3.10.1 Ep 2 Dok Fix PKM Wates Rko 2022

LAPORAN RENCANA KEBUTUHAN OBAT 2022
ISI DATA RKO
DATA
ISI DATA PUSKESMAS
KONVERSI DATA RKO RENCANA KEBUTUHAN OB

022
HAN OBAT
DATA PUSKESMAS
KODE PUSKESMAS 1032498

NAMA PUSKESMAS WATES
KECEMATAN WATES
KEPALA PUSKESMAS dr. INDAH AMALIA NIP 19810315 201502 2 002
PENGELOLA OBAT apt. PUTRI MARGARETA,S.Farm NIP 19940321 201903 2 004
02 2 002
03 2 004
PEMAKAIAN OBAT TAHUN
2019 2020 2021
CEK DATA
KONVERSI RATA PEMAKAIAN 2019(dari file exel wates fix baper 13/2/2020 sheet rko2020)
PEMAKAIAN BULAN KE -
NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
1 2 WAY FOLEY CATHETER NO.16
4 ALAT SUNTIK SEKALI PAKAI 1 ML
6 ALAT SUNTIK SEKALI PAKAI 2,5 ML
11 ALAT SUNTIK SEKALI PAKAI IX 0,5 ML
12 ALLOPURINOL TABLET 100 MG
13 ALPRAZOLAM 1 MG TABLET
14 AMBROXOL SIRUP 5MG/ML
15 AMBROXOL TABLET 30 MG
16 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML
17 AMINOPHYLLINE TABLET 200 MG
18 AMITRIPTYLLINE HCL TABLET 25 MG
19 AMLODIPINE TABLET 10 MG
21 AMOKSILLIN SERBUK INJEKSI 1.000 MG
22 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML
23 AMOKSISILIN TABLET 500 MG
24 AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL
25 ANTALGIN INJEKSI 250 MG/ML 2 ML
26 ANTALGIN TABLET 500 MG
27 ANTASIDA DOEN TABLET KOMBINASI
28 ANTASIDA SUSPENSI 60 ML
29 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR
30 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR
31 ANTI HAEMOROID DOEN KOMBINASI
32 ANTI INFLUENZA (EMFLU) KOMBINASI TAB

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
33 ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP
34 ANTI MIGRAIN DOEN TABLET KOMBINASI
35 ANTI SPASMODIK TABLET (DORMICOMP)
36 ANTITUSSIVE KOMBINASI TABLET
37 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML
38 ARTEMETHER INJEKSI 80 MG
39 ASAM ASKORBAT ( VIT C ) TABLET 250 MG
41 ASAM FOLAT 1MG TABLET
42 ASAM FUSIDAT KRIM 20MG/ GRAM
43 ASAM MEFENAMAT TABLET 500 MG
44 ASAM TRANEKSAMAT 100 MG/ML INJEKSI
45 ASAM TRANEKSAMAT 500 MG TABLET
46 ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER
47 ASEPTAN 500CC + PUMP
48 ASEPTIC GEL 500CC + DISPENSER
49 ASERING (ASETAT RINGER) SOFT BAG
50 ASETOSAL TABLET 100 (80) MG
51 ASIKLOVIR KREAM 5 % 5 GR
52 ASIKLOVIR TABLET 400 MG
53 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML
54 ATROPIN SULFAT TABLET 0,5 MG
55 ATROPIN SULFAT TETES MATA 0,5 % 5 ML
56 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET
57 BETAHISTINMESILAT 6 MG TABLET
58 BETAMETHASONE CREAM 0,1 % 5 GR
59 BISAKODIL ( BICOLAX ) TABLET 5 MG
60 BISAKODIL SUPPOSITORIA 10 MG
62 BISOPROLOL 5 MG TABLET
63 BROMHEXINE SIRUP (HUSTAB)
64 CAT GUT NO.2/0 CHROMIC + JARUM 1/2 GT 35 MM
65 CAT GUT NO.2/0-3/0 PLAIN & CHROMIC
66 CITICHOLIN 250 MG/ML-2ML INJEKSI

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
67 COMBIVENT UDV INHALASI
68 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML
69 DEKSAMETHASONE TABLET 0,5 MG
70 DEVITALISASI PASTA ( NON ARSEN )
71 DIAZEPAM INJEKSI 5 MG/ML 2 ML
72 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-STESOLID
73 DIAZEPAM TABLET 2 MG
75 DIETILKARBAMAZIN SITRAT TABLET 100 MG
76 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML
77 DIGOXIN TABLET 0,25 MG
78 DIMENHYDRINATE TABLET 50 MG
79 DOKSISIKLIN TABLET 100 MG
80 DOMPERIDON SUSPENSI 5MG/ML
81 DOMPERIDON TABLET 10 MG
82 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR
83 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML
84 ERITROMISIN 200 MG/5-ML SIRUP KERING
85 ERITROMISIN KAPSUL 250 MG
86 ERITROMISIN TABLET 500 MG
87 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML
88 ETANOL (ALKOHOL) 70 % 1000 ML
89 ETANOL [ ALKOHOL ] 70 % 300 ML
90 ETHAMBUTOL HCL TABLET 250 MG
91 ETHAMBUTOL HCL TABLET 500 MG
92 ETIL KLORIDA SEMPROT 100 ML
93 EUGENOL CAIRAN 10 ML
94 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML
95 FENITOIN NATRIUM TABLET 100 MG
96 FENOBARBITAL INJEKSI 50 MG/ML 2 ML
97 FENOBARBITAL TABLET 100 MG
99 FENOL GLISEROL TETES TELINGA 10 % 5 ML
100 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 ML

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
101 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG
102 FITOMENADION INFANT INJ. 2MG/ML
103 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML
104 FRADIOMISIN + GRAMISIDIN TABLET [ FG TROCHES ]
105 FUROSEMID INJEKSI IV/ IM 10 MG/ ML
106 FUROSEMID TABLET 40 MG
107 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 GR
108 GEMFIBROZIL 300 MG KAPSUL
109 GENTAMISIN INJEKSI 80 MG/2 ML
110 GENTAMISIN SALEP KULIT 0,1 % 5 GR
111 GENTAMISIN SALEP MATA 0,3%
112 GENTAMISIN TETES MATA 0,3%
113 GENTIAN VIOLET LARUTAN 1 %
114 GLASS IONOMER CEMENT ( GC IX )
115 GLIBENCLAMIDE TABLET 5 MG
116 GLICERIL GUAIACOLAT TABLET 100 MG
117 GLIMEPIRIDE 2 MG TABLET
118 GLUKOSA LARUTAN INFUS 10 % STERIL
119 GLUKOSA LARUTAN INFUS 40 % STERIL 25 ML
121 GRISEOFULVIN TABLET 125 MG
122 HALOPERIDOL INJ. 5 MG/ML (LODOMER)
123 HALOPERIDOL TABLET 1,5 MG
124 HALOPERIDOL TABLET 5 MG
125 HEPARIN SODIUM 200 UI/GRAM-GELL (THROMBOFLASH)
126 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN INFUS 500 ML
127 HIDROCHLOROTIAZIDE (H.C.T) TABLET 25 MG
128 HIDROCORTISONE CREAM 2,5 % 5 GR
129 HYOCINE N BUTILBROMIDE 10 MG TABLET
130 HYOSIN N BUTILBROMID ( ANTI SPASMODIK-SPASI) INJEKSI
131 I.V CATHETER NO.16 WITH INJECTION PORT

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
136 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML
137 IBUPROFEN TABLET 200 MG
139 INFUSION SET ANAK
140 INFUSION SET DEWASA
141 ISONIAZIDA (INH) 100 MG TABLET
142 ISONIAZIDA (INH) 300 MG TABLET
143 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG
144 KAEN 3B
145 KALIUM DIKLOFENAK 50 MG TABLET
146 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML
147 KALSIUM HIDROKSIDA PASTA
148 KALSIUM LAKTAT (KALK) TABLET 500 MG
149 KANTONG URINE DEWASA
150 KAOLIN PEKTIN (NOVADIAR) SUSPENSI
151 KAPAS BERLEMAK 500 GR
152 KAPAS PEMBALUT/ABSORBEN 250 GR
153 KAPTOPRIL TABLET 25 MG
154 KARBAMAZEPIN TABLET 200 MG
KARBAZOKHROME SODIUM SULFONATE INJEKSI 5 MG/ML 10

155
ML (SALDONA)
156 KASA KOMPRES 40/40 STERIL
157 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL
158 KASA PEMBALUT HIDROFIL 18 X 22 CM STERIL
159 KASA PEMBALUT HIDROFIL 2 M X 80 CM
165 KASA STERIL (DARYAN TOLLE)YG DIRESAPI FRAMISETIN
166 KETOKONAZOLE TABLET 200 MG
167 KETOPROFEN 100 MG SUPPOSITORIA
168 KLINDAMISIN KAPSUL 300 MG

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
169 KLOBAZAM 10 MG TABLET
170 KLORAMFENIKOL INJEKSI 1.000 MG/VIAL
171 KLORAMFENIKOL KAPSUL 500 MG
172 KLORAMFENIKOL SALEP KULIT 2 %
173 KLORAMFENIKOL SALEP MATA 1 %
174 KLORAMFENIKOL SUSPENSI 125 MG/5 ML
175 KLORAMFENIKOL TETES MATA 0,5 % 10 ML
176 KLORAMFENIKOL TETES TELINGA 3 %
177 KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG
178 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML
180 KLORPROMAZIN HCL TABLET 100 MG
182 KLOZAPIN 100 MG TABLET
183 KODEIN HCL TABLET 10 MG
184 KOTRIMOKSAZOL DEWASA TABLET
185 KOTRIMOKSAZOL PEDIATRIK TABLET
186 KOTRIMOKSAZOL SUSPENSI 60 ML
187 LEVOFLOXACIN TABLET 500 MG
188 LIDOCAIN COMPOSITUM INJEKSI 2 ML
189 LIDOCAIN Hcl INJEKSI 2 %
190 LISOL CONCENTRATE 1000 ML
191 LOPERAMIDE TABLET 2 MG
192 LORATADIN TABLET 10 MG
193 MAGNESIUM SULFAT INJEKSI (IV) 20 % 25 ML
195 MASKER KERTAS 3 PLY EAR LOOP
196 MASKER KERTAS 3 PLY TIE ON
197 MASKER N9
198 MELOKSIKAM TABLET 7,5 MG
199 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML
200 METFORMIN TABLET 500 MG
201 METILERGOMETRIN MALEAT INJEKSI 0,200 MG 1 ML
202 METILERGOMETRIN MALEAT TABLET 0,125 MG

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
203 METILPREDNISOLON TABLET 4 MG
204 METOKLOPRAMIDE 10 MG TABLET
205 METOKLOPROMIDE (SOTATIC) INJEKSI 5 MG/ML 2 ML
206 METRONIDAZOL TABLET 250 MG
208 METRONIDAZOLE INFUS 5 MG/ML 100 ML

METRONIDAZOLE+NYSTATIN 100.000 UI (PROVAGIN)
209
VAG.SUPP.
210 MIKONAZOL KREAM 10 GR
211 MINERAL MIX
212 MONOKLORKAMFER MENTOL CAIRAN (CHKM)
213 MULTIVITAMIN (LYSOVIT ) SYRUP 100 ML
214 MULTIVITAMIN (MALTIRON PLUS) KOMBINASI TABLET
215 MUMMIFYING PASTA
216 NATRIUM DIKLOFENAK TABLET 50 MG
217 NATRIUM KLORIDA INFUS 0,9 % STERIL
218 NEUROTROPIK (IKANEURON) INJEKSI
219 NEUROTROPIK KOMBINASI (IKANEURON) TABLET
220 NEVIRAPINE TABLET 200 MG
221 NIFEDIPINE TABLET 10 MG
222 NISTATIN TABLET 500.000 UI
223 NISTATIN VAGINAL TABLET 100.000 UI
224 OBAT BATUK HITAM (OBH) CAIRAN 100 ML
225 OKSIGEN NASAL CANNULA ADULT
226 OKSIGEN NASAL CANNULA INFANT
227 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR
228 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR
229 OKSITOSIN INJEKSI 10 IU/ML 1 ML
230 OMEPRAZOLE TABLET 20 MG
231 ONDANSENTRON 4 MG/2 ML INJEKSI
232 PARACETAMOL SYRUP 120 MG/5 ML 60 ML
233 PARACETAMOL TABLET 100 MG
235 PARACETAMOL TETES 100 MG/ML 15 ML
236 PERAK SULFADIAZIN KRIM 1 %

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
237 PERHYDROL [ H2O2 ] 3 % 800 ML
238 PIRACETAM TABLET 800 MG
239 PIRANTEL PAMOAT TABLET 125 MG
240 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG
242 PIROKSIKAM KAPSUL 10 MG
243 PLESTER 5 YARD X 2 INCI
244 PREDNISON TABLET 5 MG
245 PROPANOLOL HCL TABLET 40 MG
246 PROPILTHIOURACIL TABLET 100 MG
247 RANITIDIN INJEKSI 25 MG/ ML
248 RANITIDIN TABLET 150 MG
249 RESPERIDON 2 MG TABLET
250 RINGER LAKTATE LARUTAN INFUS STERIL
251 SALBUTAMOL TABLET 2 MG
253 SALEP 2-4 KOMBINASI 30 GR
254 SALICYL BEDAK 2 %
255 SARUNG TANGAM NON STERIL L
256 SARUNG TANGAN NON STERIL M
257 SARUNG TANGAN NON STERIL S
258 SARUNG TANGAN OBGYN
259 SARUNG TANGAN STERIL NO 6
260 SARUNG TANGAN STERIL NO. 8
261 SARUNG TANGAN STERILE NO.6,5
262 SARUNG TANGAN STERILE NO.7
263 SEFADROKSIL KAPSUL 500 MG
264 SEFIKSIM KAPSUL 100 MG
265 SEFOTAKSIM INJEKSI 1.000 MG
266 SEMEN SENG FOSFAT SERBUK DAN CAIRAN 30 GR
267 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML (ABU I)
268 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP (ATS)
269 SERUM ANTI TETANUS INJEKSI 20.000 IU/VIAL (ATS)
270 SETIRIZINE TABLET 10 MG

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
271 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 MCG/ML 1 ML
272 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG
273 SILK (BENANG BEDAH SUTERA) NO.3/0
274 SILVER AMALGAM SERBUK 65-75 %
275 SIMETIDINE TABLET 200 MG
276 SIMVASTATIN TABLET 10 MG
277 SIPROFLOXACIN INFUS 2%
278 SIPROFLOXACIN TABLET 500 MG
279 SIPROHEPTADINE 4 MG TABLET (PRONICY)
280 SPONS GELATIN CUBICLES 1x1x1 CM
281 SULFADOXINE - PYRIMETHAMINE 525 MG
282 SULFASETAMID NATRIUM TETES MATA 15 % 5 ML
283 TABLET TAMBAH DARAH

TEMPORARY CAVITY SEALER [TUMPATAN SEMENTARA]
284
(CAVIT G)
285 TEMPORARY STOPPING FLECHTER SERBUK DAN CAIRAN
286 TETRAKAIN HCL TETES MATA 5 ML
287 TETRASIKLIN HCL TABLET 500 MG
288 THIAMFENIKOL SIRUP 60 ML
289 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML
290 THIAMIN HCL MONONITRAT (VIT B1) TABLET 100 MG
292 TRAMADOL INJEKSI 50 MG/ML
293 TRANFUSION SET ADULT WITH Y INJECTION
294 TRIAMSINOLON ACETONIDE (BUFACOMB) 1MG/GR SALEP
295 TRIFLOUPERASIN TABLET 5 MG
296 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG
297 TRIKRESOL FORMALIN (PENGANTI TKF)
298 TRIPROLIDINE|PSEUDOEPHEDRINE (ZENTRA)
299 VIKIA HIV 1/2/0 RAPID TEST STRIPS
300 VITAMIN B COMPLEX TABLET
301 YODIUM POVIDON LARUTAN 10 % 30 ML
302 YODIUM POVIDON LARUTAN 10% 1000 ML
303 YODIUM POVIDON LARUTAN 10% 300 ML ML

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
305 ZINK 20 MG TABLET

RATA-RATA
PEMAKAIAN
2019
10
86
120
45
300
35
1,373
26
280
553
459
133
61
3,044
32
888
2,741
103
12
0
RATA-RATA
PEMAKAIAN
2019
46
15
3,562
2,012
10
248
49
30
85
325
25
15
18
58
0
RATA-RATA
PEMAKAIAN
2019
18
17
1,373
32
355
95
20
534
32
431
19
23
10
RATA-RATA
PEMAKAIAN
2019
200
20
45
357
15
15
14
10
297
2,087
46
368
322
34
55
11
10
13
27
35
RATA-RATA
PEMAKAIAN
2019
43
71
158
19
44
14
18
3,952
14
1,013
200
56
37
20
10
694
14
230
RATA-RATA
PEMAKAIAN
2019
100
118
12
11
1,828
13
951
20
61
457
100
43
75
647
64
473
28
121
RATA-RATA
PEMAKAIAN
2019
143
200
13
25
536
53
631
291
40
31
39
1,344
58
79
7,467
0
RATA-RATA
PEMAKAIAN
2019
40
2,207
482
85
256
57
347
19
200
315
249
23
112
111
74
376
256
RATA-RATA
PEMAKAIAN
2019
322
815
319
68
94
2,217
36
143
1,708
25
RATA-RATA
PEMAKAIAN
2019
0
KONVERSI RATA PEMAKAIAN 2020(dari file exel rekap baper 2021)
NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
4 ALABETIK TABLET
10 ALLOPURINOL TABLET 100 MG
11 ALPRAZOLAM 1 MG TABLET
12 AMBROXOL SIRUP 5MG/ML
13 AMBROXOL TABLET 30 MG
14 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML
15 AMINOPHYLLINE TABLET 200 MG
16 AMITRIPTYLLINE HCL TABLET 25 MG
19 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML
20 AMOKSISILIN TABLET 500 MG
21 AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL
22 ANTALGIN 500 MG TABLET (METAMIZOL)
23 ANTASIDA DOEN TABLET KOMBINASI
24 ANTASIDA SUSPENSI 60 ML
25 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR
26 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR
27 ANTI HAEMOROID DOEN KOMBINASI
28 ANTI INFLUENZA (EMFLU) KOMBINASI TAB
29 ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP
30 ANTI MIGRAIN DOEN TABLET KOMBINASI
31 ANTI SPASMODIK INJEKSI (SPASHI)
32 ANTI SPASMODIK TABLET (DORMICOMP)

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
33 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML
36 ASAM FOLAT 1MG TABLET
37 ASAM MEFENAMAT TABLET 500 MG
38 ASAM TRANEKSAMAT 100 MG/ML INJEKSI
39 ASAM TRANEKSAMAT 500 MG TABLET
40 ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER
41 ASEPTAN 500CC + PUMP
42 ASEPTIC GEL 500CC + DISPENSER
43 ASERING (ASETAT RINGER) SOFT BAG
44 ASETOSAL TABLET 100 (80) MG
45 ASIKLOVIR KREAM 5 % 5 GR
46 ASIKLOVIR TABLET 400 MG
47 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML
48 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET
49 BETAHISTINMESILAT 6 MG TABLET
50 BETAMETHASONE CREAM 0,1 % 5 GR
51 BISAKODIL ( BICOLAX ) TABLET 5 MG
54 BISOPROLOL 2,5 MG TABLET (CONCOR)
55 BISOPROLOL 5 MG TABLET
56 BROMHEXINE SIRUP (HUSTAB)
57 CAT GUT NO.2/0 CHROMIC
58 CAT GUT NO.2/0-3/0 PLAIN
59 CITICHOLIN 250 MG/ML-2ML INJEKSI
60 COMBIVENT UDV INHALASI
61 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML
62 DEKSAMETHASONE TABLET 0,5 MG
63 DEVITALISASI PASTA ( NON ARSEN )
64 DIAZEPAM INJEKSI 5 MG/ML 2 ML
65 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-STESOLID
NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
68 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML
69 DIGOXIN TABLET 0,25 MG
70 DIMENHYDRINATE TABLET 50 MG
71 DOKSISIKLIN TABLET 100 MG
72 DOMPERIDON SUSPENSI 5MG/ML
73 DOMPERIDON TABLET 10 MG
74 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR
75 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML
76 ERITROMISIN KAPSUL 250 MG
77 ERITROMISIN SIRUP KERING 200 MG/5ML
78 ERITROMISIN TABLET 500 MG
79 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML
80 ETANOL [ ALKOHOL ] 70 % 1000 ML
81 ETIL KLORIDA SEMPROT 100 ML
82 EUGENOL CAIRAN 10 ML
83 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML
84 FENITOIN NATRIUM TABLET 100 MG
85 FENOBARBITAL INJEKSI 50 MG/ML 2 ML
87 FENOL GLISEROL TETES TELINGA 10 % 5 ML
88 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 ML
89 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG
90 FITOMENADION INFANT INJ. 2MG/ML
91 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML
92 FUROSEMID INJEKSI
93 FUROSEMID TABLET 40 MG
94 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 GR
95 GEMFIBROZIL 300 MG KAPSUL
96 GENTAMISIN SALEP KULIT 0,1 % 5 GR
97 GENTAMISIN SALEP MATA 0,3%
98 GENTAMISIN TETES MATA 0,3%
99 GLASS IONOMER CEMENT ( GC IX )
100 GLIBENCLAMIDE TABLET 5 MG

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
101 GLICERIL GUAIACOLAT TABLET 100 MG
102 GLIMEPIRIDE 2 MG TABLET
103 GLUKOSA 40% DEXTROSE INJECTION U.S.P CAIRAN INJEKSI
106 GRISEOFULVIN TABLET 125 MG
107 HALOPERIDOL DEKANOAT INJ 50 MG
108 HALOPERIDOL INJ. 5 MG/ML (LODOMER)
109 HALOPERIDOL TABLET 1,5 MG
110 HALOPERIDOL TABLET 5 MG
111 HEPARIN SODIUM 200 UI (THROMBOFLASH)
112 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN INFUS 500 ML
113 HIDROCORTISONE CREAM 2,5 % 5 GR
120 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML
122 INFUSION SET ANAK
123 INFUSION SET DEWASA
124 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG
125 KAEN 3B
126 KALIUM DIKLOFENAK 50 MG TABLET
127 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML
128 KALSIUM LAKTAT (KALK) TABLET 500 MG
129 KANTONG URINE DEWASA
130 KAOLIN PEKTIN (NOVADIAR) SUSPENSI
131 KAPAS PEMBALUT/ABSORBEN 250 GR
132 KAPTOPRIL TABLET 25 MG
133 KARBAMAZEPIN TABLET 200 MG

134
ML (SALDONA)
NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
135 KASA KOMPRES 40/40 STERIL
136 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL
140 KASA STERIL (DARYAN TOLLE)YG DIRESAPI FRAMISETIN
141 KETOKONAZOLE TABLET 200 MG
142 KETOPROFEN 100 MG SUPPOSITORIA
145 KLOBAZAM 10 MG TABLET
146 KLORAMFENIKOL KAPSUL 500 MG
147 KLORAMFENIKOL SALEP KULIT 2 %
148 KLORAMFENIKOL SALEP MATA 1 %
149 KLORAMFENIKOL SUSPENSI 125 MG/5 ML
150 KLORAMFENIKOL TETES TELINGA 3 %
151 KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG

156 KODEIN HCL TABLET 10 MG
157 KOTRIMOKSAZOL DEWASA TABLET
158 KOTRIMOKSAZOL SUSPENSI 60 ML
159 LEVOFLOXACIN TABLET 500 MG
160 LIDOCAIN COMPOSITUM INJEKSI 2 ML
161 LISOL CONCENTRATE 1000 ML
162 LOPERAMIDE TABLET 2 MG
163 LORATADIN TABLET 10 MG
165 MASKER KERTAS 3 PLY EAR LOOP
166 MASKER KERTAS 3 PLY TIE ON
167 MELOKSIKAM TABLET 7,5 MG
168 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
169 METFORMIN TABLET 500 MG
170 METILERGOMETRIN MALEAT INJEKSI 0,200 MG 1 ML
171 METILERGOMETRIN MALEAT TABLET 0,125 MG
172 METILPREDNISOLON TABLET 4 MG
175 METOKLOPROMIDE (SOTATIC) INJEKSI 5 MG/ML 2 ML
176 METOKLOPROMIDE SIRUP
177 METRONIDAZOL + NYSTATIN VAG. (PROVAGIN) INJEKSI
180 METRONIDAZOLE INFUS 5 MG/ML 100 ML
181 MIKONAZOL KREAM 10 GR
182 MINERAL MIX
183 MULTIVITAMIN (LYSOVIT ) SYRUP 100 ML
184 MULTIVITAMIN (MALTIRON PLUS) KOMBINASI TABLET
187 NATRIUM KLORIDA INFUS 0,9 % STERIL
188 NEUROTROPIK (IKANEURON) INJEKSI
189 NEUROTROPIK KOMBINASI (IKANEURON) TABLET
190 NIFEDIPINE TABLET 10 MG
191 NISTATIN TABLET 500.000 UI
192 NISTATIN VAGINAL TABLET 100.000 UI
193 NOREPINEPHRINE CAIRAN INJEKSI
194 OBAT BATUK HITAM (OBH) CAIRAN 100 ML
195 OKSIGEN NASAL CANNULA ADULT
196 OKSIGEN NASAL CANNULA INFANT
197 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR
198 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR
199 OKSITOSIN INJEKSI 10 IU/ML 1 ML
200 OMEPRAZOLE TABLET 20 MG
201 ONDANSENTRON 4 MG/2 ML INJEKSI
202 PARACETAMOL SYRUP 120 MG/5 ML 60 ML

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
204 PARACETAMOL TETES 100 MG/ML 15 ML
205 PERAK SULFADIAZIN KRIM 1 %
206 PERHYDROL [ H2O2 ] 3 % 800 ML
207 PIRACETAM TABLET 800 MG
209 PIROKSIKAM KAPSUL 10 MG
210 PLESTER 5 YARD X 2 INCI (LEUKOPLAST)
211 PREDNISON TABLET 5 MG
212 PROPANOLOL HCL TABLET 40 MG
213 PROPILTHIOURACIL TABLET 100 MG
214 RANITIDIN INJEKSI 25 MG/ ML
215 RESPERIDON 2 MG TABLET
216 RINGER LAKTATE LARUTAN INFUS STERIL
219 SALEP 2-4 KOMBINASI 30 GR
220 SALICYL BEDAK 2 %
221 SARUNG TANGAM NON STERIL L
222 SARUNG TANGAN NON STERIL M
223 SARUNG TANGAN NON STERIL S
224 SARUNG TANGAN STERIL NO 6
225 SARUNG TANGAN STERIL NO. 7,5
226 SARUNG TANGAN STERILE NO.6,5
227 SARUNG TANGAN STERILE NO.7
228 SEFADROKSIL KAPSUL 500 MG
229 SEFIKSIM KAPSUL 100 MG
230 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML (ABU I)
231 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP (ATS)
232 SETIRIZINE TABLET 10 MG
233 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 MCG/ML 1 ML
234 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG
235 SILK (BENANG BEDAH SUTERA) NO.3/0
236 SIMETIDINE TABLET 200 MG

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
237 SIMVASTATIN TABLET 10 MG
238 SIPROFLOXACIN INFUS 2%
239 SIPROFLOXACIN TABLET 500 MG
240 SIPROHEPTADINE 4 MG TABLET (PRONICY)
241 SPONS GELATIN CUBICLES 1x1x1 CM
242 SULFADOKSIN TABLET
243 SULFASETAMID NATRIUM TETES MATA 15 % 5 ML
244 TABLET TAMBAH DARAH (DAK)

245
(CAVIT G)
246 TETRAKAIN HCL TETES MATA 5 ML
247 TETRASIKLIN HCL TABLET 500 MG
248 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML
251 TRAMADOL INJEKSI 50 MG/ML
252 TRANFUSION SET ADULT WITH Y INJECTION
253 TRIAMSINOLON ACETONIDE (BUFACOMB) 1MG/GR SALEP
254 TRIFLOUPERASIN TABLET 5 MG
255 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG
256 VITAMIN B COMPLEX TABLET
257 YODIUM POVIDON LARUTAN 10 % 30 ML
259 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE)
260 ZINK 20 MG TABLET
261 ZINK SYRUP

RATA-RATA
PEMAKAIAN
2020
10
16
22
145
47
4615
116
37
995
291
20
1064
246
2013
22
19
110
110
RATA-RATA
PEMAKAIAN
2020
207
1818
25
281
20
49
21
12
1320
305
220
45
12
260
12
18
39
1186
11
0
RATA-RATA
PEMAKAIAN
2020
141
13
21
359
18
825
36
10
18
302
35
13
15
341
RATA-RATA
PEMAKAIAN
2020
1149
626
24
16
371
163
10
10
20
20
276
21
16
128
29
138
682
107
0
RATA-RATA
PEMAKAIAN
2020
33
16
11
27
164
74
33
107
30
1892
10
491
41
52
105
654
19
10
324
212
33
RATA-RATA
PEMAKAIAN
2020
579
21
88
65
38
16
11
434
308
27
189
222
84
107
10
11
176
18
27
RATA-RATA
PEMAKAIAN
2020
2263
28
445
57
20
133
49
168
135
443
325
39
48
934
14
18
RATA-RATA
PEMAKAIAN
2020
180
128
2765
2335
1500
1523
23
10
123
738
1808
167
0
KONVERSI RATA PEMAKAIAN 2021(dari file exel rekap baper 2021)
NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
1 2 WAY FOLEY CATHETER NO.16 11 3 3 3 1 0 4 0 0 1 1 2
4 ACETYLCYSTEINE CAPSULE 200 MG 0 0 0 0 0 10 505 85 210 40 80 50
5 ALABETIK TABLET 0 0 0 0 0 0 0 0 0 0 0 0
6 ALAT SUNTIK SEKALI PAKAI 1 ML 0 0 0 0 0 0 0 0 200 0 1 1
11 ALLOPURINOL TABLET 100 MG 2030 375 329 467 352 140 10 2541 0 0 0 0
12 ALPRAZOLAM 1 MG TABLET 0 0 0 0 0 0 0 0 0 0 0 0
13 AMBROXOL SIRUP 5MG/ML 1 0 4 1 0 1 3 67 0 0 0 0
14 AMBROXOL TABLET 30 MG 0 0 0 0 0 0 0 0 0 0 0 0
15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML 0 0 0 0 0 0 0 30 0 0 0 0
16 AMINOPHYLLINE TABLET 200 MG 0 0 0 0 0 0 0 0 0 0 0 0
17 AMITRIPTYLLINE HCL TABLET 25 MG 202 60 45 31 98 60 120 20 13 0 0 0
18 AMLODIPINE TABLET 10 MG 1720 395 1491 300 972 599 785 134 660 740 1800 1565
19 AMLODIPINE TABLET 5 MG 1604 810 300 250 280 255 150 324 540 920 245 495
20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML 16 6 12 8 6 3 4 7 1 6 61 6
21 AMOKSISILIN SERBUK INJEKSI 10 12 11 23 10 11 3 5 12 6 7 7
22 AMOKSISILIN TABLET 500 MG 416 630 310 4974 140 315 240 280 195 315 885 290
23 AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL 0 0 0 0 0 0 0 0 0 0 0 0
24 ANTALGIN 500 MG TABLET (METAMIZOL) 782 100 190 443 268 130 100 60 130 120 260 64
25 ANTASIDA DOEN TABLET KOMBINASI 945 2245 1046 2499 962 1092 1114 900 1190 912 3181 1071
26 ANTASIDA SUSPENSI 60 ML 0 0 0 0 0 0 0 0 0 0 0 0
27 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR 0 0 0 0 0 0 0 0 0 0 0 0
28 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR 0 0 0 0 0 1 0 1 0 0 0 0
29 ANTI HAEMOROID DOEN KOMBINASI 11 0 3 13 0 0 10 30 9 10 9 2
30 ANTI INFLUENZA (EMFLU) KOMBINASI TAB 850 290 262 638 140 190 155 0 10 250 0 0
31 ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP 0 3 4 9 20 25 0 0 0 0 0 0
32 ANTI MIGRAIN DOEN TABLET KOMBINASI 0 0 0 0 0 0 0 0 0 0 0 0

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
33 ANTI SPASMODIK INJEKSI (SPASHI) 45 0 0 0 0 0 0 0 0 0 0 0
34 ANTI SPASMODIK TABLET (DORMICOMP) 395 0 0 0 0 0 0 0 0 0 0 0
35 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML 0 0 0 0 0 0 0 0 0 0 0 0
36 ASAM ASKORBAT ( VIT C ) TABLET 250 MG 0 0 0 0 0 0 0 0 0 0 0 0
37 ASAM ASKORBAT ( VIT C ) TABLET 50 MG 3389 2645 1134 415 100 0 0 0 0 0 0 0
38 ASAM FOLAT 1MG TABLET 220 70 60 70 0 0 0 20 0 0 10 10
39 ASAM MEFENAMAT TABLET 500 MG 100 365 538 761 380 614 480 386 2425 130 0 0
40 ASAM TRANEKSAMAT 100 MG/ML INJEKSI 20 20 0 0 0 0 0 0 0 0 0 0
41 ASAM TRANEKSAMAT 500 MG TABLET 0 10 960 0 0 0 0 0 0 0 0 0
42 ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER 100 90 10 0 0 0 0 0 0 0 0 0
43 ASEPTAN 500CC + PUMP 0 0 0 0 0 0 0 0 0 0 0 0
44 ASEPTIC GEL 500CC + DISPENSER 0 0 0 0 0 0 0 0 0 0 0 1
45 ASERING (ASETAT RINGER) SOFT BAG 0 0 0 1 0 0 0 0 0 0 0 0
46 ASETOSAL TABLET 100 (80) MG 0 0 0 0 0 0 0 0 0 0 0 0
47 ASIKLOVIR KREAM 5 % 5 GR 18 16 4 11 6 6 3 4 15 5 1 2
48 ASIKLOVIR TABLET 400 MG 25 0 0 0 0 0 0 0 0 0 0 0
49 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML 0 0 0 0 0 0 0 0 0 0 0 0
50 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET 2212 60 252 399 240 144 140 2538 0 0 0 0
51 BETAHISTINMESILAT 6 MG TABLET 0 0 0 0 0 0 0 0 0 0 0 0
52 BETAMETHASONE CREAM 0,1 % 5 GR 0 0 0 0 0 0 0 0 0 0 0 0
53 BISAKODIL ( BICOLAX ) TABLET 5 MG 0 0 0 0 0 0 0 0 0 0 0 0
54 BISAKODIL SUPPOSITORIA 10 MG 0 0 0 0 0 0 0 0 0 0 0 0
55 BISAKODIL SUPPOSITORIA 5 MG 0 0 0 0 0 0 0 1 0 0 0 0
56 BISOPROLOL 2,5 MG TABLET (CONCOR) 0 0 10 0 30 60 40 40 60 60 0 0
57 BISOPROLOL 5 MG TABLET 420 0 0 0 0 0 0 0 0 0 0 0
58 BROMHEXINE SIRUP (HUSTAB) 0 0 0 0 0 0 0 0 0 0 0 0
59 CAT GUT NO.2/0 CHROMIC 71 0 4 2 1 0 3 0 7 2 2 2
60 CAT GUT NO.2/0-3/0 PLAIN 1 205 0 0 0 0 0 0 0 0 53 0
61 CITICHOLIN 250 MG/ML-2ML INJEKSI 0 40 0 0 0 0 0 0 0 0 0 0
62 COMBIVENT UDV INHALASI 44 80 0 20 0 0 0 0 0 60 0 0
63 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML 0 0 0 1 0 0 0 0 0 0 74 0
64 DEKSAMETHASONE TABLET 0,5 MG 0 0 0 0 0 0 0 0 0 0 0 0
65 DEVITALISASI PASTA ( NON ARSEN ) 0 0 0 0 0 0 0 0 0 0 0 0
66 DIAZEPAM INJEKSI 5 MG/ML 2 ML 11 1 0 0 0 0 0 0 0 0 0 0

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
67 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-STESOLID 0 1 0 3 0 0 0 0 3 1 0 0
68 DIAZEPAM TABLET 2 MG 0 0 0 0 0 0 0 0 0 0 0 0
69 DIAZEPAM TABLET 5 MG 411 126 131 92 91 140 160 60 319 165 225 225
70 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML 2 2 51 0 0 0 1 0 0 0 18 0
71 DIGOXIN TABLET 0,25 MG 40 0 825 0 0 0 0 0 0 0 0 0
72 DIMENHYDRINATE TABLET 50 MG 1197 850 280 212 119 172 130 243 160 140 280 190
73 DOKSISIKLIN TABLET 100 MG 0 0 0 0 0 0 0 0 0 0 0 0
74 DOMPERIDON SUSPENSI 5MG/ML 1 0 2 55 0 0 0 0 0 95 0 0
75 DOMPERIDON TABLET 10 MG 0 0 0 0 0 0 0 0 0 0 0 0
76 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR 0 0 0 0 0 0 0 0 0 0 0 0
77 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML 0 0 0 0 0 0 0 0 0 0 0 0
78 ERITROMISIN KAPSUL 250 MG 0 0 0 0 0 0 0 0 0 0 0 0
79 ERITROMISIN SIRUP KERING 200 MG/5ML 0 0 0 0 0 0 0 0 0 0 0 0
80 ERITROMISIN TABLET 500 MG 0 0 0 0 0 0 0 0 0 0 0 0
81 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML 0 0 0 0 0 0 0 0 0 0 0 0
82 ETANOL [ ALKOHOL ] 70 % 1000 ML 3 1 12 3 0 2 0 0 0 0 0 5
83 ETIL KLORIDA SEMPROT 100 ML 0 1 2 1 0 2 0 3 0 0 0 0
84 EUGENOL CAIRAN 10 ML 0 0 0 0 0 0 0 0 0 0 0 0
85 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML 0 0 0 0 0 0 0 0 0 0 0 0
86 FENITOIN NATRIUM TABLET 100 MG 60 0 60 0 10 90 40 30 150 30 30 30
87 FENOBARBITAL INJEKSI 50 MG/ML 2 ML 0 0 0 0 0 0 0 0 0 0 0 0
88 FENOBARBITAL TABLET 30 MG 0 0 0 0 0 0 0 0 0 0 0 0
89 FENOL GLISEROL TETES TELINGA 10 % 5 ML 0 0 0 0 0 0 0 0 0 0 0 0
90 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 ML 0 0 0 0 0 0 0 0 0 0 0 0
91 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG 0 0 0 0 0 0 0 0 0 0 0 0
92 FITOMENADION INFANT INJ. 2MG/ML 0 0 0 0 0 0 0 0 0 0 0 0
93 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML 2 0 6 5 8 8 17 7 4 8 13 11
94 FUROSEMID INJEKSI 0 0 0 0 0 0 0 0 0 0 0 0
95 FUROSEMID TABLET 40 MG 15 0 100 112 116 303 170 190 165 235 954 355
96 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 GR 2 0 2 1 2 1 0 0 2 2 0 1
97 GEMFIBROZIL 300 MG KAPSUL 0 0 0 0 0 0 0 0 0 0 0 0
98 GENTAMISIN SALEP KULIT 0,1 % 5 GR 0 0 0 0 0 0 0 0 0 0 0 0
99 GENTAMISIN SALEP MATA 0,3% 0 0 0 0 0 0 0 0 0 0 0 0
100 GENTAMISIN TETES MATA 0,3% 0 0 0 0 0 0 0 0 0 0 0 0

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
101 GLASS IONOMER CEMENT ( GC IX ) 0 0 0 0 0 0 0 0 0 0 0 0
102 GLIBENCLAMIDE TABLET 5 MG 40 10 170 342 150 190 150 100 350 210 668 250
103 GLICERIL GUAIACOLAT TABLET 100 MG 1106 1228 720 586 0 0 0 4436 0 0 0 0
104 GLIMEPIRIDE 2 MG TABLET 4480 435 724 625 410 625 525 400 500 410 1310 570
105 GLUKOSA 40% DEXTROSE INJECTION U.S.P CAIRAN INJEKSI 0 0 0 4 0 0 0 14 0 0 0 0
106 GLUKOSA LARUTAN INFUS 10 % STERIL 0 0 0 10 0 0 12 0 0 0 0 0
107 GLUKOSA LARUTAN INFUS 5 % STERIL 0 0 0 0 0 0 0 0 0 0 0 0
108 GRISEOFULVIN TABLET 125 MG 0 0 0 0 0 0 0 0 0 0 500 0
109 HALOPERIDOL 2 MG 0 0 0 0 30 90 180 220 200 0 0 0
110 HALOPERIDOL DEKANOAT INJ 50 MG 13 19 3 3 0 0 0 0 0 0 0 0
111 HALOPERIDOL INJ. 5 MG/ML (LODOMER) 0 0 0 0 0 0 0 0 0 210 330 330
112 HALOPERIDOL TABLET 1,5 MG 2124 255 535 520 536 490 250 315 315 190 230 60
113 HALOPERIDOL TABLET 5 MG 200 190 75 0 0 0 0 0 0 0 0 0
114 HEPARIN SODIUM 200 UI (THROMBOFLASH) 0 0 0 0 0 0 0 0 0 0 0 0
115 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN INFUS 500 ML 0 0 0 0 0 0 0 0 0 0 0 0
116 HIDROCORTISONE CREAM 2,5 % 5 GR 13 4 68 2 0 0 0 0 0 65 0 0
117 I.V CATHETER NO.16 WITH INJECTION PORT 4 50 1 0 0 0 0 0 0 1 0 22
123 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML 4 0 1 6 0 0 0 139 0 0 0 0
124 IBUPROFEN TABLET 400 MG 100 245 350 95 0 0 0 0 0 0 0 0
125 INFUSION SET ANAK 0 1 2 0 0 0 0 3 0 1 0 0
126 INFUSION SET DEWASA 61 10 17 15 10 1 18 6 16 9 5 5
127 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG 80 210 0 13 0 12 10 40 10 1040 0 0
128 KAEN 3B 20 2 5 7 4 1 0 0 1 1 0 0
129 KALIUM DIKLOFENAK 50 MG TABLET 0 0 0 0 0 0 0 0 0 0 0 0
130 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML 0 0 0 0 0 0 0 0 0 0 0 0
131 KALSIUM LAKTAT (KALK) TABLET 500 MG 6320 1455 1810 2820 1608 2171 2010 1755 1799 1421 6566 2722
132 KANTONG URINE DEWASA 0 0 0 0 0 0 0 0 0 25 8 0
133 KAOLIN PEKTIN (NOVADIAR) SUSPENSI 0 1 0 2 4 0 0 0 0 42 0 0
134 KAPAS PEMBALUT/ABSORBEN 250 GR 3 0 7 2 0 1 0 0 8 0 0 1

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
135 KAPTOPRIL TABLET 25 MG 595 980 1392 1238 1010 1536 150 156 0 0 0 0
136 KARBAMAZEPIN TABLET 200 MG 332 0 190 90 60 275 0 115 100 120 90 100
137 0 0 0 0 0 0 0 0 0 0 0 0
ML (SALDONA)
138 KASA KOMPRES 40/40 STERIL 8 0 7 0 4 0 10 4 13 10 8 8
139 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL 58 12 14 13 18 5 17 44 45 13 17 17
140 KASA PEMBALUT HIDROFIL 2 M X 80 CM 27 0 1 7 2 0 0 6 7 1 0 0
143 KASA STERIL (DARYAN TOLLE)YG DIRESAPI FRAMISETIN 0 0 0 0 0 0 0 30 0 0 0 0
144 KETOKONAZOLE TABLET 200 MG 70 320 202 200 90 380 150 320 1803 0 0 0
145 KETOPROFEN 100 MG SUPPOSITORIA 0 0 0 0 0 0 0 0 0 0 0 0
146 KLINDAMISIN KAPSUL 150 MG 15 40 0 20 10 20 0 10 40 20 80 10
147 KLINDAMISIN KAPSUL 300 MG 0 0 0 0 0 0 0 0 0 0 0 0
148 KLOBAZAM 10 MG TABLET 44 30 120 60 80 90 120 60 595 90 90 90
149 KLORAMFENIKOL KAPSUL 500 MG 0 30 45 142 28 0 20 0 1663 20 80 900
150 KLORAMFENIKOL SALEP KULIT 2 % 0 0 0 0 0 0 0 0 0 19 0 0
151 KLORAMFENIKOL SALEP MATA 1 % 22 0 0 0 0 0 0 0 0 0 0 0
152 KLORAMFENIKOL SUSPENSI 125 MG/5 ML 0 0 0 4 0 0 0 0 0 35 0 150
153 KLORAMFENIKOL TETES TELINGA 3 % 0 0 0 0 0 0 0 0 0 0 0 0
154 KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG 5824 1147 903 808 766 766 814 790 760 470 1584 517
155 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML 6 4 6 0 1 0 30 1 0 1 0 0
156 KLORPROMAZIN HCL TABLET 100 MG 3180 515 520 410 495 405 330 320 599 210 653 440
157 KLOZAPIN 100 MG TABLET 710 65 141 75 75 120 75 75 124 45 154 115
158 KLOZAPIN 25 MG TABLET 0 0 0 0 0 0 0 0 0 0 0 0
159 KODEIN HCL TABLET 10 MG 40 10 0 0 20 10 75 0 0 0 5 5
160 KOTRIMOKSAZOL DEWASA TABLET 0 0 1968 0 0 0 0 0 0 0 0 0
161 KOTRIMOKSAZOL SUSPENSI 60 ML 0 0 2 0 1 3 3 0 0 0 1 1
162 LEVOFLOXACIN TABLET 500 MG 0 0 0 0 0 0 0 0 0 0 0 0
163 LIDOCAIN 2% INJ 2 13 12 0 0 0 0 3 0 1 2 2
164 LIDOCAIN COMPOSITUM INJEKSI 2 ML 0 0 0 0 0 0 0 0 0 0 0 0
165 LISOL CONCENTRATE 1000 ML 0 0 2 0 0 0 0 0 0 0 0 0
166 LOPERAMIDE TABLET 2 MG 0 0 0 0 0 0 0 0 0 0 0 0
167 LORATADIN TABLET 10 MG 0 0 0 0 0 0 0 0 0 10 340 0
168 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML 24 0 20 0 2 0 0 18 0 0 0 0

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
169 MASKER KERTAS 3 PLY EAR LOOP 0 0 0 0 0 0 0 0 0 0 0 0
170 MASKER KERTAS 3 PLY TIE ON 85 0 0 0 0 0 0 0 0 0 0 0
171 MELOKSIKAM TABLET 7,5 MG 0 0 0 0 0 0 0 0 0 0 0 0
172 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML 5 8 17 13 4 0 1 0 1 0 0 0
173 METFORMIN TABLET 500 MG 0 0 0 0 0 0 0 0 0 0 0 0
174 METILERGOMETRIN MALEAT INJEKSI 0,200 MG 1 ML 500 0 0 0 0 0 0 0 8 0 0 0
175 METILERGOMETRIN MALEAT TABLET 0,125 MG 0 450 50 40 20 40 20 50 60 60 30 20
176 METILPREDNISOLON TABLET 4 MG 0 125 51 102 85 150 40 50 155 70 143 869
177 METOKLOPRAMIDE 10 MG TABLET 0 0 0 0 0 0 0 0 0 0 0 0
178 METOKLOPRAMIDE 5 MG TABLET 0 0 0 0 0 0 0 0 0 0 0 0
179 METOKLOPROMIDE (SOTATIC) INJEKSI 5 MG/ML 2 ML 0 0 0 0 0 0 0 0 0 0 0 0
180 METOKLOPROMIDE SIRUP 0 0 0 0 0 0 0 0 0 0 0 0
181 METRONIDAZOL + NYSTATIN VAG. (PROVAGIN) INJEKSI 0 0 0 0 0 0 0 0 0 0 0 0
182 METRONIDAZOL TABLET 250 MG 0 0 0 0 0 0 0 0 0 0 0 0
183 METRONIDAZOL TABLET 500 MG 180 45 72 140 51 80 60 140 110 0 647 0
184 METRONIDAZOLE INFUS 5 MG/ML 100 ML 0 0 0 0 0 0 0 0 0 0 0 0
185 MIKONAZOL KREAM 10 GR 18 5 3 9 0 0 0 0 0 0 1 1
186 MINERAL MIX 40 0 0 0 0 0 0 0 0 0 0 0
187 MULTIVITAMIN (LYSOVIT ) SYRUP 100 ML 0 0 0 0 0 0 0 0 0 0 0 0
188 MULTIVITAMIN (MALTIRON PLUS) KOMBINASI TABLET 0 0 0 0 0 0 0 0 0 0 0 0
189 NATRIUM DIKLOFENAK TABLET 25 MG 145 445 529 474 315 360 240 290 2770 454 1355 758
190 NATRIUM DIKLOFENAK TABLET 50 MG 0 0 0 0 0 0 0 0 0 0 0 0
191 NATRIUM KLORIDA INFUS 0,9 % STERIL 0 0 56 0 7 4 13 4 2 7 4 4
192 NEUROTROPIK (IKANEURON) INJEKSI 0 0 0 0 0 0 0 0 0 0 0 0
193 NEUROTROPIK KOMBINASI (IKANEURON) TABLET 0 0 0 0 0 0 0 0 0 0 0 0
194 NIFEDIPINE TABLET 10 MG 0 0 0 0 0 0 0 0 0 0 0 0
195 NISTATIN TABLET 500.000 UI 110 70 10 100 10 720 10 120 0 0 0 0
196 NISTATIN VAGINAL TABLET 100.000 UI 5 5 26 5 35 24 6 33 40 4 24 7
197 NOREPINEPHRINE CAIRAN INJEKSI 0 50 0 0 0 0 0 0 0 0 0 0
198 OBAT BATUK HITAM (OBH) CAIRAN 100 ML 3 5 13 21 12 6 1 0 0 0 0 0
199 OKSIGEN NASAL CANNULA ADULT 1 0 2 1 1 0 16 4 1 7 5 5
200 OKSIGEN NASAL CANNULA INFANT 0 1 2 0 4 0 10 3 0 1 5 5
201 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR 0 0 0 0 0 0 0 95 0 0 0 0
202 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR 0 0 0 0 0 0 0 0 0 0 0 0

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
203 OKSITOSIN INJEKSI 10 IU/ML 1 ML 0 0 0 0 0 0 1 0 32 0 0 0
204 OMEPRAZOLE TABLET 20 MG 169 56 0 0 10 0 0 0 0 0 0 0
205 ONDANSENTRON 4 MG/2 ML INJEKSI 3 1 190 2 11 0 0 1 0 0 0 86
206 PARACETAMOL SYRUP 120 MG/5 ML 60 ML 0 0 0 0 0 0 0 0 1 4 66 64
207 PARACETAMOL TABLET 500 MG 500 0 0 0 0 0 0 0 0 0 0 0
208 PARACETAMOL TETES 100 MG/ML 15 ML 0 0 0 0 0 0 0 0 0 0 0 0
209 PEHAVRAL TABLET 0 0 0 0 0 0 0 0 0 0 0 0
210 PERAK SULFADIAZIN KRIM 1 % 0 0 0 0 0 0 0 0 0 0 0 0
211 PERHYDROL [ H2O2 ] 3 % 800 ML 0 0 0 0 0 0 0 0 0 0 0 0
212 PIRACETAM TABLET 800 MG 55 70 60 30 0 30 0 20 0 0 0 0
213 PIRANTEL PAMOAT TABLET 0 0 0 0 0 0 0 0 0 0 0 0
214 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG 0 0 0 0 0 0 0 0 0 0 0 0
215 PIROKSIKAM KAPSUL 10 MG 0 0 0 0 0 0 0 0 0 0 0 0
216 PLESTER 5 YARD X 2 INCI (LEUKOPLAST) 0 0 0 0 0 0 0 0 0 0 0 0
217 PREDNISON TABLET 5 MG 1045 120 176 235 316 266 50 60 55 300 1155 150
218 PROPANOLOL HCL TABLET 40 MG 0 0 0 0 0 0 0 0 0 0 0 0
219 PROPILTHIOURACIL TABLET 100 MG 0 0 0 0 0 0 0 0 0 0 0 0
220 RANITIDIN INJEKSI 25 MG/ ML 77 79 0 3 6 0 0 1 0 0 0 0
221 RESPERIDON 2 MG TABLET 2220 240 260 165 270 230 180 150 340 120 296 180
222 RINGER LAKTATE LARUTAN INFUS STERIL 107 20 31 28 13 8 26 7 9 9 5 5
223 SALBUTAMOL TABLET 2 MG 0 0 0 0 0 0 0 0 0 0 0 0
224 SALBUTAMOL TABLET 4 MG 0 0 0 0 0 0 0 0 0 0 0 0
225 SALEP 2-4 KOMBINASI 30 GR 0 0 0 0 1 0 1 1 4 2 3 3
226 SALICYL BEDAK 2 % 0 0 0 0 0 0 0 0 0 0 0 0
227 SARUNG TANGAM NON STERIL L 0 88 0 0 0 0 0 100 0 10 0 0
228 SARUNG TANGAN NON STERIL M 0 0 0 0 0 0 0 0 400 0 0 0
229 SARUNG TANGAN NON STERIL S 0 0 0 0 0 0 0 100 400 0 0 0
230 SARUNG TANGAN STERIL NO 6 0 0 0 0 0 0 0 0 0 0 0 0
231 SARUNG TANGAN STERIL NO. 7,5 0 0 0 0 0 0 0 0 0 0 0 0
232 SARUNG TANGAN STERILE NO.6,5 14 8 7 4 0 0 9 3 0 0 0 0
233 SARUNG TANGAN STERILE NO.7 83 2 19 21 3 1 20 53 21 10 2 2
234 SEFADROKSIL KAPSUL 500 MG 0 0 0 0 0 0 0 0 0 0 0 0
235 SEFIKSIM KAPSUL 100 MG 0 0 0 0 0 0 0 0 0 0 0 0
236 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML (ABU I) 5 1 0 0 0 0 0 0 0 0 0 0

NO NAMA OBAT
1 2 3 4 5 6 7 8 9 10 11 12
237 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP (ATS) 13 0 0 0 0 0 1 0 0 0 0 0
238 SETIRIZINE TABLET 10 MG 0 0 0 0 0 23 0 0 0 0 0 0
239 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 MCG/ML 1 ML 0 0 0 0 0 0 0 0 0 0 0 0
240 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG 2010 300 260 450 584 555 530 370 1235 738 1327 541
241 SILK (BENANG BEDAH SUTERA) NO.3/0 1 25 0 1 3 0 0 108 2 0 0 0
242 SIMETIDINE TABLET 200 MG 0 0 0 0 0 0 0 0 0 0 0 0
243 SIMVASTATIN TABLET 10 MG 0 55 199 114 131 420 130 90 60 180 842 440
244 SIPROFLOXACIN INFUS 2% 0 0 0 0 0 0 0 0 0 0 0 0
245 SIPROFLOXACIN TABLET 500 MG 0 0 0 0 0 0 0 0 0 0 0 0
246 SIPROHEPTADINE 4 MG TABLET (PRONICY) 0 0 0 0 0 0 0 0 0 0 0 0
247 SPONS GELATIN CUBICLES 1x1x1 CM 0 0 0 0 0 0 0 0 0 0 0 0
248 STIMUNO SYR 0 0 0 0 0 0 0 0 0 0 0 0
249 STIMUNO TAB (100) 0 0 0 0 0 0 0 0 0 0 0 0
250 STIMUNO TAB (30) 0 0 0 0 0 0 0 0 0 0 0 0
251 SULFADOKSIN TABLET 0 0 0 0 0 0 0 0 0 0 0 0
252 SULFASETAMID NATRIUM TETES MATA 15 % 5 ML 0 0 0 0 0 0 0 0 0 0 0 0
253 TABLET TAMBAH DARAH (DAK) 0 0 0 0 830 1600 1575 990 605 0 0 0
254 0 0 0 0 0 0 0 0 0 0 0 0
(CAVIT G)
255 TETRAKAIN HCL TETES MATA 5 ML 0 0 0 0 0 0 0 0 0 0 0 0
256 TETRASIKLIN HCL TABLET 500 MG 0 0 0 0 0 0 0 0 0 0 0 0
257 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML 0 0 0 0 0 0 0 0 0 0 0 0
258 THIAMIN HCL MONONITRAT (VIT B1) TABLET 100 MG 0 0 0 0 0 0 0 0 0 0 0 0
259 THIAMIN HCL MONONITRAT (VIT B1) TABLET 50 MG 541 850 780 132 460 218 490 570 1212 312 2395 40
260 TRAMADOL INJEKSI 50 MG/ML 0 0 0 0 0 0 0 0 0 0 0 0
261 TRANFUSION SET ADULT WITH Y INJECTION 102 0 1 0 1 0 5 0 0 0 0 0
262 TRIAMSINOLON ACETONIDE (BUFACOMB) 1MG/GR SALEP 0 0 0 0 0 0 0 0 0 0 0 0
263 TRIFLOUPERASIN TABLET 5 MG 150 0 95 60 95 95 135 155 155 40 145 105
264 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG 2889 1770 835 535 685 555 585 385 781 285 708 570
265 VITAMIN B COMPLEX TABLET 6693 1635 1169 920 388 855 1854 825 3978 1480 2073 1963
266 YODIUM POVIDON LARUTAN 10 % 30 ML 0 0 2 0 0 0 1 2 2 20 6 0
267 YODIUM POVIDON LARUTAN 10% 60 ML 0 0 1 0 0 0 0 0 0 6 0 0
268 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) 0 0 0 0 0 0 0 0 0 0 0 0
269 ZINK 20 MG TABLET 0 0 0 0 0 0 0 0 40 170 10 10
270 ZINK SYRUP 0 0 0 0 0 0 0 0 0 0 0

RATA-RATA
PEMAKAIAN
2021
203
200
78
1,561
19
162
1,764
1,128
16
15
1,875
551
2,998
19
634
15
0
RATA-RATA
PEMAKAIAN
2021
11
99
1,921
110
1,512
10
243
50
21
1,496
60
420
22
52
10
36
6
RATA-RATA
PEMAKAIAN
2021
383
14
216
841
15
110
14
293
0
RATA-RATA
PEMAKAIAN
2021
376
2,019
2,181
180
10
1,335
116
22
14
16
38
198
39
94
10
5,437
5
RATA-RATA
PEMAKAIAN
2021
1,764
291
12
57
13
62
12
884
39
300
482
3,145
12
1,694
365
39
492
16
RATA-RATA
PEMAKAIAN
2021
21
12
127
183
190
220
10
1,392
22
288
45
13
15
24
0
RATA-RATA
PEMAKAIAN
2021
59
52
125
66
581
42
1,014
62
47
100
125
11
56
2
RATA-RATA
PEMAKAIAN
2021
1,574
35
300
1,400
1,313
27
235
2,255
4,579
10
0
2022 CETAK RKO
NO NAMA OBAT SATUAN 2019 2020
1 2 WAY FOLEY CATHETER NO.16 PCS 10 6
4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE 0 0
5 ALABETIK TABLET TABLET 0 0
6 ALAT SUNTIK SEKALI PAKAI 1 ML PCS 86 16
11 ALLOPURINOL TABLET 100 MG TABLET 300 47
12 ALPRAZOLAM 1 MG TABLET TABLET 0 0
13 AMBROXOL SIRUP 5MG/ML BOTOL 35 8
14 AMBROXOL TABLET 30 MG TABLET 1,373 4,615
15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL 26 0
16 AMINOPHYLLINE TABLET 200 MG TABLET 0 116
17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET 280 37
18 AMLODIPINE TABLET 10 MG TABLET 553 995
19 AMLODIPINE TABLET 5 MG TABLET 459 291
20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL 61 20
22 AMOKSISILIN SERBUK INJEKSI VIAL 0 0
21 AMOKSISILIN TABLET 500 MG KAPLET 3,044 1,064
23 AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL VIAL 32 0
24 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET 0 246
25 ANTASIDA DOEN TABLET KOMBINASI TABLET 2,741 2,013
26 ANTASIDA SUSPENSI 60 ML BOTOL 103 22

27 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT 0 0
28 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT 5 0
29 ANTI HAEMOROID DOEN KOMBINASI SUPP. 12 19
30 ANTI INFLUENZA (EMFLU) KOMBINASI TAB TABLET 0 110
31 ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP BOTOL 46 7
32 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET 0 0
33 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL 0 4
34 ANTI SPASMODIK TABLET (DORMICOMP) TABLET 0 110
35 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML BOTOL 15 207
36 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET 3,562 0
37 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET 2,012 1,818
38 ASAM FOLAT 1MG TABLET TABLET 0 25
39 ASAM MEFENAMAT TABLET 500 MG TABLET 0 281
40 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL 10 20
41 ASAM TRANEKSAMAT 500 MG TABLET TABLET 248 49
42 ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER TABLET 0 0
43 ASEPTAN 500CC + PUMP BOTOL 3 2
44 ASEPTIC GEL 500CC + DISPENSER BOTOL 5 2
45 ASERING (ASETAT RINGER) SOFT BAG BOTOL 0 21
46 ASETOSAL TABLET 100 (80) MG TABLET 49 0
47 ASIKLOVIR KREAM 5 % 5 GR TUBE 30 12
48 ASIKLOVIR TABLET 400 MG TABLET 85 1,320
49 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL 4 0
50 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET TABLET 325 305
51 BETAHISTINMESILAT 6 MG TABLET TABLET 0 220
52 BETAMETHASONE CREAM 0,1 % 5 GR TUBE 25 45
53 BISAKODIL ( BICOLAX ) TABLET 5 MG TABLET 0 0
54 BISAKODIL SUPPOSITORIA 10 MG SUPP. 15 12
55 BISAKODIL SUPPOSITORIA 5 MG SUPP. 6 4

56 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET 0 0
57 BISOPROLOL 5 MG TABLET TABLET 0 260
58 BROMHEXINE SIRUP (HUSTAB) BOTOL 0 0
59 CAT GUT NO.2/0 CHROMIC PCS 18 0
60 CAT GUT NO.2/0-3/0 PLAIN PCS 58 12
61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL 0 1
62 COMBIVENT UDV INHALASI VIAL 18 18
63 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL 17 39
64 DEKSAMETHASONE TABLET 0,5 MG TABLET 1,373 1,186
65 DEVITALISASI PASTA ( NON ARSEN ) POT 0 0
66 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL 32 11
67 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-STESOLID TUBE 5 1
68 DIAZEPAM TABLET 2 MG TABLET 0 0
69 DIAZEPAM TABLET 5 MG TABLET 355 141
70 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL 95 13
71 DIGOXIN TABLET 0,25 MG TABLET 20 21
72 DIMENHYDRINATE TABLET 50 MG TABLET 534 359
73 DOKSISIKLIN TABLET 100 MG KAPSUL 0 0
74 DOMPERIDON SUSPENSI 5MG/ML BOTOL 32 18
75 DOMPERIDON TABLET 10 MG TABLET 431 825
76 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR TUBE 4 36
77 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL 6 0
78 ERITROMISIN KAPSUL 250 MG KAPSUL 0 0
79 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL 0 1
80 ERITROMISIN TABLET 500 MG KAPSUL 0 0
81 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML BOTOL 5 0
82 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL 0 3
83 ETIL KLORIDA SEMPROT 100 ML BOTOL 3 1
84 EUGENOL CAIRAN 10 ML BOTOL 0 0

85 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL 0 0
86 FENITOIN NATRIUM TABLET 100 MG KAPSUL 0 10
87 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL 19 0
88 FENOBARBITAL TABLET 30 MG TABLET 0 0
89 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL 23 0
90 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 ML AMPUL 10 18
91 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG TABLET 200 0
92 FITOMENADION INFANT INJ. 2MG/ML AMPUL 9 0
93 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML AMPUL 20 2
94 FUROSEMID INJEKSI VIAL 0 0
95 FUROSEMID TABLET 40 MG TABLET 357 302
96 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 GR TUBE 3 5
97 GEMFIBROZIL 300 MG KAPSUL KAPSUL 15 35
98 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE 15 13
99 GENTAMISIN SALEP MATA 0,3% TUBE 14 9
100 GENTAMISIN TETES MATA 0,3% BOTOL 10 15
101 GLASS IONOMER CEMENT ( GC IX ) BOTOL 0 0
102 GLIBENCLAMIDE TABLET 5 MG TABLET 297 341
103 GLICERIL GUAIACOLAT TABLET 100 MG TABLET 2,087 1,149
104 GLIMEPIRIDE 2 MG TABLET TABLET 0 626
GLUKOSA 40% DEXTROSE INJECTION U.S.P CAIRAN

105 VIAL 0 1
INJEKSI
106 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL 0 2
107 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL 46 24
108 GRISEOFULVIN TABLET 125 MG TABLET 368 16
112 HALOPERIDOL 2 MG TABLET 0 0
109 HALOPERIDOL DEKANOAT INJ 50 MG VIAL 0 4
110 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL 0 0
111 HALOPERIDOL TABLET 1,5 MG TABLET 322 371
113 HALOPERIDOL TABLET 5 MG TABLET 0 163

114 HEPARIN SODIUM 200 UI (THROMBOFLASH) TUBE 0 0
HES-HYDROXYETHYL STARCH 6 %/VOLUVEN INFUS 500

115 BOTOL 4 1
ML
116 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE 34 10
117 I.V CATHETER NO.16 WITH INJECTION PORT PCS 10 6
123 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL 71 0
124 IBUPROFEN TABLET 400 MG TABLET 158 276
125 INFUSION SET ANAK PCS 19 21
126 INFUSION SET DEWASA PCS 44 16
127 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET 14 128
128 KAEN 3B BOTOL 18 9
129 KALIUM DIKLOFENAK 50 MG TABLET TABLET 0 0
130 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML AMPUL 6 29
131 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET 3,952 138
132 KANTONG URINE DEWASA PCS 9 5
133 KAOLIN PEKTIN (NOVADIAR) SUSPENSI BOTOL 14 6
134 KAPAS PEMBALUT/ABSORBEN 250 GR BKS 2 8
135 KAPTOPRIL TABLET 25 MG TABLET 1,013 682
136 KARBAMAZEPIN TABLET 200 MG TABLET 200 107
KARBAZOKHROME SODIUM SULFONATE INJEKSI 5

137 AMPUL 0 0
MG/ML 10 ML (SALDONA)
138 KASA KOMPRES 40/40 STERIL BKS 56 33
139 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL 37 16
140 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL 9 11

KASA STERIL (DARYAN TOLLE)YG DIRESAPI
143 PCS 10 1
FRAMISETIN
144 KETOKONAZOLE TABLET 200 MG TABLET 694 164
145 KETOPROFEN 100 MG SUPPOSITORIA SUPP. 14 0
146 KLINDAMISIN KAPSUL 150 MG TABLET 0 74
147 KLINDAMISIN KAPSUL 300 MG KAPSUL 230 0
148 KLOBAZAM 10 MG TABLET TABLET 100 33
149 KLORAMFENIKOL KAPSUL 500 MG KAPSUL 118 107
150 KLORAMFENIKOL SALEP KULIT 2 % TUBE 0 9
151 KLORAMFENIKOL SALEP MATA 1 % TUBE 12 30
152 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL 9 4
153 KLORAMFENIKOL TETES TELINGA 3 % BOTOL 11 9
154 KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG TABLET 1,828 1,892
155 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL 13 10
156 KLORPROMAZIN HCL TABLET 100 MG TABLET 951 491
157 KLOZAPIN 100 MG TABLET TABLET 20 41
158 KLOZAPIN 25 MG TABLET TABLET 0 52
159 KODEIN HCL TABLET 10 MG TABLET 61 105
160 KOTRIMOKSAZOL DEWASA TABLET TABLET 457 654
161 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL 100 0
162 LEVOFLOXACIN TABLET 500 MG TABLET 0 0
163 LIDOCAIN 2% INJ AMPUL 0 0
164 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL 43 19
165 LISOL CONCENTRATE 1000 ML BOTOL 1 1
166 LOPERAMIDE TABLET 2 MG TABLET 75 0
167 LORATADIN TABLET 10 MG TABLET 3 0
168 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL 2 10
169 MASKER KERTAS 3 PLY EAR LOOP PCS 647 324
170 MASKER KERTAS 3 PLY TIE ON PCS 0 212
171 MELOKSIKAM TABLET 7,5 MG TABLET 0 0

172 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL 64 33
173 METFORMIN TABLET 500 MG TABLET 473 579
174 METILERGOMETRIN MALEAT INJEKSI 0,200 MG 1 ML AMPUL 28 21
175 METILERGOMETRIN MALEAT TABLET 0,125 MG TABLET 121 88
176 METILPREDNISOLON TABLET 4 MG TABLET 0 65
177 METOKLOPRAMIDE 10 MG TABLET TABLET 0 0
178 METOKLOPRAMIDE 5 MG TABLET TABLET 0 0
179 METOKLOPROMIDE (SOTATIC) INJEKSI 5 MG/ML 2 ML AMPUL 0 3
180 METOKLOPROMIDE SIRUP BOTOL 0 0
METRONIDAZOL + NYSTATIN VAG. (PROVAGIN)

181 VIAL 0 0
INJEKSI
182 METRONIDAZOL TABLET 250 MG TABLET 143 0
183 METRONIDAZOL TABLET 500 MG TABLET 200 38
184 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL 0 0
185 MIKONAZOL KREAM 10 GR TUBE 13 16
186 MINERAL MIX SACHET 0 0
187 MULTIVITAMIN (LYSOVIT ) SYRUP 100 ML BOTOL 25 11
188 MULTIVITAMIN (MALTIRON PLUS) KOMBINASI TABLET TABLET 0 0
189 NATRIUM DIKLOFENAK TABLET 25 MG TABLET 0 434
190 NATRIUM DIKLOFENAK TABLET 50 MG TABLET 536 308
191 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL 53 27
192 NEUROTROPIK (IKANEURON) INJEKSI AMPUL 0 0
193 NEUROTROPIK KOMBINASI (IKANEURON) TABLET TABLET 0 189
194 NIFEDIPINE TABLET 10 MG TABLET 631 222
195 NISTATIN TABLET 500.000 UI TABLET 291 84
196 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB 40 107
197 NOREPINEPHRINE CAIRAN INJEKSI AMPUL 0 2
198 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL 31 4
199 OKSIGEN NASAL CANNULA ADULT PCS 6 3
200 OKSIGEN NASAL CANNULA INFANT PCS 6 10

201 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE 0 0
202 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE 0 0
203 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL 39 11
204 OMEPRAZOLE TABLET 20 MG KAPSUL 1,344 176
205 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL 58 18
206 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL 79 27
207 PARACETAMOL TABLET 500 MG TABLET 7,467 2,263
208 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL 0 0
209 PEHAVRAL TABLET TABLET 0 0
210 PERAK SULFADIAZIN KRIM 1 % TUBE 0 0
211 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL 0 0
212 PIRACETAM TABLET 800 MG TABLET 40 28
213 PIRANTEL PAMOAT TABLET TABLET 0 0
214 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET 2,207 445
215 PIROKSIKAM KAPSUL 10 MG KAPSUL 0 0
216 PLESTER 5 YARD X 2 INCI (LEUKOPLAST) ROL 0 0
217 PREDNISON TABLET 5 MG TABLET 482 57
218 PROPANOLOL HCL TABLET 40 MG TABLET 0 0
219 PROPILTHIOURACIL TABLET 100 MG TABLET 0 0
220 RANITIDIN INJEKSI 25 MG/ ML AMPUL 85 20
221 RESPERIDON 2 MG TABLET TABLET 256 133
222 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL 57 49
223 SALBUTAMOL TABLET 2 MG TABLET 0 0
224 SALBUTAMOL TABLET 4 MG TABLET 347 168
225 SALEP 2-4 KOMBINASI 30 GR POT 2 0
226 SALICYL BEDAK 2 % KOTAK 19 6
227 SARUNG TANGAM NON STERIL L PCS 200 135
228 SARUNG TANGAN NON STERIL M PCS 315 443
229 SARUNG TANGAN NON STERIL S PCS 249 325

230 SARUNG TANGAN STERIL NO 6 PSG 112 0
231 SARUNG TANGAN STERIL NO. 7,5 PSG 0 0
232 SARUNG TANGAN STERILE NO.6,5 PSG 111 39
233 SARUNG TANGAN STERILE NO.7 PSG 74 48
234 SEFADROKSIL KAPSUL 500 MG KAPSUL 376 0
235 SEFIKSIM KAPSUL 100 MG KAPSUL 0 0
236 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML (ABU I) VIAL 4 1
237 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP (ATS) VIAL 2 3
238 SETIRIZINE TABLET 10 MG TABLET 256 0
SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 MCG/ML 1

239 AMPUL 0 0
ML
240 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET 322 934
241 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS 6 14
242 SIMETIDINE TABLET 200 MG TABLET 815 18
243 SIMVASTATIN TABLET 10 MG TABLET 319 180
244 SIPROFLOXACIN INFUS 2% BOTOL 0 0
245 SIPROFLOXACIN TABLET 500 MG TABLET 68 128
246 SIPROHEPTADINE 4 MG TABLET (PRONICY) TABLET 0 0
247 SPONS GELATIN CUBICLES 1x1x1 CM PCS 0 0
252 STIMUNO SYR BOTOL 0 0
250 STIMUNO TAB (100) TABLET 0 0
251 STIMUNO TAB (30) BOTOL 0 0
248 SULFADOKSIN TABLET TABLET 0 0
249 SULFASETAMID NATRIUM TETES MATA 15 % 5 ML BOTOL 0 0
253 TABLET TAMBAH DARAH (DAK) TABLET 0 2,765
TEMPORARY CAVITY SEALER [TUMPATAN

254 PCS 0 0
SEMENTARA] (CAVIT G)
255 TETRAKAIN HCL TETES MATA 5 ML BOTOL 0 0
256 TETRASIKLIN HCL TABLET 500 MG KAPSUL 94 2,335
257 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL 0 0
258 THIAMIN HCL MONONITRAT (VIT B1) TABLET 100 MG TABLET 0 1,500
259 THIAMIN HCL MONONITRAT (VIT B1) TABLET 50 MG TABLET 2,217 1,523
260 TRAMADOL INJEKSI 50 MG/ML AMPUL 36 23
261 TRANFUSION SET ADULT WITH Y INJECTION PCS 4 8
TRIAMSINOLON ACETONIDE (BUFACOMB) 1MG/GR

262 TUBE 6 10
SALEP
263 TRIFLOUPERASIN TABLET 5 MG TABLET 0 123
264 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG TABLET 143 738
265 VITAMIN B COMPLEX TABLET TABLET 1,708 1,808
266 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL 0 1
267 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL 25 7
268 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET 0 0
269 ZINK 20 MG TABLET TABLET 0 167
270 ZINK SYRUP BOTOL 0 0

CD
2021
203
200
78
1,561
19
162
1,764
1,128
16
15
551
2,998
0
0
19
634
15
11
99
1,921
110
1,512
10
243
50
21
1,496
1
60
420
22
52
10
36
383
14
216
841
15
0
0
110
14
293
376
2,019
2,181
180
10
1,335
116
0
22
14
16
38
198
39
94
10
5,437
1,764
291
12
57
13
62
12
8
884
39
300
482
3,145
12
1,694
365
39
492
16
21
0
12
127
183
190
220
10
1,392
22
288
45
13
15
5
24
59
52
125
66
581
42
1,014
62
47
100
125
0
11
56
1,574
35
300
1,400
0
1,313
27
235
2,255
4,579
10
0
DINAS KESEHATAN KABUPATEN BLITAR
LAPORAN RENCANA KEBUTUHAN OBAT 202
KODE : 1032498
PUSKESMAS : WATES
KECAMATAN : WATES
KABUPATEN : BLITAR
PROPINSI : JAWA TIMUR
PEMAKAIAN RATA - RATA PER TAHUN

HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
1 2 WAY FOLEY CATHETER NO.16 PCS Rp 10,340 10 6
4 ACETYLCYSTEINE CAPSULE 200 MG CAPSULE Rp 373 0 0
5 ALABETIK TABLET TABLET Rp 4,400 0 0
6 ALAT SUNTIK SEKALI PAKAI 1 ML PCS Rp 1,023 86 16
9 ALAT SUNTIK SEKALI PAKAI 3 ML PCS Rp 924 120 145
11 ALLOPURINOL TABLET 100 MG TABLET Rp 89 300 47
12 ALPRAZOLAM 1 MG TABLET TABLET Rp 128 0 0
13 AMBROXOL SIRUP 5MG/ML BOTOL Rp 4,950 35 8
14 AMBROXOL TABLET 30 MG TABLET Rp 187 1,373 4,615
15 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML AMPUL Rp 3,345 26 0
16 AMINOPHYLLINE TABLET 200 MG TABLET Rp 91 0 116
17 AMITRIPTYLLINE HCL TABLET 25 MG TABLET Rp 167 280 37
18 AMLODIPINE TABLET 10 MG TABLET Rp 99 553 995
19 AMLODIPINE TABLET 5 MG TABLET Rp 75 459 291
20 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML BOTOL Rp 3,960 61 20
21 AMOKSISILIN SERBUK INJEKSI VIAL Rp 14,300 0 0
22 AMOKSISILIN TABLET 500 MG KAPLET Rp 249 3,044 1,064
23 AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL VIAL Rp 8,237 32 0
24 ANTALGIN 500 MG TABLET (METAMIZOL) TABLET Rp 209 0 246
25 ANTASIDA DOEN TABLET KOMBINASI TABLET Rp 58 2,741 2,013
26 ANTASIDA SUSPENSI 60 ML BOTOL Rp 2,129 103 22
27 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR POT Rp 2,924 0 0
28 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR POT Rp 4,798 5 0
29 ANTI HAEMOROID DOEN KOMBINASI SUPP. Rp 3,045 12 19

HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
30 ANTI INFLUENZA (EMFLU) KOMBINASI TAB TABLET Rp 360 0 110
31 ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP BOTOL Rp 6,600 46 7
32 ANTI MIGRAIN DOEN TABLET KOMBINASI TABLET Rp 185 0 0
33 ANTI SPASMODIK INJEKSI (SPASHI) AMPUL Rp 10,890 0 4
34 ANTI SPASMODIK TABLET (DORMICOMP) TABLET Rp 3,080 0 110
35 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML BOTOL Rp 2,860 15 207
36 ASAM ASKORBAT ( VIT C ) TABLET 250 MG TABLET Rp 114 3,562 0
37 ASAM ASKORBAT ( VIT C ) TABLET 50 MG TABLET Rp 105 2,012 1,818
38 ASAM FOLAT 1MG TABLET TABLET Rp 75 0 25
39 ASAM MEFENAMAT TABLET 500 MG TABLET Rp 2,904 0 281
40 ASAM TRANEKSAMAT 100 MG/ML INJEKSI AMPUL Rp 2,190 10 20
41 ASAM TRANEKSAMAT 500 MG TABLET TABLET Rp 1,540 248 49
42 ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER TABLET Rp 1,200 0 0
43 ASEPTAN 500CC + PUMP BOTOL Rp 36,630 3 2
44 ASEPTIC GEL 500CC + DISPENSER BOTOL Rp 26,500 5 2
45 ASERING (ASETAT RINGER) SOFT BAG BOTOL Rp 9,646 0 21
46 ASETOSAL TABLET 100 (80) MG TABLET Rp 92 49 0
47 ASIKLOVIR KREAM 5 % 5 GR TUBE Rp 3,160 30 12
48 ASIKLOVIR TABLET 400 MG TABLET Rp 407 85 1,320
49 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML AMPUL Rp 1,639 4 0
50 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET TABLET Rp 140 325 305
51 BETAHISTINMESILAT 6 MG TABLET TABLET Rp 149 0 220
52 BETAMETHASONE CREAM 0,1 % 5 GR TUBE Rp 1,349 25 45
53 BISAKODIL ( BICOLAX ) TABLET 5 MG TABLET Rp 300 0 0
54 BISAKODIL SUPPOSITORIA 10 MG SUPP. Rp 5,900 15 12
55 BISAKODIL SUPPOSITORIA 5 MG SUPP. Rp 6,000 6 4
56 BISOPROLOL 2,5 MG TABLET (CONCOR) TABLET Rp 626 0 0
57 BISOPROLOL 5 MG TABLET TABLET Rp 645 0 260
58 BROMHEXINE SIRUP (HUSTAB) BOTOL Rp 11,550 0 0
59 CAT GUT NO.2/0 CHROMIC PCS Rp 5,000 18 0
60 CAT GUT NO.2/0-3/0 PLAIN PCS Rp 5,000 58 12
61 CITICHOLIN 250 MG/ML-2ML INJEKSI AMPUL Rp 16,390 0 1
62 COMBIVENT UDV INHALASI VIAL Rp 4,550 18 18
63 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML AMPUL Rp 1,097 17 39
64 DEKSAMETHASONE TABLET 0,5 MG TABLET Rp 176 1,373 1,186

HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
65 DEVITALISASI PASTA ( NON ARSEN ) POT Rp 223,300 0 0
66 DIAZEPAM INJEKSI 5 MG/ML 2 ML AMPUL Rp 1,735 32 11
67 DIAZEPAM LARUTAN RECTAL 5MG/ 2,5ML-STESOLID TUBE Rp 12,573 5 1
68 DIAZEPAM TABLET 2 MG TABLET Rp 86 0 0
69 DIAZEPAM TABLET 5 MG TABLET Rp 114 355 141
70 DIFENHIDRAMINE HCL INJEKSI 10 MG/ML 1 ML AMPUL Rp 1,168 95 13
71 DIGOXIN TABLET 0,25 MG TABLET Rp 104 20 21
72 DIMENHYDRINATE TABLET 50 MG TABLET Rp 99 534 359
73 DOKSISIKLIN TABLET 100 MG KAPSUL Rp 269 0 0
74 DOMPERIDON SUSPENSI 5MG/ML BOTOL Rp 3,000 32 18
75 DOMPERIDON TABLET 10 MG TABLET Rp 118 431 825
76 EKSTRACT PLASENTA + NEOMYSIN SALEP 15 GR TUBE Rp 18,150 4 36
77 EPINEFRIN (ADRENALIN) HCL INJ.0,1 % 1 ML AMPUL Rp 25,839 6 0
78 ERITROMISIN KAPSUL 250 MG KAPSUL Rp 566 0 0
79 ERITROMISIN SIRUP KERING 200 MG/5ML BOTOL Rp 11,000 0 1
80 ERITROMISIN TABLET 500 MG KAPSUL Rp 770 0 0
81 ETAKRIDIN ( RIVANOL ) LARUTAN 0,1 % 300 ML BOTOL Rp 3,000 5 0
82 ETANOL [ ALKOHOL ] 70 % 1000 ML BOTOL Rp 27,500 0 3
83 ETIL KLORIDA SEMPROT 100 ML BOTOL Rp 169,400 3 1
84 EUGENOL CAIRAN 10 ML BOTOL Rp 18,824 0 0
85 FENITOIN NATRIUM INJEKSI 50 MG/ML 2 ML AMPUL Rp 3,738 0 0
86 FENITOIN NATRIUM TABLET 100 MG KAPSUL Rp 158 0 10
87 FENOBARBITAL INJEKSI 50 MG/ML 2 ML AMPUL Rp 1,969 19 0
88 FENOBARBITAL TABLET 30 MG TABLET Rp 171 0 0
89 FENOL GLISEROL TETES TELINGA 10 % 5 ML BOTOL Rp 2,764 23 0
90 FITOMENADION ( VIT K1 ) INJEKSI 10 MG/ML 1 ML AMPUL Rp 3,682 10 18
91 FITOMENADION ( VIT K1 ) TABLET SALUT 10 MG TABLET Rp 758 200 0
92 FITOMENADION INFANT INJ. 2MG/ML AMPUL Rp 1,386 9 0
93 FLUPHENASINE DEKANOAT INJEKSI 25 MG 1 ML AMPUL Rp 63,986 20 2
94 FUROSEMID INJEKSI VIAL Rp - 0 0
95 FUROSEMID TABLET 40 MG TABLET Rp 77 357 302
96 GAMEKSAN (SCABICID)/PERMETRIN KRIM 1 % 10 GR TUBE Rp 11,852 3 5
97 GEMFIBROZIL 300 MG KAPSUL KAPSUL Rp 380 15 35
98 GENTAMISIN SALEP KULIT 0,1 % 5 GR TUBE Rp 3,520 15 13
99 GENTAMISIN SALEP MATA 0,3% TUBE Rp 3,083 14 9

HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
100 GENTAMISIN TETES MATA 0,3% BOTOL Rp 4,000 10 15
101 GLASS IONOMER CEMENT ( GC IX ) BOTOL Rp 863,500 0 0
102 GLIBENCLAMIDE TABLET 5 MG TABLET Rp 119 297 341
103 GLICERIL GUAIACOLAT TABLET 100 MG TABLET Rp 121 2,087 1,149
104 GLIMEPIRIDE 2 MG TABLET TABLET Rp 207 0 626
105 GLUKOSA 40% DEXTROSE INJECTION U.S.P CAIRAN INJEKSI VIAL Rp 11,220 0 1
106 GLUKOSA LARUTAN INFUS 10 % STERIL BOTOL Rp 8,003 0 2
107 GLUKOSA LARUTAN INFUS 5 % STERIL BOTOL Rp 7,363 46 24
108 GRISEOFULVIN TABLET 125 MG TABLET Rp 224 368 16
109 HALOPERIDOL 2 MG TABLET Rp 90 0 0
110 HALOPERIDOL DEKANOAT INJ 50 MG VIAL Rp 101,300 0 4
111 HALOPERIDOL INJ. 5 MG/ML (LODOMER) AMPUL Rp 4,974 0 0
112 HALOPERIDOL TABLET 1,5 MG TABLET Rp 59 322 371
113 HALOPERIDOL TABLET 5 MG TABLET Rp 60 0 163
114 HEPARIN SODIUM 200 UI (THROMBOFLASH) TUBE Rp 46,200 0 0
115 HES-HYDROXYETHYL STARCH 6 %/VOLUVEN INFUS 500 ML BOTOL Rp 21,780 4 1
116 HIDROCORTISONE CREAM 2,5 % 5 GR TUBE Rp 2,650 34 10
117 I.V CATHETER NO.16 WITH INJECTION PORT PCS Rp 5,500 10 6
123 IBUPROFEN SUSPENSI 100 MG/5 ML 60 ML BOTOL Rp 2,721 71 0
124 IBUPROFEN TABLET 400 MG TABLET Rp 352 158 276
125 INFUSION SET ANAK PCS Rp 6,400 19 21
126 INFUSION SET DEWASA PCS Rp 8,140 44 16
127 ISOSORBIDE DINITRATE SUBLINGUAL 5 MG TABLET Rp 1,793 14 128
128 KAEN 3B BOTOL Rp 11,500 18 9
129 KALIUM DIKLOFENAK 50 MG TABLET TABLET Rp 682 0 0
130 KALSIUM GLUCONAS INJEKSI 100 MG/ML 10 ML AMPUL Rp 9,955 6 29
131 KALSIUM LAKTAT (KALK) TABLET 500 MG TABLET Rp 63 3,952 138
132 KANTONG URINE DEWASA PCS Rp 10,920 9 5
133 KAOLIN PEKTIN (NOVADIAR) SUSPENSI BOTOL Rp 7,700 14 6
134 KAPAS PEMBALUT/ABSORBEN 250 GR BKS Rp 12,496 2 8

HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
135 KAPTOPRIL TABLET 25 MG TABLET Rp 75 1,013 682
136 KARBAMAZEPIN TABLET 200 MG TABLET Rp 189 200 107

137 AMPUL Rp 13,200 0 0
ML (SALDONA)
138 KASA KOMPRES 40/40 STERIL BKS Rp 1,595 56 33
139 KASA PEMBALUT HIDROFIL 16 X 16 CM STRIL ROL Rp 8,000 37 16
140 KASA PEMBALUT HIDROFIL 2 M X 80 CM ROL Rp 7,700 9 11
143 KASA STERIL (DARYAN TOLLE)YG DIRESAPI FRAMISETIN PCS Rp 8,990 10 1
144 KETOKONAZOLE TABLET 200 MG TABLET Rp 280 694 164
145 KETOPROFEN 100 MG SUPPOSITORIA SUPP. Rp 2,640 14 0
146 KLINDAMISIN KAPSUL 150 MG TABLET Rp 759 0 74
147 KLINDAMISIN KAPSUL 300 MG KAPSUL Rp 759 230 0
148 KLOBAZAM 10 MG TABLET TABLET Rp 776 100 33
149 KLORAMFENIKOL KAPSUL 500 MG KAPSUL Rp 1,163 118 107
150 KLORAMFENIKOL SALEP KULIT 2 % TUBE Rp 3,242 0 9
151 KLORAMFENIKOL SALEP MATA 1 % TUBE Rp 2,487 12 30
152 KLORAMFENIKOL SUSPENSI 125 MG/5 ML BOTOL Rp 4,700 9 4
153 KLORAMFENIKOL TETES TELINGA 3 % BOTOL Rp 6,600 11 9
154 KLORFENIRAMINE MALEAT (CTM) TABLET 4 MG TABLET Rp 24 1,828 1,892
155 KLORPROMAZIN HCL INJEKSI 25 MG/ML 1 ML AMPUL Rp 1,326 13 10
156 KLORPROMAZIN HCL TABLET 100 MG TABLET Rp 250 951 491
157 KLOZAPIN 100 MG TABLET TABLET Rp 3,288 20 41
158 KLOZAPIN 25 MG TABLET TABLET Rp 1,121 0 52
159 KODEIN HCL TABLET 10 MG TABLET Rp 571 61 105
160 KOTRIMOKSAZOL DEWASA TABLET TABLET Rp 325 457 654
161 KOTRIMOKSAZOL SUSPENSI 60 ML BOTOL Rp 2,190 100 0
162 LEVOFLOXACIN TABLET 500 MG TABLET Rp 452 0 0
163 LIDOCAIN 2% INJ AMPUL Rp 847 0 0
164 LIDOCAIN COMPOSITUM INJEKSI 2 ML AMPUL Rp 1,222 43 19
165 LISOL CONCENTRATE 1000 ML BOTOL Rp 24,200 1 1
166 LOPERAMIDE TABLET 2 MG TABLET Rp 85 75 0
167 LORATADIN TABLET 10 MG TABLET Rp 131 3 0
168 MAGNESIUM SULFAT INJEKSI (IV) 40 % 25 ML AMPUL Rp 3,796 2 10
169 MASKER KERTAS 3 PLY EAR LOOP PCS Rp 440 647 324
HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
170 MASKER KERTAS 3 PLY TIE ON PCS Rp 330 0 212
171 MELOKSIKAM TABLET 7,5 MG TABLET Rp 418 0 0
172 METAMIZOL (NORAGES) INJEKSI 500 MG/2ML AMPUL Rp 8,800 64 33
173 METFORMIN TABLET 500 MG TABLET Rp 102 473 579
174 METILERGOMETRIN MALEAT INJEKSI 0,200 MG 1 ML AMPUL Rp 2,684 28 21
175 METILERGOMETRIN MALEAT TABLET 0,125 MG TABLET Rp 224 121 88
176 METILPREDNISOLON TABLET 4 MG TABLET Rp 143 0 65
177 METOKLOPRAMIDE 10 MG TABLET TABLET Rp 85 0 0
178 METOKLOPRAMIDE 5 MG TABLET TABLET Rp 121 0 0
179 METOKLOPROMIDE (SOTATIC) INJEKSI 5 MG/ML 2 ML AMPUL Rp 3,960 0 3
180 METOKLOPROMIDE SIRUP BOTOL Rp - 0 0
181 METRONIDAZOL + NYSTATIN VAG. (PROVAGIN) INJEKSI VIAL Rp 1,573 0 0
182 METRONIDAZOL TABLET 250 MG TABLET Rp 94 143 0
183 METRONIDAZOL TABLET 500 MG TABLET Rp 407 200 38
184 METRONIDAZOLE INFUS 5 MG/ML 100 ML BOTOL Rp 8,110 0 0
185 MIKONAZOL KREAM 10 GR TUBE Rp 3,250 13 16
186 MINERAL MIX SACHET Rp 3,116 0 0
187 MULTIVITAMIN (LYSOVIT ) SYRUP 100 ML BOTOL Rp 24,200 25 11
188 MULTIVITAMIN (MALTIRON PLUS) KOMBINASI TABLET TABLET Rp 1,430 0 0
189 NATRIUM DIKLOFENAK TABLET 25 MG TABLET Rp 137 0 434
190 NATRIUM DIKLOFENAK TABLET 50 MG TABLET Rp 123 536 308
191 NATRIUM KLORIDA INFUS 0,9 % STERIL BOTOL Rp 6,840 53 27
192 NEUROTROPIK (IKANEURON) INJEKSI AMPUL Rp 4,180 0 0
193 NEUROTROPIK KOMBINASI (IKANEURON) TABLET TABLET Rp 1,210 0 189
194 NIFEDIPINE TABLET 10 MG TABLET Rp 104 631 222
195 NISTATIN TABLET 500.000 UI TABLET Rp 843 291 84
196 NISTATIN VAGINAL TABLET 100.000 UI VAGTAB Rp 598 40 107
197 NOREPINEPHRINE CAIRAN INJEKSI AMPUL Rp 25,839 0 2
198 OBAT BATUK HITAM (OBH) CAIRAN 100 ML BOTOL Rp 5,500 31 4
199 OKSIGEN NASAL CANNULA ADULT PCS Rp 4,250 6 3
200 OKSIGEN NASAL CANNULA INFANT PCS Rp 5,500 6 10
201 OKSITETRACYCLIN SALEP KULIT 3 % 5 GR TUBE Rp 2,772 0 0
202 OKSITETRACYCLIN SALEP MATA 1 % 3,5 GR TUBE Rp 2,668 0 0
203 OKSITOSIN INJEKSI 10 IU/ML 1 ML AMPUL Rp 1,199 39 11
204 OMEPRAZOLE TABLET 20 MG KAPSUL Rp 587 1,344 176

HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
205 ONDANSENTRON 4 MG/2 ML INJEKSI AMPUL Rp 1,124 58 18
206 PARACETAMOL SYRUP 120 MG/5 ML 60 ML BOTOL Rp 1,181 79 27
207 PARACETAMOL TABLET 500 MG TABLET Rp 107 7,467 2,263
208 PARACETAMOL TETES 100 MG/ML 15 ML BOTOL Rp 6,649 0 0
209 PEHAVRAL TABLET TABLET Rp 889 0 0
210 PERAK SULFADIAZIN KRIM 1 % TUBE Rp 20,700 0 0
211 PERHYDROL [ H2O2 ] 3 % 800 ML BOTOL Rp 24,200 0 0
212 PIRACETAM TABLET 800 MG TABLET Rp 964 40 28
213 PIRANTEL PAMOAT TABLET TABLET Rp 306 0 0
214 PIRIDOKSIN HCL (VIT B6) TABLET 10 MG TABLET Rp 222 2,207 445
215 PIROKSIKAM KAPSUL 10 MG KAPSUL Rp 132 0 0
216 PLESTER 5 YARD X 2 INCI (LEUKOPLAST) ROL Rp 32,450 0 0
217 PREDNISON TABLET 5 MG TABLET Rp 73 482 57
218 PROPANOLOL HCL TABLET 40 MG TABLET Rp 81 0 0
219 PROPILTHIOURACIL TABLET 100 MG TABLET Rp 660 0 0
220 RANITIDIN INJEKSI 25 MG/ ML AMPUL Rp 814 85 20
221 RESPERIDON 2 MG TABLET TABLET Rp 287 256 133
222 RINGER LAKTATE LARUTAN INFUS STERIL BOTOL Rp 7,630 57 49
223 SALBUTAMOL TABLET 2 MG TABLET Rp 67 0 0
224 SALBUTAMOL TABLET 4 MG TABLET Rp 83 347 168
225 SALEP 2-4 KOMBINASI 30 GR POT Rp 2,796 2 0
226 SALICYL BEDAK 2 % KOTAK Rp 1,020 19 6
227 SARUNG TANGAM NON STERIL L PCS Rp 583 200 135
228 SARUNG TANGAN NON STERIL M PCS Rp 1,188 315 443
229 SARUNG TANGAN NON STERIL S PCS Rp 1,188 249 325
230 SARUNG TANGAN STERIL NO 6 PSG Rp 4,180 112 0
231 SARUNG TANGAN STERIL NO. 7,5 PSG Rp 6,160 0 0
232 SARUNG TANGAN STERILE NO.6,5 PSG Rp 6,006 111 39
233 SARUNG TANGAN STERILE NO.7 PSG Rp 6,006 74 48
234 SEFADROKSIL KAPSUL 500 MG KAPSUL Rp 1,540 376 0
235 SEFIKSIM KAPSUL 100 MG KAPSUL Rp 590 0 0
236 SERUM ANTI BISA ULAR POLIVALEN INJ.5 ML (ABU I) VIAL Rp 512,204 4 1
237 SERUM ANTI TETANUS INJEKSI 1.500 IU/AMP (ATS) VIAL Rp 130,999 2 3
238 SETIRIZINE TABLET 10 MG TABLET Rp 90 256 0
239 SIANOKOBALAMIN ( VIT B12 ) INJEKSI 500 MCG/ML 1 ML AMPUL Rp 1,087 0 0

HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
240 SIANOKOBALAMIN ( VIT B12 ) TABLET 50 MCG TABLET Rp 49 322 934
241 SILK (BENANG BEDAH SUTERA) NO.3/0 PCS Rp 2,777 6 14
242 SIMETIDINE TABLET 200 MG TABLET Rp 242 815 18
243 SIMVASTATIN TABLET 10 MG TABLET Rp 117 319 180
244 SIPROFLOXACIN INFUS 2% BOTOL Rp 10,184 0 0
245 SIPROFLOXACIN TABLET 500 MG TABLET Rp 281 68 128
246 SIPROHEPTADINE 4 MG TABLET (PRONICY) TABLET Rp 275 0 0
247 SPONS GELATIN CUBICLES 1x1x1 CM PCS Rp 132,000 0 0
248 STIMUNO SYR BOTOL Rp 23,650 0 0
249 STIMUNO TAB (100) TABLET Rp 2,475 0 0
250 STIMUNO TAB (30) BOTOL Rp 2,016 0 0
251 SULFADOKSIN TABLET TABLET Rp 2,016 0 0
252 SULFASETAMID NATRIUM TETES MATA 15 % 5 ML BOTOL Rp 17,600 0 0
253 TABLET TAMBAH DARAH (DAK) TABLET Rp 354 0 2,765

254 PCS Rp 133,650 0 0
(CAVIT G)
255 TETRAKAIN HCL TETES MATA 5 ML BOTOL Rp 17,380 0 0
256 TETRASIKLIN HCL TABLET 500 MG KAPSUL Rp 323 94 2,335
257 THIAMIN HCL (VIT B1) INJEKSI 100 MG/ML 1 ML AMPUL Rp 1,320 0 0
258 THIAMIN HCL MONONITRAT (VIT B1) TABLET 100 MG TABLET Rp 200 0 1,500
259 THIAMIN HCL MONONITRAT (VIT B1) TABLET 50 MG TABLET Rp 91 2,217 1,523
260 TRAMADOL INJEKSI 50 MG/ML AMPUL Rp 1,710 36 23
261 TRANFUSION SET ADULT WITH Y INJECTION PCS Rp 13,761 4 8
262 TRIAMSINOLON ACETONIDE (BUFACOMB) 1MG/GR SALEP TUBE Rp 16,500 6 10
263 TRIFLOUPERASIN TABLET 5 MG TABLET Rp 287 0 123
264 TRIHEKSIFENIDIL HIDROKLORIDA TABLET 2 MG TABLET Rp 63 143 738
265 VITAMIN B COMPLEX TABLET TABLET Rp 83 1,708 1,808
266 YODIUM POVIDON LARUTAN 10 % 30 ML BOTOL Rp 2,900 0 1
267 YODIUM POVIDON LARUTAN 10% 60 ML BOTOL Rp 3,700 25 7
268 ZENTRA (TRIPROLIDINE|PSEUDOEPHEDRINE) TABLET Rp 990 0 0
269 ZINK 20 MG TABLET TABLET Rp 524 0 167
270 ZINK SYRUP BOTOL Rp 3,171 0 0
JUMLAH NILAI
Blitar , 30 September 2021

Mengetahui Menyetujui
Kepala Puskesmas Kepala UPT
WATES Instalasi Farmasi Kesehatan
HARGA SATUAN
NO NAMA OBAT SATUAN
TERBARU 2019 2020
1 2 3 4 5 6
dr. INDAH AMALIA dr. FARUQ AKBAR AI R.

NIP : 19810315 201502 2 002 NIP : 19880803 201502 1 001
N OBAT 2022
A PER TAHUN PEMAKAIAN RATA-RATA

PER BULAN SELAMA 3 RKO 2022 JUMLAH NILAI HARGA
2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
4 7 120 Rp 1,244,936
1 6 101 Rp 1,094,445
0 0 0 Rp -
203 203 3,645 Rp 1,359,585
0 0 0 Rp -
200 101 1,811 Rp 1,852,994
0 22 396 Rp 579,348
0 0 0 Rp -
78 114 2,060 Rp 1,903,255
0 45 818 Rp 854,810
1,561 636 11,447 Rp 1,018,800
0 0 0 Rp -
19 21 376 Rp 1,861,554
0 2,994 53,896 Rp 10,078,552
8 17 300 Rp 1,002,497
0 116 2,080 Rp 189,280
162 160 2,874 Rp 479,986
1,764 1,104 19,873 Rp 1,967,460
1,128 626 11,271 Rp 845,325
16 32 579 Rp 2,293,689
117 117 2,106 Rp 30,115,800
1,875 1,994 35,894 Rp 8,937,606
0 11 192 Rp 1,581,504
551 398 7,167 Rp 1,497,934
2,998 2,584 46,514 Rp 2,697,783
0 62 1,124 Rp 2,393,756
0 0 0 Rp -
1 3 50 Rp 237,501
19 17 300 Rp 914,515
2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
634 372 6,697 Rp 2,410,965
15 23 408 Rp 2,694,780
0 0 0 Rp -
11 5 92 Rp 996,435
99 70 1,253 Rp 3,857,700
0 74 1,332 Rp 3,809,520
0 3,562 64,122 Rp 7,309,908
1,921 1,917 34,506 Rp 3,623,104
110 68 1,215 Rp 91,125
1,512 598 10,757 Rp 31,239,054
10 13 240 Rp 525,600
243 180 3,237 Rp 4,984,980
50 50 900 Rp 1,080,000
0 2 40 Rp 1,450,548
0 4 65 Rp 1,717,200
0 7 128 Rp 1,229,865
0 49 877 Rp 80,671
21 21 379 Rp 1,196,060
6 471 8,470 Rp 3,447,249
0 4 72 Rp 118,008
1,496 709 12,755 Rp 1,785,723
0 220 3,960 Rp 590,040
0 23 422 Rp 568,893
0 0 0 Rp -
0 9 160 Rp 941,640
1 4 63 Rp 378,000
60 60 1,080 Rp 676,080
420 227 4,080 Rp 2,631,600
0 0 0 Rp -
22 13 242 Rp 1,210,000
52 40 727 Rp 3,635,000
10 4 67 Rp 1,092,667
36 24 434 Rp 1,974,700
0 19 342 Rp 375,527
0 1,280 23,033 Rp 4,053,843

2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
0 0 0 Rp -
6 16 292 Rp 505,926
2 3 49 Rp 618,173
0 0 0 Rp -
383 293 5,270 Rp 600,780
14 41 730 Rp 852,251
216 86 1,545 Rp 160,649
841 578 10,400 Rp 1,029,584
0 0 0 Rp -
15 21 386 Rp 1,157,857
0 419 7,537 Rp 889,327
0 13 242 Rp 4,396,838
0 3 52 Rp 1,348,796
0 0 0 Rp -
0 1 20 Rp 220,000
0 0 0 Rp -
0 5 95 Rp 283,500
5 4 72 Rp 1,980,000
2 3 56 Rp 9,528,750
0 0 0 Rp -
0 0 0 Rp -
110 60 1,080 Rp 170,640
0 6 116 Rp 228,404
0 0 0 Rp -
0 23 409 Rp 1,129,370
0 14 253 Rp 932,598
0 100 1,804 Rp 1,367,432
0 9 156 Rp 216,216
14 12 218 Rp 13,916,955
0 0 0 Rp -
293 317 5,711 Rp 439,760
3 3 62 Rp 734,034
0 25 450 Rp 171,000
0 14 246 Rp 865,040
0 12 208 Rp 641,264
2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
0 12 219 Rp 876,000
0 0 0 Rp -
376 338 6,080 Rp 723,470
2,019 1,752 31,530 Rp 3,815,130
2,181 1,404 25,266 Rp 5,229,973
5 3 47 Rp 521,730
6 4 66 Rp 524,197
0 35 632 Rp 4,653,416
0 192 3,457 Rp 774,368
180 90 1,620 Rp 145,800
10 7 123 Rp 12,503,314
0 0 0 Rp -
1,335 676 12,170 Rp 718,013
116 140 2,516 Rp 150,975
0 0 0 Rp -
0 2 41 Rp 892,980
22 22 391 Rp 1,034,825
14 10 179 Rp 985,417
0 11 203 Rp 1,382,713
0 24 428 Rp 2,909,544
16 19 344 Rp 2,340,778
5 23 407 Rp 2,763,954
4 4 79 Rp 952,875
38 54 979 Rp 2,664,096
198 210 3,783 Rp 1,331,616
2 14 249 Rp 1,590,857
39 33 588 Rp 4,789,033
94 78 1,411 Rp 2,529,283
10 12 221 Rp 2,544,375
0 0 0 Rp -
0 18 315 Rp 3,135,825
5,437 3,175 57,158 Rp 3,600,925
0 7 128 Rp 1,398,735
2 7 127 Rp 979,183
5 5 94 Rp 1,176,707
2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
1,764 1,153 20,754 Rp 1,556,556
291 199 3,582 Rp 676,998
0 0 0 Rp -
12 34 604 Rp 963,380
57 36 656 Rp 5,245,333
13 11 193 Rp 1,488,300
62 36 655 Rp 981,750
12 4 76 Rp 160,300
8 6 112 Rp 1,003,883
884 581 10,454 Rp 2,927,073
0 14 257 Rp 678,857
39 57 1,019 Rp 773,231
0 77 1,380 Rp 1,047,420
300 144 2,595 Rp 2,013,849
482 236 4,239 Rp 4,929,957
0 3 52 Rp 168,584
6 16 285 Rp 709,624
1 5 84 Rp 394,800
0 10 179 Rp 1,181,400
3,145 2,288 41,188 Rp 988,504
12 12 209 Rp 276,869
1,694 1,045 18,815 Rp 4,703,792
365 142 2,556 Rp 8,404,128
0 52 929 Rp 1,041,185
39 68 1,231 Rp 702,616
492 534 9,620 Rp 3,126,500
2 51 923 Rp 2,020,979
0 0 0 Rp -
8 8 144 Rp 121,968
0 21 370 Rp 452,140
1 1 15 Rp 363,000
0 25 450 Rp 38,250
0 1 20 Rp 2,620
16 9 166 Rp 630,136
0 323 5,823 Rp 2,561,973

2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
21 78 1,402 Rp 462,715
0 0 0 Rp -
12 36 655 Rp 5,759,600
0 526 9,463 Rp 965,175
127 59 1,053 Rp 2,827,147
183 130 2,348 Rp 526,027
190 85 1,527 Rp 218,361
0 0 0 Rp -
0 0 0 Rp -
0 1 20 Rp 79,200
0 0 0 Rp -
0 0 0 Rp -
0 48 855 Rp 80,401
220 152 2,744 Rp 1,116,672
0 0 0 Rp -
9 13 225 Rp 731,792
10 3 60 Rp 186,960
0 18 327 Rp 7,913,400
0 0 0 Rp -
1,392 913 16,433 Rp 2,251,304
0 422 7,597 Rp 934,446
22 34 609 Rp 4,165,560
0 0 0 Rp -
0 189 3,400 Rp 4,114,000
0 427 7,678 Rp 798,499
288 221 3,977 Rp 3,352,752
45 64 1,153 Rp 689,693
13 7 133 Rp 3,423,668
15 17 300 Rp 1,647,250
7 5 93 Rp 395,250
5 7 120 Rp 660,000
24 8 143 Rp 395,010
0 0 0 Rp -
8 20 352 Rp 422,248
59 526 9,470 Rp 5,558,848

2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
52 43 765 Rp 860,235
1 54 963 Rp 1,137,598
125 3,285 59,130 Rp 6,326,874
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
66 45 807 Rp 777,787
0 0 0 Rp -
0 1,326 23,865 Rp 5,298,002
0 0 0 Rp -
0 0 0 Rp -
581 373 6,719 Rp 490,471
0 0 0 Rp -
0 0 0 Rp -
42 49 874 Rp 711,504
1,014 468 8,419 Rp 2,416,110
62 56 1,008 Rp 7,691,040
0 0 0 Rp -
0 258 4,637 Rp 384,871
2 2 32 Rp 88,074
0 13 226 Rp 230,520
47 127 2,291 Rp 1,335,847
100 286 5,149 Rp 6,117,069
125 233 4,194 Rp 4,982,472
0 112 2,013 Rp 8,414,340
0 0 0 Rp -
11 54 965 Rp 5,793,788
56 59 1,067 Rp 6,409,403
0 125 2,255 Rp 3,473,213
0 0 0 Rp -
2 2 41 Rp 21,000,364
4 3 52 Rp 6,785,748
6 87 1,569 Rp 141,225
0 0 0 Rp -
2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
1,574 943 16,975 Rp 831,771
35 18 330 Rp 916,410
0 417 7,498 Rp 1,814,516
300 266 4,790 Rp 560,422
0 0 0 Rp -
0 98 1,764 Rp 495,684
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
0 0 0 Rp -
1,400 2,083 37,485 Rp 13,269,690
0 0 0 Rp -
0 0 0 Rp -
0 1,215 21,864 Rp 7,061,934
0 0 0 Rp -
0 750 13,500 Rp 2,700,000
1,313 1,684 30,318 Rp 2,758,917
0 29 524 Rp 895,185
27 13 231 Rp 3,171,911
0 5 95 Rp 1,574,100
235 179 3,220 Rp 924,140
2,255 1,046 18,820 Rp 1,185,660
4,579 2,698 48,572 Rp 4,031,490
2 1 25 Rp 71,775
0 11 191 Rp 705,775
0 0 0 Rp -
10 59 1,060 Rp 555,440
0 0 0 Rp -
Rp 519,207,955
Yang Menyerahkan
Pengelola Obat
WATES
2021 TAHUN
7 8 = (5+6+7)/3 9 = 8 * 18 10 = 9 * 4
apt. PUTRI MARGARETA,S.Farm

NIP : 19940321 201903 2 004

3.10.1 Ep 2 Dok Fix PKM Wates Rko 2022

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LAPORAN RENCANA KEBUTUHAN OBAT 2022

ISI DATA RKO

KONVERSI DATA RKO RENCANA KEBUTUHAN OB

KODE PUSKESMAS 1032498

2019 2020 2021

1 2 WAY FOLEY CATHETER NO.16

2 2 WAY FOLEY CATHETER NO.18

3 2 WAY FOLEY CATHETER NO.20

4 ALAT SUNTIK SEKALI PAKAI 1 ML

5 ALAT SUNTIK SEKALI PAKAI 10 ML

6 ALAT SUNTIK SEKALI PAKAI 2,5 ML

7 ALAT SUNTIK SEKALI PAKAI 20 ML

8 ALAT SUNTIK SEKALI PAKAI 3 ML

9 ALAT SUNTIK SEKALI PAKAI 5 ML

10 ALAT SUNTIK SEKALI PAKAI 50 ML

11 ALAT SUNTIK SEKALI PAKAI IX 0,5 ML

12 ALLOPURINOL TABLET 100 MG

14 AMBROXOL SIRUP 5MG/ML

16 AMINOPHYLLINE INJEKSI 24 MG/ML 10 ML

17 AMINOPHYLLINE TABLET 200 MG

18 AMITRIPTYLLINE HCL TABLET 25 MG

21 AMOKSILLIN SERBUK INJEKSI 1.000 MG

22 AMOKSISILIN DRY SYRUP 125 MG/5 ML 60 ML

23 AMOKSISILIN TABLET 500 MG

24 AMPICILLIN SERBUK INJEKSI 1.000 MG MG/VIAL

25 ANTALGIN INJEKSI 250 MG/ML 2 ML

26 ANTALGIN TABLET 500 MG

27 ANTASIDA DOEN TABLET KOMBINASI

29 ANTI BAKTERI DOEN SALEP KOMBINASI 5 GR

30 ANTI FUNGI DOEN SALEP KOMBINASI 30 GR

31 ANTI HAEMOROID DOEN KOMBINASI

32 ANTI INFLUENZA (EMFLU) KOMBINASI TAB

33 ANTI INFLUENZA (SOLAFLUZ) KOMBINASI SYRUP

34 ANTI MIGRAIN DOEN TABLET KOMBINASI

35 ANTI SPASMODIK TABLET (DORMICOMP)

36 ANTITUSSIVE KOMBINASI TABLET

37 AQUA PRO INJEKSI STERIL BEBAS PIROGEN 20 ML

39 ASAM ASKORBAT ( VIT C ) TABLET 250 MG

40 ASAM ASKORBAT ( VIT C ) TABLET 50 MG

41 ASAM FOLAT 1MG TABLET

42 ASAM FUSIDAT KRIM 20MG/ GRAM

43 ASAM MEFENAMAT TABLET 500 MG

44 ASAM TRANEKSAMAT 100 MG/ML INJEKSI

45 ASAM TRANEKSAMAT 500 MG TABLET

46 ASAM VALPROAT 250 MG TABLET / DEPAKOTE ER

47 ASEPTAN 500CC + PUMP

48 ASEPTIC GEL 500CC + DISPENSER

49 ASERING (ASETAT RINGER) SOFT BAG

50 ASETOSAL TABLET 100 (80) MG

52 ASIKLOVIR TABLET 400 MG

53 ATROPIN SULFAT INJEKSI 0,25 MG/ML 1 ML

54 ATROPIN SULFAT TABLET 0,5 MG

55 ATROPIN SULFAT TETES MATA 0,5 % 5 ML

56 ATTAPULGIT + PECTIN ( NEO DIASTOP ) TABLET

58 BETAMETHASONE CREAM 0,1 % 5 GR

59 BISAKODIL ( BICOLAX ) TABLET 5 MG

63 BROMHEXINE SIRUP (HUSTAB)

64 CAT GUT NO.2/0 CHROMIC + JARUM 1/2 GT 35 MM

65 CAT GUT NO.2/0-3/0 PLAIN & CHROMIC

66 CITICHOLIN 250 MG/ML-2ML INJEKSI

67 COMBIVENT UDV INHALASI

68 DEKSAMETHASONE INJEKSI 5 MG/ML 1 ML

69 DEKSAMETHASONE TABLET 0,5 MG