SK Tentang Peresepan Pemesannan Dan Pengelolaan Obat

REKAPITULASI LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(LPLPO) Triwulan I
PUSKESMAS : LIWA
PUSKESMAS PEMBANTU : -
KECAMATAN : LIWA LAPORAN BULAN/PERIODE : Januari - Maret 2018
KABUPATEN : Lampung Barat
Harga Penerimaan/Triwulan Total Pemakaian/Triwulan Total

No. Nama Generik Satuan Stock Awal Sisa Stock Jumlah Pemakaian (Rp)
Per satuan Januari Februari Maret Penerimaan Januari Februari Maret Pemakaian
1 2 3 4 5 6 7 8 9 10 11
1 Alat suntik sekali pakai 1 ml pcs 990 2,520 500 3020 2,020 100 2120 900 2,098,800.00
2 Alat suntik sekali pakai 2,5 ml pcs 792 1,100 1,000 2100 650 100 400 1150 950 910,800.00
3 Alat suntik sekali pakai 5 ml pcs 979 1,300 500 1800 900 100 1000 800 979,000.00
4 Alat tes gula darah kotak 1,771,000 - 0 0 0 -
5 Alat tes HB / HB sahli one med set 88,000 5 5 1 1 2 3 176,000.00
6 Albendazol 400 mg tab 392 0 0 0 -
7 Allupurinol tab 100 mg tab 110 1,300 1300 500 500 800 55,000.00
8 Aminofilin tablet 200 mg tab 91 1,100 2,000 3100 1,600 1600 1500 145,600.00
9 Aminofilina injeksi 24 mg/ml - 10 ml ampul 2,998 55 55 25 25 30 74,950.00
10 Amitriptillin tab salut 25 mg (HCL) tab 143 1,400 1400 100 100 1300 14,300.00
11 Amlodipine tab 105 1,600 3,000 4600 1,800 750 750 3300 1300 346,500.00
12 Amoksisilin kaplet 500 mg tab 190 4,600 8,000 12600 5,300 2,800 2,400 10500 2100 1,995,000.00
13 Amoksisilin kapsul 250 mg tablet 195 - 1,100 1100 300 300 600 500 117,000.00
14 Amoksisilin sirup kering 125 mg/5ml btl 1,881 20 150 170 35 25 35 95 75 178,695.00
15 Ampisillin inj 1 gr vial 9,270 30 30 0 30 -
16 Antasida Doen II Suspensi suspensi 2,025 110 150 260 180 60 20 260 0 526,500.00
17 Antasida Doen tab kombinasi tab 62 5,400 6,000 11400 5,000 1,500 1,200 7700 3700 477,400.00
18 Anti Bakteri DOEN salep kombinasi:Basitrasin 500 IU/g + Po tube 2,924 - 25 25 25 25 0 73,100.00
19 Anti konstipasi dulcolax supp supositoria 5,800 50 50 10 5 15 35 87,000.00
20 Anti Hemoroid DOEN Kombinasi supp 3,045 45 45 25 25 20 76,125.00
21 Anti Malaria kombinasi (Artemether) ampul 25,490 12 18 30 18 18 12 458,820.00
22 Anti Skabies cream tube 12,155 30 30 60 2 10 12 48 145,860.00
23 Antifungi DOEN Kombinasi:Asam Benzoat 6% + Asam Salisi pot 4,323 50 48 98 45 45 53 194,535.00
24 Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg tab 135 1,000 1000 300 100 400 600 54,000.00
25 Aqua pro injeksi steril,bebas pirogen 20 ml/vial vial 2,750 36 50 86 57 15 72 14 198,000.00
26 Asam Askorbat (Vit C) tablet 50 mg tab 104 5,800 5,000 10800 5,600 500 2,000 8100 2700 842,400.00
27 Asam Mefenamat tab 500 mg tab 100 2,100 3,000 5100 1,500 500 1,000 3000 2100 300,000.00
28 Asam tranexamic injeksi ampul 1,956 20 20 0 20 -
29 Asetosal / miniaspi 80 tab 92 500 500 200 200 300 18,400.00
1 2 3 4 5 6 7 8 9 10 11
30 Asetosal tablet 100 mg tab 130 700 700 0 700 -
31 Asiklovir 400 mg tab tab 365 600 600 300 300 300 109,500.00
32 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 1,540 80 80 0 80 -
33 Atropin tab 0,5 mg tab tab 74 1,100 1100 0 1100 -
34 Becefort syr (multi vitamin 60 ml) botol 17,360 50 50 5 - 5 45 86,800.00
35 Betametason krim 0.1% tube 3,388 - 30 30 10 8 6 24 6 81,312.00
36 Bisacodyl tab 5 mg tab 300 300 300 60 90 150 150 45,000.00
37 Bisturi pcs 300,000 - 2 2 0 2 -
38 Buscopan 10 mg tab 2,972 300 300 300 300 0 891,600.00
39 Calprosis 500 tab 430 1,500 1500 120 120 460 700 800 301,000.00
40 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah set 32,800 48 48 96 64 8 12 84 12 2,755,200.00
41 Cefadroksil 500 mg kapsul kapsul 516 - 0 0 0 -
42 Cetirizine 5 mg/5 ml syr btl 3,150 54 50 104 40 40 64 126,000.00
43 Cetirizine kap 10 mg kapsul 143 900 1,000 1900 500 800 1300 600 185,900.00
44 Cuticell classic 10x10cm buah 5,198 100 100 20 20 80 103,960.00
45 Deck Glas set 82,500 - 0 0 0 -
46 Deksametason injeksi 5 mg/ml - 1 ml ampul 1,540 100 50 150 50 25 75 75 115,500.00
47 Deksametason tablet 0,5 mg tab 44 4,300 5,000 9300 4,500 1,000 1,000 6500 2800 286,000.00
48 Devitalisasi Pasta (Non Arsen) btl 220,000 - 0 0 0 -
49 Diapecta tab tab 510 - 0 0 0 -
50 Difenhidramin HCl inj 10 mg/ml-1 ml ampul 1,176 110 30 140 0 140 -
51 Digoksin tablet 0,25 mg tab 104 500 500 0 500 -
52 Doksisiklin kapsul 100 mg kapsul 268 1,800 1,000 2800 1,000 1000 1800 268,000.00
53 Domperidone 10 mg tablet tablet 95 - 200 200 100 100 200 0 19,000.00
54 Dopamet 250 mg tab tab 911 0 0 0 -
55 EDTA 250gr set 74,100 - 0 0 0 -
56 Eosin (px faeces) 250 set 176,225 - 0 0 0 -
57 Epineprin injeksi 0,1% ampul 2,204 60 30 90 30 30 60 66,120.00
58 Erytromysin 200 mg/5ml btl 6,700 55 55 20 20 35 134,000.00
59 Erytromysin tab 250 mg kapsul 566 700 700 100 200 300 400 169,800.00
60 Erytromysin tab 500 mg tab 730 - 1,000 1000 200 400 600 400 438,000.00
61 Etakridina (Rivanol) lar 0,1% btl 3,000 24 24 48 31 31 17 93,000.00
62 Etanol 70 % btl 2,500 51 51 0 51 -
63 etanol 70 % 1 liter botol 21,000 - 0 0 0 -
64 Eugenol cairan btl 18,100 38 38 3 3 35 54,300.00
65 Fenitoin Natrium kapsul 30 mg kapsul 154 1,000 1000 0 1000 -
66 Fenol Gliserol tetes telinga 10% btl 2,500 - 48 48 24 24 24 60,000.00
1 2 3 4 5 6 7 8 9 10 11
67 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml ampul 4,167 78 60 138 50 50 88 208,350.00
68 Fitomenadion (Vit.K1) tablet salut gula 10 mg tab 695 2,900 1,000 3900 1,700 200 1900 2000 1,320,500.00
69 Foley cateter 16 pcs 11,000 12 12 3 3 9 33,000.00
70 Foley cateter 18 pcs 11,000 6 6 0 6 -
71 Furosemid inj i.v/i.m 10/ml mg ampul 1,829 50 25 75 50 50 25 91,450.00
72 Furosemid tablet 40 mg tab 80 200 1,000 1200 500 200 700 500 56,000.00
73 Garam Oralit untuk 200 ml air sachet 260 480 480 255 255 225 66,300.00
74 Glass Ionomer Cement ART set 521,000 - 0 0 0 -
75 Glibenklamid tablet 5 mg tab 101 1,500 1500 0 1500 -
76 Glimepiride 2 mg tablet 436 600 600 0 600 -
77 Glukosa larutan infus 5 % steril (Produk lokal) btl 6,900 95 100 195 105 20 15 140 55 966,000.00
78 Griseofulvin tab 125 mg tab 249 100 100 100 100 0 24,900.00
79 H2O2 3% btl 30,855 - 0 0 0 -
80 H2O2 100 ml btl 4,780 0 0 0 -
81 Haloperidol injeksi ampul 4,974 62 24 86 86 86 0 427,764.00
82 Haloperidol tablet 1,5 mg tab 66 1,300 1,000 2300 400 400 1900 26,400.00
83 Handscoon pcs 7,600 10 10 10 10 0 76,000.00
84 Handscoon no 8 pcs 7,600 100 100 73 27 100 0 760,000.00
85 Hidroklorotiazid (HCT) tablet 25 mg tab 149 100 100 0 100 -
86 Hidrokortison krim 2,5 % tube 2,640 - 48 48 24 5 19 48 0 126,720.00
87 Ibuprofen suspensi 100 mg/5 ml btl 2,475 150 150 90 30 120 30 297,000.00
88 Ibuprofen tablet 400 mg tab 127 500 5,000 5500 2,700 1,300 900 4900 600 622,300.00
89 Infusion set anak set 9,200 200 200 20 20 180 184,000.00
90 Infusion set dewasa set 8,200 50 50 20 20 10 50 0 410,000.00
91 Isosorbid Dinitrat tablet sublingual 5 mg tab 90 2,000 2000 300 400 700 1300 63,000.00
92 IV Catheter 18 G pcs 7,000 120 120 0 120 -
93 IV Catheter No.20 G pcs 7,000 295 295 165 165 130 1,155,000.00
94 IV Catheter No.22G pcs 7,000 200 200 95 34 129 71 903,000.00
95 IV Catheter No.24 G pcs 7,000 279 279 95 50 145 134 1,015,000.00
96 IV Catheter No.26 G set 21,065 17 17 0 17 -
97 Kalsium Glukonas inj ampul 9,955 48 48 0 48 -
98 Kalsium Hidroksida Pasta tube 159,500 4 4 4 4 0 638,000.00
99 Kalsium Laktat (Kalk) tablet 500 mg tab 56 1,000 1,000 2000 1,000 200 1200 800 67,200.00
100 Kapas pembalut absorben 250 mg glg 24,000 84 84 50 5 55 29 1,320,000.00
101 Kaptopril tab 12,5 mg tab 62 200 1,000 1200 500 500 700 31,000.00
102 Kaptopril tab 25 mg tab 80 - 1,000 1000 300 300 400 1000 0 80,000.00
103 Karbamazepin tablet 200 mg tab 245 800 800 300 200 500 300 122,500.00
1 2 3 4 5 6 7 8 9 10 11
104 Kartu Golongan Darah Set 33,000 - 0 0 0 -
105 kasa gulung besar 1 meter glg 130,000 2 10 12 2 3 5 7 650,000.00
106 Kasa hidrofil steril 18x22 ktk 5,900 - 0 0 0 -
107 Kasa kompres 16x16 steril ktk 7,900 122 122 55 10 65 57 513,500.00
108 Kasa pembalu hidrofil 4 x 10 cm elastis glg 2,300 110 110 0 110 -
109 Kasa pembalut elastis 3 inch rol 27,660 50 50 50 50 0 1,383,000.00
110 kasa pembalut hidrofil 4 x 5 cm glg 750 150 150 150 150 0 112,500.00
111 Kertas perkamen kantong 104,032 13 18 31 10 - - 10 21 1,040,320.00
112 ketokonazole krim 2% tube 2,545 25 10 35 10 25 35 0 89,075.00
113 Ketokonazole tab 200 mg tab 280 - 200 200 100 100 100 28,000.00
114 Ketoprofen suppos supositoria 2,640 10 10 0 10 -
115 Klindamysin kapsul 150 mg kapsul 578 700 300 1000 300 400 700 300 404,600.00
116 Kloramfenikol kapsul 250 mg kapsul 428 800 800 800 800 0 342,400.00
117 Kloramfenikol kapsul 500 mg kapsul 1,048 500 500 200 200 300 209,600.00
118 Kloramfenikol syr 60 ml btl 4,700 40 70 110 60 60 50 282,000.00
119 Klorfeniramin Maleat (CTM) tablet 4 mg tab 42 2,000 5,000 7000 3,800 2,000 1,200 7000 0 294,000.00
120 Klorfenol kamper menthol (CHKM) btl 55,000 17 17 0 17 -
121 Klorpromazin HCl injeksi 25 mg/ml - 1 ml ampul 1,205 144 144 114 114 30 137,370.00
122 Klorpromazin HCl tablet salut 25 mg tab 148 800 200 1000 400 400 600 59,200.00
123 Klorpromazine tab 100 mg tab 148 300 300 0 300 -
124 Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Tr btl 2,286 40 50 90 20 20 70 45,720.00
125 Kotrimoksazol tablet kombinasi: Sulfametoksazol 400 mg + tab 129 1,000 500 1500 1,100 200 1300 200 167,700.00
126 Larutan Hayem (px erytrosit) 250 set 29,450 - 0 0 0 -
127 Larutan HCL 0,1 N (px HB) 250 set 19,950 - 0 0 0 -
128 Larutan Na Citrat 3,8% (Px LED)250 set 19,475 - 0 0 0 -
129 Larutan Resseker (px Trombosit) 250 set 46,550 - 0 0 0 -
130 Larutan Truks (px leukosit)250 set 23,750 - 0 0 0 -
131 Lidokain hcl 2% injeksi ampul 860 - 200 200 90 10 - 100 100 86,000.00
132 Lidokain jelly syringe 40,000 - 10 10 10 10 0 400,000.00
133 Lidokain komp. injeksi, Kombinasi:Lidokain HCl 2% + Epinefr ampul 1,937 180 120 300 140 60 200 100 387,400.00
134 Lidokain spray 10 % (xylocaine) btl 170,400 - 3 3 1 1 2 170,400.00
135 Lisol btl 41,000 6 10 16 6 6 10 246,000.00
136 Lodomer 2 mg tab tab 94 - 0 0 0 -
137 Loperamid 2 mg tab tab 85 200 200 0 200 -
138 Loratadine tab 10 mg tablet 125 2,250 1,000 3250 1,600 50 1650 1600 206,250.00
139 Lugol (px feaces)250 set 102,960 - 0 0 0 -
140 Masker ear loop pcs 396 250 300 550 225 100 25 350 200 138,600.00
1 2 3 4 5 6 7 8 9 10 11
141 Masker ties on pcs 480 50 200 250 130 40 170 80 81,600.00
142 Metanol 250cc set 135,907 - 0 0 0 -
143 Metformin 500 mg tablet tab 100 3,700 3700 1,000 500 1500 2200 150,000.00
144 Metilen Blue (px Diffcort) set 118,329 - 0 0 0 -
145 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 tab 154 2,000 500 2500 1,900 1900 600 292,600.00
146 Metilergometrin Maleat inj 0,200 mg-1 ml ampul 2,849 200 200 110 110 90 313,390.00
147 Metilprednisolon tab 4 mg tablet 194 - 0 0 0 -
148 Metoklopramid tablet 10 mg tab 87 900 900 300 300 600 26,100.00
149 Metronidazol tablet 250 mg tab 90 300 500 800 300 300 500 27,000.00
150 Metronidazol tablet 500 mg tab 113 1,700 500 2200 1,400 200 300 1900 300 214,700.00
151 MgSO4 20% btl 3,200 50 60 110 70 70 40 224,000.00
152 MgSO4 40% btl 3,650 50 60 110 94 94 16 343,100.00
153 Mikonazole salep 2% tube 3,250 24 10 34 15 15 19 48,750.00
154 Mummifying pasta btl 176,000 - 0 0 0 -
155 N-asetil sistein kapsul kapsul 1,100 2,400 2400 400 900 1300 1100 1,430,000.00
156 Nasal oxygen size m pcs 6,600 10 10 2 2 8 13,200.00
157 Nasal oxygen size xs pcs 6,600 10 10 2 2 8 13,200.00
158 Natrium diklofenak tablet 50mg tab 122 1,650 2,000 3650 500 500 1,000 2000 1650 244,000.00
159 Natrium Klorida larutan infus 0,9 % steril (Produk lokal) btl 6,410 40 40 40 40 0 256,400.00
160 Neo K (vitamin K untuk bayi) 2 ml ampul 3,550 30 30 0 30 -
161 Nifedipine tab 10 mg tab 110 900 500 1400 0 1400 -
162 Nistatin tablet salut 500.000 IU tab 765 700 700 200 200 500 153,000.00
163 Nistatin tablet vaginal 100.000 IU/g tab 545 750 750 400 400 350 218,000.00
164 Obat Anti Tuberkulosa Kategori I paket 374,384 - 0 0 0 -
165 Obat Anti Tuberkulosa Kategori I anak paket 223,585 - 0 0 0 -
166 Obat Anti Tuberkulosa Kategori II paket 1,247,980 - - 2 2 1 1 1 1,247,980.00
167 Obat batuk hitam (OBH) botol 10,000 - 48 48 12 12 36 120,000.00
168 Objek Glass set 22,000 - 0 0 0 -
169 Oksitosin injeksi 10 IU/ml - 1 ml ampul 1,900 90 90 45 45 45 85,500.00
170 Omeprazole injeksi 40 mg/10 ml vial 11,868 34 20 54 45 5 50 4 593,400.00
171 Omeprazole kapsul 20 mg kapsul 140 - 1,200 1200 660 400 140 1200 0 168,000.00
172 Paracetamol drop botol 5,200 38 38 8 8 30 41,600.00
173 Parasetamol sirup 120 mg/5 ml btl 1,074 - 168 168 90 28 40 158 10 169,692.00
174 Parasetamol tablet 500 mg tab 211 6,300 10,000 16300 7,000 2,000 2,400 11400 4900 2,405,400.00
175 Pehavral tab (multivitamin tab) tab 930 0 0 0 -
176 Pembalut Gips glg 28,000 50 50 30 30 20 840,000.00
177 Penjepit tali pusar set 1,300 135 135 135 135 0 175,500.00
1 2 3 4 5 6 7 8 9 10 11
178 Phenobarbital injeksi 50 mg/ml 1ml ampul 1,969 180 180 125 125 55 246,125.00
179 Pirantel tablet 125 mg tab 277 300 300 0 300 -
180 Piridoksin HCl (Vit.B6) tablet 10 mg tab 45 4,800 5,000 9800 5,000 500 500 6000 3800 270,000.00
181 Plastik obat 7x10 kantong 16,731 15 25 40 5 5 10 30 167,310.00
182 Plester roll 10 cm x 5 cm roll 41,360 - 30 30 10 2 2 14 16 579,040.00
183 Plester roll kain roll 11,964 6 20 26 6 5 5 16 10 191,424.00
184 Prednison tablet 5 mg tab 76 3,000 3,000 6000 2,900 300 900 4100 1900 311,600.00
185 Primakuin tablet 15 mg tab 224 1,000 1000 0 1000 -
186 Propiltiourasil tab100 mg tab 319 1,700 1700 1,000 400 1400 300 446,600.00
187 Propranolol 10 mg tab tab 60 1,300 1300 300 300 1000 18,000.00
188 Ramaflu tab (obat flu) tab 645 0 0 0 -
189 Ranitidin injeksi ampul 1,390 - 20 20 20 20 0 27,800.00
190 Ranitidin tab 150 mg tab 98 1,000 2,000 3000 1,800 1,200 3000 0 294,000.00
191 RDT @25pcs ktk 476,373 - 1 1 1 1 0 476,373.00
192 Retinol (vitamin A) kap 100,000 IU kapsul 284 - 0 0 0 -
193 Retinol (vitamin A) kap 200,000 IU kapsul 460 - 0 0 0 -
194 Ringer Laktat larutan infus steril (Produk lokal) btl 7,150 25 120 145 115 25 140 5 1,001,000.00
195 Sabun cair (softaman) btl 78,750 0 0 0 -
196 Sabun cair (one scrub 4 %) btl 62,491 0 0 0 -
197 Salbutamol tablet 4 mg tab 95 1,600 1600 1,000 300 1300 300 123,500.00
198 Salbutamol inheler (combivent) dosis 5,700 0 0 0 -
199 Salep 2-4 , Kombinasi:Asam Salisilat 2% + Belerang Enda pot 2,527 24 48 72 24 24 48 60,648.00
200 Salicyl bedak 2 % pot 1,020 76 50 126 75 20 95 31 96,900.00
201 Semen Seng Fosfat Serbuk & Cairan set 165,000 1 - 1 1 1 0 165,000.00
202 Sendok takar obat bh 2,145 250 250 500 250 250 250 536,250.00
203 Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I) vial 462,000 3 2 5 2 2 3 924,000.00
204 Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.) ampul 126,500 5 5 10 3 6 9 1 1,138,500.00
205 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml ampul 1,098 224 100 324 225 225 99 247,050.00
206 Sianokobalamin (Vit.B12) tablet 50 mcg tab 51 - - 0 0 0 -
207 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah set 19,700 60 60 120 56 16 24 96 24 1,891,200.00
208 Simvastatin 10 mg tab 111 - 600 600 150 150 450 16,650.00
209 Siprofloksasin tablet 500 mg tab 281 - 500 500 200 300 500 0 140,500.00
210 Spironolactone tab 25 mg tab 244 - 0 0 0 -
211 Strip pemeriksaan gula darah kotak 305,329 - 0 0 0 -
212 Strip tes kehamilan pcs 1,936 0 0 0 -
213 Stesolid rectal tube 5mg tube 12,090 20 20 5 8 13 7 157,170.00
214 Sulfadiazine silver 10 gr tube 20,700 10 10 3 3 7 62,100.00
1 2 3 4 5 6 7 8 9 10 11
215 Swab 2 ply dus 11,000 80 100 180 45 5 21 71 109 781,000.00
216 Tablet tambah darah kombinasi (Besi II Sulfat 200mg + Asam tab 352 1,900 1900 300 750 1050 850 369,600.00
217 Test Golongan Darah Anti A Set 68,200 - 0 0 0 -
218 Test Golongan Darah Anti AB Set 92,510 - 0 0 0 -
219 Test Golongan Darah Anti B Set 68,200 - 0 0 0 -
220 Test Golongan Darah Anti D (Rho) Set 114,070 - 0 0 0 -
221 Test Kehamilan Beta HCG Set 80,416 8 8 0 8 -
222 Tetrasiklin HCl kapsul 250 mg kapsul 168 1,200 1,000 2200 1,600 300 1900 300 319,200.00
223 Tetrasiklin HCl kapsul 500 mg tab 310 1,600 1600 700 500 1200 400 372,000.00
224 Tiamin HCl / Mononitrat (Vit.B1) tablet 50 mg tab 82 1,000 5,000 6000 3,600 500 500 4600 1400 377,200.00
225 Tranfusi set set 3,600 15 15 0 15 -
226 Triheksipenidil tab 2 mg tab 80 600 600 300 300 300 24,000.00
227 Trombophop gel tube 51,975 - 10 10 2 2 4 6 207,900.00
228 Urine bag pcs 5,500 20 30 50 0 50 -
229 Urine Strip 10P set 334,840 - 1 1 1 1 0 334,840.00
230 Vaksin Rabies Vero vial 174,500 - 0 0 0 -
231 Ventolin nebules amp/salbutamol cairan nebu 4,000 210 100 310 200 200 110 800,000.00
232 Vitamin B Kompleks tab 115 1,200 5,000 6200 4,300 1,900 6200 0 713,000.00
233 Vitamin neurotropik injeksi ampul 4,336 15 10 25 0 25 -
234 Vitamin neurotropik tablet tablet 975 - 0 0 0 -
235 Wing Needle No. 27 G set 1,400 - 0 0 0 -
236 Wing Needle No.21 G set 1,400 - 0 0 0 -
239 Yodium povidon lar 10 % 1000 ml btl 149,314 6 6 6 6 0 895,884.00
242 Yodium povidon lar 10 % 500 ml btl 95,264 0 0 0 -
243 Yodium povidon 60 ml btl 23,890 0 0 0 -
244 Zinc tab 513 2,500 3,000 5500 3,600 3600 1900 1,846,800.00
245 Zinc syrup (interzinc) btl 6,600 21 50 71 36 2 38 33 250,800.00
246 Alkohol 70 % 300 ml btl 21,500 - - 0 0 0 -
247 Allopurinol tab tab 90 2,000 2,000 4000 2,300 2300 1700 207,000.00
248 Amoxicillin kap 500mg tab 190 0 0 -
249 Amoxicillin dry sirup btl 1,881 0 0 -
250 Asam mefenamat 500 mg tab tab 100 0 0 -
251 Acyclovir 200mg tab tab 249 1,000 500 1,000 1000 0 249,000.00
1 2 3 4 5 6 7 8 9 10 11
252 Betametason cream tube 1,380 0 0 -
253 Cefadroxil 500 mg kapsul kapsul 450 0 0 -
254 Ciprofloxacin kap kaplet 281 - 0 0 0 -
255 Chloramex-kloramfenikol kap 500 mg kapsul 1,007 - - 0 0 -
256 Ctm tab tab 42 0 0 -
257 Chlorpromazine 100mg tab tab 162 0 0 -
258 Cefotaxime inj vial 5,500 0 0 -
259 Deksamethason 0,5mg tab tab 44 0 0 -
260 Domperidon 10 mg tablet tab 95 0 0 -
261 Glimepiride tab 3 mg tab 319 350 0 0 -
262 Glukosa 5% infus btl 6,900 0 0 -
263 Ibuprofen 200 mg tab tab 102 0 0 -
264 Ibuprofen 400 mg tab tab 127 - 3,000 500 1,800 2300 700 292,100.00
265 Ketokonazol cream tube 2,545 0 0 -
266 Lidokain comp injeksi ampul 1,845 0 0 -
267 Loperamide tab 2 mg tab 80 500 0 0 -
268 Metylprednisolone tab 8 mg tab 309 0 0 -
269 Metylprednisolone tab 4 mg tab 150 0 0 -
270 Metoklopropamid tab 10 mg tab 87 1,000 0 0 -
271 Metformin HCL 500mg tab 100 0 0 -
272 Nacl 0,9% infus btl 6,410 0 0 -
273 Nipedifine tab tab 110 - - - 0 - 0 0 -
274 Omeprazole kap 20 mg kapsul 140 460 - 280 280 180 39,200.00
275 Povidone iodine 10 % 300 ml btl 18,656 0 0 -
276 Piridoksin HCl (Vit.B6) tablet 10 mg tab 118 0 0 -
277 Ranitidin tab 150 mg tab 98 0 0 -
278 RL infus btl 7,150 55 - - 0 - 0 0 -
279 Salep 2-4 pot 2,527 0 0 -
280 Simvastatin 20 mg tab 504 900 300 150 450 450 226,800.00
281 Spirinolactone tab 25 mg tab 244 1,300 0 0 -
282 Vit b komplek tab 115 0 0 -
283 Cutgut 2/0 pcs 33,643 0 0 0 -
284 Cutgut 3/0 pcs 33,643 0 0 0 -
285 IV cath no 20 pcs 10,483 0 0 0 -
286 IV cath no 22 pcs 10,480 0 0 0 -
287 IV cath no 24 pcs 10,480 0 0 0 -
288 Cuticell classic 10x10cm buah 5,198 0 0 0 -
1 2 3 4 5 6 7 8 9 10 11
289 Handscoon 7,5 pcs 8,250 0 0 0 -
290 Iodine Povidone btl 6,550 50 30 30 20 196,500.00
291 Infus set anak pcs 5,661 50 200 140 140 0 792,540.00
292 Infus set Dewasa pcs 6,644 150 250 400 140 140 260 930,160.00
293 Kapas pembalut absorben 250 mg Roll 12,500 0 50 0 0 0 0 -
294 Kasa hidrofil 40 yard x 80 cm Roll 255,750 0 0 -
295 Kasa hidrofil 3 yard x 15 cm Roll 1,577 0 0 -
296 Kasa kompres 16 x 16 steril pack 5,820 0 0 0 -
297 Masker pcs 762 0 0 0 -
298 Spuit 3 cc pcs 916 0 0 0 -
299 Spuit 5 cc pcs 1,030 0 0 0 -
300 Urine bag pcs 6,036 0 0 0 -
65,655,172.00
LAPORAN KUNJUNGAN
Bulan BPJS UMUM Jumlah
Jan
Peb 418 471 889
Maret
(LPLPO) Triwulan II
PUSKESMAS : LIWA
KECAMATAN : LIWA LAPORAN BULAN/PERIODE : April - Juni 2018
KJABUPATEN : Lampung Barat

Per satuan April Mei Juni Penerimaan April Mei Juni Pemakaian
1 2 3 4 5 6 7 8 9 10 11
1 Alat suntik sekali pakai 1 ml pcs 990.00 900 500 1400 950 100 - 1050 350 1,039,500.00
2 Alat suntik sekali pakai 2,5 ml pcs 792.00 950 1,000 1950 1,150 200 300 1650 300 1,306,800.00
3 Alat suntik sekali pakai 5 ml pcs 979.00 800 500 1300 900 100 1000 300 979,000.00
4 Alat tes gula darah kotak 1,771,000.00 0 0 - 0 0 -
5 Alat tes HB / HB sahli one med set 88,000.00 3 3 - 0 3 -
6 Albendazol 400 mg tab 392.00 0 0 - 0 0 -
7 Allupurinol tab 100 mg tab 110.00 800 2,000 2800 1,900 500 2400 400 264,000.00
8 Aminofilin tablet 200 mg tab 91.00 1500 500 2000 1,000 100 1100 900 100,100.00
9 Aminofilina injeksi 24 mg/ml - 10 ml ampul 2,998.00 30 30 - 0 30 -
10 Amitriptillin tab salut 25 mg (HCL) tab 143.00 1300 1300 - 0 1300 -
11 Amlodipine tab 105.00 1300 3,000 4300 1,950 300 450 2700 1600 283,500.00
12 Amoksisilin kaplet 500 mg tab 190.00 2100 6,000 8100 3,200 1,800 1,800 6800 1300 1,292,000.00
13 Amoksisilin kapsul 250 mg tablet 195.00 500 500 300 200 500 0 97,500.00
14 Amoksisilin sirup kering 125 mg/5ml btl 1,881.00 75 150 225 70 45 35 150 75 282,150.00
15 Ampisillin inj 1 gr vial 9,270.00 30 30 - 0 30 -
16 Antasida Doen II Suspensi suspensi 2,025.00 0 150 150 35 55 20 110 40 222,750.00
17 Antasida Doen tab kombinasi tab 62.00 3700 2,000 5700 1,500 500 1,700 3700 2000 229,400.00
18 Anti Bakteri DOEN salep kombinasi:Basitrasin 500 IU/g + Po tube 2,924.00 0 25 25 25 - 25 0 73,100.00
19 Anti konstipasi dulcolax supp supositoria 5,800.00 35 25 60 10 - 10 50 58,000.00
20 Anti Hemoroid DOEN Kombinasi supp 3,045.00 20 20 - 0 20 -
21 Anti Malaria kombinasi (Artemether) ampul 25,490.00 12 12 - 0 12 -
22 Anti Skabies cream tube 12,155.00 48 30 78 25 20 45 33 546,975.00
23 Antifungi DOEN Kombinasi:Asam Benzoat 6% + Asam Salisi pot 4,323.00 53 24 77 50 - 50 27 216,150.00
24 Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg tab 135.00 600 500 1100 200 - 200 900 27,000.00
25 Aqua pro injeksi steril,bebas pirogen 20 ml/vial vial 2,750.00 14 50 64 35 - 35 29 96,250.00
26 Asam Askorbat (Vit C) tablet 50 mg tab 104.00 2700 3,000 5700 2,400 500 900 3800 1900 395,200.00
27 Asam Mefenamat tab 500 mg tab 100.00 2100 3,000 5100 1,000 600 1600 3500 160,000.00
28 Asam tranexamic injeksi ampul 1,956.00 20 50 70 10 - 10 60 19,560.00
29 Asetosal / miniaspi 80 tab 92.00 300 500 800 - 0 800 -
30 Asetosal tablet 100 mg tab 130.00 700 700 - 0 700 -
31 Asiklovir 400 mg tab tab 365.00 300 500 800 - 0 800 -
32 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 1,540.00 80 80 - 0 80 -
33 Atropin tab 0,5 mg tab tab 74.00 1100 1100 0 1100 -
1 2 3 4 5 6 7 8 9 10 11
34 Becefort syr (multi vitamin 60 ml) botol 17,360.00 45 25 70 20 10 28 58 12 1,006,880.00
35 Betametason krim 0.1% tube 3,388.00 6 50 56 6 12 25 43 13 145,684.00
36 Bisacodyl tab 5 mg tab 300.00 150 300 450 - 0 450 -
37 Bisturi pcs 300,000.00 2 2 - 0 2 -
38 Buscopan 10 mg tab 2,972.00 0 300 300 - 0 300 -
39 Calprosis 500 tab 430.00 800 1,500 2300 1,350 - 1350 950 580,500.00
40 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah set 32,800.00 12 60 72 38 15 53 19 1,738,400.00
41 Cefadroksil 500 mg kapsul kapsul 516.00 0 0 - 0 0 -
42 Cetirizine 5 mg/5 ml syr btl 3,150.00 64 60 124 45 - 45 79 141,750.00
43 Cetirizine kap 10 mg kapsul 143.00 600 2,000 2600 600 500 700 1800 800 257,400.00
44 Cuticell classic 10x10cm buah 5,198.00 80 80 - 0 80 -
45 Deck Glas set 82,500.00 0 0 - 0 0 -
46 Deksametason injeksi 5 mg/ml - 1 ml ampul 1,540.00 75 75 20 - 20 55 30,800.00
47 Deksametason tablet 0,5 mg tab 44.00 2800 3,000 5800 2,800 1,000 900 4700 1100 206,800.00
48 Devitalisasi Pasta (Non Arsen) btl 220,000.00 0 0 - 0 0 -
49 Diapecta tab tab 510.00 0 500 500 - 0 500 -
50 Difenhidramin HCl inj 10 mg/ml-1 ml ampul 1,176.00 140 140 - 0 140 -
51 Digoksin tablet 0,25 mg tab 104.00 500 500 300 - 300 200 31,200.00
52 Doksisiklin kapsul 100 mg kapsul 268.00 1800 1800 1,000 - 1000 800 268,000.00
53 Domperidone 10 mg tablet tablet 95.00 0 0 - 0 0 -
54 Dopamet 250 mg tab tab 911.00 0 1,000 1000 - 0 1000 -
55 EDTA 250gr set 74,100.00 0 1 1 1 - 1 0 74,100.00
56 Eosin (px faeces) 250 set 176,225.00 0 1 1 1 - 1 0 176,225.00
57 Epineprin injeksi 0,1% ampul 2,204.00 60 60 60 - 60 0 132,240.00
58 Erytromysin 200 mg/5ml btl 6,700.00 35 35 16 19 - 35 0 234,500.00
59 Erytromysin tab 250 mg kapsul 566.00 400 400 200 200 200 113,200.00
60 Erytromysin tab 500 mg tab 730.00 400 400 300 100 400 0 292,000.00
61 Etakridina (Rivanol) lar 0,1% btl 3,000.00 17 24 41 31 1 32 9 96,000.00
62 Etanol 70 % btl 2,500.00 51 51 2 2 49 5,000.00
63 etanol 70 % 1 liter botol 21,000.00 0 10 10 10 - 10 0 210,000.00
64 Eugenol cairan btl 18,100.00 35 35 - 0 35 -
65 Fenitoin Natrium kapsul 30 mg kapsul 154.00 1000 1000 - 0 1000 -
66 Fenol Gliserol tetes telinga 10% btl 2,500.00 24 24 48 48 - 48 0 120,000.00
67 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml ampul 4,167.00 88 88 63 - 63 25 262,521.00
68 Fitomenadion (Vit.K1) tablet salut gula 10 mg tab 695.00 2000 2000 1,400 - 1400 600 973,000.00
69 Foley cateter 16 pcs 11,000.00 9 9 2 2 7 22,000.00
70 Foley cateter 18 pcs 11,000.00 6 6 3 1 4 2 44,000.00
71 Furosemid inj i.v/i.m 10/ml mg ampul 1,829.00 25 25 5 - 5 20 9,145.00
72 Furosemid tablet 40 mg tab 80.00 500 1,000 1500 300 300 1200 24,000.00
73 Garam Oralit untuk 200 ml air sachet 260.00 225 225 - 0 225 -
74 Glass Ionomer Cement ART set 521,000.00 0 1 1 1 - 1 0 521,000.00
75 Glibenklamid tablet 5 mg tab 101.00 1500 1500 200 - 200 1300 20,200.00
1 2 3 4 5 6 7 8 9 10 11
76 Glimepiride 2 mg tablet 436.00 600 600 - 0 600 -
77 Glukosa larutan infus 5 % steril (Produk lokal) btl 6,900.00 55 60 115 64 - 64 51 441,600.00
78 Griseofulvin tab 125 mg tab 249.00 0 0 - 0 0 -
79 H2O2 3% btl 30,855.00 0 0 - 0 0 -
80 H2O2 100 ml btl 4,780.00 0 0 0 0 -
81 Haloperidol injeksi ampul 4,974.00 0 0 - 0 0 -
82 Haloperidol tablet 1,5 mg tab 66.00 1900 1900 400 400 1500 26,400.00
83 Handscoon pcs 7,600.00 0 0 - 0 0 -
84 Handscoon no 8 pcs 7,600.00 0 0 - 0 0 -
85 Hidroklorotiazid (HCT) tablet 25 mg tab 149.00 100 500 600 - 0 600 -
86 Hidrokortison krim 2,5 % tube 2,640.00 0 24 24 24 - 24 0 63,360.00
87 Ibuprofen suspensi 100 mg/5 ml btl 2,475.00 30 100 130 62 18 20 100 30 247,500.00
88 Ibuprofen tablet 400 mg tab 127.00 600 3,000 3600 600 500 2,000 3100 500 393,700.00
89 Infusion set anak set 9,200.00 180 180 7 - 7 173 64,400.00
90 Infusion set dewasa set 8,200.00 0 0 - 0 0 -
91 Isosorbid Dinitrat tablet sublingual 5 mg tab 90.00 1300 1300 - 0 1300 -
92 IV Catheter 18 G pcs 7,000.00 120 120 50 5 55 65 385,000.00
93 IV Catheter No.20 G pcs 7,000.00 130 130 50 15 5 70 60 490,000.00
94 IV Catheter No.22G pcs 7,000.00 71 71 21 20 30 71 0 497,000.00
95 IV Catheter No.24 G pcs 7,000.00 134 134 50 4 54 80 378,000.00
96 IV Catheter No.26 G set 21,065.00 17 17 5 2 7 10 147,455.00
97 Kalsium Glukonas inj ampul 9,955.00 48 48 24 - 24 24 238,920.00
98 Kalsium Hidroksida Pasta tube 159,500.00 0 1 1 1 - 1 0 159,500.00
99 Kalsium Laktat (Kalk) tablet 500 mg tab 56.00 800 1,000 1800 800 - 800 1000 44,800.00
100 Kapas pembalut absorben 250 mg glg 24,000.00 29 29 28 1 29 0 696,000.00
101 Kaptopril tab 12,5 mg tab 62.00 700 500 1200 800 800 400 49,600.00
102 Kaptopril tab 25 mg tab 80.00 0 500 500 500 - 500 0 40,000.00
103 Karbamazepin tablet 200 mg tab 245.00 300 300 300 - 300 0 73,500.00
104 Kartu Golongan Darah Set 33,000.00 0 0 - 0 0 -
105 kasa gulung besar 1 meter glg 130,000.00 7 10 17 2 4 6 11 780,000.00
106 Kasa hidrofil steril 18x22 ktk 5,900.00 0 0 - 0 0 -
107 Kasa kompres 16x16 steril ktk 7,900.00 57 57 13 13 21 47 10 371,300.00
108 Kasa pembalu hidrofil 4 x 10 cm elastis glg 2,300.00 110 110 20 20 90 46,000.00
109 Kasa pembalut elastis 3 inch rol 27,660.00 0 10 10 - 0 10 -
110 kasa pembalut hidrofil 4 x 5 cm glg 750.00 0 100 100 - 0 100 -
111 Kertas perkamen kantong 104,032.00 21 - 21 18 18 3 1,872,576.00
112 ketokonazole krim 2% tube 2,545.00 0 0 - 0 0 -
113 Ketokonazole tab 200 mg tab 280.00 100 500 600 200 200 400 56,000.00
114 Ketoprofen suppos supositoria 2,640.00 10 10 20 10 - 10 10 26,400.00
115 Klindamysin kapsul 150 mg kapsul 578.00 300 500 800 - 0 800 -
116 Kloramfenikol kapsul 250 mg kapsul 428.00 0 0 - 0 0 -
117 Kloramfenikol kapsul 500 mg kapsul 1,048.00 300 500 800 700 700 100 733,600.00
1 2 3 4 5 6 7 8 9 10 11
118 Kloramfenikol syr 60 ml btl 4,700.00 50 50 - 0 50 -
119 Klorfeniramin Maleat (CTM) tablet 4 mg tab 42.00 0 3,000 3000 500 500 1,300 2300 700 96,600.00
120 Klorfenol kamper menthol (CHKM) btl 55,000.00 17 1 18 - 0 18 -
121 Klorpromazin HCl injeksi 25 mg/ml - 1 ml ampul 1,205.00 30 30 - 0 30 -
122 Klorpromazin HCl tablet salut 25 mg tab 148.00 600 600 - 0 600 -
123 Klorpromazine tab 100 mg tab 148.00 300 300 - 0 300 -
124 Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Tr btl 2,286.00 70 70 20 20 15 55 15 125,730.00
125 Kotrimoksazol tablet kombinasi: Sulfametoksazol 400 mg + tab 129.00 200 500 700 300 200 500 200 64,500.00
126 Larutan Hayem (px erytrosit) 250 set 29,450.00 0 1 1 1 - 1 0 29,450.00
127 Larutan HCL 0,1 N (px HB) 250 set 19,950.00 0 1 1 1 - 1 0 19,950.00
128 Larutan Na Citrat 3,8% (Px LED)250 set 19,475.00 0 1 1 1 - 1 0 19,475.00
129 Larutan Resseker (px Trombosit) 250 set 46,550.00 0 1 1 1 - 1 0 46,550.00
130 Larutan Truks (px leukosit)250 set 23,750.00 0 1 1 1 - 1 0 23,750.00
131 Lidokain hcl 2% injeksi ampul 860.00 100 200 300 155 38 100 293 7 251,980.00
132 Lidokain jelly syringe 40,000.00 0 10 10 1 1 9 40,000.00
133 Lidokain komp. injeksi, Kombinasi:Lidokain HCl 2% + Epinefr ampul 1,937.00 100 120 220 60 100 20 180 40 348,660.00
134 Lidokain spray 10 % (xylocaine) btl 170,400.00 2 2 4 - 0 4 -
135 Lisol btl 41,000.00 10 10 2 - 2 8 82,000.00
136 Lodomer 2 mg tab tab 94.00 0 0 - 0 0 -
137 Loperamid 2 mg tab tab 85.00 200 200 - 0 200 -
138 Loratadine tab 10 mg tablet 125.00 1600 500 2100 1,200 - 1200 900 150,000.00
139 Lugol (px feaces)250 set 102,960.00 0 0 - 0 0 -
140 Masker ear loop pcs 396.00 200 100 300 200 - 200 100 79,200.00
141 Masker ties on pcs 480.00 80 100 180 50 100 20 170 10 81,600.00
142 Metanol 250cc set 135,907.00 0 0 - 0 0 -
143 Metformin 500 mg tablet tab 100.00 2200 2200 1,900 - 1900 300 190,000.00
144 Metilen Blue (px Diffcort) set 118,329.00 0 0 - 0 0 -
145 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 tab 154.00 600 600 - 0 600 -
146 Metilergometrin Maleat inj 0,200 mg-1 ml ampul 2,849.00 90 90 50 - 50 40 142,450.00
147 Metilprednisolon tab 4 mg tablet 194.00 0 0 - 0 0 -
148 Metoklopramid tablet 10 mg tab 87.00 600 600 300 300 300 26,100.00
149 Metronidazol tablet 250 mg tab 90.00 500 500 1000 - 0 1000 -
150 Metronidazol tablet 500 mg tab 113.00 300 500 800 200 200 600 22,600.00
151 MgSO4 20% btl 3,200.00 40 40 21 - 21 19 67,200.00
152 MgSO4 40% btl 3,650.00 16 16 - 0 16 -
153 Mikonazole salep 2% tube 3,250.00 19 19 19 - 19 0 61,750.00
154 Mummifying pasta btl 176,000.00 0 0 - 0 0 -
155 N-asetil sistein kapsul kapsul 1,100.00 1100 1,200 2300 1,680 120 1800 500 1,980,000.00
156 Nasal oxygen size m pcs 6,600.00 8 5 13 - 0 13 -
157 Nasal oxygen size xs pcs 6,600.00 8 5 13 - 0 13 -
158 Natrium diklofenak tablet 50mg tab 122.00 1650 3,000 4650 2,050 100 300 2450 2200 298,900.00
159 Natrium Klorida larutan infus 0,9 % steril (Produk lokal) btl 6,410.00 0 100 100 60 7 28 95 5 608,950.00
1 2 3 4 5 6 7 8 9 10 11
160 Neo K (vitamin K untuk bayi) 2 ml ampul 3,550.00 30 30 30 - 30 0 106,500.00
161 Nifedipine tab 10 mg tab 110.00 1400 1400 700 700 700 77,000.00
162 Nistatin tablet salut 500.000 IU tab 765.00 500 500 1000 - 0 1000 -
163 Nistatin tablet vaginal 100.000 IU/g tab 545.00 350 350 190 - 190 160 103,550.00
164 Obat Anti Tuberkulosa Kategori I paket 374,384.00 0 0 - 0 0 -
165 Obat Anti Tuberkulosa Kategori I anak paket 223,585.00 0 0 - 0 0 -
166 Obat Anti Tuberkulosa Kategori II paket 1,247,980.00 1 1 - 0 1 -
167 Obat batuk hitam (OBH) botol 10,000.00 36 48 84 62 22 - 84 0 840,000.00
168 Objek Glass set 22,000.00 0 0 - 0 0 -
169 Oksitosin injeksi 10 IU/ml - 1 ml ampul 1,900.00 45 45 45 - 45 0 85,500.00
170 Omeprazole injeksi 40 mg/10 ml vial 11,868.00 4 50 54 4 8 - 12 42 142,416.00
171 Omeprazole kapsul 20 mg kapsul 140.00 0 0 - 0 0 -
172 Paracetamol drop botol 5,200.00 30 30 30 - 30 0 156,000.00
173 Parasetamol sirup 120 mg/5 ml btl 1,074.00 10 100 110 10 20 80 110 0 118,140.00
174 Parasetamol tablet 500 mg tab 211.00 4900 8,000 12900 5,700 2,500 2,200 10400 2500 2,194,400.00
175 Pehavral tab (multivitamin tab) tab 930.00 0 500 500 0 500 -
176 Pembalut Gips glg 28,000.00 20 20 - 0 20 -
177 Penjepit tali pusar set 1,300.00 0 100 100 0 100 -
178 Phenobarbital injeksi 50 mg/ml 1ml ampul 1,969.00 55 55 - 0 55 -
179 Pirantel tablet 125 mg tab 277.00 300 300 - 0 300 -
180 Piridoksin HCl (Vit.B6) tablet 10 mg tab 45.00 3800 2,000 5800 2,800 900 - 3700 2100 166,500.00
181 Plastik obat 7x10 kantong 16,731.00 30 20 50 27 - 27 23 451,737.00
182 Plester roll 10 cm x 5 cm roll 41,360.00 16 5 21 12 1 - 13 8 537,680.00
183 Plester roll kain roll 11,964.00 10 20 30 11 4 8 23 7 275,172.00
184 Prednison tablet 5 mg tab 76.00 1900 1,000 2900 1,700 500 - 2200 700 167,200.00
185 Primakuin tablet 15 mg tab 224.00 1000 1000 - 0 1000 -
186 Propiltiourasil tab100 mg tab 319.00 300 300 - 0 300 -
187 Propranolol 10 mg tab tab 60.00 1000 1000 - 0 1000 -
188 Ramaflu tab (obat flu) tab 645.00 0 1,000 1000 300 700 1000 0 645,000.00
189 Ranitidin injeksi ampul 1,390.00 0 0 - 0 0 -
190 Ranitidin tab 150 mg tab 98.00 0 2,000 2000 500 500 800 1800 200 176,400.00
191 RDT @25pcs ktk 476,373.00 0 0 - 0 0 -
192 Retinol (vitamin A) kap 100,000 IU kapsul 284.00 0 250 250 - 0 250 -
193 Retinol (vitamin A) kap 200,000 IU kapsul 460.00 0 500 500 - 0 500 -
194 Ringer Laktat larutan infus steril (Produk lokal) btl 7,150.00 5 100 105 66 25 91 14 650,650.00
195 Sabun cair (softaman) btl 78,750.00 0 0 - 0 0 -
196 Sabun cair (one scrub 4 %) btl 62,491.00 0 0 - 0 0 -
197 Salbutamol tablet 4 mg tab 95.00 300 300 200 200 100 19,000.00
198 Salbutamol inheler (combivent) dosis 5,700.00 0 0 - 0 0 -
199 Salep 2-4 , Kombinasi:Asam Salisilat 2% + Belerang Enda pot 2,527.00 48 48 - 0 48 -
200 Salicyl bedak 2 % pot 1,020.00 31 50 81 45 - 45 36 45,900.00
201 Semen Seng Fosfat Serbuk & Cairan set 165,000.00 0 1 1 - 0 1 -
1 2 3 4 5 6 7 8 9 10 11
202 Sendok takar obat bh 2,145.00 250 250 0 250 -
203 Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I) vial 462,000.00 3 2 5 3 2 5 0 2,310,000.00
204 Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.) ampul 126,500.00 1 5 6 1 4 5 1 632,500.00
205 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml ampul 1,098.00 99 100 199 45 - 45 154 49,410.00
206 Sianokobalamin (Vit.B12) tablet 50 mcg tab 51.00 0 500 500 - 0 500 -
207 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah set 19,700.00 24 36 60 12 24 12 48 12 945,600.00
208 Simvastatin 10 mg tab 111.00 450 300 750 300 300 450 33,300.00
209 Siprofloksasin tablet 500 mg tab 281.00 0 500 500 300 200 500 0 140,500.00
210 Spironolactone tab 25 mg tab 244.00 0 0 - 0 0 -
211 Strip pemeriksaan gula darah kotak 305,329.00 0 1 1 1 - 1 0 305,329.00
212 Strip tes kehamilan pcs 1,936.00 0 0 - 0 0 -
213 Stesolid rectal tube 5mg tube 12,090.00 7 10 17 5 5 12 60,450.00
214 Sulfadiazine silver 10 gr tube 20,700.00 7 10 17 - 0 17 -
215 Swab 2 ply dus 11,000.00 109 109 31 3 34 75 374,000.00
216 Tablet tambah darah kombinasi (Besi II Sulfat 200mg + Asam tab 352.00 850 850 600 250 850 0 299,200.00
217 Test Golongan Darah Anti A Set 68,200.00 0 0 - 0 0 -
218 Test Golongan Darah Anti AB Set 92,510.00 0 0 - 0 0 -
219 Test Golongan Darah Anti B Set 68,200.00 0 0 - 0 0 -
220 Test Golongan Darah Anti D (Rho) Set 114,070.00 0 0 - 0 0 -
221 Test Kehamilan Beta HCG Set 80,416.00 8 2 10 10 10 0 804,160.00
222 Tetrasiklin HCl kapsul 250 mg kapsul 168.00 300 500 800 - 0 800 -
223 Tetrasiklin HCl kapsul 500 mg tab 310.00 400 400 - 0 400 -
224 Tiamin HCl / Mononitrat (Vit.B1) tablet 50 mg tab 82.00 1400 2,000 3400 500 500 500 1500 1900 123,000.00
225 Tranfusi set set 3,600.00 15 15 - 0 15 -
226 Triheksipenidil tab 2 mg tab 80.00 300 300 - 0 300 -
227 Trombophop gel tube 51,975.00 6 5 11 - 0 11 -
228 Urine bag pcs 5,500.00 50 50 5 5 45 27,500.00
229 Urine Strip 10P set 334,840.00 0 1 1 1 - 1 0 334,840.00
230 Vaksin Rabies Vero vial 174,500.00 0 0 - 0 0 -
231 Ventolin nebules amp/salbutamol cairan nebu 4,000.00 110 20 130 95 20 115 15 460,000.00
232 Vitamin B Kompleks tab 115.00 0 3,000 3000 500 500 900 1900 1100 218,500.00
233 Vitamin neurotropik injeksi ampul 4,336.00 25 50 75 10 10 65 43,360.00
234 Vitamin neurotropik tablet tablet 975.00 0 500 500 200 200 300 195,000.00
235 Wing Needle No. 27 G set 1,400.00 0 0 - 0 0 -
236 Wing Needle No.21 G set 1,400.00 0 0 - 0 0 -
239 Yodium povidon lar 10 % 1000 ml btl 149,314.00 0 0 - 0 0 -
240 Yodium povidon lar 10 % 30 ml btl 2,900.00 42 42 10 2 12 30 34,800.00
241 Yodium povidon lar 10 % 300 ml btl 18,000.00 7 50 57 47 1 48 9 864,000.00
242 Yodium povidon lar 10 % 500 ml btl 95,264.00 0 0 - 0 0 -
243 Yodium povidon 60 ml btl 23,890.00 0 0 - 0 0 -
1 2 3 4 5 6 7 8 9 10 11
244 Zinc tab 513.00 1900 1900 1,000 - 1000 900 513,000.00
245 Zinc syrup (interzinc) btl 6,600.00 33 24 57 27 10 37 20 244,200.00
246 Alkohol 70 % 300 ml btl 21,500.00 0 0 - 0 0 -
247 Allopurinol tab tab 90.00 1700 1700 - 0 1700 -
248 Amoxicillin kap 500mg tab 190.00 0 0 - 0 0 -
249 Amoxicillin dry sirup btl 1,881.00 0 0 - 0 0 -
250 Asam mefenamat 500 mg tab tab 100.00 0 0 - 0 0 -
251 Acyclovir 200mg tab tab 249.00 0 0 - 0 0 -
252 Betametason cream tube 1,380.00 0 0 0 0 -
253 Cefadroxil 500 mg kapsul kapsul 450.00 0 500 500 300 200 500 0 225,000.00
254 Ciprofloxacin kap kaplet 281.00 0 0 - 0 0 -
255 Chloramex-kloramfenikol kap 500 mg kapsul 1,007.00 0 - 0 - 0 0 -
256 Ctm tab tab 42.00 0 0 - 0 0 -
257 Chlorpromazine 100mg tab tab 162.00 0 0 - 0 0 -
258 Cefotaxime inj vial 5,500.00 0 0 - 0 0 -
259 Deksamethason 0,5mg tab tab 44.00 0 0 - 0 0 -
260 Domperidon 10 mg tablet tab 95.00 0 500 500 - 0 500 -
261 Glimepiride tab 3 mg tab 319.00 0 500 500 - 0 500 -
262 Glukosa 5% infus btl 6,900.00 0 0 - 0 0 -
263 Ibuprofen 200 mg tab tab 102.00 0 0 - 0 0 -
264 Ibuprofen 400 mg tab tab 127.00 700 700 400 300 - 700 0 88,900.00
265 Ketokonazol cream tube 2,545.00 0 0 - 0 0 -
266 Lidokain comp injeksi ampul 1,845.00 0 0 - 0 0 -
267 Loperamide tab 2 mg tab 80.00 0 500 500 - - 0 500 -
268 Metylprednisolone tab 8 mg tab 309.00 0 0 - 0 0 -
269 Metylprednisolone tab 4 mg tab 150.00 0 0 - 0 0 -
270 Metoklopropamid tab 10 mg tab 87.00 0 1,000 1000 - 0 1000 -
271 Metformin HCL 500mg tab 100.00 0 0 - 0 0 -
272 Nacl 0,9% infus btl 6,410.00 0 0 - 0 0 -
273 Nipedifine tab tab 110.00 0 - 0 - 0 0 -
274 Omeprazole kap 20 mg kapsul 140.00 180 600 780 330 450 - 780 0 109,200.00
275 Povidone iodine 10 % 300 ml btl 18,656.00 0 0 - 0 0 -
276 Piridoksin HCl (Vit.B6) tablet 10 mg tab 118.00 0 0 0 0 -
277 Ranitidin tab 150 mg tab 98.00 0 0 0 0 -
278 RL infus btl 7,150.00 55 55 15 40 55 0 393,250.00
279 Salep 2-4 pot 2,527.00 0 0 0 0 -
280 Simvastatin 20 mg tab 504.00 450 450 0 450 -
281 Spirinolactone tab 25 mg tab 244.00 0 0 0 0 -
282 Vit b komplek tab 115.00 0 0 0 0 -
283 Cutgut 2/0 pcs 33,643.00 0 0 0 0 -
284 Cutgut 3/0 pcs 33,643.00 0 0 0 0 -
285 IV cath no 20 pcs 10,483.00 0 0 0 0 -
1 2 3 4 5 6 7 8 9 10 11
286 IV cath no 22 pcs 10,480.00 0 0 0 0 -
287 IV cath no 24 pcs 10,480.00 0 0 0 0 -
288 Cuticell classic 10x10cm buah 5,198.00 0 0 0 0 -
289 Handscoon 7,5 pcs 8,250.00 0 0 0 0 -
290 Iodine Povidone btl 6,550.00 20 20 4 4 16 26,200.00
291 Infus set anak pcs 5,661.00 0 100 100 95 - 95 5 537,795.00
292 Infus set Dewasa pcs 6,644.00 260 100 360 180 15 35 230 130 1,528,120.00
293 Kapas pembalut absorben 250 mg Roll 12,500.00 50 50 2 2 48 25,000.00
294 Kasa hidrofil 40 yard x 80 cm Roll 255,750.00 0 0 0 0 -
296 Kasa kompres 16 x 16 steril pack 5,820.00 0 0 0 0 -
297 Masker pcs 762.00 0 0 0 0 -
298 Spuit 3 cc pcs 916.00 0 0 0 0 -
299 Spuit 5 cc pcs 1,030.00 0 0 0 0 -
300 Urine bag pcs 6,036.00 0 0 0 0 -
47,510,345.00
LAPORAN KUNJUNGAN
Bulan
April
Mei
Juni
(LPLPO) Triwulan III
PUSKESMAS : LIWA
KECAMATAN : LIWA LAPORAN BULAN/PERIODE : Juli - September 2018

Per satuan Juli Agustus Sep Penerimaan Juli Agustus Sep Pemakaian
1 2 3 4 5 6 7 8 9 10 11
1 Alat suntik sekali pakai 1 ml pcs 990.00 350 500 850 50 150 200 650 198,000.00
2 Alat suntik sekali pakai 2,5 ml pcs 792.00 300 300 100 200 - 300 0 237,600.00
3 Alat suntik sekali pakai 5 ml pcs 979.00 300 500 800 100 100 700 97,900.00
4 Alat tes gula darah kotak 1,771,000.00 0 0 - 0 0 -
5 Alat tes HB / HB sahli one med set 88,000.00 3 3 0 3 -
6 Albendazol 400 mg tab 392.00 0 0 - 0 0 -
7 Allupurinol tab 100 mg tab 110.00 400 400 400 - 400 0 44,000.00
8 Aminofilin tablet 200 mg tab 91.00 900 900 500 500 400 45,500.00
9 Aminofilina injeksi 24 mg/ml - 10 ml ampul 2,998.00 30 30 - 0 30 -
10 Amitriptillin tab salut 25 mg (HCL) tab 143.00 1300 1300 700 - 700 600 100,100.00
11 Amlodipine tab 105.00 1600 1,500 3100 300 2,500 300 3100 0 325,500.00
12 Amoksisilin kaplet 500 mg tab 190.00 1300 8,000 9300 2,200 1,600 2,100 5900 3400 1,121,000.00
13 Amoksisilin kapsul 250 mg tablet 195.00 0 500 500 300 - 300 200 58,500.00
14 Amoksisilin sirup kering 125 mg/5ml btl 1,881.00 75 150 225 60 30 52 142 83 267,102.00
15 Ampisillin inj 1 gr vial 9,270.00 30 30 0 30 -
16 Antasida Doen II Suspensi suspensi 2,025.00 40 40 30 10 40 0 81,000.00
17 Antasida Doen tab kombinasi tab 62.00 2000 1,000 3000 1,000 2,000 3000 0 186,000.00
18 Anti Bakteri DOEN salep kombinasi:Basitrasin 500 IU/g + Po tube 2,924.00 0 0 0 0 -
19 Anti konstipasi dulcolax supp supositoria 5,800.00 50 50 0 50 -
20 Anti Hemoroid DOEN Kombinasi supp 3,045.00 20 20 0 20 -
21 Anti Malaria kombinasi (Artemether) ampul 25,490.00 12 12 12 12 0 305,880.00
22 Anti Skabies cream tube 12,155.00 33 33 8 10 5 23 10 279,565.00
23 Antifungi DOEN Kombinasi:Asam Benzoat 6% + Asam Salisi pot 4,323.00 27 27 27 27 0 116,721.00
24 Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg tab 135.00 900 2,000 2900 2,900 2900 0 391,500.00
25 Aqua pro injeksi steril,bebas pirogen 20 ml/vial vial 2,750.00 29 29 11 11 18 30,250.00
26 Asam Askorbat (Vit C) tablet 50 mg tab 104.00 1900 3,000 4900 500 500 500 1500 3400 156,000.00
27 Asam Mefenamat tab 500 mg tab 100.00 3500 800 4300 500 500 1,200 2200 2100 220,000.00
28 Asam tranexamic injeksi ampul 1,956.00 60 50 110 10 10 100 19,560.00
29 Asetosal / miniaspi 80 tab 92.00 800 500 1300 0 1300 -
1 2 3 4 5 6 7 8 9 10 11
30 Asetosal tablet 100 mg tab 130.00 700 700 0 700 -
31 Asiklovir 400 mg tab tab 365.00 800 800 500 500 300 182,500.00
32 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 1,540.00 80 80 0 80 -
34 Becefort syr (multi vitamin 60 ml) botol 17,360.00 12 25 37 17 13 7 37 0 642,320.00
35 Betametason krim 0.1% tube 3,388.00 13 100 113 13 12 12 37 76 125,356.00
36 Bisacodyl tab 5 mg tab 300.00 450 450 200 200 250 60,000.00
37 Bisturi pcs 300,000.00 2 2 0 2 -
38 Buscopan 10 mg tab 2,972.00 300 300 0 300 -
39 Calprosis 500 tab 430.00 950 1,200 2150 400 24 424 1726 182,320.00
40 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah set 32,800.00 19 120 139 24 24 12 60 79 1,968,000.00
41 Cefadroksil 500 mg kapsul kapsul 516.00 0 0 0 0 -
42 Cetirizine 5 mg/5 ml syr btl 3,150.00 79 79 15 10 25 54 78,750.00
43 Cetirizine kap 10 mg kapsul 143.00 800 1,500 2300 500 500 1000 1300 143,000.00
44 Cuticell classic 10x10cm buah 5,198.00 80 100 180 20 20 160 103,960.00
45 Deck Glas set 82,500.00 0 1 1 1 1 0 82,500.00
46 Deksametason injeksi 5 mg/ml - 1 ml ampul 1,540.00 55 55 20 10 30 25 46,200.00
47 Deksametason tablet 0,5 mg tab 44.00 1100 4,000 5100 700 500 1,700 2900 2200 127,600.00
48 Devitalisasi Pasta (Non Arsen) btl 220,000.00 0 0 0 0 -
49 Diapecta tab tab 510.00 500 500 200 300 500 0 255,000.00
50 Difenhidramin HCl inj 10 mg/ml-1 ml ampul 1,176.00 140 140 0 140 -
51 Digoksin tablet 0,25 mg tab 104.00 200 500 700 0 700 -
52 Doksisiklin kapsul 100 mg kapsul 268.00 800 100 900 400 400 500 107,200.00
53 Domperidone 10 mg tablet tablet 95.00 0 0 0 0 -
54 Dopamet 250 mg tab tab 911.00 1000 1,000 2000 0 2000 -
55 EDTA 250gr set 74,100.00 0 0 0 0 -
56 Eosin (px faeces) 250 set 176,225.00 0 0 0 0 -
57 Epineprin injeksi 0,1% ampul 2,204.00 0 50 50 0 50 -
58 Erytromysin 200 mg/5ml btl 6,700.00 0 4 4 4 4 0 26,800.00
59 Erytromysin tab 250 mg kapsul 566.00 200 200 0 200 -
60 Erytromysin tab 500 mg tab 730.00 0 0 0 0 -
61 Etakridina (Rivanol) lar 0,1% btl 3,000.00 9 24 33 0 33 -
62 Etanol 70 % btl 2,500.00 49 49 0 49 -
63 etanol 70 % 1 liter botol 21,000.00 0 20 20 0 20 -
64 Eugenol cairan btl 18,100.00 35 35 0 35 -
65 Fenitoin Natrium kapsul 30 mg kapsul 154.00 1000 500 1500 900 900 600 138,600.00
66 Fenol Gliserol tetes telinga 10% btl 2,500.00 0 20 20 0 20 -
1 2 3 4 5 6 7 8 9 10 11
67 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml ampul 4,167.00 25 90 115 35 35 80 145,845.00
68 Fitomenadion (Vit.K1) tablet salut gula 10 mg tab 695.00 600 1,500 2100 0 2100 -
69 Foley cateter 16 pcs 11,000.00 7 1 8 0 8 -
71 Furosemid inj i.v/i.m 10/ml mg ampul 1,829.00 20 20 0 20 -
72 Furosemid tablet 40 mg tab 80.00 1200 500 1700 400 500 900 800 72,000.00
73 Garam Oralit untuk 200 ml air sachet 260.00 225 225 0 225 -
74 Glass Ionomer Cement ART set 521,000.00 0 1 1 1 1 0 521,000.00
75 Glibenklamid tablet 5 mg tab 101.00 1300 1300 400 500 900 400 90,900.00
76 Glimepiride 2 mg tablet 436.00 600 600 50 50 550 21,800.00
77 Glukosa larutan infus 5 % steril (Produk lokal) btl 6,900.00 51 160 211 27 16 78 121 90 834,900.00
78 Griseofulvin tab 125 mg tab 249.00 0 0 0 0 -
79 H2O2 3% btl 30,855.00 0 0 0 0 -
80 H2O2 100 ml btl 4,780.00 0 0 0 0 -
81 Haloperidol injeksi ampul 4,974.00 0 0 0 0 -
82 Haloperidol tablet 1,5 mg tab 66.00 1500 1,000 2500 400 400 2100 26,400.00
83 Handscoon pcs 7,600.00 0 0 0 0 -
84 Handscoon no 8 pcs 7,600.00 0 0 0 0 -
85 Hidroklorotiazid (HCT) tablet 25 mg tab 149.00 600 600 1200 0 1200 -
86 Hidrokortison krim 2,5 % tube 2,640.00 0 150 150 24 24 48 102 126,720.00
87 Ibuprofen suspensi 100 mg/5 ml btl 2,475.00 30 180 210 12 17 29 181 71,775.00
88 Ibuprofen tablet 400 mg tab 127.00 500 5,000 5500 500 500 2,500 3500 2000 444,500.00
89 Infusion set anak set 9,200.00 173 173 0 173 -
90 Infusion set dewasa set 8,200.00 0 150 150 20 20 130 164,000.00
91 Isosorbid Dinitrat tablet sublingual 5 mg tab 90.00 1300 1300 0 1300 -
92 IV Catheter 18 G pcs 7,000.00 65 20 85 0 85 -
94 IV Catheter No.22G pcs 7,000.00 0 50 50 10 15 25 25 175,000.00
95 IV Catheter No.24 G pcs 7,000.00 80 50 130 35 20 55 75 385,000.00
96 IV Catheter No.26 G set 21,065.00 10 10 10 10 0 210,650.00
97 Kalsium Glukonas inj ampul 9,955.00 24 24 5 5 19 49,775.00
98 Kalsium Hidroksida Pasta tube 159,500.00 0 0 0 0 -
99 Kalsium Laktat (Kalk) tablet 500 mg tab 56.00 1000 1000 300 300 700 16,800.00
100 Kapas pembalut absorben 250 mg glg 24,000.00 0 50 50 0 50 -
101 Kaptopril tab 12,5 mg tab 62.00 400 400 200 200 200 12,400.00
102 Kaptopril tab 25 mg tab 80.00 0 500 500 200 100 200 500 0 40,000.00
103 Karbamazepin tablet 200 mg tab 245.00 0 0 0 0 -
1 2 3 4 5 6 7 8 9 10 11
104 Kartu Golongan Darah Set 33,000.00 0 0 0 0 -
105 kasa gulung besar 1 meter glg 130,000.00 11 11 4 4 7 520,000.00
106 Kasa hidrofil steril 18x22 ktk 5,900.00 0 0 0 0 -
107 Kasa kompres 16x16 steril ktk 7,900.00 10 37 47 5 5 42 39,500.00
108 Kasa pembalu hidrofil 4 x 10 cm elastis glg 2,300.00 90 100 190 10 50 60 130 138,000.00
109 Kasa pembalut elastis 3 inch rol 27,660.00 10 10 0 10 -
110 kasa pembalut hidrofil 4 x 5 cm glg 750.00 100 100 0 100 -
111 Kertas perkamen kantong 104,032.00 3 12 15 6 6 9 624,192.00
112 ketokonazole krim 2% tube 2,545.00 0 0 0 0 -
113 Ketokonazole tab 200 mg tab 280.00 400 400 200 200 200 56,000.00
114 Ketoprofen suppos supositoria 2,640.00 10 30 40 0 40 -
115 Klindamysin kapsul 150 mg kapsul 578.00 800 100 900 300 300 600 173,400.00
116 Kloramfenikol kapsul 250 mg kapsul 428.00 0 0 0 0 -
117 Kloramfenikol kapsul 500 mg kapsul 1,048.00 100 500 600 200 100 300 300 314,400.00
118 Kloramfenikol syr 60 ml btl 4,700.00 50 50 15 15 35 70,500.00
119 Klorfeniramin Maleat (CTM) tablet 4 mg tab 42.00 700 8,000 8700 700 1,000 1,100 2800 5900 117,600.00
120 Klorfenol kamper menthol (CHKM) btl 55,000.00 18 18 0 18 -
121 Klorpromazin HCl injeksi 25 mg/ml - 1 ml ampul 1,205.00 30 30 15 15 15 18,075.00
122 Klorpromazin HCl tablet salut 25 mg tab 148.00 600 600 200 200 400 29,600.00
123 Klorpromazine tab 100 mg tab 148.00 300 300 100 100 200 14,800.00
124 Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Tr btl 2,286.00 15 15 15 15 0 34,290.00
125 Kotrimoksazol tablet kombinasi: Sulfametoksazol 400 mg + tab 129.00 200 500 700 500 200 700 0 90,300.00
126 Larutan Hayem (px erytrosit) 250 set 29,450.00 0 0 0 0 -
127 Larutan HCL 0,1 N (px HB) 250 set 19,950.00 0 0 0 0 -
128 Larutan Na Citrat 3,8% (Px LED)250 set 19,475.00 0 0 0 0 -
129 Larutan Resseker (px Trombosit) 250 set 46,550.00 0 0 0 0 -
130 Larutan Truks (px leukosit)250 set 23,750.00 0 0 0 0 -
131 Lidokain hcl 2% injeksi ampul 860.00 7 7 0 7 -
132 Lidokain jelly syringe 40,000.00 9 10 19 0 19 -
133 Lidokain komp. injeksi, Kombinasi:Lidokain HCl 2% + Epinefr ampul 1,937.00 40 300 340 60 60 120 220 232,440.00
134 Lidokain spray 10 % (xylocaine) btl 170,400.00 4 4 1 1 3 170,400.00
135 Lisol btl 41,000.00 8 2 10 2 3 5 5 205,000.00
136 Lodomer 2 mg tab tab 94.00 0 0 0 0 -
137 Loperamid 2 mg tab tab 85.00 200 200 200 200 0 17,000.00
138 Loratadine tab 10 mg tablet 125.00 900 1,500 2400 0 2400 -
139 Lugol (px feaces)250 set 102,960.00 0 0 0 0 -
140 Masker ear loop pcs 396.00 100 200 300 150 150 150 59,400.00
1 2 3 4 5 6 7 8 9 10 11
141 Masker ties on pcs 480.00 10 300 310 50 100 150 160 72,000.00
142 Metanol 250cc set 135,907.00 0 0 0 0 -
143 Metformin 500 mg tablet tab 100.00 300 3,000 3300 300 500 2,500 3300 0 330,000.00
144 Metilen Blue (px Diffcort) set 118,329.00 0 0 0 0 -
145 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 tab 154.00 600 600 0 600 -
146 Metilergometrin Maleat inj 0,200 mg-1 ml ampul 2,849.00 40 100 140 46 46 94 131,054.00
147 Metilprednisolon tab 4 mg tablet 194.00 0 0 0 0 -
148 Metoklopramid tablet 10 mg tab 87.00 300 300 300 300 0 26,100.00
149 Metronidazol tablet 250 mg tab 90.00 1000 1,000 2000 1,500 1500 500 135,000.00
150 Metronidazol tablet 500 mg tab 113.00 600 600 200 200 400 200 45,200.00
151 MgSO4 20% btl 3,200.00 19 19 0 19 -
152 MgSO4 40% btl 3,650.00 16 16 0 16 -
153 Mikonazole salep 2% tube 3,250.00 0 0 0 0 -
154 Mummifying pasta btl 176,000.00 0 0 0 0 -
155 N-asetil sistein kapsul kapsul 1,100.00 500 1,200 1700 0 1700 -
156 Nasal oxygen size m pcs 6,600.00 13 13 0 13 -
157 Nasal oxygen size xs pcs 6,600.00 13 13 0 13 -
158 Natrium diklofenak tablet 50mg tab 122.00 2200 2,000 4200 500 1,800 2300 1900 280,600.00
159 Natrium Klorida larutan infus 0,9 % steril (Produk lokal) btl 6,410.00 5 5 5 5 0 32,050.00
160 Neo K (vitamin K untuk bayi) 2 ml ampul 3,550.00 0 150 150 0 150 -
161 Nifedipine tab 10 mg tab 110.00 700 700 0 700 -
162 Nistatin tablet salut 500.000 IU tab 765.00 1000 1000 0 1000 -
163 Nistatin tablet vaginal 100.000 IU/g tab 545.00 160 160 0 160 -
164 Obat Anti Tuberkulosa Kategori I paket 374,384.00 0 0 0 0 -
165 Obat Anti Tuberkulosa Kategori I anak paket 223,585.00 0 0 0 0 -
166 Obat Anti Tuberkulosa Kategori II paket 1,247,980.00 1 1 0 1 -
167 Obat batuk hitam (OBH) botol 10,000.00 0 0 0 0 -
168 Objek Glass set 22,000.00 0 0 0 0 -
169 Oksitosin injeksi 10 IU/ml - 1 ml ampul 1,900.00 0 300 300 100 100 200 190,000.00
170 Omeprazole injeksi 40 mg/10 ml vial 11,868.00 42 30 72 10 10 20 52 237,360.00
171 Omeprazole kapsul 20 mg kapsul 140.00 0 0 0 0 -
172 Paracetamol drop botol 5,200.00 0 0 0 0 -
173 Parasetamol sirup 120 mg/5 ml btl 1,074.00 0 200 200 20 30 65 115 85 123,510.00
174 Parasetamol tablet 500 mg tab 211.00 2500 8,000 10500 2,000 2,700 2,500 7200 3300 1,519,200.00
175 Pehavral tab (multivitamin tab) tab 930.00 500 500 0 500 -
176 Pembalut Gips glg 28,000.00 20 20 0 20 -
177 Penjepit tali pusar set 1,300.00 100 100 0 100 -
1 2 3 4 5 6 7 8 9 10 11
178 Phenobarbital injeksi 50 mg/ml 1ml ampul 1,969.00 55 55 0 55 -
179 Pirantel tablet 125 mg tab 277.00 300 500 800 0 800 -
180 Piridoksin HCl (Vit.B6) tablet 10 mg tab 45.00 2100 1,000 3100 500 500 2600 22,500.00
181 Plastik obat 7x10 kantong 16,731.00 23 30 53 8 8 45 133,848.00
182 Plester roll 10 cm x 5 cm roll 41,360.00 8 5 13 4 4 9 165,440.00
183 Plester roll kain roll 11,964.00 7 30 37 4 10 14 23 167,496.00
184 Prednison tablet 5 mg tab 76.00 700 3,000 3700 700 500 500 1700 2000 129,200.00
185 Primakuin tablet 15 mg tab 224.00 1000 1000 0 1000 -
186 Propiltiourasil tab100 mg tab 319.00 300 300 0 300 -
187 Propranolol 10 mg tab tab 60.00 1000 1000 500 200 700 300 42,000.00
188 Ramaflu tab (obat flu) tab 645.00 0 0 0 0 -
189 Ranitidin injeksi ampul 1,390.00 0 150 150 50 6 56 94 77,840.00
190 Ranitidin tab 150 mg tab 98.00 200 1,500 1700 500 500 700 1700 0 166,600.00
191 RDT @25pcs ktk 476,373.00 0 0 0 0 -
192 Retinol (vitamin A) kap 100,000 IU kapsul 284.00 250 250 0 250 -
194 Ringer Laktat larutan infus steril (Produk lokal) btl 7,150.00 14 14 14 14 0 100,100.00
195 Sabun cair (softaman) btl 78,750.00 0 0 0 0 -
196 Sabun cair (one scrub 4 %) btl 62,491.00 0 10 10 0 10 -
197 Salbutamol tablet 4 mg tab 95.00 100 1,000 1100 300 300 600 500 57,000.00
198 Salbutamol inheler (combivent) dosis 5,700.00 0 0 0 0 -
199 Salep 2-4 , Kombinasi:Asam Salisilat 2% + Belerang Enda pot 2,527.00 48 48 96 24 24 72 60,648.00
200 Salicyl bedak 2 % pot 1,020.00 36 20 56 0 56 -
201 Semen Seng Fosfat Serbuk & Cairan set 165,000.00 1 1 1 1 0 165,000.00
202 Sendok takar obat bh 2,145.00 250 250 0 250 -
203 Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I) vial 462,000.00 0 3 3 2 2 1 924,000.00
204 Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.) ampul 126,500.00 1 3 4 4 4 0 506,000.00
205 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml ampul 1,098.00 154 154 0 154 -
206 Sianokobalamin (Vit.B12) tablet 50 mcg tab 51.00 500 1,000 1500 300 300 1200 15,300.00
207 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah set 19,700.00 12 6 18 12 6 18 0 354,600.00
209 Siprofloksasin tablet 500 mg tab 281.00 0 1,200 1200 200 200 600 1000 200 281,000.00
210 Spironolactone tab 25 mg tab 244.00 0 1,500 1500 500 200 500 1200 300 292,800.00
211 Strip pemeriksaan gula darah kotak 305,329.00 0 0 0 0 -
212 Strip tes kehamilan pcs 1,936.00 0 0 0 0 -
214 Sulfadiazine silver 10 gr tube 20,700.00 17 10 27 0 27 -
1 2 3 4 5 6 7 8 9 10 11
215 Swab 2 ply dus 11,000.00 75 50 125 10 10 5 25 100 275,000.00
216 Tablet tambah darah kombinasi (Besi II Sulfat 200mg + Asam tab 352.00 0 0 0 0 -
217 Test Golongan Darah Anti A Set 68,200.00 0 0 0 0 -
218 Test Golongan Darah Anti AB Set 92,510.00 0 0 0 0 -
219 Test Golongan Darah Anti B Set 68,200.00 0 0 0 0 -
220 Test Golongan Darah Anti D (Rho) Set 114,070.00 0 0 0 0 -
221 Test Kehamilan Beta HCG Set 80,416.00 0 0 0 0 -
222 Tetrasiklin HCl kapsul 250 mg kapsul 168.00 800 800 0 800 -
223 Tetrasiklin HCl kapsul 500 mg tab 310.00 400 400 300 300 100 93,000.00
224 Tiamin HCl / Mononitrat (Vit.B1) tablet 50 mg tab 82.00 1900 1900 600 500 500 1600 300 131,200.00
225 Tranfusi set set 3,600.00 15 15 0 15 -
226 Triheksipenidil tab 2 mg tab 80.00 300 300 600 600 600 0 48,000.00
227 Trombophop gel tube 51,975.00 11 11 0 11 -
228 Urine bag pcs 5,500.00 45 45 10 10 35 55,000.00
229 Urine Strip 10P set 334,840.00 0 0 0 0 -
230 Vaksin Rabies Vero vial 174,500.00 0 0 0 0 -
231 Ventolin nebules amp/salbutamol cairan nebu 4,000.00 15 15 0 15 -
232 Vitamin B Kompleks tab 115.00 1100 1100 1,100 1100 0 126,500.00
233 Vitamin neurotropik injeksi ampul 4,336.00 65 65 0 65 -
234 Vitamin neurotropik tablet tablet 975.00 300 300 300 300 0 292,500.00
235 Wing Needle No. 27 G set 1,400.00 0 0 0 0 -
236 Wing Needle No.21 G set 1,400.00 0 0 0 0 -
239 Yodium povidon lar 10 % 1000 ml btl 149,314.00 0 0 0 0 -
241 Yodium povidon lar 10 % 300 ml btl 18,000.00 9 50 59 0 59 -
243 Yodium povidon 60 ml btl 23,890.00 0 0 0 0 -
244 Zinc tab 513.00 900 1,000 1900 500 1,400 1900 0 974,700.00
246 Alkohol 70 % 300 ml btl 21,500.00 0 0 0 0 -
247 Allopurinol tab tab 90.00 1700 1700 100 100 1600 9,000.00
248 Amoxicillin kap 500mg tab 190.00 0 0 0 0 -
249 Amoxicillin dry sirup btl 1,881.00 0 0 0 0 -
250 Asam mefenamat 500 mg tab tab 100.00 0 2,000 2000 0 2000 -
251 Acyclovir 200mg tab tab 249.00 0 0 0 0 -
1 2 3 4 5 6 7 8 9 10 11
253 Cefadroxil 500 mg kapsul kapsul 450.00 0 1,000 1000 200 400 200 800 200 360,000.00
254 Ciprofloxacin kap kaplet 281.00 0 0 0 0 -
255 Chloramex-kloramfenikol kap 500 mg kapsul 1,007.00 0 0 - 0 0 -
256 Ctm tab tab 42.00 0 1,800 1800 0 1800 -
257 Chlorpromazine 100mg tab tab 162.00 0 0 0 0 -
258 Cefotaxime inj vial 5,500.00 0 0 0 0 -
259 Deksamethason 0,5mg tab tab 44.00 0 0 - 0 0 -
260 Domperidon 10 mg tablet tab 95.00 500 1,000 1500 400 400 1100 38,000.00
261 Glimepiride tab 3 mg tab 319.00 500 500 350 350 150 111,650.00
262 Glukosa 5% infus btl 6,900.00 0 0 0 0 -
263 Ibuprofen 200 mg tab tab 102.00 0 0 0 0 -
265 Ketokonazol cream tube 2,545.00 0 0 0 0 -
266 Lidokain comp injeksi ampul 1,845.00 0 90 90 0 90 -
267 Loperamide tab 2 mg tab 80.00 500 500 1000 0 1000 -
268 Metylprednisolone tab 8 mg tab 309.00 0 0 0 0 -
269 Metylprednisolone tab 4 mg tab 150.00 0 500 500 500 500 0 75,000.00
270 Metoklopropamid tab 10 mg tab 87.00 1000 1000 0 1000 -
271 Metformin HCL 500mg tab 100.00 0 3,000 3000 0 3000 -
272 Nacl 0,9% infus btl 6,410.00 0 200 200 15 63 78 122 499,980.00
273 Nipedifine tab tab 110.00 0 2,500 2500 0 2500 -
274 Omeprazole kap 20 mg kapsul 140.00 0 1,500 1500 150 300 450 1050 63,000.00
275 Povidone iodine 10 % 300 ml btl 18,656.00 0 0 0 0 -
278 RL infus btl 7,150.00 0 160 160 29 58 87 73 622,050.00
279 Salep 2-4 pot 2,527.00 0 0 0 0 -
281 Spirinolactone tab 25 mg tab 244.00 0 1,000 1000 0 1000 -
282 Vit b komplek tab 115.00 0 3,000 3000 1,500 1500 1500 172,500.00
283 Cutgut 2/0 pcs 33,643.00 0 0 0 0 -
284 Cutgut 3/0 pcs 33,643.00 0 0 0 0 -
285 IV cath no 20 pcs 10,483.00 0 0 0 0 -
286 IV cath no 22 pcs 10,480.00 0 0 0 0 -
287 IV cath no 24 pcs 10,480.00 0 0 0 0 -
1 2 3 4 5 6 7 8 9 10 11
289 Handscoon 7,5 pcs 8,250.00 0 0 0 0 -
290 Iodine Povidone btl 6,550.00 16 16 0 16 -
291 Infus set anak pcs 5,661.00 5 200 205 0 205 -
292 Infus set Dewasa pcs 6,644.00 130 160 290 12 15 27 263 179,388.00
293 Kapas pembalut absorben 250 mg Roll 12,500.00 48 48 0 48 -
294 Kasa hidrofil 40 yard x 80 cm Roll 255,750.00 0 10 10 0 10 -
296 Kasa kompres 16 x 16 steril pack 5,820.00 0 0 0 0 -
297 Masker pcs 762.00 0 0 0 0 -
298 Spuit 3 cc pcs 916.00 0 1,000 1000 300 400 700 300 641,200.00
299 Spuit 5 cc pcs 1,030.00 0 500 500 0 500 -
300 Urine bag pcs 6,036.00 0 20 20 0 20 -
18,836,704.00
LAPORAN KUNJUNGAN
Juli
Agustus
Sep
(LPLPO) Triwulan IV
PUSKESMAS : LIWA
KECAMATAN : LIWA LAPORAN BULAN/PERIODE : Oktober - Desember 2018

Per satuan Okto Nop Des Penerimaan Okto Nop Des Pemakaian
1 2 3 4 5 6 7 8 9 10 11
2 Alat suntik sekali pakai 2,5 ml pcs 792.00 0 0 0 0 -
4 Alat tes gula darah kotak 1,771,000.00 0 0 0 0 -
5 Alat tes HB / HB sahli one med set 88,000.00 3 3 0 3 -
6 Albendazol 400 mg tab 392.00 0 0 0 0 -
7 Allupurinol tab 100 mg tab 110.00 0 0 0 0 -
8 Aminofilin tablet 200 mg tab 91.00 400 1,000 1400 600 600 800 54,600.00
9 Aminofilina injeksi 24 mg/ml - 10 ml ampul 2,998.00 30 30 60 33 33 27 98,934.00
10 Amitriptillin tab salut 25 mg (HCL) tab 143.00 600 600 1200 1,000 1000 200 143,000.00
11 Amlodipine tab 105.00 0 1,500 1500 600 300 900 600 94,500.00
12 Amoksisilin kaplet 500 mg tab 190.00 3400 10,000 13400 2,800 1,500 4300 9100 817,000.00
13 Amoksisilin kapsul 250 mg tablet 195.00 200 2,000 2200 300 300 1900 58,500.00
14 Amoksisilin sirup kering 125 mg/5ml btl 1,881.00 83 83 53 30 83 0 156,123.00
15 Ampisillin inj 1 gr vial 9,270.00 30 30 10 10 20 92,700.00
16 Antasida Doen II Suspensi suspensi 2,025.00 0 100 100 57 43 100 0 202,500.00
17 Antasida Doen tab kombinasi tab 62.00 0 0 0 0 -
18 Anti Bakteri DOEN salep kombinasi:Basitrasin 500 IU/g + Po tube 2,924.00 0 0 0 0 -
19 Anti konstipasi dulcolax supp supositoria 5,800.00 50 50 0 50 -
20 Anti Hemoroid DOEN Kombinasi supp 3,045.00 20 20 20 20 0 60,900.00
21 Anti Malaria kombinasi (Artemether) ampul 25,490.00 0 0 0 0 -
22 Anti Skabies cream tube 12,155.00 10 10 10 10 0 121,550.00
23 Antifungi DOEN Kombinasi:Asam Benzoat 6% + Asam Salisi pot 4,323.00 0 24 24 0 24 -
24 Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg tab 135.00 0 0 0 0 -
25 Aqua pro injeksi steril,bebas pirogen 20 ml/vial vial 2,750.00 18 50 68 29 29 39 79,750.00
26 Asam Askorbat (Vit C) tablet 50 mg tab 104.00 3400 3,000 6400 3,400 600 4000 2400 416,000.00
27 Asam Mefenamat tab 500 mg tab 100.00 2100 2100 2,100 2100 0 210,000.00
28 Asam tranexamic injeksi ampul 1,956.00 100 100 10 10 90 19,560.00
29 Asetosal / miniaspi 80 tab 92.00 1300 1300 0 1300 -
1 2 3 4 5 6 7 8 9 10 11
30 Asetosal tablet 100 mg tab 130.00 700 700 500 500 200 65,000.00
31 Asiklovir 400 mg tab tab 365.00 300 500 800 100 100 700 36,500.00
32 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 1,540.00 80 80 0 80 -
34 Becefort syr (multi vitamin 60 ml) botol 17,360.00 0 0 0 0 -
35 Betametason krim 0.1% tube 3,388.00 76 60 136 55 18 73 63 247,324.00
36 Bisacodyl tab 5 mg tab 300.00 250 600 850 0 850 -
37 Bisturi pcs 300,000.00 2 3 5 3 3 2 900,000.00
38 Buscopan 10 mg tab 2,972.00 300 100 400 0 400 -
39 Calprosis 500 tab 430.00 1726 1726 1,260 1260 466 541,800.00
40 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah set 32,800.00 79 79 31 36 67 12 2,197,600.00
41 Cefadroksil 500 mg kapsul kapsul 516.00 0 1,000 1000 200 200 800 103,200.00
42 Cetirizine 5 mg/5 ml syr btl 3,150.00 54 54 26 28 54 0 170,100.00
43 Cetirizine kap 10 mg kapsul 143.00 1300 1,000 2300 800 800 1600 700 228,800.00
44 Cuticell classic 10x10cm buah 5,198.00 160 100 260 61 61 199 317,078.00
45 Deck Glas set 82,500.00 0 0 0 0 -
46 Deksametason injeksi 5 mg/ml - 1 ml ampul 1,540.00 25 100 125 5 5 120 7,700.00
47 Deksametason tablet 0,5 mg tab 44.00 2200 2200 500 1,200 1700 500 74,800.00
48 Devitalisasi Pasta (Non Arsen) btl 220,000.00 0 1 1 0 1 -
49 Diapecta tab tab 510.00 0 500 500 500 500 0 255,000.00
50 Difenhidramin HCl inj 10 mg/ml-1 ml ampul 1,176.00 140 90 230 45 45 185 52,920.00
51 Digoksin tablet 0,25 mg tab 104.00 700 700 300 300 400 31,200.00
52 Doksisiklin kapsul 100 mg kapsul 268.00 500 500 1000 0 1000 -
53 Domperidone 10 mg tablet tablet 95.00 0 0 0 0 -
54 Dopamet 250 mg tab tab 911.00 2000 2000 200 200 1800 182,200.00
55 EDTA 250gr set 74,100.00 0 2 2 0 2 -
56 Eosin (px faeces) 250 set 176,225.00 0 2 2 0 2 -
57 Epineprin injeksi 0,1% ampul 2,204.00 50 100 150 60 60 90 132,240.00
58 Erytromysin 200 mg/5ml btl 6,700.00 0 0 0 0 -
59 Erytromysin tab 250 mg kapsul 566.00 200 1,500 1700 300 500 800 900 452,800.00
60 Erytromysin tab 500 mg tab 730.00 0 1,000 1000 200 200 800 146,000.00
61 Etakridina (Rivanol) lar 0,1% btl 3,000.00 33 24 57 40 40 17 120,000.00
62 Etanol 70 % btl 2,500.00 49 49 24 24 25 60,000.00
63 etanol 70 % 1 liter botol 21,000.00 20 20 40 24 24 16 504,000.00
64 Eugenol cairan btl 18,100.00 35 35 0 35 -
65 Fenitoin Natrium kapsul 30 mg kapsul 154.00 600 200 800 200 200 600 30,800.00
66 Fenol Gliserol tetes telinga 10% btl 2,500.00 20 48 68 26 26 42 65,000.00
1 2 3 4 5 6 7 8 9 10 11
67 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml ampul 4,167.00 80 80 31 31 49 129,177.00
68 Fitomenadion (Vit.K1) tablet salut gula 10 mg tab 695.00 2100 2100 0 2100 -
70 Foley cateter 18 pcs 11,000.00 3 20 23 3 3 20 33,000.00
71 Furosemid inj i.v/i.m 10/ml mg ampul 1,829.00 20 20 0 20 -
72 Furosemid tablet 40 mg tab 80.00 800 500 1300 200 200 1100 16,000.00
73 Garam Oralit untuk 200 ml air sachet 260.00 225 225 95 95 130 24,700.00
74 Glass Ionomer Cement ART set 521,000.00 0 1 1 1 1 0 521,000.00
75 Glibenklamid tablet 5 mg tab 101.00 400 1,000 1400 800 300 1100 300 111,100.00
76 Glimepiride 2 mg tablet 436.00 550 550 200 200 350 87,200.00
77 Glukosa larutan infus 5 % steril (Produk lokal) btl 6,900.00 90 80 170 75 35 110 60 759,000.00
78 Griseofulvin tab 125 mg tab 249.00 0 2,000 2000 300 300 1700 74,700.00
79 H2O2 3% btl 30,855.00 0 0 0 0 -
80 H2O2 100 ml btl 4,780.00 0 0 0 0 -
81 Haloperidol injeksi ampul 4,974.00 0 0 0 0 -
82 Haloperidol tablet 1,5 mg tab 66.00 2100 1,000 3100 2,600 2600 500 171,600.00
83 Handscoon pcs 7,600.00 0 0 0 0 -
84 Handscoon no 8 pcs 7,600.00 0 0 0 0 -
85 Hidroklorotiazid (HCT) tablet 25 mg tab 149.00 1200 1200 0 1200 -
86 Hidrokortison krim 2,5 % tube 2,640.00 102 48 150 75 75 75 198,000.00
87 Ibuprofen suspensi 100 mg/5 ml btl 2,475.00 181 181 116 116 65 287,100.00
88 Ibuprofen tablet 400 mg tab 127.00 2000 5,000 7000 3,300 1,800 5100 1900 647,700.00
89 Infusion set anak set 9,200.00 173 173 100 100 73 920,000.00
90 Infusion set dewasa set 8,200.00 130 50 180 129 129 51 1,057,800.00
91 Isosorbid Dinitrat tablet sublingual 5 mg tab 90.00 1300 1300 0 1300 -
92 IV Catheter 18 G pcs 7,000.00 85 85 15 15 70 105,000.00
93 IV Catheter No.20 G pcs 7,000.00 80 80 45 45 35 315,000.00
94 IV Catheter No.22G pcs 7,000.00 25 25 15 15 10 105,000.00
96 IV Catheter No.26 G set 21,065.00 0 100 100 36 36 64 758,340.00
97 Kalsium Glukonas inj ampul 9,955.00 19 19 0 19 -
98 Kalsium Hidroksida Pasta tube 159,500.00 0 0 0 0 -
99 Kalsium Laktat (Kalk) tablet 500 mg tab 56.00 700 700 100 100 200 500 11,200.00
100 Kapas pembalut absorben 250 mg glg 24,000.00 50 50 100 26 26 74 624,000.00
101 Kaptopril tab 12,5 mg tab 62.00 200 200 0 200 -
102 Kaptopril tab 25 mg tab 80.00 0 2,000 2000 300 1,000 1300 700 104,000.00
103 Karbamazepin tablet 200 mg tab 245.00 0 0 0 0 -
1 2 3 4 5 6 7 8 9 10 11
104 Kartu Golongan Darah Set 33,000.00 0 2 2 2 2 0 66,000.00
105 kasa gulung besar 1 meter glg 130,000.00 7 7 0 7 -
106 Kasa hidrofil steril 18x22 ktk 5,900.00 0 0 0 0 -
107 Kasa kompres 16x16 steril ktk 7,900.00 42 42 5 15 20 22 158,000.00
108 Kasa pembalu hidrofil 4 x 10 cm elastis glg 2,300.00 130 130 45 45 85 103,500.00
109 Kasa pembalut elastis 3 inch rol 27,660.00 10 10 10 10 0 276,600.00
110 kasa pembalut hidrofil 4 x 5 cm glg 750.00 100 100 100 100 0 75,000.00
111 Kertas perkamen kantong 104,032.00 9 9 2 2 7 208,064.00
112 ketokonazole krim 2% tube 2,545.00 0 0 0 0 -
113 Ketokonazole tab 200 mg tab 280.00 200 500 700 0 700 -
114 Ketoprofen suppos supositoria 2,640.00 40 40 0 40 -
115 Klindamysin kapsul 150 mg kapsul 578.00 600 200 800 200 200 600 115,600.00
116 Kloramfenikol kapsul 250 mg kapsul 428.00 0 0 0 0 -
117 Kloramfenikol kapsul 500 mg kapsul 1,048.00 300 500 800 200 200 400 400 419,200.00
118 Kloramfenikol syr 60 ml btl 4,700.00 35 35 10 10 25 47,000.00
119 Klorfeniramin Maleat (CTM) tablet 4 mg tab 42.00 5900 3,600 9500 3,800 1,500 5300 4200 222,600.00
120 Klorfenol kamper menthol (CHKM) btl 55,000.00 18 18 0 18 -
121 Klorpromazin HCl injeksi 25 mg/ml - 1 ml ampul 1,205.00 15 60 75 0 75 -
122 Klorpromazin HCl tablet salut 25 mg tab 148.00 400 400 0 400 -
123 Klorpromazine tab 100 mg tab 148.00 200 200 200 200 0 29,600.00
124 Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Tr btl 2,286.00 0 0 0 0 -
125 Kotrimoksazol tablet kombinasi: Sulfametoksazol 400 mg + tab 129.00 0 0 0 0 -
126 Larutan Hayem (px erytrosit) 250 set 29,450.00 0 2 2 0 2 -
127 Larutan HCL 0,1 N (px HB) 250 set 19,950.00 0 2 2 0 2 -
128 Larutan Na Citrat 3,8% (Px LED)250 set 19,475.00 0 2 2 0 2 -
129 Larutan Resseker (px Trombosit) 250 set 46,550.00 0 2 2 0 2 -
130 Larutan Truks (px leukosit)250 set 23,750.00 0 2 2 0 2 -
131 Lidokain hcl 2% injeksi ampul 860.00 7 7 7 7 0 6,020.00
132 Lidokain jelly syringe 40,000.00 19 19 3 16 19 0 760,000.00
133 Lidokain komp. injeksi, Kombinasi:Lidokain HCl 2% + Epinefr ampul 1,937.00 220 0 180 180 40 348,660.00
134 Lidokain spray 10 % (xylocaine) btl 170,400.00 3 5 8 3 3 5 511,200.00
135 Lisol btl 41,000.00 5 20 25 12 12 13 492,000.00
136 Lodomer 2 mg tab tab 94.00 0 0 0 0 -
137 Loperamid 2 mg tab tab 85.00 0 0 0 -
138 Loratadine tab 10 mg tablet 125.00 2400 2400 0 2400 -
139 Lugol (px feaces)250 set 102,960.00 0 0 0 0 -
140 Masker ear loop pcs 396.00 150 200 350 170 80 250 100 99,000.00
1 2 3 4 5 6 7 8 9 10 11
141 Masker ties on pcs 480.00 160 200 360 160 160 200 76,800.00
142 Metanol 250cc set 135,907.00 0 0 0 0 -
143 Metformin 500 mg tablet tab 100.00 0 0 0 0 -
144 Metilen Blue (px Diffcort) set 118,329.00 0 0 0 0 -
145 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 tab 154.00 600 3,000 3600 1,900 1900 1700 292,600.00
146 Metilergometrin Maleat inj 0,200 mg-1 ml ampul 2,849.00 94 100 194 45 10 55 139 156,695.00
147 Metilprednisolon tab 4 mg tablet 194.00 0 2,000 2000 300 300 600 1400 116,400.00
148 Metoklopramid tablet 10 mg tab 87.00 0 0 0 0 -
149 Metronidazol tablet 250 mg tab 90.00 500 1,000 1500 800 800 700 72,000.00
150 Metronidazol tablet 500 mg tab 113.00 200 200 100 100 100 11,300.00
151 MgSO4 20% btl 3,200.00 19 19 0 19 -
152 MgSO4 40% btl 3,650.00 16 16 0 16 -
153 Mikonazole salep 2% tube 3,250.00 0 50 50 24 24 26 78,000.00
154 Mummifying pasta btl 176,000.00 0 0 0 0 -
155 N-asetil sistein kapsul kapsul 1,100.00 1700 1,500 3200 2,100 2100 1100 2,310,000.00
156 Nasal oxygen size m pcs 6,600.00 13 13 0 13 -
157 Nasal oxygen size xs pcs 6,600.00 13 13 0 13 -
158 Natrium diklofenak tablet 50mg tab 122.00 1900 2,000 3900 2,650 500 3150 750 384,300.00
159 Natrium Klorida larutan infus 0,9 % steril (Produk lokal) btl 6,410.00 0 0 0 0 -
160 Neo K (vitamin K untuk bayi) 2 ml ampul 3,550.00 150 150 45 45 105 159,750.00
161 Nifedipine tab 10 mg tab 110.00 700 700 500 500 200 55,000.00
162 Nistatin tablet salut 500.000 IU tab 765.00 1000 1000 0 1000 -
163 Nistatin tablet vaginal 100.000 IU/g tab 545.00 160 160 0 160 -
164 Obat Anti Tuberkulosa Kategori I paket 374,384.00 0 0 0 0 -
165 Obat Anti Tuberkulosa Kategori I anak paket 223,585.00 0 0 0 0 -
166 Obat Anti Tuberkulosa Kategori II paket 1,247,980.00 1 1 0 1 -
167 Obat batuk hitam (OBH) botol 10,000.00 0 0 0 0 -
168 Objek Glass set 22,000.00 0 0 0 0 -
169 Oksitosin injeksi 10 IU/ml - 1 ml ampul 1,900.00 200 200 400 85 85 315 161,500.00
170 Omeprazole injeksi 40 mg/10 ml vial 11,868.00 52 52 52 52 0 617,136.00
171 Omeprazole kapsul 20 mg kapsul 140.00 0 900 900 300 330 630 270 88,200.00
172 Paracetamol drop botol 5,200.00 0 56 56 36 36 20 187,200.00
173 Parasetamol sirup 120 mg/5 ml btl 1,074.00 85 50 135 57 64 121 14 129,954.00
174 Parasetamol tablet 500 mg tab 211.00 3300 5,000 8300 4,700 2,700 7400 900 1,561,400.00
175 Pehavral tab (multivitamin tab) tab 930.00 500 1,000 1500 200 300 500 1000 465,000.00
176 Pembalut Gips glg 28,000.00 20 20 0 20 -
177 Penjepit tali pusar set 1,300.00 100 200 300 243 243 57 315,900.00
1 2 3 4 5 6 7 8 9 10 11
178 Phenobarbital injeksi 50 mg/ml 1ml ampul 1,969.00 55 55 0 55 -
179 Pirantel tablet 125 mg tab 277.00 800 800 0 800 -
180 Piridoksin HCl (Vit.B6) tablet 10 mg tab 45.00 2600 3,000 5600 2,400 2400 3200 108,000.00
181 Plastik obat 7x10 kantong 16,731.00 45 30 75 20 10 30 45 501,930.00
182 Plester roll 10 cm x 5 cm roll 41,360.00 9 10 19 10 10 9 413,600.00
183 Plester roll kain roll 11,964.00 23 10 33 24 24 9 287,136.00
184 Prednison tablet 5 mg tab 76.00 2000 1,000 3000 500 500 1000 2000 76,000.00
185 Primakuin tablet 15 mg tab 224.00 1000 500 1500 100 100 1400 22,400.00
186 Propiltiourasil tab100 mg tab 319.00 300 2,000 2300 300 300 2000 95,700.00
187 Propranolol 10 mg tab tab 60.00 300 600 900 0 900 -
188 Ramaflu tab (obat flu) tab 645.00 0 0 0 0 -
189 Ranitidin injeksi ampul 1,390.00 94 100 194 194 194 0 269,660.00
190 Ranitidin tab 150 mg tab 98.00 0 1,000 1000 300 700 1000 0 98,000.00
191 RDT @25pcs ktk 476,373.00 0 0 0 0 -
194 Ringer Laktat larutan infus steril (Produk lokal) btl 7,150.00 0 0 0 0 -
195 Sabun cair (softaman) btl 78,750.00 0 0 0 0 -
196 Sabun cair (one scrub 4 %) btl 62,491.00 10 12 22 1 1 21 62,491.00
197 Salbutamol tablet 4 mg tab 95.00 500 500 0 500 -
198 Salbutamol inheler (combivent) dosis 5,700.00 0 50 50 0 50 -
199 Salep 2-4 , Kombinasi:Asam Salisilat 2% + Belerang Enda pot 2,527.00 72 72 0 72 -
200 Salicyl bedak 2 % pot 1,020.00 56 56 26 19 45 11 45,900.00
201 Semen Seng Fosfat Serbuk & Cairan set 165,000.00 0 1 1 1 1 0 165,000.00
202 Sendok takar obat bh 2,145.00 250 250 500 250 250 250 536,250.00
203 Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I) vial 462,000.00 1 5 6 0 6 -
204 Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.) ampul 126,500.00 0 5 5 3 3 2 379,500.00
205 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml ampul 1,098.00 154 154 100 100 54 109,800.00
206 Sianokobalamin (Vit.B12) tablet 50 mcg tab 51.00 1200 1200 300 300 900 15,300.00
207 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah set 19,700.00 0 128 128 46 36 82 46 1,615,400.00
208 Simvastatin 10 mg tab 111.00 450 30 480 300 300 180 33,300.00
209 Siprofloksasin tablet 500 mg tab 281.00 200 1,000 1200 200 900 1100 100 309,100.00
210 Spironolactone tab 25 mg tab 244.00 300 300 0 300 -
211 Strip pemeriksaan gula darah kotak 305,329.00 0 5 5 0 5 -
212 Strip tes kehamilan pcs 1,936.00 0 0 0 0 -
214 Sulfadiazine silver 10 gr tube 20,700.00 27 27 10 10 17 207,000.00
1 2 3 4 5 6 7 8 9 10 11
215 Swab 2 ply dus 11,000.00 100 100 50 50 50 550,000.00
216 Tablet tambah darah kombinasi (Besi II Sulfat 200mg + Asam tab 352.00 0 0 0 0 -
217 Test Golongan Darah Anti A Set 68,200.00 0 1 1 0 1 -
218 Test Golongan Darah Anti AB Set 92,510.00 0 1 1 0 1 -
219 Test Golongan Darah Anti B Set 68,200.00 0 1 1 0 1 -
220 Test Golongan Darah Anti D (Rho) Set 114,070.00 0 1 1 0 1 -
221 Test Kehamilan Beta HCG Set 80,416.00 6 - 6 3 3 3 241,248.00
222 Tetrasiklin HCl kapsul 250 mg kapsul 168.00 800 800 0 800 -
223 Tetrasiklin HCl kapsul 500 mg tab 310.00 100 500 600 0 600 -
224 Tiamin HCl / Mononitrat (Vit.B1) tablet 50 mg tab 82.00 300 4,000 4300 1,300 500 1800 2500 147,600.00
225 Tranfusi set set 3,600.00 15 15 0 15 -
226 Triheksipenidil tab 2 mg tab 80.00 0 0 0 0 -
227 Trombophop gel tube 51,975.00 11 1 12 0 12 -
228 Urine bag pcs 5,500.00 35 35 35 35 0 192,500.00
229 Urine Strip 10P set 334,840.00 0 2 2 0 2 -
230 Vaksin Rabies Vero vial 174,500.00 0 0 0 0 -
231 Ventolin nebules amp/salbutamol cairan nebu 4,000.00 15 15 0 15 -
232 Vitamin B Kompleks tab 115.00 0 0 0 0 -
233 Vitamin neurotropik injeksi ampul 4,336.00 65 65 0 65 -
234 Vitamin neurotropik tablet tablet 975.00 0 0 0 0 -
235 Wing Needle No. 27 G set 1,400.00 0 0 0 0 -
239 Yodium povidon lar 10 % 1000 ml btl 149,314.00 0 12 12 8 8 4 1,194,512.00
240 Yodium povidon lar 10 % 30 ml btl 2,900.00 30 30 5 5 25 14,500.00
241 Yodium povidon lar 10 % 300 ml btl 18,000.00 59 59 40 40 19 720,000.00
242 Yodium povidon lar 10 % 500 ml btl 95,264.00 0 24 24 0 24 -
243 Yodium povidon 60 ml btl 23,890.00 0 0 0 0 -
244 Zinc tab 513.00 0 1,500 1500 200 1,000 1200 300 615,600.00
246 Alkohol 70 % 300 ml btl 21,500.00 0 0 0 0 -
247 Allopurinol tab tab 90.00 1600 1600 500 500 1100 45,000.00
248 Amoxicillin kap 500mg tab 190.00 0 0 0 0 -
249 Amoxicillin dry sirup btl 1,881.00 0 0 0 0 -
250 Asam mefenamat 500 mg tab tab 100.00 2000 2,000 4000 700 600 1300 2700 130,000.00
251 Acyclovir 200mg tab tab 249.00 0 0 0 0 -
1 2 3 4 5 6 7 8 9 10 11
253 Cefadroxil 500 mg kapsul kapsul 450.00 200 200 0 200 -
254 Ciprofloxacin kap kaplet 281.00 0 0 0 0 -
255 Chloramex-kloramfenikol kap 500 mg kapsul 1,007.00 0 0 0 0 -
256 Ctm tab tab 42.00 1800 1800 0 1800 -
257 Chlorpromazine 100mg tab tab 162.00 0 0 0 0 -
258 Cefotaxime inj vial 5,500.00 0 0 0 0 -
259 Deksamethason 0,5mg tab tab 44.00 0 0 0 0 -
260 Domperidon 10 mg tablet tab 95.00 1100 500 1600 1,100 300 1400 200 133,000.00
261 Glimepiride tab 3 mg tab 319.00 150 150 0 150 -
262 Glukosa 5% infus btl 6,900.00 0 0 0 0 -
265 Ketokonazol cream tube 2,545.00 0 50 50 25 25 25 63,625.00
266 Lidokain comp injeksi ampul 1,845.00 90 240 330 15 75 90 240 166,050.00
267 Loperamide tab 2 mg tab 80.00 1000 500 1500 0 1500 -
270 Metoklopropamid tab 10 mg tab 87.00 1000 2,000 3000 3,000 3000 0 261,000.00
271 Metformin HCL 500mg tab 100.00 3000 4,000 7000 2,300 200 2500 4500 250,000.00
272 Nacl 0,9% infus btl 6,410.00 122 120 242 41 23 64 178 410,240.00
273 Nipedifine tab tab 110.00 2500 2,000 4500 2,600 2600 1900 286,000.00
274 Omeprazole kap 20 mg kapsul 140.00 1050 1050 420 420 630 58,800.00
275 Povidone iodine 10 % 300 ml btl 18,656.00 0 0 0 0 -
278 RL infus btl 7,150.00 73 160 233 55 30 85 148 607,750.00
279 Salep 2-4 pot 2,527.00 0 0 0 0 -
281 Spirinolactone tab 25 mg tab 244.00 1000 500 1500 0 1500 -
282 Vit b komplek tab 115.00 1500 2,600 4100 2,400 800 3200 900 368,000.00
283 Cutgut 2/0 pcs 33,643.00 0 60 60 0 60 -
284 Cutgut 3/0 pcs 33,643.00 0 60 60 0 60 -
285 IV cath no 20 pcs 10,483.00 0 50 50 0 50 -
286 IV cath no 22 pcs 10,480.00 0 50 50 0 50 -
287 IV cath no 24 pcs 10,480.00 0 0 0 0 -
1 2 3 4 5 6 7 8 9 10 11
289 Handscoon 7,5 pcs 8,250.00 0 0 0 0 -
290 Iodine Povidone btl 6,550.00 16 16 0 16 -
291 Infus set anak pcs 5,661.00 205 205 0 205 -
292 Infus set Dewasa pcs 6,644.00 263 263 0 263 -
293 Kapas pembalut absorben 250 mg Roll 12,500.00 48 48 11 11 37 137,500.00
294 Kasa hidrofil 40 yard x 80 cm Roll 255,750.00 10 10 10 10 0 2,557,500.00
295 Kasa hidrofil 3 yard x 15 cm Roll 1,577.00 0 100 100 0 100 -
296 Kasa kompres 16 x 16 steril pack 5,820.00 0 50 50 0 50 -
297 Masker pcs 762.00 0 0 0 0 -
298 Spuit 3 cc pcs 916.00 300 1,500 1800 650 650 1150 595,400.00
299 Spuit 5 cc pcs 1,030.00 500 500 0 500 -
300 Urine bag pcs 6,036.00 20 20 5 5 15 30,180.00
30,617,891.00
LAPORAN KUNJUNGAN
Okto 0
Nop 421 429 850
Des 0
0 0 0 0 0
REKAPITULASI LPLPO PKM SBY TAHUN 2018
( PEMAKAIAN )
Harga Total Pemakaian Total Pemakaian

No. Nama Sediaan Satuan
Per Satuan Jan Feb Maret Apr Mei Juni Juli Agust Sept Okt Nop Des Setahun Setahun (Rp)
1 Alat suntik sekali pakai 1 ml pcs 990.00 2020 0 100 950 100 0 0 50 150 710 0 0 4080 4,039,200.00
2 Alat suntik sekali pakai 2,5 ml pcs 792.00 650 100 400 1150 200 300 100 200 0 0 0 0 3100 2,455,200.00
3 Alat suntik sekali pakai 5 ml pcs 979.00 900 0 100 900 0 100 0 0 100 550 0 0 2650 2,594,350.00
4 Alat tes gula darah kotak 1,771,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
5 Alat tes HB / HB sahli one med set 88,000.00 1 1 0 0 0 0 0 0 0 0 0 0 2 176,000.00
6 Albendazol 400 mg tab 392.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
7 Allupurinol tab 100 mg tab 110.00 0 0 500 1900 0 500 0 400 0 0 0 0 3300 363,000.00
8 Aminofilin tablet 200 mg tab 91.00 1600 0 0 1000 0 100 0 0 500 600 0 0 3800 345,800.00
9 Aminofilina injeksi 24 mg/ml - 10 ml ampul 2,998.00 0 25 0 0 0 0 0 0 0 33 0 0 58 173,884.00
10 Amitriptillin tab salut 25 mg (HCL) tab 143.00 100 0 0 0 0 0 700 0 0 1000 0 0 1800 257,400.00
11 Amlodipine tab 105.00 1800 750 750 1950 300 450 300 2500 300 600 300 0 10000 1,050,000.00
12 Amoksisilin kaplet 500 mg tab 190.00 5300 2800 2400 3200 1800 1800 2200 1600 2100 2800 1500 0 27500 5,225,000.00
13 Amoksisilin kapsul 250 mg tablet 195.00 300 300 0 300 0 200 0 300 0 0 300 0 1700 331,500.00
14 Amoksisilin sirup kering 125 mg/5ml btl 1,881.00 35 25 35 70 45 35 60 30 52 53 30 0 470 884,070.00
15 Ampisillin inj 1 gr vial 9,270.00 0 0 0 0 0 0 0 0 0 10 0 0 10 92,700.00
16 Antasida Doen II Suspensi suspensi 2,025.00 180 60 20 35 55 20 30 10 0 57 43 0 510 1,032,750.00
17 Antasida Doen tab kombinasi tab 62.00 5000 1500 1200 1500 500 1700 1000 2000 0 0 0 0 14400 892,800.00
18 Anti Bakteri DOEN salep kombinasi:Basitrasin 500 IU/g + Po tube 2,924.00 25 0 0 25 0 0 0 0 0 0 0 0 50 146,200.00
19 Anti konstipasi dulcolax supp supositoria 5,800.00 0 10 5 10 0 0 0 0 0 0 0 0 25 145,000.00
20 Anti Hemoroid DOEN Kombinasi supp 3,045.00 25 0 0 0 0 0 0 0 0 0 20 0 45 137,025.00
21 Anti Malaria kombinasi (Artemether) ampul 25,490.00 18 0 0 0 0 0 0 0 12 0 0 0 30 764,700.00
22 Anti Skabies cream tube 12,155.00 2 0 10 25 0 20 8 10 5 10 0 0 90 1,093,950.00
23 Antifungi DOEN Kombinasi:Asam Benzoat 6% + Asam Salis pot 4,323.00 45 0 0 50 0 0 27 0 0 0 0 0 122 527,406.00
24 Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg tab 135.00 300 0 100 200 0 0 2900 0 0 0 0 0 3500 472,500.00
25 Aqua pro injeksi steril,bebas pirogen 20 ml/vial vial 2,750.00 57 0 15 35 0 0 0 11 0 29 0 0 147 404,250.00
26 Asam Askorbat (Vit C) tablet 50 mg tab 104.00 5600 500 2000 2400 500 900 500 500 500 3400 600 0 17400 1,809,600.00
27 Asam Mefenamat tab 500 mg tab 100.00 1500 500 1000 1000 0 600 500 500 1200 2100 0 0 8900 890,000.00
28 Asam tranexamic injeksi ampul 1,956.00 0 0 0 0 10 0 10 0 0 10 0 0 30 58,680.00
29 Asetosal / miniaspi 80 tab 92.00 200 0 0 0 0 0 0 0 0 0 0 0 200 18,400.00
30 Asetosal tablet 100 mg tab 130.00 0 0 0 0 0 0 0 0 0 500 0 0 500 65,000.00
31 Asiklovir 400 mg tab tab 365.00 0 0 300 0 0 0 500 0 0 100 0 0 900 328,500.00
32 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 1,540.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
33 Atropin tab 0,5 mg tab tab 74.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
34 Becefort syr (multi vitamin 60 ml) botol 17,360.00 0 5 0 20 10 28 17 13 7 0 0 0 100 1,736,000.00
35 Betametason krim 0.1% tube 3,388.00 10 8 6 6 12 25 13 12 12 55 18 0 177 599,676.00
36 Bisacodyl tab 5 mg tab 300.00 0 60 90 0 0 0 0 0 200 0 0 0 350 105,000.00
37 Bisturi pcs 300,000.00 0 0 0 0 0 0 0 0 0 3 0 0 3 900,000.00
38 Buscopan 10 mg tab 2,972.00 0 300 0 0 0 0 0 0 0 0 0 0 300 891,600.00
39 Calprosis 500 tab 430.00 120 120 460 1350 0 0 400 0 24 1260 0 0 3734 1,605,620.00
40 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah set 32,800.00 64 8 12 38 0 15 24 24 12 31 36 0 264 8,659,200.00
41 Cefadroksil 500 mg kapsul kapsul 516.00 0 0 0 0 0 0 0 0 0 200 0 0 200 103,200.00
42 Cetirizine 5 mg/5 ml syr btl 3,150.00 40 0 0 45 0 0 0 15 10 26 28 0 164 516,600.00
43 Cetirizine kap 10 mg kapsul 143.00 0 500 800 600 500 700 500 0 500 800 800 0 5700 815,100.00
44 Cuticell classic 10x10cm buah 5,198.00 0 20 0 0 0 0 20 0 0 61 0 0 101 524,998.00
45 Deck Glas set 82,500.00 0 0 0 0 0 0 1 0 0 0 0 0 1 82,500.00
46 Deksametason injeksi 5 mg/ml - 1 ml ampul 1,540.00 50 25 0 20 0 0 0 20 10 5 0 0 130 200,200.00
47 Deksametason tablet 0,5 mg tab 44.00 4500 1000 1000 2800 1000 900 700 500 1700 500 1200 0 15800 695,200.00
48 Devitalisasi Pasta (Non Arsen) btl 220,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
49 Diapecta tab tab 510.00 0 0 0 0 0 0 200 300 0 500 0 0 1000 510,000.00
50 Difenhidramin HCl inj 10 mg/ml-1 ml ampul 1,176.00 0 0 0 0 0 0 0 0 0 45 0 0 45 52,920.00
51 Digoksin tablet 0,25 mg tab 104.00 0 0 0 300 0 0 0 0 0 0 300 0 600 62,400.00
52 Doksisiklin kapsul 100 mg kapsul 268.00 1000 0 0 1000 0 0 400 0 0 0 0 0 2400 643,200.00
53 Domperidone 10 mg tablet tablet 95.00 100 0 100 0 0 0 0 0 0 0 0 0 200 19,000.00
54 Dopamet 250 mg tab tab 911.00 0 0 0 0 0 0 0 0 0 200 0 0 200 182,200.00
55 EDTA 250gr set 74,100.00 0 0 0 1 0 0 0 0 0 0 0 0 1 74,100.00
56 Eosin (px faeces) 250 set 176,225.00 0 0 0 1 0 0 0 0 0 0 0 0 1 176,225.00
57 Epineprin injeksi 0,1% ampul 2,204.00 0 0 30 0 60 0 0 0 0 60 0 0 150 330,600.00
58 Erytromysin 200 mg/5ml btl 6,700.00 0 20 0 16 19 0 4 0 0 0 0 0 59 395,300.00
59 Erytromysin tab 250 mg kapsul 566.00 100 200 0 0 0 200 0 0 0 300 500 0 1300 735,800.00
60 Erytromysin tab 500 mg tab 730.00 200 400 0 0 300 100 0 0 0 200 0 0 1200 876,000.00
61 Etakridina (Rivanol) lar 0,1% btl 3,000.00 31 0 0 31 0 1 0 0 0 40 0 0 103 309,000.00
62 Etanol 70 % btl 2,500.00 0 0 0 0 0 2 0 0 0 24 0 0 26 65,000.00
63 etanol 70 % 1 liter botol 21,000.00 0 0 0 10 0 0 0 0 0 24 0 0 34 714,000.00
64 Eugenol cairan btl 18,100.00 3 0 0 0 0 0 0 0 0 0 0 0 3 54,300.00
65 Fenitoin Natrium kapsul 30 mg kapsul 154.00 0 0 0 0 0 0 0 0 900 0 200 0 1100 169,400.00
66 Fenol Gliserol tetes telinga 10% btl 2,500.00 0 0 24 48 0 0 0 0 0 26 0 0 98 245,000.00
67 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml ampul 4,167.00 50 0 0 63 0 0 0 35 0 31 0 0 179 745,893.00
68 Fitomenadion (Vit.K1) tablet salut gula 10 mg tab 695.00 1700 0 200 1400 0 0 0 0 0 0 0 0 3300 2,293,500.00
69 Foley cateter 16 pcs 11,000.00 3 0 0 0 0 2 0 0 0 0 0 0 5 55,000.00
70 Foley cateter 18 pcs 11,000.00 0 0 0 3 0 1 0 0 0 3 0 0 7 77,000.00
71 Furosemid inj i.v/i.m 10/ml mg ampul 1,829.00 0 50 0 0 5 0 0 0 0 0 0 0 55 100,595.00
72 Furosemid tablet 40 mg tab 80.00 0 500 200 0 0 300 0 400 500 0 200 0 2100 168,000.00
73 Garam Oralit untuk 200 ml air sachet 260.00 255 0 0 0 0 0 0 0 0 95 0 0 350 91,000.00
74 Glass Ionomer Cement ART set 521,000.00 0 0 0 1 0 0 1 0 0 1 0 0 3 1,563,000.00
75 Glibenklamid tablet 5 mg tab 101.00 0 0 0 0 200 0 400 0 500 800 300 0 2200 222,200.00
76 Glimepiride 2 mg tablet 436.00 0 0 0 0 0 0 0 0 50 200 0 0 250 109,000.00
77 Glukosa larutan infus 5 % steril (Produk lokal) btl 6,900.00 105 20 15 64 0 0 27 16 78 75 35 0 435 3,001,500.00
78 Griseofulvin tab 125 mg tab 249.00 0 0 100 0 0 0 0 0 0 0 300 0 400 99,600.00
79 H2O2 3% btl 30,855.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
80 H2O2 100 ml btl 4,780.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
81 Haloperidol injeksi ampul 4,974.00 86 0 0 0 0 0 0 0 0 0 0 0 86 427,764.00
82 Haloperidol tablet 1,5 mg tab 66.00 0 400 0 0 0 400 0 0 400 2600 0 0 3800 250,800.00
83 Handscoon pcs 7,600.00 10 0 0 0 0 0 0 0 0 0 0 0 10 76,000.00
84 Handscoon no 8 pcs 7,600.00 73 27 0 0 0 0 0 0 0 0 0 0 100 760,000.00
85 Hidroklorotiazid (HCT) tablet 25 mg tab 149.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
86 Hidrokortison krim 2,5 % tube 2,640.00 24 5 19 24 0 0 24 0 24 75 0 0 195 514,800.00
87 Ibuprofen suspensi 100 mg/5 ml btl 2,475.00 90 0 30 62 18 20 12 17 0 116 0 0 365 903,375.00
88 Ibuprofen tablet 400 mg tab 127.00 2700 1300 900 600 500 2000 500 500 2500 3300 1800 0 16600 2,108,200.00
89 Infusion set anak set 9,200.00 20 0 0 0 7 0 0 0 0 100 0 0 127 1,168,400.00
90 Infusion set dewasa set 8,200.00 20 20 10 0 0 0 0 0 20 129 0 0 199 1,631,800.00
91 Isosorbid Dinitrat tablet sublingual 5 mg tab 90.00 300 400 0 0 0 0 0 0 0 0 0 0 700 63,000.00
92 IV Catheter 18 G pcs 7,000.00 0 0 0 50 0 5 0 0 0 15 0 0 70 490,000.00
93 IV Catheter No.20 G pcs 7,000.00 165 0 0 50 15 5 0 30 0 45 0 0 310 2,170,000.00
94 IV Catheter No.22G pcs 7,000.00 95 34 0 21 20 30 0 10 15 15 0 0 240 1,680,000.00
95 IV Catheter No.24 G pcs 7,000.00 95 0 50 50 0 4 35 20 0 26 0 0 280 1,960,000.00
96 IV Catheter No.26 G set 21,065.00 0 0 0 0 5 2 0 10 0 36 0 0 53 1,116,445.00
97 Kalsium Glukonas inj ampul 9,955.00 0 0 0 24 0 0 5 0 0 0 0 0 29 288,695.00
98 Kalsium Hidroksida Pasta tube 159,500.00 0 4 0 1 0 0 0 0 0 0 0 0 5 797,500.00
99 Kalsium Laktat (Kalk) tablet 500 mg tab 56.00 1000 0 200 0 800 0 300 0 0 100 100 0 2500 140,000.00
100 Kapas pembalut absorben 250 mg glg 24,000.00 50 0 5 28 0 1 0 0 0 26 0 0 110 2,640,000.00
101 Kaptopril tab 12,5 mg tab 62.00 0 500 0 0 0 800 0 200 0 0 0 0 1500 93,000.00
102 Kaptopril tab 25 mg tab 80.00 300 300 400 500 0 0 200 100 200 300 1000 0 3300 264,000.00
103 Karbamazepin tablet 200 mg tab 245.00 0 300 200 300 0 0 0 0 0 0 0 0 800 196,000.00
104 Kartu Golongan Darah Set 33,000.00 0 0 0 0 0 0 0 0 0 0 2 0 2 66,000.00
105 kasa gulung besar 1 meter glg 130,000.00 2 0 3 2 0 4 0 4 0 0 0 0 15 1,950,000.00
106 Kasa hidrofil steril 18x22 ktk 5,900.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
107 Kasa kompres 16x16 steril ktk 7,900.00 55 0 10 13 13 21 5 0 0 5 15 0 137 1,082,300.00
108 Kasa pembalu hidrofil 4 x 10 cm elastis glg 2,300.00 0 0 0 0 0 20 0 10 50 45 0 0 125 287,500.00
109 Kasa pembalut elastis 3 inch rol 27,660.00 50 0 0 0 0 0 0 0 0 10 0 0 60 1,659,600.00
110 kasa pembalut hidrofil 4 x 5 cm glg 750.00 150 0 0 0 0 0 0 0 0 100 0 0 250 187,500.00
111 Kertas perkamen kantong 104,032.00 10 0 0 0 18 0 0 0 6 2 0 0 36 3,745,152.00
112 ketokonazole krim 2% tube 2,545.00 0 10 25 0 0 0 0 0 0 0 0 0 35 89,075.00
113 Ketokonazole tab 200 mg tab 280.00 0 100 0 0 0 200 0 0 200 0 0 0 500 140,000.00
114 Ketoprofen suppos supositoria 2,640.00 0 0 0 0 10 0 0 0 0 0 0 0 10 26,400.00
115 Klindamysin kapsul 150 mg kapsul 578.00 300 0 400 0 0 0 300 0 0 200 0 0 1200 693,600.00
116 Kloramfenikol kapsul 250 mg kapsul 428.00 800 0 0 0 0 0 0 0 0 0 0 0 800 342,400.00
117 Kloramfenikol kapsul 500 mg kapsul 1,048.00 0 200 0 0 0 700 0 200 100 200 200 0 1600 1,676,800.00
118 Kloramfenikol syr 60 ml btl 4,700.00 60 0 0 0 0 0 0 15 0 0 10 0 85 399,500.00
119 Klorfeniramin Maleat (CTM) tablet 4 mg tab 42.00 3800 2000 1200 500 500 1300 700 1000 1100 3800 1500 0 17400 730,800.00
120 Klorfenol kamper menthol (CHKM) btl 55,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
121 Klorpromazin HCl injeksi 25 mg/ml - 1 ml ampul 1,205.00 114 0 0 0 0 0 15 0 0 0 0 0 129 155,445.00
122 Klorpromazin HCl tablet salut 25 mg tab 148.00 400 0 0 0 0 0 200 0 0 0 0 0 600 88,800.00
123 Klorpromazine tab 100 mg tab 148.00 0 0 0 0 0 0 100 0 0 0 200 0 300 44,400.00
124 Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + T btl 2,286.00 0 0 20 20 20 15 15 0 0 0 0 0 90 205,740.00
125 Kotrimoksazol tablet kombinasi: Sulfametoksazol 400 mg tab 129.00 1100 200 0 0 300 200 500 200 0 0 0 0 2500 322,500.00
126 Larutan Hayem (px erytrosit) 250 set 29,450.00 0 0 0 1 0 0 0 0 0 0 0 0 1 29,450.00
127 Larutan HCL 0,1 N (px HB) 250 set 19,950.00 0 0 0 1 0 0 0 0 0 0 0 0 1 19,950.00
128 Larutan Na Citrat 3,8% (Px LED)250 set 19,475.00 0 0 0 1 0 0 0 0 0 0 0 0 1 19,475.00
129 Larutan Resseker (px Trombosit) 250 set 46,550.00 0 0 0 1 0 0 0 0 0 0 0 0 1 46,550.00
130 Larutan Truks (px leukosit)250 set 23,750.00 0 0 0 1 0 0 0 0 0 0 0 0 1 23,750.00
131 Lidokain hcl 2% injeksi ampul 860.00 90 10 0 155 38 100 0 0 0 7 0 0 400 344,000.00
132 Lidokain jelly syringe 40,000.00 10 0 0 0 0 1 0 0 0 3 16 0 30 1,200,000.00
133 Lidokain komp. injeksi, Kombinasi:Lidokain HCl 2% + Epinef ampul 1,937.00 140 60 0 60 100 20 0 60 60 180 0 0 680 1,317,160.00
134 Lidokain spray 10 % (xylocaine) btl 170,400.00 1 0 0 0 0 0 1 0 0 3 0 0 5 852,000.00
135 Lisol btl 41,000.00 6 0 0 0 2 0 2 0 3 12 0 0 25 1,025,000.00
136 Lodomer 2 mg tab tab 94.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
137 Loperamid 2 mg tab tab 85.00 0 0 0 0 0 0 200 0 0 0 0 0 200 17,000.00
138 Loratadine tab 10 mg tablet 125.00 1600 50 0 1200 0 0 0 0 0 0 0 0 2850 356,250.00
139 Lugol (px feaces)250 set 102,960.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
140 Masker ear loop pcs 396.00 225 100 25 200 0 0 150 0 0 170 80 0 950 376,200.00
141 Masker ties on pcs 480.00 130 40 0 50 100 20 50 100 0 160 0 0 650 312,000.00
142 Metanol 250cc set 135,907.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
143 Metformin 500 mg tablet tab 100.00 1000 500 0 1900 0 0 300 500 2500 0 0 0 6700 670,000.00
144 Metilen Blue (px Diffcort) set 118,329.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
145 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 tab 154.00 1900 0 0 0 0 0 0 0 0 1900 0 0 3800 585,200.00
146 Metilergometrin Maleat inj 0,200 mg-1 ml ampul 2,849.00 110 0 0 0 50 0 0 0 46 45 10 0 261 743,589.00
147 Metilprednisolon tab 4 mg tablet 194.00 0 0 0 0 0 0 0 0 0 300 300 0 600 116,400.00
148 Metoklopramid tablet 10 mg tab 87.00 0 0 300 0 0 300 300 0 0 0 0 0 900 78,300.00
149 Metronidazol tablet 250 mg tab 90.00 0 0 300 0 0 0 0 0 1500 0 800 0 2600 234,000.00
150 Metronidazol tablet 500 mg tab 113.00 1400 200 300 0 0 200 0 200 200 100 0 0 2600 293,800.00
151 MgSO4 20% btl 3,200.00 70 0 0 21 0 0 0 0 0 0 0 0 91 291,200.00
152 MgSO4 40% btl 3,650.00 94 0 0 0 0 0 0 0 0 0 0 0 94 343,100.00
153 Mikonazole salep 2% tube 3,250.00 0 15 0 19 0 0 0 0 0 0 24 0 58 188,500.00
154 Mummifying pasta btl 176,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
155 N-asetil sistein kapsul kapsul 1,100.00 400 900 0 1680 0 120 0 0 0 2100 0 0 5200 5,720,000.00
156 Nasal oxygen size m pcs 6,600.00 2 0 0 0 0 0 0 0 0 0 0 0 2 13,200.00
157 Nasal oxygen size xs pcs 6,600.00 2 0 0 0 0 0 0 0 0 0 0 0 2 13,200.00
158 Natrium diklofenak tablet 50mg tab 122.00 500 500 1000 2050 100 300 0 500 1800 2650 500 0 9900 1,207,800.00
159 Natrium Klorida larutan infus 0,9 % steril (Produk lokal) btl 6,410.00 40 0 0 60 7 28 5 0 0 0 0 0 140 897,400.00
160 Neo K (vitamin K untuk bayi) 2 ml ampul 3,550.00 0 0 0 30 0 0 0 0 0 45 0 0 75 266,250.00
161 Nifedipine tab 10 mg tab 110.00 0 0 0 0 0 700 0 0 0 500 0 0 1200 132,000.00
162 Nistatin tablet salut 500.000 IU tab 765.00 0 0 200 0 0 0 0 0 0 0 0 0 200 153,000.00
163 Nistatin tablet vaginal 100.000 IU/g tab 545.00 400 0 0 190 0 0 0 0 0 0 0 0 590 321,550.00
164 Obat Anti Tuberkulosa Kategori I paket 374,384.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
165 Obat Anti Tuberkulosa Kategori I anak paket 223,585.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
166 Obat Anti Tuberkulosa Kategori II paket 1,247,980.00 0 0 1 0 0 0 0 0 0 0 0 0 1 1,247,980.00
167 Obat batuk hitam (OBH) botol 10,000.00 0 12 0 62 22 0 0 0 0 0 0 0 96 960,000.00
168 Objek Glass set 22,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
169 Oksitosin injeksi 10 IU/ml - 1 ml ampul 1,900.00 45 0 0 45 0 0 0 0 100 85 0 0 275 522,500.00
170 Omeprazole injeksi 40 mg/10 ml vial 11,868.00 0 45 5 4 8 0 10 10 0 52 0 0 134 1,590,312.00
171 Omeprazole kapsul 20 mg kapsul 140.00 660 400 140 0 0 0 0 0 0 300 330 0 1830 256,200.00
172 Paracetamol drop botol 5,200.00 8 0 0 30 0 0 0 0 0 36 0 0 74 384,800.00
173 Parasetamol sirup 120 mg/5 ml btl 1,074.00 90 28 40 10 20 80 20 30 65 57 64 0 504 541,296.00
174 Parasetamol tablet 500 mg tab 211.00 7000 2000 2400 5700 2500 2200 2000 2700 2500 4700 2700 0 36400 7,680,400.00
175 Pehavral tab (multivitamin tab) tab 930.00 0 0 0 0 0 0 0 0 0 200 300 0 500 465,000.00
176 Pembalut Gips glg 28,000.00 30 0 0 0 0 0 0 0 0 0 0 0 30 840,000.00
177 Penjepit tali pusar set 1,300.00 135 0 0 0 0 0 0 0 0 243 0 0 378 491,400.00
178 Phenobarbital injeksi 50 mg/ml 1ml ampul 1,969.00 125 0 0 0 0 0 0 0 0 0 0 0 125 246,125.00
179 Pirantel tablet 125 mg tab 277.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
180 Piridoksin HCl (Vit.B6) tablet 10 mg tab 45.00 5000 500 500 2800 900 0 0 500 0 2400 0 0 12600 567,000.00
181 Plastik obat 7x10 kantong 16,731.00 5 5 0 27 0 0 8 0 0 20 10 0 75 1,254,825.00
182 Plester roll 10 cm x 5 cm roll 41,360.00 10 2 2 12 1 0 4 0 0 10 0 0 41 1,695,760.00
183 Plester roll kain roll 11,964.00 6 5 5 11 4 8 4 10 0 24 0 0 77 921,228.00
184 Prednison tablet 5 mg tab 76.00 2900 300 900 1700 500 0 700 500 500 500 500 0 9000 684,000.00
185 Primakuin tablet 15 mg tab 224.00 0 0 0 0 0 0 0 0 0 100 0 0 100 22,400.00
186 Propiltiourasil tab100 mg tab 319.00 1000 0 400 0 0 0 0 0 0 300 0 0 1700 542,300.00
187 Propranolol 10 mg tab tab 60.00 300 0 0 0 0 0 0 500 200 0 0 0 1000 60,000.00
188 Ramaflu tab (obat flu) tab 645.00 0 0 0 0 300 700 0 0 0 0 0 0 1000 645,000.00
189 Ranitidin injeksi ampul 1,390.00 0 20 0 0 0 0 0 50 6 194 0 0 270 375,300.00
190 Ranitidin tab 150 mg tab 98.00 1800 1200 0 500 500 800 500 500 700 300 700 0 7500 735,000.00
191 RDT @25pcs ktk 476,373.00 1 0 0 0 0 0 0 0 0 0 0 0 1 476,373.00
192 Retinol (vitamin A) kap 100,000 IU kapsul 284.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
193 Retinol (vitamin A) kap 200,000 IU kapsul 460.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
194 Ringer Laktat larutan infus steril (Produk lokal) btl 7,150.00 115 0 25 66 0 25 14 0 0 0 0 0 245 1,751,750.00
195 Sabun cair (softaman) btl 78,750.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
196 Sabun cair (one scrub 4 %) btl 62,491.00 0 0 0 0 0 0 0 0 0 1 0 0 1 62,491.00
197 Salbutamol tablet 4 mg tab 95.00 1000 300 0 0 0 200 300 0 300 0 0 0 2100 199,500.00
198 Salbutamol inheler (combivent) dosis 5,700.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
199 Salep 2-4 , Kombinasi:Asam Salisilat 2% + Belerang End pot 2,527.00 0 24 0 0 0 0 24 0 0 0 0 0 48 121,296.00
200 Salicyl bedak 2 % pot 1,020.00 75 0 20 45 0 0 0 0 0 26 19 0 185 188,700.00
201 Semen Seng Fosfat Serbuk & Cairan set 165,000.00 0 1 0 0 0 0 0 0 1 0 1 0 3 495,000.00
202 Sendok takar obat bh 2,145.00 0 0 250 0 0 0 0 0 0 250 0 0 500 1,072,500.00
203 Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I) vial 462,000.00 0 2 0 3 0 2 2 0 0 0 0 0 9 4,158,000.00
204 Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.) ampul 126,500.00 3 6 0 1 0 4 0 4 0 3 0 0 21 2,656,500.00
205 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml ampul 1,098.00 225 0 0 45 0 0 0 0 0 100 0 0 370 406,260.00
206 Sianokobalamin (Vit.B12) tablet 50 mcg tab 51.00 0 0 0 0 0 0 300 0 0 0 300 0 600 30,600.00
207 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah set 19,700.00 56 16 24 12 24 12 12 6 0 46 36 0 244 4,806,800.00
208 Simvastatin 10 mg tab 111.00 0 0 150 0 0 300 0 0 0 0 300 0 750 83,250.00
209 Siprofloksasin tablet 500 mg tab 281.00 0 200 300 0 300 200 200 200 600 200 900 0 3100 871,100.00
210 Spironolactone tab 25 mg tab 244.00 0 0 0 0 0 0 500 200 500 0 0 0 1200 292,800.00
211 Strip pemeriksaan gula darah kotak 305,329.00 0 0 0 1 0 0 0 0 0 0 0 0 1 305,329.00
212 Strip tes kehamilan pcs 1,936.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
213 Stesolid rectal tube 5mg tube 12,090.00 5 8 0 0 0 5 0 13 0 5 0 0 36 435,240.00
214 Sulfadiazine silver 10 gr tube 20,700.00 0 3 0 0 0 0 0 0 0 10 0 0 13 269,100.00
215 Swab 2 ply dus 11,000.00 45 5 21 31 0 3 10 10 5 50 0 0 180 1,980,000.00
216 Tablet tambah darah kombinasi (Besi II Sulfat 200mg + Asa tab 352.00 0 300 750 0 600 250 0 0 0 0 0 0 1900 668,800.00
217 Test Golongan Darah Anti A Set 68,200.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
218 Test Golongan Darah Anti AB Set 92,510.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
219 Test Golongan Darah Anti B Set 68,200.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
220 Test Golongan Darah Anti D (Rho) Set 114,070.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
221 Test Kehamilan Beta HCG Set 80,416.00 0 0 0 10 0 0 0 0 0 3 0 0 13 1,045,408.00
222 Tetrasiklin HCl kapsul 250 mg kapsul 168.00 1600 300 0 0 0 0 0 0 0 0 0 0 1900 319,200.00
223 Tetrasiklin HCl kapsul 500 mg tab 310.00 700 500 0 0 0 0 0 300 0 0 0 0 1500 465,000.00
224 Tiamin HCl / Mononitrat (Vit.B1) tablet 50 mg tab 82.00 3600 500 500 500 500 500 600 500 500 1300 500 0 9500 779,000.00
225 Tranfusi set set 3,600.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
226 Triheksipenidil tab 2 mg tab 80.00 0 300 0 0 0 0 600 0 0 0 0 0 900 72,000.00
227 Trombophop gel tube 51,975.00 2 2 0 0 0 0 0 0 0 0 0 0 4 207,900.00
228 Urine bag pcs 5,500.00 0 0 0 0 0 5 10 0 0 35 0 0 50 275,000.00
229 Urine Strip 10P set 334,840.00 1 0 0 1 0 0 0 0 0 0 0 0 2 669,680.00
230 Vaksin Rabies Vero vial 174,500.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
231 Ventolin nebules amp/salbutamol cairan nebu 4,000.00 200 0 0 95 0 20 0 0 0 0 0 0 315 1,260,000.00
232 Vitamin B Kompleks tab 115.00 4300 1900 0 500 500 900 1100 0 0 0 0 0 9200 1,058,000.00
233 Vitamin neurotropik injeksi ampul 4,336.00 0 0 0 0 0 10 0 0 0 0 0 0 10 43,360.00
234 Vitamin neurotropik tablet tablet 975.00 0 0 0 0 0 200 0 300 0 0 0 0 500 487,500.00
235 Wing Needle No. 27 G set 1,400.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
236 Wing Needle No.21 G set 1,400.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
239 Yodium povidon lar 10 % 1000 ml btl 149,314.00 6 0 0 0 0 0 0 0 0 8 0 0 14 2,090,396.00
240 Yodium povidon lar 10 % 30 ml btl 2,900.00 20 0 0 10 0 2 0 0 0 0 5 0 37 107,300.00
241 Yodium povidon lar 10 % 300 ml btl 18,000.00 26 0 0 47 0 1 0 0 0 40 0 0 114 2,052,000.00
242 Yodium povidon lar 10 % 500 ml btl 95,264.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
243 Yodium povidon 60 ml btl 23,890.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
244 Zinc tab 513.00 3600 0 0 1000 0 0 0 500 1400 200 1000 0 7700 3,950,100.00
245 Zinc syrup (interzinc) btl 6,600.00 36 2 0 27 0 10 12 32 0 44 32 0 195 1,287,000.00
246 Alkohol 70 % 300 ml btl 21,500.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
247 Allopurinol tab tab 90.00 2,300 0 0 0 0 0 0 100 0 500 0 0 2900 261,000.00
248 Amoxicillin kap 500mg tab 190.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
249 Amoxicillin dry sirup btl 1,881.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
250 Asam mefenamat 500 mg tab tab 100.00 - 0 0 0 0 0 0 0 0 700 600 0 1300 130,000.00
251 Acyclovir 200mg tab tab 249.00 1,000 0 0 0 0 0 0 0 0 0 0 0 1000 249,000.00
252 Betametason cream tube 1,380.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
253 Cefadroxil 500 mg kapsul kapsul 450.00 - 0 0 300 0 200 200 400 200 0 0 0 1300 585,000.00
254 Ciprofloxacin kap kaplet 281.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
255 Chloramex-kloramfenikol kap 500 mg kapsul 1,007.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
256 Ctm tab tab 42.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
257 Chlorpromazine 100mg tab tab 162.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
258 Cefotaxime inj vial 5,500.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
259 Deksamethason 0,5mg tab tab 44.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
260 Domperidon 10 mg tablet tab 95.00 - 0 0 0 0 0 400 0 0 1100 300 0 1800 171,000.00
261 Glimepiride tab 3 mg tab 319.00 - 0 0 0 0 0 350 0 0 0 0 0 350 111,650.00
262 Glukosa 5% infus btl 6,900.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
263 Ibuprofen 200 mg tab tab 102.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
264 Ibuprofen 400 mg tab tab 127.00 500 0 1800 400 300 0 0 0 0 0 0 0 3000 381,000.00
265 Ketokonazol cream tube 2,545.00 - 0 0 0 0 0 0 0 0 0 25 0 25 63,625.00
266 Lidokain comp injeksi ampul 1,845.00 - 0 0 0 0 0 0 0 0 15 75 0 90 166,050.00
267 Loperamide tab 2 mg tab 80.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
268 Metylprednisolone tab 8 mg tab 309.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
269 Metylprednisolone tab 4 mg tab 150.00 - 0 0 0 0 0 0 500 0 0 0 0 500 75,000.00
270 Metoklopropamid tab 10 mg tab 87.00 - 0 0 0 0 0 0 0 0 3000 0 0 3000 261,000.00
271 Metformin HCL 500mg tab 100.00 - 0 0 0 0 0 0 0 0 2300 200 0 2500 250,000.00
272 Nacl 0,9% infus btl 6,410.00 - 0 0 0 0 0 15 63 0 41 23 0 142 910,220.00
273 Nipedifine tab tab 110.00 - 0 0 0 0 0 0 0 0 2600 0 0 2600 286,000.00
274 Omeprazole kap 20 mg kapsul 140.00 - 0 280 330 450 0 150 300 0 420 0 0 1930 270,200.00
275 Povidone iodine 10 % 300 ml btl 18,656.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
276 Piridoksin HCl (Vit.B6) tablet 10 mg tab 118.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
277 Ranitidin tab 150 mg tab 98.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
278 RL infus btl 7,150.00 - 0 0 15 40 0 29 58 0 55 30 0 227 1,623,050.00
279 Salep 2-4 pot 2,527.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
280 Simvastatin 20 mg tab 504.00 300 0 150 0 0 0 0 0 0 0 0 0 450 226,800.00
281 Spirinolactone tab 25 mg tab 244.00 - 0 0 0 0 0 0 0 0 0 0 0 0 -
282 Vit b komplek tab 115.00 - 0 0 0 0 0 0 1500 0 2400 800 0 4700 540,500.00
283 Cutgut 2/0 pcs 33,643.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
284 Cutgut 3/0 pcs 33,643.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
285 IV cath no 20 pcs 10,483.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
286 IV cath no 22 pcs 10,480.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
287 IV cath no 24 pcs 10,480.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
288 Cuticell classic 10x10cm buah 5,198.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
289 Handscoon 7,5 pcs 8,250.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
290 Iodine Povidone btl 6,550.00 30 0 0 0 0 4 0 0 0 0 0 0 34 222,700.00
291 Infus set anak pcs 5,661.00 140 0 0 95 0 0 0 0 0 0 0 0 235 1,330,335.00
292 Infus set Dewasa pcs 6,644.00 140 0 0 180 15 35 12 15 0 0 0 0 397 2,637,668.00
293 Kapas pembalut absorben 250 mg Roll 12,500.00 0 0 0 0 0 2 0 0 0 11 0 0 13 162,500.00
294 Kasa hidrofil 40 yard x 80 cm Roll 255,750.00 0 0 0 0 0 0 0 0 0 10 0 0 10 2,557,500.00
295 Kasa hidrofil 3 yard x 15 cm Roll 1,577.00 0 0 0 0 0 0 0 0 0 0 0 0 -
296 Kasa kompres 16 x 16 steril pack 5,820.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
297 Masker pcs 762.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
298 Spuit 3 cc pcs 916.00 0 0 0 0 0 0 0 300 400 650 0 0 1350 1,236,600.00
299 Spuit 5 cc pcs 1,030.00 0 0 0 0 0 0 0 0 0 0 0 0 0 -
300 Urine bag pcs 6,036.00 0 0 0 0 0 0 0 0 0 5 0 0 5 30,180.00
185,158,694.00
LAPORAN KUNJUNGAN
Bulan JKN UMUM Jumlah
Jan 396 501 897
Feb 418 471 889
Mar 523 551 1074
Apr 478 483 961
Mei 485 348 833
Juni 295 395 690
Juli 354 365 719
Agust m 0 0
Sep 397 528 925
Okt 372 451 823
Nop 421 429 850
Des 349 394 743
TOTAL 4488 4916 9404
REKAPITULASI LPLPO PKM SBY TAHUN 2018
(PENERIMAAN)
Harga Total Penerimaan Total Penerimaan

Per Satuan Jan Feb Mar Apr Mei Juni Juli Agust Sept Okt Nop Des Setahun Setahun (Rp)
1 Alat suntik sekali pakai 1 ml pcs 990.00 500 0 0 500 500 0 0 500 500 0 0 500 500 0 0 500 3500 3,465,000.00
2 Alat suntik sekali pakai 2,5 ml pcs 792.00 1000 0 0 1000 1000 0 0 1000 0 0 0 0 0 0 0 0 4000 3,168,000.00
3 Alat suntik sekali pakai 5 ml pcs 979.00 500 0 0 500 500 0 0 500 500 0 0 500 500 0 0 500 3500 3,426,500.00
4 Alat tes gula darah kotak 1,771,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
5 Alat tes HB / HB sahli one med set 88,000.00 5 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0 10 880,000.00
6 Albendazol 400 mg tab 392.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
7 Allupurinol tab 100 mg tab 110.00 0 0 0 0 2000 0 0 2000 0 0 0 0 0 0 0 0 4000 440,000.00
8 Aminofilin tablet 200 mg tab 91.00 2000 0 0 2000 500 0 0 500 0 0 0 0 1000 0 0 1000 6000 546,000.00
9 Aminofilina injeksi 24 mg/ml - 10 ml ampul 2,998.00 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 30 30 89,940.00
10 Amitriptillin tab salut 25 mg (HCL) tab 143.00 0 0 0 0 0 0 0 0 0 0 0 0 600 0 0 600 600 85,800.00
11 Amlodipine tab 105.00 3000 0 0 3000 3000 0 0 3000 1500 0 0 1500 1500 0 0 1500 16500 1,732,500.00
12 Amoksisilin kaplet 500 mg tab 190.00 8000 0 0 8000 6000 0 0 6000 8000 0 0 8000 10000 0 0 10000 54000 10,260,000.00
13 Amoksisilin kapsul 250 mg tablet 195.00 1100 0 0 1100 0 0 0 0 500 0 0 500 2000 0 0 2000 5200 1,014,000.00
14 Amoksisilin sirup kering 125 mg/5ml btl 1,881.00 150 0 0 150 150 0 0 150 150 0 0 150 0 0 0 0 900 1,692,900.00
15 Ampisillin inj 1 gr vial 9,270.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
16 Antasida Doen II Suspensi suspensi 2,025.00 150 0 0 150 150 0 0 150 0 0 0 0 100 0 0 100 700 1,417,500.00
17 Antasida Doen tab kombinasi tab 62.00 6000 0 0 6000 2000 0 0 2000 1000 0 0 1000 0 0 0 0 18000 1,116,000.00
18 Anti Bakteri DOEN salep kombinasi:Basitrasin 500 IU/g + Pol tube 2,924.00 25 0 0 25 25 0 0 25 0 0 0 0 0 0 0 0 100 292,400.00
19 Anti konstipasi dulcolax supp supositoria 5,800.00 50 0 0 50 25 0 0 25 0 0 0 0 0 0 0 0 150 870,000.00
20 Anti Hemoroid DOEN Kombinasi supp 3,045.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
21 Anti Malaria kombinasi (Artemether) ampul 25,490.00 18 0 0 18 0 0 0 0 0 0 0 0 0 0 0 0 36 917,640.00
22 Anti Skabies cream tube 12,155.00 30 0 0 30 30 0 0 30 0 0 0 0 0 0 0 0 120 1,458,600.00
23 Antifungi DOEN Kombinasi:Asam Benzoat 6% + Asam Salisil pot 4,323.00 48 0 0 48 24 0 0 24 0 0 0 0 24 0 0 24 168 726,264.00
24 Antimigren:Ergotamin Tartrat 1 mg + Kofein 50 mg tab 135.00 0 0 0 0 500 0 0 500 2000 0 0 2000 0 0 0 0 5000 675,000.00
25 Aqua pro injeksi steril,bebas pirogen 20 ml/vial vial 2,750.00 50 0 0 50 50 0 0 50 0 0 0 0 50 0 0 50 250 687,500.00
26 Asam Askorbat (Vit C) tablet 50 mg tab 104.00 5000 0 0 5000 3000 0 0 3000 3000 0 0 3000 3000 0 0 3000 25000 2,600,000.00
27 Asam Mefenamat tab 500 mg tab 100.00 3000 0 0 3000 3000 0 0 3000 800 0 0 800 0 0 0 0 13600 1,360,000.00
28 Asam tranexamic injeksi ampul 1,956.00 20 0 0 20 50 0 0 50 50 0 0 50 0 0 0 0 240 469,440.00
29 Asetosal / miniaspi 80 tab 92.00 500 0 0 500 500 0 0 500 500 0 0 500 0 0 0 0 3000 276,000.00
30 Asetosal tablet 100 mg tab 130.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
31 Asiklovir 400 mg tab tab 365.00 0 0 0 0 500 0 0 500 0 0 0 0 500 0 0 500 1500 547,500.00
32 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 1,540.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
33 Atropin tab 0,5 mg tab tab 74.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
34 Becefort syr (multi vitamin 60 ml) botol 17,360.00 30 0 0 30 25 0 0 25 25 0 0 25 0 0 0 0 160 2,777,600.00
35 Betametason krim 0.1% tube 3,388.00 300 0 0 300 50 0 0 50 100 0 0 100 60 0 0 60 960 3,252,480.00
36 Bisacodyl tab 5 mg tab 300.00 2 0 0 2 300 0 0 300 0 0 0 0 600 0 0 600 1204 361,200.00
37 Bisturi pcs 300,000.00 300 0 0 300 0 0 0 0 0 0 0 0 3 0 0 3 603 180,900,000.00
38 Buscopan 10 mg tab 2,972.00 1500 0 0 1500 300 0 0 300 0 0 0 0 100 0 0 100 3700 10,996,400.00
39 Calprosis 500 tab 430.00 48 0 0 48 1500 0 0 1500 1200 0 0 1200 0 0 0 0 5496 2,363,280.00
40 Catgut / Benang Bedah No. 2/0 - 3/0 dengan jarum bedah set 32,800.00 0 0 0 0 60 0 0 60 120 0 0 120 0 0 0 0 360 11,808,000.00
41 Cefadroksil 500 mg kapsul kapsul 516.00 50 0 0 50 0 0 0 0 0 0 0 0 1000 0 0 1000 1100 567,600.00
42 Cetirizine 5 mg/5 ml syr btl 3,150.00 1000 0 0 1000 60 0 0 60 0 0 0 0 0 0 0 0 2120 6,678,000.00
43 Cetirizine kap 10 mg kapsul 143.00 100 0 0 100 2000 0 0 2000 1500 0 0 1500 1000 0 0 1000 8200 1,172,600.00
44 Cuticell classic 10x10cm buah 5,198.00 0 0 0 0 0 0 0 0 100 0 0 100 100 0 0 100 300 1,559,400.00
45 Deck Glas set 82,500.00 50 0 0 50 0 0 0 0 1 0 0 1 0 0 0 0 102 8,415,000.00
46 Deksametason injeksi 5 mg/ml - 1 ml ampul 1,540.00 5000 0 0 5000 0 0 0 0 0 0 0 0 100 0 0 100 10100 15,554,000.00
47 Deksametason tablet 0,5 mg tab 44.00 0 0 0 0 3000 0 0 3000 4000 0 0 4000 0 0 0 0 14000 616,000.00
48 Devitalisasi Pasta (Non Arsen) btl 220,000.00 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 220,000.00
49 Diapecta tab tab 510.00 30 0 0 30 500 0 0 500 0 0 0 0 500 0 0 500 1560 795,600.00
50 Difenhidramin HCl inj 10 mg/ml-1 ml ampul 1,176.00 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 90 90 105,840.00
51 Digoksin tablet 0,25 mg tab 104.00 1000 0 0 1000 0 0 0 0 500 0 0 500 0 0 0 0 3000 312,000.00
52 Doksisiklin kapsul 100 mg kapsul 268.00 200 0 0 200 0 0 0 0 100 0 0 100 500 0 0 500 1100 294,800.00
53 Domperidone 10 mg tablet tablet 95.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
54 Dopamet 250 mg tab tab 911.00 0 0 0 0 1000 0 0 1000 1000 0 0 1000 0 0 0 0 4000 3,644,000.00
55 EDTA 250gr set 74,100.00 0 0 0 0 1 0 0 1 0 0 0 0 2 0 0 2 4 296,400.00
56 Eosin (px faeces) 250 set 176,225.00 30 0 0 30 1 0 0 1 0 0 0 0 2 0 0 2 64 11,278,400.00
57 Epineprin injeksi 0,1% ampul 2,204.00 0 0 0 0 0 0 0 0 50 0 0 50 100 0 0 100 200 440,800.00
58 Erytromysin 200 mg/5ml btl 6,700.00 0 0 0 0 0 0 0 0 4 0 0 4 0 0 0 0 8 53,600.00
59 Erytromysin tab 250 mg kapsul 566.00 1000 0 0 1000 0 0 0 0 0 0 0 0 1500 0 0 1500 3500 1,981,000.00
60 Erytromysin tab 500 mg tab 730.00 24 0 0 24 0 0 0 0 0 0 0 0 1000 0 0 1000 1048 765,040.00
61 Etakridina (Rivanol) lar 0,1% btl 3,000.00 0 0 0 0 24 0 0 24 24 0 0 24 24 0 0 24 120 360,000.00
62 Etanol 70 % btl 2,500.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
63 etanol 70 % 1 liter botol 21,000.00 0 0 0 0 10 0 0 10 20 0 0 20 20 0 0 20 80 1,680,000.00
64 Eugenol cairan btl 18,100.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
65 Fenitoin Natrium kapsul 30 mg kapsul 154.00 48 0 0 48 0 0 0 0 500 0 0 500 200 0 0 200 1296 199,584.00
66 Fenol Gliserol tetes telinga 10% btl 2,500.00 60 0 0 60 24 0 0 24 20 0 0 20 48 0 0 48 256 640,000.00
67 Fitomenadion (Vit.K1) injeksi 10 mg/ml - 1 ml ampul 4,167.00 1000 0 0 1000 0 0 0 0 90 0 0 90 0 0 0 0 2180 9,084,060.00
68 Fitomenadion (Vit.K1) tablet salut gula 10 mg tab 695.00 0 0 0 0 0 0 0 0 1500 0 0 1500 0 0 0 0 3000 2,085,000.00
69 Foley cateter 16 pcs 11,000.00 0 0 0 0 0 0 0 0 1 0 0 1 10 0 0 10 12 132,000.00
70 Foley cateter 18 pcs 11,000.00 0 0 0 0 0 0 0 0 1 0 0 1 20 0 0 20 22 242,000.00
71 Furosemid inj i.v/i.m 10/ml mg ampul 1,829.00 25 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 50 91,450.00
72 Furosemid tablet 40 mg tab 80.00 1000 0 0 1000 1000 0 0 1000 500 0 0 500 500 0 0 500 5500 440,000.00
73 Garam Oralit untuk 200 ml air sachet 260.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
74 Glass Ionomer Cement ART set 521,000.00 0 0 0 0 1 0 0 1 1 0 0 1 1 0 0 1 5 2,605,000.00
75 Glibenklamid tablet 5 mg tab 101.00 0 0 0 0 0 0 0 0 0 0 0 0 1000 0 0 1000 1000 101,000.00
76 Glimepiride 2 mg tablet 436.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
77 Glukosa larutan infus 5 % steril (Produk lokal) btl 6,900.00 100 0 0 100 60 0 0 60 160 0 0 160 80 0 0 80 720 4,968,000.00
78 Griseofulvin tab 125 mg tab 249.00 0 0 0 0 0 0 0 0 0 0 0 0 2000 0 0 2000 2000 498,000.00
79 H2O2 3% btl 30,855.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
80 H2O2 100 ml btl 4,780.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
81 Haloperidol injeksi ampul 4,974.00 24 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 48 238,752.00
82 Haloperidol tablet 1,5 mg tab 66.00 1000 0 0 1000 0 0 0 0 1000 0 0 1000 1000 0 0 1000 5000 330,000.00
83 Handscoon pcs 7,600.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
84 Handscoon no 8 pcs 7,600.00 100 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 200 1,520,000.00
85 Hidroklorotiazid (HCT) tablet 25 mg tab 149.00 0 0 0 0 500 0 0 500 600 0 0 600 0 0 0 0 2200 327,800.00
86 Hidrokortison krim 2,5 % tube 2,640.00 48 0 0 48 24 0 0 24 150 0 0 150 48 0 0 48 492 1,298,880.00
87 Ibuprofen suspensi 100 mg/5 ml btl 2,475.00 0 0 0 0 100 0 0 100 180 0 0 180 0 0 0 0 560 1,386,000.00
88 Ibuprofen tablet 400 mg tab 127.00 5000 0 0 5000 3000 0 0 3000 5000 0 0 5000 5000 0 0 5000 31000 3,937,000.00
89 Infusion set anak set 9,200.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
90 Infusion set dewasa set 8,200.00 0 0 0 0 0 0 0 0 150 0 0 150 50 0 0 50 350 2,870,000.00
91 Isosorbid Dinitrat tablet sublingual 5 mg tab 90.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
92 IV Catheter 18 G pcs 7,000.00 0 0 0 0 0 0 0 0 20 0 0 20 0 0 0 0 40 280,000.00
93 IV Catheter No.20 G pcs 7,000.00 0 0 0 0 0 0 0 0 50 0 0 50 0 0 0 0 100 700,000.00
94 IV Catheter No.22G pcs 7,000.00 0 0 0 0 0 0 0 0 50 0 0 50 0 0 0 0 100 700,000.00
95 IV Catheter No.24 G pcs 7,000.00 0 0 0 0 0 0 0 0 50 0 0 50 50 0 0 50 150 1,050,000.00
96 IV Catheter No.26 G set 21,065.00 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 100 100 2,106,500.00
97 Kalsium Glukonas inj ampul 9,955.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
98 Kalsium Hidroksida Pasta tube 159,500.00 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 2 319,000.00
99 Kalsium Laktat (Kalk) tablet 500 mg tab 56.00 1000 0 0 1000 1000 0 0 1000 0 0 0 0 0 0 0 0 4000 224,000.00
100 Kapas pembalut absorben 250 mg glg 24,000.00 0 0 0 0 0 0 0 0 50 0 0 50 50 0 0 50 150 3,600,000.00
101 Kaptopril tab 12,5 mg tab 62.00 1000 0 0 1000 500 0 0 500 0 0 0 0 0 0 0 0 3000 186,000.00
102 Kaptopril tab 25 mg tab 80.00 1000 0 0 1000 500 0 0 500 500 0 0 500 2000 0 0 2000 6000 480,000.00
103 Karbamazepin tablet 200 mg tab 245.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
104 Kartu Golongan Darah Set 33,000.00 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 2 2 66,000.00
105 kasa gulung besar 1 meter glg 130,000.00 10 0 0 10 10 0 0 10 0 0 0 0 0 0 0 0 40 5,200,000.00
106 Kasa hidrofil steril 18x22 ktk 5,900.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
107 Kasa kompres 16x16 steril ktk 7,900.00 0 0 0 0 0 0 0 0 37 0 0 37 0 0 0 0 74 584,600.00
108 Kasa pembalu hidrofil 4 x 10 cm elastis glg 2,300.00 0 0 0 0 0 0 0 0 100 0 0 100 0 0 0 0 200 460,000.00
109 Kasa pembalut elastis 3 inch rol 27,660.00 0 0 0 0 10 0 0 10 0 0 0 0 0 0 0 0 20 553,200.00
110 kasa pembalut hidrofil 4 x 5 cm glg 750.00 0 0 0 0 100 0 0 100 0 0 0 0 0 0 0 0 200 150,000.00
111 Kertas perkamen kantong 104,032.00 18 0 0 18 0 0 0 0 12 0 0 12 0 0 0 0 60 6,241,920.00
112 ketokonazole krim 2% tube 2,545.00 10 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 20 50,900.00
113 Ketokonazole tab 200 mg tab 280.00 200 0 0 200 500 0 0 500 0 0 0 0 500 0 0 500 1900 532,000.00
114 Ketoprofen suppos supositoria 2,640.00 10 0 0 10 10 0 0 10 30 0 0 30 0 0 0 0 100 264,000.00
115 Klindamysin kapsul 150 mg kapsul 578.00 300 0 0 300 500 0 0 500 100 0 0 100 200 0 0 200 2000 1,156,000.00
116 Kloramfenikol kapsul 250 mg kapsul 428.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
117 Kloramfenikol kapsul 500 mg kapsul 1,048.00 500 0 0 500 500 0 0 500 500 0 0 500 500 0 0 500 3500 3,668,000.00
118 Kloramfenikol syr 60 ml btl 4,700.00 70 0 0 70 0 0 0 0 0 0 0 0 0 0 0 0 140 658,000.00
119 Klorfeniramin Maleat (CTM) tablet 4 mg tab 42.00 5000 0 0 5000 3000 0 0 3000 8000 0 0 8000 3600 0 0 3600 35600 1,495,200.00
120 Klorfenol kamper menthol (CHKM) btl 55,000.00 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 2 110,000.00
121 Klorpromazin HCl injeksi 25 mg/ml - 1 ml ampul 1,205.00 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 60 60 72,300.00
122 Klorpromazin HCl tablet salut 25 mg tab 148.00 200 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 400 59,200.00
123 Klorpromazine tab 100 mg tab 148.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
124 Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Tr btl 2,286.00 50 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 100 228,600.00
125 Kotrimoksazol tablet kombinasi: Sulfametoksazol 400 mg + tab 129.00 500 0 0 500 500 0 0 500 500 0 0 500 0 0 0 0 3000 387,000.00
126 Larutan Hayem (px erytrosit) 250 set 29,450.00 0 0 0 0 1 0 0 1 0 0 0 0 2 0 0 2 4 117,800.00
127 Larutan HCL 0,1 N (px HB) 250 set 19,950.00 0 0 0 0 1 0 0 1 0 0 0 0 2 0 0 2 4 79,800.00
128 Larutan Na Citrat 3,8% (Px LED)250 set 19,475.00 0 0 0 0 1 0 0 1 0 0 0 0 2 0 0 2 4 77,900.00
129 Larutan Resseker (px Trombosit) 250 set 46,550.00 0 0 0 0 1 0 0 1 0 0 0 0 2 0 0 2 4 186,200.00
130 Larutan Truks (px leukosit)250 set 23,750.00 0 0 0 0 1 0 0 1 0 0 0 0 2 0 0 2 4 95,000.00
131 Lidokain hcl 2% injeksi ampul 860.00 200 0 0 200 200 0 0 200 0 0 0 0 0 0 0 0 800 688,000.00
132 Lidokain jelly syringe 40,000.00 10 0 0 10 10 0 0 10 10 0 0 10 0 0 0 0 60 2,400,000.00
133 Lidokain komp. injeksi, Kombinasi:Lidokain HCl 2% + Epinefr ampul 1,937.00 120 0 0 120 120 0 0 120 300 0 0 300 0 0 0 0 1080 2,091,960.00
134 Lidokain spray 10 % (xylocaine) btl 170,400.00 3 0 0 3 2 0 0 2 0 0 0 0 5 0 0 5 15 2,556,000.00
135 Lisol btl 41,000.00 10 0 0 10 0 0 0 0 2 0 0 2 20 0 0 20 44 1,804,000.00
136 Lodomer 2 mg tab tab 94.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
137 Loperamid 2 mg tab tab 85.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
138 Loratadine tab 10 mg tablet 125.00 1000 0 0 1000 500 0 0 500 1500 0 0 1500 0 0 0 0 6000 750,000.00
139 Lugol (px feaces)250 set 102,960.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
140 Masker ear loop pcs 396.00 300 0 0 300 100 0 0 100 200 0 0 200 200 0 0 200 1400 554,400.00
141 Masker ties on pcs 480.00 200 0 0 200 100 0 0 100 300 0 0 300 200 0 0 200 1400 672,000.00
142 Metanol 250cc set 135,907.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
143 Metformin 500 mg tablet tab 100.00 0 0 0 0 0 0 0 0 3000 0 0 3000 0 0 0 0 6000 600,000.00
144 Metilen Blue (px Diffcort) set 118,329.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
145 Metilergometrin Maleat (Metilergometrin) tablet salut 0,125 m tab 154.00 500 0 0 500 0 0 0 0 0 0 0 0 3000 0 0 3000 4000 616,000.00
146 Metilergometrin Maleat inj 0,200 mg-1 ml ampul 2,849.00 0 0 0 0 0 0 0 0 100 0 0 100 100 0 0 100 300 854,700.00
147 Metilprednisolon tab 4 mg tablet 194.00 0 0 0 0 0 0 0 0 0 0 0 0 2000 0 0 2000 2000 388,000.00
148 Metoklopramid tablet 10 mg tab 87.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
149 Metronidazol tablet 250 mg tab 90.00 500 0 0 500 500 0 0 500 1000 0 0 1000 1000 0 0 1000 5000 450,000.00
150 Metronidazol tablet 500 mg tab 113.00 500 0 0 500 500 0 0 500 0 0 0 0 0 0 0 0 2000 226,000.00
151 MgSO4 20% btl 3,200.00 60 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 120 384,000.00
152 MgSO4 40% btl 3,650.00 60 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 120 438,000.00
153 Mikonazole salep 2% tube 3,250.00 10 0 0 10 0 0 0 0 0 0 0 0 50 0 0 50 70 227,500.00
154 Mummifying pasta btl 176,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
155 N-asetil sistein kapsul kapsul 1,100.00 2400 0 0 2400 1200 0 0 1200 1200 0 0 1200 1500 0 0 1500 11100 12,210,000.00
156 Nasal oxygen size m pcs 6,600.00 10 0 0 10 5 0 0 5 0 0 0 0 0 0 0 0 30 198,000.00
157 Nasal oxygen size xs pcs 6,600.00 10 0 0 10 5 0 0 5 0 0 0 0 0 0 0 0 30 198,000.00
158 Natrium diklofenak tablet 50mg tab 122.00 2000 0 0 2000 3000 0 0 3000 2000 0 0 2000 2000 0 0 2000 16000 1,952,000.00
159 Natrium Klorida larutan infus 0,9 % steril (Produk lokal) btl 6,410.00 0 0 0 0 100 0 0 100 0 0 0 0 0 0 0 0 200 1,282,000.00
160 Neo K (vitamin K untuk bayi) 2 ml ampul 3,550.00 0 0 0 0 0 0 0 0 150 0 0 150 0 0 0 0 300 1,065,000.00
161 Nifedipine tab 10 mg tab 110.00 500 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 1000 110,000.00
162 Nistatin tablet salut 500.000 IU tab 765.00 0 0 0 0 500 0 0 500 0 0 0 0 0 0 0 0 1000 765,000.00
163 Nistatin tablet vaginal 100.000 IU/g tab 545.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
164 Obat Anti Tuberkulosa Kategori I paket 374,384.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
165 Obat Anti Tuberkulosa Kategori I anak paket 223,585.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
166 Obat Anti Tuberkulosa Kategori II paket 1,247,980.00 0 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 4 4,991,920.00
167 Obat batuk hitam (OBH) botol 10,000.00 48 0 0 48 48 0 0 48 0 0 0 0 0 0 0 0 192 1,920,000.00
168 Objek Glass set 22,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
169 Oksitosin injeksi 10 IU/ml - 1 ml ampul 1,900.00 0 0 0 0 0 0 0 0 300 0 0 300 200 0 0 200 800 1,520,000.00
170 Omeprazole injeksi 40 mg/10 ml vial 11,868.00 20 0 0 20 50 0 0 50 30 0 0 30 0 0 0 0 200 2,373,600.00
171 Omeprazole kapsul 20 mg kapsul 140.00 1200 0 0 1200 0 0 0 0 0 0 0 0 900 0 0 900 3300 462,000.00
172 Paracetamol drop botol 5,200.00 0 0 0 0 0 0 0 0 0 0 0 0 56 0 0 56 56 291,200.00
173 Parasetamol sirup 120 mg/5 ml btl 1,074.00 168 0 0 168 100 0 0 100 200 0 0 200 50 0 0 50 986 1,058,964.00
174 Parasetamol tablet 500 mg tab 211.00 10000 0 0 10000 8000 0 0 8000 8000 0 0 8000 5000 0 0 5000 57000 12,027,000.00
175 Pehavral tab (multivitamin tab) tab 930.00 0 0 0 0 500 0 0 500 0 0 0 0 1000 0 0 1000 2000 1,860,000.00
176 Pembalut Gips glg 28,000.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
177 Penjepit tali pusar set 1,300.00 0 0 0 0 100 0 0 100 0 0 0 0 200 0 0 200 400 520,000.00
178 Phenobarbital injeksi 50 mg/ml 1ml ampul 1,969.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
179 Pirantel tablet 125 mg tab 277.00 0 0 0 0 0 0 0 0 500 0 0 500 0 0 0 0 1000 277,000.00
180 Piridoksin HCl (Vit.B6) tablet 10 mg tab 45.00 5000 0 0 5000 2000 0 0 2000 1000 0 0 1000 3000 0 0 3000 19000 855,000.00
181 Plastik obat 7x10 kantong 16,731.00 25 0 0 25 20 0 0 20 30 0 0 30 30 0 0 30 180 3,011,580.00
182 Plester roll 10 cm x 5 cm roll 41,360.00 30 0 0 30 5 0 0 5 5 0 0 5 10 0 0 10 90 3,722,400.00
183 Plester roll kain roll 11,964.00 20 0 0 20 20 0 0 20 30 0 0 30 10 0 0 10 150 1,794,600.00
184 Prednison tablet 5 mg tab 76.00 3000 0 0 3000 1000 0 0 1000 3000 0 0 3000 1000 0 0 1000 15000 1,140,000.00
185 Primakuin tablet 15 mg tab 224.00 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 500 500 112,000.00
186 Propiltiourasil tab100 mg tab 319.00 0 0 0 0 0 0 0 0 0 0 0 0 2000 0 0 2000 2000 638,000.00
187 Propranolol 10 mg tab tab 60.00 0 0 0 0 0 0 0 0 0 0 0 0 600 0 0 600 600 36,000.00
188 Ramaflu tab (obat flu) tab 645.00 0 0 0 0 1000 0 0 1000 0 0 0 0 0 0 0 0 2000 1,290,000.00
189 Ranitidin injeksi ampul 1,390.00 20 0 0 20 0 0 0 0 150 0 0 150 100 0 0 100 440 611,600.00
190 Ranitidin tab 150 mg tab 98.00 2000 0 0 2000 2000 0 0 2000 1500 0 0 1500 1000 0 0 1000 12000 1,176,000.00
191 RDT @25pcs ktk 476,373.00 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 2 952,746.00
192 Retinol (vitamin A) kap 100,000 IU kapsul 284.00 0 0 0 0 250 0 0 250 0 0 0 0 0 0 0 0 500 142,000.00
193 Retinol (vitamin A) kap 200,000 IU kapsul 460.00 0 0 0 0 500 0 0 500 0 0 0 0 0 0 0 0 1000 460,000.00
194 Ringer Laktat larutan infus steril (Produk lokal) btl 7,150.00 120 0 0 120 100 0 0 100 0 0 0 0 0 0 0 0 440 3,146,000.00
195 Sabun cair (softaman) btl 78,750.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
196 Sabun cair (one scrub 4 %) btl 62,491.00 0 0 0 0 0 0 0 0 10 0 0 10 12 0 0 12 32 1,999,712.00
197 Salbutamol tablet 4 mg tab 95.00 0 0 0 0 0 0 0 0 1000 0 0 1000 0 0 0 0 2000 190,000.00
198 Salbutamol inheler (combivent) dosis 5,700.00 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 50 50 285,000.00
199 Salep 2-4 , Kombinasi:Asam Salisilat 2% + Belerang Endap pot 2,527.00 48 0 0 48 0 0 0 0 48 0 0 48 0 0 0 0 192 485,184.00
200 Salicyl bedak 2 % pot 1,020.00 50 0 0 50 50 0 0 50 20 0 0 20 0 0 0 0 240 244,800.00
201 Semen Seng Fosfat Serbuk & Cairan set 165,000.00 0 0 0 0 1 0 0 1 0 0 0 0 1 0 0 1 3 495,000.00
202 Sendok takar obat bh 2,145.00 250 0 0 250 0 0 0 0 0 0 0 0 250 0 0 250 750 1,608,750.00
203 Serum Anti Bisa Ular Polivalen injeksi 5 ml (ABU I) vial 462,000.00 2 0 0 2 2 0 0 2 3 0 0 3 5 0 0 5 19 8,778,000.00
204 Serum Anti Tetanus Injeksi 1.500 IU/ampul (A.T.S.) ampul 126,500.00 5 0 0 5 5 0 0 5 3 0 0 3 5 0 0 5 31 3,921,500.00
205 Sianokobalamin (Vit.B12) injeksi 500 mcg-ml ampul 1,098.00 100 0 0 100 100 0 0 100 0 0 0 0 0 0 0 0 400 439,200.00
206 Sianokobalamin (Vit.B12) tablet 50 mcg tab 51.00 0 0 0 0 500 0 0 500 1000 0 0 1000 0 0 0 0 3000 153,000.00
207 Silk (Benang Bedah Sutera) No. 3/0 dengan jarum bedah set 19,700.00 60 0 0 60 36 0 0 36 6 0 0 6 128 0 0 128 332 6,540,400.00
208 Simvastatin 10 mg tab 111.00 600 0 0 600 300 0 0 300 0 0 0 0 30 0 0 30 1830 203,130.00
209 Siprofloksasin tablet 500 mg tab 281.00 500 0 0 500 500 0 0 500 1200 0 0 1200 1000 0 0 1000 5400 1,517,400.00
210 Spironolactone tab 25 mg tab 244.00 0 0 0 0 0 0 0 0 1500 0 0 1500 0 0 0 0 3000 732,000.00
211 Strip pemeriksaan gula darah kotak 305,329.00 20 0 0 20 1 0 0 1 0 0 0 0 5 0 0 5 47 14,350,463.00
212 Strip tes kehamilan pcs 1,936.00 10 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 20 38,720.00
213 Stesolid rectal tube 5mg tube 12,090.00 100 0 0 100 10 0 0 10 20 0 0 20 30 0 0 30 290 3,506,100.00
214 Sulfadiazine silver 10 gr tube 20,700.00 10 0 0 10 10 0 0 10 10 0 0 10 0 0 0 0 60 1,242,000.00
215 Swab 2 ply dus 11,000.00 100 0 0 100 0 0 0 0 50 0 0 50 0 0 0 0 300 3,300,000.00
216 Tablet tambah darah kombinasi (Besi II Sulfat 200mg + Asam tab 352.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
217 Test Golongan Darah Anti A Set 68,200.00 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 68,200.00
218 Test Golongan Darah Anti AB Set 92,510.00 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 92,510.00
219 Test Golongan Darah Anti B Set 68,200.00 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 1 68,200.00
220 Test Golongan Darah Anti D (Rho) Set 114,070.00 1000 0 0 1000 0 0 0 0 0 0 0 0 1 0 0 1 2001 228,254,070.00
221 Test Kehamilan Beta HCG Set 80,416.00 0 0 0 0 2 0 0 2 0 0 0 0 0 0 0 0 4 321,664.00
222 Tetrasiklin HCl kapsul 250 mg kapsul 168.00 5000 0 0 5000 500 0 0 500 0 0 0 0 0 0 0 0 11000 1,848,000.00
223 Tetrasiklin HCl kapsul 500 mg tab 310.00 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 500 500 155,000.00
224 Tiamin HCl / Mononitrat (Vit.B1) tablet 50 mg tab 82.00 5000 0 0 5000 2000 0 0 2000 0 0 0 0 4000 0 0 4000 18000 1,476,000.00
225 Tranfusi set set 3,600.00 10 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 20 72,000.00
226 Triheksipenidil tab 2 mg tab 80.00 30 0 0 30 0 0 0 0 300 0 0 300 0 0 0 0 660 52,800.00
227 Trombophop gel tube 51,975.00 1 0 0 1 5 0 0 5 0 0 0 0 1 0 0 1 13 675,675.00
228 Urine bag pcs 5,500.00 30 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0 60 330,000.00
229 Urine Strip 10P set 334,840.00 100 0 0 100 1 0 0 1 0 0 0 0 2 0 0 2 204 68,307,360.00
230 Vaksin Rabies Vero vial 174,500.00 5000 0 0 5000 0 0 0 0 0 0 0 0 0 0 0 0 10000 1,745,000,000.00
231 Ventolin nebules amp/salbutamol cairan nebu 4,000.00 10 0 0 10 20 0 0 20 0 0 0 0 0 0 0 0 60 240,000.00
232 Vitamin B Kompleks tab 115.00 5000 0 0 5000 3000 0 0 3000 0 0 0 0 0 0 0 0 16000 1,840,000.00
233 Vitamin neurotropik injeksi ampul 4,336.00 10 0 0 10 50 0 0 50 0 0 0 0 0 0 0 0 120 520,320.00
234 Vitamin neurotropik tablet tablet 975.00 0 0 0 0 500 0 0 500 0 0 0 0 0 0 0 0 1000 975,000.00
235 Wing Needle No. 27 G set 1,400.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
236 Wing Needle No.21 G set 1,400.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
239 Yodium povidon lar 10 % 1000 ml btl 149,314.00 0 0 0 0 0 0 0 0 0 0 0 0 12 0 0 12 12 1,791,768.00
240 Yodium povidon lar 10 % 30 ml btl 2,900.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
243 Yodium povidon 60 ml btl 23,890.00 50 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 100 2,389,000.00
244 Zinc tab 513.00 3000 0 0 3000 0 0 0 0 1000 0 0 1000 1500 0 0 1500 9500 4,873,500.00
245 Zinc syrup (interzinc) btl 6,600.00 50 0 0 50 24 0 0 24 24 0 0 24 100 0 0 100 296 1,953,600.00
246 Alkohol 70 % 300 ml btl 21,500.00 0 0 0 0 500 0 0 500 0 0 0 0 0 0 0 0 1000 21,500,000.00
247 Allopurinol tab tab 90.00 2000 0 0 2000 0 0 0 0 0 0 0 0 0 0 0 0 4000 360,000.00
248 Amoxicillin kap 500mg tab 190.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
249 Amoxicillin dry sirup btl 1,881.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
250 Asam mefenamat 500 mg tab tab 100.00 0 0 0 0 0 0 0 0 2000 0 0 2000 2000 0 0 2000 6000 600,000.00
251 Acyclovir 200mg tab tab 249.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
252 Betametason cream tube 1,380.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
253 Cefadroxil 500 mg kapsul kapsul 450.00 0 0 0 0 500 0 0 500 1000 0 0 1000 0 0 0 0 3000 1,350,000.00
254 Ciprofloxacin kap kaplet 281.00 0 0 0 0 500 0 0 500 0 0 0 0 0 0 0 0 1000 281,000.00
255 Chloramex-kloramfenikol kap 500 mg kapsul 1,007.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
256 Ctm tab tab 42.00 0 0 0 0 0 0 0 0 1800 0 0 1800 0 0 0 0 3600 151,200.00
257 Chlorpromazine 100mg tab tab 162.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
258 Cefotaxime inj vial 5,500.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
259 Deksamethason 0,5mg tab tab 44.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
260 Domperidon 10 mg tablet tab 95.00 0 0 0 0 500 0 0 500 1000 0 0 1000 500 0 0 500 3500 332,500.00
261 Glimepiride tab 3 mg tab 319.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
262 Glukosa 5% infus btl 6,900.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
263 Ibuprofen 200 mg tab tab 102.00 0 0 0 0 1000 0 0 1000 0 0 0 0 0 0 0 0 2000 204,000.00
264 Ibuprofen 400 mg tab tab 127.00 3000 0 0 3000 0 0 0 0 0 0 0 0 0 0 0 0 6000 762,000.00
265 Ketokonazol cream tube 2,545.00 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 50 50 127,250.00
266 Lidokain comp injeksi ampul 1,845.00 0 0 0 0 0 0 0 0 90 0 0 90 240 0 0 240 420 774,900.00
267 Loperamide tab 2 mg tab 80.00 500 0 0 500 600 0 0 600 500 0 0 500 500 0 0 500 3700 296,000.00
268 Metylprednisolone tab 8 mg tab 309.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
269 Metylprednisolone tab 4 mg tab 150.00 0 0 0 0 0 0 0 0 500 0 0 500 0 0 0 0 1000 150,000.00
270 Metoklopropamid tab 10 mg tab 87.00 1000 0 0 1000 0 0 0 0 0 0 0 0 2000 0 0 2000 4000 348,000.00
271 Metformin HCL 500mg tab 100.00 0 0 0 0 0 0 0 0 3000 0 0 3000 4000 0 0 4000 10000 1,000,000.00
272 Nacl 0,9% infus btl 6,410.00 0 0 0 0 0 0 0 0 200 0 0 200 120 0 0 120 520 3,333,200.00
273 Nipedifine tab tab 110.00 0 0 0 0 0 0 0 0 2500 0 0 2500 2000 0 0 2000 7000 770,000.00
274 Omeprazole kap 20 mg kapsul 140.00 0 0 0 0 0 0 0 0 1500 0 0 1500 0 0 0 0 3000 420,000.00
275 Povidone iodine 10 % 300 ml btl 18,656.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
276 Piridoksin HCl (Vit.B6) tablet 10 mg tab 118.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
277 Ranitidin tab 150 mg tab 98.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
278 RL infus btl 7,150.00 0 0 0 0 0 0 0 0 160 0 0 160 160 0 0 160 480 3,432,000.00
279 Salep 2-4 pot 2,527.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
280 Simvastatin 20 mg tab 504.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
281 Spirinolactone tab 25 mg tab 244.00 0 0 0 0 0 0 0 0 1000 0 0 1000 500 0 0 500 2500 610,000.00
282 Vit b komplek tab 115.00 0 0 0 0 0 0 0 0 3000 0 0 3000 2600 0 0 2600 8600 989,000.00
283 Cutgut 2/0 pcs 33,643.00 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 60 60 2,018,580.00
284 Cutgut 3/0 pcs 33,643.00 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 60 60 2,018,580.00
285 IV cath no 20 pcs 10,483.00 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 50 50 524,150.00
286 IV cath no 22 pcs 10,480.00 0 0 0 0 100 0 0 100 0 0 0 0 50 0 0 50 250 2,620,000.00
287 IV cath no 24 pcs 10,480.00 0 0 0 0 100 0 0 100 0 0 0 0 0 0 0 0 200 2,096,000.00
288 Cuticell classic 10x10cm buah 5,198.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
289 Handscoon 7,5 pcs 8,250.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
290 Iodine Povidone btl 6,550.00 50 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 100 655,000.00
291 Infus set anak pcs 5,661.00 200 0 0 200 0 0 0 0 200 0 0 200 0 0 0 0 800 4,528,800.00
292 Infus set Dewasa pcs 6,644.00 50 0 0 50 0 0 0 0 160 0 0 160 0 0 0 0 420 2,790,480.00
293 Kapas pembalut absorben 250 mg Roll 12,500.00 200 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 400 5,000,000.00
294 Kasa hidrofil 40 yard x 80 cm Roll 255,750.00 250 0 0 250 0 0 0 0 10 0 0 10 0 0 0 0 520 132,990,000.00
295 Kasa hidrofil 3 yard x 15 cm Roll 1,577.00 50 0 0 50 0 0 0 0 0 0 0 0 100 0 0 100 200 315,400.00
296 Kasa kompres 16 x 16 steril pack 5,820.00 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 50 50 291,000.00
297 Masker pcs 762.00 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -
298 Spuit 3 cc pcs 916.00 0 0 0 0 0 0 0 0 1000 0 0 1000 1500 0 0 1500 3500 3,206,000.00
299 Spuit 5 cc pcs 1,030.00 0 0 0 0 0 0 0 0 500 0 0 500 0 0 0 0 1000 1,030,000.00
300 Urine bag pcs 6,036.00 0 0 0 0 0 0 0 0 20 0 0 20 0 0 0 0 40 241,440.00
TOTAL 3,341,389,182.00
LAPORAN KUNJUNGAN
Bulan JKN UMUM Jumlah
Jan 0 0 0
Feb 418 471 889
Mar 0 0 0
Apr 0 0 0
Mei 0 0 0
Juni 0 0 0
Juli 0 0 0
Agust 0 0 0
Sep 0 0 0
Okt 0 0 0
Nop 421 429 850
Des 0 0 0
TOTAL 839 900 1739

SK Tentang Peresepan Pemesannan Dan Pengelolaan Obat

Diunggah oleh

Informasi Dokumen

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

SK Tentang Peresepan Pemesannan Dan Pengelolaan Obat

Diunggah oleh

Hak Cipta:

Format Tersedia

REKAPITULASI LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

Harga Penerimaan/Triwulan Total Pemakaian/Triwulan Total

Harga Penerimaan/Triwulan Total Pemakaian/Triwulan Total

Harga Penerimaan/Triwulan Total Pemakaian/Triwulan Total

Harga Penerimaan/Triwulan Total Pemakaian/Triwulan Total

Harga Total Pemakaian Total Pemakaian

Harga Total Penerimaan Total Penerimaan

Anda mungkin juga menyukai