DINAS KESEHATAN KOTA BANJARMASIN

RENCANA KEBUTUHAN OBAT TAHUN 2022

PUSKESMAS : KELAYAN TIMUR

USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
1 2 3 4 5 6 7=5*6 8 9= 5*8 10 = 7 + 9 11 = 5 * 10
A OBAT
1 Albendazol tablet 400 mg* tablet 23,200 463 23,200 10,741,600 - 23,200 10,741,600
2 Allopurinol tablet 100 mg tablet 2,430 105 2,430 255,150 - 2,430 255,150
3 Aminofilin injeksi 24 mg/ml-10 ml ampul - 3,071 - - - - -
4 Aminofilin tablet 200 mg tablet - 101 - - - - -
5 Amitriptilin Hcl tablet salut 25 mg tablet 1,000 237 1,000 237,160 - 1,000 237,160
6 Amlodipin 5 mg tablet 14,055 81 14,055 1,138,455 - 14,055 1,138,455
7 Amoksisilin 500 mg kaplet tablet 11,080 265 11,080 2,936,200 - 11,080 2,936,200
8 Amoksisilin Sirup kering 125 mg/5 botol 370 3,665 370 1,356,124 - 370 1,356,124
9 Ampisilin serbuk injeksi i.m.i.v 10 vial - 8,237 - - - - -
10 Antasida doen tablet kombinasi tablet 11,935 60 11,935 716,100 - 11,935 716,100
11 Antasida sirup botol 1,500 2,098 1,500 3,147,000 - 1,500 3,147,000
12 Antifungi doen kombinasi tube - 5,517 - - - - -
13 Artemether injeksi 80 Mg* ampul - 29,925 - - - - -
14 Artesunate cairan injeksi 60 mg* ampul - 52,350 - - - - -
15 Asam Askorbat(vit C) tablet 50 mg tablet 32,600 120 32,600 3,912,000 - 32,600 3,912,000
16 Asam Folat 1 mg tablet tablet 200 81 200 16,200 - 200 16,200
17 Asam mefenamat 500 mg kaplet tablet 12,265 250 12,265 3,066,250 - 12,265 3,066,250
18 Asiklovir 200 mg tablet tablet 372 706 372 262,465 - 372 262,465
19 Asiklovir 400 mg tablet tablet 1,020 454 1,020 462,815 - 1,020 462,815
20 Atropin Sulfat tablet 0,5 mg tablet - 26 - - - - -
21 Benzatin Benzil Penisilin inj 1,2 juta vial - 10,780 - - - - -
22 Benzatin Benzil Penisilin inj 1,4 juta vial - 14,740 - - - - -
23 Betametason krim 0,1 % tube 220 1,465 220 322,300 - 220 322,300
24 Clindamisin kapsul 300 mg kapsul - 1,017 - - - - -
25 Deksametason tablet 0,5 mg tablet 11,119 143 11,119 1,590,017 - 11,119 1,590,017
26 Deksametason inj 5 mg/ml-1 ml ampul 10 1,210 10 12,100 - 10 12,100
DHP / Darplex / D-Artepp
(Dehidro artemisin Piperaquin) - - - - - -
27 tab* tablet 2,134
28 Diazepam inj 5 mg/ml-2 ml ampul 4 1,913 4 7,652 - 4 7,652
29 Diazepam tablet 2 mg tablet 100 86 100 8,600 - 100 8,600
Page 1 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
30 Diazepam tablet 5 mg tablet - 109 - - - - -
31 Dietilkarbamazin sitrat tablet 100 tablet - 180 - - - - -
32 Difenhidramin Hcl inj 10 mg/ml-1 m ampul - 1,347 - - - - -
33 Digoksin tablet 0,25 mg tablet 100 104 100 10,400 - 100 10,400
34 Dimenhidrinate tablet tablet 200 129 200 25,800 - 200 25,800
35 Doksisiklin 100 mg kapsul kapsul - 299 - - - - -
36 Domperidon 10 mg tablet 500 522 500 261,058 - 500 261,058
37 Epinefrin Hcl/Bitartrat(adrenalin)in ampul 10 1,518 10 15,180 - 10 15,180
38 Erytromisin sirup (trovilon) botol 50 13,176 50 658,790 - 50 658,790
39 Erytromisin 500 mg kaplet tablet 200 730 200 146,001 - 200 146,001
40 Etambutol 500 mg tablet tablet - 4,661 - - - - -
41 Fenitoin kapsul 50 mg kapsul - 1 - - - - -
42 Fenobarbital inj 50 mg / ml - 2 ml ampul - 2,135 - - - - -
43 Fenobarbital tablet 30 mg tablet - 197.00 - - - - -
44 Ferrous sulphate tab selaput 300 m tablet - 1 - - - - -
Ferro folat tab sal selaput 200 mg
+ 0,25 mg (Tablet tambah darah 30,000 30,000 12,270,000 - 30,000 12,270,000
45 komb.) tablet 409
46 Fitomenadion ( vit k 1 ) tablet salu tablet 1,549 818 1,549 1,267,082 - 1,549 1,267,082
47 Fitomenadion ( vit k 1 ) inj 10 mg / ampul 30 4,236 30 127,080 - 30 127,080
48 Furosemid tablet 40 mg tablet 1,000 84 1,000 84,000 - 1,000 84,000
49 Furosemid Cairan Injeksi 10 mg/ml ampul - 1,555 - - - - -
50 Garam oralit untuk 200 ml air sachet 896 281 896 251,776 - 896 251,776
51 Gentamisin inj 40 mg/2 ml* ampul - 3,509 - - - - -
52 Gentamisin inj 80 mg/2 ml* ampul - 2,750 - - - - -
53 Glibenklamid tablet 5 mg tablet 2,325 137 2,325 318,525 - 2,325 318,525
54 Glimepirid tab 1 mg tablet 2,080 174 2,080 361,920 - 2,080 361,920
55 Griseofulvin tablet 125 mg microni tablet 259 238 259 61,642 - 259 61,642
56 Haloperidol tablet 0,5 mg tablet - 55 - - - - -
57 Haloperidol tablet 5 mg tablet 650 56 650 36,400 - 650 36,400
58 Hidroklortiazid ( Hct ) tablet 25 mg tablet - 163 - - - - -
59 Hidrokortison krim 2,5 % tube 500 2,533 500 1,266,500 - 500 1,266,500
60 Ibuprofen tablet 200 mg tablet 6,670 237 6,670 1,581,857 - 6,670 1,581,857
61 Ibuprofen tablet 400 mg tablet 6,290 345 6,290 2,169,798 - 6,290 2,169,798
62 Isoniazid tablet 100 mg tablet 180 143 180 25,740 - 180 25,740
63 Isoniazid tablet 300 mg tablet 280 173 280 48,440 - 280 48,440
64 Isosorbit dinitrat tablet sublingual tablet 135 178 135 24,012 - 135 24,012
65 Kalsium Gluconas inj* ampul - 10,351 - - - - -
66 Kalsium Karbonat tablet 500 mg tablet - 1 - - - - -
67 Kaptopril 25 mg tablet tablet 500 147 500 73,376 - 500 73,376
68 Karbamazepin tablet 200 mg tablet 1,510 250 1,510 377,500 - 1,510 377,500
69 Ketokenazol 200 mg tablet tablet - 681 - - - - -
70 Kloramfenikol kapsul 250 mg kapsul - 711 - - - - -
Page 2 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
71 Kloramfenikol salep 2 % tube - 1 - - - - -
72 Kloramfenikol salep mata 1 % tube 66 10,197 66 673,002 - 66 673,002
73 Kloramfenikol sirup botol 36 5,319 36 191,484 - 36 191,484
74 Klorfeniramin maleat ( CTM ) table tablet 9,645 60 9,645 577,561 - 9,645 577,561
75 Klorpromazin Hcl inj 5 mg / ml - 2 m ampul - 376 - - - - -
76 Klorpromazin Hcl tablet salut 100 tablet 300 181 300 54,300 - 300 54,300
77 Kodein tablet 10 mg tablet - 600 - - - - -
78 Kotrimoksazol DOEN I (dewasa) tab tablet 300 133 300 39,900 - 300 39,900
79 Kotrimoksazol suspensi botol 33 2,052 33 67,716 - 33 67,716
80 Kuinine tablet salut selaput 200 mg tablet - 311 - - - - -
81 Kuinine Dihydrochloride cairan inj ampul - 2,616 - - - - -
82 Lidocain injeksi 2 % ampul - 1,408 - - - - -
83 Lidokain kompositum injeksi ampul 300 1,405 300 421,500 - 300 421,500
84 Loratadin tablet tablet 2,000 136 2,000 272,000 - 2,000 272,000
85 Magnesium sulfat inj ( 1V ) 20 % - vial - 3,328 - - - - -
86 Magnesium sulfat inj ( 1V ) 40 % - vial 10 3,796 10 37,960 - 10 37,960
87 Mebendazol tablet 100 mg (vermox tablet - 9,150 - - - - -
88 Metformin tab 500 mg tablet 15,000 109 15,000 1,635,000 - 15,000 1,635,000
89 Metformin tab 850 mg tablet - 178 - - - - -
90 Metilergometrin maleat tablet salu tablet - 271 - - - - -
91 Metilergometrin maleat inj 0,200 m ampul 5 3,399 5 16,995 - 5 16,995
92 Metilprednisolon 4 mg tablet tablet 1,193 148 1,193 176,564 - 1,193 176,564
93 Metilprednisolon 16 mg tablet tablet - 875 - - - - -
94 Metoklorpropamid tablet tablet - 124 - - - - -
95 Metronidazol tablet 250 mg tablet - 94 - - - - -
96 Metronidazol tablet 500 mg (Farizo tablet 165 282 165 46,547 - 165 46,547
97 Metronidazol suspension 125 mg/m botol - 3,800 - - - - -
98 Miconazol krim tube 234 3,926 234 918,684 - 234 918,684
99 Mineral mix serbuk 8 gr* sachet - 2,920 - - - - -
100 Natrium Bikarbonat tablet 500 mg tablet - 10 - - - - -
101 Natrium Diklofenak tablet 25 mg tablet 3,000 152 3,000 456,000 - 3,000 456,000
102 Natrium Diklofenak tablet 50 mg tablet - 136 - - - - -
Natrium Tiroksin (Levotiroksin) - - - - - -
103 tablet 100 mg (Euthyrox) tablet 1,072
104 Nipedipin 10 mg tablet tablet 30 193 30 5,790 - 30 5,790
105 Nicotinamida tablet 20 mg tablet - 1 - - - - -
106 Nistatin 100.000 iu /g tablet vagina tablet 60 688 60 41,280 - 60 41,280
107 Obat antituberkolusis katagori 1* paket - 317,018 - - - - -
108 Obat antituberkolusis katagori 2* paket - 1,379,984 - - - - -
109 Obat antituberkulosis anak* paket 4 285,343 4 1,141,372 - 4 1,141,372
110 Obat FDC Kategori 1* paket 66 477,791 66 31,534,206 - 66 31,534,206
111 obat FDC KATEGORI 2* paket 1 1,379,984 1 1,379,984 - 1 1,379,984

Page 3 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
112 Oksitetrasiklin Hcl salep mata 1 % tube 100 2,600 100 260,000 - 100 260,000
113 Oksitosin injeksi 10 iu / ml ampul 9 1,232 9 11,088 - 9 11,088
114 Omeprazol inj 40 mg/10 ml ampul - 10,002 - - - - -
115 Omeprazole 20 mg capsul kapsul 2,510 480 2,510 1,205,360 - 2,510 1,205,360
116 Parasetamol sirup 120 mg / 5 ml botol 718 3,739 718 2,684,602 - 718 2,684,602
117 Parasetamol tablet 500 mg tablet 34,964 178 34,964 6,219,047 - 34,964 6,219,047
118 Pirantel pamoat 125 mg tablet tablet 53 353 53 18,709 - 53 18,709
119 Pirantel suspensi 5 mg/ml botol - 9,100 - - - - -
120 Piridoksin Hcl tablet 10 mg tablet 11,500 150 11,500 1,725,000 - 11,500 1,725,000
121 Piridoksin Hcl tablet 25 mg tablet - 222 - - - - -
122 Prednison tablet 5 mg tablet - 79 - - - - -
123 Primakuin tablet 15 mg* tablet - 253 - - - - -
124 Prokain benzil penisilin 3 juta iu / vi vial - 7,910 - - - - -
125 Propanolol Hcl tablet 40 mg tablet - 300 - - - - -
126 Propiltiourasil tablet 100 mg tablet 200 500 200 100,000 - 200 100,000
127 Ranitidin tablet tablet 230 229 230 52,636 - 230 52,636
128 Retinol ( Vit A ) 100.000 IU kapsul* kapsul 6,000 356 6,000 2,136,000 - 6,000 2,136,000
129 Retinol ( Vit A ) 200.000 IU kapsul* kapsul 15,000 637 15,000 9,555,000 - 15,000 9,555,000
130 Salbutamol tablet 2 mg tablet 1,000 122 1,000 122,111 - 1,000 122,111
131 Salbutamol tablet 4 mg tablet 1,000 128 1,000 127,985 - 1,000 127,985
132 Salep 2 - 4 kombinasi tablet 48 3,219 48 154,512 - 48 154,512
133 Sefadroxil kapsul 500 mg tablet 2,180 809 2,180 1,762,530 - 2,180 1,762,530
134 Sefadroxil syp kering 125 ml / 5 ml botol 100 4,360 100 436,000 - 100 436,000
135 Sianokobalamin ( Vit.B.12 ) inj 500 ampul - 1,067 - - - - -
136 Simpastatin 10 mg tablet tablet 8,450 664 8,450 5,607,420 - 8,450 5,607,420
137 Siprofloksasin 500 mg tablet tablet 920 306 920 281,366 - 920 281,366
138 Tetrasiklin Hcl kapsul 250 mg kapsul - 200 - - - - -
139 Tetrasiklin Hcl kapsul 500 mg kapsul - 310 - - - - -
140 Thiamin Hcl monohidrat ( Vit B1 ) tablet 1,630 94 1,630 153,220 - 1,630 153,220
141 Triheksilfenidil hidroklorida tablet tablet 1,898 95 1,898 180,310 - 1,898 180,310
142 Vitamin B komplek tablet tablet 33,493 135 33,493 4,521,555 - 33,493 4,521,555
143 Zink 20 mg tablet (generik) tablet 3,210 604 3,210 1,938,840 - 3,210 1,938,840
144 Vaksin BCG* vial 405 66,154 405 26,792,370 - 405 26,792,370
145 Vaksin Jerap D T* vial 300 17,450 300 5,235,000 - 300 5,235,000
146 Vaksin CAMPAK 10 Dosis* vial - 28,204 - - - - -
147 Vaksin POLIO 10 Dosis* vial 494 21,285 494 10,514,790 - 494 10,514,790
148 Vaksin HEPATITIS B 0,5 ml ADS* vial 520 23,270 520 12,100,400 - 520 12,100,400
149 Pentabio Vaksin DTP-HB-HIB inj* vial 585 84,282 585 49,304,970 - 585 49,304,970
150 Vaksin Td* vial 221 18,128 221 4,006,288 - 221 4,006,288
Vaksin IPV (Poliomyelitis Vaccine 339 339 48,999,060 - 339 48,999,060
151 inj (ShanIPV)* vial 144,540
152 Vaksin MR* vial 458 166,265 458 76,149,370 - 458 76,149,370
153 Acdat salep tube - 6,241 - - - - -
Page 4 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
154 Air untuk irigasi lar infus 1000 ml botol - 12,100 - - - - -
155 Akarbose tablet 100 mg tablet - 960 - - - - -
156 Albendazol suspensi 200mg/5 ml botol - 4,146 - - - - -
157 Alprazolam 0,5 mg tablet - 94 - - - - -
158 Alprazolam 1 mg tablet - 128 - - - - -
159 Alvit drops botol - 12,500 - - - - -
160 Ambroxol sirup botol 58 4,861 58 281,932 - 58 281,932
161 Ambroxol tablet tablet 1,740 150 1,740 261,000 - 1,740 261,000
162 Amlodipin 10 mg tablet 5,000 94 5,000 470,000 - 5,000 470,000
163 Amoksisilin 250 mg tablet 2,600 377 2,600 980,980 - 2,600 980,980
164 Anemolat 1 mg tablet tablet - 81 - - - - -
165 Antalgin (Metampiron) tablet 500 tablet - 67 - - - - -
166 Antalgin injeksi 250 mg/5 ml ampul - 408 - - - - -
167 Anti bakteri doen salep kombinasi tube 31 5,455 31 169,095 - 31 169,095
168 Antihemaroid doen kombinasi supp 54 3,642 54 196,668 - 54 196,668
169 Antimigrain doen kombinasi tablet - 149 - - - - -
170 Antiparkinson doen tablet kombina tablet - 1,035 - - - - -
171 Antrain inj ampul - 12,000 - - - - -
172 Apialis Drops botol - 21,175 - - - - -
173 Apialys sirup botol - 33,000 - - - - -
174 Aqua proinjeksi steril,bebas piroge vial - 2,860 - - - - -
175 Arkavit tablet 10,000 244 10,000 2,436,720 - 10,000 2,436,720
176 Asam Asetilsalisilat tablet 100 mg ( tablet - 356 - - - - -
177 Asam Asetilsalisilat tablet 500 mg ( tablet - 100 - - - - -
178 Asam askorbat(vit C) tablet 250 mg tablet 200 164 200 32,808 - 200 32,808
179 Asam Folat 5 mg tablet tablet - 64 - - - - -
180 Asam Traneksamat 500 mg kapsul kapsul 500 3,202 500 1,600,830 - 500 1,600,830
181 Asam Traneksamat injeksi 5 % 250 ampul - 1,813 - - - - -
182 Asiklovir salep kulit tube 57 3,773 57 215,061 - 57 215,061
183 Atropin Sulfat injeksi 0,25 mg/ml-1 ampul - 1,859 - - - - -
184 Atropin Sulfat tetes mata 0,5 % botol - 2,801 - - - - -
185 Atrovent HFA kotak - 83,500 - - - - -
186 Azitromisin 500 mg tablet tablet 400 1,778 400 711,200 - 400 711,200
187 Baby Cough sirup botol 100 4,851 100 485,100 - 100 485,100
188 Betahistin mesilat tablet 6 mg tablet 530 119 530 63,070 - 530 63,070
189 Bioplacenton Cream tube 66 23,716 66 1,565,256 - 66 1,565,256
190 Bisoprolol tablet 5 mg tablet 600 264 600 158,400 - 600 158,400
191 Buscopan tablet tablet 380 4,346 380 1,651,480 - 380 1,651,480
192 Cendo Augentonic tetes mata botol - 29,792 - - - - -
193 Cendo Catarlent tetes mata botol 20 35,200 20 704,000 - 20 704,000
194 Cendo Edta tetes mata botol - 37,500 - - - - -
195 Cendo Floxa tetes mata botol - 30,800 - - - - -
196 Cendo fungicide tetes mata botol - 18,500 - - - - -
Page 5 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
197 Cendo Homatrol tetes mata botol - 43,785 - - - - -
198 Cendo Lyteers tetes mata botol - 26,681 - - - - -
199 Cendo mydriatil tetes mata botol - 34,100 - - - - -
200 Cendo Tobroson tetes mata botol - 54,843 - - - - -
201 Cendo tropin tetes mata botol - 13,200 - - - - -
202 Cendo Xytrol tetes mata botol 3 32,313 3 96,938 - 3 96,938
203 Cetop-zink kaplet tablet - 4,840 - - - - -
204 Clopidogrel 75 mg tablet tablet 500 1,469 500 734,500 - 500 734,500
205 Curcuma tablet tablet 8,000 1,049 8,000 8,395,464 - 8,000 8,395,464
206 Dekstran 70 larutan infus 6 % steril botol - 35,526 - - - - -
207 Depakene sirup botol - 17,789 - - - - -
208 Depakote tablet tablet 200 1,200 200 240,000 - 200 240,000
209 Desoksimetason 0,25 mg (Denomix tube 200 12,075 200 2,415,000 - 200 2,415,000
210 Dextamine tablet tablet 500 1,957 500 978,285 - 500 978,285
211 DEXTAMIN SYR botol - 30,200 - - - - -
212 Dextrofen sirup botol 14 12,451 14 174,313 - 14 174,313
213 Diamicron MR 30 mg tablet tablet - 638 - - - - -
214 Diltiazem tablet tablet - 143 - - - - -
215 Domperidon Suspensi 5 mg/5 ml botol - 4,312 - - - - -
216 Dopamet (metildopa) tablet - 1,088 - - - - -
217 Dulcolax 10 mg supp supp 14 5,900 14 82,600 - 14 82,600
218 Dulcolax 5 mg tablet tablet 212 1,661 212 352,089 - 212 352,089
219 Efedrin Hcl tablet 25 mg tablet - 198 - - - - -
220 Erytromisin 250 mg kapsul kapsul - 636 - - - - -
221 Etakridin ( Rivanol ) larutan 0,1 % botol - 11,103 - - - - -
222 Etambutol Hcl tablet 250 mg tablet - 186 - - - - -
223 Famotidin 40 mg tablet tablet - 192 - - - - -
224 Fenitoin natrium inj 50 mg / ml ampul - 11,856 - - - - -
225 Fenitoin natrium kapsul 100 mg kapsul - 158 - - - - -
226 Fenobarbital tablet 100 mg tablet - 127 - - - - -
227 Fenofibrat kaps 100 mg tablet 600 1,191 600 714,582 - 600 714,582
228 Fenol gliserol tetes telinga 10 % botol 76 2,764 76 210,064 - 76 210,064
229 Flukonazol tab 150 mg tablet - 21,528 - - - - -
230 Fluor tablet 0,5 mg tablet - 33 - - - - -
231 Fucilex ointment (natrium fusidat) tube - 4,889 - - - - -
232 Fungasol 2 % botol - 24,200 - - - - -
233 Fuson ointment tube - 7,500 - - - - -
234 Gemfibrozil 300 mg tablet 302 436 302 131,784 - 302 131,784
235 Gentamisin salep kulit tube 340 2,572 340 874,412 - 340 874,412
236 Gentamisin salep mata tube - 3,075 - - - - -
237 Gentamisin Tetes mata botol 100 4,885 100 488,500 - 100 488,500
238 Gentian violet larutan 1 % pot 15 3,258 15 48,873 - 15 48,873
239 Glimepirid tab 2 mg tablet 3,560 207 3,560 736,920 - 3,560 736,920
Page 6 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
240 Gliseril guayakolat tablet 100 mg tablet 6,988 167 6,988 1,163,782 - 6,988 1,163,782
241 Gliserin larutan 50% botol - 5,867 - - - - -
242 Glukosa larutan infus 10 % steril botol - 8,003 - - - - -
243 Glukosa larutan infus 40 % steril botol - 10,790 - - - - -
244 Glukosa larutan infus 5 % steril botol 10 7,363 10 73,630 - 10 73,630
245 Glukosamin 250 mg tablet (osmin) tablet 2,500 949 2,500 2,371,600 - 2,500 2,371,600
246 H.Booster sirup botol - 14,168 - - - - -
247 Haloperidol tablet 1,5 mg tablet 451 59 451 26,609 - 451 26,609
248 Hemafort tablet tablet 40,000 920 40,000 36,819,200 - 40,000 36,819,200
249 HEXADOL (Larutan Hexetidine) botol 78 20,752 78 1,618,617 - 78 1,618,617
250 Hidrokortison krim 1% tube - 10,724 - - - - -
251 Hyorex 10 mg tablet tablet - 405 - - - - -
252 Hyoscine N Butilbromida 10 mg tab tablet - 1,626 - - - - -
253 Ibuprofen syr 100 mg/5ml botol 100 4,522 100 452,210 - 100 452,210
254 Ichtyol salep tube - 6,200 - - - - -
255 Inhitril 10 mg tablet - 385 - - - - -
256 Inhitril 5 mg tablet - 660 - - - - -
257 Interhistin tablet tablet - 984 - - - - -
258 Irbesartan tab 150 mg tablet - 425 - - - - -
259 Kalsium laktat ( Kalk ) tablet 500 m tablet 50,000 63 50,000 3,150,000 - 50,000 3,150,000
260 Kandesartan 8 mg tablet tablet 3,000 629 3,000 1,887,000 - 3,000 1,887,000
261 Kandesartan 16 mg tablet tablet 8,000 998 8,000 7,984,000 - 8,000 7,984,000
262 Kandistatin drops (nistatin 100.000 botol 20 36,300 20 726,000 - 20 726,000
263 Kaptopril 12,5 mg tablet tablet 80 69 80 5,520 - 80 5,520
264 Kaptopril 50 mg tablet tablet - 135 - - - - -
265 Ketokonazol Krim tube - 2,577 - - - - -
266 Ketoprofen 100 mg tablet tablet - 1,366 - - - - -
267 Klindamisin 150 mg tablet tablet 300 803 300 240,900 - 300 240,900
268 Klobazam 10 mg tablet tablet 300 916 300 274,800 - 300 274,800
269 Klonidin 0,15 mg tablet tablet - 224 - - - - -
270 Kloramfenikol tetes telinga 3 % botol 200 8,894 200 1,778,700 - 200 1,778,700
271 Klorpromazin Hcl inj 25 mg / ml - 1 ampul - 1,243 - - - - -
272 Klorpromazin Hcl tablet salut 25 m tablet - 252 - - - - -
273 Klozapin 25 mg tablet tablet 800 1,121 800 896,800 - 800 896,800
274 Kodein tablet 15 mg tablet 200 728 200 145,600 - 200 145,600
275 Kodein tablet 20 mg tablet - 1,494 - - - - -
276 Kombinasi pirimetamin 25 mg / sul tablet - 380 - - - - -
277 Kombipak Azitromycin-Cefixim paket - 44,550 - - - - -
278 Kotrimoksazol DOEN II (pedriatik) t tablet - 79 - - - - -
279 Lanzoprazol tablet 4,000 352 4,000 1,408,000 - 4,000 1,408,000
280 Lapalos Cream tube 200 14,300 200 2,860,000 - 200 2,860,000
281 Laxadine emulsi botol 20 41,250 20 825,000 - 20 825,000
282 L-Bio sachet sachet 300 5,775 300 1,732,500 - 300 1,732,500
Page 7 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
283 Lanzoprazol tablet - 86,000 - - - - -
284 Lapalos Cream tube - 14,304 - - - - -
285 Levofloksasin tab 500 mg tablet - 479 - - - - -
286 Lexapram sirup botol - 2,900 - - - - -
287 Lidocain jeli 2 % (Xylocaine Jelly 2% syringe - 40,000 - - - - -
288 Lincomisin 500 mg tablet - 1,601 - - - - -
289 Lisinopril 10 mg tablet tablet - 341 - - - - -
290 Lisinopril 5 mg tablet tablet - 250 - - - - -
291 Lisol botol - 45,100 - - - - -
292 Livertran salep tube - 4,600 - - - - -
293 Longatin 25 mg tablet 6,000 3,320 6,000 19,921,440 - 6,000 19,921,440
294 Loperamida tablet tablet - 85 - - - - -
295 Lorazepam (Merlopam) 2 mg tablet tablet 200 995 200 199,000 - 200 199,000
296 Lytacur botol 60ml botol - 16,500 - - - - -
297 MDT Combi* paket - 41,240 - - - - -
298 Mebendazol sirup 100 mg / 5 ml botol - 957 - - - - -
299 Meloxikam 15 mg tablet tablet 2,000 540 2,000 1,079,078 - 2,000 1,079,078
300 Meloxikam 7,5 mg tablet tablet 7,100 448 7,100 3,182,419 - 7,100 3,182,419
301 Mersibion injeksi ampul - 6,000.0 - - - - -
302 Metoklorpropamid sirup botol - 16,500 - - - - -
303 Metronidazol infus 500 mg/100 ml botol - 8,250 - - - - -
304 Metronidazol supp 500 mg (Flagyl supp - 3,655 - - - - -
305 Metronidazol sirup botol - 3,950 - - - - -
306 Miniaspi 80 mg tablet 330 105 330 34,650 - 330 34,650
307 Misoprostol 200 mg (gastrul) tablet - 13,044 - - - - -
308 Mixaria sachet - 1,260 - - - - -
309 Moksifloksasin tetes mata 0,5% (V botol - 81,000 - - - - -
310 Mometason furoat krim 0,1 % tube - 8,437 - - - - -
311 Natrium klorida larutan infus 0,9 % botol 82 6,840 82 560,880 - 82 560,880
312 Neo Diaform tablet 1,485 273 1,485 405,010 - 1,485 405,010
313 Neurodex tablet tablet - 495 - - - - -
314 New Diatabs tablet - 557 - - - - -
315 Nistatin 500.000 iu /g tablet salut tablet - 910 - - - - -
316 Nitral (gliseril trinitras sublingual 0 tablet - 1,400 - - - - -
317 Nopres 20 mg tablet tablet - 4,565 - - - - -
318 Norages Injeksi ampul - 7,700 - - - - -
319 novadium tablet 110 200 110 22,000 - 110 22,000
320 Novastan sirup botol - 8,800 - - - - -
321 Noza tablet tablet 1,000 880 1,000 880,000 - 1,000 880,000
322 Obat antituberkulosis kat.3* paket - 154,000 - - - - -
323 Obat antituberkulosis kat.sisipan* paket - 160,000 - - - - -
324 Obat Batuk Hitam ( OBH ) cairan botol 75 4,733 75 354,998 - 75 354,998
325 Obat suntik KB I (3 bulan) ampul 80 7,175 80 574,000 - 80 574,000
Page 8 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
326 Obat suntik KB II (1 bulan) ampul 23 6,342 23 145,866 - 23 145,866
327 Ofloksasin tab 400 mg tablet - 700 - - - - -
Oksimetazolin tts hidung 0,025% - - - - - -
328 (Iliadin drops) botol 60,229
329 Oksitetrasiklin Hcl salep kulit 3 % tube 129 2,230 129 287,631 - 129 287,631
330 Ondansetron inj 4 mg/2ml ampul - 1,258 - - - - -
331 Ondansetron tab 4 mg tablet - 429 - - - - -
332 Optiflox tetes mata botol - 14,005 - - - - -
333 Pamol supp supp - 15,178 - - - - -
334 Pantocain 0,5 % TM botol - 17,500 - - - - -
335 Papaverin 40 mg tablet tablet 2,300 660 2,300 1,518,000 - 2,300 1,518,000
336 Parasetamol Drop 100 mg/ml botol 520 7,646 520 3,975,920 - 520 3,975,920
337 Pedialyte botol - 32,287 - - - - -
338 Pehacain injeksi ampul 100 3,381 100 338,140 - 100 338,140
339 Pil KB I tablet - 1,350 - - - - -
340 Pil KB II / Laktasi tablet - 11,062 - - - - -
341 Pim-Tra-Kol sirup botol 150 11,296 150 1,694,385 - 150 1,694,385
342 Pirazinamid tab 500 mg tablet - 238 - - - - -
343 Piroksikam 10 mg tablet tablet - 244 - - - - -
344 Piroksikam 20 mg tablet tablet - 316 - - - - -
345 Polikresulen botol - 43,976 - - - - -
346 Povidon Iodida larutan 10 % 30 ml botol 40 5,929 40 237,160 - 40 237,160
347 Povidon Iodida larutan 10 % 300 ml botol - 14,350 - - - - -
348 Povidon Iodida Larutan 1000 ml botol - 66,000 - - - - -
349 Povidon Iodida Larutan 60 ml botol 40 6,772 40 270,864 - 40 270,864
350 PP Isoniazide 100 mg* tablet - 282 - - - - -
351 Prazikuantel tablet 600 mg tablet - 2,295 - - - - -
352 Prenatin DF tablet tablet - 3,300 - - - - -
353 Primolut N tablet - 2,618 - - - - -
354 Protofen supp supp - 2,380 - - - - -
355 Protofen tablet tablet - 880 - - - - -
356 Pularex tablet tablet - 187 - - - - -
357 Pulmicort respules ampul - 9,725 - - - - -
358 Pulmicort turbuhaler kotak - 101,000 - - - - -
359 Ramabion tab tablet - 6,490 - - - - -
360 Ranitidin inj 25mg/2ml ampul - 1,188 - - - - -
361 Recovit sirup botol - 8,650 - - - - -
362 Reserpin tablet 0,25 mg tablet - 114 - - - - -
363 Rifampisin kaplet 600 mg tablet - 1,209 - - - - -
364 Rifampisin kapsul 300 mg tablet - 670 - - - - -
365 Rifampisin kapsul 450 mg tablet - 868 - - - - -
366 Ringer laktat larutan infus steril botol 20 7,630 20 152,600 - 20 152,600
367 Risperidon 2 mg tab tablet - 287 - - - - -
Page 9 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
368 Salisil bedak 2 % kotak 77 6,927 77 533,356 - 77 533,356
369 Sandepril 50 mg tablet - 8,250 - - - - -
370 Sangobion kids drop botol - 35,000 - - - - -
371 Sangobion Kids Sirup botol 222 29,645 222 6,581,190 - 222 6,581,190
372 Scabicid cream 10 gram tube - 11,475 - - - - -
373 Scabimite cream 10 gram tube 200 50,397 200 10,079,300 - 200 10,079,300
374 Scopma tablet tablet - 1,418 - - - - -
375 Sefaleksin kapsul 500 mg kapsul - 717 - - - - -
376 Sefiksim kapsul 100 mg kapsul 192 2,668 192 512,266 - 192 512,266
377 Sefiksim syr kering 100mg/5ml botol 50 32,577 50 1,628,825 - 50 1,628,825
378 Seretide Inhaler 50 mcg kotak - 58,000 - - - - -
379 Serum anti bisa ular polivalen inj 5 vial - 512,204 - - - - -
380 Serum anti bisa ular polivalen inj 50 vial - 28,468,086 - - - - -
381 Serum anti defteri inj 1000 mg / via vial - 2,200,000 - - - - -
382 Serum anti tetanus inj 1.500 IU / am ampul - 130,999 - - - - -
383 Serum anti tetanus inj 20.000 IU / ampul - 604,670 - - - - -
384 Setirizin sirup 5 mg/ml botol 250 3,061 250 765,250 - 250 765,250
385 Setirizine tablet 10 mg tablet 8,000 104 8,000 832,000 - 8,000 832,000
386 Simetidin tablet tablet - 330 - - - - -
387 Simpastatin 20 mg tablet tablet 2,460 225 2,460 553,500 - 2,460 553,500
388 Sohobion tablet tablet - 2,200 - - - - -
389 Spiramisin 500 mg tablet tablet - 1,223 - - - - -
390 Spironolakton tab 25 mg tablet 200 226 200 45,200 - 200 45,200
391 Stesolid rectal 5 mg supp 5 14,459 5 72,295 - 5 72,295
392 Stimuno Forte tablet tablet - 2,668 - - - - -
393 Stimuno Sirup botol 87 27,500 87 2,392,500 - 87 2,392,500
394 Sucralfate 500 mg/5 ml suspensi botol 350 7,338 350 2,568,300 - 350 2,568,300
395 Sulfasetamid natrium tetes mata 1 botol - 8,500 - - - - -
396 Susuk KB II set - 213,937 - - - - -
397 Symbicort turbuhaler 160/4.5 mg kotak 100 134,284 100 13,428,400 - 100 13,428,400
398 Symbicort turbuhaler 80/4.5 mg kotak - 121,000 - - - - -
399 Synarcus krim tube - 2,534 - - - - -
400 Taburia sachet - 888 - - - - -
401 Tanapress 5 mg (imidapril ) tablet - 2,530 - - - - -
402 Tensigard tablet tablet - 2,293 - - - - -
403 Terra Flu tablet tablet 1,460 807 1,460 1,178,220 - 1,460 1,178,220
404 Tetagam ampul - 188,663 - - - - -
405 Thiamfenicol 500 mg kapsul kapsul - 2,600 - - - - -
406 Thiamin Hcl ( Vit B1 ) inj.100 mg / m ampul - 730 - - - - -
407 Thrombophob gel tube 25 58,697 25 1,467,428 - 25 1,467,428

Page 10 of 14
 USULAN TOTAL
NO NAMA OBAT SATUAN HARGA OBAT PROYEKSI PENGADAAN TOTAL RUPIAH
PENGADAAN 2022 PENGADAAN
APBD total Rp APBD JKN total Rp JKN
408 Timolol tetes mata 0,5% botol - 10,286 - - - - -
409 Tramadol 50 mg kapsul kapsul 200 580 200 116,000 - 200 116,000
410 Tramadol inj 50 mg/ml ampul - 1,882 - - - - -
411 Triflouperazin 5mg tablet tablet 100 330 100 33,000 - 100 33,000
412 Truvit drops botol 200 32,253 200 6,450,620 - 200 6,450,620
413 Truvit sirup botol 200 18,973 200 3,794,560 - 200 3,794,560
414 Ulsafate sirup botol - 7,338 - - - - -
415 Ulsidex tablet tablet - 296 - - - - -
416 Urea krim (Soft U derm) botol - 7,040 - - - - -
417 Urotractin (asam pipemidat) 400 m tablet - 3,866 - - - - -
418 Vagizol ovula (metronidazol ovula) ovula - 3,590 - - - - -
419 valisanbe 2 mg tablet - 236 - - - - -
420 Valsartan tab 80 mg (Diovan 80mg) tablet - 3,900 - - - - -
421 Vastral tablet - 605 - - - - -
422 Ventolin inhaler kotak - 60,000 - - - - -
423 Ventolin Nebulizer ampul - 11,191 - - - - -

Page 11 of 14
 DINAS KESEHATAN KOTA BANJARMASIN

RENCANA KEBUTUHAN BMHP TAHUN 2022

PUSKESMAS : KELAYAN TIMUR

TOTAL
SISA STOK TOTAL SISA PEMAKAIAN PEMAKAIAN 1PREDIKSI PREDIKSI SISA RENCANA USULAN
SISA STOK PEMAKAIAN
BMHP JKN STOK BMHP RATA2/BULAN RATA2/BULAN PENERIMAA STOK PER KEBUTUHAN PENGADAAN
NO NAMA OBAT SATUAN BMHP APBD RATA2 /
31 OKT PER 31 OKT BMHP APBD BMHP JKN N NOV & DES DESEMBER BMHP 2022
31 OKT 2021 BULAN
2021 2021 2021 2021 TAHUN 2022 (PEMBULATAN)

1 2 3 4 5 6=4+5 7 8 9=7+8 10 11 = (6+10)-(9X2) 12 = (9 * 18)- 11 13

C BMHP
1 Alat suntik sekali pakai 1 ml pcs 142 142 2 2 138 (102) 500
2 Alat suntik sekali pakai 10 ml pcs 0 0 0 0 0 - -
3 Alat suntik sekali pakai 2,5 ml pcs 190 190 0 0 190 (190) 200
4 Alat suntik sekali pakai 3 ml pcs 258 258 20.3 20.3 217.4 148 1,000
5 Alat suntik sekali pakai 5 ml pcs 16 16 73.5 73.5 -131 1,454 1,000
6 Albothyl botol 0 0 0 - -
7 Alkohol Swab lembar 2150 2150 348.5 348.5 1453 4,820 5,000
8 Bioplacenton tulle pcs 0 0 0 0 0 - 5
9 Bistruri/scalpel balde No 10 pcs 0 0 0 0 0 - -
10 Bistruri/scalpel balde No 11 pcs 0 0 0 0 0 - -
11 Bisturi/scalpel balde No 15 pcs 0 0 0 0 0 - -
12 Blood Lancet pcs 3200 3200 210 210 2780 1,000 2,000
13 Blood transfusion set pcs 0 0 0 0 0 - -
14 Blue Tip pack 0 0 0 0 0 - 1
15 Box slide TB kotak 2 2 0 0 2 (2) 0
16 canula dewasa pcs 0 0 0 0 0 - 0
17 Cat Gut chromic No 1 pcs 0 0 0 0 0 - 0
18 Catgut/benang bedah no 2/0 chronic pcs 0 0 0 0 0 - 0
19 Catgut/benang bedah no 2/0 plain pcs 0 0 0 0 0 - 0
20 Catgut/benang bedah no 3/0 chronic pcs 0 0 0 0 0 - 0
21 Catgut/benang bedah no 3/0 plain pcs 0 0 0 0 0 - 0
22 Celulid strip pcs 0 0 0 0 0 - 0
23 Cetride 5 Liter galon 0 0 0 0 0 - 0
24 Clorheksidin 2,5 % botol 0 0 0 0 0 - 0
25 Coverplast pcs 0 0 0 0 0 - 0
26 Deck glass / objek glass 20 x 20 mm pack 0 0 0 0 0 - 10
27 Deck glass / objek glass 22 x 22 mm pack 0 0 0 0 0 - 0
28 Deck gelas / objek glass 24 x 24 mm pack 0 0 0 0 0 - 0
29 Disposibel vagina speculum pcs 0 0 0 0 0 - 0
30 D-Pierce X12 box 0 0 0 0 0 - 0
31 ECG 112 mm x 30 mm x 16 mm roll 0 0 0 0 0 - 0
32 ECG 58 mm x 25 mm x 16 mm roll 0 0 0 0 0 - 0
33 Film Rontgen 24 x 30 cm lembar 0 0 0 0 0 - 0
34 Film Rontgen 30 x 40 cm lembar 0 0 0 0 0 - 0
35 Film Rontgen 35 x 35 cm lembar 0 0 0 0 0 - 0
36 Fixomull pcs 13 13 0.6 0.6 11.8 (1) 20
37 Foley cateter no 16 pcs 0 0 0 0 0 - 0
38 Foley cateter no 18 pcs 0 0 0 0 0 - 0
39 Fukuda M.E.ECG Paper pcs 0 0 0 0 0 - 0
40 handiplast pcs 0 0 0 0 0 - 0
41 Holder tube vacutainer pcs 0 0 0 0 0 - 10
42 Hypafix uk. Kecil 5 cm x 5 m pcs 0 0 0 0 0 - 0
43 IUD set 10 10 0 0 10 (10) 0
44 Infusiun set anak pcs 12 12 0 0 12 (12) 20
45 Infusiun set dewasa pcs 4 4 0.3 0.3 3.4 2 20
46 IV Catheter no 18 G pcs 16 16 0 0 16 (16) 20
47 IV Catheter no 20 G pcs 7 7 0 0 7 (7) 10
48 IV Catheter no 22 G pcs 12 12 0 0 12 (12) 20
49 IV Catheter no 24 G pcs 0 0 0 0 0 - 0
50 Jarum (Needle) no 23 pcs 461 461 17.5 17.5 426 (111) 1000
51 Jarum (Needle) no 25 pcs 0 0 0 0 0 - 0
52 Jarum Jahit kulit no 10 GT pack 0 0 0 0 0 - 0
53 Jarum Jahit Kulit No 11 GT pack 0 0 0 0 0 - 0
54 Jarum Jahit kulit no 12 GT pack 0 0 0 0 0 - 0
55 Jarum Jahit Kulit No 13 GT pack 0 0 0 0 0 - 0
56 Jarum Jahit Kulit No 14 GT pack 0 0 0 0 0 - 0
57 jarum K-File no 15-40 kotak 0 0 0 0 0 - 0
58 jarum K-File no 45-80 kotak 0 0 0 0 0 - 0
59 jarum K-File no 90-140 kotak 0 0 0 0 0 - 0
60 Jelly (Aquagel) botol 1 1 0.5 0.5 0 9 20
61 kantongan plastik pack 0 0 0 0 0 - 0
62 Kapas berlemak 500 mg roll 0 0 0 0 0 - 0
63 Kapas pembalut / absorben 250 mg roll 3 3 0.6 0.6 1.8 9 20
64 Kasa kompres 40 / 40 steril pcs 105 105 30.2 30.2 44.6 499 500
65 Kasa pembalut 2 m x80 cm pcs 0 0 0 0 0 - 0
66 Kasa pembalut hidrofil 4m x 15 cm pcs 0 0 0 0 0 - 0
67 Kasa pembalut hidrofil 4m x 3 cm pcs 0 0 0 0 0 - 0
68 Kasa steril 16 cm x 16 cm box 0 0 0 0 0 - 0
69 Kertas EKG (uk 80 x 90 x 280) lembar 0 0 0 0 0 - 0
70 Kertas Puyer lembar 55672 55672 120 120 55432 (53,272) 0
71 Kertas Thermal roll 5 5 0 0 5 (5) 5
72 kertas thermal 50 mm x 57 mm roll 0 0 0 0 0 - 0
73 Kertas thermal mindray 50mm x 50 mm roll 0 0 0 0 0 - 0
74 Kertas thermal mindray 80 x 50 roll 0 0 0 0 0 - 0
75 Kertas thermal mindray 80 x 80 roll 0 0 0 0 0 - 0
76 Klorin botol 0 0 3.1 3.1 -6.2 62 62
77 Kondom pcs 0 0 0 0 0 - 0
78 Larutan antiseptik (Aseptan) botol 0 0 0 0 0 - 0
79 Lidi Kapas/cotton swab pcs 0 0 0 0 0 - 0
80 Markerpen pcs 0 0 0 0 0 - 0
81 Masker N 95 3M 1860 pcs 0 0 0.4 0.4 -0.8 8 500
82 Masker N 95 3M 1860S pcs 100 100 0 0 100 (100) 1000
83 Masker N 95 3M 1870 pcs 0 0 0 0 0 - 0
84 masker nebule dewasa pcs 0 0 0 0 0 - 0
85 masker oksigen anak pcs 0 0 0 0 0 - 0
86 masker oksigen dewasa pcs 0 0 0 0 0 - 0
87 Mata Bor high speed pack 0 0 0 0 0 - 0
88 Microtube 1,5 cc pack 0 0 0 0 0 - 0
89 Minyak handpiece 500 ml botol 0 0 0 0 0 - 0
90 Mouthpiece sterilbreath 250s box 0 0 0 0 0 - 0
91 NaOcl 2,5 % untuk sal irigasi botol 0 0 0 0 0 - 0
92 Needle flashback pcs 0 0 0 0 0 - 0
93 Obyek glass* biasa pack 3 3 0 0 3 (3) 10
94 Open akses bur pcs 0 0 0 0 0 - 0
95 Pembalut gips pcs 0 0 0 0 0 - 0
96 Penjepit tali pusat pcs 0 0 0 0 0 - 0
97 Pharmafix pcs 0 0 0 0 0 - 20
98 pipet ESR citotes pcs 0 0 0 0 0 - 0
99 Plastik klip sedang pack/100s 0 0 5 5 -10 100 100
100 Plastik Obat kecil (uk. 8 cm x 5 cm) pack 0 0 0 0 0 - 0
101 Plastik Obat pembungkus puyer (uk. Besar) pack 0 0 3 3 -6 60 60
102 Plester (hansaplast 5 cm x 4,5 m) pcs 0 0 0 0 0 - 0
103 Plesterin pcs 200 200 20 20 160 200 1000
104 Pot Sputum pcs 0 0 100 100 -200 2,000 2000
105 safety box* pcs 0 0 0 0 0 - 0
106 sealing wax pcs 0 0 0 0 0 - 0
107 Serum gel tes tube 5 ml / tabung gel & cloat acti pcs 100 100 30 30 40 500 500
108 Silk ( benang bedah sutra ) no.3/0 pcs 5 5 0.6 0.6 3.8 7 7
109 silk no 2/0 pcs 0 0 0 0 0 - 0
110 Spon gelatin cubicle 1 x 1 x 1 cm pcs 0 0 0 0 0 - 0
111 Spuit 0,05 ml pcs 100 100 30 30 40 500 2000
112 Spuit 0,5 ml pcs 0 0 210 210 -420 4,200 4500
113 Steril Pouch 9 x 26 cm kotak 0 0 0 0 0 - 0
114 Suction tips pack 0 0 0 0 0 - 0
115 Surflo No 18 pcs 8 8 0 0 8 (8) 10
116 Surflo No 20 pcs 19 19 0 0 19 (19) 20
117 Surflo No 22 pcs 0 0 0 0 0 - 20
118 Surflo No 24 pcs 2 2 0 0 2 (2) 20
119 Surgical Glove No 6,5 pcs 0 0 0 0 0 - 0
120 Surgical Glove No 8 pcs 0 0 0 0 0 - 0
121 Surgical Glove obsgyn / gynecolog No 6,5 pcs 0 0 0 0 0 - 0
122 Surgical Glove obsgyn / gynecolog No 7 pcs 0 0 0 0 0 - 0
123 Surgical Gloves non steril uk L pcs 0 0 50 50 -100 1,000 1000