RENCANA KEBUTUHAN OBAT PKD TAHUN 2022

KABUPATEN KERINCI
OBAT NON FORNAS
HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

1 Acyclovir krim tube 5 g Tube 4,414 525 2523 210 3,780 3,255 5,000 22,070,000
2 Ambroxol syrup 15 mg botol 7,350 - 9520 793 14,274 14,274 15,000 110,250,000
3 Ambroxol tablet 30 mg Tablet 317 19,800 89687 7474 134,532 114,732 150,000 47,550,000
4 Asam Klorida 0,1 N Botol - 3 0 - - 10 -
5 Asam Sulfosalisilat Botol - 0 0 - - 10 -
6 Asam Traneksamat 500 mg Tablet - 10721 893 16,074 16,074 50,000 -
7 betahistin Tablet - 20800 1733 31,194 31,194 50,000 -
8 bioplacenton tube - 237 20 360 360 500 -
9 bromhexin tablet Tablet - 1333 111 1,998 1,998 50,000 -
10 Cefixime kapsul 100 mg Kapsul 3,058 - 35400 2950 53,100 53,100 100,000 305,800,000
11 Cefixime sirup kering 100 mg/5 ml Botol 9,355 900 - (900) 500 4,677,500
12 celecoxib Tablet - 0 0 - - 50,000 -
13 cendo xitrol ampul - 17 1 18 18 50 -
14 Dextrofen syrup botol 15,437 1,000 5133 428 7,704 6,704 5,000 77,185,000
15 Digoksin 0,25 mg Tablet 104 3,200 - (3,200) 5,000 520,000
16 Etakridina Laktat Lar. (Rivanol) Botol 5,278 417 224 19 342 (75) 100 527,800
17 Fenol Gliserol Tetes Telinga 10 % Botol 3,300 - - - 500 1,650,000
18 gentamisin salp kulit Tube - - - 500 -
19 gentamisin salp mata Tube - 100 8 144 144 500 -
20 Gliseril Guayakolat 100 mg Tablet 23 200,000 222080 18507 333,126 133,126 150,000 3,450,000
21 Hepagard Tablet Tablet 4,150 4,460 - (4,460) 5,000 20,750,000
22 Hyocine-N-Butilbromide tablet 10 mg tablet 1,050 - 34787 2899 52,182 52,182 50,000 52,500,000
23 ichtiol salp pot - 97 8 144 144 150 -
24 ketorolac inj ampul - 5931 494 8,892 8,892 5,000 -
25 Klobazam 10 mg Tablet 384 7,500 - (7,500) 5,000 1,920,000
26 Klozapin 25 mg Tablet 473 2,950 12253 1021 18,378 15,428 5,000 2,365,000
27 lacto B Sachet - - - 5,000 -
28 Lansoprazol kapsul 30 mg kapsul 473 - 34933 2911 52,398 52,398 50,000 23,650,000
29 Lisol Botol 164,488 - 37 3 54 54 50 8,224,400
30 Loperamide 2 mg Tablet 82 - 25067 2089 37,602 37,602 40,000 3,280,000
31 Metilprednisolon 4 mg tablet 146 245,200 62040 5170 93,060 (152,140) -
32 Mineral Mix Sachet 2,920 - 67 6 108 108 -
 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

33 Minyak emersi Botol - 0 0 - - -

34 Multivitamin lansia ( Geriavita Tab ) Tablet 969 22,840 19960 1663 29,934 7,094 5,000 4,845,000
35 Neurobion tablet tablet 3,000 20,000 60,000,000
36 neurobion inj ampul - - - 5,000 -
37 Oksitetrasiklin Salap kulit 3 % Tube - 613 51 918 918 1,000 -
38 ondansentron inj ampul - 6311 526 9,468 9,468 5,000 -
39 paracetamol suppos tube - 40 3 54 54 100 -
40 Propil thio urasil ( PTU ) Tablet 123 15,000 105200 8767 157,806 142,806 200,000 24,600,000
41 Propranolol 40 mg Tablet 80 17,500 5800 483 8,694 (8,806) 30,000 2,400,000
42 Piroxicam 20 mg Tablet 30,000
43 Ranitidin injeksi 25 mg/5 ml ampul 858 350 6470 539 9,702 9,352 10,000 8,580,000
44 Risperidon 2 mg Tablet 405 - 49668 4139 74,502 74,502 100,000 40,500,000
45 Sefotaksim injeksi 1 gr vial 6,322 - 3769 314 5,652 5,652 1,000 6,322,000
46 Skizonoate Inj Ampul 63,813 - 105 9 162 162 150 9,571,950
47 Stesolid-Diazepam larutan rektal 10 mg/2.5 ml Tube 19,193 320 53 4 72 (248) 30 575,790
48 Stesolid-Diazepam larutan rektal 5 mg/2.5 ml Tube 13,202 165 90 8 144 (21) 30 396,060
49 sukralfat syrup botol - 800 67 1,206 1,206 2,000 -
50 Tetrakain Tetes Mata 0,5 % Botol - 0 0 - - 1,000 -
51 Thiamin HCl injeksi 100mg /ml-1ml Ampul 1,536 510 725 60 1,080 570 1,000 1,536,000
52 Triheksifenidil 2 mg Tablet 63 782,500 224440 18703 336,654 (445,846) -
53 truvit syrup botol - 669 56 1,008 1,008 1,000 -

JUMLAH 845,696,500
BAHAN MEDIS HABIS PAKAI

1 Alat Suntik Sekali Pakai 1 ml Set 880 9,100 8053 671 12,080 2,980 2,000 1,760,000
2 Alat Suntik Sekali Pakai 3 ml Set 1,021 46,400 19943 1662 29,915 (16,486) 15,000 15,315,000
3 Alat Suntik Sekali Pakai 5 ml Set 943 7,000 8559 713 12,839 5,839 5,000 4,715,000
4 Alat Suntik Sekali Pakai 10 ml Set 1,143 4,400 1933 161 2,900 (1,501) 500 571,500
5 Antiseptic Gel Botol 30,475 360 33 3 50 (311) 300 9,142,500
6 Asculap Blades B Bround (pisau bedah) #10 pcs 3,000 1076 90 1,614 1,614 1,500 4,500,000
7 Asculap Blades B Bround (pisau bedah) #11 pcs 3,000 1077 90 1,616 1,616 1,500 4,500,000
8 Aximed churgic gloves 6,5 pcs 5,100 9113 759 13,670 13,670 15,000 76,500,000
9 Aximed churgic gloves 7,0 pcs 7,600 10447 871 15,671 15,671 10,000 76,000,000
 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

10 Aximed churgic gloves 7,5 pcs 7,600 0 0 - - -

11 Blood Administration Set With Airvent pcs 14,042 1,413 781 65 1,172 (242) -
12 Catgut No. 2/0 dengan jarum bedah Sachet 34,363 564 2074 173 3,111 2,547 2,500 85,907,500
13 Catgut No. 3/0 dengan jarum bedah Sachet 32,800 2121 177 3,182 3,182 3,000 98,400,000
14 Ecolab aquagel sterile jelly 82gr tube 42,588 246 21 369 369 400 17,035,200
15 Foley Catheter 14 fr pcs 18,450 110 9 165 165 150 2,767,500
16 Foley Catheter 16 fr pcs 18,450 170 14 255 255 250 4,612,500
17 Foley Catheter 18 fr pcs 18450 85 162 14 243 158 150 2,767,500
18 Handscoon size L pcs 890 1,200 0 0 - (1,200) -
19 Handscoon size M pcs 890 14,900 37400 3117 56,100 41,200 40,000 35,600,000
20 Handscoon size S pcs 890 7,900 26540 2212 39,810 31,910 30,000 26,700,000
21 Infusion Set Anak pcs 5,100 2,900 1239 103 1,859 (1,042) -
22 Infusion Set Dewasa pcs 7,409 1,800 4876 406 7,314 5,514 7,000 51,863,000
23 Iodium test Botol 293,738 0 0 - - -
24 IV Catheter No.18 G pcs 6,336 89 4464 372 6,696 6,607 7,000 44,352,000
25 IV Catheter No.20 G pcs 9,060 4163 347 6,245 6,245 6,500 58,890,000
26 IV Catheter No.22 G pcs 6,314 7,278 4475 373 6,713 (566) 1,000 6,314,000
27 IV Catheter No.24 G pcs 6,314 635 5661 472 8,492 7,857 5,000 31,570,000
28 Kapas Pembalut / Absorben 250 gram Rol 28,530 900 403 34 605 (296) -
29 kasas Hidropil 3 yard x 10 cm Rol 63,500 869 72 1,304 1,304 300 19,050,000
30 Kassa Hidropil steril uk. 16x16 (isi 16 lembar ) kotak 8,800 3,040 6001 500 9,002 5,962 6,000 52,800,000
31 Kassa Pembalut Elastis 10 x 4,55 cm Rol 43,987 89 7 134 134 130 5,718,310
32 Kassa Pembalut Elastis 10 x 4,55 cm(terentang) Rol 33,000 12 51 4 77 65 65 2,145,000
33 Kassa Pembalut Elastis 15 x 4,55cm Rol 54,139 25 37 3 56 31 30 1,624,170
34 Kassa Pembalut Elastis 15 x 4,55cm(terentang) Rol 41910 41 62 5 93 52 30 1,257,300
35 Kassa Pembalut Hidropil 4 x 10 cm Rol 607 340 28 510 510 500 303,500
36 Kassa Pembalut Hidropil 4 x 5 cm Rol 0 0 0 - - -
37 Kassa Pembalut Hidropil 40Y x 80 cm Rol 149,987 224 165 14 248 24 25 3,749,675
38 Masker pcs 647 17,650 54421 4535 81,632 63,982 60,000 38,820,000
39 Masker Karet pcs 19,800 0 0 - - -
40 Masker N95 pcs 153,000 208 0 0 - (208) -
41 Masker Oksigen anak pcs 13,552 86 57 5 86 (1) -
42 Masker Oksigen Bayi pcs 14,520 92 47 4 71 (22) -
43 Masker Oksigen Dewasa pcs 13,552 16 50 4 75 59 -
44 Odex Botol 98,900 84 247 21 371 287 200 19,780,000
45 Paper Tape 2,5 x 9,14 M Rol 12,742 281 252 21 378 97 100 1,274,200
 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

46 Plester 5 yard x 2 inch Rol 17,685 36 301 25 452 416 450 7,958,250
47 Plester 5 cm x 10 cm Rol 49,244 687 4 0 6 (681) -
48 Plester 15 cm x 5 m Rol 108,167 197 123 10 185 (13) -
49 Plester 20 cm x 5 m Rol 129,825 159 13 239 239 100 12,982,500
50 Plester 5 cm x 5 m Rol 42,252 407 180 15 270 (137) -
51 Poli Aid 1 Ltr LA (Antiseptik Pembersih) Botol 147,640 33 157 13 236 203 150 22,146,000
52 Policlean Handrub Botol 86,733 35 837 70 1,256 1,221 300 26,019,900
53 Sarung Tangan Obgyn pasang 20,900 200 33 3 50 (151) -
54 Selang Oksigen Anak pcs 7,200 100 13 1 20 (81) 100 720,000
55 Selang Oksigen Bayi pcs 7,200 100 13 1 20 (81) 100 720,000
56 Selang Oksigen Dewasa pcs 7,200 80 33 3 50 (31) 100 720,000
57 Silk dengan jarum bedah 2/0 HR Sachet 21,125 352 2023 169 3,035 2,683 2,500 52,812,500
58 Silk dengan jarum bedah 3/0 HR Sachet 20,525 384 2162 180 3,243 2,859 2,500 51,312,500
59 Test Glucose strips kotak 255,300 146 303 25 455 309 200 51,060,000
60 Test Total Cholesterol strips kotak 547,400 160 209 17 314 154 150 82,110,000
61 Test Uric Acid strips kotak 553,800 160 217 18 326 166 170 94,146,000
62 Urine Bag pcs 4,215 340 198 17 297 (43) -
63 Lancet pcs 100
64 Daryantul pcs 100

JUMLAH 1,209,013,005

Siulak, Februari 2021

 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

KEPALA INSTALASI FARMASI

DINAS KESEHATAN KABUPATEN KERINCI

ZETRA NOPAL, SKM

NIP. 19850305 200902 1 005
 RENCANA KEBUTUHAN OBAT PKD TAHUN 2022
KABUPATEN KERINCI
FORNAS
HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

1 Albendazol 400 mg Tablet 422 26327 2194 39,491 39,491 10,000 4,220,000
2 Albendazol susp 200 mg/5ml Botol 4,300 1627 136 2,441 2,441 -
3 Alopurinol 100 mg Tablet 87 52,400 114693 9558 172,040 119,640 120,000 10,440,000
4 Alopurinol 300 mg Tablet 200 19427 1619 29,141 29,141 50,000 10,000,000
5 Aminopilin 200 mg Tablet 96 45,500 41323 3444 61,985 16,485 20,000 1,920,000
6 Aminopilin Injeksi 24 mg /ml-10ml Ampul 2,789 570 781 65 1,172 602 500 1,394,500
7 Amitriptilin 25 mg Tablet 168 33,000 43855 3655 65,783 32,783 30,000 5,040,000
8 Amlodipin tablet 5 mg Tablet 53 112,800 282753 23563 424,130 311,330 320,000 16,960,000
9 Amoksisilin Dry Syrup 125mg/5ml Botol 2,050 24,700 9553 796 14,330 (10,371) 5,000 10,250,000
10 Amoksisilin sirup kering forte 250 mg/5 ml Botol 3,510 8329 694 12,494 12,494 5,000 17,550,000
11 Amoksisilin 250 mg Kapsul 194 48,700 64726 5394 97,089 48,389 50,000 9,700,000
12 Amoksisilin 500 mg Kaplet 211 785,300 386893 32241 580,340 (204,961) 300,000 63,300,000
13 Ampisilina inj 1000 mg/ml Vial 23 2 35 35 -
14 Antasida DOEN Tablet 54 84,000 313871 26156 470,807 386,807 400,000 21,600,000
15 Antasida Doen Suspensi Botol 1,725 5,250 20547 1712 30,821 25,571 20,000 34,500,000
16 Anti Bakteri DOEN salap Tube 3,017 4771 398 7,157 7,157 5,000 15,085,000
17 Anti Haemoroid suppos Suppos 3,250 600 3237 270 4,856 4,256 3,000 9,750,000
18 Anti Fungi DOEN salap Pot 3,573 216 3581 298 5,372 5,156 5,000 17,865,000
19 Anti Migrain (ergotamin+cafein) Tablet 194 48,900 7933 661 11,900 (37,001) -
Anti Asma,Kombinasi:Ipratropium Bromida
20 Ampul 4,550 327 27 491 491 200 910,000
Inhalsi 0,5 mg+salbutamol 2,5 mg
21 Aqua Pro Injeksi steril Vial 5,852 2,186 2073 173 3,110 924 1,000 5,852,000
22 Asam Folat tab 1 mg Tablet 43 5867 489 8,801 8,801 10,000 430,000
23 Asam Folat tab 0,4 mg Tablet 58 96267 8022 144,401 144,401 100,000 5,800,000
24 Asam Mefenamat 500 mg Tablet 111 180,100 224140 18678 336,210 156,110 30,000 3,330,000
25 Vitamin C 50 mg Tablet 43 284,200 303715 25310 455,573 171,373 200,000 8,600,000
26 Acetosal 100 mg Tablet 135 333 28 500 500 -
27 Acetosal 80 mg Tablet 89 14,400 7600 633 11,400 (3,000) 5,000 445,000
28 Acyclovir tab 200 mg Tablet 236 12,000 31471 2623 47,207 35,207 30,000 7,080,000
 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

29 Acyclovir tab 400 mg Tablet 426 16,100 31940 2662 47,910 31,810 40,000 17,040,000
30 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 1,694 4,050 433 36 650 (3,401) 500 847,000
31 Atropin Sulfat 0,5 mg Tablet 77 480 40 720 720 10,000 770,000
32 Atapulgit tab 600 mg(Pularex) Tablet 171 69253 5771 103,880 103,880 100,000 17,100,000
33 Betametason Cream Tube 1,540 7133 594 10,700 10,700 10,000 15,400,000
34 Bisacodil 10 mg Suppos 5,900 300 1614 135 2,421 2,121 2,000 11,800,000
35 Cetirizine 10 mg tablet Tablet 50 189,800 78733 6561 118,100 (71,701) -
36 Cetirizine 5 mg/5 ml sirup Botol 2,973 19,200 7479 623 11,219 (7,982) 2,500 7,432,500
37 Depakene-Valproat sirup 250mg/5 ml Botol 16,789 210 105 9 158 (53) 300 5,036,700
38 Deksametason Injeksi 5 mg / ml-1ml Ampul 968 4513 376 6,770 6,770 7,000 6,776,000
39 Deksametason 0,5 mg Tablet 35 53,700 249016 20751 373,524 319,824 300,000 10,500,000
40 Diazepam injeksi 5 mg/ml-2ml Ampul 1,545 5,130 633 53 950 (4,181) -
41 Diazepam 5 mg Tablet 114 91,500 26000 2167 39,000 (52,500) -
42 Diazepam 2 mg Tablet 86 68,100 45909 3826 68,864 764 20,000 1,720,000
43 Diphenhidramin Injeksi 10 mg/ml-1ml Ampul 1,152 2,000 1702 142 2,553 553 500 576,000
44 Domperidon tablet 10 mg Tablet 73 117,300 42879 3573 64,319 (52,982) -
45 Domperidon Suspensi 5 mg/5 ml btl 60 ml 2,359 1,350 3539 295 5,309 3,959 2,000 4,718,000
46 Efinefrin Injeksi Ampul 1,590 1056 88 1,584 1,584 1,000 1,590,000
47 Eritromosin kaplet 500 mg Kaplet 785 46,100 20071 1673 30,107 (15,994) 10,000 7,850,000
48 Eritromosin kaplet 250 mg Kaplet 576 12,200 5907 492 8,861 (3,340) 10,000 5,760,000
49 Eritromosin sirup 200 mg/ml botol 25,500 272 595 50 893 621 300 7,650,000
50 Etanol 70 % 1000 ml Botol 78,854 264 484 40 726 462 500 39,427,000
51 Etanol 70 % cairan 100 ml Botol 10,740 474 40 711 711 -
52 Fenitoin Natrium 30 mg Kapsul 19 2 29 29 10,000 -
53 Fenobarbital Injeksi 50 mg/ml-2ml Ampul 2,081 4,590 221 18 332 (4,259) -
54 Fenobarbital 100 mg Tablet 1067 89 1,601 1,601 -
55 Fenobarbital 30 mg Tablet 180 194,700 17467 1456 26,201 (168,500) -
56 Fitomenadion Injeksi 10 mg/ml-1ml Ampul 3,867 1,000 2619 218 3,929 2,929 5,000 19,335,000
57 Fitomenadion 10 mg Tablet 797 32,100 30560 2547 45,840 13,740 10,000 7,970,000
58 Furosemida 40 mg Tablet 77 800 20187 1682 30,281 29,481 50,000 3,850,000
59 Garam Oralit 200 ml Sach 280 28636 2386 42,954 42,954 30,000 8,400,000
60 Glibenklamid 5 mg Tablet 86 4,200 36227 3019 54,341 50,141 100,000 8,600,000
61 Gliserin Botol 3,650 439 37 659 659 1,000 3,650,000
 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

62 Glukosa Lar. 10 % Infus Botol 7,200 100 1179 98 1,769 1,669 1,500 10,800,000
63 Glukosa Lar. 5 % Infus Botol 6,627 120 1735 145 2,603 2,483 2,000 13,254,000
64 Griseofulfin 125 mg Tablet 232 16,900 15187 1266 22,781 5,881 10,000 2,320,000
65 Griseofulfin 500 mg Tablet 892 10800 900 16,200 16,200 10,000 8,920,000
66 Haloperidol 0,5 mg Tablet 55 109,700 50701 4225 76,052 (33,649) -
67 Haloperidol 1,5 mg Tablet 59 92,900 52803 4400 79,205 (13,696) 10,000 590,000
68 Haloperidol 5 mg Tablet 60 78,300 61923 5160 92,885 14,585 20,000 1,200,000
69 Haloperidol inj.i.m 5 mg/5 ml Ampul 101,300 60 105 9 158 98 200 20,260,000
70 Hidroklorotiazid 25 mg( HCT ) Tablet 148 4933 411 7,400 7,400 20,000 2,960,000
71 Hidrogen Peroksida 3 % Botol 299,613 100 8 150 150 21 6,291,873
72 Hidrokortison Cream Tube 2,750 3,192 5639 470 8,459 5,267 6,000 16,500,000
73 Ibuprofen 200 mg Tablet 252 18,500 107727 8977 161,591 143,091 150,000 37,800,000
74 Ibuprofen 400 mg Tablet 130 141800 11817 212,700 212,700 100,000 13,000,000
75 Ibuprofen Susp 100mg/5 ml Botol 2,776 3,950 3136 261 4,704 754 1,000 2,776,000
76 Isoniazide 300 mg Tablet 667 56 1,001 1,001 -
77 Isosorbit Dinitrat Tablet 88 6300 525 9,450 9,450 30,000 2,640,000

78 Ipratropium Bromida Aerosol 20 mcg/semprot Dus 86,600 368 243 20 365 (4) 50 4,330,000

79 Kalsium Laktat Tablet 60 25,900 189880 15823 284,820 258,920 200,000 12,000,000
80 Kaptopril tablet 12.5 mg Tablet 64 153,100 98001 8167 147,002 (6,099) -
81 Kaptopril tablet 25 mg Tablet 77 62060 5172 93,090 93,090 50,000 3,850,000
82 Karbamazepin 200 mg tab Tablet 198 44,400 9000 750 13,500 (30,900) -
83 Ketokenazol 200 mg Tablet 260 45,900 35167 2931 52,751 6,851 10,000 2,600,000
84 Klindamisin kapsul 300 mg kapsul 522 18800 1567 28,200 28,200 30,000 15,660,000
85 Kloramfenikol 250 mg Kapsul 14700 1225 22,050 22,050 20,000 -
86 Kloramfenikol Salap Mata 1 % Tube 2,007 144 2525 210 3,788 3,644 3,500 7,024,500
87 Kloramfenikol Tetes Mata 0,5 % Botol 3091 258 4,637 4,637 5,000 -
88 Kloramfenikol Tetes Telinga 3 % Botol 12,028 800 2625 219 3,938 3,138 3,000 36,084,000
89 Kloramfenikol suspensi 125 mg/5 ml botol 4,841 965 80 1,448 1,448 500 2,420,500
90 Klorfeniramin Maleat ( CTM ) Tablet 24 464,100 400830 33403 601,245 137,145 150,000 3,600,000
91 Klorfromazin HCl 100 mg Tablet 414 31,100 66027 5502 99,041 67,941 150,000 62,100,000
92 Kodein HCl 10 mg Tablet 600 43,300 7733 644 11,600 (31,701) -
93 Kotrimoksazol 480 mg Tablet 133 193,500 65867 5489 98,801 (94,700) -
94 Kotrimoksazol forte 960 mg Tablet 319 191,000 39293 3274 58,940 (132,061) -
 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

95 Kotrimoksazol Suspensi Botol 2,190 12,030 7105 592 10,658 (1,373) -

96 Laktulosa sirup 3,335g/5ml Botol 15,060 1303 109 1,955 1,955 1,500 22,590,000
97 Lidokain Kombinasi epinefrin. Injeksi Ampul 1,205 3,600 7187 599 10,781 7,181 7,000 8,435,000
98 Loratadin tab Tablet 133 52,050 39720 3310 59,580 7,530 20,000 2,660,000
99 Magnesium sulfat injeksi 20% 5-25 ml Ampul 3,760 44 231 19 347 303 200 752,000
100 Magnesium sulfat injeksi 40 % Ampul 4,290 110 229 19 344 234 200 858,000
101 Metformin 500 mg tablet Tablet 159 75,600 67233 5603 100,850 25,250 100,000 15,900,000
102 Metil Ergometrin 0,125 mg Tablet 214 45,290 13293 1108 19,940 (25,351) -
103 Metil Ergometrin Injeksi Ampul 1,023 300 1717 143 2,576 2,276 2,000 2,046,000
104 Metoklopramid 10 mg tablet 66 37299 3108 55,949 55,949 20,000 1,320,000
105 Metoklopramid 5 mg tablet 108 3067 256 4,601 4,601 -
106 Metoklopramid inj 5 mg/ml Ampul 10,247 4520 377 6,780 6,780 2,000 20,494,000
107 Metronidazol 500 mg Tablet 289 17,700 56800 4733 85,200 67,500 50,000 14,450,000
108 Metronidazol sirup 125mg/5ml Botol 3,950 1,650 1351 113 2,027 377 500 1,975,000
109 Mikonazol krim/salep 2% (Nitrat) tube 1,900 2,424 4327 361 6,491 4,067 4,000 7,600,000
110 N-asetilsistein 200 mg kapsul 307 182,820 218427 18202 327,641 144,821 50,000 15,350,000
111 Natrium Bikarbonat Tablet 24 175,700 26033 2169 39,050 (136,651) -
112 Natrium Diklofenak tablet 50 mg Tablet 108 264967 22081 397,451 397,451 200,000 21,600,000
113 Natrium Klorida 0,9% Infus Botol 6,410 7,318 2327 194 3,491 (3,828) -
114 Nystatin Tablet Vagina Tablet 630 10,400 5307 442 7,961 (2,440) 2,500 1,575,000
115 Oksitetrasiklin Salap Mata 1 % Tube 3,500 1,725 3344 279 5,016 3,291 3,000 10,500,000
116 Oksitosin Injeksi Ampul 1,126 1,000 3296 275 4,944 3,944 2,000 2,252,000
117 Omeprazol kapsul 20 mg Kapsul 129 3,510 139633 11636 209,450 205,940 200,000 25,800,000
118 Parasetamol Syrup Botol 1,160 29,800 30966 2581 46,449 16,649 10,000 11,600,000
119 Parasetamol 500 mg Tablet 275 438,100 650617 54218 975,926 537,826 500,000 137,500,000
120 Parasetamol drops 100 mg/ml Botol 5,113 5,000 3626 302 5,439 439 2,000 10,226,000
121 Pirantel Tablet score(base) 125 mg Tablet 302 12,300 4088 341 6,132 (6,168) -
122 Pirantel pamoat susp 125 mg/5 ml Botol 10,100 881 73 1,322 1,322 -
123 Piridoksin ( Vit. B 6 ) Tablet 71 145,800 219553 18296 329,330 183,530 200,000 14,200,000
124 Prednison Tablet 77 210,000 243133 20261 364,700 154,700 150,000 11,550,000
125 Propanolol 10 mg Tablet 61 89,400 62960 5247 94,440 5,040 20,000 1,220,000
126 Ranitidin 150 mg Tablet 85 320233 26686 480,350 480,350 500,000 42,500,000
127 Ringer Laktat lar. infus Botol 7,703 340 18011 1501 27,017 26,677 - -
 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

128 Salap 2-4 kombinasi Pot 1,449 1,320 3142 262 4,713 3,393 3,500 5,071,500
129 Salbutamol tab 4 mg Tablet 65 180 30533 2544 45,800 45,620 50,000 3,250,000
130 Salbutamol tab 2 mg Tablet 67 23,800 19467 1622 29,201 5,401 -
131 Salbutamol Sir 2 mg/5ml botol 4,446 1,400 413 34 620 (781) -
132 Salisil bedak Kotak 7,349 500 3108 259 4,662 4,162 4,000 29,396,000
133 Sefadroksil kaplet 500 mg Tablet 388 36160 3013 54,240 54,240 50,000 19,400,000
134 Sefadroksil sirup kering 125mg/ml Botol 3,914 1,000 1754 146 2,631 1,631 1,000 3,914,000
135 Sefadroksil sirup kering 250mg/ml Botol 5,660 1140 95 1,710 1,710 2,000 11,320,000
136 Serum Anti Bisa ular Polivalen 5 ml Vial 517,132 27 85 7 128 101 20 10,342,640
137 Serum Anti Tetanus 1.500 UI Ampul 130,999 266 363 30 545 279 150 19,649,850
138 Serum Anti Tetanus 20.000 UI Vial 16 1 24 24 25 -
139 Sianokabalamin Injeksi 500 Mcg/ml Ampul 1,136 1,650 2615 218 3,923 2,273 2,000 2,272,000
140 Simvastatin scored tablet 10 mg tablet 68 2,050 44384 3699 66,576 64,526 100,000 6,800,000
141 Siprofloksasin 500 mg Tablet 250 131480 10957 197,220 197,220 200,000 50,000,000
142 Spironolakton tablet 25 mg Tablet 208 49,800 3467 289 5,201 (44,600) -
143 Spironolakton tablet 100 mg Tablet 539 2133 178 3,200 3,200 10,000 5,390,000
144 Thiamin HCl 50 mg ( Vit. B 1 ) Tube 59 8,100 183931 15328 275,897 267,797 300,000 17,700,000
145 Vaksin Rabies Vero Tube 165,000 559 35 3 53 (507) 100 16,500,000
146 Vit. A 100.000 IU Kotak 302 2010 168 3,015 3,015 -
147 Vit. A 200.000 IU Botol 543 10,899 4943 412 7,415 (3,485) -
148 Vitamin B komplex Kapsul 123 216,200 233822 19485 350,733 134,533 250,000 30,750,000
149 Yodium Povidon 10 % - 30 ml Kapsul 13,380 2264 189 3,396 3,396 1,000 13,380,000
150 Yodium Povidon 10 % - 60 ml Tablet 8,395 1,336 145068 12089 217,602 216,266 500 4,197,500
151 Yodium Povidon 10 % - 300 ml Botol 100,740 353 29 530 530 100 10,074,000
152 Zinc tablet 20 mg Botol 253 28,800 44573 3714 66,860 38,060 100,000 25,300,000
153 Zinc drop 10 mg/ml Botol 48,823 200 1207 101 1,811 1,611 1,000 48,823,000
154 Zinc sirup Tablet 2,489 830 18217 1518 27,326 26,496 5,000 12,445,000
155 Zinc sir 10 mg/5ml Botol 1227 102 1,841 1,841 -
-
-
-
-
-
 HARGA Sisa Stok Total Pemakaian USULAN USULAN
NO NAMA OBAT SATUAN SATUAN IFK Pemakaian Rata-rata KEBUTUHAN Kecukupan KEBUTUHAN TOTAL Rp
(HNA + PPN)* per 01 Jan 21 *) tahun 2020 per Bulan AWAL Th.2022
1 2 3 4 5 6=5/12bln 7=6x18bln 8=7-4 9 15

0 0 - - -
0 0 - - -
0 0 - - -
0 0 - - -
OBAT GIGI
Air Raksa Dental Use
1 Botol 0 0 - - -
2 Devitalisasi pasta (non Arsen) Botol 820,600 44 29 2 44 (1) 5 4,103,000
3 Etil klorida Semprot Tabung 380,600 41 214 18 321 280 100 38,060,000
4 Eugenol Cairan Botol 20,150 40 81 7 122 82 30 604,500
5 Kalsium Hidroksida Pasta kotak 647,900 44 27 2 41 (4) 5 3,239,500
6 Klorfenol kamfer Menthol ( CHKM ) botol 216,700 61 27 2 41 (21) 5 1,083,500
0 0 - -
JUMLAH 1,582,819,563

Siulak, Februari 2021

KEPALA INSTALASI FARMASI

DINAS KESEHATAN KABUPATEN KERINCI

ZETRA NOPAL, SKM

NIP. 19850305 200902 1 005