RENCANA KEBUTUHAN OBAT (RKO)

PUSKESMAS : SEPUTIH SURABAYA

TAHUN 2023

: LAMPUNG
KABUPATEN/ KOTA
TENGAH
PROPINSI : LAMPUNG
: SEPUTIH
PUSKESMAS
SURABAYA

JUMLAH PEMAKAIAN OBAT TAHUN 2022

TOTAL HARGA
PEMAKAIAN PEMAKAIAN
OBAT TAHUN RATA-RATA PER
TOTAL JUMLAH
HARGA 2022 BULAN
NO NAMA OBAT PEMAKAIAN OBAT
(SATUAN)
JAN FEB MAR APR MEI JUN JUL AGS SEP OKT NOV DES TAHUN 2019
(4x17) (17/ 8 BULAN)

1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

OBAT

1 Air Untuk Injeksi 25 ml 2,750 - - -

2 Air Untuk Injeksi 20 ml 2,000 2 22 27 182 233 466,000 29

3 Albendazol tablet 400 Mg 296 - - -

4 Albendazole Suspensi 200 mg/5ml 3,849 - - -

5 Alopurinol tablet 100 mg 105 354 295 899 210 206 74 285 585 2,908 305,340 364

6 Aminofillin injeksi 24 mg/ml 10 ml @ 30 amp 3,345 - - -

7 Aminofillin tablet 200 mg 95 - - -

8 Amitriptilin tablet 25 mg 167 - - -

9 Amlodipin tablet 10 mg 104 295 395 978 905 444 874 330 844 5,065 526,760 633

10 Amlodipin tablet 5 mg 78 605 1,255 1,255 541 465 2,995 647 270 8,033 626,574 1,004

11 Amoksillin kaplet 500 mg 233 1,549 33P7 1,781 1,887 2,063 1,818 1,253 3,029 13,380 3,117,540 1,673

12 Amoksillin kapsul 250 mg 195 - - -

13 Amoksillin sirup kering 125 mg /5ml 2,090 - - -

14 Amoksillin sirup kering forte 250 mg /5ml 3,400 20 28 59 5 11 48 171 581,400 21

15 Ampicilin Serbuk inj 1000mg 8,237 - - -

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg Magnesium
16 72 824 149 270 1,717 1,439 1,253 1,025 2,457 9,134 657,648 1,142
Hidroksida 200 mg
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg/5 ml, Magnesium
17 2,025 85 127 44 103 76 161 103 89 788 1,595,700 99
Hidroksida 200 mg/ 5 ml.

18 Anti Bakteri Basitrin 500 m/l + Polimiskin 10.000 iu/g (tube) 2,924 3 3 8,772 0
19 Antifungi DOEN Salep Kombinasi : Asam Benzoat 6 % Asam Salisilat 3 % 4,158 6 24 47 22 21 100 13 16 249 1,035,342 31
Antihemoroid, Kombinasi : bismut subgalat 150 mg heksaklorofen 2,5 mg lidocain 10 mg seng
20 3,167 12 26 184 222 703,074 28
oksida 120 mg
21 Antimigren Ergotamin tatrat 1mg+kofein50 mg 173 120 133 127 386 120 150 1,036 179,228 130

22 Asam Asetilsalisilat tablet 80 mg 114 200 200 5 125 530 60,420 66

23 Asam Askorbat (Vitamin C) tablet 250 mg 125 - - -

24 Asam Askorbat (Vitamin C) tablet 50 mg 105 - - -

25 Asam Folat 63 - - -

26 Asam Mefenamat tablet 500 mg 106 1,064 150 1,964 3,178 336,868 397

27 Asam Traneksamat Inj 50 mg/ml @ 10 amp-5 ml 2,445 - - -

28 Asiklovir crem 5 % 2,152 - - -

29 Asiklovir tablet 200 mg 249 200 200 49,800 25

30 Asiklovir tablet 400 mg 405 20 375 106 501 202,905 63

31 Atenolol tablet 50 mg 330 - - -

32 Atropin injeksi 0,25 mg / ml 1,672 - - -

33 Attapulgite 600 mg tablet ( NEW ANTIDES) 136 140 140 340 420 40 108 86 151 1,425 193,800 178

34 Betahistin tablet 6 mg 149 20 220 950 100 106 280 1,676 249,724 210

35 Betametason Krim 0,1 % Sebagai Valerat (SKIZONE) 3,388 22 38 22 64 35 76 13 40 310 1,050,280 39

36 Betametason Valerat Krim 0,1 % 1,340 - - -

37 Bisoprolol tablet 5 mg 330 100 100 33,000 13

38 Deksametason injeksi i.v./i.m. 5 mg/ml 2,002 2 43 41 45 40 154 325 650,650 41

39 Deksametason tablet 0,5 mg 154 172 172 26,488 22

40 Diazepam tablet 5 mg 103 170 45 182 76 34 120 115 742 76,426 93

41 Difenhidramin injeksi i.v./i.m. 10 mg/ml (HCl) 1,176 5 15 40 60 70,560 8

42 Digoksin 0,25 mg 105 - - -

43 Doksisiklin kapsul 100 mg 220 10 10 2,200 1

44 Domperidon suspensi 2,700 1 24 21 1 10 2 20 79 213,300 10

45 Domperidon tablet 10 mg 91 150 271 116 170 91 859 20 10 1,687 153,517 211

46 Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml (0,1%) 2,204 10 10 6 20 46 101,384 6

47 Erytromisin sirup 200 mg/5 ml @ 60 ml 7,700 2 2 15,400 0

48 Erytromisin tablet 250 mg 566 - - -

49 Erytromisin tablet 500 mg 730 - - -

50 Etanol 70 % @ 100 ml 2,500 - - -

51 FDC Kategoi I 359,985 - - -

52 Fenitoin kapsul 100 mg 133 - - -

53 Fenobarbital injeksi i.m./i.v. 50 mg/ml 1,969 - - -

54 Fitomenadion injeksi 2mg 3,682 - - -

55 Fitomenadion tablet (Vit.K1) tablet/kaplet salut gula 10 mg 695 76 60 89 10 5 255 30 47 572 397,540 72

56 Fluoksetin kapsul 20 mg 419 150 5 60 22 237 99,303 30

57 Furosemid tablet 40 mg 80 - - -

58 Furosemid tablet 40 mg 82 - - -

59 Garam Oralit @ 100 saschet 264 100 50 6 156 41,184 20

60 Gentamisin injeksi 40 mg/ ml 3,083 - - -

61 Gentamisin Salep Kulit 0,1 % 1,350 - - -

62 Gentamisin Salep Mata 0,3 % tube 3,5 gr 2,600 - - -

63 Gentamisin Tetes Mata 4,000 2 2 8,000 0

64 Glibenklamida tablet 5 mg 56 360 10 120 490 27,440 61

65 Glimepirid tablet 1 mg 218 2,000 500 34 442 177 465 3,618 788,724 452

66 Glimepiride tablet 2 mg 289 95 278 832 1,205 348,245 151

67 Glukosa larutan infus 5 % steril 5,200 2 3 11 14 5 10 45 234,000 6

68 Griseofulvin tablet 125 mg 224 40 210 150 76 234 10 60 780 174,720 98

69 Haloperidol injeksi 5 mg 4,974 - - -

70 Haloperidol injeksi 50 mg/ml 101,300 - - -

71 Haloperidol tablet 1,5 mg 66 - - -

72 Haloperidol tablet 2 mg 90 90 60 500 220 50 378 220 90 1,608 144,720 201

73 Haloperidol tablet 5 mg 75 220 150 150 318 2 55 125 1,020 76,500 128

74 Hidroklorotiazid tablet 25 mg 149 - - -

75 Hidrokortison krim 2,5 % 2,798 28 45 63 15 19 77 26 56 329 920,542 41

76 Ibuprofen suspensi 100 mg/5 ml 2,721 10 15 45 12 17 56 16 13 184 500,664 23

77 Ibuprofen tablet 200 mg 105 - - -

78 Ibuprofen tablet 400 mg 150 295 215 510 76,500 64

79 Isoniazid 100 mg 71 - - -

80 Isoniazid 300 mg 173 - - -

81 Issosorbid Dinitrat 5 mg 88 862 862 75,856 108

82 Kalsium Glukonat Injeksi 100 mg/ml 9,955 - - -

83 Kalsium Karbonat 500 mg 430 - - -

84 Kalsium Laktat (Kalk) tablet 500 mg 63 481 785 789 148 621 576 863 989 5,252 330,876 657

85 Kaptopril tablet/kaplet scored 12,5 mg 62 260 405 956 320 265 604 538 727 4,075 252,650 509

86 Kaptopril tablet/kaplet scored 25 mg 84 555 436 1,644 851 399 453 496 726 5,560 467,040 695

87 Karbamazepin tablet 200 mg 230 - - -

88 Ketokonazol krim 2 % 2,569 6 20 25 7 8 54 15 24 159 408,471 20

89 Ketokonazol Tablet 288 10 10 200 62 90 372 107,136 47

90 Ketorolak injeksi 30 mg/ml 1,290 - - -

91 Klindamisin kapsul 150 mg 759 110 90 50 250 189,750 31

92 Klindamisin kapsul 300 mg 603 30 30 18,090 4

93 Kloramfenikol kapsul 250 mg 310 - - -

94 Kloramfenikol kapsul 500 mg 1,007 120 80 100 505 895 1,700 1,711,900 213

95 Kloramfenikol salep kulit 2% 3,038 25 35 40 29 21 31 20 32 233 707,854 29

96 Kloramfenikol salep mata 1 % 1,881 11 11 20,691 1

97 Klorfeniramina Maleat (CTM) tablet 4 mg 23 1,123 702 1,045 316 39 3,225 74,175 403

98 Klorpromazin tablet salut 100 mg (HCl) 149 - - -

99 Klorpromazin tablet salut 25 mg 68 - - -

100 Klozapin tablet 25 mg 1,121 - - -

101 Kodein Tab 10 mg 550 - - -

Kotrimoksazol (Anak ) kombinasi tiap 5 ml Suspensi :Sulfametoksazol 200 mg + Trimetoprim 40
102 2,052 35 66 39 75 46 19 63 69 412 845,424 52
mg
103 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+ trimetoprim 80 mg 151 215 830 785 515 439 1,185 307 577 4,853 732,803 607

104 Kotrimoksazol forte (dewasa) kombinasi: sulfametoksazol 800 mg trimetoprim 160 mg 308 - - -

105 Kuinin Tab 200 Mg (222 Mg sebagai Garam ) 670 - - -

106 Lansoprazol kapsul 30 mg 323 136 228 298 314 84 36 126 355 1,577 509,371 197

107 Lidokain injeksi 2% (HCl) 1,845 30 23 27 72 152 280,440 19

108 Lidokain injeksi 2% (HCL) + Epinefrin 1: 80.000 - 2 ml 860 12 45 57 20 22 156 134,160 20

109 Loperamide 2 mg 80 - - -

110 Loratadin tablet 10 mg 154 115 359 609 478 104 618 345 359 2,987 459,998 373

111 Magnesium sulfat injeksi 20% 3,200 - - -

112 Magnesium sulfat injeksi 40% 3,650 - - -

113 Metformin HCl tablet 500 mg 113 623 715 765 1,341 556 3,753 7,753 872,213 969

114 Metformin HCl tablet 850 mg 185 - - -

115 Metilergometrin Injeksi 0,2 mg/ml 2,684 130 130 348,920 16

116 Metilergometrin Maleat tablet 0,125 mg 154 100 105 10 116 334 100 765 117,810 96

117 Metoklorpropamide 10 mg 85 114 315 364 123 335 740 176 440 2,607 221,595 326

118 Metronidazol Syr 125 mg/ 5 ml 3,950 10 10 39,500 1

119 Metronidazol tablet 500 mg 164 - - -

120 Metronidazol tablet 250 mg 94 - - -

121 Mikonazol krim/salep 2 % (Nitrat) 3,250 7 3 10 32,500 1

122 N. Acetil Sistein tab 200 mg @ 60 tab 358 695 1,364 2,650 630 145 162 43 5,689 2,036,662 711

123 Nacl larutan infus 0,9 % steril 4,700 5 10 27 25 9 19 95 446,500 12

124 Natrium diklofenak tablet 25 mg 145 - - -

125 Natrium diklofenak tablet 50 mg 123 330 940 632 638 828 717 677 1,223 5,985 736,155 748

126 Nifedipin tablet 10 mg 108 - - -

127 Nistatin vaginal tablet 100.000 IU/ g 640 5 15 126 480 70 80 776 496,640 97

128 Nistatin vaginal tablet 500.000 IU/ g 745 100 100 74,500 13

129 Oksitetrasikllin sk 3 % 1,529 - - -

130 Oksitetrasikllin sm 1 % 2,668 46 26 72 192,096 9

131 Oksitosin Inj 10 IU/ml @ ampul 1 ml 1,900 - - -

132 Omeprazol inj 40 mg/ 10 ml 16,997 - - -

133 Omeprazol kapsul/kaplet 20 mg 211 - - -

134 Ondansetron injeksi 4 mg/ 2 ml 1,070 155 50 15 35 55 30 70 410 438,700 51

135 Ondansetron tablet 8 mg 351 30 60 10 100 35,100 13

136 Parasetamol drop 100 mg/ml 6,649 4 5 11 6 11 37 246,013 5

137 Parasetamol sirup 120 mg / 5 ml 1,181 81 150 288 155 135 130 143 172 1,254 1,480,974 157

138 Parasetamol tablet 500 mg 80 2277 948 2,763 508 2,900 5,236 14,632 1,170,560 1,829
139 Pirantel tablet score (base) 125 mg 306 10 10 10 30 9,180 4

140 Piridoksin (Vitamin B6) Injeksi 980 2 10 28 40 39,200 5

141 Piridoksin (Vitamin B6) tablet 10 mg (HCl) 118 64 100 50 72 33 257 576 67,968 72

142 Povidon Iodida larutan 10% 300 ml 14,203 3 3 1 7 99,421 1

143 Povidon Iodida larutan 10% 60 ml 6,550 - - -

144 Prednison 5 mg 73 661 1,065 438 2,015 4,409 2,983 342 2,296 14,209 1,037,257 1,776

145 Propanolol tablet 10 mg ( HCl ) 65 - - -

146 Propiltiourasil tablet 100 mg 319 - - -

147 Ranitidin injeksi 25 mg/ml 1,188 55 35 70 15 25 45 65 310 368,280 39

148 Ranitidin tablet 150 mg 98 263 775 758 770 288 448 1,069 724 5,095 499,310 637

149 Retinol (Vitamin A) 100.000 IU 284 - - -

150 Ringer Laktat larutan infus steril 7,630 62 161 102 184 20 176 78 201 984 7,507,920 123

151 Risperidon tablet 2 mg 1,008 220 150 590 245 72 90 192 344 1,903 1,918,224 238

152 Salbutamol cairan ih 0,1% (Ventolin Nebules) 4,000 13 14 5 12 3 3 50 200,000 6

153 Salbutamol tablet 2 mg (sebagai Sulfat) 59 75 144 230 140 50 470 204 165 1,478 87,202 185

154 Salbutamol tablet 4 mg 83 100 80 30 60 533 65 100 968 80,344 121

155 Salep 2-4 , Kombinasi : Asam Salisilat 2% + Belerang endap 4% 4,560 10 40 9 9 43 34 21 166 756,960 21

156 Salep Antiseptik 10 gr (Betadine ) 11,433 - - -

157 Salisil Bedak 2 % @ 50 gr 1,250 - - -

158 Scabimite Cream 12,155 8 3 11 13 3 3 7 9 57 692,835 7

159 Sefadroksil kapsul/kaplet 500 mg 509 - - -

160 Sefadroksil Sirup Kering 125 mg/5 ml 3,984 - - -

161 Sefotaksim injeksi 1 gr @ 10 vial 2,950 - - -

162 Serum ABU Poli inj 5ml 479,996 - - -

163 Serum ATS 1500 ui/ Amp 130,999 - - -

164 Setirizin kapsul 10 mg 91 374 777 2,073 412 465 1,300 716 1,035 7,152 647,256 894

165 Setirizin Sirup 5 mg/5 ml 2,915 6 9 16 4 17 6 20 78 227,370 10

166 Sianokobalamin (vitamin B12) injeksi 500 mcg 1,098 800 800 878,400 100

167 Sianokobalamin (vitamin B12) Tablet 50 mcg 46 341 867 710 140 2,058 94,668 257

168 Simvastatin 10 mg 131 45 10 20 75 9,825 9

169 Siprofloksasin tablet scored 500 mg 265 - - -

170 Spiramisin tablet 500 mg 1,499 - - -

171 Spironolakton 25mg 208 - - -

172 Tetagam (Human Tetanus Imunoglobulin injeksi 250 IU) 170,000 - - -

173 Tetrasiklin kapsul/kaplet 250 mg 149 - - -

174 Tetrasiklin tablet/kapsul/kaplet 500 mg 310 - - -

175 Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat) 91 - - -

176 Tramadol injeksi 50 mg/ml 1,800 - - -

177 Triheksifenidil tablet/kapsul/kaplet 2 mg 91 2,740 200 395 2,710 35 315 350 6,745 613,795 843

178 Valproat (Depakote tablet 250 mg) 1,750 4,251 4,058 8,309 14,540,750 1,039

179 Vitamin B Kompleks tablet 117 1,581 3,620 1,839 5 7,045 824,265 881

180 Zinc Sirup 10 mg/ml 14,980 4 11 2 205 222 3,325,560 28

181 Zinc tablet dispersible 20 mg 524 100 52 152 79,648 19

BHP (BAHAN HABIS PAKAI)

182 Alat Suntik 1 ml @ 100 bh 911 13 445 635 20 50 134 340 1,637 1,491,388 205

183 Alat Suntik 3 ml @ 100 bh 739 135 471 320 105 283 370 328 563 2,575 1,902,925 322

184 Alat Suntik 5 ml @ 100 bh 1,012 297 160 200 105 986 220 130 2,098 2,122,169 262

185 Alkohol Swab 21,800 5 14 2 1 330 3 4 359 7,826,200 45

186 Bbraun Premilene 3/0 (2) 75 Cm Ds 24 (M) 51,989 16 16 831,820 2

187 Bbraun Premilene 6/0 (0.7) 45 Cm Ds 12 (M) 57,186 2 2 114,371 0

188 Bbraun Silkam Black 3/0 (2) 45 Cm Ds 24 (M) 25,567 - - -

189 Bbraun Softaman 500 ML (Hands Rub) 78,750 - - -

190 BeneCheck Plus Glucose Test Strip 50's - - -

150,933
191 BeneCheck Plus Total cholesterol Test Strip 10's - - -
233,857
192 BeneCheck Plus Uric Test Strips 25's - - -
129,357
193 Cat Gut Chromic 3/0 HR 26 MM 33,645 - - -

194 Cat Gut Chromic 3/0 HR 30 MM 35,015 5 8 4 15 5 24 61 2,135,915 8

195 Cat Gut Chromic 3/0 HR 37 MM 34,170 - - -

196 Cat Gut Chromic 3/0,75 cm,3/8RC,24mm 46,628 - - -

197 Cat Gut Plain 3/0,75cm,3/8RC,23mm 44,268 - - -

198 Foley Catheter 14 11,990 - - -

199 Foley Catheter 16 11,990 1 1 2 23,980 0

200 Foley Catheter 18 11,990 17 17 203,830 2

201 Hanscone Non Steril 499 10 10 4,990 1

202 Hanscone Steril 4,100 2 2 8,200 0

203 Hanscone Steril Ukuran 7 (Surgical Gloves Steril 7) 8,052 40 40 322,080 5

204 Hanscone Steril Ukuran 7,5 (Surgical Gloves Steril 7,5) 8,052 - - -

205 Infus Set Dewasa (Polyfusion Infus Set 20 drop/ml) 6,466 - - -

206 infusion set anak 5,610 16 11 64 37 101 229 1,284,690 29

207 Infusion Set Dewasa 6,142 6 29 51 40 24 3 19 24 196 1,203,832 25

208 Infusion Set with Needle (adult) 8,200 - - -

209 IV Canula with Injection Port, Snap Fit Cap Surutable Wings No 18 12,682 - - -

210 IV Canula with Injection Port, Snap Fit Cap Surutable Wings No 26 14,131 3 3 10 24 2 11 53 748,938 7

211 IV Chateter no.18 @ 50 bh 6,600 11 3 2 193 2 211 1,392,600 26

212 IV Chateter no.20 @ 50 bh 10,000 11 2 12 4 23 10 62 620,000 8

213 IV Chateter no.22 @ 50 bh 10,000 16 28 15 7 7 28 31 132 1,320,000 17

214 IV Chateter no.24 @ 50 bh 10,000 6 18 187 16 41 268 2,680,000 34

215 IV Chateter Trovensite Safety Plus 18g 23,100 - - -

216 Kapas 1000 gr 37,700 - - -

217 Kapas 250 gr 16,080 1 3 6 2 12 192,960 2

218 Kapas 500 gr 29,190 1 1 4 1 1 8 233,520 1

219 Kasa 2 x 80 cm 9,516 5 14 10 7 8 2 1 47 447,252 6

220 Kasa 3 x 15 cm 78 68 4 22 3 1 98 7,644 12

221 Kasa 4 x 15 cm 2,092 - - -

222 kasa steril 16 x 16 3,500 18 12 5 7 28 1 3 74 259,000 9

223 kasa steril 40 x40 1,942 22 1 20 30 15 88 170,861 11

224 kasa steril 40 x 80 yard 123,000 2 1 2 1 2 1 9 1,107,000 1

225 Masker 693 1 4 6 21 3 5 40 27,720 5

226 Masker 20 pcs 1,125 - - -

227 Paper Tape /SCM x 9.14m 16,078 1 2 3 48,233 0

228 Pharmafix (Non Woven Dresing For Fixation Size 10 cm x 50 cm) 54,383 1 1 1 1 4 217,533 1

229 Pharmafix (Non Woven Dresing For Fixation Size 5 cm x 50 cm) 28,620 3 3 85,860 0

230 Plester Roll 2,50 cm x 4,5 m ( Leukoplast) 12,076 10 3 4 32 2 51 615,876 6

231 Plester Roll 7,5 cm x 4,5 m ( Leukoplast) 35,532 2 2 1 1 1 3 10 355,320 1

232 Powdered Latex Sterile Surgical Gloves (7) 7,000 - - -

233 Silk no 2/0 HR 30 MM dgn jarum Bedah 38,065 9 6 46 6 5 72 2,740,697 9

234 Silk no 3/0 HR 30 MM dgn jarum Bedah 38,559 4 2 1 20 5 9 2 43 1,658,047 5

235 Stomach Tube 85 cm no 12 8,033 - - -

236 Stomach Tube 85 cm no 14 8,033 32 32 257,066 4

237 Stomach Tube 85 cm no 16 8,033 17 17 136,566 2

238 Stomach Tube 85 cm no 18 8,033 33 33 265,099 4

239 Surgical Scrub 500 ml 91,978 - - -

240 Urine Bag 6,105 3 3 18,315 0

241 Urine Bag Tro-Urocol Plus Urine Bag Steril 8,554 - - -

OBAT GIGI

242 Eugenol cairan 18,100 0 -

OBAT TAMBAHAN USULAN PUSKESMAS (JKN)

243 Amoksillin kaplet 500 mg 301 800 500 1300 700 600 700 400 700 5700 Rp 1,715,700 713

244 Anabion syr 5,600 2 4 4 9 12 10 3 44 Rp 246,400 6

245 Antasida DOEN I tablet kunyah, kombinasi : Aluminium 85 200 430 370 1000 800 1200 4000 Rp 340,000 500

246 Asam Askorbat (Vitamin C) tablet 50 mg 137 0 Rp - 0

247 Asam Folat 121 30 70 100 Rp 12,100 13

248 Asiklovir crem 5 % 2,583 0 Rp - 0

249 Asiklovir tablet 400 mg 385 100 140 60 300 Rp 115,500 38

250 Betahistin tablet 6 mg 172 50 75 25 430 370 950 Rp 163,400 119

251 Betametason Valerat Krim 0,1 % 2,800 12 8 20 Rp 56,000 3

252 Digoksin 0,25 mg 1,983 76 54 70 200 Rp 396,600 25

253 Domperidon tablet 10 mg 153 150 120 130 400 Rp 61,200 50

254 Furosemid tablet 40 mg 224 30 140 130 300 Rp 67,200 38

255 Ichtyol Salep 15 gram 5,149 0 Rp - 0

256 Kaptopril tablet/kaplet scored 25 mg 184 100 200 100 300 300 400 300 500 2200 Rp 404,800 275

257 Ketorolak injeksi 30 mg/ml 1,731 15 10 10 10 5 15 65 Rp 112,515 8

258 Kloramfenicol Tetes Telinga 1% 6,552 3 2 2 5 5 17 Rp 111,384 2

259 Kloramfenicol Tetes Mata 0,5% 11,088 5 8 5 3 5 6 5 5 42 Rp 465,696 5

260 Prednison 5 mg 79 0 Rp - 0

261 Propanolol tablet 10 mg ( HCl ) 90 25 35 40 100 200 Rp 18,000 25

262 Propiltiourasil tablet 100 mg 505 100 100 200 Rp 101,000 25

263 Ranitidin injeksi 25 mg/ml 1,426 0 Rp - 0

264 Salbutamol tablet 4 mg 105 230 270 161 661 Rp 69,405 83

265 Salisil Bedak 2 % @ 50 gr 6,216 3 7 8 18 Rp 111,888 2

266 Sefadroksil kapsul/kaplet 500 mg 560 360 440 200 243 345 126 240 170 2124 Rp 1,189,440 266

267 Sefadroksil Sirup Kering 125 mg/5 ml 5,152 24 23 3 7 57 Rp 293,664 7

268 Sefotaxim Serbuk Injeksi 1 Gram 5,010 0 Rp - 0

269 Setirizin kapsul 10 mg 163 0 Rp - 0

270 Salbutamol tablet 4 mg 105 0 Rp - 0

271 Siprofloksasin tablet scored 500 mg 356 500 700 400 125 320 179 2224 Rp 791,744 278

272 Spironolakton 25mg 426 130 170 100 100 50 150 700 Rp 298,200 88

MENGETAHUI L
KEPALA PUSKESMAS P

Umi Kulsum,S.Kep.Ns
NIP.19861123 201101 2 002
 USULAN
KEBUTUHAN
PUSKESMAS
TOTAL HARGA USULAN KEBUTUHAN PUSKESMAS TAHUN 2023 KET
TAHUN 2023

(19x 18 BULAN)

20 21 22

- -

524 1,048,500

- -

- -

6,543 687,015

- -

- -

- -

11,396 1,185,210

18,074 1,409,792

30,105 7,014,465

- -

- -

385 1,308,150

- -

20,552 1,479,708

1,773 3,590,325

7 19,737
 560 2,329,520

500 1,581,917

2,331 403,263

1,193 135,945

- -

- -

- -

7,151 757,953

- -

- -

450 112,050

1,127 456,536

- -

- -

3,206 436,050

3,771 561,879

698 2,363,130

- -

225 74,250

731 1,463,963

387 59,598

1,670 171,959

135 158,760

- -

23 4,950

178 479,925

3,796 345,413

104 228,114

5 34,650

- -
 - -

- -

- -

- -

- -

- -

1,287 894,465

533 223,432

- -

- -

351 92,664

- -

- -

- -

5 18,000

1,103 61,740

8,141 1,774,629

2,711 783,551

101 526,500

1,755 393,120

- -

- -

- -

3,618 325,620

2,295 172,125

- -

740 2,071,220

414 1,126,494

- -

1,148 172,125
 - -

- -

1,940 170,676

- -

- -

11,817 744,471

9,169 568,463

12,510 1,050,840

- -

358 919,060

837 241,056

- -

563 426,938

68 40,703

- -

3,825 3,851,775

524 1,592,672

25 46,555

7,256 166,894

- -

- -

- -

- -

927 1,902,204

10,919 1,648,807

- -

- -

3,548 1,146,085

342 630,990

351 301,860
 - -

6,721 1,034,996

- -

- -

17,444 1,962,478

- -

293 785,070

1,721 265,073

5,866 498,589

23 88,875

- -

- -

23 73,125

12,800 4,582,490

214 1,004,625

- -

13,466 1,656,349

- -

1,746 1,117,440

225 167,625

- -

162 432,216

- -

- -

- -

923 987,075

225 78,975

83 553,529

2,822 3,332,192

32,922 2,633,760
 68 20,655

90 88,200

1,296 152,928

16 223,697

- -

31,970 2,333,828

- -

- -

698 828,630

11,464 1,123,448

- -

2,214 16,892,820

4,282 4,316,004

113 450,000

3,326 196,205

2,178 180,774

374 1,703,160

- -

- -

128 1,558,879

- -

- -

- -

- -

- -

16,092 1,456,326

176 511,583

1,800 1,976,400

4,631 213,003

169 22,106
 - -

- -

- -

- -

- -

- -

- -

- -

15,176 1,381,039

18,695 32,716,688

15,851 1,854,596

500 7,482,510

342 179,208

3,683 3,355,622

5,794 4,281,581

4,721 4,774,880

808 17,608,950

36 1,871,594

5 257,335

- -

- -

- -

- -

- -

- -

137 4,805,809

- -

- -

- -
 - -

5 53,955

38 458,618

23 11,228

5 18,450

90 724,680

- -

- -

515 2,890,553

441 2,708,622

- -

- -

119 1,685,110

475 3,133,350

140 1,395,000

297 2,970,000

603 6,030,000

- -

- -

27 434,160

18 525,420

106 1,006,317

221 17,199

- -

167 582,750

198 384,437

20 2,490,750

90 62,370

- -

7 108,523
 9 489,450

7 193,185

115 1,385,721

23 799,470

- -

162 6,166,569

97 3,730,606

- -

72 578,398

38 307,274

74 596,473

- -

7 41,209

- -

12825 Rp 3,860,325

99 Rp 554,400

9000 Rp 765,000

0 Rp -

225 Rp 27,225

0 Rp -

675 Rp 259,875

2138 Rp 367,650

45 Rp 126,000

450 Rp 892,350

900 Rp 137,700

675 Rp 151,200

0 Rp -
4950 Rp 910,800

146 Rp 253,159

38 Rp 250,614

95 Rp 1,047,816

0 Rp -

450 Rp 40,500

450 Rp 227,250

0 Rp -

1487 Rp 156,161

41 Rp 251,748

4779 Rp 2,676,240

128 Rp 660,744

0 Rp -

0 Rp -

0 Rp -

5004 Rp 1,781,424

1575 Rp 670,950

LAMPUNG TENGAH , 23SEPTEMBER 2022

PETUGAS PENGELOLA OBAT PUSKESMAS

Lestari Nunyai Putri, A.Md. F

NIP.19910620 201903 2 004
 RENCANA KEBUTUHAN OBAT (RKO)
PUSKESMAS : SEPUTIH SURABAYA
TAHUN 2023

: LAMPUNG
KABUPATEN/ KOTA
TENGAH
PROPINSI : LAMPUNG
: SEPUTIH
PUSKESMAS
SURABAYA

JUMLAH PEMAKAIAN OBAT TAHUN 2022

TOTAL HARGA
PEMAKAIAN PEMAKAIAN
OBAT TAHUN RATA-RATA PER
TOTAL JUMLAH
HARGA 2022 BULAN
NO NAMA OBAT PEMAKAIAN OBAT
(SATUAN)
JAN FEB MAR APR MEI JUN JUL AGS SEP OKT NOV DES TAHUN 2019
(4x17) (17/ 8 BULAN)

1 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

OBAT

1 Air Untuk Injeksi 25 ml 2,750 - - -

2 Air Untuk Injeksi 20 ml 2,000 2 22 27 182 2 235 470,000 29

3 Albendazol tablet 400 Mg 296 - - -

4 Albendazole Suspensi 200 mg/5ml 3,849 - - -

5 Alopurinol tablet 100 mg 105 354 295 899 210 206 74 285 585 175 556 276 2,588 6,503 682,815 813

6 Aminofillin injeksi 24 mg/ml 10 ml @ 30 amp 3,345 - - -

7 Aminofillin tablet 200 mg 95 - - -

8 Amitriptilin tablet 25 mg 167 - - -

9 Amlodipin tablet 10 mg 104 295 395 978 905 444 874 330 844 8 837 1,274 1,734 8,918 927,472 1,115

10 Amlodipin tablet 5 mg 78 605 1,255 1,255 541 465 2,995 647 270 842 1,091 79 10,045 783,510 1,256

11 Amoksillin kaplet 500 mg 233 1,549 33P7 1,781 1,887 2,063 1,818 1,253 3,029 226 1,741 1,454 855 17,656 4,113,848 2,207

12 Amoksillin kapsul 250 mg 195 - - -

13 Amoksillin sirup kering 125 mg /5ml 2,090 - - -

14 Amoksillin sirup kering forte 250 mg /5ml 3,400 20 28 59 5 11 48 159 12 58 400 1,360,000 50

15 Ampicilin Serbuk inj 1000mg 8,237 - - -

Antasida DOEN I tablet kunyah, kombinasi : Aluminium Hidroksida 200 mg Magnesium
16 72 824 149 270 1,717 1,439 1,253 1,025 2,457 1,910 1,736 2,511 4,364 19,655 1,415,160 2,457
Hidroksida 200 mg
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200 mg/5 ml, Magnesium
17 2,025 85 127 44 103 76 161 103 89 67 68 107 274 1,304 2,640,600 163
Hidroksida 200 mg/ 5 ml.

18 Anti Bakteri Basitrin 500 m/l + Polimiskin 10.000 iu/g (tube) 2,924 3 3 8,772 0
19 Antifungi DOEN Salep Kombinasi : Asam Benzoat 6 % Asam Salisilat 3 % 4,158 6 24 47 22 21 100 13 16 20 22 23 64 378 1,571,724 47
Antihemoroid, Kombinasi : bismut subgalat 150 mg heksaklorofen 2,5 mg lidocain 10 mg seng
20 3,167 12 26 184 222 703,074 28
oksida 120 mg
21 Antimigren Ergotamin tatrat 1mg+kofein50 mg 173 120 133 127 386 120 150 1,036 179,228 130

22 Asam Asetilsalisilat tablet 80 mg 114 200 200 5 125 10 35 155 730 83,220 91

23 Asam Askorbat (Vitamin C) tablet 250 mg 125 - - -

24 Asam Askorbat (Vitamin C) tablet 50 mg 105 700 700 73,500 88

25 Asam Folat 63 - - -

26 Asam Mefenamat tablet 500 mg 106 1,064 150 1,964 300 3,478 368,668 435

27 Asam Traneksamat Inj 50 mg/ml @ 10 amp-5 ml 2,445 - - -

28 Asiklovir crem 5 % 2,152 - - -

29 Asiklovir tablet 200 mg 249 200 200 49,800 25

30 Asiklovir tablet 400 mg 405 20 375 106 4 210 715 289,575 89

31 Atenolol tablet 50 mg 330 - - -

32 Atropin injeksi 0,25 mg / ml 1,672 - - -

33 Attapulgite 600 mg tablet ( NEW ANTIDES) 136 140 140 340 420 40 108 86 151 75 1,500 204,000 188

34 Betahistin tablet 6 mg 149 20 220 950 100 106 280 172 136 392 2,376 354,024 297

35 Betametason Krim 0,1 % Sebagai Valerat (SKIZONE) 3,388 22 38 22 64 35 76 13 40 61 28 40 4 443 1,500,884 55

36 Betametason Valerat Krim 0,1 % 1,340 - - -

37 Bisoprolol tablet 5 mg 330 100 100 33,000 13

38 Deksametason injeksi i.v./i.m. 5 mg/ml 2,002 2 43 41 45 40 154 325 650,650 41

39 Deksametason tablet 0,5 mg 154 172 172 26,488 22

40 Diazepam tablet 5 mg 103 170 45 182 76 34 120 115 255 95 305 1,397 143,891 175

41 Difenhidramin injeksi i.v./i.m. 10 mg/ml (HCl) 1,176 5 15 40 60 70,560 8

42 Digoksin 0,25 mg 105 - - -

43 Doksisiklin kapsul 100 mg 220 10 90 24 20 156 300 66,000 38

44 Domperidon suspensi 2,700 1 24 21 1 10 2 20 11 11 49 150 405,000 19

45 Domperidon tablet 10 mg 91 150 271 116 170 91 859 20 10 10 90 1,787 162,617 223

46 Epinefrin (Adrenalin) injeksi i.v/s.k./i.m 1 mg/ml (0,1%) 2,204 10 10 6 20 91 137 301,948 17

47 Erytromisin sirup 200 mg/5 ml @ 60 ml 7,700 2 7 5 18 32 246,400 4

48 Erytromisin tablet 250 mg 566 - - -

49 Erytromisin tablet 500 mg 730 - - -

50 Etanol 70 % @ 100 ml 2,500 - - -

51 FDC Kategoi I 359,985 - - -

52 Fenitoin kapsul 100 mg 133 - - -

53 Fenobarbital injeksi i.m./i.v. 50 mg/ml 1,969 - - -

54 Fitomenadion injeksi 2mg 3,682 - - -

55 Fitomenadion tablet (Vit.K1) tablet/kaplet salut gula 10 mg 695 76 60 89 10 5 255 30 47 20 33 20 120 765 531,675 96

56 Fluoksetin kapsul 20 mg 419 150 5 60 22 213 450 188,550 56

57 Furosemid tablet 40 mg 80 - - -

58 Furosemid tablet 40 mg 82 - - -

59 Garam Oralit @ 100 saschet 264 100 50 6 212 121 11 500 132,000 63

60 Gentamisin injeksi 40 mg/ ml 3,083 - - -

61 Gentamisin Salep Kulit 0,1 % 1,350 - - -

62 Gentamisin Salep Mata 0,3 % tube 3,5 gr 2,600 - - -

63 Gentamisin Tetes Mata 4,000 2 2 8,000 0

64 Glibenklamida tablet 5 mg 56 360 10 120 500 990 55,440 124

65 Glimepirid tablet 1 mg 218 2,000 500 34 442 177 465 882 615 836 1,109 7,060 1,539,080 883

66 Glimepiride tablet 2 mg 289 95 278 832 1,205 348,245 151

67 Glukosa larutan infus 5 % steril 5,200 2 3 11 14 5 10 12 13 24 94 488,800 12

68 Griseofulvin tablet 125 mg 224 40 210 150 76 234 10 60 130 910 203,840 114

69 Haloperidol injeksi 5 mg 4,974 - - -

70 Haloperidol injeksi 50 mg/ml 101,300 - - -

71 Haloperidol tablet 1,5 mg 66 - - -

72 Haloperidol tablet 2 mg 90 90 60 500 220 50 378 220 90 742 342 296 362 3,350 301,500 419

73 Haloperidol tablet 5 mg 75 220 150 150 318 2 55 125 300 80 120 1,520 114,000 190

74 Hidroklorotiazid tablet 25 mg 149 - - -

75 Hidrokortison krim 2,5 % 2,798 28 45 63 15 19 77 26 56 55 27 54 47 512 1,432,576 64

76 Ibuprofen suspensi 100 mg/5 ml 2,721 10 15 45 12 17 56 16 13 57 22 4 223 490 1,333,290 61

77 Ibuprofen tablet 200 mg 105 - - -

78 Ibuprofen tablet 400 mg 150 295 215 510 76,500 64

79 Isoniazid 100 mg 71 - - -

80 Isoniazid 300 mg 173 - - -

81 Issosorbid Dinitrat 5 mg 88 862 862 75,856 108

82 Kalsium Glukonat Injeksi 100 mg/ml 9,955 - - -

83 Kalsium Karbonat 500 mg 430 - - -

84 Kalsium Laktat (Kalk) tablet 500 mg 63 481 785 789 148 621 576 863 989 963 1,115 1,492 2,254 11,076 697,788 1,385

85 Kaptopril tablet/kaplet scored 12,5 mg 62 260 405 956 320 265 604 538 727 1,497 607 699 894 7,772 481,864 972

86 Kaptopril tablet/kaplet scored 25 mg 84 555 436 1,644 851 399 453 496 726 855 1,191 584 8,190 687,960 1,024

87 Karbamazepin tablet 200 mg 230 - - -

88 Ketokonazol krim 2 % 2,569 6 20 25 7 8 54 15 24 20 18 30 45 272 698,768 34

89 Ketokonazol Tablet 288 10 10 200 62 90 90 90 240 792 228,096 99

90 Ketorolak injeksi 30 mg/ml 1,290 - - -

91 Klindamisin kapsul 150 mg 759 110 90 50 250 189,750 31

92 Klindamisin kapsul 300 mg 603 30 170 200 120,600 25

93 Kloramfenikol kapsul 250 mg 310 - - -

94 Kloramfenikol kapsul 500 mg 1,007 120 80 100 505 895 1,700 1,711,900 213

95 Kloramfenikol salep kulit 2% 3,038 25 35 40 29 21 31 20 32 59 40 40 58 430 1,306,340 54

96 Kloramfenikol salep mata 1 % 1,881 11 11 20,691 1

97 Klorfeniramina Maleat (CTM) tablet 4 mg 23 1,123 702 1,045 316 39 3,225 74,175 403

98 Klorpromazin tablet salut 100 mg (HCl) 149 - - -

99 Klorpromazin tablet salut 25 mg 68 - - -

100 Klozapin tablet 25 mg 1,121 - - -

101 Kodein Tab 10 mg 550 - - -

Kotrimoksazol (Anak ) kombinasi tiap 5 ml Suspensi :Sulfametoksazol 200 mg + Trimetoprim 40
102 2,052 35 66 39 75 46 19 63 69 412 845,424 52
mg
103 Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 mg+ trimetoprim 80 mg 151 215 830 785 515 439 1,185 307 577 4,853 732,803 607

104 Kotrimoksazol forte (dewasa) kombinasi: sulfametoksazol 800 mg trimetoprim 160 mg 308 - - -

105 Kuinin Tab 200 Mg (222 Mg sebagai Garam ) 670 - - -

106 Lansoprazol kapsul 30 mg 323 136 228 298 314 84 36 126 355 1,577 509,371 197

107 Lidokain injeksi 2% (HCl) 1,845 30 23 27 72 152 280,440 19

108 Lidokain injeksi 2% (HCL) + Epinefrin 1: 80.000 - 2 ml 860 12 45 57 20 22 156 134,160 20

109 Loperamide 2 mg 80 - - -

110 Loratadin tablet 10 mg 154 115 359 609 478 104 618 345 359 2,987 459,998 373

111 Magnesium sulfat injeksi 20% 3,200 - - -

112 Magnesium sulfat injeksi 40% 3,650 - - -

113 Metformin HCl tablet 500 mg 113 623 715 765 1,341 556 3,753 7,753 872,213 969

114 Metformin HCl tablet 850 mg 185 - - -

115 Metilergometrin Injeksi 0,2 mg/ml 2,684 130 130 348,920 16

116 Metilergometrin Maleat tablet 0,125 mg 154 100 105 10 116 334 100 765 117,810 96

117 Metoklorpropamide 10 mg 85 114 315 364 123 335 740 176 440 2,607 221,595 326

118 Metronidazol Syr 125 mg/ 5 ml 3,950 10 10 39,500 1

119 Metronidazol tablet 500 mg 164 - - -

120 Metronidazol tablet 250 mg 94 - - -

121 Mikonazol krim/salep 2 % (Nitrat) 3,250 7 3 10 32,500 1

122 N. Acetil Sistein tab 200 mg @ 60 tab 358 695 1,364 2,650 630 145 162 43 5,689 2,036,662 711

123 Nacl larutan infus 0,9 % steril 4,700 5 10 27 25 9 19 95 446,500 12

124 Natrium diklofenak tablet 25 mg 145 - - -

125 Natrium diklofenak tablet 50 mg 123 330 940 632 638 828 717 677 1,223 5,985 736,155 748

126 Nifedipin tablet 10 mg 108 - - -

127 Nistatin vaginal tablet 100.000 IU/ g 640 5 15 126 480 70 80 776 496,640 97

128 Nistatin vaginal tablet 500.000 IU/ g 745 100 100 74,500 13

129 Oksitetrasikllin sk 3 % 1,529 - - -

130 Oksitetrasikllin sm 1 % 2,668 46 26 72 192,096 9

131 Oksitosin Inj 10 IU/ml @ ampul 1 ml 1,900 - - -

132 Omeprazol inj 40 mg/ 10 ml 16,997 - - -

133 Omeprazol kapsul/kaplet 20 mg 211 - - -

134 Ondansetron injeksi 4 mg/ 2 ml 1,070 155 50 15 35 55 30 70 410 438,700 51

135 Ondansetron tablet 8 mg 351 30 60 10 100 35,100 13

136 Parasetamol drop 100 mg/ml 6,649 4 5 11 6 11 37 246,013 5

137 Parasetamol sirup 120 mg / 5 ml 1,181 81 150 288 155 135 130 143 172 1,254 1,480,974 157

138 Parasetamol tablet 500 mg 80 2277 948 2,763 508 2,900 5,236 14,632 1,170,560 1,829
139 Pirantel tablet score (base) 125 mg 306 10 10 10 30 9,180 4

140 Piridoksin (Vitamin B6) Injeksi 980 2 10 28 40 39,200 5

141 Piridoksin (Vitamin B6) tablet 10 mg (HCl) 118 64 100 50 72 33 257 576 67,968 72

142 Povidon Iodida larutan 10% 300 ml 14,203 3 3 1 7 99,421 1

143 Povidon Iodida larutan 10% 60 ml 6,550 - - -

144 Prednison 5 mg 73 661 1,065 438 2,015 4,409 2,983 342 2,296 14,209 1,037,257 1,776

145 Propanolol tablet 10 mg ( HCl ) 65 - - -

146 Propiltiourasil tablet 100 mg 319 - - -

147 Ranitidin injeksi 25 mg/ml 1,188 55 35 70 15 25 45 65 310 368,280 39

148 Ranitidin tablet 150 mg 98 263 775 758 770 288 448 1,069 724 5,095 499,310 637

149 Retinol (Vitamin A) 100.000 IU 284 - - -

150 Ringer Laktat larutan infus steril 7,630 62 161 102 184 20 176 78 201 984 7,507,920 123

151 Risperidon tablet 2 mg 1,008 220 150 590 245 72 90 192 344 1,903 1,918,224 238

152 Salbutamol cairan ih 0,1% (Ventolin Nebules) 4,000 13 14 5 12 3 3 50 200,000 6

153 Salbutamol tablet 2 mg (sebagai Sulfat) 59 75 144 230 140 50 470 204 165 1,478 87,202 185

154 Salbutamol tablet 4 mg 83 100 80 30 60 533 65 100 968 80,344 121

155 Salep 2-4 , Kombinasi : Asam Salisilat 2% + Belerang endap 4% 4,560 10 40 9 9 43 34 21 166 756,960 21

156 Salep Antiseptik 10 gr (Betadine ) 11,433 - - -

157 Salisil Bedak 2 % @ 50 gr 1,250 - - -

158 Scabimite Cream 12,155 8 3 11 13 3 3 7 9 57 692,835 7

159 Sefadroksil kapsul/kaplet 500 mg 509 - - -

160 Sefadroksil Sirup Kering 125 mg/5 ml 3,984 - - -

161 Sefotaksim injeksi 1 gr @ 10 vial 2,950 - - -

162 Serum ABU Poli inj 5ml 479,996 - - -

163 Serum ATS 1500 ui/ Amp 130,999 - - -

164 Setirizin kapsul 10 mg 91 374 777 2,073 412 465 1,300 716 1,035 7,152 647,256 894

165 Setirizin Sirup 5 mg/5 ml 2,915 6 9 16 4 17 6 20 78 227,370 10

166 Sianokobalamin (vitamin B12) injeksi 500 mcg 1,098 800 800 878,400 100

167 Sianokobalamin (vitamin B12) Tablet 50 mcg 46 341 867 710 140 2,058 94,668 257

168 Simvastatin 10 mg 131 45 10 20 75 9,825 9

169 Siprofloksasin tablet scored 500 mg 265 - - -

170 Spiramisin tablet 500 mg 1,499 - - -

171 Spironolakton 25mg 208 - - -

172 Tetagam (Human Tetanus Imunoglobulin injeksi 250 IU) 170,000 - - -

173 Tetrasiklin kapsul/kaplet 250 mg 149 - - -

174 Tetrasiklin tablet/kapsul/kaplet 500 mg 310 - - -

175 Tiamin (Vitamin B1) tablet 50 mg (HCl/ Nitrat) 91 - - -

176 Tramadol injeksi 50 mg/ml 1,800 - - -

177 Triheksifenidil tablet/kapsul/kaplet 2 mg 91 2,740 200 395 2,710 35 315 350 6,745 613,795 843

178 Valproat (Depakote tablet 250 mg) 1,750 4,251 4,058 8,309 14,540,750 1,039

179 Vitamin B Kompleks tablet 117 1,581 3,620 1,839 5 7,045 824,265 881

180 Zinc Sirup 10 mg/ml 14,980 4 11 2 205 222 3,325,560 28

181 Zinc tablet dispersible 20 mg 524 100 52 152 79,648 19

BHP (BAHAN HABIS PAKAI)

182 Alat Suntik 1 ml @ 100 bh 911 13 445 635 20 50 134 340 1,637 1,491,388 205

183 Alat Suntik 3 ml @ 100 bh 739 135 471 320 105 283 370 328 563 2,575 1,902,925 322

184 Alat Suntik 5 ml @ 100 bh 1,012 297 160 200 105 986 220 130 2,098 2,122,169 262

185 Alkohol Swab 21,800 5 14 2 1 330 3 4 359 7,826,200 45

186 Bbraun Premilene 3/0 (2) 75 Cm Ds 24 (M) 51,989 16 16 831,820 2

187 Bbraun Premilene 6/0 (0.7) 45 Cm Ds 12 (M) 57,186 2 2 114,371 0

188 Bbraun Silkam Black 3/0 (2) 45 Cm Ds 24 (M) 25,567 - - -

189 Bbraun Softaman 500 ML (Hands Rub) 78,750 - - -

190 BeneCheck Plus Glucose Test Strip 50's - - -

150,933
191 BeneCheck Plus Total cholesterol Test Strip 10's - - -
233,857
192 BeneCheck Plus Uric Test Strips 25's - - -
129,357
193 Cat Gut Chromic 3/0 HR 26 MM 33,645 - - -

194 Cat Gut Chromic 3/0 HR 30 MM 35,015 5 8 4 15 5 24 61 2,135,915 8

195 Cat Gut Chromic 3/0 HR 37 MM 34,170 - - -

196 Cat Gut Chromic 3/0,75 cm,3/8RC,24mm 46,628 - - -

197 Cat Gut Plain 3/0,75cm,3/8RC,23mm 44,268 - - -

198 Foley Catheter 14 11,990 - - -

199 Foley Catheter 16 11,990 1 1 2 23,980 0

200 Foley Catheter 18 11,990 17 17 203,830 2

201 Hanscone Non Steril 499 10 10 4,990 1

202 Hanscone Steril 4,100 2 2 8,200 0

203 Hanscone Steril Ukuran 7 (Surgical Gloves Steril 7) 8,052 40 40 322,080 5

204 Hanscone Steril Ukuran 7,5 (Surgical Gloves Steril 7,5) 8,052 - - -

205 Infus Set Dewasa (Polyfusion Infus Set 20 drop/ml) 6,466 - - -

206 infusion set anak 5,610 16 11 64 37 101 229 1,284,690 29

207 Infusion Set Dewasa 6,142 6 29 51 40 24 3 19 24 196 1,203,832 25

208 Infusion Set with Needle (adult) 8,200 - - -

209 IV Canula with Injection Port, Snap Fit Cap Surutable Wings No 18 12,682 - - -

210 IV Canula with Injection Port, Snap Fit Cap Surutable Wings No 26 14,131 3 3 10 24 2 11 53 748,938 7

211 IV Chateter no.18 @ 50 bh 6,600 11 3 2 193 2 211 1,392,600 26

212 IV Chateter no.20 @ 50 bh 10,000 11 2 12 4 23 10 62 620,000 8

213 IV Chateter no.22 @ 50 bh 10,000 16 28 15 7 7 28 31 132 1,320,000 17

214 IV Chateter no.24 @ 50 bh 10,000 6 18 187 16 41 268 2,680,000 34

215 IV Chateter Trovensite Safety Plus 18g 23,100 - - -

216 Kapas 1000 gr 37,700 - - -

217 Kapas 250 gr 16,080 1 3 6 2 12 192,960 2

218 Kapas 500 gr 29,190 1 1 4 1 1 8 233,520 1

219 Kasa 2 x 80 cm 9,516 5 14 10 7 8 2 1 47 447,252 6

220 Kasa 3 x 15 cm 78 68 4 22 3 1 98 7,644 12

221 Kasa 4 x 15 cm 2,092 - - -

222 kasa steril 16 x 16 3,500 18 12 5 7 28 1 3 74 259,000 9

223 kasa steril 40 x40 1,942 22 1 20 30 15 88 170,861 11

224 kasa steril 40 x 80 yard 123,000 2 1 2 1 2 1 9 1,107,000 1

225 Masker 693 1 4 6 21 3 5 40 27,720 5

226 Masker 20 pcs 1,125 - - -

227 Paper Tape /SCM x 9.14m 16,078 1 2 3 48,233 0

228 Pharmafix (Non Woven Dresing For Fixation Size 10 cm x 50 cm) 54,383 1 1 1 1 4 217,533 1

229 Pharmafix (Non Woven Dresing For Fixation Size 5 cm x 50 cm) 28,620 3 3 85,860 0

230 Plester Roll 2,50 cm x 4,5 m ( Leukoplast) 12,076 10 3 4 32 2 51 615,876 6

231 Plester Roll 7,5 cm x 4,5 m ( Leukoplast) 35,532 2 2 1 1 1 3 10 355,320 1

232 Powdered Latex Sterile Surgical Gloves (7) 7,000 - - -

233 Silk no 2/0 HR 30 MM dgn jarum Bedah 38,065 9 6 46 6 5 72 2,740,697 9

234 Silk no 3/0 HR 30 MM dgn jarum Bedah 38,559 4 2 1 20 5 9 2 43 1,658,047 5

235 Stomach Tube 85 cm no 12 8,033 - - -

236 Stomach Tube 85 cm no 14 8,033 32 32 257,066 4

237 Stomach Tube 85 cm no 16 8,033 17 17 136,566 2

238 Stomach Tube 85 cm no 18 8,033 33 33 265,099 4

239 Surgical Scrub 500 ml 91,978 - - -

240 Urine Bag 6,105 3 3 18,315 0

241 Urine Bag Tro-Urocol Plus Urine Bag Steril 8,554 - - -

OBAT GIGI

242 Eugenol cairan 18,100 0 -

OBAT TAMBAHAN USULAN PUSKESMAS (JKN)

243 Amoksillin kaplet 500 mg 301 800 500 1300 700 600 700 400 700 5700 Rp 1,715,700 713

244 Anabion syr 5,600 2 4 4 9 12 10 3 44 Rp 246,400 6

245 Antasida DOEN I tablet kunyah, kombinasi : Aluminium 85 200 430 370 1000 800 1200 4000 Rp 340,000 500

246 Asam Askorbat (Vitamin C) tablet 50 mg 137 0 Rp - 0

247 Asam Folat 121 30 70 100 Rp 12,100 13

248 Asiklovir crem 5 % 2,583 0 Rp - 0

249 Asiklovir tablet 400 mg 385 100 140 60 300 Rp 115,500 38

250 Betahistin tablet 6 mg 172 50 75 25 430 370 950 Rp 163,400 119

251 Betametason Valerat Krim 0,1 % 2,800 12 8 20 Rp 56,000 3

252 Digoksin 0,25 mg 1,983 76 54 70 200 Rp 396,600 25

253 Domperidon tablet 10 mg 153 150 120 130 400 Rp 61,200 50

254 Furosemid tablet 40 mg 224 30 140 130 300 Rp 67,200 38

255 Ichtyol Salep 15 gram 5,149 0 Rp - 0

256 Kaptopril tablet/kaplet scored 25 mg 184 100 200 100 300 300 400 300 500 2200 Rp 404,800 275

257 Ketorolak injeksi 30 mg/ml 1,731 15 10 10 10 5 15 65 Rp 112,515 8

258 Kloramfenicol Tetes Telinga 1% 6,552 3 2 2 5 5 17 Rp 111,384 2

259 Kloramfenicol Tetes Mata 0,5% 11,088 5 8 5 3 5 6 5 5 42 Rp 465,696 5

260 Prednison 5 mg 79 0 Rp - 0

261 Propanolol tablet 10 mg ( HCl ) 90 25 35 40 100 200 Rp 18,000 25

262 Propiltiourasil tablet 100 mg 505 100 100 200 Rp 101,000 25

263 Ranitidin injeksi 25 mg/ml 1,426 0 Rp - 0

264 Salbutamol tablet 4 mg 105 230 270 161 661 Rp 69,405 83

265 Salisil Bedak 2 % @ 50 gr 6,216 3 7 8 18 Rp 111,888 2

266 Sefadroksil kapsul/kaplet 500 mg 560 360 440 200 243 345 126 240 170 2124 Rp 1,189,440 266

267 Sefadroksil Sirup Kering 125 mg/5 ml 5,152 24 23 3 7 57 Rp 293,664 7

268 Sefotaxim Serbuk Injeksi 1 Gram 5,010 0 Rp - 0

269 Setirizin kapsul 10 mg 163 0 Rp - 0

270 Salbutamol tablet 4 mg 105 0 Rp - 0

271 Siprofloksasin tablet scored 500 mg 356 500 700 400 125 320 179 2224 Rp 791,744 278

272 Spironolakton 25mg 426 130 170 100 100 50 150 700 Rp 298,200 88

MENGETAHUI L
KEPALA PUSKESMAS P

Umi Kulsum,S.Kep.Ns
NIP.19861123 201101 2 002
 USULAN
KEBUTUHAN
PUSKESMAS
TOTAL HARGA USULAN KEBUTUHAN PUSKESMAS TAHUN 2023 KET
TAHUN 2023

(19x 18 BULAN)

20 21 22

- -

529 1,057,500

- -

- -

14,632 1,536,334

- -

- -

- -

20,066 2,086,812

22,601 1,762,898

39,726 9,256,158

- -

- -

900 3,060,000

- -

44,224 3,184,110

2,934 5,941,350

7 19,737
 851 3,536,379

500 1,581,917

2,331 403,263

1,643 187,245

- -

1,575 165,375

- -

7,826 829,503

- -

- -

450 112,050

1,609 651,544

- -

- -

3,375 459,000

5,346 796,554

997 3,376,989

- -

225 74,250

731 1,463,963

387 59,598

3,143 323,755

135 158,760

- -

675 148,500

338 911,250

4,021 365,888

308 679,383

72 554,400

- -
 - -

- -

- -

- -

- -

- -

1,721 1,196,269

1,013 424,238

- -

- -

1,125 297,000

- -

- -

- -

5 18,000

2,228 124,740

15,885 3,462,930

2,711 783,551

212 1,099,800

2,048 458,640

- -

- -

- -

7,538 678,375

3,420 256,500

- -

1,152 3,223,296

1,103 2,999,903

- -

1,148 172,125
 - -

- -

1,940 170,676

- -

- -

24,921 1,570,023

17,487 1,084,194

18,428 1,547,910

- -

612 1,572,228

1,782 513,216

- -

563 426,938

450 271,350

- -

3,825 3,851,775

968 2,939,265

25 46,555

7,256 166,894

- -

- -

- -

- -

927 1,902,204

10,919 1,648,807

- -

- -

3,548 1,146,085

342 630,990

351 301,860
 - -

6,721 1,034,996

- -

- -

17,444 1,962,478

- -

293 785,070

1,721 265,073

5,866 498,589

23 88,875

- -

- -

23 73,125

12,800 4,582,490

214 1,004,625

- -

13,466 1,656,349

- -

1,746 1,117,440

225 167,625

- -

162 432,216

- -

- -

- -

923 987,075

225 78,975

83 553,529

2,822 3,332,192

32,922 2,633,760
 68 20,655

90 88,200

1,296 152,928

16 223,697

- -

31,970 2,333,828

- -

- -

698 828,630

11,464 1,123,448

- -

2,214 16,892,820

4,282 4,316,004

113 450,000

3,326 196,205

2,178 180,774

374 1,703,160

- -

- -

128 1,558,879

- -

- -

- -

- -

- -

16,092 1,456,326

176 511,583

1,800 1,976,400

4,631 213,003

169 22,106
 - -

- -

- -

- -

- -

- -

- -

- -

15,176 1,381,039

18,695 32,716,688

15,851 1,854,596

500 7,482,510

342 179,208

3,683 3,355,622

5,794 4,281,581

4,721 4,774,880

808 17,608,950

36 1,871,594

5 257,335

- -

- -

- -

- -

- -

- -

137 4,805,809

- -

- -

- -
 - -

5 53,955

38 458,618

23 11,228

5 18,450

90 724,680

- -

- -

515 2,890,553

441 2,708,622

- -

- -

119 1,685,110

475 3,133,350

140 1,395,000

297 2,970,000

603 6,030,000

- -

- -

27 434,160

18 525,420

106 1,006,317

221 17,199

- -

167 582,750

198 384,437

20 2,490,750

90 62,370

- -

7 108,523
 9 489,450

7 193,185

115 1,385,721

23 799,470

- -

162 6,166,569

97 3,730,606

- -

72 578,398

38 307,274

74 596,473

- -

7 41,209

- -

12825 Rp 3,860,325

99 Rp 554,400

9000 Rp 765,000

0 Rp -

225 Rp 27,225

0 Rp -

675 Rp 259,875

2138 Rp 367,650

45 Rp 126,000

450 Rp 892,350

900 Rp 137,700

675 Rp 151,200

0 Rp -
4950 Rp 910,800

146 Rp 253,159

38 Rp 250,614

95 Rp 1,047,816

0 Rp -

450 Rp 40,500

450 Rp 227,250

0 Rp -

1487 Rp 156,161

41 Rp 251,748

4779 Rp 2,676,240

128 Rp 660,744

0 Rp -

0 Rp -

0 Rp -

5004 Rp 1,781,424

1575 Rp 670,950

LAMPUNG TENGAH , 23SEPTEMBER 2022

PETUGAS PENGELOLA OBAT PUSKESMAS

Lestari Nunyai Putri, A.Md. F

NIP.19910620 201903 2 004