JUMLAH PEMAKAIAN OBAT TAHUN 2021

PUSKESMAS SUKOHARJO

Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
OBAT OBATAN
1 Acdat (asam fusidat)/ Fucilek tube 5,997 26
2 Albendazol tablet 85 9,000
3 Allupurinol Tab. 100 mg. tablet 105 1,390
4 Allupurinol Tab. 300 mg. tablet 245
5 Alpentin (Gabapentin) 100 mg Kapsul 1,045
6 Alpentin (Gabapentin) 300 mg tablet 1,397
7 Ambroxol syr botol 4,950 809
8 Ambroxol tab 30 mg tablet 160 26,946
9 Aminofillin inj. 24mg/ml-10 ml ampul 2,976
10 Aminofillin tab. 200 mg. tablet 139 175
11 Amitriptillin HCl tab salut 25 mg tablet 167
12 Amlodipine tab 10 mg tablet 92 7,475
13 Amlodipine tab 5 mg tablet 53 43,784
14 Ampisillin inj Ampul 8,237
15 Amoksisillin Kaplet 500 mg. tablet 201 27,322
16 Amoksisillin Kapsul 250 mg. tablet 195
17 Amoksisillin Syrup Kering 125/5ml botol 3,400
18 Amoksisillin Syrup Kering 250/5ml botol 3,498 527
19 Anabion (multivitamin anak syr) botol 4,950 240
20 Antalgin inj 250 mg/ml-2ml. ampul 407
21 Antalgin tab. 500 mg. tablet 51
22 Antasida Doen tab. Kombinasi tablet 54 47,893
23 Antasida Syrup botol 1,679 191
24 Anti Malaria Kombinasi ( ACT ) tablet 1,375
25 Antibakteri Doen Salep Kombinasi pot 3,035
26 Antifungi Doen Kombinasi pot 4,798 122
27 Antihemoroid doen Komb. Supp. supp 3,167 50
28 Apidra solostar (analog insulin rapi pen 87,000
29 Aqu pro inj. Steril, bebas pirogen vial 7,649 231
30 Artemether inj 80 mg/ml (Artem) ampul 25,490
31 Artesunat inj ampul 38,999
32 Asam Asetil salisilat (miniaspi) tablet 99 3,300
33 Asam Askorbat tab 250 mg. tablet 110
34 Asam Askorbat tab 50 mg./ Vitami tablet 42 14,244
35 Asam folat (Profolat) tablet 55 4,500
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
36 Asam Mefenamat 500 mg tablet 111 24,437
37 Asam Traneksamat inj 100mg/ml ampul 1,880
38 Asam traneksamat inj 50mg/ml ampul 3,334 23
39 asam retinoat/Neotinex tube 9,759
40 Asiklovir tab 200 mg tablet 249 886
41 Asiklovir krim tube 4,807 120
42 Asiklovir Tablet 400 mg tablet 407 440
43 Atropin Sulfat Inj 0,25 mg/ml-1ml ampul 1,540
44 Attalpugite ( atagip) tablet 671 460
45 Azithromycin 250 mg tablet 1,778 300
46 Alprazolam tablet 108 100
47 Berotec pcs 83,190 48
48 Benzatin B. Penisillin inj. 1,2 juta IU ampul 7,200
49 Benzatin B. Penisillin inj. 3 juta IU ampul 10,175
50 Betahistin Mesilat tab 6 mg tablet 88 1,773
51 Betametason krim 0,1 % tube 1,540 998
52 Betason N tube 12,874 300
53 Bisakodil 10 mg suppositria supp 5,800 100
54 Bisakodil 5 mg suppositria supp 5,670
55 Bisoprolol 5 mg tablet 252 758
56 Bisoprolol 2.5 mg / Concor 2.5 Tablet 597 200
57 Bromheksin tab 8 mg tablet 51
58 Betadin salep tube 7,039 29
59 Candesartan 8 mg tablet 212 110
60 Carbamazepine 200 mg tablet 189 240
61 Cefixim tablet 387 2,275
62 Cefixim syr botol 4,723 298
63 Cendo Lyteers botol 19,125 24
64 Cendo Mydriatil botol 36,740 24
65 Cetirizine syr botol 2,090 298
66 Cetirizine tab 10 mg tablet 49 18,057
67 Cloramfecort cr tablet 9,955 240
68 Combivent vial 4,550 260
69 Clozapin tablet 1,121
70 Colchitine / Kolkisin tablet 2,299
71 Clobazam tablet 739 100
72 D artep tablet 20
73 Deksametason inj. 5mg/ml-1ml. ampul 924 200
74 Deksametason tab 0,5 mg. tablet 72 27,848
75 Dexosimethason tube 8,700 120
76 Diazepam inj 5 mg/ml-2ml. ampul 1,735 70
77 Diazepam tab 2mg. tablet 86 300
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
78 Diazepam tab 5mg. tablet 117 105
79 Dietilkarbamazin Sitrat tab 100 mg tablet 119
80 Difenhidramin HCL inj 10 mg/ml ampul 1,168 30
81 Digoksin tab. 0,25 mg tablet 250 295
82 Dihidroartemisin+ Piperaquin ( DHP tablet 8,000
83 Dimenhidrinat 50 mg tablet 108 50
84 Doksisiklin kap 100 mg tablet 275
85 Domperidon suspensi botol 2,296 201
86 Domperidon tab 10 mg tablet 71 711
87 Domperidon 5 mg Drop Botol 23,760 50
88 Dopamed tablet 946 240
89 Efineprin HCL/bitartat inj 0,1%-1ml ampul 1,515 115
90 Ekstrak Belladon tab 10 mg. tablet 38
91 Erithromisin 250 mg tablet 546
92 Erithromisin 500 mg tablet 730
93 Erithromisin syr 200 mg/5 ml botol 7,700
94 Erphavitalgin (Multivitamin Neurotr tablet 526
95 Etakridin (Rivanol) Lar 0,1 % botol 3,000
96 Etambutol 250 mg. tablet 417
97 Etambutol 500 mg tablet 574
98 Etanol 70 % 100 ml botol 2,500 60
99 Etanol 70 % 1000 ml botol 21,500 120
100 Etanol 70 % 300 ml botol 7,161 60
101 Elizac 20 tablet 225
102 Famotidine tablet 113
103 Fenitoin 100 mg tablet 158 5,500
104 Fenobarbital inj 50 mg/ml-2ml. ampul 1,857
105 Fenofibrate 100 mg tablet 1,073
106 Fenol Gliserol Tetes Telinga 10 % botol 3,300 120
107 Fitomenadion (Vit. K) inj 2 mg/ml. ampul 3,682 120
108 Fitomenadion (Vit. K) tab. 10 mg. tablet 748 300
109 Flixotide Nebules 0,5mg/2ml ampul 14,929
110 Flumin (Obat Batuk Kombinasi dew tube 250
111 Furosemid inj ampul 1,333 120
112 Furosemid tab 40 mg. tablet 260 1,000
113 Flurin DMP tablet 1,100
114 Flufenazine Decanoat Injeksi 25 mg Ampul 59,800
115 Garam Oralit untuk 200ml air sack 257 3,000
116 Genoint SM tube 2,830 600
117 Gentamisin sulfat 0,5 % OTM botol 4,232 600
118 Gentamisin Sulfat 1 mg/g salep kuli tube 4,818 138
119 Gentamisin sulfat inj ampul 3,509 10
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
120 Gentianviolet 1 % botol 900
121 Glibenklamid tab 5 mg. tablet 82 4,505
122 Glikazid ( Glikab ) tablet 220 1,145
123 Glimepirid 2 mg tablet 207 729
124 Glimepirid 3 mg tablet 143 2,347
125 Gliseril Guayakolat tab. 100 mg. tablet 28
126 Glukosa Lar Infus 10 %. plabot 5,700 10
127 Glukosa Lar Infus 40 %. plabot 145
128 Glukosa Lar Infus 5 %. plabot 6,627
129 GOM botol 3,500 15
130 Gored 80 mg tablet 210
131 Griseufulvin tab 125 mg. tablet 240
132 Guaiafenesin tablet 132 1,426
133 Gemfribozil 300 mg tablet 372 200
134 Haloperidol tab 0,5 mg tablet 47 280
135 Haloperidol tab 1,5 mg tablet 51 100
136 Haloperidol tab 5 mg tablet 60 400
137 Haloperidol injeksi 5 mg (Lodomer) ampul 6,250
138 Haldol Decanoat ampul 101,300
139 Herbesser CD 100 tablet 4,460
140 Hidroklortiazida (Hct) tab 25 mg. tablet 148
141 Hidrokortison Krim 25 % tube 2,325 266
142 Herbakof botol 14,273 200
143 Ibuprofen Tab. 200 mg. tablet 110
144 Ibuprofen Tab. 400 mg tablet 704 6,403
145 Ibupropen Suspensi botol 2,721 85
146 Ichtiol pot 6,300
147 Iliadin Tetes hidung botol 30,000
148 Irbesartan 150 mg tablet 483
149 Isoniazid 100 mg. tablet 97
150 Isosorbit Dinitrat tab subling 5 mg. tablet 86 731
151 Imundo Capl tablet 4,584
152 Kalsium Glukonas ampul 10,351
153 Kalsium Laktat (Kalk) tab 500 mg. tablet 63 18,672
154 Kaptoril 12,5 mg tablet 65 869
155 Kaptoril 25 mg tablet 75 869
156 Ketokonazol 200 mg. tablet 252 1,245
157 Ketokonazol Krim 2 % tube 2,349 110
158 Ketorolac inj 10 mg ampul 1,616
159 Ketorolac inj 30 mg ampul 839 255
160 Klindamisin 150 mg Kapsul 715
161 Klindamisin 300 mg Kapsul 522
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
162 Kloram fenikol kap 500mg. (Chlora Kapsul 1,007
163 Kloramfenikol 0,5 % TTM (Decaceti botol 1,440
164 Kloramfenikol Salep Mata 1 % tube 2,007 11
165 Kloramfenikol Tetes Telinga 3 % ( E botol 9,450 159
166 Klorfeniramine Mal. Tab. 4 mg. (CT tablet 24 22,226
167 Klorpromazin Inj. 5 mg/ml - 2 ml ampul 1,243
168 Klorpromazin tab 100 mg tablet 147 15,200
169 Klorpromazin tab 25 mg tablet 36
170 Kodein Hcl tab 10 mg. tablet 39
171 Kombinasi Obat Flu untuk dewasa ( Tablet 557 1,200
172 Kombinasi Obat Flu untuk anak ( So botol 13,860 300
173 Kotrimoksazol Dewasa tab. 480 mg. tablet 126 3,152
174 Kotrimoksazol Suspensi botol 2,100 568
175 KSR tablet 1,700
176 Kloramfenicol SK/Bufacetine Salep tube 3,266 359
177 Lansoprazole Kapsul 278 350
178 Lar mengandung Karboh + Elekt ( K plabot 10,050
179 Larutan mengandung Elektrolit ( As plabot 8,800
180 Levemir Flexpen pen 83,950 120
181 Levertran salep pot 2,000 24
182 Levopar 100 mg tablet 1,030
183 Lidokain 2% Injeksi ampul 847 49
184 Lidokain kompositum injeksi Ampul 1,222 470
185 Lisinopril 10 mg tablet 448
186 Lisinopril 5 mg tablet 209
187 Lisol botol 43,549 12
188 Loperamid tablet 2 mg tablet 59
189 Loratadin tablet 10 mg tablet 123
190 Latus Analog Insulin Injeksi Solotar Pen 83,950
191 Lactulosa Syrup botol 16,566 11
192 Lytacur Syrup botol 13,200
193 Magnesium Sulfat Inj.20%-25 ml. ampul 3,328
194 Magnesium Sulfat Inj.40%-25 ml. ampul 3,796 18
195 Mebendazol syr botol 3,534
196 Mebendazol tab 100 mg. tablet 210
197 Meloksikam tablet 15 mg tablet 1,199
198 Meloksikam tablet 7,5 mg tablet 830
199 Mersibion inj ampul 4,400
200 Metformin 500 mg tablet 102 8,225
201 Metformin 850 mg tablet 150
202 Metil Prednisolon 16 mg tablet 516
203 Metil Prednisolon Tab 4 mg tablet 102 9,520
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
204 Metil Prednisolon Tab 8 mg tablet 300
205 Metoklopamid inj 5 mg/ml ampul 2,100
206 Metoklopamid tab 10 mg tablet 110
207 Metronidazol infus botol 9,200
208 Metronidazol tab 250 mg. tablet 94
209 Metronidazol tab 500 mg. tablet 205 1,000
210 Metronidazol syr botol 3,765 13
211 Metyl Ergometrin Mal. inj 0,200 mg. ampul 1,490 20
212 Metyl Ergometrin Mal. Tab 0,125 mg tablet 214 100
213 Mikonazol krim 2 % tube 1,900 95
214 Multivitamin untuk dewasa Tablet 500 5,600
215 Multivitamin untuk anak Botol 25,548 600
216 N Acetyl Sistein Kapsul 358 900
217 Natrium Bikarbonat tab 500 mg. tablet 15 1,000
218 Natrium Diklofenak 25 mg tablet 115
219 Natrium Diklofenak 50 mg tablet 99 22,262
220 Natrium Klorida lar infus 0,9 % (Na plabot 6,800 219
221 Natrium Tiosulfat Inj 25 %-10 ml. ampul 2,700
222 Natrium Tiroksin tab (Euthyrox) tablet 668
223 Nerilon krim tube 12,250
224 Neurodial tablet 1,091
225 Nifedipin tab tablet 108 500
226 Nistatin 100.000 iu/g tab Vagina tablet 560 67
227 Nistatin 500.000 iu/g tab salut tablet 790 212
228 Nitral-Gliseril trinitrat tablet 1,500
229 Novabion tablet 500 13,279
230 Novorapid Flexpen pen 87,000 120
231 Obat Batuk Hitam (OBH) botol 13,750 120
232 Oksitetrasiklin HCl Salep 3 % tube 1,529
233 OksitetrasiklinHCl Salep 1 % tube 3,500 95
234 Oksitosin inj. 10 IU/ ml-1ml. ampul 1,126 19
235 Omeprazole 20 mg tablet 129 5,314
236 Ondansentron Dihidrate inj ampul 873 450
237 Ondansetron tablet 4 mg tablet 270 300
238 Ondansetron tablet 8 mg tablet 299
239 Papaverin Tab tablet 100
240 Paracetamol drop botol 6,649
241 Parasetamol Syrup 120 mg/ml. botol 1,160 1,418
242 Parasetamol tablet 100 mg tablet 32
243 Parasetamol tablet 500 mg tablet 290 154,464
244 Paracetamol Infuse botol 10,556 24
245 Permetrim krim (Scabimite) tube 11,825 75
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
246 Piracetam 400 mg tab tablet 803
247 Piracetam 800 mg tab tablet 803
248 Piracetam inj ampul 5,499
249 Pirantel Pamoat tablet 125 mg. tablet 310
250 Piridoksin Hcl tablet 10 mg. tablet 131 3,261
251 Piroksikam 10 mg tablet 100
252 Piroksikam 20 mg tablet 129 11,134
253 Povidon Iodida Lar. 10 % 300 ml. botol 18,000 40
254 Povidon Iodida Lar. 10 % 60 ml. botol 23,890 84
255 Povidon Iodida Lar. 10% 30 ml botol 2,900 4
256 Prednison Tablet 5 mg. tablet 73
257 Primakuina tablet 15 mg tablet 109
258 Prokain Penisilin Vial ampul 5,600
259 Propanolol HCl tablet 10 mg. tablet 77
260 Propanolol HCl tablet 40 mg. tablet 107
261 Propil Tio Urasil Tablet 100 mg. tablet 300
262 Ranitidin Inj 25 mg/ ml ampul 814 850
263 Ranitidin tab 150 mg tablet 85 3,764
264 Rifampisin Kaplet 300 mg tablet 480
265 Rifampisin Kaplet 600 mg tablet 922
266 Rifampisin Kapsul 450 mg tablet 660
267 Ringer Laktat Larutan Infus Steril plabot 7,630 2,240
268 Risperidon 1 mg tablet 1,400
269 Risperidon 2 mg tablet 287 10,525
270 Salbutamol nebules ampul 4,000 200
271 Salbutamol Tablet 2 mg. tablet 48 4,682
272 Salbutamol Tablet 4 mg. tablet 63
273 Salep 2-4 Kombinasi pot 2,797 54
274 Salisil Bedak 2 % sak 1,025
275 Sefadroksil Kaplet 500 mg tablet 388 3,000
276 Sefadroksil syrup botol 3,800 157
277 Sefotaksim injeksi 1 g ampul 2,850 229
278 Seftriakson injeksi 1 g ampul 2,745 364
279 Seretide diskus 250 mcg pcs 116,687 12
280 Seretide diskus 50 mcg pcs 55,000 24
281 Sianokobalamin Inj 500 mcg/ml. ampul 916
282 Sianokobalamin tablet tablet 49 17,788
283 Simetidin 200 mg tablet 111
284 Simvastatin 10 mg tablet 68
285 Simvastatin 20 mg tablet 150 465
286 Siprofloksasin 500 mg tablet 248 500
287 Sorvitral (Multivitamin dan Mineral tablet 435
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
288 Spiriva (Tiotropium) 18 mcg + Handi kotak 162,000
289 Spiriva (Tiotropium) 18 mcg Reffil Kapsul 15,100
290 Spironolakton tab 25 mg tablet 467
291 Stesolid 5 mg diazepam supp 12,573 24
292 Sulfasetamid Nat. Tetes Mata 15 % botol 3,226
293 Suprafenid ( Ketoprofen supp 100m supp 2,380 19
294 Synarcus Huocinolone tube 2,374
295 Sucralfat Syrup 500 mg botol 4,989 170
296 Tiamfenikol 500 mg tablet 580
297 Tiamina Mononitrat tab 50 mg. tablet 86 1,540
298 Tiamina HCl Inj. 100 mg/ml-1ml ampul 700
299 Tramadol inj 50 mg/ml ampul 2,395
300 Tramadol Tablet 50 mg tablet 189
301 Triheksifenidil HCl tab 2 mg tablet 63 12,154
302 Urinter (asam pipemidat 400 mg) tablet 1,485
303 Valsartan 80 mg tablet 655
304 Ventolin Inhaler tablet 63,750
305 Vitamin B komplek Tablet tablet 117 12,500
306 Xylocaine Jelly 2% Syringe 41,600
307 Zink tablet 216 1,930
308 Zink sir 20 mg/5 ml botol 2,489 48
VAKSIN
309 ABU vial 517,132
310 ATS 1500 IU ampul 130,999 30
311 VAR ampul 153,000 8
OBAT PROGRAM GIZI
312 Mineral Mix sack 2,920
313 Retinol (Vitamin A) kap. 100.000 IU Kapsul 306 1,069
314 Retinol (Vitamin A) kap. 200.000 IU Kapsul 517 10,873
315 Tablet Tambah Darah Kombinasi tablet 354 112,414
OBAT PROGRAM P2PL
316 OAT KAT ANAK paket 389,334 60
317 OAT KAT I paket 389,344 60
318 OAT KAT II paket 1,297,894 5
319 OAT KAT SISIPAN paket 159,968
REAGEN
320 Anti -A Monoclonal Blood Grouping botol 120,225
321 Anti -A,B Monoclonal Blood Reagen botol 94,535
322 Anti -B Monoclonal Blood Reagent botol 70,225
323 Anti -D Duoclone Monoclonal botol 116,095
324 Dengue Tes kotak 1,050,000
325 Febrile Antigen H Typhi Pcs 26,203
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
326 Febrile Antigen H-A paratyphi Pcs 26,203
327 Febrile Antigen H-B paratyphi Pcs 26,203
328 Febrile Antigen H-C paratyphi pcs 26,203
329 Febrile Antigen O-A paratyphi pcs 26,203
330 Febrile Antigen O-D paratyphi pcs 26,203
331 H2O2 botol 66,000
332 Larutan Asam Asetat botol 95,000
333 Larutan Asam Sulfosalisilat botol 645,000
334 Larutan EDTA botol 78,100
335 Larutan Giemsa botol 244,844
336 Larutan HCL 0,5 N botol 66,000
337 Larutan Ress Ecker botol 93,000
338 Larutan Turk botol 140,000
339 Larutan Ziehl Nelsen botol 411,000
340 Tabung EDTA pack 202,150
341 Tabung Non EDTA pack 125,818
OBAT GIGI
342 Cavit pcs 160,003
343 Devitalisasi Pasta pcs 223,000
344 Etil Klorida Semprot pcs 140,081
345 Eugenol Cairan botol 20,150
346 Eviplac Disclosing pcs 200,700
347 Glass Ionomer Cement (gc IX) botol 780,000
348 Hydral pcs 160,000
349 Kalsium Hidroksida Pasta pcs 132,000
350 Monoklor Mentol Cairan/CHKM/pa pcs 66,900
351 Mummfying Pasta / Iodoform pcs 141,909
352 Semen Seng Fosfat Cair pcs 93,500
353 Trikloroformalin/formocresol pcs 60,000
354 Zinc Sement pcs 171,710
355 Tooth Mousse GC Tube Stawberry / botol 200,031
ALAT-ALAT KESEHATAN
356 Alat Suntik 1 ml. pcs 1,086 1,200
357 Alat Suntik 10 ml pcs 925
358 Alat Suntik 20 ml pcs 1,500
359 Alat Suntik 3 ml. pcs 997 3,562
360 Alat Suntik 5 ml. pcs 1,153 1,300
361 Alat Suntik Spuit 0,05 cc pcs 1,384 385
362 Alat Suntik Spuit 0,5 cc pcs 1,500 500
363 Alkohol swab kotak 37,400 7
364 Antiseptik 500 ml (Pribac) botol 75,000
365 Alkapharm (pencuci instrumen med Botol 2,702,700
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
366 Benechek asam urat kotak 153,875 12
367 Benechek cholesterol kotak 254,125 12
368 Benechek glukosa kotak 166,700 36
369 Blood lanset box 16,632 27
370 Blood tranfusion set pcs 3,600
371 Box object glass pcs 75,436
372 Cat gut plain 2/0 kotak 50,212
373 Cat Gut/ Benang Bedah no. 3/0/ch pcs 44,825 360
374 Cat Gut/ Benang Bedah no. 3/0/pla pcs 45,220 360
375 Cuticell classic 10 x 10 cm box 5,198
376 Easy Touch HB kotak 220,000
377 Feeding tube no.10 pcs 7,700
378 Fixomul pcs 49,501
379 Folley Cathether No. 16 pcs 11,000 15
380 Folley Cathether No. 18 pcs 45,782 15
381 Folley Cathether No. 20 pcs 45,782 15
382 Handscon Nonsteril Uk S kotak 123,585 120
383 Handscon Nonsteril Uk M kotak 123,585 120
384 Hanscond Nonsteril Uk XS kotak 123,585 120
385 Hanscond steril Size 7,5 (DAK 2017) pcs 6,985 120
386 Hydrogel Wound dressing kotak 1,450,000
387 Infusion Set anak pcs 9,054 225
388 Infusion Set dewasa pcs 7,762 680
389 IV Cateter No.18 pcs 6,591 63
390 IV Cateter No.20 2021 pcs 6,295 327
391 IV Cateter No.22 pcs 11,330 450
392 IV Cateter No.24 2021 pcs 6,295 250
393 IV catheter no 26 pcs 24,668 30
394 Kapas Pembalut/Adsorben 250 mg. pcs 22,600 56
395 Kasa Elastis 4 inchi pcs 10,000
396 Kasa Meteran 36 m x 80 cm pcs 145,500 36
397 Kasa Pembalut 2m x 80cm. pcs 8,799
398 Kasa Pembalut Hidrofil 4m x 15cm. pcs 2,687 350
399 Kasa Steril (16 x 16 ) pcs 10,560 100
400 Masker ear loop box 43,451
401 Masker plus 3 play plus earloop box 43,076
402 Masker ties on (headloop) box 43,416
403 Mikropipet pcs 480,000
404 Nasal Oxygen Uk L pcs 6,600
405 Nasal Oxygen Uk M pcs 6,600
406 Nasal Oxygen Uk S pcs 6,600
407 Nasal Oxygen Uk XS pcs 3,600
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
408 Needle 25 G Pcs 700
409 Needle Vacutainer flashback kotak 130,000
410 Plester 5 Yard x 2 Inc. pcs 23,600
411 Pot sputum pcs 5,890
412 Queck Cek Hb Kotak 565,000
413 Safety Box 5 Liter pcs 14,700
414 Silk (benang bedah sutra) no 3/0 pcs 23,548
415 Slide (hibah propinsi) kotak 22,900
416 Stomach tube no. 18 pcs 7,370
417 Stomach tube no. 20 pcs 7,370
418 Surgical Blade no.11 kotak 99,000
419 Softaman antiseptic gel btl 78,750
420 Terumo nanopass needle (32,5G x 4 pcs 1,998
421 Test pack pcs 1,939
422 Underpad pcs 8,295
423 Urine bag pcs 5,500
424 White Tips pack 93,550
425 Wing Needle 25 G pcs 1,400
426 Wing Needle 27 G pcs 1,400
427 Wing Needle 21 G pcs 1,400
428 Wing Needle 23 G pcs 1,400
429 Yellow Tips pack 182,450
OBAT BARU
430 Multivitamin Neurotropik (Fornero tablet 612
431 Obat Flu dan Antiinflamasi (Herbac tablet 2,475
432 Silk (benang bedah sutra) no 2/0 pcs 38,822
433 VTM Lituo kit 1,764,049
434 IV catheteter 20 2020 Pcs 8,783
435 IV catheteter 24 2020 Pcs 11,330
436 IV catheteter 26 2020 Pcs 6,270
437 Rdt Sifilis Trepocheck Pcs 9,503
438 Rdt Hiv Virocheck Pcs 9,463
439 Strip Autocheck gula Kotak
PROVINSI
440 Albendazol tablet 85
441 Aminofillin tab. 200 mg. tablet 139
442 Amoksisillin Kaplet 500 mg. tablet 102
443 Antibakteri Doen Salep Kombinasi pot 3035
444 Antifungi Doen Kombinasi pot 4798
445 Asam Askorbat tab 50 mg / Vitami tablet 105
446 Asiklovir krim tube 2600
447 Asiklovir Tablet 400 mg tablet 405
 Harga
NO. NAMA OBAT SATUAN
Satuan
Jumlah Pemakaian

1 2 3 4 5
448 Betametason krim 0,1 % tube 1430
449 Diazepam tab 2mg. tablet 86
450 Fitomenadion (Vit. K) inj 2 mg/ml.ampul 3682
451 Garam Oralit untuk 200ml air sack 257
452 Glibenklamid tab 5 mg. tablet 119
453 Hidrokortison Krim 25 % tube 2400
454 Kotrimoksazol Dewasa tab. 480 mg.tablet 319
455 Kotrimoksazol Suspensi botol 1865
456 Metformin 500 mg tablet 102
457 Mikonazol krim 2 % tube 3414
458 Natrium Diklofenak 25 mg tablet 128
459 Natrium Diklofenak 50 mg tablet 123
460 Natrium Klorida lar infus 0,9 % (Naplabot 6840
461 OksitetrasiklinHCl Salep 1 % tube 2500
462 Parasetamol Syrup 120 mg/ml. botol 1181
463 Piridoksin Hcl tablet 10 mg. tablet 131
464 Ringer Laktat Larutan Infus Steril plabot 7630
465 Salbutamol Tablet 2 mg. tablet 67
466 Vitamin B komplek Tablet tablet 117
467 Zink tablet 524
468 Mineral Mix sack 2920
469 Retinol (Vitamin A) kap. 100.000 IUKapsul 306
470 Retinol (Vitamin A) kap. 200.000 IUKapsul 517
471 Tablet Tambah Darah Kombinasi tablet 354
472 Alat Suntik 3 ml. pcs 685
473 Alkohol swab kotak 37400
474 Cat gut plain 2/0 kotak 28984
475 Cat Gut/ Benang Bedah no. 3/0/plapcs 45075
476 Infusion Set anak pcs 5600
477 Infusion Set dewasa pcs 6090
478 IV Cateter No.20 pcs 8783
479 Masker plus 3 play plus earloop box 43076
480 Albendazol suspensi Botol 4000

TOTAL NILAI PERSEDIAAN

Pringsewu, 19 Januari 2022

Ka. UPT PKM Rawat Inap Sukoharjo Pengelola Obat UPT PKM Rawat Inap Sukoharjo

Yohanes Purwanto,S.Kep,M.M Ayu Anggilia P,Amd.F

NIP. 197407021994031002 NIP. 198711302010012013
 NILAI
PERSEDIAAN

Rp 155,922
Rp 765,000
Rp 145,950
Rp -
Rp -
Rp -
Rp 4,004,550
Rp 4,311,360
Rp -
Rp 24,325
Rp -
Rp 687,700
Rp 2,320,552
Rp -
Rp 5,491,722
Rp -
Rp -
Rp 1,843,446
Rp 1,188,000
Rp -
Rp -
Rp 2,586,222
Rp 320,689
Rp -
Rp -
Rp 585,356
Rp 158,350
Rp -
Rp 1,766,919
Rp -
Rp -
Rp 326,700
Rp -
Rp 598,248
Rp 247,500
 NILAI
PERSEDIAAN

6
Rp 2,712,507
Rp -
Rp 76,682
Rp -
Rp 220,614
Rp 576,840
Rp 179,080
Rp -
Rp 308,660
Rp 533,400
Rp 10,800
Rp 3,993,120
Rp -
Rp -
Rp 156,024
Rp 1,536,920
Rp 3,862,200
Rp 580,000
Rp -
Rp 191,016
Rp 119,400
Rp -
Rp 204,131
Rp 23,320
Rp 45,360
Rp 880,425
Rp 1,407,454
Rp 459,000
Rp 881,760
Rp 622,820
Rp 884,793
Rp 2,389,200
Rp 1,183,000
Rp -
Rp -
Rp 73,900
Rp -
Rp 184,800
Rp 2,005,056
Rp 1,044,000
Rp 121,450
Rp 25,800
 NILAI
PERSEDIAAN

6
Rp 12,285
Rp -
Rp 35,040
Rp 73,750
Rp -
Rp 5,400
Rp -
Rp 461,496
Rp 50,481
Rp 1,188,000
Rp 227,040
Rp 174,225
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 150,000
Rp 2,580,000
Rp 429,660
Rp -
Rp -
Rp 869,000
Rp -
Rp -
Rp 396,000
Rp 441,840
Rp 224,400
Rp -
Rp -
Rp 159,960
Rp 260,000
Rp -
Rp -
Rp 771,000
Rp 1,698,000
Rp 2,539,200
Rp 664,884
Rp 35,090
 NILAI
PERSEDIAAN

6
Rp -
Rp 369,410
Rp 251,900
Rp 150,903
Rp 335,621
Rp -
Rp 57,000
Rp -
Rp -
Rp 52,500
Rp -
Rp -
Rp 188,232
Rp 74,400
Rp 13,160
Rp 5,100
Rp 24,000
Rp -
Rp -
Rp -
Rp -
Rp 618,450
Rp 2,854,600
Rp -
Rp 4,507,712
Rp 231,285
Rp -
Rp -
Rp -
Rp -
Rp 62,866
Rp -
Rp -
Rp 1,176,336
Rp 56,485
Rp 65,175
Rp 313,740
Rp 258,390
Rp -
Rp 213,945
Rp -
Rp -
 NILAI
PERSEDIAAN

6
Rp -
Rp -
Rp 22,077
Rp 1,502,550
Rp 533,424
Rp -
Rp 2,234,400
Rp -
Rp -
Rp 668,400
Rp 4,158,000
Rp 397,152
Rp 1,192,800
Rp -
Rp 1,172,494
Rp 97,300
Rp -
Rp -
Rp 10,074,000
Rp 48,000
Rp -
Rp 41,503
Rp 574,340
Rp -
Rp -
Rp 522,588
Rp -
Rp -
Rp -
Rp 182,226
Rp -
Rp -
Rp 68,328
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 838,950
Rp -
Rp -
Rp 971,040
 NILAI
PERSEDIAAN

6
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 205,000
Rp 48,945
Rp 29,800
Rp 21,400
Rp 180,500
Rp 2,800,000
Rp 15,328,800
Rp 322,200
Rp 15,000
Rp -
Rp 2,203,938
Rp 1,489,200
Rp -
Rp -
Rp -
Rp -
Rp 54,000
Rp 37,520
Rp 167,480
Rp -
Rp 6,639,500
Rp 10,440,000
Rp 1,650,000
Rp -
Rp 332,500
Rp 21,394
Rp 685,506
Rp 392,850
Rp 81,000
Rp -
Rp -
Rp -
Rp 1,644,880
Rp -
Rp 44,794,560
Rp 253,344
Rp 886,875
 NILAI
PERSEDIAAN

6
Rp -
Rp -
Rp -
Rp -
Rp 427,191
Rp -
Rp 1,436,286
Rp 720,000
Rp 2,006,760
Rp 11,600
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 691,900
Rp 319,940
Rp -
Rp -
Rp -
Rp 17,091,200
Rp -
Rp 3,020,675
Rp 800,000
Rp 224,736
Rp -

Rp -
Rp 1,164,000
Rp 596,600
Rp 652,650
Rp 999,180
Rp 1,400,244
Rp 1,320,000
Rp -
Rp 871,612
Rp -
Rp -
Rp 69,750
Rp 124,000
Rp -
 NILAI
PERSEDIAAN

6
Rp -
Rp -
Rp -
Rp 301,752
Rp -
Rp 45,220
Rp -
Rp 848,130
Rp -
Rp 132,440
Rp -
Rp -
Rp -
Rp 765,702
Rp -
Rp -
Rp -
Rp 1,462,500
Rp -
Rp 416,880
Rp 119,472
Rp -
Rp -
Rp 3,929,970
Rp 1,224,000
Rp -
Rp -
Rp 327,114
Rp 5,621,341
Rp 39,794,556
Rp -
Rp 23,360,040
Rp 23,360,640
Rp 6,489,470
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
 NILAI
PERSEDIAAN

6
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp 1,303,200
Rp -
Rp -
Rp 3,551,314
Rp 1,498,900
Rp 532,840
Rp 750,000
Rp 261,800
Rp -
Rp -
 NILAI
PERSEDIAAN

6
Rp 1,846,500
Rp 3,049,500
Rp 6,001,200
Rp 449,064
Rp -
Rp -
Rp -
Rp 16,137,000
Rp 16,279,200
Rp -
Rp -
Rp -
Rp -
Rp 165,000
Rp 686,730
Rp 686,730
Rp 14,830,200
Rp 14,830,200
Rp 14,830,200
Rp 838,200
Rp -
Rp 2,037,150
Rp 5,278,160
Rp 415,233
Rp 2,058,465
Rp 5,098,500
Rp 1,573,750
Rp 740,040
Rp 1,265,600
Rp -
Rp 5,238,000
Rp -
Rp 940,450
Rp 1,056,000
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
 NILAI
PERSEDIAAN

6
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
 NILAI
PERSEDIAAN

6
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -
Rp -

462,752,445

anuari 2022
Rawat Inap Sukoharjo

P,Amd.F
010012013
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO) TAHUN 2021
PUSKESMAS RAWAT INAP SUKOHARJO
BULAN : januari - desember

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOCK AKHIR PERMINTAAN

1 Acdat (asam fusidat)/ Fucilek tube - - - - -

2 Albendazol tablet - 9,000 9,000 9,000 -
3 Allupurinol Tab. 100 mg. tablet 656 8,900 9,556 4,352 5,204
4 Allupurinol Tab. 300 mg. tablet - - - - -
5 Alpentin (Gabapentin) 100 mg Kapsul - - - - -
6 Alpentin (Gabapentin) 300 mg tablet - - - - -
7 Ambroxol syr botol 676 600 1,276 809 467
8 Ambroxol tab 30 mg tablet 16,716 18,700 35,416 26,946 8,470
9 Aminofillin inj. 24mg/ml-10 ml ampul - - - - -
10 Aminofillin tab. 200 mg. tablet 275 - 275 175 100
11 Amitriptillin HCl tab salut 25 mg tablet 699 700 1,399 419 980
12 Amlodipine tab 10 mg tablet 10,017 1,290 11,307 7,475 3,832
13 Amlodipine tab 5 mg tablet 39,039 6,300 45,339 43,784 1,555
14 Ampisillin inj Ampul - - - - -
15 Amoksisillin Kaplet 500 mg. tablet 10,854 64,200 75,054 27,322 47,732
16 Amoksisillin Kapsul 250 mg. tablet - - - - -
17 Amoksisillin Syrup Kering 125/5ml botol 3 - 3 - 3
18 Amoksisillin Syrup Kering 250/5ml botol 328 420 748 527 221
19 Anabion (multivitamin anak syr) botol - - - - -
20 Antalgin inj 250 mg/ml-2ml. ampul - - - - -
21 Antalgin tab. 500 mg. tablet - - - - -
22 Antasida Doen tab. Kombinasi tablet 10,061 67,900 77,961 47,893 30,068
23 Antasida Syrup botol 106 1,500 1,606 191 1,415
24 Anti Malaria Kombinasi ( ACT ) tablet - - - - -
25 Antibakteri Doen Salep Kombinasi pot - - - - -
26 Antifungi Doen Kombinasi pot 214 1,440 1,654 311 1,343
27 Antihemoroid doen Komb. Supp. supp 50 - 50 50 -
28 Apidra solostar (analog insulin rap pen - - - - -
29 Aqu pro inj. Steril, bebas pirogen vial 139 150 289 231 58
30 Artemether inj 80 mg/ml (Artem) ampul - - - - -
31 Artesunat inj ampul - - - - -
32 Asam Asetil salisilat (miniaspi) tablet - - - - -
33 Asam Askorbat tab 250 mg. tablet - - - - -
34 Asam Askorbat tab 50 mg. tablet 3,187 15,300 18,487 14,244 4,243
35 Asam folat (Profolat) tablet 5,555 - 5,555 4,500 1,055
36 Asam Mefenamat 500 mg tablet 19,850 22,000 41,850 24,437 17,413
37 Asam Traneksamat inj 100mg/ml ampul - - - - -
38 Asam traneksamat inj 50mg/ml ampul 13 280 293 23 270
39 asam retinoat/Neotinex tube - - - - -
40 Asiklovir tab 200 mg tablet 686 300 986 886 100
41 Asiklovir krim tube 68 180 248 120 128
42 Asiklovir Tablet 400 mg tablet - 3,200 3,200 440 2,760
43 Atropin Sulfat Inj 0,25 mg/ml-1ml ampul 37 - 37 - 37
44 Attalpugite ( new antides) tablet 283 1,200 1,483 460 1,023
45 Azithromycin 250 mg tablet - 300 300 300 -
46 Alprazolam tablet - - - - -
47 Berotec pcs - - - - -
48 Benzatin B. Penisillin inj. 1,2 juta ampul - - - - -
49 Benzatin B. Penisillin inj. 3 juta IU ampul - - - - -
50 Betahistin Mesilat tab 6 mg tablet 1,551 2,000 3,551 1,773 1,778
51 Betametason krim 0,1 % tube 86 1,050 1,136 998 138
52 Betason N tube - - - - -
53 Bisakodil 10 mg suppositria supp - - - - -
54 Bisakodil 5 mg suppositria supp - - - - -
55 Bisoprolol 5 mg tablet 848 - 848 758 90
56 Bisoprolol 2.5 mg / Concor 2.5 Tablet 200 - 200 200 -
57 Bromheksin tab 8 mg tablet - - - - -
58 Betadin salep tube 100 - 100 29 71
59 Candesartan 8 mg tablet - 600 600 110 490
60 Carbamazepine 200 mg tablet - 100 100 60 40
61 Cefixim tablet - 3,400 3,400 2,275 1,125
62 Cefixim syr botol - 25 25 - 25
63 Cendo Lyteers botol - - - - -
64 Cendo Mydriatil botol - - - - -
65 Cetirizine syr botol 224 270 494 298 196
66 Cetirizine tab 10 mg tablet 21,945 5,200 27,145 18,057 9,088
 67 Cloramfecort cr tablet - - - - -
68 Combivent vial 260 - 260 260 -
69 Clozapin tablet - - - - -
70 Colchitine / Kolkisin tablet - - - - -
71 Clobazam tablet 250 - 250 - 250
72 D artep tablet - - - - -
73 Deksametason inj. 5mg/ml-1ml. ampul 230 150 380 200 180
74 Deksametason tab 0,5 mg. tablet 6,324 23,300 29,624 27,848 1,776
75 Dexosimethason tube - 120 120 - 120
76 Diazepam inj 5 mg/ml-2ml. ampul 20 50 70 70 -
77 Diazepam tab 2mg. tablet 300 - 300 300 -
78 Diazepam tab 5mg. tablet 494 500 994 105 889
79 Dietilkarbamazin Sitrat tab 100 m tablet - - - - -
80 Difenhidramin HCL inj 10 mg/ml ampul 30 - 30 30 -
81 Digoksin tab. 0,25 mg tablet 250 800 1,050 295 755
82 Dihidroartemisin+ Piperaquin ( DH tablet - - - - -
83 Dimenhidrinat 50 mg tablet - 500 500 50 450
84 Doksisiklin kap 100 mg tablet - 200 200 - 200
85 Domperidon suspensi botol 230 150 380 201 179
86 Domperidon tab 10 mg tablet 60 7,000 7,060 711 6,349
87 Domperidon 5 mg Drop Botol 50 - 50 50 -
88 Dopamed tablet - - - - -
89 Efineprin HCL/bitartat inj 0,1%-1m ampul 62 70 132 115 17
90 Ekstrak Belladon tab 10 mg. tablet - - - - -
91 Erithromisin 250 mg tablet - - - - -
92 Erithromisin 500 mg tablet - - - - -
93 Erithromisin syr 200 mg/5 ml botol - - - - -
94 Erphavitalgin (Multivitamin Neurot tablet - - - - -
95 Etakridin (Rivanol) Lar 0,1 % botol - - - - -
96 Etambutol 250 mg. tablet - - - - -
97 Etambutol 500 mg tablet - - - - -
98 Etanol 70 % 100 ml botol - - - - -
99 Etanol 70 % 1000 ml botol 24 - 24 24 -
100 Etanol 70 % 300 ml botol 14 - 14 12 2
101 Elizac 20 tablet - - - - -
102 Famotidine tablet - - - - -
103 Fenitoin 100 mg tablet - - - - -
104 Fenobarbital inj 50 mg/ml-2ml. ampul 60 - 60 - 60
105 Fenofibrate 100 mg tablet - - - - -
106 Fenol Gliserol Tetes Telinga 10 % botol 1 96 97 5 92
107 Fitomenadion (Vit. K) inj 2 mg/ml ampul - - - - -
108 Fitomenadion (Vit. K) tab. 10 mg. tablet 40 700 740 40 700
109 Flixotide Nebules 0,5mg/2ml ampul - 2 2 2 -
110 Flumin (Obat Batuk Kombinasi de tube - - - - -
111 Furosemid inj ampul 25 - 25 25 -
112 Furosemid tab 40 mg. tablet 1,083 - 1,083 966 117
113 Flurin DMP tablet - - - - -
114 Flufenazine Decanoat Injeksi 25 Ampul 10 - 10 10 -
115 Garam Oralit untuk 200ml air sack 2,392 7,400 9,792 5,161 4,631
116 Genoint SM tube - - - - -
117 Gentamisin sulfat 0,5 % OTM botol 89 24 113 113 -
118 Gentamisin Sulfat 1 mg/g salep ku tube - 250 250 38 212
119 Gentamisin sulfat inj ampul - - - - -
120 Gentianviolet 1 % botol - - - - -
121 Glibenklamid tab 5 mg. tablet 3,465 4,000 7,465 4,505 2,960
122 Glikazid ( Glikab ) tablet 1,145 - 1,145 1,145 -
123 Glimepirid 2 mg tablet 729 - 729 729 -
124 Glimepirid 3 mg tablet 2,047 300 2,347 2,347 -
125 Gliseril Guayakolat tab. 100 mg. tablet - - - - -
126 Glukosa Lar Infus 10 %. plabot - - - - -
127 Glukosa Lar Infus 40 %. plabot - - - - -
128 Glukosa Lar Infus 5 %. plabot - 10 10 10 -
129 GOM botol - 48 48 3 45
130 Gored 80 mg tablet - - - - -
131 Griseufulvin tab 125 mg. tablet - - - - -
132 Guaiafenesin tablet 1,572 - 1,572 1,426 146
133 Gemfribozil 300 mg tablet - 200 200 200 -
134 Haloperidol tab 0,5 mg tablet 280 - 280 280 -
135 Haloperidol tab 1,5 mg tablet - 10 10 10 -
136 Haloperidol tab 5 mg tablet 100 1,700 1,800 400 1,400
137 Haloperidol injeksi 5 mg (Lodome ampul - - - - -
138 Haldol Decanoat ampul - - - - -
139 Herbesser CD 100 tablet - - - - -
140 Hidroklortiazida (Hct) tab 25 mg. tablet - 800 800 - 800
141 Hidrokortison Krim 25 % tube 154 336 490 266 224
142 Herbakof botol - 48 48 3 45
143 Ibuprofen Tab. 200 mg. tablet - - - - -
144 Ibuprofen Tab. 400 mg tablet - 4,300 4,300 2,403 1,897
145 Ibupropen Suspensi botol 85 - 85 85 -
146 Ichtiol pot 3 - 3 3 -
147 Iliadin Tetes hidung botol - - - - -
148 Irbesartan 150 mg tablet - - - - -
149 Isoniazid 300 mg. tablet - - - - -
150 Isosorbit Dinitrat tab subling 5 mg tablet 731 200 931 731 200
151 Imundo Capl tablet - - - - -
152 Kalsium Glukonas ampul 72 - 72 - 72
153 Kalsium Laktat (Kalk) tab 500 mg. tablet 4,963 4,000 8,963 8,672 291
154 Kaptoril 12,5 mg tablet 367 4,200 4,567 869 3,698
155 Kaptoril 25 mg tablet 33 1,300 1,333 - 1,333
156 Ketokonazol 200 mg. tablet 1,088 1,200 2,288 1,245 1,043
157 Ketokonazol Krim 2 % tube 11 148 159 11 148
158 Ketorolac inj 10 mg ampul - 50 50 - 50
159 Ketorolac inj 30 mg ampul 200 130 330 255 75
160 Klindamisin 150 mg Kapsul - - - - -
161 Klindamisin 300 mg Kapsul - 500 500 - 500
162 Kloram fenikol kap 500mg. (Chlo Kapsul - - - - -
163 Kloramfenikol 0,5 % TTM (Decace botol - 10 10 - 10
164 Kloramfenikol Salep Mata 1 % tube 28 - 28 11 17
165 Kloramfenikol Tetes Telinga 3 % ( botol 59 - 59 59 -
166 Klorfeniramine Mal. Tab. 4 mg. ( tablet 9,120 15,300 24,420 22,226 2,194
167 Klorpromazin Inj. 5 mg/ml - 2 ml ampul 30 - 30 - 30
168 Klorpromazin tab 100 mg tablet - 700 700 1,035 (335)
169 Klorpromazin tab 25 mg tablet - - - - -
170 Kodein Hcl tab 10 mg. tablet - - - - -
171 Kombinasi Obat Flu Anak ( Colortu botol - - - - -
172 Kombinasi Obat Flu Dewasa ( Color tablet - - - - -
173 Kotrimoksazol Dewasa tab. 480 m tablet 1,520 5,000 6,520 3,152 3,368
174 Kotrimoksazol Suspensi botol 302 500 802 568 234
175 KSR tablet - - - - -
176 Kloramfenicol SK/Bufacetine Sale tube 292 72 364 359 5
177 Lansoprazole Kapsul - 600 600 350 250
178 Lar mengandung Karboh + Elekt ( plabot - - - - -
179 Larutan mengandung Elektrolit ( A plabot - - - - -
180 Levemir Flexpen pen - - - - -
181 Levertran salep pot 5 - 5 5 -
182 Levopar 100 mg tablet - - - - -
183 Lidokain 2% Injeksi ampul 64 100 164 49 115
184 Lidokain kompositum injeksi Ampul - 720 720 470 250
185 Lisinopril 10 mg tablet - - - - -
186 Lisinopril 5 mg tablet - - - - -
187 Lisol botol 24 5 29 2 27
188 Loperamid tablet 2 mg tablet - - - - -
189 Loratadin tablet 10 mg tablet - - - - -
190 Latus Analog Insulin Injeksi Solotar Pen - - - - -
191 Lactulosa Syrup botol - 20 20 11 9
192 Lytacur Syrup botol - - - - -
193 Magnesium Sulfat Inj.20%-25 ml. ampul - - - - -
194 Magnesium Sulfat Inj.40%-25 ml. ampul 54 - 54 18 36
195 Mebendazol syr botol - - - - -
196 Mebendazol tab 100 mg. tablet - - - - -
197 Meloksikam tablet 15 mg tablet - - - - -
198 Meloksikam tablet 7,5 mg tablet 100 - 100 - 100
199 Mersibion inj ampul - - - - -
200 Metformin 500 mg tablet 6,005 3,000 9,005 8,225 780
201 Metformin 850 mg tablet - - - - -
202 Metil Prednisolon 16 mg tablet - - - - -
203 Metil Prednisolon Tab 4 mg tablet 2,620 10,500 13,120 9,520 3,600
204 Metil Prednisolon Tab 8 mg tablet - - - - -
205 Metoklopamid inj 5 mg/ml ampul - - - - -
206 Metoklopamid tab 10 mg tablet - - - - -
207 Metronidazol infus botol - - - - -
208 Metronidazol tab 250 mg. tablet - - - - -
209 Metronidazol tab 500 mg. tablet 85 - 85 100 (15)
210 Metronidazol syr botol - 100 100 13 87
211 Metyl Ergometrin Mal. inj 0,200 ampul - - - - -
212 Metyl Ergometrin Mal. Tab 0,125 tablet - 200 200 - 200
213 Mikonazol krim 2 % tube 20 384 404 95 309
214 Multivitamin untuk dewasa (Bioly Tablet 1,200 - 1,200 1,200 -
215 Multivitamin untuk anak (Biolysin Botol 1 - 1 18 (17)
216 N-Acetyl Sistein tablet - - - 387 (387)
217 Natrium Bikarbonat tab 500 mg. tablet - - - - -
218 Natrium Diklofenak 25 mg tablet - 1,300 1,300 - 1,300
219 Natrium Diklofenak 50 mg tablet 16,472 7,900 24,372 22,262 2,110
220 Natrium Klorida lar infus 0,9 % (N plabot 40 340 380 219 161
221 Natrium Tiosulfat Inj 25 %-10 ml. ampul - - - - -
222 Natrium Tiroksin tab (Euthyrox) tablet - - - - -
223 Nerilon krim tube - - - - -
224 Neurodial tablet - - - - -
225 Nifedipin tab tablet 500 - 500 500 -
226 Nistatin 100.000 iu/g tab Vagina tablet 95 - 95 67 28
227 Nistatin 500.000 iu/g tab salut tablet 212 - 212 212 -
228 Nitral-Gliseril trinitrat tablet - - - - -
229 Novabion tablet 4,345 9,500 13,845 13,279 566
230 Novorapid Flexpen pen - - - - -
231 Obat Batuk Hitam (OBH) botol - - - 2 (2)
232 Oksitetrasiklin HCl Salep 3 % tube - - - - -
233 OksitetrasiklinHCl Salep 1 % tube 45 275 320 95 225
234 Oksitosin inj. 10 IU/ ml-1ml. ampul - 100 100 19 81
235 Omeprazole 20 mg tablet 3,604 6,200 9,804 5,314 4,490
236 Ondansentron Dihidrate inj ampul - 750 750 450 300
237 Ondansetron tablet 4 mg tablet - 2,160 2,160 300 1,860
238 Ondansetron tablet 8 mg tablet - - - - -
239 Papaverin Tab tablet - - - - -
240 Paracetamol drop botol - - - - -
241 Parasetamol Syrup 120 mg/ml. botol 749 1,370 2,119 1,418 701
242 Parasetamol tablet 100 mg tablet - - - - -
243 Parasetamol tablet 500 mg tablet 13,917 92,700 106,617 92,464 14,153
244 Paracetamol Infuse botol - - - - -
245 Permetrim krim (Scabimite) tube 75 - 75 75 -
246 Piracetam 400 mg tab tablet - - - - -
247 Piracetam 800 mg tab tablet - - - - -
248 Piracetam inj ampul - - - - -
249 Pirantel Pamoat tablet 125 mg. tablet - - - - -
250 Piridoksin Hcl tablet 10 mg. tablet 3,391 - 3,391 3,261 130
251 Piroksikam 10 mg tablet - - - - -
252 Piroksikam 20 mg tablet 8,796 3,000 11,796 11,134 662
253 Povidon Iodida Lar. 10 % 300 ml. botol 35 5 40 40 -
254 Povidon Iodida Lar. 10 % 60 ml. botol 84 - 84 84 -
255 Povidon Iodida Lar. 10% 30 ml botol - 4 4 4 -
256 Prednison Tablet 5 mg. tablet - - - - -
257 Primakuina tablet 15 mg tablet - - - - -
258 Prokain Penisilin Vial ampul - - - - -
259 Propanolol HCl tablet 10 mg. tablet - - - - -
260 Propanolol HCl tablet 40 mg. tablet - - - - -
261 Propil Tio Urasil Tablet 100 mg. tablet - - - - -
262 Ranitidin Inj 25 mg/ ml ampul 600 450 1,050 850 200
263 Ranitidin tab 150 mg tablet 313 7,500 7,813 3,764 4,049
264 Rifampisin Kaplet 300 mg tablet - - - - -
265 Rifampisin Kaplet 600 mg tablet - - - - -
266 Rifampisin Kapsul 450 mg tablet - - - - -
267 Ringer Laktat Larutan Infus Steril plabot 480 3,120 3,600 2,240 1,360
268 Risperidon 1 mg tablet - - - - -
269 Risperidon 2 mg tablet 1,300 7,900 9,200 8,625 575
270 Salbutamol nebules ampul - - - - -
271 Salbutamol Tablet 2 mg. tablet 4,510 1,500 6,010 4,682 1,328
272 Salbutamol Tablet 4 mg. tablet - - - - -
273 Salep 2-4 Kombinasi pot 78 - 78 52 26
274 Salisil Bedak 2 % sak - - - - -
275 Sefadroksil Kaplet 500 mg tablet - 3,000 3,000 3,000 -
276 Sefadroksil syrup botol 220 - 220 157 63
277 Sefotaksim injeksi 1 g ampul 209 360 569 229 340
278 Seftriakson injeksi 1 g ampul 530 400 930 364 566
279 Seretide diskus 250 mcg pcs 4 - 4 4 -
280 Seretide diskus 50 mcg pcs - - - - -
281 Sianokobalamin Inj 500 mcg/ml. ampul - - - - -
282 Sianokobalamin tablet tablet 3,268 15,000 18,268 17,788 480
283 Simetidin 200 mg tablet - - - - -
284 Simvastatin 10 mg tablet 4,250 1,100 5,350 4,650 700
285 Simvastatin 20 mg tablet - - - - -
286 Siprofloksasin 500 mg tablet - 1,000 1,000 500 500
287 Sorvitral (Multivitamin dan Minera tablet - - - - -
288 Spiriva (Tiotropium) 18 mcg + Han kotak - - - - -
289 Spiriva (Tiotropium) 18 mcg Reffil Kapsul - - - - -
290 Spironolakton tab 25 mg tablet - - - - -
291 Stesolid 5 mg diazepam tablet 7 10 17 12 5
292 Sulfasetamid Nat. Tetes Mata 15 botol - - - - -
293 Suprafenid ( Ketoprofen supp 10 supp 17 - 17 19 (2)
294 Synarcus Huocinolone tube - - - - -
295 Sucralfat Syrup 500 mg botol - 327 327 70 257
296 Tiamfenikol 500 mg tablet - - - - -
297 Tiamina Mononitrat tab 50 mg. tablet 540 - 540 540 -
298 Tiamina HCl Inj. 100 mg/ml-1ml ampul - - - - -
299 Tramadol inj 50 mg/ml ampul - - - - -
300 Tramadol Tablet 50 mg tablet - - - - -
301 Triheksifenidil HCl tab 2 mg tablet 4,639 12,000 16,639 12,154 4,485
302 Urinter (asam pipemidat 400 mg) tablet - - - - -
303 Valsartan 80 mg tablet - - - - -
304 Ventolin Inhaler tablet - - - - -
305 Vitamin B komplek Tablet tablet 708 - 708 1,250 (542)
306 Xylocaine Jelly 2% Syringe 10 - 10 - 10
307 Zink tablet 1,350 572 1,922 1,930 (8)
308 Zink sir 20 mg/5 ml botol 3 216 219 24 195
VAKSIN - - - - -
309 ABU vial - - - - -
310 ATS 1500 IU ampul - 60 60 10 50
311 VAR ampul - 4 4 4 -
OBAT PROGRAM GIZI - - - - -
312 Mineral Mix sack - - - - -
313 Retinol (Vitamin A) kap. 100.000 Kapsul 44 1,700 1,744 1,069 675
314 Retinol (Vitamin A) kap. 200.000 Kapsul 4,573 6,300 10,873 10,873 -
315 Tablet Tambah Darah Kombinasi tablet 2,830 112,094 114,924 112,414 2,510
OBAT PROGRAM P2PL - - - - -
316 OAT KAT ANAK paket - - - - -
317 OAT KAT I paket - - - - -
318 OAT KAT II paket - - - - -
319 OAT KAT SISIPAN paket - - - - -
REAGEN - - - - -
320 Anti -A Monoclonal Blood Groupi botol - - - - -
321 Anti -A,B Monoclonal Blood Reage botol - - - - -
322 Anti -B Monoclonal Blood Reagent botol - - - - -
323 Anti -D Duoclone Monoclonal botol - - - - -
- - - - -
324 Febrile Antigen H Typhi Pcs - - - - -
325 Febrile Antigen H-A paratyphi Pcs - - - - -
326 Febrile Antigen H-B paratyphi Pcs - - - - -
327 Febrile Antigen H-C paratyphi pcs - - - - -
328 Febrile Antigen O-A paratyphi pcs - - - - -
329 Febrile Antigen O-D paratyphi pcs - - - - -
330 H2O2 botol - - - - -
331 Larutan Asam Asetat botol - - - - -
332 Larutan Asam Sulfosalisilat botol - - - - -
333 Larutan EDTA botol - 1 1 1 -
334 Larutan Giemsa botol - - - - -
335 Larutan HCL 0,5 N botol - - - - -
336 Larutan Ress Ecker botol - - - - -
337 Larutan Turk botol - - - - -
338 Larutan Ziehl Nelsen botol - - - - -
339 Tabung EDTA pack - 200 200 200 -
340 Tabung Non EDTA pack - - - - -
OBAT GIGI - - - - -
341 Cavit pcs - - - - -
342 Devitalisasi Pasta pcs - 2 2 2 -
343 Etil Klorida Semprot pcs - 15 15 - 15
344 Eugenol Cairan botol - 3 3 3 -
345 Eviplac Disclosing pcs - - - - -
346 Glass Ionomer Cement (gc IX) botol - - - - -
347 Hydral pcs - - - - -
348 Kalsium Hidroksida Pasta pcs - - - - -
349 Monoklor Mentol Cairan/CHKM/p pcs - - - - -
350 Mummfying Pasta / Iodoform pcs - - - - -
351 Semen Seng Fosfat Cair pcs - - - - -
352 Trikloroformalin/formocresol pcs - - - - -
353 Zinc Sement pcs - - - - -
354 Tooth Mousse GC Tube Stawberry botol - - - - -
ALAT-ALAT KESEHATAN - - - - -
355 Alat Suntik 1 ml. pcs 3,700 - 3,700 1,200 2,500
356 Alat Suntik 10 ml pcs - - - - -
357 Alat Suntik 20 ml pcs 168 - 168 - 168
358 Alat Suntik 3 ml. pcs 772 3,100 3,872 3,562 310
359 Alat Suntik 5 ml. pcs 800 1,400 2,200 1,300 900
360 Alat Suntik Spuit 0,05 cc pcs 385 - 385 385 -
361 Alat Suntik Spuit 0,5 cc pcs - 500 500 500 -
362 Alkohol swab kotak 7 - 7 7 -
363 Antiseptik gel botol 13 - 13 13 -
364 Alkapharm (pencuci instrumen me Botol - - - - -
365 Benechek asam urat kotak - 30 30 2 28
366 Benechek cholesterol kotak - 30 30 3 27
367 Benechek glukosa kotak - 70 70 - 70
368 Blood lanset box 17 10 27 27 -
369 Blood tranfusion set pcs - - - - -
370 Box object glass pcs - - - - -
371 Cat gut plain 2/0 pcs - - - - -
372 Cat Gut/ Benang Bedah no. 3/0/c pcs - 72 72 - 72
373 Cat Gut/ Benang Bedah no. 3/0/pl pcs - 72 72 36 36
374 Cuticell classic 10 x 10 cm box - - - - -
375 Easy Touch HB kotak - - - - -
376 Feeding tube no.10 pcs - - - - -
377 Fixomul pcs 79 40 119 95 24
378 Folley Cathether No. 16 pcs - - - - -
379 Folley Cathether No. 18 pcs 8 - 8 - 8
380 Folley Cathether No. 20 pcs 20 - 20 13 7
381 Handscon Nonsteril Uk S kotak - 29 29 9 20
382 Handscon Nonsteril Uk M kotak - 20 20 10 10
383 Hanscond non steril All size kotak - 5 5 5 -
384 Hanscond steril Size 7,5 (DAK 201 pcs - - - - -
385 Hydrogel Wound dressing kotak - - - - -
386 Infusion Set anak pcs 325 100 425 225 200
387 Infusion Set dewasa pcs 580 100 680 680 -
388 IV Cateter No.18 pcs 50 100 150 63 87
389 IV Cateter No.20 pcs - 400 400 327 73
390 IV Cateter No.22 pcs - 150 150 150 -
391 IV Cateter No.24 pcs 230 - 230 230 -
392 IV catheter no 26 pcs 150 - 150 50 100
393 Kapas Pembalut/Adsorben 250 m pcs 1 6 7 7 -
394 Kasa Elastis 4 inchi pcs 6 - 6 6 -
395 Kasa Meteran 36 m x 80 cm pcs 2 - 2 2 -
396 Kasa Pembalut 2m x 80cm. pcs 14 10 24 11 13
397 Kasa Pembalut Hidrofil 4m x 15cm pcs 50 380 430 240 190
398 Kasa Steril (16 x 16 ) pcs 159 15 174 168 6
399 Masker ear loop box - 70 70 69 1
400 Masker plus 3 play plus earloop box - 25 25 25 -
401 Masker ties on pcs - 42 42 42 -
402 Mikropipet pcs - - - - -
403 Nasal Oxygen Uk L pcs 52 - 52 56 (4)
404 Nasal Oxygen Uk M pcs - - - - -
405 Nasal Oxygen Uk S pcs - - - 25 (25)
406 Nasal Oxygen Uk XS pcs - - - - -
407 Needle 25 G Pcs - - - - -
408 Needle Vacutainer flashback kotak 15 - 15 6 9
409 Plester 5 Yard x 2 Inc. pcs 88 - 88 41 47
410 Pot sputum pcs 580 - 580 - 580
411 Queck Cek Hb Kotak - - - - -
412 Safety Box 5 Liter pcs 46 - 46 45 1
413 Silk (benang bedah sutra) no 3/0 pcs - 36 36 72 (36)
414 Slide (hibah propinsi) kotak - - - - -
415 Stomach tube no. 18 pcs - - - - -
416 Stomach tube no. 20 pcs - - - - -
417 Surgical Blade no.11 kotak 5 - 5 5 -
418 Softaman antiseptic gel btl - - - - -
419 Terumo nanopass needle (32,5G pcs - - - - -
420 Test pack pcs - - - - -
421 Underpad pcs 55 - 55 1 54
422 Urine bag pcs 40 20 60 10 50
423 White Tips pack - - - - -
424 Wing Needle 25 G pcs - - - - -
425 Wing Needle 27 G pcs - - - - -
426 Wing Needle 21 G pcs - - - - -
427 Wing Needle 23 G pcs - - - - -
428 Yellow Tips pcs - - - - -
429 Herbacof tablet tablet - 2,192 2,192 182 2,010
430 Herbacof sirup btl - 368 368 30 338
431 Forneuro tablet - 412 412 12 400
432 Solaflus btl - 50 50 10 40
433 Stimunos btl - 200 200 10 190