NO NAMA OBAT DAN BHP SATUAN HARGA SUMBER DANA

1 Omeprazole kapsul 20 mg Kapsul 148 OBAT DAK 2017

Kombinasi ferro fumarat 60 mg + as folat 0.4
2 mg tablet salut gula Tablet 410 OBAT DAK 2017
3 Zinc tablet dispersible 20 mg Tablet 592.00 OBAT DAK 2016
4 BUFACETINE Kloramfenikol salep kulit 2 % Tube 3,327.00 OBAT DAK 2017
5 BUFACETINE Kloramfenikol salep kulit 2 % Tube 3,360.00 OBAT DAK 2018
6 Triheksifenidil tablet kapsul 1,205.00 OBAT DAK 2017
7 Bedak salisil serbuk 2 % Dus 1071 OBAT DAK 2017
8 Ibuprofen susp 100 mg/5 ml Botol 2560 OBAT DAK 2017
9 Kalsium Laktat (Kalk) tablet 500 mg Tablet 57.00 OBAT DAK 2017
10 Parasetamol tablet 500 mg Tablet 58 OBAT DAK 2016
11 NaCl 0.9 % Botol 6410 OBAT JKN 2016
12 NaCl 0.9 % Botol 6,410.00 OBAT DAK 2017
13 Asam Askorbat (vitamin C) tablet 50 mg Tablet 120 OBAT DAK 2018
14 Asam Askorbat (vitamin C) tablet 50 mg Tablet 120 OBAT DAK 2017
15 Kloramfenikol salep mata 1 % Tube 1850 OBAT DAK 2017
16 Piridoksin (Vitamin B6) tablet 10 mg Tablet 136 OBAT DAK 2017
17 Vitamin B Kompleks tablet Tablet 49 OBAT JKN 2016
18 Vitamin B Kompleks tablet Tablet 132 OBAT DAK 2017
19 Triheksifenidil tablet Tablet
Tablet Salut 80 OBAT DAK 2017
20 Atorvastatin tablet salut selaput Selaput 908 OBAT DAK 2018
21 Klorfeniramina Maleat (CTM) tablet 4 mg Tablet 39 OBAT DAK 2017
22 Klorfeniramina Maleat (CTM) tablet 4 mg Tablet 45 OBAT DAK 2016
23 Loperamid tablet 2 mg Tablet 85 OBAT DAK 2017
24 Amlodipin tablet 5 mg Tablet 74.00 OBAT DAK 2018
25 Amlodipin tablet 5 mg Tablet 105 OBAT DAK 2016
26 Oksitosin inj 10 UI/ml Ampul 1900 OBAT DAK 2017
27 Alopurinol tablet 300 mg Tablet 230.00 OBAT DAK 2017
28 Kaptopril tablet 50 mg Tablet 143 OBAT JKN 2016
29 Ranitidin tablet 150 mg Tablet 105 OBAT DAK 2017
30 Garam Oralit Sachet 275 PROGRAM DIARE 2018
31 Garam Oralit Sachet 317 OBAT JKN 2015
Masker Oksigen Dewasa (Oksigen Non-
32 Rebreathing Mask Dewasa) (Nasal Oxygen) Pcs 43,230.00 BHP JKN 2015
PG PENGEMBALIAN
33 Papaverin 40 mg Tablet 128.00 PUSKESMAS
34 Pirantel 125 mg Tablet 331.00 DAKOBAT DAK 2018
PENGEMBALIAN
35 Propiltiourasil 100 mg Tablet 297.00 BHP PUSKESMAS
PENGEMBALIAN
36 Alat suntik sekali pakai 3cc Pcs 1,072.50 PUSKESMAS
PROGRAM FILARIASIS
37 Albendazole 400 mg Tablet 323 (KECACINGAN)
PROGRAM 2017
FILARIASIS
38 Albendazole 400 mg Tablet 323 (CACING) 2018
39 Allopurinol 100 mg Tablet 99 OBAT DAK 2018
40 Alopurinol tablet 100 mg Tablet 95 OBAT DAK 2016
41 Ambroksol sirup Botol 60 cc 4840 OBAT JKN 2017
42 Amitriptillin tablet 123.00 Kurang Catat
43 Amitriptillin Tablet 123.00 OBAT PG 2015
44 Amlodipin 10 mg Tablet 95.00 OBAT JKN 2018
45 Amlodipin 5 mg Tablet 90.00 OBAT DAK 2017
46 Amlodipin tablet 10 mg Tablet 163.00 OBAT DAK 2016
47 Amoksisillin kaplet 500 mg Kaplet 233.00 OBAT DAK 2016
1 Amoksisilin 500 mg OBAT JKN 2016
48 Amoksisilin Sirup Kering 125 mg/5 ml Botol 1,920.00 OBAT DAK 2017
49 Amoksisilin Sirup Kering 125 mg/5 ml Botol 2,200.00 OBAT DAK 2016
50 Amoksisilin Sirup Kering 125 mg/5 ml Botol 60 ml
Tablet 3520 OBAT JKN 2018
51 Antasida DOEN Kunyah 56 OBAT DAK 2018
52 Antasida DOEN suspensi Botol 2,098.00 OBAT DAK 2018
53 Antihaemorroid SUPPO SUPPO 3502 OBAT JKN 2016
54 Antihaemorroid SUPPO SUPPO 3850 OBAT DAK 2017
55 Asam Mefenamat 500 mg Tablet 122 PG 2014
56 Asam Mefenamat 500 mg Tablet 177.79 OBAT JKN 2015
57 Asam Tranexamat inj Ampul 3,250.00 OBAT PG 2015
58 Asiklovir 400 mg Tablet 362 ASKESJKN 2014
59 Asiklovir 400 mg Tablet 425.00 OBAT DAK 2018
60 Asiklovir 200 mg Tablet 251.00 PG 2014
61 Asiklovir krim 5 % Tube 4,180.00 OBAT DAK 2018
AXIMED IV-CATH WP with wings & port
62 (No. 18) IV Catheter 18 Pcs 7,656.00 Kurang Catat
AXIMED IV-CATH WP with wings & port
63 (No. 20) IV Catheter 20 pcs 7,656.00 Kurang Catat
AXIMED IV-CATH WP with wings & port
64 (No. 26) IV Catheter 26 PCS 7,700.00 Kurang Catat
65 Betametason krim 0,1 % (sebagai Valerat) Tube 1,420.00 OBAT DAK 2018
66 Betametason krim 0,1 % (sebagai Valerat) Tube 1,450.00 OBAT JKN 2017
67 Budesonid inhaler 80/4.5 mcg (Symbicort) Dus 1 Tur 121,000.00 OBAT DAK 2017
68 CHKM Botol 10 ml 135,300.00 BHP PG 2015
69 Chlorpeniramine maleat 4mg (CTM) TABLET 24.00 OBAT JKN 2018
70 COSMOMED Infusion Set (Dewasa) Pcs 4,756.00 BHP DAK 2016
71 Tablet 45.00 OBAT JKN 2017
72 Deksametason tablet 0.5 mg Tablet 48.00 OBAT DAK 2016
73 Deksametasone injeksi i.v/i.m Ampul 1,738.00 OBAT JKN 2015
74 Diazepam 2 mg Tablet 86.00 OBAT DAK 2018
75 Digoksin 0,25 mg Tablet 103 DAK 2013 ANGGARAN 2015
76 Diltiazem tab Tablet 141.00 ASKESJKN 2014
77 Omeprazole kapsul 20 mg BOTOL 2,862.00 OBAT DAK 2018
78 Domperidon suspensi/sirup 5 mg/5 ml Botol 3,180.00 OBAT DAK 2016
79 Domperidon tablet 10 mg Tablet 133 OBAT DAK 2016
Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1
80 mg/ml Ampul 1848 OBAT JKN 2017
81 Ethyl Chlorida Spray 100 ml Botol 108900 BHP DAK 2016
82 ETT Anak No. 3 mm PCS 27830 Kurang Catat
83 ETT Anak No. 3,5 mm PCS 27,830.00 Kurang Catat
84 ETT Dewasa No. 6,5 mm PCS 27,830.00 Kurang Catat
85 ETT Dewasa No. 7 mm PCS 27830 Kurang Catat
86 ETT Dewasa No. 7,5 mm PCS 27830 Kurang Catat
87 Fitomenadion (Vitamin K1) 10 mg Tablet 818 OBAT DAK 2018

88 Fitomenadion (Vitamin K1) injeksi i.m 2 mg/ml Ampul 4083 OBAT JKN 2017
89 Folay Cateter Anak No. 10 PCS 36000 Kurang Catat
90 Folay Cateter Anak No. 6 PCS 43800 Kurang Catat
91 Folay Cateter Anak No. 8 PCS 36,000.00 Kurang Catat
92 Folay Cateter Dewasa No. 12 PCS 9600 Kurang Catat
93 Folay Cateter Dewasa No. 14 PCS 9,600.00 Kurang Catat
94 Folay Cateter Dewasa No. 16 PCS 9,600.00 Kurang Catat
95 Folay Cateter Dewasa No. 18 PCS 9,600.00 Kurang Catat
96 Folay Cateter dewasa No.20 PCS 9,600.00 Kurang Catat
97 Folay Cateter Dewasa No.22 PCS 9600 Kurang Catat
98 Furosemide 40 mg Tablet 84.00 OBAT JKN 2015
Gavistal Drops - Metoklopramid drop botol 10
99 ml Botol 5,200.00 OBAT DAK 2016
100 Gentamisin Salep Kulit Tube 3,850.00 OBAT DAK 2016
101 Gentamisin Salep Kulit Tube 3,960.00 OBAT DAK 2018
102 Gentamisin salep mata 0,3% Tube 3075 OBAT DAK 2018
103 Glass Ionomer (Fuji ART 1X Minipack) Pack 601,700.00 DAKBHP DAK 2016
PENGEMBALIAN
104 Glibenklamide 5 mg Tablet 59.00 PUSKESMAS
105 Glibenklamide 5 mg Tablet 61.00 OBAT JKN 2015
106 Glimepiride 2 mg Tablet 231.00 OBAT DAK 2017
107 Griseofulvin tablet 125 mg Tablet 263 OBAT DAK 2017
HALONI JANE PROTOS Surgical Sterile
108 Powder Glove (Size 7.5) Pasang 4,600.00 BHPM JKN 2018
109 Haloperidol 5 mg TABLET 94 Kurang Catat
110 Haloperidol tablet 0,5 mg Tablet 64.00 OBAT DAK 2016
111 Hidrokortison krim Tube 2,648.00 OBAT DAK 2018
112 Hidrokortison krim 2,5 % TUBE 2,838.00 OBAT JKN 2017
DAK PENGEMBALIAN
113 Hiosine Tablet 405.00 PUSKESMAS
114 Ibuprofen 200 mg Tablet 121.00 ASKESJKN 2014
115 Ibuprofen 200 mg Tablet 121.00 DAK 2013 ANGGARAN 2015
116 Ibuprofen 400 mg Tablet 157.00 ASKESJKN 2014
117 Ibuprofen 400 mg Tablet 157.00 OBAT PG 2015
118 Ibuprofen 400 mg tablet Tablet 133 OBAT DAK 2016
119 Infusion set anak Pcs 7509 BHP 2014
120 Isoniazid 100 mg Tablet 137 PROGRAM 2015
121 Isoniazid 100 mg Tablet 145 PROGRAM TB PARU 2018
122 IV cateter no 22 G pcs 7828 BHP 2014
123 IV Catheter No. 20 G (Jelco 20 RD) Pcs 7,334.00 BHP PG 2015
124 Jarum Injeksi Gigi Sekali Pakai (CK Jeet) Pcs 1,892.00 BHP DAK 2016
125 Jarum Injeksi Untuk Gigi sekali pakai Pcs 2530 BHP PG 2015
126 JAYAMAS Onemed Alkohol 70% 1 L Botol 25800 BHP DAK 2016
127 JAYAMAS ONEMED BLOOD LANCET Pcs 160.23 BHP JKN
128 JAYAMAS ONEMED KAPAS PEMBALUT Roll 13750 BHP JKN
129 JAYAMAS Onemed Lysol 1 liter Botol 47,150.00 BHP JKN
130 JAYAMAS Onemed Rivanol 300 cc Botol 3060 BHP DAK 2016
JAYAMAS ONEMED ULTRA ONE TEST
131 HAMIL Pcs 2,133.00 BHP JKN
132 Kalium Diklofenak 50 mg Tablet 500.50 OBAT JKN 2018
133 Kapas pembalut 250 gram Roll 17,286.00 BHP DAK 2016
134 Kaptopril 25 mg Tablet 86.00 OBAT DAK 2017
136 Kasa pembalut hidrofil 40 yard x 80 cm ROLL 129,030.00 Kurang Catat
137 Kasa pembalut hidrofil 40 yard x 80 cm Roll 150,150.00 BHP 2014
138 Ketokonazole 2 % krim Tube 2,694.00 OBAT DAK 2018
139 Klorpromazin HCI 100 mg Tablet 179.00 OBAT DAK 2016
140 Kodein 10 mg Tablet 630 OBAT JKN 2016
141 Kotri syr Botol 2225 OBAT DAK 2016
Kotrimoksazol 480 mg kombinasi :
142 Sulfametoksazol 400 mg Trimetoprim 80 mg TABLET 131.00 OBAT DAK 2017
143 Kotrimoksazol Doen I (dewasa) kombinasi tablet
Botol 100 158 OBAT JKN 2016
144 Larutan Barium Klorida 10 % ml 22,000.00 BHP DAK 2016
145 Larutan Barium Klorida 10 % botol
Botol100
100ml 24,200.00 Kurang Catat
146 Larutan Hayem ml100
Botol 25,300.00 BHP PG 2015
147 Larutan HCl 0.1 N ml 12100 BHP PG 2015
Larutan Injeksi Untuk Gigi (Inibsa/Artinibsa 4
148 %) Ampul
Botol 100 6853 BHP DAK 2016
149 Larutan Turk ml100
Botol 35,200.00 BHP DAK 2016
150 Larutan Turk ml 35200 BHP PG 2015
Lidokain injeksi 2% (HCl) + Epinefrin
151 1:80.000 2 ml Ampul 2227 OBAT DAK 2017
BOTOL 1
152 Lisol Liter 52030 Kurang Catat
153 Meloksikam 15 mg Tablet 1012 OBAT DAK 2016
154 Meloksikam 7.5 mg Tablet 599.5 OBAT JKN 2018
155 Metformin HCl tablet 500 mg Tablet 115 OBAT DAK 2016
156 Metilprednisolon 4 mg Tablet 165.00 OBAT DAK 2017
157 Metilprednisolon tablet 4 mg Tablet 139 OBAT DAK 2018
DAK PENGEMBALIAN
158 Metoklopramid tablet 10 mg Tablet 100.00 PUSKESMAS
159 Metoklopramide 10 mg Tablet 110 OBAT PG 2015
160 Metronidazol 500 mg Tablet 115 OBAT DAK 2017
161 Mikonazole krim/Salep 2% Nitrat Tube 3,737.00 OBAT DAK 2016
162 Mikonazole krim/Salep 2% Nitrat Tube 3,926.00 OBAT DAK 2018

163 Natrium Diklofenak 50 mg Tablet 193.00 DAK 2013 ANGGARAN 2015

164 Natrium Diklofenak 50 mg Tablet 193 OBAT JKN 2015
165 Natrium Diklofenak tablet 25 mg Tablet 142 OBAT DAK 2018
166 Natrium Diklofenak tablet 50 mg Tablet 161.00 OBAT DAK 2016
167 Nipro IV Catheter 16 PCS 8281.24 Kurang Catat
168 Nistatin tab vaginal 100.000 IU/g Vagtablet 645 OBAT DAK 2018
169 O2 Binasal Anak PCS 10,000.00 Kurang Catat
170 O2 Binasal Dewasa PCS 10,000.00 Kurang Catat
171 Obat Anti Tuberculosis FDC Kategori Anak Paket 236500 PROGRAM TB PARU 2018
172 Obat Anti Tuberculosis FDC Kategori Anak Paket 267,397.00 PROGRAM TB PARU 2018
173 Obat Antituberkulosis FDC Kategori I Paket 413,984.00 PROGRAM TB PARU 2017
174 Obat Antituberkulosis FDC Kategori I Paket 413984 PROGRAM TB PARU 2018
175 Obat Antituberkulosis FDC Kategori I Paket 447,747.00 PROGRAM TB PARU 2018
176 Obat Antituberkulosis FDC Kategori II Paket 1379984 PROGRAM TB PARU 2017
177 Obat Antituberkulosis FDC Kategori II Paket 1,379,984.00 PROGRAM TB PARU 2018
178 Obat Antituberkulosis FDC Kategori II Paket 1,492,579.00 PROGRAM TB PARU 2018
179 Obat Antituberkulosis Kategori Anak Paket 236,500.00 PROGRAM TB PARU 2017
180 Obat Antituberkulosis Kategori Anak Paket 247,229.00 PROGRAM TB PARU 2017
181 Object Glass (Sail Brand) Pcs 259.73 BHP DAK 2016
JKN PENGEMBALIAN
182 Ofloksaasin 400 mg Tablet 720.00 PUSKESMAS
 Botol 100
183 Paket Pewarna Gram ml 199,100.00 BHP PG 2015
DAK PENGEMBALIAN
184 Papaverin 40mg Tablet 128.00 PUSKESMAS
ASKES 2013 ANGGARAN
185 Parasetamol 500 mg Tablet 88.00 2015
186 Parasetamol Drops (Fasidol Drops) Botol 15 11,440.00 OBAT DAK 2017
187 Parasetamol sirup Botol 4,180.00 OBAT JKN 2018
188 Parasetamol syrup 120 mg/5 ml Botol 1,119.00 OBAT DAK 2016
189 Permetrin krim 5 % (Scabimite) TUBE 10 g 11,475.00 Kurang Catat
190 Pirantel suspensi 125 mg/5 ml Botol 11,050.00 OBAT DAK 2018
191 Piridoksin (Vitamin B6) tablet 10 mg (HCl) Tablet 136.00 OBAT DAK 2016
192 Piroksikam 10 mg Tablet 150.00 OBAT PG 2015
193 Piroksikam 20 mg Tablet 198.00 OBAT JKN 2018
194 Pot Dahak Pcs 2,950.00 HIBAH GF
195 Pot Dahak Pcs 5472.77 BHPM DAK 2017
196 Prednison 5 mg Tablet 125.00 OBAT JKN 2015
197 Prednison tablet/kapsul/kaplet 5 mg Tablet 74 OBAT DAK 2018
198 Ranitidin 150 mg Tablet
Kapsul 114 OBAT DAK 2018
199 Retinol (Vitamin A) 100.000 IU Lunak 286.00 PROGRAM 2015
200 Retinol (Vitamin A) 100.000 IU Kapsul 286.00 PROGRAM GIZI 2017
KAPSUL
201 Retinol (Vitamin A) 100.000 IU LUNAK 327.00 Kurang Catat
Kapsul
202 Retinol (Vitamin A) 100.000 IU Lunak 332.00 PROGRAM GIZI 2018
 Kapsul
203 Retinol (Vitamin A) 200.000 IU Lunak 505.00 PROGRAM 2016
204 Retinol (Vitamin A) 200.000 IU Kapsul Lun 583.00 PROGRAM GIZI 2018
205 Retinol (Vitamin A) 200.000 IU kapsul lunak Kapsul Lun 519.20 PROGRAM GIZI 2017
206 Ringer Laktat Botol 7,150.00 OBAT JKN 2018
207 Ringer Laktat Botol 7,150.00 OBAT JKN 2016
208 Safety Box 5 Liter Buah 26,158.28 VAKSIN
PG PENGEMBALIAN
209 Salbutamol 4 mg Tablet 99.00 PUSKESMAS
210 Salbutamol 4 mg Tablet 99.00 ASKESJKN 2014
Salep 2-4 , Kombinasi : Asam Salisilat 2% +
211 Belerang endap 4% Pot 3,017.00 OBAT DAK 2018
212 Sefadroksil 500 mg Kapsul 455 OBAT JKN 2017
213 Sefadroksil kapsul/kaplet 500 mg Kapsul 557 OBAT JKN 2016
214 Sefadroksil sirup kering 125 mg/5ml Botol 60 ml 5286 OBAT JKN 2015
SERENITY Benang Operasi Cromic Catgut
215 with Needle 2.0 Pcs 9850 BHP DAK 2016
SERENITY Benang Operasi Cromic Catgut
216 with Needle 3.0 PCS 9,850.00 Kurang Catat
SERENITY Benang Operasi Cromic Catgut
217 with Needle 3.0 Pcs 9,850.00 BHPM DAK 2017
218 SERENITY Twist Blood Lancet Pcs 192 BHPM DAK 2018
219 SERENITY Twist Blood Lancet pcs 192.00 BHPM DAK 2017
220 Setirizin 10 mg Tablet 115.00 OBAT JKN 2017
221 Setirizin sirup 5 mg/5 ml Botol 7,756.00 OBAT JKN 2016
222 Simvastatin 10 mg Tablet 113.00 OBAT DAK 2017
223 Simvastatin scored tablet 10 mg Tablet 135.00 OBAT DAK 2019
SINOPHARM SURGICAL SUTURE +
224 NEEDLE SILK BLACK BRAIDED 3/0 PCS 3,937.50 Kurang Catat
SINOPHARM SURGICAL SUTURE +
225 NEEDLE SILK BLACK BRAIDED 3/0 Pcs 3,937.50 BHP DAK 2016
JKN PENGEMBALIAN
226 Siprofloksasin 500 mg Tablet 265.00 PUSKESMAS
BHP PENGEMBALIAN
227 Speculum Disposable Pcs 12800 PUSKESMAS
228 Speculum Disposable PCS 14080 Kurang Catat
229 Spoit 1 cc PCS 818 Kurang Catat
230 Spoit 10 cc PCS 1,305.60 Kurang Catat
231 Spoit 20 cc PCS 989.00 Kurang Catat
232 Spoit 50 cc PCS 3,121.00 Kurang Catat
233 Stardec Infusuion Set New PCS 4,686.00 Kurang Catat
234 Strip Cholesterol PCS 24,112.00 BHPM JKN 2017
235 Strip Cholesterol Stripe 24,530.00 BHPM DAK 2018
236 Strip Cholesterol Pcs 25,822.50 BHPM DAK 2017
237 Strip Glucose Pcs 5,434.00 BHPM DAK 2017
238 Strip Glucose (Autocheck) Strip 5544 BHP DAK 2016
239 Strip Uric Acid Pcs 7238 BHPM JKN 2017
240 Strip Urine Analisys (Onemed/Combur) Pcs 1,584.00 BHP DAK 2016
241 Stripe Cholesterol Strip 25,960.00 BHP JKN
242 Stripe Glucose Strip 5,427.40 BHP JKN
243 Stripe Glucose Strip 5508.8 BHP JKN
244 Stripe Uric Acid Strip 7,269.00 BHP JKN
245 Suction Catheter Anak No. 10 PCS 8,844.00 Kurang Catat
246 Suction Catheter Anak No.6 PCS 8,844.00 Kurang Catat
247 Suction Catheter Anak No.8 PCS 8,844.00 Kurang Catat
248 Suction Catheter dewasa No.12 PCS 8,844.00 Kurang Catat
249 Suction Catheter Dewasa No.14 PCS 8844 Kurang Catat
250 Suction Catheter Dewasa No.16 PCS 8844 Kurang Catat
251 Surgical Blades Pcs 783.20 BHP JKN
252 Tablet tambah darah tablet 410 PROGRAM GIZI 2017
253 Tes Golongan Darah PAKET 422,980.00 Dinkes Kota Mks
254 Thiamin (Vitamin B1) tablet 50 mg Tablet 87.00 OBAT DAK 2017
255 Thiamin (Vitamin B1) tablet 50 mg Tablet 91.00 OBAT JKN 2016
256 Triheksifenedil 2 mg TABLET 275.00 Kurang Catat
UNOLAB EURODERM Latex Powdered
257 Surgical Glove 7.0 Pasang 11,841.20 BHPM DAK 2018
UNOLAB EURODERM Latex Powdered
258 Surgical Glove 8.0 Pasang 11,774.53 BHPM DAK 2018
259 Urine Bag Set 5,005.00 BHP JKN 2015
261 Vaksin BCG Flakon 61,996.00 VAKSIN
262 Vaksin Campak VIAL 20,900.00 VAKSIN
263 Vaksin Campak VIAL 28,204.00 VAKSIN
264 Vaksin DPT/HIB VIAL 76,285.00 VAKSIN
265 Vaksin DPT/HIB Paket 78,991.00 VAKSIN
266 Vaksin DT VIAL 14,498.00 VAKSIN
267 Vaksin DT Vial 17,996.00 VAKSIN
268 Vaksin HB-UNIJECT VIAL 28,204.00 VAKSIN
269 Vaksin Polio VIAL 19,954.00 VAKSIN
270 Vaksin Polio Suntik (IPV) VIAL 139,000.00 VAKSIN
271 Vaksin Polio Suntik (IPV) VIAL 285000 VAKSIN
272 Vaksin Td VIAL 16,500.00 VAKSIN
273 Vaksin Td Vial 16995 VAKSIN
274 Widal Test (OMEGA Diagnostic) Vial 184,800.00 BHP DAK 2016
Tablet
275 Zink 20 mg Dispersible 521 OBAT JKN 2015
Tablet
276 Zink 20 mg Dispersible 521.00 OBAT PG 2015
GP CARE 3 Ply Face Mask with Ear-Loops
277 (Jenis Karet) PCS 536.00 BHPM JKN 2017
GP CARE 3-Ply Face Mask With Tie-On (Jenis
278 Tali) Pcs 622.00 BHPM DAK 2018
279 KONIX ECG Gel 1000 ml Dus 26000 BHPM JKN 2018
280 KONIX ECG Gel 1000 ml Dus 31900 BHPM DAK 2017
281 Karbogliserin tetes telinga 10% Botol 2,500.00 OBAT JKN 2016
282 Karbogliserin tetes telinga 10% Botol 2,590.00 OBAT DAK 2018
283 Sianokobalamin(Vitamin B12) tablet 50 mcg Tablet 55.00 OBAT DAK 2017
284 Mineral Mix Sachet 2,550.00 PROGRAM GIZI 2018
Botol 100
285 Larutan Rees Eckher ml 56,100.00 BHP DAK 2016
286 ADS 0,05 ml Pcs 1,240.00 VAKSIN
287 ADS 0,05 ml PCS 1,650.00 VAKSIN
288 ADS 0,5 ml PCS 1,240.00 VAKSIN
289 ADS 5 ml Pcs 1,640.00 VAKSIN
290 ADS 5 ml PCS 1705 VAKSIN
291 Penutup Luka Lebar (Daryantulle) Pcs 28820 BHPM DAK 2018
292 Plaster Luka 2 x 5 (Onemed) Roll 21340 BHPM DAK 2017
293 Kapas Lidi IVA pcs 1155 BHPM JKN 2017
294 Plester Non Woven ( Hypavix) Roll 18480 BHPM DAK 2018
295 Plester Non Woven ( Hypavix) Roll 19415 BHPM DAK 2017
296 Polikresulen Cairan (Albothyl) Bottle/10 ml 64020 BHPM DAK 2017
297 Loratadine tablet (Winatin) Tablet 330 OBAT DAK 2017
298 Reagen Urinaria Test Pcs 13618 BHPM DAK 2018
299 N Asetyl Cystein Kapsul 968 ctm
300 Ambroksol tablet Tablet 159.5 OBAT JKN 2017
301 Clotrimazol cream Tube 5 gr 4180 OBAT JKN 2017
302 Metil Ergometrin tablet 1980 OBAT JKN 2017
LEXAPRAM SIRUP Metoklopramida sirup 5
303 mg/5 ml Botol 2950 OBAT JKN 2017

304 ILIADIN Oksimetazolin tetes hidung 0,025 % Botol 36000 OBAT JKN 2017
305 Setrizin sirup 5 mg/5 ml BOTOL 3300 OBAT JKN 2017
306 TARIVID Ofloksasin tetes telinga 3 % Botol 36900 OBAT JKN 2017
307 Gentamisin tetes mata 0.2 % Botol 4800 OBAT JKN 2017
308 Lansoprazol kapsul 30 mg Kapsul 360 OBAT JKN 2017
309 Betahistin tablet 6 mg TABLET 151 OBAT JKN 2017
310 GEA HCG Pregnancy Test/ Test Kehamilan Pcs 1380 BHPM JKN 2017
311 BRAUN INTROCAN G 18 (Abbocath iv 18) Pcs 9150 BHPM JKN 2017
312 ILIADIN Oksimetazolin tetes hidung 0,05 % Botol 37900 OBAT JKN 2017
313 Omeprazole kapsul Kapsul 148 OBAT JKN 2017
314 Strip Asam Urat Pcs 7145.6 BHPM DAK 2018
315 Strip Asam Urat Pcs 7759.4 BHPM DAK 2017
GEA-GEA HCG Pregnancy Test-Tes
316 Kehamilan Pcs 1350 BHPM DAK 2017
UNOLAB EURODERM Latex Powdered
317 Surgical Glove 7.5 PCS 8865.19 BHPM JKN 2017
318 JAYAMAS Onemed Povidone Iodine 300 ml BOTOL 20695.4 BHPM JKN 2017
STESOLID 5 MG Diazepam enema 5 mg/2.5
319 ml Tube 13384 OBAT DAK 2017
320 COSMOMED Syringe 3 ml Pcs 909 BHPM DAK 2018
321 COSMOMED Syringe 3 ml Pcs 915.24 BHPM JKN 2017
322 DPT-HB-Hib VIAL 76285 VAKSIN
323 Face Masker Lembar 726 HIBAH APBN 2018
324 Handscoen Steril Buah 4598 HIBAH APBN 2018
325 IUD Copper T SET 11800 HIBAH APBN
326 IUD Copper T Set 11800 HIBAH APBN 2018
327 Pil KB STRIP 1518 HIBAH APBN
328 Pil KB Strip 1518 HIBAH APBN 2018
329 Spoit Buah 1260 HIBAH APBN 2018
330 Spoit Imp Buah 1215 HIBAH APBN 2018
331 Susuk KB II Inserter Set 211398 HIBAH APBN 2018
332 Susuk KB II Inserter Set 213220 HIBAH APBN 2018
333 Susuk KB II + Inserter Set 213220 HIBAH APBN 2018
334 ADS/Spoit Set 1215 HIBAH APBN 2018
335 ADS/Spoit Set 1260 HIBAH APBN 2018
336 SAFETY BOX 2.5 ML BOX 19600 VAKSIN
337 SAFETY BOX 2.5 ML PCS 21395 VAKSIN
338 HB.O POUCHES 20900 VAKSIN
339 HB.O Pouches 23991 VAKSIN
340 Rapid Test HBSAg Test 9870 PROGRAM P2 HEPATITIS
PROGRAM P2 HEPATITIS
341 Rapid Test HBSAg STRIP 10847 PKM

342 Rapid Test Anti HCV Test 13329 PROGRAM HEPATITIS PKM

343 SUSUK KB II PLUS INSERTER/IMPLANT Set 211398 HIBAH APBN 2018

344 Handscun Steril pasang 5000 HIBAH APBN 2018
345 Lidocaine Injeksi Ampul 860 HIBAH APBN 2018
346 Povidone Lodine Botol 3335 HIBAH APBN 2018
PROGRAM HIV AIDS DAN
347 SD HIV-1/2 3.0 (multi)(R1) STRIP 22385 PMS PKM
348 Primaquine 15 mg Tablet 205 PROGRAM MALARIA 2018
349 Retinol 100.000 IU Kapsul 327 PROGRAM GIZI 2018
Dehydro Artemisin 40 mg + Piperaquine 320
350 mg (DHP-Firmal) (DMP) Tablet 2160 PROGRAM MALARIA 2018
351 Suntik KB I VIAL 6100 HIBAH APBN
352 SUNTIK KB I VIAL 6100 HIBAH APBN 2018
353 ADS / Spoit Buah 1215 HIBAH APBN 2018

354 OAM tablet 3498 PROGRAM MALARIA PKM

355 Primaquine tablet 205 PROGRAM MALARIA PKM

356 Handscune Steril Pasang 4598 HIBAH APBN 2018
357 Dermatic 10 x 18 cm Lembar 4633 HIBAH APBN 2018
RAPID TEST Care Start Malaria HRP2/PLDH
358 Combo (RDT) Strip 5271 PROGRAM MALARIA 2018
359 HBIG Bx/1 Vial 1300000 PROGRAM P2 HEPATITIS
360 Dermafix 10 x 8 cm Lembar 4633 HIBAH APBN 2018
PROGRAM HIV AIDS dan
361 SD HIV-1/2 3.0 (Multi) Test 14340 PMS
362 Suntik KB III Vial 6100 HIBAH APBN 2018
363 Dermatik 10 x 8 cm Lembar 4633 HIBAH APBN 2018
364 BRAUN INTROCAN G 22 Pcs 9150 BHPM DAK 2018
365 Alat Deteksi Risiko Kehamilan PAKET 522083 Dinkes Kota Mks
366 Primaquine tab 15 mg Tablet 224 PROGRAM MALARIA 2018
367 Kombinasi Kaolin + Pektin NOVADIAR Botol 60 ml 6270 OBAT DAK 2018
368 Vaksin Campak + MR Vial 155813 VAKSIN
369 ADS 0.5 ml Pcs 1650 VAKSIN
370 Vaksin IPV Vial 158994 VAKSIN
371 Symbicort Nebulizer (Budesonid) Can 125840 OBAT JKN 2018
372 Kalamin Lotion Botol 14630 OBAT DAK 2018
373 Prontosan Wound Gel 30 ml BRAUN Botol 203500 BHPM JKN 2018
374 Rapid Test Demam Berdarah(NS1) Panbio pcs 129580 BHPM DAK 2018
375 OAT Kombipak Kategori 1 Paket 316635 PROGRAM TB PARU 2018
376 Lancet Pcs 192 PROGRAM LANSIA 2018
377 Autoklik Pcs 2066.66 PROGRAM LANSIA 2018
378 Autoklik Pcs 2066.67 PROGRAM LANSIA 2018
379 Alkohol Swab Pcs 66.66 PROGRAM LANSIA 2018
380 Alkohol Swab Pcs 66.67 PROGRAM LANSIA 2018
 Reagen Rapid Tes Tifoid (RDT) Fokus
381 Salmonella IgM Test 1809.4 PROGRAM P2 TIFOID 2018
382 Strip Uji Glukosa Strip 6400 PROGRAM LANSIA 2018
383 Strip Uji Kolesterol Strip 18500 PROGRAM LANSIA 2018
384 Strip Uji Asam Urat Strip 8000 PROGRAM LANSIA 2018
385 Safety Box Pcs 11000 PROGRAM LANSIA 2018
Alat Deteksi Resiko Ibu Hamil (Reagen APBN Direktorat Kesehatan
386 Pemeriksaan Goldar) Paket 409816 Keluarga Tahun 2018

Alat Deteksi Resiko Ibu Hamil (Test

Kehamilan+Urine Gluko Protein Test+Blood APBN Direktorat Kesehatan
387 Lancet+Autoclick+Lar. HCl 0.1 N+HB Sahli) Paket 501745 Keluarga Tahun 2018
388 Guaifenesin tablet (GG) Tablet 93.5 OBAT JKN 2018
389 Elkana Sirup (Multivitamin Anak) Botol 60 ml 22000 OBAT JKN 2018
390 Thiamex ( Thiamfenikol) 500 mg tablet Tablet 1402.5 OBAT JKN 2018
391 Widal Test Set 1991000 BHPM DAK 2018
392 JAYAMAS Onemed Alcohol Swab Pcs 110 BHPM JKN 2018
393 Vaksin HPV Vial 150000 VAKSIN
394 Deksametasone tablet
395 Salbutamol 4 mg
396 zink syr
397 Glimepiride 1 mg
398 Simvastatin 20 mg
399 Kalsium Laktat (Kalk) tablet 500 mg
STOK 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
10 10

3 4 1

1 4 1

40 20 28 131 100 120 25 100 103

1
10 30 40 10

47 20 20 48 145 61 112 70 67 105

10 12 12 30

10
10 20 10 60
 5

40 10 20
 20 10 40 40 20 80

20 10 113 115 71 50 70 118

1 6 2 3 2
20 10 10 10

20 10
2 1 1
 1 1 2 1

47 18 116 101 56 119 99 72

10 5

10
 1

1
30

30

1
 6
1 1

12 12 12 24

30 60

20 20 3 73 51 41 60 46

10
20 60 30 60 70 40 60

1
25 40 45 137 153 45 50 96 130
1
5 2 1 1

70 60 10 10

15 32 19 3

40 30 10 20
 1

40 10 80
10 10 10 40 10 30 50

30
10 10 10 30 10
 10 5 20

20 20
33 30 20 10 20 20 40

10
10
1
24 30 15 36 36 49 35 7 17

10 40 50 50 44 20 40

3 1

40 40 30
230 100 190 30 40 120
16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
20 10 10 10

1 1 1 1 1 1 1 1

1 1

162 84 52 65 40 110 108 184 115 40

1
50 30 50 25 110 90 20

138 49 52 60 42 43 71 136 115 20

12 10

13 10
40 10 20
 20 10 10

5 5

10 10 20
 10 20 90 10

84 45 33 37 67 89 103 60 53 70

2 1 2 1 1 1
20 20 20 10 30

20

2
 1 1 1 1

94 51 66 25 44 94 47 91 43 75

20 20

1 1 1
10 2 5

10
 1

1
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10
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2 1 1

10

20 40 60

70 10 25 29 33 74 43 55 20 10

10 10 10 10
 2 1

100 20 70 40 110 70 100 70 20 30

1
126 85 98 79 47 97 69 62 73 85
1 1
2 1 3 1 1 2 1 1
2

55

5 3 5 20 16 27 3 10 10

20 20 30 10 20 10
 1

1
40 20 10 10 10
1
60 20 30 20 30 35 50 30 20
 1
40 20 30 20 20 20 35 40 10 10
 1
10 5 5 10 5 5

10
20 20 10 31 45 20 20 50 30

5
10 10
 35 39 17 5 20 6 14 30 3

30 33 13 12 20 35 20 15
15
1 2 1
60
10 10 30 30 10
130 40 30 10 40 30 140 120 20
JML
70

-
-
-
16
-
8
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-
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1,627
-
2
465
-
1,421
-
86
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33
170
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15
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110
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340
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1,208

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22
150
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20
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6

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 9
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1,258
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6 dak 2016

70
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NO NAMA OBAT DAN BHP
Omeprazole kapsul 20 mg

BUFACETINE Kloramfenikol salep kulit 2 %

Triheksifenidil tablet
Bedak salisil serbuk 2 %
Asam Askorbat (vitamin C) tablet 50 mg
Kloramfenikol salep mata 1 %
Piridoksin (Vitamin B6) tablet 10 mg
Vitamin B Kompleks tablet
Atorvastatin tablet salut selaput
Loperamid tablet 2 mg
Amlodipin tablet 5 mg
Alopurinol tablet 300 mg
Garam Oralit
Pirantel 125 mg
Allopurinol 100 mg
Amlodipin 10 mg
Amoksisillin kaplet 500 mg
Amoksisilin Sirup Kering 125 mg/5 ml
Antasida DOEN
Antihaemorroid SUPPO
Asiklovir 400 mg
Asiklovir 200 mg
Asiklovir krim 5 %
Betametason krim 0,1 % (sebagai Valerat)
Chlorpeniramine maleat 4mg (CTM)
Diazepam 2 mg
Domperidon suspensi/sirup 5 mg/5 ml
Domperidon tablet 10 mg
Fitomenadion (Vitamin K1) 10 mg
Gentamisin Salep Kulit
Hidrokortison krim
Ibuprofen 400 mg tablet
Kalium Diklofenak 50 mg
Ketokonazole 2 % krim
Kodein 10 mg
Kotri syr
Kotrimoksazol 480 mg kombinasi : Sulfametoksazol 400 mg
Trimetoprim 80 mg
Metformin HCl tablet 500 mg
Metilprednisolon tablet 4 mg
Metronidazol 500 mg
Mikonazole krim/Salep 2% Nitrat
Natrium Diklofenak tablet 25 mg
Obat Anti Tuberculosis FDC Kategori Anak
Obat Antituberkulosis FDC Kategori I

Parasetamol 500 mg
Parasetamol Drops (Fasidol Drops)
Parasetamol sirup
Parasetamol syrup 120 mg/5 ml
Piridoksin (Vitamin B6) tablet 10 mg (HCl)
Prednison 5 mg
Ranitidin 150 mg
Salep 2-4 , Kombinasi : Asam Salisilat 2% + Belerang endap
4%
Setirizin sirup 5 mg/5 ml
Simvastatin 10 mg
Spoit 50 cc
Thiamin (Vitamin B1) tablet 50 mg
Triheksifenedil 2 mg
Karbogliserin tetes telinga 10%
Sianokobalamin(Vitamin B12) tablet 50 mcg
Polikresulen Cairan (Albothyl)
Loratadine tablet (Winatin)
N Asetyl Cystein lama
N Asetyl Cystein baru
Ambroksol tablet
Lansoprazol kapsul 30 mg
Betahistin tablet 6 mg
Kalamin Lotion
Guaifenesin tablet (GG)
Deksametasone tablet
Salbutamol 4 mg
zink syr
Glimepiride 1 mg
Simvastatin 20 mg
Kalsium Laktat (Kalk) tablet 500 mg
 SUMBER DANA
OBAT DAK 2017

OBAT DAK 2018

OBAT DAK 2017
OBAT DAK 2017
OBAT DAK 2018
OBAT DAK 2017
OBAT DAK 2017
OBAT DAK 2017
OBAT DAK 2018
OBAT DAK 2017
OBAT DAK 2018
OBAT DAK 2017
PROGRAM DIARE 2018
OBAT DAK 2018
OBAT DAK 2018
OBAT JKN 2018
OBAT DAK 2016
OBAT JKN 2018
OBAT DAK 2018
OBAT DAK 2017
OBAT DAK 2018
PG 2014
OBAT DAK 2018
OBAT DAK 2018
OBAT JKN 2018
OBAT DAK 2018
OBAT DAK 2016
OBAT DAK 2016
OBAT DAK 2018
OBAT DAK 2018
OBAT DAK 2018
OBAT DAK 2016
OBAT JKN 2018
OBAT DAK 2018
OBAT JKN 2016
OBAT DAK 2016
 OBAT DAK 2017
OBAT DAK 2016
OBAT DAK 2018
OBAT DAK 2017
OBAT DAK 2018
OBAT DAK 2018
PROGRAM TB PARU 2018
PROGRAM TB PARU 2018

ASKES 2013 ANGGARAN 2015

OBAT DAK 2017
OBAT JKN 2018
OBAT DAK 2016
OBAT DAK 2016
OBAT JKN 2015
OBAT DAK 2018

OBAT DAK 2018

OBAT JKN 2016
OBAT DAK 2017
Kurang Catat
OBAT DAK 2017
Kurang Catat
OBAT DAK 2018
OBAT DAK 2017
BHPM DAK 2017
OBAT DAK 2017
OBAT DAK 2017
OBAT DAK 2019
OBAT JKN 2017
OBAT JKN 2017
OBAT JKN 2017
OBAT DAK 2018
OBAT JKN 2018
OBAT DAK 2018
OBAT JKN 2018
OBAT DAK 2018
OBAT DAK 2017
OBAT DAK 2019
OBAT DAK 2019