Lampiran permintaan obat sesuai formularium 10 besar penyakit

No. Nama Obat Sediaan Dosis

1 Captopril Tablet 25mg
2 Amlodipine Tablet 10mg
3 Thiazide Tablet 20mg
4 Glimepiride Tablet 2 mg
4 mg
5 Methformin Tablet 500mg
6 Salep 2-4 oint 1 pot
7 Scabimite Cream Tube
8 Cetirizine Tablet 10mg
9 Erytromicyn Tablet 500mg
10 Asam salisilat Serbuk campuran 2%
11 Vaselin album oint 1 pot
12 Hydrocortison 2,5% Cream Tube
13 Bethametasone 0,1% Cream Tube
14 Gentamicin Cream Salep kulit Tube
Oint Salep mata
15 Ctm Tablet 4 mg
16 Ketoconazole Tablet 200mg
17 Griseofluvin Tablet 500mg
18 Ketoconazole Cream Tube
19 Guaifenisin Tablet 100mg
20 Gg Tablet 100mg
21 Ambroxol Tablet 30mg
22 Bromhexin HCl Tablet 8 mg
23 Ibuprofen Tablet 400mg
24 Paracetamol Tablet 500mg
25 Vitamin c Tablet 50mg
26 Vitamin B6 Tablet 10mg
27 Antasida doen Tablet 200mg
28 Amoxicilin Tablet 500mg
29 Dexamethasone Tablet 0.5mg
30 Prednison Tablet 5mg
31 Salbutamol Tablet 4mg
32 Ranitidine Tablet 150mg
33 Chloramphenicol Tablet 500mg