J

U
M
L
A
RKO Tahun 2021 Kab. Pasaman Barat H
PROVINSI SUMATERA BARAT K
E
B
U
T
PEMAKAIAN
SISA STOK PER U RENCANA
RATA-RATA HARGA
NO NAMA OBAT SATUAN 31 DESEMBER HPENGADAAN TOTAL 69,720
PER BULAN SATUAN
2019 ATAHUN 2021
SELAMA 2019
N

T
(a) (b) (A(e)
cH
)U
N
=
2
(0
b
2
)1

1
8

1 Air untuk injeksi amp 25 ml ampul/vial/ 801 41 2,860

### 500 1,430,000
botol 25 mL
2 Alopurinol tab 100 mg Tab 35,600 6,833 105
### 100,000 10,500,000
3 Aminofilin Tab 200 mg tablet/ 42,200 3,325 ###
96 20,000 1,920,000
kapsul/kaplet
4 Amitriptilin tab sal 25 mg tablet/ 10,500 3,260 117
### 50,000 5,850,000
kapsul/kaplet
5 Amlodipin tab 5 mg tablet/ 16,800 9,468 ###
78 160,000 12,480,000
kapsul/kaplet
6 Amoksisilin sir kering 125 mg/5 ml Botol 7,320 1,170 4,500
### 12,000 54,000,000
7 Amoksisilin tab 250 mg tablet/ 36,500 8,500 203
### 100,000 20,300,000
kapsul/kaplet
8 Amoksisilin tab 500 mg tablet/ 51,100 46,542 261
### 350,000 91,350,000
kapsul/kaplet
 9 Anestetik lokal gigi kombinasi : lidokain hcl 2% + 37,770 365 1,286
### 3,000 3,858,000
ampul/vial
epinefrin 1 : 80.000 inj 2 ml
10 Antasida, kombinasi : aluminium hidroksida 200 mg + tablet/ 434,200 43,350 ###
56 350,000 19,600,000
magnesium hidroksida 200 mg kapsul/kaplet
11 Antasida, kombinasi : aluminium hidroksida 200 mg + 9,340 1,347 2,189
### 15,000 32,835,000
botol 60 ml
magnesium hidroksida 200 mg
12 Antifungi salep, kombinasi : asam benzoat 6%+ asam 1,967 92 5,038
### 960 4,836,480
pot 30 g
salisilat 3%
13 Antihemoroid, kombinasi: bismut subgalat 150 mg + 150 103 3,325
### 2,000 6,650,000
heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng Suppositoria
oksida 120 mg + sup ad 2 g
14 Asam asetilsalisilat (asetosal) tab 80 mg tablet/ 1,300 2,282 105
### 40,000 4,200,000
kapsul/kaplet
15 Asam askorbat (vitamin C) tab 50 mg tablet/ 600,200 34,900 110
### 200,000 22,000,000
kapsul/kaplet
16 Asam mefenamat kaps 500 mg tablet/ 43,000 27,233 255
### 300,000 76,500,000
kapsul/
kaplet/kaptab
17 Asiklovir tab 200 mg tablet/ 14,800 2,125 261
### 25,000 6,525,000
kapsul/kaplet
18 Asiklovir tab 400 mg tablet/ 34,400 2,817 399
### 20,000 7,980,000
kapsul/kaplet
19 Bedak salisil serb 2% Dus/Sachet/ 0 250 1,046
### 8,000 8,368,000
Plastik
20 Betametason krim 0,1% tube 5 gram 7,450 505 1,520
### 2,350 3,572,000
21 Bisakodil sup 10 mg Suppositoria 735 48 5,900
### 500 2,950,000
22 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial 6,183 114 1,152
### 500 576,000
23 Deksametason tab 0,5 mg tablet/ 0 25,333 ###
33 400,000 13,200,000
kapsul/kaplet
24 Diazepam enema 5 mg/2,5 ml tube @ 2,5 10 18 13,202
### 350 4,620,700
mL
25 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial 878 14 1,822
### 200 364,400
26 Diazepam tab 2 mg tablet/ 0 2,940 ###
86 60,000 5,160,000
kapsul/kaplet
27 Diazepam tab 5 mg tablet/ 21,300 1,567 114
### 15,000 1,710,000
kapsul/kaplet
28 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial 190 26 1,226
### 300 367,800
29 Digoksin tab 0,25 mg tablet/ 14,800 350 104
### 8,000 832,000
kapsul/kaplet
30 Dimenhidrinat tab 50 mg tablet/ 3,400 383 117
### 5,000 585,000
kapsul/kaplet
31 Domperidon tab 10 mg tablet/ 80,400 13,583 ###
86 150,000 12,900,000
kapsul/kaplet
32 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) ampul/vial 679 35 1,408
### 300 422,400
33 Eritromisin sir 200 mg/5 ml 240 109 6,290
### 1,000 6,290,000
Botol @ 60 ml
34 Eritromisin tab 500 mg tablet/kapsul/ 188,600 3,158 765
### 20,000 15,300,000
kaplet
35 Etanol 70% cairan 70% (1 Liter) Botol 160 32 37,639
### 330 12,420,870
36 Fenobarbital tab 30 mg tablet/kapsul/ 59,100 2,708 182
### 30,000 5,460,000
kaplet
37 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) ampul/vial 6,765 471 3,867
### 2,100 8,120,700
38 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 17,600 4,575 797
### 50,000 39,850,000
39 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) tablet salut 1,460 123 3,000
### 750 2,250,000
gula/kaplet
salut gula
40 Furosemid tab 40 mg tablet/kapsul/ 1,200 1,200 ###
82 20,000 1,640,000
kaplet
41 Garam oralit kombinasi : natrium klorida 0,52 g + 38,700 3,200 274
### 20,000 5,480,000
kalium klorida 0,30 g + trinatrium sitrat 0,58 g + sachet
glukosa anhidrat 2,7 g
42 Glibenklamid tab 5 mg tablet/kapsul/ 39,800 2,667 125
### 10,000 1,250,000
kaplet
43 Glimepirid tab 1 mg tablet/kapsul/ 34,500 8,100 174
### 100,000 17,400,000
kaplet
44 Glimepirid tab 2 mg tablet/kapsul/ 31,000 6,889 207
### 90,000 18,630,000
kaplet
45 Griseofulvin (micronized) tab 125 mg tablet/kapsul/ 6,000 4,734 232
### 50,000 11,600,000
kaplet
46 Haloperidol inj 5 mg/ml (i.m.) Vial 106 25 4,000
### 300 1,200,000
47 Haloperidol tab 0,5 mg tablet/kapsul/ 26,000 5,167 ###
55 70,000 3,850,000
kaplet
48 Haloperidol tab 1,5 mg tablet/kapsul/ 8,600 4,409 ###
59 75,000 4,425,000
kaplet
49 Hidrogen peroksida cairan 3% Botol 1,039 7 3,874
### 1,000 3,874,000
50 Hidroklorotiazid tab 25 mg tablet/kapsul/ 17,100 992 163
### 20,000 3,260,000
kaplet
51 Hidrokortison krim 2,5% tube @ 5 g 3,864 358 2,475
### 3,000 7,425,000
52 Ibuprofen tab 200 mg tablet/kapsul/ 2,500 14,758 108
### 200,000 21,600,000
kaplet
53 Ibuprofen tab 400 mg tablet/kapsul/ 27,000 24,335 125
### 300,000 37,500,000
kaplet
54 Isoniazid tab 100 mg Tab 2,200 850 ###
75 10,000 750,000
55 Isoniazid tab 300 mg Tab 300 358 173
### 5,000 865,000
56 Isosorbid dinitrat tab 5 mg tablet/kapsul/ 4,100 467 ###
89 5,000 445,000
kaplet
57 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/ 98,800 30,809 ###
63 300,000 18,900,000
kaplet
58 Kaptopril tab 12,5 mg tablet/kaplet 71,800 9,608 ###
68 100,000 6,800,000
59 Kaptopril tab 25 mg tablet/kaplet 14,800 12,225 ###
77 100,000 7,700,000
60 Karbamazepin Tab 200 mg Tablet 24,900 1,510 247
### 25,000 6,175,000
61 Ketokonazol tab 200 mg tablet/kapsul/ 18,350 2,655 297
### 30,000 8,910,000
kaplet
62 Klindamisin kaps 150 mg Kaps 10,100 1,206 770
### 5,000 3,850,000
63 Klindamisin kaps 300 mg tablet/ 0 230 370
### 5,000 1,850,000
kapsul/kaplet
64 Kloramfenikol kaps 250 mg tablet/ 17,000 5,741 320
### 50,000 16,000,000
kapsul/kaplet
65 Kloramfenikol salep kulit 2% tube 15g 1,128 56 3,383
### 1,200 4,059,600
66 Kloramfenikol salep mata 1% tube @ 5 1,649 282 2,007
### 3,000 6,019,500
gram
67 Kloramfenikol tetes telinga 3% Botol 270 181 8,000
### 1,500 12,000,000
68 Klorfeniramin tab 4 mg tablet/kapsul/ 126,000 58,058 ###
25 500,000 12,500,000
kaplet
69 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial 1,198 63 1,691
### 300 507,297
70 Klorpromazin tab sal 100 mg 12,900 2,575 165
### 35,000 5,775,000
tablet salut
selaput/kaplet
salut selaput

71 Klorpromazin tab sal 25 mg Tab sal 0 10,625 223

### 50,000 11,150,000
72 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/ 7,400 325 194
### 5,000 970,000
kaplet
73 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 28,500 16,058 133
### 300,000 39,900,000
tab/kaptab
400 mg+ trimetoprim 80 mg
74 Kotrimoksazol kombinasi tiap 5 ml suspensi : 4,750 582 2,190
### 5,000 10,950,000
botol 60 mL
sulfametoksazol 200 mg + trimetoprim 40 mg
75 Lidokain inj 2% (infiltr/p.v.) ampul/vial 11,995 283 1,289
### 2,400 3,093,600
76 Loratadin tab 10 mg tablet/kapsul/ 57,600 6,492 133
### 75,000 9,975,000
kaplet
77 Metformin tab 500 mg tablet/kapsul/ 67,900 12,964 106
### 165,000 17,490,000
kaplet
78 Metilergometrin inj 0,2 mg/ml ampul/vial 4,380 111 3,102
### 1,000 3,102,000
79 Metilergometrin tab salut 0,125 mg tablet/kaplet 12,100 1,233 236
### 11,000 2,596,000
salut selaput
80 Metilprednisolon tab 4 mg tablet/kapsul/ 10,100 20,225 146
### 360,000 52,560,000
kaplet
81 Metoklopramid tab 10 mg tablet/kapsul/ 6,600 2,550 ###
85 45,000 3,825,000
kaplet
82 Metronidazol tab 250 mg tablet/kapsul/ 0 4,082 ###
91 80,000 7,280,000
kaplet
83 Metronidazol tab 500 mg tablet/kapsul/ 1,000 4,900 126
### 90,000 11,340,000
kaplet
84 Mikonazol krim 2% tube 528 596 3,585
### 7,000 25,095,000
85 N-asetil sistein kaps 200 mg tablet/kapsul/ 448,200 7,300 381
### 20,000 7,620,000
kaplet
86 NaCl 0,9% Larutan Botol 1,678 288 6,840
### 2,000 13,680,000
plastik/botol
plastik pi
87 Natrium diklofenak tab 25 mg 0 6,955 141
### 140,000 19,740,000
tablet salut
enterik/kaplet
salut enterik

88 Natrium diklofenak tab 50 mg 0 11,164 136

### 200,000 27,200,000
tablet salut
enterik/kaplet
salut enterik

89 Nifedipin kaps 10 mg tablet/kapsul/ 0 2,713 200

### 50,000 10,000,000
kaplet
 90 Nistatin tab salut 500.000 UI tablet salut 4,500 317 886
### 2,000 1,772,000
gula/kaplet
salut gula
91 Nistatin tab vaginal 100.000 UI tablet/kaplet 3,800 233 630
### 1,000 630,000
92 Oksitosin inj 10 UI/ml ampul/vial 520 307 1,199
### 3,000 3,597,000
93 Omeprazol kaps 20 mg tablet/kapsul/ 74,670 9,525 143
### 100,000 14,300,000
kaplet
94 Parasetamol sir 120 mg/5 ml 3,400 1,575 1,184
### 30,000 35,520,000
botol @ 60 mL
95 Parasetamol tab 500 mg tablet/kapsul/ 381,100 104,383 ###
56 600,000 33,600,000
kaplet
96 Parasetamol tts 60 mg/0,6 ml 994 323 6,981
### 2,000 13,962,000
botol @ 15 mL
97 Perak sulfadiazin krim 1% Tube 352 17 20,700
### 100 2,070,000
98 Permetrin krim 5 % Tube 0 44 11,825
### 1,000 11,825,000
99 Pirantel pamoat tab scored 125 mg tablet/kapsul/ 2,000 409 322
### 6,000 1,932,000
kaplet
100 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl 238,900 13,567 138
### 10,000 1,380,000
101 Povidon iodin lar 100 mg/ml 259 36 4,400
### 770 3,388,000
botol @ 60 mL
102 Povidon iodin lar 100 mg/ml 220 29 17,740
### 500 8,870,000
Botol 300 ml
103 Prednison tab 5 mg tablet/kapsul/ 50,000 8,570 ###
77 105,000 8,085,000
kaplet
104 Primakuin tab 15 mg Tab 2,500 317 235
### 3,500 822,500
105 Propiltiourasil tab 100 mg tablet/kapsul/ 0 125 335
### 5,000 1,675,000
kaplet
106 Propranolol tab 10 mg tablet/kapsul/ 10,600 1,325 ###
61 15,000 915,000
kaplet
107 Ranitidin tab 150 mg tablet/kapsul/ 195,000 44,063 200
### 210,000 42,000,000
kaplet
108 Ringer Laktat Larutan Botol 28,073 1,942 7,630
### 3,000 22,890,027
109 Risperidon tab sal 1 mg tablet/kapsul/ 15,500 6,900 240
### 104,500 25,080,000
kaplet
110 Salbutamol tab 2 mg tablet/kapsul/ 22,000 5,408 ###
67 80,000 5,366,400
kaplet
111 Salbutamol tab 4 mg tablet/kapsul/ 29,900 6,150 ###
74 85,000 6,290,000
kaplet
112 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang 1,200 182 2,938
### 2,160 6,346,080
pot 30 gram
endap 4 %
113 Serum anti bisa ular : A.B.U. I (khusus ular dari luar 1 2 512,204
### 10 5,122,040
Vial
Papua) inj (i.m./i.v.)
114 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul 0 13 130,999
### 80 10,479,920
115 Sianokobalamin (vitamin B12) inj 500 mcg/ml ampul/vial 1,820 135 1,136
### 1,000 1,136,000
116 Sianokobalamin (vitamin B12) tab 50 mcg tablet/
tablet/kapsul/ 281,500 16,767 ###
50 30,000 1,500,000
kapsul/
kaplet
117 Simvastatin tab sal 10 mg kaplet/tablet 25,110 5,368 117
### 85,000 9,945,000
salut
selaput
118 Siprofloksasin tab scored 500 mg tablet
/kapletsalut
salut 137,500 12,875 272
### 60,000 16,320,000
selaput/kaplet
selaput
salut selaput
119 Spironolakton tab 25 mg tablet/kapsul/ 0 2,291 208
### 40,000 8,320,000
kaplet
120 Tiamin (vitamin B1) tab 50 mg tablet/kapsul/ 1,000,800 22,859 ###
92 50,000 4,600,000
kaplet
121 Triheksifenidil tab 2 mg tablet/kapsul/ 14,500 9,350 ###
93 120,000 11,160,000
kaplet
122 Vitamin B kompleks tablet 1,102,800 52,183 131
### 50,000 6,550,254
TOTAL 1,385,390,567 69,720

Mengetahui,
Kepala Dinas Kesehatan

JON HARDI, SKM, M.Kes apt. Efjunilda, SSi.

NIP.19700627 199001 1 001 NIP. 19760920 200604 2 004

2,103,836,280
 RKBMHP Tahun 2021 Kab. Pasaman Barat
PROVINSI SUMATERA BARAT

PEMAKAIAN
SISA STOK PER JUMLAH RENCANA RENCANA
NO NAMA OBAT SATUAN 31 DESEMBER RATA-RATA PER HARGA KEBUTUHAN KEBUTUHAN PENGADAAN TOTAL
BULAN SELAMA SATUAN
2019 TAHUN 2021 TAHUN 2021 TAHUN 2021
2019
(a) (b) (c) = (b) x 18 (d) = (c) - (a) (e)

1 Alkohol
Swab Box 18 16 11,604 288 270 500 5,802,000
2 Anti A Mono Gol Darah 10 ml vial - 2 72,750 32 32 20 1,455,000
3 Anti AB Mono Gol Darah 10 ml vial - 2 94,750 32 32 20 1,895,000
4 Anti B Mono Gol Darah 10 ml vial - 2 72,750 32 32 20 1,455,000
5 Anti D Mono Gol Darah 10 ml vial - 2 114,750 32 32 20 2,295,000
6 Benechek Cholesterol Tes pcs - 720 25,495 12,960 12,960 2,500 63,737,500
7 Benechek Glukosa Tes pcs - 1,065 3,370 19,170 19,170 5,000 16,850,000
8 Benechek Uric Acid Tes pcs 66 634 6,496 11,412 11,346 3,000 19,488,000
9 Blood Lancet Kotak 57 10 18,340 180 123 151 2,769,340
10 Catgut Chromic 2/0 pcs 4,776 120 8,421 2,160 -2,616 1,200 10,105,200
11 Catgut Chromic 3/0 pcs 5,796 135 8,464 2,430 -3,366 1,200 10,156,800
12 Catgut Plain 2/0 pcs 5,988 153 7,565 2,754 -3,234 1,200 9,078,000
13 Catgut Plain 3/0 pcs 5,628 88 7,565 1,584 -4,044 1,200 9,078,000
14 Foley Cath No. 16 Pcs 217 24 11,565 432 215 300 3,469,500
15 Foley Cath No. 18 Pcs 262 7 11,565 126 -136 200 2,313,000
16 Iodium Tes botol - 14 3,000 252 252 500 1,500,000
17 IV Cath 18 pcs - 192 5,828 3,456 3,456 2,800 16,318,400
18 IV Cath 20 pcs 250 348 5,828 6,264 6,014 4,700 27,391,600
19 IV Cath 22 pcs - 595 5,828 10,710 10,710 4,700 27,391,600
20 IV Cath 24 pcs 150 265 5,828 4,770 4,620 2,300 13,404,400
21 Kassa 4 m x 10 cm roll 10,640 356 1,760 6,408 -4,232 2,800 4,928,000
22 Kassa 4 m x 5 cm Roll 8,110 368 880 6,624 -1,486 4,600 4,048,000
23 Kassa Hidrofile 16 cm x 16 cm Box 802 195 7,755 3,510 2,708 1,350 10,469,250
24 Kassa Hidrofile 18 cm x 22 cm Box 827 152 17,397 2,736 1,909 730 12,699,810
25 Kassa Hidrofile 40 yard x 80 cm Roll 194 32 209,620 576 382 290 60,789,800
26 Larutan Ammonium Oksalat botol - - 90,000 0 0 5 450,000
27 Larutan Barium Chlorida 10% 100 ml botol 11 1 39,200 18 7 5 196,000
28 Larutan Benedict 100 ml botol 24 1 26,790 18 -6 5 133,950
29 Larutan EDTA 10% 100 ml botol 7 1 80,940 18 11 5 404,700
30 Larutan Eosin 2% 100 ml botol 8 1 183,065 18 10 5 915,325
31 Larutan Fouchet 100 ml botol 24 1 182,590 18 -6 5 912,950
32 Larutan Giemsa 100 ml botol 2 1 363,090 18 16 5 1,815,450
33 Larutan HCL 0,1 N 100 ml botol 16 1 25,950 18 2 10 259,500
34 Larutan Immersion Oil 100 ml botol 8 1 374,490 18 10 5 1,872,450
35 Larutan Rees Ecker 100 ml botol 2 1 53,390 18 16 5 266,950
36 Larutan Turk 100 ml botol 5 1 30,590 18 13 5 152,950
37 Lysol 1 liter Botol 366 20 43,167 360 -6 100 4,316,700
38 Masker Pcs 110,600 21,600 1,670 388,800 278,200 37,500 62,625,000
39 Masker N95 Pcs 144 46 23,313 828 684 420 9,791,460
40 Micropipet 10 µl pack - - 526,086 0 0 5 2,630,428
41 Nald Heacting Kulit No. 28 Pcs - - 11,500 0 0 240 2,760,000
42 Nald Heacting Kulit No. 32 Pcs - - 11,500 0 0 240 2,760,000
43 Nald Heacting Kulit No. 36 Pcs - - 11,500 0 0 240 2,760,000
44 Nald Heacting Otot No. 28 Pcs - - 11,500 0 0 240 2,760,000
45 Nald Heacting Otot No. 32 Pcs - - 11,500 0 0 240 2,760,000
46 Nald Heacting Otot No. 36 Pcs - - 11,500 0 0 240 2,760,000
47 Nasal Oxygen Anak pcs 33 2 6,389 36 3 200 1,277,800
48 Nasal Oxygen Bayi pcs 30 2 6,389 36 6 100 638,900
49 Nasal Oxygen Dewasa pcs 15 2 6,389 36 21 250 1,597,250
50 Pharmafix (Plester)/polifix Roll 778 105 41,000 1,890 1,112 472 19,352,000
51 Pipet Hematokrit/Kapiler Botol - 1 33,000 18 18 10 330,000
52 Salmonella Typhi H Widal 5 ml vial - 2 71,750 36 36 20 1,435,000
53 Salmonella Typhi O Widal 5 ml vial - 2 71,750 36 36 20 1,435,000
54 Silk 3/0 Pcs 14,868 235 20,193 4,230 -10,638 900 18,173,250
55 Skifa Examination Latex L box/100 89 9 61,425 161 72 100 6,142,500
56 Skifa Examination Latex M box/100 - 9 61,425 161 161 100 6,142,500
57 Skifa Infusion Set Anak pcs 10,250 186 9,486 3,348 -6,902 850 8,063,100
58 Skifa Infusion Set Dewasa pcs 520 856 8,131 15,408 14,888 3,500 28,458,500
59 Surgical Glove Steril 6,5 Pair 6,700 835 6,595 15,030 8,330 5,000 32,975,000
60 Surgical Glove Steril 7 Pair 6,950 1,175 6,595 21,150 14,200 10,000 65,950,000
61 SurgicalGlove Steril 7,5 Pair 5,150 985 6,595 17,730 12,580 8,000 52,760,000
62 Syringe 1 ml pcs 6,100 830 1,023 14,940 8,840 5,000 5,115,000
63 Syringe 3 ml pcs 22,800 2,670 1,045 48,060 25,260 20,300 21,213,500
64 Syringe 5 ml pcs 6,200 750 1,208 13,500 7,300 4,300 5,194,400
TOTAL 718,445,713

Mengetahui, Simpang Empat, 26 Oktober 2020

Kepala Dinas Kesehatan Kepala UPTD Instalasi Farmasi Kabupaten

JON HARDI, SKM, M.Kes apt. Efjunilda, SSi

NIP.19700627 199001 1 001 NIP. 19760920 200604 2 004
harga perubahan
8,600
69,720
 RKO Tahun 2021 Kab. Pasaman Barat
PROVINSI SUMATERA BARAT

SEBELUM PERUBAHAN SETELAH PERUBAHAN

NO NAMA OBAT SISA STOK PER PEMAKAIAN RENCANA RENCANA

RATA-RATA HARGA HARGA
SATUAN 31 DESEMBER PENGADAAN TOTAL SATUAN PENGADAAN TOTAL
2019 PER BULAN SATUAN TAHUN 2021 SATUAN TAHUN 2021
SELAMA 2019

(a) (b) (e)

1 Air untuk injeksi amp 25 ml ampul/vial/ 801 41 2,860 500 1,430,000 ampul/vial/ 2,860 500 1,430,000
botol 25 mL botol 25 mL
2 Alopurinol tab 100 mg Tab 35,600 6,833 105 100,000 10,500,000 Tab 105 100,000 10,500,000
3 Aminofilin Tab 200 mg tablet/kapsul/ 42,200 3,325 96 20,000 1,920,000 Botol 100 10,290 185 1,903,650
kaplet
4 Amitriptilin tab sal 25 mg tablet/kapsul/ 10,500 3,260 117 50,000 5,850,000 box/100 20,000 300 6,000,000
kaplet
5 Amlodipin tab 5 mg tablet/kapsul/ 16,800 9,468 78 160,000 12,480,000 tablet/kapsul/ 78 160,000 12,480,000
kaplet kaplet
6 Amoksisilin sir kering 125 mg/5 ml Botol 7,320 1,170 4,500 12,000 54,000,000 Botol 3,360 15,000 50,400,000
7 Amoksisilin tab 250 mg tablet/kapsul/ 36,500 8,500 203 100,000 20,300,000 tablet/kapsul/ 203 100,000 20,300,000
kaplet kaplet
8 Amoksisilin tab 500 mg tablet/kapsul/ 51,100 46,542 261 350,000 91,350,000 tablet/kapsul/ 261 350,000 91,350,000
kaplet kaplet
9 Anestetik lokal gigi kombinasi : lidokain hcl 2% + 37,770 365 1,286 3,000 3,858,000 847 3,000 2,541,000
ampul/vial ampul/vial
epinefrin 1 : 80.000 inj 2 ml
10 Antasida, kombinasi : aluminium hidroksida 200 mg + tablet/kapsul/ 434,200 43,350 56 350,000 19,600,000 tablet/kapsul/ 56 350,000 19,600,000
magnesium hidroksida 200 mg kaplet kaplet
11 Antasida, kombinasi : aluminium hidroksida 200 mg + 9,340 1,347 2,189 15,000 32,835,000 2,189 15,000 32,835,000
botol 60 ml botol 60 ml
magnesium hidroksida 200 mg
12 Antifungi salep, kombinasi : asam benzoat 6%+ asam 1,967 92 5,038 960 4,836,480 5,038 960 4,836,480
pot 30 g pot 30 g
salisilat 3%
13 Antihemoroid, kombinasi: bismut subgalat 150 mg + 150 103 3,325 2,000 6,650,000 3,325 2,000 6,650,000
heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng Suppositoria Suppositoria
oksida 120 mg + sup ad 2 g
14 Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/ 1,300 2,282 105 40,000 4,200,000 tablet/kapsul/ 105 40,000 4,200,000
kaplet kaplet
15 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/ 600,200 34,900 110 200,000 22,000,000 tablet/kapsul/ 110 200,000 22,000,000
kaplet kaplet
16 Asam mefenamat kaps 500 mg 43,000 27,233 255 300,000 76,500,000 255 300,000 76,500,000
tablet/kapsul/ tablet/kapsul/
kaplet/kaptab kaplet/kaptab

17 Asiklovir tab 200 mg tablet/kapsul/ 14,800 2,125 261 25,000 6,525,000 box/100 59,500 110 6,545,000
kaplet
18 Asiklovir tab 400 mg tablet/kapsul/ 34,400 2,817 399 20,000 7,980,000 Tablet 429 20,000 8,580,000
kaplet
19 Bedak salisil serb 2% Dus/Sachet/ 0 250 1,046 8,000 8,368,000 Dus/Sachet/ 2,500 3,000 7,500,000
Plastik Plastik
20 Betametason krim 0,1% tube 5 gram 7,450 505 1,520 2,350 3,572,000 Tube 1,540 2,300 3,542,000
21 Bisakodil sup 10 mg Suppositoria 735 48 5,900 500 2,950,000 suppositoria 5,900 500 2,950,000
22 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial 6,183 114 1,152 500 576,000 ampul/vial 968 500 484,000
23 Deksametason tab 0,5 mg tablet/kapsul/ 0 25,333 33 400,000 13,200,000 Tablet 35 350,000 12,250,000
kaplet
24 Diazepam enema 5 mg/2,5 ml 10 18 13,202 350 4,620,700 13,202 350 4,620,700
tube @ 2,5 mL tube @ 2,5 mL
25 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial 878 14 1,822 200 364,400 ampul/vial 1,545 200 309,000
26 Diazepam tab 2 mg tablet/kapsul/ 0 2,940 86 60,000 5,160,000 tablet/kapsul/ 86 60,000 5,160,000
kaplet kaplet
27 Diazepam tab 5 mg tablet/kapsul/ 21,300 1,567 114 15,000 1,710,000 tablet/kapsul/ 114 15,000 1,710,000
kaplet kaplet
28 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial 190 26 1,226 300 367,800 ampul/vial 825 300 247,500
29 Digoksin tab 0,25 mg tablet/kapsul/ 14,800 350 104 8,000 832,000 box/100 16,883 50 844,150
kaplet
30 Dimenhidrinat tab 50 mg tablet/kapsul/ 3,400 383 117 5,000 585,000 tablet/kapsul/ 117 5,000 585,000
kaplet kaplet
31 Domperidon tab 10 mg tablet/kapsul/ 80,400 13,583 86 150,000 12,900,000 tablet/kapsul/ 86 150,000 12,900,000
kaplet kaplet
32 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) ampul/vial 679 35 1,408 300 422,400 ampul/vial 1,590 300 477,000
33 Eritromisin sir 200 mg/5 ml 240 109 6,290 1,000 6,290,000 botol/60ml 6,786 900 6,107,400
Botol @ 60 ml
34 Eritromisin tab 500 mg tablet/kapsul/ 188,600 3,158 765 20,000 15,300,000 box/100 84,461 180 15,202,980
kaplet
35 Etanol 70% cairan 70% (1 Liter) Botol 160 32 37,639 330 12,420,870 Botol 37,639 330 12,420,870
36 Fenobarbital tab 30 mg tablet/kapsul/ 59,100 2,708 182 30,000 5,460,000 tablet/kapsul/ 182 30,000 5,460,000
kaplet kaplet
37 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) ampul/vial 6,765 471 3,867 2,100 8,120,700 ampul/vial 1,452 2,100 3,049,200
38 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 17,600 4,575 797 50,000 39,850,000 Tab sal 781 50,000 39,050,000
39 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) tablet salut 1,460 123 3,000 750 2,250,000 ampul/vial 5,000 500 2,500,000
gula/kaplet
salut gula
40 Furosemid tab 40 mg tablet/kapsul/ 1,200 1,200 82 20,000 1,640,000 tablet/kapsul/ 82 20,000 1,640,000
kaplet kaplet
41 Garam oralit kombinasi : natrium klorida 0,52 g + 38,700 3,200 274 20,000 5,480,000 Tablet 280 18,000 5,040,000
kalium klorida 0,30 g + trinatrium sitrat 0,58 g + sachet
glukosa anhidrat 2,7 g
42 Glibenklamid tab 5 mg tablet/kapsul/ 39,800 2,667 125 10,000 1,250,000 tablet/kapsul/ 87 10,000 870,000
kaplet kaplet
43 Glimepirid tab 1 mg tablet/kapsul/ 34,500 8,100 174 100,000 17,400,000 tablet/kapsul/ 93 100,000 9,300,000
kaplet kaplet
44 Glimepirid tab 2 mg tablet/kapsul/ 31,000 6,889 207 90,000 18,630,000 box/50 71,592 260 18,613,920
kaplet
45 Griseofulvin (micronized) tab 125 mg tablet/kapsul/ 6,000 4,734 232 50,000 11,600,000 tablet/kapsul/ 232 50,000 11,600,000
kaplet kaplet
46 Haloperidol inj 5 mg/ml (i.m.) Vial 106 25 4,000 300 1,200,000 Vial 13,500 - -
47 Haloperidol tab 0,5 mg tablet/kapsul/ 26,000 5,167 55 70,000 3,850,000 box/100 25,275 150 3,791,250
kaplet
48 Haloperidol tab 1,5 mg tablet/kapsul/ 8,600 4,409 59 75,000 4,425,000 box/100 9,374 470 4,405,780
kaplet
49 Hidrogen peroksida cairan 3% Botol 1,039 7 3,874 1,000 3,874,000 botol 8,250 - -
50 Hidroklorotiazid tab 25 mg tablet/kapsul/ 17,100 992 163 20,000 3,260,000 tablet/kapsul/ 163 20,000 3,260,000
kaplet kaplet
51 Hidrokortison krim 2,5% tube @ 5 g 3,864 358 2,475 3,000 7,425,000 tube @ 5 g 2,475 3,000 7,425,000
52 Ibuprofen tab 200 mg tablet/kapsul/ 2,500 14,758 108 200,000 21,600,000 Botol 100 18,900 1,100 20,790,000
kaplet
53 Ibuprofen tab 400 mg tablet/kapsul/ 27,000 24,335 125 300,000 37,500,000 tablet/kapsul/ 250 150,000 37,500,000
kaplet kaplet
54 Isoniazid tab 100 mg Tab 2,200 850 75 10,000 750,000 tablet 160 6,000 960,000
55 Isoniazid tab 300 mg Tab 300 358 173 5,000 865,000 Tab 173 5,000 865,000
56 Isosorbid dinitrat tab 5 mg tablet/kapsul/ 4,100 467 89 5,000 445,000 tablet/kapsul/ 89 5,000 445,000
kaplet kaplet
57 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/ 98,800 30,809 63 300,000 18,900,000 tablet/kapsul/ 63 300,000 18,900,000
kaplet kaplet
58 Kaptopril tab 12,5 mg tablet/kaplet 71,800 9,608 68 100,000 6,800,000 tablet/kaplet 68 100,000 6,800,000
59 Kaptopril tab 25 mg tablet/kaplet 14,800 12,225 77 100,000 7,700,000 tablet/kaplet 75 100,000 7,500,000
60 Karbamazepin Tab 200 mg Tablet 24,900 1,510 247 25,000 6,175,000 Tablet 247 25,000 6,175,000
61 Ketokonazol tab 200 mg tablet/kapsul/ 18,350 2,655 297 30,000 8,910,000 tablet/kapsul/ 297 30,000 8,910,000
kaplet kaplet
62 Klindamisin kaps 150 mg Kaps 10,100 1,206 770 5,000 3,850,000 box/50 31,920 100 3,192,000
63 Klindamisin kaps 300 mg tablet/kapsul/ 0 230 370 5,000 1,850,000 Tablet 522 5,000 2,610,000
kaplet
64 Kloramfenikol kaps 250 mg tablet/kapsul/ 17,000 5,741 320 50,000 16,000,000 box/120 68,000 200 13,600,000
kaplet
65 Kloramfenikol salep kulit 2% tube 15g 1,128 56 3,383 1,200 4,059,600 tube 15g 3,383 1,200 4,059,600
66 Kloramfenikol salep mata 1% 1,649 282 2,007 3,000 6,019,500 2,007 3,000 6,021,000
tube @ 5 gram tube @ 5 gram
67 Kloramfenikol tetes telinga 3% Botol 270 181 8,000 1,500 12,000,000 Botol 10,000 1,200 12,000,000
68 Klorfeniramin tab 4 mg tablet/kapsul/ 126,000 58,058 25 500,000 12,500,000 tablet/kapsul/ 60 200,000 12,000,000
kaplet kaplet
69 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial 1,198 63 1,691 300 507,297 ampul/vial 1,691 280 473,480
70 Klorpromazin tab sal 100 mg 12,900 2,575 165 35,000 5,775,000 165 35,000 5,775,000
tablet salut tablet salut
selaput/kaplet selaput/kaplet
salut selaput salut selaput

71 Klorpromazin tab sal 25 mg Tab sal 0 10,625 223 50,000 11,150,000 tablet salut 233 30,000 6,990,000
72 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/ 7,400 325 194 5,000 970,000 tablet/kapsul/ 194 5,000 970,000
kaplet kaplet
73 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 28,500 16,058 133 300,000 39,900,000 133 300,000 39,900,000
tab/kaptab tab/kaptab
400 mg+ trimetoprim 80 mg
74 Kotrimoksazol kombinasi tiap 5 ml suspensi : 4,750 582 2,190 5,000 10,950,000 2,190 5,000 10,950,000
botol 60 mL botol 60 mL
sulfametoksazol 200 mg + trimetoprim 40 mg
75 Lidokain inj 2% (infiltr/p.v.) ampul/vial 11,995 283 1,289 2,400 3,093,600 ampul/vial 891 2,400 2,138,400
76 Loratadin tab 10 mg tablet/kapsul/ 57,600 6,492 133 75,000 9,975,000 tablet/kapsul/ 133 75,000 9,975,000
kaplet kaplet
77 Metformin tab 500 mg tablet/kapsul/ 67,900 12,964 106 165,000 17,490,000 tablet/kapsul/ 106 165,000 17,490,000
kaplet kaplet
78 Metilergometrin inj 0,2 mg/ml ampul/vial 4,380 111 3,102 1,000 3,102,000 ampul/vial 1,023 1,000 1,023,000
79 Metilergometrin tab salut 0,125 mg tablet/kaplet 12,100 1,233 236 11,000 2,596,000 tablet/kaplet 236 11,000 2,596,000
salut selaput salut selaput
80 Metilprednisolon tab 4 mg tablet/kapsul/ 10,100 20,225 146 360,000 52,560,000 tablet/kapsul/ 146 360,000 52,560,000
kaplet kaplet
81 Metoklopramid tab 10 mg tablet/kapsul/ 6,600 2,550 85 45,000 3,825,000 tablet/kapsul/ 85 45,000 3,825,000
kaplet kaplet
82 Metronidazol tab 250 mg tablet/kapsul/ 0 4,082 91 80,000 7,280,000 box/100 12,987 560 7,272,720
kaplet
83 Metronidazol tab 500 mg tablet/kapsul/ 1,000 4,900 126 90,000 11,340,000 box/100 35,385 320 11,323,200
kaplet
84 Mikonazol krim 2% tube 528 596 3,585 7,000 25,095,000 tube 3,585 7,000 25,095,000
85 N-asetil sistein kaps 200 mg tablet/kapsul/ 448,200 7,300 381 20,000 7,620,000 tablet/kapsul/ 381 20,000 7,620,000
kaplet kaplet
 86 NaCl 0,9% Larutan Botol 1,678 288 6,840 2,000 13,680,000 botol 6,900 2,000 13,800,000
plastik/botol
plastik pi
87 Natrium diklofenak tab 25 mg 0 6,955 141 140,000 19,740,000 115 140,000 16,100,000
tablet salut tablet salut
enterik/kaplet enterik/kaplet
salut enterik salut enterik

88 Natrium diklofenak tab 50 mg 0 11,164 136 200,000 27,200,000 108 200,000 21,600,000
tablet salut tablet salut
enterik/kaplet enterik/kaplet
salut enterik salut enterik

89 Nifedipin kaps 10 mg tablet/kapsul/ 0 2,713 200 50,000 10,000,000 tablet/kapsul/ 200 50,000 10,000,000
kaplet kaplet
90 Nistatin tab salut 500.000 UI tablet salut 4,500 317 886 2,000 1,772,000 tablet salut 869 2,000 1,738,000
gula/kaplet gula/kaplet
salut gula salut gula
91 Nistatin tab vaginal 100.000 UI tablet/kaplet 3,800 233 630 1,000 630,000 tablet/kaplet 550 1,000 550,000
92 Oksitosin inj 10 UI/ml ampul/vial 520 307 1,199 3,000 3,597,000 ampul/vial 1,126 3,000 3,378,000
93 Omeprazol kaps 20 mg tablet/kapsul/ 74,670 9,525 143 100,000 14,300,000 tablet/kapsul/ 143 100,000 14,300,000
kaplet kaplet
94 Parasetamol sir 120 mg/5 ml 3,400 1,575 1,184 30,000 35,520,000 1,184 30,000 35,520,000
botol @ 60 mL botol @ 60 mL
95 Parasetamol tab 500 mg tablet/kapsul/ 381,100 104,383 56 600,000 33,600,000 tablet/kapsul/ 130 427,500 55,575,000
kaplet kaplet
96 Parasetamol tts 60 mg/0,6 ml 994 323 6,981 2,000 13,962,000 6,981 2,000 13,962,000
botol @ 15 mL botol @ 15 mL
97 Perak sulfadiazin krim 1% Tube 352 17 20,700 100 2,070,000 Tube 20,700 100 2,070,000
98 Permetrin krim 5 % Tube 0 44 11,825 1,000 11,825,000 Tube 11,825 1,000 11,825,000
99 Pirantel pamoat tab scored 125 mg tablet/kapsul/ 2,000 409 322 6,000 1,932,000 tablet/kapsul/ 317 6,000 1,902,000
kaplet kaplet
100 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl 238,900 13,567 138 10,000 1,380,000 tab/kap/kapl 138 10,000 1,380,000
101 Povidon iodin lar 100 mg/ml 259 36 4,400 770 3,388,000 4,400 770 3,388,000
botol @ 60 mL botol @ 60 mL
102 Povidon iodin lar 100 mg/ml Botol 300 ml 220 29 17,740 500 8,870,000 Botol 300 ml 17,740 500 8,870,000
103 Prednison tab 5 mg tablet/kapsul/ 50,000 8,570 77 105,000 8,085,000 tablet/kapsul/ 71 105,000 7,455,000
kaplet kaplet
104 Primakuin tab 15 mg Tab 2,500 317 235 3,500 822,500 Tab 235 3,500 822,500
105 Propiltiourasil tab 100 mg tablet/kapsul/ 0 125 335 5,000 1,675,000 Tablet 405 3,500 1,417,500
kaplet
106 Propranolol tab 10 mg tablet/kapsul/ 10,600 1,325 61 15,000 915,000 tablet/kapsul/ 61 15,000 915,000
kaplet kaplet
107 Ranitidin tab 150 mg tablet/kapsul/ 195,000 44,063 200 210,000 42,000,000 tablet/kapsul/ 85 210,000 17,850,000
kaplet kaplet
108 Ringer Laktat Larutan Botol 28,073 1,942 7,630 3,000 22,890,027 botol 7,703 2,500 19,257,500
109 Risperidon tab sal 1 mg tablet/kapsul/ 15,500 6,900 240 104,500 25,080,000 tablet/kapsul/ 123 104,500 12,853,500
kaplet kaplet
110 Salbutamol tab 2 mg tablet/kapsul/ 22,000 5,408 67 80,000 5,366,400 tablet/kapsul/ 68 75,000 5,100,000
kaplet kaplet
111 Salbutamol tab 4 mg tablet/kapsul/ 29,900 6,150 74 85,000 6,290,000 tablet/kapsul/ 74 85,000 6,290,000
kaplet kaplet
112 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang 1,200 182 2,938 2,160 6,346,080 2,938 2,160 6,346,080
pot 30 gram pot 30 gram
endap 4 %
113 Serum anti bisa ular : A.B.U. I (khusus ular dari luar 1 2 512,204 10 5,122,040 vial 517,132 10 5,171,320
Vial
Papua) inj (i.m./i.v.)
114 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul 0 13 130,999 80 10,479,920 Ampul 130,999 80 10,479,920
115 Sianokobalamin (vitamin B12) inj 500 mcg/ml ampul/vial 1,820 135 1,136 1,000 1,136,000 ampul/vial 1,136 1,000 1,136,189
116 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/ 281,500 16,767 50 30,000 1,500,000 tablet/kapsul/ 50 30,000 1,500,000
tablet/kapsul/
kaplet tablet/kapsul/
kaplet
117 Simvastatin tab sal 10 mg kaplet/tablet 25,110 5,368 117 85,000 9,945,000 kaplet/tablet 117 85,000 9,945,000
salut selaput salut
/kaplet salut selaput /kaplet
118 Siprofloksasin tab scored 500 mg tablet
selaputsalut 137,500 12,875 272 60,000 16,320,000 tablet salut
salut selaput 272 60,000 16,320,000
selaput/kaplet selaput/kaplet
salut selaput salut selaput
119 Spironolakton tab 25 mg tablet/kapsul/ 0 2,291 208 40,000 8,320,000 tablet/kapsul/ 200 40,000 8,000,000
kaplet kaplet
120 Tiamin (vitamin B1) tab 50 mg tablet/kapsul/ 1,000,800 22,859 92 50,000 4,600,000 tablet/kapsul/ 92 50,000 4,600,000
kaplet kaplet
121 Triheksifenidil tab 2 mg tablet/kapsul/ 14,500 9,350 93 120,000 11,160,000 tablet/kapsul/ 93 120,000 11,161,625
kaplet kaplet
122 Vitamin B kompleks tablet 1,102,800 52,183 131 50,000 6,550,254 tablet 131 50,000 6,550,254
TOTAL 1,385,390,567 1,319,400,667

Mengetahui,
Kepala Dinas Kesehatan

JON HARDI, SKM, M.Kes

NIP.19700627 199001 1 001
2,103,836,280
selisih

-
(16,350)

150,000

(3,600,000)
-

(1,317,000)

-
 -

20,000

600,000

(868,000)

(30,000)
-
(92,000)
(950,000)

(55,400)
-

(120,300)
12,150

54,600
(182,600)

(97,020)

-
-

(5,071,500)
(800,000)
 250,000

(440,000)

(380,000)

(8,100,000)

(16,080)

(1,200,000)
(58,750)

(19,220)

(3,874,000)
-

-
(810,000)

210,000
-
-

-
(200,000)
-
-

(658,000)
 760,000

(2,400,000)

-
1,500

-
(500,000)

(33,817)
-

(4,160,000)
-

(955,200)
-

(2,079,000)
-

(7,280)

(16,800)

-
-
 120,000

(3,640,000)

(5,600,000)

(34,000)

(80,000)
(219,000)
-

21,975,000

-
-
(30,000)

-
-

-
(630,000)

-
(257,500)

-
(24,150,000)

(3,632,527)
(12,226,500)

(266,400)

49,280

-
189
-

(320,000)

1,625
-
65,989,900
 RKBMHP Tahun 2021 Kab. Pasaman Barat
PROVINSI SUMATERA BARAT
sebelum perubahan setelah perubahan

SISA STOK PEMAKAIAN

RENCANA RENCANA
NO NAMA OBAT SATUAN PER 31 RATA-RATA PER HARGA PENGADAAN TOTAL HARGA PENGADAAN TOTAL
DESEMBER BULAN SELAMA SATUAN SATUAN
TAHUN 2021 TAHUN 2021
2019 2019
(a) (b) (e)

1 Alkohol
Swab Box 18 16 11,604 500 5,802,000 11,500 724 8,326,000
2 Anti A Mono Gol Darah 10 ml vial - 2 72,750 20 1,455,000 115,500 15 1,732,500
3 Anti AB Mono Gol Darah 10 ml vial - 2 94,750 20 1,895,000 115,500 15 1,732,500
4 Anti B Mono Gol Darah 10 ml vial - 2 72,750 20 1,455,000 164,000 15 2,460,000
5 Anti D Mono Gol Darah 10 ml vial - 2 114,750 20 2,295,000 205,000 15 3,075,000
6 Benechek Cholesterol Tes pcs - 720 25,495 2,500 63,737,500 25,400 2,500 63,500,000
7 Benechek Glukosa Tes pcs - 1,065 3,370 5,000 16,850,000 3,360 5,000 16,800,000
8 Benechek Uric Acid Tes pcs 66 634 6,496 3,000 19,488,000 6,167 3,000 18,500,010
9 Blood Lancet Kotak 57 10 18,340 151 2,769,340 15,840 150 2,376,000
10 Catgut Chromic 2/0 pcs 4,776 120 8,421 1,200 10,105,200 8,421 1,200 10,105,200
11 Catgut Chromic 3/0 pcs 5,796 135 8,464 1,200 10,156,800 8,464 1,200 10,156,800
12 Catgut Plain 2/0 pcs 5,988 153 7,565 1,200 9,078,000 7,565 1,200 9,078,000
13 Catgut Plain 3/0 pcs 5,628 88 7,565 1,200 9,078,000 7,565 1,200 9,078,000
14 Foley Cath No. 16 Pcs 217 24 11,565 300 3,469,500 11,565 300 3,469,500
15 Foley Cath No. 18 Pcs 262 7 11,565 200 2,313,000 11,565 200 2,313,000
16 Iodium Tes botol - 14 3,000 500 1,500,000 3,000 450 1,350,000
17 IV Cath 18 pcs - 192 5,828 2,800 16,318,400 5,828 2,800 16,318,400
18 IV Cath 20 pcs 250 348 5,828 4,700 27,391,600 5,828 4,700 27,391,600
19 IV Cath 22 pcs - 595 5,828 4,700 27,391,600 5,828 4,700 27,391,600
20 IV Cath 24 pcs 150 265 5,828 2,300 13,404,400 5,828 2,300 13,404,400
21 Kassa 4 m x 10 cm roll 10,640 356 1,760 2,800 4,928,000 3,965 2,000 7,930,000
22 Kassa 4 m x 5 cm Roll 8,110 368 880 4,600 4,048,000 1,100 2,000 2,200,000
23 Kassa Hidrofile 16 cm x 16 cm Box 802 195 7,755 1,350 10,469,250 4,830 1,350 6,520,500
24 Kassa Hidrofile 18 cm x 22 cm Box 827 152 17,397 730 12,699,810 17,397 800 13,917,600
25 Kassa Hidrofile 40 yard x 80 cm Roll 194 32 209,620 290 60,789,800 134,925 450 60,716,250
26 Larutan Ammonium Oksalat botol - - 90,000 5 450,000 23,699 5 118,496
27 Larutan Barium Chlorida 10% 100 ml botol 11 1 39,200 5 196,000 39,200 5 196,000
28 Larutan Benedict 100 ml botol 24 1 26,790 5 133,950 23,099 5 115,496
29 Larutan EDTA 10% 100 ml botol 7 1 80,940 5 404,700 65,009 5 325,046
30 Larutan Eosin 2% 100 ml botol 8 1 183,065 5 915,325 170,199 5 850,996
31 Larutan Fouchet 100 ml botol 24 1 182,590 5 912,950 178,199 5 890,996
32 Larutan Giemsa 100 ml botol 2 1 363,090 5 1,815,450 355,199 5 1,775,996
33 Larutan HCL 0,1 N 100 ml botol 16 1 25,950 10 259,500 22,199 10 221,992
34 Larutan Immersion Oil 100 ml botol 8 1 374,490 5 1,872,450 360,000 5 1,800,000
35 Larutan Rees Ecker 100 ml botol 2 1 53,390 5 266,950 47,199 5 235,996
36 Larutan Turk 100 ml botol 5 1 30,590 5 152,950 28,439 5 142,195
37 Lysol 1 liter Botol 366 20 43,167 100 4,316,700 43,167 100 4,316,700
38 Masker Pcs 110,600 21,600 1,670 37,500 62,625,000 945 37,500 35,442,000
39 Masker N95 Pcs 144 46 23,313 420 9,791,460 23,313 1,400 32,638,200
40 Micropipet 10 µl pack - - 526,086 5 2,630,428 2,312,200 - -
41 Nald Heacting Kulit No. 28 Pcs - - 11,500 240 2,760,000 11,500 240 2,760,000
42 Nald Heacting Kulit No. 32 Pcs - - 11,500 240 2,760,000 11,500 240 2,760,000
43 Nald Heacting Kulit No. 36 Pcs - - 11,500 240 2,760,000 11,500 240 2,760,000
44 Nald Heacting Otot No. 28 Pcs - - 11,500 240 2,760,000 11,500 240 2,760,000
45 Nald Heacting Otot No. 32 Pcs - - 11,500 240 2,760,000 11,500 240 2,760,000
46 Nald Heacting Otot No. 36 Pcs - - 11,500 240 2,760,000 11,500 240 2,760,000
47 Nasal Oxygen Anak pcs 33 2 6,389 200 1,277,800 4,807 200 961,400
48 Nasal Oxygen Bayi pcs 30 2 6,389 100 638,900 5,126 100 512,600
49 Nasal Oxygen Dewasa pcs 15 2 6,389 250 1,597,250 4,807 250 1,201,750
50 Pharmafix (Plester)/polifix Roll 778 105 41,000 472 19,352,000 31,900 472 15,056,800
51 Pipet Hematokrit/Kapiler Botol - 1 33,000 10 330,000 33,888 10 338,880
52 Salmonella Typhi H Widal 5 ml vial - 2 71,750 20 1,435,000 103,656 20 2,073,120
53 Salmonella Typhi O Widal 5 ml vial - 2 71,750 20 1,435,000 103,656 20 2,073,120
54 Silk 3/0 Pcs 14,868 235 20,193 900 18,173,250 18,360 900 16,524,000
55 Skifa Examination Latex L box/100 89 9 61,425 100 6,142,500 112,365 180 20,225,610
56 Skifa Examination Latex M box/100 - 9 61,425 100 6,142,500 112,365 160 17,978,320
57 Skifa Infusion Set Anak pcs 10,250 186 9,486 850 8,063,100 8,128 850 6,908,800
58 Skifa Infusion Set Dewasa pcs 520 856 8,131 3,500 28,458,500 6,112 3,500 21,392,955
59 Surgical Glove Steril 6,5 Pair 6,700 835 6,595 5,000 32,975,000 6,595 5,000 32,975,000
60 Surgical Glove Steril 7 Pair 6,950 1,175 6,595 10,000 65,950,000 6,595 10,000 65,950,000
61 SurgicalGlove Steril 7,5 Pair 5,150 985 6,595 8,000 52,760,000 6,595 8,000 52,760,000
62 Syringe 1 ml pcs 6,100 830 1,023 5,000 5,115,000 876 5,000 4,381,250
63 Syringe 3 ml pcs 22,800 2,670 1,045 20,300 21,213,500 851 20,300 17,268,113
64 Syringe 5 ml pcs 6,200 750 1,208 4,300 5,194,400 1,021 4,300 4,391,026
TOTAL 718,445,713 718,445,713

Mengetahui,
Kepala Dinas Kesehatan

JON HARDI, SKM, M.Kes

NIP.19700627 199001 1 001
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