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1. SATUAN KERJA ADALAH NAMA APOTEK, KLINIK, FKTP, FKRTL atau DINKES PROVINSI dan KAB/KO
2. JUMLAH KEBUTUHAN TAHUN 2019 ADALAH PEMAKAIAN RATA-RATA PER BULAN SELAMA 2017
3. RENCANA KEBUTUHAN TAHUN 2019 ADALAH RENCANA KEBUTUHAN YANG DIHITUNG BERDAS
4. RENCANA PENGADAAN TAHUN 2019 ADALAH RENCANA OBAT DALAM SATUAN TERKECIL SEPER
5. SURAT PENGANTAR DAN LAMPIRAN HARUS DI TANDATANGANI OLEH KEPALA SATUAN KERJA DA
6. MOHON UNTUK TIDAK MELAKUKAN PENAMBAHAN MAUPUN PENGURANGAN BARIS/KOLOM P

RENCANA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN RUJUKA


SATUAN KERJA : RSKM Regina Eye Center Padang

NO NAMA OBAT

1 1 153-Sm-EDTMP (ethylenediamine tetramethylene phosphonic acid) 44


2 2 mg Ca/Nadipivoksil
Adefovir EDTMP, 5-46
tab 10?gmg
samarium, dan 1850 ± 185 mbq samarium 153
1154 3 Afatinib tab sal selaput 20 mg
1155 4 Afatinib tab sal selaput 30 mg
1127 5 Afatinib tab sal selaput 40 mg
944 6 Air untuk injeksi amp 20 ml
3 7 Air untuk injeksi amp 25 ml
4 8 Air untuk irigasi lar inf 1000 ml
5 9 Akarbose tab 100 mg
6 10 Akarbose tab 50 mg
7 11 Albendazol susp 200 mg/5 ml
8 12 Albendazol tab 400 mg
10 13 Albumin serum normal (human albumin) inj 20% 100 ml
940 14 Albumin serum normal (human albumin) inj 20% 50 ml
9 15 Albumin serum normal (human albumin) inj 25% 100 ml
939 16 Albumin serum normal (human albumin) inj 25% 20 ml
938 17 Albumin serum normal (human albumin) inj 25% 50 ml
11 18 Albumin serum normal (human albumin) inj 5% 250 ml
941 19 Albumin serum normal (human albumin) inj 5% 50 ml
1179 20 Alendronat Tab 70 mg
12 21 Alopurinol tab 100 mg
13 22 Alopurinol tab 300 mg
14 23 Alprazolam tab 0,25 mg
15 24 Alprazolam tab 0,5 mg
16 25 Alprazolam tab 1 mg
17 26 Alteplase serb inj 50 mg/vial
18 27 Amfoterisin B inj 50 mg/10 ml (i.v.)
19 28 Amfoterisin B salep mata 1%
20 29 Amfoterisin B salep mata 3%
22 30 Amikasin inj 250 mg/ml
27 31 Aminofilin inj 24 mg/ml
25 32 Aminofilin tab 150 mg
26 33 Aminofilin Tab 200 mg
28 34 Amiodaron inj 150 mg/3 ml
29 35 Amiodaron tab 200 mg
30 36 Amitriptilin tab sal 25 mg
31 37 Amlodipin tab 10 mg
32 38 Amlodipin tab 5 mg
1091 39 Amoksisilin drops 100 mg/ml
33 40 Amoksisilin sir forte 250 mg/5 ml
34 41 Amoksisilin sir kering 125 mg/5 ml
35 42 Amoksisilin tab 250 mg
36 43 Amoksisilin tab 500 mg
37 44 Ampisilin serb inj 1000 mg/vial
38 45 Ampisilin serb inj 250 mg/vial
946 46 Analog insulin : fast acting inj 100 UI/ml (kemasan vial, cartridge
947 47 disposible, penfil
Analog insulin cartridge) acting inj 100 UI/ml (kemasan vial, cartridge
: intermediate
945 disposible, penfill
48 Analog insulin : mix cartridge)
insulin (inj 100 UI/ml)
41 49 Analog insulin intermediate acting combine with short or long acting inj
40 50 100 IU/ml,
Analog vial/cartridge
Insulin long actingdiposible/penfill cartridge
inj 100 IU/mL, vial/cartridge disposible/penfill
42 cartridge
51 Anastrozol tab 1 mg
43 52 Anestetik lokal gigi kombinasi : lidokain hcl 2% + epinefrin 1 : 80.000 inj 2
44 53 ml
Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium
45 54 hidroksida 200 mg : aluminium hidroksida 200 mg + magnesium
Antasida, kombinasi
50 hidroksida 200 kombinasi
55 Anti Parkinson mg : benzerasid 25 mg + levodopa 100 mg
46 56 Antibakteri, kombinasi : basitrasin 500 UI/g+ Polimiskin B 10.000 UI/g
47 57 Antifungi salep, kombinasi : asam benzoat 6%+ asam salisilat 3%
48 58 Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5
1025 59 mg + lidokainoral
Aripiperazol lidokain 10 mg+
solution seng oksida 120 mg + sup ad 2 g
1 mg/ml
1026 60 Aripiperazol tab discmelt 10 mg
1027 61 Aripiperazol tab discmelt 15 mg
52 62 Artesunat serb inj 60 mg/ml (i.v./i.m.)
53 63 Articulating paper kertas warna penanda oklusi
1178 64 Asam asetat tetes telinga 2%
54 65 Asam asetilsalisilat (asetosal) tab 100 mg
55 66 Asam asetilsalisilat (asetosal) tab 80 mg
56 67 Asam askorbat (vitamin C) tab 250 mg
57 68 Asam askorbat (vitamin C) tab 50 mg
58 69 Asam folat tab 0,4 mg
59 70 Asam folat tab 1 mg
60 71 Asam folat tab 5 mg
1068 72 Asam fusidat tts mata 1%
61 73 Asam ibandronat inj 1 mg/ml
62 74 Asam mefenamat kaps 250 mg
63 75 Asam mefenamat kaps 500 mg
64 76 Asam pipemidat kaps 400 mg
65 77 Asam retinoat krim 0,1%
66 78 Asam salisilat lar 0,1%
67 79 Asam salisilat salep 10%
68 80 Asam salisilat salep 2%
69 81 Asam salisilat salep 5%
70 82 Asam traneksamat inj 100 mg/ml
71 83 Asam traneksamat inj 50 mg/ml
72 84 Asam traneksamat tab 500 mg
73 85 Asam ursodeoksikolat kaps 250 mg
1131 86 Asam zoledronat inf 4 mg/100 ml
1180 87 Asam Zoledronat Inf 5 mg/100 ml
75 88 Asetazolamid tab 250 mg
76 89 Asiklovir salep mata 3%
77 90 Asiklovir tab 200 mg
78 91 Asiklovir tab 400 mg
79 92 Asparaginase serb inj 10.000 UI/vial
80 93 Atapulgit 600 mg
1092 94 Atapulgit tab 630 mg
942 95 Atapulgit tablet 650 mg
943 96 Atapulgit tablet 750 mg
82 97 Atenolol tab 100 mg
81 98 Atenolol tab 50 mg
1028 99 Atorvastatin tab 10 mg
1029 100 Atorvastatin tab 20 mg
1142 101 Atrakurium inj 10 mg/ml (i.v)
84 102 Atropin inj 0,25 mg/ml (i.m./i.v./s.k)
86 103 Atropin tab 0,5 mg
87 104 Atropin tts mata 0,5%
88 105 Atropin tts mata 1%
89 106 Azatioprin tab 50 mg
1049 107 Azitromisin serb inj 500 mg
90 108 Azitromisin sir kering 200 mg/5 ml
91 109 Azitromisin tab 250 mg
92 110 Azitromisin tab 500 mg
93 111 Bahan tumpatan sementara lar, serb
94 112 Barium sulfat serb 92 g/100 ml
95 113 Barium sulfat susp 2,2%
96 114 Barium sulfat susp 55%
97 115 Barium sulfat susp 65%
1153 116 Basiliksimab Inj 20 mg
98 117 Bedak salisil serb 2%
1157 118 Bendamustin serb inj 100 mg
1156 119 Bendamustin serb inj 25 mg
100 120 Benzatin penisilin inj 1,2 juta UI/ml (i.m.)
99 121 Benzatin penisilin inj 2,4 juta UI/ml (i.m.)
101 122 Beractant susp 25 mg/ml (intratekal)
102 123 Beraprost sodium tab 20 mcg
1030 124 Betahistin tab 24 mg
1031 125 Betahistin tab 6 mg
1070 126 Betaksolol tts mata 0,5%
104 127 Betametason krim 0,1%
105 128 Betametason krim 0,5 mg/g
106 129 Betametason salep 0,1%
103 130 Betametason tts mata 1 mg/ml
107 131 Bevasizumab inj 25 mg/ml
108 132 Bikalutamid tab sal 150 mg
109 133 Bikalutamid tab sal 50 mg
110 134 Bisakodil sup 10 mg
111 135 Bisakodil sup 5 mg
112 136 Bisakodil tab sal 5 mg
1086 137 Bisoprolol tab 1,25 mg
1087 138 Bisoprolol tab 10 mg
113 139 Bisoprolol tab 2,5 mg
114 140 Bisoprolol tab 5 mg
115 141 Bleomisin serb inj 15 mg/ml
1071 142 Brinzolamid tetes mata
116 143 Bromokriptin tab 2,5 mg
117 144 Budesonid cairan ih 0,25mg/ml
118 145 Budesonid ih 200 mcg/dosis
119 146 Budesonid serb ih 100 mcg/dosis
1182 147 Budesonid-formoterol (fixed combination) 160/4,5 mg (inhalasi), 120
1183 148 dosis
Budesonid-formoterol (fixed combination) 160/4,5 mg (inhalasi), 60 dosis
121 149 Budesonid-formoterol (fixed combination)* ih 80/4,5 mcg
122 150 Bupivakain heavy inj 5 mg/ml (hcl) + glukosa 8%
123 151 Bupivakain inj 5 mg/ml (p.v.)
124 152 Busulfan tab salut 2 mg
125 153 Coal tar lar 5 %
126 154 Copper T
127 155 Dabigatran eteksilat kaps 110 mg
128 156 Dabigatran eteksilat kaps 75 mg
129 157 Dakarbazin serb inj 100 mg/vial
130 158 Dakarbazin serb inj 200 mg/vial
131 159 Daktinomisin inj 0,5 mg/vial (i.v.)
132 160 Dapson tab scored 100 mg
133 161 Daunorubisin serb inj 20 mg/vial
134 162 Deferasiroks tab disp 250 mg
135 163 Deferasiroks tab disp 500 mg
136 164 Deferipron lar oral 100 mg/ml
137 165 Deferipron tab sal 500 mg
138 166 Deferoksamin mesilat serb inj 500 mg/vial
141 167 Deksametason inj 5 mg/ml (i.v./i.m.)
139 168 Deksametason tab 0,5 mg
140 169 Deksametason tab 4 mg
1040 170 Deksmedetomidin Inj 100 mcg/ml
1135 171 Desmopresin nasal spray 10 mcg/puff
142 172 Desmopresin tab 0,1 mg
143 173 Desmopresin tab 0,2 mg
144 174 Desogestrel tab 75 mcg
145 175 Desoksimetason gel 0,05%
146 176 Desoksimetason krim 0,25%
147 177 Desoksimetason salep 0,25%
1163 178 Dialisa Peritoneal : Lar intraperitoneal dengan dekstrose 1,5%
1164 179 Dialisa Peritoneal : Lar intraperitoneal dengan dekstrose 12,5%
148 180 Dialisa peritoneal lar intraperitonial
149 181 Diazepam inj 5 mg/ml (i.v./i.m.)
150 182 Diazepam lar rektal 10 mg/2,5 ml
151 183 Diazepam lar rektal 5 mg/2,5 ml
152 184 Diazepam tab 2 mg
153 185 Diazepam tab 5 mg
1122 186 Dienogest tab 2 mg
154 187 Dietilkarbamazin tab 100 mg
155 188 Difenhidramin inj 10 mg/ml (i.v./i.m.)
156 189 Diflukortolon valerat salep berlemak 0,1%
157 190 Digoksin inj 0,25 mg/ml
158 191 Digoksin tab 0,25 mg
159 192 Diltiazem hcl inj 5 mg/5 ml
160 193 Diltiazem hcl tab 30 mg
161 194 Diltiazem inj 25 mg/5 ml
162 195 Diltiazem kaps SR 100 mg
163 196 Diltiazem kaps SR 200 mg
164 197 Diltiazem serb inj 10 mg/10 ml
165 198 Diltiazem serb inj 50 mg/vial
166 199 Diltiazem tab 30 mg
167 200 Dimenhidrinat tab 50 mg
168 201 Dinatrium edetat tts mata 0,35%
169 202 Dinatrium klodronat inj 60 mg/ml
170 203 DMSA (dimercapto succinic acid) 1,1 mg meso-2, 3-dimercaptosuccinic
171 204 acid/vial
Dobutamin inj 12,5 mg/ml
172 205 Dobutamin inj 25 mg/ml
173 206 Dobutamin inj 50 mg/ml
174 207 Doksazosin mesilat tab 1 mg
175 208 Doksazosin mesilat tab 2 mg
176 209 Doksazosin tab 1 mg
177 210 Doksazosin tab 2 mg
178 211 Doksisiklin kaps 100 mg
179 212 Doksisiklin kaps 50 mg
180 213 Doksorubisin serb inj 10 mg/vial (i.v.)
181 214 Doksorubisin serb inj 50 mg/vial
182 215 Domperidon susp 5 mg/5 ml
183 216 Domperidon tab 10 mg
184 217 Domperidon tts 5 mg/ml
1032 218 Donepezil tab 5 mg
1033 219 Donepezil tab eff 10 mg
185 220 Dopamin inj 40 mg/ml
1185 221 Dosetaksel Inj 40 mg/ml (vial 0,5 ml)
1184 222 Dosetaksel inj 40 mg/ml (vial 2 ml)
188 223 DTPA (diethylene triamine pentaacetic acid) 2,06-2,5 mg pentetate
189 224 calcium
Dutasteridtrisodium/ml
kaps 0,5 mg
190 225 Efavirens tab sal 600 mg
1094 226 Efavirenz tab 200 mg
191 227 Efedrin inj 50 mg/ml
192 228 Eksemestan tab 25 mg
193 229 Enoksaparin sodium inj 20 mg/0,2 ml
194 230 Enoksaparin sodium inj 40 mg/0,4 ml
195 231 Enoksaparin sodium inj 60 mg/0,6 ml
1056 232 Entekavir tab sal selaput 0,5 mg
1057 233 Entekavir tab sal selaput 1 mg
196 234 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.)
197 235 Epinefrin (adrenalin) inj 1 mg/ml
198 236 Epirubisin serb inj 2 mg/ml
199 237 Epirubisin serb inj 50 mg
200 238 Ergokalsiferol (vitamin D2) kaps 50.000 UI
201 239 Ergokalsiferol (vitamin D2) susp 10.000 UI/ml
202 240 Ergotamin tab 1 mg
203 241 Eritromisin kaps 250 mg
204 242 Eritromisin sir 200 mg/5 ml
205 243 Eritromisin tab 500 mg
206 244 Eritropoetin-alfa inj 10.000 UI/ml
207 245 Eritropoetin-alfa inj 2.000 UI/ml
208 246 Eritropoetin-alfa inj 3.000 UI/ml
209 247 Eritropoetin-beta inj 2000 UI/0,3 ml
1158 248 Eritropoietin-Alfa Inj 4000 IU/0,5 ml
1034 249 Erlotinib tab sal selaput 100 mg
1035 250 Erlotinib tab sal selaput 150 mg
948 251 Esomeprazole inj 40 mg/vial
211 252 Estrogen terkonjugasi tab sal 0,625 mg
212 253 Etambutol tab 250 mg
213 254 Etambutol tab 400 mg
214 255 Etambutol tab 500 mg
215 256 Etanol 70% cairan 70%
216 257 Etil klorida semprot 100 ml
217 258 Etinilestradiol tab 0,05 mg
218 259 Etinilestradiol tab 0,5 mg
1093 260 Etonogestrel implan 68 mg
219 261 Etoposid inj 20 mg/ml
220 262 Etoposid kaps 100 mg
221 263 Eugenol
222 264 Everolimus tab 0,25 mg
223 265 Everolimus tab 0,5 mg
1159 266 Faktor IX Kompleks Inj 50 IU/mL
224 267 Faktor IX kompleks serb inj 1.000 UI/vial + pelarut 10 ml
225 268 Faktor IX kompleks serb inj 500 UI/vial + pelarut
1080 269 Faktor koagulasi II 14-35 UI, faktor koagulasi VII 7-20 UI, faktor koagulasi
226 270 IX 25 UI,
Faktor faktor koagulasi
koagulasi X 14-35
II 14-35 UI, faktorserb inj 250VII
koagulasi IU/10
7-20ml
UI, faktor koagulasi
227 IX 25 UI, faktor koagulasi X 14-35 serb inj 500 UI/10 ml
271 Faktor viia (rekombinan) serb inj 1 mg/vial + pelarut untuk UI injeksi
228 272 Faktor VIII (konsentrat) serb inj 230 -340 UI
229 273 Faktor VIII (konsentrat) serb inj 250 UI/vial + pelarut 5 ml
230 274 Faktor VIII (konsentrat) serb inj 480 - 600 UI
231 275 Faktor VIII (konsentrat) serb inj 500 UI/vial + pelarut 5 ml
1085 276 Faktor VIII serb inj 1000 mg/vial
949 277 Faktor VIII serb inj 2000 mg/vial
232 278 Fenitoin Na inj 100 mg/2 ml
233 279 Fenitoin Na inj 50 mg/ml
234 280 Fenitoin Na kaps 100 mg
235 281 Fenitoin Na kaps 30 mg
236 282 Fenobarbital inj 50 mg/ml
237 283 Fenobarbital tab 100 mg
238 284 Fenobarbital tab 30 mg
239 285 Fenofibrat kaps 100 mg
240 286 Fenofibrat kaps 300 mg
241 287 Fenoksimetil penisilin (penisilin V) tab 125 mg
242 288 Fenoksimetil penisilin (penisilin V) tab 250 mg
243 289 Fenoksimetil penisilin (penisilin V) tab 500 mg
244 290 Fenoterol hbr aerosol 100 mcg/puff
245 291 Fenoterol hbr cairan ih 0,1%
1187 292 Fentanil inj 0,05 mg/ml (ampul 10 ml)
1186 293 Fentanil inj 0,05 mg/ml (ampul 2 ml)
247 294 Fentanil patch 12,5 mcg/jam
248 295 Fentanil patch 25 mcg/jam
249 296 Fentanil patch 50 mcg/jam
1063 297 Ferrakrilum cairan 1%
250 298 Ferro fumarat kaps lunak 300 mg
251 299 Ferro sulfat sir. 150 mg/5 ml
252 300 Ferro sulfat tab salut 300 mg
253 301 Filgrastim inj 300 mcg/ml
254 302 Finasterid tab 5 mg
255 303 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.)
256 304 Fitomenadion (vitamin K 1) tab sal 10 mg
1081 305 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m)
257 306 Fludarabin inj 50 mg/vial
258 307 Fludarabin tab sal 10 mg
259 308 Flufenazin inj 25 mg/ml (i.m.)
260 309 Flukonazol inj 2 mg/ml
261 310 Flukonazol kaps 150 mg
262 311 Flukonazol kaps 50 mg
263 312 Fluoksetin kaps 10 mg
264 313 Fluoksetin kaps 20 mg
267 314 Fluor kapl 1 mg
265 315 Fluor sediaan topikal
950 316 Fluoresein injeksi 10%
268 317 Fluoresein tts mata 2,5 mg/ml
269 318 Fluoro deoxy glucose (FDG)
270 319 Fluorometolon tts mata 0,1%
1119 320 Fluorourasil Inj 25 mg/ml
271 321 Fluorourasil inj 250 mg/ml
1188 322 Fluorourasil inj 50 mg/mL (@ 10 mL)
1189 323 Fluorourasil inj 50 mg/mL (@ 5 mL)
273 324 Fluorourasil serb inj 250 mg
274 325 Flusinolon asetonid krim 0,025%
275 326 Flusinolon asetonid salep 0,025%
276 327 Flutikason furoat intranasal spray
277 328 Flutikason propionat cairan ih 0,5 mg/dosis
278 329 Fondaparinuks inj 2,5 mg/0,5 ml
281 330 Formokresol
282 331 Fraksi protein plasma lar inf 5%
1095 332 Framisetin Sulfat Tulle 1%
283 333 Furosemid inj 10 mg/ml (i.v./i.m.)
284 334 Furosemid tab 40 mg
951 335 Gabapentin kaps 100 mg
952 336 Gabapentin kaps 300 mg
1190 337 Gadobutrol Macrocyclic 5 mg
1191 338 Gadobutrol Macrocyclic 7,5 mg
287 339 Gadoksetat disodium 0,25 mmol gadoksetat disodium/ml
288 340 Galactose microparticle 200-400 mg micropart/ml
289 341 Gansiklovir serb inj 500 mg/vial
290 342 Garam oralit kombinasi : natrium klorida 0,52 g + kalium klorida 0,30 g +
291 343 trinatrium sitrat
Gefitinib tab 2500,58
mg g + glukosa anhidrat 2,7 g
292 344 Gemfibrozil kaps 300 mg
293 345 Gemfibrozil kaps 600 mg
294 346 Gemsitabin inj 1000 mg/vial
295 347 Gemsitabin inj 200 mg/vial
296 348 Gentamisin inj 10 mg/ml
297 349 Gentamisin inj 40 mg/ml
298 350 Gentamisin inj 80 mg/ml
299 351 Gentamisin salep mata 0,3%
300 352 Gentamisin tts mata 0,3%
301 353 Glass ionomer ART (Atraumatic Restorative Treatment) cocoa butter 5 g
302 354 Glass ionomer ART (Atraumatic Restorative Treatment) lar
303 355 Glass ionomer ART (Atraumatic Restorative Treatment) serb
304 356 Glibenklamid tab 2,5 mg
305 357 Glibenklamid tab 5 mg
306 358 Gliklazid tab 80 mg
307 359 Gliklazid tab MR 30 mg
308 360 Gliklazid tab SR 60 mg
309 361 Glikuidon tab 30 mg
310 362 Glimepirid tab 1 mg
311 363 Glimepirid tab 2 mg
312 364 Glimepirid tab 3 mg
313 365 Glimepirid tab 4 mg
314 366 Glipizid tab 10 mg
315 367 Glipizid tab 5 mg
316 368 Gliseril trinitrat inj 10 mg/ml
1138 369 Gliseril trinitrat inj 5 mg/ml
318 370 Gliseril trinitrat kaps lepas lambat 2,5 mg
319 371 Gliseril trinitrat kaps lepas lambat 5 mg
320 372 Gliseril trinitrat tab 0,5 mg
321 373 Gliserin lar 50%
323 374 Gliserin tts 100 mg/ml
955 375 Glukosa Larutan Infus 10% steril 100 ml
956 376 Glukosa Larutan Infus 10% steril 250 ml
514 377 Glukosa Larutan Infus 10% steril 500 ml
953 378 Glukosa Larutan Infus 5% steril 100 ml
954 379 Glukosa Larutan Infus 5% steril 250 ml
513 380 Glukosa Larutan Infus 5% steril 500 ml
324 381 Goserelin asetat inj 10,8 mg/vial
325 382 Goserelin asetat inj 3,6 mg/vial
326 383 Griseofulvin (micronized) tab 125 mg
327 384 Griseofulvin (micronized) tab 500 mg
328 385 Griseofulvin (micronized) tab scored 250 mg
329 386 Gutta percha dan paper points 15 - 40 mm
330 387 Gutta percha dan paper points 45 - 80 mm
331 388 Haloperidol inj 5 mg/ml (i.m.)
332 389 Haloperidol inj 50 mg/ml (decanoat)
333 390 Haloperidol tab 0,5 mg
334 391 Haloperidol tab 1,5 mg
335 392 Haloperidol tab 2 mg
336 393 Haloperidol tab 5 mg
337 394 Haloperidol tts 2 mg/ml
338 395 Halotan ih
339 396 Hemodialisa lar konsentrat basis asetat
340 397 Hemodialisa lar konsentrat basis natrium bikarbonat
341 398 Heparin, Na inj 5.000 UI/ml (i.v./s.k.)
342 399 Hepatitis B imunoglobulin (human) inj 0,5 ml
1096 400 Hepatitis B imunoglobulin (human) Inj 220 IU/ml
345 401 Hidrogen peroksida cairan 3%
346 402 Hidrogen peroksida lar. Konsentrat 3%
347 403 Hidroklorotiazid tab 12,5 mg
348 404 Hidroklorotiazid tab 25 mg
349 405 Hidrokortison inj 100 mg/vial
350 406 Hidrokortison krim 1%
351 407 Hidrokortison krim 2,5%
352 408 Hidrokortison serb inj 100 mg/vial
1161 409 Hidrokortison Tab 20 mg
343 410 Hidroksi klorokuin tab 200 mg
355 411 Hidroksi urea tab 500 mg
357 412 Hiosina butilbromida inj 20 mg/ml
358 413 Hiosina butilbromida tab 10 mg
359 414 Homatropin tts mata 2%
1198 415 Human insulin fast acting inj 100 IU/ml, cartridge disposible/penfill
1199 416 cartridge
Human insulin fast acting inj 100 IU/ml, Vial 10 mL
1200 417 Human insulin fast acting inj 100 IU/ml, Vial 5 mL
1195 418 Human Insulin intermediate acting combine with short or long acting inj
1197 419 100
HumanIU/mL, cartridge
insulin disposible/penfill
intermediate cartridge
acting combine with short or long acting inj
1192 100 IU/mL, Vial 5 mL
420 Human Insulin intermediate acting inj 100 IU/ml, cartridge
1193 421 disposible/penfill cartridge acting inj 100 IU/Ml, Vial 10 mL
Human Insulin intermediate
1196 422 Human insulin intermediate acting inj 100 IU/mL, Vial 10 mL
1194 423 Human Insulin intermediate acting inj 100 IU/mL, Vial 5 mL
363 424 Human tetanus imunoglobulin inj 250 UI (i.m.)
364 425 Human tetanus imunoglobulin inj 500 UI (i.m.)
958 426 Hydromorphone HCl tab oros 16 mg
959 427 Hydromorphone HCl tab oros 8 mg
365 428 Ibuprofen sir 100 mg/5 ml
366 429 Ibuprofen sir 200 mg/5 ml
367 430 Ibuprofen tab 200 mg
368 431 Ibuprofen tab 400 mg
1061 432 Idarubisin serb inj 20 mg
369 433 Ifosfamid serb inj 1000 mg/vial
960 434 Ifosfamid serb inj 2000 mg/vial
370 435 Ifosfamid serb inj 500 mg/vial
371 436 Imatinib mesilat tab 100 mg
1076 437 Imatinib Mesilat tab 400 mg
372 438 Imidapril tab 10 mg
373 439 Imidapril tab 5 mg
1097 440 Imunoglobulin Intravena Inj 50 mg/ml, untuk terapi GBS (Guillain Bare
961 441 Syndrom)
Imunoglobullin Intravena inj 250 mg/50 ml
962 442 Indakaterol serb ih 150 mcg
963 443 Indakaterol serb ih 300 mcg
375 444 Iodiksanol vial 320 mg Iodium/50 ml
376 445 Iodium 131
377 446 Iodohippurate sodium I 131 37-74 mbq/ multiple-dose
1203 447 Ioheksol 180 - 300 mg Iodium/mL (300 mg/20 mL)
379 448 Ioheksol 240-350 mg Iodium/ml
1204 449 Ioheksol Inj 140 - 350 mg Iodium/mL (350 mg/100 ml)
1205 450 Ioheksol Inj 140 - 350 mg Iodium/mL (350 mg/50 ml)
1201 451 Ioheksol Inj 180 - 300 mg Iodium/mL (300 mg/100 ml)
1202 452 Ioheksol Inj 180 - 300 mg Iodium/mL (300 mg/50 ml)
381 453 Iopamidol 200 - 300 mg Iodium/mL (300 mg/200 mL)
382 454 Iopamidol 300 - 370 mg Iodium/mL (370 mg/200 mL)
383 455 Iopamidol inj 200-370 mg Iodium/ml
384 456 Iopromid 240 -370 mg Iodium/ml
1206 457 Iopromid 300 - 370 mg (300 mg/100 mL)
1207 458 Iopromid 300 - 370 mg (300 mg/50 mL)
1208 459 Iopromid 300 - 370 mg (370 mg/100 mL)
1209 460 Iopromid 300 - 370 mg (370 mg/50 mL)
386 461 Ipratropium bromida ih 20mcg/puff
387 462 Ipratropium bromida ih padat 20 mcg
388 463 Ipratropium bromida nebulizer 0,025%
389 464 Irbesartan tab 150 mg
390 465 Irbesartan tab 300 mg
391 466 Irinotekan inf 20 mg/ml
392 467 Irinotekan inj 20 mg/ml
393 468 Isofluran inhalasi 100 ml
964 469 Isofluran inhalasi 250 ml
394 470 Isoniazid tab 100 mg
395 471 Isoniazid tab 300 mg
396 472 Isosorbid dinitrat inj 1 mg/ml (i.v)
397 473 Isosorbid dinitrat tab 10 mg
398 474 Isosorbid dinitrat tab 5 mg
1148 475 Itrakonazol Kaps 100 mg
1136 476 IUD Cu T 380 A
1137 477 IUD Levonorgestrel
1139 478 Ivabradin tab 5 mg
1062 479 k.y jelly
399 480 Kalamin
400 481 Kalium aspartat tab 300 mg
401 482 Kalium klorida tab siap larut 300 mg
402 483 Kalium klorida tab SR 600 mg
1098 484 Kalsitriol kaps lunak 0,25 mcg
1099 485 Kalsitriol kaps lunak 0,5 mcg
1100 486 Kalsium Folinat (Leukovorin, Ca) Inj 10 mg/ml
403 487 Kalsium folinat (leukovorin, Ca) inj 3 mg/ml
1132 488 Kalsium folinat (leukovorin, Ca) inj 5 mg/ml
405 489 Kalsium folinat (leukovorin, Ca) tab 15 mg
406 490 Kalsium glukonat inj 100 mg/ml
407 491 Kalsium hidroksida bubuk, pasta
1101 492 Kalsium hipoklorit
408 493 Kalsium karbonat tab 500 mg
409 494 Kalsium laktat (kalk) tab 500 mg
410 495 Kalsium polistirena sulfonat ktg 5 g
411 496 Kanamisin inj 1.000 mg/ vial
412 497 Kandesartan tab 16 mg
413 498 Kandesartan tab 8 mg
414 499 Kapesitabin tab sal 500 mg
415 500 Kaptopril tab 12,5 mg
416 501 Kaptopril tab 25 mg
417 502 Kaptopril tab 50 mg
418 503 Karbamazepin sir 100 mg/5 ml
419 504 Karbamazepin tab 100 mg
1102 505 Karbamazepin Tab 200 mg
420 506 Karbimazol tab 5 mg
421 507 Karbo adsorben tab 0,5 g
422 508 Karbogliserin tts telinga 10 %
423 509 Karboksimetilselulosa tts mata
1103 510 Karbon aktif tab 0,5 mg
1211 511 Karboplatin Inj 10 mg (vial 45 ml)
1210 512 Karboplatin inj 10 mg/ml (vial 15 ml
1104 513 Karvedilol tab 25 mg
427 514 Karvediol kaps 6,25 mg
428 515 Ketamin inj 100 mg/ml (i.v.)
429 516 Ketamin inj 50 mg/ml (i.v.)
431 517 Ketokonazol krim 2%
432 518 Ketokonazol scalp sol 2%
430 519 Ketokonazol tab 200 mg
1146 520 Ketoprofen Inj 25 mg/ml
433 521 Ketoprofen sup 100 mg
434 522 Ketorolak inj 30 mg/ml
1050 523 Klaritromisin sir kering 125 mg/5 ml
1051 524 Klaritromisin sir kering 250 mg/5 ml
435 525 Klaritromisin tab 500 mg
436 526 Klindamisin kaps 150 mg
437 527 Klindamisin kaps 300 mg
438 528 Klobazam tab 10 mg
1105 529 Klofazimin, micronized kaps 50 mg
439 530 Klofazimin, micronizedkaps 100 mg
440 531 Klomifen sitrat tab 50 mg
441 532 Klomipramin tab 25
1006 533 Klonazepam kaps 2 mg
442 534 Klonidin inj 150 mcg/ml
443 535 Klonidin tab 0,15 mg
444 536 Klopidogrel tab 75 mg
1082 537 Klopidogrel tab sal selaput 300 mg
445 538 Kloral hidrat lar
446 539 Klorambusil tab 2 mg
1077 540 Klorambusil tab sal selaput 5 mg
449 541 Kloramfenikol kaps 250 mg
450 542 Kloramfenikol kaps 500 mg
451 543 Kloramfenikol salep kulit 2%
452 544 Kloramfenikol salep mata 1%
453 545 Kloramfenikol serb inj 1.000 mg/ml
454 546 Kloramfenikol susp 125 mg/5 ml
1088 547 Kloramfenikol tetes telinga 3%
447 548 Kloramfenikol tts mata 0,5%
448 549 Kloramfenikol tts mata 1%
455 550 Klorfeniramin tab 4 mg
456 551 Klorfenol kamfer mentol (CHKM)
457 552 Klorheksidin lar 0,2%
458 553 Klorheksidin lar 15%
1055 554 Klorokuin tab 250 mg
459 555 Klorpromazin inj 25 mg/ml (i.m.)
460 556 Klorpromazin inj 5 mg/ml (i.m.)
461 557 Klorpromazin tab sal 100 mg
462 558 Klorpromazin tab sal 25 mg
463 559 Klortalidon tab 50 mg
464 560 Klotrimazol tab vagina 100 mg
465 561 Klozapin tab 100 mg
466 562 Klozapin tab 25 mg
467 563 Kodein tab 10 mg
468 564 Kodein tab 15 mg
469 565 Kodein tab 20 mg
470 566 Kolekalsiferol (vitamin D3) kaps lunak 0,25 mcg
471 567 Kolekalsiferol (vitamin D3) kaps lunak 0,5 mcg
472 568 Kolestiramin serb, 4 g
473 569 Kolkisin tab 500 mcg
474 570 Koloid HES BM 130 000 lar inf 6%
1106 571 Kombinasi (DHP) : dihidroartemisin 40 mg + Piperakuin 320 mg tab sal
1046 572 selaput
Kombinasi : (Ampisilin 1000 mg + Sulbaktam 500 mg) serb inj 1500 mg
1047 573 Kombinasi : (Sefoperazon 500 mg + Sulbaktam 500 mg) serb inj 1000 mg
1109 574 Kombinasi : (Zidovudin 60 mg + Lamivudin 30 mg + Nevirapin 50 mg) Ped
1045 575 Triple FDC : Ampisilin 500 mg + Sulbaktam 250 mg serb inj 750 mg
Kombinasi
485 576 Kombinasi : artemether 20 mg + lumefantrin 120 mg
481 577 Kombinasi : artesunat tab 50 mg + amodiakuin tab 200
1007 578 Kombinasi : Desogestrel 150 mcg Etinilestradiol 30 mcg
486 579 Kombinasi : ergotamin 1 mg+ kafein 50 mg
1108 580 Kombinasi : Ferro fumarat 60 mg + asam folat 0,4 mg tab salut
1172 581 Kombinasi : Ipratropium bromida 0,02 mg + fenoterol HBr 0,05 mg
482 582 aerosol
Kombinasi : levodopa 100 mg+Karbidopa 25 mg + entekapon 200 mg
483 583 Kombinasi : levonorgestrel 150 mcg + etinilestradiol 30 mcg
488 584 Kombinasi : medroksi progesteron asetat+ estradiol sipionat inj depot 25
21 585 mg + 5 mg : Meglumin amidotrizoat + Sodium amidotrizoat inj 76%
Kombinasi
1149 586 Kombinasi : Tenofovir 300 mg + Emtrisitabin 200 mg
1150 587 Kombinasi : Tenofovir 300 mg + Lamivudin 300 mg + Efavirenz 600 mg
1064 588 Kombinasi : triamsinolon + dementilklortetrasiklin
484 589 Kombinasi : zidovudin 300 mg +lamivudin 150 mg
489 590 Kombinasi: ipratropium Br 0,5 mg+ salbutamol 2,5 mg nebules
493 591 Kombinasi: kaolin 550 mg + pektin 20 mg
494 592 Kombinasi: lopinavir 200 mg + ritonavir (LVP) 50 mg, tab 250 mg
495 593 Kombinasi: natrium klorida 8,664 mg + kalium klorida 1,32 mg (tetes
mata)
496 594 Kombinasi: parafin + gliserin + fenolftalein
490 595 Kombinasi: salmeterol 25 mcg + flutikason propionat 50 mcg ih 50
491 596 mcg/puff
Kombinasi: salmeterol 50 mcg + flutikason propionat 100 mcg ih 100
1008 597 mcg/puff
Kombinasi: salmeterol 50 mcg + flutikason propionat 500 mcg ih 500
492 598 mcg/puff
Kombinasi: salmeterol 50 mcg+ flutikason propionat 250 mcg ih 250
497 599 mcg/puff
Kombinasi: spironolakton 25 mg + tiabutazin 2,5 mg
498 600 Komposit resin
499 601 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+
500 602 trimetoprim
Kotrimoksazol 80(dewasa)
mg kombinasi : sulfametoksazol 800 mg+
501 trimetoprim 160 mg
603 Kotrimoksazol (dewasa) kombinasi tiap 5 ml suspensi : sulfametoksazol
502 604 200 mginj
Kuinin + trimetoprim
25% (i.v.) 40 mg
503 605 Kuinin tab 200 mg
506 606 Laktulosa sir 3,335 g/5 ml
508 607 Lamivudin (3TC) tab 150 mg
507 608 Lamivudin tab 100 mg
1147 609 Lamotrigin Tab 100 mg
1042 610 Lamotrigin tab 50 mg
1041 611 Lamotrigin tab dispersible 25 mg
509 612 Lansoprazol inj 30 mg/ml
510 613 Lansoprazol kaps 30 mg
511 614 Lapatinib tab 250 mg
965 615 Larutan mengandung Asam Amino (Asam Amino 10%)
966 616 Larutan mengandung Asam Amino (Asam Amino 100 g, Total N 15,7 g,
967 617 Na+ 2 mEq,
Larutan Asetat 120Asam
mengandung mEq)Amino (Asam Amino 27 g, Sorbitol 50 g, Cl-
968 618 52 mEq)mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3 % dan
Larutan
969 elektrolit) 1000 ml Asam Amino (Asam Amino 30 g, Glukosa 7,3 % dan
619 Larutan mengandung
970 620 elektrolit) 500 ml
Larutan mengandung Asam Amino (Asam Amino 5% dengan BCAA 45%,
971 L-Ornithine L Aspartate
621 Larutan mengandung Asam 8.03Amino
gr/L, Sorbitol 50 gr/L,6%,
(Asam Amino Xylitol 50 gr/L)
mengandung
972 Taurine 0,24 gr/l) : Aminosteril Infant 6%
622 Larutan mengandung Asam Amino (Asam Amino 7%, Komposisi: Asam
973 623 Amino
Larutanesensial:
mengandungAsamAsam
AminoAmino
non esensial = 60 : 40)
(Asam Amino 72.05 g, Total N 11.53 g,
974 AAE/AANE ratio 2.6, Na+ 2 mEq, Asetat 46 mEq)
624 Larutan mengandung Asam Amino (Asam Amino 79.9 g, Total N 12.2 g,
520 625 Na+ 14 mEq,
Larutan Cl 94 mEq)
mengandung Asam Amino (Asam amino 8%) : Aminosteril N-
975 Hepa
626 Larutan mengandung Asam Amino (Asam Amino esensial 7%+Xylitol 10
976 627 g/L)
Larutan mengandung Asam Amino (BCAA 25 gr/L, L-Ornithine L
977 628 Aspartate 10 gr/L, Xylitol
Larutan mengandung Asam 50 Amino
gr/L, Malic Acid 7 gr/L,
(Kombinasi AsamPiridoxin
amino 500.12 gr/L)
g/L,
978 vitamin dan elektrolit)
629 Larutan mengandung Asam Amino (Kombinasi Asam Amino: 34gr,
979 630 Glukosa: 97gr, Lipid: 51gr
Larutan mengandung Asam dan Elektrolit
Amino (Kalori =Asam
(Kombinasi 1000Amino:
kkal, Akses
45gr,
980 Glukosa: 130gr, Lipid: 68gr dan Elektrolit (Kalori = 1400 kkal,
631 Larutan mengandung Asam Amino (Kombinasi Glukosa dan elektrolit 150 Akses
981 632 gr + Asam
Larutan Amino 48 grAsam
mengandung dgn akses
Aminosentral)
(Kombinasi Glukosa dan elektrolit 80
982 gr + Asam Amino 40 gr)
633 Larutan mengandung Elektrolit (Kalium Klorida)
983 634 Larutan mengandung Elektrolit (Na 130 mEq, Cl 109 mEq, Ca 3 mEq,
984 635 Asetat
Larutan28mengandung
mEq) Elektrolit (NaCl 1.125 gr, Dekstrosa 18.75 gr)
985 636 Larutan mengandung Elektrolit (Sodium Lactate sol (50%) 113 gr/L,
986 637 Potassium Chloride 0.3Elektrolit
Larutan mengandung gr/L, Calcium Chloride
(Tiap 1000 0.2 gr/L, elektrolit)
ml mengandung electrolit:
994 Sodium 145 mmol/l, Potassium 4.0 mmol/l, Calcium 2.5 mmol/l,
638 Larutan mengandung Karbohidrat (Fructose 200 g, glucose 110 g, Xylitol
988 639 100 g/ L)mengandung Karbohidrat (Fructose 60 g, glucose 33 g, Xylitol 30
Larutan
989 640 g/ L) mengandung Karbohidrat (Maltose 100 gr)
Larutan
990 641 Larutan mengandung Karbohidrat + Elektrolit (25.00g maltose, 3.00 g
991 642 sodium
Larutan chloride,
mengandung 0.15 Karbohidrat
g potassium+chloride,
Elektrolit0.10 g calcium
(Acetate, Na, chloride
K, Cl, Ca, Mg,
992 Sorbitol 50 gr/L)
643 Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28 gr/L,
993 644 Glukosa 100 gr/L, elektrolit)
Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28 gr/L,
987 Glukosa 75 gr/L, elektrolit)
645 Larutan mengandung Karbohidrat + Elektrolit (Fructose 120 g, glucose 66
995 646 g, Xylitolmengandung
Larutan 60 g/ L + elektrolit)
Karbohidrat + Elektrolit (Glukosa 25 g, NaCl 2,0 g,
996 KCl 1,3 g, Natrium Laktat
647 Larutan mengandung Karbohidrat 3,1 g, air untuk injeksi
+ Elektrolit ad 100055ml)
(Glukosa g ; Natrium
997 Chloride 9 g, air untuk injeksi ad 1000 ml) (D5-NS)
648 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 25,0 g; NaCl: 4,5
998 649 g)
Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 2.25
999 650 g)
Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 4.5
1000 651 g)
Larutan mengandung Karbohidrat + Elektrolit (Larutan nutrisi kombinasi
516 652 infus permengandung
Larutan L: Na. 100mEQ, K 18mEQ,+ Ca.
Karbohidrat 4mEQ,(Larutan
Elektrolit Mg 6mEQ, Cl 90mEQ,
Ringer & Glukosa
517 5%)
653 Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.75 g, KCL 1.5g,
518 654 Glukosa 100 gr)
Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr, Na
519 Lactat 2.24 gr, Dekstrosa
655 Larutan mengandung Karbohidrat 27 gr) (KA+EN 3B) (Nacl 2.34 gr, Na Laktat
Elektrolit
521 656 Larutan mengandung Lipid (Emulsi lemakEN
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KA 3A)
20%)
1001 657 Larutan mengandung Lipid (Infus Lipid Emulsi MCT/LCT 20% 100 ml)
1002 658 Larutan mengandung Lipid (Infus Lipid Emulsi MCT/LCT 20% 250 ml)
1003 659 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 180 gr +
1004 660 Asam
LarutanAmino 71.8 gr +Lipid
mengandung Lipid(Kombinasi
50 gr dgn akses sentral)
Glukosa dan elektrolit 80 gr +
1005 Asam Amino 40 gr + Lipid MCT/LCT 50 gr)
661 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 90 gr +
522 662 Asam Aminotts
Latanoprost 35.9 gr +0,005%
mata Lipid 25 gr dgn akses sentral)
1058 663 Leflunomid tab sal selaput 20 mg
524 664 Lenograstim inj 263 mcg/vial
525 665 Letrozol tab 2,5 mg
526 666 Leuprorelin asetat serb inj 1,88 mg
527 667 Leuprorelin asetat serb inj 11,25 mg
1151 668 Leuprorelin asetat serb inj 22,5 mg
528 669 Leuprorelin asetat serb inj 3,75 mg
1152 670 Leuprorelin asetat serb inj 7,5 mg
1043 671 Levetirasetam tab 250 mg
1044 672 levetirasetam tab 500 mg
529 673 Levofloksasin inf 5 mg/ml
530 674 Levofloksasin tab 500 mg
531 675 Levofloksasin tts mata 0,5%
532 676 Levonorgestrel implan 2 rods, 75 mg (3-4 tahun)
533 677 Levotiroksin tab 100 mcg
534 678 Levotiroksin tab 50 mcg
535 679 Lidokain gel 2%
536 680 Lidokain inj 1 % (infltr)
537 681 Lidokain inj 100 mg, vial (i.v.)
539 682 Lidokain inj 2% (infiltr/p.v.)
540 683 Lidokain inj 5% + glukosa (dekstrosa) 5 %
542 684 Lidokain spray oral 10%
544 685 Linestrenol tab 0,5 mg
1009 686 Linestrenol tablet 5 mg
545 687 Lisinopril tab 10 mg
546 688 Lisinopril tab 20 mg
547 689 Lisinopril tab 5 mg
548 690 Litium karbonat tab 200 mg
549 691 Litium karbonat tab 400 mg
550 692 Loperamid tab 2 mg
551 693 Loratadin tab 10 mg
552 694 Lorazepam tab 0,5 mg
553 695 Lorazepam tab 1 mg
554 696 Lorazepam tab sal 2 mg
555 697 Low molecular weight iron dextran inj 100mg/2 ml
556 698 Low molecule feri sucrose inj amp 100 mg/5 ml
557 699 Lugol
558 700 MAA (macro agregate albumin) 0,11-2,5 mg albumin
559 701 aggregated/reaction
MAG3 (mercapto acetyl vialtri glysine) 1 mg betiatide/vial
560 702 Magnesium sulfat inj 20%
561 703 Magnesium sulfat inj 40%
562 704 Magnesium sulfat serb, ktg 30 g
563 705 Manitol lar infus 20%
564 706 Maprotilin hcl tab sal 25 mg
565 707 Maprotilin hcl tab sal 50 mg
566 708 MDP (methylene diphosphonate) 1 mg methylene diphosphonic acid/ml
567 709 Mebendazol sir 100 mg/5 ml
568 710 Mebendazol tab 100 mg
569 711 Mebendazol tab 500 mg
571 712 Medroksi progesteron asetat inj 150 mg/ml
570 713 Medroksi progesteron asetat inj 200 mg/ml
1074 714 Medroksi Progesteron Asetat Inj 50 mg/ml
572 715 Medroksi progesteron asetat tab 10 mg
573 716 Medroksi progesteron asetat tab 100 mg
574 717 Medroksi progesteron asetat tab 250 mg
575 718 Medroksi progesteron asetat tab 5 mg
577 719 Melfalan tab 2 mg
578 720 Merkaptopurin tab 50 mg
579 721 Meropenem serb inj 1000 mg/vial
580 722 Meropenem serb inj 500 mg/vial
581 723 Mesalazin tab sal 250 mg
582 724 Mesna inj 100 mg/ml
583 725 Metadon sir 50 mg/5 ml
1038 726 Metamizol Inj 500 mg/ml
584 727 Metenamin mandelat (heksamin mandelat) tab salut enterik 500 mg
585 728 Metformin tab 500 mg
586 729 Metformin tab 850 mg
587 730 Metildopa tab sal 250 mg
588 731 Metilergometrin inj 0,2 mg/ml
589 732 Metilergometrin tab salut 0,125 mg
590 733 Metilfenidat tab SR 10 mg
591 734 Metilfenidat tab SR 20 mg
592 735 Metilprednisolon inj 125 mg/2 ml
593 736 Metilprednisolon inj 500 mg/8 ml
594 737 Metilprednisolon tab 16 mg
595 738 Metilprednisolon tab 4 mg
596 739 Metilprednisolon tab 8 mg
598 740 Metoklopramid drop botol 10 ml
599 741 Metoklopramid inj 5 mg/ml
600 742 Metoklopramid sir 5 mg/5 ml
601 743 Metoklopramid tab 10 mg
597 744 Metoklopramid tab 5 mg
1067 745 Metoprolol tartat inj 1 mg/ml
1078 746 Metotreksat Inj 10 mg/ml
1128 747 Metotreksat inj 2,5 mg/ml
603 748 Metotreksat serb inj 25 mg/ml
602 749 Metotreksat serb inj 5 mg/vial
604 750 Metotreksat tab 2,5 mg
605 751 Metronidazol lar inf 5 mg/ml
606 752 Metronidazol ovula 500 mg
607 753 Metronidazol sir 125 mg/5 Ml
608 754 Metronidazol sup 500 mg
609 755 Metronidazol tab 250 mg
610 756 Metronidazol tab 500 mg
611 757 MIBG (meta-iodobenzylguanidine)
612 758 MIBI (metoxy iso butyl isonitril) 5-ml reaction vial
613 759 Midazolam inj 1 mg/ml (i.v.)
614 760 Midazolam inj 5 mg/ml (i.v.)
615 761 Mikafungin Na serb inj 50 mg/vial
616 762 Mikofenolat mofetil tab 500 mg
1123 763 Mikofenolat Sodium Tab Sal 180 mg
1124 764 Mikofenolat Sodium Tab Sal 360 mg
617 765 Mikonazol krim 2%
618 766 Mikonazol serb 2%
620 767 Mitomisin serb inj 10 mg
619 768 Mitomisin serb inj 2 mg
621 769 Modified fluid gelatine BM 30 000 lar inf 4%
1010 770 Moksifloksasin inf 1,6 mg/mL
1011 771 Moksifloksasin tab 400 mg
622 772 Moksifloksasin tts mata 0,5%
623 773 Mometason furoat krim 0,1%
624 774 Morfin Hcl inj 10 mg/ml (i.m./s.k./i.v.)
625 775 Morfin Hcl tab 10 mg
626 776 Morfin Hcl tab SR 10 mg
627 777 Morfin Hcl tab SR 15 mg
628 778 Morfin Hcl tab SR 30 mg
1144 779 N-asetil sistein granula 200 mg
634 780 N-asetil sistein ih 100 mg/ml
635 781 N-asetil sistein kaps 200 mg
515 782 NaCl 0,9% Larutan
629 783 Nadroparin inj 10 mg/ml
630 784 Nadroparin inj 9.500 Axa/ml syringe 0,3 Ml
631 785 Nadroparin inj 9.500 Axa/ml, syringe 0,4 ml
632 786 Nadroparin inj 9.500 Axa/ml, syringe 0,6 ml
633 787 Nalokson inj 0,4 mg/ml
636 788 Natamisin tts mata 5%
637 789 Natamisin tts mata 50 mg/ml
638 790 Natrium aminohipurat inj 200 mg/ml (i.v.)
639 791 Natrium bikarbonat High alert medicine.
640 792 Natrium bikarbonat inj 8,4% (i.v.)
641 793 Natrium bikarbonat tab 500 mg
642 794 Natrium diklofenak tab 25 mg
643 795 Natrium diklofenak tab 50 mg
1110 796 Natrium Diklofenak Tetes Mata 1 mg/ml
644 797 Natrium fluoresein tts mata 2%
645 798 Natrium fosfat btl, 133 ml
646 799 Natrium fosfat lar oral 45 ml
647 800 Natrium fusidat krim 20 mg/g
648 801 Natrium fusidat salep 20 mg/g
1072 802 Natrium hialuronat gel
649 803 Natrium hipoklorit cairan konsentrat 5%
650 804 Natrium tiosulfat inj 25% (i.v.)
651 805 Neostigmin inj 0,5 mg/ml
652 806 Nevirapin tab 200 g
653 807 Nifedipin kaps 10 mg
654 808 Nifedipin tab SR 20 mg
655 809 Nifedipin tab SR 30 mg
656 810 Nikardipin inj 10 mg/vial
657 811 Nikotinamid tab 100 mg
659 812 Nikotinamid tab 5 mg
1012 813 Nilotinib kaps 150 mg
660 814 Nilotinib tab 200 mg
1013 815 Nimodipin inf 0,2 mg/ml
1014 816 Nimodipin tab 30 mg
661 817 Nistatin susp 100.000 UI/ml
662 818 Nistatin tab salut 500.000 UI
663 819 Nistatin tab vaginal 100.000 UI
664 820 Nitrofurantoin tab 50 mg
665 821 Nitrogen oksida ih, gas dlm tabung
1066 822 Nomegestrol asetat Kaps/tab 5 mg
666 823 Norepinefrin inj 1 mg/ml
667 824 Noretisteron tab 5 mg
478 825 Obat Anti Tuberculosis FDC Kategori Anak
475 826 Obat Anti Tuberculosis FDC Kategori I
476 827 Obat Anti Tuberculosis FDC Kategori II
477 828 Obat Anti Tuberculosis FDC Kategori Sisipan
480 829 Obat Anti Tuberculosis Kombipak Anak
479 830 Obat Anti Tuberculosis Kombipak Dewasa
1015 831 Octreotide acetate 0,05 - 6 mg/ml
668 832 Ofloksasin tab 200 mg
669 833 Ofloksasin tab 400 mg
670 834 Ofloksasin tts telinga 3%
671 835 Oksaliplatin serb inj 100 mg/vial
672 836 Oksaliplatin serb inj 50 mg/vial
673 837 Oksigen ih, gas dlm tabung
674 838 Oksimetazolin tts hidung 0,025%
675 839 Oksimetazolin tts hidung 0,050%
677 840 Oksitetrasiklin hcl inj 50 mg/ml (i.m.)
679 841 Oksitosin inj 10 UI/ml
1111 842 Oktreotid asetat 0,05 - 6 mg/ml
680 843 Oktreotid serb inj 20 mg
1037 844 Oktreotid serb inj 30 mg
681 845 Olanzapin inj 10 mg/2 ml
682 846 Olanzapin tab sal 10 mg
683 847 Olanzapin tab sal 5 mg
1174 848 Olodaterol cairan ih 2,5 mcg/semprot
684 849 Olopatadin tts mata 0,1%
685 850 Omeprazol inj 40 mg/10 ml
686 851 Omeprazol kaps 20 mg
687 852 Ondansetron inj 2 mg/ml
688 853 Ondansetron tab 4 mg
689 854 Ondansetron tab 8 mg
690 855 Paklitaksel inj 100 mg/vial
691 856 Paklitaksel inj 30 mg/vial
692 857 Paklitaksel inj 300 mg/vial
1112 858 Paklitaksel Inj 6 mg/ml
1169 859 Paliperidon palmitat Inj 100 mg/mL
1170 860 Paliperidon palmitat Inj 150 mg/1,5 mL
1167 861 Paliperidon palmitat Inj 50 mg/0,5 mL
1168 862 Paliperidon palmitat Inj 75 mg/0,75 mL
1073 863 Pankuronium inj 2 mg/ml
279 864 Paraformaldehid lar buffer 10%
280 865 Paraformaldehid tab 1 g
693 866 Parasetamol drips (infus) 1000 mg/100 ml
694 867 Parasetamol sir 120 mg/5 ml
695 868 Parasetamol tab 500 mg
696 869 Parasetamol tts 60 mg/0,6 ml
697 870 Pasta devitalisasi (non arsen)
698 871 Pasta pengisi saluran akar (pasta)
699 872 Pegylated interferon alfa-2a inj 135 mcg/0,5 ml
700 873 Pegylated interferon alfa-2a inj 180 mcg/0,5 ml
701 874 Pegylated interferon alfa-2b serb inj 100 mcg/ml
702 875 Pegylated interferon alfa-2b serb inj 120 mcg/ml
703 876 Pegylated interferon alfa-2b serb inj 50 mcg/ml
704 877 Pegylated interferon alfa-2b serb inj 80 mcg/ml
1129 878 Pemetreksed serb inj 500 mg
705 879 Pengganti plasma kombinasi : poligelin (ekivalen dengan 0,63 g nitrogen
706 880 17,5
Perakgnitrat
; natrium klorida 0,19 g ; kalsium klorida 0,19 g ; kalsium (terikat
lar 20%
708 881 Perak sulfadiazin krim 1%
709 882 Perindoprilarginin tab 5 mg
710 883 Permetrin krim 5 %
711 884 Petidin inj 50 mg/ml (i.m./s.k./i.v.)
712 885 Pilokarpin tts mata 2%
713 886 Pioglitazon tab 15 mg
714 887 Pioglitazon tab 30 mg
715 888 Pirantel pamoat susp 125 mg/5 ml
716 889 Pirantel pamoat tab 500 mg
717 890 Pirantel pamoat tab scored 125 mg
718 891 Pirantel pamoat tab scored 250 mg
719 892 Pirazinamid tab 500 mg
720 893 Piridoksin (vitamin B6) inj 100 mg/ml
721 894 Piridoksin (vitamin B6) tab 10 mg
722 895 Piridoksin (vitamin B6) tab 25 mg
723 896 Piridostigmin tab sal 60 mg
1052 897 Pirimetamin tab 25 mg
724 898 Podofilin tingtur 25 %
725 899 Polietilen glikol
726 900 Polikresulen
728 901 Povidon iodin lar 100 mg/ml
730 902 Povidon iodin lar 100 mg/ml
727 903 Povidon iodin lar 100 mg/ml
729 904 Povidon iodin lar 100 mg/ml
1113 905 Pramipeksol tab 0,125 mg
731 906 Pramipeksol tab ER 0,375 mg
732 907 Pramipeksol tab ER 0,750 mg
733 908 Pravastatin tab 10 mg
734 909 Pravastatin tab 20 mg
735 910 Prazikuantel tab scored 300 mg
736 911 Prazikuantel tab scored 600 mg
737 912 Prednisolon tts mata 10 mg/ml
738 913 Prednison tab 5 mg
739 914 Primakuin tab 15 mg
740 915 Probenesid tab 500 mg
742 916 Prokain benzilpenisilin serb inj 3 juta UI/vial (i.m.)
1016 917 Prokaterol HCl cairan ih 30 mcg
1017 918 Prokaterol HCl cairan ih 50 mcg
1018 919 Prokaterol HCl serb ih 10 mcg
743 920 Propiltiourasil tab 100 mg
744 921 Propofol inj 1% (i.v. Bolus)
745 922 Propranolol inj 1 mg/ml (i.v.)
746 923 Propranolol tab 10 mg
747 924 Propranolol tab 40 mg
1114 925 Prostaglandin (PGE 1) Inj 500 mcg/ml
748 926 Protamin sulfat inj 10 mg/ml (i.m.)
749 927 Quetiapin tab SR 200 mg
750 928 Quetiapin tab SR 300 mg
751 929 Quetiapin tab SR 400 mg
752 930 Ramipril tab 10 mg
754 931 Ramipril tab 2,5 mg
753 932 Ramipril tab 5 mg
1141 933 Ranibizumab inj 10 mg/ml
755 934 Ranitidin inj 25 mg/ml
756 935 Ranitidin tab 150 mg
757 936 Retinol (vitamin A) kaps lunak 100.000 UI
758 937 Retinol (vitamin A) kaps lunak 200.000 UI
759 938 Ribavirin tab 200 mg
760 939 Rifampisin kaps 300 mg
761 940 Rifampisin tab 450 mg
762 941 Rifampisin tab 600 mg
512 942 Ringer Laktat Larutan
1019 943 Ringer Laktat Larutan 1000 ml
1133 944 Risedronat tab sal selaput 35 mg
763 945 Risperidon tab 3 mg
764 946 Risperidon tab sal 1 mg
765 947 Risperidon tab sal 2 mg
1214 948 Rituksimab inf 10 mg/ml (vial 10 ml)
1215 949 Rituksimab Inf 10 mg/ml (vial 50 ml)
766 950 Rituksimab inj 100 mg/ml
767 951 Rituksimab inj 500 mg/ml
768 952 Rivaroksaban tab sal 10 mg
769 953 Rivaroksaban tab sal 15 mg
770 954 Rivaroksaban tab sal 20 mg
771 955 Rokuronium inj 50 mg/5 ml (i.v.)
772 956 Ropinirol tab lepas lambat 2 mg
773 957 Ropinirol tab lepas lambat 4 mg
774 958 Ropinirol tab lepas lambat 8 mg
1039 959 Ropivakain Inj 7,5 mg/ml
1020 960 Rosuvastatin tab 10 mg
775 961 Salbutamol aerosol 100 mcg
776 962 Salbutamol cairan ih 0,1%
777 963 Salbutamol cairan serb ih 200 mcg/kaps + rotahaler
779 964 Salbutamol lar ih 0,5 %
780 965 Salbutamol nebules vial 2,5 mg
781 966 Salbutamol sir 2 mg/5 ml
782 967 Salbutamol tab 2 mg
783 968 Salbutamol tab 4 mg
784 969 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang endap 4 %
785 970 Sefadroksil kaps 250 mg
786 971 Sefadroksil kaps/tab 500 mg
787 972 Sefadroksil sir kering 125 mg/5 ml
788 973 Sefadroksil sir kering 250 mg/5 ml
789 974 Sefaleksin kaps 250 mg
790 975 Sefaleksin kaps 500 mg
791 976 Sefazolin serb inj 1 g/vial
792 977 Sefepim serb inj 1000 mg/vial
793 978 Sefiksim sir 100 mg/5 ml
794 979 Sefiksim tab 100 mg
1115 980 Sefiksim Tab 200 mg
795 981 Sefoperazon serb inj 1.000 mg/vial
796 982 Sefotaksim inj 500 mg/vial
797 983 Sefotaksim serb inj 1.000 mg/vial
1048 984 Sefpirom serb inj 1000 mg
798 985 Sefpodoksim proksetil tab sal 100 mg
799 986 Seftazidim serb inj 1.000 mg/vial
800 987 Seftriakson serb inj 1.000 mg/vial
801 988 Sefuroksim serb inj 750 mg/vial
802 989 Sefuroksim tab 250 mg
803 990 Sefuroksim tab sal 500 mg
804 991 Sertralin tab sal 50 mg
805 992 Serum anti bisa ular : A.B.U. I (khusus ular dari luar ) inj (i.m./i.v.) Papua
806 993 Serum anti bisa ular :A.B.U.II (khusus ular dari Papua) inj (i.m./i.v.)
807 994 Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m 10.000 UI/
808 995 Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m 20.000 UI/
809 996 Serum antirabies inj 100 UI/ml
810 997 Serum antirabies inj 200 UI/ml
811 998 Serum antitetanus (A.T.S) (i.m.) Inj 10.000 UI/vial (i.m /i.v.)
812 999 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.)
813 1000 Serum antitetanus (A.T.S) inj 20.000 UI/vial (i.m /i.v.)
814 1001 Setirizin sir 5 mg/5 ml.
815 1002 Setirizin tab 10 mg
816 1003 Setuksimab inj 5 mg/ml
1181 1004 Sevelamer karbonat Tab 800 mg
817 1005 Sevofluran cairan ih 250 ml
818 1006 Sianokobalamin (vitamin B12) inj 500 mcg/ml
819 1007 Sianokobalamin (vitamin B12) tab 50 mcg
820 1008 Siklofosfamid serb inj 1000 mg/vial (i.v.)
821 1009 Siklofosfamid serb inj 200 mg/vial (i.v.)
822 1010 Siklofosfamid serb inj 500 mg/vial (i.v.)
1166 1011 Siklopentotat tetes mata 1%
1060 1012 Siklosporin inj 100 mg/ml
824 1013 Siklosporin inj 50 mg/ml
825 1014 Siklosporin kaps 100 mg
826 1015 Siklosporin kaps lunak 25 mg
1059 1016 Siklosporin Kaps lunak 50 mg
1162 1017 Sildenafil Tab 20 mg
1160 1018 Silodosin tab 4 mg
827 1019 Silostazol tab 100 mg
1120 1020 Simeprevir tab 150 mg
828 1021 Simvastatin tab sal 10 mg
829 1022 Simvastatin tab sal 20 mg
1218 1023 Simvastatin tab sal selaput 40 mg
830 1024 Siprofloksasin inf 2 mg/ml
831 1025 Siprofloksasin tab scored 500 mg
1116 1026 Siprofloksasin tetes mata 3 mg/ml
832 1027 Sisplatin serb inj 10 mg
833 1028 Sisplatin serb inj 50 mg
835 1029 Sitarabin inj 50 mg
834 1030 Sitarabin serb inj 100 mg (i.m./i.v./s.k.)
1121 1031 Sofosbuvir tab sal selaput 400 mg
1171 1032 Somatostatin serb Inj 3000 mcg/mL
836 1033 Spiramisin tab 250 mg
837 1034 Spiramisin tab 500 mg
838 1035 Spironolakton tab 100 mg
839 1036 Spironolakton tab 25 mg
840 1037 Stannous pyrophosphate 27,6 mg sodium pyrophosphate/vial
841 1038 Stavudin tab 30 mg
842 1039 Streptokinase serb inj 1,5 juta UI/vial
843 1040 Streptomisin serb inj 1.000 mg/vial
844 1041 Sufentanil inj 5 mcg/ml (i.v.)
1143 1042 Sugammadeks inj 100 mg/ml
845 1043 Sukralfat susp 500 mg/5 ml
846 1044 Sukralfat tab 500 mg
847 1045 Suksinilkolin inj 20 mg/ml (i.v./i.m.)
848 1046 Suksinilkolin inj 50 mg/ml (i.v./i.m.)
849 1047 Suksinilkolin serb inj 100 mg/vial (i.v./i.m.)
1053 1048 Sulfadiazin tab 500 mg
850 1049 Sulfasalazin kapl sal enterik 500 mg
851 1050 Sulfur colloid 4,5 mg gelatin/reaction vial
1145 1051 Surfaktan susp 25 mg/ml (intratrakeal)
852 1052 Surgical ginggival pack
853 1053 Takrolimus kaps 0,5 mg
854 1054 Takrolimus kaps 1 mg
1125 1055 Takrolimus kaps lepas lambat 0,5 mg
1126 1056 Takrolimus kaps lepas lambat 1 mg
1117 1057 Tamoksifen tab 10 mg
855 1058 Tamoksifen tab 20 mg
856 1059 Tamsulosin tab 0,2 mg
857 1060 Tamsulosin tab SR 0,4 mg
858 1061 Technetium 99m 740 mbq - 3,7 gbq (20 to 100 millicuries)/ml
859 1062 Telbivudin tab 600 mg
860 1063 Telmisartan tab 40 mg
861 1064 Telmisartan tab 80 mg
862 1065 Temozolamid kaps 100 mg
863 1066 Temozolamid kaps 20 mg
864 1067 Tenofovir tab 300 mg
866 1068 Teofilin tab 150 mg
867 1069 Teofilin tab SR 300 mg
868 1070 Terazosin hcl tab 1 mg
869 1071 Terazosin hcl tab 2 mg
1054 1072 Terbinafrin tab 250 mg
870 1073 Terbutalin cairan ih 2,5 mg/ml
871 1074 Terbutalin inj 0,5 mg/ml
872 1075 Terbutalin serb ih 0,50 mg/dose
873 1076 Terbutalin sir 1,5 mg/5 ml
874 1077 Terbutalin tab 2,5 mg
1216 1078 Testosteron inj 250 mg/ml (vial 1 ml)
1217 1079 Testosteron Inj 250 mg/ml (vial 4 ml)
876 1080 Testosteron kaps lunak 40 mg
877 1081 Testoteron kombinasi : benserazin 25 mg +levodopa 100 mg
878 1082 Tetanus toxoid inj
879 1083 Tetrakain tts mata 0,5%
880 1084 Tetrasiklin kaps 250 mg
881 1085 Tetrasiklin kaps 500 mg
1165 1086 Tetrasiklin Salep Mata 1%
882 1087 Thallous Chloride Tl-202 1 mg methylene diphosphonic acid/ml
883 1088 Tiamazol tab 10 mg
884 1089 Tiamazol tab 5 mg
885 1090 Tiamin (vitamin B1) tab 50 mg
1021 1091 Tikagrelor tab 90 mg
886 1092 Timolol tts mata 0,25%
887 1093 Timolol tts mata 0,5%
888 1094 Tiopental serb inj 500 mg/amp (i.v. Bolus)
889 1095 Tiopental serb serb inj 1.000 mg/amp (i.v.)
1173 1096 Tiotropium respimat ih 5 mcg/semprot
890 1097 Tiotropium serb ih 18 mcg + handihaller
891 1098 Tiotropium serb ih 18 mcg, refill
1069 1099 Tobramisin tetes mata 0,3%
1022 1100 Topiramat tab 100 mg
1023 1101 Topiramat tab 25 mg
1024 1102 Topiramat tab 50 mg
893 1103 Trastuzumab serb inj 440 mg/vial
894 1104 Travoprost tts mata 0,004%
896 1105 Triamsinolon asetonid nasal spray 55 mcg/puff
895 1106 Triamsinolon inj 10 mg/ml
897 1107 Trifluoperazin tab sal 5 mg
898 1108 Triheksifenidil tab 2 mg
1083 1109 Tropikamid tts mata 0,5%
899 1110 Tropikamid tts mata 1%
900 1111 Tuberkulin protein purified derivative 1:10 (i.k)
901 1112 Urea krim 10 %
902 1113 Vaksin BCG inj (i.k)
1177 1114 Vaksin bivalen OPV (b-OPV) drops 10 dosis
903 1115 Vaksin campak inj (s.k.)
1175 1116 Vaksin Hepatitis Rekombinan Inj Prefilled Injection Device (Uniject) 0,5 ml
905 1117 (i.m)
Vaksin jerap difteri tetanus (DT)
1036 1118 Vaksin jerap difteri tetanus (Td)
907 1119 Vaksin kombinasi DPT-HB-Hib
1176 1120 Vaksin measless rubella (MR) Inj 0,5 mL (s.k)
908 1121 Vaksin polio IPV inj 0,5 ml
910 1122 Vaksin rabies, untuk manusia serb inj (s.k./i.k) + booster
1118 1123 Vaksin rabies, untuk manusia serb Inj 2,5 IU
911 1124 Valasiklovir tab 500 mg
912 1125 Valgansiklovir tab sal 450 mg
913 1126 Valproat sir 250 mg/5 ml
914 1127 Valproat tab sal 250 mg
915 1128 Valproat tab sal 500 mg
916 1129 Valproat tab sal enterik 200 mg
918 1130 Valproat tab SR 250 mg
917 1131 Valproat tab SR 500 mg
919 1132 Valsartan tab 160 mg
920 1133 Valsartan tab 80 mg
921 1134 Vankomisin serb inj 500 mg/vial
922 1135 Vasopresin inj 20 UI/ml (i.m./s.k.)
923 1136 Verapamil inj 2,5 mg/ml
925 1137 Verapamil tab 240 mg
924 1138 Verapamil tab 80 mg
1130 1139 Vinblastin inj 1 mg/ml
1212 1140 Vinkristin inj 1 mg/ml (vial 1 mL)
1213 1141 Vinkristin inj 1 mg/ml (vial 2 mL)
929 1142 Vinorelbin inj 10 mg/ml
937 1143 Vitamin B kompleks
931 1144 Warfarin tab 1 mg
930 1145 Warfarin tab 2 mg
932 1146 Zidovudin kaps 100 mg
1140 1147 Zinc drops 10 mg/ml
935 1148 Zinc serb 10 mg
933 1149 Zinc sir 10 mg/ml
936 1150 Zinc sir 20 mg/5 ml
934 1151 Zinc tab disp 20 mg
DINKES PROVINSI dan KAB/KOTA
ATA PER BULAN SELAMA 2017 DIKALI 18 BULAN DALAM SATUAN TERKECIL SEPERTI : TABLET / KAPSUL / KAPLET / BOTOL / AMPUL / VIAL / T
HAN YANG DIHITUNG BERDASARKAN METODE KONSUMSI DIKURANGI DENGAN SISA STOK PER 31 DESEMBER 2017
LAM SATUAN TERKECIL SEPERTI: TABLET / KAPSUL / KAPLET / BOTOL / AMPUL / VIAL / TUBE / SACCHET / PUFF YANG AKAN DIADAKAN TAH
LEH KEPALA SATUAN KERJA DAN DIBERI STEMPEL
NGURANGAN BARIS/KOLOM PADA FORMAT

KESEHATAN RUJUKAN TINGKAT LANJUT (FKRTL) TAHUN 2019

SATUAN SISA STOK PER 31 PEMAKAIAN JUMLAH RENCANA RENCANA


DESEMBER
(a) 2017 RATA-RATA
(b) PER KEBUTUHAN
(c) = (b) x 18 KEBUTUHAN
(d) = (c) - (a) PENGADAAN
(e)
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tablet 0 0
Ampul 0 0
Ampul 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Ampul 0 0
Tube 0 0
Tube 0 0
Vial 0 0
Ampul 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Tab 0 0
Tab sal 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial/Cartridge 0 0
vial/cartridge 0 0
Vial/Cartridge 0 0
Penfill 0 0
Vial/Cartridge/Penfill 0 0
Tab 0 0
Vial 0 0
Tab 0 0
Botol 0 0
Kaps 0 0
Tube 0 0
Tube 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Kertas warna penanda oklusi 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Vial 0 0
Kaps 0 0
Kaps 0 0
Kaps 0 0
Tube 0 0
Botol 0 0
Tube 0 0
Tube 0 0
Tube 0 0
Ampul 0 0
Ampul 0 0
Tab 0 0
Kaps 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Tube 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Tab 0 0
Tablet 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Ampul 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Tube 0 0
Tube 0 0
Tube 0 0
Botol 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Tab sal 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Ampul 0 0
Ampul 0 0
Tab 0 0
Botol 0 0
set/buah 0 0
Kaps 0 0
Kaps 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tube 0 0
Tube 15 g 0 0
Tube 10 g 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tablet 0 0
Tab 0 0
Ampul 0 0
Tube 0 0
Vial 0 0
Tab 0 0
Ampul 0 0
Tab 0 0
Ampul 0 0
Kaps 0 0
Kaps 0 0
Ampul 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Kaps 0 0
Kaps 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Tab eff 0 0
Vial 0 0
Ampul 0 0
Ampul 0 0
Vial 0 0
Kaps 0 0
Tab sal 0 0
Tablet 0 0
Ampul 0 0
Tab 0 0
Ampul 0 0
Ampul 0 0
Ampul 0 0
Tablet 0 0
Tablet 0 0
Ampul 0 0
Ampul 0 0
Vial 0 0
Vial 0 0
Kaps 0 0
Botol 0 0
Tab 0 0
Kaps 0 0
Botol 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Tab sal 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Set 0 0
Vial 0 0
Kaps 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Ampul 0 0
Kaps 0 0
Kaps 0 0
Ampul 0 0
Tab 0 0
Tab 0 0
Kaps 0 0
Kaps 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Pack 0 0
Pack 0 0
Pack 0 0
Botol 0 0
Kaps lunak 0 0
Botol 0 0
Tab sal 0 0
Vial 0 0
Tab 0 0
Vial 0 0
Tab sal 0 0
Ampul 0 0
Vial 0 0
Tab 0 0
Vial 0 0
Ampul 0 0
Kaps 0 0
Kaps 0 0
Kaps 0 0
Kaps 0 0
Kaplet 0 0
Tube 0 0
Ampul 0 0
Botol 0 0
Vial 0 0
Botol 0 0
Vial 0 0
Ampul 0 0
Ampul 0 0
Ampul 0 0
Ampul 0 0
Tube 5 g 0 0
Tube 10 g 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Patch 0 0
Ampul 0 0
Tab 0 0
Kaps 0 0
Kaps 0 0
Macrocyclic 0 0
Macrocyclic 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Sachet 0 0
Tab 0 0
Kaps 0 0
Kaps 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Ampul 0 0
Ampul 0 0
Tube 0 0
Botol 0 0
Sachet 0 0
Botol 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Ampul 0 0
Kaps 0 0
Kaps 0 0
Tab sub 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Roll 0 0
Roll 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Ampul 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Tube 0 0
Tube 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Tab 0 0
Botol 0 0
Cartridge, Penfill Cartridge 0 0
Cartridge, Penfill Cartridge 0 0
Cartridge, Penfill Cartridge 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Ampul 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Botol 0 0
Kaps 0 0
Kaps 0 0
Vial 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Puff 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Ampul 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Tab 0 0
Tab 0 0
Kaps 0 0
Set 0 0
Set 0 0
Tab 0 0
Tube gel 0 0
Tube 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Kapsul 0 0
Kapsul 0 0
Ampul 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Ampul 0 0
Tube 0 0
Sachet 0 0
Tab 0 0
Tab 0 0
Sachet 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab sal 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Tablet 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Tablet 0 0
Vial 0 0
Vial 0 0
Tablet 0 0
Kaps 0 0
Ampul 0 0
Ampul 0 0
Tube 10 g 0 0
Tube 0 0
Tab 0 0
Ampul 0 0
Botol 0 0
Ampul 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Kaps 0 0
Kaps 0 0
Tab 0 0
Kapsul 0 0
kapsul 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Kaps 0 0
Kaps 0 0
Tube 0 0
Tube 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tablet 0 0
Ampul 0 0
Ampul 0 0
Tab sal 0 0
Tab sal 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Kaps lunak 0 0
Kaps lunak 0 0
Ampul 0 0
Tab 0 0
Botol 0 0
Tablet 0 0
Vial 0 0
Vial 0 0
Tablet 0 0
Vial 0 0
Kaps 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tablet 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Pasta tube 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Set 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Vial 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tablet 0 0
Tablet 0 0
Vial 0 0
Kaps 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tablet 0 0
Vial 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tablet 0 0
Tablet 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Set 0 0
Tab 0 0
Tab 0 0
Tube 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Ampul 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab sal 0 0
Ampul 0 0
Ampul 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Sachet 0 0
Botol 0 0
Tab sal 0 0
Tab sal 0 0
Vial 0 0
Botol 0 0
Tan 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Vial 0 0
Botol 1000 ml 0 0
Ampul 0 0
Tab salut 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Tab sal 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Botol 0 0
Supp 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tablet 0 0
Tablet 0 0
Tube 0 0
Tube 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Tube 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Kaps 0 0
Botol 0 0
Kaps 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Botol 0 0
Botol 0 0
Ampul 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tube 0 0
Tube 0 0
Tube 0 0
Botol 0 0
Ampul 0 0
Vial 0 0
Tab 0 0
Kaps 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Kaps 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Tablet 0 0
Ampul 0 0
Tab 0 0
Paket 0 0
Paket 0 0
Paket 0 0
Paket 0 0
Paket 0 0
Paket 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Ampul 0 0
Vial 0 0
Ampul 0 0
vial 0 0
Ampul 0 0
Tab sal 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Kaps 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Ampul 0 0
Ampul 0 0
Ampul 0 0
Ampul 0 0
Ampul 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Tube 0 0
Tube 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Tube 0 0
Tab 0 0
Tube 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Tab 0 0
Tab 0 0
Tab sal 0 0
Tablet 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 60 ml 0 0
Botol 1000 ml 0 0
Botol 30 ml 0 0
Botol 300 ml 0 0
Tablet 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Ampul 0 0
Ampul 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Ampul 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Ampul 0 0
Tab 0 0
Kaps lunak 0 0
Kaps lunak 0 0
Tab 0 0
Kaps 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab sal 0 0
Tab sal 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Ampul 0 0
Tab sal 0 0
Tab sal 0 0
Tab sal 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tube 0 0
Vial 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Kaps 0 0
Kaps 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Tablet 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab sal 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Vial 0 0
Tab 0 0
Botol 0 0
Vial 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Ampul 0 0
Ampul 0 0
Kaps 0 0
Kaps 0 0
Kapsul 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tablet 0 0
Tab sal 0 0
Tab sal 0 0
Tab sal 0 0
Botol 0 0
Tab 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tablet 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Ampul 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tablet 0 0
Kaps salut 0 0
Vial 0 0
Botol 0 0
Tube 0 0
Kaps 0 0
Kaps 0 0
Kaps 0 0
Kaps 0 0
Tablet 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Set 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Kaps 0 0
Kaps 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tablet 0 0
Botol 0 0
Vial 0 0
Vial 0 0
Botol 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Kaps 0 0
Kaps 0 0
Ampul 0 0
Botol 0 0
Kaps 0 0
Kaps 0 0
Tube 0 0
Set 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Ampul 0 0
Ampul 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Botol 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Botol 0 0
Botol 0 0
Ampul 0 0
Tab sal 0 0
Tab 0 0
Botol 0 0
Botol 0 0
Ampul 0 0
Tube 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab sal 0 0
Botol 0 0
Tab sal 0 0
Tab sal 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Ampul 0 0
Vial 0 0
Vial 0 0
Vial 0 0
Tab 0 0
Tab 0 0
Tab 0 0
Kaps 0 0
Botol 0 0
Sachet 0 0
Botol 0 0
Botol 0 0
Tab 0 0
/ BOTOL / AMPUL / VIAL / TUBE / SACCHET / PUFF

YANG AKAN DIADAKAN TAHUN 2019 BERDASARKAN PERKIRAAN ANGGARAN YANG DIPEROLEH TAHUN 2019

RENCANA KETERANGAN
PENGADAAN
(f) (g)
0
0
0
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