LAPORAN PERSEDIAAN OBAT PUSKESMAS SAWANG

Puskesmas : Sawang
Bulan : April
Tahun : 2022

NO NAMA OBAT -OBATAN SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK STOK APT HARGA SATUAN JMLH HARGA KET/ED
1 2 3 4 5 6(4+5) 7 8 (6-7) 9=8 10 11(9x10)
1 Abbocath NO. 18 PCS 0 0 0 0 0 0 7,000 -
2 Abbocath NO. 20 PCS 0 0 0 0 0 0 7,000 -
3 Abbocath NO. 22 PCS 0 0 0 0 0 0 7,000 -
4 Abbocath NO. 24 PCS 0 0 0 0 0 0 8,566 -
5 ACT (Artesunate tab 50 Mg + Amodiquain anhidrida tab 200 mg) TAB 0 0 0 0 0 0 2,646 -
6 Acyclovir cream TUBE 28 0 28 0 28 28 10,000 280,000
7 Acyclovir tablet 200 Mg TAB 400 0 400 0 400 400 800 320,000
8 Acyclovir tablet 400 Mg TAB 750 0 750 0 750 750 726 544,500
9 Alat Suntik sekali Pakai 1 ml PCS 84 0 84 9 75 75 1,202 90,150
10 Alat Suntik sekali Pakai 2,5- 3 ml PCS 42 0 42 4 38 38 935 35,530
11 Alat Suntik sekali Pakai 5 ml PCS 40 0 40 7 33 33 900 29,700
12 Allopurinol tablet 100 mg TAB 800 0 800 400 400 400 105 42,000
13 Ambroksol syrup 15 mg/ 5ml BTL 0 0 0 0 0 0 4,950 -
14 Ambroksol tablet 30 mg TAB 0 1000 1000 600 400 400 154 61,600
15 Aminophilin 100 mg tablet TAB 0 0 0 0 0 0 115 -
16 Amlodipin 10 mg TAB 100 1000 1100 900 200 200 163 32,600
17 Amlodipin 5 mg TAB 300 500 800 600 200 200 800 160,000
18 Amoksisilin kaplet 500 mg TAB 0 1000 1000 600 400 400 266 106,400
19 Amoksisilin kapsul 250 mg TAB 0 0 0 0 0 0 209 -
20 Amoksisilin Syrup kering 5 ml/Amox 250mg BTL 0 0 0 0 0 0 3,604 -
21 Amoksisilin Syrup kering 5 ml/Amox 125mg BTL 0 0 0 0 0 0 3,604 -
22 Amoksisilin Injeksi VIAL 0 0 0 0 0 0 -
23 Antalgin tablet 500 mg TAB 0 0 0 0 0 0 275 -
24 Antalgin Injeksi VIAL 0 0 0 0 0 0 1,466 -
25 Antasida Doen tablet kombinasI TAB 0 300 300 300 0 0 60 -
26 Antasida Suspensi BTL 50 0 50 40 10 10 2,239 22,390
NO NAMA OBAT -OBATAN SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK STOK APT HARGA SATUAN JMLH HARGA
1 2 3 4 5 6(4+5) 7 8 (6-7) 9=8 10
27 Aqua pro injeksi steril,bebas ,pirogen VIAL 0 0 0 0 0 0 6,050 0
28 Asam Askroba tablet 50 mg TAB 800 1000 1800 900 900 900 891 801900
29 Asam Mefenamat Kaplet 500 mg TAB 600 0 600 200 400 400 250 100000
30 Atropin injeksi i.m/i.v/s.k/ 0,25 mg/ml (sulfat) AMPUL 0 0 0 0 0 0 1,672 0
31 Asam Folat TAB 0 1000 1000 100 900 900 86 77400
32 ATS ( Anti Tetanus Serum) VIAL 0 0 0 0 0 0 0
33 Albendazole TAB 0 0 0 0 0 0 456 0
34 Besi II Sulfat tablet 200mg+as.Folat 0,25mg TTD TAB 0 900 900 900 0 0 400 0
35 Betahistin Mesileat Tablet 6 mg TAB 0 0 0 0 0 0 10,818 0
36 Betametason krim 0,1mg TUBE 0 0 0 0 0 0 1,420 0
37 Bromhexin TAB 500 500 1000 500 500 500 165 82500
38 Captopril tablet 12,5mg TAB 1800 0 1800 500 1300 1300 73 94900
39 Captopril tablet 25 mg TAB 200 500 700 200 500 500 138 69000
40 Catgut/benang bedah N0. 2/0-3/0 PCS 19 0 19 0 19 19 160,800 3055200
41 Cefadroksil kapsul 500 mg KAPSUL 100 480 580 220 360 360 1,210 435600
42 Cefiksim kapsul 100 mg KAPSUL 400 200 600 300 300 300 923 276900
43 Cefixime Syrup BTL 0 0 0 0 0 0 7,688 0
44 Ceftriakson injeksi 1 gram FLACON 0 0 0 0 0 0 10,000 0
45 Cetirisine tablet 10 mg TAB 300 100 400 400 0 0 104 0
46 Chatether No. 16 PCS 0 0 0 0 0 0 8,000 0
47 Chatether No. 18 PCS 0 0 0 0 0 0 9,345 0
48 Chloramenikol kapsul 250 mg KAPSUL 100 0 100 0 100 100 329 32900
49 Chloramfenikol salep mata 1 % TUBE 0 0 0 0 0 0 3585 0
50 Chloramfenikol tetes mata 1 % BTL 5 ML 10 10 5 5 5 2,700 13500
51 Chloramfenikol tetes telinga 3% BTL 5 ML 0 20 20 6 14 14 2,800 39200
52 Chlorfeniramin meleat tablet 4 mg (CTM) TAB 1000 0 1000 1000 0 0 26 0
53 Cimetidin tablet 200 mg TAB 0 0 0 0 0 0 146 0
54 Ciprofloksacin larutan infus 2 % BTL 0 0 0 0 0 0 36,300 0
55 Ciprofloksacin tablet 500mg TAB 400 0 400 200 200 200 1,210 242000
56 Clindamicin 300mg KAPSUL 300 0 300 0 300 300 1650 495000
57 Cotrimoksasol tablet 480 mg dewasa TAB 300 0 300 300 0 0 158 0
58 Curbion Syr BTL 0 0 0 0 0 0 17500 0
59 Deksametason injeksi 50 mg/ml AMPUL 0 0 0 0 0 0 1,745 0
60 Deksametason tablet 0,5 mg TAB 200 200 400 400 0 0 34 0
61 Difenhidramin HCl injeksi 10 mg/ml AMPUL 0 0 0 0 0 0 1,262 0
62 Diazepam injeksi 5mg AMPUL 0 0 0 0 0 0 2,604 0
63 Domperidon Syrup 60 ml BTL 10 0 10 6 4 4 2,862 11448
64 Domperidon tablet 10 mg TAB 300 500 800 200 600 600 174 104400
65 Doksisilin Kapsul 00mg KAPSUL 0 0 0 0 0 0 298 0
66 Epinefrin ( adrenalin) injeksi 0,1 % AMPUL 0 0 0 0 0 0 8,910 0
67 Erithromycin 500mg TAB 400 0 400 400 0 0 781 0
NO NAMA OBAT -OBATAN SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK STOK APT HARGA SATUAN JMLH HARGA
1 2 3 4 5 6(4+5) 7 8(6-7) 9=8 10
68 Erithromycin Syrup 200ml BTL 0 0 0 0 0 0 8,910 0
69 Etakridin Laktat Cairan 0,1% BTL 0 0 0 0 0 0 4,400 0
70 Etanol 70% Alkohol 70% 100 ml BTL 0 0 0 0 0 0 3,950 0
71 Etil Klorida semprot CAN 0 0 0 0 0 0 165,000 0
72 Fitomenadion injeksi 10 mg/ml AMPUL 0 0 0 0 0 0 3,754 0
73 Fitomenadion tablet 10 mg( Vit K 1) TAB 0 0 0 0 0 0 690 0
74 Furosemid tablet 40 mg TAB 0 0 0 0 0 0 182 0
75 Garam oralit 200 ml/100scht SACHET 68 0 68 16 52 52 317 16,484
76 Gentamisin krim TUBE 0 0 0 0 0 0 3,520 0
77 Gentamisin Salep Mata TUBE 0 0 0 0 0 0 3,050 0
78 Glibenklamid tablet 5 mg TAB 0 500 500 500 0 0 7,920 0
79 Gliquidon tablet 30 mg TAB 0 0 0 0 0 0 1,100 0
80 Gliseril Guaiakolat tablet 100 mg TAB 0 0 0 0 0 0 141 0
81 GLukosa 40 % BTL 0 0 0 0 0 0 1,598 0
82 Glukosa Larutan infus 5 % BTL 3 0 3 0 3 3 6,900 20,700
83 Griseofulvin TAB 0 300 300 0 300 300 230 69,000
84 Glimepirid 4mg TAB 0 0 0 0 0 0 291 0
85 Glimepirid 2 mg/3mg TAB 300 0 300 100 200 200 458 91,600
86 Halloperidol TAB 0 0 0 0 0 0 134 0
87 Handscoen 6,5 PCS 0 0 0 0 0 0 4,675 0
88 Handscoen Non Steril M PCS 0 0 0 0 0 0 32,500 0
89 Handscoen Non Steril S PCS 0 0 0 0 0 0 32,500 0
90 Handscoen Steril No.7 PCS 4 0 4 4 0 0 8,400 0
91 Handscoen Steril No.7,5 PCS 7 17 24 0 24 24 8,382 201,168
92 Handscoen Steril No.8 PCS 0 0 0 0 0 0 8,382 0
93 Hidrokortiasid 25 mg TAB 0 0 0 0 0 0 178 0
94 Hidrokortison krim 2,5 mg TUBE 32 0 32 0 32 32 2,648 84,736
95 Ibuprofen 400mg TAB 0 100 100 100 0 0 660 0
96 Infus set Anak SET 50 0 50 0 50 50 3,500 175,000
97 Infus Set Dewasa SET 50 0 50 0 50 50 3,840 192,000
98 Isosrbid Dinitrat tablet sublingual 5mg TAB 0 0 0 0 0 0 98 0
NO NAMA OBAT -OBATAN SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK STOK APT HARGA SATUAN JMLH HARGA
1 2 3 4 5 6(4+5) 7 8(6-7) 9=8 10
99 Kasa Hydrofil 16x16cm KTK 17 0 17 12 5 5 9,600 48,000
100 Kapas Pembalut 250 gram BGKS 3 0 3 1 2 2 12,500 25,000
101 Kasa Hydrofil 40 yard x 80 cm ROLL 6 5 11 0 11 11 126,000 1,386,000
102 Kasa Pembalut 4x10 cm ROLL 0 0 0 0 0 0 750 -
103 Kasa Pembalut Hydrofil 3,6x 5 cm ROLL 0 0 0 0 0 0 750 -
104 Ketokonasol tablet 200 mg TAB 0 0 0 0 0 0 320 -
105 Kodein Tablet 10mg TAB 0 0 0 0 0 0 630 -
106 Ketofen Sup KTK 0 0 0 0 0 0 2,858 -
107 Lansoprazole 30mg KAPSUL 600 0 600 400 200 200 297 59,400
108 Lidokain Injeksi 2% + epinefrin AMPUL 0 0 0 0 0 0 1,291 -
109 Lidokain 2% AMPUL 43 0 43 3 40 40 1,408 56,320
110 Loperamid tablet 2 mg TAB 600 0 600 600 0 0 330 -
111 Loratadin tablet 10 mg TAB 500 0 500 200 300 300 127 38,100
112 Masker box 0 5 5 5 0 0 18,150 -
113 Magnesium Sulfat 40 % injeksi VIAL 0 0 0 0 0 0 2,143 -
114 Magnesium Sulfat 20 % injeksi VIAL 0 600 600 600 0 0 1,694 -
115 Meloxicam tablet 15 mg TAB 0 0 0 0 0 0 1,100 -
116 Meloxicam tablet 7,5 mg TAB 0 500 500 500 0 0 660 -
117 Metformin tablet 500mg TAB 400 0 400 200 200 200 119 23,800
118 Metilergometrin Maleat tablet salut 0,125 m TAB 0 0 0 0 36,000 -
119 Metilergometrin Maleat Injeksi 0,2mg/5mg AMPUL 0 0 0 0 2,684 -
120 Metilprednisolon tablet 8mg TAB 350 300 650 0 650 650 440 286,000
121 Metilprednisolon tablet 4mg TAB 0 0 0 0 0 0 990 -
122 Metoklopramide tablet 10mg TAB 0 0 0 0 0 0 93 -
123 Metoklorpamide Syrup Btl 0 0 0 0 0 0 2,310 -
124 Metronidasole Tablet 500mg TAB 400 0 400 100 300 300 140 42,000
125 Mikonasole Cream TUBE 12 0 12 0 12 12 3,926 47,112
126 NaCl BTL 16 20 36 4 32 32 6,410 205,120
127 Natrium Diclofenat 50mg TAB 200 0 200 200 0 0 193 -
128 Nifedipin TAB 100 0 100 100 0 0 123 -
129 Obat Antituberkulosis Kat. Anak PAKET 0 0 0 0 0 0 236,500 -
130 Obat Antituberkulosis Kat. I Dewasa FDC PAKET 0 0 0 0 0 0 447,747 -
131 Obat Antituberkulosis Kat.II Dewasa FDC PAKET 0 0 0 0 0 0 1,499,579 -
132 Oksitosin Injeksi 10 UI/Ml-2ml AMPUL 0 0 0 0 0 0 34,375 -
133 Oksitetrasiklin Salep Mata 1 % TUBE 0 0 0 0 0 0 -
134 Omeprazole Kapsul 20mg KAPSUL 800 0 800 400 400 400 1000 400,000
135 Omegavit KAPSUL 0 0 0 0 0 0 451 -
136 Ondansentron TAB 0 0 0 0 0 0 1,320 -
137 PCT Drops / Fasidol drop BTL 0 0 0 0 0 0 5,720 -
138 Paracetamol Syrup BTL 0 0 0 0 0 0 1,160 -
139 Paracetamol Tablet 500mg TAB 0 200 200 200 0 0 198 -
NO NAMA OBAT -OBATAN SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK STOK APT HARGA SATUAN JMLH HARGA
1 2 3 4 5 6(4+5) 7 8(-6-7) 9=8 10
140 Piracetam 800mg TAB 0 0 0 0 0 0 980 -
141 Piracetam 1200mg TAB 0 0 0 0 0 0 4,312 -
142 Primakuin Tablet TAB 0 0 0 0 0 0 -
143 Piridoksin tablet 10mg vitamin B6 TAB 0 0 0 0 0 0 141 -
144 Piroksicam tablet 10mg TAB 0 0 0 0 0 0 110 -
145 Piroksicam kapsul 20mg KAPSUL 0 0 0 0 0 0 116 -
146 Povidin Iodida larutan 10%- 60ml BTL 0 0 0 0 0 0 4,625 -
147 Povidin Iodida Larutan 10%- 300Ml BTL 0 0 0 0 0 0 22,500 -
148 Plester roll 7,5x5cm ROLL 8 0 8 0 8 8 28,600 228,800
149 Prednison Tablet 100mg TAB 900 0 900 300 600 600 74 44,400
150 Prophiltiuracil tablet 100mg TAB 0 0 0 0 0 0 320 -
151 Propanolol tablet 40mg TAB 0 0 0 0 0 0 69 -
152 Ranitidin tablet 150mg TAB 0 0 0 0 0 0 220 -
153 Ranitidin Injeksi 25mg/2ml AMPUL 24 0 24 0 24 24 1,600 38,400
154 Ringer Laktat Larutan Infus BTL 0 0 0 0 0 0 7,150 -
155 Salbutamol 2 mg TAB 200 0 200 100 100 100 110 11,000
156 Salbutamol 4mg TAB 100 0 100 100 0 0 132 -
157 Salep 2-4 POT 17 0 17 0 17 17 3,213 54,621
158 Silk Benang Bedah PCS 10 0 10 2 8 8 3,055 24,440
159 Stesolit Diazepam Allubag 5 0 5 0 5 5 17,600 88,000
160 Simvastatin Tablet 10mg TAB 600 0 600 100 500 500 615 307,500
161 Thiamin Injeksi 100mg/ml AMPUL 0 0 0 0 1,012 -
162 Thiamin Tablet 50mg vitamin B1 TAB 500 1000 1500 900 600 600 90 54,000
163 Prodex Tablet TAB 0 0 0 0 0 0 275 -
164 Vitamin A.100.000 IU KAPSUL 0 0 0 0 0 0 331 -
165 Vitamin 200.000 IU KAPSUL 0 0 0 0 0 0 596 -
166 Verorab Injeksi AMPUL 0 0 0 0 0 0 243,200 -
167 Vitami B.Kompleks TAB 0 1000 1000 1000 0 0 144 -
168 Zinc TAB 0 0 0 0 0 0 57 -
169 Nasal Canula Anak PCS 0 0 0 0 0 0 17,249 -
170 Nasal Canula Dewasa PCS 4 0 4 0 4 4 17,249 68,996
171 Pharmafix KTK 2 0 2 0 2 2 51,305 102,610
172 Salicyl Talk KTK 0 24 24 16 8 8 2,750 22,000
173 Diazepam injeksi 5mg TAB 0 0 0 0 0 0 2,604 -
174 Alkohol 70% 1000 ml/ 1 liter botol 6 5 11 7 4 4 31,250 125,000
175 natrium diclofenak 25 mg TAB 0 0 0 0 0 0 152 -
176 ketokonazole krim 2% TUBE 24 0 24 0 24 24 2,694 64,656
177 Rivanol 0,1% 300 ML botol 0 0 0 0 0 0 3,750 -
178 Simvastatin Tablet 20mg tab 1400 0 1400 300 1100 1100 660 726,000
179 Atorvastatin 10 mg box 0 0 0 0 0 1,172 -
180 Calcium laktat box 0 0 0 0 0 0 63 -
181 cyanocobalamin Vit.12 box 200 1000 1200 400 800 800 48 38,400
UMUM BPJS TOTAL OKSIGEN
LAPORAN KUNJUNGAN PASIEN
13,123,081
Mengetahui Pengelola Gudang Obat
Kepala Puskesmas

dr.Solaiman R.M Gagola Dwi Handayani S.Farm.,Apt

NIP.19911118 201903 1 008 NIP.19871102 201903 2 013
NO NAMA OBAT -OBATAN HARGA
1 2 3
1 Abbocath NO. 18
2 Abbocath NO. 20
3 Abbocath NO. 22
4 Abbocath NO. 24
5 ACT (Artesunate tab 50 Mg + Amodiquain anhidrida tab 200 mg)
6 acyclovir cream Rp. 4. 410
7 Acyclovir tablet 200 Mg Rp. 33. 344
8 Acyclovir tablet 400 Mg Rp. 39.406
9 Alat Suntik sekali Pakai 1 ml
10 Alat Suntik sekali Pakai 2,5- 3 ml
11 Alat Suntik sekali Pakai 5 ml
12 Allopurinol tablet 100 mg Rp. 18.480
13 Ambroksol syrup 15 mg/ 5ml Rp. 3.230
14 Ambroksol tablet 30 mg Rp. 14. 159
15 Aminophilin 200 mg tablet
16 Amitriptilin HCL table Salut 25 Mg Rp. 11. 513
17 Amlodipin 10 mg
18 Amlodipin 5 mg
19 Amoksisilin kaplet 500 mg Rp. 140. 000
20 Amoksisilin kapsul 250 mg Rp. 46. 200
21 Amoksisilin Syrup kering 125 mg/5 ml Rp. 4. 420
22 Antalgin injeksi 250 mg/ml-20 ml
23 antalgin tablet 500 mg
24 Antasida Doen tablet kombinasai Rp. 48. 750
25 Antasida supensi 60 ml
26 Anti haermohoid supp. Doen kombinasi

NO NAMA OBAT -OBATAN SATUAN

1 2 3
27 Aqua pro injeksi steril,bebas ,pirogen
28 Asam Askroba tablet 50 mg Rp. 25. 500
29 Asam Mefenamat Kaplet 500 mg Rp.15. 875
30 Atropin injeksi i.m/i.v/s.k/ 0,25 mg/ml (sulfat)
31 Atropin Sulfat tetes mata 0,5 mg
32 ATS ( Anti Tetanus Serum)
33 Basitrasin Polimiksin Krim
34 Besi II Sulfat tablet 300 mg
35 Besi II Sulfat tablet 200 mg + as. Folat 0,25 mg (sach)
36 Betahistin Mesileat Tablet 6 mg Rp. 38. 808
37 Betametason krim 0,1 % Rp. 2. 836
38 Bisoprorol tablet 5 mg Rp. 87. 063
39 Bromhexin Rp. 22. 000
40 Captopril tablet 12,5 mg
41 Captopril tablet 25 mg Rp. 19. 825
42 Catgut/benang bedah N0. 2/0-3/0
43 Cefadroksil kapsul 500 mg
44 Cefadroksil Syrup Rp. 9. 038
45 Cefiksim kapsul 500 mg Rp. 167. 622
46 Cefixime Syrup
47 Cefotaksim injeksi 1 gram
48 Ceftriakso injeksi 1 gram Rp. 119. 365
49 Cepezet Rp. 151. 250
Cefaleksin kapsul 500 mg Rp. 82. 188
50 Cetirisine tablet 10 mg
51 Chatether No. 16
52 Chatether No. 18
53 Chloramenikol kapsul 250 mg Rp. 610. 010
54 Chloramfenikol salep mata 1 %
55 Chloramfenikol tetes telinga 3%
56 Chlorfeniramin meleat tablet 4 mg (CTM)
57 Cimetidin tablet 200 mg Rp. 9. 032
58 Ciprofloksacin larutan infus 2 %
59 Ciprofloxacin tablet 500 mg
60 Clobasan tablet 10 mg

NO NAMA OBAT -OBATAN SATUAN

1 2 3
61 Clonidin tablet 0,15 mg Rp. 25. 625
62 Cotrimoksasol pediatrik tablet 120 mg Rp. 6. 235
63 Cotrimoksasol suspensi 240 mg/5 ml Rp. 3. 550
64 Cotrimoksasol tablet 480 mg dewasa Rp. 12. 500
65 Deksametason injeksi 50 mg/ml Rp. 131. 471
66 Deksametason tablet 0,5 mg Rp. 30. 110
67 Dekstrometorphan HBr Syrup 10 Mg/ml Rp. 3. 000
68 Dektran 70 larutan infus 6 % steril Rp
69 Difenhidramin HCl injeksi 10 mg/ml Rp
70 Digoksin tablet 0,25 mg Rp. 10. 401
71 Diltiasem tablet 30 mg Rp.18.954
72 Diasepam tablet 5 mg Rp
73 Diasepam tablet 2 mg Rp
74 Domperidon Syrup 60 ml Rp. 47. 438
75 Domperidon tablet 10 mg (OMEDON) Rp. 1851. 35
76 Efedrin tablet 25 mg Rp
77 Epinefrin ( adrenalin) injeksi 0,1 % Rp
78 Erithromycin Syrup 200 ml Rp
79 Erithromycin kapsul 500 mg Rp. 125. 125
80 Erithromycin kapsul 250 mg Rp
81 Etabion tablet Rp
82 Etakridin laktat Cairan 0,1 % Rp
83 Etanol 70 % Rp
84 Etil Klorida semprot Rp
85 Famotidin tablet 20 mg Rp
86 Fenitoin Natrium kapsul 100 mg Rp
87 Fenitoin Natrium kapsul 30 mg Rp
88 Fenol gliserol tetes telinga 10 % Rp
89 Fitomenadion injeksi 10 mg/ml Rp
90 Fitomenadion tablet 10 mg( Vit K 1) Rp
91 Furosemid injeksi Rp
92 Furosemid tablet 40 mg Rp . 8. 177
93 Garam oralit 200 ml Rp
94 Garam oralit 200 ml Rp

NO NAMA OBAT -OBATAN SATUAN

1 2 3
95 Gentamisin injeksi 80 mg/ 2ml Rp.
96 Gentamisin krim Rp.
97 Gentian Violet larutan 1 % Rp.
98 Glibenklamid tablet 5 mg Rp. 7. 499
99 Gliquidon tablet 30 mg Rp.
100 Gliseril Guaiakolat tablet 100 mg Rp. 29. 250
101 Gliserin Rp.
102 Glukosa 40 % Rp.
103 Glukosa Larutan infus 10 % Rp.
104 Glukosa Larutan infus 5 % Rp.
105 Griseofulvin tablet 125 mg Rp.
106 Hallopurinol Rp.
107 Handscoen non steril L Rp.
108 Handscoen non steril M Rp.
109 Handscoen non steril S Rp.
110 Handscoen Steril No.7 Rp.
111 Handscoen Steril No. 7,5 Rp.
112 Handscoen Steril No. 8 Rp.
113 Hidroklortiazid tablet 25 mg Rp.
114 Hidrokortison krim 2,5 mg Rp.
115 Hyoscini N Butilbromide tablet 10 mg Rp.
116 Ibuprofen 200 mg Rp.
117 Ibuprofen 400 mg Rp.
118 Infus set anak Rp.
119 Infus set dewasa Rp.
120 Isoniazid tablet 300 mg Rp.
121 Isosorbid Dinitrat tablet sublingual 5 mg Rp. 816
122 Itrakonazol tablet 100 mg Rp.
123 Jarum Jahit lengkung 1/2 lingkaran penampa Rp.
124 Jarum Jahit lengkung 3/8 lingkaran penampa Rp.
125 Kalium Diklofenat 50 mg Rp.
126 Kalsium Laktat tablet 100 mg Rp.
127 Kapas Pembalut 250 gram Rp.

NO NAMA OBAT -OBATAN SATUAN

1 2 3
128 Kasa Hydrofil 40 yard x 80 cm Rp.
129 Kasa Kompres 40 x 40 Rp.
130 Kasa Pembalut 2 m x 80 cm Rp.
131 Kasa Pembalut 4 X 15 cm elastic Rp.
132 Kasa Pembalut 4 x 3 cm elastic Rp.
133 Kasa Pembalut Hydrofil 4 x 15 cm Rp.
134 Kasa Pembalut Hydrofil 4 x 5 cm Rp.
135 Ketokonasol krim 2 % Rp.
136 Ketokonasol tablet 200 mg Rp.
137 Kinina Sulfat tablet 200 mg Rp.
138 Kloroquin tablet 150 mg Rp.
139 Lanzoprasole 30 mg Rp.
140 Lidokain Comp injeksi 25 % 2 ml Rp.
141 Loperamid tablet 2 mg Rp.
142 Loratadin tablet 10 mg Rp.
143 Magnesium Sulfat 20 % injeksi Rp.
144 Magnesium Sulfat 40 % injeksi Rp.
145 Meloxicam tablet 15 mg Rp.
146 Meloxicam tablet 7,5 mg Rp.
147 Metformin tablet 500 mg Rp.
148 Metilergometrin Maleat injeksi 0,2 mg/ 5 ml Rp.
149 Metilergometrin Maleat tablet salut 0,125 m Rp.
150 Metilprednisolon tablet 4 mg Rp.
151 Metoklopropamid injeksi 5 mg/ ml Rp.
152 Metoklopropamid tablet 40 mg Rp.
153 Metronidasol infus 500 mg/ 100 ml Rp.
154 Metronidasol tablet 500 mg Rp.
155 Mikonasol krim 2 % Rp.
156 NaCl larutan infus 0,9 % Rp.
157 Natrium Diklofenac 50 mg Rp.
158 Nifedipin tablet 10 mg Rp.
159 Nistatin Vaginal tablet 100000 Ul Rp.
160 Obat Antituberkulosis Kat. Sisipan Dewasa Rp.
161 Obat Antituberkulosis Kat. Anak Rp.
NO NAMA OBAT -OBATAN SATUAN
1 2 3
162 Obat Antituberkulosis Kat. I dewasa FDC Rp.
163 Obat Antituberkulosis Kat. II dewASA FDC Rp.
164 Obat Batuk Hitam Rp.
165 Oksitetrasiklin Salep mata 1 % Rp.
166 Oksitosin injeksi 10 UI/ml - 2 ml Rp.
167 Omeprasol Kapsul 20 mg Rp.
168 Oksitetrasiklin Salep kulit 3 % Rp.
169 Omedon Syrup Rp.
170 Osetlamivir Rp.
171 Paracetamol Syrup 120 mg/ ml Rp.
172 Parasetamol tablet 500 mg Rp.
173 Pembalut Gips Rp.
174 Piracetam 400 mg Rp.
175 Piracetam 800 mg Rp.
176 Piracetam injeksi 3 gram Rp.
177 Piracetam tablet 1200 mg Rp.
178 Pirantel Pamoat Kaplet 125 mg Rp.
179 Piridoksin tablet 10 mg Rp.
180 Piroxicam kapsul 20 mg Rp.
) Piracetam injeksi 1 gr/ ampul Rp.
182 Plester 5 yard x 2 inch Rp.
183 Povidon iodida Larutan 10 % - 30 % ml Rp.
184 Povidon iodida Larutan 10 % - 300 ml Rp.
185 Prednison tablet 5 mg Rp. 60. 000
186 Propanolol tablet 40 mg 10. 273
187 Propilithiouracil tablet 100 mg Rp. 38. 604
188 Pacdin syrup Rp.
189 Ranitidin injeksi 25 mg/ 2 ml
190 Ranitidin tablet 150 mg Rp. 26. 250
191 Reserpin tablet 0,25 mg Rp.
192 Ringer Laktat larutan infus Rp.
193 Salbutamol tablet 2 mg Rp. 11.-056
194 Salbutamol tablet 4 mg Rp. 13. 469
195 Salep 2 -4 Rp. 1. 031, 15

NO NAMA OBAT -OBATAN SATUAN

1 2 3
196 Salisil bedak 2 % Rp. 4. 000
197 Silk benang bedah Rp.
198 Simvastatin tablet 10 mg Rp.
199 Spiramisin tablet 500 mg Rp.
200 Sulfadoksin Pirimetamin tablet kombinasi 525 mg Rp.
201 Solathim Rp.
202 Tetrasiklin kapsul 500 mg Rp. 61. 875
203 Thiamfenikol kapsul 500 mg Rp.
204 Thiamin injeksi 100 mg/ ml (Vit B1) Rp.
205 Thiamin tablet 50 mg (Vit B1) Rp. 72.000
206 Tramadol injeksi 50 mg/ml Rp.
207 Tramadol tablet 50 mg Rp. 21. 500
208 Vitamin B kompleks Rp.
209 Wing Needle No. 23 Rp.
210 Wing Needle No. 25 Rp.
211 Wing Needle No. 27 Rp.
212 Wing Needle No. 21 G Rp.
213 ZINC Rp.
214 Trimeta syrup Rp. 8. 350
215 Rp.
216 Rp.
217 Rp.
218 PRENASE Rp.
219 SELTIFORT KIDS Rp.