1.

SATUAN KERJA ADALAH NAMA APOTEK, FKTP, FKRTL atau DINKES PROVINSI dan KAB/KOTA
2. SISA STOK PER 31 DESEMBER 2021 ADALAH SISA STOK PER 31 DESEMBER 2021 DI SATUAN KERJA
3. PREDIKSI PENGADAAN TAHUN 2021 ADALAH PREDIKSI JUMLAH YANG DIRENCANAKAN UNTUK DIADAKAN TAHUN 2022
4. PEMAKAIAN RATA-RATA PER BULAN SELAMA 2021 ADALAH PEMAKAIAN RATA-RATA PER BULAN DI SATKER SELAMA TAHUN
5. PREDIKSI SISA STOK 31 DESEMBER 2022 ADALAH SISA STOK PER 31 DESEMBER 2021 DITAMBAH PREDIKSI PENGADAAN TAH
6. JUMLAH KEBUTUHAN TAHUN 2023 ADALAH PEMAKAIAN RATA-RATA PER BULAN SELAMA 2021 DIKALI 15 BULAN DALAM SA
7. RENCANA KEBUTUHAN TAHUN 2023 ADALAH JUMLAH KEBUTUHAN YANG DIHITUNG BERDASARKAN METODE KONSUMSI D
8. RENCANA PENGADAAN TAHUN 2023 ADALAH RENCANA UNTUK PENGADAAN DI TAHUN 2023 DALAM SATUAN TERKECIL SE
9. RENCANA PENGADAAN TAHUN 2022 ADALAH OTOMATIS TERISI DARI SISTEM JIKA SATKER TELAH MENGIRIMKAN PELAPOR
10. REALISASI PENGADAAN TAHUN 2021 ADALAH REALISASI PENGADAAN OBAT JKN BAIK E-PURCHASING MAUPUN MANUAL

RENCANA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN RUJUKAN TINGKAT LANJU

SATUAN KERJA : RS Sumber Waras

NO NAMA OBAT SATUAN

1 153-Sm-EDTMP (ethylenediamine tetramethylene phosphonic acid) 44 Tab

mg Ca/Na EDTMP, 5-46 ?g samarium, dan 1850 ± 185 mbq samarium 153
per ml

2 Abacavir 300 mg Tablet/kaplet/kaps

3 Adefovir dipivoksil tab 10 mg tablet/kapsul/kapl
4 Adenosin inj 3 mg/mL ampul/vial
5 Afatinib tab sal selaput 20 mg tablet salut selap
6 Afatinib tab sal selaput 30 mg tablet salut selap
7 Afatinib tab sal selaput 40 mg tablet salut selapu
8 Air untuk injeksi Botol 100 ml
9 Air untuk injeksi Botol 250 ml
10 Air untuk injeksi ampul/vial/botol 1
11 Air untuk injeksi amp 20 ml ampul/vial/botol
12 Air untuk injeksi amp 25 ml ampul/vial/botol 2
13 Air untuk irigasi Flexy bag 500 ml
14 Air untuk irigasi inf Botol 500 ml
15 Air untuk irigasi lar inf 1000 ml botol @ 1.000 mL
16 Akarbose tab 100 mg tablet/kapsul/kapl
17 Akarbose tab 50 mg tablet/kapsul/kapl
18 Albendazol susp 200 mg/5 ml Botol
19 Albendazol tab 400 mg tablet/kapsul/kapl
20 Albumin serum normal (human albumin) inj 20% 100 ml Botol
21 Albumin serum normal (human albumin) inj 20% 50 ml Botol
22 Albumin serum normal (human albumin) inj 25% 100 ml Botol
23 Albumin serum normal (human albumin) inj 25% 20 ml Botol
24 Albumin serum normal (human albumin) inj 25% 50 ml Botol
25 Albumin serum normal (human albumin) inj 5% 250 ml Botol
26 Albumin serum normal (human albumin) inj 5% 50 ml Botol
27 Alendronat Tab 70 mg tablet/kapsul/kapl
28 Alopurinol tab 100 mg Tab
29 Alopurinol tab 300 mg tablet/kapsul/kapl
30 Alprazolam tab 0,25 mg tablet/kapsul/kapl
31 Alprazolam tab 0,5 mg tablet/kapsul/kapl
32 Alprazolam tab 1 mg tablet/kapsul/kapl
33 Alteplase serb inj 50 mg/vial Vial
34 Amfoterisin B inj 50 mg/10 ml (i.v.) Ampul
35 Amfoterisin B salep mata 1% Tube
36 Amfoterisin B salep mata 3% Tube
37 Amikasin inj 250 mg/ml vial/ampul
38 Aminofilin inj 24 mg/ml ampul/vial 10 ml
39 Aminofilin tab 150 mg tablet/kapsul/kapl
40 Aminofilin Tab 200 mg tablet/kapsul/kapl
41 Amiodaron inj 150 mg/3 ml ampul/vial
42 Amiodaron tab 200 mg Tab
43 Amitriptilin tab sal 25 mg tablet/kapsul/kapl
44 Amlodipin tab 10 mg tablet/kapsul/kapl
45 Amlodipin tab 5 mg tablet/kapsul/kapl
46 Amoksisilin drops 100 mg/ml Botol @10 ml
47 Amoksisilin drops 100 mg/ml Botol @20 ml
48 Amoksisilin drops 100 mg/ml Botol @15 ml
49 Amoksisilin sir forte 250 mg/5 ml botol 60 ml
50 Amoksisilin sir kering 125 mg/5 ml Botol
51 Amoksisilin tab 250 mg tablet/kapsul/kapl
52 Amoksisilin tab 500 mg tablet/kapsul/kapl
53 Ampisilin serb inj 1000 mg/vial ampul/vial
54 Ampisilin serb inj 250 mg/vial Vial
55 Analog insulin : intermediate acting inj 100 UI/ml (kemasan vial, cartridge vial/cartridge
disposible, penfill cartridge)
56 Analog insulin : mix insulin (inj 100 UI/ml) Vial/Cartridge
57 Analog insulin intermediate acting combine with short or long acting inj Penfill
100 IU/ml (25% insulin lispro), vial/cartridge diposible/penfill cartridge

58 Analog insulin intermediate acting combine with short or long acting inj Penfill
100 IU/ml (50% insulin lispro), vial/cartridge diposible/penfill cartridge

59 Analog Insulin long acting inj 100 IU/mL, vial/cartridge disposible/penfill Vial/Cartridge/Penf
cartridge
60 Analog insulin rapid acting inj 100 IU/mL Vial @10 ml
61 Analog insulin rapid acting inj 100 IU/mL cartridge disposible
 62 Analog Insulin: insulin basal inj 300 IU/mL vial/disposable car
63 Anastrozol tab 1 mg tablet/kapsul/kapl
64 Anestetik lokal gigi kombinasi : lidokain hcl 2% + epinefrin 1 : 80.000 inj 2 ampul/vial
ml
65 Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium tablet/kapsul/kapl
hidroksida 200 mg
66 Antasida, kombinasi : aluminium hidroksida 200 mg + magnesium botol 60 ml
hidroksida 200 mg
67 Anti Parkinson kombinasi : benzerasid 25 mg + levodopa 100 mg Kaps
68 Antibakteri, kombinasi : basitrasin 500 UI/g+ Polimiksin B 10.000 UI/g Tube

69 Antifungi salep, kombinasi : asam benzoat 6%+ asam salisilat 3% pot 30 g

70 Antihemoroid, kombinasi: bismut subgalat 150 mg + heksaklorofen 2,5 Suppositoria
mg + lidokain lidokain 10 mg+ seng oksida 120 mg + sup ad 2 g

71 Aquadest cairan 500 ml Botol 500 ml

72 Aripiprazol oral solution 1 mg/ml botol
73 Aripiprazol tab 5 mg tablet/kapsul/kapl
74 Aripiprazol tab discmelt 10 mg tab discmelt/tab ce
75 Aripiprazol tab discmelt 15 mg tab discmelt/ tab c
76 Artesunat serb inj 60 mg/ml (i.v./i.m.) ampul/vial
77 Articulating paper kertas warna penanda oklusi Kertas warna penan
78 Asam asetat tetes telinga 2% Botol
79 Asam asetilsalisilat (asetosal) tab 100 mg tablet sal enterik/k
80 Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/kapl
81 Asam askorbat (vitamin C) tab 250 mg Tab
82 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/kapl
83 Asam folat tab 0,4 mg tablet/kapsul/kapl
84 Asam folat tab 1 mg tablet/kapsul/kapl
85 Asam folat tab 5 mg Tab
86 Asam Fusidat tts mata 1% catchcover, botol
87 Asam fusidat tts mata 1% Botol @5 ml
88 Asam ibandronat inj 1 mg/ml ampul/vial
89 Asam mefenamat kaps 250 mg tablet/kapsul/kapl
90 Asam mefenamat kaps 500 mg tablet/kapsul/kapl
91 Asam pipemidat kaps 400 mg tablet/kapsul/kapl
92 Asam retinoat krim 0,05% Tube/pot
93 Asam retinoat krim 0,1% Tube @ 20 gram
94 Asam retinoat krim 0,1% Tube @ 10 gram
95 Asam salisilat lar 0,1% Botol
96 Asam salisilat salep 10% Tube
97 Asam salisilat salep 2% Tube
98 Asam salisilat salep 5% Tube
99 Asam traneksamat inj 100 mg/ml ampul/vial
100 Asam traneksamat inj 50 mg/ml Ampul
101 Asam traneksamat tab 500 mg ampul/vial
102 Asam ursodeoksikolat kaps 250 mg tablet/kapsul/kapl
103 Asam zoledronat inf 4 mg/100 ml Botol
104 Asam Zoledronat Inf 5 mg/100 ml Botol
105 Asetazolamid tab 250 mg tablet/kapsul/kapl
106 Asiklovir salep mata 3% tube
107 Asiklovir serb inj 250 mg Ampul/vial
108 Asiklovir tab 200 mg tablet/kapsul/kapl
109 Asiklovir tab 400 mg tablet/kapsul/kapl
110 Asparaginase serb inj 10.000 UI/vial Vial
111 Atapulgit 600 mg tablet/kapsul/kapl
112 Atapulgit tab 630 mg tablet/kapsul/kapl
113 Atapulgit tablet 650 mg tablet/kapsul/kapl
114 Atapulgit tablet 750 mg Tab
115 Atenolol tab 100 mg tablet/kapsul/kapl
116 Atenolol tab 50 mg tablet/kapsul/kapl
117 Atorvastatin tab 10 mg tablet salut selapu
118 Atorvastatin tab 20 mg tablet salut selapu
119 Atrakurium inj 10 mg/ml (i.v) ampul/vial @ 5 ml
120 Atrakurium inj 10 mg/ml (i.v) ampul/vial @ 2,5 m
121 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul
122 Atropin tab 0,5 mg Tab
123 Atropin tts mata 0,5% Botol
124 Atropin tts mata 1% Botol
125 Azatioprin tab 50 mg Tab
126 Azitromisin serb inj 500 mg ampul/vial
127 Azitromisin sir kering 200 mg/5 ml maks botol @60 m
128 Azitromisin tab 250 mg tablet/kapsul/kapl
129 Azitromisin tab 500 mg tablet salut selapu
130 Bahan tumpatan sementara lar, serb Botol
131 Barium sulfat serb 92 g/100 ml Botol
132 Barium sulfat serb 92 g/100 ml Disposible plastic
133 Barium sulfat susp 95% Botol plastik
134 Basiliksimab Inj 20 mg Vial
135 Bedak salisil serb 2% Dus/Sachet/Plastik
136 Bedakuilin fumarat tab 100 mg tablet/kapsul/kapl
137 Bendamustin serb inj 100 mg Vial
138 Bendamustin serb inj 25 mg Vial
139 Benzatin penisilin inj 1,2 juta UI/ml (i.m.) Vial
140 Benzatin penisilin inj 2,4 juta UI/ml (i.m.) Vial
141 Beraprost sodium tab 20 mcg tablet/kapsul/kapl
142 Betahistin tab 24 mg Tab
143 Betahistin tab 6 mg tablet/kapsul/kapl
144 Betaksolol tts mata 0,5% Catchcover, botol
145 Betaksolol tts mata 0,5% Botol @ 5 ml
146 Betametason krim 0,1% tube 5 gram
147 Betametason krim 0,5 mg/g Tube
148 Betametason salep 0,1% tube 5 gram
149 Betametason tts mata 1 mg/ml botol @5 ml
150 Betametason tts mata 1 mg/ml catchcover, botol
151 Bikalutamid tab sal 150 mg tablet salut/kaplet
152 Bikalutamid tab sal 50 mg tablet salut/kaplet
153 Bisakodil sup 10 mg Suppositoria
154 Bisakodil sup 5 mg Suppositoria
155 Bisakodil tab sal 5 mg tablet/kapsul/kapl
156 Bisoprolol tab 1,25 mg tablet/kapsul/kapl
157 Bisoprolol tab 10 mg tablet salut selapu
158 Bisoprolol tab 2,5 mg tablet/kapsul/kapl
159 Bisoprolol tab 5 mg tablet salut selap
160 Bleomisin serb inj 15 mg/ml Vial
161 Bortezomib serb inj 3,5 mg ampul/vial
162 Brinzolamid tetes mata Botol
163 Bromokriptin tab 2,5 mg Tab
164 Budesonid cairan ih 0,25mg/ml Botol @ 4 ml
165 Budesonid cairan ih 0,25mg/ml, respoules 2 ml respoules
166 Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml
167 Budesonid cairan ih 0,5 mg/ml, respoules 2 ml respoules
168 Budesonid serb ih 100 mcg/dosis Botol
169 Budesonid serb ih 200 mcg/dosis 100 dosis
170 Budesonid serb ih 200 mcg/dosis 200 dosis
171 Budesonid-formoterol (fixed combination) 160/4,5 mg (inhalasi), 120 Turbuhaler
dosis
172 Budesonid-formoterol (fixed combination) 160/4,5 mg (inhalasi), 120 rapihaler
dosis
173 Budesonid-formoterol (fixed combination) 160/4,5 mg (inhalasi), 60 dosis Turbuhaler

174 Budesonid-formoterol (fixed combination)* ih 80/4,5 mcg Turbuhaler

175 Budesonid-formoterol (fixed combination)* ih 80/4,5 mcg rapihaler
176 Bupivakain heavy inj 5 mg/ml (hcl) + glukosa 8% vial/ampul @4 ml
177 Bupivakain inj 5 mg/ml (p.v.) ampul/vial
178 Busulfan tab salut 2 mg Tab
179 Cardioplegia inj ampul/vial
180 Cisaprid tab 5 mg tablet
181 Copper T set/buah
182 Dabigatran eteksilat kaps 110 mg tablet/kapsul/kapl
183 Dabigatran eteksilat kaps 75 mg tablet/kapsul/kapl
184 Dakarbazin serb inj 100 mg/vial Vial
185 Dakarbazin serb inj 200 mg/vial Vial
186 Daklatasvir tab sal selaput 30 mg Tab
187 Daklatasvir tab sal selaput 60 mg Tab
188 Daktinomisin inj 0,5 mg/vial (i.v.) Vial
189 Dapson tab scored 100 mg Tab
190 Daunorubisin serb inj 20 mg/vial Vial
191 Deferasiroks tab disp 250 mg Tab
192 Deferasiroks tab disp 500 mg tablet dispersible/
193 Deferasiroks tab sal selaput 180 mg tablet salut selapu
194 Deferasiroks tab sal selaput 360 mg tablet salut selapu
195 Deferipron lar oral 100 mg/ml Botol
196 Deferipron tab sal 500 mg tab salut selaput/k
197 Deferoksamin mesilat serb inj 500 mg/vial Vial
198 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial
199 Deksametason tab 0,5 mg tablet/kapsul/kapl
200 Deksmedetomidin Inj 100 mcg/ml ampul/vial
201 Delamanid tab 50 mg tablet/kapsul/kapl
202 Desfluran cairan ih Botol
203 Desmopresin nasal spray 10 mcg/puff Botol
204 Desmopresin tab 0,1 mg Tab
205 Desmopresin tab 0,2 mg Tab
206 Desogestrel tab 75 mcg Tab
207 Desoksimetason gel 0,05% Tube
208 Desoksimetason krim 0,25% tube 10 g
209 Desoksimetason krim 0,25% tube 15 g
210 Desoksimetason salep 0,25% tube 10 g
211 Dialisis peritoneal, larutan intraperitoneal - Extraneal ultrabag
212 Diazepam enema 10 mg/2,5 ml tube @ 2,5 mL
213 Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL
214 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial
215 Diazepam tab 2 mg tablet/kapsul/kapl
216 Diazepam tab 5 mg tablet/kapsul/kapl
217 Dienogest tab 2 mg tablet/kapsul/kapl
218 Dietilkarbamazin tab 100 mg tablet/kapsul/kapl
219 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial
220 Diflukortolon valerat salep berlemak 0,1% Tube
221 Digoksin inj 0,25 mg/ml ampul/vial
222 Digoksin tab 0,25 mg tablet/kapsul/kapl
223 Diltiazem hcl inj 5 mg/5 ml Ampul
224 Diltiazem inj 25 mg/5 ml ampul/vial
225 Diltiazem kaps SR 100 mg Kapsul lepas lamba
226 Diltiazem kaps SR 200 mg Kapsul lepas lamba
227 Diltiazem serb inj 10 mg/10 ml Ampul
228 Diltiazem serb inj 50 mg/vial Vial
229 Diltiazem tab 30 mg Tab
230 Dimenhidrinat tab 50 mg tablet/kapsul/kapl
231 Dinatrium edetat tts mata 0,35% (3,5 mg/ml) Botol
232 Dinatrium klodronat inj 60 mg/ml Botol
233 DMSA (dimercapto succinic acid) 1,1 mg meso-2, 3-dimercaptosuccinic Vial
acid/vial
234 Dobutamin inj 12,5 mg/ml ampul/vial
235 Dobutamin inj 25 mg/ml ampul/vial
236 Dobutamin inj 50 mg/ml ampul/vial
237 Doksazosin tab 1 mg tablet/kapsul/kapl
238 Doksazosin tab 2 mg tablet/kapsul/kapl
239 Doksisiklin kaps 100 mg tablet/kapsul/kapl
240 Doksisiklin kaps 50 mg tablet/kapsul/kapl
241 Doksorubisin serb inj 10 mg/vial (i.v.) Vial
242 Doksorubisin serb inj 50 mg/vial Vial
243 Dolutegravir tab 50 mg tablet/kapsul/kapl
244 Domperidon susp 5 mg/5 ml botol @60 ml
245 Domperidon tab 10 mg tablet/kapsul/kapl
246 Domperidon tts 5 mg/ml Botol
247 Donepezil tab 5 mg tablet salut selapu
248 Donepezil tab eff 10 mg tablet dispersible /
249 Dopamin inj 40 mg/ml ampul/vial
250 Dosetaksel inj 20 mg Vial
251 Dosetaksel inj 40 mg/ml (vial 0,5 ml) Vial
252 Dosetaksel inj 40 mg/ml (vial 2 ml) Vial
253 Dosetaksel inj 80 mg Vial
254 DTPA (diethylene triamine pentaacetic acid) 2,06-2,5 mg pentetate Vial
calcium trisodium/ml
255 Dutasterid kaps 0,5 mg Kaps lunak
256 Efavirenz tab 200 mg Tablet
257 Efavirenz tab sal 600 mg tablet salut selapu
258 Efedrin inj 50 mg/ml ampul/vial
259 Eksemestan tab 25 mg tablet salut gula
260 Eltrombopag tab sal selaput 25 mg Tab
261 Eltrombopag tab sal selaput 50 mg Tab
262 Enoksaparin sodium inj 20 mg/0,2 ml Ampul
263 Enoksaparin sodium inj 40 mg/0,4 ml Ampul
264 Enoksaparin sodium inj 60 mg/0,6 ml Ampul
265 Entekavir tab sal selaput 0,5 mg tablet salut selapu
266 Entekavir tab sal selaput 1 mg tablet salut selapu
267 Epinefrin (adrenalin) inj 1 mg/ml Ampul
268 Epirubisin serb inj 2 mg/ml, vial 25 ml Vial 25 ml
269 Epirubisin serb inj 2 mg/ml, vial 5 ml Vial 5 ml
270 Epirubisin serb inj 50 mg Vial 25 mL
271 Ergokalsiferol (vitamin D2) kaps 50.000 UI Kaps
272 Ergokalsiferol (vitamin D2) susp 10.000 UI/ml Botol
273 Ergotamin tab 1 mg Tab
274 Eribulin inj 0,44 mg/ml ampul/vial
275 Eritromisin kaps 250 mg tablet/kapsul/kapl
276 Eritromisin sir 200 mg/5 ml Botol @ 60 ml
277 Eritromisin tab 500 mg tablet/kapsul/kapl
278 Eritropoetin-alfa inj 10.000 IU Vial
279 Eritropoetin-alfa inj 2.000 IU Vial
280 Eritropoetin-alfa inj 3.000 IU Vial
281 Eritropoetin-alfa inj 4.000 IU Vial
282 Eritropoetin-beta inj 2000 UI/0,3 ml Vial
283 Eritropoietin-alfa inj 40.000 IU ampul/vial
284 Eritropoietin-Alfa Inj 4000 IU/0,5 ml Ampul
285 Erlotinib tab sal selaput 100 mg tablet salut selapu
286 Erlotinib tab sal selaput 150 mg tablet salut selapu
287 Esomeprazole inj 40 mg/vial ampul/vial
288 Estrogen terkonjugasi tab sal 0,625 mg tablet salut gula/ka
289 Etambutol tab 400 mg tablet/kapsul/kapl
290 Etanercept inj 50 mg/ml ampul/vial
291 Etanol 70% cairan 70% Botol
292 Etil klorida semprot 100 ml Botol
293 Etonogestrel implan 68 mg Set
294 Etoposid inj 20 mg/ml Vial
295 Eugenol Botol
296 Everolimus tab 0,25 mg tablet/kapsul/kapl
297 Everolimus tab 0,5 mg tablet/kapsul/kapl
298 Everolimus tab 0,75 mg tablet/kapsul/kapl
299 Faktor IX Kompleks Inj 50 IU/mL ampul/vial
300 Faktor IX kompleks serb inj 1.000 UI/vial + pelarut 10 ml Vial
301 Faktor IX kompleks serb inj 500 UI/vial + pelarut Vial
302 Faktor koagulasi II 14-35 UI, faktor koagulasi VII 7-20 UI, faktor koagulasi Vial
IX 25 UI, faktor koagulasi X 14-35 serb inj 250 IU/10 ml
303 Faktor koagulasi II 14-35 UI, faktor koagulasi VII 7-20 UI, faktor koagulasi Vial
IX 25 UI, faktor koagulasi X 14-35 serb inj 500 UI/20 ml UI

304 Faktor viia (rekombinan) serb inj 1 mg/vial + pelarut untuk injeksi ampul/vial

305 Faktor VIII (konsentrat) serb inj 230 -340 UI Vial

306 Faktor VIII (konsentrat) serb inj 480 - 600 UI Vial
307 Faktor VIII serb inj 1000 mg/vial Vial
308 Faktor VIII serb inj 250 IU Vial
309 Faktor VIII serb inj 500 IU Vial
310 Fenilefrin drops 10% Botol
311 Fenitoin Na inj 50 mg/ml (100 mg/ 2 mL) ampul @ 2 ml
312 Fenitoin Na kaps 100 mg Kaps
313 Fenitoin Na kaps 30 mg Kaps
314 Fenobarbital inj 100 mg/mL ampul/vial
315 Fenobarbital inj 50 mg/ml Ampul
316 Fenobarbital tab 100 mg Tab
317 Fenobarbital tab 30 mg tablet/kapsul/kapl
318 Fenofibrat kaps 100 mg tablet/kapsul/kapl
319 Fenofibrat kaps 300 mg tablet/kapsul/kapl
320 Fenoksimetil penisilin (penisilin V) tab 250 mg Tab
321 Fenoksimetil penisilin (penisilin V) tab 500 mg Tab
322 Fenoterol hbr aerosol 100 mcg/puff Botol
323 Fenoterol hbr cairan ih 0,1% Botol
324 Fentanil inj 0,05 mg/ml (ampul 10 ml) ampul/vial, @ 10
325 Fentanil inj 0,05 mg/ml (ampul 2 ml) ampul @ 2 mL
326 Fentanil patch 12,5 mcg/jam Patch
327 Fentanil patch 25 mcg/jam Patch
328 Fentanil patch 50 mcg/jam Patch
329 Ferrakrilum cairan 1% Botol
330 Filgrastim inj 300 mcg/ml ampul/vial
331 Finasterid tab 5 mg tablet/kapsul/kapl
332 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) ampul/vial
333 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal
334 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) tablet salut gula/ka
335 Fludarabin inj 50 mg/vial Vial
336 Fludarabin tab sal 10 mg tablet salut/kaplet
337 Flufenazin inj 25 mg/ml (i.m.) Vial
338 Flukonazol inj 2 mg/ml Ampul
339 Flukonazol kaps 150 mg tablet/kapsul/kapl
340 Flukonazol kaps 50 mg Kaps
341 Fluoksetin kaps 10 mg tablet/kapsul/kapl
342 Fluoksetin kaps 20 mg tablet/kapsul/kapl
343 Fluor kapl 1 mg Kaplet
344 Fluor sediaan topikal Tube
345 Fluorescein Sodium/ Natrium Fluoresein inj 100 mg/mL Ampul/vial
346 Fluoro deoxy glucose (FDG) Vial
347 Fluorometolon tts mata 0,1% botol @5 ml
348 Fluorometolon tts mata 0,1% catchcover, botol
349 Fluorourasil inj 50 mg/mL (@ 10 mL) Ampul
350 Fluorourasil inj 50 mg/mL (@ 5 mL) Ampul
351 Flusinolon asetonid krim 0,025% tube @ 5g
352 Flusinolon asetonid salep 0,025% Tube 10 g
353 Flutikason furoat intranasal spray Botol
354 Flutikason propionat cairan ih 0,5 mg/dosis Botol
355 Flutikason Propionat MDI 50 mcg/semprot Botol
356 Fluvoksamin tab sal selaput 100 mg tablet salut selapu
357 Fluvoksamin tab sal selaput 50 mg tablet salut selapu
358 Fondaparinuks inj 2,5 mg/0,5 ml ampul/vial/prefille
359 Formokresol Botol
360 Fosfomisin Trometamol granula 3 g Sachet
361 Fraksi protein plasma lar inf 5% Botol
362 Framisetin Sulfat Tulle 1% Patch
363 Furosemid inj 10 mg/ml (i.v./i.m.) ampul/vial
364 Furosemid tab 40 mg tablet/kapsul/kaple
365 Gabapentin kaps 100 mg tablet/kapsul/kapl
366 Gabapentin kaps 300 mg tablet/kapsul/kapl
367 Gadobutrol Macrocyclic 5 ml Prefilled Syringe @
368 Gadobutrol Macrocyclic 7,5 ml Prefilled Syringe @
369 Gadoksetat disodium 0,25 mmol gadoksetat disodium/ml Vial
370 Gadoteric acid inj 279,32 mg/ml Vial @15 ml
371 Gadoteric acid inj 279,32 mg/ml Vial @20 ml
372 Gadoteric acid inj 279,32 mg/ml Vial @10 ml
373 Galactose microparticle 200-400 mg micropart/ml Vial
374 Gansiklovir serb inj 500 mg/vial Vial
375 Garam Fe, setara dengan Fe elemental 15 mg/5 mL Botol
376 Garam Fe, setara dengan Fe elemental 60 mg Sachet
377 Garam Fe, setara dengan Fe elemental 60 mg Botol
378 Garam oralit kombinasi : natrium klorida 0,52 g + kalium klorida 0,30 g + sachet
trinatrium sitrat 0,58 g + glukosa anhidrat 2,7 g
379 Gefitinib tab 250 mg tablet/kapsul/kaple
380 Gemfibrozil kaps 300 mg tablet/kapsul/kaple
381 Gemfibrozil kaps 600 mg tablet/kapsul/kaple
382 Gemsitabin inj 1000 mg/vial Vial
383 Gemsitabin inj 200 mg/vial Vial
384 Gentamisin inj 40 mg/ml ampul/vial
385 Gentamisin salep mata 0,3% Tube
386 Gentamisin tsts mata 1% Botol
387 Gentamisin tts mata 0,3% Botol
388 Glass ionomer ART (Atraumatic Restorative Treatment) cocoa butter 5 g Sachet

389 Glass ionomer ART (Atraumatic Restorative Treatment) lar Botol

390 Glass ionomer ART (Atraumatic Restorative Treatment) serb Vial
391 Glibenklamid tab 2,5 mg tablet/kapsul/kaple
392 Glibenklamid tab 5 mg tablet/kapsul/kaple
393 Gliklazid tab 80 mg Tab
394 Gliklazid tab MR 30 mg Tab
395 Gliklazid tab SR 60 mg tablet lepas lamba
396 Glikopironium serb ih 50 mcg kapsul
397 Glikuidon tab 30 mg tablet/kapsul/kaple
398 Glimepirid tab 1 mg tablet/kapsul/kaple
399 Glimepirid tab 2 mg tablet/kapsul/kaple
400 Glimepirid tab 3 mg tablet/kapsul/kaple
401 Glimepirid tab 4 mg tablet/kapsul/kaple
402 Glipizid tab 10 mg tablet/kapsul/kaple
403 Glipizid tab 5 mg tablet/kapsul/kaple
404 Gliseril trinitrat inj 5 mg/ml Ampul
405 Gliseril trinitrat kaps lepas lambat 2,5 mg kapsul lepas lamba
406 Gliseril trinitrat kaps lepas lambat 5 mg kapsul lepas lamba
407 Gliseril trinitrat tab 0,5 mg tablet/kapsul/kapl
408 Gliserin lar 50% Botol
409 Gliserin tts 100 mg/ml Botol
410 Glukosa Larutan Infus 10% steril 100 ml Botol
411 Glukosa Larutan Infus 10% steril 250 ml Botol
412 Glukosa Larutan Infus 10% steril 500 ml Botol
413 Glukosa Larutan Infus 40% Ampul @25 ml
414 Glukosa Larutan Infus 5% steril 100 ml Botol
415 Glukosa Larutan Infus 5% steril 250 ml Botol
416 Glukosa Larutan Infus 5% steril 500 ml Botol
417 Goserelin asetat inj 10,8 mg/vial Vial
418 Goserelin asetat inj 3,6 mg/vial Vial
419 Griseofulvin (micronized) tab 125 mg tablet/kapsul/kapl
420 Griseofulvin (micronized) tab 500 mg Tab
421 Griseofulvin (micronized) tab scored 250 mg tablet/kapsul/kapl
422 Gutta percha dan paper points 15 - 40 mm Roll
423 Gutta percha dan paper points 45 - 80 mm Roll
424 Haloperidol inj 5 mg/ml (i.m.) Vial
425 Haloperidol inj 50 mg/ml (decanoat) Vial
426 Haloperidol tab 0,5 mg tablet/kapsul/kapl
427 Haloperidol tab 1,5 mg tablet/kapsul/kapl
428 Haloperidol tab 2 mg tablet/kapsul/kapl
429 Haloperidol tab 5 mg tablet/kapsul/kapl
430 Haloperidol tts 2 mg/ml botol
431 Halotan ih Botol
432 Hemodialisa lar Botol
433 Heparin, Na inj 5.000 UI/ml (i.v./s.k.) Vial
434 Hepatitis B imunoglobulin (human) inj 150 IU/1,5 ml Ampul
435 Hepatitis B imunoglobulin (human) Inj 220 IU/ml Syringe
436 Hidrogen peroksida cairan 3% Botol
437 Hidroklorotiazid tab 12,5 mg Tab
438 Hidroklorotiazid tab 25 mg tablet/kapsul/kapl
439 Hidrokortison krim 1% tube @ 5 g
440 Hidrokortison krim 2,5% tube @ 5 g
441 Hidrokortison serb inj 100 mg Vial
442 Hidrokortison Tab 20 mg Tab
443 Hidroksi klorokuin tab 200 mg Tab
444 Hidroksi urea tab 500 mg tablet/kapsul/kapl
445 Hiosina butilbromida inj 20 mg/ml ampul/vial
446 Hiosina butilbromida tab 10 mg tablet/kapsul/kapl
447 Homatropin tts mata 2% Botol
448 Human insulin : mix insulin inj 100 UI/ml Vial @10 mL
449 Human insulin : mix insulin inj 100 UI/ml vial/ cartridge disp
450 Human Insulin intermediate acting combine with short or long acting inj Cartridge, Penfill C
100 IU/mL, cartridge disposible/penfill cartridge
451 Human insulin intermediate acting combine with short or long acting inj Vial
100 IU/mL, Vial 10 mL
452 Human Insulin intermediate acting inj 100 IU/ml, cartridge Cartridge, Penfill C
disposible/penfill cartridge
453 Human Insulin intermediate acting inj 100 IU/Ml, Vial 10 mL Vial
454 Human Insulin intermediate acting inj 100 IU/mL, Vial 5 mL Vial
455 Human insulin short acting inj 100 IU/ml Vial @10 mL
456 Human insulin short acting inj 100 IU/ml Cartridge disposibl
457 Human tetanus imunoglobulin inj 250 UI (i.m.) Ampul
458 Human tetanus imunoglobulin inj 500 UI (i.m.) Ampul
459 Hydromorphone HCl tab oros 16 mg tablet lepas lamba
460 Hydromorphone HCl tab oros 8 mg tablet lepas lamba
461 Ibuprofen Inj 100 mg/ml ampul/vial
462 Ibuprofen sir 100 mg/5 ml botol @ 60 ml
463 Ibuprofen sir 200 mg/5 ml botol @ 60 ml
464 Ibuprofen tab 200 mg tablet/kapsul/kapl
465 Ibuprofen tab 400 mg tablet/kapsul/kapl
466 Idarubisin serb inj 20 mg Vial
467 Ifosfamid serb inj 1000 mg/vial Vial
468 Ifosfamid serb inj 2000 mg/vial Vial
469 Ifosfamid serb inj 500 mg/vial Vial
470 Iloprost ih 10 mcg/mL ampul/vial
471 Imatinib mesilat tab 100 mg tablet/kapsul/kapl
472 Imatinib Mesilat tab 400 mg tablet/kapsul/kapl
473 Imidafenasin tab sal selaput 0,1 mg tablet salut selapu
474 Imidapril tab 10 mg tablet/kapsul/kapl
475 Imidapril tab 5 mg tablet/kapsul/kapl
476 Imunoglobulin Intravena Inj 50 mg/ml, untuk terapi GBS (Guillain Bare Vial
Syndrom)
477 Indakaterol serb ih 150 mcg Kaps
478 Indakaterol serb ih 300 mcg Kaps
479 Iodiksanol vial 320 mg Iodium/100 ml ampul/vial/botol
480 Iodiksanol vial 320 mg Iodium/50 ml ampul/vial/botol
481 Iodium 131 Botol
482 Iodohippurate sodium I 131 37-74 mbq/ multiple-dose Vial
483 Ioheksol 180 - 300 mg Iodium/mL (300 mg/20 mL) ampul/vial/botol
484 Ioheksol 240-350 mg Iodium/ml (300 mg/75 ml) Vial
485 Ioheksol 240-350 mg Iodium/ml (350 mg/75 ml) ampul/vial/botol
486 Ioheksol Inj 140 - 350 mg Iodium/mL (350 mg/100 ml) ampul/vial/botol
487 Ioheksol Inj 140 - 350 mg Iodium/mL (350 mg/50 ml) Vial
488 Ioheksol Inj 180 - 300 mg Iodium/mL (300 mg/100 ml) ampul/vial/botol
489 Ioheksol Inj 180 - 300 mg Iodium/mL (300 mg/50 ml) ampul/vial/botol
490 Iopamidol 300 - 370 mg Iodium/mL (300 mg/100 mL) Ampul/vial/botol
491 Iopamidol 300 - 370 mg Iodium/mL (300 mg/50 mL) Ampul/vial/botol
492 Iopamidol 300 - 370 mg Iodium/mL (370 mg/100 mL) Vial
493 Iopamidol 300 - 370 mg Iodium/mL (370 mg/200 mL) Vial
494 Iopamidol 300 - 370 mg Iodium/mL (370 mg/50 mL) ampul/vial/botol
495 Iopromid 300 - 370 mg (300 mg/100 mL) Vial
496 Iopromid 300 - 370 mg (300 mg/50 mL) Vial
497 Iopromid 300 - 370 mg (370 mg/100 mL) Vial
498 Iopromid 300 - 370 mg (370 mg/50 mL) Vial
499 Ipratropium bromida aerosol 20 mcg/semprot Botol
500 Ipratropium bromida cairan ih 0,025% Botol
501 Irbesartan tab 150 mg tablet/kapsul/kapl
502 Irbesartan tab 300 mg tablet/kapsul/kapl
503 Irinotekan inf 20 mg/ml Ampul/vial @ 2 mL
504 Irinotekan inf 20 mg/ml Ampul/vial @ 5 mL
505 Irinotekan inj 20 mg/ml Ampul/vial @ 5 mL
506 Irinotekan inj 20 mg/ml Ampul/vial @ 2 mL
507 Isofluran inhalasi 100 ml Botol
508 Isofluran inhalasi 250 ml botol @ 250 mL
509 Isoniazid tab 100 mg Tab
510 Isoniazid tab 300 mg Tab
511 Isosorbid dinitrat inj 1 mg/ml (i.v) ampul/vial
512 Isosorbid dinitrat tab 10 mg tablet/kapsul/kapl
513 Isosorbid dinitrat tab 5 mg tablet/kapsul/kapl
514 Itrakonazol Kaps 100 mg tablet/kapsul/kapl
515 IUD Cu T 380 A Set
516 IUD Levonorgestrel Set
517 Ivabradin tab 5 mg tablet /kapsul/kapl
518 k.y jelly Tube gel
519 Kalamin Tube
520 Kalium aspartat tab 300 mg tablet salut selapu
521 Kalium klorida / Potasium klorida injeksi 25 mg 7,46%, 25 mL Ampul/vial
522 Kalium klorida tab SR 600 mg tablet lepas lamba
523 Kalsitriol kaps lunak 0,25 mcg kapsul lunak
524 Kalsitriol kaps lunak 0,5 mcg kapsul lunak
525 Kalsium Folinat (Leukovorin, Ca) Inj 10 mg/ml ampul/vial
526 Kalsium folinat (leukovorin, Ca) tab 15 mg Tab
527 Kalsium glukonat inj 100 mg/ml ampul/vial
528 Kalsium hidroksida bubuk, pasta Tube
529 Kalsium hipoklorit Sachet
530 Kalsium karbonat tab 500 mg tablet/kapsul/kapl
531 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/kapl
532 Kalsium polistirena sulfonat ktg 5 g Sachet
533 Kandesartan tab 16 mg tablet/kapsul/kapl
534 Kandesartan tab 8 mg tablet/kapsul/kapl
535 Kapesitabin tab sal 500 mg tab salut/kaplet sa
536 Kaptopril tab 12,5 mg tablet/kaplet
537 Kaptopril tab 25 mg tablet/kaplet
538 Kaptopril tab 50 mg tablet/kaplet
539 Karbamazepin sir 100 mg/5 ml Botol
540 Karbamazepin Tab 200 mg Tablet
541 Karbimazol tab 5 mg tablet/kapsul/kapl
542 Karbogliserin tts telinga 10 % Botol
543 Karboksimetilselulosa tts mata Botol
544 Karboplatin Inj 10 mg (vial 45 ml) Vial
545 Karboplatin inj 10 mg/ml (vial 15 ml Vial
546 Karvedilol kaps 6,25 mg tablet/kapsul/kapl
547 Karvedilol tab 25 mg tablet/kapsul/kapl
548 Ketamin inj 100 mg/ml (i.v.) ampul/vial
549 Ketamin inj 50 mg/ml (i.v.) ampul/vial
550 Ketokonazol krim 2% Tube 10 g
551 Ketokonazol scalp sol 2% botol
552 Ketokonazol tab 200 mg tablet/kapsul/kapl
553 Ketoprofen Inj 25 mg/ml ampul/vial
554 Ketoprofen sup 100 mg Suppositoria
555 Ketorolak inj 30 mg/ml ampul/vial
556 Klaritromisin sir kering 125 mg/5 ml botol maks 60 mL
557 Klaritromisin sir kering 250 mg/5 ml Botol
558 Klaritromisin tab 500 mg tablet salut selapu
559 Klindamisin kaps 150 mg Kaps
560 Klindamisin kaps 300 mg tablet/kapsul/kapl
561 Klobazam tab 10 mg tablet/kapsul/kapl
562 Klobetasol propionat krim 0,05% tube
563 Klobetasol propionat salep 0,05% tube
564 Klofazimin, micronized kaps 50 mg Kapsul
565 Klofazimin, micronizedkaps 100 mg kapsul
566 Klomipramin tab 25 Tab
567 Klonazepam kaps 2 mg tablet salut selapu
568 Klonidin inj 150 mcg/ml Vial
569 Klonidin tab 0,15 mg tablet/kapsul/kapl
570 Klopidogrel tab 75 mg tablet salut selapu
571 Klopidogrel tab sal selaput 300 mg tablet salut selapu
572 Kloral hidrat lar Botol
573 Klorambusil tab sal selaput 5 mg tab sal selaput
574 Kloramfenikol kaps 250 mg tablet/kapsul/kapl
575 Kloramfenikol kaps 500 mg tablet/kapsul/kapl
576 Kloramfenikol salep mata 1% tube @ 5 gram
577 Kloramfenikol serb inj 1.000 mg/ml vial/ampul
578 Kloramfenikol susp 125 mg/5 ml botol 60 ml
579 Kloramfenikol tetes telinga 3% Botol
580 Kloramfenikol tts mata 0,5% botol
581 Kloramfenikol tts mata 1% Botol
582 Klorfeniramin tab 4 mg tablet/kapsul/kapl
583 Klorfenol kamfer mentol (CHKM) Botol
584 Klorheksidin lar 0,2% Botol
585 Klorheksidin lar 15% Botol
586 Klorokuin tab 250 mg Tablet
587 Klorpromazin inj 25 mg/ml (i.m.) ampul/vial
588 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial
589 Klorpromazin tab sal 100 mg tablet salut selapu
590 Klorpromazin tab sal 25 mg Tab sal
591 Klortalidon tab 50 mg Tab
592 Klotrimazol tab vagina 100 mg Tab
593 Klozapin tab 100 mg tablet
594 Klozapin tab 25 mg tablet
595 Kodein tab 10 mg tablet/kapsul/kapl
596 Kodein tab 15 mg tablet/kapsul/kapl
597 Kodein tab 20 mg tablet/kapsul/kapl
598 Kolestiramin serb, 4 g Ampul
599 Kolkisin tab 500 mcg Tab
600 Komb: Deksametason 0,1% Thymol 5% Paraklorphenol 30 Botol
601 Kombinasi (DHP) : dihidroartemisin 40 mg + Piperakuin 320 mg tab sal tablet salut selapu
selaput
602 Kombinasi : (Ampisilin 1000 mg + Sulbaktam 500 mg) serb inj 1500 mg ampul/vial

603 Kombinasi : (Sefoperazon 500 mg + Sulbaktam 500 mg) serb inj 1000 mg ampul/vial

604 Kombinasi : (Zidovudin 60 mg + Lamivudin 30 mg + Nevirapin 50 mg) Ped Tab dispersible

Triple FDC
605 Kombinasi : Ampisilin 500 mg + Sulbaktam 250 mg serb inj 750 mg ampul/vial
606 Kombinasi : artemether 20 mg + lumefantrin 120 mg tablet/kapsul/kapl
607 kombinasi : benserazid 25 mg + levodopa 100 mg tablet dispersible/
608 Kombinasi : Brinzolamid 1% + Timolol 0,5%, tts mata Botol
609 Kombinasi : Desogestrel 150 mcg Etinilestradiol 30 mcg Tab
610 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/kapl
611 Kombinasi : Ferro fumarat 60 mg + asam folat 0,4 mg tab salut tablet salut gula
612 Kombinasi : Indakaterol 110 mcg + Glycopyrronium 50 mcg serb ih + alat Botol
breezhaler
613 Kombinasi : Ipratropium bromida 0,02 mg + fenoterol HBr 0,05 mg Botol
aerosol
614 Kombinasi : levodopa 100 mg+Karbidopa 25 mg + entekapon 200 mg tablet/kapsul/kapl

615 Kombinasi : levonorgestrel 150 mcg + etinilestradiol 30 mcg tab salut gula
616 Kombinasi : medroksi progesteron asetat+ estradiol sipionat inj depot 25 Vial
mg + 5 mg
617 Kombinasi : Meglumin amidotrizoat + Sodium amidotrizoat inj 76% Vial

618 Kombinasi : Sefiksim 400 mg + Azitromisin 1000 mg Paket

619 Kombinasi : Tenofovir 300 mg + Emtrisitabin 200 mg Tab
620 Kombinasi : Tenofovir 300 mg + Lamivudin 300 mg + Efavirenz 600 mg Tab

621 Kombinasi : Travoprost 0,004% + Timolol 0,5%, tts mata Botol

622 Kombinasi : triamsinolon + dementilklortetrasiklin Pasta tube
623 Kombinasi : zidovudin 300 mg +lamivudin 150 mg Tab
624 Kombinasi KDT/FDC mengandung: (medroksi progesteron asetat 120 mg ampul/vial
+ estradiol sipionat 10 mg) inj
625 Kombinasi KDT/FDC mengandung: (salmeterol 50 mcg + flutikason Diskus
propionat 250 mcg) serb ih
626 Kombinasi KDT/FDC mengandung: (salmeterol 50 mcg + flutikason Diskus
propionat 500 mcg) serb ih
627 Kombinasi KDT/FDC mengandung: (tiotropium 2,5 mcg + olodaterol 2,5 Cartridge
mcg) cairan ih
628 Kombinasi KDT/FDC mengandung: (tiotropium 2,5 mcg + olodaterol 2,5 Cartridge
mcg) cairan ih, refill
629 Kombinasi KDT/FDC, setiap mL mengandung: latanoprost 0,05 mg + Botol 2,5 mL
timolol 5 mg tetes mata
630 Kombinasi KDT/FDC, setiap mL mengandung: latanoprost 0,05 mg + catchcover, botol
timolol 5 mg tetes mata
631 Kombinasi, setiap ml mengandung: natrium klorida 4,40 mg + kalium Catchcover, botol p
klorida 0,80 mg (tetes mata)
632 Kombinasi, setiap ml mengandung: natrium klorida 4,40 mg + kalium Botol plastik @ 5 m
klorida 0,80 mg (tetes mata)
633 Kombinasi, setiap ml mengandung: natrium klorida 4,40 mg + kalium Botol Plastik @ 15
klorida 0,80 mg (tetes mata)
634 Kombinasi: Amoksisilin 1.000 mg + Asam klavulanat 200 mg, Inj 1.200 mg vial

635 Kombinasi: Elbasvir 50 mg dan Grazoprevir 100 mg tablet salut selaput tablet salut selapu

636 Kombinasi: Ipratropium bromida 0,5 mg + Salbutamol 2,5 mg, cairan ih Ampul/vial

637 Kombinasi: kaolin 550 mg + pektin 20 mg Tab

638 Kombinasi: lopinavir 200 mg + ritonavir (LVP) 50 mg, tab 250 mg Tab
639 Kombinasi: parafin + gliserin + fenolftalein Botol
640 Kombinasi: salmeterol 25 mcg + flutikason propionat 50 mcg ih 50 aerosol can/canist
mcg/puff
641 Kombinasi: salmeterol 50 mcg + flutikason propionat 100 mcg ih 100 Botol
mcg/puff
642 Kombinasi: salmeterol 50 mcg + flutikason propionat 500 mcg ih 500 Botol
mcg/puff
643 Kombinasi: salmeterol 50 mcg+ flutikason propionat 250 mcg ih 250 Botol
mcg/puff
644 Kombinasi: Tenofovir 300 mg + Lamivudin 300 mg + Dolutegravir 50 mg, Tablet/kapsul/kapl
tablet
645 Komibinasi: lidokain + medisinal creosote phenol + eugenol + benzil Botol
alkohol, cairan
646 Komposit resin Set
647 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+ tab/kaptab
trimetoprim 80 mg
648 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 800 mg+ tab/kaptab
trimetoprim 160 mg
649 Kotrimoksazol kombinasi tiap 5 ml suspensi : sulfametoksazol 200 mg + botol 60 mL
trimetoprim 40 mg
650 Kuinin inj 25% (i.v.) Vial
651 Kuinin tab 200 mg tablet/kapsul/kapl
652 Laktulosa sir 3,335 g/5 ml botol @ 60 mL
653 Lamivudin (3TC) tab 150 mg tablet/kapsul/kapl
654 Lamivudin tab 100 mg tablet/kapsul/kapl
655 Lamotrigin Tab 100 mg Tab
656 Lamotrigin tab 50 mg Tablet
657 Lamotrigin tab dispersible 25 mg tablet dispersible/
658 Lansoprazol inj 30 mg/ml Vial
659 Lansoprazol kaps 30 mg tablet/kapsul/kapl
660 Lapatinib tab 250 mg tablet/kapsul/kapl
661 Larutan mengandung Asam Amino (Asam Amino 10%) Botol
662 Larutan mengandung Asam Amino (Asam Amino 100 g, Total N 15,7 g, Botol
Na+ 2 mEq, Asetat 120 mEq)
663 Larutan mengandung Asam Amino (Asam Amino 15 g, Glukosa 37,5 g, Softbag @500 mL
Tiamin HCl 0,75 mg, elektrolit)
664 Larutan mengandung Asam Amino (Asam Amino 27 g, Sorbitol 50 g, Cl-52 Botol
mEq)
665 Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3 % dan Botol
elektrolit) 1000 ml
666 Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 7,3 % dan Botol
elektrolit) 500 ml
667 Larutan mengandung Asam Amino (Asam Amino 30 g, Glukosa 75 g, Softbag @1.000 m
Tiamin HCl 1,5 mg, elektrolit)
668 Larutan mengandung Asam Amino (Asam Amino 5% dengan BCAA 45%, L- Botol
Ornithine L Aspartate 8.03 gr/L, Sorbitol 50 gr/L, Xylitol 50 gr/L)

669 Larutan mengandung Asam Amino (Asam Amino 6%, mengandung Botol
Taurine 0,24 gr/l) : Aminosteril Infant 6%
670 Larutan mengandung Asam Amino (Asam Amino 7% (total protein 17,5 g) Botol
dengan kandungan asam amino esensial (EAA) dan non esensial (NEAA)
yang seimbang EAA : NEAA = 60 : 40))
671 Larutan mengandung Asam Amino (Asam Amino 72.05 g, Total N 11.53 g, Botol
AAE/AANE ratio 2.6, Na+ 2 mEq, Asetat 46 mEq)
672 Larutan mengandung Asam Amino (Asam Amino 79.9 g, Total N 12.2 g, Botol
Na+ 14 mEq, Cl 94 mEq)
673 Larutan mengandung Asam Amino (Asam amino 8%) : Aminosteril N- Botol
Hepa
674 Larutan mengandung Asam Amino (Asam Amino 9%, Komposisi: Asam Botol
Amino esensial: Asam Amino non esensial = 60 : 40)
675 Larutan mengandung Asam Amino (Asam Amino esensial 7%+Xylitol 10 Botol
g/L)
676 Larutan mengandung Asam Amino (BCAA 25 gr/L, L-Ornithine L Aspartate Botol
10 gr/L, Xylitol 50 gr/L, Malic Acid 7 gr/L, Piridoxin 0.12 gr/L)

677 Larutan mengandung Asam Amino (Glutamine 20 g) Botol

678 Larutan mengandung Asam Amino (Kombinasi : asam amino, glukosa, dan Botol
lipid) (Lipid Peri 1250)
679 Larutan mengandung Asam Amino (Kombinasi : glukosa, emulsi lemak, Botol
dan asam amino) (Lipid Special 1250)
680 Larutan mengandung Asam Amino (Kombinasi : glukosa, emulsi lemak, Botol
dan asam amino) (Lipid Special 625)
681 Larutan mengandung asam amino (kombinasi AA 50 g/L, sorbitol 50 g/L, Botol
Xylitol 50 g/L, vit C 0,4 g/L, Inositol 0,5 g/L, Niasinamid 0,06 g/L, vit B6
0,04 g/L, Riboplavin Na Fosfat 2,5 mg/L, elektrolit)

682 Larutan mengandung Asam Amino (Kombinasi Asam amino 50 g/L, Botol
vitamin dan elektrolit)
683 Larutan mengandung Asam Amino (Kombinasi Glukosa dan elektrolit 150 Botol
gr + Asam Amino 48 gr dgn akses sentral)
684 Larutan mengandung Asam Amino (Kombinasi Glukosa dan elektrolit 80 Botol
gr + Asam Amino 40 gr)
685 Larutan mengandung Asam Amino (N(2)-L-Alanyl-L-Glutamine/ N(2)-L- Botol/vial
Alanyl-L-Glutamine 20%)
686 Larutan mengandung Asam Amino + Elektrolit + Karbohidrat + Lipid Botol
(Kombinasi Asam Amino: 45gr, Glukosa: 130gr, Lipid: 68gr dan Elektrolit
(Kalori = 1400 kkal, Akses peripheral))

687 Larutan mengandung asam amino + elektrolit + Karbohidrat + Lipid Bag

(Glukosa 103 g, Asam amino 46 g, Elektrolit, Lipid 41 g dengan Fish Oil 6,1
g)

688 Larutan mengandung asam amino + elektrolit + Karbohidrat + Lipid Bag

(Glukosa 135 g, Asam amino 60 g, Elektrolit, Lipid 54 g dengan Fish Oil 8
g)

689 Larutan mengandung asam amino + elektrolit + Karbohidrat + Lipid Bag

(Glukosa 63 g, Asam amino 25 g, Elektrolit, Lipid 19 g dengan Fish Oil 2,8
g)
690 Larutan Mengandung Asam amino + Elektrolit + Karbohidrat + Lipid Botol
(Kombinasi Asam amino 56,9 g, Lipid 40 g, Glukosa 110 g dan Elektrolit)

691 Larutan mengandung Asam Amino + Elektrolit + Karbohidrat + Lipid Botol

(Kombinasi Asam Amino: 34gr, Glukosa: 97gr, Lipid: 51gr dan Elektrolit
(Kalori = 1000 kkal, Akses peripheral))

692 Larutan mengandung asam amino + Karbohidrat + Lipid (Glukosa 63 g, Bag

Asam amino 25 g, Lipid 19 g dengan Fish Oil 2,8 g)
693 Larutan mengandung elektrolit (CaCl2H2O 0,165 gr, KCl 0,15 gr, NaCl 4,3 Botol plastik @500
gr)
694 Larutan mengandung Elektrolit (Kalium Klorida) Botol
695 Larutan mengandung Elektrolit (KCl 0,15%, NaCL 0,9%) (KN1) Botol
696 Larutan mengandung Elektrolit (KCl 0,3%,NaCl 0,9%) (KN2) Botol
697 Larutan mengandung Elektrolit (Na 130 mEq, K 4 mEq, Cl 109 mEq, Ca 3 Softbag @ 500 ml
mEq, Asetat 28 mEq) Ringer Asetat
698 Larutan mengandung Elektrolit (Na 130 mEq, K 4 mEq, Cl 109 mEq, Ca 3 Botol plastik @ 50
mEq, Asetat 28 mEq) Ringer Asetat
699 Larutan mengandung Elektrolit (Sodium Lactate sol (50%) 113 gr/L, Botol
Potassium Chloride 0.3 gr/L, Calcium Chloride 0.2 gr/L, elektrolit)

700 Larutan mengandung Elektrolit (Tiap 1000 ml mengandung electrolit: Botol

Sodium 145 mmol/l, Potassium 4.0 mmol/l, Calcium 2.5 mmol/l,
Magnesium 1.0 mmol/l, Chloride 118 mmol/l, Acetate 24 mmol/l, Malate
5.0 mmol/l)

701 Larutan mengandung Karbohidrat + Elektrolit (D2,5%+KCL 0,15%+NaCl Botol

0,45%) (KDN1)
702 Larutan mengandung Karbohidrat + Elektrolit (D2,5%+KCL 0,3%+NaCl Botol
0,45%) (KDN2)
703 Larutan mengandung Karbohidrat (Fructose 120 g, glucose 66 g, Xylitol 60 Botol
g/ L)
704 Larutan mengandung Karbohidrat (Fructose 15 mg, glucose monohydrate softbag
30 mg, xylitol 15 mg)
705 Larutan mengandung Karbohidrat (Fructose 200 g, glucose 110 g, Xylitol Botol
100 g/ L)
706 Larutan mengandung Karbohidrat (Fructose 60 g, glucose 33 g, Xylitol 30 Botol
g/ L)
707 Larutan mengandung Karbohidrat (Maltose 10%) Botol
708 Larutan mengandung Karbohidrat + Elektrolit (25.00g dextrose anhidrat, Botol plastik @500
3.00 g sodium chloride, 0.15 g potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate)

709 Larutan mengandung Karbohidrat + Elektrolit (25.00g maltose, 3.00 g Botol plastik @500
sodium chloride, 0.15 g potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate)

710 Larutan mengandung Karbohidrat + Elektrolit (Acetate, Na, K, Cl, Ca, Mg, Botol
Sorbitol 50 gr/L)
711 Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28 gr/L, Botol
Glukosa 100 gr/L, elektrolit)
712 Larutan mengandung Karbohidrat + Elektrolit (Asam amino 28 gr/L, Botol
Glukosa 75 gr/L, elektrolit)
713 Larutan mengandung karbohidrat + elektrolit (Dextran 40 50 gr, Botol plastik @500
CaCl2H2O 0,1 gr, KCl 0,15 gr, NaCl 3 gr, Na lactate 1,55 gr)
714 Larutan mengandung Karbohidrat + Elektrolit (Dextrose 5%, NaCL 0,45%, Botol
KCl) (HSD)
715 Larutan mengandung Karbohidrat + Elektrolit (Fructose 120 g, glucose 66 Botol
g, Xylitol 60 g/ L + elektrolit)
716 Larutan mengandung Karbohidrat + Elektrolit (Glukosa 25 g, NaCl 2,0 g, Botol
KCl 1,3 g, Natrium Laktat 3,1 g, air untuk injeksi ad 1000 ml)
717 Larutan mengandung Karbohidrat + Elektrolit (Glukosa 55 g ; Natrium Botol
Chloride 9 g, air untuk injeksi ad 1000 ml) (D5-NS)
718 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 110.0 g; NaCl: botol/softbag
1.80 g) (D10-1/5NS)
719 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 25,0 g; NaCl: 4,5 Botol
g)
720 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 2.25 botol/softbag @ 5
g) (D5-1/4NS)
721 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 2.25 botol/softbag @ 1
g) (D5-1/4NS)
722 Larutan mengandung Karbohidrat + Elektrolit (Glukosa: 55.0 g; NaCl: 4.5 Botol
g) (D5-1/2NS)
723 Larutan mengandung karbohidrat + elektrolit (Kombinasi NaCl 18,6 g, KCl Botol
0,3 g, CaCl2 0,48 g, dextrose 50 g per 1000 ml)
724 Larutan mengandung Karbohidrat + Elektrolit (Larutan nutrisi kombinasi Botol
infus per L: Na. 100mEQ, K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl 90mEQ,
Asetat 38mEQ, Sorbitol 50g)

725 Larutan mengandung Karbohidrat + Elektrolit (Larutan Ringer & Glukosa Botol
5%)
726 Larutan mengandung Karbohidrat + Elektrolit (NaCl 0.585 gr, KCl 0.3 gr, Botol plastik @500
Na Lactat 0.56 gr, Dekstrosa 18,75 gr) (KA EN 4B)
727 Larutan mengandung Karbohidrat + Elektrolit (NaCl 0.585 gr, Na Lactat Botol plastik @500
0.56 gr, anhydrous dekstrosa 20 gr) (KA EN 4A)
728 Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.125 gr, Dekstrosa Botol
18.75 gr) (KA EN 1B)
729 Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.75 g, KCL 1.5g, Botol
Glukosa 100 gr)
730 Larutan mengandung Karbohidrat + Elektrolit (NaCl 1.75 g, KCL 1.5g, Na Botol
Lactate 2.24 g, Glukosa 100 gr)
731 Larutan mengandung Karbohidrat + Elektrolit (Nacl 1.75 gr, KCl 1.5 gr, Na Botol
Lactat 2.24 gr, Dekstrosa 27 gr) (KA EN 3B)
732 Larutan mengandung Karbohidrat + Elektrolit (Nacl 2.34 gr, Na Laktat Botol
2.24 gr, KCL 0.75 gr Dekstrosa 27 gr) (KA EN 3A)
733 Larutan mengandung Lipid (Emulsi lemak 20%) Botol
734 Larutan mengandung Lipid (Highly refined fish oil, Glyserol dan purified Botol
egg phospolipid)
735 Larutan mengandung Lipid (Infus Lipid Emulsi MCT/LCT 20% 100 ml) Botol

736 Larutan mengandung Lipid (Infus Lipid Emulsi MCT/LCT 20% 250 ml) Botol

737 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 180 gr + Botol
Asam Amino 71.8 gr + Lipid 50 gr dgn akses sentral)
738 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 80 gr + Botol
Asam Amino 40 gr + Lipid MCT/LCT 50 gr)
739 Larutan mengandung Lipid (Kombinasi Glukosa dan elektrolit 90 gr + Botol
Asam Amino 35.9 gr + Lipid 25 gr dgn akses sentral)
740 Latanoprost tts mata 0,005% catchcover, botol
741 Latanoprost tts mata 0,005% botol @ 2,5 mL
742 Leflunomid tab sal selaput 20 mg tablet salut selapu
743 Lenograstim inj 263 mcg/vial Vial
744 Letrozol tab 2,5 mg tablet/kapsul/kapl
745 Leuprorelin asetat serb inj 1,88 mg Vial
746 Leuprorelin asetat serb inj 11,25 mg Vial
747 Leuprorelin asetat serb inj 22,5 mg Vial
748 Leuprorelin asetat serb inj 3,75 mg ampul/vial
749 Leuprorelin asetat serb inj 7,5 mg Vial
750 Levetirasetam tab 250 mg Tablet
751 levetirasetam tab 500 mg Tablet
752 Levofloksasin inf 5 mg/ml vial/ botol/ flexy
753 Levofloksasin inf 5 mg/ml vial / botol / flex
754 Levofloksasin tab 250 mg tablet/kapsul/kapl
755 Levofloksasin tab 500 mg tablet salut selapu
756 Levofloksasin tts mata 0,5% botol @ 5mL
757 Levonorgestrel implan 2 rods, 75 mg (3-4 tahun) pack/ sachet/ set
758 Levotiroksin tab 100 mcg tablet/kaplet/kaps
759 Levotiroksin tab 50 mcg tablet/kaplet/kaps
760 Lidokain gel 2% syringe/syringe pla
761 Lidokain inj 100 mg, vial (i.v.) Vial
762 Lidokain inj 2% (infiltr/p.v.) ampul/vial
763 Lidokain salep 5% Tube
764 Lidokain spray oral 10% botol
765 Linestrenol tab 0,5 mg tablet/kapsul/kapl
766 Linestrenol tablet 5 mg Tab
767 Liquor carbonis detergens lar 5% Botol
768 Lisinopril tab 10 mg tablet/kapsul/kapl
769 Lisinopril tab 20 mg Tab
770 Lisinopril tab 5 mg tablet/kapsul/kapl
771 Litium karbonat tab 200 mg tablet/kapsul/kapl
772 Litium karbonat tab 400 mg tablet/kapsul/kapl
773 Loperamid tab 2 mg Tab
774 Lopinavir 100 mg + Ritonavir 25 mg tab sal selaput
775 Loratadin tab 10 mg tablet/kapsul/kapl
776 Lorazepam tab 0,5 mg tablet/kapsul/kapl
777 Lorazepam tab 1 mg tablet/kapsul/kapl
778 Lorazepam tab sal 2 mg Tab sal
779 Low molecule feri sucrose inj amp 100 mg/5 ml ampul/vial
780 MAA (macro agregate albumin) 0,11-2,5 mg albumin aggregated/reaction Vial
vial
781 MAG3 (mercapto acetyl tri glysine) 1 mg betiatide/vial Vial
782 Magnesium sulfat inj 20% ampul/vial @25 ml
783 Magnesium sulfat inj 20% ampul/vial
784 Magnesium sulfat inj 40% ampul/vial @25 ml
785 Magnesium sulfat inj 40% ampul/vial
786 Magnesium sulfat serb, ktg 30 g Sachet
787 Manitol lar infus 20% Botol @ 250 ml
788 Manitol lar infus 20% Botol @ 100 ml
789 Manitol lar infus 20% Botol @ 500 ml
790 Maprotilin hcl tab sal 25 mg Tab sal
791 Maprotilin hcl tab sal 50 mg tablet salut selapu
792 MDP (methylene diphosphonate) 1 mg methylene diphosphonic acid/ml Vial

793 Mebendazol sir 100 mg/5 ml Botol

794 Mebendazol tab 100 mg Tan
795 Mebendazol tab 500 mg tablet/kapsul/kapl
796 Medroksi progesteron asetat inj 150 mg/ml ampul/vial
797 Medroksi Progesteron Asetat Inj 50 mg/ml ampul/vial
798 Medroksi progesteron asetat tab 10 mg tablet/kapsul/kapl
799 Medroksi progesteron asetat tab 100 mg tablet/kapsul/kapl
800 Medroksi progesteron asetat tab 5 mg Tab
801 Melfalan tab 2 mg tablet/kapsul/kapl
802 Merkaptopurin tab 50 mg Tab
803 Meropenem serb inj 1000 mg/vial ampul/vial
804 Meropenem serb inj 500 mg/vial ampul/vial
805 Mesalazin enema 4 gram enema
806 Mesalazin tab sal 250 mg tablet salut enterik
807 Mesna inj 100 mg/ml Vial
808 Metadon sir 50 mg/5 ml Botol 1000 ml
809 Metamizol Inj 500 mg/ml Ampul
810 Metenamin mandelat (heksamin mandelat) tab salut enterik 500 mg Tab salut

811 Metformin tab 500 mg tablet/kapsul/kapl

812 Metformin tab 850 mg tablet/kapsul/kapl
813 Metildopa tab sal 250 mg tablet/kapsul/kapl
814 Metilergometrin inj 0,2 mg/ml ampul/vial
815 Metilergometrin tab salut 0,125 mg tablet/kaplet salut
816 Metilfenidat tab 10 mg tablet/kapsul/kapl
817 Metilfenidat tab lepas lambat 18 mg tablet/kapsul/kapl
818 Metilfenidat tab lepas lambat 36 mg tablet/kapsul/kapl
819 Metilprednisolon inj 125 mg/2 ml ampul/vial
820 Metilprednisolon inj 500 mg/8 ml ampul/vial
821 Metilprednisolon tab 16 mg tablet/kapsul/kapl
822 Metilprednisolon tab 4 mg tablet/kapsul/kapl
823 Metilprednisolon tab 8 mg tablet/kapsul/kapl
824 Metoklopramid inj 5 mg/ml ampul/vial
825 Metoklopramid tab 10 mg tablet/kapsul/kapl
826 Metoklopramid tab 5 mg tablet/kapsul/kapl
827 Metoksi polietilen glikol-epoetin beta inj 50 mcg/0,3 ml ampul/vial
828 Metoksi polietilen glikol-epoetin beta inj 75 mcg/0,3 ml ampul/vial
829 Metoprolol tartat inj 1 mg/ml Ampul
830 Metotreksat Inj 10 mg/ml Vial
831 Metotreksat inj 2,5 mg/ml Vial
832 Metotreksat serb inj 25 mg/ml Vial
833 Metotreksat serb inj 5 mg/vial Vial
834 Metotreksat tab 2,5 mg Tab
835 Metronidazol lar inf 5 mg/ml botol
836 Metronidazol ovula 500 mg Ovula
837 Metronidazol sup 500 mg Suppositoria
838 Metronidazol susp 125 mg/5 ml Botol @ 60 ml
839 Metronidazol susp 125 mg/5 ml Botol @ 100 ml
840 Metronidazol tab 250 mg tablet/kapsul/kapl
841 Metronidazol tab 500 mg tablet/kapsul/kapl
842 MIBG (meta-iodobenzylguanidine) Vial
843 MIBI (metoxy iso butyl isonitril) 5-ml reaction vial Vial
844 Midazolam inj 1 mg/ml (i.v.) Vial
845 Midazolam inj 5 mg/ml (i.v.) Vial
846 Mikafungin Na serb inj 50 mg/vial Vial
847 Mikofenolat mofetil tab 500 mg tablet/kapsul/kapl
848 Mikofenolat Sodium Tab Sal 180 mg tablet salut/kaplet
849 Mikofenolat Sodium Tab Sal 360 mg tablet salut/kaplet
850 Mikonazol krim 2% tube
851 Mikonazol serb 2% botol / sachet
852 Milrinone inj 1 mg/ml ampul/vial
853 Mineral Mix (Bismuth Subcitrate Tripotasium, Copper sulfate, Magnesium Sachet
Chloride Anhydrous, Potassium Chloride, Zinc Acetate)

854 Mitomisin serb inj 10 mg Vial

855 Mitomisin serb inj 2 mg Vial
856 Moksifloksasin inf 1,6 mg/mL vial/ampul/botol/
857 Moksifloksasin tab 400 mg tablet salut selapu
858 Moksifloksasin tts mata 0,5% Botol
859 Mometason furoat krim 0,1% tube 10 gram
860 Mometason furoat krim 0,1% Tube 5 gram
861 Morfin Hcl inj 10 mg/ml (i.m./s.k./i.v.) Vial
862 Morfin Hcl tab 10 mg tablet/kapsul/kapl
863 Morfin Hcl tab SR 10 mg tablet lepas lamba
864 Morfin Hcl tab SR 15 mg tablet lepas lamba
865 Morfin Hcl tab SR 30 mg Tab
866 Mupirosin krim 2% tube
867 Mupirosin salep 2% tube
868 N-asetil sistein granula 200 mg Sachet
869 N-asetil sistein ih 100 mg/ml Botol
870 N-asetil sistein kaps 200 mg tablet/kapsul/kapl
871 NaCl 0,9% Larutan Botol @25 ml
872 NaCl 0,9% Larutan Botol @250 ml
873 NaCl 0,9% Larutan Botol @100 ml
874 NaCl 0,9% Larutan Ampul/botol @ 10
875 NaCl 0,9% Larutan Botol @500 ml
876 NaCl 0,9% Larutan Botol @1.000 mL
877 NaCl 3% Larutan Botol plastik @500
878 Nadroparin inj 9.500 Axa/ml syringe 0,3 Ml Vial
879 Nadroparin inj 9.500 Axa/ml, syringe 0,4 ml Vial
880 Nadroparin inj 9.500 Axa/ml, syringe 0,6 ml Vial
881 Nalokson inj 0,4 mg/ml Ampul
882 Natamisin tts mata 5% (50 mg/ml) Botol @5 ml
883 Natamisin tts mata 5% (50 mg/ml) botol @ 15 mL
884 Natamisin tts mata 5% (50 mg/ml) catchcover, botol
885 Natrium aminohipurat inj 200 mg/ml (i.v.) Ampul
886 Natrium bikarbonat inj 8,4% (i.v.) Vial
887 Natrium bikarbonat tab 500 mg tablet/kapsul/kapl
888 Natrium diklofenak inj 25 mg/mL ampul/vial
889 Natrium diklofenak tab 25 mg tablet salut enteri
890 Natrium diklofenak tab 50 mg tablet salut enteri
891 Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL
892 Natrium fluoresein tts mata 2% Botol
893 Natrium fosfat lar oral botol
894 Natrium fusidat krim 20 mg/g tube
895 Natrium fusidat salep 20 mg/g Tube
896 Natrium hialuronat tts mata botol
897 Natrium hipoklorit cairan konsentrat 5% Botol
898 Natrium klorida tts mata 50 mg/mL ampul/vial
899 Natrium tiosulfat inj 25% (i.v.) Ampul
900 Neostigmin inj 0,5 mg/ml Vial
901 Nevirapin tab 200 mg tablet/kapsul/kapl
902 Nifedipin kaps 10 mg tablet/kapsul/kapl
903 Nifedipin tab SR 20 mg tablet lepas lamba
904 Nifedipin tab SR 30 mg tablet lepas lamba
905 Nikardipin inj 10 mg/vial ampul/vial
906 Nilotinib kaps 150 mg tablet/kapsul/kapl
907 Nilotinib tab 200 mg tablet/kapsul/kapl
908 Nimodipin inf 0,2 mg/ml ampul/vial/botol
909 Nimodipin tab 30 mg tablet salut selapu
910 Nistatin susp 100.000 UI/ml botol/vial
911 Nistatin tab salut 500.000 UI tablet salut gula/ka
912 Nistatin tab vaginal 100.000 UI tablet/kaplet
913 Nitrogen oksida ih, gas dlm tabung Botol
914 Nomegestrol asetat Kaps/tab 5 mg tablet/kapsul/kapl
915 Norepinefrin inj 1 mg/ml ampul/vial
916 Noretisteron tab 5 mg tablet/kapsul/kapl
917 Obat Anti Tuberculosis FDC Kategori Anak paket
918 Obat Anti Tuberculosis FDC Kategori I paket
919 Obat Anti Tuberculosis FDC Kategori II paket
920 Obat Anti Tuberculosis FDC Kategori Sisipan paket
921 Obat Anti Tuberculosis Kombipak Anak Paket
922 Obat Anti Tuberculosis Kombipak Dewasa paket
923 Ofloksasin tab 200 mg tablet salut selaput
924 Ofloksasin tab 400 mg tablet salut selaput
925 Ofloksasin tts telinga 3% Botol @ 5 mL
926 Oksaliplatin serb inj 100 mg/vial Vial
927 Oksaliplatin serb inj 50 mg/vial Vial
928 Oksigen ih, gas dlm tabung Botol
929 Oksikodon inj 10 mg/ml Ampul/vial @1 mL
930 Oksikodon inj 10 mg/ml Ampul/vial @2 mL
931 Oksikodon kapsul 10 mg Kaps
932 Oksikodon kapsul 20 mg Kaps
933 Oksikodon kapsul 5 mg tablet/kapsul/kapl
934 Oksikodon larutan oral 5 mg/5 ml Botol
935 Oksikodon larutan oral concentrate 10 mg/ml Botol
936 Oksikodon tab lepas lambat 10 mg Tab
937 Oksikodon tab lepas lambat 15 mg Tab
938 Oksikodon tab lepas lambat 20 mg Tab
939 Oksimetazolin tts hidung 0,025% botol @ 10 mL
940 Oksimetazolin tts hidung 0,050% botol @ 10 mL
941 Oksitetrasiklin 1% Salep Mata tube
942 Oksitetrasiklin hcl inj 50 mg/ml (i.m.) Vial
943 Oksitosin inj 10 UI/ml ampul/vial
944 Okskarbazepin susp 60 mg/mL botol
945 Oktreotid asetat 0,05 - 6 mg/ml ampul/vial
946 Oktreotid LAR serb inj 20 mg Vial
947 Oktreotid LAR serb inj 30 mg vial
948 Olanzapin inj 10 mg/2 ml Ampul
949 Olanzapin tab sal 10 mg tablet salut selapu
950 Olanzapin tab sal 5 mg tablet salut selapu
951 Olodaterol cairan ih 2,5 mcg/semprot Botol
952 Olodaterol cairan ih 2,5 mcg/semprot, refill cartridge
953 Olopatadin tts mata 0,1% Botol
954 Omeprazol inj 40 mg/10 ml ampul/vial
955 Omeprazol kaps 20 mg tablet/kapsul/kapl
956 Ondansetron inj 2 mg/ml ampul/vial
957 Ondansetron tab 4 mg tablet/kapsul/kapl
958 Ondansetron tab 8 mg tablet/kapsul/kapl
959 Paklitaksel inj 6 mg/ml, vial@16,7 ml (inj 100 mg) Vial
960 Paklitaksel inj 6 mg/ml, vial@5 ml (inj 30 mg) Vial
961 Paklitaksel inj 6 mg/ml, vial@50 ml (inj 300 mg) Vial
962 Paliperidon palmitat Inj 100 mg/mL Ampul
963 Paliperidon palmitat Inj 150 mg/1,5 mL Ampul
964 Paliperidon palmitat Inj 75 mg/0,75 mL Ampul
965 Pankuronium inj 2 mg/ml Ampul
966 Paraformaldehid lar buffer 10% Botol
967 Paraformaldehid tab 1 g Tab
968 Parasetamol drips (infus) 1000 mg/100 ml vial/ flexybag/bot
969 Parasetamol sir 120 mg/5 ml botol @ 60 mL
970 Parasetamol tab 500 mg tablet/kapsul/kapl
971 Parasetamol tts 60 mg/0,6 ml botol @ 15 mL
972 Pasta devitalisasi (non arsen) Tube
973 Pasta pengisi saluran akar (pasta) Tube
974 Pazopanib tab sal selaput 200 mg tablet salut selapu
975 Pazopanib tab sal selaput 400 mg tablet salut selapu
976 Pegylated interferon alfa-2a inj 135 mcg/0,5 ml Vial
977 Pegylated interferon alfa-2a inj 180 mcg/0,5 ml Vial
978 Pegylated interferon alfa-2b serb inj 100 mcg/ml Vial
979 Pegylated interferon alfa-2b serb inj 50 mcg/ml Vial
980 Pegylated interferon alfa-2b serb inj 80 mcg/ml Vial
981 Pemetreksed serb inj 500 mg Vial
982 Pengganti plasma golongan gelatin inf Botol
983 Perak nitrat lar 20% Botol
984 Perak sulfadiazin krim 1% Tube
985 Perindoprilarginin tab 5 mg tablet/kapsul/kapl
986 Permetrin krim 5 % Tube 30 g
987 Permetrin krim 5 % Tube 15 g
988 Permetrin krim 5 % Tube 10 g
989 Petidin inj 50 mg/ml (i.m./s.k./i.v.) Vial
990 Pilokarpin tts mata 2% Botol 5 ml
991 Pilokarpin tts mata 2% Catchcover, botol
 992 Pioglitazon tab 15 mg tablet
993 Pioglitazon tab 30 mg tablet/kapsul/kapl
994 Pirantel pamoat susp 125 mg/5 ml Botol
995 Pirantel pamoat tab 500 mg Tab
996 Pirantel pamoat tab scored 125 mg tablet/kapsul/kapl
997 Pirantel pamoat tab scored 250 mg Tab
998 Pirazinamid tab 500 mg tablet/kapsul/kapl
999 Piridoksin (vitamin B6) inj 100 mg/ml Ampul
1000 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl
1001 Piridoksin (vitamin B6) tab 25 mg tablet/kapsul/kapl
1002 Piridostigmin tab sal 60 mg tablet/kapsul/kapl
1003 Pirimetamin tab 25 mg Tablet
1004 Podofilin tingtur 25 % Botol
1005 Polietilen glikol Botol
1006 Polikresulen Botol
1007 Povidon iodin lar 100 mg/ml botol @ 1.000 mL
1008 Povidon iodin lar 100 mg/ml botol 30 mL
1009 Povidon iodin lar 100 mg/ml botol @ 60 mL
1010 Povidon iodin lar 100 mg/ml Botol 300 ml
1011 Povidon iodin lar obat kumur 1% Botol
1012 Povidon iodin tts mata 2,5% botol/strip
1013 Pramipeksol tab 0,125 mg tablet/kapsul/kapl
1014 Pramipeksol tab ER 0,375 mg tablet lepas lamba
1015 Pramipeksol tab ER 0,750 mg tablet lepas lamba
1016 Pravastatin tab 10 mg Tab
1017 Pravastatin tab 20 mg tablet/kapsul/kapl
1018 Prazikuantel tab scored 600 mg Tab
1019 Prednisolon tts mata 10 mg/ml catchcover, botol
1020 Prednisolon tts mata 10 mg/ml Botol @5mL
1021 Prednison tab 5 mg tablet/kapsul/kapl
1022 Pregabalin kaps 75 mg Kapsul
1023 Primakuin tab 15 mg Tab
1024 Probenesid tab 500 mg tablet/kapsul/kapl
1025 Produk untuk Dialisis Peritoneal Paket
1026 Prokain benzilpenisilin serb inj 3 juta UI/vial (i.m.) ampul/vial
1027 Prokaterol HCl cairan ih 30 mcg Vial
1028 Prokaterol HCl cairan ih 50 mcg Botol
1029 Prokaterol HCl serb ih 10 mcg Botol
1030 Propiltiourasil tab 100 mg tablet/kapsul/kapl
1031 Propofol inj 1% (i.v. Bolus) ampul/vial
1032 Propranolol inj 1 mg/ml (i.v.) Ampul
1033 Propranolol tab 10 mg tablet/kapsul/kapl
1034 Propranolol tab 40 mg tablet/kapsul/kapl
1035 Prostaglandin (PGE 1) Inj 500 mcg/ml Vial
1036 Protamin sulfat inj 10 mg/ml (i.m.) Ampul
1037 Quetiapin tab 100 mg tablet/kapsul/kapl
1038 Quetiapin tab pelepasan lambat 150 mg tablet SR
1039 Quetiapin tab pelepasan lambat 200 mg tablet SR/kaplet SR
1040 Quetiapin tab pelepasan lambat 300 mg tab SR
1041 Quetiapin tab pelepasan lambat 400 mg tablet SR/kaplet SR
1042 Ramipril tab 10 mg tablet/kapsul/kapl
1043 Ramipril tab 2,5 mg tablet/kapsul/kapl
1044 Ramipril tab 5 mg tablet/kapsul/kapl
1045 Ranibizumab inj 10 mg/ml Vial
1046 Ranitidin inj 25 mg/ml ampul/vial
1047 Ranitidin tab 150 mg tablet/kapsul/kapl
1048 Remifentanil inj 1 mg ampul/vial
1049 Remifentanil inj 2 mg ampul/vial
1050 Remifentanil inj 5 mg ampul/vial
1051 Retinol (vitamin A) kaps lunak 100.000 UI kaps lunak
1052 Retinol (vitamin A) kaps lunak 200.000 UI kaps lunak
1053 Ribavirin tab 200 mg tab sal selaput
1054 Rifampisin kaps 300 mg tablet/kapsul/kapl
1055 Rifampisin tab 450 mg tablet/kapsul/kapl
1056 Rifampisin tab 600 mg tablet/kapsul/kapl
1057 Rifapentin tablet 150 mg Tablet/kapsul/kapl
1058 Rilpivirine 25 mg tablet
1059 Ringer Laktat Larutan Botol
1060 Ringer Laktat Larutan 1000 ml Botol
1061 Risedronat tab sal selaput 35 mg tablet salut selaput
1062 Risperidon oral solution 1 mg/mL botol
1063 Risperidon tab 3 mg tablet/kapsul/kapl
1064 Risperidon tab sal 1 mg tablet/kapsul/kapl
1065 Risperidon tab sal 2 mg tablet/kapsul/kapl
1066 Rituksimab inf 10 mg/ml (vial 10 ml) Vial
1067 Rituksimab Inf 10 mg/ml (vial 50 ml) Vial
1068 Rituksimab inj 100 mg/ml Ampul
1069 Rituksimab inj 500 mg/ml Ampul
1070 Rivaroksaban tab sal 10 mg tablet salut/kaplet
1071 Rivaroksaban tab sal 15 mg tablet salut/kaplet
1072 Rivaroksaban tab sal 20 mg tablet salut/kaplet
1073 Rokuronium inj 50 mg/5 ml (i.v.) ampul/vial
1074 Ropinirol tab lepas lambat 2 mg tablet lepas lamba
1075 Ropinirol tab lepas lambat 4 mg tablet lepas lamba
1076 Ropinirol tab lepas lambat 8 mg tablet lepas lamba
1077 Ropivakain Inj 7,5 mg/ml ampul/polyamp/via
1078 Rosuvastatin tab 10 mg tablet/kapsul/kapl
1079 Sacubitril valsartan tab sal selaput 24,3/25,7 mg tablet salut selapu
1080 Sacubitril valsartan tab sal selaput 48,6/51,4 mg tablet salut selapu
1081 Sacubitril valsartan tab sal selaput 97,2/102,8 mg tablet salut selapu
1082 Salbutamol aerosol 100 mcg canister / botol
1083 Salbutamol cairan ih 1 mg/mL ampul/vial/botol
1084 Salbutamol cairan serb ih 200 mcg/kaps + rotahaler Botol
1085 Salbutamol sir 2 mg/5 ml Botol
1086 Salbutamol tab 2 mg tablet/kapsul/kapl
1087 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang endap 4 % pot 30 gram
1088 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang endap 4 % pot 15 gram
1089 Secukinumab serb inj 150 mg Vial
1090 Sefadroksil kaps 250 mg tablet/kapsul/kapl
1091 Sefadroksil kaps/tab 500 mg tablet/kapsul/kapl
1092 Sefadroksil sir kering 125 mg/5 ml botol @ 60 mL
1093 Sefadroksil sir kering 250 mg/5 ml botol @ 60 mL
1094 Sefaleksin kaps 500 mg tablet/kapsul/kapl
1095 Sefazolin serb inj 1 g/vial ampul/vial
1096 Sefepim serb inj 1000 mg/vial ampul/vial
1097 Sefiksim sir 100 mg/5 ml botol
1098 Sefiksim tab 100 mg Tab
1099 Sefiksim Tab 200 mg Tablet
1100 Sefoperazon serb inj 1.000 mg/vial ampul/vial
1101 Sefotaksim inj 500 mg/vial ampul/vial
1102 Sefotaksim serb inj 1.000 mg/vial ampul/vial
1103 Sefpirom serb inj 1000 mg ampul/vial
1104 Sefpodoksim proksetil tab sal 100 mg Tab
1105 Seftazidim serb inj 1.000 mg/vial ampul/vial
1106 Seftriakson serb inj 1.000 mg/vial ampul/vial
1107 Sefuroksim serb inj 750 mg/vial ampul/vial
1108 Sefuroksim tab 250 mg tablet salut selapu
1109 Sefuroksim tab sal 500 mg tablet salut selapu
1110 Sertralin tab sal 50 mg tablet salut/kaplet
1111 Serum anti bisa ular : A.B.U. I (khusus ular dari luar Papua) inj (i.m./i.v.) Vial

1112 Serum anti bisa ular :A.B.U.II (khusus ular dari Papua) inj (i.m./i.v.) Vial

1113 Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m 10.000 UI/ Vial
1114 Serum antirabies inj 100 UI/ml Vial
1115 Serum antirabies inj 200 UI/ml Vial
1116 Serum antitetanus (A.T.S) (i.m.) Inj 10.000 UI/vial (i.m /i.v.) Vial
1117 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul
1118 Serum antitetanus (A.T.S) inj 20.000 UI/vial (i.m /i.v.) Vial
1119 Serum antitetanus (A.T.S) inj 5.000 IU/mL (i.m) Ampul/vial
1120 Setirizin sir 5 mg/5 ml. botol @ 60 mL
1121 Setirizin tab 10 mg tablet/kapsul/kapl
1122 Setuksimab inj 5 mg/ml Vial
1123 Sevelamer karbonat Tab 800 mg Tab
1124 Sevofluran cairan ih 250 ml botol
1125 Sianokobalamin (vitamin B12) inj 500 mcg/ml ampul/vial
1126 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kapl
1127 Siklofosfamid serb inj 1000 mg/vial (i.v.) Vial
1128 Siklofosfamid serb inj 200 mg/vial (i.v.) Vial
1129 Siklofosfamid serb inj 500 mg/vial (i.v.) Vial
1130 Siklopentolat tetes mata 1% Botol
1131 Siklosporin inj 100 mg/ml Ampul
1132 Siklosporin inj 50 mg/ml Ampul
1133 Siklosporin kaps 100 mg kaps lunak
1134 Siklosporin kaps lunak 25 mg kaps lunak
1135 Siklosporin Kaps lunak 50 mg Kaps lunak
1136 Sildenafil sirup kering 10 mg/ml Botol
1137 Sildenafil Tab 20 mg Tab
1138 Silodosin tab 4 mg Tab
1139 Silostazol kaps SR 100 mg tablet/kapsul/kapl
1140 Silostazol tab 100 mg Tab
1141 Simvastatin tab sal 10 mg tablet/kapsul/kaple
1142 Simvastatin tab sal 20 mg tablet/kapsul/kaple
1143 Simvastatin tab sal selaput 40 mg Tab sal
1144 Siprofloksasin inf 2 mg/ml vial/ botol 100 ml
1145 Siprofloksasin tab scored 500 mg tablet salut selapu
1146 Sisplatin serb inj 10 mg Vial
1147 Sisplatin serb inj 50 mg Vial
1148 Sitagliptin tab sal selaput 100 mg tablet salut selapu
1149 Sitarabin serb inj 100 mg ampul/vial @ 10 m
1150 Sitarabin serb inj 100 mg ampul/vial @ 1 mL
1151 Sodium Glycerophosphate 216 mg Ampul/vial
1152 Sodium hialuronat Inj 10 mg/ml ampul/vial
1153 Sofosbuvir tab sal selaput 400 mg tablet salut selaput
1154 Solifenasin tab 10 mg tablet/kapsul/kapl
1155 Solifenasin tab 5 mg tablet/kapsul/kapl
1156 Somatostatin serb Inj 3000 mcg/mL Vial
1157 Soybean oil 200 g, ovolecithin 12 g, glycerol 22 g, Na hydroxide Softbag @ 250 ml
1158 Spiramisin tab 500 mg tablet salut selapu
1159 Spironolakton tab 100 mg tablet/kapsul/kapl
1160 Spironolakton tab 25 mg tablet/kapsul/kapl
1161 Stannous pyrophosphate 27,6 mg sodium pyrophosphate/vial Vial
1162 Streptokinase serb inj 1,5 juta UI/vial Vial
1163 Streptomisin serb inj 1.000 mg/vial ampul/vial
1164 Sufentanil inj 5 mcg/ml (i.v.) Ampul
1165 Sugammadeks inj 100 mg/ml Vial
1166 Sukralfat susp 500 mg/5 ml botol
1167 Sukralfat tab 500 mg tablet/kapsul/kapl
1168 Suksinilkolin inj 20 mg/ml (i.v./i.m.) Vial
1169 Suksinilkolin inj 50 mg/ml (i.v./i.m.) Vial
1170 Suksinilkolin serb inj 100 mg/vial (i.v./i.m.) Vial
1171 Sulfadiazin tab 500 mg tablet/kapsul/kapl
1172 Sulfasalazin kapl sal enterik 500 mg tablet salut enteri
1173 Sulfur colloid 4,5 mg gelatin/reaction vial Vial
1174 Surfaktan susp 25 mg/ml (intratrakeal) Botol
1175 Surgical ginggival pack Tube
1176 Takrolimus kaps 0,5 mg tablet/kapsul/kapl
1177 Takrolimus kaps 1 mg tablet/kapsul/kapl
1178 Takrolimus kaps lepas lambat 0,5 mg kapsul lepas lamba
1179 Takrolimus kaps lepas lambat 1 mg kapsul lepas lamba
1180 Tamoksifen tab 10 mg Tablet
1181 Tamoksifen tab 20 mg Tab
1182 Tamsulosin tab 0,2 mg tablet/kapsul/kapl
1183 Tamsulosin tab SR 0,4 mg tab lepas lambat /
1184 Technetium 99m 740 mbq - 3,7 gbq (20 to 100 millicuries)/ml Set
1185 Telbivudin tab 600 mg tablet/kapsul/kapl
1186 Telmisartan tab 40 mg tablet/kapsul/kapl
1187 Telmisartan tab 80 mg tablet/kapsul/kapl
1188 Temozolamid kaps 100 mg tablet/kapsul/kapl
1189 Temozolamid kaps 20 mg tablet/kapsul/kapl
1190 Tenofovir tab 300 mg tablet salut selapu
1191 Teofilin tab 150 mg tablet/kapsul/kapl
1192 Teofilin tab SR 300 mg tablet lepas lamba
1193 Terazosin hcl tab 1 mg tablet/kapsul/kapl
1194 Terazosin hcl tab 2 mg tablet/kapsul/kapl
1195 Terbinafin tab 250 mg tablet/kapsul/kapl
1196 Terbutalin cairan ih 2,5 mg/ml Botol
1197 Terbutalin inj 0,5 mg/ml ampul/vial
1198 Terbutalin serb ih 0,50 mg/dose Vial
1199 Terbutalin sir 1,5 mg/5 ml botol
1200 Terbutalin tab 2,5 mg tablet/kapsul/kapl
1201 Testosteron inj 250 mg/ml (vial 1 ml) Vial
1202 Testosteron Inj 250 mg/ml (vial 4 ml) Vial
1203 Testosteron kaps lunak 40 mg kapsul lunak
1204 Tetanus toxoid inj Ampul
1205 Tetrakain tts mata 0,5% Botol
1206 Tetrasiklin kaps 250 mg tablet/kapsul/kapl
1207 Tetrasiklin kaps 500 mg tablet/kapsul/kapl
1208 Tetrasiklin Salep Mata 1% Tube
1209 Thallous Chloride Tl-202 1 mg methylene diphosphonic acid/ml Set
1210 Tiamazol tab 10 mg tablet salut selap
1211 Tiamazol tab 5 mg tablet salut selap
1212 Tiamin (vitamin B1) tab 50 mg tablet/kapsul/kapl
1213 Tikagrelor tab 90 mg tablet/kapsul/kapl
1214 Timolol tts mata 0,25% botol @ 5 mL
1215 Timolol tts mata 0,5% botol @ 5 mL
1216 Tiopental serb inj 500 mg/amp (i.v. Bolus) Ampul
1217 Tiopental serb serb inj 1.000 mg/amp (i.v.) Ampul
1218 Tiotropium cairan ih 2,5 mcg/semprot, refill Cartridge
1219 Tiotropium respimat ih 5 mcg/semprot Handihaler
1220 Tiotropium respimat ih 5 mcg/semprot Botol
1221 Tobramisin tetes mata 0,3% Catchcover, botol
1222 Tobramisin tetes mata 0,3% Botol @ 5 ml
1223 Topiramat tab 100 mg tablet/kapsul/kapl
1224 Topiramat tab 25 mg tablet/kapsul/kapl
1225 Topiramat tab 50 mg tablet/kapsul/kapl
1226 Tosilizumab inf 400 mg/20 mL vial
1227 Tosilizumab inf 80 mg/4 mL vial
1228 Tramadol inj 50 mg/ml ampul/vial
1229 Trastuzumab serb inj 440 mg/vial ampul/vial
1230 Travoprost tts mata 0,004% Botol
1231 Triamsinolon asetonid nasal spray 55 mcg/puff Botol
1232 Triamsinolon inj 10 mg/ml Ampul
1233 Triamsinolon inj 40 mg/ml ampul/vial
1234 Trifluoperazin tab sal 5 mg tablet salut selapu
1235 Triheksifenidil tab 2 mg tablet/kapsul/kapl
1236 Tropikamid tts mata 0,5% Botol @ 5 ml
1237 Tropikamid tts mata 0,5% Catchcover, botol
1238 Tropikamid tts mata 1% Botol
1239 Tuberkulin protein purified derivative 1:10 (i.k) Ampul
1240 Urea krim 10 % Tube/pot
1241 Urea krim 20 % Tube/pot
1242 Vaksin BCG inj (i.k) Vial
1243 Vaksin bivalen OPV (b-OPV) drops 10 dosis Vial
1244 Vaksin Hepatitis Rekombinan Inj Prefilled Injection Device (Uniject) 0,5 ml Vial
(i.m)
1245 Vaksin HPV (Human Papilloma Virus), vial 0,5 mL Ampul/vial
1246 Vaksin Influenza Vial
1247 Vaksin Japanese Enchepalitis (J.E) Vial
1248 Vaksin jerap difteri tetanus (DT) Vial
1249 Vaksin jerap difteri tetanus (Td) Vial
1250 Vaksin kombinasi DPT-HB-Hib Vial
1251 Vaksin measless rubella (MR) Inj 0,5 mL (s.k) Vial
1252 Vaksin Meningitis Meningokokus Vial
1253 Vaksin polio IPV inj 0,5 ml Vial
1254 Vaksin rabies, untuk manusia serb inj (s.k./i.k) + booster Vial
1255 Vaksin rabies, untuk manusia serb Inj 2,5 IU Vial
1256 Vaksin Yellow Fever Vial
1257 Valasiklovir tab 500 mg tablet/kapsul/kapl
1258 Valgansiklovir tab sal 450 mg tablet salut/kaplet
1259 Valproat sir 250 mg/5 ml botol @ 120 ml
1260 Valproat tab lepas lambat 250 mg tabet lepas lambat
1261 Valproat tab lepas lambat 500 mg tabet lepas lambat
1262 Valproat tab sal enterik 250 mg tablet salut enterik
1263 Valsartan tab 160 mg tablet/kapsul/kapl
1264 Valsartan tab 80 mg tablet salut/kaplet
1265 Vankomisin serb inj 500 mg/vial Vial
1266 Vasopresin inj 20 UI/ml (i.m./s.k.) Vial
1267 Verapamil inj 2,5 mg/ml Vial
1268 Verapamil tab 240 mg tablet lepas lamba
1269 Verapamil tab 80 mg tablet/kapsul/kapl
1270 Vildagliptin tab 50 mg Tab
1271 Vinblastin inj 1 mg/ml Ampul
1272 Vinkristin inj 1 mg/ml (vial 1 mL) Vial
1273 Vinkristin inj 1 mg/ml (vial 2 mL) Vial
1274 Vinorelbin inj 10 mg/ml, kemasan 1 ml Vial
1275 Vinorelbin inj 10 mg/ml, kemasan 5 ml Vial
1276 Vitamin B kompleks tablet
1277 Vitamin C 500 mg minimal non acidic 250 mg Tablet/kapsul/kaple
1278 Vorikonazol inj 200 mg vial
1279 Vorikonazol tab sal selaput 200 mg tablet/kapsul/kapl
1280 Warfarin tab 1 mg tablet/kapsul/kapl
1281 Warfarin tab 2 mg tablet/kapsul/kapl
1282 Zidovudin kaps 100 mg tablet/kapsul/kapl
1283 Zinc drops 10 mg/ml Botol
1284 Zinc sir 20 mg/5 ml botol
1285 Zinc tab disp 20 mg tablet dispersible
1286 Zonisamid tab sal selaput 100 mg Tab sal selaput
 TUK DIADAKAN TAHUN 2022
BULAN DI SATKER SELAMA TAHUN 2021
MBAH PREDIKSI PENGADAAN TAHUN 2022 DIKURANGI (12 x PEMAKAIAN RATA-RATA PER BULAN TAHUN 2021)
2021 DIKALI 15 BULAN DALAM SATUAN TERKECIL SEPERTI : TABLET / KAPSUL / KAPLET / BOTOL / AMPUL / VIAL / TUBE / SACCHET / PUFF
DASARKAN METODE KONSUMSI DIKURANGI DENGAN PREDIKSI SISA STOK PER 31 DESEMBER 2022
023 DALAM SATUAN TERKECIL SEPERTI: TABLET / KAPSUL / KAPLET / BOTOL / AMPUL / VIAL / TUBE / SACCHET / PUFF YANG AKAN DIADAK
TELAH MENGIRIMKAN PELAPORAN RKO TAHUN 2022
PURCHASING MAUPUN MANUAL SELAMA TAHUN 2023

JUKAN TINGKAT LANJUT (FKRTL) TAHUN 2023

SISA STOK PER 31 PREDIKSI PEMAKAIAN PREDIKSI SISA STOK 31 JUMLAH

DESEMBER 2021 PENGADAAN RATA-RATA PER DESEMBER 2022 KEBUTUHAN
TAHUN 2022 BULAN SELAMA TAHUN 2023
2021

(a) (b) (c) (d) = (a)+(b)-(12x(c)) (e) = (c) x 15

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 8500 600 1500 9000
480 15000 1200 1080 18000
0 0 0 0 0
0 0 0 0 0
60 3700 240 880 3600
200 8000 600 1000 9000
300 18150 1200 4050 18000
0 0 0 0 0
0 0 0 0 0
10 1053 50 463 750
8 430 30 78 450
8 597 30 245 450
 0 0 0 0 0
8 450 30 98 450
0 0 0 0 0
6 279 20 45 300
0 0 0 0 0
300 32000 2000 8300 30000
400 21000 1500 3400 22500
0 0 0 0 0
600 15000 1200 1200 18000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
30 950 60 260 900
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
30 556 40 106 600
300 10000 700 1900 10500
500 12000 800 2900 12000
2000 120000 9000 14000 135000
2000 40000 3000 6000 45000
10 300 20 70 300
0 0 0 0 0
0 0 0 0 0
9 300 19 81 285
12 300 20 72 300
0 0 0 0 0
200 10000 700 1800 10500
0 0 0 0 0
0 0 0 0 0
20 1500 110 200 1650

20 500 35 100 525

15 650 50 65 750

0 0 0 0 0

20 650 45 130 675

0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
20 560 40 100 600

400 7000 600 200 9000

50 3500 240 670 3600

0 0 0 0 0
6 120 9 18 135

5 120 10 5 150
20 250 18 54 270

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 100 6 32 90
0 0 0 0 0
2000 54000 4000 8000 60000
500 9700 500 4200 7500
300 22900 1000 11200 15000
0 0 0 0 0
4000 150000 12000 10000 180000
0 0 0 0 0
0 0 0 0 0
5 119 8 28 120
0 0 0 0 0
0 0 0 0 0
2000 78400 6500 2400 97500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
5 284 16 97 240
5 232 12 93 180
5 206 12 67 180
200 9700 750 900 11250
0 0 0 0 0
 300 21200 1600 2300 24000
90 2390 200 80 3000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 6700 500 900 7500
0 0 0 0 0
400 6000 460 880 6900
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
150 5650 450 400 6750
150 4000 300 550 4500
0 0 0 0 0
0 0 0 0 0
100 1230 100 130 1500
0 0 0 0 0
4 85 6 17 90
3 85 6 16 90
0 0 0 0 0
10 133 10 23 150
4 80 6 12 90
0 0 0 0 0
100 500 40 120 600
0 0 0 0 0
4 140 8 48 120
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1000 40000 3000 5000 45000
0 0 0 0 0
0 0 0 0 0
 8 195 15 23 225
8 195 15 23 225
8 195 15 23 225
8 195 15 23 225
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 360 25 70 375
10 190 14 32 210
100 2760 200 460 3000
0 0 0 0 0
1000 18000 1350 2800 20250
0 0 0 0 0
1000 43000 3200 5600 48000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 578 43 72 645

0 0 0 0 0

20 1076 80 136 1200

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
50 1975 150 225 2250
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 220 15 44 225
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 16060 1200 1860 18000
500 13260 1000 1760 15000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
24 1441 110 145 1650
0 0 0 0 0
0 0 0 0 0
6 215 16 29 240
10 450 34 52 510
50 3000 230 290 3450
500 7500 600 800 9000
300 3000 250 300 3750
0 0 0 0 0
0 0 0 0 0
10 665 50 75 750
0 0 0 0 0
10 690 50 100 750
1500 26000 2000 3500 30000
10 676 50 86 750
10 655 49 77 735
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 2800 210 380 3150
6 198 15 24 225
0 0 0 0 0
 0 0 0 0 0

100 4300 320 560 4800

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 4300 320 560 4800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
12 650 47 98 705
300 11200 800 1900 12000
12 647 50 59 750
100 2070 170 130 2550
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
40 612 47 88 705
0 0 0 0 0
0 0 0 0 0
 6 234 14 72 210
100 1545 120 205 1800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
20 646 50 66 750
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 238 16 50 240
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
3 69 5 12 75
3 69 5 12 75
3 69 5 12 75
0 0 0 0 0
0 0 0 0 0
1000 52700 4000 5700 60000
0 0 0 0 0
0 0 0 0 0
30 732 60 42 900
0 0 0 0 0
400 14300 1100 1500 16500
150 2800 230 190 3450
150 2800 230 190 3450
0 0 0 0 0
0 0 0 0 0
5 123 9 20 135
2 93 7 11 105
30 536 44 38 660
50 2479 185 309 2775
0 0 0 0 0
10 169 13 23 195
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 5870 480 310 7200
200 6240 500 440 7500
100 2860 240 80 3600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
30 729 56 87 840
45 685 55 70 825
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
20 760 58 84 870
18 616 47 70 705
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
300 11800 900 1300 13500
3000 37660 3000 4660 45000
2000 76710 5800 9110 87000
600 16085 1250 1685 18750
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
3000 65950 5000 8950 75000
0 0 0 0 0

0 0 0 0 0
300 11215 850 1315 12750
150 6695 500 845 7500
0 0 0 0 0
0 0 0 0 0
200 5869 450 669 6750
15 337 27 28 405
0 0 0 0 0
5 285 23 14 345
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2000 64500 5200 4100 78000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 5800 450 600 6750
900 33000 2500 3900 37500
1000 41500 3200 4100 48000
900 20300 1600 2000 24000
3000 118000 9000 13000 135000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
30 1788 130 258 1950
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
40 5390 430 270 6450
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 4420 360 300 5400
5 90 6 23 90
0 0 0 0 0
0 0 0 0 0
8 93 8 5 120
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
300 8160 650 660 9750
6 164 13 14 195
20 670 53 54 795
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0

0 0 0 0 0

10 700 54 62 810

10 830 64 72 960
12 830 64 74 960
0 0 0 0 0
0 0 0 0 0
20 471 36 59 540
6 205 16 19 240
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
20 775 59 87 885
0 0 0 0 0
300 12900 1000 1200 15000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
5 222 17 23 255
12 529 40 61 600
1 54 4 7 60
2 122 9 16 135
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
150 4300 350 250 5250
400 14500 1100 1700 16500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 7750 600 750 9000
600 16800 1300 1800 19500
10 470 35 60 525
0 0 0 0 0
1000 48000 3800 3400 57000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 2570 200 270 3000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
30 420 34 42 510
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1500 60400 4600 6700 69000
0 0 0 0 0
2000 103000 7800 11400 117000
3000 118100 9500 7100 142500
0 0 0 0 0
 40 1235 100 75 1500
100 2150 170 210 2550
0 0 0 0 0
0 0 0 0 0
500 14400 1200 500 18000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 285 22 31 330
10 236 18 30 270
12 650 53 26 795
2 70 5 12 75
70 800 62 126 930
5 193 15 18 225
10 332 26 30 390
400 11000 900 600 13500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
400 34800 2600 4000 39000
500 18000 1500 500 22500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1000 28000 2200 2600 33000
1000 33000 2600 2800 39000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
8 232 18 24 270
0 0 0 0 0
0 0 0 0 0
7 276 22 19 330
12 425 33 41 495
 11 425 32 52 480
11 425 32 52 480
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
30 775 60 85 900
0 0 0 0 0
0 0 0 0 0
200 5800 475 300 7125
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
150 8400 700 150 10500
150 8400 700 150 10500
2000 105100 8300 7500 124500
1000 43000 3300 4400 49500
1000 35500 2900 1700 43500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

6 144 11 18 165

10 423 33 37 495

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

9 360 28 33 420

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

100 4250 320 510 4800

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

30 1065 80 135 1200

 0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
80 2047 160 207 2400

0 0 0 0 0

10 365 28 39 420

0 0 0 0 0
0 0 0 0 0
20 730 55 90 825
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1000 40600 3200 3200 48000
0 0 0 0 0
10 720 55 70 825
10 500 39 42 585

0 0 0 0 0

10 533 40 63 600

8 235 18 27 270

8 346 26 42 390

0 0 0 0 0

5 360 27 41 405

10 495 37 61 555

10 795 60 85 900
 6 232 18 22 270

0 0 0 0 0

4 123 10 7 150

0 0 0 0 0

10 259 20 29 300

10 355 28 29 420

0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

20 783 59 95 885

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

5 132 10 17 150

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
 0 0 0 0 0

4 109 8 17 120

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

14 260 20 34 300

4 110 9 6 135

0 0 0 0 0
0 0 0 0 0

5 110 9 7 135

4 110 9 6 135
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

5 110 9 7 135

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

5 110 9 7 135

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
30 1029 79 111 1185
0 0 0 0 0
0 0 0 0 0
150 44000 3300 4550 49500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
60 1350 105 150 1575
60 1350 105 150 1575
0 0 0 0 0
2 88 7 6 105
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
100 2671 213 215 3195
0 0 0 0 0
50 935 72 121 1080
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
10 258 20 28 300
0 0 0 0 0
30 1327 100 157 1500
0 0 0 0 0
0 0 0 0 0
30 1327 100 157 1500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
20 655 53 39 795
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
400 18700 1500 1100 22500
0 0 0 0 0

5000 293000 22000 34000 330000

1000 44500 3500 3500 52500
900 16000 1300 1300 19500
 40 730 60 50 900
70 1564 120 194 1800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 5900 480 240 7200
30 768 59 90 885
1000 25900 2000 2900 30000
3000 73000 5550 9400 83250
1000 42300 3200 4900 48000
200 8700 660 980 9900
40 1300 100 140 1500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
6 256 20 22 300
0 0 0 0 0
0 0 0 0 0
100 4516 340 536 5100
7 236 18 27 270
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 10950 860 830 12900
0 0 0 0 0
0 0 0 0 0
20 438 35 38 525
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
8 440 33 52 495
 90 2691 200 381 3000
0 0 0 0 0
100 3000 230 340 3450
0 0 0 0 0
8 146 11 22 165
0 0 0 0 0
50 1327 105 117 1575
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
17 730 55 87 825
40 1290 100 130 1500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
600 28000 2100 3400 31500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 112 8 20 120
3 85 6 16 90
0 0 0 0 0
6 234 18 24 270
0 0 0 0 0
0 0 0 0 0
100 3890 300 390 4500
900 26594 2050 2894 30750
3 98 7 17 105
4 98 7 18 105
0 0 0 0 0
5 122 9 19 135
5 122 9 19 135
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
9 122 10 11 150
0 0 0 0 0
600 31900 2500 2500 37500
0 0 0 0 0
0 0 0 0 0
30 846 65 96 975
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 520 41 38 615
4 88 7 8 105
0 0 0 0 0
4 86 7 6 105
10 284 22 30 330
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 5000 400 300 6000
10 437 34 39 510
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 275 21 33 315
10 275 21 33 315
0 0 0 0 0
0 0 0 0 0
300 8975 700 875 10500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
20 727 55 87 825
1000 47000 3600 4800 54000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
500 18000 1400 1700 21000
1500 41000 3100 5300 46500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
90 2950 240 160 3600
19 655 50 74 750
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 6500 500 600 7500
0 0 0 0 0
100 6000 450 700 6750
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 3000 230 340 3450
100 3000 230 340 3450
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 5000 400 300 6000
100 6450 500 550 7500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 445 34 47 510
10 445 34 47 510
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 6500 500 600 7500
100 6500 500 600 7500
60 2000 160 140 2400
0 0 0 0 0
40 1000 80 80 1200
 60 1500 100 360 1500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
60 1300 100 160 1500
0 0 0 0 0
80 2500 200 180 3000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
150 6000 500 150 7500
12 577 44 61 660
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 8 234 19 14 285
40 830 64 102 960
0 0 0 0 0
120 2500 200 220 3000
60 2000 90 980 1350
60 2000 90 980 1350
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
3000 78500 6300 5900 94500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
5 100 8 9 120
4 70 6 2 90
0 0 0 0 0
0 0 0 0 0
AHUN 2021)
MPUL / VIAL / TUBE / SACCHET / PUFF

/ SACCHET / PUFF YANG AKAN DIADAKAN TAHUN 2022 BERDASARKAN

RENCANA RENCANA RENCANA REALISASI KETERANGAN

KEBUTUHAN PENGADAAN PENGADAAN PENGADAAN
TAHUN 2023 TAHUN 2023 TAHUN 2022 TAHUN 2021

(f) = (e) - (d) (g) (h) (i) (j)

0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7500 7500 8500 7500
16920 16900 15000 15500
0 0 0 0
0 0 0 0
2720 2700 3700 2700
8000 8000 8000 8000
13950 13950 18150 13000
0 0 0 0
0 0 0 0
287 290 1053 260
372 372 430 370
205 230 597 200
 0 0 0 0
352 352 450 320
0 0 0 0
255 255 279 250
0 0 0 0
21700 21700 32000 21000
19100 19100 21000 19000
0 0 0 0
16800 16800 15000 16000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
640 640 950 600
0 0 0 0
0 0 0 0
0 0 0 0
494 494 556 490
8600 8600 10000 8500
9100 9100 12000 9000
121000 121000 120000 110000
39000 40000 40000 39000
230 230 300 200
0 0 0 0
0 0 0 0
204 204 300 200
228 228 300 200
0 0 0 0
8700 9000 10000 8700
0 0 0 0
0 0 0 0
1450 1500 1500 1400

425 425 500 400

685 685 650 650

0 0 0 0

545 545 650 500

0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
500 560 560 500

8800 8800 7000 7500

2930 3000 3500 2600

0 0 0 0
117 120 120 116

145 145 120 130

216 250 250 215

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
58 58 100 45
0 0 0 0
52000 52000 54000 50000
3300 3300 9700 3000
3800 3800 22900 3000
0 0 0 0
170000 170000 150000 165000
0 0 0 0
0 0 0 0
92 92 119 85
0 0 0 0
0 0 0 0
95100 95100 78400 80000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
143 143 284 100
87 87 232 80
113 113 206 90
10350 10350 9700 9500
0 0 0 0
21700 21700 21200 21500
2920 2390 2390 2300
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6600 6700 6700 6500
0 0 0 0
6020 6000 6000 6000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6350 6350 5650 6000
3950 4000 4000 4000
0 0 0 0
0 0 0 0
1370 1370 1230 1300
0 0 0 0
73 73 85 70
74 74 85 70
0 0 0 0
127 127 133 120
78 80 80 80
0 0 0 0
480 500 500 500
0 0 0 0
72 72 140 70
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
40000 40000 40000 39000
0 0 0 0
0 0 0 0
 202 202 195 200
202 202 195 200
202 202 195 200
202 202 195 200
0 0 0 0
0 0 0 0
0 0 0 0
305 305 360 300
178 178 190 170
2540 2540 2780 2500
0 0 0 0
17450 18000 18000 17500
0 0 0 0
42400 43000 43000 43000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
573 578 578 570

0 0 0 0

1064 1076 1076 1070

0 0 0 0
0 0 0 0
0 0 0 0
2025 2025 1975 2000
0 0 0 0
0 0 0 0
0 0 0 0
181 181 220 180
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
16140 16060 16060 16000
13240 13260 13260 13200
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1505 1500 1441 1450
0 0 0 0
0 0 0 0
211 215 215 210
458 450 450 420
3160 3160 3000 3100
8200 8200 7500 7800
3450 3450 3000 3100
0 0 0 0
0 0 0 0
675 675 665 660
0 0 0 0
650 650 690 600
26500 26500 26000 26000
664 664 676 660
658 658 655 650
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2770 2800 2800 2700
201 201 198 190
0 0 0 0
 0 0 0 0

4240 4300 4300 4200

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
4240 4300 4300 4200
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
607 607 650 600
10100 10100 11200 10000
691 691 647 640
2420 2420 2070 2100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
617 617 612 600
0 0 0 0
0 0 0 0
 138 138 234 130
1595 1595 1545 1500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
684 684 646 650
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
190 190 238 185
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0
0 0 0 0
63 63 69 60
63 63 69 60
63 63 69 60
0 0 0 0
0 0 0 0
54300 54300 52700 52000
0 0 0 0
0 0 0 0
858 858 732 700
0 0 0 0
15000 15000 14300 14500
3260 3260 2800 3000
3260 3260 2800 3000
0 0 0 0
0 0 0 0
115 115 123 110
94 94 93 90
622 622 536 550
2466 2466 2479 2400
0 0 0 0
172 172 169 160
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6890 6890 5870 5700
7060 7060 6240 6500
3520 3520 2860 2800
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
753 753 729 720
755 755 685 720
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
786 786 760 750
635 635 616 610
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
12200 12200 11800 11500
40340 40340 37660 39000
77890 77890 76710 76000
17065 17065 16085 16000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
66050 66050 65950 65000
0 0 0 0

0 0 0 0
11435 11435 11215 11200
6655 6655 6695 6600
0 0 0 0
0 0 0 0
6081 6081 5869 5800
377 377 337 330
0 0 0 0
331 331 285 280
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
73900 73900 64500 65000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6150 6150 5800 5500
33600 33600 33000 31000
43900 43900 41500 41000
22000 22000 20300 21000
122000 122000 118000 112000
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1692 1692 1788 1600
0 0 0 0
0 0 0 0
0 0 0 0
6180 6180 5390 5400
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
5100 5100 4420 4500
67 67 90 60
0 0 0 0
0 0 0 0
115 115 93 100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
9090 9090 8160 8100
181 181 164 160
741 741 670 660
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0

0 0 0 0

748 748 700 700

888 888 830 800

886 886 830 850
0 0 0 0
0 0 0 0
481 481 471 471
221 221 205 200
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
798 798 775 770
0 0 0 0
13800 13800 12900 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
232 232 222 230
539 539 529 530
53 53 54 49
119 119 122 110
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
5000 5000 4300 4500
14800 14800 14500 14500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
8250 8250 7750 7700
17700 17700 16800 16500
465 465 470 460
0 0 0 0
53600 53600 48000 47000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
2730 2730 2570 2600
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
468 468 420 450
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
62300 62300 60400 60000
0 0 0 0
105600 105600 103000 104000
135400 135400 118100 120000
0 0 0 0
 1425 1425 1235 1300
2340 2340 2150 2100
0 0 0 0
0 0 0 0
17500 17500 14400 16000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 642 0
0 0 642 0
0 0 0 0
0 0 0 0
299 299 285 270
240 240 236 230
769 769 650 670
63 63 70 60
804 800 800 780
207 207 193 190
360 360 332 330
12900 12900 11000 11500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
35000 35000 34800 34000
22000 22000 18000 19000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
30400 30400 28000 29000
36200 36200 33000 30000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
246 246 232 240
0 0 0 0
0 0 0 0
311 311 276 280
454 454 425 430
 428 428 425 420
428 428 425 426
0 0 0 0
0 0 0 0
0 0 0 0
815 815 775 770
0 0 0 0
0 0 0 0
6825 6825 5800 5900
0 0 0 0
0 0 0 0
0 0 0 0
10350 10350 8400 9000
10350 10350 8400 9000
117000 117000 105100 110000
45100 45100 43000 42000
41800 41800 35500 36000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

147 147 144 140

458 458 423 430

0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0
0 0 0 0
 0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

387 387 360 370

0 0 0 0

0 0 0 0

0 0 0 0

4290 4290 4250 4260

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0

1065 1065 1065 1010

 0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0
2193 2193 2047 2050

0 0 0 0

381 381 365 370

0 0 0 0
0 0 0 0
735 730 730 720
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
44800 44800 40600 42000
0 0 0 0
755 755 720 720
543 543 500 500

0 0 0 0

537 537 533 530

243 243 235 230

348 348 346 340

0 0 0 0

364 364 360 364

494 494 495 490

815 815 795 790

248 248 232 230

0 0 0 0

143 143 123 140

0 0 0 0

271 271 259 265

391 391 355 360

0 0 0 0
0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

790 790 783 780

0 0 0 0

0 0 0 0

0 0 0 0

133 133 132 130

0 0 0 0

0 0 0 0

0 0 0 0
 0 0 0 0

103 103 109 100

0 0 0 0

0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

266 266 260 262

129 129 110 120

0 0 0 0
0 0 0 0

128 128 110 120

129 129 110 120

 0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

128 128 110 120

0 0 0 0

0 0 0 0

0 0 0 0

128 128 110 120

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0
 0 0 0 0
0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1074 1074 1029 1030
0 0 0 0
0 0 0 0
44950 44950 44000 44000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1425 1425 1350 1380
1425 1425 1350 1380
0 0 0 0
99 99 88 90
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
2980 2980 2671 2700
0 0 0 0
959 1000 935 900
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
272 270 258 250
0 0 0 0
1343 1343 1327 1330
0 0 0 0
0 0 0 0
1343 1343 1327 1330
0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
756 756 655 670
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
21400 21400 18700 19000
0 0 0 0

296000 296000 293000 290000

49000 49000 44500 45000
18200 18200 16000 17000
 850 850 730 700
1606 1606 1564 1600
0 0 0 0
0 0 0 0
0 0 0 0
6960 6960 5900 6000
795 795 768 770
27100 27100 25900 26000
73850 73850 73000 69500
43100 43100 42300 42000
8920 8920 8700 8900
1360 1360 1300 1300
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
278 278 256 260
0 0 0 0
0 0 0 0
4564 4564 4516 4500
243 243 236 230
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
12070 12070 10950 11000
0 0 0 0
0 0 0 0
487 487 438 450
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
443 443 440 439
 2619 2619 2691 2500
0 0 0 0
3110 3110 3000 3100
0 0 0 0
143 143 146 140
0 0 0 0
1458 1458 1327 1400
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
738 738 730 735
1370 1370 1290 1300
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
28100 28100 28000 27500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
100 100 112 98
74 74 85 70
0 0 0 0
246 246 234 240
0 0 0 0
0 0 0 0
4110 4110 3890 4000
27856 27856 26594 26500
88 88 98 80
87 87 98 80
0 0 0 0
116 116 122 100
116 116 122 100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
139 139 122 120
0 0 0 0
35000 35000 31900 32000
0 0 0 0
0 0 0 0
879 879 846 850
0 0 0 0
0 0 0 0
0 0 0 0
577 577 520 530
97 97 88 90
0 0 0 0
99 99 86 90
300 300 284 290
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
5700 5700 5000 5500
471 471 437 445
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
282 282 275 278
282 282 275 278
0 0 0 0
0 0 0 0
9625 9625 8975 9000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
738 738 727 730
49200 49200 47000 48000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
19300 19300 18000 18500
41200 41200 41000 39000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
3440 3440 2950 3100
676 676 655 670
0 0 0 0
0 0 0 0
 0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6900 6900 6500 6600
0 0 0 0
6050 6050 6000 5900
0 0 0 0
0 0 0 0
0 0 0 0
3110 3110 3000 3100
3110 3110 3000 3100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
5700 5700 5000 5500
6950 6950 6450 6500
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
463 463 445 450
463 563 445 450
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
6900 6900 6500 6600
6900 6900 6500 6600
2260 2260 2000 2100
0 0 0 0
1120 1120 1000 1100
1140 1140 1500 1000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
1340 1340 1300 1300
0 0 0 0
2820 2820 2500 2600
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
7350 7350 6000 6700
599 599 577 580
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 271 271 234 250
858 858 830 840
0 0 0 0
2780 2780 2500 2600
370 370 2000 300
370 370 2000 300
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
88600 88600 78500 79000
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
111 111 100 110
88 88 70 80
0 0 0 0
0 0 0 0