RENCANA KEBUTUHAN OBAT DAN BMHP PUSKESMAS TAHU

PUSKESMAS : PASEAN
ANGGARAN OBAT KAPITASI 2019 : 220,000,000
ANGGARAN BMHP KAPITASI 2019 : 256,000,000

SISA OBAT PKM PER 31 DES

KEMASAN HARGA 2018
OBAT 2018 PEMAKAIAN
NO NAMA OBAT
SATUAN PER SATUAN RATA2 / BULAN
ISI TERKECIL PKD KAPITASI JUMLAH
TERKECIL

1 2 3 4 5 6

OBAT

1 ADONA / SALDONA tab 100 Tablet 1,876 - -

2 ALBENDAZOLE 400 MG 30 Tablet 344 - -

3 ALBENDAZOLE SIRUP 1 Botol 3,849 - -

4 ALLOPURINOL 100 MG 100 Tablet 97 800 5,990 - 5,990

5 ALLOPURINOL 300 MG 100 Tablet 210 300 60 - 60

6 ALPRAZOLAM 0,25 MG 100 Tablet 316 - - - -

7 ALPRAZOLAM 0,5 MG 100 Tablet 108 5 460 - 460

8 AMBROXOL 30 MG 100 Tablet 206 - - 25,000 25,000

9 AMBROXOL DROP 1 Botol 29,370 - - - -

10 AMBROXOL SYIRUP 1 Botol 5,866 - - - -

11 AMINOFLUID CAIRAN 500 ml 1 Flash 67,590 - - 20 20

12 AMINOPHILLIN 200 MG 100 Tablet 80 200 - - -

13 AMINOPHILLIN INJEKSI 30 Ampul 2,998 15 60 41 101

14 AMINOPHILLIN TAB 100 Tablet 177 - - - -

15 AMITRIPTILIN TAB 25 MG 100 Tablet 167 10 500 - 500

16 AMLODIPIN 10 MG 30 Tablet 104 - - - -

17 AMLODIPIN 5 MG 30 Tablet 85 100 - - -

18 AMOKSISILIN 250 mg 100 Tablet 184 654 12,470 - 12,470

19 AMOKSISILIN 500 mg 100 Tablet 233 3,858 7,955 42,730 50,685

20 AMOXICILIN 125 SYIRUP 1 Botol 1,881 73 405 615 1,020

21 AMOXICILIN 250 mg SYIRUP 1 Botol 3,473 2 135 - 135

22 AMOXICILIN INJEKSI 10 Vial 9,000 - -

23 AMPICILIN 500 mg 100 Tablet 398 - -

24 AMPICILIN 1 GR INJEKSI 1 Ampul 40,000 - -

25 AMPICILIN SYIRUP 1 Botol 4,900 - -

26 ANTALGIN 500 mg 100 Tablet 323 16 - - -

27 ANTALGIN INJ 30 Ampul 9,240 18 44 - 44

1 2 3 4 5 6

28 ANTALGIN INJ 1000mg/2ml Ampul 3,500 14 - 27 27

29 ANTASIDA DOEN 100 Tablet 54 3,168 10,680 23,920 34,600

30 ANTASIDA DOEN SYIRUP 1 Botol 1,995 31 273 - 273

31 ANTI ANEMIA KOMBINASI 100 Tablet 835 201 5,600 - 5,600

32 ANTI ASMA NEBULES (Ventolin) 20 Botol 10,332 - - - -

33 ANTI BACTERI DOEN SK 25 Tablet 2,924 6 74 - 74

34 ANTI HAEMOROID 10 Tablet 3,045 - -

35 ANTI INFLAMASI TETES MATA 1 Botol 15,125 - -

36 ANTI PERDARAHAN (Saldona) 100 Tablet 1,595 - -

37 ANTI PIRETIK SUPPOSITORIA 12 Supp 12,100 - -

38 ANTIBIOTIKA AMFENIKOL 1 Botol 12,980 - -

39 ANTIFUNGI SALEP 24 Tube 1,904 - -

40 AQUA PRO 25 ML INJ 1 Botol 2,750 - 220 - 220

41 ASAM TRANEXAMAT INJEKSI 10 Ampul 1,748 13 115 - 115

42 ASAM ASCORBAT 250 MG 100 Tablet 164 319 - -

43 ASAM ASCORBAT 50 MG 100 Tablet 104 30 4,640 4,640

44 ASAM MEFENAMAT 250 MG 100 Kaplet 300 - -

45 ASAM MEFENAMAT 500 MG 100 Tablet 106 7,070 23,785 - 23,785

46 ASETOSAL 100mg 100 Tablet 164 - -

47 ASIKLOVIR 200 mg 100 Tablet 240 72 40 1,315 1,355

48 ASIKLOVIR 400 mg 100 Tablet 240 111 620 1,800 2,420

49 ASIKLOVIR CREAM 25 Tube 2,997 0 - -

50 ATROPIN SULFAS INJ 100 Tablet 1,540 4 11 11

51 ATS 1500.000 IU 10 Ampul 130,999 0 18 18

52 BB.PENISILIN 1,2 UI/ML 10 Vial 10,700 - -

53 BB.PENISILIN 2,4 UI/ML 10 Vial 14,500 - -

54 BETAHISTIN MESILAT 6MG 30 Tablet 110 28 480 480

55 BETAMETHASONE CREAM 25 Tube 1,340 24 283 283

56 BIO ATP 100 Tablet 2,356 58 - -

57 BRICASMA 2,5 mg/ml (Terbutaline Sulfate) 10 Botol 7,124 - 200 200

58 CAPTOPRIL 12,5 MG 100 Tablet 62 - -

59 CAPTOPRIL 25 MG 100 Tablet 75 885 3,675 4,600 8,275

60 CAPTOPRIL 50 MG 100 Tablet 124 - -

61 CEFOTAXIM 1G INJEKSI 10 Ampul 4,200 174 144 - 144

62 CETERIZINE 10 MG 100 Tablet 90 8 100 810 910

63 CETERIZINE sirup 1 Botol 2,850 3 - - -

1 2 3 4 5 6

64 CHANNA (STRIATUS) 30 Kotak 199,650 - -

65 CIPROFLOXACIN 500MG 100 Tablet 1,200 1,060 2,500 10,600 13,100

66 CITICOLIN INJEKSI 10 Ampul 11,880 - -

67 CODEIN 10 MG 100 Tablet 550 - -

68 COMBIVENT NEBULASER 20 Botol 4,550 10 1 1

69 DEXAMETHASONE 0,5 TAB 100 Tablet 32 725 9,065 9,065

70 DEXAMETHASONE INJEKSI 100 Ampul 1,097 19 65 65

71 DIAZEPAM /STESOLID RECTAL 5 Supp 12,090 2 30 30

72 DIAZEPAM 2 mg 100 Botol 86 - 1,000 1,000

73 DIAZEPAM 5MG 100 Tablet 109 - -

74 DIAZEPAM INJEKSI 30 Ampul 2,150 - -

75 DIFENHIDRAMIN HCL INJ 30 Ampul 1,095 308 5,204 152 5,356

76 DIGOXIN 0,25 100 Tablet 104 25 - -

77 DIMENHIDRINAT 50 MG 100 Tablet 99 - -

78 DOMPERIDONE 10 MG 100 Tablet 85 20 400 400

79 DOMPERIDONE SUSPENSI 1 Botol 2,700 7 - -

80 DULCOLAX SUPP DEWASA 10 Supp 5,800 2 273 273

81 DULCOLAX SUPP PED 6 Supp 5,800 - 120 120

82 DURADRIL / ADIDRYL INJ 30 Ampul 9,442 - -

83 EPHINEPRINE INJ 30 Ampul 1,408 12 102 - 102

84 ERITROMICYN 250 MG 100 Tablet 546 75 900 900

85 ERITROMICYN 500 MG 100 Tablet 750 3 460 460

86 ERITROMICYN SYIRUP 200 mg/5 ml 1 Botol 6,090 - -

87 ETAKRIDIN LAR (RIVANOL) 0.1 % 300 cc 1 Botol 3,000 - -

88 ETANOL 70% 1 liter 1 Botol 25,000 - -

89 ETANOL 70% 1L 1 Botol 24,992 - -

90 EUGENOL CAIRAN 12 Botol 18,100 - -

91 FENITOIN INJ. 10 Ampul 4,956 - -

92 FENOBARBITAL 30 mg 100 Tablet 171 - -

93 FENOBARBITAL 50 mg INJ. 30 Ampul 1,857 - -

94 FENOL GLISEROL TT 10% 1 Botol 2,590 - -

95 FITOMENADION 10 mg TAB 100 Tablet 710 - 3,000 3,000

96 FITOMENADION INJEKSI 30 Ampul 3,550 49 135 135

97 FUROSEMIDE 40 mg 100 Tablet 77 60 2,590 2,590

98 FUROSEMIDE INJEKSI 25 Ampul 1,333 - -

99 GARAM ORALIT 200 100 Sachet 260 96 2,045 2,045

 1 2 3 4 5 6

100 GEMFIBROZIL 300 MG 120 Tablet 372 87 716 716

101 GENTAMICYN 40 MG INJ. 5 Ampul 3,399 - -

102 GENTAMICYN 80 MG INJ. 5 Ampul 3,386 8 - -

103 GENTAMICYN SK 1 Tube 2,126 0 13 13

104 GENTAMICYN TM 3% 1 Botol 4,232 4 33 33

105 GENTIAN VIOLET 1 Botol 1,760 - -

106 GLIBENCLAMIDE 5 mg 100 Tablet 119 609 10,728 10,728

107 GLIMEPIRIDE 1 MG 50 Tablet 174 23 1,600 1,600

108 GLIMEPIRIDE 2 MG 50 Tablet 207 - -

109 GLIMEPIRIDE 3 MG 50 Tablet 245 - -

110 GLIMEPIRIDE 4 MG 50 Tablet 270 - -

111 GLISERIL GUAIACOLAT 100 mg 100 Tablet 260 327 - -

112 GLUCO PROTEIN URINE TES 10 Pcs 1,045 - -

113 GLUCOSE 10 % INFUS 1 Botol 7,500 - -

114 GLUCOSE 40 % INFUS 10 Botol 13,200 - -

115 GLUCOSE 5 % INFUS 1 Botol 6,900 72 60 1,808 1,868

116 GRISEOFULVIN 125 mg 100 Tablet 210 100 1,790 1,790

117 GRISEOFULVIN 500 mg 100 Tablet 849 - -

118 HALDOL INJ. I.M 5 MG/ML (LODOMER) 12 Ampul 4,000 - -

119 HALOPERIDOL 1,5 mg 100 Tablet 59 42 - -

120 HALOPERIDOL 2mg/Lodomer 100 Tablet 84 - -

121 HALOPERIDOL 5 mg 100 Tablet 69 363 640 640

122 HEMOGLOBIN 1 Botol 51,450 - -

123 HIDROKLORTIAZID (HCT) 25 mg 100 Tablet 155 - -

124 HIDROKORTISON KRIM 2,5% 24 Tube 2,475 24 312 312

125 IBUPROFEN 200 mg 100 Tablet 102 1,416 12,000 9,460 21,460

126 IBUPROFEN 400 mg 100 Tablet 111 954 - - -

127 IBUPROFEN SIRUP 100 mg / 5 ml 1 Botol 2,475 16 27 27

128 INFUS ASERING/WIDABES 1 Botol 9,646 2 72 72

129 INFUS KA-EN 3 B 1 Botol 10,696 - -

130 INFUS PAN AMIN-G 1 Botol 47,788 - 20 20

131 ISOSORBID 5 MG 100 Tablet 89 12 - -

132 JELLY/Cathejell Lidocain 2% 1 Tube 41,600 - - 80 80

133 KALSIUM LACTAT 500 mg 100 Kotak 56 3,026 9,700 21,700 31,400

134 KETOKONAZOLE KRIM 2 % 25 Tube 2,518 15 64 64

135 KETOKONAZOLE 200 mg 50 Tablet 280 68 1,190 1,190

1 2 3 4 5 6

136 KETOROLAC INJEKSI 1 Ampul 1,045 - -

137 KLINDAMISIN KAPS 300 MG 100 Tablet 1,540 115 - -

138 KLINDAMYCIN 150 mg 50 Tablet 715 - -

139 KLORAMFENICOL TM 0,5% 1 Botol 3,250 19 75 75

140 KLORAMFENIKOL 250 mg 100 Tablet 310 - -

141 KLORAMFENIKOL 500 mg/CHLORAMEX 100 Tablet 1,090 621 1,640 1,640

142 KLORAMPHENICOL INJ 1 Vial 13,970 - -

143 KLORAMPHENICOL SIRUP 1 Botol 4,700 52 205 205

144 KLORAMPHENICOL SK 24 Tube 3,008 9 28 28

145 KLORAMPHENICOL SM 25 Tube 1,881 15 287 287

146 KLORAMPHENICOL TM 0,5 % 1 Botol 3,250 19 75 75

147 KLORAMPHENICOL TT 1 Flash 1,757 - -

148 KLORFENIRAMIN/ CTM 4 mg 100 Tablet 22 1,598 12,075 12,075

149 KLORPROMAZIN 100 mg 100 Kotak 14,400 138 875 875

150 KLORPROMAZIN 25 MG/1 ml INJ. 30 Ampul 1,243 - -

151 KLORPROMAZIN INJ. 30 Ampul 1,205 - -

152 KOTRIMOXAZOL 120 mg 100 Tablet 72 - -

153 KOTRIMOXAZOL 480 mg 100 Tablet 129 1,045 1,100 4,000 5,100

154 KOTRIMOXAZOLE SYIRUP 100 Botol 2,140 69 198 62 260

155 LEVEMIR 1 Vial 83,950 - 10 5 15

156 LIDOKAIN INJEKSI COMB. 30 Ampul 1,145 142 - 2,169 2,169

157 LOPERAMID 2 MG 100 Tablet 400 422 - 1,465 1,465

158 LORATADIN 10 MG 50 Tablet 123 61 - 4,900 4,900

159 MAGNESIUM SULFAS INJ.20% 120 Botol 3,328 2 30 30

160 MAGNESIUM SULFAS INJ.40% 120 Botol 3,796 2 40 40

161 METFORMIN 500 mg 100 Tablet 96 469 3,630 3,630

162 METFORMIN 850 mg 100 Tablet 156 - -

163 METHIL ERGOMETRIN 0,125 TAB 100 Tablet 210 18 1,190 1,190

164 METHISOPRINOL 500Mg 50 Tablet 3,300 - -

165 METIL ERGOMETRIN INJEKSI 30 Ampul 2,959 10 61 61

166 METILPREDNISOLON 4 MG 100 Tablet 134 31 10 10

167 METILPREDNISOLON INJEKSI 1 Botol 12,090 9 - -

168 METOCLOPRAMIDE DROP 100 Botol 3,900 56 175 175

169 METOCLOPRAMIDE INJEKSI 30 Ampul 3,960 31 20 435 455

170 METOCLOPRAMIDE TAB 10 MG 100 Tablet 87 - -

171 METOKLORPAMIDE SIRUP (lexapram) 1 Botol 2,650 3 112 60 172

 1 2 3 4 5 6

172 METOKLORPAMIDE TAB 5 MG 100 Tablet 121 168 1,020 1,600 2,620

173 METRONIDAZOLE 250 mg 100 Tablet 89 872 4,559 4,559

174 METRONIDAZOLE 500 mg 100 Tablet 113 11 - -

175 METRONIDAZOLE INFUS 1 Botol 8,110 - -

176 METRONIDAZOLE SIRUP 1 Botol 3,800 6 22 22

177 MICONAZOL KRIM/SALEP 24 Tube 3,414 42 33 119 152

178 Na Cl INFUS 1 Botol 6,410 170 963 963

179 NA.DIKLOFENAC 25 mg 50 Tablet 132 634 - - -

180 NA.DIKLOFENAC 50 mg 50 Kotak 115 23 9,750 9,750

181 NATURAL HEPATOPROTEKTOR 30 Kapsul 2,795 - -

182 NATURAL VITAMIN MATA(Ocugard) 30 Tablet 4,728 - -

183 NIFEDIPIN 10 Mg 100 Tablet 129 193 1,000 1,000

184 NISTATIN VAG. 100.000 IU 100 Botol 545 - -

185 NOVORAPIDE 1 Pen 87,000 1 50 23 73

186 OBH SYRUP 1 Botol 5,566 - -

187 OMEPRAZOLE 20 mg 30 Tablet 140 - -

188 OXITOCIN INJ 100 Ampul 9,460 52 980 980

189 OXYTETRA SM 25 Tube 2,500 - -

190 PAPAVERIN 40Mg 100 Tablet 660 - -

191 PARASETAMOL 100 mg 100 Tablet 49 - -

192 PARASETAMOL 500 mg 100 Tablet 53 5,198 22,840 500 23,340

193 PARASETAMOL DROP 1 Botol 5,200 5 - -

194 PARASETAMOL SIRUP 1 Botol 1,010 298 566 250 816

195 PARASETAMOL/PROPYRETIC SUPP 12 Supp 8,000 - -

196 PIRACETAM 400mg 1 Vial 7,700 - -

197 PIRACETAM INJEKSI 1gr 10 Ampul 6,600 - -

198 PIRANTEL 125 MG 100 Tablet 269 - -

199 PIRANTEL SIRUP 125 mg/5 ml 1 Tablet 9,510 4 - -

200 PIRIDOXIN HCL 10 MG TAB 100 Tablet 123 787 1,984 1,984

201 PIROXICAM 10mg 100 Tablet 300 100 - -

202 PREDNISON TAB 100 Tablet 68 2,768 - 1,154 1,154

203 PROPANOLOL HCl 10 mg 100 Tablet 60 - -

204 PROPANOLOL HCl 40 mg 100 Tablet 74 - -

205 PTU 100mg 100 Tablet 432 - -

206 PULMICORT 0,5 mg (Budesonide) 20 Botol 13,242 - 200 200

207 RANITIDIN 150 mg 100 Tablet 214 516 - - -

 1 2 3 4 5 6

208 RANITIDIN INJEKSI 10 Ampul 1,155 105 740 1,971 2,711

209 RETINOL 100.000 IU 50 Kotak 14,200 - -

210 RETINOL 200.000 IU 50 Kotak 25,850 - -

211 RINGER LACTAT INFUS 1 Botol 7,150 450 242 - 242

212 SABU I ( BIO SAVE ) 1 Kotak 479,996 - -

213 SALBUTAMOL 2 mg 100 Tablet 63 258 625 40 665

214 SALBUTAMOL 4 mg 100 Tablet 78 52 2,380 2,380

215 SALEP 2-4 24 Tube 2,620 3 2 94 96

216 SALICYL BEDAK 2% 1 Pak 2,420 25 21 235 256

217 SCABIMITE CREAM 10 gram 1 Tube 12,155 2 101 101

218 SEDIAAN ANALGESIK KOMBINASI 30 Vial 19,250 - -

219 SEDIAAN ANTI INFLUENZA 100 Kaplet 797 - -

220 SEDIAAN ANTI MIKROBA salep kulit 24 Tube 2,010 - -

221 SEDIAAN MENGANDUNG ZINK DROP 1 Botol 29,040 - -

222 SEDIAAN STERIL ANALGESIK (NORAGES) 10 Ampul 9,185 - -

223 SEDIAAN UROLITAS (Cystone) 100 Kapsul 3,078 - -

224 SEFADROXIL 500 CAPSUL 100 Tablet 450 907 2,920 - 2,920

225 SEFADROXIL SYIRUP 125 mg/5ml 1 Botol 3,980 10 39 13 52

226 SIANOCOBALAMIN (B12) TAB 250 Tablet 51 - -

227 SIANOKOBALAMIN HCL/B12 INJ. 100 Ampul 1,035 258 -

228 SIKZONOATE INJ/ MODECATE 5 Ampul 59,800 3 - -

229 SIMVASTATIN 10 Mg 30 Tablet 110 - -

230 SIMVASTATIN 20 Mg 50 Tablet 229 162 -

231 SIRUP ANTITUSIF KOMBINASI ANAK 1 Botol 11,550 - -

232 TETAGAM 1 Ampul 176,800 - -

233 TETRASIKLIN 250 MG 100 Tablet 149 - -

234 TETRASIKLIN 500 MG 100 Tablet 310 14 - -

235 THIAMFENICOL 500 100 Tablet 2,110 - -

236 THIAMIN HCL ( BI ) 50 MG 100 Tablet 85 884 14,715 14,715

237 THIAMIN HCL ( BI ) Injeksi 30 Ampul 1,139 - -

238 TRAMADOL INJEKSI 5 Ampul 1,764 - 50 50

239 TRIHEXYPENIDIL 2 MG 100 Tablet 80 167 - -

240 VIT.B.COMPLEX INJEKSI 10 Ampul 6,600 - -

241 VIT.B.COMPLEX TAB 100 Tablet 83 4,224 100 3,310 3,410

242 ZINK SIRUP 20 mg/5ml (ZIRCUM) 1 Botol 4,788 - -

243 ZINK 20 MG TAB 100 Tablet 513 - -

1 2 3 4 5 6

BAHAN MEDIS HABIS PAKAI

1 ALAT SUNTIK 0,05 ML 100 Pcs 1,656 42 - -

2 ALAT SUNTIK 0,5 ML 100 Pcs 1,195 42 100 - 100

3 ALAT SUNTIK 1 ML 100 Pcs 650 1 500 500

4 ALAT SUNTIK 10 ML 100 Pcs 976 0 795 795

5 ALAT SUNTIK 2,5 ML 100 Pcs 650 - -

6 ALAT SUNTIK 3 ML 100 Pcs 792 1,395 3,110 7,910 11,020

7 ALAT SUNTIK 5 ML 100 Pcs 968 304 917 917

8 ALKACIDE 1L 1 Botol 2,702,700 - 2 2

9 ALKAZYME 25 Sachet 801,000 - 2 2

10 AQUABIDEST (Water One) 1 ltr 1 Botol 14,960 - 20 20

11 BLUE TIPS 1000 piece 236,600 - -

12 CAT GUT CHROMIC 2/0 DS 24 MM-19 MM 12 piece 40,934 - 17 17

13 CAT GUT CHROMIC 3/0 HR 26 MM - 20 MM 12 piece 34,664 1 6 6

14 CAT GUT PLAIN HR 2/0 26 MM - 19 MM 12 piece 40,934 10 50 50

15 COVER GLASS 20X20 1 Box 125,743 1 - -

16 CYBOW (URINE TEST) 100 Botol 138,250 0 - -

17 DACLON 6/0 DS 12 MM 12 38,555 - 24 24

18 DERMAFIX T 5 X 7 CM 1 Kotak 1,629 - 50 50

19 FOLLEY CATETER 16 10 Pcs 10,340 9 160 160

20 FOLLEY CATETER 18 10 Pcs 10,890 - 30 30

21 GEL USG 1 Botol 12,584 - 3 3

22 HAND SCOEN Non Steril S,M free pwdr 1 Kotak 60,109 - -

23 HAND SCOEN steril uk. 7/7,5 1 Kotak 4,038 171 - -

24 HANDRUB 500ml 10 Botol 608,000 1 203 203

25 INFUS SET ANAK 100 Piece 7,920 44 318 641 959

26 INFUS SET DEWASA 100 Piece 7,920 135 253 100 353

27 IV Dressing 6x7 P 100 Pcs 220,000 - -

28 IV. CATHETER NO. 18 100 Pcs 7,700 29 234 234

29 IV. CATHETER NO. 20 100 Pcs 16,250 34 1,836 1,836

30 IV. CATHETER NO. 22 50 Pcs 10,395 112 243 1,090 1,333

31 IV. CATHETER NO. 24 50 Pcs 10,395 42 400 2,085 2,485

32 JARUM NOVO NORDISK N 32 GX5 mm 100 Pcs 2,083 - -

33 KAPAS BERLEMAK 500 gr 1 Roll 16,500 - -

34 KAPAS PEMBALUT/ABSORBEN 250 MG 1 ROLL 12,500 10 14 134 148

35 KASA hydrofil ( 40 yard X 80 cm ) 1 Roll 105,000 4 30 30

1 2 3 4 5 6

36 KASA 4 M X 15 CM 1 Roll 2,100 18 - 465 465

37 KASA 4 M X 3 CM 1 Roll 590 42 - -

38 KASA Hidrofil 2MX 80CM 100 Kotak 9,400 - -

39 KASA KOMPRES steril 40X40 1 Roll 1,600 11 80 427 507

40 KASA Steril DRC 16 X 16 100 Kotak 7,900 16 550 550

41 Leukoplast 2,5cm x 4,5m 1 Roll 12,076 7 - -

42 Leukoplast 7,5cm x 4,5m 1 Roll 35,532 3 - -

43 LISOL 50% 1 ltr 1 Botol 41,000 1 - 3 3

44 MASKER 1 Kotak 16,947 743 750 790 1,540

45 MESS/ SCALPEL BLADE No.15 1 Box 279,000 9 695 695

46 OBJEK GLASS 7105 72 Pcs 20,747 - -

47 PERHIDROL 3% 1 Botol 19,800 - -

48 PLASTER Ecare 2 inci (18352) 6 Kotak 15,333 2 180 7 187

49 PLESTER 5 YARD 1 Roll 35,532 - -

50 POVIDON IODINE 1 LITER 1 Botol 79,650 1 7 7

51 POVIDON IODINE 300 ML 1 Botol 18,000 2 - -

52 POVIDON IODINE 60 mL 1 Botol 3,700 3 22 22

53 POVIDON YODIDA 30 ML 1 Botol 2,400 39 12 12

54 SELANG OXYGEN ANAK 1 Pcs 9,631 - -

55 SELANG OXYGEN DEWASA 1 Pcs 9,630 - -

56 SELANG OXYGEN MASKER 1 Pcs 24,360 - -

57 SILK BLACK 2/0 DS 24 MM - 19 MM 12 Pcs 24,701 12 87 329 416

58 SILK BLACK 2/0 HR 26 MM - 30 MM 12 Pcs 21,571 13 280 280

59 SILK BLACK 3/0 DS 24 MM - 19 MM 12 Pcs 23,921 - -

60 SILK BLACK 3/0 HR 26 MM - 30 MM 12 Pcs 21,051 - -

61 SPALK KAYU 1 Buah 61,600 - -

62 STERICLIN FLAT 20CM X 200M 1 Roll 1,538,000 - -

63 STERICLIN FLAT 7,5CM X 200M 1 Roll 705,000 - -

64 STERICLIN GUSSETE 15CM X 5CM 1 Roll 1,056,000 - -

65 STERICLIN GUSSETE 20CM X 5CM 1 Roll 1,271,000 - -

66 STERICLIN GUSSETE 25CM X 6,5M 1 Roll 1,542,000 - -

67 STIK GDA On CALL Plus 25 Botol 183,833 - -

68 STIK Asam Urat (Benecheck) 1 Botol (25) 127,973.48 - -

69 STIK Gula Darah (Benecheck) 1 Botol (50) 152,133.78 - -

70 STIK Kolesterol (Benecheck) 1 Botol (10) 232,637.55 - -

71 TES KEHAMILAN 1 Pcs 1,939 3 - -

1 2 3 4 5 6

72 Test trip Cholesterol (easy touch) 10 strip Pak 282,700.00 - -

73 Test trip Cholesterol (Nesco) 10 strip Pak 286,000.00 - -

74 Test trip Glukosa (easy touch) 25 strip Pak 147,400.00 - -

75 Test trip Glukosa (Nesco) 25 strip Pak 154,000.00 - -

76 Test trip Urid Asid (easy touch) 25 strip Pak 147,500.00 - -

77 Test trip Urid Asid (Nesco) 25 strip Pak 159,500.00 - -

78 UNDERPAD 60 X 90 1 Pcs 4,759 32 929 929

79 URINE BAG 100 Pcs 5,005 3 14 14

80 WHITE TIPS 100 Pcs 97,300 - -

81 YELLOW TIPS 1000 Pcs 185,200 - -

82 ETHIL KLORIDA - 4 4

BAHAN GIGI (E Katalog)

1 ABDER SINGLE BOND2 6 gr Botol 260,925 - -

2 ALGENIUX 1 453 gr Pak 102,800 - -

3 ANTI SEPTIC LIQUID NO.2 100 ml Botol 64,000 - -

4 ATTAQUE GEL 3X3 Syringe 1 Tube 97,000 - -

5 BIOCLASS C 1 Set 356,000 - -

6 BULK FILL 1 Syringe 276,246 - -

7 CALCETIN CAVITY LINER PASTE 7G 7 gr Syringe 134,000 - -

8 CALCIGEL 3 gr Syringe 87,000 - -

9 CALPLUS 1 Pak 87,000 - -

10 CAMPHENOL 15 ml Botol 65,000 - -

11 CAVIT G RF 28G 28 gr Pak 115,365 - -

12 CAVIT RF 28G 28 gr Pak 122,400 - -

13 CAVIT W 28 gr Pak 109,714 - -

14 CLOREXORAL 2% 1 Botol 208,000 - -

15 CRESOTIN LIQUID NO.2 15 ml Botol 160,500 - -

16 CRESOTIN PASTE 25 gr Pot 112,000 - -

17 EDTA GEL 2 x 3 gr Pak 206,000 - -

18 ENDOSEAL 1 Pak 167,000 - -

19 EPOXIDIN ROOT CANAL 1 Tube 417,000 - -

20 ETCHANT GEL VIAL 9ML 1 Botol 120,227 - -

21 FILLTEMP 1 Pak 120,000 - -

22 FILTEK P60 A3 4 gr Syringe 215,504 - -

23 FILTEK Z250 XT A3 1 Syringe 187,725 - -

24 GUTTA PERCHA POINT 15/40 1 Pak 45,000 1 - -

1 2 3 4 5 6

25 GUTTA PERCHA POINT 45/80 1 Pak 45,000 1 - -

26 HYDCAL 1 Set 133,000 - -

27 HYPOSOL 500 ml Botol 77,000 - -

28 IODOTIN PASTE IN JAR 25 gr Pot 95,500 - -

29 KETAC MOLAR 1 Set 388,791 - -

30 KETAC UNIVERSAL INTRO KIT A3 1 Set 437,547 - -

31 LT CURE ION 1 Set 502,786 - -

32 MASTER BOND 5 ml Botol 237,000 - -

33 MASTER FILL 4 gr Syringe 152,000 - -

34 MASTER FLOW 2 gr Syringe 174,000 - -

35 MICRON SUPERIOR Pak 270,000 - -

36 ORAFIL PLUS 40 gr Botol 52,000 - -

37 PARAMONOCHLOROFENOL 20 ml Botol 65,000 - -

38 POLIREN PASTA NO.1 45 gr Pot 167,000 - -

39 PULP-X 6 gr Pot 217,000 - -

40 RELYX TEMP NE 1 Set 301,086 - -

41 RELYX U200 A2 11 gr Pcs 528,838 - -

42 RELYX U200 A3 11 gr Pcs 547,596 - -

43 RELYX ULTIMATE CLIKER A1 4,5 gr Pcs 636,833 - -

44 RELYX ULTIMATE CLIKER A3 4,5 gr Pcs 657,241 - -

45 RETRAFLEX 1 Set 140,000 - -

46 ROOTDENT QUICK 10 x 2,5 gr Pak 311,800 - -

47 SCOTCHBOND UNIVERSAL ETCHANT 3 ml Gel 385,268 - -

48 SOF LEX DIAMOND SPIRAL 1 Set 893,806 - -

49 SOF LEX EXTRA XTHIN FINE 30 Buah 109,756 - -

50 SOF LEX PREPOLISH SPIRAL 1 Set 389,275 - -

51 SOF LEX XTHIN COARSE 30 Buah 109,755 - -

52 SOF LEX XTHIN MEDIUM 30 Buah 109,751 - -

53 SOF LEX XTHIN/SFINE 30 Buah 109,754 - -

54 TRICRESOL FORMALINA 10 ml Botol 72,000 - -

55 VARNAL Botol 71,000 - -

56 ZINC F 1 Set 151,000 - -

57 ZITEMP 1 Set 64,000 - -

REAGEN

1 ALBUMIN 1000 ml Botol 739,200.00 1 - -

2 BILIRUBIN T/D 2 x 100 ml Set 850,300.00 - -

1 2 3 4 5 6

3 Cell Clean (CL - 50) 50 ml Botol 1,210,000.00 - -

4 Cell Pack (PK-30L) 20 LITER Botol 1,980,000.00 - -

5 CHOLESTEROL 4 x 100 ml Set 2,093,300.00 - -

6 CREATININ 200 ml Botol 733,920.00 - -

7 E-Check XS (LNH) kontrol 3 X 1,5 ML Botol 2,643,300.00 - -

8 EDTA 1x100 ml Botol 76,600 - -

9 EOSIN 2% 1x100 ml Botol 178,725 - -

10 GLUCOSE 4 x 100 ml Set 889,570.00 - -

11 GOL DARAH A 1 BOTOL 440,000.00 - -

12 GOL DARAH AB 1 BOTOL 440,000.00 - -

13 GOL DARAH B 1 BOTOL 440,000.00 - -

14 GOL DARAH O 1 BOTOL 440,000.00 - -

15 GOT (ASAT) 8 x 50 ml Set 2,028,400.00 1 - -

16 GPT (ALAT) 8 x 50 ml Set 2,028,400.00 1 - -

17 HCL 0,1N 1x100 ml Botol 22,331 - -

18 IMMERSION OIL 1x100 ml Botol 370,150 - -

19 Reagen fotometer (serum kontrol) 1 Botol 1,498,640.00 - -

20 Reagen hematologi ( serum kontrol ) Abacus 3 2 ml Kit 418,000.00 - -

21 reagent diatro cleaner Abacus 3 1 L Botol 313,500.00 - -

22 Reagent diluent Abacus 3 20 L Botol 1,650,000.00 - -

23 reagent lyse Abacus 3 1 L Botol 1,595,000.00 - -

24 Stromatolyser - 4DL (XS) 2 LITER Botol 2,778,600.00 - -

25 Stromatolyser - 4DS 42 ML Botol 2,599,300.00 - -

26 Sulfolyser (SLS - 210A) 500 ML Botol 679,800.00 - -

27 TOTAL PROTEIN 1000ml Botol 915,750.00 - -

28 TRIGLYCERIDA 4 x 100 ml Set 3,021,810.00 - -

29 TYPOID H Tiphy 1 Botol 25,893 - -

30 TYPOID O-A Paratiphy 1 Botol 25,906 - 25 25

31 TYPOID O-B Paratiphy 1 Botol 25,906 - 25 25

32 TYPOID O-D Paratiphy 1 Botol 25,906 - -

33 UREA FS 2 x 100 ml Set 690,690.00 - -

34 URIC ACID 4x100 ml Set 1,870,660.00 - -

TAMBAHAN

KETOPROFEN 100 MG 100 TAB

1,735 - -
KETOPROFEN INJ 100 MG 10 AMP
40,000 - -
Glukonas Kalsikus injeksi 10 % ampul
1 2 3 4 5 6

PLESTER HYPAFIX BESAR BOX

C0-AMOXYCLAV 500MG/125 MG TABLET

NORETISTERON/PRIMOLUT N 5 MG TABLET

ONDANSENTRON INJ 4MG/2 ML AMPUL

BIONIC DROPS FLS

PEHACAIN INJEKSI AMPUL

KALIUM DIKLOFENAK 50 MG TABLET

HUFABION CAPSUL

BLOOD TRANSFUSION SET SET

KLORAMPHENICOL TT FLS

MESS/Scalpel Blade NO.15 BOX

OBJEK GLASS KOTAK FROSTED KOTAK

ULTRA ONE TEST KEHAMILAN PCS

BECEFORT SYR BTL

MELOXICAM TABLET

TABUNG K3EDTA BOX

STICK ON CALL PLUS BOX

HBS AG BOX

HBS AB BOX

Alginate 1 Botol -

Alvogyl Box -

Calcium Hydroxide Paste Box -

CARPULA CITOJECT Box -

Cement Zinc Fosfat/Semen seng fosfat (Powder
Box -
Liquid)
CHKM ( Chlorophenol Champor Mentol ) Box -

CITOJECT NEDLE Box -

Composit Set (untuk Anterior, Posterior: 4 syringe,
Filtek 250 kit
1 etcha, 1 bonding, 25 tip applicators, 25 etcha -
set
dispending, 1 shade guide)
Cotton Roll Pak -

Dental Gypsum Type II (Putih) Zak -

Dental Gypsum Type III (Biru)/promodel Zak -

Devitalisasi Paste Box -

ETIL KLORIDA 1 Botol -

Glass Ionomer Cement/GIC (Powder liquid untuk
Kit -
anterior, posterior)
Spongoston Dental/Hemospon/Spon Gelatin Box -

TRIKRESOL FORMALIN (TKF)/Formokresol Box -

Tumpatan Sementara Box 28 gr -

1 2 3 4 5 6

Mengetahui,
Kepala Puskesmas Pasean

Kusmanto, S.Kep, Ns.

NIP. 19671026 199103 1 007
DAN BMHP PUSKESMAS TAHUN 2019

USULAN 2019
USULAN
KEBUTUHAN KAPITASI 2019
DAK KAPITASI
+ HARGA 2018

7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

- 500 500 937,750

- -

- -

8,410 7,000 21,000 2,037,000

5,340 3,000 2,000 420,000

- -

(370) -

(25,000) 6,000 8,000 1,648,000

- 200 100 2,937,000

- 390 200 1,173,200

(20) -

3,600 500 500 40,000

169 100 200 599,600

- -

(320) 500 -

- 5000 15000 1,559,999

1,800 3000 8000 679,999

(703) 30000 -

18,758 60000 40000 9,320,000

288 1200 900 1,692,900

(104) -

- 30 -

- -

- 10 -

- -

285 20000 15000 4,845,000

286 340 204 1,884,958

7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

233 500 600 2,100,000

22,430 20000 40000 2,160,000

290 500 1000 1,995,000

(1,985) 5000 -

- 300 300 3,099,600

30 300 -

- -

- 24 -

- -

- 100 30 363,000

- -

- -

(220) 300 700 1,925,000

118 500 500 874,000

5,745 3000 1000 164,000

(4,100) 3000 1000 104,005

- 5,600 -

103,483 50000 50000 5,300,000

- 500 -

(58) 4500 2800 672,000

(418) 4500 3400 816,000

3 200 400 1,198,800

55 100 -

(15) 5 -

- -

- -

15 -

146 800 600 804,000

1,035 6000 -

(200) 0 100 712,400

- -

7,655 20000 40000 2,999,999

- -

2,987 400 500 2,100,000

(775) 1000 -

50 50 -
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

- -

5,980 5000 5000 6,000,000

- 60 100 1,188,000

- -

178 100 -

3,993 40000 30000 960,000

271 100 200 219,400

- 200 -

(1,000) -

- -

- 1000 100 215,000

188 2000 4000 4,380,000

450 300 -

- -

(40) 2000 1000 85,000

134 -

(233) -

(120) -

- 600 100 944,167

117 100 200 281,600

450 -

(400) -

- -

- 100 -

- 60 100 2,500,000

- -

- -

- -

- -

- -

- 200 -

(3,000) 6600 5600 3,976,000

743 620 280 994,000

(1,518) 7800 3400 261,800

- 500 300 399,900

(326) 4000 -
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

853 2640 7200 2,678,400

- -

150 -

(10) -

35 -

- 24 -

240 20000 40000 4,760,000

(1,195) 2000 -

- -

- -

- -

5,882 40000 30000 7,800,000

- -

- -

- 100 50 660,000

(575) 1000 -

18 5400 3900 819,000

- -

- -

750 -

- 2000 -

5,900 -

- -

- -

125 780 440 1,089,000

4,025 8000 10000 1,020,000

17,180 15000 20000 2,220,020

255 100 200 495,000

(30) -

- -

(20) -

210 500 -

(80) -

23,065 5000 5000 280,000

197 200 300 755,400

25 3000 1000 280,000

7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

- 500 522,500

2,070 1000 -

- 3000 -

258 440 200 650,000

- 8600 5600 1,736,000

9,543 3200 3200 3,488,000

- 300 -

724 200 300 1,410,000

131 500 300 902,400

(22) 300 400 752,400

258 -

- 300 300 527,100

16,692 30000 60000 1,320,000

1,600 -

- -

- 2000 -

- -

13,709 5000 5000 644,985

975 300 500 1,070,000

(15) -

380 400 500 572,500

6,133 5000 5000 2,000,000

(3,805) 2200 5800 713,400

- 10 -

(10) 10 -

4,815 14800 27600 2,649,567

- 5000 -

(875) -

- -

127 200 100 295,900

545 2000 5000 670,000

153 50 100 1,209,000

826 -

94 300 500 1,980,000

- -

(117) 300 -
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

395 3000 -

11,133 8000 -

195 8000 5000 565,000

- 20 162,200

80 300 50 190,000

607 200 100 341,400

2,094 6000 -

11,406 5600 6600 871,200

(9,345) 10000 21800 2,507,000

- 2000 1000 2,795,000

- 5000 1000 4,728,000

2,465 8800 6900 890,100

- 100 -

(63) -

- 500 -

- 200 -

(50) 500 300 2,838,000

- 100 50 125,000

- -

- 11400 17200 842,800

70,230 40000 30000 1,589,983

84 300 400 2,080,000

4,547 1860 1800 1,818,000

- 200 50 400,000

- 2000 300 2,310,000

- 100 200 1,320,000

- -

66 -

12,182 9800 2000 246,000

1,800 3000 6000 1,800,000

48,670 6000 5000 340,000

- -

- -

- -

(200) -

9,285 3000 3000 642,000

7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

(818) 800 700 808,500

- -

- -

7,858 10000 -

- 2 2 959,992

3,981 7100 6600 415,800

(1,450) -

(39) 400 -

185 200 50 121,000

(65) 400 -

- 100 1,925,000

- 7000 10000 7,970,000

- -

- -

- 300 500 4,592,500

- 100 -

13,400 4000 8000 3,600,000

136 600 400 1,592,000

- 3000 2000 101,200

4,652 2000 3000 3,105,000

45 50 10 598,000

- 6800 8000 880,000

2,909 8000 15000 3,435,000

- 100 1,155,000

- 100 5 884,000

- -

255 -

- 6000 3000 6,330,000

1,193 30000 20000 1,700,000

- 1000 1000 1,139,000

(50) 50 -

3,000 500 -

- 100 660,000

72,622 40000 30000 2,490,000

- 300 500 2,394,150

- 1000 2000 1,025,992

7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

750 -

650 -

(484) -

(788) -

- -

14,098 6000 9000 7,128,000

4,560 2000 3000 2,904,000

(2) -

(2) -

(20) 20 100 1,496,000

- -

(17) 200 100 4,093,383

9 200 100 3,466,383

126 200 100 4,093,383

23 -

2 -

(24) -

(50) 500 814,500

10 100 -

(30) 50 544,500

(3) -

- 600 100 6,010,908

3,078 1000 2000 8,075,980

(178) 50 10 6,080,000

(169) 500 600 4,752,000

2,083 800 1200 9,504,000

- 5 1,100,000

281 200 300 2,310,000

(1,221) 300 400 6,500,000

677 500 500 5,197,500

(1,737) 800 1000 10,395,000

- -

- -

34 68 200 2,500,000

44 68 60 6,300,000
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

(134) 300 200 420,000

750 200 500 295,000

- -

(315) 300 500 800,000

(265) 280 200 1,580,000

128 100 300 3,622,800

60 100 300 10,659,600

21 20 820,000

11,840 200 500 8,473,667

(538) -

- -

- 40 60 1,188,000

(144) -

- 20 710,640

5 12 10 796,500

30 68 50 900,000

25 120 100 370,000

692 620 300 720,000

- -

- -

- -

(197) 200 -

(40) 200 -

- 200 -

- 200 -

- -

- -

- -

- -

- -

- -

- 20 3,676,667

- -

- -

- -

60 200 387,800
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

- -

- -

- -

- -

- -

- -

(353) 400 -

45 50 100 500,500

- -

- -

(4) 50 -

- 2 521,850

- -

- 4 256,000

- -

- -

- 2 552,492

- 2 268,000

- 2 174,000

- 2 174,000

- 2 130,000

- 1 115,365

- 1 122,400

- 1 109,714

- 1 208,000

- 1 160,500

- 1 112,000

- -

- 1 167,000

- 1 417,000

- -

- -

- -

- -

18 -
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

18 -

- -

- -

- -

- -

- -

- -

- 2 474,000

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

- -

18 1 739,200

- 1 850,300
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

- -

- -

- 3 6,279,900

- 1 733,920

- -

- 2 153,200

- -

- -

- -

- -

- -

- -

18 1 2,028,400

18 1 2,028,400

- -

- 1 370,150

- 1 1,498,640

- 18 7,524,000

- 7 2,194,500

- 14 23,100,000

- 7 11,165,000

- -

- -

- -

- 1 915,750

- 3 9,065,430

- 12 310,715

(25) 12 310,878

(25) 12 310,878

- 12 310,878

- 1 690,690

- 3 5,611,980

1,000 500
- 867,500
100 50
- 2,000,000
122 56
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

500

100

100

200 150

1,000 2,000

1,500

5,000

100 300

100 100

30

500

300 100

5,000 -

36

50

- - 4

- - 2

- - 2

- - 2

- - 4

- - 24

- - 4

- - 2

- - 10

- - 2

- - 2

- - 12

- - 12

- - 12

- - 1

- - 12

- - 12
7=(Kolom 5 x 18 10 = Kolom 4 x
8 9
bln)-Kolom 6 Kolom 9

Pengelola Obat Puskesmas

Agus Robbian Fenny

NIP. 19820825 200903 1 002