BUKU PENERIMAAN OBAT JKN

Tanggal

No Faktur

Nama Distributor

Nama Obat

PT. USAHATAMA

KOMBINASI INJEKSI DEPOT : MEDROKSI

POGESTERON ASETAT 25 mg ESTRADIOL
SIPIONAT 5 mg

20 juli 2015

PT. SANBE FARMA

BISAKODIL SUPPOSITORIA 10 mg

13 AGUSTUS

PT AAM

Stardex surgical powdered 7, 7.5

PT. Sinar Roda

Utama

NIPRO Syringe 10cc Luer Lock With Needle

NIPRO Syringe 1cc Tuberculin With Needle
NIPRO Syringe 3cc Lock With Needle
NIPRO Syringe 5cc Luer Lock With Needle

4-Sep-15

PT Marin Liza
Farmasi

Salep 24
Fitomenadion (Vit K1) tablet salut 10 mg
Karbogliserin tetes telinga 10% (Fenol
Glyserol)
Sianokobalamin (Vit B12) injeksi 500 mcg

4-Sep-15

PT. KFTD BANDUNG Metronidazole Tablet 500 MG

ZincTablet Reversible 20 mg
Vitamin B Komplek Tablet
Mikonazole Krim/Salep 2%

Kontrasepsi Pil Oral

Betametason Krim 0,1%
Antimigren
Antihemoroid
7-Sep-15

PT. Rajawali Nusindo

AHMADARIS
Alkes
AHMADARIS
AHMADARIS
AHMADARIS

DRC 250 mg
DRC 36x80
kasahidrofil 2x80
kasakompres DRC 40x40

AHMADARIS Kasapembalut DRC 4 10 cm

AHMADARIS KasaSteril DRC/16 pad 16 x 16
cm
JELCO 1 (20G)
JELCO 1 (22G)
JELCO 1 (24G)
CATGUT PLAIN SMI 2/0 HR 26 MM
CATGUT PLAIN SMI 3/0 HR 26 MM
CATGUT CHROMIC SMI 2/0 HR 37 MM
CATGUT PLAIN SMI 3/0 HR 26 MM
7-Sep-15

PT. Rajawali Nusindo

Obat anti Tuberculosis FDC Kategori 1
Obat
Fitomenadion (vitamin k1) injeki.m. 2 mg/ml
Epinefrin (Adrenalin) injeksii.v/s.k./i.m 1
mg/ml

11-Sep-15

PT. AMS

Ofloxacin tablet 200 mg

Natrium Diklofenak Tablet

Permetrin Krim 5% (Scabimite cream 10)

Laxadine Emulsi 60 ML
18-Sep

pt mensabinasukses Terumo Terufusion Solution Administrasi Set

Terumo Pediatric Solution Administrasi Set

17-Sep-15

PT. Sapta Sari Tama Garam Oralit

Klorfeniramine Maleate CTM tablet 4 mg
Bedak Salisil Serbuk 2%

21-Sep-15

PT. Bina San Prima

Bisakodil Suppositoria 10 mg

29-Sep-15

PT. Merapi Utama

Pharma
Magnesium Sulfat
Injeksi

Magnesium Sulfat Injeksi

Pirantel tablet score (base) 125 mg

1 oktober 15

16 Oktober 2015

3-Nov-15

FJ-2720150033561

pt ppg

Oksitosin Injek 10 IU/ml

PT. Holi Pharma

Sefadroxil Kapsul/ Kaplet 500 mg

bina san prima

Pirantel tablet score (base) 125 mg

Pirantel suspensi 125 mg/5 ml
Kotrimoxazole Doen
Multivitamin syrup (Sanvita B )

Multivitamin tab (komposisi : vit A

4000IU,Vit C 50 mg, Vit D 400IU, VitE 10
mg, vit B1 20 mg, Vit B2 5 mg,Vit B6 10 mg,
Vit B12 5 mg, Nicotinamide 50 mg, Ca-Pan
11,6 mg, Asam folat 0,4 mg, Biotin 0,25 mg,
Besi 10 mg,Kalsium 50 mg, tembaga 0,712
mg, Mn 0,5 mg, Mg 16,4 mg, Zn 0,343 mg,
fosfor 38,64 mg, Mangan 0,379 mg, kalium
0,035 mg, selenium 0,061 mg, molibdenum
0,083 mg) (Pervita)
Nystatin susp 100000 IU/ml (Nymiko)
OBH (Phenacold)
Obat Flue tab komb Tripolidin 2,5 mg,
Pseudoefedrin HCl 30 mg (Tremenza)
Tablet Tambah darah Komb :Besi (II)
Gluconat 250 mg, Mn (II) sulfat 0,2 mg,
Cu(II)SO4 0,2 mg, Asam Folat 1 mg,Vit C 50
mg, Vit B12 7,5 Mcg, serbuk sorbitol 25 mg
(Biosanbe)
Koamoksiklav (Capsinat)
Vitamin Neurotropik (kombinsi Thiamin HCL
100mg,Pyridoksin HCL 200mg dan
Cyanokobalamin 200mcg) (Neurosanbe
tablet)
20-Nov-15

MS-RH/XI/2015/0910

PT. Muara Sakti

H2O2 3% 100 mL
PP Test Onemed
Sarung tangan Gynaecolog
Strip Test Asam urat Benecheck
Strip Kolesterol Benecheck
Strip Test Glukosa Benecheck

24-Nov-15
11 Desember
2015

4037908916

PT. Metro Drug

Indonesia

Carbol Fuchsin 100 mL

Amoxicilline kapsul/kaplet/tablet scored 500
mg

PT. IMS

ONEMED Alkohol 70% 1 lt

ONEMED Alkohol Swab
ONEMED urocare Folley Catheter 2 Way
No.18
ONEMED urocare Folley Catheter 2 Way
No.20
ONEMED Lysol 1 liter
ONEMED Rivanol 300cc
ONEMED Surgical Mask-3 ply Earloop
ONEMED Umbilical Cord Klem Steril Nylon

21 Desember
2015

PT. IGM

Povidon iodida larutan 10% 300 ml

Povidon iodida larutan 10% 30 ml
Parasetamol sirup 120 mg/5ml
Kalsium laktat tablet 500 mg
NaCl 0,9%
Rifampicin tablet 300 mg
Sefixim sirup kering 100 mg/5 ml
Ondansentron inj 4 mg/2 ml
Karbamazepin tablet 200 mg
Isosorbid Dinitrat tablet Sublingual 5 mg

Glibenklamid tablet 5 mg
Furosemid Tablet 40 mg
Eritromisin Kapsul 500 mg
Deksameason injeksi i.v/i.m 5 mg/ml
Omeprazole Kapsul 20 mg
Etanol 70% cairan
Domperidon suspensi 5 mg/5ml
Amoksisilin Kapsul 250 mg
29 Desember
2015

PT. IGM non

Ambroxol syr 15mg/5ml

Ambroxol tab 30mg
Bioplacenton jelly
Bromhexin tablet 8 mg
Etil Klorida semprot
Gentian violet larutan 0,14 10 ml
Gliseril guaiacolat 100 mg
Gliseril guaiacolat Syrup
Metoklopramide 10 mg tab
Natrium bikarbonat 500 mg
Obat Batuk Flue Syrup Alpara
Obat Diare Tab (Komb atapulgit dan pektin)
Pyridoksin HCl 10 mg
Piroksikam 20 mg
Salbutamol 4 mg
Sulfasetamide Na TM 15 % 5 ml

30 Desember
2015

PT. IMS

STERA Infusion Set Dewasa (20 drops/ml)

ONEMED Kasa Hidrophil Steril 16 x 16 cm
ONEMED Safeglove PF

ONEMED Silk 3/0 + jarum GT 35 mm

30 Desember
2015

30 Desember
2015

PT. Rajawali Nusindo

Metisoprinol 500 mg tab
Non
Lidocain comp adrenalin (Pehacain)
Fitomenadion inj 10 mg/ml
Asam Mafenamat
PT. AMS Non

Sefixim Tablet 100 mg

Dimetylpolisiloksan aktif 40 mg
Lacto B

30 Desember

PT saptasari non

AMOXICILLINE DRY SYRUP (Solpenox Syr)

OBH Tropica Madu Anak 60 ml
OBH Tropika Berdahak 60 ml
Obat Flu Tablet Antiza

AAN OBAT JKN 2015

Nama Pabrik

Kemasan

PT. TRIYASA

VIAL

200

PT. SANBE FARMA

Supp

48

PT. Djembatan Dua

PASANG

600

PT. Sinar Roda Utama

Set

100

PT. Sinar Roda Utama

Set

800

PT. Sinar Roda Utama

Set

3000

PT. Sinar Roda Utama

Set

800

PT Marin Liza Farmasi

POT

240

PT Marin Liza Farmasi

TABLET

300

PT. Lucas Djaja

BOTOL

24

PT. Lucas Djaja

AMPUL

300

PT. Phyto Kemo Agung Farma 10 Strip @ 10 Tablet

PT. Kimia Farma
PT. Kimia Farma
PT. Kimia Farma

Kotak 10 X 10 Tablet
Dus10 Strip X 10 Tablet
Tube 10 G

Jumlah

1500
4,800
18,000
120

No Batch

Exp date

PT.
PT.
PT.
PT.

Kimia
Kimia
Kimia
Kimia

Farma
Farma
Farma
Farma

Dus, 100 Blister @ 28 Tablet

Tube 5 G
Btl 100 Tablet
Dus, 10 Supp @ 2 Gram

476
300
100
120

PT. Ahmadaris

10

PT. Ahmadaris
PT. Ahmadaris
PT. Ahmadaris

15
200
100

PT. Ahmadaris

400

PT. Ahmadaris

12

PT.
PT.
PT.
PT.
PT.
PT.
PT.

Rajawali
Rajawali
Rajawali
Rajawali
Rajawali
Rajawali
Rajawali

Nusindo
Nusindo
Nusindo
Nusindo
Nusindo
Nusindo
Nusindo

400
400
400
96
96
96
96

PT. Phapros, Tbk

Paket

16

PT. Phapros, Tbk

Dus @30 ampul

90

PT. Phapros, Tbk

Dus @30 ampul

30

PT. Novell Pharmaceutical

laboratories

Box 5 strip @ 10 tablet

PT. Novell Pharmaceutical

laboratories

Box 5 Blister @ 10 tablet

500

3,600

PT.Galenium Pharmasia
laboratories
PT.Galenium Pharmasia
laboratories

Tube @ 10 g

200

Botol @ 60 ml

100

PT. Terumo Indonesia

Set

400

PT. Terumo Indonesia

Set

100

PT. Rama Emerald Multi

Sukses
PT. Rama Emerald Multi
Sukses
PT. Rama Emerald Multi
Sukses

Kotak 100 Sachet

Kotak 10 strip @ 10 tablet
Dus @50 gram

3000
18000
200

PT Sanbe Farma

supp 48

48

PT. Otsuka Indonesia

Dus, 120 Ampul plastik @ 25ml

120

PT. Otsuka Indonesia

Dus, 120 Ampul plastik @ 25ml

120

PT. Ethica industri Farmasi

Ampul @ 1 ml

400

PT. Holi Pharma

Dus, 10 Strip @ 10 Kapsul

8,000

PT. Holi Pharma

PT. Holi Pharma
PT. Holi Pharma
Sanbe

Dus, 25 Blister @4 Tablet

Botol 60 ml
Dus, 10 Strip @ 10 Kaptab
Botol

300
50
7,000
300

18-May

Sanbe

Ktk 100

30

Sanbe

Botol

37

Capri

Botol 100 ml

Sanbe

Kk 25 x 4t

20

Sanbe

Ktk 100

50

Capri

Kaplet

1.98

Sanbe

Tablet

20

Botol
Buah
Pasang
Tube
Tube
Tube

20
4
50
8
20
8

300

Botol
PT. Bernofarm

Dus, 10 strip @ 10 Kaptab

6
7500

PT. Jayamas Medica Industri Botol

40

PT. Jayamas Medica Industri Botol

10

PT. Jayamas Medica Industri Pcs

100

PT. Jayamas Medica Industri Pcs

100

PT. Jayamas Medica Industri Botol

PT. Jayamas Medica Industri Botol

30

PT. Jayamas Medica Industri Box

20

PT. Jayamas Medica Industri Pcs

100

PT. Afifarma

Botol @300 ml

PT. Afifarma
PT. Afifarma
PT. Afifarma
PT. Widatra Bhakti
PT. Indofarma
PT. Ifars Pharmaceutical
Laboratories
PT. Indofarma
PT. Indofarma

Botol @30 ml
Botol 60 ml
Dus, 10 Strip @ 10 tablet
Botol 500 ml
Dus, 10 Strip @ 10 kapsul

PT. Indofarma

60
150
7,200
5,000
200
500

Dus, Botol 30 ml

560

Dus 5 Ampul @2ml

Dus 10 Blister @10 tablet

200
300

Dus 10 Strip @10 tablet

200

PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.

Indofarma
Indofarma
Indofarma
Indofarma
Novarin
Novarin
Novarin
Novarin

Dus, 10 Blister @10 kaptab

Dus 10 Strip @10 tablet
Dus 10 Blister @10 tablet
Dus 100 Ampul @ 1 ml
Dus 10x 3S
Botol @ 100 ml
Botol @ 60 ml
Dus 10 x 10S

1,000
400
1,000
200
3,000
60
100
10,000

PT. Indofarma

Botol

500

PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.
PT.

Ktk 100
Tube
Tablet
Botol
Botol
Tablet
Botol
Tablet
Tablet
botol 60 ml

80
50
2
10
150
20
576
2
1
200

Novapharin
Kalbe
Novapharin
Bintang Saudara
Bintang Saudara
Lucas
Lucas
Novapharin
Lucas
Molex Ayus

PT. Molex Ayus

Tablet

PT.
PT.
PT.
PT.

Tablet
Kapsul
Tablet
Botol

6
4
800
40

Lucas
Novapharin
Molex Ayus
Erela

PT. Jayamas Medica Industri Pcs

300

PT. Jayamas Medica Industri Box

200

PT. Jayamas Medica Industri Psg

30

PT. Jayamas Medica Industri Box

PT. Phapros, Tbk

Tablet

2,000

PT. Phapros, Tbk

PT. Phapros, Tbk
PT. Phapros, Tbk

Ktk 20 Amp
Ampul
Tablet

72
60
30000

PT. Novel

Dus, 5 strip @ 10 tab

90

PT. Phoros
PT. Novel

Dus, 10 strip @ 10 tab

Dus isi 40 Sachet

30
20

PT. Solas

BOTOL

3000

PT. Tropicana

BOTOL

480

PT. Tropicana

BOTOL

480

Coronet

Tablet

4000