Anda di halaman 1dari 29

LAMPIRAN

LAMPIRAN 1

LEMBAR PERSETUJUAN PENELITIAN

(Informed Consent)

Saya Siska Sartika / 10101001020, Mahasiswa tingkat akhir peminatan

Administrasi Kebijakan Kesehatan Fakultas Kesehatan Masyarakat Universitas

Sriwjaya. Dengan penelitian saya berjudul “Analisis Perencanaan Obat dengan

Analisis ABC Indeks Kritis Dalam Rangka Pengendalian Obat di Instalasi

Farmasi RSUP Dr. Mohammad Hoesin Palembang Tahun 2015”, maka saya

memohon bantuannya kepada Dokter RSUP Dr. Mohammad Hoesin untuk

mengisi kuesioner daftar obat umum yang telah disediakan berdasarkan kritis

tidaknya persediaan obat tersebut dengan memberikan tanda check list (√) pada

kolom yang sesuai.

Adapun keterangan dari kolom tersebut adalah:

a. Kelompok obat vital

Adalah kelompok obat yang sangat vital untuk memperpanjang hidup,

untuk mengatasi penyakit penyebab kematian ataupun untuk pelayanan

pokok kesehatan dan item obat ini tidak bisa diganti. Kekosongan dan

kehabisan obat tidak bisa ditoleransi dalam proses pelayanan pasien.

b. Kelompok obat essensial

Adalah obat yang bekerja kausal yaitu obat yang bekerja pada sumber

penyebab penyakit, logistic farmasi yang banyak digunakan dalam

pengobatan penyakit terbanyak dan item obat ini dapat diganti dengan

item yang ada di rumah sakit waktu itu walaupun tidak sama dengan yang

diinginkan. Kekosongan kurang dari 48 jam masih dapat ditoleransi.


c. Kelompok obat non essensial

Adalah obat penunjang agar tindakan atau pengobatan menjadi lebih baik

untuk kenyamanan atau untuk mengatasi keluhan dan item obat ini dapat

diganti. Kekosongan lebih dari 48 jam masih dapat ditoleransi.

Atas bantuan dan kerjasama Dokter saya ucapkan terima kasih.

Palembang, Juli 2015

Peneliti,

( Siska Sartika )

NIM. 10101001020
FORM CHECK LIST NILAI KRITIS OBAT

Nama Dokter :

NO NAMA OBAT Bentuk Vital Essensial Non


Essensial
1 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL
2 ASABIUM TABLET TAB
3 AVASTIN 100MG/4ML INJ VIAL
4 BECOM Z. TABLET TAB
5 BETAMESON CREAM TUBE
6 BISOPROLOL TABLET TAB
7 BREXEL 20 MG/VIAL VIAL
8 CALNIC PLUS SYR BTL
9 CAPTOPRIL 25 MG TABLET TAB
10 CARBOL GLYCERIN TETES TELINGA BTL
11 CATAPRES INJEKSI AMP
12 CEFOTAXIM I GR INJEKSI VIAL
13 CEFIXIM 100MG CAP CAPSULE
14 CEFIROME INJ VIAL
15 CENDO LYTEERS EYE DROP 15 ML BTL
16 CENDO TROPIN 0,5% EYE DROP 5 ML BTL
17 CEPEZET 100MG TAB TAB
18 CHLORAMPHENICOL 250MG CAPSUL CAP
19 CIPROFLOXACINE 500 MG TAB
20 CITICHOLIN 250 MG INJEKSI AMP
21 CLINIMIC INFUS BTL
22 CO AMOXYCLAVE 625MG TABLET TAB
23 CROME INJ AMP
24 CURCUMA TABLET (BLISTER) TAB
25 CYCLOVID 200 MG INJEKSI VIAL
26 DANOCRINE 200 MG CAPSUL CAP
27 DEPAKENE 250 MG SYRUP BTL
28 DEXTROMETHORPAN SYRUP 60 ML BTL
29 DIAZEPAM 2 MG TAB
30 DIMENHYDRINAT 50 MG TAB TAB
31 DEXORUBICIN 10MG INJEKSI VIAL
32 DUMIN 125 MG SUPPOS SUPP
33 ECOSOL RL B BRAUN BOTOL
34 ELOXATIN 100 INJ VIAL
35 ENYSTIN DROP FLS
36 ETHAMBUTOL 500 MG TABLET TAB
37 FARGOXIN INJ AMP
38 FERRIPROX FCT 500 MG TAB TAB
39 FLUCONAZOLE INF FLS
40 FUROSEMIDA INJEKSI AMP
41 GAMARAAS INJEKSI VIAL
42 GLIBENCLAMIDE TABLET TAB
43 GLUCOBAY 50MG TABLET TAB
44 H2O2 3% TETES TELINGA 15 ML BTL
45 HARNAL 0,2 MG CAPSULE CAP
46 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB
47 HYTRIN 1 MG TABLET TAB
48 INVICLOT INJEKSI VIAL
49 ISONIAZIDE 300 MG (INH) TABLET TAB
50 IVELIP 20% 100 CC BTL
51 KALITAKE 5G SACHET SACH
52 KENDARON INJEKSI AMP
53 KETOPROFEN 100 MG TAB TAB
54 KSR 600MG TAB ASKIN TAB
55 LAXADIN 60 ML SYRUP BTL
56 LEVEMIR FLEXPEN VIAL
57 LOVENOX P F S 40 MG INJEKSI AMP
58 MEBO OINT TUBE
59 MELOXICAM 15 MG TABLET TAB
60 METRONIDAZOLE 500MG TAB
61 METHYL ERGOMETRINE TAB
62 MIKASIN 250 MG INJ VIAL
63 MUCOGARD SYR FLS
64 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL
65 NEUROBION 5000 INJEKSI AMP
66 NOCID KAPLET
67 NUTRIVISION CAPSULE
68 OMEPRAZOLE CAPSULE SANBE/AMS CAP
69 OTSU SALIN 3% ASKIN BTL
70 OXALIPLATIN MEDAC 100MG INJ VIAL
71 PARASETAMOL SYRUP BTL
72 PENICILLIN PROC. 3 JUTA UNIT INJ VIAL
73 PHENITOIN 100MG CAP CAP
74 PIRACETAM 800 TABLET TAB
75 PREDNISON 5MG TABLET TAB
76 PROFIBRAT 300 KAP CAPSULE
77 RANITIDIN 150 MG TABLET TAB
78 RIFAMPICIN 300MG CAPSULE CAP
79 RIVANOL KOMPRES BTL
80 SALOFALK 250 CAPSUL CAP
81 SIMARC 2 TABLET BTL
82 SOTATIC 10 MG TABLET TAB
83 SPIRIVA 18 MCG REFILL (A) CAP
84 STREPTOMYCIN 1G INJEKSI VIAL
85 SYNTOCINON 1 ML INJEKSI AMP
86 THEOPHILLIN 150MG CAP CAP
87 TRAMADOL TABLET TAB
88 UNALIUM 5MG TABLET TAB
89 VELCHROME INJ AMP
90 VICCILLIN 1 GR INJEKSI AMP
91 VITAMIN C 50 MG TAB
92 VITKA INFANT AMP
93 XYLOCAIN 2% PDF INJEKSI 20 ML AMP
94 ACYCLOVIR 200 MG TAB
95 ALINAMIN F INJEKSI AMP
96 ALPRAZOLAM 0,5 TABLET TAB
97 AMBROXOL SYRUP 15 MG BTL
98 AMINOPHYLLIN 200 MG TAB
99 AMOXISILLIN DRY SYRUP BTL
LAMPIRAN 2

NO NAMA OBAT SATUAN JUMLAH KOMULATIF % KOMULATIF KEL W1


1 FERRIPROX FCT 500 MG TAB TAB 420.828 420.828 12,26758582 A 3
2 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 296.998 717.826 20,92539484 A 3
3 PREDNISON 5MG TABLET TAB 248.472 966.298 28,16861911 A 3
4 ECOSOL RL B BRAUN BOTOL 205.302 1.171.600 34,15339176 A 3
5 ISONIAZIDE 300 MG (INH) TABLET TAB 184.772 1.356.372 39,53969297 A 3
6 RANITIDIN 150 MG TABLET TAB 161.482 1.517.854 44,2470658 A 3
7 METRONIDAZOLE 500MG TAB 147.606 1.665.460 48,5499384 A 3
8 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 137.544 1.803.004 52,55949296 A 3
9 CAPTOPRIL 25 MG TABLET TAB 118.556 1.921.560 56,01552703 A 3
10 CIPROFLOXACINE 500 MG TAB 109.062 2.030.622 59,19480085 A 3
11 OMEPRAZOLE CAPSULE SANBE/AMS CAP 101.109 2.131.731 62,14223623 A 3
12 CHLORAMPHENICOL 250MG CAPSUL CAP 93.968 2.225.699 64,88150382 A 3
13 ACYCLOVIR 200 MG TAB 83.663 2.309.362 67,32036966 A 3
14 VITAMIN C 50 MG TAB 81.147 2.390.509 69,68589141 A 3
15 DIAZEPAM 2 MG TAB 76.603 2.467.112 71,9189507 B 2
16 FUROSEMIDA INJEKSI AMP 71.004 2.538.116 73,98879316 B 2
17 SOTATIC 10 MG TABLET TAB 63.132 2.601.248 75,82915841 B 2
18 CURCUMA TABLET (BLISTER) TAB 54.612 2.655.860 77,42115656 B 2
19 ASAM TRANEKSAMAT 500 MG TAB 51.528 2.707.388 78,92325282 B 2
20 ALPRAZOLAM 0,5 TABLET TAB 48.039 2.755.427 80,32364099 B 2
21 ETHAMBUTOL 500 MG TABLET TAB 47.065 2.802.492 81,69563603 B 2
22 BISOPROLOL TABLET TAB 43.738 2.846.230 82,97064546 B 2
23 CEFIXIM 100MG CAP CAPSULE 41.710 2.887.940 84,18653652 B 2
24 RIFAMPICIN 300MG CAPSULE CAP 40.411 2.928.351 85,36456035 B 2
25 MELOXICAM 15 MG TABLET TAB 39.519 2.967.870 86,51658142 B 2
26 KETOPROFEN 100 MG TAB TAB 35.624 3.003.494 87,55505908 B 2
27 PHENITOIN 100MG CAP CAP 29.132 3.032.626 88,40428801 B 2
28 GLIBENCLAMIDE TABLET TAB 26.210 3.058.836 89,16833751 B 2
29 GLUCOBAY 50MG TABLET TAB 26.048 3.084.884 89,92766454 B 2
30 AMINOPHYLLIN 200 MG TAB 25.480 3.110.364 90,67043376 B 2
31 SIMARC 2 TABLET TAB 24.912 3.135.276 91,39664518 C 1
32 CO AMOXYCLAVE 625MG TABLET TAB 22.883 3.158.159 92,06370908 C 1
33 TRAMADOL TABLET TAB 22.315 3.180.474 92,71421517 C 1
34 CITICHOLIN 250 MG INJEKSI AMP 21.991 3.202.465 93,35527631 C 1
35 DIMENHYDRINAT 50 MG TAB TAB 20.043 3.222.508 93,93955118 C 1

LAMPIRAN 2
NO NAMA OBAT SATUAN JUMLAH KOMULATIF % KOMULATIF KEL W1
36 METHYL ERGOMETRINE TAB 18.502 3.241.010 94,47890425 C 1
37 VICCILLIN 1 GR INJEKSI AMP 16.311 3.257.321 94,95438732 C 1
38 IBUPROFEN 200 MG TABLET TAB 14.444 3.271.765 95,37544536 C 1
39 THEOPHILLIN 150MG CAP CAP 14.120 3.285.885 95,78705844 C 1
40 CEFOTAXIM I GR INJEKSI VIAL 10.306 3.296.191 96,08748935 C 1
41 VELCHROME INJ AMP 8.926 3.305.117 96,34769179 C 1
42 PIRACETAM 800 TABLET TAB 8.115 3.313.232 96,58425271 C 1
43 SPIRIVA 18 MCG REFILL (A) CAP 7.303 3.320.535 96,79714296 C 1
44 SYNTOCINON 1 ML INJEKSI AMP 6.979 3.327.514 97,00058827 C 1
45 SALOFALK 250 CAPSUL CAP 5.275 3.332.789 97,15436015 C 1
46 FLUCONAZOLE INF FLS 5.193 3.337.982 97,30574165 C 1
47 LAXADIN 60 ML SYRUP BTL 5.031 3.343.013 97,45240068 C 1
48 ALINAMIN F INJEKSI AMP 4.950 3.347.963 97,59669847 C 1
49 AMBROXOL SYRUP 15 MG BTL 4.788 3.352.751 97,73627378 C 1
50 PARASETAMOL SYRUP BTL 4.707 3.357.458 97,87348786 C 1
51 CENDO LYTEERS EYE DROP 15 ML BTL 4.544 3.362.002 98,00595032 C 1
52 MUCOGARD SYR FLS 4.544 3.366.546 98,13841277 C 1
53 VITKA INFANT AMP 4.463 3.371.009 98,26851399 C 1
54 DANOCRINE 200 MG CAPSUL CAP 3.327 3.374.336 98,36549959 C 1
55 ENYSTIN DROP FLS 3.246 3.377.582 98,46012396 C 1
56 OTSU SALIN 3% ASKIN BTL 3.246 3.380.828 98,55474833 C 1
57 STREPTOMYCIN 1G INJEKSI VIAL 3.246 3.384.074 98,6493727 C 1
58 KALITAKE 5G SACHET SACH 3.002 3.387.076 98,73688421 C 1
59 PHENOBARBITAL 30 MG BTL 3.002 3.390.078 98,82439571 C 1
60 IVELIP 20% 100 CC BTL 2.921 3.392.999 98,90954598 C 1
61 UNALIUM 5MG TABLET TAB 2.597 3.395.596 98,98525131 C 1
62 CROME INJ AMP 2.434 3.398.030 99,05620501 C 1
63 H2O2 3% TETES TELINGA 15 ML BTL 2.434 3.400.464 99,12715871 C 1
64 CLINIMIC INFUS BTL 2.191 3.402.655 99,1910287 C 1
65 NOCID KAPLET 2.029 3.404.684 99,25017622 C 1
66 PROFIBRAT 300 KAP CAPSULE 1.866 3.406.550 99,30457211 C 1
67 NUTRIVISION CAPSULE 1.785 3.408.335 99,35660677 C 1
68 BETAMESON CREAM TUBE 1.623 3.409.958 99,40391895 C 1
69 CEPEZET 100MG TAB TAB 1.623 3.411.581 99,45123114 C 1
70 INVICLOT INJEKSI VIAL 1.623 3.413.204 99,49854332 C 1
LAMPIRAN 2
NO NAMA OBAT SATUAN JUMLAH KOMULATIF % KOMULATIF KEL W1
71 CEFIROME INJ VIAL 1.298 3.414.502 99,53638141 C 1
72 CARBOL GLYCERIN TETES TELINGA BTL 1.217 3.415.719 99,57185826 C 1
73 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL 1.136 3.416.855 99,60497387 C 1
74 HARNAL 0,2 MG CAPSULE CAP 1.136 3.417.991 99,63808949 C 1
75 CYCLOVID 200 MG INJEKSI VIAL 1.055 3.419.046 99,66884386 C 1
76 FARGOXIN INJ AMP 974 3.420.020 99,697237 C 1
77 DEPAKENE 250 MG SYRUP BTL 893 3.420.913 99,72326891 C 1
78 KENDARON INJEKSI AMP 893 3.421.806 99,74930081 C 1
79 LOVENOX P F S 40 MG INJEKSI AMP 811 3.422.617 99,77294233 C 1
80 BECOM Z. TABLET TAB 730 3.423.347 99,79422261 C 1
81 LEVEMIR FLEXPEN VIAL 730 3.424.077 99,81550289 C 1
82 RIVANOL KOMPRES BTL 730 3.424.807 99,83678317 C 1
83 CATAPRES INJEKSI AMP 649 3.425.456 99,85570221 C 1
84 DUMIN 125 MG SUPPOS SUPP 649 3.426.105 99,87462125 C 1
85 DEXORUBICIN 10MG INJEKSI VIAL 568 3.426.673 99,89117906 C 1
86 GAMARAAS INJEKSI VIAL 568 3.427.241 99,90773687 C 1
87 DEXTROMETHORPAN SYRUP 60 ML BTL 487 3.427.728 99,92193344 C 1
88 MIKASIN 250 MG INJ VIAL 487 3.428.215 99,93613001 C 1
89 AMOXISILLIN DRY SYRUP BTL 487 3.428.702 99,95032658 C 1
90 KSR 600MG TAB ASKIN TAB 406 3.429.108 99,96216191 C 1
91 MEBO OINT TUBE 325 3.429.433 99,97163601 C 1
92 OXALIPLATIN MEDAC 100MG INJ VIAL 325 3.429.758 99,98111011 C 1
93 NEUROBION 5000 INJEKSI AMP 162 3.429.920 99,98583258 C 1
94 AVASTIN 100MG/4ML INJ VIAL 81 3.430.001 99,98819382 C 1
95 BREXEL 20 MG/VIAL VIAL 81 3.430.082 99,99055505 C 1
96 CALNIC PLUS SYR BTL 81 3.430.163 99,99291629 C 1
97 CENDO TROPIN 0,5% EYE DROP 5 ML BTL 81 3.430.244 99,99527753 C 1
98 ELOXATIN 100 INJ VIAL 81 3.430.325 99,99763876 C 1
99 XYLOCAIN 2% PDF INJEKSI 20 ML AMP 81 3.430.406 100 C 1
LAMPIRAN 3
NO NAMA OBAT SATUAN TOTAL KOMULATIF % KOMULATIF KEL W2
1 FERRIPROX FCT 500 MG TAB TAB 10.941.533.881,00 10.941.533.881,00 48,39191455 A 3
2 OXALIPLATIN MEDAC 100MG INJ VIAL 1.392.157.548,00 12.333.691.429,00 54,54911059 A 3
3 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 1.389.059.357,00 13.722.750.786,00 60,69260404 A 3
4 GAMARAAS INJEKSI VIAL 1.249.663.456,00 14.972.414.242,00 66,21958114 A 3
5 ECOSOL RL B BRAUN BOTOL 1.019.118.400,00 15.991.532.642,00 70,72690992 A 3
6 CLINIMIC INFUS BTL 613.471.151,00 16.605.003.793,00 73,44015322 B 2
7 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL 586.205.766,00 17.191.209.559,00 76,03280793 B 2
8 FLUCONAZOLE INF FLS 545.307.689,00 17.736.517.248,00 78,44457975 B 2
9 ELOXATIN 100 INJ VIAL 460.103.363,00 18.196.620.611,00 80,47951223 B 2
10 IVELIP 20% 100 CC BTL 406.059.476,00 18.602.680.087,00 82,27542089 B 2
11 AVASTIN 100MG/4ML INJ VIAL 363.475.459,00 18.966.155.546,00 83,88299013 B 2
12 CITICHOLIN 250 MG INJEKSI AMP 345.256.045,00 19.311.411.591,00 85,40997905 B 2
13 CEFIROME INJ VIAL 168.785.713,00 19.480.197.304,00 86,15647985 B 2
14 VICCILLIN 1 GR INJEKSI AMP 156.581.208,00 19.636.778.512,00 86,84900291 B 2
15 LAXADIN 60 ML SYRUP BTL 133.324.484,00 19.770.102.996,00 87,43866676 B 2
16 FUROSEMIDA INJEKSI AMP 124.707.892,00 19.894.810.888,00 87,99022139 B 2
17 LEVEMIR FLEXPEN VIAL 114.133.240,00 20.008.944.128,00 88,49500674 B 2
18 DEPAKENE 250 MG SYRUP BTL 109.791.860,00 20.118.735.988,00 88,98059115 B 2
19 CO AMOXYCLAVE 625MG TABLET TAB 105.721.528,00 20.224.457.516,00 89,44817341 B 2
20 CYCLOVID 200 MG INJEKSI VIAL 104.436.160,00 20.328.893.676,00 89,91007078 B 2
21 MUCOGARD SYR FLS 101.212.424,00 20.430.106.100,00 90,3577103 B 2
22 CEFOTAXIM I GR INJEKSI VIAL 99.372.385,00 20.529.478.485,00 90,79721175 B 2
23 LOVENOX P F S 40 MG INJEKSI AMP 98.463.742,00 20.627.942.227,00 91,23269447 C 1
24 BREXEL 20 MG/VIAL VIAL 95.900.958,00 20.723.843.185,00 91,65684259 C 1
25 CEFIXIM 100MG CAP CAPSULE 95.338.013,00 20.819.181.198,00 92,07850092 C 1
26 SPIRIVA 18 MCG REFILL (A) CAP 93.614.090,00 20.912.795.288,00 92,49253474 C 1
27 BISOPROLOL TABLET TAB 92.314.326,00 21.005.109.614,00 92,90082 C 1
28 VELCHROME INJ AMP 89.261.675,00 21.094.371.289,00 93,29560408 C 1
29 DEXORUBICIN 10MG INJEKSI VIAL 87.486.030,00 21.181.857.319,00 93,68253488 C 1
30 KETOPROFEN 100 MG TAB TAB 83.487.288,00 21.265.344.607,00 94,05178016 C 1
31 ENYSTIN DROP FLS 81.146.977,00 21.346.491.584,00 94,41067477 C 1
32 CENDO LYTEERS EYE DROP 15 ML BTL 78.387.980,00 21.424.879.564,00 94,75736697 C 1
33 SYNTOCINON 1 ML INJEKSI AMP 76.423.087,00 21.501.302.651,00 95,09536889 C 1
34 ALINAMIN F INJEKSI AMP 55.680.183,00 21.556.982.834,00 95,34162967 C 1
35 MELOXICAM 15 MG TABLET TAB 53.350.080,00 21.610.332.914,00 95,57758493 C 1
LAMPIRAN 3
NO NAMA OBAT SATUAN TOTAL KOMULATIF % KOMULATIF KEL W2
36 ASAM TRANEKSAMAT 500 MG TAB 51.013.047,00 21.661.345.961,00 95,80320403 C 1
37 MIKASIN 250 MG INJ VIAL 42.358.722,00 21.703.704.683,00 95,99054702 C 1
38 GLUCOBAY 50MG TABLET TAB 40.166.293,00 21.743.870.976,00 96,16819339 C 1
39 KALITAKE 5G SACHET SACH 38.872.567,00 21.782.743.543,00 96,34011791 C 1
40 OMEPRAZOLE CAPSULE SANBE/AMS CAP 38.300.140,00 21.821.043.683,00 96,50951072 C 1
41 CROME INJ AMP 36.272.699,00 21.857.316.382,00 96,66993661 C 1
42 CURCUMA TABLET (BLISTER) TAB 36.043.864,00 21.893.360.246,00 96,82935042 C 1
43 OTSU SALIN 3% ASKIN BTL 34.231.041,00 21.927.591.287,00 96,98074652 C 1
44 VITKA INFANT AMP 33.473.128,00 21.961.064.415,00 97,12879055 C 1
45 CIPROFLOXACINE 500 MG TAB 32.718.461,00 21.993.782.876,00 97,27349686 C 1
46 ACYCLOVIR 200 MG TAB 30.999.478,00 22.024.782.354,00 97,4106005 C 1
47 RANITIDIN 150 MG TABLET TAB 30.828.621,00 22.055.610.975,00 97,54694847 C 1
48 SALOFALK 250 CAPSUL CAP 30.697.901,00 22.086.308.876,00 97,6827183 C 1
49 METRONIDAZOLE 500MG TAB 30.594.368,00 22.116.903.244,00 97,81803023 C 1
50 SIMARC 2 TABLET TAB 29.894.546,00 22.146.797.790,00 97,950247 C 1
51 FARGOXIN INJ AMP 29.212.911,00 22.176.010.701,00 98,07944906 C 1
52 DANOCRINE 200 MG CAPSUL CAP 29.082.133,00 22.205.092.834,00 98,20807272 C 1
53 ALPRAZOLAM 0,5 TABLET TAB 26.825.464,00 22.231.918.298,00 98,32671564 C 1
54 CATAPRES INJEKSI AMP 23.019.774,00 22.254.938.072,00 98,42852686 C 1
55 SOTATIC 10 MG TABLET TAB 22.096.322,00 22.277.034.394,00 98,52625387 C 1
56 ETHAMBUTOL 500 MG TABLET TAB 21.474.460,00 22.298.508.854,00 98,62123052 C 1
57 MEBO OINT TUBE 19.637.568,00 22.318.146.422,00 98,70808301 C 1
58 KENDARON INJEKSI AMP 19.161.509,00 22.337.307.931,00 98,79283001 C 1
59 INVICLOT INJEKSI VIAL 17.852.335,00 22.355.160.266,00 98,87178682 C 1
60 PROFIBRAT 300 KAP CAPSULE 17.124.040,00 22.372.284.306,00 98,94752255 C 1
61 ISONIAZIDE 300 MG (INH) TABLET TAB 17.108.008,00 22.389.392.314,00 99,02318738 C 1
62 PHENITOIN 100MG CAP CAP 16.022.470,00 22.405.414.784,00 99,09405112 C 1
63 CAPTOPRIL 25 MG TABLET TAB 15.588.893,00 22.421.003.677,00 99,16299725 C 1
64 AMBROXOL SYRUP 15 MG BTL 15.081.165,00 22.436.084.842,00 99,22969781 C 1
65 STREPTOMYCIN 1G INJEKSI VIAL 14.931.043,00 22.451.015.885,00 99,29573441 C 1
66 RIFAMPICIN 300MG CAPSULE CAP 13.500.976,00 22.464.516.861,00 99,35544616 C 1
67 CHLORAMPHENICOL 250MG CAPSUL CAP 12.818.202,00 22.477.335.063,00 99,41213815 C 1
68 NOCID KAPLET 12.269.423,00 22.489.604.486,00 99,46640301 C 1
69 HARNAL 0,2 MG CAPSULE CAP 11.551.559,00 22.501.156.045,00 99,51749293 C 1
70 PREDNISON 5MG TABLET TAB 10.617.210,00 22.511.773.255,00 99,56445043 C 1
LAMPIRAN 3
NO NAMA OBAT SATUAN TOTAL KOMULATIF % KOMULATIF KEL W2
71 PARASETAMOL SYRUP BTL 10.330.821,00 22.522.104.076,00 99,6101413 C 1
72 UNALIUM 5MG TABLET TAB 9.607.802,00 22.531.711.878,00 99,65263443 C 1
73 NUTRIVISION CAPSULE 8.926.167,00 22.540.638.045,00 99,69211283 C 1
74 PIRACETAM 800 TABLET TAB 8.114.697,00 22.548.752.742,00 99,72800229 C 1
75 TRAMADOL TABLET TAB 7.587.242,00 22.556.339.984,00 99,76155893 C 1
76 CARBOL GLYCERIN TETES TELINGA BTL 7.303.227,00 22.563.643.211,00 99,79385945 C 1
77 DUMIN 125 MG SUPPOS SUPP 6.232.087,00 22.569.875.298,00 99,82142255 C 1
78 XYLOCAIN 2% PDF INJEKSI 20 ML AMP 3.921.379,00 22.573.796.677,00 99,83876592 C 1
79 CALNIC PLUS SYR BTL 3.651.614,00 22.577.448.291,00 99,85491617 C 1
80 BETAMESON CREAM TUBE 3.319.560,00 22.580.767.851,00 99,86959783 C 1
81 DIAZEPAM 2 MG TAB 3.217.315,00 22.583.985.166,00 99,88382728 C 1
82 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 2.750.882,00 22.586.736.048,00 99,89599381 C 1
83 AMINOPHYLLIN 200 MG TAB 2.541.645,00 22.589.277.693,00 99,90723493 C 1
84 THEOPHILLIN 150MG CAP CAP 2.292.877,00 22.591.570.570,00 99,9173758 C 1
85 RIVANOL KOMPRES BTL 2.190.968,00 22.593.761.538,00 99,92706595 C 1
86 VITAMIN C 50 MG TAB 2.047.338,00 22.595.808.876,00 99,93612086 C 1
87 METHYL ERGOMETRINE TAB 1.849.226,00 22.597.658.102,00 99,94429957 C 1
88 AMOXISILLIN DRY SYRUP BTL 1.719.666,00 22.599.377.768,00 99,95190526 C 1
89 H2O2 3% TETES TELINGA 15 ML BTL 1.663.091,00 22.601.040.859,00 99,95926073 C 1
90 DIMENHYDRINAT 50 MG TAB TAB 1.620.701,00 22.602.661.560,00 99,96642872 C 1
91 GLIBENCLAMIDE TABLET TAB 1.501.073,00 22.604.162.633,00 99,97306763 C 1
92 DEXTROMETHORPAN SYRUP 60 ML BTL 1.195.294,00 22.605.357.927,00 99,97835414 C 1
93 BECOM Z. TABLET TAB 1.026.103,00 22.606.384.030,00 99,98289236 C 1
94 IBUPROFEN 200 MG TABLET TAB 965.881,00 22.607.349.911,00 99,98716423 C 1
95 CENDO TROPIN 0,5% EYE DROP 5 ML BTL 912.903,00 22.608.262.814,00 99,9912018 C 1
96 NEUROBION 5000 INJEKSI AMP 886.125,00 22.609.148.939,00 99,99512093 C 1
97 KSR 600MG TAB ASKIN TAB 682.373,00 22.609.831.312,00 99,99813891 C 1
98 CEPEZET 100MG TAB TAB 331.956,00 22.610.163.268,00 99,99960707 C 1
99 PHENOBARBITAL 30 MG BTL 88.842,00 22.610.252.110,00 100 C 1
LAMPIRAN 4
N
O NAMA OBAT SATUAN User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8 User 9 User 10 User 11 User 12
1 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL 3 3 2 1 3 1 1 3 3 3 3 1
2 DUMIN 125 MG SUPPOS SUPP 3 3 1 1 2 1 1 3 1 2 1 1
3 DEPAKENE 250 MG SYRUP BTL 2 2 1 1 3 1 1 3 1 2 1 1
4 DIAZEPAM 2 MG TAB 1 3 2 1 3 1 1 1 1 2 1 1
5 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 2 3 1 1 1 1 1 2 1 2 1 2
6 PHENOBARBITAL 30 MG BTL 2 2 2 1 3 1 1 1 1 2 1 1
7 ASAM TRANEKSAMAT 500 MG TAB 1 2 1 1 1 1 1 1 2 2 2 2
8 FARGOXIN INJ AMP 3 3 1 1 1 1 1 1 1 2 1 1
9 CEPEZET 100MG TAB TAB 2 1 2 1 2 1 1 1 1 2 1 1
10 FUROSEMIDA INJEKSI AMP 2 3 1 1 1 1 1 1 1 2 1 1
11 METRONIDAZOLE 500MG TAB 2 1 1 1 1 1 1 1 1 2 1 3
12 PARASETAMOL SYRUP BTL 2 1 1 1 1 1 1 2 1 1 1 3
13 PHENITOIN 100MG CAP CAP 2 1 1 1 3 1 1 1 1 2 1 1
14 PIRACETAM 800 TABLET TAB 2 1 1 1 3 1 1 1 1 2 1 1
15 RIFAMPICIN 300MG CAPSULE CAP 2 1 1 1 1 1 1 2 1 2 1 2
16 RIVANOL KOMPRES BTL 2 2 1 1 1 1 1 1 1 1 2 2
17 XYLOCAIN 2% PDF INJEKSI 20 ML AMP 1 3 1 1 1 1 1 1 1 1 1 3
18 BISOPROLOL TABLET TAB 2 2 1 1 1 1 1 1 1 2 1 1
19 CITICHOLIN 250 MG INJEKSI AMP 2 1 1 1 2 1 1 1 1 2 1 1
20 DIMENHYDRINAT 50 MG TAB TAB 1 2 1 1 2 1 1 1 1 2 1 1
21 DEXORUBICIN 10MG INJEKSI VIAL 2 1 1 1 1 1 1 3 1 1 1 1
22 ETHAMBUTOL 500 MG TABLET TAB 2 1 1 1 1 1 1 2 1 2 1 1
23 H2O2 3% TETES TELINGA 15 ML BTL 2 1 1 1 1 1 3 1 1 1 1 1
24 IBUPROFEN 200 MG TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 3
25 ISONIAZIDE 300 MG (INH) TABLET TAB 2 1 1 1 1 1 1 2 1 2 1 1
26 OTSU SALIN 3% ASKIN BTL 2 2 1 1 1 1 1 1 1 2 1 1
27 ACYCLOVIR 200 MG TAB 1 1 1 1 1 1 1 1 2 2 1 2
28 AMBROXOL SYRUP 15 MG BTL 2 1 1 1 1 1 1 2 1 1 1 2
29 BETAMESON CREAM TUBE 1 1 1 1 1 3 1 1 1 1 1 1
30 CAPTOPRIL 25 MG TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
LAMPIRAN 4
NO NAMA OBAT SATUAN User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8 User 9 User 10 User 11 User 12
31 CARBOL GLYCERIN TETES TELINGA BTL 1 1 1 1 1 1 3 1 1 1 1 1
32 CATAPRES INJEKSI AMP 2 1 1 1 1 1 1 1 1 2 1 1
33 CENDO LYTEERS EYE DROP 15 ML BTL 1 1 1 3 1 1 1 1 1 1 1 1
34 CENDO TROPIN 0,5% EYE DROP 5 ML BTL 1 1 1 3 1 1 1 1 1 1 1 1
35 ELOXATIN 100 INJ VIAL 2 1 1 1 1 1 1 1 1 2 1 1
36 FERRIPROX FCT 500 MG TAB TAB 2 1 1 1 1 1 1 1 1 2 1 1
37 FLUCONAZOLE INF FLS 2 1 1 1 1 1 1 1 1 1 1 2
38 GAMARAAS INJEKSI VIAL 2 1 1 1 1 1 1 1 1 2 1 1
39 GLIBENCLAMIDE TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
40 GLUCOBAY 50MG TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
41 HARNAL 0,2 MG CAPSULE CAP 2 1 1 1 1 1 1 1 1 2 1 1
42 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 2 1 1 1 1 1 1 1 1 2 1 1
43 KSR 600MG TAB ASKIN TAB 2 1 1 1 1 1 1 1 1 2 1 1
44 METHYL ERGOMETRINE TAB 2 1 1 1 1 1 1 1 1 2 1 1
45 NEUROBION 5000 INJEKSI AMP 2 1 1 1 2 1 1 1 1 1 1 1
46 OMEPRAZOLE CAPSULE SANBE/AMS CAP 2 1 1 1 1 1 1 1 1 2 1 1
47 OXALIPLATIN MEDAC 100MG INJ VIAL 2 1 1 1 1 1 1 1 1 2 1 1
48 PREDNISON 5MG TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
49 PROFIBRAT 300 KAP CAPSULE 2 1 1 1 1 1 1 1 1 2 1 1
50 RANITIDIN 150 MG TABLET TAB 2 1 1 1 1 1 1 1 1 2 1 1
51 STREPTOMYCIN 1G INJEKSI VIAL 2 1 1 1 1 1 1 1 1 2 1 1
52 THEOPHILLIN 150MG CAP CAP 2 2 1 1 1 1 1 1 1 1 1 1
53 VITKA INFANT AMP 1 1 1 1 1 1 1 3 1 1 1 1
54 ALPRAZOLAM 0,5 TABLET TAB 1 2 1 1 1 1 1 1 1 2 1 1
55 AMOXISILLIN DRY SYRUP BTL 2 1 1 1 1 1 1 2 1 1 1 1
56 AVASTIN 100MG/4ML INJ VIAL 1 1 1 1 1 1 1 1 1 2 1 1
57 BECOM Z. TABLET TAB 1 1 1 1 1 1 1 1 1 1 1 2
58 BREXEL 20 MG/VIAL VIAL 1 1 1 1 1 1 1 1 1 2 1 1
59 CEFOTAXIM I GR INJEKSI VIAL 1 1 1 1 1 1 1 1 1 1 1 2
60 CHLORAMPHENICOL 250MG CAPSUL CAP 2 1 1 1 1 1 1 1 1 1 1 1
LAMPIRAN 4
NO NAMA OBAT SATUAN User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8 User 9 User 10 User 11 User 12
61 CIPROFLOXACINE 500 MG TAB 2 1 1 1 1 1 1 1 1 1 1 1
62 CLINIMIC INFUS BTL 1 1 1 1 1 1 1 1 1 2 1 1
63 CROME INJ AMP 1 1 1 1 1 1 1 1 1 2 1 1
64 CYCLOVID 200 MG INJEKSI VIAL 2 1 1 1 1 1 1 1 1 1 1 1
65 DANOCRINE 200 MG CAPSUL CAP 2 1 1 1 1 1 1 1 1 1 1 1
66 ENYSTIN DROP FLS 2 1 1 1 1 1 1 1 1 1 1 1
67 INVICLOT INJEKSI VIAL 2 1 1 1 1 1 1 1 1 1 1 1
68 IVELIP 20% 100 CC BTL 2 1 1 1 1 1 1 1 1 1 1 1
69 KALITAKE 5G SACHET SACH 2 1 1 1 1 1 1 1 1 1 1 1
70 KENDARON INJEKSI AMP 2 1 1 1 1 1 1 1 1 1 1 1
71 KETOPROFEN 100 MG TAB TAB 2 1 1 1 1 1 1 1 1 1 1 1
72 LAXADIN 60 ML SYRUP BTL 2 1 1 1 1 1 1 1 1 1 1 1
73 LEVEMIR FLEXPEN VIAL 2 1 1 1 1 1 1 1 1 1 1 1
74 LOVENOX P F S 40 MG INJEKSI AMP 2 1 1 1 1 1 1 1 1 1 1 1
75 MEBO OINT TUBE 2 1 1 1 1 1 1 1 1 1 1 1
76 MELOXICAM 15 MG TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 1
77 MIKASIN 250 MG INJ VIAL 2 1 1 1 1 1 1 1 1 1 1 1
78 MUCOGARD SYR FLS 2 1 1 1 1 1 1 1 1 1 1 1
79 NOCID KAPLET 2 1 1 1 1 1 1 1 1 1 1 1
80 NUTRIVISION CAPSULE 2 1 1 1 1 1 1 1 1 1 1 1
81 SALOFALK 250 CAPSUL CAP 2 1 1 1 1 1 1 1 1 1 1 1
82 SIMARC 2 TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 1
83 SOTATIC 10 MG TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 1
84 SPIRIVA 18 MCG REFILL (A) CAP 2 1 1 1 1 1 1 1 1 1 1 1
85 SYNTOCINON 1 ML INJEKSI AMP 2 1 1 1 1 1 1 1 1 1 1 1
LAMPIRAN 4

NO NAMA OBAT SATUAN User 1 User 2 User 3 User 4 User 5 User 6 User 7 User 8 User 9 User 10 User 11 User 12
86 TRAMADOL TABLET TAB 2 1 1 1 1 1 1 1 1 1 1 1
87 VITAMIN C 50 MG TAB 1 1 1 1 1 1 1 1 1 1 1 2
88 CALNIC PLUS SYR BTL 1 1 1 1 1 1 1 1 1 1 1 1
89 CEFIXIM 100MG CAP CAPSULE 1 1 1 1 1 1 1 1 1 1 1 1
90 CEFIROME INJ VIAL 1 1 1 1 1 1 1 1 1 1 1 1
91 CO AMOXYCLAVE 625MG TABLET TAB 1 1 1 1 1 1 1 1 1 1 1 1
92 CURCUMA TABLET (BLISTER) TAB 1 1 1 1 1 1 1 1 1 1 1 1
93 DEXTROMETHORPAN SYRUP 60 ML BTL 1 1 1 1 1 1 1 1 1 1 1 1
94 ECOSOL RL B BRAUN BOTOL 1 1 1 1 1 1 1 1 1 1 1 1
95 UNALIUM 5MG TABLET TAB 1 1 1 1 1 1 1 1 1 1 1 1
96 VELCHROME INJ AMP 1 1 1 1 1 1 1 1 1 1 1 1
97 VICCILLIN 1 GR INJEKSI AMP 1 1 1 1 1 1 1 1 1 1 1 1
98 ALINAMIN F INJEKSI AMP 1 1 1 1 1 1 1 1 1 1 1 1
99 AMINOPHYLLIN 200 MG TAB 1 1 1 1 1 1 1 1 1 1 1 1
LAMPIRAN 4

NO JUMLAH KOMULATIF % KOMULATIF KEL W3


NAMA OBAT

1 ANTI TETANUS SERUM 20.000 IU (ATS)


27 27 1,927194861 A 3

2 DUMIN 125 MG SUPPOS


20 47 3,35474661 A 3

3 DEPAKENE 250 MG SYRUP


19 66 4,710920771 A 3

4 DIAZEPAM 2 MG
18 84 5,995717345 A 3

5 NATRIUM KLORIDA 0,9% 500ML (OGB)


18 102 7,280513919 A 3

6 PHENOBARBITAL 30 MG
18 120 8,565310493 A 3

7 ASAM TRANEKSAMAT 500 MG


17 137 9,778729479 A 3

8 FARGOXIN INJ
17 154 10,99214847 A 3

9 CEPEZET 100MG TAB


16 170 12,13418986 A 3

10 FUROSEMIDA INJEKSI
16 186 13,27623126 A 3

11 METRONIDAZOLE 500MG
16 202 14,41827266 A 3

12 PARASETAMOL SYRUP
16 218 15,56031406 A 3

13 PHENITOIN 100MG CAP


16 234 16,70235546 A 3

14 PIRACETAM 800 TABLET


16 250 17,84439686 A 3

15 RIFAMPICIN 300MG CAPSULE


16 266 18,98643826 A 3

16 RIVANOL KOMPRES
16 282 20,12847966 A 3

17 XYLOCAIN 2% PDF INJEKSI 20 ML


16 298 21,27052106 A 3

18 BISOPROLOL TABLET
15 313 22,34118487 A 3

19 CITICHOLIN 250 MG INJEKSI


15 328 23,41184868 A 3

20 DIMENHYDRINAT 50 MG TAB
15 343 24,48251249 A 3

21 DEXORUBICIN 10MG INJEKSI


15 358 25,5531763 A 3
LAMPIRAN 4

22 15 373 26,62384011 A 3
ETHAMBUTOL 500 MG TABLET

23 H2O2 3% TETES TELINGA 15 ML


15 388 27,69450393 A 3

24 IBUPROFEN 200 MG TABLET


15 403 28,76516774 A 3

25 ISONIAZIDE 300 MG (INH) TABLET


15 418 29,83583155 A 3

26 OTSU SALIN 3% ASKIN


15 433 30,90649536 A 3

27 ACYCLOVIR 200 MG
15 448 31,97715917 A 3

28 AMBROXOL SYRUP 15 MG
15 463 33,04782298 A 3

29 BETAMESON CREAM
14 477 34,04710921 A 3

30 CAPTOPRIL 25 MG TABLET
14 491 35,04639543 A 3

31 CARBOL GLYCERIN TETES TELINGA


14 505 36,04568166 A 3

32 CATAPRES INJEKSI
14 519 37,04496788 A 3

33 CENDO LYTEERS EYE DROP 15 ML


14 533 38,0442541 A 3

34 CENDO TROPIN 0,5% EYE DROP 5 ML


14 547 39,04354033 A 3

35 ELOXATIN 100 INJ


14 561 40,04282655 A 3

36 FERRIPROX FCT 500 MG TAB


14 575 41,04211278 A 3

37 FLUCONAZOLE INF
14 589 42,041399 A 3

38 GAMARAAS INJEKSI
14 603 43,04068522 A 3

39 GLIBENCLAMIDE TABLET
14 617 44,03997145 A 3

40 GLUCOBAY 50MG TABLET


14 631 45,03925767 A 3

41 HARNAL 0,2 MG CAPSULE


14 645 46,0385439 A 3

42 HYDROCHLOROTHIAZIDE (HCT) 25MG


14 659 47,03783012 A 3

43 KSR 600MG TAB ASKIN


14 673 48,03711635 A 3
LAMPIRAN 4

44 14 687 49,03640257 A 3
METHYL ERGOMETRINE

45 NEUROBION 5000 INJEKSI


14 701 50,03568879 A 3

46 OMEPRAZOLE CAPSULE SANBE/AMS


14 715 51,03497502 A 3

47 OXALIPLATIN MEDAC 100MG INJ


14 729 52,03426124 A 3

48 PREDNISON 5MG TABLET


14 743 53,03354747 A 3

49 PROFIBRAT 300 KAP


14 757 54,03283369 A 3

50 RANITIDIN 150 MG TABLET


14 771 55,03211991 A 3

51 STREPTOMYCIN 1G INJEKSI
14 785 56,03140614 A 3

52 THEOPHILLIN 150MG CAP


14 799 57,03069236 A 3

53 VITKA INFANT
14 813 58,02997859 A 3

54 ALPRAZOLAM 0,5 TABLET


14 827 59,02926481 A 3

55 AMOXISILLIN DRY SYRUP


14 841 60,02855103 A 3

56 AVASTIN 100MG/4ML INJ


13 854 60,95645967 A 3

57 BECOM Z. TABLET
13 867 61,88436831 A 3

58 BREXEL 20 MG/VIAL
13 880 62,81227695 A 3

59 CEFOTAXIM I GR INJEKSI
13 893 63,74018558 A 3

60 CHLORAMPHENICOL 250MG CAPSUL


13 906 64,66809422 A 3

61 CIPROFLOXACINE 500 MG
13 919 65,59600286 A 3

62 CLINIMIC INFUS
13 932 66,52391149 A 3

63 CROME INJ
13 945 67,45182013 A 3

64 CYCLOVID 200 MG INJEKSI


13 958 68,37972877 A 3

65 DANOCRINE 200 MG CAPSUL


13 971 69,3076374 A 3
LAMPIRAN 4

66 13 984 70,23554604 B 2
ENYSTIN DROP

67 INVICLOT INJEKSI
13 997 71,16345468 B 2

68 IVELIP 20% 100 CC


13 1010 72,09136331 B 2

69 KALITAKE 5G SACHET
13 1023 73,01927195 B 2

70 KENDARON INJEKSI
13 1036 73,94718059 B 2

71 KETOPROFEN 100 MG TAB


13 1049 74,87508922 B 2

72 LAXADIN 60 ML SYRUP
13 1062 75,80299786 B 2

73 LEVEMIR FLEXPEN
13 1075 76,7309065 B 2

74 LOVENOX P F S 40 MG INJEKSI
13 1088 77,65881513 B 2

75 MEBO OINT
13 1101 78,58672377 B 2

76 MELOXICAM 15 MG TABLET
13 1114 79,51463241 B 2

77 MIKASIN 250 MG INJ


13 1127 80,44254104 B 2

78 MUCOGARD SYR
13 1140 81,37044968 B 2

79 NOCID
13 1153 82,29835832 B 2

80 NUTRIVISION
13 1166 83,22626695 B 2

81 SALOFALK 250 CAPSUL


13 1179 84,15417559 B 2

82 SIMARC 2 TABLET
13 1192 85,08208423 B 2

83 SOTATIC 10 MG TABLET
13 1205 86,00999286 B 2

84 SPIRIVA 18 MCG REFILL (A)


13 1218 86,9379015 B 2

85 SYNTOCINON 1 ML INJEKSI
13 1231 87,86581014 B 2

86 TRAMADOL TABLET
13 1244 88,79371877 B 2

87 VITAMIN C 50 MG
13 1257 89,72162741 B 2
LAMPIRAN 4

88 12 1269 90,57815846 C 1
CALNIC PLUS SYR

89 CEFIXIM 100MG CAP


12 1281 91,43468951 C 1

90 CEFIROME INJ
12 1293 92,29122056 C 1

91 CO AMOXYCLAVE 625MG TABLET


12 1305 93,14775161 C 1

92 CURCUMA TABLET (BLISTER)


12 1317 94,00428266 C 1

93 DEXTROMETHORPAN SYRUP 60 ML
12 1329 94,8608137 C 1

94 ECOSOL RL B BRAUN
12 1341 95,71734475 C 1

95 UNALIUM 5MG TABLET


12 1353 96,5738758 C 1

96 VELCHROME INJ
12 1365 97,43040685 C 1

97 VICCILLIN 1 GR INJEKSI
12 1377 98,2869379 C 1

98 ALINAMIN F INJEKSI
12 1389 99,14346895 C 1

99 AMINOPHYLLIN 200 MG
12 1401 100 C 1
LAMPIRAN 5

NO NAMA OBAT SATUAN W1 (Nilai Pemakaian) W2 (Nilai Invetasi) W3 (Nilai Kritis) NIK (W1+W2+2W3) KEL
1 FERRIPROX FCT 500 MG TAB TAB 3 3 3 12 A
2 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 3 3 3 12 A
3 CAPTOPRIL 25 MG TABLET TAB 3 1 3 10 A
4 CHLORAMPHENICOL 250MG CAPSUL CAP 3 1 3 10 A
5 CIPROFLOXACINE 500 MG TAB 3 1 3 10 A
6 FUROSEMIDA INJEKSI AMP 2 2 3 10 A
7 GAMARAAS INJEKSI VIAL 1 3 3 10 A
8 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 3 1 3 10 A
9 ISONIAZIDE 300 MG (INH) TABLET TAB 3 1 3 10 A
10 METRONIDAZOLE 500MG TAB 3 1 3 10 A
11 OMEPRAZOLE CAPSULE SANBE/AMS CAP 3 1 3 10 A
12 OXALIPLATIN MEDAC 100MG INJ VIAL 1 3 3 10 A
13 PREDNISON 5MG TABLET TAB 3 1 3 10 A
14 RANITIDIN 150 MG TABLET TAB 3 1 3 10 A
15 ACYCLOVIR 200 MG TAB 3 1 3 10 A
16 ANTI TETANUS SERUM 20.000 IU (ATS) VIAL 1 2 3 9 B
17 ASAM TRANEKSAMAT 500 MG TAB 2 1 3 9 B
18 AVASTIN 100MG/4ML INJ VIAL 1 2 3 9 B
19 BISOPROLOL TABLET TAB 2 1 3 9 B
20 CEFOTAXIM I GR INJEKSI VIAL 1 2 3 9 B
21 CITICHOLIN 250 MG INJEKSI AMP 1 2 3 9 B
22 CLINIMIC INFUS BTL 1 2 3 9 B
23 CYCLOVID 200 MG INJEKSI VIAL 1 2 3 9 B
24 DEPAKENE 250 MG SYRUP BTL 1 2 3 9 B
25 DIAZEPAM 2 MG TAB 2 1 3 9 B
26 ELOXATIN 100 INJ VIAL 1 2 3 9 B
27 ETHAMBUTOL 500 MG TABLET TAB 2 1 3 9 B
28 FLUCONAZOLE INF FLS 1 2 3 9 B
29 GLIBENCLAMIDE TABLET TAB 2 1 3 9 B
30 GLUCOBAY 50MG TABLET TAB 2 1 3 9 B
31 PHENITOIN 100MG CAP CAP 2 1 3 9 B
32 RIFAMPICIN 300MG CAPSULE CAP 2 1 3 9 B
33 ALPRAZOLAM 0,5 TABLET TAB 2 1 3 9 B
34 BECOM Z. TABLET TAB 1 1 3 8 B
35 BETAMESON CREAM TUBE 1 1 3 8 B
LAMPIRAN 5
NO NAMA OBAT SATUAN W1 (Nilai Pemakaian) W2 (Nilai Invetasi) W3 (Nilai Kritis) NIK (W1+W2+2W3) KEL
36 BREXEL 20 MG/VIAL VIAL 1 1 3 8 B
37 CARBOL GLYCERIN TETES TELINGA BTL 1 1 3 8 B
38 CATAPRES INJEKSI AMP 1 1 3 8 B
39 CENDO LYTEERS EYE DROP 15 ML BTL 1 1 3 8 B
40 CENDO TROPIN 0,5% EYE DROP 5 ML BTL 1 1 3 8 B
41 CEPEZET 100MG TAB TAB 1 1 3 8 B
42 CROME INJ AMP 1 1 3 8 B
43 DANOCRINE 200 MG CAPSUL CAP 1 1 3 8 B
44 DIMENHYDRINAT 50 MG TAB TAB 1 1 3 8 B
45 DEXORUBICIN 10MG INJEKSI VIAL 1 1 3 8 B
46 DUMIN 125 MG SUPPOS SUPP 1 1 3 8 B
47 ECOSOL RL B BRAUN BOTOL 3 3 1 8 B
48 FARGOXIN INJ AMP 1 1 3 8 B
49 H2O2 3% TETES TELINGA 15 ML BTL 1 1 3 8 B
50 HARNAL 0,2 MG CAPSULE CAP 1 1 3 8 B
51 IBUPROFEN 200 MG TABLET TAB 1 1 3 8 B
52 KSR 600MG TAB ASKIN TAB 1 1 3 8 B
53 METHYL ERGOMETRINE TAB 1 1 3 8 B
54 NEUROBION 5000 INJEKSI AMP 1 1 3 8 B
55 OTSU SALIN 3% ASKIN BTL 1 1 3 8 B
56 PARASETAMOL SYRUP BTL 1 1 3 8 B
57 PHENOBARBITAL 30 MG BTL 1 1 3 8 B
58 PIRACETAM 800 TABLET TAB 1 1 3 8 B
59 PROFIBRAT 300 KAP CAPSULE 1 1 3 8 B
60 RIVANOL KOMPRES BTL 1 1 3 8 B
61 STREPTOMYCIN 1G INJEKSI VIAL 1 1 3 8 B
62 THEOPHILLIN 150MG CAP CAP 1 1 3 8 B
63 VITAMIN C 50 MG TAB 3 1 2 8 B
64 VITKA INFANT AMP 1 1 3 8 B
65 XYLOCAIN 2% PDF INJEKSI 20 ML AMP 1 1 3 8 B
66 AMBROXOL SYRUP 15 MG BTL 1 1 3 8 B
67 AMOXISILLIN DRY SYRUP BTL 1 1 3 8 B
68 IVELIP 20% 100 CC BTL 1 2 2 7 B
69 KETOPROFEN 100 MG TAB TAB 2 1 2 7 B
70 LAXADIN 60 ML SYRUP BTL 1 2 2 7 B
LAMPIRAN 5

NO NAMA OBAT SATUAN W1 (Nilai Pemakaian) W2 (Nilai Invetasi) W3 (Nilai Kritis) NIK (W1+W2+2W3) KEL
71 LEVEMIR FLEXPEN VIAL 1 2 2 7 B
72 MELOXICAM 15 MG TABLET TAB 2 1 2 7 B
73 MUCOGARD SYR FLS 1 2 2 7 B
74 SOTATIC 10 MG TABLET TAB 2 1 2 7 B
75 ENYSTIN DROP FLS 1 1 2 6 C
76 INVICLOT INJEKSI VIAL 1 1 2 6 C
77 KALITAKE 5G SACHET SACH 1 1 2 6 C
78 KENDARON INJEKSI AMP 1 1 2 6 C
79 LOVENOX P F S 40 MG INJEKSI AMP 1 1 2 6 C
80 MEBO OINT TUBE 1 1 2 6 C
81 MIKASIN 250 MG INJ VIAL 1 1 2 6 C
82 NOCID KAPLET 1 1 2 6 C
83 NUTRIVISION CAPSULE 1 1 2 6 C
84 SALOFALK 250 CAPSUL CAP 1 1 2 6 C
85 SIMARC 2 TABLET TAB 1 1 2 6 C
86 SPIRIVA 18 MCG REFILL (A) CAP 1 1 2 6 C
87 SYNTOCINON 1 ML INJEKSI AMP 1 1 2 6 C
88 TRAMADOL TABLET TAB 1 1 2 6 C
89 CEFIXIM 100MG CAP CAPSULE 2 1 1 5 C
90 CEFIROME INJ VIAL 1 2 1 5 C
91 CO AMOXYCLAVE 625MG TABLET TAB 1 2 1 5 C
92 CURCUMA TABLET (BLISTER) TAB 2 1 1 5 C
93 VICCILLIN 1 GR INJEKSI AMP 1 2 1 5 C
94 AMINOPHYLLIN 200 MG TAB 2 1 1 5 C
95 CALNIC PLUS SYR BTL 1 1 1 4 C
96 DEXTROMETHORPAN SYRUP 60 ML BTL 1 1 1 4 C
97 UNALIUM 5MG TABLET TAB 1 1 1 4 C
98 VELCHROME INJ AMP 1 1 1 4 C
99 ALINAMIN F INJEKSI AMP 1 1 1 4 C
LAMPIRAN 6

WAKTU WAKTU LEAD LIFE WAKTU JUMLAH KENAIKAN JUMLAH


NO NAMA OBAT PAKAI KOSONG TIME SAFING RENCANA PAKAI PASIEN KEBUTUHAN
1 FERRIPROX FCT 500 MG TAB 31 10 7 7 55 9000 1.1 17564
2 NATRIUM KLORIDA 0,9% 500ML (OGB) 31 7 7 7 52 600 1.1 1107
3 CAPTOPRIL 25 MG TABLET 31 12 7 7 57 2200 1.1 4449
4 CHLORAMPHENICOL 250MG CAPSUL 31 0 7 7 45 6720 1.1 10730
5 CIPROFLOXACINE 500 MG 31 0 7 7 45 6400 1.1 9740
6 FUROSEMIDA INJEKSI 31 5 7 7 50 3275 1.1 5810
7 GAMARAAS INJEKSI 31 1 7 7 46 2000 1.1 3264
8 HYDROCHLOROTHIAZIDE (HCT) 25MG 31 30 7 7 75 8000 1.1 21290
9 ISONIAZIDE 300 MG (INH) TABLET 31 0 7 7 45 10 1.1 15
10 METRONIDAZOLE 500MG 31 0 7 7 45 1300 1.1 2075
11 OMEPRAZOLE CAPSULE SANBE/AMS 31 6 7 7 51 24600 1.1 44518
12 OXALIPLATIN MEDAC 100MG INJ 31 29 7 7 74 0 1.1 0
13 PREDNISON 5MG TABLET 31 0 7 7 45 5200 1.1 8303
14 RANITIDIN 150 MG TABLET 31 7 7 7 52 11800 1.1 21772
15 ACYCLOVIR 200 MG 31 30 7 7 75 3148 1.1 8377
WAKTU WAKTU LEAD LIFE WAKTU JUMLAH KENAIKAN JUMLAH
NO NAMA OBAT PAKAI KOSONG TIME SAFING RENCANA PAKAI PASIEN KEBUTUHAN
1 FERRIPROX FCT 500 MG TAB 28 4 7 7 46 9300 1.1 16806
2 NATRIUM KLORIDA 0,9% 500ML (OGB) 28 1 7 7 43 1600 1.1 2702
3 CAPTOPRIL 25 MG TABLET 28 2 7 7 44 4900 1.1 8470
4 CHLORAMPHENICOL 250MG CAPSUL 28 5 7 7 47 6170 1.1 11392
5 CIPROFLOXACINE 500 MG 28 0 7 7 42 8400 1.1 13860
6 FUROSEMIDA INJEKSI 28 7 7 7 49 3060 1.1 5890
7 GAMARAAS INJEKSI 28 8 7 7 50 110 1.1 216
8 HYDROCHLOROTHIAZIDE (HCT) 25MG 28 26 7 7 70 1980 1.1 5445
9 ISONIAZIDE 300 MG (INH) TABLET 28 0 7 7 42 10 1.1 16
10 METRONIDAZOLE 500MG 28 0 7 7 42 1900 1.1 3135
11 OMEPRAZOLE CAPSULE SANBE/AMS 28 0 7 7 42 23090 1.1 38098
12 OXALIPLATIN MEDAC 100MG INJ 28 26 7 7 63 0 1.1 26
13 PREDNISON 5MG TABLET 28 0 7 7 42 5100 1.1 8415
14 RANITIDIN 150 MG TABLET 28 0 7 7 42 11800 1.1 19470
15 ACYCLOVIR 200 MG 28 26 7 7 68 500 1.1 1335
WAKTU WAKTU LEAD WAKTU JUMLAH KENAIKAN JUMLAH
NO NAMA OBAT PAKAI KOSONG TIME LIFE SAFING RENCANA PAKAI PASIEN KEBUTUHAN
1 FERRIPROX FCT 500 MG TAB 31 0 7 7 45 10700 1.1 17085
2 NATRIUM KLORIDA 0,9% 500ML (OGB) 31 4 7 7 49 1600 1.1 2781
3 CAPTOPRIL 25 MG TABLET 31 3 7 7 48 3300 1.1 5620
4 CHLORAMPHENICOL 250MG CAPSUL 31 1 7 7 46 6730 1.1 10985
5 CIPROFLOXACINE 500 MG 31 0 7 7 45 5400 1.1 8622
6 FUROSEMIDA INJEKSI 31 0 7 7 45 3925 1.1 6267
7 GAMARAAS INJEKSI 31 3 7 7 48 270 1.1 459
8 HYDROCHLOROTHIAZIDE (HCT) 25MG 31 30 7 7 75 1020 1.1 2714
9 ISONIAZIDE 300 MG (INH) TABLET 31 0 7 7 45 30 1.1 47
10 METRONIDAZOLE 500MG 31 0 7 7 45 2400 1.1 3832
11 OMEPRAZOLE CAPSULE SANBE/AMS 31 0 7 7 45 11920 1.1 19033
12 OXALIPLATIN MEDAC 100MG INJ 31 29 7 7 74 0 1.1 26
13 PREDNISON 5MG TABLET 31 0 7 7 45 4700 1.1 7504
14 RANITIDIN 150 MG TABLET 31 0 7 7 45 10100 1.1 16127
15 ACYCLOVIR 200 MG 31 30 7 7 75 50 1.1 133
LAMPIRAN 7

NO NAMA OBAT SATUAN JUMLAH KEBUTUHAN PERENCANAAN IFRS KET


1 FERRIPROX FCT 500 MG TAB TAB 17564 9000 TS
2 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 1107 600 TS
3 CAPTOPRIL 25 MG TABLET TAB 4449 2200 TS
4 CHLORAMPHENICOL 250MG CAPSUL CAP 10730 6720 TS
5 CIPROFLOXACINE 500 MG TAB 9740 6400 TS
6 FUROSEMIDA INJEKSI AMP 5810 3275 TS
7 GAMARAAS INJEKSI VIAL 3264 2000 TS
8 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 21290 8000 TS
9 ISONIAZIDE 300 MG (INH) TABLET TAB 15 10 TS
10 METRONIDAZOLE 500MG TAB 2075 1300 TS
11 OMEPRAZOLE CAPSULE SANBE/AMS CAP 44518 24600 TS
12 OXALIPLATIN MEDAC 100MG INJ VIAL 0 0 S
13 PREDNISON 5MG TABLET TAB 8303 5200 TS
14 RANITIDIN 150 MG TABLET TAB 21772 11800 TS
15 ACYCLOVIR 200 MG TAB 8377 3148 TS
NO NAMA OBAT SATUAN JUMLAH KEBUTUHAN PERENCANAAN IFRS KET
1 FERRIPROX FCT 500 MG TAB TAB 16806 9300 TS
2 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 2702 1600 TS
3 CAPTOPRIL 25 MG TABLET TAB 8470 4900 TS
4 CHLORAMPHENICOL 250MG CAPSUL CAP 11392 6170 TS
5 CIPROFLOXACINE 500 MG TAB 13860 8400 TS
6 FUROSEMIDA INJEKSI AMP 5890 3060 TS
7 GAMARAAS INJEKSI VIAL 216 110 TS
8 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 5445 1980 TS
9 ISONIAZIDE 300 MG (INH) TABLET TAB 16 10 TS
10 METRONIDAZOLE 500MG TAB 3135 1900 TS
11 OMEPRAZOLE CAPSULE SANBE/AMS CAP 38098 23090 TS
12 OXALIPLATIN MEDAC 100MG INJ VIAL 26 0 TS
13 PREDNISON 5MG TABLET TAB 8415 5100 TS
14 RANITIDIN 150 MG TABLET TAB 19470 11800 TS
15 ACYCLOVIR 200 MG TAB 1335 500 TS
NO NAMA OBAT SATUAN JUMLAH KEBUTUHAN PERENCANAAN IFRS KET
1 FERRIPROX FCT 500 MG TAB TAB 17085 10700 TS
2 NATRIUM KLORIDA 0,9% 500ML (OGB) BTL 2781 1600 TS
3 CAPTOPRIL 25 MG TABLET TAB 5620 3300 TS
4 CHLORAMPHENICOL 250MG CAPSUL CAP 10985 6730 TS
5 CIPROFLOXACINE 500 MG TAB 8622 5400 TS
6 FUROSEMIDA INJEKSI AMP 6267 3925 TS
7 GAMARAAS INJEKSI VIAL 459 270 TS
8 HYDROCHLOROTHIAZIDE (HCT) 25MG TAB 2714 1020 TS
9 ISONIAZIDE 300 MG (INH) TABLET TAB 47 30 TS
10 METRONIDAZOLE 500MG TAB 3832 2400 TS
11 OMEPRAZOLE CAPSULE SANBE/AMS CAP 19033 11920 TS
12 OXALIPLATIN MEDAC 100MG INJ VIAL 26 0 TS
13 PREDNISON 5MG TABLET TAB 7504 4700 TS
14 RANITIDIN 150 MG TABLET TAB 16127 10100 TS
15 ACYCLOVIR 200 MG TAB 133 50 TS