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

SISA STOK PER 31 RENCANA HARGA JUMLAH ALASAN

NO NAMA OBAT SATUAN PENGADAAN SATUAN HARGA
DESEMBER 2022 TAHUN 2023 (Rp) (Rp) PENGADAAN

1 Air untuk injeksi amp 20 ml ampul/vial/botol 0 200 0 0

Air untuk injeksi amp 25 ml 0 500 2860 1430000
2 ampul/vial/botol 25 mL

3 Albendazol susp 200 mg/5 ml Botol 0 - 5000 0

Albendazol tab 400 mg 73 2,000 539 1078000
4 tablet/kapsul/kaplet

5 Alopurinol tab 100 mg Tab 695 20,000 108 2160000

Alopurinol tab 300 mg 0 10,000 352 3520000
6 tablet/kapsul/kaplet

7 Aminofilin inj 24 mg/ml ampul/vial 10 ml 0 500 4186 2093000

Aminofilin tab 150 mg 0 1,000 0 0
8 tablet/kapsul/kaplet
Aminofilin Tab 200 mg 0 - 130 0
9 tablet/kapsul/kaplet
Amitriptilin tab sal 25 mg 0 5,000 168 840000
10 tablet/kapsul/kaplet
Amlodipin tab 10 mg 0 50,000 99 4950000
11 tablet/kapsul/kaplet
Amlodipin tab 5 mg 695 30,000 83 2490000
12 tablet/kapsul/kaplet

13 Amoksisilin drops 100 mg/ml Botol 0 500 11777 5888500

14 Amoksisilin sir forte 250 mg/5 ml botol 60 ml 0 200 3615 723000
15 Amoksisilin sir kering 125 mg/5 ml Botol 5 1,000 1974 1974000
Amoksisilin tab 250 mg 0 - 212 0
16 tablet/kapsul/kaplet
Amoksisilin tab 500 mg 1850 30,000 251 7530000
17 tablet/kapsul/kaplet

18 Ampisilin serb inj 1000 mg/vial ampul/vial 0 100 10296 1029600

19 Ampisilin serb inj 250 mg/vial Vial 0 - 0 0
Anestetik lokal gigi kombinasi : lidokain hcl 2% + 0 500 924 462000
20 epinefrin 1 : 80.000 inj 2 ml ampul/vial
Antasida, kombinasi : aluminium hidroksida 200 1210 50,000 55 2750000
21 mg + magnesium hidroksida 200 mg tablet/kapsul/kaplet

Antasida, kombinasi : aluminium hidroksida 200 0 1,000 2408 2408000

22 mg + magnesium hidroksida 200 mg botol 60 ml

Anti Parkinson kombinasi : benzerasid 25 mg + 0 - 930 0

23 levodopa 100 mg Kaps
Antifungi salep, kombinasi : asam benzoat 6%+ 0 - 5997 0
24 asam salisilat 3% pot 30 g
Antihemoroid, kombinasi: bismut subgalat 150 0 100 3280 328000
mg + heksaklorofen 2,5 mg + lidokain lidokain 10
25 mg+ seng oksida 120 mg + sup ad 2 g Suppositoria

26 Artesunat serb inj 60 mg/ml (i.v./i.m.) ampul/vial 0 - 17100 0

Articulating paper kertas warna penanda oklusi Kertas warna penanda 0 1212 0
27
oklusi
28 Asam asetat tetes telinga 2% Botol 0 50 0 0
29 Asam asetilsalisilat (asetosal) tab 80 mg tablet/kapsul/kaplet 0 2,000 104 208000
30 Asam askorbat (vitamin C) tab 250 mg Tab 0 - 307 0
31 Asam askorbat (vitamin C) tab 50 mg tablet/kapsul/kaplet 5 10,000 51 510000
32 Asam folat tab 0,4 mg tablet/kapsul/kaplet 0 - 48 0
33 Asam folat tab 1 mg tablet/kapsul/kaplet 1000 10,000 0 0
34 Asam folat tab 5 mg Tab 0 - 0 0
35 Asam mefenamat kaps 250 mg tablet/kapsul/kaplet 0 - 0 0
Asam mefenamat kaps 500 mg tablet/kapsul/kaplet/ 1650 50,000 139 6950000
36
kaptab
37 Asam salisilat lar 0,1% Botol 0 - 0 0
38 Asam salisilat salep 10% Tube 0 - 0 0
39 Asam salisilat salep 2% Tube 0 - 0 0
40 Asam salisilat salep 5% Tube 0 50 25000 1250000
41 Asiklovir tab 200 mg tablet/kapsul/kaplet 0 - 500 0
42 Asiklovir tab 400 mg tablet/kapsul/kaplet 0 10,000 473 4730000
43 Atapulgit 600 mg tablet/kapsul/kaplet 0 1602 0
44 Atapulgit tab 630 mg tablet/kapsul/kaplet 0 3200 0
45 Atapulgit tablet 650 mg tablet/kapsul/kaplet 0 0 0
46 Atapulgit tablet 750 mg Tab 0 0 0
47 Atenolol tab 100 mg tablet/kapsul/kaplet 0 - 0 0
48 Atenolol tab 50 mg tablet/kapsul/kaplet 0 - 3000 0
49 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul 0 50 1718 85900
50 Atropin tab 0,5 mg Tab 0 - 375 0
51 Bahan tumpatan sementara lar, serb Botol 0 246499 0
52 Bedak salisil serb 2% Dus/Sachet/Plastik 10 20 1165 23300
53 Betametason krim 0,1% tube 5 gram 0 - 0 0
54 Betametason krim 0,5 mg/g Tube 0 - 0 0
55 Betametason salep 0,1% tube 5 gram 75 500 1540 770000
56 Betametason tts mata 1 mg/ml botol 0 - 5000 0
57 Bisakodil sup 10 mg Suppositoria 0 10 35000 350000
58 Bisakodil sup 5 mg Suppositoria 0 20 24399 487980
59 Bisakodil tab sal 5 mg tablet/kapsul/kaplet 0 2,000 549 1098000
60 Budesonid cairan ih 0,25mg/ml Botol @ 4 ml 0 - 0 0
Budesonid cairan ih 0,25mg/ml, respoules 2 ml 0 - 0 0
61 respoules
62 Budesonid cairan ih 0,5 mg/ml Botol @ 4 ml 0 - 0 0
Budesonid cairan ih 0,5 mg/ml, respoules 2 ml 0 5 234902 1174508.5
63 respoules

64 Budesonid serb ih 100 mcg/dosis Botol 0 - 0 0

65 Budesonid serb ih 200 mcg/dosis 100 dosis 0 2 189000 378000
66 Budesonid serb ih 200 mcg/dosis 200 dosis 0 - 0 0
67 Coal tar lar 5 % Botol 0 - 0 0
68 Copper T set/buah 0 - 0 0
69 Deksametason inj 5 mg/ml (i.v./i.m.) ampul/vial 185 500 1012 506000
70 Deksametason tab 0,5 mg tablet/kapsul/kaplet 1614 50,000 35 1750000
71 Diazepam enema 10 mg/2,5 ml tube @ 2,5 mL 0 - 30000 0
72 Diazepam enema 5 mg/2,5 ml tube @ 2,5 mL 0 - 15717 0
73 Diazepam inj 5 mg/ml (i.v./i.m.) ampul/vial 0 - 1595 0
Diazepam tab 2 mg 200 1,000 77 77000
74 tablet/kapsul/kaplet

75 Diazepam tab 5 mg tablet/kapsul/kaplet 0 - 111 0

76 Dietilkarbamazin tab 100 mg tablet/kapsul/kaplet 0 - 138 0
77 Difenhidramin inj 10 mg/ml (i.v./i.m.) ampul/vial 60 500 902 451000
78 Digoksin tab 0,25 mg tablet/kapsul/kaplet 0 - 119 0
79 Diltiazem hcl tab 30 mg tablet/kapsul/kaplet 0 - 0 0
80 Diltiazem kaps SR 100 mg Kapsul lepas lambat 0 - 0 0
81 Diltiazem kaps SR 200 mg Kapsul lepas lambat 0 - 5150 0
82 Diltiazem tab 30 mg Tab 0 200 153 30600
83 Dimenhidrinat tab 50 mg tablet/kapsul/kaplet 0 500 140 70000
84 Doksisiklin kaps 100 mg tablet/kapsul/kaplet 80 1,000 280 280000
85 Domperidon susp 5 mg/5 ml botol @60 ml 0 200 3105 621000
86 Domperidon tab 10 mg tablet/kapsul/kaplet 35 20,000 96 1920000
Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) 10 200 2486 497200
87 ampul/vial

88 Epinefrin (adrenalin) inj 1 mg/ml Ampul 0 - 0 0

89 Ergotamin tab 1 mg Tab 0 - 0 0
90 Eritromisin kaps 250 mg tablet/kapsul/kaplet 0 - 588 0
91 Eritromisin sir 200 mg/5 ml Botol @ 60 ml 0 - 8083 0
92 Eritromisin tab 500 mg tablet/kapsul/kaplet 786 5,000 833 4165000
Estrogen terkonjugasi tab sal 0,625 mg 0 - 7800 0
tablet salut gula/kaplet
93
salut gula

94 Etanol 70% cairan 70% Botol 6 20 250000 5000000

95 Etil klorida semprot 100 ml Botol 0 - 277200 0
96 Etonogestrel implan 68 mg Set 0 - 0 0
97 Eugenol Botol 0 - 20190 0
98 Fenitoin Na inj 50 mg/ml ampul @ 2 ml 0 20 4543 90860
99 Fenitoin Na kaps 100 mg Kaps 0 200 158 31600
100 Fenitoin Na kaps 30 mg Kaps 0 - 0 0
101 Fenobarbital tab 100 mg Tab 0 - 0 0
102 Fenobarbital tab 30 mg tablet/kapsul/kaplet 0 200 132 26400
Fenoksimetil penisilin (penisilin V) tab 250 mg 0 - 0 0
103 Tab
Fenoksimetil penisilin (penisilin V) tab 500 mg 0 - 0 0
104 Tab

105 Ferro fumarat kaps lunak 300 mg Kaps lunak 0 - 0 0

106 Ferro sulfat sir. 150 mg/5 ml Botol 0 - 0 0
107 Ferro sulfat tab salut 300 mg Tab sal 0 - 0 0
Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) 0 100 1595 159500
108 ampul/vial

109 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 0 2,000 847 1694000
Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) 0 - 0 0
tablet salut gula/kaplet
110 salut gula

111 Fluoksetin kaps 10 mg tablet/kapsul/kaplet 0 - 0 0

112 Fluor kapl 1 mg Kaplet 0 - 0 0
113 Fluor sediaan topikal Tube 0 - 0 0
114 Fluoresein tts mata 2,5 mg/ml Botol 0 - 0 0
115 Formokresol Botol 0 - 0 0
116 Framisetin Sulfat Tulle 1% Patch 0 - 0 0
117 Furosemid inj 10 mg/ml (i.v./i.m.) ampul/vial 0 - 1870 0
118 Furosemid tab 40 mg tablet/kapsul/kaplet 20 10,000 97 970000
Galactose microparticle 200-400 mg 0 - 0 0
119 micropart/ml Vial
Garam oralit kombinasi : natrium klorida 0,52 g + 0 2,000 316 632000
120 kalium klorida 0,30 g + trinatrium sitrat 0,58 g + sachet
glukosa anhidrat 2,7 g

121 Gentamisin salep mata 0,3% Tube 55 200 3345 669000

122 Gentamisin tts mata 0,3% Botol 10 500 5570 2785000
Glass ionomer ART (Atraumatic Restorative 0 - 0 0
123 Treatment) cocoa butter 5 g Sachet
Glass ionomer ART (Atraumatic Restorative 0 - 0 0
124 Treatment) lar Botol
Glass ionomer ART (Atraumatic Restorative 0 - 0 0
125 Treatment) serb Vial

126 Glibenklamid tab 2,5 mg tablet/kapsul/kaplet 0 - 0 0

127 Glibenklamid tab 5 mg tablet/kapsul/kaplet 582 20,000 95 1900000
128 Glikuidon tab 30 mg tablet/kapsul/kaplet 0 - 1000 0
129 Glimepirid tab 1 mg tablet/kapsul/kaplet 0 5,000 190 950000
130 Glimepirid tab 2 mg tablet/kapsul/kaplet 580 20,000 230 4600000
131 Glipizid tab 5 mg tablet/kapsul/kaplet 0 - 7280 0
132 Gliseril trinitrat tab 0,5 mg tablet/kapsul/kaplet 0 - 5070 0
133 Gliserin tts 100 mg/ml Botol 0 - 3300 0
134 Glukosa Larutan Infus 10% steril 100 ml Botol 0 - 5006 0
135 Glukosa Larutan Infus 10% steril 250 ml Botol 0 - 0 0
136 Glukosa Larutan Infus 10% steril 500 ml Botol 0 - 7200 0
137 Glukosa Larutan Infus 40% Ampul @25 ml 0 - 0
138 Glukosa Larutan Infus 5% steril 100 ml Botol 0 - 3313 0
139 Glukosa Larutan Infus 5% steril 250 ml Botol 0 - 0
140 Glukosa Larutan Infus 5% steril 500 ml Botol 0 - 6627 0
141 Griseofulvin (micronized) tab 125 mg tablet/kapsul/kaplet 3617 1,000 220 220000
Griseofulvin (micronized) tab scored 250 mg 0 - 2200 0
142 tablet/kapsul/kaplet

143 Gutta percha dan paper points 15 - 40 mm Roll 0 - 0 0

144 Gutta percha dan paper points 45 - 80 mm Roll 0 - 0 0
145 Haloperidol inj 5 mg/ml (i.m.) Vial 2 20 9375 187500
146 Haloperidol tab 0,5 mg tablet/kapsul/kaplet 0 500 55 27500
147 Haloperidol tab 1,5 mg tablet/kapsul/kaplet 0 500 59 29500
148 Haloperidol tab 2 mg tablet/kapsul/kaplet 30 1,000 83 83000
149 Haloperidol tab 5 mg tablet/kapsul/kaplet 0 - 56 0
150 Haloperidol tts 2 mg/ml botol 0 - 19467 0
Hepatitis B imunoglobulin (human) inj 150 IU/1,5 0 - 0 0
151 ml Ampul

152 Hidrogen peroksida cairan 3% Botol 0 - 0 0

153 Hidrogen peroksida lar. Konsentrat 3% Botol 0 - 0 0
154 Hidroklorotiazid tab 25 mg tablet/kapsul/kaplet 0 500 128 64000
155 Hidrokortison krim 2,5% tube @ 5 g 20 500 2558 1279000
156 Hidrokortison serb inj 100 mg Vial 0 - 0 0
157 Hiosina butilbromida tab 10 mg tablet/kapsul/kaplet 0 - 0 0
Human tetanus imunoglobulin inj 250 UI (i.m.) 0 - 0 0
158 Ampul
Human tetanus imunoglobulin inj 500 UI (i.m.) 0 - 0 0
159 Ampul

160 Ibuprofen sir 100 mg/5 ml botol @ 60 ml 1 50 2523 126150

161 Ibuprofen sir 200 mg/5 ml botol @ 60 ml 0 - 0 0
Ibuprofen tab 200 mg 0 - 121 0
162 tablet/kapsul/kaplet

163 Ibuprofen tab 400 mg tablet/kapsul/kaplet 200 20,000 960 19200000

Ipratropium bromida aerosol 20 mcg/semprot 0 - 220000 0
164 Botol

165 Ipratropium bromida cairan ih 0,025% Botol 0 - 0 0

166 Ipratropium bromida ih 20mcg/puff Botol 0 - 0 0
167 Isoniazid tab 100 mg Tab 0 - 0 0
168 Isoniazid tab 300 mg Tab 0 - 0 0
169 Isosorbid dinitrat tab 5 mg tablet/kapsul/kaplet 400 1,000 103 103000
170 IUD Cu T 380 A Set 0 - 0 0
171 IUD Levonorgestrel Set 0 - 0 0
172 Kalamin Tube 0 - 20500 0
173 Kalsium glukonat inj 100 mg/ml ampul/vial 0 - 10351 0
174 Kalsium hidroksida bubuk, pasta Tube 0 - 0 0
175 Kalsium karbonat tab 500 mg tablet/kapsul/kaplet 0 - 0 0
176 Kalsium laktat (kalk) tab 500 mg tablet/kapsul/kaplet 100 10,000 62 620000
177 Kaptopril tab 12,5 mg tablet/kaplet 1700 5,000 75 375000
178 Kaptopril tab 25 mg tablet/kaplet 70 5,000 75 375000
179 Kaptopril tab 50 mg tablet/kaplet 0 - 153 0
180 Karbamazepin sir 100 mg/5 ml Botol 0 - 142490 0
181 Karbamazepin tab 100 mg Tab 0 - 0 0
182 Karbamazepin Tab 200 mg Tablet 180 500 241 120500
183 Karbo adsorben tab 0,5 g Tab 0 - 0 0
184 Karbogliserin tts telinga 10 % Botol 0 10 3300 33000
185 Ketokonazol tab 200 mg tablet/kapsul/kaplet 780 2,000 280 560000
186 Klindamisin kaps 150 mg Kaps 0 - 800 0
Klindamisin kaps 300 mg 345 1,000 630 630000
187 tablet/kapsul/kaplet

188 Klofazimin, micronized kaps 50 mg Kapsul 0 - 0 0

189 Klofazimin, micronizedkaps 100 mg kapsul 0 - 0 0
Klonidin tab 0,15 mg 200 - 165 0
190 tablet/kapsul/kaplet
Kloramfenikol kaps 250 mg 60 500 357 178500
191 tablet/kapsul/kaplet

192 Kloramfenikol salep kulit 2% tube 15g 0 10 22668 226680

193 Kloramfenikol salep mata 1% tube @ 5 gram 8 50 2305 115250
194 Kloramfenikol susp 125 mg/5 ml botol 60 ml 5 20 5807 116140
195 Kloramfenikol tetes telinga 3% Botol 0 20 11055 221100
196 Kloramfenikol tts mata 0,5% botol 0 20 2500 50000
197 Kloramfenikol tts mata 1% Botol 0 - 0 0
Klorfeniramin tab 4 mg 1287 20,000 24 480000
198 tablet/kapsul/kaplet

199 Klorfenol kamfer mentol (CHKM) Botol 0 - 99110 0

200 Klorheksidin lar 0,2% Botol 0 - 0 0
201 Klorheksidin lar 15% Botol 0 - 0 0
202 Klorpromazin inj 25 mg/ml (i.m.) ampul/vial 0 - 0 0
203 Klorpromazin inj 5 mg/ml (i.m.) ampul/vial 0 - 3500 0
Klorpromazin tab sal 100 mg tablet salut 0 - 179 0
204 selaput/kaplet salut
selaput
205 Klorpromazin tab sal 25 mg Tab sal 0 - 82 0
206 Klortalidon tab 50 mg Tab 0 - 0 0
207 Klozapin tab 100 mg tablet - 0 0
208 Klozapin tab 25 mg tablet 0 - 0 0
209 Kodein tab 10 mg tablet/kapsul/kaplet 0 - 607 0
Kombinasi (DHP) : dihidroartemisin 40 mg + tablet salut 0 - 1238 0
210 Piperakuin 320 mg tab sal selaput selaput/kaplet salut
selaput
Kombinasi : artemether 20 mg + lumefantrin 120 0 - 0 0
211 mg tablet/kapsul/kaplet
 Kombinasi : artesunat tab 50 mg + amodiakuin 0 - 0 0
212 tab 200 Tab
Kombinasi : Desogestrel 150 mcg Etinilestradiol 0 - 0 0
213 30 mcg Tab

214 Kombinasi : ergotamin 1 mg+ kafein 50 mg tablet/kapsul/kaplet 0 - 0 0

Kombinasi : Ferro fumarat 60 mg + asam folat 0 - 445 0
215 0,4 mg tab salut tablet salut gula
Kombinasi : levonorgestrel 150 mcg + 0 - 0 0
216 etinilestradiol 30 mcg tab salut gula
Kombinasi : Tenofovir 300 mg + Emtrisitabin 200 0 - 0 0
217 mg Tab
Kombinasi : Tenofovir 300 mg + Lamivudin 300 0 - 0 0
218 mg + Efavirenz 600 mg Tab
Kombinasi: ipratropium Br 0,5 mg+ salbutamol ampul/vial 0 - 4063 0
219 2,5 mg nebules
220 Kombinasi: kaolin 550 mg + pektin 20 mg Tab 0 - 1000 0
221 Komposit resin Set 0 - 10000 0
Kotrimoksazol (dewasa) kombinasi : 446 1,000 130 130000
222 sulfametoksazol 400 mg+ trimetoprim 80 mg tab/kaptab

Kotrimoksazol (dewasa) kombinasi : 0 - 245 0

223 sulfametoksazol 800 mg+ trimetoprim 160 mg tab/kaptab

Kotrimoksazol kombinasi tiap 5 ml suspensi : 0 - 2163 0

224 sulfametoksazol 200 mg + trimetoprim 40 mg botol 60 mL

225 Kuinin inj 25% (i.v.) Vial 0 - 7440 0

226 Kuinin tab 200 mg tablet/kapsul/kaplet 0 - 0 0
227 Laktulosa sir 3,335 g/5 ml botol @ 60 mL 0 10 15060 150600
Larutan mengandung Elektrolit (Kalium Klorida) 0 0 0 0
228 Botol
Larutan mengandung Elektrolit (KCl 0,15%, NaCL 0 0 0 0
229 0,9%) (KN1) Botol
Larutan mengandung Elektrolit (KCl 0,3%,NaCl 0 0 0 0
230 0,9%) (KN2) Botol
Larutan mengandung Elektrolit (Na 130 mEq, K 4 0 0 0 0
231 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq) Botol plastik @ 500 ml
Ringer Asetat

Larutan mengandung Elektrolit (Na 130 mEq, K 4 0 0 0 0

232 mEq, Cl 109 mEq, Ca 3 mEq, Asetat 28 mEq) Softbag @ 500 ml
Ringer Asetat

Larutan mengandung Elektrolit (NaCl 1.125 gr, 0 0 0 0

233 Dekstrosa 18.75 gr) (KA EN 1B) Botol
Larutan mengandung Elektrolit (Sodium Lactate 0 0 0 0
sol (50%) 113 gr/L, Potassium Chloride 0.3 gr/L,
234 Calcium Chloride 0.2 gr/L, elektrolit) Botol

Larutan mengandung Elektrolit (Tiap 1000 ml 0 0 0 0

mengandung electrolit: Sodium 145 mmol/l,
Potassium 4.0 mmol/l, Calcium 2.5 mmol/l,
235 Magnesium 1.0 mmol/l, Chloride 118 mmol/l, Botol
Acetate 24 mmol/l, Malate 5.0 mmol/l)

Larutan mengandung Karbohidrat (Fructose 120 0 0 0 0

236 g, glucose 66 g, Xylitol 60 g/ L) Botol

Larutan mengandung Karbohidrat (Fructose 200 0 0 0 0

237 g, glucose 110 g, Xylitol 100 g/ L) Botol

Larutan mengandung Karbohidrat (Fructose 60 0 0 0 0

238 g, glucose 33 g, Xylitol 30 g/ L) Botol
Larutan mengandung Karbohidrat (Maltose 10%) 0 0 0 0
239 Botol
Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0
(25.00g maltose, 3.00 g sodium chloride, 0.15 g
potassium chloride, 0.10 g calcium chloride
240 dihydrate dan 1.55 g sodium lactate) Botol

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

241 (Acetate, Na, K, Cl, Ca, Mg, Sorbitol 50 gr/L) Botol

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

242 (Dextrose 5%, NaCL 0,45%, KCl) (HSD) Botol

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

243 (Fructose 120 g, glucose 66 g, Xylitol 60 g/ L + Botol
elektrolit)

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

(Glukosa 25 g, NaCl 2,0 g, KCl 1,3 g, Natrium
244 Laktat 3,1 g, air untuk injeksi ad 1000 ml) Botol

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

245 (Glukosa 55 g ; Natrium Chloride 9 g, air untuk Botol
injeksi ad 1000 ml) (D5-NS)

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

246 (Glukosa: 25,0 g; NaCl: 4,5 g) Botol
Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0
247 (Glukosa: 55.0 g; NaCl: 2.25 g) (D5-1/4NS) Botol
 Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0
248 (Glukosa: 55.0 g; NaCl: 4.5 g) (D5-1/2NS) Botol

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

(Larutan nutrisi kombinasi infus per L: Na.
100mEQ, K 18mEQ, Ca. 4mEQ, Mg 6mEQ, Cl
249 90mEQ, Asetat 38mEQ, Sorbitol 50g) Botol

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

250 (Larutan Ringer & Glukosa 5%) Botol
Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0
251 (NaCl 1.75 g, KCL 1.5g, Glukosa 100 gr) Botol

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

252 (NaCl 1.75 g, KCL 1.5g, Na Lactate 2.24 g, Botol
Glukosa 100 gr)

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

253 (Nacl 1.75 gr, KCl 1.5 gr, Na Lactat 2.24 gr, Botol
Dekstrosa 27 gr) (KA EN 3B)

Larutan mengandung Karbohidrat + Elektrolit 0 0 0 0

254 (Nacl 2.34 gr, Na Laktat 2.24 gr, KCL 0.75 gr Botol
Dekstrosa 27 gr) (KA EN 3A)

Levonorgestrel implan 2 rods, 75 mg (3-4 tahun) 0 5 305000 1525000

255 pack/ sachet/ set
Lidokain gel 2% 0 - 175000 0
256 syringe/syringe plastik

257 Lidokain inj 2% (infiltr/p.v.) ampul/vial 0 500 105 52500

258 Lidokain spray oral 10% botol 0 - 303000 0
259 Linestrenol tab 0,5 mg tablet/kapsul/kaplet 0 - 0 0
260 Loperamid tab 2 mg Tab 27 5,000 240 1200000
261 Loratadin tab 10 mg tablet/kapsul/kaplet 534 2,000 180 360000
262 Lorazepam tab 0,5 mg tablet/kapsul/kaplet 0 - 0 0
263 Lorazepam tab 1 mg tablet/kapsul/kaplet 0 - 0 0
264 Lorazepam tab sal 2 mg Tab sal 0 - 0 0
265 Lugol Botol 0 - 0 0
266 Magnesium sulfat inj 20% ampul/vial 0 - 0 0
267 Magnesium sulfat inj 20% ampul/vial @25 ml 2 20 3328 66560
268 Magnesium sulfat inj 40% ampul/vial 0 - 0 0
269 Magnesium sulfat inj 40% ampul/vial @25 ml 4 20 3796 75920
270 Magnesium sulfat serb, ktg 30 g Sachet 0 0 0 0
271 Mebendazol sir 100 mg/5 ml Botol 0 0 0 0
272 Mebendazol tab 100 mg Tan 0 0 0 0
273 Mebendazol tab 500 mg tablet/kapsul/kaplet 0 0 0 0
274 Medroksi progesteron asetat inj 150 mg/ml ampul/vial 0 0 0 0
275 Medroksi Progesteron Asetat Inj 50 mg/ml ampul/vial 0 0 0 0
Metenamin mandelat (heksamin mandelat) tab 0 0 0 0
276 salut enterik 500 mg Tab salut

277 Metformin tab 500 mg tablet/kapsul/kaplet 1010 10,000 123 1230000

278 Metformin tab 850 mg tablet/kapsul/kaplet 0 - 589 0
279 Metilergometrin inj 0,2 mg/ml ampul/vial 20 50 3,696 184800
Metilergometrin tab salut 0,125 mg tablet/kaplet salut 200 1,000 267 267000
280
selaput
281 Metilprednisolon tab 4 mg tablet/kapsul/kaplet 400 20,000 153 3060000
282 Metoklopramid inj 5 mg/ml ampul/vial 0 - 7425 0
283 Metoklopramid tab 10 mg tablet/kapsul/kaplet 0 - 0 0
284 Metoklopramid tab 5 mg tablet/kapsul/kaplet 806 5,000 139 695000
285 Metronidazol lar inf 5 mg/ml botol 0 - 8250 0
286 Metronidazol susp 125 mg/5 ml Botol @ 60 ml 0 100 3950 395000
287 Metronidazol susp 125 mg/5 ml Botol @ 100 ml 0 - 0 0
288 Metronidazol tab 250 mg tablet/kapsul/kaplet 713 - 0 0
289 Metronidazol tab 500 mg tablet/kapsul/kaplet 713 2,000 870 1740000
290 Mikonazol krim 2% tube 21 100 4268 426800
291 Mikonazol serb 2% botol / sachet 0 - 0 0
Mineral Mix (Bismuth Subcitrate Tripotasium, 0 - 2970 0
Copper sulfate, Magnesium Chloride Anhydrous,
292 Potassium Chloride, Zinc Acetate) Sachet

N-asetil sistein kaps 200 mg 0 5,000 479 2395000

293 tablet/kapsul/kaplet

294 NaCl 0,9% Larutan Botol 0 0 0

NaCl 0,9% Larutan ampul/botol 6 100 6840 684000
295
plastik/botol plas
NaCl 0,9% Larutan Botol plastik/botol 0 - 0 0
296
plastik pi
Natrium diklofenak tab 25 mg tablet salut 0 - 174 0
297 enterik/kaplet salut
enterik
Natrium diklofenak tab 50 mg tablet salut 250 20,000 154 3080000
298 enterik/kaplet salut
enterik
299 Natrium Diklofenak Tetes Mata 1 mg/ml botol 5 mL 0 - 10200 0
300 Natrium hipoklorit cairan konsentrat 5% Botol 0 - 0 0
301 Natrium tiosulfat inj 25% (i.v.) Ampul 0 - 0 0
302 Nifedipin kaps 10 mg tablet/kapsul/kaplet 59 1,000 330 330000
303 Nikotinamid tab 100 mg Tab 0 - 0 0
304 Nikotinamid tab 5 mg Tab 0 - 0 0
305 Nistatin susp 100.000 UI/ml botol/vial 0 10000 0
Nistatin tab salut 500.000 UI 0 - 1056 0
306 tablet salut gula/kaplet
salut gula

307 Nistatin tab vaginal 100.000 UI tablet/kaplet 80 500 747 373500

308 Nitrofurantoin tab 50 mg Tab 0 - 0 0
309 Norepinefrin inj 1 mg/ml ampul/vial 0 20 10000 200000
310 Obat Anti Tuberculosis FDC Kategori Anak paket 290650 0
311 Obat Anti Tuberculosis FDC Kategori I paket 486683 0
312 Obat Anti Tuberculosis FDC Kategori II paket 1622364 0
Obat Anti Tuberculosis FDC Kategori Sisipan 0 0
313 paket

314 Obat Anti Tuberculosis Kombipak Anak Paket 0 0

315 Obat Anti Tuberculosis Kombipak Dewasa paket 0 0
316 Oksigen ih, gas dlm tabung Botol 0 87339 0
317 Oksimetazolin tts hidung 0,025% botol @ 10 mL 0 0 0 0
318 Oksimetazolin tts hidung 0,050% botol @ 10 mL 0 0 0 0
319 Oksitetrasiklin 1% Salep Mata tube 75 100 2774 277400
320 Oksitosin inj 10 UI/ml ampul/vial 0 - 9240 0
321 Olopatadin tts mata 0,1% Botol 0 - 0 0
322 Omeprazol inj 40 mg/10 ml ampul/vial 30 100 11868 1186800
323 Omeprazol kaps 20 mg tablet/kapsul/kaplet 200 10,000 150 1500000
324 Paraformaldehid tab 1 g Tab 0 - 0 0
325 Parasetamol sir 120 mg/5 ml botol @ 60 mL 0 100 6635 663500
326 Parasetamol tab 500 mg tablet/kapsul/kaplet 1277 20,000 540 10800000
327 Parasetamol tts 60 mg/0,6 ml botol @ 15 mL 0 20 8311 166220
328 Pasta devitalisasi (non arsen) Tube 0 - 237000 0
329 Pasta pengisi saluran akar (pasta) Tube 0 - 116796 0
330 Perak nitrat lar 20% Botol 0 - 0 0
331 Perak sulfadiazin krim 1% Tube 0 - 20700 0
332 Permetrin krim 5 % Tube 13 10 63750 637500
333 Pirantel pamoat susp 125 mg/5 ml Botol 0 - 0 0
334 Pirantel pamoat tab 500 mg Tab 0 - 0 0
335 Pirantel pamoat tab scored 125 mg tablet/kapsul/kaplet 400 1,000 385 385000
336 Pirantel pamoat tab scored 250 mg Tab 0 - 0 0
337 Piridoksin (vitamin B6) inj 100 mg/ml Ampul 0 20 1280 25600
338 Piridoksin (vitamin B6) tab 10 mg tab/kap/kapl 200 2,000 164 328000
339 Piridoksin (vitamin B6) tab 25 mg tablet/kapsul/kaplet 0 - 0 0
340 Povidon iodin lar 100 mg/ml botol @ 60 mL 5 50 7532 376600
341 Povidon iodin lar 100 mg/ml Botol 300 ml 0 - 23400 0
342 Povidon iodin lar 100 mg/ml botol @ 1.000 mL 0 - 85000 0
343 Povidon iodin lar 100 mg/ml botol 30 mL 0 - 0 0
344 Prednison tab 5 mg tablet/kapsul/kaplet 50 2,000 86 172000
345 Primakuin tab 15 mg Tab 0 - 123 0
346 Probenesid tab 500 mg tablet/kapsul/kaplet 0 - 0 0
Prokain benzilpenisilin serb inj 3 juta UI/vial 0 - 0 0
347 (i.m.) ampul/vial

348 Propiltiourasil tab 100 mg tablet/kapsul/kaplet 276 1,000 745 745000

349 Propranolol tab 10 mg tablet/kapsul/kaplet 350 2,000 71 142000
350 Ranitidin tab 150 mg tablet/kapsul/kaplet 500 10,000 230 2300000
351 Retinol (vitamin A) kaps lunak 100.000 UI kaps lunak 200 200 328 65600
352 Retinol (vitamin A) kaps lunak 200.000 UI kaps lunak 200 200 691 138200
353 Rifampisin kaps 300 mg tablet/kapsul/kaplet 0 - 1023 0
354 Ringer Laktat Larutan Botol 2 500 7630 3815000
355 Risperidon tab sal 1 mg tablet/kapsul/kaplet 0 0 0
356 Risperidon tab sal 2 mg tablet/kapsul/kaplet 0 5002 0
357 Salbutamol cairan ih 0,1% ampul/vial/botol 0 10000 0
358 Salbutamol lar ih 0,5 % Botol 0 5200 0
359 Salbutamol sir 2 mg/5 ml Botol 0 4446 0
360 Salbutamol tab 2 mg tablet/kapsul/kaplet 230 10,000 77 770000
361 Salbutamol tab 4 mg tablet/kapsul/kaplet 0 10,000 80.3 803000
Salep 2-4, kombinasi : asam salisilat 2 %+ 0 - 0 0
362 belerang endap 4 % pot 15 gram
Salep 2-4, kombinasi : asam salisilat 2 %+ 12 20 3494 69880
363 belerang endap 4 % pot 30 gram
Serum anti bisa ular : A.B.U. I (khusus ular dari 0 5 512204 2561020
364 luar Papua) inj (i.m./i.v.) Vial
Serum anti bisa ular :A.B.U.II (khusus ular dari 0 - 0 0
365 Papua) inj (i.m./i.v.) Vial
Serum antidifteri (A.D.S) inj (i.m./i.v.) Inj i.m 0 - 0 0
366 10.000 UI/ Vial

367 Serum antirabies inj 100 UI/ml Vial 165000 0

368 Serum antirabies inj 200 UI/ml Vial 0 0
Serum antitetanus (A.T.S) (i.m.) Inj 10.000 UI/vial 0
369 (i.m /i.v.) Vial
Serum antitetanus (A.T.S) inj 1500 UI/amp (i.m.) 130999 0
370 Ampul
Serum antitetanus (A.T.S) inj 20.000 UI/vial 0 0
371 (i.m /i.v.) Vial

372 Setirizin sir 5 mg/5 ml. botol @ 60 mL 0 3265 0

Sianokobalamin (vitamin B12) inj 500 mcg/ml 0 1335 0
373 ampul/vial

374 Sianokobalamin (vitamin B12) tab 50 mcg tablet/kapsul/kaplet 3200 2,000 57 114000
Simvastatin tab sal 10 mg 0 5,000 330 1650000
tablet/kapsul/kaplet/
tablet salut
375
selaput/kaplet salut
selaput
Simvastatin tab sal 20 mg 550 10,000 240 2400000
tablet/kapsul/kaplet/
376 tablet salut
selaput/kaplet salut
selaput
377 Simvastatin tab sal selaput 40 mg Tab sal 0 - 500 0
Siprofloksasin tab scored 500 mg tablet salut 0 5,000 324 1620000
378 selaput/kaplet salut
selaput
 Siprofloksasin tetes mata 3 mg/ml Catchcover, botol 0,6 0 20 5000 100000
379 ml
380 Spironolakton tab 25 mg tablet/kapsul/kaplet 0 - 10000 0
Stannous pyrophosphate 27,6 mg sodium 0 - 0 0
381 pyrophosphate/vial Vial

382 Streptomisin serb inj 1.000 mg/vial ampul/vial 0 - 10100 0

383 Surgical ginggival pack Tube 0 - 0 0
Tenofovir tab 300 mg tablet salut 0 - 0 0
384 selaput/kaplet salut
selaput
385 Tetanus toxoid inj Ampul 0 - 0 0
386 Tetrakain tts mata 0,5% Botol 0 - 1000 0
Tetrasiklin kaps 250 mg 0 - 0
387 tablet/kapsul/kaplet
Tetrasiklin kaps 500 mg 120 - 371 0
388 tablet/kapsul/kaplet

389 Tetrasiklin Salep Mata 1% Tube 0 - 1000 0

Tiamin (vitamin B1) tab 50 mg 0 2,000 98 196000
390 tablet/kapsul/kaplet

391 Timolol tts mata 0,25% botol @ 5 mL 0 - 0 0

392 Timolol tts mata 0,5% botol @ 5 mL 0 50 14900 745000
Triheksifenidil tab 2 mg 0 200 65 13000
393 tablet/kapsul/kaplet

394 Urea krim 10 % pot 0 - 0 0

395 Vaksin BCG inj (i.k) Vial 0 - 0 0
396 Vaksin bivalen OPV (b-OPV) drops 10 dosis Vial 0 - 0 0
Vaksin Hepatitis Rekombinan Inj Prefilled 0 - 0 0
397 Injection Device (Uniject) 0,5 ml (i.m) Vial

398 Vaksin Influenza Vial 82335 0

399 Vaksin Japanese Enchepalitis (J.E) Vial 0 - 0 0
400 Vaksin jerap difteri tetanus (DT) Vial 0 - 0 0
401 Vaksin jerap difteri tetanus (Td) Vial 0 - 0 0
402 Vaksin kombinasi DPT-HB-Hib Vial 0 - 0 0
Vaksin measless rubella (MR) Inj 0,5 mL (s.k) 0 - 0 0
403 Vial

404 Vaksin Meningitis Meningokokus Vial 0 - 0 0

405 Vaksin polio IPV inj 0,5 ml Vial 0 - 0 0
Vaksin rabies, untuk manusia serb inj (s.k./i.k) + 0 - 0 0
406 booster Vial
Vaksin rabies, untuk manusia serb Inj 2,5 IU 0 - 0 0
407 Vial

408 Vaksin Yellow Fever Vial 0 - 0 0

409 Valproat sir 250 mg/5 ml botol @ 120 ml 0 - 69300 0
Valproat tab sal 250 mg tablet salut enterik/ 0 - 0 0
410
kaplet salut enterik
411 Valproat tab sal 500 mg Tab sal 0 500 502 251000
412 Vitamin B kompleks tablet 7800 - 157 0
413 Zinc drops 10 mg/ml Botol 0 50 5397 269850
414 Zinc serb 10 mg Sachet 0 - 10000 0
415 Zinc sir 10 mg/ml Botol 0 - 0 0
416 Zinc sir 20 mg/5 ml botol 0 - 2750 0
417 Zinc tab disp 20 mg tablet dispersible 0 2,000 275 550000
TOTAL 168,605,769
RENCANA KEBUTUHAN OBAT PADA FASILITAS KESEHATAN TINGKAT PERTAMA (FKTP

SISA STOK PER 31 RENCANA

NO NAMA OBAT SATUAN PENGADAAN
DESEMBER 2021 TAHUN 2022

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
 85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
TOTAL

Kabupaten Halmahera Selatan

TINGKAT PERTAMA (FKTP) TAHUN 2022

ALASAN
PENGDAAN
 Labuha,,,,,,,,,,,

Mengetahui :
Kepala Puskesmas
Kabupaten Halmahera Selatan

NAMA
NIP.
RENCANA KEBUTUHAN OBAT PROGRAM TAHUN 2023

SISA STOK
RENCANA
PER 31 ALASAN
NO NAMA OBAT SATUAN PENGADAAN
DESEMBER PENGDAAN
TAHUN 2022
2022

PROGRAM HIV
1
2
3
4
5
6
7
8
9
10
11
12