2 32
205 Salisil Bedak 2 % Kotak 151 43 108 20 25 103
206 Scabicid krim Tube 0 0 0
207 Sefotaksim Injeksi 1 g Vial 193 91 102 102 0
208 Seftriakson Injeksi 1 gr Vial 66 38 28 86 18 96
209 Serum Anti Tetanus inj. 1500 2 2
Ampul 2
UI/vial amp (ATS)
210 Setirizine sirup 5 mg/5ml Botol 12 3 9 1 8
211 Setirizine tablet 10 mg Tablet 538 30 508 10 498
212 Sianokobalamin (vit. B12) tablet 816 28 788
Tablet 816
50 mcg
213 Simetidin tablet 200 mg Tablet 209 86 123 200 96 227
214 Simvastatin tablet 10 mg Tablet 357 79 278 100 64 314
215 Simvastatin tablet 20 mg Tablet 62 30 32 10 22
216 Siprofloksasin tablet 500 mg Tablet 1,119 363 756 400 140 1,016
(sebagai HCl)
217 Siprofloksasin tetes mata Botol 9 9 3 6
218 Spironolakton tablet 100 mg Tablet 0 0 0
219 Spironolakton tablet 25 mg Tablet 245 48 197 83 114
220 Stesolid Rectal supp 5 mg Supp 7 7 3 4
221 Sulfasetamid Natrium tetes mata 6 0 0
Botol 6
15 %
222 Tablet Tambah Darah Kombinasi Sachet 7,092 327 6,765 287 6,478
223 Terbutalin sulfat 0,5 mg - spray 2 2
Botol 2
100 dosis
224 Terbutalin sulfat 2,5 mg/ml 20 20
Ampul 20
respules
225 Tetrakain Tetes Mata 0,5% Botol 2 2 2
226 Tetrasiklin HCL Kapsul/kaplet 250 0 0
Kapsul 0
mg
227 Thrombo Aspilet tablet 80 mg Tablet 0 0 0
228 Tiamin HCL (Vit B1) Inj. 100 0 0
Ampul 0
mg/ml-1 ml
229 Tiamin HCL Mononitrat (Vitamin 1,310 2,256 5,000 746 6,510
Tablet 3,566
B1) Tablet 100 mg
230 Trifluoperazin tablet 5 mg Tablet 205 400 132 473 185 288
231 Triheksifenidil Hidroklorida tablet 2
mg
Tablet 343 1,000 174 1,169 276 893
232 Ventolin Nebulizer Ampul 79 80 116 43 100 52 91
233 Vit K Infant / Neo - K injeksi Ampul 0 0 0
234 Vitamin B Komplek Tablet Tablet 15,618 6,800 9,119 13,299 13,600 8,006 18,893
235 Y-Rins cuci mata Botol 0 0 0
236 Zinc Drop 10mg/ml Botol 0 0 0
237 Zinc sirup 20 mg/5 ml Botol 8 2 6 3 3
238 Zinc tablet 20 mg Tablet 2,768 290 2,478 234 2,244
II. OBAT PROGRAM

1 Benzatin Benzil Penisilin injeksi Vial 10 10 10
2 Flukonazol kapsul 150 mg kapsul 0 0 0
3 Haloperidol inj 5mg/ml (Lodomer) Ampul 0 0 0
4 Klobazam tablet 10 mg (obat Tablet 100 100 100

program jiwa)
5 Klozapin tablet 25 mg (obat Tablet 158 158 158
program jiwa)
6 Kombipak azitrhromycin-cefixim Paket 42 1 41 2 39
7 tab 25 mg Sulfadoksin tablet 500 Sachet 0 0
mg 0
8 Obat Antituberkulosis FDC Paket 0 0 0
Kategori Anak
9 Obat Antituberkulosis FDC Paket 2 2 4 0 7 4 3
Kategori I
10 Obat Antituberkulosis FDC 1 2 2 1
Paket 1
Kategori II
11 Procain Benzil Penisillin 3 juta 225 225
Vial 225
IU/vial inj
12 Retinol (Vitamin A) 100.000 IU 150 150 150 0
Kapsul 0
kapsul lunak
13 Retinol (Vitamin A) 200.000 IU
kapsul lunak
Kapsul 0 1,100 1,100 1,100 0
Risperidon tablet 2 mg (obat
14 Tablet 160 160 30 130
program jiwa)
15 Speculum Vagina Biji 0 0 0
III. ALKES
1 Alat suntik sekali pakai 1 ml Biji 18 4 14 7 7
2 Alat suntik sekali pakai 10 ml Biji 306 306 113 193
3 Alat suntik sekali pakai 2,5 ml Biji 0 0 0
4 Alat suntik sekali pakai 3 ml Biji 996 500 444 1,052 300 221 1,131
5 Alat suntik sekali pakai 5 ml Biji 268 400 174 494 205 289
6 Alkohol Swab Kotak 4 12 4 12 10 22
7 Benang Cat Gut Chromic 2/0 Sachet 38 2 36 8 28
8 Benang Cat Gut Chromic 3/0 Sachet 36 4 32 6 26
9 Benang Cat Gut Plain 2/0 Sachet 0 0 0
10 Benang Cat Gut Plain 3/0 Sachet 17 12 1 28 28
11 Benang Silk/Side 2/0 Sachet 0 0 0
12 Benang Silk/Side 3/0 Sachet 26 1 25 4 21
13 Blood Set Biji 58 1 57 57
14 Foley Catheter no. 14 Biji 7 2 5 1 4
15 Foley Catheter no. 16 Biji 1 4 5 5 0
16 Handscun Panjang Biji 198 198 2 196
17 Handscun non steril L Biji 200 100 100 100 0
18 Handscun non steril M Biji 200 100 300 200 100
19 Handscun non steril S Biji 200 200 200
20 Handscun steril 7 Pasang 423 213 210 400 208 402
21 Handscun steril 6,5 Pasang 53 400 453 150 303
22 Handscun steril 7,5 Pasang 400 310 90 50 40
23 Handscun steril 8 Pasang 400 310 90 50 40
24 Hansaplast Biji 377 400 502 275 1,000 205 1,070
25 Infusion set anak Set 79 39 40 50 49 41
26 Infusion set dewasa Set 158 100 103 155 100 83 172
27 IV Chateter 18 (Surflo 18) Biji 71 9 62 8 54
29 IV Chateter 22 (Surflo 22) Biji 194 60 109 145 200 78 267
30 IV Chateter 24 (Surflo 24) Biji 176 77 99 150 66 183
32 Jarum suntik 23 G Biji 0 100 100 0 100 100
33 Kapas Pembalut/ Adsorben 250 Biji 5 3 2 6 1 5
mg
34 Kasa Hidrofil gulung Rol 0 0 0
35 Kasa Husada Steril 16x16 Kit 0 0 10 10
36 Kasa Pembalut 2 x 80 cm Biji 0 0 0
37 Kasa Pembalut Hidrofil 4 m x 15 50 172 183 500 126 557
Biji 305
cm
38 Masker Kain Biji 0 0 0
39 Masker O2 anak Buah 6 6 1 5
40 Masker O2 bayi Buah 12 12 1 11
41 Masker O2 dewasa Buah 7 5 12 2 10
42 Masker N95 Biji 0 0 0
43 Masker Tissue Biji 453 500 238 715 500 430 785
44 Nasal O2 ukuran M Biji 10 10 3 7
45 Nasal O2 ukuran S Biji 10 10 1 9
46 Plester 5 yard x 2 inch Rol 16 48 25 39 36 36 39
47 Silk (Benang Bedah Sutera) No. 0 0
Kotak 0
3/0
48 Scafel Handle Biji 1 1 1
49 Slim Suiqer Biji 0 0 0
50 Surgical Blade Biji 118 18 100 100
51 Surgical Needle Sak 4 4 4
52 Urin bag Biji 0 10 10 0 10 10
IV. OBAT GIGI

1 Air Raksa dental Botol 1 1 1
2 Alvogyl pasta Pot 0 0 0
3 Articulaying Paper Paket 2 2 2
4 Bonding Botol 1 1 1
5 Bonding Aplikator Kotak 0 0 0
6 Calsium Hidroxyd tube 1 1 1
7 Cotton Roll Gigi Dos 1 1 0 1 1
8 Devitalisasi Pasta (non Arsen) Botol 3 3 3
9 Etching Botol 1 1 1
10 Eugenol Cairan Botol 0 0 0
11 Glass Ionomer Cement (GC IX) Set 3 1 2 2
12 Instrumen Gigi Set Paket 0 0 0
13 Iodoform Botol 1 1 1
14 Kaca Mulut Buah 1 1 1
15 Kalsium Hidroksida (CaOH2) tube 0 0 0
16 Komposit Resin Anterior A2 tube 0 0 0
17 Komposit Resin Anterior A3 tube 0 0 0
18 Komposit Resin Anterior A3.5 tube 0 0 0
19 Komposit Resin Posterior tube 0 0 0
QA3,5/A3
20 Mata Boor Kotak 1 1 0 0
21 Mata Boor Frisure Besar Biji 3 3 3
22 Mata Boor Frisure Kecil Biji 2 2 2
23 Mata Boor Frisure Sedang Biji 3 3 3
24 Mata Boor Inverted Biji 0 0 0
25 Mata Boor Inverted Kecil Biji 2 2 2
26 Mata Boor Inverted Sedang Biji 4 4 4
27 Mata Boor Round Besar Biji 2 2 2
28 Mata Boor Round Sedang Biji 2 2 2
29 Mata Boor Tapper Besar Biji 0 0 0
30 Mata Boor Tapper Kecil Biji 0 0 0
31 Mata Boor Tapper Sedang Biji 0 0 0
32 Monoklorkamfer Mentol cairan 1 1 1
Botol 2
(CHKM)
33 Mumifying pasta Botol 1 1 1
34 Polikresulen 10 ml (Albothyl) Botol 2 1 1 2 3
35 Polising Amalgam Restoration Set 1 1 1
36 Root Canal Filling Buah 0 0 0
37 Selleloid strip Sachet 0 0 0
38 Semen Seng Fosfat serbuk dan 0 0
Set 0
cairan
39 Silver Amalgam Serbuk 65-75 % Botol 1 1 1
40 Spongostan Kotak 0 0 0
41 Surgical Blade / Mess no 11 Biji 0 0 0
42 Temporary Stopping Fletcher Cair Set 0 0 0
43 Temporary Stopping Fletcher Set 0 0 0

Serbuk dan cairan
44 Trikresol Formalin (TKF) Cairan Botol 3 3 3
45 TSR Botol 0 0 0
46 Tumpatan sementara Botol 1 1 1
V. LABORATORIUM
1 Alat Pemeriksaan Gula Darah Kit 0 0 0
2 Bilirubin Kit 0 0 0
3 Blood Lancet Kotak 0 0 0
4 Blue Tip Sak 0 0 0
5 Cover glass Kotak 0 0 0
6 Darah Kontrol Ampul 0 0 0
7 Diluent 20 ltr Galon 0 0 0
8 EDTA Cair 10% 100 mL Botol 0 0 0
9 ETA cair 10% 100ml Botol 0 0 0
10 Glucosa Enzimatik Trinder Kit 0 0 0
11 Gol. Darah A Vial 0 0 0
12 Gol. Darah AB Vial 0 0 0
13 Gol. Darah B Vial 0 0 0
14 Gol. Darah Rhesus Vial 0 0 0
15 H2O2 3% Botol 3 3 2 3 2
16 Hb-Cyanmet 1 liter Botol 0 0 0
17 Kartu Golongan Darah Kotak 0 0 0
18 Kertas Lensa Buah 0 0 0
19 Kotak slide Buah 0 0 0
20 Larutan Zheil Nielson/BTA 100 ml Botol 0 0 0
21 Larutan Emersi Oil Botol 0 0 0
22 Larutan Eter alkohol Botol 0 0 0
23 Larutan Klorin / NaClO 5,25% Botol 2 2 2
(bayclin)
24 Larutan KOH 10% Botol 0 0 0
25 Larutan Metilen Biru Botol 0 0 0
26 Larutan NaCl 0,9% 100 ml Botol 0 0 0
27 Larutan VDRL 10 ml Botol 0 0 0
28 M-18 E-cfd lyse 500ml Botol 0 0 0
29 M-18 E-Z cleaner Botol 0 0 0
30 M-18 R rinse Botol 0 0 0
31 M-18P probe cleanser Botol 0 0 0
32 Methilen Blue 0,3% Botol 0 0 0
33 Obyek Glass 72 Dos 0 0 0
34 Ose Buah 0 0 0
35 PH Paper Vagina Kotak 0 0 0
36 Pot Dahak Buah 0 0 0
37 Reagen Asam Urat Kit 0 0 0
38 Reagen Drabkin 1000ml Botol 0 0 0
39 Reagen Gula Darah Vial 0 0 0
40 Reagen Hbs Ag Kotak 0 0 0
41 Ragen HIV/intec/II Sachet 0 0 0
42 Reagen HIV / oncoprobe / I Sachet 0 0 0
43 Reagen HIV / vikia / III Sachet 0 0 0
44 Reagen Kolesterol HDL Kit 0 0 0
45 Reagen Kolesterol LDL Kit 0 0 0
46 Reagen Kolesterol Total Vial 0 0 0
47 Reagen Kreatinin Kit 0 0 0
48 Reagen Thypoid IgG/IgM+B383 Kotak 0 0 0
49 Reagen Trigliserida Kit 0 0 0
50 Reagen Urea Kit 0 0 0
51 Reagent SGOT 4x20 UV Kinetik 0 0
Kit 0
(IFCC)
52 Reagent SGPT 4x20 UV Kinetik 0 0
Kit 0
(IFCC)
53 Reagen Shipilis / VDRL test 0 0
Kotak 0
(Syphillis device)
54 Reagent Standart Trucal U Vial 0 0 0
55 Reagent Standart Trulab N Vial 0 0 0
56 Selleloid strip Sachet 0 0 0
57 Serum Kontrol Vial 0 0 0
58 Slide Object Glass Kotak 0 0 0
59 Spiritus Botol 0 0 0
60 Strip Gula Darah Kotak 0 0 0
61 Tabung centrifuge 15 TP Buah 0 0 0
62 Tabung Vacuntainer EDTA (tutup Kotak 0 0 0
merah)
63 Tabung Vacuntainer EDTA (tutup 400 400 0 0
Kotak 0
ungu)
64 Tes Kehamilan Buah 0 0 0
65 Thermal Paper Rol 0 0 0
66 Uric Acid Trinder 4x30 ml Botol 0 0 0
67 Urinalisis Strip 10 Parameter Tube 0 0 0
68 Urinalisis Strip 2 Parameter Tube 0 0 0
69 Uro Paper/ Urine 10 pm Botol 0 0 0
70 Widal AO Vial 0 0 0
71 Widal BO Vial 0 0 0
72 Widal H Vial 0 0 0
73 Widal O Vial 0 0 0
74 Yellow Tip Sak 0 0 0
VI. VAKSIN
1 Vaksin BCG + Pelarut Vial 0 0 0
2 Vaksin Campak + Pelarut Vial 0 0 0
3 Vaksin Campak 10 DS (MR) Vial 0 0 0
4 Vaksin DPT-HB-Hib (Penta Valent) Vial 0 0

0
5 Vaksin DT Ampul 0 0 0
6 Vaksin HB-ADS Vial 0 0 0
7 Vaksin Meningitis Vial 0 0 0
8 Vaksin POLIO bopv Vial 0 0 0
9 Vaksin POLIO IPV 5 dosis Vial 0 0 0
10 Vaksin Safety box 2,5 ml Biji 0 0 0
11 Vaksin Spuit 0,5 ml Biji 0 0 0
12 Vaksin Spuit 0,05 ml Biji 0 0 0
13 Vaksin Spuit 5 ml Biji 0 0 0
14 Vaksin Td Biji 0 0 0
15
Kepala Puskesmas Perawa

PEMASUKAN DAN PENGELUARAN PUSKESMAS NGLETIH KOTA KEDIRI
TAHUN 2017
Maret April Mei Juni Juli
masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk
12 157 9 148 148 148

90 134 100 56 178 50 128 10 118
111 93 200 55 238 49 189 189
4 31 1 30 5 25 5 20 96
483 834 500 400 934 100 492 542 700 517 725 2,500
13 13 13 13
60 60 60 60
10 108 28 80 40 40 100 26 114 200
2,200 8,955 1,993 6,962 2,648 4,314 7,920 3,480 8,754 15,840
896 2,268 1,670 598 7,200 1,921 5,877 821 5,056
362 950 100 392 658 500 335 823 100 188 735 400
600 3,354 6,601 2,200 3,555 5,246 10,000 3,395 11,851 2,325 9,526 10,000
120 109 171 66 105 67 38 5 33
50 6 58 100 8 150 10 140 29 111 100

7 11 7 1 17 2 15 4 11 24
400 188 402 207 195 400 132 463 69 394 300
400 154 492 169 323 100 117 306 69 237 400
2,000 4,460 6,937 5,000 4,871 7,066 8,000 4,780 10,286 2,000 3,774 8,512
0 0 0 0
3 8 4 4 4 4
0 0 0 0
0 0 0 0
31 74 10 46 38 50 9 79 5 74 30
100 50 91 20 71 20 51 51 0
0 0 0 0
108 238 127 111 200 88 223 66 157 220
0 0 0 0
0 0 0 5 1 4 2
0 0 0 0
0 0 0 0
397 40 357 17 340 36 304
0 0 0 0
1,144 141 82 59 42 17 10 7
100 397 433 600 377 656 200 366 490 333 157
500 716 766 1,200 438 1,528 995 533 533 0
8 27 11 16 25 5 36 5 31 25
24 55 30 25 100 125 125
200 10 309 94 215 50 104 161 100 46 215 100
0 0 0 0
200 256 519 200 274 445 300 357 388 700 283 805 1,000
72 72 72 72
0 0 0 0
71 122 50 84 88 125 79 134 75 57 152 200

0 0 0 10 1 9
15 99 16 83 6 77 6 71
3 3 3 3
1 19 19 19 4 15 10
3 3 3 2 1 3
240 95 292 102 190 80 118 152 140 58 234 120
43 2 2 0 0 160 18 142 100

0 0 0 0
10 10 10 4 6 6 0
0 0 0 0
0 0 0 0
0 0 0 0
24 37 100 17 120 120 25 95

1,000 263 1,215 393 822 200 468 554 700 296 958 1,000
15 15 15 0 0
400 156 293 87 206 173 33 33 0 500
0 0 0 0
61 182 182 0 400 17 383 383
271 271 271 271
600 280 927 402 525 600 265 860 197 663 600
0 0 0 0
27 1 26 1 25 4 21
213 394 200 149 445 166 279 200 75 404 100
20 357 10 347 15 332 332 0
200 200 200 62 138 30 108
5 5 5 10 15
100 100 100 100
22 48 34 14 6 8 8
6 17 1 16 4 12 12
0 0 0 0
1 1 2 2 2 2
28 117 1 12 106 7 99 18 81 100
1 6 6 1 5 1 4
3 8 2 6 1 5 4 1 20
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
30 8 30 9 21 7 14 5 4 15
50 62 62 0 100 56 44 44 0 100
300 347 976 292 684 100 412 372 700 186 886 300
100 214 610 309 301 500 359 442 500 239 703
200 200 200 200
40 33 54 30 21 63 26 37 30 14 53 30
21 98 13 85 17 68 21 47
799 1,117 1,000 735 1,382 500 804 1,078 1,000 574 1,504 2,000
500 215 510 6,500 203 6,807 952 5,855 2,123 3,732 11,000
1,250 1,478 2,533 1,406 1,127 1,127 0 0
7,000 5,266 10,971 4,000 4,000 10,971 3,894 7,077 3,000 2,140 7,937 5,000
54 54 54 54
12 90 28 62 15 47 12 35 80
21 246 26 220 58 162 31 131 100
24 361 10 351 58 293 20 273
0 0 0 0
10 14 12 10 16 10 14 12 25 6 31 5
400 405 408 700 342 766 100 528 338 1,500 315 1,523 400
341 70 271 84 187 100 132 155 700
11 10 20 5 25 20 7 38 20 14 44 40
960 2,088 700 1,006 1,782 800 957 1,625 800 465 1,960 1,000
24 21 46 24 36 34 72 27 79 17 62 48
4 48 1 47 1 46 1 45
190 330 200 110 420 150 270 100 74 296 200
6 4 10 14 14 14
1,007 569 2,100 609 2,060 520 1,540 310 1,230 700
5,000 6,418 4,855 15,000 8,575 11,280 15,000 7,717 18,563 6,287 12,276 30,000
0 0 0 0
146 153 200 149 204 200 164 240 200 108 332 400
135 135 135 135
330 0 0 0 0
4,000 8,249 6,347 5,204 1,143 592 551 1,000 253 1,298
256 282 102 180 10,000 90 10,090 198 9,892 5,000
0 3,000 210 2,790 1,390 1,400 1,154 246
34 34 34 34
0 0 0 0
0 0 0 0
0 0 0 0
44 80 100 42 138 12 126 126
0 0 0 0
700 220 746 379 367 600 312 655 200 92 763 100
0 0 0 0
2 48 2 46 2 44 44
0 0 0 100 8 92
0 0 0 100 3 97
10,000 7,014 19,494 5,996 13,498 2,000 6,207 9,291 10,000 3,462 15,829 10,000
200 205 421 238 183 183 0 0
0 0 1,000 396 604 900 1,218 286 8,000

200 240 532 100 270 362 400 140 622 70 552
30 40 4 36 3 33 3 30
9 544 56 488 88 400 32 368

29 265 49 216 45 171 43 128 100
17 11 5 6 6 6
2 2 1 1 1 0
0 0 0 0
0 0 0 0
0 0 0 0
252 252 28 224 224
151 424 238 186 500 112 574 118 456 300
1 13 3 10 10 2 8
0 0 0 0
305 305 305 8 297

10 28 3 25 25 2 23
309 0 0 0 0
6,900 4,996 10,666 6,900 4,468 13,098 5,404 7,694 6,800 3,132 11,362 10,000
7 7 7 500 183 324 800
2 95 95 1 94 1 93
0 0 0 0
156 393 78 315 58 257 151 106
27 84 6 78 78 2 76
21 152 49 103 10 93 14 79
7 59 59 59 59
124 148 40 108 108 108
100 79 425 99 326 142 184 200 119 265 500
27 62 28 34 48 31 51 48 10 89
1,000 1,027 1,679 1,000 430 2,249 500 462 2,287 696 1,591 2,600
2,092 0 0 0 0
10 310 310 120 190 190 0 120
0 0 0 0
10 110 82 28 1,000 288 740 186 554 600
354 609 300 505 404 283 121 121
9 108 26 82 25 57 20 8 69 100
0 0 0 0
0 0 0 0
675 2,799 633 2,166 618 1,548 489 1,059
5 5 5 5
7 6 12 1 17 3 14 14
0 0 0 0
3 137 137 137 137
72 23 73 9 64 8 56 2 54
406 0 0 0 0
96 92 240 92 148 96 60 184 51 133 192
25 20 45 25 28 42 50 58 34 100 18 116
50 21 76 37 39 39 0 0
23 30 100 5 125 14 111 9 102
0 0 0 0
0 0 0 0
143 572 104 468 143 325 30 84 271
30 12 25 11 14 12 2 2
350 292 428 350 247 531 100 240 391 200 178 413 500
2,000 4,929 254 5,000 215 5,039 2,319 2,720 2,008 712
70 147 40 92 95 200 34 261 73 188 260
5 5 5 1 4 2
4 17 17 3 14 2 12
0 0 0 0
2,358 3,633 3,000 2,105 4,528 2,000 2,115 4,413 1,000 1,574 3,839 6,000
6 161 43 118 33 85 6 79
1 3 3 3 3 1
2 14 14 24 38 5 33
0 0 0 0
20 949 949 949 949
159 159 23 136 136
0 0 0 0
328 0 0 0 0
0 0 0 0
0 0 0 100 6 94 200
500 1,301 2,010 2,010 0 500 139 361 2,000 651 1,710 2,200
313 663 160 221 602 249 353 280 54 579
0 0 0 0
800 565 1,009 420 589 500 613 476 1,100 625 951 2,800
0 0 0 0
2 30 5 25 6 19 3 16 24
35 68 100 28 140 32 108 25 83 100
0 0 0 0
0 0 0 30 30 100
37 59 59 2 57 13 44
2 2 2 2
1 7 7 2 5 2 3 20
10 488 488 1 487 487
5 783 389 394 600 528 466 1,000 384 1,082 1,300
74 153 76 77 800 877 0 0
42 272 61 211 22 189 57 132
15 7 7 7 7 100
334 682 200 172 710 206 504 139 365 500
10 1 15 3 12 12 3 9
0 0 0 0
114 0 0 0 0
5 1 8 2 6 6 1 5 5
0 0 0 0
353 6,125 2,198 3,927 3,927 0 3,000 3,000
2 2 2 0 0
20 20 1 19 19
2 2 2 2
0 0 0 0
0 0 0 0
0 0 0 0
863 5,647 1,807 3,840 1,000 1,418 3,422 717 2,705 2,000
200 90 398 150 248 200 90 358 150 208 700
195 698 276 422 1,000 258 1,164 357 807 1,000
60 44 107 52 55 80 40 95 20 53 62 260
0 0 0 0
3,000 7,640 14,253 6,800 8,374 12,679 13,600 7,790 18,489 6,381 12,108 18,800
0 0 0 0
0 0 0 0
5 8 1 7 1 6 6
185 2,059 221 1,838 306 1,532 97 1,435
10 10 10 10
0 0 0 0
0 0 0 0
100 100 100 100
158 158 158 158

7 32 6 26 7 19 19
0 0 0 0
0 0 0 0
4 1 6 6 3 3 3 2 4 4
1 1 1 1 1
225 1 224 224 224
0 0 0 0 150
0 0 0 0 1,250
130 14 116 21 95 95
0 0 0 0
7 0 0 19 19 0 400 100 300 300

200 190 203 100 303 303 303
0 0 0 0
532 599 800 235 1,164 235 929 320 609 1,400
291 163 417 136 281 100 2 379 191 188 1,000
20 12 30 8 38 20 2 56 6 50
28 8 20 10 10 24 4 30
8 18 18 18 18
0 0 0 0
21 7 28 35 35 15 20 72
0 0 0 0
5 16 16 16 5 11 24
57 0 0 0 50 50
4 5 1 8 1 7 7 5
0 5 5 1 4 5 1 8 5
56 140 25 115 115 115
91 91 0 0 0 0
500 600 0 0 1,000 400 600 1,000 900 700 5,000
200 100 100 100 0 0
243 159 400 350 209 131 78 10 68
200 103 75 28 12 16 400 113 303 400
40 0 0 0 0
40 0 0 0 300 50 250
91 501 660 700 105 1,255 103 1,152 266 886 1,000
100 29 112 17 95 17 78 11 67
50 83 139 100 61 178 64 114 50 101 63 600
16 38 46 13 71 3 68 6 62
10 94 50 15 129 129 2 127
60 207 43 164 57 107 50 25 132 50
49 134 29 105 48 57 100 26 131 50
24 112 11 101 6 95 3 92
100 100 19 119 0 100 100
3 2 6 8 8 4 4 20
0 0 0 0
1 9 9 9 2 7 5
0 0 0 0
212 345 200 120 425 101 324 117 207 500
0 0 0 0
5 5 5 5
11 1 10 10 10
10 10 10 2 8 4
0 0 0 0
400 664 521 1,200 217 1,504 610 894 2,500 559 2,835 700
7 7 7 1 6
1 8 8 8 8
48 30 57 11 46 15 31 10 22 19 144
0 0 0 0
1 1 0 0 0
0 0 0 0 100
100 0 0 0 0
4 4 4 2 2
10 0 0 0 0 10
1 1 1 1
0 0 0 0 2
2 2 2 2
1 1 1 1 3
0 0 0 0 1
1 1 1 1
1 1 1 1 3
1 2 2 2 2 3
1 1 1 1 3
0 0 0 0 3
1 1 1 0 1 1 1 0 8
0 0 0 0
1 1 1 1
1 0 0 0 0
0 0 0 0
0 0 0 0 2
0 0 0 0 2
0 0 0 0
0 0 0 0 2
0 0 0 0
3 3 3 3
2 2 2 2
3 3 3 3
0 0 0 0
2 2 2 2
4 4 4 4
2 2 2 2
2 2 2 2
0 0 0 0
0 0 0 0
0 0 0 0
1 1 1 1 3
1 1 1 1 1
3 1 2 2 2 2
1 1 1 1
0 0 0 0
0 0 0 0 2
0 0 0 0 3
1 1 1 1
0 0 0 0 2
0 0 0 0
0 0 0 0
0 0 0 0
1 2 2 2 2 3
0 0 0 0 2
1 1 1 1 10
0 0 0 0
0 0 0 0
2 2 0 0 0 0
0 0 0 0
0 0 0 0
0 1 1 0 0 2 2 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1 1 2 1 1 1 1 0
0 0 0 0
2 2 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2 2 2 2
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2 2 0 0 0 0
2 2 0 0 0 0
0 0 0 0
2 2 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 2 2 0
0 0 0 0
0 0 0 0
15 15 0 0 0 0
0 0 0 0
91 91 0 0 0 0
10 10 0 0 0 0
2 2 0 0 0 0
0 0 0 0
0 0 0 0
5 5 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
5 5 0 20 20 5 11 14 4 10
5 5 0 20 20 10 16 14 6 8 5
0 0 0 0 155
15 15 0 70 70 30 75 25 16 9 30
0 0 0 0
0 34 34 65 64 35 15 20
0 0 19 19 0 0
0 25 25 30 40 15 12 3 20
0 10 10 10 12 8 2 6 5
0 10 10 10 10
0 500 500 200 500 200 200 1,700
100 100 0 200 200 100 200 100 100 100
0 0 0 0 600
0 20 20 5 18 7 1 6
Mengetahui Pengelola Obat,

Kepala Puskesmas Perawatan Ngletih
NGLETIH KOTA KEDIRI
Juli Agustus September Oktober Nopember
keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar sisa masuk keluar
2 146 9 137 1 136 136 6

20 98 20 78 20 58 8 50
17 172 20 152 7 145 3 142
15 101 1 100 1 99 3 96 2
822 2,403 564 1,839 748 1,091 700 614 1,177 186
13 13 3 10 10 5 1
60 60 60 60
17 297 15 282 24 258 52 206 100 85
3,348 21,246 14 3,005 18,255 14 3,001 15,268 3,050 12,218 2,995
674 4,382 1,012 3,370 1,077 2,293 210 1,082 1,421 1,110 1,172
278 857 242 615 320 295 500 308 487 300 200
2,818 16,708 12 2,870 13,850 2,862 10,988 2,424 8,564 1,000 2,020
6 27 8 19 150 12 157 5 152 7
58 153 2 86 65 150 77 138 50 63 125 50 56

7 28 9 19 9 10 11 5 16 10 1
84 610 108 502 62 440 108 332 100 77
98 539 67 472 28 444 107 337 100 166
3,676 4,836 4,000 4,462 4,374 5,000 3,038 6,336 8,200 4,014 10,522 4,000 3,938
0 0 0 0 500
1 3 3 1 2 50 2 50 5
0 0 0 0
0 0 0 0
12 92 31 61 20 8 73 12 61 18
0 0 0 0
0 0 0 0
70 307 87 220 22 198 101 97 120 104
0 0 0 0
1 5 2 3 5 8 1 7
0 0 0 0
0 0 0 0
34 270 270 270 270 33
0 0 6,800 25 6,775 288 6,487 317
7 0 0 1,000 148 852 288 564 200 201

157 0 0 0 0
0 2,000 100 1,900 262 1,638 697 941 1,000 878
10 46 1 9 36 3 33 1 32 10
12 113 100 213 25 188 188 15
75 240 200 145 295 100 120 275 134 141 300 106
0 0 0 0
268 1,537 280 1,257 254 1,003 2 202 799 252
72 72 72 72
0 20 20 20 20 10 10
73 279 46 233 46 187 77 110 100 84

9 2 7 5 2 10 12
45 26 100 22 104 30 74 28 46 100
3 3 3 3
25 25 1 24 24
4 1 3 3 3 1
82 272 61 211 121 90 300 119 271 60 143
28 214 40 81 173 80 33 220 127 93 200 123

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
12 83 12 71 48 23 100 25 98 27
577 1,381 563 818 600 531 887 400 614 673 1,000 591
0 0 0 0 50
6 494 500 90 904 105 799 133 666 42
0 10 10 10 10 5
28 355 21 334 92 242 42 200 100 77
271 271 40 231 231
370 893 241 652 226 426 100 194 332 200 315
0 0 0 0
4 17 6 11 4 5 10 5 5 10 10 6
198 306 100 126 280 100 138 242 100 179 163 300 96
0 0 0 0
49 59 38 21 21 0 100 100 10
15 15 15 15 3
100 100 100 100 9
8 8 8 0 0
2 10 10 10 10 10
0 0 0 0
2 2 2 2
13 168 33 135 4 131 26 105 51
4 4 4 4
21 3 18 2 16 16 3
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
9 6 100 1 105 20 85 5 80 6
5 95 74 21 200 10 211 62 149 58

116 1,070 121 949 74 875 102 773 116
330 373 100 385 88 900 374 614 3 611 0 1,200 185
200 200 200 200
16 67 4 46 17 100 23 94 21 73 22
15 32 1 18 13 68 16 65 23 42 24 7
604 2,900 630 2,270 464 1,806 598 1,208 300 725
2,501 12,231 3,231 9,000 2,658 6,342 2,982 3,360 1,048
0 0 0 5,000 5,000 2,250 1,078
3,137 9,800 3,525 6,275 3,000 4,004 5,271 3,999 4,953 4,317 8,000 4,811
54 54 54 2 52 2
20 95 40 16 39 60 15 84 17 67 27
41 190 18 172 200 36 336 66 270 100 65
74 199 72 127 12 115 25 90 200 30
0 0 0 0
7 29 7 22 17 5 35 4 36 4
388 1,535 342 1,193 359 834 468 366 800 216
90 765 120 645 645 56 589 70
2 82 10 72 17 55 3 52 10 20
750 2,210 746 1,464 400 750 1,114 714 499 1,329 491
26 84 3 29 52 72 31 93 34 59 48 34
45 0 0 0 0
30 466 26 440 44 396 40 356 10
6 8 10 3 15 2 13 13 0
341 1,589 478 1,111 478 633 490 504 619 600 752
8,234 34,042 20 8,113 25,949 8,062 17,887 800 9,420 9,267 15,000 9,614
0 0 0 0
99 633 85 548 84 464 56 408 40

135 135 135 135
0 0 6,400 314 6,086 615 5,471 547
387 911 18 338 555 2,200 237 2,518 229 2,289 223
2,562 12,330 2,558 9,772 2,370 7,402 3,155 4,247 3,500 2,374
246 0 0 0 0
34 34 34 34
0 0 0 0
0 0 0 0
0 0 0 0
126 126 126 44 82 100 34
0 0 0 0
207 656 319 337 500 88 749 341 408 500 575
0 0 0 0
2 42 1 41 41 8 33 11
28 64 35 29 60 38 51 40 29 62 30 28
12 85 5 80 11 69 10 59 9
4,879 20,950 4,715 16,235 6,271 9,964 4,499 6,555 7,908 7,500 5,985
0 0 0 0
1,108 7,178 1,116 6,062 570 5,492 950 4,542 724

90 462 60 402 80 322 40 282 90
4 26 6 20 3 17 5 12 2
21 347 36 311 52 259 15 244 3

19 209 10 199 20 179 6 173 25
6 6 6 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 60 60
224 5 219 4 215 9 206 23
35 721 130 591 45 546 500 180 866 100 49
8 8 1 7 7
0 0 0 0
297 235 62 62 62
3 20 20 10 10 20 11 19 50 18
0 0 0 0
4,391 16,971 10,000 5,699 21,272 3,839 17,433 4,794 12,639 2,000 5,202
84 1,040 56 984 148 836 53 783 30
1 92 92 2 90 3 87 1
0 0 0 0
106 0 0 0 0
19 57 8 49 9 40 13 27 10 16
22 57 30 27 100 50 77 100 3 174
59 59 59 59
108 0 0 0 0
102 663 219 444 100 131 413 203 210 300 64
18 71 1 34 36 96 26 106 40 66 48 34
789 3,402 10 927 2,485 842 1,643 300 1,024 919 1,500 943
0 0 0 0
120 120 120 120
0 0 0 0
262 892 600 324 1,168 150 258 1,060 373 687 294
120 1 1 0 0 1,000 100 900 142
52 117 32 85 60 57 88 40 30 98 62
0 0 0 0
0 0 0 0
527 532 1,000 319 1,213 217 996 258 738 352
5 0 0 0 0
4 10 2 8 10 5 13 6 7 10 4
0 0 0 0
137 14 123 123 123
7 47 6 53 20 3 70 1 1 70 17
0 0 0 0
60 265 60 63 262 61 201 65 136 60 115
23 93 36 57 50 32 75 24 51 25 27
0 0 0 0
11 91 22 69 17 52 13 39 100 7
0 0 0 0
0 0 0 0
145 126 600 144 582 116 466 87 379 150 22
2 56 2 56 14 42 7 35 8
258 655 3 252 400 250 308 342 350 421 271 1,120 389
712 0 0 0 0
106 342 83 259 96 163 34 129 75
6 6 6 2 4 5 1
4 8 60 10 58 6 52 60 16 96 31
0 0 0 0
1,304 8,535 3 1,355 7,183 1,402 5,781 10 1,591 4,200 1,000 1,652
20 59 5 54 25 29 100 6 123 34
1 3 1 2 2 2
2 31 7 24 4 20 2 18 1
0 0 24 24 24
10 939 46 893 893 71 822 13
136 136 136 4 140
0 0 0 0
0 0 0 0
0 0 0 0
97 197 300 112 385 85 300 58 242 59
870 3,040 699 2,341 993 1,348 999 991 1,356 1,000 1,038
141 438 100 145 393 164 229 160 126 263 40 224
0 0 0 0
530 3,221 248 2,973 545 2,428 499 1,929 393
0 0 0 0
6 34 7 27 2 25 25 11
21 162 18 144 35 109 35 74 20 31
0 0 0 0
7 123 15 108 108 14 94 34
44 5 1 38 38 38
2 2 2 2
4 19 2 17 17 3 14 5 3
105 382 59 323 20 303 18 285 31
206 2,176 277 1,899 192 1,707 10 158 1,539 143
0 110 110 110 110 6
21 111 46 65 45 20 20
107 100 45 162 162 26 136 32
100 765 184 581 116 465 84 381 131
1 8 1 7 7 1 6
0 0 0 0
0 0 0 0
10 10 2 8 5 9 4 15 7
0 0 0 0
120 2,880 250 2,630 260 2,370 360 2,010 19,200 19,640
0 0 0 0
19 19 19 19
2 2 2 2
0 0 0 0
0 0 0 0
0 0 0 0
983 3,722 1,123 2,599 3,000 1,045 4,554 677 3,877 345
90 818 150 668 90 578 150 428 90
270 1,537 324 1,213 174 1,039 246 793 132
39 283 30 253 76 177 77 100 80 69
0 0 0 0
9,724 21,184 12,000 9,542 23,642 30 9,920 13,752 9,400 10,783 12,369 9,400 9,689
0 0 0 0
0 0 0 0
6 4 2 10 4 8 5 5 8 4 1
211 1,224 324 900 486 414 700 127 987 69
10 10 10 10
0 0 0 0
0 0 0 0
100 100 100 100
158 158 158 0 0

19 0 0 0 0
0 0 0 0
0 0 0 0
1 7 1 6 1 5 5 1
1 1 1 1 1
224 224 224 224
150 0 0 0 0
1,250 0 0 0 0
95 95 95 95
0 0 0 0
100 500 8 492 9 483 5 478 111

303 3 300 1 299 2 297 3
0 0 0 0
229 1,780 339 1,441 539 902 400 639 663 1,000 740
2 1,186 103 1,083 104 979 206 773 306
11 39 12 7 44 19 25 5 6 24 14
6 24 8 16 1 15 9 6 2
4 14 4 10 12 10 12 12 24 11
0 0 0 0
8 84 2 82 8 74 74
0 0 0 0
35 35 6 29 29 5
50 8 42 10 32 5 27 4
12 2 10 4 6 3 9
3 10 2 8 1 7 7 2
115 115 115 115
0 300 300 300 0 700 200 500 400
700 5,000 400 950 4,450 2,504 1,946 2,000 1,022 2,924 1,000 1,615
0 0 0 0
6 62 62 54 8 4 4 2
100 603 150 453 108 345 200 155 390 200 100
0 0 0 0
250 37 213 28 185 185
372 1,514 218 1,296 249 1,047 325 722 100 717
22 45 100 20 125 39 86 30 56 100 47
57 606 69 537 156 381 81 300 85
62 0 0 0 0
5 122 3 119 10 109 92 17 50 7
52 130 100 45 185 60 125 50 59 116 200 107
32 149 100 42 207 52 155 103 52 200 66
3 89 3 86 13 73 25 48 50 36
100 100 100 100
3 21 21 7 14 2 16 1
0 0 0 0
12 1 11 11 11
0 0 0 0
192 515 120 395 178 217 200 246 171 200 116
0 0 0 0
5 1 4 4 4 10
10 1 9 2 7 7 10
2 10 2 8 3 5 2 7 10 4
0 0 0 0
160 3,375 640 2,735 501 2,234 377 1,857 500 1,235
6 6 2 4 4
8 1 7 2 5 5 10 1
18 145 19 126 23 103 24 79 48 26
0 0 0 0
0 0 0 0
100 4 96 9 87 6 81 2
0 0 0 0
1 1 1 1 1
10 10 1 9 1 2 8 1
1 1 1 0 0
2 1 1 1 0 0
2 2 4 4 0 0
4 4 4 0 0
1 1 0 0 0
1 1 1 0 0
4 1 3 3 0 0
5 5 5 0 0
4 2 2 2 0 0
3 2 5 5 0 0
8 2 6 6 0 0
0 1 1 1 0 0
1 1 0 0 0
0 0 0 0
0 0 0 0
2 2 2 0 0
2 1 1 1 0 0
0 0 0 0
2 2 2 0 0
0 0 0 0
3 3 0 0 0
2 2 2 0 0
3 3 3 0 0
0 0 0 0
2 2 2 0 0
4 4 4 0 0
2 2 2 0 0
2 2 2 0 0
0 0 0 0
0 0 0 0
0 0 0 0
4 4 4 0 0
2 2 2 0 0
4 4 4 0 0
1 1 1 0 0
0 0 0 0
2 2 2 0 0
3 1 2 2 0 0
1 1 1 0 0
2 1 1 1 0 0
0 0 0 0
0 0 0 0
0 0 0 0
5 5 5 0 0
2 2 2 0 0
11 2 9 9 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0 1
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 2 2 2 0 0
0 2 2 2 0 0
0 2 2 2 0 0
0 2 2 2 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2 2 2 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 1 1 1 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 4 4 4 0 0
0 1 1 1 0 0
0 1 1 1 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 10 10 10 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 2 2 2 0 0
0 1 1 1 0 0
0 0 0 0
0 1 1 1 0 0
0 1 1 1 0 0
0 1 1 1 0 0
0 1 1 1 0 0
0 0 0 0
10 10 9 11 5 6 10 6 4 10 1
13 8 5 5 0 0
155 277 340 92 106 112 86 7 79 8
39 10 42 7 30 14 23 20 22 21 30 24
0 0 0 52 52 45
20 20 28 12 20 10 22 10 24 8 20 21
0 0 0 0
23 20 29 14 20 12 22 10 15 17 20 15
11 4 7 3 8 2 10 4 8 5 6
10 1 9 1 8 50 3 55 20
1,900 1,900 0 0 0 500 200
200 100 200 100 100 200 200 100
600 500 100 100 100
6 3 3 5 8 48 1 55 47
ngelola Obat,
Rata-
Nopember Desember rata
Total Total Pemak
Penerim Pengelu aian
sisa masuk keluar sisa aan aran per
bulan
130 130 0 40 3
50 50 100 294 25
142 7 135 400 371 31
94 10 84 96 51 4
991 249 742 5,400 6,009 501
14 30 6 38 35 10 1
60 60 0 10 1
221 34 187 400 429 36
9,223 2,829 6,394 31,708 33,907 2,826
1,359 7,200 968 7,591 15,720 12,399 1,033
587 130 457 3,300 3,823 319
7,544 1,805 5,739 34,312 35,373 2,948
145 12 133 450 487 41
119 41 78 501 447 37

25 5 20 52 53 4
355 105 250 1,600 1,501 125
271 200 151 320 1,700 1,504 125
10,584 3,938 6,646 45,200 49,438 4,120

500 27 473 500 27 2
45 6 39 50 63 5
0 0 0 0 0
0 0 0 0 0
43 10 36 17 220 241 20
0 0 100 197 16
0 0 0 0 0
113 240 80 273 1,233 1,018 85
0 0 0 0 0
7 7 12 10 1
0 0 0 0 0
0 0 0 0 0
237 70 167 300 347 29
6,170 315 5,855 6,800 954 80
563 127 436 3,200 4,313 359

0 0 1,700 2,263 189
1,063 11,600 990 11,673 17,300 7,513 626
22 50 16 56 99 99 8
173 60 113 200 166 14
335 300 152 483 1,350 1,147 96
0 0 0 0 0
547 500 429 618 3,198 3,396 283
72 72 0 0 72 6
20 20 30 10 1
126 100 61 165 850 835 70

12 12 20 8 1
146 12 134 300 223 19
3 3 2 1 0
24 24 10 6 1
2 1 1 2 4 5 0
188 200 81 307 1,320 1,205 100
170 160 57 273 740 724 60

0 0 0 0 0
0 0 10 10 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
71 38 33 200 268 22
1,082 1,000 504 1,578 6,600 5,422 452
50 1 49 50 18 2
624 84 540 1,500 1,068 89
15 15 15 0 0
223 35 188 700 764 64
231 231 0 40 3
217 900 170 947 3,400 3,407 284
0 0 0 0 0
14 5 9 19 46 4
367 145 222 1,100 1,812 151
0 0 0 377 31
90 25 65 300 235 20
12 12 15 3 0
91 91 100 9 1
0 0 0 202 17
0 0 0 35 3
0 0 0 0 0
2 2 1 3 0
54 100 7 147 301 258 22
4 2 2 0 5 0
13 2 11 20 20 2
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 24 24 24 0 0
74 74 135 76 6
91 100 16 175 500 493 41

657 66 591 2,300 2,802 234
1,015 521 494 4,097 4,147 346
200 200 0 0 0
51 30 15 66 316 291 24
59 9 50 185 196 16
783 2,000 636 2,147 8,700 8,037 670
2,312 449 1,863 18,300 16,766 1,397
6,172 2,500 1,344 7,328 13,700 9,043 754
7,506 5,000 3,909 8,597 50,999 50,452 4,204
50 50 0 4 0
40 40 22 58 200 237 20
305 46 259 400 471 39
260 260 500 409 34
0 0 0 0 0
32 13 19 104 112 9
950 363 587 4,500 4,158 347
519 165 354 1,200 1,003 84
42 10 3 49 130 95 8
838 400 438 800 7,514 9,612 801
73 24 37 60 333 329 27
0 0 0 56 5
346 25 321 1,100 999 83
0 0 20 31 3
467 1,500 535 1,432 5,490 6,813 568
14,653 7,797 6,856 87,820 86,538 7,212
0 0 0 0 0
368 368 1,300 1,161 97

135 135 0 0 0
4,924 541 4,383 6,900 2,602 217
2,066 402 1,664 23,182 22,462 1,872
5,373 10,000 2,046 13,327 28,500 21,561 1,797
0 0 3,000 3,000 250
34 34 0 16 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
148 68 80 200 304 25
0 0 0 0 0
333 2,000 317 2,016 4,700 3,410 284

0 0 0 0 0
22 50 2 70 50 33 3
64 30 16 78 260 192 16
50 9 41 100 59 5
9,423 19,800 5,101 24,122 83,199 72,701 6,058
0 0 700 1,053 88
3,818 1,135 2,683 9,900 7,217 601

192 100 40 252 900 1,678 140
10 2 8 30 46 4
241 16 225 400 556 46

148 148 100 298 25
0 24 3 21 74 59 5
0 0 0 2 0
0 0 0 0 0
0 0 0 0 0
60 60 60 0 0
183 16 167 0 113 9
917 63 854 2,000 1,414 118
7 7 0 10 1
0 0 0 0 0
62 62 0 243 20
51 20 31 80 78 7
0 0 0 990 83
9,437 10,000 4,854 14,583 60,000 56,125 4,677
753 753 1,300 554 46
86 86 0 13 1
0 0 0 0 0
0 0 0 849 71
21 20 2 39 30 110 9
174 2 172 200 201 17
59 59 0 7 1
0 0 0 578 48
446 75 371 1,500 1,428 119
80 48 23 105 359 325 27
1,476 1,000 581 1,895 9,410 9,544 795
0 0 1,600 4,049 337

120 120 120 320 27
0 0 0 0 0
393 200 193 2,400 2,333 194
758 294 464 1,900 2,580 215
36 200 69 167 540 419 35
0 0 0 0 0
0 0 0 0 0
386 500 142 744 1,500 6,043 504
0 0 0 90 8
13 50 8 55 82 47 4
0 0 0 0 0
123 123 0 17 1
53 11 42 99 102 9
0 0 500 895 75
81 240 90 231 936 963 80
49 25 21 53 350 325 27
0 0 100 149 12
132 132 200 136 11
0 0 0 0 0
0 0 0 0 0
507 57 450 1,590 1,482 124
27 6 21 86 87 7
1,002 295 707 3,517 3,396 283
0 16,800 16,800 27,800 32,687 2,724
54 15 39 700 797 66
8 8 11 4 0
65 20 8 77 140 87 7
0 0 0 0 0
3,548 1,000 1,178 3,370 20,013 21,410 1,784
89 20 69 100 238 20
2 2 1 3 0
17 1 16 34 25 2
24 24 24 0 0
809 809 0 0 1,020 85
140 140 4 174 15
0 0 0 0 0
0 0 0 500 42
0 0 0 0 0
183 79 104 600 496 41
1,318 1,500 1,053 1,765 11,799 12,369 1,031
79 500 98 481 2,500 2,520 210
0 0 0 0 0
1,536 357 1,179 6,000 5,821 485
0 0 0 0 0
14 24 38 72 48 4
63 100 30 133 340 358 30
0 0 0 0 0
60 30 28 62 160 291 24
38 38 81 109 9
2 2 0 0 0
16 1 15 25 22 2
254 6 248 0 290 24
1,396 163 1,233 2,890 2,473 206
104 104 1,110 1,215 101
20 20 100 437 36
104 53 51 200 211 18
250 100 117 233 1,200 2,086 174
6 2 4 10 15 1
0 0 0 0 0
0 0 0 245 20
12 12 30 25 2
0 0 0 6 1
1,570 545 1,025 22,200 28,267 2,356
0 0 0 2 0
19 19 0 1 0
2 2 0 0 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
3,532 644 2,888 11,000 11,678 973

338 102 236 1,500 1,469 122
661 405 256 3,000 3,087 257
111 40 81 70 720 729 61
0 0 0 0 0
12,080 18,800 8,322 22,558 112,230 105,290 8,774
0 0 0 0 0
0 0 0 0 0
11 4 7 24 25 2
918 30 888 700 2,580 215
10 10 0 0 0
0 0 0 0 0
0 0 0 0 0
100 100 0 0 0
0 0 0 158 13
0 0 0 42 4
0 0 0 0 0
0 0 0 0 0
4 1 3 20 19 2
1 1 3 3 0
224 224 0 1 0
0 0 300 300 25
0 0 2,350 2,350 196
95 95 0 65 5
0 0 0 0 0
367 8 359 719 378 32

294 100 194 300 412 34
0 0 0 0 0
923 1,800 420 2,303 6,200 4,893 408
467 300 406 361 2,091 1,998 167
10 7 3 87 88 7
4 4 24 58 5
13 24 37 48 47 4
0 0 0 0 0
74 10 64 112 65 5
0 0 0 0 0
24 2 22 24 28 2
23 23 50 85 7
9 9 0 13 20 2
5 5 0 19 20 2
115 115 0 83 7
100 200 100 200 1,291 1,291 108
2,309 3,000 1,024 4,285 14,000 9,915 826
0 0 0 200 17
2 2 800 1,221 102
490 200 120 570 1,800 1,283 107
0 0 0 400 33
185 185 300 515 43
105 1,000 220 885 4,291 3,783 315
109 50 22 137 400 342 29
215 50 32 233 1,050 975 81
0 0 46 117 10
60 5 55 100 182 15
209 100 43 266 810 738 62
186 50 21 215 650 611 51
62 50 42 70 100 183 15
100 100 319 219 18
15 1 14 31 22 2
0 0 0 0 0
11 11 15 4 0
0 0 0 0 0
255 50 91 214 1,700 1,791 149
0 0 0 0 0
14 1 13 10 3 0
17 5 12 10 10 1
13 3 10 21 18 2
0 0 0 0 0
1,122 2,000 274 2,848 8,300 5,905 492
4 4 0 6 1
14 14 10 6 1
101 21 80 334 270 23
0 0 0 0 0
0 0 0 1 0
79 79 100 21 2
0 200 100 100 200 218 18
1 1 0 0 4 0
7 7 0 31 31 3
0 0 0 1 0
0 0 2 2 0
0 0 2 4 0
0 0 3 4 0
0 0 1 1 0
0 0 0 1 0
0 0 4 5 0
0 0 3 6 1
0 0 3 4 0
0 0 5 5 0
0 0 9 12 1
0 0 1 1 0
0 0 0 1 0
0 0 0 1 0
0 0 0 0 0
0 0 2 2 0
0 0 2 2 0
0 0 0 0 0
0 0 2 2 0
0 0 0 1 0
0 0 0 3 0
0 0 0 2 0
0 0 0 3 0
0 0 0 0 0
0 0 0 2 0
0 0 0 4 0
0 0 0 2 0
0 0 0 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 3 5 0
0 0 1 2 0
0 0 4 6 1
0 0 0 1 0
0 0 0 0 0
0 0 2 2 0
0 0 3 3 0
0 0 0 1 0
0 0 2 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 3 6 1
0 0 2 2 0
0 0 10 11 1
0 0 0 0 0
0 0 0 0 0
0 0 2 2 0
0 0 0 0 0
0 0 0 0 0
1 1 3 4 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 2 2 0
0 0 2 2 0
0 0 2 2 0
0 0 2 2 0
0 0 3 6 1
0 0 0 0 0
0 0 2 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 3 3 0
0 0 2 2 0
0 0 0 0 0
0 0 2 2 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 4 4 0
0 0 1 1 0
0 0 1 1 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 2 2 0
0 0 0 0 0
0 0 0 0 0
0 0 25 25 2
0 0 0 0 0
0 0 91 91 8
0 0 410 410 34
0 0 2 2 0
0 0 0 0 0
0 0 0 0 0
0 0 7 7 1
0 0 1 1 0
0 0 0 0 0
0 0 1 1 0
0 0 1 1 0
0 0 1 1 0
0 0 1 1 0
0 0 0 0 0
13 3 10 55 45 4
0 0 40 40 3
71 7 64 538 474 40
27 22 5 235 230 19
7 7 52 45 4
7 4 3 169 166 14
0 0 19 19 2
22 15 7 145 138 12
7 6 1 43 42 4
35 5 30 60 30 3
300 300 2,900 2,600 217
100 100 700 600 50
100 100 600 500 42
8 8 78 70 6

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PERENCANAAN OBAT PUSKESMAS NGLETIH KOTA KEDIRI

PENGELUARAN KEKOSO SISA KEBUTU PEREN

31 OA037 Asam Asetilsalisilat tablet 500 mg

32 OA038 Asam Asetilsalisilat tablet 80 mg

II. OBAT PROGRAM

1 OA002 Air Raksa dental Botol 0

19 OK036 Komposit Resin Posterior

dr. Susana Dewi Hanik Mariana Dewi, S.Farm. M. Farm. Klin.,Apt

KEBUTU PEREN HARGA

S.Farm. M. Farm. Klin.,Apt

15 OA018 Amoksisilin sirup kering forte 250 501 447 78 2,195,382

16 OA014 Amoksisilin drop 100 mg/ml Botol 52 53 20 0

18 OA021 Ampisilin Serbuk injeksi 1,700 1,504 320 9,537,000

20 OA026 Antasida Doen II suspensi Botol 2,115 500 27 473 1,057,500

22 Antidiare tablet (kaolin+pektin) Tablet 0 0 0 0

23 OA028 Antifungi Doen kombinasi Pot 4,574 0 0 0 0

24 OA029 Antihemoroid Doen kombinasi Supp 4,180 220 241 17 919,600

26 Antrain injeksi Ampul 0 0 0 0

36 OA042 Asam Mefenamat kapsul/kaplet 17,300 7,513 11,673 1,903,000

37 OA044 Asiklovir krim 5% Tube 3,795 99 99 56 375,705

48 OB014 Budesonid cairan inhalasi 0,25 10 6 24 106,980

49 OB015 Budesonid inhaler 200 mcg/puff Botol 116,600 4 5 2 466,400

53 OC006 Cendo Lyteers Botol 21,038 10 10 0 210,380

55 Corobion tablet Tablet 0 0 0 0

56 OD002 Dasabion tablet ( multivitamin + 0 0 0 0

60 OD010 Diazepam tablet 2 mg Tablet 1,122 1,500 1,068 540 1,683,000

61 OD014 Difenhidramin HCL injeksi i.m. 10 15 0 15 17,325

65 OD018 Doksisiklin kapsul 100 mg Kapsul 0 0 0 0

74 OE011 Etakridin (Rivanol) Larutan 0,1 % 0 0 0 0

77 OE015 Etanol 95% 1 liter Botol 42,834 0 5 2 0

82 OF011 Fenoksimetil Penicilina tablet 500 0 0 0 0

83 OF013 Fenol Gliserol tetes telinga 10% Botol 2,750 24 0 24 66,000

88 OG002 Gentamisin Inj. 80 mg/ml (Sulfat) Ampul 0 0 200 0

106 OH010 Hiosin-N-butilbromida injeksi Ampul 14,850 0 56 0 0

117 OK007 Kaptopril tablet 50 mg Tablet 154 3,000 3,000 0 462,000

126 OK021 Kloramfenikol suspensi 125 mg/5 53 50 33 70 217,550

129 OK024 Klorfeniramin Maleat ( CTM ) 83,200 72,702 24,122 3,827,200

133 OK038 Kontrasepsi oral Linesterol tablet 30 46 8 528,000

134 OK039 Kotrimoksazol Doen I (dewasa) 400 556 225 60,800

136 OK041 Kotrimoksazol suspensi kombinasi Botol 2,515 74 59 21 186,110

137 OL001 Lactulax sirup Botol 0 2 0 0

145 OM003 Magnesium Sulfat injeksi (IV) 0 243 62 0

146 OM006 Metamizol injeksi 500 mg/ml Ampul 11,550 80 78 31 924,000

147 OM007 Metampiron tablet 500 mg Tablet 281 0 990 0 0

152 OM012 Metilprednisolon tablet 4 mg Tablet 194 0 849 0 0

153 OM013 Metoklopramid Injeksi 5mg/ml Ampul 13,750 30 110 39 412,500

162 ON003 Natrium Bikarbonat tablet 500 mg Tablet 24 0 0 0 0

167 Neurovit E tablet Kaplet 0 0 0 0

179 OO015 Omegdiar tablet Tablet 0 0 0 0

182 OP002 Parasetamol drop 100 mg/ml Botol 8,140 86 87 21 700,040

193 OP020 Povidon Iodida Larutan 10% 300 24 0 24 475,200

194 OP022 Prednison tablet 5 mg Tablet 84 0 1,020 0 0

203 OS001 Salbutamol tablet 2 mg (sebagai 6,000 5,821 1,179 390,000

204 OS002 Salbutamol tablet 4 mg (sebagai 0 0 0 0

210 OS013 Serum Anti Tetanus inj. 1500 0 0 2 0

217 OS024 Siprofloksasin tablet 500 mg 1,200 2,086 233 370,800

222 OS032 Sulfasetamid Natrium tetes mata 0 6 0 0

224 OT008 Terbutalin sulfat 0,5 mg - spray 0 2 0 0

227 OT012 Tetrasiklin HCL Kapsul/kaplet 250 0 0 0 0

229 Tiamin HCL (Vit B1) Inj. 100 502 0 0 0 0

232 OT020 Triheksifenidil Hidroklorida tablet 2 3,000 3,087 256 264,000

1 Benzatin benzil penisilin 2,4 ui/ml Vial 10 15,950 0 10 0 0