Untitled

total jkn total dak
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 200 200 0 0 0
0 0 0 110 230 340
0 0 0 0 0 0
1450 600 2050 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
50 0 50 0 0 0
490 300 790 0 130 130
403 650 1053 0 0 0
0 0 0 0 0 0
0 0 0 1714 880 2594
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 47 18 65
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1170 200 1370 730 3450 4180
0 0 0 0 0 0
1510 0 1510 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 3 0 3
0 5 5 5 13 18
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
8237 0 8237 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 135 0 135
0 0 0 97 200 297
465 550 1015 0 0 0
0 0 0 60 0 60
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 190 250 440
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 10 20 30
0 0 0 13 10 23
0 0 0 0 0 0
0 0 0 40 0 40
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 2 0 2
65 0 65 1394 300 1694
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 1 0 1
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 80 0 80
0 0 0 0 0 0
58 110 168 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 10 0 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 2 2 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
20 0 20 0 0 0
0 0 0 0 0 0
55 0 55 35 235 270
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 350 0 350
0 0 0 190 600 790
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 250 0 250
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 20 16 36
0 0 0 0 0 0
0 0 0 255 2850 3105
0 0 0 0 0 0
0 0 0 0 0 0
408 100 508 0 0 0
1000 0 1000 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 1290 300 1590
0 0 0 30 200 230
0 0 0 10 700 710
0 0 0 0 0 0
0 0 0 1 11 12
20 0 20 2 50 52
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 21 2 23
0 0 0 14 0 14
0 0 0 16 10 26
0 0 0 2613 900 3513
11 4 15 0 0 0
0 0 0 115 0 115
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
565 0 565 0 0 0
0 0 0 10 0 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 430 50 480
0 0 0 0 700 700
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 10 0 10
0 0 0 0 0 0
0 0 0 165 0 165
60 0 60 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 210 250 460
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 13 4 17
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 200 50 250
0 0 0 2 0 2
0 0 0 0 0 0
0 0 0 12 0 12
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 22 2 24
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 385 0 385
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 1 0 1
0 0 0 0 0 0
0 0 0 2064 2950 5014
0 0 0 0 0 0
0 0 0 0 0 0
2438 0 2438 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1269 300 1569 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 70 100 170
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 4 24 28
0 0 0 0 0 0
0 20 20 0 0 0
45 0 45 0 0 0
0 0 0 14 8 22
13 0 13 0 0 0
134 0 134 0 0 0
0 0 0 4 13 17
0 0 0 0 0 0
280 0 280 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 127 0 127
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 430 0 430
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 290 0 290
0 0 0 0 0 0
0 0 0 120 0 120
0 0 0 20 0 20
0 0 0 0 0 0
0 0 0 0 150 150
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 1311 200 1511
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 290 0 290
0 0 0 0 0 0
540 400 940 70 1000 1070
90 200 290 0 0 0
0 0 0 145 100 245
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
5 12 17 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
46 12 58 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 15 0 15
0 0 0 185 0 185
353 100 453 0 0 0
0 0 0 481 0 481
840 950 1790 0 0 0
3 30 33 0 0 0
0 0 0 0 1100 1100
485 0 485 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 30 0 30
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 30 30
0 0 0 630 0 630
0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 300 300 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 100 700 800
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 10 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 100 100 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 600 600
0 0 0 0 200 200
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 10 10 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 1000 900 1900
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 1 1 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 24 24
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 24 24
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 50 50
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
NO NAMA SEDIAAN SATUAN Stok Awal JKN Non JKN Persediaan 1
A. O B A T
1 Air Raksa Dental Use Botol -
-
2
Albendazole Tablet 400 mg Tablet
- -
3 Albendazole susp 200 mg/5 ml Botol - -
4 Alopurinol Tablet 100 mg Tablet 1,000 1,000
5 Alopurinol Tablet 300 mg Tablet - -
6 Alprazolam tablet 1 mg Tablet - -
7 Ambroksol Tablet 30 mg Tablet 19,507 19,507
8 Ambroksol sirup 15 mg/5 ml Botol - -
9
Aminofillin Injeksi 24 mg/ml-10 ml Ampul
- -
10 Aminofillin Tablet 200 mg Tablet - -
11
Amitriptillin Hcl Tablet Salut 25 mg Tablet
1,460 1,460
12 Amlodipin Tablet 5 mg Tablet 31,460 31,460
13 Amlodipin Tablet 10 mg Tablet 17,950 17,950
14 Amoksisillin Kapsul 250 mg Kapsul - -
15 Amoksisillin Kaplet 500 mg Kaplet - -
16
Amoksisillin Serbuk Injeksi 1000 mg vial
- -
17
Amoksisillin Sirup Kering 125 mg/5ml Botol
- -
18 Amoksisillin Double Strengh Sirup
Botol
Kering 250 mg/5 ml - -
19 Ampisilin Kapsul 250 mg Kapsul - -
20 Ampisillin Kaplet 500 mg Tablet 25,000 25,000
21 Ampisilin Sirup 125 mg / 5 ml Botol - -
22 Ampisillin Injeksi 1000 mg Vial - -
23 Analgetik Plus Tablet - -
24
Antasida Doen Suspensi Kombinasi :
Magnesium Hidroksida 200 mg+ Botol
Alumunium Hidroksida 200 mg/5 ml
124 124
25
Antasida Doen Tablet, Kombinasi :
Magnesium Hidroksida 200 mg+ Tablet
Alumunium Hidroksida 200 mg
25,492 25,492
26 Antasida Plus Tablet Tablet - -
27 Antalgin (Metampiron) Tablet 500
Tablet
mg 3,675 3,675
28
Antalgin Injeksi 250 mg/ml-2ml Ampul
- -
29
Anti Bakteri DOEN Salep Kombinasi :
Basitrasin 500 Tube
IU/g + Polimiksin 1000 IU/g
- -
30 Anti Hemoroid Doen komb Supp - -
31 Anti Fungi DOEN Kombinasi :
Asam Benzoat Pot
6% + Asam Salisilat 3% 343 343
32 Antimigren DOEN Kombinasi :
Ergotamin Tartrat 1 Tablet
mg + Kofein 50 mg - -
33 Anti Diare Suspensi Botol - -
34 Anti Diare Tablet Tablet - -
35 Anti Dotum Oral Tablet Tablet - -
36 Anti Hipertensi Kapsul Tablet - -
37
Antihistamin Tablet kombinasi Tablet
8,237 8,237
38 Antispasmodik Tablet Tablet - -
39 Antitusiva Sirup Botol - -
40 Antitusiva Tablet Tablet - -
41 Asam Folat Tablet 1 mg Tablet - -
42
Asam Askorbat (Vit. C) Tablet 50 mg Tablet
- -
43
Asam Mefenamat Kapsul 500 mg Kapsul
8,000 8,000
44 Acetylsistein tablet Tablet 4,800 4,800
45 Asetosal Tablet 80 mg Tablet - -
48 Asiklovir Krim 5 % Tube - -
49 Asiklovir Tablet 200 mg Tablet - -
51 Attapulgit Tablet - -
52
Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul
- -
53 Aqua Pro Injeksi Steril, bebas Pirogen
Vial
20 ml - -
54 Bahan Tambal Sementara Set - -
55
Benzatin Benzil Penisilin injeksi Vial
- -
56 Betahistin Mesilat 6 mg Tablet 2,000 2,000
57 Betametason Krim 0,1 %- 5g - -
58 Bisakodil Tablet 5 mg Tablet 200 200
59 Bisoprolol Tablet 5 mg Tablet - -
60 Bromheksin 8 mg Tablet - -
61 Cresotin Pasta Botol - -
62 Cresotin Liquid No 2 Botol - -
63
Deksametason Injeksi 5mg/ml-1ml Ampul
- -
64 Deksametason Tablet 0,5 mg Tablet 9,960 9,960
65 Devitalisasi Pasta (Non Arsen) Botol - -
66 Diazepam tablet 2 mg Tablet - -
68
Diazepam Injeksi i.v/i.m 5 mg/ml Ampul
- -
69
Diazepam Larutan Rektal 5 mg/ml Supp
- -
70
- -
71
Dietilkarbamazin Sitrat Tablet 100 mg Tablet
- -
72 Difenhidramin HCl Injeksi 10 mg/ml-
Ampul
1ml - -
Ampul
1ml - -
74 Digoksin Tablet 0,25 mg Tablet - -
75 Dimenhidrinat Tablet 50 mg Tablet 1,000 1,000
76 Domperidon Tablet 10 mg Tablet 990 990
77
Donperidon Suspensi 5 mg/5ml Botol
88 88
78 Efedrin Hcl Tablet 25 mg Tablet - -
79
Ekstrak Belladone Tablet 10 mg Tablet
- -
80 Epinefrin HCl / Bitartrat
(Epinefrina / Ampul
Adrenalina) Injeksi 0,1%/- 1ml - -
81 Eritromisin Kapsul 250 mg Kapsul - -
83 Eritromisin Sirup 200 mg / 5 ml Botol - -
84 Etambutol Tablet 500 mg Tablet - -
85 Etanol 70 % 100 ml Botol - -
86 Etil Klorida Semprot -100 ml Botol - -
87 Eugenol Cairan -10 ml Botol - -
88
Fenitoin Natrium Kapsul 100 mg Kapsul
- -
89
30 30
90 Fenobarbital tablet 30 mg Tablet 415 415
91
Fenobarbital injeksi 50 mg / ml Ampul
- -
92
Fenoksimeti Penisilin 250 mg tablet Tablet
- -
93
- -
94 Fenol Gliserol TK Botol 162 162
95 Flufenazine decanoat injeksi 25
Ampul
mg/ml - -
96 Flukonazole tablet 150 mg Tablet - -
97 Fitomenadion tablet 10 mg Tablet 350 350
98 Fitomenadion (Vit K1) Injeksi 2
Ampul
mg/ml-1ml - -
99 Furosemid Tablet 40 mg Tablet 360 360
100 Furosemid injeksi Ampul - -
101
Garam Oralit I serbuk, kombinasi :
( Nacl 0,52
gr, Kalium Klorida 0,30 gr, Trinatrium Kantong
Sitrat dihidrat 0,58 gr, Glukosa
Anhidrat 2,70 g )200 ml Air
- -
102 Gemfibrozil Tablet 600 mg Tablet - -
103 Gentian Violet Botol - -
104
Gentamisin injeksi 80 mg / 2 ml Vial
- -
105 Gentamisin Salep Kulit 0,1 % Tube - -
106 Glass Ionomer Set - -
107 Glibenklamid Tablet 5 mg Tablet - -
108 Glimepiride 2 mg Tablet 15,000 15,000
109
Gliseril Guayakolat Tablet 100 mg Tablet
- -
110 Gliseril Guayakolat sirup Botol - -
111 Glukonas Kalsikus injeksi Ampul 24 24
112 Glukosa Larutan Infus 5 % Botol - -
113 Glukosa Larutan Infus10 % Botol - -
114 Griseofulvin Tablet 125
Tablet
mg,micronized - -
Tablet
mg,micronized 3,000 3,000
116 Haloperidol Tablet 0,5 mg Tablet - -
118 Haloperidol Tablet 5 mg Tablet - -
119 Haloperidol injeksi 5 mg/ml Ampul - -
121
Hidroklortiazid (HCT) Tablet 25 mg Tablet
- -
122
- -
123 Hidrokortison Krim 2,5 % Tube 408 408
124 Ibuprofen Tablet 200 mg Tablet 5,000 5,000
125 Ibuprofen Tablet 400 mg Tablet 3,902 3,902
126
Ibuprofen Suspensi 100 mg/5 ml Botol
- -
127 Ichtyol salep Kulit Pot - -
128 Isoniazid tablet 100 mg Tablet - -
130 Isosorbid Dinitrat 5 mg Tablet - -
131
Kalium Diklofenak Tablet 25 mg Tablet
- -
132
- -
133 Kalsium Hidroksida Pasta Tube - -
134 Kalsium Laktat Tablet 500 mg Tablet 20,000 20,000
135 Kaptopril 12,5 mg Tablet 1,660 1,660
136 Kaptopril 25 mg Tablet - -
137 Karbamazepin Tablet 200 mg Tablet - -
138 Ketokonazole Krim 2 % - 15 gr Tube 96 96
139 Ketokonazole Tablet 200 mg Tablet - -
140 Ketoprofen Tablet 100 mg Tablet - -
141
Ketoprofen Injeksi 100 mg / 1 ml Ampul
- -
142 Ketorolac 10 mg injeksi Ampul - -
144 Klindamisin Kapsul 150 mg Kapsul - -
146 Kloramfenikol Kapsul 250 mg Kapsul - -
147
Kloramfenikol suspensi125mg/5 ml Botol
- -
148
Kloramfenikol Salep Mata 1%-3,5 g Tube
- -
149 Kloramfenikol Salep Kulit 2% Tube 120 120
150
Kloramfenikol Tetes Mata -5 ml Botol
4 4
151
Kloramfenikol Tetes Telinga 3%-5 ml Botol
- -
152 Klorfeniramin Maleat (CTM) Tablet 4
Tablet
mg 25,000 25,000
153
Klorpromazin Hcl Tablet Salut 25 mg Tablet
- -
154 Klorpromazin Hcl Tablet Salut 100
Tablet
mg - -
155
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul
- -
156 Kombinasi Ipatropium Bromide +
Salbutamol Vial
Sulphate for inhalation 2,5 ml - -
157
Kombipak Cefixime+ Azithromisin Kotak
- -
158 Kotrimoksazol Pedriatik Tablet,
Kombinasi :
Sulfametoksazol 100 mg + Tablet
Trimetroprim 20 mg - -
159
Kotrimoksazol Tablet, Kombinasi :
Sulfametoksazol 400 Tablet
mg + Trimetroprim 80 mg
258 258
160
Kotrimoksazol Suspensi Kombinasi :
Sulfametoksazol 200 Botol
mg + Trimetroprim 40 mg/5 ml
- -
161 Lansoprazole 30 mg Kapsul Tablet 3,385 3,385
162 Larutan mengadung Elektrolit
(Na 130
Botol
mEq,Cl 109 mEq, Asetat 28 mEq)
/Asering - -
(Nacl 1,125 Botol
gr , Dekstrosa 18,75 gr) - -
164 Larutan mengadung Karbohidrat +
Elektrolit (Nacl Botol
1,75 gr, KCL 1,5 gr, Na Lactat 2,24 gr,
Dekstrosa 27 gr) - -
165 Lidokain injeksi 2 % Ampul 200 200
166
Lidokain Komp Injeksi, Kombinasi :
Lidokain Hcl 2% Ampul
+Epinefrin 1 : 80.000-2 ml
- -
167 Lidokain Spray Botol - -
168 Loperamid Tablet 2 mg Tablet - -
169 Loratadin tablet 10 mg Tablet 500 500
170
Magnesium Sulfat (IV) 20 %-25 ml Ampul
- -
171 Loperamid Tablet 2 mg Tablet - -
172
- -
173
- -
174 MB Anak Blister - -
175 MB Dewasa Blister - -
176 Meloksikam tablet 15 mg Tablet 110 110
177 Meloksikam Suppositoria Supp - -
178 Metformin Hcl Tablet 500 mg Tablet 20,000 20,000
179 Metformin 850 mg Tablet 5,000 5,000
180 Metildopa 250 mg tablet Tablet 3,350 3,350
181 Methisoprinol 500 mg Tablet 1,940 1,940
182 Metilergometrin Maleat (Metergin)
Tablet
Tablet 0,125 mg 300 300
183 Metilergometrin Maleat Injeksi 0,200
Ampul
mg-1ml 100 100
184 Metilprednisolon tablet 4 mg Tablet 5,000 5,000
185 Metoklopramid 10 mg Tablet - -
186 Metoklorpropamid Injeksi 5 mg/ 5
Ampul
ml - -
187 Metronidazol Tablet 250 mg Tablet - -
188 Metronidazole Tablet 500 mg Tablet 10,000 10,000
189
Metronidazole sirup 125 mg/ml Botol
- -
190
Metronidazole Infus 500 mg /100 ml Ampul
- -
191 Mikonazole KrIm 2 % - 10 gr Tube - -
192 Multivitamin + Mineral tablet Tablet - -
193 Multivitamin sirup Botol - -
194 Mummifying Pasta Botol - -
195
Natrium Bikarbonat Tablet 500 mg Tablet
- -
196
Natrum Diklofenak Tablet 25 mg Tablet
- -
197
Natrium Diklofenak Tablet 50 mg Tablet
15,000 15,000
198 Natrium Klorida Larutan infus 0,9%-
Botol
Steril 500 ml - -
199 Nipedifin Tablet 10 mg Tablet - -
200
Nistatin suspensi 100.000 IU/ml Botol
- -
201 Nistatin 100.000 IU/gram Tablet
Tablet
Vagina - -
Tablet
Salut - -
203
Obat Antitiuberkolosis Kategori Anak Paket
- -
204 Obat Antitiuberkolosis Kategori 1
Paket
Dewasa - -
Paket
Dewasa - -
Paket
Dewasa - -
207
Obat Anti Tuberkulosis FDC Kat Anak Paket
- -
208
Obat Anti Tuberkulosis FDC Kat I & II Paket
- -
209 Obat Anti Tuberkulosis FDC Kat I &
Paket
III - -
210 Obat Anti Tuberkolosis FDC Sisipan
Paket
Dewasa - -
211 Obat Batuk Hitam (OBH) Cairan 100
Botol
ml - -
212
Obat Batuk Cair Sirup (Ekspektoran) Botol
- -
213 Obat Batuk Hitam Plus Sirup Botol - -
214 Obat Flu Sirup Botol - -
215 Oksiterasiklin Hcl injeksi i.m.50
Vial
mg/ml-10 ml - -
216
Oksiterasiklin Salep Mata 1%-3,5g Tube
- -
217
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube
- -
218 Oksitosin Injeksi 10 IU/ml-1ml Ampul - -
219 Omeprazole injeksi 40mg/10ml Ampul - -
220 Omeprazole Kapsul 20 mg Tablet 6,000 6,000
221 Ondansetron inj 4 mg/ 2 mL Ampul - -
222 Parasetamol drop 100 mg/ml btl
Botol
@15ml (60mg/0,6ml) - -
Botol
@15ml (60mg/0,6ml) - -
224
Parasetamol Sirup 120 mg/5ml-60 ml Botol
- -
225 Parasetamol Tablet 500 mg Tablet 65,294 65,294
226 PB Anak Blister - -
227 PB Dewasa Blister - -
228 Pehacain injeksi Ampul - -
229
Perak Sulfadiazin krim 1 % 35 gr Tube
- -
230 Permetrin krim 5 % Tube - -
231 Piracetam Tablet 400 mg Tablet - -
233 Piroksikam Tablet 20 mg Tablet - -
234 Pirantel Pamoat Tablet 365 mg
Tablet
(Setara dng 125 mg Basa) - -
235
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet
6,116 6,116
236 Povidon Iodida 10% 30 ml Botol - -
239 Prednison Tablet 5 mg Tablet - -
240 Primakuin tablet 15 mg Tablet - -
241 Prokain Benzil Penisilin Injeksi
Vial
3,000,000 IU - -
242 Propanolol Hcl Tablet 40 mg Tablet - -
243 Propilturasil Tablet 100 mg Tablet - -
244 Ranitidin Injeksi 25 mg / ml Ampul - -
245 Ranitidin Tablet 150 mg Tablet 5,000 5,000
246
Retinol (Vit. A) 100.000 IU Kapsul Kapsul
- -
247
- -
248 Reserpin Tablet 0, 25 mg Tablet - -
249 Rifampisin Tablet 450 mg Tablet - -
250 Ringer Laktat Larutan Infus Steril 500
Botol
ml - -
251 Salbutamol Tablet 2 mg Tablet 67 67
253
Salbutamol solution for Inhalation
Ampul
single dose units 2,5 ml
- -
254 Salep 2-4 Kombinasi :
Asam Salisilat Pot
2 % + Belerang Endap 4 % - 30 gram 296 296
255 Salisil bedak 2% -50 gr Kotak 150 150
256 Salep Luka Bakar Tube - -
257 Sefadroksil Sirup Kering 125 mg / 5
Botol
ml sirup - -
258 Sefadroksil Tablet 500 mg Tablet 5,000 5,000
259 Sefiksim Kapsul 100 mg Kapsul - -
260 Sefiksim 400 mg + Azitromisin 1000
Paket
mg - -
261 Sefotaksim Injeksi 1 gr Ampul - -
262 Seftriakson Injeksi 1 gr / vial Ampul - -
263
Semen Seng Fosfat Serbuk & Cairan Botol
- -
264 Setirizin Tablet 10 mg Tablet 30,000 30,000
265 Setirizin Sirup 5 mg / 5 ml Botol - -
266 Sianokobalamin Injeksi 500 mcg/ml-
Ampul
1ml - -
267 Sianokobalamin Tablet 50 mcg Tablet - -
268 Silver Amalgam Serbuk 65-75% Botol - -
269 Simetidin 200 mg Tablet Tablet - -
270 Simvastatin Tablet 10 mg Tablet - -
271 Siprofloksasin 500mg Tablet 984 984
272 Spironolakton Tablet 25 mg Tablet 830 830
273
Sulfacetamid Tetes Mata 15 %-5ml Botol
- -
274
Tablet Tambah Darah Kombinasi:
Besi II Sulfat Tablet
200 mg + Asam Folat 0,25 mg
- -
275 Temporary Stopping Fletcher
Set
(Fletcher) Serbuk & Cairan - -
276
Trikesol formalin ( T K F ) Cairan 10 ml Botol
- -
277 Tetrasiklin Kapsul 250 mg Kapsul - -
279 Thiamin Hcl (Vit B1) Injeksi 100
Ampul
mg/ml-1ml - -
280 Tiamin Hcl /Mononitrat (Vit.B1)
Tablet
Tablet 50 mg 15,000 15,000
281 Thiamfenikol Kapsul 500 mg Kapsul - -
282 Tramadol Injeksi 50 mg/ ml Ampul - -
283 Tramadol Tablet 50 mg Tablet - -
284 Triheksifenidil Hidroklorida Tablet 2
Tablet
mg - -
Tablet
mg - -
286 Vitamin B .Komplek Tablet Tablet 64,726 64,726
287 Vitamin Neurotropik Tablet Tablet 11,607 11,607
288 Zinc Tablet 20 mg Tablet - -
289 Zinc Sulfat 20 mg/5 ml Tablet - -
290 Aminofillin Tablet 150 mg Tablet - -
291 Asam Folat Tablet 0,4 mg Tablet 950 950
292
Gentamisin Sulfat tetes mata 0,3% Botol
96 96
293 Obat Kumur Botol - -
294
Salep Betametason + Neomisin Tube
- -
295
Salep Kloramfenikol + Hidrokortison Tube
- -
296 Propanolol 10mg Tablet - -
297 Tablet Pemanis Botol - -
298 Bisakodil Suppositoria 5 mg Supp 12 12
299 Obat Batuk Herbal (Herbakof) Botol 500 500
300 Amoksisillin Drops Botol - -
301
Tablet Hepatoprotector (Curcuma) Pot
- -
302 Simvastatin 20mg Tablet - -
303 Klozapine 25mg Tablet - -
304 Bisoprolol 2,5mg Tablet 2,000 2,000
305 Vitamin C 500mg Tablet - -
306 RAMVIT-C C 500mg Tablet 29,444 29,444
307 Vitamin D 1000 IU Tablet - -
308
Multivitamin Tablet Kombinasi Tablet
VitC,Vit D, Zinc, Folic Acid
34,616 34,616
309 Multivitamin Syrup Tablet 388 388
310 Risperidon 2 mg Tablet - -
311 Alpara Tablet Tablet 2,407 2,407
312 Asam Traneksamat Tablet 1,000 1,000
313 Novagrip Tablet 10,000 10,000
314 FORNERO TABLET Tablet 10,000 10,000
B BMHP - -
1
Abbocath No 18 ( IV Chateter 18 ) Buah
- -
2
- -
3
- -
4
- -
5
Alat Gula, Kolesterol, Asam Urat Unit
- -
6 Alat Suntik Sekali Pakai 1 ml Set - -
11 Alkohol Swab Kotak 2,500 2,500
12 Auto Disposable Syringe (ADS) 0,05
Set
ml - -
13
Auto Disposable Syringe (ADS) 0,5 ml Set
- -
14
Auto Disposable Syringe (ADS) 5 ml Set
- -
15 Blood Set Set 2 2
16
Catgut/Benang Bedah No.2/0 Plain Sachet
- -
17
Catgut/Benang Bedah No.3/0 Cromic Sachet
- -
18 Etakridin Larutan (Rivanol) 0,1% - 300
Botol
ml - -
19 Etanol 70 % 1.000 ml Botol 30 30
20 Eter Alkohol Botol - -
21 Folley Catheter no 14 Set - -
22 Folley Catheter no 16 Set 30 30
23 Folley Catheter no 18 Set 30 30
24 Infus set Anak Set - -
26 Infus set Dewasa Set 100 100
27 Iodina Test Botol - -
28 Kaca Slide Pcs - -
29 Kapas Berlemak 500 gram Bungkus - -
30 Kapas Pembalut / Adsorbens 250
Bungkus
gram - -
31 Kassa Pembalut 2 m x 80 cm Rol - -
32
Kassa Pembalut Hidrofil 4 m x 3 cm Rol
- -
33
- -
34 Kassa Hidrofil Steril 16 x 16 Kotak 100 100
35 Kassa Kompres 40 x 40 steril Bungkus - -
36 Kertas Puyer Pcs - -
37 Kertas Saring Lembar - -
38 Kertas Lensa Lembar - -
39 Lysol 1,000 ml Botol - -
40 Masker Buah 1,550 1,550
41 Masker Ear Loop Buah 8,000 8,000
42 Masker Head Loop Buah - -
43 Masker Rajawali Buah - -
44 Masker Head Loop Buah - -
45 Masker N 95 Pcs - -
46 Minyak Imersi Botol - -
47 Plester Kertas Rol - -
48 Polifix Rol 50 50
49 Pot Dahak Pcs - -
50 Rapid 2 HIV Fokus Test - -
51 Rapid HIV 1 (SD HIV) Test - -
52 Rapid HIV 2 (Intec HIV) Test - -
53 Rapid HIV 2 (Biomeriux HIV) Test - -
54 Rapid Tes SD Bioline HBSAG Test - -
55 Rapid Test Syphilis Test - -
56 Reagen CD 4 Control Test - -
57 Reagen CD 4 Test - -
58 Reagen Ziehl Nielsen Botol - -
59 RPR Test Syphilis Test - -
60
Silk( Benang Bedah Sutra ) No 3/0 Sachet
72 72
61 Safety Box Pcs - -
62 Sarung tangan Steril No 6 Pcs - -
63 Sarung tangan Steril No 7 Pcs 150 150
64 Sarung tangan Steril No 7,5 Pcs - -
65 Sarung tangan Steril No 7,5 Pcs 140 140
66 Sarung tangan Non Steril S Pcs 2,700 2,700
67 Sarung tangan Non Steril M Pcs 4,800 4,800
68 Sarung tangan Non Steril L Pcs 3,400 3,400
69 Sountimer Buah - -
70 Stik Pemeriksaan Gula Darah Test - -
71 Stik Pemeriksaan Gula Darah
Test
Benecheck - -
72 Stik Pemeriksaan Gula Darah One
Test
Touch Verio - -
73 Stik Pemeriksaan Kolesterol Test - -
74 Stik Pemeriksaan Kolesterol
Test
Benecheck - -
75 Stik Pemeriksaan Asam Urat Test - -
76 Stik Pemeriksaan Asam Urat
Test
Benecheck - -
77 Supratul Lembar - -
78 Urine Bag set 50 50
79 Wing Neddle No 23 Set - -
80 Blood Lancet Pcs - -
81 Cairan Antiseptik Botol 500 ml Botol 35 35
82 Bisturi Pcs 20 20
83 Cairan Antiseptik Botol 5 Liter Botol - -
84 3 Surface Desintfectan 5L Botol 3 3
85 Cairan Desinfektan 5 Liter Botol - -
86
High Level Desintfectan/sterald Botol
1 1
87 Cairan Detergen 5 Liter Botol - -
88 Gel USG Botol 38 38
89 IV Dressing Pcs - -
90 Mucus Extractor Pcs - -
91 Nasal Oxygen Anak Pcs 5 5
92 Nasal Oxygen Bayi Pcs 25 25
93 Nasal Oxygen Dewasa Pcs 100 100
94 Plester Bulat Non Woven Pcs - -
95 Plester Transparan Pcs - -
96 PP test Pcs 500 500
98 Sarung Tangan Obgyn Steril Pcs - -
99 Stik Pemeriksaan Hb Pcs - -
100
Umbilical Cord Klem Steril Nylon Pcs
- -
101 Underpad 60x90 cm Non Steril Pcs - -
102 Stik Gula Darah Baru Pcs - -
103 Stik Asam Urat Baru Pcs - -
104 Stik Hb Test 100 100
105 ChOLESTROL chod-pap Kit - -
106 Creatinin mod iaffe Kit - -
107 Glucosa God-pap Kit - -
108 GOT (AST) mod iffe Kit - -
109 GPT Kit - -
110 Trigliserida GPO-PAP Kit - -
111 Urea UV-auto,Urease/GLDH Kit - -
112 Urid Acid TBHA Kit - -
113 Dumacon Auto Kit - -
114 Micropipet 5,0-50 Ul Kit - -
115 Micropipet 10-100UL Kit - -
116 Tabung Vacutainer Kit - -
117 HGB Drab Kin Kit - -
118 Nasal Kanul Dewasa Pcs - -
119 Nasal Kanul Anak Pcs - -
120 Nasal Kanul Anak Pcs - -
121 Coveral II (APD) Non Woven Pcs - -
122 Coveral II (APD) Non Woven Pcs 100 100
123
Pak
Kantong Plastik Kuning 60cmx100cm - -
124
Pak
Kantong Plastik Kuning 80cmx120cm 10 10
125
Pak
Kantong Plastik Hitam 60cmx100cm - -
126
Pak
Kantong Plastik Hitam 80cmx120cm 10 10
127
Pcs
Forsch Medical Disposible Gown - -
C. SERUM DAN VAKSIN - -
1 Serum Anti Bisa Ular Polivalen Injeksi
Vial
5 ml (ABU I ) - -
2
Vial
Serum Anti Rabies untuk manusia - -
Ampul
5 ml (ABU I ) - -
4 Serum Anti Tetanus (ATS) Injeksi
Vial
20.000 IU/ampul 10 10
5 Human Tetanus Imunoglobin inj 250
Vial
IU - -
6 Vaksin BCG Ampul - -
7 Vaksin Campak 10 Dosis Vial - -
8 Vaksin DT Vial - -
9 Vaksin TD Vial - -
10 Vaksin DTP-HB Vial - -
11 Vaksin DPT-HB/Hib Vial - -
12 Vaksin HB Uniject Pcs - -
13 Vaksin MR (VVM.A) Vial - -
14 Vaksin Polio Vial - -
15 Vaksin Polio IPV 5 Dosis Vial - -
16 Vaksin Polio 10 IPV Dosis Vial - -
17 Vaksin TT Vial 0 -
18 Buku Kontrak 0 -
19 0 -
20 0 -
2 3 4 5 6 7 8 9 10 11
99 42 27 65 33 63 50 68 56
20 10 10 10 40 30 20
10 20 20 30
124
100 70 70 60 50 70 145 80 130
100 70 50 60 30 70 20 100 70
7300
10 30 20 10 20 60 10 10
10 10 5
25 10 5 10
4 5 5 5
21 10 10 16 10 35 20 15
600 200 200
10
1 5 5
205 180 20 30
20 10
223 175 145 130 116 278 235 107 198
80 100 30 30 30 50 10 64 136
14 5 10 5
1 2 1
1 1 1 1
20 20 20 50 20
29 47 10 14 5 10 10 28
20 10 10
3 3 5 5 7 1 3 1 3
20 10 42 20 10
60 20 90 200 10 110 30 60
1
20 30 40 40 20 30 20 20
12 13 14 15 16 17 18 19 20 21
63 34 42 117 21 62 24 45 37
10 50 50 10 20 10 10
10 20 40 20 10 10 10 10
65 90 10 140 60 30
10 60 50 130 50 40 30 80 35
0
30 10 25 20 10 10
33
5
5
5 30 30 20 5 20 10
10
40 5
10
168 131 102 277 153
20 50 60 100 60 20 40
1 10
2 1 3
1 1 3
10 40 10 10 20
10 4 20 30 30 35 15 20
50
2 10 3
10 20 30 20 30 50
20 20 30 30 10 20
1 1
35 10 30 50 20 10 10
22 23 24 25 26 27 28 29 30 31
55 60 42 119 41 132 53
40 10
60 60 20 40 10
50 10 30 20 30 53
60 20 40 120 115 70 30
237 700
30 50 20 50 10 30
65
10 10
20 10 20 20 55 26
2902
2
5 10 10 10 50
20
20 210 27 70 30 10 22
47
2 1
125
10 10 10 30
64 10 39 42 10 31 27
2 1 1
40 10 10 21 10
10 80 10 20 10
20 30 10 10 20 10
SISA STOK
TOTAL
0
0 -
0 -
0 -
0 1,000
0 -
0 -
1450 18,057
0 -
0 -
0 -
50 1,410
490 30,970
403 17,547
0 -
0 -
0 -
0 -
0 -
0 -
0 25,000
0 -
0 -
0 -
124 -
1170 24,322
0 -
1510 2,165
0 -
0 -
0 -
0 343
0 -
0 -
0 -
0 -
0 -
8237 -
0 -
0 -
0 -
0 -
0 -
465 7,535
0 4,800
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 2,000
0 -
0 200
0 -
0 -
0 -
0 -
0 -
65 9,895
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 1,000
58 932
0 88
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 30
0 415
0 -
0 -
0 -
0 162
0 -
0 -
20 330
0 -
55 305
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 15,000
0 -
0 -
0 24
0 -
0 -
0 -
0 3,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
24 384
408 4,592
3902 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 20,000
20 1,640
0 -
0 -
0 96
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
13 107
0 4
0 -
0 25,000
0 -
0 -
0 -
0 -
0 -
0 -
0 258
0 -
565 2,820
0 -
0 -
0 -
0 200
0 -
0 -
0 -
0 500
0 -
0 -
0 -
0 -
0 -
0 -
0 110
0 -
0 20,000
0 5,000
60 3,290
0 1,940
0 300
0 100
0 5,000
0 -
0 -
0 -
0 10,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 15,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 6,000
0 -
0 -
0 -
0 -
2438 62,856
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1269 4,847
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5,000
0 -
0 -
0 -
0 -
0 -
47 20
45 435
0 -
13 283
134 16
0 -
0 -
280 4,720
0 -
0 -
0 -
0 -
0 -
0 30,000
0 -
0 -
0 -
0 -
0 -
0 -
0 984
0 830
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 15,000
0 -
0 -
0 -
0 -
0 -
540 64,186
90 11,517
0 -
0 -
0 -
0 950
5 91
0 -
0 -
0 -
0 -
0 -
0 12
46 454
0 -
0 -
0 -
0 -
0 2,000
0 -
353 29,091
0 -
840 33,776
3 385
0 -
485 1,922
0 1,000
0 10,000
0 10,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 2,500
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 30
0 -
0 -
0 30
0 30
0 -
0 -
0 100
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 100
0 -
0 -
0 -
0 -
0 -
0 1,550
0 8,000
0 -
0 -
0 -
0 -
0 -
0 -
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 72
0 -
0 -
0 150
0 -
0 140
0 2,700
0 4,800
0 3,400
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 50
0 -
0 -
0 35
0 20
0 -
0 3
0 -
0 1
0 -
0 38
0 -
0 -
0 5
0 25
0 100
0 -
0 -
0 500
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 100
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 100
0 -
0 10
0 -
0 10
0 -
0 -
0 -
0 -
0 -
0 10
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
NO NAMA SEDIAAN SATUAN
Stok Awal Non JKN Persediaan 1
A. OBAT
1 Air Raksa Dental Use Botol - -
2 Albendazole Tablet 400 mg Tablet - -
3 Albendazole susp 200 mg/5 ml Botol - -
4 Alopurinol Tablet 100 mg Tablet 905 905.00
5 Alopurinol Tablet 300 mg Tablet 700 700.00
6 Alprazolam tablet 1 mg Tablet - -
7 Ambroksol Tablet 30 mg Tablet - -
8 Ambroksol sirup 15 mg/5 ml Botol 50 50.00
9 Aminofillin Injeksi 24 mg/ml-10 ml Ampul - 10.00 10.00
10 Aminofillin Tablet 200 mg Tablet 1,000 1,000.00
11
Amitriptillin Hcl Tablet Salut 25 mg Tablet -
-
12 Amlodipin Tablet 5 mg Tablet 3,000 3,000.00
13 Amlodipin Tablet 10 mg Tablet - -
14 Amoksisillin Kapsul 250 mg Kapsul - -
15 Amoksisillin Kaplet 500 mg Kaplet 5,300 5,300.00
16 Amoksisillin Serbuk Injeksi 1000 mg vial - -
17 Amoksisillin Sirup Kering 125 mg/5ml Botol - -
18 Amoksisillin Double Strengh Sirup Kering
Botol 123.00
250 mg/5 ml 23 100.00
19 Ampisilin Kapsul 250 mg Kapsul - -
20 Ampisillin Kaplet 500 mg Tablet - -
21 Ampisilin Sirup 125 mg / 5 ml Botol - -
22 Ampisillin Injeksi 1000 mg Vial - -
23 Analgetik Plus Tablet - -
24
- -
25 Antasida Doen Tablet, Kombinasi :
Alumunium Hidroksida 200 mg - 10,000.00 10,000.00
26 Antasida Plus Tablet Tablet - -
27 Antalgin (Metampiron) Tablet 500 mg Tablet - -
28 Antalgin Injeksi 250 mg/ml-2ml Ampul - -
29 Anti Bakteri DOEN Salep Kombinasi : Tube - -
30 Anti Hemoroid Doen komb Supp 17 50.00 67.00
31 Anti Fungi DOEN Kombinasi : Pot 65 65.00
32 Antimigren DOEN Kombinasi : Tablet 390 390.00
33 Anti Diare Suspensi Botol - -
34 Anti Diare Tablet Tablet - -
35 Anti Dotum Oral Tablet Tablet - -
36 Anti Hipertensi Kapsul Tablet - -
37 Antihistamin Tablet kombinasi Tablet - -
38 Antispasmodik Tablet Tablet - -
39 Antitusiva Sirup Botol - -
40 Antitusiva Tablet Tablet - -
41 Asam Folat Tablet 1 mg Tablet 490 490.00
42
Asam Askorbat (Vit. C) Tablet 50 mg Tablet 965.00
965
43 Asam Mefenamat Kapsul 500 mg Kapsul - -
44 Acetylsistein tablet Tablet 600 600.00
45 Asetosal Tablet 80 mg Tablet 70 70.00
48 Asiklovir Krim 5 % Tube - -
51 Attapulgit Tablet 810 810.00
52 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 30 30.00
53 Aqua Pro Injeksi Steril, bebas Pirogen 1
Vial 60.00
Liter 30 30.00
54 Bahan Tambal Sementara Set - -
55 Benzatin Benzil Penisilin injeksi Vial - -
56 Betahistin Mesilat 6 mg Tablet 450 450.00
57 Betametason Krim 0,1 %- 5g Tube 16 16.00
58 Bisakodil suppositoria 10 mg Supp - -
59 Bisoprolol Tablet 2,5 mg Tablet 80 80.00
60 Bromheksin 8 mg Tablet - -
61 Cresotin Pasta Botol - -
62 Cresotin Liquid No 2 Botol - -
63 Deksametason Injeksi 5mg/ml-1ml Ampul 20 20.00
64 Deksametason Tablet 0,5 mg Tablet 2,675 2,675.00
65 Devitalisasi Pasta (Non Arsen) Botol - -
68 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul 25 25.00
69
Diazepam Larutan Rektal 5 mg/ml Supp 10.00
10
70 Diazepam Larutan Rektal 10 mg/ml Supp - -
71
Dietilkarbamazin Sitrat Tablet 100 mg Tablet -
-
72
Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul -
-
73 Digoksin Tablet 0,25 mg Tablet - -
74 Dimenhidrinat Tablet 50 mg Tablet 840 840.00
75 Domperidon Tablet 10 mg Tablet - -
76 Donperidon Suspensi 5 mg/5ml Botol - -
77 Efedrin Hcl Tablet 25 mg Tablet - -
78 Ekstrak Belladone Tablet 10 mg Tablet - 100.00 100.00
79 Epinefrin HCl / Bitartrat Ampul 5 5.00
82 Eritromisin Sirup 200 mg / 5 ml Botol - -
83 Etambutol Tablet 500 mg Tablet - -
84 Etanol 70 % 100 ml Botol - -
85 Etil Klorida Semprot -100 ml Botol 2 2.00
86 Eugenol Cairan -10 ml Botol - -
87 Fenitoin Natrium Kapsul 100 mg Kapsul 90 90.00
88 Fenobarbital tablet 30 mg Tablet - -
89 Fenobarbital injeksi 50 mg / ml Ampul 30 30.00
90
Fenoksimeti Penisilin 250 mg tablet Tablet -
-
91 Fenoksimeti Penisilin 500 mg tablet Tablet - -
92 Fenol Gliserol TK Botol - -
93
Flufenazine decanoat injeksi 25 mg/ml Ampul -
-
94 Flukonazole tablet 150 mg Tablet - -
95 Fitomenadion tablet 10 mg Tablet - 100.00 100.00
96 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 20 100.00 120.00
97 Furosemid Tablet 40 mg Tablet - 100.00 100.00
98 Furosemid injeksi Ampul - -
99 Garam Oralit I serbuk, kombinasi :
( Nacl 0,52 gr,
Kalium Klorida 0,30 gr, Trinatrium Sitrat Kantong
dihidrat 0,58 gr, Glukosa Anhidrat 2,70
g )200 ml Air 2,415 2,415.00
100 Gemfibrozil Tablet 600 mg Tablet - -
101 Gentian Violet Botol - -
102 Gentamisin injeksi 80 mg / 2 ml Vial - -
103 Gentamisin Salep Kulit 0,1 % Tube - -
104 Glass Ionomer Set - -
105 Glibenklamid Tablet 5 mg Tablet 1,450 1,450.00
106 Glimepiride 2 mg Tablet 1,000 1,000.00
107 Gliseril Guayakolat Tablet 100 mg Tablet - -
108 Gliseril Guayakolat sirup Botol - -
109 Glukonas Kalsikus injeksi Ampul 20 20.00
110 Glukosa Larutan Infus 5 % Botol 20 20.00
111 Glukosa Larutan Infus10 % Botol 20 20.00
112
Griseofulvin Tablet 125 mg,micronized Tablet -
-
114 Haloperidol Tablet 1,5 mg Tablet 15,545 15,545.00
115 Haloperidol Tablet 5 mg Tablet 2,045 2,045.00
118
Hidroklortiazid (HCT) Tablet 25 mg Tablet -
-
119 Hidrokortison Krim 2,5 % Tube 22 22.00
120 Ibuprofen Tablet 200 mg Tablet - -
121 Ibuprofen Tablet 400 mg Tablet 3,000 3,000.00
122 Ibuprofen Suspensi 100 mg/5 ml Botol - -
123 Ichtyol salep Kulit Pot - -
126 Isosorbid Dinitrat 5 mg Tablet - -
127 Kalium Diklofenak Tablet 25 mg Tablet - -
128 Kalium Diklofenak Tablet 50 mg Tablet - -
129 Kalsium Hidroksida Pasta Tube - -
130 Kalsium Laktat Tablet 500 mg Tablet 4,380 4,380.00
131 Kaptopril 12,5 mg Tablet 3,000 3,000.00
132 Kaptopril 25 mg Tablet 2,000 2,000.00
133 Karbamazepin Tablet 200 mg Tablet - -
134 Ketokonazole Krim 2 % - 15 gr Tube 30 30.00
135 Ketokonazole Tablet 200 mg Tablet 420 420.00
136 Ketoprofen Tablet 100 mg Tablet - -
137 Ketoprofen Injeksi 100 mg / 1 ml Ampul - -
141 Klindamisin Kapsul 300 mg Kapsul 200 200.00
142 Kloramfenikol Kapsul 250 mg Kapsul - -
143
Kloramfenikol suspensi125mg/5 ml Botol -
-
144 Kloramfenikol Salep Mata 1%-3,5 g Tube - -
145 Kloramfenikol Salep Kulit 2% Tube 21 21.00
146 Kloramfenikol Tetes Mata -5 ml Botol 20 20.00
147 Kloramfenikol Tetes Telinga 3%-5 ml Botol 51 51.00
148 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 9,650 9,650.00
149
Klorpromazin Hcl Tablet Salut 25 mg Tablet 500.00
- 500.00
150
290
151
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul -
-
Salbutamol Vial
Sulphate for inhalation 2,5 ml - -
153 Kombipak Cefixime+ Azithromisin Kotak - -
154 Kotrimoksazol Pedriatik Tablet, Kombinasi : Tablet - -
155 Kotrimoksazol Tablet, Kombinasi : Tablet - -
156 Kotrimoksazol Suspensi Kombinasi :
Sulfametoksazol 200 mg + Botol
Trimetroprim 40 mg/5 ml 95 95.00
157 Lansoprazole 30 mg Kapsul Tablet - -
158 Larutan mengadung Elektrolit Botol - -
(Nacl 1,125 gr , Botol
Dekstrosa 18,75 gr) 20 20.00 40.00
Dekstrosa 18,75 gr) - -
161 Larutan mengadung Karbohidrat + Elektrolit Botol - -
162 Lidokain injeksi 2 % Tablet 45 45.00
163
Lidokain Komp Injeksi, Kombinasi : Ampul
- -
164 Lidokain Spray Botol - -
165 Loperamid Tablet 2 mg Tablet 480 480.00
166 Loratadin tablet 10 mg Tablet - -
167 Magnesium Sulfat (IV) 20 %-25 ml Ampul - 50.00 50.00
168 Magnesium Sulfat (IV) 40 %-25 ml Ampul - 43.00 43.00
169 MB Anak Blister - -
170 MB Dewasa Blister - -
171 Meloksikam tablet 15 mg Tablet - -
172 Meloksikam Suppositoria Supp - -
173 Metformin Hcl Tablet 500 mg Tablet 1,640 1,640.00
174 Metformin 850 mg Tablet 1,950 1,950.00
175 Metildopa 250 mg tablet Tablet - -
176 Methisoprinol 500 mg Tablet - -
Tablet 120.00
Tablet 0,125 mg 120
178 Metilergometrin Maleat Injeksi 0,200 mg- Ampul 197 197.00
179 Metilprednisolon tablet 4 mg Tablet 2,000 2,000.00
180 Metoklopramid 10 mg Tablet - -
181
Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul -
-
182 Metronidazol Tablet 250 mg Tablet - -
183 Metronidazole Tablet 500 mg Tablet 2,000 2,000.00
184 Metronidazole sirup 125 mg/ml Botol 40 40.00
185
Metronidazole Infus 500 mg /100 ml Ampul 50.00
- 50.00
186 Mikonazole KrIm 2 % - 10 gr Tube 29 29.00
187 Multivitamin + Mineral tablet Tablet - -
188 Multivitamin sirup Botol - -
189 Mummifying Pasta Botol - -
190 Natrium Bikarbonat Tablet 500 mg Tablet - -
191 Natrum Diklofenak Tablet 25 mg Tablet - -
192 Natrium Diklofenak Tablet 50 mg Tablet 1,700 1,700.00
193 Natrium Klorida Larutan infus 0,9%-Steril Botol 95 95.00
194 Nipedifin Tablet 10 mg Tablet - -
195 Nistatin suspensi 100.000 IU/ml Botol 24 50.00 74.00
196 Nistatin 100.000 IU/gram Tablet Vagina - -
197 Nistatin 500.000 IU/gram Tablet Salut Tablet 100 100.00
198 Obat Antitiuberkolosis Kategori Anak Paket - -
199 Obat Antitiuberkolosis Kategori 1 Dewasa Paket - -
Paket -
Dewasa -
Paket -
Dewasa -
202
Obat Anti Tuberkulosis FDC Kat Anak Paket -
-
203
Obat Anti Tuberkulosis FDC Kat I & II Paket -
-
204 Obat Anti Tuberkulosis FDC Kat I & III Paket - -
205 Obat Anti Tuberkulosis FDC Kat I & III Paket - -
206 Obat Anti Tuberkolosis FDC Sisipan Dew Paket - 5.00 5.00
207 Obat Batuk Hitam (OBH) Cairan 100 ml Botol - -
208 Obat Batuk Cair Sirup (Ekspektoran) Botol - -
209 Obat Batuk Hitam Plus Sirup Botol - -
210 Obat Flu Sirup Botol - -
211 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10
Vial -
ml -
212 Oksiterasiklin Salep Mata 1%-3,5g Tube - 50.00 50.00
213
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube -
-
214 Oksitosin Injeksi 10 IU/ml-1ml Ampul 250 250.00
215 Omeprazole injeksi 40mg/10ml Ampul - 30.00 30.00
216 Omeprazole Kapsul 20 mg Kapsul 660 660.00
217 Ondansetron inj 4 mg/ 2 mL Ampul - -
218 Parasetamol drop 100 mg/ml btl @15ml
Botol -
(60mg/0,6ml) -
219 Parasetamol drop 100 mg/ml btl @15ml ( Botol - -
220
Parasetamol Sirup 120 mg/5ml-60 ml Botol 190.00
190
221 Parasetamol Tablet 100 mg Tablet - -
222 Parasetamol Tablet 500 mg Tablet - 16,500.00 16,500.00
223 PB Anak Blister - -
224 PB Dewasa Blister - -
225 Pehacain injeksi Ampul - -
226 Perak Sulfadiazin krim 1 % 35 gr Tube - -
227 Permetrin krim 5 % Tube 17 17.00
230 Piroksikam Tablet 20 mg Tablet - -
231 Pirantel Pamoat Tablet 365 mg (Setara d Tablet - -
232
Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet -
-
233 Piridoksin Hcl (Vit.B6) Tablet 25 mg Tablet - -
237 Prednison Tablet 5 mg Tablet 210 210.00
238 Primakuin tablet 15 mg Tablet - -
239 Prokain Benzil Penisilin Injeksi 3,000,000
Vial -
IU -
240 Propanolol Hcl Tablet 40 mg Tablet - -
241 Propanolol Hcl Tablet 10 mg Tablet 100 100.00
242 Propilturasil Tablet 100 mg Tablet - -
243 Ranitidin Injeksi 25 mg / ml Ampul - -
244 Ranitidin Tablet 150 mg Tablet 710 710.00
245 Retinol (Vit. A) 100.000 IU Kapsul Kapsul - 300.00 300.00
246 Retinol (Vit. A) 200.000 IU Kapsul Kapsul - 1,000.00 1,000.00
247 Reserpin Tablet 0, 25 mg Tablet - -
248 Rifampisin Tablet 450 mg Tablet - -
249
Ringer Laktat Larutan Infus Steril 500 ml Botol 210.00
210
250 Salbutamol 2mg Tablet - -
251 Salbutamol Tablet 4 mg Tablet - -
252 Salbutamol solution for Inhalation single d Ampul - -
Asam Salisilat 2 Pot
% + Belerang Endap 4 % - 30 gram 48 48.00
254 Salisil bedak 2% -50 gr Kotak - -
255 Salep Luka Bakar Tube - -
256 Sefadroksil Sirup Kering 125 mg / 5 ml
Botol 84.00
sirup 84
257 Sefadroksil Tablet 500 mg Tablet - -
258 Sefiksim Kapsul 100 mg Kapsul - -
259 Sefiksim 400 mg + Azitromisin 1000 mg Paket - -
260 Sefotaksim Injeksi 1 gr Ampul - -
261 Seftriakson Injeksi 1 gr / vial Ampul - -
262 Semen Seng Fosfat Serbuk & Cairan Botol - -
263 Setirizin Tablet 10 mg Tablet 800 800.00
264 Setirizin Sirup 5 mg / 5 ml Botol 20 20.00
265 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul - -
266 Sianokobalamin Tablet 50 mcg Tablet 430 200.00 630.00
267 Silver Amalgam Serbuk 65-75% Botol - -
268 Simetidin 200 mg Tablet Tablet - -
269 Simvastatin Tablet 10 mg Tablet 605 605.00
270 Simvastatin Tablet 20 mg Tablet - -
271 Siprofloksasin 500mg Tablet 670 670.00
272 Spironolakton Tablet 25 mg Tablet 350 350.00
273 Sulfacetamid Tetes Mata 15 %-5ml Botol - -
274 Tablet Tambah Darah Kombinasi:
Besi II Sulfat 200 Tablet
mg + Asam Folat 0,25 mg - 36,400.00 36,400.00
275 Temporary Stopping Fletcher (Fletcher)
Set -
Serbuk & Cairan -
276 Trikesol formalin ( T K F ) Cairan 10 ml Botol - -
279 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1m Ampul - -
280 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 Tablet 1,130 500.00 1,630.00
281 Thiamfenikol Kapsul 500 mg Kapsul - -
282 Tramadol Injeksi 50 mg/ ml Ampul - -
283 Tramadol Tablet 50 mg Tablet - -
284 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 26,745 26,745.00
285 Vitamin B .Komplek Tablet Tablet - -
286 Vitamin Neurotropik Tablet Tablet 1,500 1,500.00
287 Zinc Sulfat 20 mg/5 ml Botol 55 55.00
288 Zinc Sulfat 20 mg Tablet 1,000 1,000.00
289 Hepatorotector tablet (Curcuma) Tablet - -
290 Obat Batuk Herbal Botol - -
291 Obat Kumur Botol - -
292 Salep Kloramfenikol + Hidrokortison Tube - -
293 Tablet Pemanis Botol - -
294 Bahan Pembersih Kavitas Botol - -
295 Flour Gel Botol - -
296 Glass Lonomer Posterior set - -
297 Hyposol 3% Botol - -
298 Paramonochlorofenol/CHKM Botol - -
299 Saliva Ejector Pcs - -
300 Salep Betametason + Neomisin Tube - -
301 Bahan Pemutih Gigi Pot - -
302 Metronidazol Inj Ampul - -
303 Box Slide Pcs - -
304 Klozapine 100 mg Tablet 610 610.00
305 Klozapine 25mg Tablet 1,403 1,403.00
306 Mineral Mix Sachet - 140.00 140.00
307 Risperidon 2mg Tablet 2,710 2,710.00
308
Budensoid Cairan Inhalasi (Pulmicort) Respules -
-
309 Box Object Glass isi 50 Grey Orange Pcs - -
310 Vitamin C 500mg Tablet 1,300 3,000.00 4,300.00
311 Multivitamin Tablet - 3,000.00 3,000.00
312 Poli Aid 1 Liter Botol - 10.00 10.00
313 Trifluoperazine Hcl Tablet 5 mg Tablet - -
314 Divalproex Sodium 250mg Tablet 100 100.00
315 Calcetin Calcium Hydroxide Paste Botol - -
316 Pilp-X Pot - -
317 Karbogliserin Tetes Telinga Botol - -
318 Larvasida Paket - 5.00 5.00
319 Kalsitrol Kapsul Lunak 0,5 mcg Kapsul 1,520 1,520.00
320 Vitamin D 1000IU Tablet 1,800 2,000.00 3,800.00
1.00 1.00
B. BAHAN MEDIS HABIS PAKAI (BMHP) - -
1 Abbocath No 18 ( IV Chateter 18 ) Buah - 50.00 50.00
2 Abbocath No 20 ( IV Chateter 20 ) Buah 60 60.00
3 Abbocath No 22 ( IV Chateter 22 ) Buah - 50.00 50.00
4 Abbocath No 24 ( IV Chateter 24 ) Buah - -
5 Alat Gula, Kolesterol, Asam Urat Unit - -
8 Alat Suntik Sekali Pakai 5 ml Set 400 400.00
10 Alkohol Swab Kotak 8,900 8,900.00
11
Set 300.00
Auto Disposable Syringe (ADS) 0,05 ml 300
12
Set
Auto Disposable Syringe (ADS) 0,5 ml 1,900 1,900.00
13 Auto Disposable Syringe (ADS) 5 ml Set 1,000 1,000.00
14 Blood Set Set - -
15
Sachet
Catgut/Benang Bedah No.3/0 Cromic 20 20.00
Botol
ml - -
17 Etanol 70 % 1.000 ml Botol - -
18 Eter Alkohol Botol - -
23 Infus set Dewasa Set 45 45.00
24 Iodina Test Botol 40 30.00 70.00
25 Kaca Slide Pcs - -
26 Kapas Berlemak 500 gram Bungkus - -
27
Bungkus -
Kapas Pembalut / Adsorbens 250 gram -
28 Kassa Pembalut 2 m x 80 cm Rol 36 36.00
29 Kassa Pembalut Hidrofil 4 m x 3 cm Rol - -
30 Kassa Pembalut Hidrofil 4 m x 15 cm Rol - -
31 Kassa Hidrofil Steril 16 x 16 Kotak - -
32 Kassa Kompres 40 x 40 steril Bungkus - -
33 Kertas Puyer Bungkus - -
34 Kertas Saring Lembar - -
35 Kertas Lensa Lembar - -
36 Lysol 1,000 ml Botol - -
37 Masker Buah - -
38 Masker Kain Headloop KEMKES Pcs - -
39 Masker Kain Earloop KEMKES Pcs - -
40 Masker N 96 Pcs 50 50.00
41 Masker KN95 Pcs - -
42 Minyak Imersi Botol - -
43 Plester Kertas Rol - -
44 Polifix 5 cm x 5 m Rol 3 3.00
45 Pot Dahak Pcs 200 200.00
46 Rapid 2 HIV Fokus Test - -
47 Rapid HIV 1+2KHB Test - -
48 Rapid Test HIV 1/2 Vikia DS Test - 200.00 200.00
49 Rapid HIV 1 (SD HIV) Test - -
50 Rapid HIV 2 (Intec HIV) Test - -
51 Rapid HIV 2 (Biomeriux HIV) Test - -
52 Rapid Tes SD Bioline HBSAG Test - -
53 Hepatitis B Imunoglobulin inj 220 IU (Hbig Vial - -
54 Rapid Test Syphilis Test - 200.00 200.00
55 Reagen CD 4 Control Test - -
56 Reagen CD 4 Test - -
57
Botol -
Reagen Ziehl Nielsen -
58 RPR Test Syphilis Test - -
59 Silk( Benang Bedah Sutra ) No 3/0 Sachet - -
60 Safety Box Pcs 180 180.00
64 Sarung tangan Non Steril S Pcs 1,200 1,200.00
65 Sarung tangan Non Steril M Pcs 200 200.00
66 Sarung tangan Non Steril L Pcs - -
67 Sountimer Buah - -
68 Stik Pemeriksaan Gula Darah Test 14,000 14,000.00
69 Stik Pemeriksaan Kolesterol Test - -
70 Stik Pemeriksaan Asam Urat Test - -
71 Supratul Lembar - -
72 Urine Bag set - -
73 Wing Neddle No 23 Set - -
74 Blood Lancet Pcs 18,700 18,700.00
75 Cairan Antiseptik Botol 500 ml Botol - -
76 Rapin HIV Oncoprobe Test - -
77
Galon -
Steryzime Dual Enzymatis 5 Lt -
78 Sterald 30 High Level Surface
Galon -
Desinfektan 5Lt -
79 Gentamisin Sulfat Tetes Mata 0,3% Botol - -
80 Bioplacenton Tulle 10 x 10 Lembar - -
81 Vikia Biumeric Test - -
82 Sterald Galon - -
83 Hepatitis B Imunolobin syringe - -
84
Slide - -
85 IV Catheter 20 Pcs - -
86 Stericide 3 Surface Desinfektan 5Lt Galon - -
87 Serum Tetagam P Injeksi PFS - -
88 Biosave Serum ABU Injeksi Vial - -
89 Baju APD (COVER ALL) Pcs - -
90 Sepatu Boot Saffety Pcs - -
91 Kacatamata Google Pcs - -
92 Sarung Tangan Karet Latex Pcs - -
93 Rapid Test Kit Covid-19 Test - -
94 VTM & Swab Dacron Citodia Pcs - -
95 VTM + Swab (KH Medial) Test - -
96 Panbio Covid-19 Antigen Test 250 250.00
97 ADS 0,5 ml Alokasi Pcs - -
98 Alkohol Swab Alokasi Pcs 16,380 16,380.00
99 Safety Box Alokasi Pcs - -
100 Parafilm Pcs - -
101 Vaccum Tube Sterile EDTA K-3 (3ml Pcs - -
102 Vaccum Tube Sterile Clot Activator(3ml Pcs - -
103 Umbilical Cord Klem Steril Nylon Pcs 50 50.00
C. SERUM DAN VAKSIN
- -
1 Serum Anti Bisa Ular Polivalen Injeksi 5
Vial -
ml (ABU I ) -
2 Serum Anti Rabies untuk manusia Vial - -
3 Serum Anti Tetanus (ATS) Injeksi 1.500 Ampul - -
4 Serum Anti Tetanus (ATS) Injeksi 20.000 Vial - -
5
Vial
Human Tetanus Imunoglobin inj 250 IU - -
6 Vaksin BCG Ampul 31 31.00
7 Vaksin Campak 10 Dosis Vial - -
8 Vaksin DT Vial - -
9 Vaksin TD Vial 25 25.00
10 Vaksin DTP-HB Vial - -
11 Vaksin DPT-HB/Hib Vial 65 65.00
12 Vaksin HB Uniject Pcs 91 91.00
13 Vaksin MR (VVM.A) Vial 33 33.00
14 Vaksin Polio Vial 40 40.00
15 Vaksin Polio IPV 5 Dosis Vial 30 30.00
16 Vaksin Polio 10 IPV Dosis Vial - -
17 Vaksin TT Vial - -
18 Vaksin Campak Bias Vial - -
19 Vaksin Covid-19 (10 d0sis) Vial 0 -
20 0 -
2 3 4 5 6 7 8 9 10
5
10
104 72 55 50 42 68 80 85
1 1 6 2
1
10 10 10 2
10 20
10 10 10 20 30
2
0
63 36 74 35 10 33 35 10
20 20 10
10
30
10 30 20
20 30
30 40
1 4 2 1 1 1
10 20 10 10 40 10
40 100 40 30 90
10
1
2
2 1 1 1 1
1 1 1 1
1 1 1
73 144 78 93 58 109 48 89
20
10 30 10 20
10
20 20 10 30
20 10 10 20
20 10 10 30 10
1
1 1 2
10 45 5 60 5 50 10
10 20 10
10 10 4 30
430
10 35 30 10 10
10 20 20
10
50 70 40 60 25 50 40 90
30 30 15
10 10 10 10
15
30 10
40 30 20 30 15 20
11 12 13 14 15 16 17 18 19
15 10 45
40 87 75 50 94 40 52 47
2 1 4 1
40
1
20 13 40 10
2 4 6 42 2
10
20 20 20
10
1 1
10
33 53 55 40 72 30 120 66
10
7 7
10 10 30 10 70 40
50 30 20
30 10
2 2 1
10
70 110 10 250 40 80 20
2 1 1
1 1 6 1 1
6 2 1
121 123 93 57 172 104 178 50
20 20
10 30 40 50 10 30 40
26
10 10 10 10 10
2 3 1 2
10 10
1 1
3
1 2 3 3
10 5 5 40 5 10 20
159 134
10
4 2
3
20 20 2 20
40 60 20 5
10 10
10
50 20 50 60 90 20 130 30
30 50 10
15 5 10
35 15
10 70 20 5
30
10 80 70
20 21 22 23 24 25 26 27 28
10 20
63 30 137 111 50 60 70
8 2 2 4 4
80 35 120 100 30 120 90
3
1
10 10
2 7 4 3 4
10
10 10 10
1 1
2
73 85 160 65 68 60 56
1
7
20 10 30 30 10
10 20
80 20 40
4 2
10 20
60 20 110 70
20
10
3 2 2 1 1
1 1
80 52 91 79 93 159 174
35 20
10
30 40 30 20
20 20 10 9
30 20
2 1 1
10 20 10 10 30
1 7
2 1 2 1 1
15 20 15 15 5 10
192 124 283 224 87 283 161
10 10
1 2
2 3 1 2
1
10
10 10 20 30
10 10 10 10 10
85 20 70 16 50 60 75
65 30 10
10 10
20 10 5
60 15 1200 13
60 50 30 30
50 40 160 10
100
1000
JUMLAH
29 30 31 PEMAKAIAN SISA STOK
0 -
0 -
0 -
5 900.00
110 590.00
0 -
0 -
0 50.00
0 10.00
0 1,000.00
0 -
0 3,000.00
0 -
0 -
80 72 1714 3,586.00
0 -
0 -
6 3 47 76.00
0 -
0 -
0 -
0 -
0 -
0 -
50 65 730 9,270.00
0 -
0 -
0 -
0 -
3 64.00
1 1 5 60.00
0 390.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
135 355.00
12 3 97 868.00
0 -
10 60 540.00
0 70.00
0 -
0 -
0 -
0 -
0 -
5 15 190 620.00
0 30.00
0 60.00
0 -
0 -
10 440.00
6 10.00
0 -
30 40 40.00
0 -
0 -
0 -
2 18.00
62 1394 1,281.00
0 -
0 -
0 -
1 24.00
0 10.00
0 -
0 -
0 -
0 -
10 10 80 760.00
0 -
0 -
0 -
0 100.00
0 5.00
0 -
0 -
0 -
0 -
0 -
0 2.00
0 -
10 80.00
0 -
0 30.00
0 -
0 -
0 -
0 -
0 -
30 70.00
0 120.00
0 100.00
0 -
7 35 2,380.00
0 -
0 -
0 -
0 -
0 -
20 350 1,100.00
10 190 810.00
0 -
0 -
0 20.00
0 20.00
0 20.00
0 -
0 -
250 15,295.00
0 2,045.00
0 -
0 -
0 -
1 22 -
0 -
10 150 2,850.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
130 20 1290 3,090.00
30 2,970.00
10 1,990.00
0 -
1 29.00
2 418.00
0 -
0 -
0 -
0 -
0 -
0 200.00
0 -
0 -
0 -
1 1 21 -
14 6.00
1 1 16 35.00
229 66 2613 7,037.00
0 500.00
115 175.00
0 -
0 -
0 -
0 -
0 -
0 95.00
0 -
0 -
0 40.00
0 -
0 -
10 35.00
0 -
0 -
0 480.00
0 -
0 50.00
0 43.00
0 -
0 -
0 -
0 -
10 20 430 1,210.00
0 1,950.00
0 -
0 -
10 110.00
0 197.00
165 1,835.00
0 -
0 -
0 -
20 30 210 1,790.00
0 40.00
0 50.00
13 16.00
0 -
0 -
0 -
0 -
0 -
20 200 1,500.00
2 93.00
0 -
12 62.00
0 -
0 100.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5.00
0 -
0 -
0 -
0 -
0 -
1 1 22 28.00
0 -
0 250.00
0 30.00
20 5 385 275.00
0 -
0 -
0 -
1 1 189.00
0 -
212 205 2064 14,436.00
0 -
0 -
0 -
0 -
0 17.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 210.00
0 -
0 -
0 -
0 100.00
0 -
0 -
70 640.00
0 300.00
0 1,000.00
0 -
0 -
4 206.00
0 -
0 -
0 -
14 34.00
0 -
0 -
4 80.00
0 -
0 -
0 -
0 -
0 -
0 -
1 127 673.00
0 20.00
0 -
430 200.00
0 -
0 -
290 315.00
0 -
120 550.00
20 330.00
0 -
0 36,400.00
0 -
0 -
0 -
0 -
0 -
40 20 1311 319.00
0 -
0 -
0 -
20 290 26,455.00
0 -
50 70 1,430.00
0 55.00
10 30 145 855.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
15 595.00
5 20 1403 -
0 140.00
20 31 481 2,229.00
0 -
0 -
0 4,300.00
0 3,000.00
0 10.00
0 -
30 70.00
0 -
0 -
0 -
0 5.00
0 1,520.00
140 70 630 3,170.00
0 1.00
0 -
0 50.00
0 60.00
0 50.00
0 -
0 -
0 -
0 -
0 400.00
0 -
100 8,800.00
0 300.00
0 1,900.00
0 1,000.00
0 -
0 20.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 45.00
0 70.00
0 -
0 -
0 -
0 36.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 50.00
0 -
0 -
0 -
0 3.00
0 200.00
0 -
0 -
0 200.00
0 -
0 -
0 -
0 -
0 -
0 200.00
0 -
0 -
0 -
0 -
0 -
0 180.00
0 -
0 -
0 -
0 1,200.00
0 200.00
0 -
0 -
0 14,000.00
0 -
0 -
0 -
0 -
0 -
1000 17,700.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 250.00
0 -
0 16,380.00
0 -
0 -
0 -
0 -
0 50.00
0 -
0 -
0 -
0 -
0 -
0 -
0 31.00
0 -
0 -
0 25.00
0 -
0 65.00
0 91.00
0 33.00
0 40.00
0 30.00
0 -
0 -
0 -
0 -
NO NAMA SEDIAAN SATUAN Persediaan 1 2 3 4
A. O B A T
1 Air Raksa Dental Use Botol -
2
Albendazole Tablet 400 mg Tablet
-
3 Albendazole susp 200 mg/5 ml Botol -
4 Alopurinol Tablet 100 mg Tablet 800
5 Alopurinol Tablet 300 mg Tablet -
6 Alprazolam tablet 1 mg Tablet -
7 Ambroksol Tablet 30 mg Tablet 17,457 39 33 63 24
8 Ambroksol sirup 15 mg/5 ml Botol -
9
Aminofillin Injeksi 24 mg/ml-10 ml Ampul
-
10 Aminofillin Tablet 200 mg Tablet -
11
Amitriptillin Hcl Tablet Salut 25 mg Tablet
1,410
12 Amlodipin Tablet 5 mg Tablet 30,670 20 30 10
13 Amlodipin Tablet 10 mg Tablet 16,897 20 20 10
14 Amoksisillin Kapsul 250 mg Kapsul -
15 Amoksisillin Kaplet 500 mg Kaplet -
16
Amoksisillin Serbuk Injeksi 1000 mg vial
-
17
Amoksisillin Sirup Kering 125 mg/5ml Botol
-
18 Amoksisillin Double Strengh Sirup
Botol
Kering 250 mg/5 ml -
19 Ampisilin Kapsul 250 mg Kapsul -
20 Ampisillin Kaplet 500 mg Tablet 25,000
21 Ampisilin Sirup 125 mg / 5 ml Botol -
22 Ampisillin Injeksi 1000 mg Vial -
23 Analgetik Plus Tablet -
24
-
25
Antasida Doen Tablet, Kombinasi :
Alumunium Hidroksida 200 mg
24,122
26 Antasida Plus Tablet Tablet -
Tablet
mg 2,165 135 80 50 10
28
Antalgin Injeksi 250 mg/ml-2ml Ampul
-
29
Anti Bakteri DOEN Salep Kombinasi :
Basitrasin 500 Tube
IU/g + Polimiksin 1000 IU/g
-
30 Anti Hemoroid Doen komb Supp -
31 Anti Fungi DOEN Kombinasi :
Asam Benzoat Pot
6% + Asam Salisilat 3% 338
32 Antimigren DOEN Kombinasi :
Ergotamin Tartrat 1 Tablet
mg + Kofein 50 mg -
33 Anti Diare Suspensi Botol -
34 Anti Diare Tablet Tablet -
35 Anti Dotum Oral Tablet Tablet -
36 Anti Hipertensi Kapsul Tablet -
37
Antihistamin Tablet kombinasi Tablet
-
38 Antispasmodik Tablet Tablet -
39 Antitusiva Sirup Botol -
40 Antitusiva Tablet Tablet -
41 Asam Folat Tablet 1 mg Tablet -
42
Asam Askorbat (Vit. C) Tablet 50 mg Tablet
-
43
18,985 40
44 Acetylsistein tablet Tablet 4,800
45 Asetosal Tablet 80 mg Tablet -
48 Asiklovir Krim 5 % Tube -
49 Asiklovir Tablet 200 mg Tablet -
50 Asiklovir Tablet 400 mg Tablet -
51 Attapulgit Tablet -
52
Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul
-
53 Aqua Pro Injeksi Steril, bebas Pirogen
Vial
20 ml -
54 Bahan Tambal Sementara Set -
55
Benzatin Benzil Penisilin injeksi Vial
-
56 Betahistin Mesilat 6 mg Tablet 2,000
57 Betametason Krim 0,1 %- 5g -
58 Bisakodil Tablet 5 mg Tablet 200
59 Bisoprolol Tablet 5 mg Tablet -
60 Bromheksin 8 mg Tablet -
61 Cresotin Pasta Botol -
62 Cresotin Liquid No 2 Botol -
63
Deksametason Injeksi 5mg/ml-1ml Ampul
-
64 Deksametason Tablet 0,5 mg Tablet 9,895 40 109 35 32
65 Devitalisasi Pasta (Non Arsen) Botol -
66 Diazepam tablet 2 mg Tablet -
67 Diazepam tablet 5 mg Tablet -
68
Diazepam Injeksi i.v/i.m 5 mg/ml Ampul
-
69
-
70
-
71
Dietilkarbamazin Sitrat Tablet 100 mg Tablet
-
Ampul
1ml -
Ampul
1ml -
74 Digoksin Tablet 0,25 mg Tablet 1,000
75 Dimenhidrinat Tablet 50 mg Tablet 822
76 Domperidon Tablet 10 mg Tablet -
77
Donperidon Suspensi 5 mg/5ml Botol
-
78 Efedrin Hcl Tablet 25 mg Tablet -
79
Ekstrak Belladone Tablet 10 mg Tablet
-
80 Epinefrin HCl / Bitartrat
(Epinefrina / Ampul
Adrenalina) Injeksi 0,1%/- 1ml -
81 Eritromisin Kapsul 250 mg Kapsul -
82 Eritromisin Kapsul 500 mg Kapsul -
83 Eritromisin Sirup 200 mg / 5 ml Botol -
84 Etambutol Tablet 500 mg Tablet -
85 Etanol 70 % 100 ml Botol -
86 Etil Klorida Semprot -100 ml Botol -
87 Eugenol Cairan -10 ml Botol -
88
30
89 Fenobarbital tablet 30 mg Tablet 415
90
Fenobarbital injeksi 50 mg / ml Ampul
-
91
-
92
-
93 Fenol Gliserol TK Botol 160
94 Flufenazine decanoat injeksi 25
Ampul
mg/ml -
95 Flukonazole tablet 150 mg Tablet -
96 Fitomenadion tablet 10 mg Tablet 330
97 Fitomenadion (Vit K1) Injeksi 2
Ampul
mg/ml-1ml -
98 Furosemid Tablet 40 mg Tablet -
99 Furosemid injeksi Ampul -
100
Garam Oralit I serbuk, kombinasi :
( Nacl 0,52
gr, Kalium Klorida 0,30 gr, Trinatrium Kantong
Sitrat dihidrat 0,58 gr, Glukosa
Anhidrat 2,70 g )200 ml Air
-
101 Gemfibrozil Tablet 600 mg Tablet -
102 Gentian Violet Botol -
103
Gentamisin injeksi 80 mg / 2 ml Vial
-
104 Gentamisin Salep Kulit 0,1 % Tube -
105 Glass Ionomer Set -
106 Glibenklamid Tablet 5 mg Tablet -
107 Glimepiride 2 mg Tablet 15,000
108
Gliseril Guayakolat Tablet 100 mg Tablet
-
109 Gliseril Guayakolat sirup Botol -
110 Glukonas Kalsikus injeksi Ampul 24
111 Glukosa Larutan Infus 5 % Botol -
112 Glukosa Larutan Infus10 % Botol -
Tablet
mg,micronized -
Tablet
mg,micronized 3,000
115 Haloperidol Tablet 0,5 mg Tablet -
116 Haloperidol Tablet 1,5 mg Tablet -
117 Haloperidol Tablet 5 mg Tablet -
118 Haloperidol injeksi 5 mg/ml Ampul -
119 Haloperidol injeksi 50 mg/ml Ampul -
120
-
121
-
122 Hidrokortison Krim 2,5 % Tube 384
123 Ibuprofen Tablet 200 mg Tablet 4,492 30 35 20 5
124 Ibuprofen Tablet 400 mg Tablet -
125
Ibuprofen Suspensi 100 mg/5 ml Botol
-
126 Ichtyol salep Kulit Pot -
127 Isoniazid tablet 100 mg Tablet -
128 Isoniazid tablet 300 mg Tablet -
129 Isosorbid Dinitrat 5 mg Tablet -
130
-
131
-
132 Kalsium Hidroksida Pasta Tube -
133 Kalsium Laktat Tablet 500 mg Tablet 20,000
134 Kaptopril 12,5 mg Tablet 1,640
135 Kaptopril 25 mg Tablet -
136 Karbamazepin Tablet 200 mg Tablet -
137 Ketokonazole Krim 2 % - 15 gr Tube 96
138 Ketokonazole Tablet 200 mg Tablet -
139 Ketoprofen Tablet 100 mg Tablet -
140
Ketoprofen Injeksi 100 mg / 1 ml Ampul
-
141 Ketorolac 10 mg injeksi Ampul -
142 Ketorolac 30 mg injeksi Ampul -
143 Klindamisin Kapsul 150 mg Kapsul -
144 Klindamisin Kapsul 300 mg Kapsul -
145 Kloramfenikol Kapsul 250 mg Kapsul -
146
Kloramfenikol suspensi125mg/5 ml Botol
-
147
Kloramfenikol Salep Mata 1%-3,5 g Tube
-
148 Kloramfenikol Salep Kulit 2% Tube 103 2 1 1 1
149
Kloramfenikol Tetes Mata -5 ml Botol
-
150
Kloramfenikol Tetes Telinga 3%-5 ml Botol
-
151 Klorfeniramin Maleat (CTM) Tablet 4
Tablet
mg 25,000
152
Klorpromazin Hcl Tablet Salut 25 mg Tablet
-
153 Klorpromazin Hcl Tablet Salut 100
Tablet
mg -
154
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul
-
Salbutamol Vial
Sulphate for inhalation 2,5 ml -
156
Kombipak Cefixime+ Azithromisin Kotak
-
157 Kotrimoksazol Pedriatik Tablet,
Kombinasi :
Tablet
Sulfametoksazol 100 mg +
Trimetroprim 20 mg -
158
Kotrimoksazol Tablet, Kombinasi :
Sulfametoksazol 400 Tablet
mg + Trimetroprim 80 mg
258
159
Kotrimoksazol Suspensi Kombinasi :
Sulfametoksazol 200 Botol
mg + Trimetroprim 40 mg/5 ml
-
160 Lansoprazole 30 mg Kapsul Tablet 2,820 50
(Na 130
mEq,Cl 109 mEq, Asetat 28 mEq) Botol
/Asering -
(Nacl 1,125 Botol
gr , Dekstrosa 18,75 gr) -
163 Larutan mengadung Karbohidrat +
Elektrolit (Nacl
Botol
1,75 gr, KCL 1,5 gr, Na Lactat 2,24 gr,
Dekstrosa 27 gr) -
164 Lidokain injeksi 2 % Ampul 200
165
Lidokain Komp Injeksi, Kombinasi :
Lidokain Hcl 2% Ampul
+Epinefrin 1 : 80.000-2 ml
-
166 Lidokain Spray Botol -
167 Loperamid Tablet 2 mg Tablet -
168 Loratadin tablet 10 mg Tablet 300
169
-
170 Loperamid Tablet 2 mg Tablet -
171
-
172
-
173 MB Anak Blister -
174 MB Dewasa Blister -
175 Meloksikam tablet 15 mg Tablet -
176 Meloksikam Suppositoria Supp -
177 Metformin Hcl Tablet 500 mg Tablet 20,000
178 Metformin 850 mg Tablet 5,000
179 Metildopa 250 mg tablet Tablet 3,290 10
180 Methisoprinol 500 mg Tablet 1,940
Tablet
Tablet 0,125 mg 300
182 Metilergometrin Maleat Injeksi 0,200
Ampul
mg-1ml 100
183 Metilprednisolon tablet 4 mg Tablet 5,000 14
184 Metoklopramid 10 mg Tablet -
185 Metoklorpropamid Injeksi 5 mg/ 5
Ampul
ml -
186 Metronidazol Tablet 250 mg Tablet -
187 Metronidazole Tablet 500 mg Tablet 10,000
188
Metronidazole sirup 125 mg/ml Botol
-
189
Metronidazole Infus 500 mg /100 ml Ampul
-
190 Mikonazole KrIm 2 % - 10 gr Tube -
191 Multivitamin + Mineral tablet Tablet -
192 Multivitamin sirup Botol -
193 Mummifying Pasta Botol -
194
Natrium Bikarbonat Tablet 500 mg Tablet
-
195
Natrum Diklofenak Tablet 25 mg Tablet
-
196
Natrium Diklofenak Tablet 50 mg Tablet
15,000
197 Natrium Klorida Larutan infus 0,9%-
Botol
Steril 500 ml -
198 Nipedifin Tablet 10 mg Tablet -
199
Nistatin suspensi 100.000 IU/ml Botol
-
Tablet
Vagina -
Tablet
Salut -
202
Obat Antitiuberkolosis Kategori Anak Paket
-
Paket
Dewasa -
Paket
Dewasa -
Paket
Dewasa -
206
Obat Anti Tuberkulosis FDC Kat Anak Paket
-
207
Obat Anti Tuberkulosis FDC Kat I & II Paket
-
208 Obat Anti Tuberkulosis FDC Kat I &
Paket
III -
209 Obat Anti Tuberkolosis FDC Sisipan
Paket
Dewasa -
210 Obat Batuk Hitam (OBH) Cairan 100
Botol
ml -
211
Obat Batuk Cair Sirup (Ekspektoran) Botol
-
212 Obat Batuk Hitam Plus Sirup Botol -
213 Obat Flu Sirup Botol -
214 Oksiterasiklin Hcl injeksi i.m.50
Vial
mg/ml-10 ml -
215
Oksiterasiklin Salep Mata 1%-3,5g Tube
-
216
Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube
-
217 Oksitosin Injeksi 10 IU/ml-1ml Ampul -
218 Omeprazole injeksi 40mg/10ml Ampul -
219 Omeprazole Kapsul 20 mg Tablet 6,000 10 10 5 10
220 Ondansetron inj 4 mg/ 2 mL Ampul -
Botol
@15ml (60mg/0,6ml) -
Botol
@15ml (60mg/0,6ml) -
223
Parasetamol Sirup 120 mg/5ml-60 ml Botol
-
224 Parasetamol Tablet 500 mg Tablet 62,856 225 99
225 PB Anak Blister -
226 PB Dewasa Blister -
227 Pehacain injeksi Ampul -
228
Perak Sulfadiazin krim 1 % 35 gr Tube
-
229 Permetrin krim 5 % Tube 150 1
230 Piracetam Tablet 400 mg Tablet -
231 Piracetam Tablet 800 mg Tablet -
232 Piroksikam Tablet 20 mg Tablet -
233 Pirantel Pamoat Tablet 365 mg
Tablet
(Setara dng 125 mg Basa) -
234
4,547 80 23 30 10
235 Povidon Iodida 10% 30 ml Botol -
238 Prednison Tablet 5 mg Tablet -
239 Primakuin tablet 15 mg Tablet -
240 Prokain Benzil Penisilin Injeksi
Vial
3,000,000 IU -
241 Propanolol Hcl Tablet 40 mg Tablet -
242 Propilturasil Tablet 100 mg Tablet -
243 Ranitidin Injeksi 25 mg / ml Ampul -
244 Ranitidin Tablet 150 mg Tablet 5,000 30
245
-
246
-
247 Reserpin Tablet 0, 25 mg Tablet -
248 Rifampisin Tablet 450 mg Tablet -
249 Ringer Laktat Larutan Infus Steril 500
Botol
ml -
250 Salbutamol Tablet 2 mg Tablet -
252
Salbutamol solution for Inhalation
Ampul
single dose units 2,5 ml
-
Asam Salisilat Pot
2 % + Belerang Endap 4 % - 30 gram 283 2 1 1 1
254 Salisil bedak 2% -50 gr Kotak -
255 Salep Luka Bakar Tube -
256 Sefadroksil Sirup Kering 125 mg / 5
Botol
ml sirup -
257 Sefadroksil Tablet 500 mg Tablet 4,720 29
258 Sefiksim Kapsul 100 mg Kapsul -
259 Sefiksim 400 mg + Azitromisin 1000
Paket
mg -
260 Sefotaksim Injeksi 1 gr Ampul -
261 Seftriakson Injeksi 1 gr / vial Ampul -
262
Semen Seng Fosfat Serbuk & Cairan Botol
-
263 Setirizin Tablet 10 mg Tablet 29,900
264 Setirizin Sirup 5 mg / 5 ml Botol -
265 Sianokobalamin Injeksi 500 mcg/ml-
Ampul
1ml -
266 Sianokobalamin Tablet 50 mcg Tablet -
267 Silver Amalgam Serbuk 65-75% Botol -
268 Simetidin 200 mg Tablet Tablet -
269 Simvastatin Tablet 10 mg Tablet -
270 Siprofloksasin 500mg Tablet 980
271 Spironolakton Tablet 25 mg Tablet 830
272
Sulfacetamid Tetes Mata 15 %-5ml Botol
-
273
Tablet Tambah Darah Kombinasi:
Besi II Sulfat Tablet
200 mg + Asam Folat 0,25 mg
-
274 Temporary Stopping Fletcher
Set
(Fletcher) Serbuk & Cairan -
275
Trikesol formalin ( T K F ) Cairan 10 ml Botol
-
276 Tetrasiklin Kapsul 250 mg Kapsul -
277 Tetrasiklin Kapsul 500 mg Kapsul -
278 Thiamin Hcl (Vit B1) Injeksi 100
Ampul
mg/ml-1ml -
Tablet
Tablet 50 mg 15,000 66 65 30
280 Thiamfenikol Kapsul 500 mg Kapsul -
281 Tramadol Injeksi 50 mg/ ml Ampul -
282 Tramadol Tablet 50 mg Tablet -
Tablet
mg -
Tablet
mg -
285 Vitamin B .Komplek Tablet Tablet 63,786 10 20
286 Vitamin Neurotropik Tablet Tablet 11,317 20 10
287 Zinc Tablet 20 mg Tablet -
288 Zinc Sulfat 20 mg/5 ml Tablet -
289 Aminofillin Tablet 150 mg Tablet -
290 Asam Folat Tablet 0,4 mg Tablet 950
291
Gentamisin Sulfat tetes mata 0,3% Botol
79 2 1 1
292 Obat Kumur Botol -
293
Salep Betametason + Neomisin Tube
-
294
Salep Kloramfenikol + Hidrokortison Tube
-
295 Propanolol 10mg Tablet -
296 Tablet Pemanis Botol -
297 Bisakodil Suppositoria 5 mg Supp 12
298 Obat Batuk Herbal (Herbakof) Botol 442 1 1 1
299 Amoksisillin Drops Botol -
300
Tablet Hepatoprotector (Curcuma) Pot
-
301 Simvastatin 20mg Tablet -
302 Klozapine 25mg Tablet -
303 Bisoprolol 2,5mg Tablet 2,000
304 Vitamin C 500mg Tablet -
305 RAMVIT-C C 500mg Tablet 28,991 20 10
306 Vitamin D 1000 IU Tablet -
307
Multivitamin Tablet Kombinasi
Tablet
VitC,Vit D, Zinc, Folic Acid
32,826 40 10
308 Multivitamin Syrup Tablet 355 2
309 Risperidon 2 mg Tablet -
310 Alpara Tablet Tablet 1,256 10 40 20
311 Asam Traneksamat Tablet 1,000
312 Novagrip Flu Batuk Tablet Tablet 10,000
313 FORNERO TABLET Tablet 10,000
B. BAHAN MEDIS HABIS PAKAI (BMHP) -
1 Abbocath No 18 ( IV Chateter 18 ) Buah -
2
-
3
-
4
-
5
Alat Gula, Kolesterol, Asam Urat Unit
-
6 Alat Suntik Sekali Pakai 1 ml Set -
11 Alkohol Swab Kotak 2,200
12 Auto Disposable Syringe (ADS) 0,05
Set
ml -
13
Auto Disposable Syringe (ADS) 0,5 ml Set
-
14
Auto Disposable Syringe (ADS) 5 ml Set
-
15 Blood Set Set 2
16
Catgut/Benang Bedah No.2/0 Plain Sachet
-
17
Catgut/Benang Bedah No.3/0 Cromic Sachet
-
Botol
ml -
19 Etanol 70 % 1.000 ml Botol 30
20 Eter Alkohol Botol -
21 Folley Catheter no 14 Set -
22 Folley Catheter no 16 Set 30
23 Folley Catheter no 18 Set 30
24 Infus set Anak Set -
25 Infus set Anak Set -
26 Infus set Dewasa Set 100
27 Iodina Test Botol -
28 Kaca Slide Pcs -
29 Kapas Berlemak 500 gram Bungkus -
30 Kapas Pembalut / Adsorbens 250
Bungkus
gram -
31 Kassa Pembalut 2 m x 80 cm Rol -
32
-
33
-
34 Kassa Hidrofil Steril 16 x 16 Kotak 100
35 Kassa Kompres 40 x 40 steril Bungkus -
36 Kertas Puyer Pcs -
37 Kertas Saring Lembar -
38 Kertas Lensa Lembar -
39 Lysol 1,000 ml Botol -
40 Masker Buah 1,450
41 Masker Ear Loop Buah 8,000
42 Masker Head Loop Buah -
43 Masker Rajawali Buah -
44 Masker Head Loop Buah -
45 Masker N 95 Pcs -
46 Minyak Imersi Botol -
47 Plester Kertas Rol -
48 Polifix Rol 50
49 Pot Dahak Pcs -
50 Rapid 2 HIV Fokus Test -
51 Rapid HIV 1 (SD HIV) Test -
52 Rapid HIV 2 (Intec HIV) Test -
53 Rapid HIV 2 (Biomeriux HIV) Test -
54 Rapid Tes SD Bioline HBSAG Test -
55 Rapid Test Syphilis Test -
56 Reagen CD 4 Control Test -
57 Reagen CD 4 Test -
58 Reagen Ziehl Nielsen Botol -
59 RPR Test Syphilis Test -
60
Silk( Benang Bedah Sutra ) No 3/0 Sachet
72
61 Safety Box Pcs -
62 Sarung tangan Steril No 6 Pcs -
63 Sarung tangan Steril No 7 Pcs 150
64 Sarung tangan Steril No 7,5 Pcs -
65 Sarung tangan Steril No 7,5 Pcs 140
66 Sarung tangan Non Steril S Pcs 2,700
67 Sarung tangan Non Steril M Pcs 4,800
68 Sarung tangan Non Steril L Pcs 3,400
69 Sountimer Buah -
70 Stik Pemeriksaan Gula Darah Test -
71 Stik Pemeriksaan Gula Darah
Test
Benecheck -
72 Stik Pemeriksaan Gula Darah One
Test
Touch Verio -
73 Stik Pemeriksaan Kolesterol Test -
74 Stik Pemeriksaan Kolesterol
Test
Benecheck -
75 Stik Pemeriksaan Asam Urat Test -
76 Stik Pemeriksaan Asam Urat
Test
Benecheck -
77 Supratul Lembar -
78 Urine Bag set 40
79 Wing Neddle No 23 Set -
80 Blood Lancet Pcs -
81 Cairan Antiseptik Botol 500 ml Botol 35
82 Bisturi Pcs 20
83 Cairan Antiseptik Botol 5 Liter Botol -
84 3 Surface Desintfectan 5L Botol 3
85 Cairan Desinfektan 5 Liter Botol -
86
High Level Desintfectan/sterald Botol
1
87 Cairan Detergen 5 Liter Botol -
88 Gel USG Botol 37
89 IV Dressing Pcs -
90 Mucus Extractor Pcs -
91 Nasal Oxygen Anak Pcs 5
92 Nasal Oxygen Bayi Pcs 25
93 Nasal Oxygen Dewasa Pcs 100
94 Plester Bulat Non Woven Pcs -
95 Plester Transparan Pcs -
96 PP test Pcs 500
97 Sarung tangan Steril No 6,5 Pcs -
98 Sarung Tangan Obgyn Steril Pcs -
99 Stik Pemeriksaan Hb Pcs -
100
Umbilical Cord Klem Steril Nylon Pcs
-
101 Underpad 60x90 cm Non Steril Pcs -
102 Stik Gula Darah Baru Pcs -
103 Stik Asam Urat Baru Pcs -
104 Stik Hb Test 100
105 ChOLESTROL chod-pap Kit -
106 Creatinin mod iaffe Kit -
107 Glucosa God-pap Kit -
108 GOT (AST) mod iffe Kit -
109 GPT Kit -
110 Trigliserida GPO-PAP Kit -
111 Urea UV-auto,Urease/GLDH Kit -
112 Urid Acid TBHA Kit -
113 Dumacon Auto Kit -
114 Micropipet 5,0-50 Ul Kit -
115 Micropipet 10-100UL Kit -
116 Tabung Vacutainer Kit -
117 HGB Drab Kin Kit -
118 Nasal Kanul Dewasa Pcs -
119 Nasal Kanul Anak Pcs -
120 Nasal Kanul Anak Pcs -
121 Coveral II (APD) Non Woven Pcs -
122 Coveral II (APD) Non Woven Pcs 100
123
Pak
Kantong Plastik Kuning 60cmx100cm -
124
Pak
Kantong Plastik Kuning 80cmx120cm 10
125
Pak
Kantong Plastik Hitam 60cmx100cm -
126
Pak
Kantong Plastik Hitam 80cmx120cm 10
127
Pcs
Forsch Medical Disposible Gown -
C. SERUM DAN VAKSIN -
Vial
5 ml (ABU I ) -
2
Vial
Serum Anti Rabies untuk manusia -
Ampul
5 ml (ABU I ) -
4 Serum Anti Tetanus (ATS) Injeksi
Vial
20.000 IU/ampul 10
5 Human Tetanus Imunoglobin inj 250
Vial
IU -
6 Vaksin BCG Ampul -
7 Vaksin Campak 10 Dosis Vial -
8 Vaksin DT Vial -
9 Vaksin TD Vial -
10 Vaksin DTP-HB Vial -
11 Vaksin DPT-HB/Hib Vial -
12 Vaksin HB Uniject Pcs -
13 Vaksin MR (VVM.A) Vial -
14 Vaksin Polio Vial -
15 Vaksin Polio IPV 5 Dosis Vial -
16 Vaksin Polio 10 IPV Dosis Vial -
17 Vaksin TT Vial -
18 Buku Kontrak -
19 -
20 -
20 -
5 6 7 8 9 10 11 12 13 14
60 42 69 45 88 64 107 66
20
60 10 20 20 10 30 10
10 20 20 10 30 10
40 40 46 40 70 20 40
30 20 40 20 20 70
87 43 81 25 13 33 102 84
2 10 10
2
30 2 30
60 20 10 10 45 30
3 3 1 4
50 10
10
10 5 20 20 5 20 30
209 133 230 99 153 139 311 156
1 1 1
70 12 80 40 80 30 10
40 20 10
10 10 10
1 2 2 1 2
10 20 10 10 20 10
148 40 80 40 60 30 100 40
35 45 35 3 20 65 25
50 10 10 60
5 1 10 3 12
10 30
50 10 20 10 20 10 10
2 1 2
10 20 30 10 10 20 30
15 16 17 18 19 20 21 22 23 24
93 77 54 83 36 108 33 30
40 10 30 40 40 60 20
10 20
20 45
2 2 1 2
50 10 20 20
30 30 30 40 20 70 1
50 75 120 124 129 20 60 40

5 10 3
10 10
30 40 30 40 10 15 30 35
1 1 1 1 2 1 2
10 20
10 10
10
10 20 40 15 10 25 35 5
203 175 231 278 208 136 80 126
1 1 3 1 1
77 10 60 106 10 33
20
10 10 5 10
2 3 1 1
10 12 20 20
70 20 40 140 40 20 10 80
40 85 10 11 25 25 25
20 20 50 30 70 30 30
1 1 1
2 1 3 1 4 1 20
20 50 20 10
20 20 10
2 3 2 1 1
20 10 30 30
SISA STOK
25 26 27 28 29 30 31 TOTAL
0
0 -
0 -
0 -
0 800
0 -
0 -
103 71 28 1416 16,041
0 -
0 -
0 -
20 1,390
20 10 490 30,180
30 10 220 16,677
0 -
65 (65)
0 -
1 8 (8)
0 -
0 -
0 25,000
0 -
0 -
0 -
0 -
0 24,122
0 -
30 701 1,464
0 -
0 -
0 -
0 338
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
20 10 30 521 18,464
0 4,800
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 2,000
0 -
0 200
0 -
0 -
0 -
0 -
0 -
53 105 70 1530 8,365
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 1,000
0 822
40 (40)
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 30
0 415
0 -
0 -
0 -
2 158
0 -
0 -
0 330
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 15,000
0 -
0 -
0 24
0 -
0 -
0 -
82 2,918
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 384
90 40 625 3,867
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 20,000
0 1,640
0 -
0 -
0 96
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
2 4 31 72
0 -
0 -
0 25,000
0 -
0 -
0 -
0 -
0 -
0 -
10 248
0 -
10 10 160 2,660
0 -
0 -
0 -
0 200
0 -
0 -
0 -
0 300
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 20,000
0 5,000
40 3,250
0 1,940
0 300
0 100
24 4,976
0 -
0 -
0 -
0 10,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 15,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
15 10 330 5,670
0 -
0 -
0 -
0 -
153 213 241 3798 59,058
0 -
0 -
0 -
0 -
11 139
0 -
0 -
0 -
0 -
10 45 816 3,731
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
10 130 4,870
0 -
0 -
0 -
0 -
0 -
0 -
75 360
0 -
1 21 262
0 -
0 -
0 -
10 10 191 4,529
0 -
0 -
0 -
0 -
0 -
0 29,900
0 -
0 -
0 -
0 -
0 -
0 -
0 980
0 830
0 -
0 -
0 -
0 -
0 -
0 -
0 -
20 30 40 1209 13,791
0 -
0 -
0 -
0 -
0 -
10 30 20 539 63,247
100 510 10,807
0 -
0 -
0 -
0 950
2 2 11 68
0 -
0 -
0 -
0 -
0 -
0 12
4 70 372
0 -
0 -
0 -
0 -
0 2,000
0 -
20 190 28,801
0 -
10 30 10 280 32,546
1 5 4 26 329
0 -
10 50 350 906
0 1,000
0 10,000
0 10,000
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 2,200
0 -
0 -
0 -
0 2
0 -
0 -
0 -
0 30
0 -
0 -
0 30
0 30
0 -
0 -
0 100
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 100
0 -
0 -
0 -
0 -
0 -
0 1,450
0 8,000
0 -
0 -
0 -
0 -
0 -
0 -
0 50
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 72
0 -
0 -
0 150
0 -
0 140
0 2,700
0 4,800
0 3,400
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 40
0 -
0 -
0 35
0 20
0 -
0 3
0 -
0 1
0 -
0 37
0 -
0 -
0 5
0 25
0 100
0 -
0 -
0 500
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 100
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 100
0 -
0 10
0 -
0 10
0 -
0 -
0 -
0 -
0 -
0 10
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
NO NAMA SEDIAAN SATUAN
Stok Awal Non JKN Persediaan 1
A. OBAT
1 Air Raksa Dental Use Botol - - -
2 Albendazole Tablet 400 mg Tablet - - -
3 Albendazole susp 200 mg/5 ml Botol - - -
4 Alopurinol Tablet 100 mg Tablet - - -
5 Alopurinol Tablet 300 mg Tablet 1,360 - 1,360.00 10
6 Alprazolam tablet 1 mg Tablet - - -
7 Ambroksol Tablet 30 mg Tablet - - -
8 Ambroksol sirup 15 mg/5 ml Botol 50 - 50.00
9 Aminofillin Injeksi 24 mg/ml-10 ml Ampul 10 - 10.00
10 Aminofillin Tablet 200 mg Tablet 1,000 - 1,000.00
11
Amitriptillin Hcl Tablet Salut 25 mg Tablet -
- -
12 Amlodipin Tablet 5 mg Tablet 2,870 - 2,870.00
13 Amlodipin Tablet 10 mg Tablet - - -
14 Amoksisillin Kapsul 250 mg Kapsul - - -
15 Amoksisillin Kaplet 500 mg Kaplet 2,306 - 2,306.00 78
16 Amoksisillin Serbuk Injeksi 1000 mg vial - - -
17 Amoksisillin Sirup Kering 125 mg/5ml Botol - - -
Botol 58.00 1
250 mg/5 ml 58 -
19 Ampisilin Kapsul 250 mg Kapsul - - -
20 Ampisillin Kaplet 500 mg Tablet - - -
21 Ampisilin Sirup 125 mg / 5 ml Botol - - -
22 Ampisillin Injeksi 1000 mg Vial - - -
23 Analgetik Plus Tablet - - -
24
- - -
Alumunium Hidroksida 200 mg 5,820 - 5,820.00 112
26 Antasida Plus Tablet Tablet - - -
27 Antalgin (Metampiron) Tablet 500 mg Tablet - - -
28 Antalgin Injeksi 250 mg/ml-2ml Ampul - - -
29 Anti Bakteri DOEN Salep Kombinasi : Tube - - -
30 Anti Hemoroid Doen komb Supp 64 - 64.00
31 Anti Fungi DOEN Kombinasi : Pot 47 - 47.00
32 Antimigren DOEN Kombinasi : Tablet 390 - 390.00
33 Anti Diare Suspensi Botol - - -
34 Anti Diare Tablet Tablet - - -
35 Anti Dotum Oral Tablet Tablet - - -
36 Anti Hipertensi Kapsul Tablet - - -
37 Antihistamin Tablet kombinasi Tablet - - -
38 Antispasmodik Tablet Tablet - - -
39 Antitusiva Sirup Botol - - -
40 Antitusiva Tablet Tablet - - -
41 Asam Folat Tablet 1 mg Tablet 355 - 355.00 30
42
Asam Askorbat (Vit. C) Tablet 50 mg Tablet 668.00 10
668 -
43 Asam Mefenamat Kapsul 500 mg Kapsul - - -
44 Acetylsistein tablet Tablet 1,670 - 1,670.00 10
45 Asetosal Tablet 80 mg Tablet 70 - 70.00
46 Asetosal Tablet 100 mg Tablet - - -
47 Asetosal Tablet 500 mg Tablet - - -
48 Asiklovir Krim 5 % Tube - - -
49 Asiklovir Tablet 200 mg Tablet - - -
50 Asiklovir Tablet 400 mg Tablet - - -
51 Attapulgit Tablet 370 - 370.00 10
52 Atropin Sulfat Injeksi 0,25 mg/ml-1ml Ampul 30 - 30.00
53 Aqua Pro Injeksi Steril, bebas Pirogen 1
Vial 60.00
Liter 60 -
54 Bahan Tambal Sementara Set - - -
55 Benzatin Benzil Penisilin injeksi Vial - - -
56 Betahistin Mesilat 6 mg Tablet 420 - 420.00
57 Betametason Krim 0,1 %- 5g Tube 25 - 25.00
58 Bisakodil suppositoria 10 mg Supp - - -
59 Bisoprolol Tablet 2,5 mg Tablet 40 - 40.00
60 Bromheksin 8 mg Tablet - - -
61 Cresotin Pasta Botol - - -
62 Cresotin Liquid No 2 Botol - - -
63 Deksametason Injeksi 5mg/ml-1ml Ampul 18 - 18.00
64 Deksametason Tablet 0,5 mg Tablet 300 - 300.00
65 Devitalisasi Pasta (Non Arsen) Botol - - -
66 Diazepam tablet 2 mg Tablet - - -
67 Diazepam tablet 5 mg Tablet - - -
68 Diazepam Injeksi i.v/i.m 5 mg/ml Ampul - - -
69
Diazepam Larutan Rektal 5 mg/ml Supp 5.00
5 -
70 Diazepam Larutan Rektal 10 mg/ml Supp - - -
71
Dietilkarbamazin Sitrat Tablet 100 mg Tablet -
- -
72
Difenhidramin HCl Injeksi 10 mg/ml-1ml Ampul -
- -
73 Digoksin Tablet 0,25 mg Tablet - - -
74 Dimenhidrinat Tablet 50 mg Tablet 760 - 760.00
75 Domperidon Tablet 10 mg Tablet - - -
76 Donperidon Suspensi 5 mg/5ml Botol - - -
77 Efedrin Hcl Tablet 25 mg Tablet - - -
78 Ekstrak Belladone Tablet 10 mg Tablet 100 - 100.00
79 Epinefrin HCl / Bitartrat Ampul 5 - 5.00
80 Eritromisin Kapsul 250 mg Kapsul - - -
81 Eritromisin Kapsul 500 mg Kapsul - - -
82 Eritromisin Sirup 200 mg / 5 ml Botol - - -
83 Etambutol Tablet 500 mg Tablet - - -
84 Etanol 70 % 100 ml Botol - - -
85 Etil Klorida Semprot -100 ml Botol 1 - 1.00
86 Eugenol Cairan -10 ml Botol - - -
87 Fenitoin Natrium Kapsul 100 mg Kapsul - - -
88 Fenobarbital tablet 30 mg Tablet - - -
89 Fenobarbital injeksi 50 mg / ml Ampul 30 - 30.00
90
Fenoksimeti Penisilin 250 mg tablet Tablet -
- -
91 Fenoksimeti Penisilin 500 mg tablet Tablet - - -
92 Fenol Gliserol TK Botol - - -
93
Flufenazine decanoat injeksi 25 mg/ml Ampul -
- -
94 Flukonazole tablet 150 mg Tablet - - -
95 Fitomenadion tablet 10 mg Tablet 70 - 70.00
96 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 150 - 150.00
97 Furosemid Tablet 40 mg Tablet 100 - 100.00
98 Furosemid injeksi Ampul - - -
( Nacl 0,52 gr,
g )200 ml Air 2,145 - 2,145.00
100 Gemfibrozil Tablet 600 mg Tablet - - -
101 Gentian Violet Botol - - -
102 Gentamisin injeksi 80 mg / 2 ml Vial - - -
103 Gentamisin Salep Kulit 0,1 % Tube - - -
104 Glass Ionomer Set - - -
105 Glibenklamid Tablet 5 mg Tablet 1,100 - 1,100.00
106 Glimepiride 2 mg Tablet 2,010 - 2,010.00
107 Gliseril Guayakolat Tablet 100 mg Tablet - - -
108 Gliseril Guayakolat sirup Botol - - -
109 Glukonas Kalsikus injeksi Ampul 20 - 20.00
110 Glukosa Larutan Infus 5 % Botol 20 - 20.00
111 Glukosa Larutan Infus10 % Botol 20 - 20.00
112
Griseofulvin Tablet 125 mg,micronized Tablet -
- -
113 Haloperidol Tablet 0,5 mg Tablet - - -
114 Haloperidol Tablet 1,5 mg Tablet 15,295 - 15,295.00
115 Haloperidol Tablet 5 mg Tablet 2,045 - 2,045.00
116 Haloperidol injeksi 5 mg/ml Ampul - - -
117 Haloperidol injeksi 50 mg/ml Ampul - - -
118
Hidroklortiazid (HCT) Tablet 25 mg Tablet -
- -
119 Hidrokortison Krim 2,5 % Tube 24 - 24.00 1
120 Ibuprofen Tablet 200 mg Tablet - - -
121 Ibuprofen Tablet 400 mg Tablet - - -
122 Ibuprofen Suspensi 100 mg/5 ml Botol - - -
123 Ichtyol salep Kulit Pot - - -
124 Isoniazid tablet 100 mg Tablet - - -
125 Isoniazid tablet 300 mg Tablet - - -
126 Isosorbid Dinitrat 5 mg Tablet - - -
127 Kalium Diklofenak Tablet 25 mg Tablet - - -
128 Kalium Diklofenak Tablet 50 mg Tablet - - -
129 Kalsium Hidroksida Pasta Tube - - -
130 Kalsium Laktat Tablet 500 mg Tablet 2,690 - 2,690.00 30
131 Kaptopril 12,5 mg Tablet 2,770 - 2,770.00
132 Kaptopril 25 mg Tablet 1,290 - 1,290.00
133 Karbamazepin Tablet 200 mg Tablet - - -
134 Ketokonazole Krim 2 % - 15 gr Tube 18 - 18.00
135 Ketokonazole Tablet 200 mg Tablet 368 - 368.00 10
136 Ketoprofen Tablet 100 mg Tablet - - -
137 Ketoprofen Injeksi 100 mg / 1 ml Ampul - - -
138 Ketorolac 10 mg injeksi Ampul - - -
139 Ketorolac 30 mg injeksi Ampul - - -
140 Klindamisin Kapsul 150 mg Kapsul - - -
141 Klindamisin Kapsul 300 mg Kapsul 200 - 200.00
142 Kloramfenikol Kapsul 250 mg Kapsul - - -
143
Kloramfenikol suspensi125mg/5 ml Botol -
- -
144 Kloramfenikol Salep Mata 1%-3,5 g Tube - - -
145 Kloramfenikol Salep Kulit 2% Tube - - -
146 Kloramfenikol Tetes Mata -5 ml Botol 6 - 6.00
147 Kloramfenikol Tetes Telinga 3%-5 ml Botol 25 - 25.00 2
148 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 6,137 - 6,137.00 153
149
500 -
150
175 -
151
Klorpromazin Hcl Injeksi 5 mg/ml-2ml Ampul -
- -
Salbutamol Vial
Sulphate for inhalation 2,5 ml - - -
153 Kombipak Cefixime+ Azithromisin Kotak - - -
154 Kotrimoksazol Pedriatik Tablet, Kombinasi : Tablet - - -
155 Kotrimoksazol Tablet, Kombinasi : Tablet - - -
156 Kotrimoksazol Suspensi Kombinasi :
Sulfametoksazol 200 mg + Botol
Trimetroprim 40 mg/5 ml 95 - 95.00
157 Lansoprazole 30 mg Kapsul Tablet - - -
158 Larutan mengadung Elektrolit Botol - - -
Dekstrosa 18,75 gr) 80 - 80.00
Dekstrosa 18,75 gr) - - -
161 Larutan mengadung Karbohidrat + Elektrolit Botol - - -
162 Lidokain injeksi 2 % Tablet 45 - 45.00
163
Lidokain Komp Injeksi, Kombinasi : Ampul
- - -
164 Lidokain Spray Botol - - -
165 Loperamid Tablet 2 mg Tablet 480 - 480.00
166 Loratadin tablet 10 mg Tablet - - -
167 Magnesium Sulfat (IV) 20 %-25 ml Ampul 50 - 50.00
168 Magnesium Sulfat (IV) 40 %-25 ml Ampul 43 - 43.00
169 MB Anak Blister - - -
170 MB Dewasa Blister - - -
171 Meloksikam tablet 15 mg Tablet - - -
172 Meloksikam Suppositoria Supp - - -
173 Metformin Hcl Tablet 500 mg Tablet 1,160 - 1,160.00
174 Metformin 850 mg Tablet 1,250 - 1,250.00
175 Metildopa 250 mg tablet Tablet - - -
176 Methisoprinol 500 mg Tablet - - -
Tablet 110.00
Tablet 0,125 mg 110 -
178 Metilergometrin Maleat Injeksi 0,200 mg- Ampul 197 - 197.00
179 Metilprednisolon tablet 4 mg Tablet 1,835 - 1,835.00
180 Metoklopramid 10 mg Tablet - - -
181
Metoklorpropamid Injeksi 5 mg/ 5 ml Ampul -
- -
182 Metronidazol Tablet 250 mg Tablet - - -
183 Metronidazole Tablet 500 mg Tablet 1,540 - 1,540.00
184 Metronidazole sirup 125 mg/ml Botol 40 - 40.00
185
Metronidazole Infus 500 mg /100 ml Ampul 50.00
50 -
186 Metronidazole Infus 500mg/100ml Botol - -
187 Mikonazole KrIm 2 % - 10 gr Tube 12 - 12.00
188 Multivitamin + Mineral tablet Tablet - - -
189 Multivitamin sirup Botol - - -
190 Mummifying Pasta Botol - - -
191 Natrium Bikarbonat Tablet 500 mg Tablet - - -
192 Natrum Diklofenak Tablet 25 mg Tablet - - -
193 Natrium Diklofenak Tablet 50 mg Tablet 1,450 - 1,450.00 20
194 Natrium Klorida Larutan infus 0,9%-Steril
Botol 93.00
500 ml 93 -
195 Nipedifin Tablet 10 mg Tablet - - -
196 Nistatin suspensi 100.000 IU/ml Botol 62 - 62.00
197 Nistatin 100.000 IU/gram Tablet Vagina - - -
198 Nistatin 500.000 IU/gram Tablet Salut Tablet 100 - 100.00
199 Obat Antitiuberkolosis Kategori Anak Paket - - -
Paket -
Dewasa - -
Paket -
Dewasa - -
Paket -
Dewasa - -
203
Obat Anti Tuberkulosis FDC Kat Anak Paket -
- -
204 Obat Anti Tuberkulosis FDC Kat I & II Paket - - -
205 Obat Anti Tuberkulosis FDC Kat I & III Paket - - -
206 Obat Anti Tuberkulosis FDC Kat I & III Paket - - -
207 Obat Anti Tuberkolosis FDC Sisipan Dew Paket 5 - 5.00
208
Obat Batuk Hitam (OBH) Cairan 100 ml Botol -
- -
209 Obat Batuk Cair Sirup (Ekspektoran) Botol - - -
210 Obat Batuk Hitam Plus Sirup Botol - - -
211 Obat Flu Sirup Botol - - -
212 Oksiterasiklin Hcl injeksi i.m.50 mg/ml-10 Vial - - -
213
Oksiterasiklin Salep Mata 1%-3,5g Tube 26.00
26 -
214 Oksitetrasiklin Hcl Salep Kulit 3%-5g Tube - - -
215 Oksitosin Injeksi 10 IU/ml-1ml Ampul 250 - 250.00
216 Omeprazole injeksi 40mg/10ml Ampul 30 - 30.00
217 Omeprazole Kapsul 20 mg Kapsul 75 - 75.00
218 Ondansetron inj 4 mg/ 2 mL Ampul - - -
219 Parasetamol drop 100 mg/ml btl @15ml ( Botol - - -
220 Parasetamol drop 100 mg/ml btl @15ml
Botol -
(60mg/0,6ml) - -
221
Parasetamol Sirup 120 mg/5ml-60 ml Botol 175.00
175 -
222 Parasetamol Tablet 100 mg Tablet - - -
223 Parasetamol Tablet 500 mg Tablet 8,686 - 8,686.00 224
224 PB Anak Blister - - -
225 PB Dewasa Blister - - -
226 Pehacain injeksi Ampul - - -
227 Perak Sulfadiazin krim 1 % 35 gr Tube - - -
228 Permetrin krim 5 % Tube 17 - 17.00
229 Piracetam Tablet 400 mg Tablet - - -
230 Piracetam Tablet 800 mg Tablet - - -
231 Piroksikam Tablet 20 mg Tablet - - -
232
Pirantel Pamoat Tablet 365 mg (Setara d Tablet -
- -
233 Piridoksin Hcl (Vit.B6) Tablet 10 mg Tablet - - -
234 Piridoksin Hcl (Vit.B6) Tablet 25 mg Tablet - - -
235 Povidon Iodida 10% 30 ml Botol - - -
238 Prednison Tablet 5 mg Tablet 1,210 - 1,210.00 40
239 Primakuin tablet 15 mg Tablet - - -
240 Prokain Benzil Penisilin Injeksi 3,000,000 Vial - - -
241 Propanolol Hcl Tablet 40 mg Tablet - - -
242 Propanolol Hcl Tablet 10 mg Tablet - - -
243 Propilturasil Tablet 100 mg Tablet - - -
244 Ranitidin Injeksi 25 mg / ml Ampul - - -
245 Ranitidin Tablet 150 mg Tablet 540 - 540.00
246 Retinol (Vit. A) 100.000 IU Kapsul Kapsul 300 - 300.00
247 Retinol (Vit. A) 200.000 IU Kapsul Kapsul 1,000 - 1,000.00
248 Reserpin Tablet 0, 25 mg Tablet - - -
249 Rifampisin Tablet 450 mg Tablet - - -
250
Ringer Laktat Larutan Infus Steril 500 ml Botol 125.00
125 -
251 Salbutamol 2mg Tablet 100 - 100.00
252 Salbutamol Tablet 4 mg Tablet - - -
253 Salbutamol solution for Inhalation single
Ampul -
dose units 2,5 ml - -
Asam Salisilat 2 Pot
% + Belerang Endap 4 % - 30 gram 26 - 26.00
255 Salisil bedak 2% -50 gr Kotak - - -
256 Salep Luka Bakar Tube - - -
Botol 67.00
sirup 67 -
258 Sefadroksil Tablet 500 mg Tablet - - -
259 Sefiksim Kapsul 100 mg Kapsul - - -
260
Sefiksim 400 mg + Azitromisin 1000 mg Paket -
- -
261 Sefotaksim Injeksi 1 gr Ampul - - -
262 Seftriakson Injeksi 1 gr / vial Ampul - - -
263 Semen Seng Fosfat Serbuk & Cairan Botol - - -
264 Setirizin Tablet 10 mg Tablet 540 - 540.00 1
265 Setirizin Sirup 5 mg / 5 ml Botol 20 - 20.00
266 Sianokobalamin Injeksi 500 mcg/ml-1ml Ampul - - -
267 Sianokobalamin Tablet 50 mcg Tablet 200 - 200.00
268 Silver Amalgam Serbuk 65-75% Botol - - -
269 Simetidin 200 mg Tablet Tablet - - -
270 Simvastatin Tablet 10 mg Tablet 485 - 485.00
271 Simvastatin Tablet 20 mg Tablet - - -
272 Siprofloksasin 500mg Tablet 550 - 550.00 10
273 Spironolakton Tablet 25 mg Tablet 330 - 330.00
274 Sulfacetamid Tetes Mata 15 %-5ml Botol - - -
mg + Asam Folat 0,25 mg 36,250 - 36,250.00 180
276 Temporary Stopping Fletcher (Fletcher) S Set - - -
277 Trikesol formalin ( T K F ) Cairan 10 ml Botol - - -
278 Tetrasiklin Kapsul 250 mg Kapsul - - -
279 Tetrasiklin Kapsul 500 mg Kapsul - - -
280 Thiamin Hcl (Vit B1) Injeksi 100 mg/ml-1m Ampul - - -
281 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50
Tablet 119.00 105
mg 119 -
282 Thiamfenikol Kapsul 500 mg Kapsul - - -
283 Tramadol Injeksi 50 mg/ ml Ampul - - -
284 Tramadol Tablet 50 mg Tablet - - -
285 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 26,445 - 26,445.00 30
286 Vitamin B .Komplek Tablet Tablet - - -
287 Vitamin Neurotropik Tablet Tablet 430 - 430.00
288 Zinc Sulfat 20 mg/5 ml Botol 55 - 55.00
289 Zinc Sulfat 20 mg Tablet 755 - 755.00 10
290 Hepatorotector tablet (Curcuma) Tablet - - -
291 Obat Batuk Herbal Botol 45 - 45.00
292 Obat Kumur Botol - - -
293 Salep Kloramfenikol + Hidrokortison Tube - - -
294 Tablet Pemanis Botol - - -
295 Bahan Pembersih Kavitas Botol - - -
296 Flour Gel Botol - - -
297 Glass Lonomer Posterior set - - -
298 Hyposol 3% Botol - - -
299 Paramonochlorofenol/CHKM Botol - - -
300 Saliva Ejector Pcs - - -
301 Salep Betametason + Neomisin Tube - - -
302 Bahan Pemutih Gigi Pot - - -
303 Metronidazol Inj Ampul - - -
304 Box Slide Pcs - - -
305 Klozapine 100 mg Tablet - - -
306 Klozapine 25mg Tablet - - - 30
307 Mineral Mix Sachet 140 - 140.00
308 Risperidon 2mg Tablet 2,229 - 2,229.00
309 Budensoid Cairan Inhalasi (Pulmicort) Respules - - -
310 Box Object Glass isi 50 Grey Orange Pcs - - -
311 Vitamin C 500mg Tablet 3,200 - 3,200.00
312 Multivitamin Tablet 2,700 - 2,700.00
313 Poli Aid 1 Liter Botol 10 - 10.00
314 Trifluoperazine Hcl Tablet 5 mg Tablet - - -
315 Divalproex Sodium 250mg Tablet 70 - 70.00
316 Calcetin Calcium Hydroxide Paste Botol - - -
317 Pilp-X Pot - - -
318 Karbogliserin Tetes Telinga Botol - - -
319 Larvasida Paket 5 - 5.00
320 Kalsitrol Kapsul Lunak 0,5 mcg Kapsul 1,430 - 1,430.00
Vitamin D 1000IU Tablet 3,170 - 3,170.00 60
1 - 1.00
1 B. BAHAN MEDIS HABIS PAKAI (BMHP) - - -
2 Abbocath No 18 ( IV Chateter 18 ) Buah 50 - 50.00
5 Abbocath No 24 ( IV Chateter 24 ) Buah - - -
6 Alat Gula, Kolesterol, Asam Urat Unit - - -
7 Alat Suntik Sekali Pakai 1 ml Set - - -
9 Alat Suntik Sekali Pakai 5 ml Set 400 - 400.00
11
Kotak 8,100.00
Alkohol Swab 8,100 -
12
Set
Auto Disposable Syringe (ADS) 0,05 ml 300 - 300.00
13
Set 1,900.00
Auto Disposable Syringe (ADS) 0,5 ml 1,900 -
14 Auto Disposable Syringe (ADS) 5 ml Set 1,000 - 1,000.00
15 Blood Set Set - - -
16
Sachet
Catgut/Benang Bedah No.3/0 Cromic 10 - 10.00
Botol
ml - - -
18 Etanol 70 % 1.000 ml Botol - - -
19 Eter Alkohol Botol - - -
20 Folley Catheter no 14 Set - - -
23 Infus set Anak Set - - -
24 Infus set Dewasa Set 45 - 45.00
25 Iodina Test Botol 70 - 70.00
26 Kaca Slide Pcs - - -
27 Kapas Berlemak 500 gram Bungkus - - -
28 Kapas Pembalut / Adsorbens 250 gram
Bungkus -
- -
29 Kassa Pembalut 2 m x 80 cm Rol 36 - 36.00
30 Kassa Pembalut Hidrofil 4 m x 3 cm Rol - - -
31 Kassa Pembalut Hidrofil 4 m x 15 cm Rol - - -
32 Kassa Hidrofil Steril 16 x 16 Kotak - - -
33 Kassa Kompres 40 x 40 steril Bungkus - - -
34 Kertas Puyer Bungkus - - -
35 Kertas Saring Lembar - - -
36 Kertas Lensa Lembar - - -
37 Lysol 1,000 ml Botol - - -
38 Masker Buah - - -
39 Masker Kain Headloop KEMKES Pcs - - -
40 Masker Kain Earloop KEMKES Pcs - - -
41 Masker N 96 Pcs 50 - 50.00
42 Masker KN95 Pcs - - -
43 Minyak Imersi Botol - - -
44 Plester Kertas Rol - - -
45 Polifix 5 cm x 5 m Rol 3 - 3.00
46 Pot Dahak Pcs 200 - 200.00
47 Rapid 2 HIV Fokus Test - - -
48 Rapid HIV 1+2KHB Test - - -
49 Rapid Test HIV 1/2 Vikia DS Test 200 - 200.00
50 Rapid HIV 1 (SD HIV) Test - - -
51 Rapid HIV 2 (Intec HIV) Test - - -
52 Rapid HIV 2 (Biomeriux HIV) Test - - -
53 Rapid Tes SD Bioline HBSAG Test - - -
54 Hepatitis B Imunoglobulin inj 220 IU
Vial -
(Hbig) - -
55 Rapid Test Syphilis Test 200 - 200.00
56 Reagen CD 4 Control Test - - -
57
Test -
Reagen CD 4 - -
58 Reagen Ziehl Nielsen Botol - - -
59 RPR Test Syphilis Test - - -
60 Silk( Benang Bedah Sutra ) No 3/0 Sachet - - -
61 Safety Box Pcs 180 - 180.00
62 Sarung tangan Steril No 6 Pcs - - -
63 Sarung tangan Steril No 7 Pcs - - -
64 Sarung tangan Steril No 7,5 Pcs - - -
65 Sarung tangan Non Steril S Pcs 600 - 600.00
66 Sarung tangan Non Steril M Pcs - - -
67 Sarung tangan Non Steril L Pcs - - -
68 Sountimer Buah - - -
69 Stik Pemeriksaan Gula Darah Test 14,000 - 14,000.00
70 Stik Pemeriksaan Kolesterol Test - - -
71 Stik Pemeriksaan Asam Urat Test - - -
72 Supratul Lembar - - -
73 Urine Bag set - - -
74 Wing Neddle No 23 Set - - -
75 Blood Lancet Pcs 16,800 - 16,800.00
76 Cairan Antiseptik Botol 500 ml Botol - - -
77
Test -
Rapin HIV Oncoprobe - -
78 Steryzime Dual Enzymatis 5 Lt Galon - - -
79 Sterald 30 High Level Surface Desinfektan Galon - - -
80 Gentamisin Sulfat Tetes Mata 0,3% Botol - - -
81 Bioplacenton Tulle 10 x 10 Lembar - - -
82 Vikia Biumeric Test - - -
83 Sterald Galon - - -
84
syringe -
Hepatitis B Imunolobin - -
85 Slide - - -
86 IV Catheter 20 Pcs - - -
87 Stericide 3 Surface Desinfektan 5Lt Galon - - -
88 Serum Tetagam P Injeksi PFS - - -
89 Biosave Serum ABU Injeksi Vial - - -
90 Baju APD (COVER ALL) Pcs - - -
91 Sepatu Boot Saffety Pcs - - -
92 Kacatamata Google Pcs - - -
93 Sarung Tangan Karet Latex Pcs - - -
94 Rapid Test Kit Covid-19 Test 226 - 226.00
95 VTM & Swab Dacron Citodia Pcs - - -
96 VTM + Swab (KH Medial) Test - - -
97 Panbio Covid-19 Antigen Test 226 - 226.00
98 ADS 0,5 ml Alokasi Pcs - - -
99 Alkohol Swab Alokasi Pcs 16,380 - 16,380.00
100 Safety Box Alokasi Pcs - - -
101 Parafilm Pcs - - -
102 Vaccum Tube Sterile EDTA K-3 (3ml Pcs - - -
103 Vaccum Tube Sterile Clot Activator(3ml Pcs - - -
Umbilical Cord Klem Steril Nylon
Pcs -
- -
1 C. SERUM DAN VAKSIN - - -
2 Serum Anti Bisa Ular Polivalen Injeksi 5 m Vial - - -
3 Serum Anti Rabies untuk manusia Vial - - -
4 Serum Anti Tetanus (ATS) Injeksi 1.500 Ampul - - -
5 Serum Anti Tetanus (ATS) Injeksi 20.000
Vial -
IU/ampul - -
6
Vial
Human Tetanus Imunoglobin inj 250 IU - - -
7 Vaksin BCG Ampul 8 - 8.00
8 Vaksin Campak 10 Dosis Vial - - -
9 Vaksin DT Vial - - -
10 Vaksin TD Vial 59 - 59.00
11 Vaksin DTP-HB Vial - - -
12 Vaksin DPT-HB/Hib Vial - - -
13 Vaksin HB Uniject Pcs 2 - 2.00
14 Vaksin MR (VVM.A) Vial - - -
15 Vaksin Polio Vial 23 - 23.00
16 Vaksin Polio IPV 5 Dosis Vial 6 - 6.00
17 Vaksin Polio 10 IPV Dosis Vial - - -
18 Vaksin TT Vial - - -
19 Vaksin Campak Bias Vial - - -
20 Vaksin Covid-19 (10 d0sis) Vial - - -
2 3 4 5 6 7 8 9 10
5 10 20
100 23 76 28 116 30 66
4 2 1 2 3
85 30 30 58 86 114 65 90
2 5 6
1 1 2 3
10 5 4 2
10 10 10 10
10
10 10 10
3 3 1
10 10
20 10 20 40 10 10 10
20 10 10
1 1 4 1 1
40 40 20 40 70 30
20 10
1 1
1 2 1 1 1 4
61 145 56 106 112 70 90 160
20
10
30 10 30 30 40 10 10
10 10 20 10 10 10
1
10 10 30 10 30
1 1
10 10
10
1 1
97
10 45 10 20 10 20 93
1 1
20 20
10
20 10
150 50 100 150 200
14
10 30 25 15 20
3
10 15 15 5 15
5 10 8
40
30 50 20 20 30 10 10
20 20 20 80
11 12 13 14 15 16 17 18 19
10
10 116 110 63 75 112
1 2 2 2 4
45 125 75 65 70 170
6 6 2
2
20
10 10 10 10
20 20 20
1 2
10
10
5
5 10
6 7
20
10 30 20 10
20 20
1 1 2 1
100 90 50 50
10
1 1
57 127 97 107 70 94
10
40 30 10 10
70 30 20
1 1 1
30 10 20 30 10
3 1 1
10 20 10 40 12
10
4 1
10 20 3 35
200
10 10
10
150 60 90
20 15
1
5 10 10 10 10
10 15 5
10 30 10
160 20 40
20 21 22 23 24 25 26 27 28
102 125 40 100 20 88 100
4 4 1 1 1 1 2 2
110 50 40 100 60 40 69 85
4
1 1
30
5 16 15 10 3
15 10 10
10 10
10
1 1 1
10
5
10 5
20 20 30 50 40
20 30
1 3 1 4 1
110 100 80 20 40 130 10
1 1 1 1 1
162 92 92 45 60 199 87 79
30 10 20 10 50 20
30 20 20 20 10 30 20 30
2
2 1 1 1
80 30 20 20
1 1 1
2 1 1
60 25 20 23 20 20
1
10
10 10
280 60 30 60 210
20 10 20 10
3
10
15 20 5 20 5
20 40 20 50 20
30 10
100 20 100 20 20 140

JUMLAH
29 30 PEMAKAIAN SISA STOK
0 -
0 -
0 -
0 -
55 1,305.00
0 -
0 -
0 50.00
0 10.00
0 1,000.00
0 -
0 2,870.00
0 -
0 -
1578 728.00
0 -
1 - 1.00
40 18.00
0 -
0 -
0 -
0 -
0 -
0 -
1774 4,046.00
0 -
0 -
0 -
0 -
31 33.00
11 36.00
0 390.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
80 275.00
80 588.00
0 -
125 1,545.00
10 60.00
0 -
0 -
0 -
0 -
0 -
120 250.00
0 30.00
0 60.00
0 -
0 -
10 410.00
13 12.00
0 -
20 20.00
0 -
0 -
0 -
0 18.00
0 300.00
0 -
0 -
0 -
0 -
0 5.00
0 -
0 -
0 -
0 -
15 745.00
0 -
0 -
0 -
0 100.00
0 5.00
0 -
0 -
0 -
0 -
0 -
0 1.00
0 -
0 -
0 -
0 30.00
0 -
0 -
0 -
0 -
0 -
25 45.00
0 150.00
30 70.00
0 -
20 2,125.00
0 -
0 -
0 -
0 -
0 -
140 960.00
270 1,740.00
0 -
0 -
0 20.00
0 20.00
0 20.00
0 -
0 -
90 15,205.00
0 2,045.00
0 -
0 -
0 -
24 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
1050 1,640.00
0 2,770.00
40 1,250.00
0 -
2 16.00
10 358.00
0 -
0 -
0 -
0 -
0 -
0 200.00
0 -
0 -
0 -
0 -
0 6.00
19 6.00
2321 3,816.00
20 480.00
10 165.00
0 -
0 -
0 -
0 -
0 -
0 95.00
0 -
0 -
0 80.00
0 -
0 -
10 35.00
0 -
0 -
0 480.00
0 -
0 50.00
0 43.00
0 -
0 -
0 -
0 -
390 770.00
0 1,250.00
0 -
0 -
0 110.00
0 197.00
0 1,835.00
0 -
0 -
0 -
370 1,170.00
3 37.00
0 50.00
0 -
8 4.00
0 -
0 -
0 -
0 -
0 -
360 1,090.00
1 92.00
0 -
5 57.00
20 - 20.00
10 90.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 5.00
0 -
0 -
0 -
0 -
0 -
11 15.00
0 -
0 250.00
0 30.00
0 75.00
0 -
0 -
0 -
0 175.00
0 -
321 8,365.00
0 -
0 -
0 -
0 -
0 17.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
508 702.00
0 -
0 -
0 -
0 -
0 -
0 -
0 540.00
0 300.00
0 1,000.00
0 -
0 -
0 125.00
10 90.00
0 -
0 -
1 25.00
0 -
0 -
8 59.00
0 -
0 -
0 -
0 -
0 -
0 -
119 421.00
0 20.00
0 -
200 -
0 -
0 -
30 455.00
0 -
70 480.00
0 330.00
0 -
1770 34,480.00
0 -
0 -
0 -
0 -
0 -
119 -
0 -
0 -
0 -
225 26,220.00
0 -
0 430.00
7 48.00
125 630.00
0 -
0 45.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
118 - 118.00
70 - 70.00
0 140.00
370 1,859.00
0 -
0 -
0 3,200.00
0 2,700.00
0 10.00
0 -
40 30.00
0 -
0 -
0 -
0 5.00
0 1,430.00
820 2,350.00
0 1.00
0 -
0 50.00
0 60.00
0 50.00
0 -
0 -
0 -
0 -
0 400.00
0 -
0 8,100.00
0 300.00
0 1,900.00
0 1,000.00
0 -
0 10.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 45.00
0 70.00
0 -
0 -
0 -
0 36.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 50.00
0 -
0 -
0 -
0 3.00
0 200.00
0 -
0 -
0 200.00
0 -
0 -
0 -
0 -
0 -
0 200.00
0 -
0 -
0 -
0 -
0 -
0 180.00
0 -
0 -
0 -
0 600.00
0 -
0 -
0 -
0 14,000.00
0 -
0 -
0 -
0 -
0 -
0 16,800.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 226.00
0 -
0 -
0 226.00
0 -
0 16,380.00
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 -
0 8.00
0 -
0 -
0 59.00
0 -
0 -
0 2.00
0 -
0 23.00
0 6.00
0 -
0 -
0 -
PEMAKAIAN BULAN MARET OBAT DAK
NO NAMA SEDIAAN SATUAN Stok Awal Non JKN Persediaan 1
5 Alopurinol Tablet 300 mg Tablet 525 - 525.00 10
8 Ambroksol sirup 15 mg/5 ml Botol - - -
15 Amoksisillin Kaplet 500 mg Kaplet 3,781 - 3,781.00 80
17 Amoksisillin Sirup Kering 125 mg/5ml Botol 216 - 216.00 2
Botol 107.00 1
250 mg/5 ml 107 -
Alumunium Hidroksida 200 mg 18,346 - 18,346.00 70
30 Anti Hemoroid Doen komb Supp 33 - 33.00 2
31 Anti Fungi DOEN Kombinasi : Pot 52 - 52.00
41 Asam Folat Tablet 1 mg Tablet 175 - 175.00
42
Asam Askorbat (Vit. C) Tablet 50 mg Tablet 588.00
588 -
44 Acetylsistein tablet Tablet 1,545 - 1,545.00 10
45 Asetosal Tablet 80 mg Tablet 60 - 60.00
51 Attapulgit Tablet 1,060 - 1,060.00 10
56 Betahistin Mesilat 6 mg Tablet 240 - 240.00
57 Betametason Krim 0,1 %- 5g Tube 9 - 9.00
59 Bisoprolol Tablet 2,5 mg Tablet 20 - 20.00
64 Deksametason Tablet 0,5 mg Tablet 700 - 700.00 105
73 Digoksin Tablet 0,25 mg Tablet - - -
74 Dimenhidrinat Tablet 50 mg Tablet 745 - 745.00
87 Fenitoin Natrium Kapsul 100 mg Kapsul 300 - 300.00
96 Fitomenadion (Vit K1) Injeksi 2 mg/ml-1ml Ampul 150 - 150.00
97 Furosemid Tablet 40 mg Tablet 70 - 70.00 10
( Nacl 0,52 gr,
g )200 ml Air 2,145 - 2,145.00
105 Glibenklamid Tablet 5 mg Tablet 960 - 960.00
106 Glimepiride 2 mg Tablet 1,440 - 1,440.00
114 Haloperidol Tablet 1,5 mg Tablet 15,205 - 15,205.00
121 Ibuprofen Tablet 400 mg Tablet 2,900 - 2,900.00 10
130 Kalsium Laktat Tablet 500 mg Tablet 4,490 - 4,490.00 40
131 Kaptopril 12,5 mg Tablet 2,770 - 2,770.00
134 Ketokonazole Krim 2 % - 15 gr Tube 40 - 40.00
135 Ketokonazole Tablet 200 mg Tablet 288 - 288.00
141 Klindamisin Kapsul 300 mg Kapsul 200 - 200.00 10
145 Kloramfenikol Salep Kulit 2% Tube 44 - 44.00 2
147 Kloramfenikol Tetes Telinga 3%-5 ml Botol 6 - 6.00
148 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 5,616 - 5,616.00 157
150
165 -
173 Metformin Hcl Tablet 500 mg Tablet 1,160 - 1,160.00 15
174 Metformin 850 mg Tablet 1,250 - 1,250.00
Tablet 110.00
Tablet 0,125 mg 110 -
179 Metilprednisolon tablet 4 mg Tablet 1,835 - 1,835.00
183 Metronidazole Tablet 500 mg Tablet 1,540 - 1,540.00 6
184 Metronidazole sirup 125 mg/ml Botol 40 - 40.00
186 Mikonazole KrIm 2 % - 10 gr Tube 36 - 36.00
192 Natrium Diklofenak Tablet 50 mg Tablet 740 - 740.00 10
193 Natrium Klorida Larutan infus 0,9%-Steril Botol 67 - 67.00
195 Nistatin suspensi 100.000 IU/ml Botol 55 - 55.00
197 Nistatin 500.000 IU/gram Tablet Salut Tablet 70 - 70.00
212 Oksiterasiklin Salep Mata 1%-3,5g Tube 65 - 65.00
216 Omeprazole Kapsul 20 mg Kapsul 1,075 - 1,075.00 40
220
Parasetamol Sirup 120 mg/5ml-60 ml Botol 175.00 2
175 -
227 Permetrin krim 5 % Tube 17 - 17.00 1
230 Piroksikam Tablet 20 mg Tablet 1,000 - 1,000.00 1000
237 Prednison Tablet 5 mg Tablet 402 - 402.00 15
244 Ranitidin Tablet 150 mg Tablet 540 - 540.00
249
Ringer Laktat Larutan Infus Steril 500 ml Botol 90.00 3
90 -
250 Salbutamol 2mg Tablet 290 - 290.00 30
254 Salisil bedak 2% -50 gr Kotak - - -
Botol 53.00
sirup 53 -
263 Setirizin Tablet 10 mg Tablet 421 - 421.00
264 Setirizin Sirup 5 mg / 5 ml Botol 20 - 20.00
266 Sianokobalamin Tablet 50 mcg Tablet - - -
269 Simvastatin Tablet 10 mg Tablet 435 - 435.00
271 Siprofloksasin 500mg Tablet 280 - 280.00
272 Spironolakton Tablet 25 mg Tablet 330 - 330.00
mg + Asam Folat 0,25 mg 144,650 - 144,650.00 30
280 Tiamin Hcl /Mononitrat (Vit.B1) Tablet 50 Tablet - - -
284 Triheksifenidil Hidroklorida Tablet 2 mg Tablet 26,220 - 26,220.00
287 Zinc Sulfat 20 mg/5 ml Botol 235 - 235.00 1
288 Zinc Sulfat 20 mg Tablet 2,477 - 2,477.00 10
305 Klozapine 100 mg Tablet 382 - 382.00
306 Klozapine 25mg Tablet 930 - 930.00
308 Risperidon 2mg Tablet 1,859 - 1,859.00 20
311 Vitamin C 500mg Tablet 2,200 - 2,200.00
320 Kalsitrol Kapsul Lunak 0,5 mcg Kapsul 1,430 - 1,430.00
321 Vitamin D 1000IU Tablet 2,350 - 2,350.00 60
2 Abbocath No 20 ( IV Chateter 20 ) Buah 60 - 60.00 2
24 Infus set Dewasa Set 45 - 45.00
32 Kassa Hidrofil Steril 16 x 16 Kotak 20 - 20.00
2 3 4 5 6 7 8 9 10 11
15 10 20
45 69 60 60 100 84 60 85 35
1 1 4 1 1 2 3
2 1 2 3 1
100 80 60 110 90 80 94 90 80
6
1
2
10
20 20 30 10 10
30
1 1 2 2 3 2
30
55 45 67 61 50 65 38 70 90
10
10 10 10 10
10 30
7 6 7
960
10 10 20 10
20 30 20
10 50 150 40 110 50 30
10 70 130 3 150 100
1 1
30
1 3 1 2 2 2 2
6
175 110 114 186 208 65 86 70 86
10 30 35 10 20 30
10 20
30 20 20 10 20 20 30
1 2 1 1
20 10 10 20
1 1 1
10
1
10 20 10 5 20 5 40 10
2 4 1 2 1 2
10 40 70 60 20
10 10 10 10 20
14 14 11 10 43
10 10 20
10 10 20
10
190 100 90 100 170
20 40 20 30 10
1 1 2
10
15 40 30 30 10
30 90 20 10 10
20 100 60
3
12 13 14 15 16 17 18 19 20 21
10 10 5
145 64 85 75 82 20 120 95
3 3 3
2 3 2 2 1 3 2
183 49 70 81 70 70 115 115
20
10
10 20 10 20
10
10 20 10
1 1 2 2 2
143 54 40 110 110 68 105 75
20 10
20 10
10 10
10
5 6 6
10 30 30
10
30 10 20 20 30 10
90 100 160 50 100 10 50 30
10 10
4
30
1 2 1 1 1 1
1 1
66 77 95 35 100 98 130 46
20
10 10 10 10 10
20
20 10 10 20
30 20 10 20 20 30
1
1 2 1
30 20 20 10 10 10 30
1 3
1 1 2 1
1 1 1
10 10 15 30
1 5 4 1 2 1 9 2
10 177
20
10 10 10
1 1
10 10 23 20 10
20 30 40 30
20 10 365
10 10 10 10
240 10 310 490 220

20
70
1 1 1 1 3 1
20
20 40
20 20 20 90
10 34
30 30 30 60
60 60 60
2
1
22 23 24 25 26 27 28 29 30 31
10 10
7
44 20 135 110 80 24 40
1 1 1 4 2 1 4
2 1
100 30 80 126 70 40 140
10
20 20 55
2 1 4 1 3 1
30 40 77 126 113 70 70
10 10 16
6 6
30 30 30 40 40 30
30 30 20
20 10 60 20 10
180 10 90 60 140 30
10
1
10 10
1 1 5 1
2 1 2
100 75 177 168 161 111 90
30 20 40 20
10
458
50 10 30 10 10 20
1
1 1
10 60 10
5
1
30 5 10 15 25 10 10
3 2 1 1 2 1 11
10
1 1
1
10 10 20 34 10
1 3
40 10 10 30 30 20 30
10 10 10
220 140 70 220 90

50 20 140 120 60 60 20
30 30 20 30
1 2 1
10
10 20 40
30 30 30
20 30 20 50
20 11 11 1 20
30 60 210 30 90
20
JUMLAH
PEMAKAIAN SISA STOK
100 425.00
7 - 7.00
1817 1,964.00
38 178.00
28 79.00
2193 16,153.00
8 25.00
1 51.00
30 145.00
12 576.00
175 1,370.00
10 50.00
146 914.00
30 210.00
31 - 22.00
30 - 10.00
1877 - 1,177.00
36 - 36.00
40 705.00
30 270.00
60 90.00
65 5.00
49 2,096.00
960 -
320 1,120.00
160 15,045.00
690 2,210.00
1603 2,887.00
30 2,740.00
7 33.00
80 208.00
10 190.00
30 14.00
13 - 7.00
2786 2,830.00
20 145.00
310 850.00
20 1,230.00
10 100.00
548 1,287.00
416 1,124.00
2 38.00
11 25.00
280 460.00
4 63.00
8 47.00
15 55.00
5 60.00
330 745.00
60 115.00
1 16.00
1000 -
402 -
80 460.00
3 87.00
70 220.00
4 - 4.00
1 52.00
249 172.00
4 16.00
290 - 290.00
435 -
110 170.00
10 320.00
2690 141,960.00
490 - 490.00
300 25,920.00
17 218.00
30 2,447.00
215 167.00
150 780.00
450 1,409.00
107 2,093.00
570 860.00
440 1,910.00
2 58.00
2 43.00
4 16.00
PEMAKAIAN BULAN OKTOBER OBAT JKN
Tgl Pemakaian Bulan Oktober 2022
SISA STOK
NO NAMA SEDIAAN SATUAN Stok Awal TOTAL
7 Ambroksol Tablet 30 mg Tablet 15,057 1500 13,557
12 Amlodipin Tablet 5 mg Tablet 29,890 455 29,435
13 Amlodipin Tablet 10 mg Tablet 15,147 330 14,817
Tablet
mg 701 701 -
43
17,885 1020 16,865
48 Asiklovir Krim 5 % Tube - 10 (10)
76 Domperidon Tablet 10 mg Tablet 702 40 662
93 Fenol Gliserol TK Botol 151 7 144
Tablet
mg,micronized 2,718 123 2,595
122 Hidrokortison Krim 2,5 % Tube 359 15 344
123 Ibuprofen Tablet 200 mg Tablet 2,267 600 1,667
158 Kotrimoksazol Tablet, Kombinasi :
Sulfametoksazol 400
mg + Trimetroprim 80 mg Tablet
198 51 147
160 Lansoprazole 30 mg Kapsul Tablet 2,460 145 2,315
164 Lidokain injeksi 2 % Ampul 200 10 190
179 Metildopa 250 mg tablet Tablet 3,250 70 3,180
224 Parasetamol Tablet 500 mg Tablet 55,058 4351 50,707
229 Permetrin krim 5 % Tube 135 15 120
234
3,431 919 2,512
244 Ranitidin Tablet 150 mg Tablet 4,870 30 4,840
251 Salbutamol Tablet 4 mg Tablet 360 30 330
Asam Salisilat Pot
2 % + Belerang Endap 4 % - 30 gram 254 20 234
257 Sefadroksil Tablet 500 mg Tablet 4,230 204 4,026
Tablet
Tablet 50 mg 13,491 860 12,631
285 Vitamin B .Komplek Tablet Tablet 61,196 301 60,895
286 Vitamin Neurotropik Tablet Tablet 9,760 480 9,280
290 Asam Folat Tablet 0,4 mg Tablet 950 90 860
291
Botol
Gentamisin Sulfat tetes mata 0,3% 67 21 46
298 Obat Batuk Herbal (Herbakof) Botol 372 43 329
303 Bisoprolol 2,5mg Tablet 2,000 10 1,990
305 RAMVIT-C C 500mg Tablet 28,701 162 28,539
307
Multivitamin Tablet Kombinasi Tablet
VitC,Vit D, Zinc, Folic Acid 30,046 495 29,551
308 Multivitamin Syrup Tablet 291 50 241
309 Risperidon 2 mg Tablet - 20 (20)
310 Alpara Tablet Tablet 266 266 -
312 Novagrip Flu Batuk Tablet Tablet 10,000 290 9,710

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total jkn total dak

100 70 70 60 50 70 145 80 130

80 35 120 100 30 120 90

192 124 283 224 87 283 161

209 133 230 99 153 139 311 156

50 75 120 124 129 20 60 40

203 175 231 278 208 136 80 126

150 50 100 150 200

10 116 110 63 75 112

102 125 40 100 20 88 100

100 20 100 20 20 140

190 100 90 100 170

183 49 70 81 70 70 115 115

143 54 40 110 110 68 105 75

240 10 310 490 220

100 30 80 126 70 40 140

220 140 70 220 90

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