DAFTAR OBAT INJEKSI KLINIK ICHSAN

No Nama obat Sediaan No batch Tanggal ED

1 Atropin Sulfat ampul 9619F0201A Jun-21
2 Buscopan inj 20mg ampul 826289 Nov-23
825182A Feb-23
3 Dexamethason inj 5MG ampul PIE61247 Apr-22
4 Diphenhydramin INJC/1ML ampul 36342011-2 Jul-22
5 Ketorolac inj 30mg MG/ML ampul 36459021 Oct-23
6 Lidocain inj ampul 26362060-2 Aug-23
A10366807 Jan-22
7 ZYFORT INJEKSI ampul 22HO19 Aug-22
8 Omeprazole inj vial 20G6632 Jul-22
9 Ondansentron inj 4mg ampul J10426805 Sep-21
A10427006 Jan-23
10 RANITIDINE INJEKSI 50MG/2ML ampul L10356916 NOVEMBER 2021
11 SAGESTAM INJEKSI ampul AH3415B Aug-23
NEAR ED s/d SEPTEMBER 2021

DAFTAR OBAT MATA,TELINGA DAN INHALASI KLINIK ICHSAN

No Nama obat Sediaan No batch Tanggal ED
1 ErlamIcetin tetes telinga botol D.0655149 Aug-23
2 Reco tetes telinga drop botol 0.100820008 Aug-23
3 Reco tetes mata botol 0.91020004 Apr-22
4 Cendo Xitrol eye oint tube 891211 Dec-21
5 Reco salep mata tube 0.151091002 Oct-22
0.150918005 Sep-21
6 Ventolin neb pcs GFV0648 May-22
GFV0634 Jan-22
GFV0618 Sep-21
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT ORAL BPJS KLINIK ICHSAN

No Nama obat Sediaan No batch Tanggal ED
1 Allopurinol tab 100 mg NTALOA06167 Dec-22
000117B Mar-22
2 Antasida tab - 000117B Mar-22
E00317B Apr-23
3 Allopurinol tab 300mg 0.27193 Jul-21
4 Amlodipin tab 5mg EEA018 Jan-23
K519073 NOVEMBER 2021
5 Asam mefenamat tab 500mg 51J0259 May-24
- -
6 Amlodipin tab 10mg EEA162 Jan-23
 - -
7 Arkavit tab - T200715 Sep-23

8 CTM tab 4mg FU06T1A Jun-24

- -
9 Arkavit C -
10 Captopril tab 12,5mg 49E0444 Apr-21
11 Decolsin tablet 4960470 Jun-21
19157702 Jul-21
12 Captopril 25mg 49H0889 Jan-22
13 Dextral tablet D03BN256 NOVEMBER 2021
14 Dexteem plus tablet T06020704 Dec-24
15 Eperisone 50mg tablet EC1114 -
16 Paracetamol Tab 500mg 00820K0080 NOV-2025
00.2241 NOV-2023
17 Dexaharsen (Dexamethasone) 0,5mg 00.83109 May-24
- -
18 Asam Folat 1mg 36352017 NOV-2022
19 Furosemid tab 40mg E91178B May-22
20 Flucadex tablet ZK165G NOV-2021
21 Guaifenesin tab 100mg C9105 Mar-22
22 Ranitidin 150mg HTRNTB04416 Aug-23
- -
23 Glimepiride tab 2mg HTGMPK96009 NOV-2023
NI0076301 Dec-21
24 Glibenclamid tab 5mg 1710075 Feb-23
25 Hufabion tablet UI.00140 Mar-22
26 Domperidone Tab 10mg A20026 Jan-23
27 Ambroxol tab 30mg PPN22248 Dec-21
EEA0991 Jan-25
28 Ketokonazole tab 200mg HTKC2A95090 Sep-21
190809103 Aug-21
29 Kolicgon Tab - T0655010 Sep-22
30 Metformin tab 500mg HTMFNA05629 Oct-22
MI0641 Sep-23
31 Methylprednisolon tab 4mg 1520038 Dec-22
32 Metronidazole tab 500mg 0.37893 Sep-23
33 Meloxicam tab 7,5mg EDC197 Dec-23
- -
34 Molexflu tab - M2880117 Oct-21
35 Metamizole tab 500mg 0.206901 Jun-23
36 Nalgestan tablet 2003301 Feb-24
37 Natrium diklofenak tab 50mg EDJ094 Oct-23
- Sep-25
38 Amoxicillin tab 500mg LI0686809 NOVEMBER 2023
39 Farsifen tab 400mg 0.1630 Oct-22
40 Ciprofloxacin tab 500mg 0.5119J0030 Oct-21
41 Nuwasir kap - PH0341 Aug-22
YL040A Dec-21
42 Omeprazole kap 20mg - -
43 Primadex Forte tab - 5IE0200 Mar-24
44 Piroxicam 10mg E80894B Apr-23
45 Primadex tab - 2790957 Jun-23
46 Cefadroxil Caps 500mg 5100575 Mar-24
47 Ramolit sachet - PC90324J Sep-21
48 Salbutamol tab 2mg A8205 Apr-23
49 Simvastatin tab 10mg HTSWND06221 NOV-2022
B00094B Feb-23
50 Molagit Tab - MIIC0045 Oct-25
51 Simvastatin tab 20mg A00007BJ Dec-22
52 Lexigo Tab 6mg L33C5013 Sep-22
53 Lopadium Tab 2mg 0.145008 Dec-22
54 Salbutamol tab 4mg 192486B Aug-23
55 Vit B6 - 600554B Jun-23
2500825 Aug-23
56 Cetirizine Tab 10mg EEA.012 Jan-23
57 Vitamin B complex - 6910541 Jul-22
58 Seremig tab 10mg 90205 May-21
59 Inamid tab 2mg 0040008-2 Mar-22
60 Calcifar tablet - 0.1330 NOVEMBER 2022
61 Hufaflox 500mg MG00010 Jan-24
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT LUAR (ATAS MEJA RACIKAN) KLINIK ICHSAN

No Nama obat Sediaan No batch Tanggal ED
1 Acyclovir Cr tube 181216 Jan-23
19324IJ Sep-21
2 Gentamycin Oint 0,1 (Salep) tube 669004 Aug-24
3 Betason Cr tube G91223T Jul-21
4 Hydrocortison 2,5% tube 1661T69 Jul-23
5 Chloramfecort-H Cr tube - -
6 Ketokonazole crm tube 2190033 Jun-21
G909921 Jul-23
7 Flamar gel 20GR tube - -
8 Farsycol Krim (Chloramfenicol) tube - -
9 Betametason Cr tube K0949T NOVEMBER 2022
10 Hydrcortison 1% tube KCHCT1705275 Sep-25
11 GOM Cito botol T12092 Sep-23
12 Chloramfecort tube K83448J NOVEMBER 2021
13 Kloderma Cr 5gr tube 1ON03A2 Oct-23
14 Erladerm-N Cr tube 19540167 Jun-21
15 Kloferson Krim (Kloranfenicol + Prednison) tube KO2C0065 Oct-22
16 Pibaksin Oint 10gr tube - -
17 Thrombhopop gel tube 99OK19 Oct-23
18 Salep 24 pot HT49-Z2A Aug-24
19 Betason-N Cr tube 191571T Sep-22
May-22
Oct-21
20 Bevalex Cr 5 Gr tube BOIC4031 May-22
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT SIRUP BPJS KLINIK ICHSAN

No Nama obat Sediaan No batch Tanggal ED
1 Amoxicillin syr 125mg botol TDAMXA04145 Aug-22
AB4304 Feb-23
2 Antasida syr botol 2344081 Dec-21
3 Axofen syr 100mg/5ml botol HH2661 Aug-22
4 Cetirizine drop 10mg/ml botol 22D4474 Apr-22
5 Cetirizine syr 5mg/5ml botol 25419L0020 Dec-22
D2211CX Mar-22
6 Erlapect syr 15mg/5ml botol 2854054 Sep-21
7 Farsifen syr 100mg/5ml botol 00.832 Jan-25
8 Fasidol drop 60mg/0,6ml botol 00.231 NOVEMBER 2022
9 Guanistrep syr botol 0.12001 Dec-24
10 Hufadon syr 5mg/5ml botol A300040 Jan-23
11 OBH Combii syr botol OEB027 Feb-22
12 OBH SYR botol 102091 Feb-25
13 OBP SYR botol 91116 NOVEMBER 2023
14 Paracetamol syr 120mg/5ml botol 64003002 Mar-22
15 Roverton drop 15mg/ml botol 90110 Oct-21
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT LAIN DAN BMHP KLINIK ICHSAN

No Nama obat Sediaan Jumlah No.batch
1 Amlodipin 5mg 3 C00121B
2 Folamef 1mg 10 Sep-02
3 Masker N95 PCS 16 B20020
4 Spuit 3CC (GEA/PKM)=FREE PCS 99 20160602
5 Nurse cap (topi operasi) pcs 80 -
6 Tongue spatel pcs 200
7 Wooden Spatula pcs 197
 8 Cytology brushes pcs 111
9 Alkohol swab pcs 200 20200921
10 Kassa berkat PCS 41
11 Nesco Asam urat pcs 25 UAS20219A35
12 HCG Testpack pcs 47
13 Cyclofem vial 16 CI802
14 Cooper T PCS 4 DaQ2126
15 Corolene 2/0 pcs 2 57245
16 Selang oksigen dewasa pcs 1 FY1711041
17 Masker Nebu dewasa pcs 1 Oct-20
18 Masker Nebu anak pcs 2 Aug-21
19 Underpad pcs 7
20 Handscoon ukuran M PCS 82 -
21 Masker hijab pcs 50 20-81850
22 Botol Gelap pcs 4
23 Apron pcs 12 202002
24 Antiseptik 70% 100ml botol 2 C9109202
25 NaCl 500ml botol 1 E202K21
26 NaCl 500ml botol 1 AD3058A
27 Spuit 0,5ml skifa pcs 23 1908401
28 Spuit 0,5ml oneject pcs 20 Jan-52
29 Spuit 5ml oneject pcs 22 Jun-66
30 Salicyl talk pcs 4 J017695
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021
 Jumlah Kartu Stok
2 2
5 6
1
1 1
1 1
1 1
2 5
3
1 1
2 2
2 7
5
3 3
2 2

K ICHSAN
Jumlah Kartu Stok
1 1
12 12
8 8
2 2
5 6
1
14 21
5
2

Jumlah KARTU STOK

100 133
33
33 231
20
45 45
75 81
3
48 156
2
125 126
 1
145 150

60 145
1

50 60
10 233
32
69 69
30 630
47 347
9 9
14 304
90
164 366
2
235 245
32 32
125 125
100 200
76 280
4
32 246
12
102 102
70 270
71 270
58 258
100
90 260
20
183 183
35 145
10
53 53
61 161
72 172
3
150 300
51 151
84 190
44 149
5
75 175
 81 181
70 241
4 42
42
-
60 60
54 54
96 194
95 295
10 35
115 215
55 279
15
100 248
20 220
110 260
69 69
86 187
74
10 184
100 200
16 118
77 177
90 90
80 80
67

Jumlah Kartu Stok

5 9
4
11 13
2 2
21 21
- -
1 2
1
- -
- -
4 29
3 3
10 34
3 3
 1 1
11 11
11 11
- -
4 4
10 10
1 4
1
2
4 4

Jumlah Kartu Stok

7 20
13
9 8
3 3
1 1
9 17
8
16 16
5 5
13 13
5 5
7 7
4 4
12 12
41 41
13
15 15

Tanggal ED
-
Jan-23
Aug-25
Jun-21
Sep-21
 Sep-25

Jan-22

May-24
Jan-25
Feb-24
Jan-23
Jul-24
May-24

Oct-25
Jul-25

Dec-23
Nov 2023
Apr-23
Jun-24
Dec-23
Jun-22
Oct-25
 DAFTAR OBAT SIRUP PRIBADI/ASURANSI KLINIK ICHSAN
No Nama obat Sediaan Jumlah No batch Tanggal ED
1 Gerdilium syr 5mg/5ml 2 20B174 Feb-23
2 Domperidone syr 5mg/5ml 7 52319056 Sep-21
3 Gerdilium drop 5mg/ml 1 19146918 Apr-21
3 19146918 Aug-21
4 Imboost syr botol 3 20B0127 Mar-22
5 Isprinol syr 250mg/5ml 1 21FO18 Jul-22
6 Kaotin syr - 1 51155002 Dec-21
2 Jan-22
7 Ottopan syr 120mg/5ml 2 20AG512 Jan-22
8 Lostacef syr 125mg/5ml 4 0.2124 Sep-21
4 0.2124 Apr-22
9 Proris syr 100mg/5ml - - -
10 Lasal syr 2mg/5ml 1 0.5039 Aug-22
1 Apr-22
11 Methopi syr 250mg/5ml 5 19J6996 Sep-21
12 Mucera syr 15mg/5ml 2 19L7100 NOVEMBER 2021
13 Opicef forte syr 250mg/5ml 3 19K0836 Oct-21
14 Opicef syr 125mg/5ml 1 19D0742 Sep-21
1 Jul-21
15 Mucohexin syr Bromhexin HCl 2 WDI1956 Apr-21
16 Ryvel syr 5mg/5ml 1 21M050 Dec-21
17 Ottopan drop 60mg/0,6ml 1 20E0452 May-22
18 Mucera drop 15mg/ml 2 19H0618 Aug-21
19 Sanadryl Exp syr - 9 K69720 Jul-22
20 Sanadryl DMP syr - - - -
21 Magtral syr - 11 20K0766 Aug-22
Sep-22
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT DI KULKAS KLINIK ICHSAN

No Nama obat Sediaan Jumlah No batch tanggal ED
1 Vaksin Polio oral vial 8 20576190 NOVEMBER 2021
4 2056819 NOVEMBER 2021
2 Vaksin BCG vial 3 0379G057 Sep-21
3 0379G147 NOVEMBER 2021
3 0379G142 NOVEMBER 2021
3 Vaksin Polio IPV vial 1 2100219 May-22
3 2100318 Apr-21
4 Vaksin Td vial 10 0.412818 Apr-21
13 0.413118 Apr-21
 4 0.413018 Apr-21
8 0.4114918 Aug-21
7 0.410319 Feb-22
5 Vaksin Pentabio vial 1 5041119 NOVEMBER 2021
6 Vaksin MR vial 6 0.128M428 Jul-21
3 0.129N062 Aug-21
2 0.129N063 Aug-21
11 0.129N258 May-22
1 0.128N400 Apr-21
1 0.128M426 Jul-21
7 Vaksin Hep-B 1ml (dewasa) sach 4 3660419 Jul-21
1 3660319 Apr-21
8 Vaksin Hep-B 0,5 (bayi) sach 2 3653619 Dec-21
9 Vaksin Prevenar vial 1 DP1771 Aug-22
1 ED2118 Mar-23
10 Vaksin Synflorix vial 1 ASPNB197A6 Feb-22
11 Vaksin Varivax vial 1 S039171 Dec-21
12 Borraginol-S supp 4 11519538 Jun-21
13 Dumin 125mg supp 3 X239107 Jan-23
14 Sankorbin inj amp 1 AD3426 Apr-22
15 Ascorbic acid/vit C inj amp 1 22L204 Oct-22
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT LAIN-LAIN KLINIK ICHSAN

No Nama obat Sediaan Jumlah No batch tanggal ED
1 CTM tab 4mg 296 0.9001009 Jan-23
2 Guaifenesin tab 100mg 99 48393 November 2024
3 Vit B comp - 89 24807002 Jul-21
4 Vit C tab 25mg 139 1905912 May-22
5 BNS Botol 1 220151 Apr-23
6 Octenic gel botol 1 U193021 Jul-21
7 Nymiko susp botol 1 WF1696 Dec-21
8 Ventolin inhaler - 1 MJ7M May-21
9 Bisolvon sol - 1 18071068 Jun-21
10 NaCl 25ml 5 85D49A Apr-21
11 Ichtyol zalf - 10 9071037 Jul-23
12 GOM - 24 T12092 Sep-23
13 Salep-24 10 HT49Z2A Aug-24
14 Stardine sol - 3 EBJ006 Oct-21
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT ORAL LAIN-LAIN KLINIK ICHSAN

No Nama obat Sediaan Jumlah No batch Tanggal ED
 1 Zink 20mg tablet 105 19ZC1027 NOVEMBER 2022
2 Vitamin C 250mg tablet 32 E00435B Apr-23
3 Vitamin C 500mg tablet 90 27921A0020 Jan-23
4 Mecobalamin 500mg kapsul 35 ECL039 Dec-22
5 Pytramic tab 500mg 17 HB194 Sep-24
6 Kalnex 500mg 50 KTKNXK04062 Jul-23
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

AR ORAL PRIBADI DI KLINIK ICHSAN

No Nama obat Sediaan Jumlah No batch Tanggal ED
1 Acetylsistein kap 200mg 50 EDK026 NOVEMBER 2022
50 20ASI076 NOVEMBER 2022
10 Jul-21
2 Acyclovir tab 400mg 95 1802006 Jul-22
3 Amoxsan kap 500mg 5 WLG711 NOVEMBER 2022
4 Mefinal tab 500mg 50 AK8076A Oct-22
5 Librozym tab 88 KTLB2E94005 Jul-21
6 Lincomycin kap 500mg 5 - -
7 Azithromycin tab 500mg 45 A1012IJ Jan-26
Jan-25
8 Alaxan FR kap 80 19152201 Jul-22
9 Atorvastatin tab 20mg 45 50J0064 Aug-21
10 Becom-C tab 180 BA8484 Jan-24
11 Cortidex tab 0,5mg 34 AE2310 May-22
12 Cefixime kap 100mg 81 51A0081 Feb-23
13 Cefixime kap 200mg 95 51J0038 Aug-22
14 Clindamycin kap 300mg 114 20CL2002 Mar-22
5 20019K0030 NOVEMBER 2021
15 Co-Amoxiclav tab 625mg 12 AC18K046 Dec-21
10 AC186006 Sep-21
16 Cataflam tab 50mg 97 ID5613 Sep-22
17 Celebrex kap 100mg 80 AI90512 May-21
18 Gerdilium tab 10mg 73 20CO302 Mar-22
19 Flunarizine tab 10mg 76 1908092 Aug-21
20 Isprinol tab 500mg - - -
21 Flunarizine tab 5mg 60 TPCU904 Feb-22
22 Flamar tab 50mg 6 - NOVEMBER 2021
23 Imboost tab 30 20L0122 NOVEMBER 2023
24 Cetirgi tab 10mg 4 - Sep-21
25 Lipitor tab 20mg 30 AH6528 Aug-21
26 Dulcolax tab 5mg 4 20060600 Jul-23
27 Lodia tab 2mg 124 AL2542 NOVEMBER 2022
28 Mucera tab 30mg 112 19JO752 Sep-21
29 Lacbon tab 28 J831550 Oct-21
 10 E91195J May-22
30 Lacto-B sachet 37 IN01T09 Aug-21
31 Lansoprazole kap 30mg 63 0.178059 Sep-22
32 Nolipo kap 500mg - - -
33 Mertigo tab 6mg 65 5IE0809 Jul-22
34 Myonep tab 50mg 75 2PO10 Jan-22
35 Neurosanbe tab 69 AG2952 Jul-22
36 Opicef tab 500mg - - -
37 Neurosanbe plus tab 15 AG2015 Jul-22
38 Ocuson tab 260 WJ2544 Sep-22
39 Rhinos kap 100 4500658 May-22
40 Triamcinolon tab 4mg 58 EDE145 May-22
41 Tequinol tab 500mg - - -
42 Sanmol tab 500mg 4 AM8350 Dec-22
43 Sanmol forte tab 650mg 40 AJ8462 Sep-22
44 Spasminal 60 HTSPLA05375 Oct-22
45 Vectrine kap 300mg 38 51B0155 Feb-22
46 Sanprima tab 50 UC2850 Mar-22
47 Sanprima forte tab 16 AD2744 Apr-24
48 Prednicort 4mg 20 20D0465 Apr-23
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR GUDANG OBAT GENERIK KLINIK ICHSAN

No Nama obat Sediaan Jumlah No batch Tanggal ED
1 Acyclovir 400mg tablet 400 G82204J Jul-23
2 Allopurinol 300mg tablet 100 HTALOB96201 NOVEMBER 2021
200 Oct-21
100 Sep-21
3 Antasida tablet 200 00420C0010 Mar-22
Feb-22
4 Ambroxol 30mg tablet 100 EDD287 Apr-24
100 Dec-25
5 Amoxicillin 500mg tablet 70 G10686702 Sep-21
6 Cefadroxil 500mg kapsul 200 51CO5235 Mar-24
Sep-24
7 Calcium lactate 500mg tablet 100 F00523T Jun-25
8 Ciprofloxacin 500mg tablet 100 05119J0030 Oct-21
9 Cetirizine 10mg tablet 100 EEA012 Jan-23
10 Guaifenesin 100mg tablet - - -
11 Gentamycin salep tube 10 L91700T Dec-23
12 GG tab tablet 200 C9015 Mar-22
13 Ketokonazole 200mg tablet 150 2590643 Apr-22
Aug-21
14 Metamizole 500mg tablet 100 212904 Dec-23
 15 Metronidazole 500mg tablet 100 GKL093400841 Sep-22
16 Mefenamic acid/as.mefenamat tablet 100 51J0318 Mar-24
17 Paracetamol 500mg tablet 200 F00629T Jun-22
NOVEMBER 2023
18 Salbutamol 2mg tablet 100 GKL0631111310AI Jun-24
19 Salbutamol 4mg tablet 100 H92101B Jul-23
20 Vitamin C 500mg tablet 400 2792IA0020 Jan-23
21 Vitamin C 250mg tablet 200 E004358 Apr-23
22 Zinc 20mg tablet 200 192C1027 NOVEMBER 2022
23 Betametason cream tube 25 100798T Sep-22
24 Glimepiride 2mg tablet 200 51J4129 Sep-22
25 Metformin 500mg tablet 100 HTMFNA0529 Oct-22
26 Domperidone 10mg tablet 200 A20026 Jan-23
27 Dexametason 0,5mg tablet 200 0.83056 Jun-22
28 Vitamin B Comp tablet 100 H91287T Aug-22
29 Vitamin B6 tablet 100 G005548 Jun-23
30 Triamcinolon 4mg tablet 163 EDE146 May-22
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR GUDANG OBAT PATEN KLINIK ICHSAN

No Nama obat Sediaan Jumlah No batch Tanggal ED
1 Mucohexin tablet 100 WJ2649 Sep-24
2 CTM 4mg tablet 312 FU06TIA Jun-24
3 Decolsin tablet 200 19250801 Jul-21
Dec-21
4 Dexteem plus tablet 300 T0620717 Dec-24
5 Dextral tablet 450 D03BN256 Feb-22
150 NOVEMBER 2021
6 Celebrex 100mg kapsul 90 A190512 May-21
7 Estalex tablet 50 131 NOVEMBER 2022
8 Hufabion tablet 200 U100140 Mar-22
9 Lexigo 6mg tablet 150 L33C5013 Sep-22
10 Fasidol forte tablet 80 00.626 Jun-24
11 Prednicort 4mg tablet 50 20D0465 Apr-23
12 Molexflu tablet 150 M28B0117 Oct-21
13 Molagit tablet 150 M11CY011 May-25
14 Opicef 500mg tablet 75 20A0097 Jan-22
15 Ramolit sachet 25 P09032AJ Sep-21
16 Rhinos SR kapsul 50 4500658 May-22
17 Primadex tablet 100 2790955 Jun-23
18 Trisela 10mg tablet 150 7455063 Sep-24
19 Seremig 10mg tablet 100 90205 May-21
20 Xepazym tablet 6 400860608 Jun-22
21 Neurosanbe plus tablet 100 AG2015 Jul-22
 22 Cortidex 0,5mg tablet 100 AM2737 Dec-22
23 Nalgestan tablet 100 20094201 Apr-24
24 Farsifen 400mg tablet 100 0.2530 Oct-22
25 Imboos tab tablet 50 20L0122 NOVEMBER 2023
26 Spasminal tablet 100 HTSPLA05375 Oct-22
27 Kolicgon tablet 100 DKL1306315304AI Sep-22
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT LAIN DI GUDANG GENERIK DI KLINIK ICHSAN

No Nama obat Sediaan Jumlah No batch Tanggal ED
1 Ranitidine tab 150mg 200 HTRNTB93107 Jun-22
2 Omeprazole kap 20mg 150 HL1094 Aug-22
3 Simvastatin tab 10mg 100 C906986 Feb-22
4 Simvastatin tab 20mg 200 LOO5758J NOVEMBER 2025
5 Meloxicam 7.5mg 100 EDJ311 NOVEMBER 2023
6 Natrium diklofenak 50mg 100 5110222 Aug-22
7 Cartylo 80mg 10 F005198 May-23
8 Isosorbide dinitrat 10mg 10 221126 Aug-22
9 Vitamin A biru (PKM) 151 H82354W Aug-21
10 Vitamin A merah (PKM) 621 F81656W Jul-21
11 Sep-22
12 Sucralfat syr 100mg/5ml 2 24121a0060 Jan-23
13 Pelarut MMR 72 0.688541352 FEB 2023, NOV 2023
14 0.688651494 SEPT 2023, MAR 2023
15 Pelarut Campak - 1 9913418 Jul-23
16 Pelarut BCG 35 070S17026E JUN 2022, OKT 2023
17 070S17014E MAR 2022, AGST 2021
18 0709S4033 Feb-23
19 0709S4017
20 0708S1009E
21 0708S4022E
22 OPIMOX TAB 500mg 50 19L0939 NOVEMBER 2022
23 CANGKANG KAPSUL NO.2 CAPSUL 322
24 CANGKANG KAPSUL NO.0 CAPSUL 519
25 KERTAS PUYER PCS 749
Kartu Stok
2
7
4

3
1
3

2
8

-
2

5
2
3
2

2
1
1
2
9
-
11
Kartu Stok
296
99
89
139
1
1
1
1
1
5
10

10
3

Kartu Stok
 305
232
490
35
17
50

Kartu Stok
110

95
5
50
88
5
45

80
45
180
134
81
95
119

22

97
80
73
76

60
6
80
4
30

124
112
38
36
63
-
65
75
69
-
115
260
100
158
-
4
40
160
38
50
38
70
 DAFTAR OBAT DAN ALKES BMHP KLINIK ICHSAN
No Nama obat Sediaan Jumlah No batch
1 Lab tabung merah 58 200428
2 Lab edta ungu GD 9 1907111
Lab edta ungu protube 2 20191130
3 Spuit 1 cc terumo 6 190927D
Spuit 1 cc Nipro 126 2062304J
4 Spuit 3cc terumo 7 200512F
Spuit 3cc Nipro 101 20J2108J
5 Spuit 5cc Terumo 29 170724C
6 Spuit 10cc Terumo 8 180404N
Spuit 10cc Nipro 3 1941207J
7 Wing needle 25 7 19001B
8 Lancet pemeriksaan darah ONSITE 26 20200320
LANCET pemeriksaan darah autoclick 44 28051988
9 Alkohol swab 178 GM2009209
10 Needle 25 16 200130E
11 Needle 26 75 180510C
12 Micropore 2.5cm 11.5
13 Kassa gulung 5cm 8,5+1
14 Kassa gulung 10cm 4
15 Kassa Husada 6
16 Vaselin swab/wintuel 5,5+5 200914
17 Vaselin swab/urgotul 7 1/4 74245
18 Underpad 1,5+0,5
19 Tabung feses 17
20 Tabung urine 7
21 Benang chromic catgut 4.0 (round) 3 805651

22 Benang T-chromic 3-0 (round) 2 180917DN

23 Benang Plain Catgut 2/0 (∆) 3 MD171890
24 Benang Catgut chromic 3/0 (∆) 3 20171118
25 Nacl 500ml 300ml E202K21
26 Nebulizer 1
27 Betadine sol botol 30ml
28 KB 3 bulan suntik BKKBN 89 6E702423
20 6G011510
29 Bisturi glassvan 1 190770A
30 Bisturi B Braun 3 B0146887
30 Bisturi B Braun 1 M7976952
31 Stik GDS Contour plus 12 DP8K0HC31B
31 Stik Cholesterol Nesco 5 CHS20709A76
32 Stik Asam urat Nesco 18 UAS20219A35
34 Stik HB Easytouch 12 HBS19702A78
36 Gel USG 50ml
 37 Hypafix Roll 3-Apr 830230
38 Pen Easytouch 3
39 Pen Accuchek 2 (rusak)
40 Pen Counterplus 2
41 Inflo plus 1 91224/1029
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT EMERGENCY KIT

KLINIK ICHSAN BINTARO
POLI GIGI
NO NAMA OBAT DAN ALKES JUMLAH SATUAN ED
1 IV Cath No. 18 1 pcs Feb-23
3 IV Cath No. 22 1 pcs Mar-24
4 IV Cath No. 24 1 pcs Jul-23
5 Selang Infus dewasa 1 pcs Oct-21
6 Selang infus anak 1 pcs Oct-21
7 Handscoon 4 pcs Sep-24
8 alkohol swab 2 pcs Aug-22
10 RL 500 CC 1 Kolf Sep-21
11 NaCL 0,9 % 500 CC 1 Kolf Aug-22
12 Spuit 3 cc 1 pcs Jul-24
13 Spuit 5 cc 1 pcs Sep-22
14 Spuit 10 cc 1 pcs Mar-23
15 Ephinefrin 2 amp -
16 Sulfa atropin 2 amp -
17 Plester Micropore 1 pcs -
18 Xylocain Gel 1 pcs Jan-22
19 Ambubag Dewasa 1 pcs -
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

NO NAMA OBAT DAN ALKES JUMLAH SATUAN ED

1 IV Cath No. 18 1 pcs Feb-23
3 IV Cath No. 22 1 pcs Mar-24
4 IV Cath No. 24 1 pcs Jul-23
5 Selang Infus dewasa 1 pcs Oct-21
6 Selang infus anak 1 pcs Oct-21
7 Handscoon 4 pcs Sep-24
8 alkohol swab 2 pcs Aug-22
10 RL 500 CC 1 Kolf Sep-21
11 NaCL 0,9 % 500 CC 1 Kolf Aug-22
12 Spuit 3 cc 1 pcs Jul-24
13 Spuit 5 cc 1 pcs Jun-22
14 Spuit 10 cc 1 pcs Mar-23
15 Ephinefrin 2 amp -
16 Sulfa atropin 2 amp -
17 Plester Micropore 1 pcs -
18 Xylocain Gel 1 pcs Jan-22
19 Ambubag Dewasa 1 pcs -
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021

DAFTAR OBAT DAN ALKES BMHP KLINIK ICHSAN

No Nama obat Sediaan Jumlah No batch
1 Plester Chusavan 18 -
2 Spuit 0,5cc BKKBN 60 18116
3 Spuit 0,5cc BKKBN 70 20115
4 Spuit 0,5cc BKKBN 97 18136
5 Pil KB BKKBN 91 BLISTER IJ0304
6 Pil KB BKKBN 45 BLISTER IJ0304
7 SPUIT 3CC BKKBN 60 16309
8 Kondom Artika BKKBN 276 180612-
NEAR ED s/d SEPTEMBER 2021
SEPTEMBER s/d DESEMBER 2021
IK ICHSAN
tanggal ED
Mar-23
JUNI 2021 & JULI 2022
November 2021
Aug-24
JUNI 2025 & OKT 2024
Apr-25
Sep-25
Jun-22
DESEMBER 2022&MARET 2023
Jul-24
Sep-22
Mar-25
Apr-24
Sep-25
Dec-24
Apr-23
Jun-23

Aug-25
Aug-22

May-23

JULI 2022&SEPT 2023

Aug-22
NOVEMBER 2022
NOVEMBER 2023

Jul-22
May-21
Jul-21
Sep-21
Oct-23
Aug-21
Oct-20
Dec-21
Jan-22
Jun-21
 Jan-25

Dec-24

KIT

No.batch
1180298
16255-01
15939-05
190524K
190514K
ada fisik tidak ada ED
ada fisik tidak ada ED
WJ3050B
TIEI92H34
19H0405J
17J2002J
180404N
tidak ada fisik
tidak ada fisik
-
963029
tidak ada fisik

No.batch
1180298
16255-01
15939-05
190524K
190514K
ada fisik, tidak ada ED
ada fisik, tidak ada ED
 WJ3050B
TIEI92H34
19H0405J
170724C
180404N
tidak ada fisik
tidak ada fisik
ada fisik, tidak ada ED
963029
ada fisik, tidak ada ED

IK ICHSAN
tanggal ED
Apr-21
Mar-23
Aug-25
Jun-23
Oct-21
Oct-21
Aug-21
May-21
 DAFTAR OBAT MENJELANG EXPIRED DATE (s/d SEPTEMBER 2021)
No Nama Obat Komposisi
1 Acetylcystein kap Acetylcystein 200mg
2 Acyclovir Cr 5 gr Acyclovir 5%
3 Allopurinol 300mg tab Allopurinol
4 Allopurinol 300mg tab Allopurinol
5 Amoxicillin tab Amoxicillin 500mg
6 Atorvastatin tab Atorvastatin 20mg
7 Betason Cr 5gr Betametasone valerate 1%
8 Bisolvon solution Bromhexin HCl 2mg
9 Captopril 12,5mg Captopril 12,5mg
10 Captopril 12,5mg Captopril 12,5mg
11 Celebrex kap Celecoxib 100mg
12 Cetirgi tab Cetirizine 10mg
13 Co-Amoxiclav tab Amoxicillin 500 dan As.clavulanat 125mg
14 Decolsin kap PCT 400mg, pseudoefedrin 30mg, CTM 1mg,
dextromethorphan HBr 10mg
15 Domperidone sirup Domperidone HCl 5mg/5ml
16 Erladerm-N Cr Betametasone valerate&Neomycin sulfat
17 Erladerm-N Cr Betametasone valerate&Neomycin sulfat
18 Erlapect sirup Ambroxol 15mg/5ml
19 Flunarizine tab Flunarizine 10mg
20 Gerdilium drop Domperidone HCl 5mg/ml
21 Gerdilium drop Domperidone HCl 5mg/ml
22 KB Suntik 3 bulan BKKBN Medroxyprogesteron asetat 150mg/3ml
23 KB Suntik 3 bulan BKKBN Medroxyprogesteron asetat 150mg/3ml
24 Ketokonazole Cr 10gr Ketokonazole 2%
25 Ketokonazole tab Ketokonazole 200mg
26 Ketokonazole tab Ketokonazole 200mg
27 Ketokonazole tab Ketokonazole 200mg
28 Lacto-B bakteri streptococus thermophilu
29 Librozym kap Amilase, Protase, Lipase
30 Lincomycin kap Lincomycin 500mg
31 Lipitor tab Atorvastatin 20mg
32 Lostacef sirup Cefadroxil 125mg/5ml
33 Methopi Sirup Methisopprinol 250mg/ml
34 Mucera drop Ambroxol 15mg/ml
35 Mucera tab Ambroxol 30mg
36 Mucohexin Sirup Bromhexin HCl
37 Octenic gel 20gram Octenidine HCl & Allantoin
38 Ondansetron inj Ondansetron 4mg/2ml
39 Opicef sirup Cefadroxil 125mg/5ml
40 Opicef sirup Cefadroxil 125mg/5ml
41 Ramolit Sachet Dextrose, NaCl, KCl, Sodium citrate
42 Reco salep mata 5gr Chloramphenicol 10mg
43 Seremig tab Flunarizine 10mg
44 Vaksin BCG BCG (mycobacterium bacilus)
45 Vaksin IPV polio inacctivated
46 Vaksin MR measless rubella
47 Vaksin MR measless rubella
48 Vaksin MR measless rubella
49 Vaksin Td tetanus dan difteri
50 vaksin Td tetanus dan difteri
51 Ventolin inhaler Salbutamol
52 Ventolin nebule Salbutamol
53 Vitamin A kapsul biru Vitamin A
54 Vitamin A kapsul merah Vitamin A
55 Vitamin B complex Vitamin B comp
56 Vitamin C 50mg tab Vitamin C 50mg
D DATE (s/d SEPTEMBER 2021)
Jumlah Tanggal ED Jaminan
10 kap Jul-21 Pribadi/Asuransi
4 tube Sep-21 BPJS/Pribadi/Asuransi
25 tab Jul-21 BPJS
100 tab Sep-21 BPJS
70 TAB Sep-21 BPJS
45 tab Aug-21 Pribadi/Asuransi
2 tube Jul-21 Pribadi/Asuransi
1 botol Jun-21 Pribadi/Asuransi
50 tab Apr-21 BPJS/Pribadi/Asuransi
10 tab Jun-21 BPJS/Pribadi/Asuransi
170 kap May-21 Pribadi/Asuransi
4 tab Sep-21 Pribadi/Asuransi
10 tab Sep-21 Pribadi/Asuransi
132 kap Jul-21 BPJS Pribadi/Asuransi

7 botol Sep-21 BPJS

2 tube Jun-21 Pribadi/Asuransi
9 tube Oct-21 Pribadi/Asuransi
14 botol Sep-21 BPJS
76 tab Aug-21 Pribadi/Asuransi
3 botol Aug-21 Pribadi/Asuransi
1 botol Apr-21 Pribadi/Asuransi
89 vial May-21 BPJS/Pribadi/Asuransi
20 vial Jul-21 BPJS/Pribadi/Asuransi
1 tube Jun-21 BPJS/Pribadi/Asuransi
20 tab Aug-21 BPJS/Pribadi/Asuransi
50 tab Aug-21 BPJS/Pribadi/Asuransi
90 tab Sep-21 BPJS/Pribadi/Asuransi
37 sachet Aug-21 Pribadi/Asuransi
82 tab Jul-21 BPJS Pribadi/Asuransi
5 kap - Pribadi/Asuransi
30 tab Aug-21 Pribadi/Asuransi
3 botol Sep-21 BPJS
5 botol Sep-21 Pribadi/Asuransi
1 botol Aug-21 Pribadi/Asuransi
112 tab Sep-21 Pribadi/Asuransi
2 botol Apr-21 Pribadi/Asuransi
1 tube Jul-21 BPJS Pribadi/Asuransi
2 amp Sep-21 BPJS/Pribadi/Asuransi
1 botol Jul-21 Pribadi/Asuransi
1 botol Aug-21 Pribadi/Asuransi
35 sachet Sep-21 BPJS/Pribadi/Asuransi
1 tube Sep-21 BPJS/Pribadi/Asuransi
177 tab May-21 BPJS
3 vial Sep-21 dari puskesmas
3 vial Apr-21 dari puskesmas
7 vial Jul-21 dari puskesmas
5 vial Aug-21 dari puskesmas
1 vial Apr-21 dari puskesmas
27 vial Apr-21 dari puskesmas
8 vial Aug-21 dari puskesmas
1 pcs May-21 Pribadi/Asuransi
2 pcs Sep-21 Pribadi/Asuransi
151 kap Aug-21 dari puskesmas
621 kap Jul-21 dari puskesmas
200 tab Jul-21 BPJS
500 tab Apr-21 BPJS
 DAFTAR OBAT MENJELANG EXPIRED DATE (s/d SEPTEMBER 2021)
No Nama Obat Komposisi Jumlah Tanggal ED
1 Acetylcystein kap Acetylcystein 200mg 10 kap Jul-21
2 Acyclovir Cr 5 gr Acyclovir 5% 4 tube Sep-21
3 Allopurinol 300mg tab Allopurinol 25 tab Jul-21
4 Allopurinol 300mg tab Allopurinol 100 tab Sep-21
5 Amoxicillin tab Amoxicillin 500mg 70 TAB Sep-21
6 Atorvastatin tab Atorvastatin 20mg 45 tab Aug-21
7 Betason Cr 5gr Betametasone valerate 1% 2 tube Jul-21
8 Bisolvon solution Bromhexin HCl 2mg 1 botol Jun-21
9 Captopril 12,5mg Captopril 12,5mg 50 tab Apr-21
10 Captopril 12,5mg Captopril 12,5mg 10 tab Jun-21
11 Celebrex kap Celecoxib 100mg 170 kap May-21
12 Cetirgi tab Cetirizine 10mg 4 tab Sep-21
13 Co-Amoxiclav tab Amoxicillin 500 dan As.clavulanat 10 tab Sep-21
14 Decolsin kap PCT 400mg, pseudoefedrin 30mg, 132 kap Jul-21
dextromethorphan HBr 10mg
15 Domperidone sirup Domperidone HCl 5mg/5ml 7 botol Sep-21
16 Erladerm-N Cr Betametasone valerate&Neomycin 2s tube Jun-21
17 Erladerm-N Cr Betametasone valerate&Neomycin 9s tube Oct-21
18 Erlapect sirup Ambroxol 15mg/5ml 14 botol Sep-21
19 Flunarizine tab Flunarizine 10mg 76 tab Aug-21
20 Gerdilium drop Domperidone HCl 5mg/ml 3 botol Aug-21
21 Gerdilium drop Domperidone HCl 5mg/ml 1 botol Apr-21
22 KB Suntik 3 bulan BKKBN Medroxyprogesteron asetat 150mg/89 vial May-21
23 KB Suntik 3 bulan BKKBN Medroxyprogesteron asetat 150mg/20 vial Jul-21
24 Ketokonazole Cr 10gr Ketokonazole 2% 1 tube Jun-21
25 Ketokonazole tab Ketokonazole 200mg 20 tab Aug-21
26 Ketokonazole tab Ketokonazole 200mg 50 tab Aug-21
27 Ketokonazole tab Ketokonazole 200mg 90 tab Sep-21
28 Lacto-B bakteri streptococus thermophilu 37 sachet Aug-21
29 Librozym kap Amilase, Protase, Lipase 82 tab Jul-21
30 Lincomycin kap Lincomycin 500mg 5 kap -
31 Lipitor tab Atorvastatin 20mg 30 tab Aug-21
32 Lostacef sirup Cefadroxil 125mg/5ml 3 botol Sep-21
33 Methopi Sirup Methisopprinol 250mg/ml 5 botol Sep-21
34 Mucera drop Ambroxol 15mg/ml 1 botol Aug-21
35 Mucera tab Ambroxol 30mg 112 tab Sep-21
36 Mucohexin Sirup Bromhexin HCl 2 botol Apr-21
37 Octenic gel 20gram Octenidine HCl & Allantoin 1 tube Jul-21
38 Ondansetron inj Ondansetron 4mg/2ml 2 amp Sep-21
39 Opicef sirup Cefadroxil 125mg/5ml 1 botol Jul-21
40 Opicef sirup Cefadroxil 125mg/5ml 1 botol Aug-21
41 Ramolit Sachet Dextrose, NaCl, KCl, Sodium citrat35 sachet Sep-21
42 Reco salep mata 5gr Chloramphenicol 10mg 1 tube Sep-21
43 Seremig tab Flunarizine 10mg 177 tab May-21
44 Vaksin BCG BCG (mycobacterium bacilus) 3 vial Sep-21
45 Vaksin IPV polio inacctivated 3 vial Apr-21
46 Vaksin MR measless rubella 7 vial Jul-21
47 Vaksin MR measless rubella 5 vial Aug-21
48 Vaksin MR measless rubella 1 vial Apr-21
49 Vaksin Td tetanus dan difteri 27 vial Apr-21
50 vaksin Td tetanus dan difteri 8 vial Aug-21
51 Ventolin inhaler Salbutamol 1 pcs May-21
52 Ventolin nebule Salbutamol 2 pcs Sep-21
53 Vitamin A kapsul biru Vitamin A 151 kap Aug-21
54 Vitamin A kapsul merah Vitamin A 621 kap Jul-21
55 Vitamin B complex Vitamin B comp 200 tab Jul-21
56 Vitamin C 50mg tab Vitamin C 50mg 500 tab Apr-21
MBER 2021)
Sisa stok

50 tab

8 tube

12 botol

5 vial

77 tab

1 botol