No.

Golongan Obat Nama Obat Zat Aktif Dosis Jumlah

1 Cardisan Amlodipine 5 mg 2 box
2 10 mg 2 box
3 Divask Amlodipine 5 mg 2 box
4 10 mg 2 box
5 Norvask Amlodipine 5 mg 10 box
6 10 mg 10 box
7 Aprovel Irbesartan 150 mg 2 box
8 300 mg 2 box
9 Cozaar Losartan 50 mg 5 box
10 Tensicap Captopril 13 mg 5 box
11 25 mg 2 box
12 Lasix Furosemide 20 mg 5 box
13 40 mg 5 box
Anti Hipertensi
14 80 mg 5 box
15 Letonal Spironolacton 25 mg 2 box
16 100 mg 2 box
17 Cardura Doxazosin 1 mg 2 box
18 2 mg 2 box
19 Concor Bisoprolol 3 mg 5 box
20 5 mg 5 box
21 10 mg 5 box
Amlodipine +
22 Caduet Atorvastatin 5/10 mg 2 box
23 10/10 mg 2 box
24 5/20 mg 2 box
25 10/20 mg 2 box
26 Lipitor Atorvastatin 10 mg 10 box
27 20 mg 10 box
28 40 mg 10 box
29 Stator Atorvastatin 10 mg 5 box
30 20 mg 5 box
Hiperlipidemia
31 Hypofil Gemfibrozil 300 mg 5 box
32 Mersikol Gemfibrozil 300 mg 5 box
33 600 mg 2 box
34 900 mg 2 box
35 Zenibroz Gemfibrozil 450 mg 5 box
36 Cormetison Prednisolon 16 mg 2 box
37 Feburic Febuxostat 80 mg 2 box
38 Puricemia Allopurinol 300 mg 2 box
Gout
39 Recolfat Colchicine 1 mg 4 box
40 Zyloric Allopurinol 100 mg 5 box
41 300 mg 5 box
42 Apidra Insulin 100 IU/mL 1 box
43 Lantus Insulin 100 IU/mL 1 box
44 Levemir Insulin 100 IU/mL 1 box
45 Novomix Insulin 100 IU/mL 1 box
46 Novorapid Insulin 100 IU/mL 1 box
47 Amaryl Glimepiride 1 mg 2 box
48 2 mg 2 box
49 3 mg 2 box
50 4 mg 2 box
51 Hiperglikemia Glucophage Metformin 500 mg 5 box
52 850 mg 5 box
53 Glucophage XR Metformin 500 mg 5 box
54 850 mg 2 box
55 1000 mg 2 box
56 Glidanil Glibenclamide 5 mg 2 box
Glibenclamide +
57 Glucovance Metformin 5/500 mg 2 box
58 2.5/500 mg 2 box
59 1.25/500 mg 2 box
60 Alphara Paracetamol 500 mg 5 box
61 Alphamol Paracetamol 500 mg 5 box
62 Aspirin Aspirin 325 mg 5 box
63 Biogesic Paracetamol 500 mg 3 box
64 Farmadol Paracetamol 500 mg 2 box
65 Itamol Paracetamol 500 mg 2 box
66 Paracetamol 650 mg 2 box
67 Itamol Syrup Paracetamol 120/5mL 10 botol
68 Kamolas Paracetamol 500 mg 2 box
69 Kamolas drop Paracetamol 120/5mL 10 botol
70 Lexagin Metamizole 500 mg 2 box
71 Pamol Paracetamol 500 mg 5 box
72 Paraco drop Paracetamol 100mg/mL 10 botol
73 Ponstan Asam Mefenamat 500 mg 5 box
Paracetamol +
74 Primadol Metoclopramide 500/5mg 2 box
75 Progesic Paracetamol 500 mg 2 box
76 Sanmol Paracetamol 500 mg 5 box
77 Paracetamol 650 mg 5 box
78 Paracetamol 120/5mL 10 botol
79 Paracetamol 250/5mL 10 botol
Paracetamol + N
80 Sistenol asetilsistein 500/200mg 5 box
81 Sumagesic Paracetamol 600 mg 5 box
DMP, PCT, CTM,
82 Tuzalos PP 5 box
 Paracetamol +
83 Dolo-Neurobion Vitamin 500 mg 5 box
84 Grafamic Asam Mefenamat 500 mg 2 box
85 Mefinal Asam Mefenamat 500 mg 10 box
86 Molasic Asam Mefenamat 500 mg 5 box
87 Solasic Asam Mefenamat 500 mg 2 box
88 Stanza Asam Mefenamat 500 mg 2 box
Analgesik
89 Tropistan Asam Mefenamat 500 mg 2 box
NSAID
90 Cataflam K Diklofenak 50 mg 5 box
91 Movix Meloxicam 8 mg 2 box
92 Meloxicam 15 mg 2 box
93 Ostelox Meloxicam 8 mg 10 box
94 Meloxin Meloxicam 8 mg 2 box
95 Meloxicam 15 mg 2 box
96 Infeld Gel 0.5% Piroxicam 15g 5 tube
97 Pirofel Piroxicam 10 mg 2 box
98 Pirofel Gel 0.5% Piroxicam 20g 5 tube
99 Feldene Flash Piroxicam 20 mg 2 box
100 Farsifen Ibuprofen 200 mg 5 box
101 Bufect Ibuprofen 100/5mL 10 botol
102 Anafen Ibuprofen 100/5mL 5 botol
103 Dolofen-F Ibuprofen 400 mg 5 box
104 Flamar Na Diklofenak 50 mg 7 box
105 Renadinac Na Diklofenak 25 mg 7 box
106 50 mg 5 box
107 Voltaren Na Diklofenak 25 mg 5 box
108 Dicloflam Na Diklofenak 25 mg 5 box
109 50 mg 5 box
110 Klotaren Na Diklofenak 25 mg 2 box
111 50 mg 2 box
112 Nadifen Na Diklofenak 50 mg 2 box
113 Celebrex Celecoxib 100 mg 5 box
114 200 mg 5 box
115 400 mg 5 box
116 Indocid Indomethacin 100 mg 5 box
117 Xenifar Naproxen 500 mg 5 box
118 Zonifar Fenilbutazon 200 mg 5 box
119 Irgapan Fenilbutazon 100 mg 5 box
120 200 mg 5 box
Ibuprofen dan
121 Iremax Paracetamol 200/400mg 3 box
122 Akilen Ofloxacin 3 mg/mL 2 box
123 Blecidex Framisetin 5 mg 2 box
124 Otilon 2 box

THT
125 Otopraf 2 box
126 Reco 0,05% Kloramfenikol 2 box
THT
127 Sagestam Tetes Mata Gentamisin 3 mg/mL 5 botol
128 Forumen Natrium dokusat 5 mg 5 botol
129 Afrin 0.05% Oxymetazolin HCl 5 botol
130 Iliadin 0.025% Oxymetazolin HCl 5 botol
131 Erlamycetin 1% Kloramfenikol 5 botol
132 Vitamin C Vitamin C 100 mg 3 box
133 Vitamin B Complex 3 box
134 Vitami B12 3 box
135 Beta C-E 3 box
136 Oxyvit 2 box
Suplemen
137 Bevizil 2 box
138 Vitamin A Kimia Farma 3 box
139 Regresor 2 box
140 Interco Mecobalamin 2 box
141 Cholesvit 2 box
142 Ringer Laktat 5 kantong
143 Infus Asering 5 kantong
144 NaCl 0,9 % 5 kantong
Ethambutol, INH,
145 Pulna Forte Vitamin B6 2 box
146 Ethambutol Ethambutol 250 mg 2 box
147 Isoniazid Isoniazid 300 mg 3 box
Anti
148 Pyratibi Pirazinamid 500 mg 2 box
Tuberkulosis
149 Rifamtibi Rifampisin 450 mg 2 box
150 TB ZET Pirazinamid 500 mg 2 box
151 Rifampicin Rifampisin 450 mg 3 box
152 600 mg 3 box
153 Aminophylline Aminofilin 200 mg 3 box
154 Intifen Ketotifen 1 mg 2 box
155 Grafalin Salbutamol 2 mg 2 box
156 Samcolat Teofilin 130 mg 2 box
157 Retaphyl SR Teofilin 300 mg 2 box
158 Salbutamol Salbutamol 4 mg 3 box
Anti Asma
159 Neo Napacin Teofilin, Efedrin 130/12.5 2 box
Salmaterol,
Fluticasone
160 seretide 124 inhaler propionate 125 mcg 5 buah
161 Ventolin Inhaler Salbutamol 5 buah
162 Bricasma Terbutalin sulfat 3 mg 5 buah
163 Isosorbid mononitrat ISMN 60 mg 3 box
164 Cedocard ISDN 5 mg 2 box
165 10 mg 2 box
Obat Jantung
166 Obat Jantung Diltiazem Diltiazem 30 mg
167 Isorbid ISDN 5 mg 3 box
168 Farsorbid ISDN 5 mg 2 box
169 10 mg 2 box
170 Cetirizine Cetirizine 10 mg 3 box
Loratadine,
171 Aldisa SR Pseudoefedrine 5/120 mg 2 box
172 Anti Alergi Alloris Loratadine 10 mg 2 box
Dexamethasone,
173 Bufacaryl DexCTM 0.5/2 mg 2 box
174 Chlorpheniramine Chlorpheniramine 4 mg 3 box
175 Adem Sari Sachet 5 box
176 Antangin Jrg Cair 5 box
177 Antangin Tab 2 box
178 Antimo Tab 2 box
179 Bodrex 2 box
180 Caladin 8 botol
181 Betadine 1 box
182 OTC Neurovit E 2 box
183 salicylfresh 10 botol
184 Asifit 2 box
185 Supra Flu 2 box
186 Magasida 2 box
187 Ersylan 2 box
188 Alkohol 70 % 10 botol
189 Alkohol 96% 10 botol
190 Spuit merk Terumo 4 set
191 Omron Termometer 10 unit
192 Omron Tensimeter Digital 3 unit
193 Kursi Roda Merk Gea FS 875 3 unit
194 Tongkat Bantu Jalan 2 unit
Alat Kesehatan
Kruk ( Alat Bantu Jalan ) merk
195 Gea 2 unit
196 Infus Set merk One Med 8 set
197 Masker merk Sensi 5 box
198 Nebulizer merk Omron 2 set
Metampiron,
199 Analsik Diazepam 200/2 mg 2 box
200 Diazepam Diazepam 2 mg 3 box
Metampiron,
201 Danalgin Diazepam 200/2 mg 2 box
202 Valdimex Diazepam 5 mg 2 box
203 Valisanbe Diazepam 5 mg 2 box
204 Xanax Alprazolam mg 1 box

Narkotika,
Psikotropika dan
OOT
205 1 mg 1 box
206 1 mg 1 box
Narkotika,
207 Alprazolam Alprazolam 3 box
Psikotropika dan
208 MST Continus Morfin Sulfat 10 mg 2 box
OOT
Kodein,
209 Codicam Paracetamol 30/500 mg 2 box
210 Codeine Kodein 15 mg 3 box
211 codikaf Kodein 10 mg 2 box
Kodein anhidrat,
212 Codifront Feniltoloksamin 5 botol
213 Dolgesik Tramadol 50 mg 2 box
214 Dolocap Tramadol 50 mg 2 box
215 Arkine Triheksifenidil 2 mg 2 box
216 Hexymer Triheksifenidil 2 mg 2 box
217 Ketokonazol 2% Ketokonazol 5 tube
218 Formyco 2% Ketokonazol 3 tube
Anti Jamur
219 Miconazole 2% Miconazole 5 tube
220 Locoriz 2% Miconazole 3 tube
221 Gentamisin 0.1% Gentamisin 5 tube
222 Sagestam 0.1% Gentamisin 3 tube
Placenta ekstrak,
223 Bioplacenton Neomicin sulfat 5 tube
224 Dermatix Ultra Dermatix 3 tube
225 Mederma Mederma 3 tube
226 Scabimite 5% Permethrin 5 tube
227 Desoximethasone 0.25% Desoximethasone 5 tube
228 Obat Kulit Esperson 0.25% Desoximethasone 3 tube
229 Betamethason 0.1% Betamethason 5 tube
Betamethason,
230 Betason Neomicin 5 tube
Betamethason.
231 Digenta Gentamisin 3 tube
Clindamicin,
232 Medi Klin Tretionin 5 tube
233 Melanox 2% Hydroquinon 5 tube
234 Antasida Doen AlOH dan MgOH 200 mg 3 box
Simeticon, AlOH
235 Lambucid dan MgOH 200 mg 3 box
Simeticon, AlOH
236 Polysilane dan MgOH 200 mg 3 box
237 Ranitidin Ranitidin HCl
3 BOX(@10STRIP) TAB, SYR 5 BOTOL 3 box
238 Radin Ranitidin HCl
2 BOX(@10STRIP) TAB, SYR 4 BOTOL 2 box
Maag
239 Ranivek Ranitidin HCl
2 BOX(@10STRIP) TAB, SYR 4 BOTOL 2 box
240 Omeprazole Omeprazole 20 mg 5 box
 Maag

241 Lokev Omeprazole 20 mg 5 box

242 OPM Omeprazole 20 mg 5 box
243 Lansoprazole Lansoprazole 30 mg 5 box
244 Lapraz Lansoprazole 30 mg 5 box
245 Lasgan Lansoprazole 30 mg 5 box
Levonogestrel,
246 Andalan Ethinylestradiol 1 box
Levonogestrel,
Ethinylestradiol dan
247 Andalan FE Fe 1 box
Kontrasepsi Levonogestrel,
248 Microgynon Ethinylestradiol 1 box
Siproteron asetat,
249 Diane Ethinylestradiol 3 box
Drospirenon,
250 Yasmin Ethinylestradiol 3 box
251 Guaifenesin Gliseril Guaiakolat 100 mg 3 box
252 Ambroxol Ambroxol 30 mg 3 box
253 Epexol Ambroxol 30 mg 2 box
254 Epexol Syr Ambroxol 5 botol
255 Epexol Drop Ambroxol 5 botol
256 Mucopect Ambroxol 5 botol
Pseudoefedrin,
257 Rhinos Syr CTM 5 botol
Pseudoefedrin,
258 Rhinos Neo Drop CTM 5 botol
Pseudoefedrin,
259 Tremenza Syr Triprolidin 5 botol
Pseudoefedrin,
260 Alco DMP BTM, DMP 5 botol
Pseudoefedrin,
Batuk Pilek
261 Alco BTM 5 botol
262 Alco Drop Pseudoefedrin 5 botol
263
Phenilpropanolamin
264 Nalgestan , CTM 15/2 mg 3 box
265 Decolgen PCT, PP, CTM 3 box
PCT,
Pseudoefedrin,
CTM, DMP,
266 Decolsin Guaifenesin 3 box
267 Bisolvon Extra Bromhexine 3 box
PCT, Guaifenesin,
268 Paratusin PP, CTM 7 box
 PCT, DMP, PP,
269 Anadex CTM 5 box
270 Acyclovir Acyclovir 200 mg 3 box
271 Ganciclovir Acyclovir 200 mg 3 box
Antivirus
272 Ribavirin Ribavirin 200 mg 3 box
273 Lamivudine Lamivudin 300 mg 2 box
274 Chloramphenicol Chloramphenicol
2 BOX (@10 STRIP) 2 box
275 Thiamphenicol Chloramphenicol
3 BOX (@10 STRIP) 3 box
276 Thiamycin Thiamphenicol 500 mg 2 box
277 Amoxicillin Amoxicilin 5 BOX (@10 STRIP) 5 box
Amoxicilin dan
278 Clabat Asam Klavulanat
6 BOX (@10 STRIP) 2 box
279 Antibiotik Cefixime Cefixime 7 BOX (@10 STRIP) 2 box
280 Cefspan Cefixime 200 mg 2 box
281 Ciprofloxacin Ciprofloxacin9 BOX (@10 STRIP) 2 box
282 Cefadroxil Cefadroxil 500 mg 2 box
283 Cefat Cefadroxil 500 mg 2 box
284 Levofloxacin Levofloxacin 500 mg 2 box
285 Levocin Levofloxacin 500 mg 2 box
286 New Diatab Attapulgite 2 box
287 Loperamid Loperamid 2 box
288 Anti Diare Lodia Loperamid 2 box
289 Imodium Loperamid 2 box
290 Lopamid Loperamid 2 box
291 Blackmores (All Item) 2 botol/item
Minyak kayu putih
292 Konicare/Lang 1 dus
293 Minyak telon Konicare/Lang 1 dus
Tambahan
294 Alpialys 1 dus
295 Natur-E 3 box
296 Imboost 3 box
297 Imboost Force 3 box