RENCANA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP) TAHUN 2022

SATUAN KERJA :

JUMLAH RENCANA RENCANA RENCANA REALISASI

SISA STOK PER RATA-RATA PER
NO NAMA OBAT SATUAN KEBUTUHAN KEBUTUHAN PENGADAAN PENGADAAN PENGADAAN
DESEMBER 2020 BULAN SELAMA
(a) (b) TAHUN
(c) = (b)2022
x 18 TAHUN
(d) = (c)2022
- (a) TAHUN
(e) 2022 TAHUN
(f) 2021 TAHUN
(g) 2020
1 Air untuk injeksi amp 20 ml ampul/vial/botol 0 0
2 Air untuk injeksi amp 25 ml ampul/vial/botol 25 mL 0 0
3 Albendazol susp 200 mg/5 ml Botol 0 0
4 Albendazol tab 400 mg tablet/kapsul/kaplet 0 0
5 Alopurinol tab 100 mg Tab 0 0
6 Alopurinol tab 300 mg tablet/kapsul/kaplet 0 0
7 Aminofilin inj 24 mg/ml ampul/vial 10 ml 0 0
8 Aminofilin tab 150 mg tablet/kapsul/kaplet 0 0
9 Aminofilin Tab 200 mg tablet/kapsul/kaplet 0 0
10 Amitriptilin tab sal 25 mg tablet/kapsul/kaplet 0 0
11 Amlodipin tab 10 mg tablet/kapsul/kaplet 0 0
12 Amlodipin tab 5 mg tablet/kapsul/kaplet 0 0
13 Amoksisilin drops 100 mg/ml Botol 0 0
14 Amoksisilin sir forte 250 mg/5 ml botol 60 ml 0 0
15 Amoksisilin sir kering 125 mg/5 ml Botol 0 0
16 Amoksisilin tab 250 mg tablet/kapsul/kaplet 0 0
17 Amoksisilin tab 500 mg tablet/kapsul/kaplet 0 0
18 Ampisilin serb inj 1000 mg/vial ampul/vial 0 0
19 Ampisilin serb inj 250 mg/vial Vial 0 0
20 Anestetik lokal gigi kombinasi : lidokain hcl ampul/vial 0 0
Antasida, kombinasi
2% + epinefrin : aluminium
1 : 80.000 inj 2 ml
21 hidroksida 200 mg + magnesium
Antasida, kombinasi : aluminium tablet/kapsul/kaplet 0 0
22 hidroksida
hidroksida 200
200 mg
mg + magnesium botol 60 ml 0 0
Anti Parkinson
hidroksida 200 kombinasi
mg : benzerasid 25
23 Kaps 0 0
mg + levodopa
Antifungi salep,100 mg
kombinasi : asam benzoat
24 pot 30 g 0 0
6%+ asam salisilat 3%
 Antihemoroid, kombinasi: bismut subgalat
150 mg + heksaklorofen 2,5 mg + lidokain
25 Suppositoria 0 0
lidokain 10 mg+ seng oksida 120 mg + sup
ad 2 g

26 Artesunat serb inj 60 mg/ml (i.v./i.m.) ampul/vial 0 0

27 Articulating paper kertas warna penanda Kertas warna penanda 0 0
oklusi oklusi
28 Asam asetat tetes telinga 2% Botol 0 0
29 Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/kaplet 0 0
30 Asam askorbat (vitamin C) tab 250 mg Tab 0 0
31 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/kaplet 0 0
32 Asam folat tab 0,4 mg tablet/kapsul/kaplet 0 0
33 Asam folat tab 1 mg tablet/kapsul/kaplet 0 0
34 Asam folat tab 5 mg Tab 0 0
35 Asam mefenamat kaps 250 mg tablet/kapsul/kaplet 0 0
tablet/kapsul/kaplet/kapta
36 Asam mefenamat kaps 500 mg 0 0
b
37 Asam salisilat lar 0,1% Botol 0 0
38 Asam salisilat salep 10% Tube 0 0
39 Asam salisilat salep 2% Tube 0 0
40 Asam salisilat salep 5% Tube 0 0
41 Asiklovir tab 200 mg tablet/kapsul/kaplet 0 0
42 Asiklovir tab 400 mg tablet/kapsul/kaplet 0 0
43 Atapulgit 600 mg tablet/kapsul/kaplet 0 0
44 Atapulgit tab 630 mg tablet/kapsul/kaplet 0 0
45 Atapulgit tablet 650 mg tablet/kapsul/kaplet 0 0
46 Atapulgit tablet 750 mg Tab 0 0
47 Atenolol tab 100 mg tablet/kapsul/kaplet 0 0
48 Atenolol tab 50 mg tablet/kapsul/kaplet 0 0
49 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul 0 0
50 Atropin tab 0,5 mg Tab 0 0
51 Bahan tumpatan sementara lar, serb Botol 0 0
52 Bedak salisil serb 2% Dus/Sachet/Plastik 0 0
53 Betametason krim 0,1% tube 5 gram 0 0
54 Betametason krim 0,5 mg/g Tube 0 0
55 Betametason salep 0,1% tube 5 gram 0 0
56 Betametason tts mata 1 mg/ml botol 0 0
57 Bisakodil sup 10 mg Suppositoria 0 0
58 Bisakodil sup 5 mg Suppositoria 0 0
59 Bisakodil tab sal 5 mg tablet/kapsul/kaplet 0 0
60 Budesonid cairan ih 0,25mg/ml Botol @ 4 ml 0 0
Budesonid cairan ih 0,25mg/ml, respoules
61 respoules 0 0
2 ml
62 Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml 0 0
Budesonid cairan ih 0,5 mg/ml, respoules
63 respoules 0 0
2 ml
64 Budesonid serb ih 100 mcg/dosis Botol 0 0
65 Budesonid serb ih 200 mcg/dosis 100 dosis 0 0
66 Budesonid serb ih 200 mcg/dosis 200 dosis 0 0
67 Coal tar lar 5 % Botol 0 0
68 Copper T set/buah 0 0
69 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial 0 0
70 Deksametason tab 0,5 mg tablet/kapsul/kaplet 0 0
71 Diazepam enema 10 mg/2,5 ml tube @ 2,5 mL 0 0
72 Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL 0 0
73 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial 0 0
74 Diazepam tab 2 mg tablet/kapsul/kaplet 0 0
75 Diazepam tab 5 mg tablet/kapsul/kaplet 0 0
76 Dietilkarbamazin tab 100 mg tablet/kapsul/kaplet 0 0
77 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial 0 0
78 Digoksin tab 0,25 mg tablet/kapsul/kaplet 0 0
79 Diltiazem hcl tab 30 mg tablet/kapsul/kaplet 0 0
80 Diltiazem kaps SR 100 mg Kapsul lepas lambat 0 0
81 Diltiazem kaps SR 200 mg Kapsul lepas lambat 0 0
82 Diltiazem tab 30 mg Tab 0 0
83 Dimenhidrinat tab 50 mg tablet/kapsul/kaplet 0 0
84 Doksisiklin kaps 100 mg tablet/kapsul/kaplet 0 0
85 Domperidon susp 5 mg/5 ml botol @60 ml 0 0
86 Domperidon tab 10 mg tablet/kapsul/kaplet 0 0
87 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) ampul/vial 0 0
88 Epinefrin (adrenalin) inj 1 mg/ml Ampul 0 0
89 Ergotamin tab 1 mg Tab 0 0
90 Eritromisin kaps 250 mg tablet/kapsul/kaplet 0 0
91 Eritromisin sir 200 mg/5 ml Botol @ 60 ml 0 0
 92 Eritromisin tab 500 mg tablet/kapsul/kaplet 0 0
tablet salut gula/kaplet
93 Estrogen terkonjugasi tab sal 0,625 mg 0 0
salut gula
94 Etanol 70% cairan 70% Botol 0 0
95 Etil klorida semprot 100 ml Botol 0 0
96 Etonogestrel implan 68 mg Set 0 0
97 Eugenol Botol 0 0
98 Fenitoin Na inj 50 mg/ml ampul @ 2 ml 0 0
99 Fenitoin Na kaps 100 mg Kaps 0 0
100 Fenitoin Na kaps 30 mg Kaps 0 0
101 Fenobarbital tab 100 mg Tab 0 0
102 Fenobarbital tab 30 mg tablet/kapsul/kaplet 0 0
Fenoksimetil penisilin (penisilin V) tab 250
103 Tab 0 0
mg
Fenoksimetil penisilin (penisilin V) tab 500
104 Tab 0 0
mg
105 Ferro fumarat kaps lunak 300 mg Kaps lunak 0 0
106 Ferro sulfat sir. 150 mg/5 ml Botol 0 0
107 Ferro sulfat tab salut 300 mg Tab sal 0 0
Fitomenadion (vitamin K 1) inj 2 mg/ml
108 ampul/vial 0 0
(i.m.)
109 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 0 0
Fitomenadion (vitamin K1) inj 10 mg/ml tablet salut gula/kaplet
110 0 0
(i.m) salut gula
111 Fluoksetin kaps 10 mg tablet/kapsul/kaplet 0 0
112 Fluor kapl 1 mg Kaplet 0 0
113 Fluor sediaan topikal Tube 0 0
114 Fluoresein tts mata 2,5 mg/ml Botol 0 0
115 Formokresol Botol 0 0
116 Framisetin Sulfat Tulle 1% Patch 0 0
117 Furosemid inj 10 mg/ml (i.v./i.m.) ampul/vial 0 0
118 Furosemid tab 40 mg tablet/kapsul/kaplet 0 0
119 Galactose microparticle 200-400 mg Vial 0 0
micropart/ml

Garam oralit kombinasi : natrium klorida

120 0,52 g + kalium klorida 0,30 g + trinatrium sachet 0 0
sitrat 0,58 g + glukosa anhidrat 2,7 g

121 Gentamisin salep mata 0,3% Tube 0 0

122 Gentamisin tts mata 0,3% Botol 0 0
 Glass ionomer ART (Atraumatic
123 Sachet 0 0
Restorative Treatment) cocoa butter 5 g

Glass ionomer ART (Atraumatic

124 Botol 0 0
Restorative Treatment) lar

Glass ionomer ART (Atraumatic

125 Vial 0 0
Restorative Treatment) serb
126 Glibenklamid tab 2,5 mg tablet/kapsul/kaplet 0 0
127 Glibenklamid tab 5 mg tablet/kapsul/kaplet 0 0
128 Glikuidon tab 30 mg tablet/kapsul/kaplet 0 0
129 Glimepirid tab 1 mg tablet/kapsul/kaplet 0 0
130 Glimepirid tab 2 mg tablet/kapsul/kaplet 0 0
131 Glipizid tab 5 mg tablet/kapsul/kaplet 0 0
132 Gliseril trinitrat tab 0,5 mg tablet/kapsul/kaplet 0 0
133 Gliserin tts 100 mg/ml Botol 0 0
134 Glukosa Larutan Infus 10% steril 100 ml Botol 0 0
135 Glukosa Larutan Infus 10% steril 250 ml Botol 0 0
136 Glukosa Larutan Infus 10% steril 500 ml Botol 0 0
137 Glukosa Larutan Infus 40% Ampul @25 ml 0 0
138 Glukosa Larutan Infus 5% steril 100 ml Botol 0 0
139 Glukosa Larutan Infus 5% steril 250 ml Botol 0 0
140 Glukosa Larutan Infus 5% steril 500 ml Botol 0 0
141 Griseofulvin (micronized) tab 125 mg tablet/kapsul/kaplet 0 0
142 Griseofulvin (micronized) tab scored 250 tablet/kapsul/kaplet 0 0
mg
143 Gutta percha dan paper points 15 - 40 mm Roll 0 0
144 Gutta percha dan paper points 45 - 80 mm Roll 0 0
145 Haloperidol inj 5 mg/ml (i.m.) Vial 0 0
146 Haloperidol tab 0,5 mg tablet/kapsul/kaplet 0 0
147 Haloperidol tab 1,5 mg tablet/kapsul/kaplet 0 0
148 Haloperidol tab 2 mg tablet/kapsul/kaplet 0 0
149 Haloperidol tab 5 mg tablet/kapsul/kaplet 0 0
150 Haloperidol tts 2 mg/ml botol 0 0
Hepatitis B imunoglobulin (human) inj 150
151 Ampul 0 0
IU/1,5 ml
152 Hidrogen peroksida cairan 3% Botol 0 0
153 Hidrogen peroksida lar. Konsentrat 3% Botol 0 0
154 Hidroklorotiazid tab 25 mg tablet/kapsul/kaplet 0 0
155 Hidrokortison krim 2,5% tube @ 5 g 0 0
156 Hidrokortison serb inj 100 mg Vial 0 0
157 Hiosina butilbromida tab 10 mg tablet/kapsul/kaplet 0 0
Human tetanus imunoglobulin inj 250 UI
158 Ampul 0 0
(i.m.)
Human tetanus imunoglobulin inj 500 UI
159 Ampul 0 0
(i.m.)
160 Ibuprofen sir 100 mg/5 ml botol @ 60 ml 0 0
161 Ibuprofen sir 200 mg/5 ml botol @ 60 ml 0 0
162 Ibuprofen tab 200 mg tablet/kapsul/kaplet 0 0
163 Ibuprofen tab 400 mg tablet/kapsul/kaplet 0 0
164 Ipratropium bromida aerosol 20 Botol 0 0
mcg/semprot
165 Ipratropium bromida cairan ih 0,025% Botol 0 0
166 Ipratropium bromida ih 20mcg/puff Botol 0 0
167 Isoniazid tab 100 mg Tab 0 0
168 Isoniazid tab 300 mg Tab 0 0
169 Isosorbid dinitrat tab 5 mg tablet/kapsul/kaplet 0 0
170 IUD Cu T 380 A Set 0 0
171 IUD Levonorgestrel Set 0 0
172 Kalamin Tube 0 0
173 Kalsium glukonat inj 100 mg/ml ampul/vial 0 0
174 Kalsium hidroksida bubuk, pasta Tube 0 0
175 Kalsium karbonat tab 500 mg tablet/kapsul/kaplet 0 0
176 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/kaplet 0 0
177 Kaptopril tab 12,5 mg tablet/kaplet 0 0
178 Kaptopril tab 25 mg tablet/kaplet 0 0
179 Kaptopril tab 50 mg tablet/kaplet 0 0
180 Karbamazepin sir 100 mg/5 ml Botol 0 0
181 Karbamazepin tab 100 mg Tab 0 0
182 Karbamazepin Tab 200 mg Tablet 0 0
183 Karbo adsorben tab 0,5 g Tab 0 0
184 Karbogliserin tts telinga 10 % Botol 0 0
185 Ketokonazol tab 200 mg tablet/kapsul/kaplet 0 0
186 Klindamisin kaps 150 mg Kaps 0 0
187 Klindamisin kaps 300 mg tablet/kapsul/kaplet 0 0
188 Klofazimin, micronized kaps 50 mg Kapsul 0 0
189 Klofazimin, micronizedkaps 100 mg kapsul 0 0
190 Klonidin tab 0,15 mg tablet/kapsul/kaplet 0 0
191 Kloramfenikol kaps 250 mg tablet/kapsul/kaplet 0 0
192 Kloramfenikol salep kulit 2% tube 15g 0 0
193 Kloramfenikol salep mata 1% tube @ 5 gram 0 0
194 Kloramfenikol susp 125 mg/5 ml botol 60 ml 0 0
195 Kloramfenikol tetes telinga 3% Botol 0 0
196 Kloramfenikol tts mata 0,5% botol 0 0
197 Kloramfenikol tts mata 1% Botol 0 0
198 Klorfeniramin tab 4 mg tablet/kapsul/kaplet 0 0
199 Klorfenol kamfer mentol (CHKM) Botol 0 0
200 Klorheksidin lar 0,2% Botol 0 0
201 Klorheksidin lar 15% Botol 0 0
202 Klorpromazin inj 25 mg/ml (i.m.) ampul/vial 0 0
203 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial 0 0
204 Klorpromazin tab sal 100 mg tablet salut selaput/kaplet 0 0
salut selaput
205 Klorpromazin tab sal 25 mg Tab sal 0 0
206 Klortalidon tab 50 mg Tab 0 0
207 Klozapin tab 100 mg tablet 0 0
208 Klozapin tab 25 mg tablet 0 0
209 Kodein tab 10 mg tablet/kapsul/kaplet 0 0
Kombinasi (DHP) : dihidroartemisin 40 mg tablet salut selaput/kaplet
210 0 0
+Kombinasi
Piperakuin 320 mg tab20
: artemether salmg
selaput
+ salut selaput
211 tablet/kapsul/kaplet 0 0
lumefantrin 120 mg
Kombinasi : artesunat tab 50 mg +
212 Tab 0 0
amodiakuin tab 200
Kombinasi : Desogestrel 150 mcg
213 Tab 0 0
Etinilestradiol 30 mcg
214 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/kaplet 0 0
Kombinasi : Ferro fumarat 60 mg + asam
215 tablet salut gula 0 0
folat 0,4 mg tab salut
Kombinasi : levonorgestrel 150 mcg +
216 tab salut gula 0 0
etinilestradiol 30 mcg
Kombinasi : Tenofovir 300 mg +
217 Tab 0 0
Emtrisitabin 200 mg
Kombinasi : Tenofovir 300 mg + Lamivudin
218 Tab 0 0
300 mg + Efavirenz 600 mg
219 Kombinasi: ipratropium Br 0,5 mg+ ampul/vial 0 0
salbutamol 2,5 mg nebules

220 Kombinasi: kaolin 550 mg + pektin 20 mg Tab 0 0

221 Komposit resin(dewasa) kombinasi :
Kotrimoksazol Set 0 0
222 sulfametoksazol 400 mg+ trimetoprim 80 tab/kaptab 0 0
mg
Kotrimoksazol (dewasa) kombinasi :
223 sulfametoksazol 800 mg+ trimetoprim 160 tab/kaptab 0 0
mg

Kotrimoksazol kombinasi tiap 5 ml

224 suspensi : sulfametoksazol 200 mg + botol 60 mL 0 0
trimetoprim 40 mg

225 Kuinin inj 25% (i.v.) Vial 0 0

226 Kuinin tab 200 mg tablet/kapsul/kaplet 0 0
227 Laktulosa sir 3,335 g/5 ml botol @ 60 mL 0 0
228 Larutan mengandung Elektrolit (Kalium Botol 0 0
Klorida)
Larutan mengandung Elektrolit (KCl 0,15%,
229 Botol 0 0
NaCL
Larutan0,9%) (KN1)
mengandung Elektrolit (KCl
230 Larutan mengandung Botol 0 0
0,3%,NaCl 0,9%) (KN2)Elektrolit (Na 130
231 mEq,
LarutanK 4mengandung
mEq, Cl 109 mEq, Ca 3(Na
Elektrolit mEq,130 Softbag @ 500 ml 0 0
232 Asetat 28 mEq) Ringer Asetat
mEq, K 4 mEq, Cl 109 mEq, Ca 3 mEq, Botol plastik @ 500 ml 0 0
233 Larutan
Asetat
Larutan mengandung
28 mEq) RingerElektrolit
mengandung Asetat (NaCl
Elektrolit (Sodium Botol 0 0
Larutan
1.125 gr,mengandung
Dekstrosa Elektrolit
18.75 gr) (Tiap
(KA 1000
EN 1B)
Lactate sol (50%) 113 gr/L, Potassium
ml mengandung electrolit: Sodium 145
234 Botol 0 0
Chloride 0.3 gr/L, Calcium
mmol/l, Potassium Chloride
4.0 mmol/l, 0.2
Calcium
235 gr/L, elektrolit)
Larutan mengandung Karbohidrat Botol 0 0
2.5 mmol/l, Magnesium 1.0 mmol/l,
236 (Fructose
Chloride 120mmol/l,
118
Larutan mengandungg, glucose 66 g, 24
Acetate Xylitol
Karbohidrat 60 g/
mmol/l, Botol 0 0
237 L)
Malate
(Fructose 5.0 mmol/l)
200 g, glucose 110 g, Xylitol 100 Botol 0 0
Larutan mengandung Karbohidrat
238 g/ L)
(Fructose 60 g, glucose 33 g, Xylitol 30 g/ Botol 0 0
Larutan
L) mengandung Karbohidrat +
239 Elektrolit (25.00g maltose, 3.00 g sodium Botol 0 0
(Maltose 10%)
240 chloride, 0.15 g potassium
Larutan mengandung chloride,+ 0.10 g
Karbohidrat Botol 0 0
241 calcium
Elektrolitchloride dihydrate
K, Cl,dan
Ca,1.55
(Acetate, Na,Karbohidrat Mg, g Botol 0 0
Larutan lactate)
sodium mengandung +
242 Sorbitol
Elektrolit 50 gr/L)
(Dextrose 5%, NaCL 0,45%, Botol 0 0
Larutan mengandung Karbohidrat + KCl)
243 (HSD)
Larutan
Elektrolitmengandung
(Fructose 120 Karbohidrat
g, glucose 66+ g, Botol 0 0
Elektrolit
Xylitol 60 (Glukosa 25 g, NaCl 2,0 g, KCl 1,3
g/ L + elektrolit)
244 Larutan mengandung Karbohidrat + Botol 0 0
g, Natrium Laktat 3,1 g, air untuk injeksi ad
245 Elektrolit
1000 ml) (Glukosa 55 g ; Natrium Chloride Botol 0 0
Larutan mengandung
9 g, air untuk injeksi adKarbohidrat +
1000 ml) (D5-NS)
246 Larutan Botol 0 0
Elektrolitmengandung
(Glukosa: 25,0 Karbohidrat
g; NaCl: 4,5+ g)
247 Elektrolit (Glukosa: 55.0 g; NaCl: 2.25 g) Botol 0 0
(D5-1/4NS)
 Larutan
Larutan mengandung
mengandung Karbohidrat
Karbohidrat ++
248 Elektrolit
Elektrolit (Glukosa: 55.0 g;kombinasi
(Larutan nutrisi NaCl: 4.5 infus
g) Botol 0 0
249 (D5-1/2NS)
per L: Na. 100mEQ, K 18mEQ, Ca. 4mEQ, Botol 0 0
250 Larutan
Mg 6mEQ, mengandung
Cl 90mEQ, Karbohidrat
Asetat 38mEQ, + Botol 0 0
Larutan
Sorbitol mengandung
Elektrolit Karbohidrat
(Larutan Ringer
50g) & Glukosa + 5%)
251 Elektrolit (NaCl 1.75 g, KCL
Larutan mengandung Karbohidrat +1.5g, Glukosa Botol 0 0
252 100 gr) (NaCl 1.75 g, KCL 1.5g, Na
Elektrolit Botol 0 0
Larutan mengandung Karbohidrat +
253 Lactate 2.24
Elektrolit g, Glukosa
(Nacl 1001.5
gr)gr, Na
1.75 gr,Karbohidrat
KCl Botol 0 0
Larutan mengandung +
254 Lactat 2.24
Elektrolit gr, Dekstrosa
(Nacl 2.34 gr, Na27Laktat
gr) (KA ENgr,
2.24 3B) Botol 0 0
255 Levonorgestrel implan27
KCL 0.75 gr Dekstrosa 2 rods, 75EN
gr) (KA mg3A)
(3-4 pack/ sachet/ set 0 0
tahun)
256 Lidokain gel 2% syringe/syringe plastik 0 0
257 Lidokain inj 2% (infiltr/p.v.) ampul/vial 0 0
258 Lidokain spray oral 10% botol 0 0
259 Linestrenol tab 0,5 mg tablet/kapsul/kaplet 0 0
260 Loperamid tab 2 mg Tab 0 0
261 Loratadin tab 10 mg tablet/kapsul/kaplet 0 0
262 Lorazepam tab 0,5 mg tablet/kapsul/kaplet 0 0
263 Lorazepam tab 1 mg tablet/kapsul/kaplet 0 0
264 Lorazepam tab sal 2 mg Tab sal 0 0
265 Lugol Botol 0 0
266 Magnesium sulfat inj 20% ampul/vial 0 0
267 Magnesium sulfat inj 20% ampul/vial @25 ml 0 0
268 Magnesium sulfat inj 40% ampul/vial @25 ml 0 0
269 Magnesium sulfat inj 40% ampul/vial 0 0
270 Magnesium sulfat serb, ktg 30 g Sachet 0 0
271 Mebendazol sir 100 mg/5 ml Botol 0 0
272 Mebendazol tab 100 mg Tan 0 0
273 Mebendazol tab 500 mg tablet/kapsul/kaplet 0 0
Medroksi progesteron asetat inj 150
274 ampul/vial 0 0
mg/ml
275 Medroksi Progesteron Asetat Inj 50 mg/ml ampul/vial 0 0
Metenamin mandelat (heksamin
276 Tab salut 0 0
mandelat) tab salut enterik 500 mg
277 Metformin tab 500 mg tablet/kapsul/kaplet 0 0
278 Metformin tab 850 mg tablet/kapsul/kaplet 0 0
279 Metilergometrin inj 0,2 mg/ml ampul/vial 0 0
280 Metilergometrin tab salut 0,125 mg tablet/kaplet salut selaput 0 0
281 Metilprednisolon tab 4 mg tablet/kapsul/kaplet 0 0
282 Metoklopramid inj 5 mg/ml ampul/vial 0 0
283 Metoklopramid tab 10 mg tablet/kapsul/kaplet 0 0
284 Metoklopramid tab 5 mg tablet/kapsul/kaplet 0 0
285 Metronidazol lar inf 5 mg/ml botol 0 0
286 Metronidazol susp 125 mg/5 ml Botol @ 60 ml 0 0
287 Metronidazol susp 125 mg/5 ml Botol @ 100 ml 0 0
288 Metronidazol tab 250 mg tablet/kapsul/kaplet 0 0
289 Metronidazol tab 500 mg tablet/kapsul/kaplet 0 0
290 Mikonazol krim 2% tube 0 0
291 Mineral
MikonazolMixserb
(Bismuth
2% Subcitrate botol / sachet 0 0
Tripotasium, Copper sulfate, Magnesium
292 Sachet 0 0
Chloride Anhydrous, Potassium Chloride,
293 N-asetil
Zinc sistein kaps 200 mg
Acetate) tablet/kapsul/kaplet 0 0
Botol plastik/botol plastik
294 NaCl 0,9% Larutan 0 0
pi
295 NaCl 0,9% Larutan Botol 0 0
ampul/botol plastik/botol
296 NaCl 0,9% Larutan 0 0
plas
tablet salut enterik/kaplet
297 Natrium diklofenak tab 25 mg 0 0
salut
tabletenterik
salut enterik/kaplet
298 Natrium diklofenak tab 50 mg 0 0
salut enterik
299 Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL 0 0
300 Natrium hipoklorit cairan konsentrat 5% Botol 0 0
301 Natrium tiosulfat inj 25% (i.v.) Ampul 0 0
302 Nifedipin kaps 10 mg tablet/kapsul/kaplet 0 0
303 Nikotinamid tab 100 mg Tab 0 0
304 Nikotinamid tab 5 mg Tab 0 0
305 Nistatin susp 100.000 UI/ml botol/vial 0 0
tablet salut gula/kaplet
306 Nistatin tab salut 500.000 UI 0 0
salut gula
307 Nistatin tab vaginal 100.000 UI tablet/kaplet 0 0
308 Nitrofurantoin tab 50 mg Tab 0 0
309 Norepinefrin inj 1 mg/ml ampul/vial 0 0
310 Obat Anti Tuberculosis FDC Kategori Anak paket 0 0
311 Obat Anti Tuberculosis FDC Kategori I paket 0 0
312 Obat Anti Tuberculosis FDC Kategori II paket 0 0
Obat Anti Tuberculosis FDC Kategori
313 paket 0 0
Sisipan
314 Obat Anti Tuberculosis Kombipak Anak Paket 0 0
315 Obat Anti Tuberculosis Kombipak Dewasa paket 0 0
316 Oksigen ih, gas dlm tabung Botol 0 0
317 Oksimetazolin tts hidung 0,025% botol @ 10 mL 0 0
318 Oksimetazolin tts hidung 0,050% botol @ 10 mL 0 0
319 Oksitetrasiklin 1% Salep Mata tube 0 0
320 Oksitosin inj 10 UI/ml ampul/vial 0 0
321 Olopatadin tts mata 0,1% Botol 0 0
322 Omeprazol inj 40 mg/10 ml ampul/vial 0 0
323 Omeprazol kaps 20 mg tablet/kapsul/kaplet 0 0
324 Paraformaldehid tab 1 g Tab 0 0
325 Parasetamol sir 120 mg/5 ml botol @ 60 mL 0 0
326 Parasetamol tab 500 mg tablet/kapsul/kaplet 0 0
327 Parasetamol tts 60 mg/0,6 ml botol @ 15 mL 0 0
328 Pasta devitalisasi (non arsen) Tube 0 0
329 Pasta pengisi saluran akar (pasta) Tube 0 0
330 Perak nitrat lar 20% Botol 0 0
331 Perak sulfadiazin krim 1% Tube 0 0
332 Permetrin krim 5 % Tube 0 0
333 Pirantel pamoat susp 125 mg/5 ml Botol 0 0
334 Pirantel pamoat tab 500 mg Tab 0 0
335 Pirantel pamoat tab scored 125 mg tablet/kapsul/kaplet 0 0
336 Pirantel pamoat tab scored 250 mg Tab 0 0
337 Piridoksin (vitamin B6) inj 100 mg/ml Ampul 0 0
338 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl 0 0
339 Piridoksin (vitamin B6) tab 25 mg tablet/kapsul/kaplet 0 0
340 Povidon iodin lar 100 mg/ml botol @ 1.000 mL 0 0
341 Povidon iodin lar 100 mg/ml botol 30 mL 0 0
342 Povidon iodin lar 100 mg/ml botol @ 60 mL 0 0
343 Povidon iodin lar 100 mg/ml Botol 300 ml 0 0
344 Prednison tab 5 mg tablet/kapsul/kaplet 0 0
345 Primakuin tab 15 mg Tab 0 0
346 Probenesid tab 500 mg tablet/kapsul/kaplet 0 0
347 Prokain benzilpenisilin serb inj 3 juta ampul/vial 0 0
UI/vial (i.m.)
348 Propiltiourasil tab 100 mg tablet/kapsul/kaplet 0 0
349 Propranolol tab 10 mg tablet/kapsul/kaplet 0 0
350 Ranitidin tab 150 mg tablet/kapsul/kaplet 0 0
351 Retinol (vitamin A) kaps lunak 100.000 UI kaps lunak 0 0
352 Retinol (vitamin A) kaps lunak 200.000 UI kaps lunak 0 0
353 Rifampisin kaps 300 mg tablet/kapsul/kaplet 0 0
354 Ringer Laktat Larutan Botol 0 0
355 Risperidon tab sal 1 mg tablet/kapsul/kaplet 0 0
356 Risperidon tab sal 2 mg tablet/kapsul/kaplet 0 0
357 Salbutamol cairan ih 0,1% ampul/vial/botol 0 0
358 Salbutamol lar ih 0,5 % Botol 0 0
359 Salbutamol sir 2 mg/5 ml Botol 0 0
360 Salbutamol tab 2 mg tablet/kapsul/kaplet 0 0
361 Salbutamol tab 4 mg tablet/kapsul/kaplet 0 0
Salep 2-4, kombinasi : asam salisilat 2 %+
362 pot 30 gram 0 0
belerang
Salep 2-4,endap 4 % : asam salisilat 2 %+
kombinasi
363 pot 15 gram 0 0
belerang
Serum anti endap 4 % : A.B.U. I (khusus ular
bisa ular
364 Vial 0 0
dari
Serumluar Papua)
anti inj (i.m./i.v.)
bisa ular :A.B.U.II (khusus ular
365 Vial 0 0
dari Papua) inj (i.m./i.v.)
Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj
366 Vial 0 0
i.m 10.000 UI/
367 Serum antirabies inj 100 UI/ml Vial 0 0
368 Serum antirabies inj 200 UI/ml Vial 0 0
Serum antitetanus (A.T.S) (i.m.) Inj 10.000
369 Vial 0 0
UI/vial (i.m /i.v.) (A.T.S) inj 1500 UI/amp
Serum antitetanus
370 Ampul 0 0
(i.m.)
Serum antitetanus (A.T.S) inj 20.000
371 Vial 0 0
UI/vial (i.m /i.v.)
372 Setirizin sir 5 mg/5 ml. botol @ 60 mL 0 0
373 Sianokobalamin (vitamin B12) inj 500 ampul/vial 0 0
mcg/ml
374 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kaplet
tablet/kapsul/kaplet/table 0 0
375 Simvastatin tab sal 10 mg ttablet/kapsul/kaplet/table
salut selaput/kaplet salut 0 0
376 Simvastatin tab sal 20 mg selaput
t salut selaput/kaplet salut 0 0
377 Simvastatin tab sal selaput 40 mg selaput
Tab sal 0 0
tablet salut selaput/kaplet
378 Siprofloksasin tab scored 500 mg 0 0
salut selaput
379 Siprofloksasin tetes mata 3 mg/ml Catchcover, botol 0,6 ml 0 0
380 Spironolakton tab 25 mg tablet/kapsul/kaplet 0 0
Stannous pyrophosphate 27,6 mg sodium
381 Vial 0 0
pyrophosphate/vial
382 Streptomisin serb inj 1.000 mg/vial ampul/vial 0 0
383 Surgical ginggival pack Tube 0 0
tablet salut selaput/kaplet
384 Tenofovir tab 300 mg 0 0
salut selaput
385 Tetanus toxoid inj Ampul 0 0
386 Tetrakain tts mata 0,5% Botol 0 0
387 Tetrasiklin kaps 250 mg tablet/kapsul/kaplet 0 0
388 Tetrasiklin kaps 500 mg tablet/kapsul/kaplet 0 0
389 Tetrasiklin Salep Mata 1% Tube 0 0
390 Tiamin (vitamin B1) tab 50 mg tablet/kapsul/kaplet 0 0
391 Timolol tts mata 0,25% botol @ 5 mL 0 0
392 Timolol tts mata 0,5% botol @ 5 mL 0 0
393 Triheksifenidil tab 2 mg tablet/kapsul/kaplet 0 0
394 Urea krim 10 % pot 0 0
395 Vaksin BCG inj (i.k) Vial 0 0
396 Vaksin bivalen OPV (b-OPV) drops 10 dosis Vial 0 0
Vaksin Hepatitis Rekombinan Inj Prefilled
397 Vial 0 0
Injection Device (Uniject) 0,5 ml (i.m)
398 Vaksin Influenza Vial 0 0
399 Vaksin Japanese Enchepalitis (J.E) Vial 0 0
400 Vaksin jerap difteri tetanus (DT) Vial 0 0
401 Vaksin jerap difteri tetanus (Td) Vial 0 0
402 Vaksin kombinasi DPT-HB-Hib Vial 0 0
403 Vaksin measless rubella (MR) Inj 0,5 mL Vial 0 0
(s.k)
404 Vaksin Meningitis Meningokokus Vial 0 0
405 Vaksin polio IPV inj 0,5 ml Vial 0 0
Vaksin rabies, untuk manusia serb inj
406 Vial 0 0
(s.k./i.k) + booster
Vaksin rabies, untuk manusia serb Inj 2,5
407 Vial 0 0
IU
408 Vaksin Yellow Fever Vial 0 0
409 Valproat sir 250 mg/5 ml botol @ 120 ml 0 0
410 Valproat tab sal 250 mg tablet salut enterik/ kaplet 0 0
salut enterik
411 Valproat tab sal 500 mg Tab sal 0 0
412 Vitamin B kompleks tablet 0 0
413 Zinc drops 10 mg/ml Botol 0 0
414 Zinc serb 10 mg Sachet 0 0
415 Zinc sir 10 mg/ml Botol 0 0
416 Zinc sir 20 mg/5 ml botol 0 0
417 Zinc tab disp 20 mg tablet dispersible 0 0
KETERANGAN
(h)