RENCANA KEBUTUHAN OBAT (RKO) PUSKESMAS

DINAS KESEHATAN KABUPATEN LAMPUNG TENGAH

TAHUN 2016
KABUPATEN/KODYA
PROPINSI
PUSKESMAS

: LAMPUNG TENGAH
: LAMPUNG
: BANDAR AGUNG

NO

NAMA GENERIK

SATUAN KEMASAN

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33

ACT ( Artesunate + Amodiaquin ) tablet

Albendazol tablet 400 mg
Alopurinol tab 100 mg
Alprazolam tab 0,25 mg
Ambroksol tablet 30 mg
Aminophilin tablet 200 mg
Amitripthillin tablet 25 mg
Amlodipin tablet 5 mg
Amlodipin tablet 10 mg
Amoksisilina kapsul 250 mg
Amoksisilina kapsul 500 mg
Ampisilina tab 500 mg
Antimigren Ergotamin tatrat 1mg+kofein tablet 50 mg
Antalgin ( Metapiron ) tablet 500 mg
Antasida DOEN tablet
Asam Askorbat (Vit C) tablet 50 mg
Asam Mefenamat tablet 500 mg
Asiclovir tablet/kapsul/kaplet 200 mg
ASIFIT
Atapulagit tablet 600 mg
Atropin Sulfat tablet 0,5 mg
Besi (II) Sulfat tablet salut 300 mg
Betahistin meisilat tablet 6 mg
Calcium Laktat tablet 500 mg
Captropil tablet 12,5 mg
Captropil tablet 25 mg
Cefadroksil kapsul 500 mg
Chlorpheniramine Maleat tablet 4 mg
Cimetidin tablet 200 mg
Ciprofloksasin tablet 500 mg
Clindamycin tablet 150 mg
Clindamycin tablet 300 mg
Deksamethason tablet 0,5 mg

KTK / 24 TAB
30 TAB
100 TAB
100 TAB
100 TAB
100 TAB
100 TAB
KTK / 30 TAB
KTK / 30 TAB
120 KAP
100 KAP
100 KAP
100 TAB
100 TAB
100 TAB
1000 TAB
100 TAB
50 TAB
BTL/ 30 Kaplet
50 TAB
500 TAB
SACHET
30 TAB
KTK / 100 TAB
100 kAP
100 TAB
KTK / 100 TAB
1000 TAB
100 TAB
50 tab
50 TAB
50 TAB
KTK / 100 TAB

JUMLAH PEMAKIAN / BULAN

jan

feb

mar

apr

mei

jun

jul

agst

sept

okt

nov

des

70

68

110

120

118

42

180

125

340

356

180

200

995
30

1,524
62

1,586
65

326
30

1,515
156

1889
150

1202
177

1530
250

1762
432

1747
400

104
270

252

60

70

150

225

196

215

180

250

220

160

234

8,054
553

8,740
85

6,140
252

8,722
185

7,692
60

8023

6012

6081

7981

6942

7344

6612

4,648
3,421
180
1,459
30

1,660
3,486
1,707
1,090

1,665
4,114
1,311
860

1,802
2,786
1,463
1,220
10

1,861
2,804
1,953
985
75

1500
2139
1301
1010

994
1962
688
855

1059
1831
1461
570
125

1330
2304
1617
975
50

2021
4034
2134
1121
100

1702
2607
2081
1089
10

1295
2359
1906
1126

700

1,040

3,910

4,420

1,660

150

165

1295

400

300

120

230

2,364
318
703
495
5,473
70
485

2,258
408
642
584
4,745
160
740

2,097
347
821
485
6,515
140
700

2,557
413
690
290
5,020
20
720

1862
811
564
515
4486
20
778

3009
523
674
220
2861
50
562

1813
798
544
300
3833
50
870

2256 10808
708
783
1134
1016
270
520
3565
7328
110
20
700
900

3164
1340
810
350
3749
110
280

4316
583
586
166
5230
34
850

4,159

2,293

2,274

2,737
437
876
180
5,580
50
755
10
50
2,861

60
2,291

1732

10
1231

60
1529

5
1951

70
1993

135
1735

2800

JUMLAH
PEMAKIAN

PEMAKAIAN
RATA - RATA

5
0
0
0
0
1,909 159.0833333333
0
0
14,180 1289.090909091
2,274
189.5
0
0
1,960 163.3333333333
0
0
0
0
88,343 7361.916666667
1,135
227
0
0
21,537
1794.75
33,847 2820.583333333
17,802
1483.5
12,360
1030
400 57.1428571429
0
0
0
0
0
0
14,390 1199.166666667
0
0
39,241 3270.083333333
7,469 622.4166666667
9,060
755
4,375 364.5833333333
58,385 4865.416666667
834
69.5
8,340
695
10
10
390 55.7142857143
26,849 2237.416666667

34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82

DIAPECTA Tablet
Diazepam tablet 2 mg
Digoxin tablet 0,25 mg
DHP tablet
Doxycycline kapsul 100 mg
Efidrina HCL (Efedrina) tablet 25 mg
Erythromycin 250 mg kapsul
Erythromycin 500 mg kapsul
Fenitoin Kapsul 100 mg
Fenobatbital Tablet 30 mg
Fitomenadion (Vit. K1)tablet salut 10 mg
FITUNO
Fluksetine tablet 10 mg
Furosemida Tablet 40 mg
Glibenklamida tablet 5 mg
Gliseril Guayakolat tablet 100 mg
Griseovulvin tablet 125 mg
Haloperidol tablet 5 mg
Hidroklorotiazida (HCT) tablet 25 mg
HUSTAB
Ibuprofen tablet 200 mg
Ibuprofen tablet 400 mg
ISDN tablet
Kalium Diklofenak tablet 50 mg
Karbamazepim tablet 200 mg
Klorpromazin Tablet 25 mg
Klorpromazin Tablet 100 mg
Kotrimokszol tab 120 mg
Kotrimokszol tab 480 mg
Lanzoprazol Kapsul 30 mg
Loratadine tablet 10 mg
Meloxikam tablet 15 mg
Metformin HCL tablet 500 Mg
Methylprednisolon tablet 4 mg
Metilergometrina Maleat tab salut 0,125 mg
Metoklorpropamide Tablet 10 mg
Metronidazol tablet 250 mg
Metronidazol tablet 500 mg
Mineral Mix
Miraclav
Natrium Bicarbonat (Bicarbonat) tab 500 mg
Natrium Diklofenak tablet 25 mg
Natrium Diklofenak tablet 50 mg
Nifedipin tablet 10 mg
NEUROVITE
Nistatin tablet salut 500.000 IU/g
NEURODIAL
OAT FDC Kategori I
OAT FDC Kategori II

KTK / 100 TAB

1000 TAB
100 TAB
KTK / 9 TAB
100 KAP
1000 TAB
100 KAP
100 KAP
Btl / Kapsul
1000 TAB
100 TAB
KTK/ 30 Kaplet
KTK /30 TAB
100 TAB
100 TAB
1000 TAB
100 TAB
100 TAB
1000 TAB
KTK / 300 TAB
100 TAB
100 TAB
100 TAB
50 TAB
KTK / 100 TAB
KTK / 100 TAB
KTK / 100 TAB
100 TAB
100 TAB
20 TAB
100 TAB
50 TAB
KTK / 100 TAB
KTK / 100 TAB
KTK / 100 TAB
100 TAB
100 TAB
100 TAB
KTK/40 sachet
Tab
1000 TAB
50 TAB
50 TAB
100 TAB
KTK / 60 Kapsul
100 TAB
KTK / 100 TAB
PAKET
PAKET

40

25

15

30

10

10

50

30

60

21

50

30

230

50

10

50

60

10

80

70

30

163

75
180

98
234
1,476
113
285
46

90
201
711
280
280
174

196
120
480
275
210

107
200
209
257
260
132

215
125
183
390
880
40

40
225
233
208
290

120
272
511
351
320
180

191
270

392
562
410
107
390
459

222
170

1,320

163
166
644
227
310

489
20

170
694

100
583

220
777

136
1,173

110
533

180
550

90
1171

60
830

20
140

630
140

90
190

238

30

486

110

60

116

20

110

270

160

285

920

910

1,360

809

1,616

1124

1120

988

929

697

6010

1776

167
80

132
74
50

431
100
90

154
135
130

380
260
15

113
106
95

354
200
30

393
130
90

208
32
90

425
180
669

257
70

135
130

205

285

441

160

255

225

330

131

220

142

373

373

1,888

868

833

1,430

1,188

764

2275

1222

2492

4066

1434

2557

114
10

870
10

501

394
10

420

424
10

612

774

987

1279
40

1348

927
10

50

60

10

70

80

50

719
630

415
360
90

188

100

10
2

0
0
0
0
151
30.2
0
0
140
28
0
0
0
0
0
0
0
0
0
0
833 69.4166666667
0
0
0
0
1,909 159.0833333333
2,725 227.0833333333
4,857 441.5454545455
3,342 303.8181818182
5,535
461.25
1,121 160.1428571429
0
0
2,295
191.25
6,801
566.75
0
0
1,358 150.8888888889
0
0
0
203.75
0
0
0
0
18,259 1521.583333333
0
0
2,982 271.0909090909
1,584
132
1,339 111.5833333333
0
0
0
0
0
0
0
0
3,140 261.6666666667
0
0
0
0
21,017 1751.416666667
0
0
8,650 720.8333333333
90
15
0
0
330 47.1428571429
0
0
0
3.1
0
0

83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119

OAT FDC Kategori Sisipan

OAT FDC Kategori Anak
OAT Kombipak Kategori I ( Dewasa )
OAT Kombipak Anak
Omeprazol kap 20 mg
Papaverin tablet 40 mg
Parasetamol tablet 500 mg
Pirantel Pamoat (Pirantel) tab 365 mg
Piridoksina HCL (Vit.B6) tab 10 mg
Piroxicam tablet 10 mg
Prednison tablet 5 mg
Propanolol HCL (Propanolol) tab 10 mg
Propanolol HCL (Propanolol) tab 40 mg
Propiltiourasile tablet 100 mg (PTU)
Ranitidine Tablet 150 mg
RAMATON
Reserpin tablet 0,25 mg
Retinol (Vit A) 100.000 IU Kapsul Lunak
Retinol (Vit A) 200.000 IU Kapsul Lunak
Risperidon tablet 2 mg
Salbutamol tablet 2 mg
Salbutamol Inhalasi / Aerosol 100 mcg/dosis
Setirizine tablet 10 mg
Simvastatin scored tablet 10 mg
Spiramisin kaps 500 mg
Spironolakton tablet 25 mg
Tetrasiklina HCL kapsul 250 mg
Tetrasiklina HCL kapsul 500 mg
Thiamfenicol 250 mg
Thiamfenicol 500 mg
Thiamin (Vit.B1) 10 mg
Tramadol tablet 50 mg
Trhexyphenidyl 2 mg tablet
Trifluoperazine HCL tablet 5 mg
Vitamin B Komplek tablet
Ventolin Nebu 2,5 mg
Zinc tablet dispersible 20 mg

PAKET
PAKET
PAKET
PAKET
20 kap
1000 TAB
100 TAB
60 TAB
1000 TAB
100 TAB
KTK / 100 TAB
100 TAB
100 TAB
100 TAB
100 TAB
KTK / 100 TAB
1000 TAB
BTL/50 KapLunak
BTL/50 KapLunak
50 tab
KTK / 100 TAB
Dus,200 dosis
KTK /
KTK / 30 TAB
KTK / 100 TAB
Dus /100 TAB
1000 TAB
100 TAB
100 TAB
100 TAB
1000 TAB
50 KAP
100 TAB
KTK / TABLET
KTK / 100 TAB
Kotak 20 Vial
KTK / 100 TAB

115
7,094

134
799
7,101

30
1,086
7,147

150
40
7,636

220
40
7,115

447
40
6706

221
169
5045

225
90
5689

288
100
7649

222
155
285
95
7295 10164

1,135
347
3,878

879
296
3,176

726
162
2,729

798
270
3,445

542
220
3,651

264
184
3149

234
169
2150

70
2109

100
3225

130
5040

58
3142

3162

560

625

646

722

472

703

530

760

902

1413

860

921

1,034

644

661

864

431

387

407

20

301

230

42

47

24

50

190

224

50

23

262
40
7518
250

210

40
40

3,418
320
1,320
3,932
4
200

292

90

530

260

941

369

60
2,464

40
2,853

2,609

2330

40
2455

20
5353

3599

5133

6509

4460

340

45
2,400
250
285

340

210

260

880

290

320

630

390

360

3,308
5
200

3,532
5
186

4,748
5
211

4,602
5
100

4467
9
100

2203
2
300

993
5
200

883
4
180

113
5
200

10
700

5
260

SIRUP
120
121
122
123
124
125
126
127
128
129

Ambroxol Sirup 15 g/ ml
Amoksillina sirup kering Forte 250 mg / 5 ml @ 60 ml
Amoksillina sirup kering 125 mg/5 ml
Ampisillina sirup kering 125 mg/5 ml
Antasida DOEN II Suspensi
BIONICK MILD WITH DHA SYR
BIONICK DROP
Erythromycin 200 mg/ml sirup
FLUTAMOL SIRUP
Garam Oralit 200 mg

0
0
0
0
0
0
0
0
2,354
214
2,899 241.5833333333
86,159 7179.916666667
0
0
4,828
603.5
2,006 182.3636363636
38,856
3238
0
0
0
0
0
0
9,114
759.5
0
0
0
0
0
0
0
0
0
0
4,979 452.6363636364
0
0
0
0
860 95.5555555556
0
0
0
0
40
40
2,522 360.2857142857
0
0
205
41
43,583 3631.916666667
570
285
5,625
468.75
0
0
28,781
2878.1
0
5.3333333333
2,837 236.4166666667

60 ML/BTL
61 ML/BTL
60 ML/BTL
60 ML/BTL
60 ML/BTL
BTL / 60 ML
BTL /15 ML
60 ML/BTL
BTL / 60 ML
KTK/100 Sacshet

70
180
28

71
10
215
25
16

73
175
16

31
20
279
52
44

99
36
195
20

125
26
154
10
72

57
14
64

75
31
122

88
28
189

35

51

87

136
30
160
44
112

155
25
150

178
15
168

137

98

1,158
96.5
235 19.5833333333
2,051 170.9166666667
175 29.1666666667
672 61.0909090909
0
0
0
0
0
0
0
0
0
0

130 Kotrimoksazol suspensi

60 ML/BTL

96

101

103

111

83

63

47

63

180

85

252

151

1,335

131
132
133
134

100 ML/BTL
60 ML/BTL
BOTOL

98
179
57

71
127
36

148
92
12

67
186
48

48
115
27

53
85
22

31
67
16

37
100
14

72
127
12

71
131
12

56
82
13

73
138
42

13

15

30

24

10

20

825
68.75
1,429 119.0833333333
311 25.9166666667
0
0
23
4.6
15
15
0
0
0
0
0
0
165
13.75
0
0
0
0
0
3
0
0
50 16.6666666667
0
0
494
49.4
88
8.8
0
0
0
0
0
0
0
0
44
4.4
0
0
0
0
264
24
724 65.8181818182
0
0
30
30
0
0
48
6
0
0
0
0
0
0
700 63.6363636364
365 33.1818181818
75 10.7142857143
1,740
145
77 25.6666666667
10
10

135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169

Obat Batuk Hitam 100 ml

Paracetamol sirup 120 mg / 5 ml
Paracetamol Drop 100 mg/ml
INJEKSI
Aminofillina Injksi 24 mg/ml-10 ml
Amoksillina Inj 1000 mg/ ml
Ampicillin Serbuk Inj i.v 1000 Mg/Vial
Ampicillin Serbuk Inj 500 Mg/ml
Antalgin Injeksi 250 mg/ml - 2 ml
Aqua Pro Injeksi
Arthemeter Injeksi 80 mg/ML
Atropin 0,25 mg/ml injeksi
Asam Traneksamat Injeksi 50 mg/ml
Benzatin penisillin inj
Dexamethason Injeksi 5 mg/ml - 1 ml
Diazepam injeksi 5 mg/ml - 2 ml
Diphenhidramin HCL Inj 10mg/ml - 1 ml
Epineprine (Adrenalin) Injeksi 1 mg/ml
Fenobarbital injeksi 50 mg/ml - 2 ml
Fitomenadion (Vit.K1) Injeksi 2 mg/ml -1 ml
Fitomenadion (Vit.K3) Injeksi 10mg/ml -1 ml
Furosemida Inj 10 mg
Gentamisin inj 40 mg / ml
Haloperidol dekanoat Injeksi 50 mg
Haloperidol inj 5 mg/ml (Lodomer)
Ketorolac Inj 30mg/1ml
Lidocaine Comp injeksi, (HCL) 2 %
MERSIBION INJEKSI
Metilergometrin Maleat Inj 0,200 mg-1ml
Metroclorpropamide Inj 5 mg
Metronidazol Infus 500 mg/ 100 ml
Oksitosin inj 10 IU/ml
Ondansentron Injeksi 4 mg/2ml
Prokain Benzil Penicillin G Injeksi 3 jt IU / vial
Ranitidine Inj 25 mg/2 ml
Sefotaksim Inj 1 gr
Seftriakson serbuk Inj 1 gr
Sianokobalamina (Vit,B12) inj 500 mcg/ml - 1 ml
Thiamin HCL (Vit. B1) injeksi 100 mg/ml - 1 ml
Tramadol Inj 50 mg/ml-2ml

30 AMP
KTK / 10 vial
KTK /10 vial
KTK / 10 vial
30 AMP
10 AMP
KTK / 6 AMPL
30 AMP
KTK / 10 AMP
10 VIAL
100 AMP
30 AMP
30 AMP
30 AMP
30 AMP
30 AMP
100 AMP
25 AMP
KTK / 5 AMP
KTK / 5 AMP
KTK / 5 AMP
12 AMPUL
30 AMP
AMPUL
30 AMP
10 AMP
100 ML/BTL
AMPUL
KTK / 5 AMP
KTK / 30 VIAL
10 AMPUL
2 VIAL
2 VIAL
100 AMP
30 AMP
10 AMPUL

15

20

110
8

54

40
85

30
102

10

10

10

30
10

40
7

60
6

50

20
71

40
106

16
76

20
76

15

30

40
11

50
16

30
11

30
12

15

12
51

26
71

20
54

20
21

20

10

45
30

70
30
160

50
37
15
370

55
20

135

50
30
5
140

11

30

40

90
45
15
70
30

50
25
145
30

10

95
55
15
155
17
10

70
42
5
125

75
40
15
120

50
11
5
135

145

SERUM DAN VAKSIN

170 Serum Anti Bisa Ular Polivalen inj 5 ml (ABU I)
171 Serum Anti Tetanus inj.1500 IU/ampul (A.T.S)
172 Vaksin BCG 20 dos

1 VIAL
10 AMPUL
AMPUL

15

15

15

15

10

10

3
10

111.25

3
95
0

3
11.875
0

173 Vaksin Campak Kering 10 dos

Vial

174 Vaksin Hepatitis B recombinan Unject

VIAL

175 Vaksin Polio 10 dos

176 Vaksin Rabies untuk manusia serbuk Inj s.k/i.k +booster

VIAL
KTK / VIAL

INFUS
177 Glukosa Larutan infus 5 %
178 Natrium Klorida Larutan Infus 0,9 % steril
179 Ringer Laktat, larutan infus steril

500 ML/BTL
500 ML/BTL
500 ML/BTL

2
93

1
2
66

2
3
63

23
17
147

5
5
75

5
4
103

5
75

90

9
5
135

5
7
150

15
6
306

5
5
110

BMHP ( BAHAN MEDIS HABIS PAKAI )

180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199

Alat Suntik 1 ml 26 G
Alat Suntik 3 CC
Alat Suntik 5 CC
Cat Gut Chromic 3/0 HR 26 MM
Foley Cateter
Sarung Tangan steril Size 7,5
Infusion set anak
Infusion set dewasa
IV Catheter No.20 G
IV Catheter No.22 G
IV Catheter No.24 G
Kapas pembalut Absorsen 250 gram
Kassa kompres steril 40 x 40 cm
Kassa pembalut Hidrofil 4 m x 15 cm
Kassa pembalut 2 m x 80 cm
Kassa steril 16 x 16 cm
Masker
Plester 5 yard x 2 inch
Silk (Benang Bedah Sutra) No.3/0 @ 24 x13x60 cm
Urine back

100 BIJI
100 BIJI
100 BIJI
SACHET
Pcs
KTK /50 PSNG
SET
SET
Pcs
Pcs
Pcs
250 G/BKS
ROL
ROL
ROL
KTK / 16 lbr
KTK / 20 Pcs
6 ROL
12 SACHET
Pcs

50
13
206
15

50
113
470
20
5
5
5
25
30
20
10
5

3
2
32
31
17
6
2

6
2
2
5
30
15
15
10
2

124

124

126

110

3
6
3

5
6
6
5

3
6
11
5

3
5
10

327
180
10

579
147
12

828
54
11

2
5
36
18
15

4
5
32
15
17
5
4

329
128
23
5
4
10
60
35
23

114

125

1
6
6

2
5
6

51
12
10

50
250
17

171
6

245
6

169
6

2
20
30
20
20
15
2

2
10
32
17
18
20
2

4
15
40
30
30
20
2

3
33
22
15
30
23
5

172
5
2
5
5
30
5
30
30
4

125

124

127

110

121

2
5
5
2

4
5
16

3
5
10

2
4
18

2
2
12

2
2
10
2

OBAT LUAR
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217

Antifungi DOEN Salep

Asiclovir Crem 5 %
Betamethason Krim 0,1 %
BETASON Krim
Clorampecort - H Cream
Etakridin lart 0,1 % 300 ml
Etanol 70 % cairan
Gentamisin salep kulit
Gentamisin Salep Mata 0,3
Gentien Violet
Gliserin 100 ml
Hidrokortison Krim 2,5 % tube 5 g
Ketokonazol Krim 2 %
Kloramfenicol 3 % tts telinga 5 ml
Kloramfenicol salep mata 1 %
Kloramfenicol Tetes mata 0,5 %
Lisol mengandung Kresol tersabun 50 %
Oksitetrasiklina HCL salep mata 1 %

24 POT
25 TUBE
25 TUBE
TUBE / 5 gr
TUBE / 10 gr
300 ML/BTL
BOTOL/ 100 ml
10 TUBE
TUBE / 3,5 gr
1 BOTOL
100 ML/BTL
24 TUBE
TUBE
1 BOTOL
TUBE
5 ml
1000ML/BTL
25 TUBE

14
13
35

14
12
63

9
8
55

13
19
64

32
18
41

31
18
41

24
13
43

34
12
44

15
11
54

42
43
59

32
58
54

58
7
33

1
7

1
8
8
10

2
2
1
10
14

2
13
22
15
11

19
16
29
12

19
16
29

20
23
19

22
18
14

20
18
10

20
34
16

27
34
34

27
23
18

23

34

29

13

32

32

58

48

11

35

17

23

105

10

29

3
123

3
6

2
15

3
13

11

5
11

3
3

0
12

0
1.3333333333

72
59
1,413

7.2
5.9
117.75

150
50
2,189 364.8333333333
2,192 199.2727272727
137 11.4166666667
14
3.5
37
3.0833333333
115 10.4545454545
420
35
0
20.25
0 20.4166666667
0 15.4444444444
40
3.3333333333
0
0
1,337 111.4166666667
0
0
0
0
32
2.6666666667
57
4.75
113
9.4166666667
14
3.5
0

318
232
586
0
0
5
198
220
204
37
0
355
0
0
150
0
20
182

26.5
19.3333333333
48.8333333333
0
0
1.6666666667
16.5
18.3333333333
18.5454545455
12.3333333333
0
29.5833333333
0
0
37.5
0
2.8571428571
26

218
219
220
221
222
223

Oksitetrasiklina salep 3% tube 5 g

Povidon Iodida Larutan 10 % @ botol 30 ml
Povidon Iodida Larutan 10 % @ botol 300 ml
Salep 2 - 4
Scabicid Cream Tube 10 gr
Salisyl Bedak 2 %

25 TUBE
BOTOL
BOTOL
24 POT
10 TUBE
KOTAK

OBAT GIGI
224
225
226
227
228
229
230
231
232
233
234

Air Raksa Dental Use

Devitalisasi Pasta
Etil Klorida Semprot
Glass Ionomer Cemen
Kalium Hidroksida Pasta
Monoklorkamfer Mentol Cairan (CHKM)
Mummifying Pasta
Semen Seng Fostat Serbuk Dan Cairan @30 g
Silver Amalgam Serbuk 65-75 @ 30g
Spon Gelatin Cublices 1 x 1 x 1 cm
Temporary Stopping Fletcher (Fletcher)

SET
SET
100 ML/BTL
1 SET
1 SET
SET
SET
1 SET
1 BOTOL
50 PELLET
1 SET

59

183

61

13

39

39

36

39

61

86

41

63

4
17

4
10

2
5

3
1

3
7

3
7

2
5

2
17

3
6

11

21

24

26

37

37

20

35

41

15

34

41

720
0
0
80
0
342

60
0
3.0909090909
8
0
28.5

0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0

REAGENSIA
235 Asam urat 30 ml x 4 kit paket
236 Bilirubin autodirect 50 ml x 4 botol
237 Bilirubin autototal 50 ml + 1 x 4 botol
238 Dengeue Tes Kit / 25 tes Paket
239 Glukosa 100 ml x 5 botol
240 Kolesterol 100 ml x 5 botol paket
241 Kreatinine 125 ml x 2 botol paket
242 Larutan Benedig
243 Larutan Eosin 2 %
244 Larutan Etanol Asam
245 Larutan Giemsa Stain
246 Larutan Karbol Fuksin
247 Larutan Metilen Biru
248 Larutan Turk
249 Malaria Test Dusx/25 test kotak
250 Metanol
251 S.G.O.T 62,5 ML X 2 botol paket
252 S.G.P.T 62,5 ML X 2 botol paket
253 Total Protein 125 ml x 2 botol paket
254 Trigelycerida 50 ml x 6 botol paket
255 Ureum 100ml x 2 kit
256 V.D.R.L dusx 10 ml paket

Mengetahui,
Kepala Puskesmas Bandar Agung

100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL
100 ML/BTL

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

Gunung Sugih, 05 Januari 2016

Pengelola Obat Puskesmas

dr. INDRA SURATMAN

NIP. 19691119 200701 1 019

NURHIDAYAH
NIP. 19681221 199001 2 001

USULAN
KEBUTUHAN
OBAT PKM

HARGA PER
TABLET

TOTAL

(klm 5 x 14)

0
0
2227.166666667
0
18047.27272727
2653
0
2286.666666667
0
0
103066.8333333
3178
0
25126.5
39488.16666667
20769
14420
800
0
0
0
16788.33333333
0
45781.16666667
8713.833333333
10570
5104.166666667
68115.83333333
973
9730
140
780
31323.83333333

1,375.00
344.00
86.00
380.00
85.93
80.00
112.00
187.00
330.00
211.00
272.00
381.00
135.00
116.00
72.00
95.00
112.00
237.00
190.00
74.00
44.00
924.00
70.00
62.00
84.00
509.00
21.00
111.00
255.00
361.00
553.00
62.00

191,536.33
1,550,802.15
212,240.00
427,606.67
28,034,178.67
1,210,818.00
2,914,674.00
2,843,148.00
1,973,055.00
1,615,040.00
189,600.00
738,686.67
3,204,681.67
540,257.67
887,880.00
2,598,020.83
1,430,432.50
108,003.00
2,481,150.00
50,540.00
431,340.00
1,942,077.67

0
0
422.8
0
392
0
0
0
0
0
971.8333333333
0
0
2227.166666667
3179.166666667
6181.636363636
4253.454545455
6457.5
2242
0
2677.5
7934.5
0
2112.444444444
0
0
0
0
21302.16666667
0
3795.272727273
1848
1562.166666667
0
0
0
0
3663.333333333
0
0
24519.83333333
0
10091.66666667
210
0
660
43.4
0
0

45.00
97.00
270.00
51.00
497.00
930.00
133.00
65.00
634.00
419.00
85.00
56.00
27.90
209.00
96.00
36.00
110.00
150.00
425.00
245.00
68.00
149.00
72.00
138.00
473.00
154.00
348.00
112.50
205.00
154.00
91.00
110.00
160.00

14.30
133.00
200.00
110.00
640.00
359,990.00
1,199,900.00

41,011.60
105,840.00
616,142.33
189,309.17
178,033.33
172,467.65
888,972.00
619,920.00
80,712.00
294,525.00
1,190,175.00
897,788.89
2,939,699.00
584,472.00
643,104.00
175,743.75
586,133.33
350,633.62
2,018,333.33
23,100.00
422,400.00
-

0
0
0
0
2996
3382.166666667
100518.8333333
0
8449
2553.090909091
45332
0
0
0
10633
0
0
0
0
0
6336.909090909
0
0
1337.777777778
0
0
560
5044
0
574
50846.83333333
3990
6562.5
0
40293.4
0
3309.833333333
0
1351
274.1666666667
2392.833333333
408.3333333333
855.2727272727
0
0
0
0
0

160,000.00
214,990.00
288,199.00
171,195.00
211.00
99.50
79.00
311.00
17.40
69.54
114.00
65.00
107.00
319.00
120.00
103.00
260.00
460.00
1,008.00
59.00
181.00
169.00
1,499.00
900.00
149.00
300.00
318.63
431.00
37.80
188.93
40.00
405.00
107.00
10,122.75
474.00
2,475.00
4,070.00
2,445.00
4,400.00
2,160.00

7,700.00
285.00

632,156.00
336,525.58
7,940,987.83
147,012.60
177,541.94
5,167,848.00
1,275,960.00
373,877.64
226,084.44
83,440.00
1,513,200.00
247,394.00
1,922,010.30
753,830.70
262,500.00
4,311,393.80
1,568,861.00
3,343,725.00
1,115,858.33
5,850,477.50
1,796,666.67
1,847,389.09
-

1557.5

2,190.00

3,410,925.00

962.5
1667.166666667
362.8333333333
0
64.4
210
0
0
0
192.5
0
0
0
0
233.3333333333
0
691.6
123.2
0
0
0
0
61.6
0
0
336
921.4545454545
0
420
0
84
0
0
0
890.9090909091
464.5454545455
150
2030
359.3333333333
140

1,258.95
1,438.00
5,200.00
3,823.00
5,100.00
5,100.00
3,000.00
1,300.00
5,300.00
22,000.00
1,230.00
2,950.00
9,800.00
1,580.00
2,344.00
1,054.00
8,100.00
1,800.00
3,417.00
1,450.00
1,829.00
3,399.00
83,333.00
6,250.00
2,300.00
1,363.00

1,211,739.38
2,397,385.67
1,886,733.33
246,201.20
1,071,000.00
1,020,250.00
368,666.67
728,946.40
997,920.00
209,378.40
772,800.00
1,255,942.55
1,155,000.00
835,800.00
1,015,636.36
1,370,409.09
495,000.00
2,186,310.00
247,940.00
335,300.00

2,750.00
1,000.00
9,950.00
2,200.00
2,400.00
7,190.00
1,140.00
2,950.00
3,300.00
1,077.00
690.00
2,395.00
-

42
166.25
0

398,475.00
91,648.00
49,115.00

16,735,950.00
15,236,480.00
-

28,655.00

26,015.00

0
18.6666666667
0
100.8
82.6
1648.5
0
700
5107.666666667
2789.818181818
159.8333333333
49
43.1666666667
146.3636363636
490
0
0
0
46.6666666667
0
1559.833333333
0
0
37.3333333333
66.5
131.8333333333
49
0
371
270.6666666667
683.6666666667
0
0
23.3333333333
231
256.6666666667
259.6363636364
172.6666666667
0
414.1666666667
0
0
525
0
40
364

17,490.00
78,500.00
5,200.00
4,700.00
5,200.00
1,092.50
739.00
1,038.00
22,599.00
8,495.00
4,211.40
4,000.00
3,500.00
7,334.00
7,334.00
7,334.00
24,000.00
1,800.00
2,070.00
7,600.00
1,225.00
23,625.00
13,616.00
4,000.00
2,516.00
2,152.00
1,520.00

2,212.00
2,500.00
1,350.00
2,600.00
900.00
4,730.00
2,798.00
2,569.00
1,599.00
1,600.00
2,500.00
49,862.00
1,600.00

1,465,333.33
524,160.00
388,220.00
8,572,200.00
764,750.00
3,774,565.67
2,895,831.27
3,612,073.50
416,255.00
181,792.10
585,454.55
1,715,000.00
1,120,000.00
3,228,855.00
45,733.33
1,571,062.50
1,795,042.67
196,000.00
933,436.00
582,474.67
1,039,173.33
51,613.33
577,500.00
346,500.00
675,054.55
155,400.00
1,158,838.33
840,000.00
1,994,480.00
582,400.00

anuari 2016
Puskesmas

840
0
0
112
0
399
0
0
0
0
0
0
0
0
0
0
0
0

1,529.00
14,203.00
2,000.00
1,250.00
103,536.00
390,000.00
105,000.00
395,000.00
242,000.00
55,000.00
137,853.00
93,500.00
227,311.00
10,998.92
34,000.00
-

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

607,090.00
423,500.00
423,500.00
2,317,012.00
605,000.00
1,265,000.00
352,000.00
27,447.00
195,000.00
32,347.00
60,046.00
22,020.00
16,195.00
13,819.00
875,875.00
23,684.00
495,000.00
495,000.00
467,500.00
1,528,470.00
486,750.00
379,500.00

1,284,360.00
224,000.00
498,750.00
-

9001 2 001