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RENCANA PENGADAAN OBAT DAN PERBEKALAN KESEHATAN

UNTUK PELAYANAN KESEHATAN DASAR
TAHUN 2012

NO

NAMA OBAT

KEMASAN

HARGA
KEMASAN

Sisa Stok

(HNA + PPN)*
1

2

1
2
3
4
5
6
7
8
9

Alopurinol tablet 100 mg
Aminofilin tablet 200 mg
Aminofilin injeksi 24 mg/ml
Amitripilin tablet salut 25 mg (HCL)
Amoksisilin kapsul 250 mg
Amoksisilin kaplet 500 mg
Amoksisilin sirup kering 125 mg/ 5 mg
Metampiron tablet 500 mg
Metampiron injeksi 250 mg

10

Antasida DOEN I tablet kunyah, kombinasi :Aluminium Hidroksida 200 mg + Magnesium
Hidroksida 200 mg

11

Anti Bakteri DOEN saleb kombinasi : Basitrasin 500 IU/g + polimiksin 10.000 IU/g

12

Antihemoroid DOEN kombinasi : Bismut Subgalat 150 mg + Heksaklorofen 250 mg

13
14

Antifungi DOEN Kombinasi : Asam Benzoat 6% + Asam Salisilat 3%
Antimigren : Ergotamin tartrat 1 mg + Kofein 50 mg

15

Antiparkinson DOEN tablet kombinasi : Karbidopa 25 mg + Levodopa 250 mg

16
17
18
19
20
21
22
23
24

Aqua Pro Injeksi Steril, bebas pirogen
Asam Askorbat (vitamin C) tablet 50 mg
Asam Asetisalisilat tablet 100 mg (Asetosal)
Asam Asetisalisilat tablet 500 mg (Asetosal)
Atropin sulfat tablet 0,5 mg
Atropin tetes mata 0,5%
Atropin injeksi l.m/lv/s.k. 0,25 mg/mL - 1 mL (sulfat)
Betametason krim 0,1 %
Deksametason Injeksi I.v. 5 mg/ml

25
26
27
28

Deksametason tablet 0,5 mg
Dekstran 70-larutan infus 6% steril
Dekstrometorfan sirup 10 mg/5 ml (HBr)
Dekstrometorfan tablet 15 mg (HBr)

3

4

5

Total
Pemakaian

Total

per Bulan

(Kemasan)

Usulan Kebutuhan

6

7= 6x 18 bulan

9=7-5

100 tablet/strip/blister , kotak
100 tablet / botol
30 ampul / kotak
100 tablet/strip/blister , kotak
120 kapsul/strip/blister, kotak
100 kaplet/strip, kotak
Botol 60 ml
1000 tablet / botol
30 ampul / kotak

13,200
10,450
77,000
11,500
33,000
37,000
3,700
51,580
36,700

btl 1000 tablet

30,530

-

25 tube @ 5 g / kotak

62,920

254

10 supp / kotak

20,000

609

24 pot @ 30 g / kotak
100 tablet / botol

41,250
10,280

187
-

0
0

ktk 10 x 10 tablet

97,700

-

0

10 vial @20 ml / kotak
1000 tablet / botol
ktk 10 x 10 tablet
ktk 10 x 10 tablet
500 tablet / botol
24 btl @ 5 ml / kotak
30 ampul / kotak
25 tube @ 5 g / kotak
100 ampul /kotak

55,000
27,500
8,800
14,300
30,000
67,216
33,000
46,650
178,000
24,090
35,526
2,700
35,640

1000 tablet / botol
Botol 500 ml
Botol 60 ml
1000 tablet / botol

215
708
145
48
6,870
26,750
-

Pemakaian
Rata-rata

22
298
11
233
142
10
4,100
-

26
60
10
208
9,964
950
724

51
36

39

49
12
60
45
261

468
1080
0
180
3744
179352
17100
13032
0
0
918
648

0
702
0
0
0
0
0
882
216
1080
0
810
4698

253
372
35
3,696
172,482
(9,650)
13,032
664
39
400
(22)
404
(11)
649
74
1,070
(3,290)
4,698

1000 tablet / botol
30 ampul /kotak
Botol 300 ml
ampul @ 2 ml
30 ampul / kotak
1000 tablet / botol
100 tablet / kotak
100 tablet / kotak
24 btl @ 5 ml / kotak
30 ampul / kotak
100 tablet / botol
ktk 20 x 10 tablet
Botol 30 ml

71,043
13,200
10,000
24,000
12,400
35,390
26,400
31,000
1,800
48,368
39,000
25,000
23,400
41,500
24,200
43,500
68,062
18,000
2,200

9
79
24
879
255
22
1,850
218
55
97
-

100 kantong/kotak tahan lembab

38,000

1,005

Gentian Violet Larutan 1 %
Glibenklamida tablet 5 mg
Gliseril Gualakolat tablet 100 mg
Gliserin
Glukosa larutan infus 5%
Glukosa larutan infus 10%
Glukosa larutan infus 40% steril (produk lokal)
Griseofulvin tablet 125 mg, micronized
Haloperidol tablet 0,5 mg
Haloperidol tablet 1,5 mg
Haloperidol tablet 5 mg
Hidroklorotiazida tablet 25 mg
Hidrkortison krim 2,5%
Ibuprofen tablet 200 mg
Ibuprofen tablet 400 mg
Isosorbid Dinitrat Tablet Sublingual 5 mg
Kalsium Laktat (Kalk) tablet 500 mg
Kaptopril tablet 12,5 mg
Kaptopril tablet 25 mg
Karbamazepim tablet 200 mg
Ketamin Injeksi 10 mg/ml

Botol 10 ml
100 tablet / kotak
1000 tablet / botol
btl 100 ml
btl 500 ml
btl 500 ml
10 amp @ 25 ml, kotak
ktk 10 x 10 tablet
ktk 10 x 10 tablet
ktk 10 x 10 tablet
ktk 10 x 10 tablet
1000 tablet / botol
24 tube @ 5 g / kotak
100 tablet / botol
ktk 10 x 10 tablet
ktk 10 x 10 tablet
1000 tablet / botol
ktk 10 x 10 tablet
ktk 10 x 10 tablet
ktk 10 x 10 tablet
10 vial @ 20 ml, kotak

70
71
72

Klofazimin kapsul 100 mg microzine
Kloramfenikol kapsul 250 mg
Kloramfenikol tetes telinga 3 %

100 kapsul / botol
250 kapsul / botol
24 botol @ 5 ml / kotak

73

Kloraniramina mealeat (CTM) tablet 4 mg

450
6,000
23,240
4,730
5,060
5,727
14,524
20,000
6,024
8,258
12,229
36,300
59,628
10,500
18,000
8,100
52,000
9,000
13,775
24,645
110,200
219,428
52,500
24,000
24,000

2,460
820
339
5,885
3,825
100
433
303
170
133
1,922
1,085
110
246
10
5
117
103
144
452

29

Diazepam Injeksi 5mg/ml

30 ampul / kotak

30
31

Diazepam tablet 2 mg
Diazepam tablet 5 mg

1000 tablet / botol
250 tablet / botol

32
33

Difenhidramin Injeksi I.M. 10 mg/ml (HCL)
Diagoksin tablet 0,25 mg

30 ampul / kotak
100 tablet / kotak

34

Efedrin tablet 25 mg (HCL)

1000 tablet / botol

35
36
37
38
39
40
41
42
43
44
45
46
47

Ekstrks belladona tablet 10 mg
Epinefrin (Adrenalin) injeksi 0,1% (sebagai HCL)
Etakridin larutan 0,1%
Fenitoin Natriun Injeksi 50 mg/ml
Fenobarbital Injeksi I.m/I.v 50 mg/ml
Fenobarbital tablet 30 mg
Fenoksimetil Penisilin tablet 250 mg
Fenoksimetil Penisilin tablet 500 mg
Fenol Gliserol tetes telinga 10%
Fitomenadion (Vit. K1) injeksi 10 mg/ml
Fitomenadion (Vit. K1) tablet salut gula 10 mg
Furosemid tablet 40 mg
Gameksan lotion 1 %

48

Garam Oralit I serbuk Kombinasi : Natrium 0,70 g ,Kalium klorida 0,30 g, Tribatrium Sitrt
dihidrat 0,58 g

49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69

1000 tablet / botol

110
46
60
1,191

5

532

24

390
7
562
5,349

1
60
505

808
70
59
842
1,169
2,320
70

100
20
9,288

0
1980
0
828
1080
21438
0
0
90
0
0
9576
0
0
0
0
432
0
0
7020
126
10116
96282
0
0
18
0
1080
9090
0
0
14544
1260
1062
15156
0
21042
41760
0
1260
0
0
1800
360
167184

(9)
1,901
(24)
(51)
825
21,416
(1,760)
9,576
(218)
(55)
335
6,015
(2,334)
9,296
95,943
(5,885)
(3,807)
(100)
647
9,090
(303)
(170)
14,411
1,260
(860)
14,071
(110)
20,796
41,750
(5)
1,143
1,697
216
166,732

1000 tablet / botol

19,750
22,000
36,300
83,190

193

100 tablet / kotak

47,300

-

botol 60 ml

3,500

16,400

Kotrimosazol DOEN I (dewasa) Kombinasi : Sulfametoksazol 400 mg, Trimetoprim 80 mg

ktk 10 x 10 tablet

16,000

3,505

81

Kotrimosazol DOEN II (pediatrik) Kombinasi : Sulfametoksazol 100 mg, Trimetoprim 20 mg

ktk 10 x 10 tablet

7,000

82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113

Kuinin (kina) tablet 200 mg
Kuinin Dihidrokklorida injeksi 25%-2 ml
Lidokain injeksi 2% (HCL) + Epinefrin 1 : 80.000-2 ml
Magnesium Sulfat inj (IV) 20%-25 ml
Magnesium Sulfat inj (IV) 40%-25 ml
Magnesium Sulfat serbuk 30 gram
Mebendazol sirup 100 mg / 5 ml
Mebendazol tablet 100 mg
Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 mg
Metilergometrin Maleat injeksi 0,200 mg -1 ml
Metronidazol tablet 250 mg
Natrium Bikarbonat tablet 500 mg
Natrium Fluoresein tetes mata 2 %
Natrium Klorida larutan infus 0,9 %
Natrium Thiosulfat injeksi I.v. 25 %
Nistatin tablet salut 500.000 IU/g
Nistatin Vaginal tablet salut 100.000 IU/g
Obat Batuk hitam ( O.B.H.)
Oksitetrasiklin HCL salep mata 1 %
Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml
Oksitosin injeksi 10 UI/ml-1 ml
Paracetamol sirup 120 mg / 5 ml
Paracetamol tablet 100 mg
Paracetamol tablet 500 mg
Pilokarpin tetes mata 2 % (HCL/Nitrat)
Pirantel tab. Score (base) 125 mg
Piridoksin (Vitamin B6) tablet 10 mg (HCL)
Povidon Iodida larutan 10 %
Povidon Iodida larutan 10 %
Prednison tablet 5 mg
Primakuin tablet 15 mg
Propillitiourasil tablet 100 mg

114
115

Propanol tablet 40 mg (HCL)
Reserpin tablet 0,10 mg

74

Klorpromazin injeksi i.m 5 mg/ml-2ml (HCL)

30 ampul / kotak

75
76

Klorpromazin injeksi i.m 25 mg/ml (HCL)
Klorpromazin tablet salut 25 mg (HCL)

30 ampul / kotak
1000 tablet / botol

77

Klorpromazin HCl tablet salut 100 mg (HCL)

78

Anti Malaria DOEN Kombinasi Pirimetamin 25 mg + Sulfadoxin 500 mg

79

Kotrimosazol Suspensi Kombinasi :Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml

80

ktk 60 tablet
30 ampul / kotak
30 vial / kotak
10 vial / kotak
10 vial / kotak
10 sase @ 30 gr / kotak
Botol 30 ml
ktk 5 x 6 tablet
ktk 10 x 10 tablet
30 ampul / kotak
100 tablet / kotak
1000 tablet / botol
24 botol @ 5 ml / kotak
Botol / plastik 500 ml
ktk 10 amp @ 10 ml
ktk 10 x 10 tablet salut
ktk 10 x 10 tablet Vaginal
Botol 100 ml
25 tube @ 3,5 g / kotak
10 vial / kotak
30 ampul / kotak
Botol 60 ml
100 tablet / botol
1000 tablet / botol
botol @ 5 ml
ktk 30 x 2 score
1000 tablet / botol
Botol 30 ml
Botol 300 ml
1000 tablet / botol
1000 tablet / botol
100 tablet / botol
100 tablet / botol
250 tablet / botol

35,000
104,000
31,000
15,398
19,479
10,266
3,000
6,300
10,996
41,000
13,000
14,300
94,216
4,900
27,000
55,000
34,500
1,500
48,000
31,000
53,550
2,300
3,800
33,700
5,214
18,600
14,300
2,000
14,500
57,500
101,800
29,957
12,100
18,800

192

0
71
1,034

295
98
34
159
110
1,560
743
11,130
505
200
16,150
479
1,130
693
588
10
-

0
0
0
3456

1278
18612
0

27

5

4

20
84

108
9,999

982

1,088

0
0
486
0
0
0
0
0
90
0
0
0
0
72
0
0
360
1512
0
0
0
1944
0
179982
0
0
17676
0
0
19584
0
0
0
0

3,263
(15,122)
15,107
191
(98)
56
(159)
(110)
(1,488)
(383)
(9,618)
(505)
1,744
(16,150)
179,982
17,197
(1,130)
(693)
18,996
(10)
-

116

Reserpin tablet 0,25 mg

117

Ringer Laktat larutan infus

118

Salep 2-4, kombinasi: Asam Salisilat 2% + Belerang endap 4%

119

Salisil bedak 2%

120
121

Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I)
Serum Anti Bisa Ular Polivalen injeksi 50 ml (ABU II)

122
123
124
125
126
127
128
129
130
131
132
133
134
135

Serum Anti Difteri Injeksi 20.000 IU/vial (A.D.S.)
Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.)
Serum Anti Tetanus Injeksi 20.000 IU/vial (A.T.S.)
Sianokobalamin (Vitamin B12) injeksi 500 mcg
Sulfasetamida Natrium tetes mata 15 %
Tetrakain HCL tetes mata 0,5%
Tetrasiklin kapsul 250 mg
Tetrasiklin kapsul 500 mg
Tiamin (vitamin B1) injeksi 100 mg/ml
Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat)
Tiopental Natrium serbuk injeksi 1000 mg/amp
Triheksifenidil tablet 2 mg
Vaksin Rabies Vero
Vitamin B Kompleks tablet
Alat Kesehatan
Alat suntik sekali pakai 1 ml
Alat suntik sekali pakai 2,5 ml
Alat suntik sekali pakai 5 ml
Catgut / Benang Bedah No. 2/0 dengan jarum bedah
Catgut / Benang Bedah No. 3/0 dengan jarum bedah
Infusion set anak
Infusion set dewasa
IV Catheter No. 20 G
IV Catheter No. 22 G
IV Catheter No. 24 G
Kapas Berlemak 500 gram
Kapas Pembalut / Absorben 250 gram
Kasa Kompres 40/40 steril
Kasa Pembalut 2 m x 80 cm
Kasa Pembalut Hidrofil 4 m x 3 cm elastic
Kasa Pembalut Hidrofil 4 m x 15 cm elastic
Pembalut Gips
Plester 5 yards x 2 inch
Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah
Wing Needle No. 21 G
Wing Needle No. 23 G
Wing Needle No. 25 G

136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159

1000 tablet /botol
btl 500 ml
24 pot @ 30 g / kotak
50 gram / kotak
10 vial / kotak
1 vial / kotak
10 vial / kotak
10 ampul / kotak
10 vial / kotak
100 ampul / kotak
ktk 24 btl @ 5 ml
ktk 24 btl @ 5 ml
1000 kapsul / botol
ktk 10 x 10 kapsul
ktk 30 amp @ 1 ml
1000 tablet / botol
Ampul @ 10 ml
ktk 10 x 10 tablet
1 kuur / set
1000 tablet / botol

88,000
5,200
29,500
1,100
707,900
26,983,968
1,934,708
151,223
1,049,895
97,000
82,686
81,514
152,000
25,000
21,000
35,200
60,579
4,077
308,000
22,200

Wing Needle No. 27 G
Obat Gigi

100 buah / kotak

109,250
103,800
103,800
640,000
640,000
4,000
3,500
389,375
389,375
389,375
17,250
7,500
1,393
8,799
733
3,373
6,071
23,625
251,400
577,000
577,000
577,000
549,750

Etil Klorida spray

Vial / Can / 100 ml

105,000

100 set / kotak
100 set / kotak
100 set / kotak
24 x 70 cm / kotak
24 x 70 cm / kotak
Set /kantong
Set /kantong
50 buah / kotak
50 buah / kotak
50 buah / kotak
Bungkus
Bungkus
Bungkus
Rol
Rol
Rol
Rol
Rol
12 x 3 x 75 cm / kotak
100 buah / kotak
100 buah / kotak
100 buah / kotak

5,425
314
2,300
791
52
277
575
11
279
175
418

1
10
63

90
11

478
10,812

6,425

1
5

###

13

7

1
41
48

###
34
19

31

4

21

7

0
18
180
1134
0
0
0
0
0
1620
198
0
0
8604
0
194616
0
0
0
115650
0
0
0
0
0
18
0
0
0
0
0
0
126
0
18
612
342
0
72
0
0
0
0
0
0
126

(5,407)
(134)
(1,166)
829
146
(277)
8,029
(11)
194,337
(175)
115,232
17
(5)
113
17
571
294
41
105

500 1 Set @ 100 gram / botol 34.082 788 630 .403 9.600 55.128 5.675 21.1% Gentamisin Sulfat tetes mata 5 ml Ketokonazol tablet 200mg Lisol Meloksikam tablet 7.126 33 370 658 12 14.000 23.133 390.500 3.884 76.300 18.880 625 3.000 40.000 395.591 4 60 552 57 26 458 6 1.920 15.950 19.360 8.819 9.890 35 370 2.000 93.818 57.072 886 208 112 1.000 55.500 10.000 4 160 161 162 Eugenol cairan Glass Ionomer Cement ART Kalsium Hidroksida Pasta 12 botol @ 10 ml / dus.793 625 180 4.543 41 288 1.320 401 13.001 126 8.000 5.499 14.5 mg Mikonazol krim /salep 2 % Natrium diklofenak tablet 50 mg Oksigen gas Piroksikam tablet 20 mg Salbutamol tablet 2 mg Salbutamol tablet 4 mg Salicyl Spiritus Siprofloksasin tablet 500mg Metilprednisolon tablet 4 mg Metronidasol tablet 500mg Oksitetrasiklin salep kulit Ranitidin tablet btl/60ml ktk/100 ktk/25 tube ktk/100 tube 5 gram ktk/10x10 ktk/10x10 ktk ktk/10x10 btl/100 ktk/10x10 btl 60 ml liter btl 250 ktk 10 tube btl ktk/5x10 btl ktk/5x10 tube 10 gr ktk 5 x 10 6 M3 ktk 10x10 box/100 box/100 btl ktk/100 ktk/100 ktk/100 tube 5 gram ktk/100 3.267 1.749 4.000 10.000 7.781 50 (60) 6.000 176.852 37 26 354 3 371 5 22 62 1 900 57 919 490 527 900 376 405 50 140 630 6660 0 51336 666 468 6372 54 0 0 6678 0 90 0 0 396 1116 18 16200 0 1026 0 16542 8820 9486 0 16200 6768 7290 900 2520 Total 530 4.500 22.1 ### Set @ 30 gram / botol 550.275 7.300 11.120 26. kotak Set / botol 2 tube / kotak 163 164 Klorfenol kamfer Menthol ( CHKM ) Mummifying Pasta Botol 10 ml Botol / kotak 165 Semen Seng Fosfat serbuk dan cairan 166 Temporary Stopping Fletcher (Fletcher) serbuk dan cairan ### 18 0 0 0 0 18 17 17 1 18 14 Catatan : Untuk Item Obat tambahan yang bersumber dari Dana DAK NAMA OBAT KEMASAN HARGA KEMASAN (HNA + PPN)* Sisa Stok NO Pemakaian Rata-rata per Bulan Total Pemakaian (Kemasan) Usulan Kebutuhan 1 2 3 4 5 6 7= 6x 18 bulan 9=7-5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Ambroxol Syrup Ambroxol tablet 30 mg Anti Bakteri Doen salep kombinasi: Asam mefenamat tablet 500mg Asiklovir krim 5 % Asiklovir tablet 200mg Asiklovir tablet 400 mg Devitalisasi Pasta Doksisiklin kapsul 100mg Ergotamin tartrat Erythromicin kapsul 500mg Erythromicin Syrup 200 mg /5 ml Ethanol 70 % Fenitoin Natrium kapsul 30 mg Gentamisin salep kulit 0.150 38.510 18.500 48.327 62.700 3.660 45.280 71.000 10.000 1.500 8.882 7.370 3.000 242.000 100 2.

700 Btl 60 ml 3.026 3.000 IU kapsul lunak 72 Thiamfenikol kapsul 500mg 73 Tramadol kapsul 50mg 74 Sefotaxim Injeksi 1 gram 75 Handscoon btl 1000 btl ktk 10x10 tablet 47.500 15.500 8.618 13.900 2.800 7.650 3.675 10.921 10 3.631 470 (250) 6.000 1.332 2.000 31.680 8.500 13.500 55.720 3.000 IU kapsul lunak 71 Retinol (Vitamin A.328 31.351 430 250 875 458 10 45 7 2.650 1.32 Asam Folat 5 mg 33 Metakresol Sulfonat solution 34 Metampiron tablet 500 mg Antasida DOEN II Suspensi kombinasi :Aluminium Hidroksida 200 mg + Magnesium 35 Hidroksida 200 mg Antasida DOEN I tablet kunyah.500 Ktk Rol Rol/100 Rol /50 tube 15 gram Ktk 5x 10 tablet Botol 10ml tube 5 gram Btl 5 ml Ktk 100 amp@ 2 ml ktk 10x10 tablet ktk 5 x 10 tablet Btl 60 ml ktk/10x10 Ktk 5x10 tablet Ktk 10x10 tablet Ktk 3 x 10 kapsul Btl 15 ml Ktk 10x10 tablet btl 50 kapsul lunak btl 50 kapsul lunak ktk 10x10 kapsul ktk 5 x 10 kapsul ktk 2 vial 50 pasang/kotak 1.243 11.764 300 13.645 1.500 Ktk 10x10 tablet Ktk 10x10 tablet btl 100 tablet btl 250 tablet btl 100 tablet btl 5 ml btl 250 tablet ktk 10x10 tablet ktk/3x10 ktk 10x10 ktk 10x10 ktk 25 sachet btl 60 ml ktk/5x10 8.5 mg 38 Dekstrometorfan tablet 15 mg (HBr) 39 Diazepam tablet 2 mg 40 Efedrin tablet 25 mg (HCL) 41 Fenobarbital tablet 30 mg 42 Kloramfenikol tetes telinga 3 % 43 Klorpromazin HCl tablet salut 100 mg (HCL) 44 Paracetamol tablet 500 mg 45 Betahistin Mesilat tab 6 mg 46 Bromheksin tablet 8 mg 47 Cetrizin tablet 10 mg 48 Garam Oralit serbuk Kombinasi 49 Ibuprofen suspensi 100mg/5ml 50 Kalium diklofenak tablet 50 mg 51 Kasa Hidrofil Steril uk.500 9.000 18.600 10.350 7. 16 x 16 ( isi 16 lembar) 52 Kasa hidrofil uk 36 m x 80 cm 53 Kasa pembalut hidrofil 4m x 5cm 54 Kasa pembalut hidrofil 4m x 10 cm 55 Ketokonazol krim 2 % 56 Ketokonazol tablet 200 mg 57 Klorfenol Kamfer Menthol (CHKM) 58 Klorampenikol salep mata 1 % 59 Klorampenikol tetes mata 0.704 216 724 - 10.5 % 60 Lidokain Injeksi 2% 61 Loperamid tablet 2 mg 62 Loratadin tablet 10 mg 63 Metoklopramida syrup 5 mg/5ml 64 Metformin Hcl tablet 600 mg 65 Natrium diklopenak tablet 25 mg 66 Nipedipin tablet 10 mg 67 Omeprazol kapsul 20 mg 68 Parasetamol drops 69 Piroksikam tablet 10mg 70 Retinol (Vitamin A.384 10.191 532 20 192 9.600 55.340 4.350 30.250 4.000 9.000 58.008 934 1.575 1.401 8.200 28.389 625 265 161 300 2.500 27.750 10.500 .106 6.563 2.999 50 390 62 15 27 8 390 57 60 152 100 3888 0 13032 0 42120 89658 4698 1980 21438 9576 360 3456 179982 900 0 0 7020 0 0 0 0 0 0 0 1116 0 270 0 486 0 0 144 7020 1026 0 1080 0 0 0 0 2736 0 0 1800 2.) 200.852 15.981 261 110 1.631 401 815 2.000 16.500 35.155 16.655 350 68 170.650 4.785 12.850 ktk 10x10 tablet kunyah 13.) 100.400 212.388 9.200 30.747 13.654 2.145 658 260 441 137 4.000 21. kombinasi :Aluminium Hidroksida 200 mg + 36 Magnesium Hidroksida 200 mg 37 Deksametason tablet 0.373 76.100 16.500 31.

000 10.110 325.000 15.Campak) Spuit 0.350 3.Campak) Spuit 0.5 ml untuk iminisasi bayi (DPT.000 2.05 ml untuk imunisasi BCG Spuit 5 ml untuk oplos vaksin 22.500 10.300 42.384 - 50 100 - 700 416 - 900 0 0 0 0 0 0 0 1800 0 0 0 0 0 0 0 0 0 0 0 0 0 OBAT DAN PERBEKALAN KESEHATAN PENUNJANG PKD NAMA OBAT KEMASAN HARGA KEMASAN (HNA + PPN)* Sisa Stok NO Pemakaian Rata-rata per Bulan Total Pemakaian (Kemasan) Usulan Kebutuhan 1 2 3 4 5 6 7= KOLOM 6 x 18 bulan 9=KOLOM 7.000 38.000 10.500 3 411 39 1 - 1 1 0 66 2 0 1 0 0 0 2 2 6 15 Biji Botol Biji 87.TT.000 75.76 77 78 79 Masker Urine bag Foley catheter Vaksin var 20 pcs/kotak pcs pcs vial 1 2 3 4 Obat Jiwa Alprazolam 0.000 8.850 396.500 97.000 biji biji Biji biji biji 2.KOLOM 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 Air Raksa Dental Use Aquadest Steril Asam Klorida 0.500 4.tambah darah) Kalium Permangat Serbuk Kodein HCl 10 mg Silver Amalgam serbuk 65-75% Spons Gelatin cubicles 1x1x1 cm Syntetic filling material cair & serbuk Trikresol Formalin (TKF) cairan Yodium Povidon 10 % / 60 mL Yodium Povidon 10 % / 1000 mL Anabion syr Anacetin syr 15 Band utk matrix 16 Xanvit syr 17 Cresopat Botol Botol Botol 1 sase @ 30 tab Pot Botol 250 tablet Botol Biji Botol Botol Botol Botol Botol Botol 103.500 3.750 200 1.181 32 4 11 7 5 7 36 38 108 270 2 907 7 6 9 4 771 (7) 4 11 7 5 6 36 38 108 270 (0) 680 6 .495 117.000 kotak /100 kotak /100 kotak /100 kotak /100 58.350 2.000 2.000 3.5 ml untuk BIAS (DT.500 2 227 1 0 50 0 Total 9 9 4 1.500 90.000 67.000 95.1 N Besi II Sulfat tab (tab.000 25.5 ml untuk imunisasi WUS dan Bumil Spuit 0.5 mg Alprazolam 1 mg Clobazam tablet 10 mg Triflouperazin tablet 5 mg 1 2 3 4 5 Imunisasi Spuit 0.350 2.000 9.

163 65.789 60.375 12.000 128.800 4.500 361.800 2 1 0 10 49 4 10 0 0 2 1 27 14 0 15 2 24 24 10 1 3 10 0 0 2 1 6 3 0 1 4 9 2 10 5 0 5 0 50 3 0 3 1 1 0 1 1 6 1 0 0 3 1 1 1 110.700 47.800 31.000 29.000 25.000 45.875 2.000 40.000 86.100 93.000 100.500 15.000 - 1 25 Dos 25x4 kaplet Dos 100 kaplet Botol Botol 1000 tablet Botol Ktk 10x10 tablet Biji Dos 10x12 kapsul Biji Set Ktk 10x10 kapsul Vial Biji Tube 10 gram Botol Dos 20x4 tablet Dos 10x10 kapsul 50 Buah / Kotak Strip 10 kapsul Dos 10x10 kaplet Biji Ktk 10x10 tablet Dos 10x10 tablet Botol Tube Set Rectal tube Btl 250 tablet Ktk 10x10 tablet Pak 10 lembar 10x10 cm Paket 20 ampul 1 mL 5 mL enema Biji Biji Botol 100 tablet 100 set / kotak Box 50 tablet Roll 16 32 4 13 54 171 4 4 27 19 108 45 7 18 75 160 27 180 90 8 90 0 900 54 4 54 20 18 4 18 11 108 18 4 1 45 22 22 29 2 11 54 171 3 3 27 9 59 45 3 18 65 160 27 180 90 7 90 0 900 54 2 (1) 54 (7) 18 4 4 11 93 18 2 1 45 (2) (2) 8 0 71 25 .000 3 2 2 0 Box 66.250 4.000 389.875 4.000 64.000 0 19 0 5 18 0 90 6.000 215.000 103.000 396.000 10.000 22.000 5.000 650.000 - 3 4 1 54 72 54 72 16 Biji Botol 650.000 171.000 12 1 18 6 Dos 100 kaplet Dos 25x4 dragee Biji 35.000 17.600 9.000 2.000 210.18 Diamond Bor High Speed 19 Extra Flu tab 20 Biopradyn tab 21 Fuji II 22 Fuji IX 23 Fumakresol 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 Hypafix 15 cm x 5 m Santa E tab 100 mg Supralivron tab Minyak Boor Spray Papaverin tab Perhidrol (H2O2) 2% Metoklopramid tab 10 mg PP Pregnancy test Pronita kaps Seloloid strip Stop TB Kit / Obat TB Paket Dewasa Tetrasiklin 500 mg Xylomidon inj.000 85.500 300. Microlax Enema Jarum Hecthing Kulit Besar Jarum Hecthing Otot Besar Asam Folat 1 mg 61 Spuit 10 mL 62 Xanvit tab 63 Tissue gulung Biji 36. Caviton Chloramfecort H krim Calortusin syr Dulcolax tab 5 mg Neurotropic kaps IV Catheter 18 G Triomin E kaps Calortusin kaplet Cresopen Dilitiazem 30 mg Prenatin Plus tab Bayclin cair K-Y Jelly Blood Test Serra Stesolid Rectal 5 mg Fenobarbital 100 mg Tablet Zink Sofratulle Obat TB Paket Anak Modecate inj.000 7.400 93.500 70.000 58.

000 Biji 2x5 supositoria Dos 20 ampul 2 mL Botol 30 mL larutan Botol 8 mL Botol Biji Dos 25 vial @ 10 mL Dos 20 ampul Botol 5 gr serbuk Botol Roll Dos 100 pcs Dos 5 ampul 1 mL 50 pasang/kotak 10x10 tablet 400 mcg Rectal tube Box 100 tablet Tube Dos 6 supositoria 2.5 mL UDV x 20 nebules Dus 20 ampul 2.000 5.000 115. Oxoferin Otopain tetes telinga Ocho Nu Alloy Neurotropin inj.250 18.5000 Nebacetin powder Mercury terdestilado Kasa Medifil 40 Y x 80 cm S 24 Surgical Blade / Mess no.000 135.30 mg 109 Asam Traneksamat / Kalnex inj.500 5.500 85.64 Tranfusi Set / Blood Set 65 Zolacort krim 66 Xylol 67 Tensimeter 68 Termometer Digital 69 Stetoskop 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 Amalgam Cair Proris supp 125 mg Pehacain inj.000 15.250 10.000 63. Metil Prednisolon inj.000 92. Neurobion inj.000 300. Albothyl sol.000 0 - 5 5 8 18 11 9 18 36 11 5 13 45 36 9 22 14 18 18 18 108 90 1.250 230.080 6 2 2 2 270 7 22 540 108 1.000 1.684 160.000 40.250 30.000 64.000 19.000 15.080 6 2 2 2 270 7 22 540 108 1.000 - 1 1 1 1 2 1 0 1 3 2 1 1 1 1 1 1 6 5 60 0 0 0 0 15 0 1 30 6 63 0 2 0 1 0 2 1 1 Ktk 5 x 10 tablet Ktk 12 ampul @ 1 mL 57.500 mg Metoklopramid inj.250 mg Set - 1 18 18 1 10 0 0 180 4 180 4 4 1 0 0 - 60.5 mg Nebules 0.50 mg/mL 65.000 - 0 5 Tube Botol Set Set Set 10.500 11. Handscoon Obgyn Folavit 400 µg Dumin Rectal supp 125 mg Demacolin tab Dexocort krim 10 gr Dulcolax supp 10 mg Combivent Nebules Ventolin Nebules Flixotide Nebules Coldrexin syr Calcil Burnazin / Dermazin krim 35 gr Blood Lancet Biovitan syr Bahan Polesing (rubber+brush) Articulating Paper Alinamin F tab Alinamin F inj.000 170.000 80.000 35.000 130.000 34.000 87.134 2 36 4 25 1 36 18 18 36 15 5 . 107 Levofloxacin 500 mg 108 Ketorolac inj.000 28.134 2 36 4 25 1 36 18 5 7 18 11 9 18 36 11 5 13 45 36 9 22 13 18 18 18 108 90 1.000 350.5 mg/2 mL x 20 nebules Botol Kotak Tube Biji Botol 60 mL Biji Box Dos 10x10 tablet Dos 5 ampul 10 mL Botol 10 mL konsentrat Ktk 25 ampul Dos 5 ampul 4 mg/2 mL Ktk 1 vial Ktk 10 ampul @ 2 mL 25.200 76. Ondancetron / Cedantron inj.250 103.22 Hyoscine / Scopamin inj. Ranitidin inj.000 61.380 - 2 1 18 36 15 Dos 10 ampul 5 mL inj.500 7.

000 150.000 15.800 54 7 890 35 71 2 1 Pak Pak Pak Pak Bks Lembar Bh Biji Bh Box isi 60.440 720 1.200 20 0 360 5 360 5 Biji Biji Bungkus Set Set 1.000 500 12.000 4.000 10.000 lembar 300.800 54 7 900 36 72 2 1 1.000.500 50 30 1 0 0 900 540 11 2 2 - 900 540 11 2 2 - 80 40 100 3 0 50 2 4 0 0 1.250 299.000 10.110 Termometer Raksa Set 1 1 11 10 BAHAN DAN ALAT LABORATORIUM 1 Stik Gula Darah 2 Reagen BTA 3 4 5 6 7 1 2 3 4 5 6 7 8 9 10 Pot Sputum Objek Glass Kertas tissue mikroskop Hb Sahli Alat tes gula darah DAN LAIN-LAIN Klip obat plastik kecil Klip obat plastik sedang Tas kresek kecil Tas kresek sedang Kertas perkamen Kartu stok obat Buku Register Obat Spidol besar hitam permanen (Boardmarker) Buku MIMS Kertas pembungkus puyer Stik Kit 9.440 720 1.000 8.000 10.000 25.000 5.000 100.000 10 1 1 0 .

850 13.381.000) 30.000 25.778.275.000 (35.500.339.000 16.000 6.705.000 (363.TOTAL Rp 10=9x4 3.720 .436.500 121.968.883.300 (8.000 (1.834.560 41.400 402.172.000) 167.776.887.110.600 3.190.880 780.000) 672.210.000) 11.

240 (3.169.000) (1.100) (21.093.224.184.001.000) 10.500 5.912.000 2.715.000 375.078.000 4.092.229.500) 22.387) 25.000 (5.800.930) 523.000) 239.160 (2.050.200 (240.168.000 .000) 1.400) 12.119.802.(639.689) (1.770 228.000 (1.174) (2.000 54.778.568.235 89.131.000 (68.940.230.776.300 75.278.502.452.392.000 (891.300) 55.570.600) (2.081.030.275.750.392.320 (29.000 757.400.875) 28.758.280 (9.000) 253.

500) 1.655.068) 615.917.000 (1.519.000) 241.100 (2.712.048.500) (14.200) (13.065.000) 6.927.006.000 (1.000) (10.271.393.427.270.092.291.430.000) (15.000 5.011.448.018.000) (7.400 245.213.000) - .970 (52.260.776 (6.921.370.000) (1.000) 4.200 (61.

104.500 149.282.150.116.475) 2.413.000 (231.000) 847.400) (3.072.543 991.558.000 12.000 .840.600) 80.583 418.625 11.953.400 (713.025.000) (1.725.400 10.156 (42.880.662.662 968.000) 200.(28.000 (20.000) 6.

000 TOTAL Rp 10=9x4 1.250.9.000 1.873 19.380.900 13.558.500.987.467 1.589.364.500 1.000 4.500 65.392.000 582.350.000 .783.387.968.238.900 134.791.000 12.640 215.750 6.749.946.000 52.221.000 742.000 1.824.923.152.230.000) 434.319.820 709.000 (1.500 476.484 139.703.240 273.800 660.057 91.000 287.

000 37.750 420.000 155.750) 61.350.535.750.000 287.955.000 1.263.625.500 13.770 12.380 13.421.984 9.600 423.800 406.750 149.193.028.700 76.500 3.578.238.411.000 139.983.000 1.400 (3.609.671.600 780.000 318.500 651.361.525.000 .945.791.918.105.900 30.

080.000 1.000 135.15.000 - TOTAL Rp 10=9x4 618.000 540.000 39.000 2.500 118.458.000 418.000 (17.587.300 .520.750.800 (23.170 2.510.600 1.800 1.380.100) 349.000 90.596 3.500) 7.541.565.000 54.

185.890.216.060 318.990 475.614) 3.000 4.000 1.220.000 273.800.623.510.000 405.044.528 259.900) 37.000 10.000 85.287 5.700.500 990.600 119.040) 855.750 1.600 4.000 411.600 699.800 3.400 151.608.400 2.000 1.110.000 76.430.200 341.400 (10.000 268.200 5.000 344.584.000 2.644.000 (6.400.200 83.000 6.000 634.780.840.900) (6.392 15.000 523.250 5.000 1.530.000 1.000 (77.000 19.600 4.121.299.663 10.200 .

405.000 16.800 198.000 243.500 1.624 2.134.000 3.138.000 1.000 549.000 1.660.260 648.300.682.000 927.845.633.000 1.000 6.000 2.160.000 315.000 1.000 153.400 810.440.000 459.000 46.000 1.000 2.700 351.620.800 882.000 172.416.000 540.080.350.000 693.000 2.1.500 180.520.620.000 734.076.000 1.000 1.000 270.000 828.000 .000 1.000 234.

500.900.000 1.000 540.333 .- 3.680 900.000 3.000 8.000 14.000 568.000 180.330.400.000 270.989.615.000 540.800.000.000 270.000 9.000 3.000 135.000 10.

5 mg 500 tablet / botol 0 22 Atropin tetes mata 0.70 g .141 35 Ekstrks belladona tablet 10 mg 1000 tablet / botol 0 36 Epinefrin (Adrenalin) injeksi 0.070 8 Metampiron tablet 500 mg 9 Antalgin tablet 500 mg 10 Metampiron injeksi 250 mg Antasida DOEN I tablet kunyah.00 613 1.1 % 25 Deksametason Injeksi I. 10 mg/ml (HCL) 30 ampul / kotak 365 33 Diagoksin tablet 0. kotak EKATALOG 4 210.v 50 mg/ml 30 ampul / kotak 0 40 Fenobarbital tablet 30 mg 1000 tablet / botol 286 41 Fenoksimetil Penisilin tablet 250 mg 100 tablet / kotak 0 42 Fenoksimetil Penisilin tablet 500 mg 100 tablet / kotak 0 43 Fenol Gliserol tetes telinga 10% 24 btl @ 5 ml / kotak 0 44 Fitomenadion (Vit.00 0 0 4 Amitripilin tablet salut 25 mg (HCL) 100 tablet/strip/blister .650 42 0 .165 68. kombinasi :Aluminium Hidroksida 200 mg + Magnesium Hidroksida 200 mg : Basitrasin 500 IU/g + polimiksin Anti Bakteri DOEN saleb kombinasi 11 12 13 14 15 10.807 0 4.v. micronized ktk 10 x 10 tablet 327 57 Haloperidol tablet 0. bebas pirogen 18 Asam Askorbat (vitamin C) tablet 50 mg 1000 tablet / botol 19. Tribatrium Sitrt dihidrat 0.k. kotak 220. kotak 205. 5 mg/ml 100 ampul /kotak 0 26 Deksametason tablet 0.25 mg/mL .00 10.Kalium klorida 0.000 IU/g DOEN kombinasi : Bismut Subgalat 150 mg + Heksaklorofen Antihemoroid 250 mg Antifungi DOEN Kombinasi : Asam Benzoat 6% + Asam Salisilat 3% Botol 60 ml 1000 tablet / botol Box/ 10 x 10 30 ampul / kotak btl 1000 tablet 116.183 6 Amoksisilin kaplet 500 mg 100 kaplet/strip.226 52 Gliserin btl 100 ml 0 53 Glukosa larutan infus 5% btl 500 ml 0 54 Glukosa larutan infus 10% btl 500 ml 0 55 Glukosa larutan infus 40% steril (produk lokal) 56 Griseofulvin tablet 125 mg.RENCANA PENGADAAN OBAT DAN PERBEKALAN KESEHATAN UNTUK PELAYANAN KESEHATAN DASAR TAHUN 2014 UPT KESMAS SUKAWATI II TOTAL: HARGA NO 1 1 NAMA OBAT 2 Alopurinol tablet 100 mg KEMASAN 3 100 tablet/strip/blister .276.356 27 Dekstran 70-larutan infus 6% steril Botol 500 ml 0 28 Dekstrometorfan sirup 10 mg/5 ml (HBr) Botol 60 ml 274 29 Dekstrometorfan tablet 15 mg (HBr) 1000 tablet / botol 647 30 Diazepam Injeksi 5mg/ml 30 ampul / kotak 0 31 Diazepam tablet 5 mg 250 tablet / botol 0 32 Difenhidramin Injeksi I.1 mL (sulfat) 24 Betametason krim 0. K1) tablet salut gula 10 mg 100 tablet / botol 50 46 Furosemid tablet 40 mg ktk 20 x 10 tablet 0 47 49 Gameksan lotion 1 % Garam Oralit I serbuk Kombinasi : Natrium 0.510 3 Aminofilin injeksi 24 mg/ml 30 ampul / kotak 3.00 SISA STOK JUMLAH PER PEMAKAIAN 1-Oct-13 1-Oct-13 5 6 730 340 2 Aminofilin tablet 200 mg 100 tablet / botol 87.5% 24 btl @ 5 ml / kotak 0 23 Atropin injeksi l.25 mg 100 tablet / kotak 0 34 Efedrin tablet 25 mg (HCL) 1000 tablet / botol 17. K1) injeksi 10 mg/ml 30 ampul / kotak 0 45 Fitomenadion (Vit.451 25 tube @ 5 g / kotak 401 10 supp / kotak 219 24 pot @ 30 g / kotak 49 100 tablet / botol 0 ktk 10 x 10 tablet 0 17 Antimigren : Ergotamin tartrat 1 mg + Kofein 50 mg Antiparkinson DOEN tablet kombinasi : Karbidopa 25 mg + Levodopa 250 mg Aqua Pro Injeksi Steril.301 19 Asam Asetisalisilat tablet 100 mg (Asetosal) ktk 10 x 10 tablet 0 20 Asam Asetisalisilat tablet 500 mg (Asetosal) ktk 10 x 10 tablet 0 21 Atropin sulfat tablet 0.1% (sebagai HCL) 30 ampul /kotak 0 37 Etakridin larutan 0.M.30 g. 0.240. kotak 0 0 5 Amoksisilin kapsul 250 mg 120 kapsul/strip/blister.m/I.71 300 1.066 7 Amoksisilin sirup kering 125 mg/ 5 mg 2.58 g Gentian Violet Larutan 1 % 50 Glibenklamida tablet 5 mg 100 tablet / kotak 3.15 649 1. kotak 0 0 864 0 3.5 mg ktk 10 x 10 tablet 0 16 48 10 vial @20 ml / kotak 30 ampul / kotak 25 tube @ 5 g / kotak Botol 30 ml 100 kantong/kotak tahan lembab Botol 10 ml 10 amp @ 25 ml.5 mg 1000 tablet / botol 12.1% Botol 300 ml 0 38 Fenitoin Natriun Injeksi 50 mg/ml ampul @ 2 ml 0 39 Fenobarbital Injeksi I.m/lv/s.852 51 Gliseril Gualakolat tablet 100 mg 1000 tablet / botol 30.92 349 1.

582 67 Kaptopril tablet 25 mg ktk 10 x 10 tablet 8.995 93 Natrium Fluoresein tetes mata 2 % 24 botol @ 5 ml / kotak 94 Natrium Klorida larutan infus 0.9 % Botol / plastik 500 ml 46 95 Natrium Thiosulfat injeksi I.600 68 Karbamazepim tablet 200 mg ktk 10 x 10 tablet 600 69 Ketamin Injeksi 10 mg/ml 10 vial @ 20 ml.HARGA SISA STOK JUMLAH NO NAMA OBAT KEMASAN EKATALOG PER PEMAKAIAN 1-Nov-13 1-Oct-13 1 2 3 4 5 6 58 Haloperidol tablet 1.000 IU/g 97 Nistatin Vaginal tablet salut 100.5 mg ktk 10 x 10 tablet 0 59 Haloperidol tablet 5 mg ktk 10 x 10 tablet 2. Kotrimosazol 100 tablet / kotak 79 80 82 Trimetoprim mg II (pediatrik) Kombinasi : Sulfametoksazol 100 mg.H.998 66 Kaptopril tablet 12.160 60 Hidroklorotiazida tablet 25 mg 1000 tablet / botol 8.000 IU/g 98 Obat Batuk hitam ( O.200 mg -1 ml 30 ampul / kotak 0 91 Metronidazol tablet 250 mg 100 tablet / kotak 136 92 Natrium Bikarbonat tablet 500 mg 1000 tablet / botol 3.B. 50 mg/ml-10 ml 10 vial / kotak 101 Oksitosin injeksi 10 UI/ml-1 ml 30 ampul / kotak 102 Paracetamol sirup 120 mg / 5 ml ktk 10 x 10 tablet salut 0 0 ktk 10 x 10 tablet Vaginal 251 Botol 100 ml 429 Botol 60 ml 97 0 0 1.5% 24 tube @ 5 g / kotak 62 Ibuprofen tablet 200 mg 100 tablet / botol 2.m 5 mg/ml-2ml (HCL) 30 ampul / kotak 0 75 Klorpromazin injeksi i.v.045 ktk 10 x 10 tablet 0 ktk 60 tablet 0 30 ampul / kotak 0 10 vial / kotak 0 10 vial / kotak 0 10 sase @ 30 gr / kotak 0 Botol 30 ml 0 ktk 5 x 6 tablet 0 Metilergometrin Maleat (Metilergometrin) tablet salut 0.125 mg ktk 10 x 10 tablet 0 90 Metilergometrin Maleat injeksi 0.775 63 Ibuprofen tablet 400 mg ktk 10 x 10 tablet 12.913 61 Hidrkortison krim 2.673 64 Isosorbid Dinitrat Tablet Sublingual 5 mg ktk 10 x 10 tablet 0 65 Kalsium Laktat (Kalk) tablet 500 mg 1000 tablet / botol 6.5 g / kotak 100 Oksitetrasiklin injeksi I. kotak 0 70 Klofazimin kapsul 100 mg microzine 100 kapsul / botol 0 71 Kloramfenikol kapsul 250 mg 250 kapsul / botol 72 Kloramfenikol tetes telinga 3 % 73 Kloraniramina mealeat (CTM) tablet 4 mg 1000 tablet / botol 65.329 103 Paracetamol tablet 100 mg 100 tablet / botol 0 104 Paracetamol tablet 500 mg 1000 tablet / botol 1.) 99 Oksitetrasiklin HCL salep mata 1 % 25 tube @ 3.5 mg ktk 10 x 10 tablet 13. Score (base) 125 mg 107 Piridoksin (Vitamin B6) tablet 10 mg (HCL) botol @ 5 ml 0 ktk 30 x 2 score 0 1000 tablet / botol 12.485 111 Primakuin tablet 15 mg 1000 tablet / botol 0 112 Propillitiourasil tablet 100 mg 100 tablet / botol 0 113 Propanol tablet 40 mg (HCL) 100 tablet / botol 0 114 Reserpin tablet 0.838 108 Povidon Iodida larutan 10 % Botol 30 ml 0 109 Povidon Iodida larutan 10 % Botol 300 ml 10 110 Prednison tablet 5 mg 1000 tablet / botol 11. Kotrimosazol80 DOEN Trimetoprim 20 mg Kuinin (kina) tablet 200 mg 83 Kuinin Dihidrokklorida injeksi 25%-2 ml 84 Magnesium Sulfat inj (IV) 20%-25 ml 85 Magnesium Sulfat inj (IV) 40%-25 ml 86 Magnesium Sulfat serbuk 30 gram 87 Mebendazol sirup 100 mg / 5 ml 88 Mebendazol tablet 100 mg 89 81 24 botol @ 5 ml / kotak botol 60 ml 135 0 128 0 392 ktk 10 x 10 tablet 7.25 mg 1000 tablet /botol 0 .m 25 mg/ml (HCL) 30 ampul / kotak 0 76 Klorpromazin tablet salut 25 mg (HCL) 1000 tablet / botol 0 77 Klorpromazin HCl tablet salut 100 mg (HCL) 1000 tablet / botol 0 78 Anti Malaria DOEN Kombinasi Pirimetamin 25 mg + Sulfadoxin 500 mg Kotrimosazol Suspensi Kombinasi :Sulfametoksazol 200 mg + Trimetoprim 40 mg/ 5 ml DOEN I (dewasa) Kombinasi : Sulfametoksazol 400 mg.10 mg 250 tablet / botol 0 115 Reserpin tablet 0. 25 % ktk 10 amp @ 10 ml 0 96 Nistatin tablet salut 500.819 105 Pilokarpin tetes mata 2 % (HCL/Nitrat) 106 Pirantel tab.m.514 74 Klorpromazin injeksi i.

3/0 dengan jarum bedah 24 x 70 cm / kotak 0 141 Infusion set anak Set /kantong 0 142 Infusion set dewasa Set /kantong 0 143 IV Catheter No.) 10 vial / kotak 0 122 Serum Anti Tetanus Injeksi 1. 22 G 50 buah / kotak 0 145 IV Catheter No.5% ktk 24 btl @ 5 ml 7 127 Tetrasiklin kapsul 250 mg 1000 kapsul / botol 0 128 Tetrasiklin kapsul 500 mg ktk 10 x 10 kapsul 2. 20 G 50 buah / kotak 0 144 IV Catheter No. 23 G 100 buah / kotak 0 157 Wing Needle No. kotak Set / botol 4 90 5 18 2 tube / kotak 0 165 Klorfenol kamfer Menthol ( CHKM ) Botol 10 ml 0 166 Mummifying Pasta Botol / kotak 6 164 Kalsium Hidroksida Pasta 167 Semen Seng Fosfat serbuk dan cairan 168 Spongostan 169 Temporary Stopping Fletcher (Caviton) Set @ 30 gram / botol 4 Box (10) 36 Set @ 30 gram / pot 20 SUB TOTAL .) 10 ampul / kotak 0 123 Serum Anti Tetanus Injeksi 20. 25 G 100 buah / kotak 0 158 Wing Needle No. 21 G 100 buah / kotak 0 156 Wing Needle No. 27 G 100 buah / kotak 0 159 Obat Gigi 160 Arsenic pasta 161 Etil Klorida spray 162 Eugenol cairan 163 Glass Ionomer Cement ART Pot Vial / Can / 100 ml 12 botol @ 10 ml / dus.S.407 135 Alat Kesehatan 136 Alat suntik sekali pakai 1 ml 100 set / kotak 0 137 Alat suntik sekali pakai 3 ml 100 set / kotak 290 100 set / kotak 70 138 Alat suntik sekali pakai 5 ml 139 Catgut / Benang Bedah No.) 10 vial / kotak 0 124 Sianokobalamin (Vitamin B12) injeksi 500 mcg 100 ampul / kotak 0 125 Sulfasetamida Natrium tetes mata 15 % ktk 24 btl @ 5 ml 47 126 Tetrakain HCL tetes mata 0.S.D. 2/0 dengan jarum bedah 24 x 70 cm / kotak 2 140 Catgut / Benang Bedah No. 24 G 50 buah / kotak 0 146 Kapas Berlemak 500 gram Bungkus 0 147 Kapas Pembalut / Absorben 250 gram Bungkus 13 148 Kasa Kompres 40/40 steril Bungkus 0 149 Kasa Pembalut 2 m x 80 cm Rol 10 150 Kasa Pembalut Hidrofil 4 m x 3 cm elastic Rol 22 151 Kasa Pembalut Hidrofil 4 m x 15 cm elastic Rol 0 152 Pembalut Gips Rol 0 153 Plester 5 yards x 2 inch Rol 43 12 x 3 x 75 cm / kotak 25 154 Silk (Benang Bedah Sutera) No.T.468 131 Tiopental Natrium serbuk injeksi 1000 mg/amp Ampul @ 10 ml 132 Triheksifenidil tablet 2 mg ktk 10 x 10 tablet 133 Vaksin Rabies Vero 134 Vitamin B Kompleks tablet 0 651 1 kuur / set 1000 tablet / botol 76. 3/0 dengan jarum bedah 155 Wing Needle No.T.116 Ringer Laktat larutan infus NO 0 btl 500 ml NAMA OBAT 1 2 117 Salep 2-4.000 IU/vial (A.S.000 IU/vial (A.500 IU/ampul (A. kombinasi: Asam Salisilat 2% + Belerang endap 4% 118 Salisil bedak 2% KEMASAN 3 24 pot @ 30 g / kotak 50 gram / kotak HARGA SISA STOK JUMLAH EKATALOG PER PEMAKAIAN 1-Nov-13 1-Oct-13 5 6 4 24 517 119 Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I) 10 vial / kotak 0 120 Serum Anti Bisa Ular Polivalen injeksi 50 ml (ABU II) 1 vial / kotak 0 121 Serum Anti Difteri Injeksi 20.554 129 Tiamin (vitamin B1) injeksi 100 mg/ml ktk 30 amp @ 1 ml 0 130 Tiamin (vitamin B1) tablet 50 mg (HCL/Nitrat) 1000 tablet / botol 39.

546 22 Piroksikam tablet 20 mg ktk 10x10 23 Salbutamol tablet 2 mg box/100 0 24 Salbutamol tablet 4 mg box/100 4.276 42 Paracetamol tablet 500 mg ktk 10x10 tablet 43 Betahistin Mesilat tab 6 mg ktk/3x10 1. 34 + Magnesium Hidroksida 200 mg 35 Deksametason tablet 0.1% 15 Gentamisin Sulfat tetes mata 5 ml 16 Ketokonazol tablet 200mg 17 Lisol btl 250 0 ktk 10 tube 394 btl 250 ktk/5x10 266 btl 0 2.777 25 Salicyl Spiritus 26 Siprofloksasin tablet 500mg 27 Metilprednisolon tablet 4 mg 28 Metronidasol tablet 500mg 29 Oksitetrasiklin salep kulit 30 Ranitidin tablet 31 Asam Folat 5 mg 32 Metampiron tablet 500 mg Antasida DOEN II Suspensi kombinasi :Aluminium Hidroksida 200 mg + 33 Magnesium Hidroksida mg kombinasi :Aluminium Hidroksida 200 mg Antasida DOEN I tablet 200 kunyah.981 45 Cetrizin tablet 10 mg ktk 10x10 245 3.141 39 Fenobarbital tablet 30 mg btl 100 tablet 40 Kloramfenikol tetes telinga 3 % 41 Klorpromazin HCl tablet salut 100 mg (HCL) btl 5 ml btl 250 tablet 128 171 73.Catatan : Untuk Item Obat tambahan yang bersumber dari Dana DAK NO NAMA OBAT KEMASAN HARGA EKATALOG 1 2 3 4 SISA STOK PER PEMAKAIAN 1-Nov-13 1-Oct-13 5 6 JUMLAH 1 Ambroxol Syrup btl/60ml 664 2 Ambroxol tablet 30 mg ktk/100 14.999 3 Anti Bakteri Doen salep kombinasi: 4 Asam mefenamat tablet 500mg 5 Asiklovir krim 5 % ktk/25 tube ktk/100 tube 5 gram 401 22.351 248 6 Asiklovir tablet 200mg ktk/10x10 0 7 Asiklovir tablet 400 mg ktk/10x10 3.177 44 Bromheksin tablet 8 mg ktk 10x10 1.308 8 Devitalisasi Pasta 9 Doksisiklin kapsul 100mg 10 Ergotamin tartrat ktk ktk/10x10 btl/100 4 50 0 11 Erythromicin kapsul 500mg ktk/10x10 1.709 0 37 Diazepam tablet 2 mg btl 100 tablet 140 38 Efedrin tablet 25 mg (HCL) btl 250 tablet 17.004 18 Meloksikam tablet 7.5 mg ktk/5x10 19 Mikonazol krim /salep 2 % tube 10 gr 294 20 Natrium diklofenak tablet 50 mg ktk 5 x 10 4.800 btl 100 1.995 tube 5 gram 228 ktk/100 4.807 Btl 60 ml ktk 10x10 tablet kunyah Ktk 10x10 tablet Ktk 10x10 tablet 0 21.250 21 Oksigen gas 6 M3 0 2.795 ktk 10x10 tablet 1. 16 x 16 ( isi 16 lembar) 49 Kasa hidrofil uk 36 m x 80 cm 50 Kasa pembalut hidrofil 4m x 5cm 51 Kasa pembalut hidrofil 4m x 10 cm 52 Ketokonazol krim 2 % Rol 0 Rol/100 135 Rol /50 109 tube 15 gram .5 mg 36 Dekstrometorfan tablet 15 mg (HBr) btl 0 ktk/100 0 ktk/100 839 ktk/100 3.110 8.226 12 Erythromicin Syrup 200 mg /5 ml btl 60 ml 0 13 Fenitoin Natrium kapsul 30 mg 14 Gentamisin salep kulit 0.650 46 Garam Oralit serbuk Kombinasi ktk 25 sachet 47 Kalium diklofenak tablet 50 mg ktk/5x10 0 Ktk 0 48 Kasa Hidrofil Steril uk.

) 100. .tambah darah) 20 pcs/kotak 1 sase @ 30 tab 0 27.005 62 Natrium diklopenak tablet 25 mg Ktk 5x10 tablet 63 Nipedipin tablet 10 mg Ktk 10x10 tablet 0 64 Omeprazol kapsul 20 mg Ktk 3 x 10 kapsul 757 65 Parasetamol drops 66 Piroksikam tablet 10mg Btl 15 ml Ktk 10x10 tablet 67 Retinol (Vitamin A.890 69 Thiamfenikol kapsul 500mg ktk 10x10 kapsul 678 70 Tramadol kapsul 50mg ktk 5 x 10 kapsul 100 71 Sefotaxim Injeksi 1 gram ktk 2 vial 0 50 pasang/kotak 0 72 Handscoon 73 Masker 74 Besi II Sulfat tab (tab.5 % Ktk 100 amp@ 2 ml 57 Lidokain Injeksi 2% 674 ktk 10x10 tablet 58 Loperamid tablet 2 mg NO NAMA OBAT KEMASAN HARGA EKATALOG 1 2 3 4 59 Loratadin tablet 10 mg ktk 5 x 10 tablet SISA STOK PER PEMAKAIAN 1-Nov-13 1-Oct-13 5 6 JUMLAH 575 60 Metoklopramida syrup 5 mg/5ml Btl 60 ml 15 61 Metformin Hcl tablet 600 mg ktk/10x10 13.000 IU kapsul lunak btl 50 kapsul lunak 15 4.Ktk 5x 10 tablet 53 Ketokonazol tablet 200 mg 54 Klorfenol Kamfer Menthol (CHKM) Botol 10ml 55 Klorampenikol salep mata 1 % tube 5 gram Btl 5 ml 56 Klorampenikol tetes mata 0.000 IU kapsul lunak btl 50 kapsul lunak 68 Retinol (Vitamin A.5 mg kotak /100 2 Alprazolam 1 mg kotak /100 0 3 Clobazam tablet 10 mg kotak /100 958 4 Triflouperazin tablet 5 mg kotak /100 0 0 SUB TOTAL Tanbahan lain-lain : Bahan dan alat Lab …………….) 200.957 Obat Jiwa 1 Alprazolam 0.

248 1.818 0 55 0 5.626 0 1.562 321.875 0 529 0 289 0 65 0 1.000 0 0 0 0 0 0 0 0 0 1.755 0 0 0 0 0 0 0 0 0 132 0 500 0 50 0 4.23.085 0 39.140 0 100 0 16.000 0 0 0 0 0 0 0 0 0 5.215.310 0 0 0 362 0 854 0 50 0 500 0 482 0 0 0 22.385 0 0 0 5.898 0 10 0 10 0 0 0 10 0 432 0 0 0 .847 19.477 0 1.66 KEBUTUHAN JUMLAH RIIL HARGA tahun 2014 KEBUTUHAN 7=6/12*10+(10%) 8=7x5 449 94.993 173.863 2.922 809 93.334.366 1.707 0 0 100 0 1.000 0 500 0 100 0 25.665.229 89.412 3.766.

237 0 17.160 0 0 0 0 0 0 0 0 0 0 0 .728 0 25 0 9.754 0 0 0 2.478 0 0 0 0 0 0 0 0 0 0 0 517 0 9.KEBUTUHAN JUMLAH RIIL HARGA tahun 2014 KEBUTUHAN 7=6/12*10+(10%) 8=7x5 0 0 2.000 0 169 0 86.352 0 792 0 0 0 0 0 5.928 0 11.851 0 11.663 0 16.273 0 0 0 161 0 0 0 0 0 331 0 566 0 128 0 0 0 25 0 1.401 0 0 0 200 0 16.765 0 178 0 3.299 0 0 0 0 0 0 0 0 0 5 0 0 0 50 0 500 0 0 0 0 0 180 0 5.946 0 0 0 513 0 15.

20 KEBUTUHAN 0 JUMLAH RIIL HARGA tahun 2014 KEBUTUHAN 7=6/12*10+(10%) 8=7x5 682 0 682 0 10 0 0 0 0 0 500 0 0 0 0 0 62 0 9 0 0 0 3.057 0 533 0 5 0 5 0 5 0 5 0 0 SUB TOTAL 5 0 119 0 7 0 24 0 0 0 0 0 8 0 5 0 48 0 26 0 23.665.083 0 92 0 103 0 100 0 10 0 25 0 25 0 35 0 25 0 100 0 117 0 100 0 38 0 529 0 500 0 0 0 1.335 .857 0 0 0 0 0 1.371 0 0 0 52.098 0 0 0 859 0 0 0 100.

KEBUTUHAN JUMLAH RIIL tahun 2014 HARGA KEBUTUHAN 7=6/12*10+(10%) 8=7x5 876 0 19.618 0 500 0 500 0 520 0 330 0 351 0 0 0 2.107 0 5.336 0 2.000 0 0 0 0 0 178 0 144 0 0 0 .503 0 327 0 1.367 0 5 0 5.799 0 529 0 29.554 0 2.273 0 301 0 6.306 0 0 0 0 0 1.369 0 2.361 0 0 0 6.818 0 1.385 0 500 0 27.724 0 1.615 0 323 0 4.645 0 388 0 5.000 0 4.626 0 0 0 169 0 226 0 96.610 0 0 0 3.496 0 0 0 185 0 22.066 0 500 0 1.865 0 11.

903 0 0 0 0 0 1.0 0 0 0 0 0 0 0 0 0 890 0 KEBUTUHAN JUMLAH RIIL tahun 2014 HARGA KEBUTUHAN 7=6/12*10+(10%) 8=7x5 SUB TOTAL 759 0 20 0 17.455 0 0 0 0 0 895 0 1.132 0 0 0 0 0 0 0 36.000 0 999 0 120 0 6.167 0 0 0 5.265 0 0 0 0 0 0 0 0 .

k 19 Ambroxol 30 20 Amitriptilin 21 Ambroxol sy 22 Acyclovir 2 23 Asetosal 50 24 Abocath no. 26 Abocath no.PEMAKAIAN OBAT UPT KESMAS SU NO NAMA OBAT JANUARI 1 Air raksa de 2 Aminofillin in 3 Aminofillin 4 Amoxicilin 5 Amoxicilin d 6 Amoxiliin 5 7 Asam mefen 8 Antalgin 50 9 Antasida do 10 Aqua pro inj 11 Aqua steril 12 Asam ascorb 13 Asam benzoa 14 Asam salisila 15 Allupurinol 16 Anti hemoro 17 Acyclovir 4 18 Acyclovir s. 27 Besi (II) sulf 28 Betametason 29 Bacitracin 1 30 Bond matrix 31 Blood test s 32 Cat gut 33 Cortison inj 34 Calcidor 35 Cyprofloxac 36 Cresofat 37 Captopril 12 0 0 110 90 124 6447 2381 108 2281 0 0 1735 4 0 10 46 147 25 1068 3 37 0 0 0 0 0 1572 63 31 0 0 2 0 0 746 0 1666 BULAN FEBRUARI MARET APRIL MEI JUNI 0 0 0 0 0 0 0 0 0 0 120 60 160 140 120 100 275 526 49 20 120 73 95 87 100 6648 5092 6982 6780 6405 2393 1586 2387 2210 2190 30 80 110 80 55 1641 529 0 0 0 0 0 0 0 0 0 0 0 0 0 1457 1977 1151 1228 1361 0 6 4 4 7 0 3 4 3 0 0 50 70 10 50 20 24 19 14 22 276 334 400 120 439 22 35 44 9 26 1300 1053 2244 1394 761 21 0 3 3 0 49 47 40 59 71 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1940 1855 2753 2881 2490 92 55 88 97 77 19 30 30 48 46 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 740 503 1491 730 1353 0 0 0 0 0 2062 2357 3037 3047 717 . 25 Abocath no.

38 Captopril 2 39 Clobazam 40 Dexametason 41 Dexametaso 42 Dexotromet 43 Dextrometor 44 Devitalisasi 45 Diazepam 2 46 Diazepam 5 47 Diazepam in 48 Difenhidrami 49 Digoxin 50 Diamond bo 51 Dulcolax 52 Dapirin 53 Epedrin 25 54 Epedrin inj 55 Etakridam la 56 Etanol 70% 57 Etil clorida 58 Eugenol 59 Eritromicyn 60 Flu stop 61 Fenobarbita 62 Fenobarbita 63 Fenobarbital 64 Fitomenadio 65 Fitomenadion 66 Folavit 67 Garam orali 68 Gentian viol 69 Glisril guaya 70 Glibenclami 71 Glukosalar i 72 Glukosalar i 73 Griseovulvi 74 Gentamicyn 75 Gentamicyn 76 Hidroclortiaz 77 Hidrocortiso 78 Halloperidol 79 Hand schoon 80 Ibupropen 2200 70 0 2895 647 39 0 0 0 0 305 0 0 13 0 1055 0 0 3 1 0 95 0 30 0 0 0 0 97 409 4 2595 465 0 0 5 14 28 598 39 60 1 170 2080 38 0 2173 0 44 0 0 0 0 3 0 0 55 0 1980 0 0 6 1 0 173 0 10 0 0 0 0 94 430 5 3459 145 0 0 0 20 39 1025 48 530 3 1310 1430 0 0 1872 0 26 0 0 0 0 9 0 0 0 0 1113 0 1 3 0 1 139 0 0 0 0 0 0 0 327 3 2228 109 0 0 10 23 15 1438 36 700 0 1102 2610 70 0 1445 0 22 0 40 0 0 18 0 0 0 0 2588 0 0 1 1 0 72 0 166 0 0 10 0 350 389 4 3252 365 0 0 130 43 49 855 5 420 0 1141 80 0 0 1037 0 17 0 25 0 0 0 0 0 0 0 1432 0 0 3 2 0 156 0 70 0 0 20 0 205 364 5 3277 570 0 0 30 25 51 532 1 150 0 1760 0 30 0 966 0 23 0 30 0 0 0 0 0 0 0 1384 0 0 2 0 0 50 0 0 0 0 0 0 30 256 3 2994 515 0 0 2 12 39 1045 2 60 0 1306 .

T 3 97 CTM 98 Klorpromazi 99 Klorpromazi 100 Kotrimoxazol 101 Kotrimoxazo 102 Karbamazep 103 Ketokenazol 104 Lidocain inj 105 Ludiomil 10 106 Lisol 107 Metakresol s 108 Metil Ergome 109 Metronidazo 110 Metronidazo 111 Monoklor (C 112 Mumifiying 113 Microlak en 114 Miconazol 115 Metformin 116 Masker 117 Minyak bor 118 Meloxicam 119 Neurobion in 120 Natrium clor 121 Nistatin 100 122 Nadipen 50 123 OBH 350 0 0 0 0 0 749 0 0 0 0 3 0 0 4 0 5821 40 0 36 475 0 12 15 0 0 0 0 5 438 0 0 0 22 1045 20 0 150 0 3 29 860 22 15 0 0 0 0 0 852 0 0 0 0 2 0 0 4 11 7375 31 0 48 582 0 38 2 0 0 1 0 0 306 0 1 0 21 1005 25 0 160 0 3 25 380 34 0 0 0 0 0 0 1101 0 0 0 0 5 0 0 2 8 4993 0 0 38 492 0 10 2 0 0 1 20 10 345 0 0 0 18 995 12 0 180 0 7 22 55 32 1050 0 0 5 0 0 865 0 0 0 10 3 3 0 2 22 7494 0 0 36 521 0 30 2 0 0 0 40 0 326 0 0 0 16 1465 4 0 170 0 12 21 175 37 0 0 0 1 0 0 355 5 0 0 1 4 0 0 9 12 7401 0 0 27 625 0 19 1 0 0 0 10 10 553 1 0 2 24 1991 23 0 150 0 4 10 390 52 0 0 0 0 0 0 487 1 0 0 0 2 0 0 10 21 5891 0 0 30 1331 100 7 7 0 0 1 0 10 530 0 0 4 42 514 0 0 418 0 4 21 530 54 .81 Ibupropen 82 Infus set an 83 Infus set de 84 Jarum bedah 85 Jarum bedah 86 Kalsium per 87 Kalsium lakt 88 Kapas 250m 89 Kasa 40 x 4 90 Kasa 2 x 80 91 Kasa 4 x 15 92 Kasa 4 x 3 93 Kasa 80 x 4 94 Kloramfenic 95 Kloro sm 1% 96 Kloro T.

124 Oxytetra SM 125 Oxytetra SK 126 Parasetamol 127 Parasetamo 128 Pirantel 12 129 Piridoxin 10 130 Prednison 5 131 Papaverin 132 Piroxicam 2 133 Piroxicam 1 134 Pronita 135 Plester 136 Ringer lakta 137 Salbutamol 138 Salbutamol 139 Salicyl talk 140 Semen seng 141 Sianocobala 142 Silk benang 143 Silver amal 144 Sulfacetami 145 Supralivron 146 Santa E 147 Seloloid stri 148 Supratul 149 Spuit 3 cc 150 Temporary st 151 Thiamine 5 152 Tkf 153 Test kehamil 154 Tetrasiklin 155 Thiamfenico 156 Topranil/ me 157 Trihexypenid 158 Triomine E 159 Vit B komple 160 Valisanbe 2 161 Valisanbe 5 162 Xanvit sirup 163 Vertiform 164 Prenatin plu 165 Cetak molarf 166 Trizin 10 17 107 159 0 811 540 0 150 320 0 1 0 0 449 45 0 14 1 0 11 0 0 0 0 27 0 3167 0 2 270 60 0 60 0 7195 0 0 0 4 0 0 0 11 29 114 1660 0 989 1165 0 250 400 0 1 0 0 439 56 0 50 1 0 3 0 0 0 0 70 0 3547 0 3 196 50 0 135 0 9014 0 0 0 0 0 1 0 2 29 16 0 0 1845 388 641 270 0 0 3 0 0 458 27 0 75 0 0 0 0 0 0 0 75 0 2896 0 4 230 114 0 55 0 3202 0 0 0 290 0 2 0 5 8 99 0 0 1441 1985 0 610 330 0 1 0 18 481 64 0 29 11 0 11 0 0 0 0 40 0 4241 0 1 342 134 0 30 0 9419 0 0 0 0 0 1 0 10 20 159 0 0 812 1224 0 450 410 0 0 0 0 641 70 1 16 3 0 2 0 0 0 0 35 0 3634 0 0 180 40 0 166 0 8520 0 0 0 0 0 0 0 6 27 157 0 0 1610 802 0 206 749 0 5 0 0 548 53 0 33 0 0 6 0 0 0 0 5 0 4779 0 2 370 60 0 45 0 6786 0 0 0 0 0 0 0 .

167 Hipapie 168 Bayclin 169 Zinc 170 Pehacain 171 Tissu 172 Spuit 10cc 173 Stesolid Sup 174 Hand schoon 175 Wing nedle 176 Recovit 177 Betadine 30 178 Kloro tetes 179 Betahistin 180 Methyl Predn 181 Doxycillin 182 Kalsium hidr 183 Metoclorpra 184 Novaheksin 185 Isosorbid din 186 Ky jelly 187 Metoklor pra 188 Nifedifin 10 189 Urin strip ut 190 Rapid test ut 191 Depoprogest 193 Microdiol 194 Ampicillin 19 195 Cefrizine 196 Loratadine 197 Ranitidine 198 Omeprasol 199 Pulperyl 200 Xanvit 201 Cresofen 202 Stik Gula Da 203 Blood Lanze 204 Kaca Mata G 205 Kasa 4x5 cm 206 Kasa 4x10 c 207 Loperamid 208 Parecetamol 209 Halloperidol 210 Novadium 0 0 235 0 0 0 0 2 0 0 1 3 5 43 0 0 30 340 20 0 6 20 0 0 0 0 0 50 80 475 120 0 0 0 0 0 0 0 0 0 0 0 200 4 1 270 0 0 0 0 0 0 0 1 1 100 76 0 0 100 660 20 0 0 0 0 0 0 0 0 5 40 401 190 0 0 0 0 0 0 90 50 0 0 0 110 0 1 185 0 0 0 0 0 0 0 0 4 92 146 0 0 90 0 0 0 5 25 0 0 0 0 0 0 56 107 122 0 0 0 0 0 0 0 0 0 0 0 70 0 0 560 0 0 0 0 0 0 0 1 0 160 225 0 0 404 20 20 0 0 30 0 0 0 0 0 0 30 7 235 0 0 0 0 0 0 0 0 0 0 0 10 10 0 540 0 0 0 5 0 0 0 2 0 80 160 0 0 336 269 30 0 0 15 0 0 0 0 0 20 10 396 80 0 0 0 0 0 0 10 10 0 0 0 0 12 0 180 0 0 0 0 0 0 0 0 11 180 140 0 0 75 172 20 0 0 10 0 0 0 0 0 10 0 634 0 0 0 0 0 0 0 10 23 0 0 0 60 .

5 mg APBD Captopril 25 mg APBD2 Caviplek Flutamol sirup Daryantule Tramadol Upixon Amlodipine 5mg Domperidon Solvita sirup Livron B plek Etil Klorida H2O2 3% Alkohol 70% 1lt Grafadon Drop Antasida Du 0 0 200 7987 0 6 30 0 1357 0 0 0 20 3099 0 17 329 2 1541 0 0 0 180 6871 0 6 236 0 3963 50 720 0 0 210 8313 0 0 50 0 2974 250 1075 0 0 0 445 1035 640 2 10 20 0 300 0 0 0 0 10 8582 0 3 148 0 2250 0 892 6 5 5 1925 1965 860 18 10 50 1 105 0 0 .211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 0 10 Ibupropen sy 20 Kalium dikl 4348 Parasetamol 0 Urine bag 1 Lidocain inj 162 Antalgin 50 0 Cetak molarfu Antasida Bl 0 Levofloxaci 0 Dexametasone Blester Masker APBD 2 Spuit APBD2 Handscoon APBD2 Captopril 12.

150 87.154 825 120 1.MAKAIAN OBAT TAHUN 2013 UPT KESMAS SUKAWATI II BULAN JULI 0 0 190 43 168 7675 2366 100 0 0 0 1701 4 2 70 17 319 22 1786 30 87 0 0 0 0 0 4048 79 44 0 0 0 0 0 1253 0 551 AGUSTUS SEPTEMBEOKTOBER NOVEMBE DESEMBE 0 0 0 0 0 0 0 0 0 0 110 280 220 220 220 20 20 40 40 40 82 112 109 109 109 6767 8070 7200 7200 7200 1922 2684 2232 2232 2232 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3422 3168 2101 2101 2101 6 7 7 7 7 5 5 2 2 2 10 40 30 30 30 27 11 19 19 19 302 500 471 471 471 11 22 32 32 32 2124 1588 1681 1681 1681 0 850 3 3 3 68 122 84 84 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3039 3254 4125 4125 4125 89 118 106 106 106 45 60 48 48 48 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1094 1635 1141 1141 1141 0 0 0 0 0 145 0 0 0 0 TOTAL 0 0 1950 1263 1288 82466 26815 613 4451 0 0 23503 63 28 400 257 4250 312 18361 919 832 0 0 0 0 0 36207 1076 497 0 0 2 0 0 12968 0 13582 HARGA SATUAN 103.500 361.500 27 1.000 8.000 265 396.000 19 1.000 80 238 3.800 2.897 15.470 571 3.500 115.500 22.000 113 92 2.584 266 22.500 71 .400 370 132 67 31 15.

200 50 0 536 0 13 0 12 0 0 0 0 0 0 0 1498 0 0 0 9 0 117 0 0 0 0 0 0 70 319 3 3201 665 0 0 20 20 45 732 0 30 0 1421 0 0 0 316 0 31 0 3 0 0 0 0 0 0 0 1403 0 0 0 0 0 159 0 0 0 0 10 0 255 361 4 2269 385 0 0 60 17 30 757 1 30 0 1064 0 700 0 698 0 33 0 30 0 0 5 0 0 0 0 2302 0 1 0 2 0 184 0 10 0 0 10 0 340 489 7 4580 170 0 0 20 45 66 1195 3 90 0 1573 0 0 0 418 0 26 0 0 0 0 25 0 0 0 0 2386 0 0 1 1 0 81 0 0 0 0 0 0 355 306 4 2371 463 0 0 50 31 32 736 0 90 0 1826 0 0 0 418 0 26 0 0 0 0 25 0 0 0 0 2386 0 0 1 1 0 81 0 0 0 0 0 0 355 306 4 2371 463 0 0 50 31 32 736 0 90 0 1826 0 0 0 418 0 26 0 0 0 0 25 0 0 0 0 2386 0 0 1 1 0 81 0 0 0 0 0 0 355 306 4 2371 463 0 0 50 31 32 736 0 90 0 1826 8600 958 0 13192 647 326 0 140 0 0 415 0 0 68 0 21913 0 2 21 19 1 1388 0 286 0 0 50 0 2506 4262 50 34968 4778 0 0 427 312 458 10385 135 2340 4 16325 138 950 908 39 36 2.833 565 31 44 978 768 305 450 23 60 3.973 1.254 22.368 689 83 36.400 650.000 45.499 105.630 111 2.000 800 21 1.650 25 2.485 122 500 148 .500 17 2.

348 1.100 420 4.875 3.999 150 1.280 0 0 0 0 0 579 2 0 0 2 2 0 0 4 12 7343 15 0 48 663 0 0 4 0 0 0 10 31 446 0 0 1 29 1465 0 0 416 0 2 32 661 48 610 0 0 2 0 0 500 2 0 0 2 0 1 0 6 14 6744 15 0 30 804 0 20 1 0 0 0 20 20 100 0 0 0 52 1185 0 0 247 0 5 17 309 53 420 0 0 0 0 0 632 2 0 0 0 1 1 0 6 15 6057 25 0 50 1022 0 70 9 0 0 0 0 20 584 0 0 0 37 1845 0 0 73 0 4 46 370 56 50 0 0 0 0 0 878 1 0 0 0 0 0 0 9 13 6395 45 0 49 530 500 60 18 0 0 0 0 30 367 0 0 0 33 1495 0 0 40 0 2 28 520 41 50 0 0 0 0 0 878 1 0 0 0 0 0 0 9 13 6395 45 0 49 530 500 60 18 0 0 0 0 30 367 0 0 0 33 1495 0 0 40 0 2 28 520 41 50 0 0 0 0 0 878 1 0 0 0 0 0 0 9 13 6395 45 0 49 530 500 60 18 0 0 0 0 30 367 0 0 0 33 1495 0 0 40 0 2 28 520 41 2875 0 0 8 0 0 8754 15 0 0 15 22 5 0 74 154 78304 261 0 490 8105 1600 386 97 0 0 3 100 196 4729 1 1 7 360 15995 84 0 2084 0 50 307 5290 511 73 22.000 31.000 149 1.563 1.266 7.839 100 246 372 821 3.228 11.250 .500 39 10.600 10.800 22.200 103.500 2.999 3.618 110 105 135 107.590 289 218 1.000 3.066 666 7.875 2.000 7 68 2.

500 585 34.4 21 185 0 0 1096 604 0 64 513 0 4 0 0 420 61 0 26 1 0 5 0 0 0 0 22 0 4733 0 1 301 30 0 25 0 8073 0 0 0 0 0 0 0 26 24 164 0 0 1189 914 0 50 948 0 4 0 0 697 64 0 52 7 0 2 0 0 0 0 13 0 3803 0 1 140 150 0 15 0 6752 0 0 0 0 0 0 0 12 17 169 0 0 1213 1463 0 290 930 0 5 0 0 365 23 1 26 1 0 3 0 0 0 0 2 0 4965 0 14 385 30 0 45 0 9574 0 0 0 0 0 0 0 11 36 159 0 0 1832 2400 0 206 290 0 19 0 0 279 54 0 33 0 0 4 0 0 0 0 1 1 3703 1 12 140 10 0 75 0 7872 0 0 0 0 0 0 0 11 36 159 0 0 1832 2400 0 206 290 0 19 0 0 279 54 0 33 0 0 4 0 0 0 0 1 1 3703 1 12 140 10 0 75 0 7872 0 0 0 0 0 0 0 11 36 159 0 0 1832 2400 0 206 290 0 19 0 0 279 54 0 33 0 0 4 0 0 0 0 1 1 3703 1 12 140 10 0 75 0 7872 0 0 0 0 0 0 0 119 300 1647 1819 0 16502 16285 641 2958 5470 0 81 0 18 5335 625 2 420 25 0 55 0 0 0 0 292 3 46874 3 64 2834 698 0 801 0 92151 0 0 0 294 0 4 0 1.025 93.400 4.850 275 530 650.445 383 1.000 3.163 22 200 250 10.500 520 12.579 84 97 1.675 1.400 186 401 41 1.357 1.163 128.000 24 125.000 325.725 46 194 10 40 63 147 75 16.000 4.000 .

1 0 0 0 0 0 0 0 0 0 0 26 180 35 50 0 130 70 20 0 0 10 0 0 0 0 0 15 60 496 0 0 0 0 0 0 0 0 22 0 0 10 70 0 0 20 0 0 0 0 0 0 0 0 7 70 4 0 0 124 80 20 0 0 10 0 0 0 0 0 85 150 436 0 0 0 0 0 0 0 0 4 0 0 10 90 2 0 115 0 0 0 0 0 0 0 2 24 170 10 0 0 150 210 20 0 0 10 0 0 0 0 0 45 94 1258 0 0 0 0 0 0 0 25 0 0 0 10 20 1 0 150 0 0 0 0 0 0 0 1 24 140 0 0 0 110 160 20 0 0 10 0 0 0 0 0 15 55 590 10 0 0 0 0 0 0 0 0 0 0 0 44 1 0 150 0 0 0 0 0 0 0 1 24 140 0 0 0 110 160 20 0 0 10 0 0 0 0 0 15 55 590 10 0 0 0 0 0 0 0 0 0 0 0 44 1 0 150 0 0 0 0 0 0 0 1 24 140 0 0 0 110 160 20 0 0 10 0 0 0 0 0 15 55 590 10 0 0 0 0 0 0 0 0 0 0 0 44 32 2 2555 0 0 0 5 2 0 0 10 148 1457 839 50 0 1769 2301 230 0 11 160 0 0 0 0 0 275 685 5980 777 0 0 0 0 0 0 135 109 0 0 30 762 61.000 3.800 7.919 108 314 333 20 408 396.500 1.500 29.700 600 6.000 1.500 1.726 14.500 83 .900 10.500 924 51 21 76 25 47.500 2.950 6.

0 0 0 10892 0 4 248 0 2248 81 1329 4 8 3 1005 810 1000 0 0 30 2 795 160 7 0 0 0 0 0 0 0 0 8134 0 4 274 0 2276 66 895 2 2 2 1640 2160 0 0 0 0 2 0 0 37 0 0 0 0 0 0 0 10 8580 0 2 130 0 2771 453 1294 0 0 0 2610 1480 0 0 0 0 5 0 40 27 0 0 0 0 0 0 0 260 6470 0 0 200 0 1730 0 2504 7 2 9 1285 2180 0 0 0 0 0 120 20 25 550 0 0 5 15 0 0 260 6470 0 0 200 0 1730 0 2504 7 2 9 1285 2180 0 0 0 0 0 120 20 25 550 0 0 5 15 0 0 260 6470 0 0 200 0 1730 0 2504 7 2 9 1285 2180 0 0 0 0 0 120 20 25 550 0 0 5 15 0 10 1430 86216 131 0 7.100 13717 33 21 37 11480 99 13990 152 2500 20 20 100 10 1560 260 300 146 3200 1650 238 0 0 15 27000 45 14000 0 TOTAL .000 24570 162 900 1.200 43 770 2207 115 2 650.

888 988.889 438.000 2.068.451 1.936.585 300.079.436.420 3.149.512.153 936.239 41.750 84.098 48.964 .096 72.594 4.790 2.794 3.538.000 377.640 2.071 135.379.702 23.428.TOTAL HARGA 156.550 17.520 962.200 30.800 1.

000 45.184.995.408.310 286.408 286.000 2.608 1.895 48.650 910.206 8.508 472.159 2.656 286.035 22.680 47.924.400 454.479 1.059 782.384 927.1.476 2.400 2.500 812.576 755.884 1.552 23.101 .886 335.700 255.298.100 508.833 784.089 54.

995 14.255 100.000 1.295 155.996 20.500 394.801 529.210.527 638.695 1.798 1.976 17.000 344.800 154.662 154.320 143.669 94.592 79.500 88.995 115.750 .000 2.080.854 10.391.580 638.800 875.110 810.220 45.415 107.383.910 23.660 39.151.000 508.

841.600 526.177 32.400 40.351 375.752 80.657 2.075 82.500 2.000 281.820 102.383 434.020 651.850 2.161.119.400 1.765 165.483 502.045.000 218.400 300.000 - .109 640.982 280.826 410.512 520.625 187.250 1.000 1.600.328.000 189.489 170.

000 149.750 21.109 17.272 2.722 1.533.346.268 42.000 370.256 86.000 1.000 14.600 317.105 119.213 228.800 21.975 5.980.000 145.400 1.045 134.477 - .1.

136.000 630.000 1.200 392.126.824 .000 3.520 2.000 467.11.110 253.299.700 405.315.805 1.340 990.980.850 33.000 131.480 78.300.