PERENCANAAN PENGADAAN PERBEKALAN FARMASI RSU KARSA HUSADA TAHUN 2020

KODE PERENCANAAN : 00 /PRCN-GN/008/102.6/2020 DIKIRIM FARMASI :

BULAN : AGUSTUS DITERIMA PENGADAAN :
TAHUN : 2020 TGL DITERIMA :
JENIS PERBEKALAN : OBAT PATEN TTD PENERIMA :

No Nama Obat Harga Stok Awal Juli Pemasukan Juli Jumlah Stok Keluar Juli Stok Akhir Juli Sisa Gudang Rata-rata Usulan Agustus Total Keterangan
1 Bamgetol 1,980 1,629 - 1,629 1,357 272 - 2,450 2,500 4,950,000
2 Benoson N cream 20,700 3 - 3 2 1 - 2 5 103,499
3 Cendo Hervis Salap mata 38,404 2 - 2 1 1 - 1 5 192,019
4 Cendo Mydriatyl 1 % 39,971 3 - 3 3 - - 6 6 239,828
5 Cendo Tropin eye drop 1 % 13,063 9 - 9 9 - - 9 9 117,563
6 Dopamet tablet 946 14 - 14 13 1 - 13 100 94,601
7 Dulcolax Supp Paed 5mg 6,000 11 - 11 5 6 - 15 6 36,000
8 Durogesic Pacth 12,5 mcg 108,454 6 - 6 4 2 - 4 5 542,270
9 Fleet Enema 35,750 37 - 37 21 16 9 21 10 357,500
10 Gelafusal infus 145,015 35 - 35 19 16 3 25 22 3,190,330
11 Harnal Ocas 5,115 3,444 - 3,444 1,303 2,141 1,230 1,800 600 3,069,000
12 Herbesser inj 154,400 71 - 71 61 10 - 20 10 1,544,000
13 Hexymer tab 2mg 424 884 500 1,384 1,028 356 200 1,500 1,200 508,200
14 Hyaloph tts mata 60,308 17 - 17 15 2 - 15 15 904,613
15 Isprinol sirup 68,063 2 - 2 2 - - 2 5 340,313
16 KTM 100 203,775 7 - 7 6 1 - 6 6 1,222,650
17 Meptin Mini 2,830 192 - 192 164 28 - 400 400 1,132,120
18 Miloz inj 5 mg 4,400 467 - 467 200 267 90 400 400 1,760,000 COVID
19 Miniaspi 80 mg 251 23,369 - 23,369 8,398 14,971 7,300 10,000 2,000 501,930
20 Neurosanbe Inj 5,867 96 - 96 42 54 - 30 30 175,997
21 Nitrokaf Retard kaps 2,5mg 1,560 10 - 10 10 - - 300 300 467,999
22 Patral tablet 7,700 4 - 4 - 4 - 30 30 231,000
23 Pehacain inj 3,113 241 - 241 123 118 69 120 40 124,522
24 Pranza inj 40mg 142,120 30 - 30 25 5 - 10 10 1,421,200
25 Prenamia 1,282 2,191 - 2,191 1,581 610 300 1,500 1,000 1,281,638
26 Prorenal tablet 6,765 250 - 250 249 1 - 300 400 2,706,000
27 Pumpisel inj 75,516 5 - 5 - 5 10 10 755,159
28 Seretide diskus 100 109,008 10 - 10 5 5 2 5 5 545,039
29 Suprafenid supp 2,380 33 - 33 14 19 - 55 60 142,798
30 Tradosik Inj 21,514 93 - 93 61 32 - 60 30 645,431
31 Valisanbe tab 5 mg 429 242 - 242 184 58 - 200 200 85,800
32 VIP Albumin KAP 6,270 4,322 - 4,322 2,260 2,062 1,710 2,000 300 1,881,000 COVID
33 Vip Albumin plus 62,700 20 - 20 18 2 - 18 18 1,128,600
No Nama Obat Harga Stok Awal Juli Pemasukan Juli Jumlah Stok Keluar Juli Stok Akhir Juli Sisa Gudang Rata-rata Usulan Agustus Total Keterangan
34 Patizra Inj 10 mg/ml 3,836,500 2 - 2 - 2 - 2 7,672,999
35 P. Pred Tetes Mata 41,023 11 - 11 6 5 2 6 7 287,162
36 Hyloquin tab 200 mg 10,120 572 - 572 320 252 - 400 400 4,048,000 COVID
37 Heparinol inj 44,000 10 180 190 108 82 30 750 750 33,000,000 COVID
38 Infimycin 87,000 - - - - - - 300 300 26,100,000 COVID
39 Precedex 159,350 - - - - - - 10 10 1,593,500 COVID
40 Roculax 71,500 - - - - - - 100 100 7,150,000 COVID
TOTAL 112,250,278

Mengetahui, Kepala Instalasi Farmasi

Kepala Sie Pelayanan Medis

YETI WAHYUNI, S.Farm., Apt.

dr. FERDINANDUS STEVANUS KAKIAY, Sp.PD NIP. 19700528 199203 2 003
NIP. 19750225 200312 10009
Menyetujui,
Direktur Rumah Sakit Karsa Husada

dr. TRIES ANGGRAINI, M.Kes

NIP. 19640620 199002 20001
rata-rata depo 6 bln terakhir

1,058
0
1
2
2
77
15
3
12
3
1,096
1
189
6
10
5
235
83
8,608
66
239
1
57
8
965
208
15
4
28
31
133
899
49
 0
2
105
 PERENCANAAN PENGADAAN PERBEKALAN FARMASI RSU KARSA HUSADA TAHUN 2020

KODE PERENCANAAN : 00 /PRCN-GN/008/102.6/2020 DIKIRIM FARMASI :

BULAN : AGUSTUS DITERIMA PENGADAAN :
TAHUN : 2020 TGL DITERIMA :
JENIS PERBEKALAN : OBAT GENERIK TTD PENERIMA :

No Nama Obat Generik Harga Stok Awal Juli Pemasukan Juli Jumlah Stok Keluar Juli Stok Akhir Juli Sisa Gudang Rata-rata Usulan Agustus Total Keterangan
1 Atropin Sulfat inj 2,000 25 100 125 95 30 - 80 100 200,000
2 Furosemid injeksi i.v./i.m. 10 mg/ml 1,333 7,211 - 7,211 2,557 4,654 4,175 5,000 500 666,500 COVID
3 Kalsium Laktat (Kalk) tab 500 mg 182 3,905 - 3,905 2,026 1,879 - 2,000 200 36,300
4 Klorfeniramin maleat (CTM) 73 577 - 577 462 115 - 500 400 29,332
5 Levofloksasin inf 5 mg/mL 19,205 490 - 490 345 145 24 350 200 3,840,933 COVID
6 Morfin HCL inj 10 mg/ml 34,050 184 - 184 61 123 20 100 100 3,404,995 COVID
7 Na Cl 0,9% 1000 ml 26,300 1,061 - 1,061 406 655 605 800 160 4,207,984
8 Nacl 0,9% 500 ml 6,840 3,368 2,200 5,568 4,321 1,247 914 4,500 3,000 20,519,400 COVID
9 Nacl 100 ml 9,350 219 1,100 1,319 459 860 660 700 60 561,000 COVID
10 Parasetamol infus 12,401 467 - 467 323 144 42 430 500 6,200,700 COVID
11 Rifampisin tablet/kaplet 600 mg 2,375 250 - 250 135 115 - 100 100 237,508
12 Setirizin tablet 10 mg 126 3,322 - 3,322 1,198 2,124 1,400 1,700 300 37,799
13 Spironolakton tablet 100 mg 575 32 - 32 32 - - 100 200 115,000
14 Vitamin B Kompleks tablet 144 5,382 - 5,382 3,867 1,515 300 4,000 2,500 359,975
15 Natrium Bikarbonat tab 500 mg 250 - 100 100 100 - - 200 200 50,000
TOTAL 40,467,426

Mengetahui,
Kepala Sie Pelayanan Medis Kepala Instalasi Farmasi

dr. FERDINANDUS STEVANUS KAKIAY, Sp.PD YETI WAHYUNI, S.Farm., Apt.

NIP. 19750225 200312 10009 NIP. 19700528 199203 2 003
Menyetujui,
Direktur Rumah Sakit Karsa Husada

dr. TRIES ANGGRAINI, M.Kes

NIP. 19640620 199002 20001
rata-rata depo 6 bln terakhir

101
2,016
1,590
1,727
277
22
197
2,875
317
427
63
858
1,310
2,462
 PERENCANAAN PENGADAAN PERBEKALAN FARMASI RSU KARSA HUSADA TAHUN 2020

KODE PERENCANAAN : 00 /PRCN-AK/008/102.6/2020 DIKIRIM FARMASI :

BULAN : AGUSTUS DITERIMA PENGADAAN :
TAHUN : 2020 TGL DITERIMA :
JENIS PERBEKALAN : ALKES TTD PENERIMA :

No Nama Alat Kesehatan Harga Stok Awal Juli Pemasukan Juli Jumlah Stok Keluar Juli Stok akhir Juli Sisa Gudang Rata-rata Usulan Agustus Total Keterangan
1 Apron Plastik 75x135 cm 2,526 2,555 500 3,055 2,384 671 582 3,000 500 1,262,800 COVID
2 Closed Suction 12 Fr 385,770 12 - 12 11 1 1 11 10 3,857,700 COVID
3 Colostomy bag 2,310 22 - 22 10 12 - 10 30 69,300
4 CSSD-Kasa Hydrofil DRC 36*80 108,500 62 - 62 32 30 30 60 30 3,255,000
5 Cydex Opa 409,853 2 - 2 2 - - 2 2 819,707
6 E Care Skin Cleans Handwash 19,318 50 - 50 30 20 - 30 20 386,353
7 ETT Non King 6.0 352,000 11 - 11 6 5 - 6 1 352,000 COVID
8 ETT w/o Cuff 2,5 49,500 5 - 5 5 - - 5 5 247,500 COVID
9 ETT w/o Cuff 4 49,500 3 - 3 3 - - 3 3 148,500 COVID
10 Hand Schoen Steril 6,5 6,595 1,613 - 1,613 1,202 411 10 1,500 2,000 13,189,000 COVID
11 Hand Schoen Steril 7 6,595 706 500 1,206 654 552 145 1,300 1,800 11,870,100 COVID
12 Hand Schoen Steril 7,5 8,888 839 1,000 1,839 1,172 667 420 1,000 700 6,221,600 COVID
13 Hand Schoen non steril L 712 150 3,500 3,650 2,287 1,363 1,363 2,000 1,000 712,400 COVID
14 Hand Schoen non steril M 955 2,409 2,000 4,409 2,560 1,849 1,100 8,000 8,000 7,640,000 COVID
15 Hand Schoen non steril S 712 6,400 500 6,900 6,370 530 - 5,000 5,000 3,562,000 COVID
16 Hand Schoen non steril XS 712 3,869 - 3,869 3,212 657 - 1,700 1,500 1,068,600 COVID
17 Hand Schoen panjang / Gynaecologi non steril 19,360 312 442 754 259 495 443 250 250 4,840,000 COVID
18 HD-Hemodialisa Set BPJS Lengkap 482,900 - 170 170 170 - - 360 360 173,844,000
19 HD-Hemodialisa Set BPJS ReUse 299,200 - 240 240 240 - - 240 240 71,808,000
20 Jackson Rees anak 330,000 8 - 8 5 3 - 5 3 990,000 COVID
21 Needle SE ME 21 99,739 16 - 16 10 6 6 10 10 997,392
22 Nurse cap 408 3,524 7,300 10,824 5,138 5,686 5,113 5,500 500 204,050 COVID
23 Opsite Post Op 25 x 10 cm 39,710 67 - 67 41 26 20 41 20 794,200
24 PD Crepe 15 cm 52,800 5 - 5 5 - - 5 10 528,000
25 Plain 0 32,083 12 - 12 12 - - 12 12 385,000
26 BENANG - Plain 2.0 Demetech 26,667 29 - 29 23 6 - 12 24 640,000
27 Polyvac 18 92,400 1 - 1 1 - - 2 2 184,800
28 Postofix 25 29,381 28 - 28 26 2 - 26 30 881,417
29 Septalkan 142,000 35 - 35 21 14 14 21 20 2,840,000 COVID
30 Suction catheter NO 10 3,597 33 - 33 26 7 - 26 60 215,820
31 Suction catheter NO 12 3,597 27 - 27 24 3 - 24 30 107,910 COVID
32 Suction catheter NO 14 3,597 34 - 34 21 13 - 21 20 71,940 COVID
33 T- Dio 3/0 137,500 14 36 50 27 23 12 27 12 1,650,000
No Nama Alat Kesehatan Harga Stok Awal Juli Pemasukan Juli Jumlah Stok Keluar Juli Stok akhir Juli Sisa Gudang Rata-rata Usulan Agustus Total Keterangan
34 Wing Needle Terumo 27 13,228 23 - 23 18 5 - 18 20 264,550
35 Breathing Coaxial w/ elbow conection 1,097,250 12 - 12 12 - - 12 5 5,486,250 COVID
36 Certofix Trio V720 712,400 2 - 2 - 2 - 5 5 3,562,000 COVID
37 Chloretyl Spray 100 ml 168,300 2 - 2 2 - - 2 4 673,200
38 HD Set Pre & Post Jatim New 22,000 200 - 200 200 - - 600 600 13,200,000
39 CSSD-Bowie & Dick Test Pack 140,250 53 - 53 45 8 8 40 35 4,908,750
40 CSSD-Indicator Steam Type 4 1,265,000 - - - - - - - 2 2,530,000
41 Steriflo 36,000 48 - 48 46 2 - 46 60 2,160,000
42 CSSD-Adhesive tape 112,200 10 - 10 8 2 2 5 5 561,000
43 PDT Kit 7mm Single Stage 3,993,000 1 - 1 - 1 - 1 1 3,993,000 COVID
44 BENANG - T-Vio 2-0 V66 88,000 19 - 19 19 - - 20 24 2,112,000
45 CSSD-Reliance 120x120 923,175 - 1 1 1 - - 1 3 2,769,525
46 CSSD - BI for Steam (324-551) 981,750 - - - - - - 5 3 2,945,250
47 CSSD - Sklar Sheen Spray foam Autoclave 112,000 - - - - - - 1 1 112,000
48 Cover Shoes 2,310 - 750 750 530 220 - 550 400 924,000 COVID
49 CSSD - Thermal printing paperi (plasma) 112,000 - - - - - - 1 1 112,000
50 CSSD - sklar sheen (stain&rust galon) 112,000 - - - - - - 1 1 112,000
51 CSSD - therminal printing paper steam 112,000 - - - - - - 1 1 112,000
52 CSSD - recording paper for VSSV - B09w 112,000 - - - - - - 1 1 112,000
53 CSSD - indikator internal EO 1,200,000 - - - - - - 1 1 1,200,000
54 CSSD - indikator eksternal EO 1,200,000 - - - - - - 1 1 1,200,000
55 CSSD - indikator biologi EO 1,200,000 - - - - - - 2 2 2,400,000
56 CSSD - aesculap spray for sterilit 112,000 - - - - - - 1 1 112,000
57 CSSD - aesculap oil sterilit 112,000 - - - - - - 1 1 112,000
58 CSSD - Beliclean Washer GKE 112,000 - - - - - - 1 1 112,000
59 Hem-O-Lok ML 850,000 - - - - - - 1 1 850,000
60 Hem-O-Lok L 750,000 - - - - - - 1 1 750,000
61 Hem-O-Lok XL 1,017,000 - - - - - - 1 1 1,017,000
62 Covidien Valleylab Eletrosurgical 72,192 - - - - - - 2 2 144,384
367,430,613

Mengetahui, Kepala Instalasi Farmasi

Kepala Sie Pelayanan Medis

YETI WAHYUNI, S.Farm., Apt.

dr. FERDINANDUS STEVANUS KAKIAY, Sp.PD NIP. 19700528 199203 2 003
NIP. 19750225 200312 10009
Menyetujui,
Direktur Rumah Sakit Karsa Husada
No Nama Alat Kesehatan Harga Stok Awal Juli Pemasukan Juli Jumlah Stok Keluar Juli Stok akhir Juli Sisa Gudang Rata-rata Usulan Agustus Total Keterangan
dr. TRIES ANGGRAINI, M.Kes
NIP. 19640620 199002 20001
rata-rata depo 6 bln terakhir
888
1
15
26
2
15
37
1
1
592
531
408
1,367
5,022
5,167
1,670
157
150
237
1
1
1,992
46
11
6
17
0
3
17
40
18
10
24
rata-rata depo 6 bln terakhir
30
4
2
3
267
23
-
27
3
0
16
1
1
0