RENCANA KEBUTUHAN BAHAN LABORATORIUM PADA FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP) TAHUN 2023

SISA STOK PEMAKAIAN

JUMLAH RENCANA HARGA JUMLAH
PER 31 RATA-RATA RENCANA PENGADAAN
NO NAMA BMHP SATUAN KEBUTUHAN KEBUTUHAN SATUAN *) HARGA KETERANGAN
DESEMBER PER BULAN TAHUN 2023
TAHUN 2023 TAHUN 2023 (Rp) (Rp)
2022 SELAMA 2022

(a) (b) (c) = (b) x 18 (d) = (c) - (a) (e) (f) (g) = (e) x (f) (h)

1 Alat GCU Benecheck ( Glukosa ) pcs 1

1

2 Alkacid ( Steral ) BOTOL

3 Alkazym ( Steryzim ) sachet

4 Auto klik BIJI 2 2

hanya pemakain di lab

5 Blood Lancet 26 G BIJI 100 111 1,998 1,898 1,900 belum termasuk pemakaian
program

6 Blood Lancet 28 G BIJI - -

7 BLUE TIP ( MT I ) bungkus 900 15 270 - -
8 Buffer PH 7,2 BOTOL - -
9 Cat Gram 100 ml Bio Analitik BOTOL - -
10 Catridge TCM Unit - -
11 Cellclean 50 ml SABA BOTOL - 0.2 4 4 4
12 CellPack 30 liter SABA BOTOL 15L 0.5 9 9 9
13 Cover Glass kotak - - -
14 Diluent M30 - 20 L BOTOL - - -
15 Eightcheck 3 WP (L,N,H ) 1, 5 ml BOTOL - - -
- -
16 Ez Cleanser 100 ml BOTOL -
- -
17 Holder Standard Yellow pcs -

- -
18 Kapas Lidi pcs -

19 Kartu Golongan Darah LEMBAR 200 42 756 556 556

- -
20 Kertas PH kotak

- -
21 Kertas Saring Whatman box

- -
22 KOH 10 % 1x 100 ml BOTOL

23 Kondom MRB BIJI - -

24 Larutan Drab Kins BOTOL - -
25 LDL Kolesterol kit - -
26 Limitor 0,5 gr 1 Kg Sachet - -
27 Lyse M 30 500 ml BOTOL - -
28 Methanol Absolut BOTOL 1 0 0.18 - 1
Micopipet Adjust volume 5- 50 µl -
29 ( Dragon ) set 1 2
30 Microlit Micropipette variabel 100 - 1000 µl set - -
31 Microlit Micropipette variabel 5 - 50 µl set - -
32 Microlit Micropipette variabel 500 - 5000 µl set - -
Microlit Micropipette variabel 500 - 5000 - -
33 set
µl
34 Micropipet Adjust volume 100 - 1000 µl ( Dragon ) set 2 - 2
35 Na.citrate 3,13 % 1x 100 ml BOTOL - -
36 Needle cnv 22x1.5 mltsmp ce pcs 200 46 828 628 650
37 Object Glass Frosted Biji 200 35 630 430 432
38 Object Glass Frosted reguler P2 biji - -
39 Oil Emerci ( 100 cc ) BOTOL - 0.01 0.18 1 1
40 Parafilm 4 X 125 Roll - -
41 PCR tube 1,5 ml biji - -
42 Pot Sputum Pcs 70 43 774 704 704
43 Pot Urine pcs 60 58 1,044 984 990
44 Probe Cleanser 17 ml BOTOL - -
45 Rak tabung pcs - -
46 Rapid Tes Covid ( rizki educalab ) Stik - -
47 Rapid Tes Covid ( rizki educalab ) Stik - -
Rapid Tes Covid Hightop ( PT. Rajawali - -
48 Stik
Nusindo )
Rapid Antigen SARS -CoV-2 Antigen - -
49 Stik
Flow Flex Acon
50 Rapid Antigen Healgen Coronavirus Ag Stik - -
51 Rapid Antigen Healgen Coronavirus Ag Stik - -
52 Rapid Antigen Test Rajawali - -
53 Rapid Tes Sipilis kit - -
54 Reagen Benedicht BOTOL - -
55 Reagen Edta (100 cc) BOTOL - -
56 Reagen Eosin 2% (100 cc) BOTOL 1 0.02 0.36 1 1
57 Reagen Giemsa Stain (100 cc) BOTOL 1 0.2 3.6 2.6 2
0 0
58 Reagen Glucose ( sumber cahaya putri ) kit

59 Reagen Glukosa kit 2 0.17 3.06 1.06 2

60 Reagen Golongan Darah KIT - 0.17 3.06 3.06 4
61 Reagen HCL 0,1 N (100 cc) BOTOL 0 0
0 0
62 Reagen kolesterol ( sumber cahaya putri ) kit

63 Reagen Kolestrol kit 3 0.7 12.6 9.6 10

64 Reagen SGOT kit 0 0
65 Reagen SGPT Kit 0 0
66 Reagen Uric acid ( sumber cahaya putri ) kit 3 0.7 12.6 9.6 10
67 Reagen Urik Acid ( 4 x 100 ml ) kit 0 0
68 Reagen Widal kit - 0.013 0.234 0.234 1
69 Reagen Widal kit - 0 0
70 RPR Antigen BIJI 0 0
 71 Slide (Obyek Gelas) biji 12 216 288 288
72 Slide Frosted biji 12 216 288 288
73 Spiritus BOTOL 1.0 0.1 1.8 0.8 1
74 Stik Kolesterol ( Benecheck) Stik 50 20 360 310 310 belum termasuk program
75 Stik Asam Urat ( Authocek Uric acid ) BOTOL 0 0
76 Stik Combur 3 Parameter KIT 0 0
77 Stik Combur 10 Parameter (100pcs) KIT 2 0.33 5.94 3.94 4
78 Stik Combur 11 P Botol 0 0
79 Stik DBD Dengue NS 1 STIK - 0 0
80 Stik Glukosa ( Authocek Glucose) BOTOL - 0 0
81 Stik HB (Acon Hemoglobulin Test) box - 109 1962 1962 1,962
82 Stik HBs AG STIK 100 26 468 368 368
83 Stik HIV stik 25 10 180 155 155
414 364
ditambah pemakaian
84 Stik Kehamilan 50 23 600
kaber/poskesdes
STIK
85 Stik Kloseterol (Authocek Cholesterol) BOTOL 0 0
86 Stik Malaria Stik - 0 0
87 Stik Narkoba (Fokus Multidrug 6 in 1) stik - 0 0
88 Stik Salmonella Thypy Stik - 0 0
89 Stik Sphylis/HIV Combo Stik 50 26 468 418 450
90 Stromatolyser WH 500 ml SABA BOTOL - 0.5 9 9 9
91 Tips Micropipettes MT I ( Yellow Tip ) bungkus 0 0
92 Tips Micropipettes MT II ( Blue Tip ) bungkus 0 0
93 Tissue lensa BIJI - 10 180 180 180
Tube EDTA Plh 13x75 3.0 blblce lav 900 900
94
( ungu )
pcs - 50 900 belum termasuk program

Tube EDTA Plh 13x75 3.0 blblce lav 0 0

95
( ungu )
1080 880
96 Tube pln plh 13 x 75 4.0 plbl rd ( Merah ) pcs 200 60 880 belum termasuk program
97 Tube Yellow pcs 0 0
98 YELLOW TIP bungkus 8,200 90 1620 0
99 Ziel Neelsen Stain BOTOL - 0.3 5.4 6 6
TOTAL -

Keterangan:
*) Harga satuan menggunakan harga yang tayang dalam katalog.
Jika BMHP tidak terdapat dalam katalog, maka harga satuan menggunakan sumber informasi lain yang dapat dipertanggungjawabkan.
pemakaian gudang rata2 sebulan 458
rata2 pemakaian gudang 108/bln
rata2 pemakaian gudang 57/bln
rata2 pemakaian gudang 160/bln

rata2 pemakaian gudang 83/bln

 jan

NO. NAMA OBAT

I PERBEKALAN KESEHATAN TOTAL RATA-RATA

01 Alat Suntik Sekali Pakai 1 ml 1,325 110 200
02 Alat Suntik Sekali Pakai 10 ml 200 17 0
03 Alat Suntik Sekali Pakai 3 ml 2,700 225 300
04 Alat Suntik Sekali Pakai 5 ml 520 43 20
05 Alkohol Swab 3,100 258 500
06 Antiseptik Hand Rub 10 BTL @ 5 L 8 1 1
07 Antiseptik Hand Rub @ 500 ml 9 1 5
08 Antiseptik Handscrub @ 5 L 5 0
09 Antiseptik Handscrub @ 500 Ml 11 1
10 Carbon Seel Salpel Blades #11 (Mess) 100 8
Catgut Cromik / Benang Bedah No. 2/0 ( Box
11 48 4
24 Biji )Cromik / Benang Bedah No. 3/0 ( Box
Catgut
12 120 10
24 Biji )Plain / Benang Bedah No. 2/0 ( Box
Catgut
13 48 4
24 Biji )Plain / Benang Bedah No. 3/0 ( Box
Catgut
14 144 12
24 Biji )
15 Cuticell Classic 10 cm x 10 cm (Perawatan Luka) 8 1
16 Cutimed Gel 15 g (Perawatan Luka) 0 0
17 Cutimed Sorbact 7 x 9 Cm (Perawatan Luka) 0 0
18 Cutisorb Sterile 10 x 10 Cm (Perawatan Luka) 0 0
19 Dower Catheter No.12 10 1
20 Dower Catheter No.14 15 1
21 Dower Catheter No.16 23 2
22 Dower Catheter No.18 20 2
23 Dower Catheter No.20 15 1
24 Gelang Pasien Anak Biru 0 0
25 Gelang Pasien Anak Kuning 0 0
26 Gelang Pasien Anak Merah 0 0
27 Gelang Pasien Anak Pink 0 0
28 Gelang Pasien Dewasa Biru 0 0
29 Gelang Pasien Dewasa Merah 0 0
30 Gelang Pasien Dewasa Kuning 0 0
31 Gelang Pasien Dewasa Pink 0 0
32 Hand Scoon Gynecologi 80 7
33 Hand Scoon Non Steril ( L ) 2,400 200 300
34 Hand Scoon Non Steril ( M ) 2,650 221 400
35 Hand Scoon Non Steril ( S ) 2,400 200 200
36 Hand Scoon Steril No.6 0 0
37 Hand Scoon Steril No.6,5 0 0
38 Hand Scoon Steril No.7 900 75 100
39 Hand Scoon Steril No.7.5 0 0
40 Heating Jarum Kulit No.10 0 0
41 Heating Jarum Kulit No.12 0 0
42 Heating Jarum Kulit No.14 0 0
43 Heating Jarum Kulit No.15 0 0
44 Heating Jarum Otot No.10 0 0
45 Heating Jarum Otot No.12 0 0
46 Heating Jarum Otot No.14 0 0
47 Heating Jarum Otot No.15 0 0
48 Infusion set anak 60 ml/drops 145 12
49 Infusion set dewasa 20ml/drops 660 55
50 IV Catheter G.18 505 42 20
51 IV Catheter G.20 230 19 30
52 IV Catheter G.22 130 11 30
53 IV Catheter G.24 190 16
54 IV Catheter G.26 0 0
55 Kapas Pembalut / Absorben 250 gram 29 2
56 Kasa Kompres 40 x 40 steril 0 0
57 Kasa Pembalut 2m x 80 cm 87 7
58 Kasa Pembalut 36 m x 80 cm / 40x80 31 3
59 Kasa Pembalut 4m x 15 cm 155 13 50
60 Kasa Pembalut 4m x 3 cm 196 16 50
61 Klip Obat Besar 4,800 400 500
62 Klip Obat Kecil 2,000 167
63 Masker 6,200 517 1000
64 Masker KN95 Non Medis 0 0
65 Masker KN95 Medis 0 0
66 Masker N95 60 5
67 Masker Nebulezer Set Anak 40 3 10
68 Masker Nebulezer Set Dewasa 50 4 10
69 My Jelly 82 gram 3 0
70 Nasal Cannula, Size L 200 17 10
71 NasalCannula, Size M 63 5
72 NasalCannula, Size S 30 3 10
73 NasalCannula, Size XS 23 2
74 Needle 22 G 0 0
75 Needle 23 G 0 0
76 Needle 25 G 0 0
77 Penjepit Tali Pusat 50 4
78 Plester 5 yards x 2 inch 100 8
79 Plesterisn Bulat Non Wofen 2,200 183 400
80 Policrepe 10cm x 4,55 M (Eelastis Banded) 16 1
81 Polifix 5cm X 1M (Pelster Hipavix) 12 1
82 Regulator 0 0
83 Silk (Benang Bedah Sutera) No. 3/0 180 15 36
84 Slang O2 Include Masker Anak 6 1
85 Slang O2 Include Masker Dewasa 5 0
86 Urine Bag 37 3
87 USG Gel 250 ml 23 2 2
88 Under Pad 150 13
89 Abate 0 0
90 APD Set 0 0
91 Apron 0 0
92 Baju Cover All 0 0
93 Surgical Gown Non Wofen L 0 0
94 Surgical Gown Non Wofen M 60 5 10
95 Surgical Gown Non Wofen S 0 0
96 Helmet + Visor 0 0
97 Kacamata Google 0 0
98 Perisai Wajah 0 0
99 Shoes Cover 0 0
100 Sepatu Boots 0 0
101 Catton Swab Steril 0 0
102 VTM 0 0
103 VTM dan Stik Steril Dackron 0 0

II OBAT
01 Acetylsistein 200 mg 5,460 455
02 Albendazol 400 mg 6,500 542 700
03 Albendazol 200 mg/5ml Suspensi 100 8 100
04 Alkohol 70 % 1 liter 33 3 3
05 Alkohol 70% cairan @100 ml 0 0 0
06 Alopurinol tablet 100 mg 1,740 145 500
07 Ambroxol tablet 30 mg 2,400 200 500
08 Aminofilin Injeksi 24 mg/ml - 10 ml 0 0
09 Aminofilin Tablet 200 mg 0 0
10 Amitriptilin HCl tablet salut 25 mg 100 8
11 Amolodipin 5 mg 0 0
12 Amlodipin 10 mg 5,860 488 660
13 Amoksisilin kaplet 500 mg 20,700 1,725 1600
14 Amoksisilin sirup kering 125 mg/5ml 260 22 20/30
15 Ampicillin serbuk injeksi i.m/i.v 1000 mg/vial 86 7 10
16 Antasida DOEN I tab kunyah,kombinasi : AlOH2 200 mg 11,800 983 500
17 + MgOH2DOEN
Antasida 200 mgII Suspensi, kombinasi : AlOH2 200 50
50 4
18 mg/5
Anti Bakteri DOEN 200
ml + MgOH2 mg/5
salep ml
kombinasi:Basitrasin 500 IU/g 0 0
19 + Polomiksin 10.000 IU/g
Anti Hemoroid DOEN Kombinasi :Bismut subgalat 150 5 0
20 mg
Anti+Migrain
Heksaklorofen 2,5 mg Tartrat 1 mg + Kofein 50
Tablet:Ergotamin 100
100 8
21 mg
Aqua pro Injeksi steril, bebas pirogen 250 21
22 Aqua DM 1 0
23 Artesunat Injeksi 60 mg 0 0
24 Asam Asetilsalisilat 80 mg 50 4
25 Asam Askorbat 50 mg 5,100 425 500
26 Asam Askorbat 500 mg 800 67
27 Asam Folat 1 mg 100 8
28 Asam Mefenamat 500 mg 9,200 767
29 Asam Traneksamat injeksi 50 mg/ml 0 0
30 Asam Tranexamat 500 mg 200 17
31 Asiklovir krim 5% 25 2
32 Asiklovir tablet 400 mg 0 0
33 Atropin Sulfat tablet 0,5 mg 0 0
34 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml 5 0
35 Attapulgit tab 650 mg 1,000 83 200
36 Azitromisin 500 mg 0 0
37 Azitromisin + Cefixim ( Kombipak ) 0 0
38 Benzatin Penisilin 2,4 UI/ml 0 0
39 Betahistin Mesilat tablet 6 mg 0 0
40 Betametason krim 0.1% 224 19 24
41 Bisakodil suppositoria 10 mg 0 0
42 Bisakodil suppositoria 5 mg 12 1
43 Deksametason Injeksi i.v 5 mg/ml - 1 ml 160 13
44 Deksametason tablet 0,5 mg 4,200 350
45 Diazepam Injeksi 5 mg/ml - 2 ml 10 1
46 Diazepam larutan rektal 10 mg/2,5 mL 12 1
47 Diazepam larutan rektal 5 mg/2,5 mL 8 1
48 Diazepam tablet 5 mg 0 0
49 Difenhidramin HCl inj 10 mg/ml-1 ml 145 12 10
50 Digoksin tablet 0,25 mg 0 0
51 Dimenhidrinat tablet 50 mg 0 0
52 Doksisiklin kapsul 100 mg 0 0
53 Domperidon Suspensi 70 6 10
54 Domperidon 10 mg 800 67
55 Epinefrin HCl/Bitartrat (Epinefrina/Adrenalina) Inj 20 2
56 Eritromicin kaplet 500 mg 0 0
57 Favifiravir 200 mg 0 0
58 Fenofibrat 300 mg 0 0
59 Fenitoin Sodium Injeksi 0 0
60 Fenitoina Natrium 100mg 0 0
61 Fenobarbital 30 mg 0 0
62 Fenobarbital Injeksi 50 mg/ml - 2 ml 0 0
63 Fenol Gliserol tetes telinga 10% 34 3
64 Fitomenadion (Vit.K1) 10 mg 600 50
65 Fitomenadion (Vit.K1) Injeksi 10 mg/ml - 1 ml 250 21 10
66 Fluimucil 200 mg ( Asetilsistein ) Granul 180 15
67 Furosemid Injeksi 0 0
68 Furosemid tablet 40 mg Tablet 100 8 100
69 Garam Oralit untuk 200 ml air 1,300 108 200
70 Gentamicin Cream 98 8 24
71 Gentamicin Injeksi 0 0
72 Gentian Violet larutan 1 % 66 6 5
73 Glibenklamid tablet 5 mg 1,800 150 300
74 Glimepirid 2 mg 300 25
75 Gliseril Guayakolat tablet 100 mg 1,800 150
76 Glukosa larutan infus 10 % steril 25 2
77 Glukosa larutan infus 40 % steril 2 0
78 Glukosa larutan infus 5 % steril 65 5
79 Haloperidol tablet 1,5 mg 1,400 117
80 Haloperidol tablet 5 mg 600 50
81 Haloperidol 50 mg/Ml Injeksi 5 0
82 Hidroklorotiazid (HCT) tablet 25 mg 0 0
83 Hidrokortison krim 2,5 % 169 14
84 Hiocine - N Butilbromide Tablet 10 mg 400 33
85 Ibupfropen 200 mg 200 17
86 Ibupfropen 400 mg 7,600 633 1000
87 Ibuprofen suspensi 200 mg/5 ml 55 5
88 Isoniazid tablet 100 mg 1,000 83
89 Isoniazid Cweb 0 0
90 Isosorbid Dinitrat tablet sublingual 5 mg 0 0
91 Kolkisin Tab 500 mg 0 0
92 Kalsium Gluconas Injeksi 0 0
93 Kalsium Laktat (Kalk) tablet 500 mg 0 0
kalsium karbonat 8,910 743
Kaptopril 12,5 mg 1,200 100
94 Kaptopril tablet 25 mg 6,000 500 1000
95 Karbamazepin tablet 200 mg 0 0
96 Ketamin Injeksi 0 0
97 Ketoconazol Cream 2 % 48 4
98 Ketoconazol 200 mg 1,000 83
99 Ketorolac injeksi 30 mg 110 9
100 Klindamisin 150 Mg 0 0
101 Klindamisin 300 Mg 0 0
102 Kloramfenikol Kapsul 250 mg 200 17
103 Kloramfenikol Kapsul 500 mg 0 0
104 Kloramfenikol Salep mata 1 % 142 12 24
105 Kloramfenikol Suspensi 125 mg/ 5 ml 10 1 10
106 Kloramfenikol Tetes Mata 0,5 % 75 6 10
107 Kloramfenikol Tetes Telinga 3 % 90 8 10
108 Klorfeniramin Maleat (CTM) tablet 4 mg 5,600 467 300
109 kloroquin 150 mg 0 0
110 Klorpromazin HCl Tablet Salut 25 mg 0 0
111 Klorpromazin HCl Tablet Salut 100 mg 0 0
112 Klorpromazin Injeksi 25 mg/ml 0 0
113 Kodein tablet 10 mg 0 0
114 Kolkisin ( Colcitine ) 0 0
115 Kombinasi Kaolin Pectin Sirup 0 0
116 Kombinasi (DHP): dihidroartemisin 40 mg + Piperakuin 2 0
117 320 mg tab: sal
Kombinasi selaput bromida 0,5 mg Salbutamol 2,5
Ipratropium 140 12
118 mg cairan inhalasi
Kombinasi: (Combivent)
ferro fumarat 60 mg + as. Folat 0,4 mg tablet 5000
53,000 4,417
119 salut gula (tablet
Kotrimoksazol tambahkombinasi:Sulfametoksazol
Suspensi darah) 200 10
130 11
120 mg + Trimetroprim 40 mg/5ml
Kotrimoksazol tablet kombonasi:Sulfametoksazol 400 800 67
121 mg + Trimetroprim
Kuinin tablet 222 mg 80 mg
10 1
122 Levofloksasin tablet 500 mg 0 0
123 Levotiroksin tablet/kapsul/kapsul 100 mcg 260 22 100
124 Lidokain injeksi 2% 482 40 60
125 Lidokain injeksi 2% (HCl) + Epinefrin 1: 80.000-2ml 80 7 10
126 Loperamid 2 mg Tablet 1,200 100 200
127 Loratadin 10 mg 3,300 275 600
128 Magnesium Sulfat inj (IV) 40% - 25 ml 17 1
129 MDT PB Child ( Kusta Biru ) 0 0
130 MDT MB Chlid ( Kusta Orange ) 0 0
131 MDT PB Adult ( Kusta Hijau ) 0 0
132 MDT MB Adult ( Kusta Merah ) 0 0
133 Meloksikam tablet 15 mg 0 0
134 Meloksikam tablet 7,5 mg 1,000 83 500
135 Metampiron (Antalgin) tablet 500 mg 800 67 500
136 Metformin HCl tablet 500 mg 3,400 283
137 Metilergometrin Maleat inj 0,200 mg-1 ml 6 1
138 Metilergometrin Maleat Tablet 700 58
139 Metilprednisolon tablet 4 mg 5,200 433 1000
140 Metoklorperamid tablet 10 mg 1,500 125 500
141 Metronidazol Infus 0 0
142 Metronidazol sirup 125 mg/5 ml 0 0
143 Metronidazol Tablet 250 mg 0 0
144 Metronidazol Tablet 500 mg 600 50
145 Multivitamin Drop 30 3 30
146 Multivitamin Tablet 3,200 267
147 Multivitamin Tablet ( Sivit-Zinc ) 510 43
148 Natrium Diclofenak 50 mg 800 67
149 Natrium Klorida larutan infus 0,9 % steril 800 67 100
150 Nifedipin Tablet 10 mg 0 0
151 Nistatin tablet vaginal 100.000 IU/g 10 1
152 Nystatin Drop 0 0
153 Obat Anti Tuberkolosis K 1 ( FDC ) 22 2 3
154 Kombipak TB 0 0
155 Obat Anti Tuberkolosis K Anak 0 0
156 Obat Batuk Hitam ( O.B.H. ) Syrup 0 0
157 Obat Batuk Anak Kombinasi ( IAFED ) sirup 10 1
158 Oksitetrasiklin HCl Salep Mata 1 % 125 10 25
159 Oksitetrasiklin HCl Salep Kulit 3 % 25 2
160 Oksitosin injeksi 10 IU/ml - 1 ml 315 26 30
161 Omeprazol kapsul 20 mg 1,750 146
162 Ondansetron Injeksi 2 mg/ ml (4 mg/ 2 ml) 110 9 10
163 Oseltamivir 75 mg 0 0
164 Paracetamol Supp 125 mg 66 6
165 Parasetamol Drop 100mg/ml 520 43 20
166 Parasetamol Sirup 120 mg/5 ml 730 61 100
167 Parasetamol tablet 500 mg 30,200 2,517 2000
168 Permetrin Krim 17 1
169 Piracetam 1 gram injeksi 0 0
170 Pirantel tablet 125 mg 0 0
171 Piridoksin HCl (Vit.B6) tablet 10 mg 1,200 100 400
172 Piroxicam tablet 20 mg 1,000 83
173 Povidon Iodida 10 % ( 30 ml ) 43 4 10
174 Povidon Iodida 10 % ( 300 ml ) 33 3 5
175 Povidon Iodida 10 % ( 1 liter ) 0 0
176 PPD (Purified Protein Derivative) 2 UT (Tes Mantoux) 12 1
177 Prednison tablet 5 mg 300 25
178 Primakuin tablet 15 mg 0 0
179 Propanolol HCl tablet 40 mg 100 8
180 Propiltiourasil tablet 100 mg ( PTU ) 0 0
181 Ranitidin 150 mg tablet 0 0
182 Ranitidin 25/ 2ml Injeksi 0 0
183 Remdesivir Injeksi 100 mg 0 0
184 Retinol ( vit A ) 100.000 IU 450 38 250
185 Retinol ( vit A ) 200.000 IU 2,800 233 1300
186 Ringer Laktat Larutan infus steril 1,280 107 140
187 Risperidon 2 mg 2,700 225
188 Salbutamol tab 2 mg 1,500 125 500
189 Salbutamol tab 4 mg 1,000 83
190 Salep 2-4 , Kombinasi: 79 7 24
191 Salisil Bedak 2% 150 13 12
192 Sefadroksil kapsul 500 mg 700 58
193 Sefadroksil sirup kering 125 mg / 5 ml 30 3 30
194 Serum Anti Bisa Ular Polivalen injeksi 5ml ( SABU ) 11 1 5
195 Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.) 0 0
196 Setirizin sirup 5 mg/5 ml 95 8
197 Setirizin tablet 10 mg 7,200 600
198 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml 0 0
199 Simetidin tablet 200 mg 500 42
200 Simvastatin tablet 20 mg 2,500 208 200
201 Siprofloksasin tablet 500 mg 600 50
202 Sukralfat Sirup 0 0
203 Streptomisin Injeksi 0 0
204 Skizonoat Injeksi 0 0
205 Tetrakain HCl tetes Mata 0,5% 0 0
206 Tetrasiklin HCl kapsul 250 mg 0 0
207 Tetrasiklin HCl kapsul 500 mg 0 0
208 Tiamin HCl (Vit.B1) injeksi 100 mg/ml-1 ml 0 0
209 Tiamin HCl / Mononitrat (Vit.B1) tablet 50 mg 1,600 133 200
210 Tramadol HCL 100mg/2ml Injeksi 0 0
211 Triheksifenidil Hidroklorida tablet 2 mg 0 0
212 Tyamphenicol 500 mg Kapsul 0 0
213 Thiamizol 0 0
214 Valproat Sir 0 0
215 Valproat 250 mg 0 0
216 Vitamin B Kompleks tablet 25,900 2,158 1000
217 Zinc tablet dispersible20 mg 2,700 225
III OBAT GIGI
01 Articulating Paper
02 Bonding
03 Calplus ( Denpro Calcigel )
04 Caviton ( Tumpatan Sementara )
05 Celluloid Strip
06 Cotton Roll
07 Cresotin Pasta
08 Dentin Conditioner
09 Etil Klorida spray
10 Etsa Asam
11 Eugenol cairan
12 Eviplac Solution ( Dislosing Solution )
13 Formokresol
14 H2 O2 3%
15 Hydcal ( Kalsium Hidroksida Pasta )
16 Iodoform pasta
17 Klorfenol kamfer Menthol ( CHKM )
18 Mummifying Pasta
19 Paper Pad
20 Paramono Clorofenol ( Parachlorofenol )
21 Pulp ( Devitalizer )
Semen Seng Fospat Serbuk + Cairan (Prevest
22
Denpro Zitemp Zeo)
23 Silver Amalgam Serbuk 65-75 %
24 Spon Gelatin
Tambalan GIC Restorative ART type IX Serbuk +
25
Cairan
Tambalan( Glass Ionomer
Resin / Micron
komposite Superior warna
gigi posterior ) A2
26
dan A3 (Master Fill A3)
Tambalan Resin komposite gigi posterior warna A2
27
dan A4 ( Master Flow A3 )
28 Technodent Antiseptic Liq No 2
29 Topical Anestesi Gel
30 Tricresol Formalin ( TKF )
31 Varnal
32 Varnish (Technodent Flor Lux Flouride Varnish)
33 Zinc Oxide ( Denpro Zinc F )
34 Devitalisasi pasta (devitex)

IV BAHAN LABORATORIUM
01 Auto Klik 0 0
02 Alkacid ( Steral ) 0 0
03 Alkazym ( Steryzim ) 0 0
04 Blood Lancet 26 G 5,500 458
05 Blood Lancet 28 G 2,300 192 500
06 Blue Tape ( MT II ) 1 0
07 Buffer PH 7,2 0 0
08 Box Slide 0 0
09 Cell Clean (CL-50) 1 0
10 Cell Pack (PK-30 L) 3 0
11 Cover Glass 22 X 22 0 0
12 Catridge TCM 0 0
13 Eight Ccheck (L,N,H) 0 0
14 Kapas Lidi 0 0
15 Kartu Golongan Darah 600 50 100
16 Kertas PH 0 0
17 Kertas Saring Whatman 0 0
18 KOH 10% 1x100mL 0 0
19 Kondom MRB 0 0
20 Larutan Drab Kins 0 0
21 Limitor 0,5 gr 1 kg 0 0
22 Methanol Absolut 0 0
23 Na Citrate 3,13% 1x100mL 0 0
24 Needle cnv 22X1.5 mltsmp ce 500 42
25 Oil Imercy 1 0
26 Pewarna Gram 3 x 100 ml 0 0
27 PCR tube 1,5 ml 0 0
28 Pot Sputum 1,300 108
29 Pot Urine 680 57
30 Rak Tabung 0 0
31 Rapid Tes Covid 19 100 8
32 Rapid Tes Spilis 250 21
33 RPR Antigen Sypilis 0 0
34 Reagen Benedic 0 0
35 Reagen EDTA ( 100 cc ) 0 0
36 Reagen Eosin 2% ( 100 cc ) 1 0
37 Reagen Giemsa Stain ( 100 cc ) 2 0
38 Reagen Glucose 2 0
39 Reagen Golongan Darah 2 0
40 Reagen HCL 0,1 N ( 100 cc ) 0 0
41 Reagen Kolesterol 2 0
42 Reagen Ress Ekker ( 100 CC ) 0 0
43 Reagen Trigliserida 0 0
44 Reagen Uric Acid 3 0
45 Reagen Widal 0 0
46 Safetybox 0 0
47 Slide ( Obyek Gelas ) 144 12
48 Slide Frosted 144 12
49 Spiritus 0 0
50 Stik Combur 10 Parameter 4 0
51 Stik Combur 3 Parameter 0 0
52 Stik DBD 25 2 25
stik DBD igG igM 165 14
Stik Hb Mission 760 63
53 Alat HB 0 0
54 Stik Chlolesterol 253 21 35
55 Alat Cek Chlolesterol 0 0
56 Stik Glukosa 40 3
57 Alat Cek Glukosa 0 0
58 Stik HBs Ag 400 33
59 Stik HIV 300 25
60 Stik Kehamilan 550 46 100
61 Stik Malaria 75 6
62 Stromstolyzer-WH 4 0.80
63 Tissue lensa / Kertas Lensa 0 0
64 Tube edta plh 13X75 3.0 blblce lav (Ungu) 800 160
65 Tube pln plh 13X75 4.0 plbl rd (Merah) 1,000 83 100
66 Tube Yellow 0 0
67 Vacum Pemegang ( Holder Standar Yellow ) 0 0
68 Yellow Tape ( MT I ) 1 0
69 Ziel Neelsen Stain 4 0
70 Stik Combur 11 parameter 5 0 1
feb mar apr mei juni juli agustus september oktober

100 100 100 200 100 200 325

20 20 100 50
100 200 300 200 300 200 300
100 100 100
400 100 200 400 200 400 200
1 2 1 1 1

1 2
6 5
100
24
24 24 24 24
24
24 24 24 24
2

5
3 10
10
5

20 10 20 20 10
300 500 200 200 300 100
300 500 200 200 300 350
200 400 500 200 200 200 100

100 100 100 50 50 100 100

 25 20 20 20 50
60 50 50 100 100 50 50
40 50 50 50 50 50 25 70
50 50 50
50
50 20 20 30

8 5 5 5

20 15 10 20 10
8 3 3 5 6 2
30 50
50 21 25 25
500 500 500 100 300 300 600 500
500 500
500 1000 400/1000 500 500 500 1000 500 700

5 25
5 25 10
3
10 20 50 30 20 30 10
10 13 10 20
5 10
7 10

50
10 4 20 4 12 10 10 6
400 400 200 200
10 2
2

36 36 36
6
5
2 5 20 10
5 4 4 2
20 10 20 30 30 20
 10 20 20

900 1200 900 600 600 660

2400 3300

5 3 8 5 7 2

500 200 40 500

500/300 1000 400

600 700 1000 300 500 600

1000 1600 2000 1400 2000 500 2000 1000 1800
50 10 100 100
10 16 10
500 800 1200 1500 500 500 1000 1500 1000

20 10 40 20 20 50 10
1

50
1000 500 500 500 500 500 700
300 500

1000 1200 1500 1000 1000 500 1000 800

100
10
 5
300 500

50 25 25 50 25

12
10 10 40 15 30 30
600 1000 1000
5 5
5 5 2
5 3

10 20 30 10 20 15

20 10 20 10
100 300 200
10

2 12 10
200 300 100
30 10 30 30 30 30 20
150 30

100 100 100 200 200

24 20

5 6 10 10 10
600 200

500 300
5 20
2
5 20 20 20
200 400 300 200
200 100
 5

25 24 24 24 24 24
200 200
200
1000 800 1200 500 1000 1500
20 10 10 10 5
100

2100 600 2400 600 450

500 300
500 500 300 700 700 700 500

12 12
500 100 200 100
20 30 30 10 10

100

10 24 24 20

20 10 10
20 20 10 20
500/500 500 1000 600 600 400 400

2
20 10 20 30 20
5000 5000 5000 5000 5600 5600 5600 5600
10 100 10
500 100
10

100 60
20 35 30 50 27 50 50 20 40
10 30
100 300 300
800 400 700 300
6 6

300 100
300
2000
2 2 2
500 200
1000 200 800 700 500 500 500
300 400 100

500

700 500 500 400 200

510
500 300
20 80 100 40 20 80 60 60

10

1 4 2 1 7

10
25 25 25
25
30 35 100 20
150 400 200
20 15 25 25 10 5

6 24
20 96 96 96 96 96
100 100 100 30 100 100 100
2000 2800 3000 3000 1000 2000 2000 3000 800
5 3 5

400 200
1000
5 5 10 5
5 2 10 5
 12
200 100

100

150 50
100 1200 100
120/100 40 200 100 80 100 80 120
200 400 500 500 300 200
500 500
200 300
5 20
24 12 24 12 24 12 12
500 100

3 1

20 20 20 20 15
500 500 600 1000 500 300 500 1000 800

500
700 600 600 200
300 100

300 500

1800 1300 2000 2000 2000 3000 3000

1000 200 300 200 200 200
 1

1000 600 500 500 1000 200

600 600 600

1
 1 1

300

100 100 100

100 100 50 50 400 200

20 60 60 120 60 120 60

100
50 50 50 50 50

1
1 1
1 1
1 1

1 1

1 1

72 72

1 1 1

10 10 30 30 30 10
10 250 200 200 100

10 15 50 45 30 20 30
 10

50 50 50 50
100 50 100
50 200 50 100
25 50
1 1 1 1

200 200 100 200

100 100 200 100

1
1 1 2
1 1 1 1
november desember

2019
2020
0 2021/2022 2021
10 2022
800
200
700
1
4
2
0
0
24
24
24
48
6

10
10
10
10
10

500
400
400

200
 10
200
100
50
50
70

12
4
25
25
1000
1000
400 bantuan

60

20
10
5
6

24
600
4 buffer
10

36

6
20
 600
100 program
0 program
0
0
0
500 2021/2022
0
0
100 program
0
1500
5800
0 2020/2021
40
2800

80

2019

400

100
1200

100
15
 25

25
1600

30

200
10

10

60 program tidak ada warna

400 program
30

20
700
300
1000

300 2019
300
 24

600

900

2760
400
1100

24
100
10

100 2018 bulan 3

40

25
10
1800 2021/2022

program
40
5600 program
0 buffer
200

100
30
300
 500
5

100

1400

200

100

900

240

4 program

25

100
1000

36

8600
4

200

8
6
 program tidak di tandai
100
420 2020/2021
600 program

500
30
18
100

1500

200
200

600

9800
600
 2019
2020
2021
2022

2019
1700 2020
2021
1 2022

dau tahun2022
 1

200

200
1

400 program
180

buffer worpower

2018
144

45 isi 30 dau dan isi 15 DAK

18
 30

200 PROGRAM TIDAK ADA WARNA

50
50
program

100
400
tahun2022