LTB Rko Dan BMHP Dinkes 2023

RENCANA KEBUTUHAN OBAT DAN BMHP PUSKESMAS 2023
PUSKESMAS : LIUKANG TUPABBIRING
SISA STOK TOTAL PEMAKAIA JUMLAH RENCANA

31 PEMAKAI N RATA- KEBUTUH KEBUTHA KEBUTUHA HARGA TOTAL
NO NAMA OBAT SATUAN
DESEMBER AN TAHUN RATA PER AN TAHUN N TAHUN N 2023 HARGA
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18 j k
a b c d e h=(g-d) i
ketersediaan bulan
1 Air untuk injeksi ampul/vial/botol 10 mL 0 0 0 0 0 0 0 0

2 Air untuk injeksi Botol 100 ml 0 0 0 0 0 0 0 0
3 Air untuk injeksi Botol 250 ml 0 0 0 0 0 0 0 0
4 Air untuk injeksi amp 20 ml ampul/vial/botol 0 0 0 0 0 0 0
5 Air untuk injeksi amp 25 ml ampul/vial/botol 25 mL 236 0 10 180 -56 200 0 0
6 Albendazol susp 200 mg/5 ml Botol 60 200 20 360 300 500 0 0
7 Albendazol tab 400 mg tablet/kapsul/kaplet 1000 344 6,192 6,192 6,000 0 0
8 Alopurinol tab 100 mg Tab 1200 5540 650 11,700 10,500 13,000 0 0
9 Alopurinol tab 300 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0 0
10 Aminofilin inj 24 mg/ml ampul/vial 10 ml 0 0 0 0 0 0 0 0
11 Aminofilin tab 150 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0 0
12 Aminofilin Tab 200 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0 0
13 Amitriptilin tab sal 25 mg tablet/kapsul/kaplet 460 60 1,080 1,080 1,000 0 0
14 Amlodipin tab 10 mg tablet/kapsul/kaplet 2500 4878 561 10,098 7,598 1,000 0 0
15 Amlodipin tab 5 mg tablet/kapsul/kaplet 5250 20800 2311 41,598 36,348 40,000 0 0
16 Amoksisilin drops 100 mg/ml Botol @15 ml 0 0 0 0 0 0 0
19 Amoksisilin sir forte 250 mg/5 ml botol 60 ml 0 0 0 0 0 0 0
20 Amoksisilin sir kering 125 mg/5 ml Botol 73 341 51 918 845 1,000 0 0
21 Amoksisilin tab 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
22 Amoksisilin tab 500 mg tablet/kapsul/kaplet 10200 32501 3611 64,998 54,798 65,000 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
a b c d e h=(g-d) i j k
ketersediaan bulan
23 Ampisilin serb inj 1000 mg/vial ampul/vial 0 0 0 0 0 0 0

24 Ampisilin serb inj 250 mg/vial Vial 7 0 0 0 -7 0 0 0
Anestetik lokal gigi kombinasi : lidokain hcl 2% + ampul/vial 623 70
25 epinefrin 1 : 80.000 inj 2 ml 1,260 1,260 1,110 0 0
Antasida, kombinasi : aluminium hidroksida 200 tablet/kapsul/kaplet 15351 1706
26 mg + magnesium hidroksida 200 mg 30,708 30,708 30,000 0 0
Antasida, kombinasi : aluminium hidroksida 200 botol 60 ml 596 67
27 mg + magnesium hidroksida 200 mg 1,206 1,206 1,200 0 0
Anti Parkinson kombinasi : benzerasid 25 mg + Kaps 0 0
28 levodopa 100 mg 0 0 0 0 0
Antifungi salep, kombinasi : asam benzoat 6%+ pot 30 g 0 0
29 asam salisilat 3% 0 0 0 0 0
Antihemoroid, kombinasi: bismut subgalat 150 Suppositoria 20 40 6
mg + heksaklorofen 2,5 mg + lidokain lidokain
30 10 mg+ seng oksida 120 mg + sup ad 2 g
108 88 100 0 0
31 Aquadest cairan 500 ml Botol 500 ml 0 0 0 0 0 0 0
32 Artesunat serb inj 60 mg/ml (i.v./i.m.) ampul/vial 0 0 0 0 0 0 0
Articulating paper kertas warna penanda oklusi Kertas warna penanda oklusi 0 0
33
0 0 0 0 0
34 Asam asetat tetes telinga 2% Botol 0 0 0 0 20 0 0
35 Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/kaplet 0 20 360 360 500 0 0
36 Asam askorbat (vitamin C) tab 250 mg Tab 0 0 0 0 0 0 0
37 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/kaplet 1920 18551 2062 37,116 35,196 40,000 0 0
38 Asam folat tab 0,4 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
39 Asam folat tab 1 mg tablet/kapsul/kaplet 1600 0 20 360 -1,240 1,000 0 0
40 Asam folat tab 5 mg Tab 0 0 0 0 0 0 0
41 Asam mefenamat kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
42 Asam mefenamat kaps 500 mg tablet/kapsul/kaplet/kap 2500 14693 1633 29,394 26,894 30,000 0 0
43 Asam retinoat krim 0,05% Tube/pot 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
44 Asam retinoat krim 0,1% Tube @ 10 gram 0 0 0 0 0 0 0

45 Asam retinoat krim 0,1% Tube @ 20 gram 0 0 0 0 0 0 0
46 Asam salisilat lar 0,1% Botol 0 0 0 0 0 0 0
47 Asam salisilat salep 10% Tube 0 0 0 0 0 0 0
50 Asiklovir tab 200 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
51 Asiklovir tab 400 mg tablet/kapsul/kaplet 270 580 40 720 450 2,000 0 0
52 Atapulgit 600 mg tablet/kapsul/kaplet 200 206 80 1,440 1,240 2,000 0 0
53 Atapulgit tab 630 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
54 Atapulgit tablet 650 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
55 Atapulgit tablet 750 mg Tab 0 0 0 0 0 0 0
56 Atenolol tab 100 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
57 Atenolol tab 50 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
58 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul 0 0 0 0 0 0 0
59 Atropin tab 0,5 mg Tab 0 0 0 0 0 0 0
60 Bahan tumpatan sementara lar, serb Botol 0 0 0 0 0 0 0
61 Bedak salisil serb 2% Dus/Sachet/Plastik 63 30 30 540 477 600 0 0
62 Betahistin tab 6 mg tablet/kapsul/kaplet 300 80 1,440 1,440 2,000 0 0
63 Betametason krim 0,1% tube 5 gram 100 680 78 1,404 1,304 900 0 0
64 Betametason krim 0,5 mg/g Tube 0 0 0 0 0 0 0
65 Betametason salep 0,1% tube 5 gram 0 0 0 0 0 0 0
66 Betametason tts mata 1 mg/ml catchcover, botol 0,6 mL 0 0 0 0 0 0 0
67 Betametason tts mata 1 mg/ml botol @5 ml 0 0 0 0 0 0 0
68 Bisakodil sup 10 mg Suppositoria 20 0 10 180 160 150 0 0
69 Bisakodil sup 5 mg Suppositoria 12 0 10 180 168 150 0 0
70 Bisakodil tab sal 5 mg tablet/kapsul/kaplet 80 30 540 540 1,500 0 0
71 Budesonid cairan ih 0,25mg/ml Botol @ 4 ml 0 30 540 540 500 0 0
Budesonid cairan ih 0,25mg/ml, respoules 2 ml respoules 0 0
72
0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
73 Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml 0 0 0 0 0 0 0

Budesonid cairan ih 0,5 mg/ml, respoules 2 ml respoules 0 0
74
0 0 0 0 0
75 Budesonid serb ih 100 mcg/dosis Botol 0 0 0 0 0 0 0
76 Budesonid serb ih 200 mcg/dosis 200 dosis 0 0 0 0 0 0 0
77 Budesonid serb ih 200 mcg/dosis 100 dosis 0 0 0 0 0 0 0
78 Copper T set/buah 0 0 0 0 0 0 0
79 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial 5 20 2 36 31 30 0 0
80 Deksametason tab 0,5 mg tablet/kapsul/kaplet 200 21715 2415 43,470 43,270 40,000 0 0
81 Diazepam enema 10 mg/2,5 ml tube @ 2,5 mL 0 0 0 0 0 0 0
82 Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL 23 4 72 72 200 0 0
83 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial 35 4 72 72 50 0 0
84 Diazepam tab 2 mg tablet/kapsul/kaplet 2340 260 4,680 4,680 1,000 0 0
85 Diazepam tab 5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
86 Dietilkarbamazin tab 100 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
87 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial 5 10 1 18 13 10 0 0
88 Digoksin tab 0,25 mg tablet/kapsul/kaplet 0 0 0 0 500 0 0
89 Diltiazem kaps SR 100 mg Kapsul lepas lambat 0 0 0 0 0 0 0
90 Diltiazem kaps SR 200 mg Kapsul lepas lambat 0 0 0 0 0 0 0
91 Dimenhidrinat tab 50 mg tablet/kapsul/kaplet 100 500 130 2,340 2,240 500 0 0
92 Doksisiklin kaps 100 mg tablet/kapsul/kaplet 100 0 20 360 260 0 0 0
93 Dolutegravir tab 50 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
94 Domperidon susp 5 mg/5 ml botol @60 ml 158 18 324 324 300 0 0
95 Domperidon tab 10 mg tablet/kapsul/kaplet 6131 681 12,258 12,258 6,000 0 0
96 Efavirenz tab 200 mg Tablet 0 0 0 0 0 0 0
97 Efavirenz tab sal 600 mg tablet salut selaput/kaplet salut selapu 0 0 0 0 0 0 0
98 Epinefrin (adrenalin) inj 1 mg/ml Ampul 8 3 54 54 10 0 0
99 Ergotamin tab 1 mg Tab 0 0 0 0 0 0 0
100 Eritromisin kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
101 Eritromisin sir 200 mg/5 ml Botol @ 60 ml 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
102 Eritromisin tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0

103 Estrogen terkonjugasi tab sal 0,625 mg tablet salut gula/kaplet salut gula 0 0 0 0 0 0 0
104 Etambutol tab 400 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
105 Etanol 70% cairan 70% Botol 26 40 8 144 118 200 0 0
106 Etil klorida semprot 100 ml Botol 3 2 36 36 5 0 0
107 Etonogestrel implan 68 mg Set 0 0 0 0 0 0 0
108 Eugenol Botol 0 1 18 18 3 0 0
109 Fenitoin Na inj 50 mg/ml (100 mg/ 2 mL) ampul @ 2 ml 0 0 0 0 0 0 0
110 Fenitoin Na kaps 100 mg Kaps 0 0 0 0 0 0 0
111 Fenitoin Na kaps 30 mg Kaps 0 0 0 0 0 0 0
112 Fenobarbital tab 100 mg Tab 0 0 0 0 0 0 0
113 Fenobarbital tab 30 mg tablet/kapsul/kaplet 50 20 360 360 100 0 0
114 Fenoksimetil penisilin (penisilin V) tab 250 mg Tab 0 0 0 0 0 0 0
115 Fenoksimetil penisilin (penisilin V) tab 500 mg Tab 200 0 0 0 -200 0 0 0
116 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) ampul/vial 30 48 7 126 96 150 0 0
117 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 200 200 20 360 160 500 0 0
118 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) tablet salut gula/kaplet salut gula 0 0 0 0 0 0 0
119 Fluoksetin kaps 10 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
121 Fluor kapl 1 mg Kaplet 0 0 0 0 0 0 0
122 Fluor sediaan topikal Tube 0 0 0 0 0 0 0
123 Formokresol Botol 0 0 0 0 0 0 0
124 Framisetin Sulfat Tulle 1% Patch 0 0 0 0 0 0 0
125 Furosemid inj 10 mg/ml (i.v./i.m.) ampul/vial 0 0 0 0 0 0 0
126 Furosemid tab 40 mg tablet/kapsul/kaplet 200 120 120 2,160 1,960 2,000 0 0
Galactose microparticle 200-400 mg Vial 0 0
127 micropart/ml
0 0 0 0 0
128 Botol 0 0 0 0 0 0 0
129 Garam Fe, setara dengan Fe elemental 60 mg Sachet 0 0 0 0 0 0 0
130 Garam Fe, setara dengan Fe elemental 60 mg Botol 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
Garam oralit kombinasi : natrium klorida 0,52 g sachet 200 164
131 + kalium klorida 0,30 g + trinatrium sitrat 0,58 g
+ glukosa anhidrat 2,7 g
2,952 2,952 500 0 0
132 Gentamisin salep mata 0,3% Tube 21 0 0 0 -21 0 0 0
133 Gentamisin tts mata 0,3% Botol 3 0 0 0 -3 5 0 0
Glass ionomer ART (Atraumatic Restorative Sachet 0 0
134 Treatment) cocoa butter 5 g
0 0 0 0 0
Glass ionomer ART (Atraumatic Restorative Botol 1 0 0
135 Treatment) lar
0 -1 0 0 0
Glass ionomer ART (Atraumatic Restorative Vial 0 0
136 Treatment) serb
0 0 0 0 0
137 Glibenklamid tab 2,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
138 Glibenklamid tab 5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
139 Glikuidon tab 30 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
140 Glimepirid tab 1 mg tablet/kapsul/kaplet 2200 3000 1500 27,000 24,800 5,000 0 0
141 Glimepirid tab 2 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
142 Glipizid tab 5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
143 Gliseril trinitrat tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
144 Gliserin tts 100 mg/ml Botol 0 10 180 180 20 0 0
145 Glukosa Larutan Infus 10% steril 100 ml Botol 0 0 0 0 0 0 0
148 Glukosa Larutan Infus 40% Ampul @25 ml 20 6 108 108 20 0 0
152 Griseofulvin (micronized) tab 125 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
153 Griseofulvin (micronized) tab scored 250 mg tablet/kapsul/kaplet 400 0 0 0 -400 0 0 0
154 Gutta percha dan paper points 15 - 40 mm Roll 0 0 0 0 0 0 0
155 Gutta percha dan paper points 45 - 80 mm Roll 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
156 Haloperidol inj 5 mg/ml (i.m.) Vial 0 0 0 0 0 0 0

157 Haloperidol tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
158 Haloperidol tab 1,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
159 Haloperidol tab 2 mg tablet/kapsul/kaplet 410 150 2,700 2,700 2,000 0 0
160 Haloperidol tab 5 mg tablet/kapsul/kaplet 0 30 540 540 500 0 0
161 Haloperidol tts 2 mg/ml botol 0 0 0 0 0 0 0
Hepatitis B imunoglobulin (human) inj 150 Ampul 0 0
162 IU/1,5 ml
0 0 0 0 0
163 Hidrogen peroksida cairan 3% Botol 0 0 0 0 0 0 0
164 Hidroklorotiazid tab 25 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
165 Hidrokortison krim 2,5% tube @ 5 g 48 130 40 720 672 500 0 0
166 Hidrokortison serb inj 100 mg Vial 0 0 0 0 0 0 0
167 Hiosina butilbromida tab 10 mg tablet/kapsul/kaplet 2000 820 120 2,160 160 1,000 0 0
Human tetanus imunoglobulin inj 250 UI (i.m.) Ampul 0 0
168
0 0 0 0 0
Human tetanus imunoglobulin inj 500 UI (i.m.) Ampul 0 0
169
0 0 0 0 0
170 Ibuprofen sir 100 mg/5 ml botol @ 60 ml 2 165 10 180 178 200 0 0
171 Ibuprofen sir 200 mg/5 ml botol @ 60 ml 5 6 108 108 100 0 0
172 Ibuprofen tab 200 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
173 Ibuprofen tab 400 mg tablet/kapsul/kaplet 8700 2700 766 13,788 5,088 15,000 0 0
Ipratropium bromida aerosol 20 mcg/semprot Botol 0 0
174
0 0 0 0 0
175 Ipratropium bromida cairan ih 0,025% Botol 30 5 0 0 -30 30 0 0
176 Isoniazid tab 100 mg Tab 1100 0 0 0 1,000 0 0
177 Isoniazid tab 300 mg Tab 0 0 0 0 0 0 0
178 Isosorbid dinitrat tab 5 mg tablet/kapsul/kaplet 10 0 0 0 100 0 0
179 IUD Cu T 380 A Set 0 0 0 0 0 0 0
180 IUD Levonorgestrel Set 0 0 0 0 0 0 0
181 Kalamin Tube 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
182 Kalsium glukonat inj 100 mg/ml ampul/vial 0 0 0 0 0 0 0

183 Kalsium hidroksida bubuk, pasta Tube 0 0 0 0 0 0 0
184 Kalsium karbonat tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
185 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/kaplet 4900 7350 820 14,760 9,860 7,000 0 0
186 Kaptopril tab 12,5 mg tablet/kaplet 0 0 0 0 0 0 0
187 Kaptopril tab 25 mg tablet/kaplet 1100 105 20 360 -740 500 0 0
188 Kaptopril tab 50 mg tablet/kaplet 0 0 0 0 0 0 0
189 Karbamazepin sir 100 mg/5 ml Botol 0 0 0 0 0 0 0
190 Karbamazepin Tab 200 mg Tablet 0 0 0 0 0 0 0
191 Karbogliserin tts telinga 10 % Botol 0 0 0 0 0 0 0
192 Ketokonazol tab 200 mg tablet/kapsul/kaplet 500 100 10 180 -320 300 0 0
193 Klindamisin kaps 150 mg Kaps 0 0 0 0 0 0 0
194 Klindamisin kaps 300 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
195 Klofazimin, micronized kaps 50 mg Kapsul 0 0 0 0 0 0 0
196 Klofazimin, micronizedkaps 100 mg kapsul 0 0 0 0 0 0 0
197 Klonidin tab 0,15 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
198 Kloramfenikol kaps 250 mg tablet/kapsul/kaplet 300 90 1,620 1,620 500 0 0
199 Kloramfenikol salep mata 1% tube @ 5 gram 0 0 0 0 0 0 0
200 Kloramfenikol serb inj 1.000 mg/ml vial/ampul 0 0 0 0 0 0 0
201 Kloramfenikol susp 125 mg/5 ml botol 60 ml 0 0 0 0 20 0 0
202 Kloramfenikol tetes telinga 3% Botol 0 0 0 0 0 0 0
203 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0
204 Kloramfenikol tts mata 1% Botol 0 0 0 0 0 0 0
205 Klorfeniramin tab 4 mg tablet/kapsul/kaplet 3400 34500 4000 72,000 68,600 90,000 0 0
206 Klorfenol kamfer mentol (CHKM) Botol 0 0 0 0 0 0 0
207 Klorheksidin lar 0,2% Botol 0 0 0 0 0 0 0
208 Klorheksidin lar 15% Botol 0 0 0 0 0 0 0
209 Klorpromazin inj 25 mg/ml (i.m.) ampul/vial 0 0 0 0 0 0 0
210 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial 0 0 0 0 0 0 0
211 Klorpromazin tab sal 100 mg tablet salut selaput/kaplet salut selapu 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
212 Klorpromazin tab sal 25 mg Tab sal 500 80 1,440 1,440 1,000 0 0
213 Klortalidon tab 50 mg Tab 0 0 0 0 0 0 0
214 Klozapin tab 100 mg tablet 0 0 0 0 0 0 0
215 Klozapin tab 25 mg tablet 1285 180 3,240 3,240 500 0 0
216 Kodein tab 10 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
Komb: Deksametason 0,1% Thymol 5% Botol 0 0
217 Paraklorphenol 30
0 0 0 0 0
Kombinasi (DHP) : dihidroartemisin 40 mg + tablet salut selaput/kaplet salut selapu 0 0
218 Piperakuin 320 mg tab sal selaput
0 0 0 0 0
Kombinasi : (Zidovudin 60 mg + Lamivudin 30 Tab dispersible 0 0
219 mg + Nevirapin 50 mg) Ped Triple FDC
0 0 0 0 0
Kombinasi : artemether 20 mg + lumefantrin tablet/kapsul/kaplet 0 0
220 120 mg
0 0 0 0 0
Kombinasi : Desogestrel 150 mcg Etinilestradiol Tab 0 0
221 30 mcg
0 0 0 0 0
222 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
Kombinasi : Ferro fumarat 60 mg + asam folat tablet salut gula 17000 16500 1850
223 0,4 mg tab salut
33,300 16,300 35,000 0 0
Kombinasi : levonorgestrel 150 mcg + tab salut gula 0 0
224 etinilestradiol 30 mcg
0 0 0 0 0
Kombinasi : Tenofovir 300 mg + Emtrisitabin Tab 0 0
225 200 mg
0 0 0 0 0
Kombinasi : Tenofovir 300 mg + Lamivudin 300 Tab 0 0
226 mg + Efavirenz 600 mg
0 0 0 0 0
Kombinasi : zidovudin 300 mg +lamivudin 150 Tab 0 0
227 mg
0 0 0 0 0
Kombinasi: Ipratropium bromida 0,5 mg + Ampul/vial 0 0
228 Salbutamol 2,5 mg, cairan ih
0 0 50 0 0
229 Kombinasi: kaolin 550 mg + pektin 20 mg Tab 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
Kombinasi: lopinavir 200 mg + ritonavir (LVP) 50 Tab 0 0
230 mg, tab 250 mg 0 0 0 0 0
Kombinasi: Tenofovir 300 mg + Lamivudin 300 Tablet/kapsul/kaplet 0 0
231 mg + Dolutegravir 50 mg, tablet
0 0 0 0 0
Komibinasi: lidokain + medisinal creosote Botol 0 0
232 phenol + eugenol + benzil alkohol, cairan
0 0 0 0 0
233 Komposit resin Set 0 0 0 0 0 0 0
Kotrimoksazol (dewasa) kombinasi : tab/kaptab 2000 3180 350
234 sulfametoksazol 400 mg+ trimetoprim 80 mg
6,300 4,300 6,000 0 0
Kotrimoksazol (dewasa) kombinasi : tab/kaptab 0 0
235 sulfametoksazol 800 mg+ trimetoprim 160 mg
0 0 0 0 0
Kotrimoksazol kombinasi tiap 5 ml suspensi : botol 60 mL 52 88 10
236 sulfametoksazol 200 mg + trimetoprim 40 mg
180 128 200 0 0
237 Kuinin inj 25% (i.v.) Vial 0 0 0 0 0 0 0
238 Kuinin tab 200 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
239 Laktulosa sir 3,335 g/5 ml botol @ 60 mL 0 10 180 180 200 0 0
240 Lamivudin (3TC) tab 150 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
Larutan mengandung elektrolit (CaCl2H2O Botol plastik @500 ml 0 0
241 0,165 gr, KCl 0,15 gr, NaCl 4,3 gr)
0 0 0 0 0
Larutan mengandung Elektrolit (Kalium Klorida) Botol 0 0
242
0 0 0 0 0
Larutan mengandung Elektrolit (KCl 0,15%, Botol 0 0
243 NaCL 0,9%) (KN1)
0 0 0 0 0
Larutan mengandung Elektrolit (KCl 0,3%,NaCl Botol 0 0
244 0,9%) (KN2)
0 0 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, K Botol plastik @ 500 ml 0 0
245 4 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq)
Ringer Asetat
0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
Larutan mengandung Elektrolit (Na 130 mEq, K Softbag @ 500 ml 0 3
246 4 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq)
Ringer Asetat
54 54 60 0 0
Larutan mengandung Elektrolit (Sodium Lactate Botol 0 0
sol (50%) 113 gr/L, Potassium Chloride 0.3 gr/L,
247 Calcium Chloride 0.2 gr/L, elektrolit)
0 0 0 0 0
Larutan mengandung Elektrolit (Tiap 1000 ml Botol 0 0
mengandung electrolit: Sodium 145 mmol/l,
Potassium 4.0 mmol/l, Calcium 2.5 mmol/l,
248 Magnesium 1.0 mmol/l, Chloride 118 mmol/l,
Acetate 24 mmol/l, Malate 5.0 mmol/l)
0 0 0 0 0
Larutan mengandung Karbohidrat (Fructose 120 Botol 0 0
249 g, glucose 66 g, Xylitol 60 g/ L)
0 0 0 0 0
Larutan mengandung Karbohidrat (Fructose 15 softbag 0 0
250 mg, glucose monohydrate 30 mg, xylitol 15 mg)
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
Larutan mengandung Karbohidrat (Maltose Botol 0 0
253 10%)
0 0 0 0 0
Larutan mengandung Karbohidrat + Elektrolit Botol plastik @500 ml 0 0
(25.00g dextrose anhidrat, 3.00 g sodium
chloride, 0.15 g potassium chloride, 0.10 g
254 calcium chloride dihydrate dan 1.55 g sodium
lactate)
0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
Larutan mengandung Karbohidrat + Elektrolit Botol plastik @500 ml 0 0
(25.00g maltose, 3.00 g sodium chloride, 0.15 g
255 potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate)
0 0 0 0 0
Larutan mengandung Karbohidrat + Elektrolit Botol 0 0
256 (Acetate, Na, K, Cl, Ca, Mg, Sorbitol 50 gr/L)
0 0 0 0 0
257 (Dextrose 5%, NaCL 0,45%, KCl) (HSD)
0 0 0 0 0
258 (Fructose 120 g, glucose 66 g, Xylitol 60 g/ L +
elektrolit)
0 0 0 0 0
259 (Glukosa 25 g, NaCl 2,0 g, KCl 1,3 g, Natrium
Laktat 3,1 g, air untuk injeksi ad 1000 ml)
0 0 0 0 0
260 (Glukosa 55 g ; Natrium Chloride 9 g, air untuk
injeksi ad 1000 ml) (D5-NS)
0 0 0 0 0
Larutan mengandung Karbohidrat + Elektrolit botol/softbag 0 0
261 (Glukosa: 110.0 g; NaCl: 1.80 g) (D10-1/5NS)
0 0 0 0 0
262 (Glukosa: 25,0 g; NaCl: 4,5 g)
0 0 0 0 0
Larutan mengandung Karbohidrat + Elektrolit botol/softbag @ 500 mL 0 0
0 0 0 0 0
Larutan mengandung Karbohidrat + Elektrolit botol/softbag @ 100 mL 0 0
0 0 0 0 0
0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
(Larutan nutrisi kombinasi infus per L: Na.
266 100mEQ, K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl
90mEQ, Asetat 38mEQ, Sorbitol 50g)
0 0 0 0 0
267 (Larutan Ringer & Glukosa 5%)
0 0 0 0 0
268 (NaCl 1.125 gr, Dekstrosa 18.75 gr) (KA EN 1B)
0 0 0 0 0
269 (NaCl 1.75 g, KCL 1.5g, Glukosa 100 gr)
0 0 0 0 0
270 (NaCl 1.75 g, KCL 1.5g, Na Lactate 2.24 g,
Glukosa 100 gr)
0 0 0 0 0
271 (Nacl 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr,
Dekstrosa 27 gr) (KA EN 3B)
90 90 100 0 0
272 (Nacl 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr
Dekstrosa 27 gr) (KA EN 3A)
0 0 0 0 0
Levonorgestrel implan 2 rods, 75 mg (3-4 tahun) pack/ sachet/ set 0 0
273
0 0 0 0 0
274 Lidokain gel 2% syringe/syringe plastik 0 1 18 18 2 0 0
275 Lidokain inj 2% (infiltr/p.v.) ampul/vial 0 0 0 0 0 0 0
276 Lidokain salep 5% Tube 0 0 0 0 0 0 0
277 Lidokain spray oral 10% botol 0 0 0 0 0 0 0
278 Linestrenol tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
279 Liquor carbonis detergens lar 5% Botol 0 0 0 0 0 0 0
280 Loperamid tab 2 mg Tab 100 650 200 3,600 3,500 2,000 0 0
281 Lopinavir 100 mg + Ritonavir 25 mg tab sal selaput 0 0 0 0 0 0 0
282 Loratadin tab 10 mg tablet/kapsul/kaplet 0 0 0 0 2,000 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
283 Lorazepam tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0

284 Lorazepam tab 1 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
285 Lorazepam tab sal 2 mg Tab sal 0 0 0 0 0 0 0
286 Magnesium sulfat inj 20% ampul/vial @25 ml 0 0 0 0 0 0 0
287 Magnesium sulfat inj 20% ampul/vial 0 0 0 0 0 0 0
289 Magnesium sulfat inj 40% ampul/vial 0 0 0 0 0 0 0
290 Magnesium sulfat serb, ktg 30 g Sachet 0 0 0 0 0 0 0
291 Manitol lar infus 20% Botol @ 100 ml 0 0 0 0 0 0 0
294 Mebendazol sir 100 mg/5 ml Botol 0 0 0 0 0 0 0
295 Mebendazol tab 100 mg Tan 0 0 0 0 0 0 0
296 Mebendazol tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
297 Medroksi progesteron asetat inj 150 mg/ml ampul/vial 0 0 0 0 0 0 0
Metenamin mandelat (heksamin mandelat) tab Tab salut 0 0
298 salut enterik 500 mg
0 0 0 0 0
299 Metformin tab 500 mg tablet/kapsul/kaplet 2200 5265 585 10,530 8,330 10,000 0 0
300 Metformin tab 850 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
301 Metilergometrin inj 0,2 mg/ml ampul/vial 0 4 72 72 50 0 0
302 Metilergometrin tab salut 0,125 mg tablet/kaplet salut selapu 100 0 0 0 -100 0 0 0
303 Metilprednisolon inj 125 mg/2 ml ampul/vial 0 0 0 0 0 0 0
304 Metoklopramid inj 5 mg/ml ampul/vial 10 0 0 0 -10 0 0 0
305 Metoklopramid tab 10 mg tablet/kapsul/kaplet 0 100 1,800 1,800 2,000 0 0
306 Metoklopramid tab 5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
307 Metronidazol lar inf 5 mg/ml botol 0 10 180 180 200 0 0
308 Metronidazol susp 125 mg/5 ml Botol @ 60 ml 0 0 0 0 20 0 0
310 Metronidazol tab 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
311 Metronidazol tab 500 mg tablet/kapsul/kaplet 2900 400 200 3,600 700 5,000 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
312 Mikonazol krim 2% tube 106 250 30 540 434 500 0 0

313 Mikonazol serb 2% botol / sachet 0 0 0 0 0 0 0
Mineral Mix (Bismuth Subcitrate Tripotasium, Sachet 0 0
314 Copper sulfate, Magnesium Chloride
Anhydrous, Potassium Chloride, Zinc Acetate)
0 0 100 0 0
315 N-asetil sistein kaps 200 mg tablet/kapsul/kaplet 1980 2025 225 4,050 2,070 7,000 0 0
316 NaCl 0,9% Larutan Botol @100 ml 20 360 360 60 0 0
317 NaCl 0,9% Larutan Botol @1.000 mL 0 0 0 0 0 0 0
318 NaCl 0,9% Larutan Botol @250 ml 0 0 0 0 0 0 0
319 NaCl 0,9% Larutan Ampul/botol @ 10 mL 0 0 0 0 0 0 0
320 NaCl 0,9% Larutan Botol @25 ml 20 0 0 0 -20 0 0 0
321 NaCl 0,9% Larutan Botol @500 ml 60 20 40 720 660 60 0 0
322 NaCl 3% Larutan Botol plastik @500 ml 0 0 0 0 0 0 0
323 Natrium diklofenak tab 25 mg tablet salut enterik/kaplet salut enteri 0 0 0 0 0 0 0
324 Natrium diklofenak tab 50 mg tablet salut enterik/kaple 300 10743 1194 21,492 21,192 20,000 0 0
325 Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL 0 0 0 0 0 0 0
326 Natrium hipoklorit cairan konsentrat 5% Botol 0 0 0 0 0 0 0
327 Natrium tiosulfat inj 25% (i.v.) Ampul 0 0 0 0 0 0 0
328 Nevirapin tab 200 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
329 Nifedipin kaps 10 mg tablet/kapsul/kaplet 100 50 200 3,600 3,500 100 0 0
330 Nistatin susp 100.000 UI/ml botol/vial 0 0 0 0 0 0 0
331 Nistatin tab salut 500.000 UI tablet salut gula/kaplet salut gula 0 0 0 0 0 0 0
332 Nistatin tab vaginal 100.000 UI tablet/kaplet 0 10 180 180 100 0 0
333 Norepinefrin inj 1 mg/ml ampul/vial 0 0 0 0 0 0 0
334 Obat Anti Tuberculosis FDC Kategori Anak paket 0 0 0 0 0 0 0
335 Obat Anti Tuberculosis FDC Kategori I paket 15 25 5 90 75 0 0 0
336 Obat Anti Tuberculosis FDC Kategori II paket 0 0 0 0 0 0 0
337 Obat Anti Tuberculosis FDC Kategori Sisipan paket 0 0 0 0 0 0 0
338 Obat Anti Tuberculosis Kombipak Anak Paket 0 0 0 0 0 0 0
339 Obat Anti Tuberculosis Kombipak Dewasa paket 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
340 Oksigen ih, gas dlm tabung Botol 0 0 0 0 0 0 0

341 Oksimetazolin tts hidung 0,025% botol @ 10 mL 0 0 0 0 10 0 0
342 Oksimetazolin tts hidung 0,050% botol @ 10 mL 0 0 0 0 10 0 0
343 Oksitetrasiklin 1% Salep Mata tube 150 60 5 90 -60 200 0 0
344 Oksitosin inj 10 UI/ml ampul/vial 100 150 20 360 260 300 0 0
345 Olopatadin tts mata 0,1% Botol 0 0 0 0 0 0 0
346 Omeprazol inj 40 mg/10 ml ampul/vial 0 0 0 0 20 0 0
347 Omeprazol kaps 20 mg tablet/kapsul/kaplet 3810 3060 340 6,120 2,310 5,000 0 0
348 Paraformaldehid tab 1 g Tab 0 0 0 0 0 0 0
349 Parasetamol sir 120 mg/5 ml botol @ 60 mL 158 650 73 1,314 1,156 1,500 0 0
350 Parasetamol tab 500 mg tablet/kapsul/kaplet 1300 47498 5278 95,004 93,704 90,000 0 0
351 Parasetamol tts 60 mg/0,6 ml botol @ 15 mL 5 0 0 0 20 0 0
352 Pasta devitalisasi (non arsen) Tube 0 1 18 18 20 0 0
353 Pasta pengisi saluran akar (pasta) Tube 0 1 18 18 1 0 0
354 Perak nitrat lar 20% Botol 0 0 0 0 0 0 0
355 Perak sulfadiazin krim 1% Tube 0 0 0 0 20 0 0
356 Permetrin krim 5 % Tube 10 g 15 20 5 90 75 50 0 0
357 Permetrin krim 5 % Tube 30 g 0 0 0 0 0 0 0
358 Permetrin krim 5 % Tube 15 g 0 0 0 0 0 0 0
359 Pirantel pamoat susp 125 mg/5 ml Botol 0 0 0 0 100 0 0
360 Pirantel pamoat tab 500 mg Tab 0 0 0 0 100 0 0
361 Pirantel pamoat tab scored 125 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
362 Pirantel pamoat tab scored 250 mg Tab 0 0 0 0 0 0 0
363 Piridoksin (vitamin B6) inj 100 mg/ml Ampul 0 0 0 0 0 0 0
364 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl 0 0 0 0 10,000 0 0
365 Piridoksin (vitamin B6) tab 25 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
366 Povidon iodin lar 100 mg/ml Botol 300 ml 5 0 0 0 -5 0 0 0
367 Povidon iodin lar 100 mg/ml botol @ 1.000 mL 1 0 0 0 -1 0 0 0
368 Povidon iodin lar 100 mg/ml botol 30 mL 0 0 0 0 0 0 0
369 Povidon iodin lar 100 mg/ml botol @ 60 mL 65 0 0 0 -65 20 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
370 Povidon iodin lar obat kumur 1% Botol 0 0 0 0 0 0 0

371 Povidon iodin tts mata 2,5% botol/strip 0 0 0 0 0 0 0
372 Prednison tab 5 mg tablet/kapsul/kaplet 3800 1350 150 2,700 -1,100 5,000 0 0
373 Primakuin tab 15 mg Tab 0 0 0 0 0 0 0
374 Probenesid tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
Prokain benzilpenisilin serb inj 3 juta UI/vial ampul/vial 0 0
375 (i.m.)
0 0 0 0 0
376 Propiltiourasil tab 100 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
377 Propranolol tab 10 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
378 Ranitidin tab 150 mg tablet/kapsul/kaplet 6800 1710 190 3,420 -3,380 1,000 0 0
379 Retinol (vitamin A) kaps lunak 100.000 UI kaps lunak 10 450 50 900 890 1,000 0 0
380 Retinol (vitamin A) kaps lunak 200.000 UI kaps lunak 5 2103 234 4,212 4,207 4,050 0 0
381 Rifampisin kaps 300 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
382 Rifapentin tablet 150 mg Tablet/kapsul/kaplet 0 0 0 0 0 0 0
383 Ringer Laktat Larutan Botol 760 1860 207 3,726 2,966 3,800 0 0
384 Risperidon tab sal 1 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
385 Risperidon tab sal 2 mg tablet/kapsul/kaplet 1929 214 3,852 3,852 2,000 0 0
386 Salbutamol cairan ih 1 mg/mL ampul/vial/botol 0 0 0 0 0 0 0
387 Salbutamol sir 2 mg/5 ml Botol 0 0 0 0 0 0 0
388 Salbutamol tab 2 mg tablet/kapsul/kaplet 1700 2835 30 540 -1,160 5,000 0 0
Salep 2-4, kombinasi : asam salisilat 2 %+ pot 15 gram 0 0
389 belerang endap 4 %
0 0 0 0 0
Salep 2-4, kombinasi : asam salisilat 2 %+ pot 30 gram 148 0 3
390 belerang endap 4 %
54 -94 300 0 0
391 Sefadroksil kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
392 Sefadroksil kaps/tab 500 mg tablet/kapsul/kaplet 0 0 0 0 5,000 0 0
393 Sefadroksil sir kering 125 mg/5 ml botol @ 60 mL 0 0 0 0 100 0 0
394 Sefadroksil sir kering 250 mg/5 ml botol @ 60 mL 0 0 0 0 0 0 0
Serum anti bisa ular : A.B.U. I (khusus ular dari Vial 0 0
395 luar Papua) inj (i.m./i.v.) 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
Serum anti bisa ular :A.B.U.II (khusus ular dari Vial 0 0
396 Papua) inj (i.m./i.v.) 0 0 0 0 0
Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m Vial 0 0
397 10.000 UI/
0 0 0 0 0
398 Serum antirabies inj 100 UI/ml Vial 0 0 0 0 0 0 0
399 Serum antirabies inj 200 UI/ml Vial 0 0 0 0 0 0 0
Serum antitetanus (A.T.S) (i.m.) Inj 10.000 Vial 0 0
400 UI/vial (i.m /i.v.)
0 0 0 0 0
Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul 0 0
401
0 0 0 0 0
Serum antitetanus (A.T.S) inj 20.000 UI/vial Vial 0 0
402 (i.m /i.v.)
0 0 0 0 0
Serum antitetanus (A.T.S) inj 5.000 IU/mL (i.m) Ampul/vial 0 0
403
0 0 0 0 0
404 Setirizin sir 5 mg/5 ml. botol @ 60 mL 52 117 10 180 128 200 0 0
405 Sianokobalamin (vitamin B12) inj 500 mcg/ml ampul/vial 0 0 0 0 0 0 0
406 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kaplet 4,500 14420 1380 24,840 20,340 25,000 0 0
407 Simvastatin tab sal 10 mg tablet/kapsul/kaplet/tablet salut selap 0 0 0 0 0 0 0
408 Simvastatin tab sal 20 mg tablet/kapsul/kaplet/table 2,500 7032 782 14,076 11,576 10,000 0 0
409 Simvastatin tab sal selaput 40 mg Tab sal 0 0 0 0 0 0 0
410 Siprofloksasin tab scored 500 mg tablet salut selaput/kaple 750 1500 90 1,620 870 2,000 0 0
411 Spironolakton tab 25 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
Stannous pyrophosphate 27,6 mg sodium Vial 0 0
412 pyrophosphate/vial
0 0 0 0 0
413 Streptomisin serb inj 1.000 mg/vial ampul/vial 0 0 0 0 0 0 0
414 Surgical ginggival pack Tube 0 0 0 0 0 0 0
415 Tenofovir tab 300 mg tablet salut selaput/kaplet salut selapu 0 0 0 0 0 0 0
416 Terbutalin cairan ih 2,5 mg/ml Botol 0 0 0 0 0 0 0
417 Terbutalin inj 0,5 mg/ml ampul/vial 0 0 0 0 0 0 0
418 Tetanus toxoid inj Ampul 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
419 Tetrakain tts mata 0,5% Botol 0 0 0 0 0 0 0

420 Tetrasiklin kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
421 Tetrasiklin kaps 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
422 Tetrasiklin Salep Mata 1% Tube 0 0 0 0 0 0 0
423 Tiamin (vitamin B1) tab 50 mg tablet/kapsul/kaplet 2300 0 0 0 -2,300 0 0 0
424 Timolol tts mata 0,25% botol @ 5 mL 0 0 0 0 0 0 0
425 Timolol tts mata 0,5% botol @ 5 mL 0 0 0 0 0 0 0
426 Tropikamid tts mata 1% Botol @ 5 ml 0 0 0 0 0 0 0
427 Tropikamid tts mata 1% Botol @ 0,6 ml 0 0 0 0 0 0 0
428 Urea krim 10 % Tube/pot 0 0 0 0 10 0 0
429 Urea krim 20 % Tube/pot 0 0 0 0 0 0 0
430 Vaksin BCG inj (i.k) Vial 0 0 0 0 0 0 0
431 Vaksin bivalen OPV (b-OPV) drops 10 dosis Vial 0 0 0 0 0 0 0
Vaksin Hepatitis Rekombinan Inj Prefilled Vial 0 0
432 Injection Device (Uniject) 0,5 ml (i.m)
0 0 0 0 0
Vaksin HPV (Human Papilloma Virus), vial 0,5 Ampul/vial 0 0
433 mL
0 0 0 0 0
434 Vaksin Influenza Vial 0 0 0 0 0 0 0
435 Vaksin Japanese Enchepalitis (J.E) Vial 0 0 0 0 0 0 0
436 Vaksin jerap difteri tetanus (DT) Vial 0 0 0 0 0 0 0
437 Vaksin jerap difteri tetanus (Td) Vial 0 0 0 0 0 0 0
438 Vaksin kombinasi DPT-HB-Hib Vial 0 0 0 0 0 0 0
439 Vaksin measless rubella (MR) Inj 0,5 mL (s.k) Vial 0 0 0 0 0 0 0
440 Vaksin Meningitis Meningokokus Vial 0 0 0 0 0 0 0
441 Vaksin polio IPV inj 0,5 ml Vial 0 0 0 0 0 0 0
Vaksin rabies, untuk manusia serb inj (s.k./i.k) + Vial 0 0
442 booster
0 0 0 0 0
443 Vaksin rabies, untuk manusia serb Inj 2,5 IU Vial 0 0 0 0 0 0 0
444 Vaksin Yellow Fever Vial 0 0 0 0 0 0 0
445 Valproat sir 250 mg/5 ml botol @ 120 ml 0 0 0 0 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
446 Valproat tab lepas lambat 250 mg tabet lepas lambat/kaplet lepas lambat 0 0 0 0 0 0 0
447 Valproat tab lepas lambat 500 mg tabet lepas lambat/kaplet lepas lambat 0 0 0 0 0 0 0
448 Valproat tab sal enterik 250 mg tablet salut enterik/ kaplet salut enteri 0 0 0 0 0 0 0
449 Vitamin B kompleks tablet 3300 37373 4153 74,754 71,454 50,000 0 0
450 Vitamin C 500 mg minimal non acidic 250 mg Tablet/kapsul/kaplet/tab sal selaput/kap 0 0 0 0 0 0 0
451 Zidovudin kaps 100 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0
452 Zinc drops 10 mg/ml Botol 0 0 0 0 0 0 0
453 Zinc sir 20 mg/5 ml botol 20 20 360 360 100 0 0
454 Zinc tab disp 20 mg tablet dispersible 2700 2000 479 8,622 5,922 5,000 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
NON FORNAS 0 0 0 0 0 0 0
1 Ambroxol tab 30 mg Tab 1400 10238 1140 20,520 19,120 10,000 0 0
2 Etakridin/ Rivanol Botol 0 0 0 0 0 0 0
3 Gliseril Guaiakolat tablet 100 mg Tab 4100 9258 1028 18,504 14,404 15,000 0 0
4 Metoklopramide sirup Botol 0 0 0 0 0 0 0
5 Multivitamin sirup Botol 48 20 360 360 500 0 0
6 Multivitamin tablet Tablet 0 0 0 0 0 0 0
7 Obat batuk Hitam (OBH) Botol 0 0 0 0 50 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
BAHAN MEDIS HABIS PAKAI (BMHP) 0 0 0 0 0 0 0
Alat pemeriksaan GCU (Glukosa, Cholesterol, Urat 0 0
1 set
Acid) 0 0 5 0 0
2 Alat suntik 0,05 ml pcs 0 0 0 0 0 0 0
3 Alat Suntik 0,5 ml pcs 0 0 0 0 0 0 0
4 Alat suntik 1 ml pcs 490 100 1,800 1,800 2,000 0 0
5 Alat Suntik 10 ml Pcs 0 0 0 0 100 0 0
6 Alat suntik 3 ml pcs 60 2170 243 4,374 4,314 1,000 0 0
7 Alat Suntik 5 ml Pcs 250 439 30 540 290 500 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
8 Alkohol 96% Botol 0 0 0 0 5 0 0

9 Alkohol swab Box/ 100 lbr 10 100 12 216 206 250 0 0
10 Aquadest Botol 0 0 0 0 0 0 0
11 Asam Urat test strip Pcs 16 500 100 1,800 1,784 2,000 0 0
12 Bioplacenton tulle Kotak/ 10 lbr 0 0 0 0 20 0 0
13 Bisturi pcs 41 0 0 0 -41 500 0 0
14 Blood Lancet Kotak/ 100 25 5 90 90 100 0 0
15 Catgut 2/0 pcs 0 0 0 0 0 0 0
16 Catgut 3/0 pcs 38 100 48 864 826 200 0 0
17 Dengue test IgG/IgM pcs 0 0 0 0 0 0 0
18 Dengue test NS 1 pcs 0 0 0 0 0 0 0
19 Dermafix s I.V Blister 0 0 0 0 0 0 0
20 Elastis Verban Pcs 0 0 0 0 100 0 0
21 Etakridin (Rivanol) Botol 0 0 0 0 100 0 0
22 Etil Klorida Botol 3 3 2 36 33 5 0 0
23 Folley Catheter no 16 Pcs 54 55 5 90 36 100 0 0
24 Folley Catheter no 18 Pcs 56 50 5 90 34 100 0 0
25 Gentian violet 1% Botol 0 0 0 0 10 0 0
26 Gluco protein Pcs 0 0 0 0 0 0 0
27 Glukosa test strip Pcs 0 100 1,800 1,800 2,000 0 0
28 Hand rub 500 ml Botol 23 54 8 144 121 150 0 0
29 Handscoon No. 6,5 Psng 0 0 0 0 100 0 0
30 Handscoon No. 7 Psng 150 200 20 360 210 350 0 0
31 Handscoon No. 7,5 Psng 150 200 20 360 210 250 0 0
32 Handscoon No. 8 Psng 0 0 0 0 0 0 0
33 Handscoon Non Steril L Kotak/ 50 4500 500 9,000 9,000 9,000 0 0
34 Handscoon Non Steril M Kotak/ 50 500 4500 700 12,600 12,100 13,000 0 0
35 Handscoon Non Steril S Kotak/ 50 100 4000 1200 21,600 21,500 22,000 0 0
36 Handscoon Obgyn steril Psng 0 10 180 180 200 0 0
37 Hepatitis BSAg Pcs 75 0 0 0 -75 0 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
38 I.V. Catheter No. 18 pcs 16 0 5 90 74 100 0 0

39 I.V. Catheter No. 20 pcs 32 533 200 3,600 3,568 3,500 0 0
40 I.V. Catheter No. 22 pcs 435 544 200 3,600 3,165 3,500 0 0
41 I.V. Catheter No. 24 pcs 63 0 50 900 837 500 0 0
42 Infusion set anak pcs 123 135 30 540 417 500 0 0
43 Infusion set dewasa Set 180 563 200 3,600 3,420 3,600 0 0
44 Jelly 50 g Pcs 0 1 18 18 20 0 0
45 Kapas 250 g bungkus 9 0 0 0 -9 0 0 0
46 Kapas Adsorben 1 Kg bungkus 0 0 0 0 0 0 0
47 Kaporit Kaleng/ 15 kg 0 0 0 0 0 0 0
48 Kasa kompres 40/40 pcs 0 0 0 0 0 0 0
49 Kasa pembalut hidrofil 4 m x 10 cm elastic pcs 0 0 0 0 0 0 0
53 Kasa pembalut 2 m x 80 cm Pcs 0 0 0 0 0 0 0
54 Kasa pembalut hidrofil 40 x 80 roll 3 0 10 180 177 200 0 0
55 Kasa 16 cm x 16 cm kotak 18 10 180 180 200 0 0
56 Kasa 18 cm x 22 cm pcs 0 0 0 0 0 0 0
57 Kolesterol test strip Pcs 550 100 1,800 1,800 2,000 0 0
58 Lisol Botol 1000 ml 0 0 0 0 0 0 0
59 Malaria test Kotak 0 0 0 0 0 0 0
60 Masker Hijab Box 315 22500 2500 45,000 44,685 45,000 0 0
61 Masker Earloop Box
62 Masker N95 Box 360 10 180 180 0 0 0
63 Masker Oksigen Anak Buah 12 0 20 360 348 100 0 0
64 Masker Oksigen Bayi Buah 0 15 270 270 100 0 0
65 Masker Oksigen Dewasa Buah 12 0 30 540 528 150 0 0
66 Objek glass frosted Box/ 72 pcs 0 0 0 0 0 0 0
67 Oxygen Canula Anak Buah 6 0 20 360 354 400 0 0
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
68 Oxygen Canula Dewasa Buah 9 0 30 540 531 500 0 0

69 Penjepit talu Pusat (Umbilical Clamp) Pcs 40 0 35 630 590 700 0 0
70 Plester roll 0 14 252 252 300 0 0
71 Plesterin Bulat Box/200 0 0 0 0 0 0 0
72 Pot Dahak 7 cm x 5 cm pcs 0 0 0 0 0 0 0
73 Pot sputum steril Pcs 79 200 15 270 191 0 0 0
74 Reagen ZN Paket 18 1 1 18 0 0 0 0
75 Safety box pcs 51 0 3 54 3 0 0 0
76 Silk 3/0, 75 cm, 3/8CC, 19 mm pcs 50 36 648 648 100 0 0
77 Spons gelatin set 0 1 18 18 1 0 0
78 Tambalan gig sementara set 0 1 18 18 1 0 0
79 Tambalan Gigi set 0 1 18 18 1 0 0
80 Test Golongan darah pcs 0 50 900 900 1,000 0 0
81 Test Kehamilan pcs 0 80 1,440 1,440 2,000 0 0
82 Tifoid test pcs 0 20 360 360 500 0 0
83 Ultrasonic Gel 250 ml (USG) Botol 0 1 18 18 20 0 0
84 Underpad 60 x 90 cm bungkus 0 1 18 18 50 0 0
85 Urine bag pcs 18 30 5 90 72 100 0 0
86 Widal test pcs 0 30 540 540 600 0 0
0 0 0 0 0 0 0
KOLOM TAMBAHAN 0 0 0 0 0 0 0
0 0 0 0 0 0 0
OBAT NON FORNAS 0 0 0 0 0 0 0
1 Fenobarbital Inj 50mg/ml Ampul 0 0 0 0 5 0 0
2 Fibumin Capsul 450 400 7,200 7,200 7,000 0 0
3 Herba Asimor Capsul 30 30 540 540 450 0 0
4 Kloramfenikol 500mg caps Capsul 40 30 540 540 500 0 0
5 Lopinavir 40mg + Ritenavir 10mg (FDC Anak) Tablet 0 0 0
6 Lytacur Syrup Botol 7 10 180 173 150
7 Methyl Prednisolon 4mg tab Tablet 1000 20 360 360 10,000
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
8 Onoiwa Capsul 0 0 0
9 Oxyvit Capsul 600 320 300 5,400 4,800 6,000
10 pritavit Tablet 0 0 0 0 0 0 0
11 Stimuno Syr Botol 8 10 180 172 200
12 TDF(300)+3TC(300)+EVF(600) Botol 50 8 144 144 150
14 Trihexyfenidil Tablet 987 90 1,620 1,620 2,000
15 Vaksin Hepatitis Immuno Globuline Vial 0 0 0 0
16 vaksin Hepatitis Kombinasi Inj (HB-Pid) Vial 0 0 0 0
17 Vaksin Polio Oral (OPV) Vial 0 0 0 0
BMHP DAN BAHAN GIGI 0 0 0 0 0 0 0 0

1 MDT MB KUSTA 18 0 0 0 -18 0 0 0
2 …………….. 0 0 0 0 0 0 0 0
3 …………… 0 0 0 0 0 0 0 0
4 …………… 0 0 0 0 0 0 0 0
Pangkajene, ...........September 2022

Mengetahui,
Kepala Puskesmas Penanggung Jawab Farmasi
NO NAMA OBAT SATUAN
2022 2022 BULAN 2022 2023 2023
f/ g = f x 18
ketersediaan bulan
( ...............................................) (.......................................)
NIP. ............................................. NIP. ...........................................
Catatan :
1 Tidak menambah Kolom dan Baris pada item obat dan BMHP yang sudah ada
2 Baris tambahan obat dan BMHP dapat diisi pada kolom tambahan
3 Pengimputan daata hanya pada kolom/baris yang berwarna hijau dan tidak merubah format/rumus exel
RENCANA KEBUTUHAN OBAT DAN BMHP PUSKESMAS 2022
DINAS KESEHATAN

RENCANA
31 PEMAKAIA N RATA- KEBUTUHA KEBUTHA HARGA
NO NAMA OBAT SATUAN PENGADAA TOTAL HARGA
DESEMBER N TAHUN RATA PER N TAHUN N TAHUN
N
2020 2020 BULAN 2022 2022
g = f x 18
a b c d e f/ ketersdiaan h=(g-d) i
bulan
1 Abacavir 300 mg Tablet/kaplet/kapsul 0 0 0 0 0 0 0
2 Air untuk injeksi Botol 100 ml 0 0 0 0 0 5720 0
3 Air untuk injeksi Botol 250 ml 0 0 0 0 0 5852 0
4 Air untuk injeksi ampul/vial/botol 10 mL 0 0 0 0 0 0
5 Air untuk injeksi amp 20 ml ampul/vial/botol 0 0 0 0 0 0
6 Air untuk injeksi amp 25 ml ampul/vial/botol 25 mL 0 0 0 0 200 2650 530,000
7 Albendazol susp 200 mg/5 ml Botol 0 0 0 0 0 4300 0
8 Albendazol tab 400 mg tablet/kapsul/kaplet 0 0 0 0 0 0
9 Alopurinol tab 100 mg Tab 0 13900 250,200 250,200 250,200 89 22,267,800
10 Alopurinol tab 300 mg tablet/kapsul/kaplet 0 0 0 0 0 200 0
11 Aminofilin inj 24 mg/ml ampul/vial 10 ml 0 0 0 0 0 2736 0
12 Aminofilin tab 150 mg tablet/kapsul/kaplet 0 0 0 0 0 0
13 Aminofilin Tab 200 mg tablet/kapsul/kaplet 0 0 0 0 0 0
14 Amitriptilin tab sal 25 mg tablet/kapsul/kaplet 39700 800 14,400 -15,700 0 0
15 Amlodipin tab 10 mg tablet/kapsul/kaplet 0 31910 574,380 574,380 574,400 74 42,505,600
16 Amlodipin tab 5 mg tablet/kapsul/kaplet 23100 30433 547,794 547,794 547,800 55 30,129,000
18 Amoksisilin drops 100 mg/ml Botol @20 ml 0 0 0 0 0 0
19 Amoksisilin drops 100 mg/ml Botol @10 ml 0 0 0 0 0 0
20 Amoksisilin sir forte 250 mg/5 ml botol 60 ml 5960 1198 21,564 21,564 10,000 3510 35,100,000
21 Amoksisilin sir kering 125 mg/5 ml Botol 0 0 0 -12,000 20,000 7700 154,000,000
22 Amoksisilin tab 250 mg tablet/kapsul/kaplet 0 0 0 0 0 198 0
23 Amoksisilin tab 500 mg tablet/kapsul/kaplet 211400 91466 1,646,388 1,646,388 1,646,400 117 192,628,800
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
24 Ampisilin serb inj 1000 mg/vial ampul/vial 0 30 540 540 0 0
25 Ampisilin serb inj 250 mg/vial Vial 0 0 0 0 0 0
Anestetik lokal gigi kombinasi : lidokain hcl 2% + 4920 1241
26 ampul/vial
epinefrin 1 : 80.000 inj 2 ml 22,338 22,338 22,300 847 18,888,100
Antasida, kombinasi : aluminium hidroksida 200 mg 0 46733
27 tablet/kapsul/kaplet
+ magnesium hidroksida 200 mg 841,194 841,194 841,200 54 45,424,800
Antasida, kombinasi : aluminium hidroksida 200 mg 2585 894
28 + magnesium hidroksida 200 mg botol 60 ml
16,092 16,092 16,000 1756 28,096,000
Anti Parkinson kombinasi : benzerasid 25 mg + 0 0
29 levodopa 100 mg Kaps
0 0 0 0
Antifungi salep, kombinasi : asam benzoat 6%+ asam 0 132
30 pot 30 g
salisilat 3% 2,376 2,376 2,000 3637 7,274,000
Antihemoroid, kombinasi: bismut subgalat 150 mg + 0 121
31 heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ Suppositoria
seng oksida 120 mg + sup ad 2 g 2,178 2,178 1,000 3260 3,260,000
32 Aquadest cairan 500 ml Botol 500 ml 0 0 0 0 500 25000 12,500,000
33 Artesunat serb inj 60 mg/ml (i.v./i.m.) ampul/vial 0 0 0 0 0 0
Kertas warna penanda 0 0
34 Articulating paper kertas warna penanda oklusi
oklusi 0 0 0 0
35 Asam asetat tetes telinga 2% Botol 0 0 0 0 0 0
36 Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/kaplet 0 800 14,400 14,400 14,400 89 1,281,600
37 Asam askorbat (vitamin C) tab 250 mg Tab 0 0 0 0 0 0
38 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/kaplet 37200 73800 1,328,400 1,328,400 1,328,400 46 61,106,400
39 Asam folat tab 0,4 mg tablet/kapsul/kaplet 0 0 0 0 0 45 0
40 Asam folat tab 1 mg tablet/kapsul/kaplet 0 18000 324,000 324,000 0 61 0
41 Asam folat tab 5 mg Tab 0 0 0 0 0 0
42 Asam mefenamat kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0
0 61446
43 Asam mefenamat kaps 500 mg tablet/kapsul/kaplet/kaptab
1,106,028 1,106,028 1,106,100 231 255,509,100
44 Asam retinoat krim 0,05% Tube/pot 0 0 0 0 0 0
45 Asam retinoat krim 0,1% Tube @ 20 gram 0 0 0 0 0 0
46 Asam retinoat krim 0,1% Tube @ 10 gram 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
47 Asam salisilat lar 0,1% Botol 0 0 0 0 0 0
48 Asam salisilat salep 10% Tube 0 0 0 0 0 0
51 Asiklovir tab 200 mg tablet/kapsul/kaplet 0 3214 57,852 57,852 57,800 267 15,432,600
52 Asiklovir tab 400 mg tablet/kapsul/kaplet 0 1866 33,588 33,588 33,500 429 14,371,500
53 Atapulgit 600 mg tablet/kapsul/kaplet 87100 11600 208,800 208,800 208,000 250 52,000,000
54 Atapulgit tab 630 mg tablet/kapsul/kaplet 9000 0 0 -9,000 0 0
55 Atapulgit tablet 650 mg tablet/kapsul/kaplet 0 1222 21,996 21,996 0 0
56 Atapulgit tablet 750 mg Tab 0 0 0 0 0 0
57 Atenolol tab 100 mg tablet/kapsul/kaplet 0 0 0 0 0 0
58 Atenolol tab 50 mg tablet/kapsul/kaplet 0 0 0 0 0 0
59 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul 0 0 0 0 0 1718 0
60 Atropin tab 0,5 mg Tab 0 0 0 0 0 0
61 Bahan tumpatan sementara lar, serb Botol 0 0 0 0 0 0
62 Bedak salisil serb 2% Dus/Sachet/Plastik 0 117 2,106 -1,490 1,500 12500 18,750,000
63 Betametason krim 0,1% tube 5 gram 0 952 17,136 17,136 17,150 2970 50,935,500
64 Betametason krim 0,5 mg/g Tube 0 0 0 0 0 0
65 Betametason salep 0,1% tube 5 gram 0 0 0 0 0 0
66 Betametason tts mata 1 mg/ml botol @5 ml 0 0 0 0 0 0
67 Betametason tts mata 1 mg/ml catchcover, botol 0,6 mL 0 0 0 0 0 0
68 Bisakodil sup 10 mg Suppositoria 0 26 468 468 400 13500 5,400,000
69 Bisakodil sup 5 mg Suppositoria 0 21 378 378 400 12000 4,800,000
70 Bisakodil tab sal 5 mg tablet/kapsul/kaplet 0 236 4,248 2,080 2,000 750 1,500,000
71 Budesonid cairan ih 0,25mg/ml Botol @ 4 ml 0 0 0 0 0 0
72 Budesonid cairan ih 0,25mg/ml, respoules 2 ml respoules 0 0 0 0 0 0
73 Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml 0 0 0 0 0 0
74 Budesonid cairan ih 0,5 mg/ml, respoules 2 ml respoules 0 0 0 0 0 0
75 Budesonid serb ih 100 mcg/dosis Botol 0 0 0 0 0 0
76 Budesonid serb ih 200 mcg/dosis 100 dosis 0 0 0 0 0 0
77 Budesonid serb ih 200 mcg/dosis 200 dosis 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
78 Copper T set/buah 0 0 0 0 0 0
79 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial 0 108 1,944 1,944 2,000 968 1,936,000
80 Deksametason tab 0,5 mg tablet/kapsul/kaplet 0 61100 1,099,800 1,099,800 1,100,000 36 39,600,000
81 Diazepam enema 10 mg/2,5 ml tube @ 2,5 mL 0 52 936 936 0 0
82 Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL 0 38 684 684 600 23760 14,256,000
83 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial 50 3 54 -160 0 1545 0
84 Diazepam tab 2 mg tablet/kapsul/kaplet 0 2537 45,666 45,666 45,600 70 3,192,000
85 Diazepam tab 5 mg tablet/kapsul/kaplet 0 0 0 0 0 108 0
86 Dietilkarbamazin tab 100 mg tablet/kapsul/kaplet 0 12082 217,476 217,476 0 168 0
87 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial 0 55 990 990 900 825 742,500
88 Digoksin tab 0,25 mg tablet/kapsul/kaplet 0 0 0 0 0 0
89 Diltiazem kaps SR 100 mg Kapsul lepas lambat 0 0 0 0 0 0
90 Diltiazem kaps SR 200 mg Kapsul lepas lambat 0 0 0 0 0 0
91 Dimenhidrinat tab 50 mg tablet/kapsul/kaplet 0 5100 91,800 91,800 200,000 109 21,800,000
92 Doksisiklin kaps 100 mg tablet/kapsul/kaplet 0 1333 23,994 23,994 24,000 289 6,936,000
93 Dolutegravir tab 50 mg tablet/kapsul/kaplet 0 0 0 0 0 0
94 Domperidon susp 5 mg/5 ml botol @60 ml 0 184 3,312 3,312 3,300 2401 7,923,300
95 Domperidon tab 10 mg tablet/kapsul/kaplet 0 5616 101,088 101,088 101,100 75 7,582,500
96 Efavirenz tab 200 mg Tablet 0 0 0 0 0 0
tablet salut selaput/kaplet 0 0
97 Efavirenz tab sal 600 mg
salut selaput 0 0 0 0
98 Epinefrin (adrenalin) inj 1 mg/ml Ampul 0 43 774 774 700 2640 1,848,000
99 Ergotamin tab 1 mg Tab 0 0 0 0 0 0
100 Eritromisin kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0
101 Eritromisin sir 200 mg/5 ml Botol @ 60 ml 0 0 0 0 0 7436 0
102 Eritromisin tab 500 mg tablet/kapsul/kaplet 0 1180 21,240 21,240 21,300 250 5,325,000
tablet salut gula/kaplet 0 0
103 Estrogen terkonjugasi tab sal 0,625 mg
salut gula 0 0 0 0
104 Etambutol tab 400 mg tablet/kapsul/kaplet 0 0 0 0 0 0
105 Etanol 70% cairan 70% Botol 0 62 1,116 1,116 1,200 50000 60,000,000
106 Etil klorida semprot 100 ml Botol 0 0 0 -200 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
107 Etonogestrel implan 68 mg Set 0 0 0 0 0 0
108 Eugenol Botol 0 100 1,800 1,800 20 20175 403,500
109 Fenitoin Na inj 50 mg/ml (100 mg/ 2 mL) ampul @ 2 ml 0 0 0 0 0 0
110 Fenitoin Na kaps 100 mg Kaps 0 0 0 0 0 0
111 Fenitoin Na kaps 30 mg Kaps 0 0 0 0 0 0
112 Fenobarbital tab 100 mg Tab 0 0 0 0 0 0
113 Fenobarbital tab 30 mg tablet/kapsul/kaplet 5600 75 1,350 -3,350 0 182 0
114 Fenoksimetil penisilin (penisilin V) tab 250 mg Tab 0 0 0 0 0 425 0
115 Fenoksimetil penisilin (penisilin V) tab 500 mg Tab 0 0 0 0 0 0
116 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) ampul/vial 1590 347 6,246 6,246 6,300 1452 9,147,600
117 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 0 2720 48,960 48,960 49,000 781 38,269,000
118 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m)
salut gula 0 0 0 0
119 Fluoksetin kaps 10 mg tablet/kapsul/kaplet 0 0 0 0 0 0
121 Fluor kapl 1 mg Kaplet 0 0 0 0 0 0
122 Fluor sediaan topikal Tube 0 0 0 0 0 0
123 Formokresol Botol 0 0 0 0 0 0
124 Framisetin Sulfat Tulle 1% Patch 0 0 0 0 0 0
125 Furosemid inj 10 mg/ml (i.v./i.m.) ampul/vial 0 0 0 0 0 969 0
126 Furosemid tab 40 mg tablet/kapsul/kaplet 0 2721 48,978 48,978 490,000 242 118,580,000
127 Galactose microparticle 200-400 mg micropart/ml Vial 0 0 0 0 0 0
128 Garam Fe, setara dengan Fe elemental 15 mg/5 mL Botol 0 0 0 0 0 0
129 Garam Fe, setara dengan Fe elemental 60 mg Sachet 0 0 0 0 0 0
130 Garam Fe, setara dengan Fe elemental 60 mg Botol 0 0 0 0 0 0
Garam oralit kombinasi : natrium klorida 0,52 g + 28800 3458
131 kalium klorida 0,30 g + trinatrium sitrat 0,58 g + sachet
glukosa anhidrat 2,7 g 62,244 62,244 62,300 280 17,444,000
132 Gentamisin salep mata 0,3% Tube 0 264 4,752 4,752 500 3065 1,532,500
133 Gentamisin tts mata 0,3% Botol 0 312 5,616 5,616 500 5170 2,585,000
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
Glass ionomer ART (Atraumatic Restorative 0 0
134 Sachet
Treatment) cocoa butter 5 g 0 0 0 0
135 Botol
Treatment) lar 0 0 0 0
136 Vial
Treatment) serb 0 0 0 0
137 Glibenklamid tab 2,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0
138 Glibenklamid tab 5 mg tablet/kapsul/kaplet 0 2333 41,994 41,994 42,000 87 3,654,000
139 Glikuidon tab 30 mg tablet/kapsul/kaplet 0 0 0 0 0 0
140 Glimepirid tab 1 mg tablet/kapsul/kaplet 0 0 0 0 0 96 0
141 Glimepirid tab 2 mg tablet/kapsul/kaplet 0 6005 108,090 108,090 0 0
142 Glipizid tab 5 mg tablet/kapsul/kaplet 0 0 0 0 0 0
143 Gliseril trinitrat tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 1415 0
144 Gliserin tts 100 mg/ml Botol 0 0 0 0 0 0
145 Glukosa Larutan Infus 10% steril 100 ml Botol 0 0 0 0 0 0
148 Glukosa Larutan Infus 40% Ampul @25 ml 0 0 0 0 0 0
151 Glukosa Larutan Infus 5% steril 500 ml Botol 0 191 3,438 3,438 3,500 6627 23,194,500
152 Griseofulvin (micronized) tab 125 mg tablet/kapsul/kaplet 0 4866 87,588 87,588 87,600 210 18,396,000
153 Griseofulvin (micronized) tab scored 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0
154 Gutta percha dan paper points 15 - 40 mm Roll 0 0 0 0 0 0
155 Gutta percha dan paper points 45 - 80 mm Roll 0 0 0 0 0 0
156 Haloperidol inj 5 mg/ml (i.m.) Vial 0 1 18 18 0 0
157 Haloperidol tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0
158 Haloperidol tab 1,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0
159 Haloperidol tab 2 mg tablet/kapsul/kaplet 1800 266 4,788 4,788 4,800 81 388,800
160 Haloperidol tab 5 mg tablet/kapsul/kaplet 1600 333 5,994 5,994 6,000 150 900,000
161 Haloperidol tts 2 mg/ml botol 0 0 0 0 0 18900 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
162 Hepatitis B imunoglobulin (human) inj 150 IU/1,5 ml Ampul 0 7 126 126 0 0
163 Hidrogen peroksida cairan 3% Botol 0 0 0 0 0 0
164 Hidroklorotiazid tab 25 mg tablet/kapsul/kaplet 0 950 17,100 17,100 17,100 148 2,530,800
165 Hidrokortison krim 2,5% tube @ 5 g 6490 714 12,852 10,680 10,700 2325 24,877,500
166 Hidrokortison serb inj 100 mg Vial 0 0 0 0 0 0
167 Hiosina butilbromida tab 10 mg tablet/kapsul/kaplet 0 2016 36,288 36,288 36,300 1050 38,115,000
168 Human tetanus imunoglobulin inj 250 UI (i.m.) Ampul 0 0 0 0 0 0
169 Human tetanus imunoglobulin inj 500 UI (i.m.) Ampul 0 0 0 0 0 0
170 Ibuprofen sir 100 mg/5 ml botol @ 60 ml 0 480 8,640 8,640 0 2339 0
171 Ibuprofen sir 200 mg/5 ml botol @ 60 ml 0 532 9,576 9,576 0 3392 0
172 Ibuprofen tab 200 mg tablet/kapsul/kaplet 0 0 0 -250,000 800,000 207 165,600,000
173 Ibuprofen tab 400 mg tablet/kapsul/kaplet 13000 0 0 -263,000 800,000 308 246,400,000
174 Ipratropium bromida aerosol 20 mcg/semprot Botol 0 0 0 0 0 0
175 Ipratropium bromida cairan ih 0,025% Botol 0 0 0 0 0 11000 0
176 Isoniazid tab 100 mg Tab 0 466 8,388 8,388 0 0
177 Isoniazid tab 300 mg Tab 0 500 9,000 9,000 0 0
178 Isosorbid dinitrat tab 5 mg tablet/kapsul/kaplet 2900 58 1,044 -1,160 0 99 0
179 IUD Cu T 380 A Set 0 0 0 0 0 0
180 IUD Levonorgestrel Set 0 0 0 0 0 0
181 Kalamin Tube 0 0 0 0 0 0
182 Kalsium glukonat inj 100 mg/ml ampul/vial 0 14 252 252 0 6199 0
183 Kalsium hidroksida bubuk, pasta Tube 0 0 0 0 0 0
184 Kalsium karbonat tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 500 0
185 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/kaplet 0 19500 351,000 351,000 351,000 60 21,060,000
186 Kaptopril tab 12,5 mg tablet/kaplet 0 0 0 0 0 68 0
187 Kaptopril tab 25 mg tablet/kaplet 0 19740 355,320 355,320 355,300 75 26,647,500
188 Kaptopril tab 50 mg tablet/kaplet 0 0 0 0 0 0
189 Karbamazepin sir 100 mg/5 ml Botol 0 0 0 0 0 0
190 Karbamazepin tab 100 mg Tab 0 0 0 0 0 0
191 Karbamazepin Tab 200 mg Tablet 0 0 0 0 0 216 0
192 Karbogliserin tts telinga 10 % Botol 0 0 0 0 1,000 3300 3,300,000
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
193 Ketokonazol tab 200 mg tablet/kapsul/kaplet 5800 1925 34,650 34,650 0 260 0
194 Klindamisin kaps 150 mg Kaps 0 500 9,000 9,000 0 0
195 Klindamisin kaps 300 mg tablet/kapsul/kaplet 0 0 0 0 0 594 0
196 Klofazimin, micronized kaps 50 mg Kapsul 0 0 0 0 0 0
197 Klofazimin, micronizedkaps 100 mg kapsul 0 0 0 0 0 0
198 Klonidin tab 0,15 mg tablet/kapsul/kaplet 0 0 0 0 0 146 0
199 Kloramfenikol kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 50,000 680 34,000,000
200 Kloramfenikol salep 2% tube 15g 0 424 7,632 7,632 7,600 3760 28,576,000
201 Kloramfenikol salep mata 1% tube @ 5 gram 0 359 6,462 6,462 6,500 5170 33,605,000
202 Kloramfenikol serb inj 1.000 mg/ml vial/ampul 0 0 0 0 0 0
203 Kloramfenikol susp 125 mg/5 ml botol 60 ml 0 0 0 0 0 5352 0
204 Kloramfenikol tetes telinga 3% Botol 0 0 0 0 2,000 12000 24,000,000
205 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0
206 Kloramfenikol tts mata 1% Botol 0 0 0 0 0 0
207 Klorfeniramin tab 4 mg tablet/kapsul/kaplet 30000 98700 1,776,600 1,776,600 1,776,600 24 42,638,400
208 Klorfenol kamfer mentol (CHKM) Botol 0 0 0 0 0 0
209 Klorheksidin lar 0,2% Botol 0 0 0 0 0 0
210 Klorheksidin lar 15% Botol 0 0 0 0 0 0
211 Klorpromazin inj 25 mg/ml (i.m.) ampul/vial 0 0 0 0 0 0
212 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial 0 0 0 0 0 0
tablet salut selaput/kaplet 0 1218
213 Klorpromazin tab sal 100 mg
salut selaput 21,924 21,924 0 0
214 Klorpromazin tab sal 25 mg Tab sal 0 0 0 0 0 0
215 Klortalidon tab 50 mg Tab 0 0 0 0 0 0
216 Klozapin tab 100 mg tablet 0 0 0 0 0 0
217 Klozapin tab 25 mg tablet 0 440 7,920 7,920 0 0
218 Kodein tab 10 mg tablet/kapsul/kaplet 0 0 0 0 0 605 0
Komb: Deksametason 0,1% Thymol 5% 0 0
219 Botol
Paraklorphenol 30 0 0 0 0
Kombinasi (DHP) : dihidroartemisin 40 mg + tablet salut selaput/kaplet 0 0
220
Piperakuin 320 mg tab sal selaput salut selaput 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
Kombinasi : (Zidovudin 60 mg + Lamivudin 30 mg + 0 0
221 Tab dispersible
Nevirapin 50 mg) Ped Triple FDC 0 0 0 0
0 0
222 Kombinasi : artemether 20 mg + lumefantrin 120 mg tablet/kapsul/kaplet
0 0 0 0
Kombinasi : Desogestrel 150 mcg Etinilestradiol 30 0 0
223 Tab
mcg 0 0 0 0
224 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/kaplet 0 757 13,626 13,626 13,600 0
Kombinasi : Ferro fumarat 60 mg + asam folat 0,4 354810 64033
225 tablet salut gula
mg tab salut 1,152,594 1,152,594 0 255 0
Kombinasi : levonorgestrel 150 mcg + etinilestradiol 0 0
226 tab salut gula
30 mcg 0 0 0 0
Kombinasi : Tenofovir 300 mg + Emtrisitabin 200 0 0
227 Tab
mg 0 0 0 0
Kombinasi : Tenofovir 300 mg + Lamivudin 300 mg 0 0
228 Tab
+ Efavirenz 600 mg 0 0 0 0
229 Kombinasi : zidovudin 300 mg +lamivudin 150 mg Tab 0 0 0 0 0 0
Kombinasi: Ipratropium bromida 0,5 mg + 0 125
230 Ampul/vial
Salbutamol 2,5 mg, cairan ih 2,250 2,250 0 0
231 Kombinasi: kaolin 550 mg + pektin 20 mg Tab 0 0 0 0 0 0
Kombinasi: lopinavir 200 mg + ritonavir (LVP) 50 0 0
232 Tab
mg, tab 250 mg 0 0 0 0
Kombinasi: Tenofovir 300 mg + Lamivudin 300 mg 0 0
233 Tablet/kapsul/kaplet
+ Dolutegravir 50 mg, tablet 0 0 0 0
Komibinasi: lidokain + medisinal creosote phenol + 0 0
234 Botol
eugenol + benzil alkohol, cairan 0 0 0 0
235 Komposit resin Set 0 0 0 0 0 0
Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 0 20327
236 tab/kaptab
400 mg+ trimetoprim 80 mg 365,886 365,886 365,900 126 46,103,400
Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 0 2866
237 tab/kaptab
800 mg+ trimetoprim 160 mg 51,588 51,588 0 240 0
Kotrimoksazol kombinasi tiap 5 ml suspensi : 0 649
238 botol 60 mL
sulfametoksazol 200 mg + trimetoprim 40 mg 11,682 11,682 8,000 2100 16,800,000
239 Kuinin inj 25% (i.v.) Vial 0 0 0 0 0 0
240 Kuinin tab 200 mg tablet/kapsul/kaplet 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
241 Laktulosa sir 3,335 g/5 ml botol @ 60 mL 0 180 3,240 3,240 0 0
242 Lamivudin (3TC) tab 150 mg tablet/kapsul/kaplet 0 0 0 0 0 0
Larutan mengandung elektrolit (CaCl2H2O 0,165 gr, 0 0
243 Botol plastik @500 ml
KCl 0,15 gr, NaCl 4,3 gr) 0 0 0 0
244 Larutan mengandung Elektrolit (Kalium Klorida) Botol 0 0 0 0 0 0
Larutan mengandung Elektrolit (KCl 0,15%, NaCL 0 0
245 Botol
0,9%) (KN1) 0 0 0 0
Larutan mengandung Elektrolit (KCl 0,3%,NaCl 0 0
246 Botol
0,9%) (KN2) 0 0 0 0
Larutan mengandung Elektrolit (Na 130 mEq, K 4 3361 838
247 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq) Ringer Softbag @ 500 ml
Asetat 15,084 15,084 0 9592 0
Larutan mengandung Elektrolit (Na 130 mEq, K 4 0 0
248 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq) Ringer Botol plastik @ 500 ml
Asetat 0 0 0 0
Larutan mengandung Elektrolit (Sodium Lactate sol 0 0
249 (50%) 113 gr/L, Potassium Chloride 0.3 gr/L, Botol
Calcium Chloride 0.2 gr/L, elektrolit) 0 0 0 0
Larutan mengandung Elektrolit (Tiap 1000 ml 0 0
mengandung electrolit: Sodium 145 mmol/l,
250 Potassium 4.0 mmol/l, Calcium 2.5 mmol/l, Botol
Magnesium 1.0 mmol/l, Chloride 118 mmol/l,
Acetate 24 mmol/l, Malate 5.0 mmol/l) 0 0 0 0
Larutan mengandung Karbohidrat (Fructose 120 g, 0 0
251 Botol
glucose 66 g, Xylitol 60 g/ L) 0 0 0 0
Larutan mengandung Karbohidrat (Fructose 15 mg, 0 0
252 softbag
glucose monohydrate 30 mg, xylitol 15 mg) 0 0 0 0
253 Botol
254 Botol
255 Larutan mengandung Karbohidrat (Maltose 10%) Botol 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
Larutan mengandung Karbohidrat + Elektrolit 0 0
(25.00g dextrose anhidrat, 3.00 g sodium chloride,
0.15 g potassium chloride, 0.10 g calcium chloride
dihydrate dan 1.55 g sodium lactate) 0 0 0 0
(25.00g maltose, 3.00 g sodium chloride, 0.15 g
potassium chloride, 0.10 g calcium chloride dihydrate
dan 1.55 g sodium lactate) 0 0 0 0
258 Botol
(Acetate, Na, K, Cl, Ca, Mg, Sorbitol 50 gr/L) 0 0 0 0
259 Botol
(Dextrose 5%, NaCL 0,45%, KCl) (HSD) 0 0 0 0
260 (Fructose 120 g, glucose 66 g, Xylitol 60 g/ L + Botol
elektrolit) 0 0 0 0
261 (Glukosa 25 g, NaCl 2,0 g, KCl 1,3 g, Natrium Laktat Botol
3,1 g, air untuk injeksi ad 1000 ml) 0 0 0 0
262 (Glukosa 55 g ; Natrium Chloride 9 g, air untuk Botol
injeksi ad 1000 ml) (D5-NS) 0 0 0 0
263 botol/softbag
(Glukosa: 110.0 g; NaCl: 1.80 g) (D10-1/5NS) 0 0 0 0
264 Botol
(Glukosa: 25,0 g; NaCl: 4,5 g) 0 0 0 0
265 botol/softbag @ 100 mL
266 botol/softbag @ 500 mL
267 Botol
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
(Larutan nutrisi kombinasi infus per L: Na. 100mEQ,
268 Botol
K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl 90mEQ, Asetat
38mEQ, Sorbitol 50g) 0 0 0 0
269 Botol
(Larutan Ringer & Glukosa 5%) 0 0 0 0
Larutan mengandung Karbohidrat + Elektrolit (NaCl 0 0
270 Botol
1.125 gr, Dekstrosa 18.75 gr) (KA EN 1B) 0 0 0 0
271 Botol
1.75 g, KCL 1.5g, Glukosa 100 gr) 0 0 0 0
272 Botol
1.75 g, KCL 1.5g, Na Lactate 2.24 g, Glukosa 100 gr) 0 0 0 0
Larutan mengandung Karbohidrat + Elektrolit (Nacl 885 30
273 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr, Dekstrosa 27 Botol
gr) (KA EN 3B) 540 15 0 11500 0
Larutan mengandung Karbohidrat + Elektrolit (Nacl 0 0
274 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr Dekstrosa 27 Botol
gr) (KA EN 3A) 0 0 0 11500 0
275 Levonorgestrel implan 2 rods, 75 mg (3-4 tahun) pack/ sachet/ set 0 0 0 0 0 0
276 Lidokain gel 2% syringe/syringe plastik 0 6 108 108 0 0
277 Lidokain inj 2% (infiltr/p.v.) ampul/vial 0 0 0 0 0 891 0
278 Lidokain salep 5% Tube 0 0 0 0 0 0
279 Lidokain spray oral 10% botol 0 8 144 144 0 0
280 Linestrenol tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0
281 Liquor carbonis detergens lar 5% Botol 0 0 0 0 0 0
282 Loperamid tab 2 mg Tab 0 0 0 -5,000 0 0
283 Lopinavir 100 mg + Ritonavir 25 mg tab sal selaput 0 0 0 0 0 0
284 Loratadin tab 10 mg tablet/kapsul/kaplet 9650 1613 29,034 29,034 0 0
285 Lorazepam tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 260 0
286 Lorazepam tab 1 mg tablet/kapsul/kaplet 0 0 0 0 0 0
287 Lorazepam tab sal 2 mg Tab sal 0 0 0 0 0 688 0
288 Lugol Botol 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
290 Magnesium sulfat inj 20% ampul/vial 0 0 0 0 0 0
291 Magnesium sulfat inj 40% ampul/vial @25 ml 62 18 324 324 300 4700 1,410,000
292 Magnesium sulfat inj 40% ampul/vial 0 0 0 0 0 0
293 Magnesium sulfat serb, ktg 30 g Sachet 0 0 0 0 0 0
294 Manitol lar infus 20% Botol @ 250 ml 0 0 0 0 0 0
297 Mebendazol sir 100 mg/5 ml Botol 0 0 0 0 0 0
298 Mebendazol tab 100 mg Tan 0 0 0 0 0 0
299 Mebendazol tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0
300 Medroksi progesteron asetat inj 150 mg/ml ampul/vial 0 0 0 0 0 0
301 Medroksi Progesteron Asetat Inj 50 mg/ml ampul/vial 0 0 0 0 0 0
Metenamin mandelat (heksamin mandelat) tab salut 0 0
302 Tab salut
enterik 500 mg 0 0 0 0
303 Metformin tab 500 mg tablet/kapsul/kaplet 0 22500 405,000 405,000 405,000 77 31,185,000
304 Metformin tab 850 mg tablet/kapsul/kaplet 0 0 0 0 0 159 0
305 Metilergometrin inj 0,2 mg/ml ampul/vial 177 47 846 846 800 1069 855,200
306 Metilergometrin tab salut 0,125 mg tablet/kaplet salut selaput 100 441 7,938 7,938 8,000 214 1,712,000
307 Metilprednisolon inj 125 mg/2 ml ampul/vial 0 0 0 0 0 0
308 Metoklopramid inj 5 mg/ml ampul/vial 0 0 0 0 0 0
309 Metoklopramid tab 10 mg tablet/kapsul/kaplet 0 4933 88,794 88,794 0 66 0
310 Metoklopramid tab 5 mg tablet/kapsul/kaplet 0 0 0 0 0 117 0
311 Metronidazol lar inf 5 mg/ml botol 0 2 36 36 0 5885 0
312 Metronidazol susp 125 mg/5 ml Botol @ 100 ml 0 0 0 0 0 0
314 Metronidazol tab 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0
315 Metronidazol tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0
316 Mikonazol krim 2% tube 0 635 11,430 11,430 11,500 1900 21,850,000
317 Mikonazol serb 2% botol / sachet 0 0 0 0 0 25000 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
Mineral Mix (Bismuth Subcitrate Tripotasium, 0 50
318 Copper sulfate, Magnesium Chloride Anhydrous, Sachet
Potassium Chloride, Zinc Acetate) 900 900 0 2981 0
319 N-asetil sistein kaps 200 mg tablet/kapsul/kaplet 0 8063 145,134 145,134 145,200 317 46,028,400
321 NaCl 0,9% Larutan Ampul/botol @ 10 mL 0 0 0 0 0 0
322 NaCl 0,9% Larutan Botol @500 ml 2330 403 7,254 7,010 7,000 6900 48,300,000
325 NaCl 0,9% Larutan Botol @1.000 mL 0 0 0 0 0 0
326 NaCl 3% Larutan Botol plastik @500 ml 0 0 0 0 0 0
0 0
tablet salut enterik/kaplet
327 Natrium diklofenak tab 25 mg
salut enterik
0 0 0 0
0 21763
tablet salut enterik/kaplet
328 Natrium diklofenak tab 50 mg
salut enterik
391,734 391,734 500,000 109 54,500,000
329 Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL 0 0 0 0 0 0
330 Natrium hipoklorit cairan konsentrat 5% Botol 0 0 0 0 0 0
331 Natrium tiosulfat inj 25% (i.v.) Ampul 0 0 0 0 0 0
332 Nevirapin tab 200 mg tablet/kapsul/kaplet 0 0 0 0 0 0
333 Nifedipin kaps 10 mg tablet/kapsul/kaplet 0 3220 57,960 57,960 58,000 221 12,818,000
334 Nistatin susp 100.000 UI/ml botol/vial 0 0 0 0 0 0
335 Nistatin tab salut 500.000 UI
salut gula 18,000 18,000 1,000 869 869,000
336 Nistatin tab vaginal 100.000 UI tablet/kaplet 0 1000 18,000 18,000 1,000 550 550,000
337 Nitrofurantoin tab 50 mg Tab 0 0 0 0 0 0
338 Norepinefrin inj 1 mg/ml ampul/vial 0 0 0 0 0 0
339 Obat Anti Tuberculosis FDC Kategori Anak paket 15 1 18 15 0 0
340 Obat Anti Tuberculosis FDC Kategori I paket 609 52 936 936 0 0
341 Obat Anti Tuberculosis FDC Kategori II paket 13 4 72 72 0 0
342 Obat Anti Tuberculosis FDC Kategori Sisipan paket 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
343 Obat Anti Tuberculosis Kombipak Anak Paket 0 0 0 0 0 0
344 Obat Anti Tuberculosis Kombipak Dewasa paket 30 1 18 0 0 0
345 Oksigen ih, gas dlm tabung Botol 0 0 0 0 0 0
346 Oksimetazolin tts hidung 0,025% botol @ 10 mL 0 76 1,368 1,368 0 0
347 Oksimetazolin tts hidung 0,050% botol @ 10 mL 0 0 0 0 0 0
348 Oksitetrasiklin 1% Salep Mata tube 3050 295 5,310 5,310 5,300 3500 18,550,000
349 Oksitosin inj 10 UI/ml ampul/vial 800 442 7,956 7,956 8,000 1348 10,784,000
350 Olopatadin tts mata 0,1% Botol 0 0 0 0 0 0
351 Omeprazol inj 40 mg/10 ml ampul/vial 0 0 0 0 0 5346 0
352 Omeprazol kaps 20 mg tablet/kapsul/kaplet 0 7845 141,210 141,210 141,200 129 18,214,800
353 Paraformaldehid tab 1 g Tab 0 0 0 0 0 0
354 Parasetamol sir 120 mg/5 ml botol @ 60 mL 80 1029 18,522 18,522 18,600 1160 21,576,000
355 Parasetamol tab 500 mg tablet/kapsul/kaplet 394500 133116 2,396,088 2,396,088 2,396,100 275 658,927,500
356 Parasetamol tts 60 mg/0,6 ml botol @ 15 mL 0 250 4,500 4,500 500 8250 4,125,000
357 Pasta devitalisasi (non arsen) Tube 0 0 0 0 0 0
358 Pasta pengisi saluran akar (pasta) Tube 0 0 0 0 0 0
359 Perak nitrat lar 20% Botol 0 0 0 0 0 0
360 Perak sulfadiazin krim 1% Tube 0 0 0 0 0 0
361 Permetrin krim 5 % Tube 10 g 0 100 1,800 1,800 1,000 11466 11,466,000
362 Permetrin krim 5 % Tube 30 g 0 0 0 0 0 0
363 Permetrin krim 5 % Tube 15 g 0 0 0 0 0 0
364 Pirantel pamoat susp 125 mg/5 ml Botol 0 0 0 0 0 0
365 Pirantel pamoat tab 500 mg Tab 0 0 0 0 0 0
366 Pirantel pamoat tab scored 125 mg tablet/kapsul/kaplet 0 0 0 0 0 341 0
367 Pirantel pamoat tab scored 250 mg Tab 0 0 0 0 0 0
368 Piridoksin (vitamin B6) inj 100 mg/ml Ampul 0 0 0 0 0 0
369 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl 5000 49900 898,200 898,200 898,200 72 64,670,400
370 Piridoksin (vitamin B6) tab 25 mg tablet/kapsul/kaplet 0 0 0 0 0 0
371 Povidon iodin lar 100 mg/ml Botol 300 ml 0 23 414 414 400 17200 6,880,000
372 Povidon iodin lar 100 mg/ml botol @ 1.000 mL 0 0 0 0 0 0
373 Povidon iodin lar 100 mg/ml botol 30 mL 0 142 2,556 2,556 2,500 5500 13,750,000
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
374 Povidon iodin lar 100 mg/ml botol @ 60 mL 0 85 1,530 1,300 0 0
375 Prednison tab 5 mg tablet/kapsul/kaplet 6000 36283 653,094 653,094 653,100 73 47,676,300
376 Primakuin tab 15 mg Tab 0 0 0 0 0 0
377 Probenesid tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0
378 Prokain benzilpenisilin serb inj 3 juta UI/vial (i.m.) ampul/vial 0 0 0 0 0 0
379 Propiltiourasil tab 100 mg tablet/kapsul/kaplet 0 0 0 0 10,000 440 4,400,000
380 Propranolol tab 10 mg tablet/kapsul/kaplet 0 0 0 0 0 63 0
381 Ranitidin tab 150 mg tablet/kapsul/kaplet 77000 21333 383,994 383,994 384,000 85 32,640,000
382 Retinol (vitamin A) kaps lunak 100.000 UI kaps lunak 0 2012 36,216 36,216 36,200 352 12,742,400
383 Retinol (vitamin A) kaps lunak 200.000 UI kaps lunak 10750 5620 101,160 101,160 101,100 637 64,400,700
384 Rifampisin kaps 300 mg tablet/kapsul/kaplet 0 0 0 0 0 0
385 Rifapentin tablet 150 mg Tablet/kapsul/kaplet 0 0 0 0 0 0
386 Ringer Laktat Larutan Botol 20525 2821 50,778 50,778 50,800 7703 391,312,400
387 Risperidon tab sal 1 mg tablet/kapsul/kaplet 0 0 0 0 0 0
388 Risperidon tab sal 2 mg tablet/kapsul/kaplet 900 1072 19,296 19,296 0 0
389 Salbutamol cairan ih 1 mg/mL ampul/vial/botol 0 0 0 0 0 0
390 Salbutamol sir 2 mg/5 ml Botol 0 0 0 0 0 4189 0
391 Salbutamol tab 2 mg tablet/kapsul/kaplet 0 0 0 0 0 0
392 Salbutamol tab 4 mg tablet/kapsul/kaplet 0 8350 150,300 150,300 150,300 67 10,070,100
Salep 2-4, kombinasi : asam salisilat 2 %+ belerang 0 0
393 pot 15 gram
endap 4 % 0 0 0 0
Salep 2-4, kombinasi : asam salisilat 2 %+ belerang 0 400
394 pot 30 gram
endap 4 % 7,200 7,200 5,000 2499 12,495,000
395 Sefadroksil kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0
396 Sefadroksil kaps/tab 500 mg tablet/kapsul/kaplet 0 0 0 0 10,000 715 7,150,000
397 Sefadroksil sir kering 125 mg/5 ml botol @ 60 mL 0 0 0 0 0 0
398 Sefadroksil sir kering 250 mg/5 ml botol @ 60 mL 0 0 0 0 0 0
Serum anti bisa ular : A.B.U. I (khusus ular dari luar 0 0
399 Vial
Papua) inj (i.m./i.v.) 0 0 0 0
Serum anti bisa ular :A.B.U.II (khusus ular dari 0 0
400 Vial
Papua) inj (i.m./i.v.) 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m 10.000 0 0
401 Vial
UI/ 0 0 0 0
402 Serum antirabies inj 100 UI/ml Vial 0 0 0 0 0 0
403 Serum antirabies inj 200 UI/ml Vial 0 0 0 0 0 0
Serum antitetanus (A.T.S) (i.m.) Inj 10.000 UI/vial 0 0
404 Vial
(i.m /i.v.) 0 0 0 0
405 Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) Ampul 0 0 0 0 0 0
Serum antitetanus (A.T.S) inj 20.000 UI/vial (i.m 0 0
406 Vial
/i.v.) 0 0 0 0
407 Serum antitetanus (A.T.S) inj 5.000 IU/mL (i.m) Ampul/vial 0 0 0 0 0 0
408 Setirizin sir 5 mg/5 ml. botol @ 60 mL 0 145 2,610 2,610 2,000 2215 4,430,000
409 Sianokobalamin (vitamin B12) inj 500 mcg/ml ampul/vial 0 0 0 0 0 0
410 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kaplet 0 34925 628,650 628,650 628,700 44 27,662,800
tablet/kapsul/kaplet/tablet 0 0
411 Simvastatin tab sal 10 mg salut selaput/kaplet salut
selaput 0 0 0 73 0
tablet/kapsul/kaplet/tablet 0 20030
412 Simvastatin tab sal 20 mg salut selaput/kaplet salut
selaput 360,540 360,540 360,500 150 54,075,000
413 Simvastatin tab sal selaput 40 mg Tab sal 0 0 0 0 0 0
tablet salut selaput/kaplet 0
414 Siprofloksasin tab scored 500 mg
salut selaput 0 0 0 200,000 260 52,000,000
415 Spironolakton tab 25 mg tablet/kapsul/kaplet 0 0 0 0 0 220 0
Stannous pyrophosphate 27,6 mg sodium 0
416 Vial
pyrophosphate/vial 0 0 0 0 0
417 Streptomisin serb inj 1.000 mg/vial ampul/vial 0 0 0 0 0 0
418 Surgical ginggival pack Tube 0 0 0 0 0 0
tablet salut selaput/kaplet 0
419 Tenofovir tab 300 mg
salut selaput 0 0 0 0 0
420 Terbutalin cairan ih 2,5 mg/ml Botol 0 0 0 0 0 0
421 Terbutalin inj 0,5 mg/ml ampul/vial 0 0 0 0 0 0
422 Tetanus toxoid inj Ampul 0 0 0 0 0 0
423 Tetrakain tts mata 0,5% Botol 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
424 Tetrasiklin kaps 250 mg tablet/kapsul/kaplet 0 0 0 0 0 0
425 Tetrasiklin kaps 500 mg tablet/kapsul/kaplet 0 7,750 139,500 139,500 139,500 1045 145,777,500
426 Tetrasiklin Salep Mata 1% Tube 0 0 0 0 0 0
427 Tiamin (vitamin B1) tab 50 mg tablet/kapsul/kaplet 0 45,200 813,600 813,600 813,600 60 48,816,000
428 Timolol tts mata 0,25% botol @ 5 mL 0 6 108 108 0 0
429 Timolol tts mata 0,5% botol @ 5 mL 0 0 0 0 0 0
430 Urea krim 10 % Tube/pot 0 0 0 0 0 0
431 Urea krim 20 % Tube/pot 0 0 0 0 0 0
432 Vaksin BCG inj (i.k) Vial 364 248 4,464 4,464 0 0
433 Vaksin bivalen OPV (b-OPV) drops 10 dosis Vial 497 418 7,524 7,524 0 0
Vaksin Hepatitis Rekombinan Inj Prefilled Injection 931
434 Vial
Device (Uniject) 0,5 ml (i.m) 499 8,982 8,982 0 0
435 Vaksin HPV (Human Papilloma Virus), vial 0,5 mL Ampul/vial 0 0 0 0 0 0
436 Vaksin Influenza Vial 0 0 0 0 0 0
437 Vaksin Japanese Enchepalitis (J.E) Vial 0 0 0 0 0 0
438 Vaksin jerap difteri tetanus (DT) Vial 90 100 1,800 1,800 0 0
439 Vaksin jerap difteri tetanus (Td) Vial 630 270 4,860 4,860 0 0
440 Vaksin kombinasi DPT-HB-Hib Vial 1009 525 9,450 9,450 0 0
441 Vaksin measless rubella (MR) Inj 0,5 mL (s.k) Vial 633 237 4,266 4,266 0 0
442 Vaksin Meningitis Meningokokus Vial 92 0 0 -92 0 0
443 Vaksin polio IPV inj 0,5 ml Vial 0 218 3,924 3,924 0 0
Vaksin rabies, untuk manusia serb inj (s.k./i.k) + 24
444 Vial
booster 37 666 666 0 0
445 Vaksin rabies, untuk manusia serb Inj 2,5 IU Vial 0 0 0 0 0 0
446 Vaksin Yellow Fever Vial 0 0 0 0 0 0
447 Valproat sir 250 mg/5 ml botol @ 120 ml 0 0 0 0 0 0
tablet salut enterik/ kaplet 0
448 Valproat tab sal 250 mg
salut enterik 0 0 0 0 0
449 Vitamin B kompleks tablet 843300 93,390 1,681,020 1,681,020 1,681,000 60 100,860,000
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
Tablet/kapsul/kaplet/tab 0
sal selaput/kaplet sal
450 Vitamin C 500 mg minimal non acidic 250 mg
selaput/tab sal gula/kaplet
sal gula 0 0 0 1,000,000 495 495,000,000
451 Zidovudin kaps 100 mg tablet/kapsul/kaplet 0 0 0 0 0 0
452 Zinc drops 10 mg/ml Botol 0 0 0 0 0 5397 0
453 Zinc serb 10 mg Sachet 0 0 0 0 0 0
454 Zinc sir 20 mg/5 ml botol 0 310 5,580 5,580 0 2489 0
455 Zinc tab disp 20 mg tablet dispersible 16500 4,525 81,450 81,450 81,000 253 20,493,000
4,814,603,100
0
NON FORNAS 0
1 Ambroxol tab 30 mg Tab 0
2 Etakridin/ Rivanol Botol 0
3 Gliseril Guaiakolat tablet 100 mg Tab 0
4 Metoklopramide sirup Botol 0
5 Multivitamin sirup Botol 0
6 Multivitamin tablet Tablet 0
7 Obat batuk Hitam (OBH) Botol 0
0
0
BAHAN MEDIS HABIS PAKAI (BMHP) 0
Alat pemeriksaan GCU (Glukosa, Cholesterol, Urat
1 set
Acid) 1 1 0 0 1 80 0 0
2 Alat suntik 0,05 ml pcs 2,100 7,000 583 10,494 8,394 8,400 0 0
3 Alat Suntik 0,5 ml pcs 17,000 3,458 3,458 62,244 45,244 45,200 0 0
4 Alat suntik 1 ml pcs 12,300 1,641 1,641 29,538 17,238 17,200 0 0
5 Alat Suntik 10 ml Pcs 0 0 0 0 0 0 0 0
6 Alat suntik 3 ml pcs 17,600 45,300 3,775 67,950 50,350 50,300 0 0
7 Alat Suntik 5 ml Pcs 20,600 10,092 0 850 19,750 0 0 0
8 Alkohol 96% Botol 0 0 0 0 0 100 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
9 Alkohol swab Box/ 100 lbr 750 1,927 160 2,880 2,130 2,130 0 0
10 Aquadest Botol 0 0 0 0 0 1,000 0 0
11 Asam Urat test strip Test 0 0 0 0 0 69,000 0 0
12 Bioplacenton tulle Kotak/ 10 lbr 0 0 0 0 0 0 0 0
13 Bisturi pcs 0 0 0 0 0 2,300 0 0
14 Blood Lancet Kotak/ 100 0 155 39 702 702 0 0 0
15 Catgut 2/0 pcs 0 0 0 0 0 0 0 0
16 Catgut 3/0 pcs 0 6,353 577 10,386 10,386 0 0 0
17 Dengue test IgG/IgM pcs 0 150 75 1,350 1,350 0 0 0
18 Dengue test NS 1 pcs 0 0 0 0 0 0 0 0
19 Dermafix s I.V Blister 48 93 7 126 78 0 0 0
20 Elastis Verban Pcs 0 0 0 0 0 0 0 0
21 Etakridin (Rivanol) Botol 0 0 0 0 0 0 0 0
22 Etil Klorida Botol 0 0 0 0 0 0 0 0
23 Folley Catheter no 16 Pcs 0 195 65 1,170 1,170 0 0 0
24 Folley Catheter no 18 Pcs 0 420 60 1,080 1,080 0 0 0
25 Gentian violet 1% Botol 0 0 0 0 0 0 0 0
26 Gluco protein Pcs 0 0 0 0 0 0 0 0
27 Glukosa test strip Pcs 0 0 0 0 0 0 0 0
28 Hand rub 500 ml Botol 0 1,230 136 2,448 2,448 0 0 0
29 Handscoon No. 6,5 Psng 0 0 0 0 0 0 0 0
30 Handscoon No. 7 Psng 0 2,350 2,350 42,300 42,300 0 0 0
31 Handscoon No. 7,5 Psng 0 1,750 1,750 31,500 31,500 0 0 0
32 Handscoon No. 8 Psng 0 0 0 0 0 0 0 0
33 Handscoon Non Steril L Kotak/ 50 181 305 51 918 737 0 0 0
34 Handscoon Non Steril M Kotak/ 50 546 379 75 1,350 804 0 0 0
35 Handscoon Non Steril S Kotak/ 50 0 96 48 864 864 0 0 0
36 Handscoon Obgyn steril Psng 0 0 0 0 0 0 0 0
37 Hepatitis BSAg Pcs 0 0 0 0 0 0 0 0
38 I.V. Catheter No. 18 pcs 0 2,300 60 1,080 1,080 0 0 0
39 I.V. Catheter No. 20 pcs 2,320 7,330 790 14,220 11,900 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
42 Infusion set anak pcs 3,175 2,636 278 5,004 1,829 0 0 0
43 Infusion set dewasa Set 5,885 12,902 1,075 19,350 13,465 0 0 0
44 Jelly 50 g Pcs 0 0 0 0 0 0 0 0
45 Kapas 250 g bungkus 400 0 0 0 400 0 0 0
46 Kapas Adsorben 1 Kg bungkus 66 106 8 144 78 0 0 0
47 Kaporit Kaleng/ 15 kg 0 0 0 0 0 0 0 0
48 Kasa kompres 40/40 pcs 0 0 0 0 0 0 0 0
49 Kasa pembalu hidrofil 4 m x 10 cm elastic pcs 0 0 0 0 0 0 0 0
50 Kasa pembalu hidrofil 4 m x 15 cm elastic pcs 0 2,935 733 13,194 13,194 0 0 0
51 Kasa pembalu hidrofil 4 m x 3 cm elastic pcs 8,325 1,650 137 2,466 5,859 0 0 0
52 Kasa pembalu hidrofil 4 m x 5 cm elastic pcs 1,800 1,890 157 2,826 1,026 0 0 0
53 Kasa pembalut 2 m x 80 cm Pcs 0 4,830 690 12,420 12,420 0 0 0
54 Kasa pembalut hidrofil 40 x 80 roll 580 280 39 702 122 0 0 0
55 Kasa steril 16 cm x 16 cm kotak 2,774 1,366 195 3,510 736 0 0 0
56 Kasa Steril 18 cm x 22 cm pcs 0 0 0 0 0 0 0 0
57 Kolesterol test strip Pcs 0 0 0 0 0 0 0 0
58 Lisol Botol 1000 ml 74 349 29 522 448 0 0 0
59 Malaria test Kotak 0 0 0 0 0 0 0 0
60 Masker Box 8 1,842 153 2,754 2,746 0 0 0
61 Masker N95 Box 0 0 0 0 0 0 0 0
62 Masker Oksigen Anak Buah 0 62 6 108 108 0 0 0
63 Masker Oksigen Bayi Buah 0 62 0 0 0 0 0 0
64 Masker Oksigen Dewasa Buah 0 0 6 108 108 0 0 0
65 Objek glass frosted Box/ 72 pcs 178 45 3 54 124 0 0 0
66 Oxygen Canula Anak Buah 130 370 33 594 464 0 0 0
67 Oxygen Canula Dewasa Buah 0 500 55 990 990 0 0 0
68 Penjepit talu Pusat (Umbilical Clamp) Pcs 0 0 0 0 0 0 0 0
69 Plester 15 cm x 5 cm roll 0 260 0 0 0 0 0 0
70 Plester 5 cm x 10 cm Roll 0 0 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
71 Plester 7,5 cm x 4,5 m roll 0 0 0 0 0 0 0 0
72 Plesterin Bulat Box/200 0 0 0 0 0 0 0 0
73 Pot Dahak 7 cm x 5 cm pcs 0 0 0 0 0 0 0 0
74 Pot sputum steril Pcs 1,260 4,900 408 7,344 6,084 0 0 0
75 Reagen ZN Paket 91 76 6 108 17 0 0 0
76 Safety box pcs 2,726 533 44 792 1,934 0 0 0
77 Silk 3/0, 75 cm, 3/8CC, 19 mm pcs 76 3,495 291 5,238 5,162 0 0 0
78 Spons gelatin set 0 44 1 18 18 0 0 0
79 Tambalan gig sementara set 0 0 0 0 0 0 0 0
80 Tambalan Gigi set 0 0 0 0 0 0 0 0
81 Test Golongan darah pcs 0 0 0 0 0 0 0 0
82 Test Kehamilan pcs 0 0 0 0 0 0 0 0
83 Tifoid test pcs 0 0 0 0 0 0 0 0
84 Ultrasonic Gel 250 ml (USG) Botol 0 0 0 0 0 0 0 0
85 Underpad 60 x 90 cm bungkus 0 0 0 0 0 0 0 0
86 Urine bag pcs 0 500 0 0 0 0 0 0
87 Widal test pcs 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
KOLOM TAMBAHAN 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
NON FORNAS 0 0 0 0 0 0 0 0
1 ….. 0 0 0 0 0 0 0 0
2 ….. 0 0 0 0 0 0 0 0
3 ….. 0 0 0 0 0 0 0 0
4 ….. 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
BMHP 0 0 0 0 0 0 0 0
1 …………….. 0 0 0 0 0 0 0 0
2 …………….. 0 0 0 0 0 0 0 0
3 …………… 0 0 0 0 0 0 0 0
RENCANA
N
2020 2020 BULAN 2022 2022
g = f x 18
bulan
4 …………… 0 0 0 0 0 0 0 0
0
0
0
0
0
0
0
0
0
4,814,603,100

LTB Rko Dan BMHP Dinkes 2023

Diunggah oleh

Informasi Dokumen

Deskripsi Asli:

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

LTB Rko Dan BMHP Dinkes 2023

Diunggah oleh

Hak Cipta:

Format Tersedia

RENCANA KEBUTUHAN OBAT DAN BMHP PUSKESMAS 2023

PUSKESMAS : LIUKANG TUPABBIRING

SISA STOK TOTAL PEMAKAIA JUMLAH RENCANA

1 Air untuk injeksi ampul/vial/botol 10 mL 0 0 0 0 0 0 0 0

23 Ampisilin serb inj 1000 mg/vial ampul/vial 0 0 0 0 0 0 0

44 Asam retinoat krim 0,1% Tube @ 10 gram 0 0 0 0 0 0 0

73 Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml 0 0 0 0 0 0 0

102 Eritromisin tab 500 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0

156 Haloperidol inj 5 mg/ml (i.m.) Vial 0 0 0 0 0 0 0

182 Kalsium glukonat inj 100 mg/ml ampul/vial 0 0 0 0 0 0 0

283 Lorazepam tab 0,5 mg tablet/kapsul/kaplet 0 0 0 0 0 0 0

312 Mikonazol krim 2% tube 106 250 30 540 434 500 0 0

340 Oksigen ih, gas dlm tabung Botol 0 0 0 0 0 0 0

370 Povidon iodin lar obat kumur 1% Botol 0 0 0 0 0 0 0

419 Tetrakain tts mata 0,5% Botol 0 0 0 0 0 0 0

8 Alkohol 96% Botol 0 0 0 0 5 0 0

38 I.V. Catheter No. 18 pcs 16 0 5 90 74 100 0 0

68 Oxygen Canula Dewasa Buah 9 0 30 540 531 500 0 0

BMHP DAN BAHAN GIGI 0 0 0 0 0 0 0 0

Pangkajene, ...........September 2022

SISA STOK TOTAL PEMAKAIA JUMLAH RENCANA

Anda mungkin juga menyukai