RENCANA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN TINGKAT P

PUSKESMAS SIMPANG DUA

PEMAKAIAN JUMLAH
SISA STOK PER 31 RATA-RATA PER
NO NAMA OBAT SATUAN KEBUTUHAN
DESEMBER 2018 BULAN NO 2018 - TAHUN 2020
OKTBR 2019
(c) = (b) x 18
1 ACT Box - - -
2 Acyclovir 400 mg Tab 500 60 1,080
3 Acyclovir Cream Tube - - -
4 Acycovir 200 mg kap - - -
5 Alat suntik sekali pakai 0,5 ml pcs 200 50 900
6 Alat Suntik Sekali pakai 0.05 ml set - 100 1,800
7 Alat Suntik Sekali pakai 1 ml set 200 30 540
8 Alat suntik sekali pakai 10 ml Set 200 - -
9 Alat suntik sekali pakai 2,5 ml Set - - -
10 Alat Suntik Sekali pakai 20 ml set - - -
11 Alat suntik sekali pakai 5 ml Set 200 10 180
12 Albendazol tablet 400 mg Tab - - -
13 Allopurinol tablet 100 mg Tab 200 500 9,000
14 Alprazolam 0,5 mg box - - -
15 Alvogyl pot 10 gr - - -
16 Ambroxol 30 mg Tab - - -
17 Aminopillin inj 24 mg/ml Amp 25 - -
18 Aminopillin tablet 200 mg Tab 600 67 1,200
19 Amitriptiline 25 mgtablet Tab 600 - -
20 Amlodipine tab 10 mg Tab 420 500 9,000
21 Amlodipine tab 5 mg Tab 600 133 2,400
22 Amoksisilin capsul 250 mg Kap - - -
23 Amoksisilin capsul 500 mg Kap 2,800 1,700 30,600
24 Amoksisilin Syr ker 125 mg/5 ml Btl 120 40 720
Amoksisilin syr ker 250 mg/5 ml btl - - -
25 forte
26 Ampicilin Inj Amp - - -
27 Ampicilin Inj Box - - -
28 Antalgin inj 500mg/ml Amp 100 10 180
29 Antalgin tablet 500 mg Tab - - -
30 Antasida Doen Syrup Btl 75 31 558
31 Antasida doen tablet Tab 1,200 1,533 27,600
32 Anti fungi doen Pot 24 - -
33 Anti hemoroid doen Sup - 6 108
34 Anti migrain doen Tab - 33 600
35 Antibakteri doen salep Tub - - -
36 Aqua pro inj Ampul 16 3 54
37 Aquadest Steril Btl - - -
38 Arthemeter Vial - - -
Asam asetilsalisilat (asetosal) tablet tab 200 - -
39 80 mg / aspilet
40 Asam askorbat (Vit c) 250 mg Tab - - -
41 Asam askorbat (Vit c) 50 mg Tab 1,000 833 14,994
Asam Askorbat (vitamin c) tablet tab - - -
42 500 mg ( vitalong C )
43 Asam Folat 1 mg tab 800 133 2,400
44 Asam Mefenamat 500 mg Kap - 533 9,600
45 Asam Traxenamat inj amp 25 1 18
46 Asam Traxenamat tablet 250 mg cap - - -
47 Asam Traxenamat tablet 500 mg cap 150 117 2,100
48 Asetosal tablet 100 mg Tab - - -
49 Atenolol tab - - -
50 Atropin sulfat inj 0,2 mg/ml Amp 15 - -
51 Atropin sulfat tablet 0,5 mg Tab - - -
52 Attapugit ( pularex ) tab 1,400 333 6,000
53 Attapulgit ( Guanistrep ) Btl - - -
54 Attapulgite Btl - - -
Bahan Tumpatan Sementara Btl - - -
55 larutan,serbuk
56 Benzatin benzil pen 2,4 juta iu Vial - - -
57 Betahistin Mesilat tablet 6 mg tab 120 40 720
58 Betamethasone cream 0.1 % Tub 50 28 504
59 Bisakodil ( dulcolax ) Tab 30 10 180
Bisakodil suppositoria 10 mg supp 10 6 108
60 ( Stolax )
61 Bisoprolol Fumarate 5 mg Tab - - -
62 Bonding btl - - -
63 Bromheksin tab 8 mg Tab - - -
Budesonid inhaler 200 mcg/puff, tube 4 1 24
64 100 dosis ( Pulmicort )

Cairan anti septik ( Detol ) 750 ml Btl - - -

65

66 Cairan Fixer Set - - -

67 Cairan Pemutih ( Bayclin ) btl - - -
68 Calcii Glukosa 100 mg/ml Amp 4 1 24
Calsium hidroksda ( hydcal technew box - - -
69 )
70 Captopril tablet 12,5 mg Tab 800 733 13,194
71 Captopril tablet 25 mg Tab 1,800 900 16,200
72 Catgut /bng bedah no 3/0 sacseht 105 11 198
73 Catgut /bngbedahno2/0 Sak 85 12 222
74 Cavit ( Tumpatan Sementara ) Btl - - -
75 Cefadroxil 500 mg Cap - - -
76 Cefixim 100 mg box - - -
77 Cefotaxime inj. 1 g- vial vial - - -
78 Ceftriaxone inj 1 g- vial vial - - -
79 Cemen Spatel bh - - -
80 Certirizine 10 mg Cap 800 467 8,400
81 Cimetidine Tab 300 100 1,800
82 Ciprofloxacin tablet 500 mg Tab 1,100 367 6,600
83 Codein 10 mg Tab 100 - -
Colurtusin ( PCT 500mg,Dmp 15 kap - - -
84 mg,PPA 12,5 mg,CTM 2 mg)
Colurtusin ( PCT 500mg,Dmp 15 Btl - - -
85 mg,PPA 12,5 mg,CTM 2 mg)
Colurtusin Komb: PCT 500 mg ,DMP tab - - -
86 15 mg,PPA 12,5 mg,CTM 2 mg
( Bronco )

87 CTPACI tube - - -
88 Darplex ( Anti Malaria ) Box - - -
89 Deksamethasone 0,5 mg tablet Tab 700 733 13,200
90 Deksamethasone inj 5mg/ml Amp 95 10 180
Dektrometorpan hbr syr 10 mg/5ml Btl - - -
91
Dektrometorpan hbr Tablet 15 mg Tab - - -
92

93 Dentika set set - - -

94 Dentin Condisioner 25 gr btl 1 - -
95 Developer Set - - -
96 Devitalisasi pasta(non arsen) Btl - - -
DHP (Dehidro Artemisinin + Tab - - -
97 Piperaquin )
98 Diamond Bor High Speed ktk - - -
99 Diazepam inj 5mg/ml Amp 20 - -
Diazepam Larutan Rektal 5 mg / 2,5 tube 9 3 54
100 ml

101 Diazepam tablet 2 mg Tab - - -

Dietilkarbamazin sitrat tablet 100 Tab - - -
102 mg

103 Digoksin tablet 0,25 mg Tab - - -

104 Dipenhidramin hcl inj 10mg/ml Amp 30 - -
105 Domperidone Tab 800 300 5,400
106 Doxycycline Cap - - -
107 Efinefrin hcl/adrenalin inj ,1 % ktk'100 Amp 48 2 36
108 Ekstrak belladone tablet 10 mg Tab - - -
109 Erytromycin 500 mg Cap 800 - -
Erytromycin sirup kering 200 mg / 5 btl - - -
110 ml

111 ESTA amp - - -

112 Etakridin (rivanol )lar 0,1 % Btl 30 10 180
113 Etanol 70 % Btl - 1 12
114 Etanol 70 % (100ml) btl 100 33 600
115 Etil klorida semprot Btl 4 1 24
116 Eugenol cairan Btl 1 - -
117 Famotidin 20 mg Kap 200 33 600
118 Farmacetin Kassa ( Bactigras ) sachest - - -
119 FDC Anak paket - 1 18
120 FDC I Paket 5 1 18
121 FDC II Paket - - -
122 FDC Sisipan Paket - - -
123 Fenitoin natrium kapsul 100 mg Kap 100 67 1,200
124 Fenobarbital inj 50 mg/ml Amp 30 - -
125 Fenobarbital Tablet 100 mg tab - - -
Fenoterol HBr inh 100 mcg/puff btl - - -
126 ( Berotec )

127 Film Dental Bh - - -

Fitomenadion (vit k) tablet salut 10 Tab 300 167 3,000
128 mg

129 Fitomenadion Inj. Amp - - -

130 Foley Catheter No 8 sachet 2 - -
131 Foley Catheter No. 12 bks / set 3 1 12
132 Foley Catheter No. 16 bks / set - 1 12
133 Foley Catheter No. 18 bks / set 10 0 6
134 Folley Catheter No 14 pcs 5 - -
135 Furosemida tablet 40 mg Tab 400 133 2,400
136 Furosemide inj. - ampul Amp 45 15 270
137 Garam oralit untuk 200 ml air Sak 400 33 600
138 Gemfibrozil 300 mg kap - - -
139 Gentamycin Cream Tube - - -
140 Gentamycin Inj. Vial - - -
141 Gentian violet lar 1 % Btl - - -
142 Gic Fuji IX box - - -
143 Gic Fuji VII box'50 kaps 1 0 6
Glass Iomer elitecement mini pack box - - -
144

145 Glass Ionomer ART btl - - -

Glass Ionomer ART coco butter 5 gr btl - - -
146

147 Glibenklamida tablet 5 mg Tab 500 100 1,800

148 Glimepiride 1 mg Tab 200 33 600
149 Glimepiride 2 mg Tab 100 - -
Gliseril guayakolat tablet 100 mg Tab - - -
150

151 Gliserin btl - - -

152 Glukosa lar inf 10 % Btl 10 - -
153 Glukosa lar inf 5 % Btl 19 13 234
Grantusif (DMP 10 mg,GG 50 tab - - -
154 mg,PPA 12,5 mg,CTM 1 mg)

155 Griseofulvin tablet 125mg Tab - - -

156 Gutta Percha Set - - -
157 Haloperidol 1,5 mg Tab 20 7 120
158 Haloperidol 5 mg tab - - -
159 Hidroklortiazide tablet 25 mg Tab 600 - -
160 Hidrokortisone krim 2,5 % Tub 96 8 144
Hufaneuron ( Vit B1 100 mg,Vit B6 tab - - -
161 100 mg, Vit B12 200 mg)

162 Hyosine N Butyl Bromide Tab Tab 700 100 1,800

163 Ibupropen 200 mg/ml Btl 78 15 276
164 Ibupropen tablet 200 mg Tab - - -
165 Ibupropen tablet 400 mg Tab - - -
166 Infusion set anak Set 15 2 36
167 Infusion set dewasa Set - - -
168 Irbesartan 300mg kap - - -
169 isi lancet pen 100 bh - - -
170 Isoniazide tablet 300 mg Tab - - -
Isosorbid dinitrat tablet sublingual Tab 300 33 600
171 5 mg

172 IV Cateter No. 18 bh - - -

173 IV Cateter No. 20 bh 80 12 216
174 IV Cateter No. 22 bh 57 9 162
175 IV Cateter No. 24 bh 20 7 120
176 IV Cateter No. 26 bh - - -
177 Jarum jahit ( Gusi ) bh - - -
178 Jarum jahit kulit bh - - -
179 Jarum Otot bh - - -
180 Kalium Diklopenak 50 mg tab - - -
181 Kalium permanganat serbuk Btl - - -
182 Kalsium hidroksda btl - - -
183 Kalsium laktat tablet 500 mg Tab 1,500 833 15,000
184 Kanamycin inj vial - - -
Kapas pembalut/adsorben 250 gr Bks 10 3 60
185

186 Karbamazepin tablet 200 mg Tab - - -

187 Karbo adsorben tablet 0,5 g tab - - -
188 Kasa hidrofil steril 16 x 16 lbr 288 160 2,880
189 Kasa hidrofil steril 16 x 16 lbr - - -
190 Kasa hidrofil steril 16 x 20 lbr - - -
191 kasa hidrofil steril 18 x 22 cm lbr - - -
192 Kasa hidrofilsteril 36 x 80cm Rol 4 1 24
193 Kasa kompres 40/40 steril Rol - - -
194 Kasa pembalut 2 m x 80 cm Roll - - -
Kasa Pembalut Elastis 3 inc ( 7,5 cm Roll - - -
195 x 4,55 m )
Kasa Pembalut Elastis 4 inc ( 10 cm Roll - - -
196 x 4,55 m )
Kasa Pembalut Elastis 6 inc ( 15 cm Roll - - -
197 x 4,55 m )
Kasa pembalut hidrofil 4 m x 15 cm Roll 18 3 48
198
Kasa pembalut hidropil 4 mx 10 cm Rol 75 10 180
199
Kasa pembalut hidropil 4 mx 5cm Rol 68 6 108
200

201 Kertas Lakmus Pack isi 100 - - -

202 Ketokonazole Tab 300 200 3,600
203 Ketokonazole salep tube 30 20 360
204 Kina inj 25 %- 2ml Amp - - -
205 Klindamicin 150 mg tablet Tab - - -
206 Klindamicin 300 mg tablet Tab 450 117 2,100
207 Klobazam 10 mg tab - - -
 Klonodin i.v 0.15 mg/ml ( catapres amp - - -
208 0.15 mg/ml )

209 Klopidogrel tablet 75 mg tab - - -

210 Kloramfenikol salep mata 1 % tube - 12 216
211 Kloramfenikol tetea mata 0.5 % btl - 17 300
212 Klorampenicol kapsul 250 mg Kap - 20 360
213 Klorampenicol tetes telinga 3 % Btl 50 17 300
Klorfenol kamfer mentol (.HKM) btl - - -
214
Klorpeniramin maleat (ctm) tablet 4 Tab 500 833 15,000
215 mg

216 Klorpromazin hcl inj 25 mg/ml Amp 29 10 174

217 Klorpromazin hcl inj 5 mg/ml Amp - - -
218 Klorpromazin hcl tablet 100 mg Tab - - -
219 Klorpromazin hcl tablet 25 mg Tab - - -
Komb: Kaolin 700 mg+Pektin 50 mg Tab - - -
220 ( Omegdiar )
Komb: PCT 500 mg ,DMP 15 tab - - -
221 mg,PPA 12,5 mg,CTM 2 mg
( Flucadex )

Komb: PCT 500 mg ,DMP 15 Btl - - -

222 mg,PPA 12,5 mg,CTM 2 mg
( Flucadex )

Kombinasi : DMP 10 mg,GG 50 Tab - - -

223 mg,PPA 12,5 mg, CTM 1 mg
( Hufagrip F)

Kombinasi : Pct 120 mg,Dmp 15 btl - - -

224 mg,PPA 12 mg, CTM 2 mg syrup
( Flutop )

Kombinasi : Piratiasin 8 mg - Tab - - -

225 kloteophilinat 40 mg,vit B6 30 mg
tab ( Ponthymer B6 )

Kombinasi : Polymicin btl - - -

226 ,Neomycin,Dexamethason / Alletrol

Kombinasi suspensi : Parafin + btl - - -

227 gliserin + fenolftalein ( Laxadine
emulsi 60 ml

228 Kombipak 2 dan 3 paket - - -

229 Komposit Solare A1,A2,A3 tube - - -
230 Kotrimoksazol dewasa tablet Tab 700 400 7,200
231 Kotrimoksazol pediatrik tablet Tab - - -
232 Kotrimoksazol suspensi Btl 89 30 534
233 Lancet Set pen set - - -
234 Lanzoprazol 30 mg kap - - -
235 Larutan Amonium Oxalat btl - - -
236 Larutan Anisol Btl - - -
237 Larutan Asam Sulfasalisilat 20 % Btl - - -
238 Larutan benedict Btl - - -
239 Larutan EDTA Btl - - -
240 Larutan eosin 2 % Btl - - -
241 Larutan giemsa stain Btl - - -
242 Larutan Gram Set - - -
243 Larutan Hayem Btl - - -
244 Larutan HCL Btl - - -
245 Larutan Hidrogen Peroksida Btl 1 - -
246 Larutan Karbol Fuchisin 0.3% btl - - -
247 Larutan metilen biru Btl - - -
248 Larutan Spiritus Btl 1 - -
249 Larutan turk Vial - - -
250 Larutan wright Btl - - -
251 Larutan Ziehl Nelson Btl 3 0 5
252 Levertran ZK Pot - - -
253 Lidocain kompositum inj Amp 98 13 228
254 Lisinopril tablet 10 mg tab - - -
255 Lisinopril tablet 5 mg tab - - -
256 Lisol Btl 3 1 18
257 Loperamide Tab Tab - - -
258 Loratadine Tab Tab 200 67 1,200
259 Magnesium sulfat injeksi 20% amp 6 2 36
260 Magnesium sulfat injeksi 40% Vial 7 2 42
261 Masker set - - -
262 Masker ( Mexicer ) bh - - -
263 Meloksikam 15 mg tab - - -
Mersibion ( Kombinasi : Vitamin B1 amp - - -
264 100 mg, B6 200 mg and B12 200
mcg )

265 Metanol Btl - - -

266 Metformin 500 mg Tab 500 167 3,000
Metil ergometrin malet injeksi Amp 30 5 90
267 0.200 mg-1 ml
Metil ergometrin malet tablet salut Tab 50 17 300
268 0.125

269 Metil Prednisolon Tablet Tab 200 433 7,800

270 Metoclopramide Syrp Btl - - -
271 Metoclopramide Tablet 5 mg Tab - - -
272 Metronidazol tablet 250 mg Tab - - -
273 Metronidazol tablet 500 mg Tab 800 267 4,800
274 Miconazole cr Tube 72 16 288
275 Mineral Mix bks 120 40 720
276 Multivitamin Tab - - -
Multivitamin + DHA syr ( Curpiplex ) Btl - - -
277
Natrium bicarbonat tablet 500 mg Tab - - -
278

279 Natrium Diclofenac 50 mg Tab 1,000 717 12,900

280 Natrium Diklofenac 25 mg Tab - - -
Natrium klorida larutan infus 0.9 % Btl 33 18 324
281 steril

282 Natrium Tiroksin 100 mg tab - - -

283 Needle No 23 Bh 390 63 1,140
284 Needle No.25 bh 300 40 720
285 Nelaton catheter bh - - -
Neomycin sulfat 0,5% tube - - -
286 (Bioplacenton)

287 NGT No. 16 bks / set - - -

288 NGT No. 18 bks / set - - -
289 NGT No.14 bh - - -
290 NGT No.8 bks / set - - -
291 Nifedipin Tab 550 283 5,100
Nistatin 100.000 iu/g tablet vaginal Tab 150 43 780
292

293 Nistatin 500.000 iu tablet salut Tab 400 33 600

Nistatin suspensi syrup 100.000 btl - 5 90
294 UI/ml ( Nistatin drop )

295 OAT Kategori Anak Paket - 0 4

296 Obat batuk hitam (o.b.h) cairan Btl 30 20 360
Obat batuk hitam kombinasi tab - - -
297 (hustab)

298 Objek glass bh - - -

299 OCO Btl - - -
300 Ofloxacin 400 mg Cap - - -
Oksitetrasiklin hcl inj. I.m. 50 Vial - - -
301 mg/ml-10 ml
Oksitetrasiklin hcl salep kulit 3% Tub - - -
302
Oksitetrasiklin hcl salep mata 1% Tub - 5 90
303

304 Oksitosin Inj. 10 iu/ml-1 ml Amp 100 30 540

305 Omeprazole Cap 450 330 5,940
306 Papaverin 40 mg amp - - -
307 Papaverin 40 mg tab - - -
308 Paracetamol Drop Btl 21 24 426
309 Parasetamol sirup 120 mg/ 5 ml Btl 150 42 750
310 Parasetamol tablet 100 mg Tab - - -
311 Parasetamol tablet 500 mg Tab 1,800 2,100 37,800
312 Pembalut Gips 3 inc Roll - - -
313 Pembalut Gips 4 inch bh - - -
314 Pembalut Gips 6 inchi rol - - -
315 Permetrin (Scabimite) tube 60 - -
316 Pil KB Kombinasi tab Strip - - -
317 Piracetam 400 mg Tab 100 33 600
318 Piracetam Injeksi Amp - - -
319 Pirantel Pamoat tablet 365 mg Tab - 67 1,200
320 Piridoksin hcl tablet 10 mg Tab 300 200 3,600
321 Piritinol Capsul cap - - -
322 Piroxicam 20 mg Cap - 300 5,400
323 Pisau Bedah ( Bisturi ) No. 11 bh - - -
324 Pisau Bedah ( Bisturi ) No. 15 bh 20 13 240
325 Pisau Bedah ( Bisturi ) No. 20 bh 10 7 120
326 Plester 5 yard x 2 inch Rol - - -
327 Prednison tablet 5 mg Tab 900 300 5,400
328 Pregmovit tab - - -
329 Primaquin Tab - - -
Prokain benzil penisilin 3 juta iu/ Vial - - -
330 vial inj

331 Propanolol hcl tablet 40 mg Tab - - -

332 Propiltiourasil tablet 100 mg Tab - - -
333 Pyrantel btl 50 5 90
334 Ranitidine Tab 500 167 3,000
335 Ranitidine Inj Amp 75 10 186
336 RDT ktk '25 - - -
337 Reagen Gol. Darah ktk - - -
338 Reserpin tablet 0.10 mg Tab - - -
339 Reserpin tablet 0.25 mg Tab - - -
Retinol (vitamin A) kapsul 100.000 Kap 900 200 3,600
340 iu
Retinol (vitamin A) kapsul 200.000 Kap 850 300 5,400
341 iu

342 Rifampisin kapsul 300 mg Kap - - -

343 Rifampisin kapsul 450 mg Kap - - -
344 Ringer laktat larutan infus steril Btl 32 32 582
345 Risperidon tablet 2 mg Tab 350 203 3,660
346 Salbutamol ( Proast ) btl - - -
Salbutamol inhalasi/aerosol 100 btl 4 1 18
347 mcg/dosis
Salbutamol cairan ( Ventolin amp - - -
348 Nebules )

349 Salbutamol tablet 2 mg Tab 600 467 8,400

350 Salep 2-4 kombinasi Pot 24 8 144
351 Salisil bedak 2% Ktk 30 7 120
352 Sarung Tangan 6,5 bh - 17 300
353 Sarung Tangan 7,5 bh 46 15 276
354 Sarung Tangan 6 bh 20 23 420
355 Sarung Tangan 7 bh - 17 300
356 Sarung Tangan Panjang pasang - 2 36
Sefadroksil sirup kering 125 mg / 5 Btl - 3 47
357 ml

358 Seluloid strip pak' 100 strip - - -

359 Semen Seng fosfat p/l set - - -
Serum anti bisa ular polivalen inj. 5 Vial 5 0 6
360 ml (abu I)
Serum anti difteri inj. 20.000 iu/vial Vial - - -
361 (a.d.s)
Serum anti tetanus inj. 1.500 Amp 2 2 36
362 iu/ampul (a.t.s)
Serum anti tetanus inj. 20.000 Vial - - -
363 iu/vial (a.t.s)
Sianokobalamin (vit. B 12) inj. 500 Vial 160 26 468
364 mcg/ml
 Silk (benang bedah sutera) no. 3/0 Sak 107 1 24
365

366 Silver amalgam serbuk 30 gr btl - - -

367 Simvastatin 10 mg Tab 450 350 6,300
368 Simvastatin 20mg tab 400 133 2,400
369 Siticholin inj 250 mg/ 2 ml amp - - -
370 Spironolakton tablet 25 mg Tab - - -
371 Spongostan Curaspon bh - - -
Spons gelatin cubicle 10 x 10 x 10 sachest - - -
372

373 Stick Gula Darah (Easy Touch) bh - - -

374 Stick Gula Darah (one made) ktk - - -
375 Stik Hb Digital Box / 25 strip - - -
376 Stik Kolesterol buah - - -
377 Stik Uric Acid buah - - -
Sulfasetamid natrium tetes mata Btl - - -
378 15%

379 Superhoid supp 60 20 360

380 Tablet tambah darah kombinasi Tab - - -
Temporary stopping fletcher serbuk set - - -
381 dan cairan

382 Teofillin tablet 150 mg tab - - -

383 Tera F kap - - -
Terbutalin tablet 2,5 mg ( Molasma Tab - - -
384 2.5 mg )

385 Tetrasiklin hcl kapsul 250 mg Kap - - -

386 Tetrasiklin hcl kapsul 500 mg Kap - - -
387 Thiamfenicol 500 mg Kap - 100 1,800
Tiamin hcl (vit B 1) inj. 100 mg/ml Amp - - -
388 -1 ml
Tiamin hcl mononitrat (vit B 1) Tab 400 120 2,160
389 tablet 50 mg

390 Timolol Maleat ™ btl - - -

391 Tissue Roll - - -
392 Tramadol Kap - - -
393 Tramadol inj Amp 25 4 78
Triheksifendil hidroklorida tablet 2 Tab - - -
394 mg

395 Trikresol formalin (tkf ) cairan Btl - - -

Umbilical Cord (Klem tali pusat ) bh 25 8 150
396

397 Underpad bh 20 13 240

398 Urine Bag bks / set 12 1 12
399 Varnis btl - - -
400 Vitamin B kompleks tablet Tab 500 1,258 22,644
401 Wing Needle No. 23 bh - - -
402 Wing Needle No.25 bh - - -
403 Wing Needle No.27 bh - - -
X-Ray Film,Sensitivity Green,18 x 24 Bh - - -
404
 X-Ray Film,Sensitivity Green,24 x 30 Bh - - -
405
X-Ray Film,Sensitivity Green,30 x 40 Bh - - -
406
X-Ray Film,Sensitivity Green,35 x 35 Bh - - -
407
X-Ray Film,Sensitivity Green,35 x 43 Bh - - -
408
Yodium povidon larutan 10 % 30 ml Btl 17 6 102
409
Yodium povidon larutan 10 % 300 Btl 6 6 114
410 ml

411 Zinc drop 10 mg/mL ( Cozind ) btl - - -

Zinc sir 20 mg/5 Ml ( Zirkum Kid ) btl 32 16 288
412

413 Zink Tab - - -

ATAN TINGKAT PERTAMA (FKTP) TAHUN 2020
ANG DUA

RENCANA RENCANA HARGA JUMLAH

KEBUTUHAN PENGADAAN SATUAN HARGA KETERANGAN
TAHUN 2020 TAHUN 2020 (Rp) (Rp)

(d) = (c) - (a) (e) (f) (g) (h)

- - 42,900.00 -
580 - 454.00 -
- 500 2,997.00 1,498,500
- - 236.00 -
700 700 1,240.00 868,000
1,800 1,800 1,565.00 2,817,000
340 400 1,291.95 516,780
- 200 - 9,158.49 -
- - 9,158.49 -
- - 1,033.56 -
- 20 - 955.00 -
- - 463.00 -
8,800 9,000 99.00 891,000
- 144.00 -
- 753,500.00 -
- 20,000 145.00 2,900,000
- 25 - 3,349.01 -
600 600 86.00 51,600
- 600 - 168.00 -
8,580 10,000 95.00 950,000
1,800 5,000 75.00 375,000
- 220.24 -
27,800 30,000 248.00 7,440,000
600 800 2,772.00 2,217,600
- - 3,846.00 -

- - 13,200.00 -
- - 4,700.00 -
80 100 5,000.00 500,000
- - 233.09 -
483 600 2,098.00 1,258,800
26,400 30,000 56.00 1,680,000
- 24 - 5,170.00 -
108 100 3,642.00 364,200
600 600 199.00 119,400
- - 3,490.00 -
38 100 2,860.00 286,000
- - 24,970.00 -
- - 4,064.00 -
- 200 - 99.00 -
 - 1,000 118.00 118,000
13,994 15,000 120.00 1,800,000
- - 1,209.63 -

1,600 16,000 81.00 1,296,000

9,600 10,000 103.00 1,030,000
- 7 - 1,813.00 -
- - 2,086.98 -
1,950 2,000 1,784.00 3,568,000
- - 110.00 -
- - 297.00 -
- 15 - 1,353.00 -
- - 81.00 -
4,600 5,000 175.00 875,000
- - 5,913.00 -
- - 4,994.00 -
- 2 257,400.00 514,800

- - 14,500.00 -
600 600 119.00 71,400
454 500 1,373.00 686,500
150 200 316.00 63,200
98 100 5,900.00 590,000

- - 695.00 -
- 1 1,716,000.00 1,716,000
- 20,000 112.00 2,240,000
20 20 105,040.00 2,100,800

- - 112,200.00 -

- - 500,500.00 -
- 12 18,975.00 227,700
20 20 10,351.00 207,020
- - 202,070.00 -

12,394 15,000 65.00 975,000

14,400 15,000 100.00 1,500,000
93 200 24,500.00 4,900,000
137 200 26,250.00 5,250,000
- 2 298,100.00 596,200
- 10,000 847.00 8,470,000
- - 649.00 -
- - 5,884.00 -
- - 4,822.00 -
- - 69,300.00 -
7,600 8,000 104.00 832,000
1,500 1,500 114.79 172,178
5,500 6,000 770.00 4,620,000
- 100 - 657.00 -
- - 278.30 -

- - 6,996.00 -

- - 360.47 -

- - 306,900.00 -
- - 55,000.00 -
12,500 13,000 79.00 1,027,000
85 200 1,210.00 242,000
- - 3,152.00 -

- - 102.00 -

- - 149,800.00 -
- 1 1 492,660.00 492,660
- - 810,700.00 -
- - 434,500.00 -
- - 2,000.00 -

- - 120,500.00 -
- 20 - 1,913.00 -
45 50 14,459.00 722,950

- 500 86.00 43,000

- - 180.00 -

- - 109.00 -
- 30 - 1,262.00 -
4,600 5,000 90.00 450,000
- 1,000 299.00 299,000
- 12 - 1,518.00 -
- - 42.00 -
- 800 - 781.00 -
- 200 6,390.00 1,278,000

- - 322,300.00 -
150 200 3,900.00 780,000
12 20 24,333.33 486,667
500 500 4,300.00 2,150,000
20 20 102,692.00 2,053,840
- 1 2 124,058.00 248,116
400 500 162.36 81,180
- - 9,158.00 -
18 20 285,339.00 5,706,780
13 30 447,747.00 13,432,410
- 5 1,592,731.00 7,963,655
- - 175,990.00 -
 1,100 1,200 158.00 189,600
- 30 - 2,265.00 -
- - 158.00 -
- - 80,000.00 -

- - 850,300.00 -
2,700 3,000 873.00 2,619,000

- 500 7,480.00 3,740,000

- 2 - 37,500.00 -
9 50 13,530.00 676,500
12 50 12,470.00 623,500
- 4 20 12,470.00 249,400
- 5 50 13,530.00 676,500
2,000 2,000 79.00 158,000
225 300 1,555.00 466,500
200 500 532.00 266,000
- - 436.00 -
- 500 6,700.00 3,350,000
- 100 4,036.00 403,600
- 100 3,195.50 319,550
- - 919,300.00 -
5 - 1,303,500.00 -
- - 330,000.00 -

- - 1,187,890.00 -
- - 825,000.00 -

1,300 2,000 90.00 180,000

400 500 174.00 87,000
- 100 - 207.00 -
- 20,000 30.69 613,800

- - 8,910.00 -
- 10 100 7,500.00 750,000
215 200 7,363.00 1,472,600
- - 299.70 -

- - 238.00 -
- - 22,880.00 -
100 5,000 59.00 295,000
- 2,000 56.00 112,000
- 600 - 171.00 -
48 100 2,533.00 253,300
- - 428.78 -

1,100 1,500 2,130.00 3,195,000

198 200 2,520.00 504,000
- 5,000 251.90 1,259,500
- 10,000 127.00 1,270,000
 21 100 3,688.00 368,800
- 300 3,574.60 1,072,380
- - 1,151.98 -
- 2,000 210.00 420,000
- - 177.00 -
300 300 268.4 80,520

- 50 8,355.00 417,750
136 300 4,959.00 1,487,700
105 200 6,724.00 1,344,800
100 100 4,959.00 495,900
- 50 25,297.80 1,264,890
- - 94,856.67 -
- - 1,650.00 -
- - 1,650.00 -
- 500 500.50 250,250
- - 5,412.00 -
- - 471,900.00 -
13,500 20,000 59.00 1,180,000
- - 12,683.00 -
50 50 16,120.00 806,000

- 5,000 234.00 1,170,000

- - 328.35 -
2,592 3,000 587.50 1,762,500
- - 304.22 -
- - 434.84 -
- - 614.58 -
20 20 129,000.00 2,580,000
- 200 2,093.60 418,719
- - 10,263.33 -
- 100 38,092.01 3,809,201

- 100 47,027.00 4,702,700

- 100 58,299.01 5,829,901

30 50 2,600.00 130,000

105 200 1,625.60 325,120

40 100 812.80 81,280

- 100 42,900.00 4,290,000

3,300 4,000 305.00 1,220,000
330 500 2,577.00 1,288,500
- - 6,820.00 -
- - 754.00 -
1,650 2,000 1,500.00 3,000,000
- - 967.00 -
 - - 30,600.00 -

- - 8,847.66 -
216 300 1,925.00 577,500
300 300 9,900.00 2,970,000
360 500 528.00 264,000
250 300 9,900.00 2,970,000
- - 110,687.50 -

14,500 15,000 26.00 390,000

145 - 1,531.00 -
- - 1,851.00 -
- - 181.00 -
- - 170.00 -
- - 1,001.00 -

- - 396.00 -

- - 9,592.00 -

- - 550.00 -

- - 6,050.00 -

- - 2,420.00 -

- - 17,999.30 -

- - 295,000.00 -

- - 654,500.00 -
- - 654,500.00 -
6,500 7,000 125.00 875,000
- 2,000 63.18 126,368
445 500 2,052.00 1,026,000
- 2 139,990.00 279,980
- - 341.00 -
- - 35,200.00 -
- - 369,050.00 -
- - 279,156.25 -
- - 25,506.25 -
- 1 79,656.25 79,656
 - - 188,558.33 -
- - 361,806.25 -
- - 536,250.00 -
- - 41,783.33 -
- - 25,506.25 -
- 1 1 32,725.00 32,725
- - 78,100.00 -
- - 77,000.00 -
- 1 3 53,350.00 160,050
- - 36,083.33 -
- - 392,700.00 -
2 5 286,000.00 1,430,000
- - 4,015.00 -
130 200 1,405.00 281,000
- - 485.01 -
- - 410.01 -
15 15 49,862.00 747,930
- - 90.00 -
1,000 1,000 243.00 243,000
30 30 3,228.00 96,840
35 40 3,796.00 151,840
- - 462.00 -
- - 330.00 -
- 2,000 1,439.00 2,878,000
- - 6,919.00 -

- - 85,030.00 -
2,500 5,000 102.00 510,000
60 100 3,399.00 339,900

250 500 243.00 121,500

7,600 8,000 139.00 1,112,000

- 200 2,750.00 550,000
- 1,000 124.00 124,000
- - 94.00 -
4,000 4,000 198.00 792,000
216 300 3,926.00 1,177,800
600 - 2,812.00 -
- - 517.00 -
- - 8,910.00 -

- - 88.00 -

11,900 12,000 145.00 1,740,000

- - 167.00 -
291 300 6,410.00 1,923,000

- - 1,700.00 -
 750 1,000 220.00 220,000
420 500 220.00 110,000
- - 8,352.00 -
- 200 15,796.00 3,159,200

- - 9,065.10 -
- - 9,065.10 -
- - 9,065.10 -
- - 9,065.10 -
4,550 5,000 107.00 535,000
630 700 688.00 481,600

200 500 971.00 485,500

90 100 24,200.00 2,420,000

4 10 236,398.00 2,363,980
330 500 6,502.00 3,251,000
- - 312.18 -

- - 257.07 -
- - 235,400.00 -
- - 636.00 -
- - 3,410.00 -

- 300 1,649.34 494,802

90 100 2,600.00 260,000

440 500 1,232.00 616,000

5,490 6,000 138.00 828,000
- - 1,275.00 -
- - 125.00 -
405 500 7,646.00 3,823,000
600 600 1,238.00 742,800
- - 41.87 -
36,000 40,000 60.00 2,400,000
- - 20,350.00 -
- - 28,600.00 -
- - 38,500.00 -
- 60 60 11,825.00 709,500
- - 2,175.00 -
500 500 943.80 471,900
- - 5,500.00 -
1,200 1,200 331.00 397,200
3,300 4,000 141.00 564,000
- - 3,520.00 -
5,400 6,000 176.00 1,056,000
- - 3,300.00 -
220 200 3,300.00 660,000
110 200 3,300.00 660,000
 - - 33,880.00 -
4,500 5,000 79.00 395,000
- - 2,508.00 -
- - 258.00 -
- - 9,908.00 -

- - 84.00 -
- 2,000 451.06 902,120
40 50 11,050.00 552,500
2,500 3,000 184.80 554,400
111 200 1,155.00 231,000
- 2 6,476.00 12,952
- 2 503,800.00 1,007,600
- 89.00 -
- 114.00 -
2,700 3,000 331.00 993,000

4,550 5,000 596.00 2,980,000

- - 862.00 -
- - 979.00 -
550 600 7,150.00 4,290,000
3,310 3,000 273.00 819,000
- - 5,463.00 -
14 15 31,200.00 468,000

- - 4,000.01 -

7,800 8,000 64.00 512,000

120 120 3,017.00 362,040
90 100 6,050.00 605,000
300 500 8,524.00 4,262,000
230 500 8,524.00 4,262,000
400 500 9,348.00 4,673,999
300 500 8,524.00 4,262,000
36 50 24,100.00 1,205,000
47 50 4,360.00 218,000

- - 2,380.00 -
- - 150,150.00 -
1 10 479,996.00 4,799,960

- - 1,050,379.00 -

34 50 130,999.00 6,549,950

- - 604,670.00 -

308 300 9,570.00 2,871,000 9

- 83 100 3,819.44 381,944

- - 29,084.00 -
5,850 6,000 110.00 660,000
2,000 3,000 225.00 675,000
- 100 41,743.90 4,174,390
- - 212.00 -
- - 11,704.00 -
- - 48,125.00 -

- 300 5,071.00 1,521,300

- - 97,900.00 -
- 3 176,000.00 528,000
- - 25,652.00 -
- - 5,236.00 -
- - 3,789.79 -

300 300 3,657.50 1,097,250

- - 494.00 -
- - 56,650.00 -

- - 310.00 -
- - 255.20 -
- - 103.00 -

- - 80.30 -
- - 329.01 -
1,800 2,000 990.00 1,980,000
- - 843.33 -

1,760 2,000 88.00 176,000

- - 9,682.00 -
- - 6,957.50 -
- - 196.35 -
53 100 2,680.00 268,000
- - 85.00 -

- - 130,900.00 -
125 200 1,250.00 250,000

220 300 9,048.00 2,714,400

- - 3,750.00 -
- - 231,000.00 -
22,144 25,000 135.00 3,375,000
- - 1,750.00 -
- - 1,750.00 -
- - 1,750.00 -
- - 1,809,500.00 -
 - - 2,926,000.00 -

- - 2,640,000.00 -

- - 5,005,000.00 -

- - 3,674,000.00 -

85 100 3,480.00 348,000

108 100 21,600.00 2,160,000

- 200 11,700.00 2,339,999

256 300 3,285.00 985,500

- - 503.00 -