LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO) PUSKESMAS

Lembar Putih : Dinkes Kabupaten

Lembar Biru/Hijau : UPTD FAMM
Lembar Kuning : Puskesmas

PUSKESMAS : SILIWANGI DOKUMEN NOMOR TANGGAL

KECAMATAN : PELAPORAN BULAN/PERIODE : JUNI 2012 DINKES KAB/KOTA
KAB/KOTA : GARUT PERMINTAAN BULAN/PERIODE : JULI 2012 DBMB
PROPINSI : JAWA BARAT PUSKESMAS

NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEKOSONGAN STOK OPTIMUM PERMINTAAN
ALAT KESEHATAN
1 Alat Suntik Sekali Pakai 1ml SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
2 ALAT SUNTIK SEKALI PAKAI 2.5 ML/3 ML SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
3 Alat Suntik Sekali Pakai 5 ml SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
4 Blood set SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
5 Bisturi SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
6 Catgut/Benang Bedah No.3/0 SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
7 Catgut/Benang Bedah No.2/0 ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
8 Folley catheter SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
9 Infusion set anak SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
10 Infusion set dewasa SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
11 Jarum cutting (Otot) SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
12 Jarum tapper (kulit) SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
13 IV Catheter No.18 SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
14 IV Catheter No.20 SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
15 IV Catheter No.22 SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
16 IV Catheter No.24 SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
17 Kapas pembalut/absorben 250 mg BUNGKUS #REF! 0 #REF! 0 #REF! 0 0 #REF!
18 Kasa Hidrofil Steril 16 X 16 ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
19 Kasa pembalut elastic 4 inchi ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
20 Kasa pembalut Hidrofil 4 X 10 cm ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
21 Kasa pembalut hidrofil 4 x 5 cm ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
22 Masker SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
23 Plester 5 yard x 2 inch ROL #REF! 0 #REF! 0 #REF! 0 0 #REF!
24 sarung Tangan non steril SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
25 Sarung Tangan Steril SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
26 SILK (BENANG BEDAH SUTRA) NO.3/0 DENGAN JARUM BEDAH SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
27 Urin Bag SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
28 Wing Needle SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANAFILAKSIS
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEKOSONGAN STOK OPTIMUM PERMINTAAN
29 Deksametason inj 5 mg/ml-1 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
30 Deksametason Tablet 0.5 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
31 Difenhidramin inj 10 mg/ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
32 Epinefrina HCl/Bitartrat (Adrenalin) inj 0.1 %-1ml Ampul #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANALGETIKA ANTIPIRETIK & ANTIINFLAMASI NON STEROID
33 Antalgin (Metampiron) Tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
34 Antalgin Injeksi 250 mg/ml-2ml TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
35 Asam Mefenamat 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
36 Asetosal Tablet 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
37 Ibuprofen tablet 400 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
38 Ketoprofen Inj Ampul #REF! 0 #REF! 0 #REF! 0 0 #REF!
39 Natrium Diklofenac 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
40 Parasetamol sirup 120 mg/5 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
41 Parasetamol tablet 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
42 Parasetamol tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
43 Tramadol Injeksi 50 mg/ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
44 Tramadol Kapsul 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANESTESI LOKAL
45 ETIL KLORIDA SEMPROT - 100 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
46 Lidokain inj Komp:Lidokain % + Epinefrin 1 : 80000-2ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTELMINTIK
47 Albendazol 400 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
48 Pirantel tablet 125 TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIALERGI
49 KLORFENIRAMIN MALEAT (CTM) TABLET 4 MG TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIAMUBA
50 Metronidazol tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIASMA
51 Aminofilin Inj 24 mg/ml-10 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
52 Aminofilin Tablet 200 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
53 Efedrin HCl tablet 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
54 Salbutamol tablet 2 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
55 Salbutamol tablet 4 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
56 Salbutamol 2.5 mg/2.5 ml NaCl AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIBAKTERI
57 Amoksilin Kapsul 500 mg KAPLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
58 Amoksilin sirup kering 125 mg/ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
59 Ampisilin inj Im/IV 1000 mg/ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
60 Antibakteri DOEN TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
61 Benzatin Benzil Penisilin Inj 2.4 juta IU/vial VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
62 Ciprofloksasin 500 mg KAPLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
63 Doksisilin 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
64 Erytromycin 250 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEKOSONGAN STOK OPTIMUM PERMINTAAN
65 Fenoksimetil Penisilin tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
66 Gentamisin Injeksi 80 mg/2 ml (sebagai sulfat) BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
67 Gentamisin Sulfat Tetes Mata 0.3% 5ML AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
68 Gentamycin S.K TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
69 Kloramfenikol kapsul 250 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
70 Kloramfenikol Salep Kulit 2% TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
71 Kloramfenikol salep mata 1 % TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
72 Kloramfenikol Suspensi 125 mg/5 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
73 Kloramfenikol tetes telinga 3 % BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
74 Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
75 Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
76 Kotrimoksazol Tab Ped:Sulf 100 + Trim 20 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
77 Oksitetrasiklin HCl 1 % Salep mata TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
78 Oksitetrasiklin HCl inj i.m 50 mg/ml-10 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
79 Oksitetrasiklin HCl Salep 3 % TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
80 Prokain Benzil Penisillin 3 juta IU / vial inj VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
81 Sefadroxil Kapsul 500 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
82 Sefotaksim Serbuk Injeksi 1 g/vial VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
83 Seftriaxon Serbuk Injeksi 1 g/vial VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
84 Sulfasetamid Natrium Tetes mata 15 % BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
85 Tetrasiklin Kapsul 250 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
86 Tetrasiklin Kapsul 500 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
87 Tiamfenikol Kapsul 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIDIABETES
88 Glibenklamid tablet 5 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
89 Metformin 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIDIARE
90 Attapulgite + pektin TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
91 Zinc Tablet TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIDOT
92 Atropin Sulfat injeksi 0.25 mg/ml-1 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIEMETIKA
93 Dimenhidrinat Tablet 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
94 domperidon suspensi 5 mg/5ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
95 Domperidon Tablet 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
96 Metoklorpropamid Injeksi 5 mg/ml Ampul #REF! 0 #REF! 0 #REF! 0 0 #REF!
97 Metoklorpropamid Tablet 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIEPILEPTIK
98 Fenitoin Natrium kapsul 30 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
99 Fenitoin Kapsul 100 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
100 Karbamazepin tablet 200 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIFUNGI
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEKOSONGAN STOK OPTIMUM PERMINTAAN
101 Antifungi DOEN kombinasi POT #REF! 0 #REF! 0 #REF! 0 0 #REF!
102 Griseofulvin tablet 125 mg micronized TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
103 Ketokonazol Tablet 200 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
104 MICONAZOL SK 2% TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
105 Nistatin tablet salut gula 500.000 IU / G TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
106 Nistatin tablet vaginal 100.000 IU / g TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIHEMOROID
107 Anti Hemmoroid DOEN SUPP TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIHIPERASIDITAS
108 Antasida DOEN TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
109 Antasida II Suspensi 60 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
110 Omeprazol Capsul 20 mg KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
111 Ranitidin 150 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
112 Ranitidin Injeksi 25 mg/ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIHIPERLIPID
113 Simvastatin 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
114 Simvastatin 20 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIHIPERTENSI
115 Captropil 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
116 Nifedipin 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIINFLAMASI KORTIKOSTEROID
117 Betametason Krim 0.1 % TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
118 Hidrokortison krim 2.5 % TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
119 Prednison tablet 5 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIMALARIA
120 Arterakina TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
121 Klorokuin tablet 150 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
122 Kuinin dihidroklorida inj 25 %-2 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
123 Primakuin tablet 15 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIMIGREN
124 Antimigren DOEN TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIPARKINSON
125 Triheksifenidil HCl tablet 2 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIPIRAI
126 Alopurinol tablet 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTISEPTIK & DESINFEKTAN
127 ETAKRIDIN (RIVANOL) LARUTAN 0.1 %-300 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
128 ETANOL 70 % - 1000 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
129 Fenol Gliserol Tetes telinga 10 % BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
130 Gentian violet larutan 1 %-10 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
131 Kaporit KG #REF! 0 #REF! 0 #REF! 0 0 #REF!
132 Lisol - Mengandung kresol tersabun 50%-1000 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEKOSONGAN STOK OPTIMUM PERMINTAAN
133 Paraformaldehid tablet 1 gram TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
134 Pine oil 7 % + benzyl chlorophenol 0.6 % BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
135 Povidon Iodida 10 % - 30 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
136 Povidon Iodida 10 % - 300 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
137 Salisil Bedak 2 % - 50 gram KOTAK #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTISKABIES
138 Lindane 1% + Usnic acid 1% TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
139 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % POT #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTISPASMODIK
140 Hyoscine-n-butilbromide Tablet 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTITIROID
141 PROPILPROTOURASIL TABLET 100 MG TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTITUSIF
142 DEKSTROMETORFAN SIRUP 10 MG/5 ML - 60 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
143 Dekstrometorfan tablet 15 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
ANTIVIRAL
144 Asiklovir Krim 5%/5g TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
145 Asiklovir Tablet 400 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
CAIRAN EKLEKTROLIT & NUTRISI
146 Garam Oralit 200 ml air SACHET #REF! 0 #REF! 0 #REF! 0 0 #REF!
147 GLUKOSA LARUTAN INFUS 5 % STERIL-500 ML BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
148 Kalsium Laktat (Kalk) tablet 500 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
149 Natrium Klorida Lar.infus 0.9 % steril BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
150 Ringer Laktat Larutan Infus Steril BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
DIURETIK
151 Furosemid tablet 40 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
152 Hidroklotiazid (HCT) tablet 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
EKSPEKTORANS & TOKOLITIK
153 Bromheksin Tablet 8 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
154 Gliseril Guayakolat tablet 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
155 Obat batuk Hitam (OBH) Cairan - 100 ml BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
GIGI DAN MULUT
156 Devitalisasi Pasta (Non arsen) BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
157 Eugenol Cairan BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
158 Glass Ionomer Cement (GC IX) SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
159 Kalsium hidroksida pasta TUBE #REF! 0 #REF! 0 #REF! 0 0 #REF!
160 Monoklor Kamfer mentol cairan BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
161 Mummifying Pasta BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
162 Semen seng fosfat serbuk cairan BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
163 Temporary Stopping Fletcher (Fletcher) SET #REF! 0 #REF! 0 #REF! 0 0 #REF!
HEMOSTATIK
164 Fitomenadion(Vit K1) inj 2 mg/ml-1ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
165 FITOMENADION (VIT K1) INJ 10 MG/ML - 1 ML AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEKOSONGAN STOK OPTIMUM PERMINTAAN
166 FITOMENADION (VIT K1) TABLET SALUT GULA 10 MG TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
HIPNOTIK
167 Fenobarbital tablet 30 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
168 Fenobarbital Inj 50 mg/2ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
KARDIOVASKULER
169 Digoksin tablet 0.25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
170 ISOSORBID DINITRAT TABLET SUBLINGUAL 5 MG TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
171 Propanolol HCl tablet 40 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
KEBIDANAN
172 Magnesium sulfat inj (IV) 20 %-25 ml VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
173 Magnesium sulfat inj(IV) 40 % VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
174 Metilergometrin maleat inj 0.200 mg - ml Ampul #REF! 0 #REF! 0 #REF! 0 0 #REF!
175 Metilergometrin maleat tab salut 0.125 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
176 Oksitoksin Inj 10 IU/ml - 1 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
LAIN-LAIN
177 Aqua Pro Injeksi steril bebas pirogen - 20 ml VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
178 Iodin Test BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
NEUROLEPTIK (TRANKUILIZER MINOR)
179 Amitriptilina HCl tablet salut 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
180 DIAZEPAM INJ 5 MG / ML - 2ML AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
181 Diazepam Rectal 5 mg/2.5 ml SUPP #REF! 0 #REF! 0 #REF! 0 0 #REF!
182 Diazepam tablet 2 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
NOOTROPIK
183 Piracetam Injeksi 1g/5mg AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
184 Piracetam Tablet 400 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
PSIKOSIS
185 Haloperidol tablet 1.5 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
186 Klorpropmazin HCl inj 5 mg/ml - 2 ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
187 Klorpropmazin HCl tablet salut 100 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
188 Klorpropmazin HCl tablet salut 25 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
189 Resperidon 2 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
VAKSIN & SERUM
190 Serum anti bisa ular Polivalen inj 5 ml (SABU) 1 VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
191 Serum anti tetanus inj 1500 IU/vial (ATS) VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
192 Serum anti tetanus inj 20.000 IU / vial (ATS) VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
193 Serum antidifteri inj 20.000 IU / vial (ADS) VIAL #REF! 0 #REF! 0 #REF! 0 0 #REF!
194 Vaksin Rabies Vero KURR #REF! 0 #REF! 0 #REF! 0 0 #REF!
VITAMIN & MINERAL
195 Asam Askorbat (VIT C) Tablet 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
196 Iodiol kapsul KAPSUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
197 Mineral Mix SACHET #REF! 0 #REF! 0 #REF! 0 0 #REF!
198 Multivitamin + DHA + Lysin BOTOL #REF! 0 #REF! 0 #REF! 0 0 #REF!
NO. NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR KEKOSONGAN STOK OPTIMUM PERMINTAAN
199 Multivitamin + Mineral TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
200 Piridoksin HCl (Vit B6) tablet 10 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
201 Retinol (VIT A) 200.000 IU KAPSUL LUNAK #REF! 0 #REF! 0 #REF! 0 0 #REF!
202 Retinol tab 100.000 IU KAPSUL LUNAK #REF! 0 #REF! 0 #REF! 0 0 #REF!
203 Sianokobalamin (Vit B 12) inj 500 mcg/ml-1ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
204 Tablet Tambah darah kombinasi : Besi II Sulfat 200 mg + Asam folat TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
205 Tiamin HCL (Vit B1) inj 100 mg/ml - 1ml AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!
206 Tiamin HCL (Vit B1) tablet 50 mg TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
207 Vitamin B Kompleks tablet TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
208 Vit B1 100 mg, Vit B6 100 mg, Vit B12 100 mcg AMPUL #REF! 0 #REF! 0 #REF! 0 0 #REF!

Vitamin A 417 mcg, Vit B1 0.5 mg, Vit B2 0.5 mg, Vit B3 5 mg, Vit
209
B6 0.5 mg, Vit B12 1 mg, Vit D3 5 mg, Vit E 6 mg, Vit K 20 mcg, Vit
TABLET #REF! 0 #REF! 0 #REF! 0 0 #REF!
C 30 mg, As. Folat 150 mcg, as Pantotenat 3 mg, Yodium 50 mcg,
Zat besi (Fe) 10 mg, Seng (Zn) 5 mg, Selenium (Se) 20 mcg
(TABURIA)

UMUM ASKES JAMKESMAS JAMKESDA JAMPERSAL JUMLAH

RAWAT JALAN
KUNJUNGAN RESEP
R/ (ITEM OBAT)
KUNJUNGAN PASIEN
RAWAT INAP
KUNJUNGAN RESEP
R/ (ITEM OBAT)
KUNJUNGAN PASIEN

Garut,
Mengetahui, Yang Melaporkan,
Kepala Puskesmas Pengelola Obat Puskesmas

….…………………………… ……………………………..
NIP. NIP.
 Pagu anggaran:
Hasil Perhitungan:
Selisih:

NO NAMA OBAT KELOMPOK FARMAKOLOGI

1 Alopurinol tablet 100 mg ANTIPIRAI

2 Aminofilin Inj 24 mg/ml-10 ml ANTIASMA
3 Aminofilin Tablet 200 mg ANTIASMA
4 Amlodipin tablet 5 mg ANTIHIPERTENSI
5 Amoksisilin Kaplet 500 mg ANTIBAKTERI
6 Amoksisilin Sirup Kering 125 mg/5 ml ANTIBAKTERI
7 Amoksisilin Sirup Kering Forte 250 mg/5 ml ANTIBAKTERI
8 Antalgin (Metampiron) Tablet 500 mg ANALGESIK NON NARKOTIK
9 Antasida DOEN I Tablet Kunyah ANTIULKUS
10 Antasida II Suspensi 60 ml ANTIULKUS
11 Anti Hemmoroid DOEN ANTIHEMOROID
12 Antibakteri DOEN ANTIBAKTERI KULIT, MATA, TELINGA
13 Antifungi DOEN kombinasi ANTIFUNGI KULIT
14 Antimigren DOEN ANTIMIGREN
15 Aqua Pro Injeksi steril bebas pirogen- 20 ml LAIN-LAIN
16 Asam Asetilsalisilat Tablet 100 mg (Asetosal) ANTIAGREGASI PLATELET
17 Asam Asetilsalisilat Tablet 80 mg (Asetosal) ANTIAGREGASI PLATELET
18 Asam Askorbat (VIT C) Tablet 50 mg VITAMIN dan MINERAL
19 Asam Mefenamat kaplet 500 mg ANALGESIK NON NARKOTIK
20 Asiklovir Krim 5%/5g ANTIVIRUS
21 Asiklovir Tablet 400 mg ANTIVIRUS
22 Atapulgit tablet 600 mg (Puralex) OBAT untuk DIARE
23 Atropin Sulfat injeksi 0,25 mg/ml-1 ml ANTIDOT dan OBAT LAIN untuk KERACUNAN
24 Benzatin Benzil Penisilin Inj 2,4 juta IU/vial ANTIBAKTERI
25 Betametason Krim 0.1 % ANTIINFLAMASI dan ANTIPRURITUS
26 Bromheksin Tablet 8 mg EKSPEKTORAN dan MUKOLITIK
27 Deksametason inj 5 mg/ml-1 ml ANTIALERGI dan OBAT ANAFILAKSIS
28 Deksametason Tablet 0,5 mg ANTIALERGI dan OBAT ANAFILAKSIS
29 Dekstrometorfan tablet kombinasi ANTITUSIF DAN DEKONGESTAN
30 Dektrometorfan sirup kombinasi ANTITUSIF DAN DEKONGESTAN
31 Dextrose Inj 40% ELEKTROLIT
32 Difenhidramin inj 10 mg/ml ANTIALERGI dan OBAT ANAFILAKSIS
33 Digoksin tablet 0,25 mg ANTIARITMIA
34 Dimenhidrinat Tablet 50 mg ANTIEMETIK
35 Domperidon Suspensi 5mg/5ml ANTIEMETIK
36 Domperidon Tablet 10 mg ANTIEMETIK
37 Efedrin HCl tablet 25 mg DEKONGESTAN
38 Epinefrina HCl/Bitartrat(Adrenalin) inj 0,1 %-1ml OBAT untuk SYOK
39 Eritromisin Kapsul 250 mg ANTIBAKTERI
40 Etakridin Larutan 0,1 % LAIN-LAIN
41 Etanol 70 %- 100 ml DESINFEKTAN
42 Etanol 70 %- 1000 ml DESINFEKTAN
43 Etil Klorida Spray ANASTETIK
44 Fenoksimetil Penisilin tablet 500 mg ANTIBAKTERI
45 Fitomenadion(Vit K1) tablet salut gula 10 mg OBAT yang MEMPENGARUHI KOAGULASI
46 Furosemid tablet 40 mg DIURETIK
47 Garam Oralit I Serbuk OBAT untuk DIARE
48 Gentamisin Injeksi 40 mg/ml (Sulfat) ANTIBAKTERI
49 Gentamisin Salep Kulit 0,1% ANTIBAKTERI KULIT, MATA, TELINGA
50 Gentian violet larutan 1 %-10 ml ANTISEPTIK
51 Glibenklamid tablet 5 mg ANTIDIABETES
52 Gliseril Guaiakolat Tablet 100 mg EKSPEKTORAN dan MUKOLITIK
53 Glukosa Laruran infus 5% steril-500 ml ELEKTROLIT
54 Griseofulvin tablet 125 mg micronized ANTIFUNGI
55 Hidroklortiazid (HCT) tablet 25 mg DIURETIK
56 Hidrokortison krim 2,5 % ANTIINFLAMASI dan ANTIPRURITUS
57 Hyoscine-n-butilbromide Tablet 10 mg ANTISPASMODIK
58 Ibuprofen tablet 400 mg ANALGESIK NON NARKOTIK
59 Isosorbid dinitrat tablet sublingual 5 mg ANTIANGINA
60 Kalsium Laktat (Kalk) tablet 500 mg VITAMIN dan MINERAL
61 Kaptropil 25 mg ANTIHIPERTENSI
62 Karbogliserin Tetes telinga 10 % OBAT untuk TELINGA
63 Karbon Aktif ANTIDOT dan OBAT LAIN untuk KERACUNAN
64 Ketokonazol Tablet 200 mg ANTIFUNGI
65 Kloramfenikol kapsul 250 mg ANTIBAKTERI
66 Kloramfenikol salep mata 1 % ANTIBAKTERI KULIT, MATA, TELINGA
67 Kloramfenikol syrup 125 mg/5 ml ANTIBAKTERI
68 Kloramfenikol Tetes Mata 0.5% ANTIBAKTERI KULIT, MATA, TELINGA
69 Kloramfenikol Tetes telinga 3 % ANTIBAKTERI KULIT, MATA, TELINGA
70 Klorfenarimin maleat (CTM) tablet 4 mg ANTIALERGI dan OBAT ANAFILAKSIS
71 Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 ml ANTIBAKTERI
72 Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg ANTIBAKTERI
73 Kotrimoksazol Tab Ped:Sulf 100 + Trim 20 mg ANTIBAKTERI
74 Lidokain inj Komp : Lidokain %+ Epinefrin 1 : 80000-2 ml ANASTETIK
75 Lisol DESINFEKTAN
76 Metformin HCl Tablet 500 mg ANTIDIABETES
77 Metilprednisolon 4 mg ANTIALERGI dan OBAT ANAFILAKSIS
78 Ondansetron inj 4 mg/2 ml ANTIEMETIK
79 Metronidazol tablet 500 mg ANTIBAKTERI
80 Mikonazol Krim/Salep 2% ANTIFUNGI KULIT
81 Multivitamin + DHA + Lysin (Truvit) VITAMIN dan MINERAL
82 Multivitamin + Mineral (Selviplex) VITAMIN dan MINERAL
83 Natrium Bikarbonat tablet 500 mg ANTIDOT dan OBAT LAIN untuk KERACUNAN
84 Natrium Diklofenak Tablet 50 mg ANALGESIK NON NARKOTIK
85 Natrium Klorida Larutan Infus 0,9% ELEKTROLIT
86 Nistatin tablet salut gula 500.000 IU/g ANTIFUNGI
87 Nistatin tablet vaginal 100.000 IU/g ANTIFUNGI
88 Obat batuk Hitam (OBH) Cairan -100 ml EKSPEKTORAN dan MUKOLITIK
89 Oksitetrasiklin HCl 1 % Salep mata ANTIBAKTERI KULIT, MATA, TELINGA
90 Oksitetrasiklin HCl inj i.m 50 mg/ml-10 ml ANTIBAKTERI
91 Oksitetrasiklin HCl Salep Kulit 3 % ANTIBAKTERI KULIT, MATA, TELINGA
92 Omeprazol kapsul 20 mg ANTIULKUS
93 Parasetamol sirup 120 mg / 5ml ANALGESIK NON NARKOTIK
94 Parasetamol tablet 500 mg ANALGESIK NON NARKOTIK
95 Permetrin krim 5% (Scabimite) ANTISKABIES
96 Piracetam Tablet 1200 mg NOOTROPIK
 97 Piridoksin HCl (Vit B6) tablet 10 mg VITAMIN dan MINERAL
98 Povidon Iodiada 10 %-30 ml ANTISEPTIK
99 Povidon Iodiada 10 %-300 ml ANTISEPTIK
100 Prednison tablet 5 mg ANTIALERGI dan OBAT ANAFILAKSIS
101 Propanolol HCl tablet 40 mg ANTIARITMIA
102 Propiltiourasil tablet 100 mg ANTITIROID
103 Ranitidin Injeksi 25 mg/ml ANTIULKUS
104 Ranitidin Tablet 150 mg ANTIULKUS
105 Ringer Laktat Larutan Infus Steril ELEKTROLIT
106 Salbutamol 2,5 mg/2,5 ml NaCl ANTIASMA
107 Salbutamol tablet 4 mg ANTIASMA
108 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % ANTISKABIES
109 Salisil Bedak 2 % - 50 gram LAIN-LAIN
110 Sefadroksil syrup 125 mg/5 ml ANTIBAKTERI
111 Sefadroxil Kapsul 500 mg ANTIBAKTERI
112 Sefotaksim Injeksi 1 g ANTIBAKTERI
113 Seftriaxon Injeksi 1 g ANTIBAKTERI
114 Sianokobalamin (Vit B12 ) inj 500 mcg/ml-1ml VITAMIN dan MINERAL
115 Simvastatin 10 mg ANTIHIPERLIPIDEMIA
116 Siprofloksasin (HCl) Kaplet 500 mg ANTIBAKTERI
117 Tetrasiklin Kapsul 250 mg ANTIBAKTERI
118 Tetrasiklin Kapsul 500 mg ANTIBAKTERI
119 Tiamfenikol Kapsul 500 mg ANTIBAKTERI
120 Tiamin HCL (Vit B1) inj 100 mg/ml-1ml VITAMIN dan MINERAL
121 Tiamin HCL (Vit B1) tablet 50 mg VITAMIN dan MINERAL
122 Tramadol Injeksi 50 mg/ml ANALGESIK NON NARKOTIK
123 Tramadol Kapsul 50 mg ANALGESIK NON NARKOTIK
124 Vitamin B Kompleks tablet VITAMIN dan MINERAL
125 Zinc Tablet 20 mg OBAT untuk DIARE
ALKES HABIS PAKAI
126 Alat Suntik Sekali Pakai 1ml BAHAN HABIS PAKAI
127 Alat Suntik Sekali Pakai 2,5 ml / 3 ml BAHAN HABIS PAKAI
128 Alat Suntik Sekali Pakai 5 ml BAHAN HABIS PAKAI
129 Bisturi BAHAN HABIS PAKAI
130 Blood set BAHAN HABIS PAKAI
131 Catgut/Benang Bedah No.2/0 dengan jarum bedah BAHAN HABIS PAKAI
132 Catgut/Benang Bedah No.3/0 dengan jarum bedah BAHAN HABIS PAKAI
133 Folley Catheter BAHAN HABIS PAKAI
134 Infusion set anak BAHAN HABIS PAKAI
135 Infusion set dewasa BAHAN HABIS PAKAI
136 IV Catheter No.18 BAHAN HABIS PAKAI
137 IV Catheter No.20 BAHAN HABIS PAKAI
138 IV Catheter No.22 BAHAN HABIS PAKAI
139 IV Catheter No.24 BAHAN HABIS PAKAI
140 Jarum kulit (GT) BAHAN HABIS PAKAI
141 Jarum otot (GR) BAHAN HABIS PAKAI
142 Kapas Pembalut/absorben 250 mg BAHAN HABIS PAKAI
143 Kasa Hidrofil 2x80 BAHAN HABIS PAKAI
144 Kasa Hidrofil Steril 16 X 16 BAHAN HABIS PAKAI
145 Kasa Pembalut Hidrofil 4 X 10 cm BAHAN HABIS PAKAI
146 Kasa Pembalut hidrofil 4 x 5 cm BAHAN HABIS PAKAI
147 Kassa Pembalut elastic 4 inchi BAHAN HABIS PAKAI
148 Masker BAHAN HABIS PAKAI
149 Plester 5 yard x 2 inch BAHAN HABIS PAKAI
150 Sarung Tangan non steril BAHAN HABIS PAKAI
151 Sarung Tangan steril BAHAN HABIS PAKAI
152 Sendok Obat BAHAN HABIS PAKAI
153 Silk (Benang Bedah Sutera) No3/0 dengan jarum bedah BAHAN HABIS PAKAI
154 Urin Bag BAHAN HABIS PAKAI
PROGRAM KESGA
155 Albendazol ANTELMINTIK
156 Fitomenadion(Vit K1) inj 2 mg/ml OBAT yang MEMPENGARUHI KOAGULASI
157 Fitomenadion(Vit K1) inj 10 mg/ml OBAT yang MEMPENGARUHI KOAGULASI
158 Iodin test REAGENT
159 Magnesium sulfat inj(IV) 20 % ANTIEPILEPSI-ANTIKONVULSAN
160 Magnesium sulfat inj(IV) 40 % ANTIEPILEPSI-ANTIKONVULSAN
161 Metilergomatrin maleat inj 0,200 mg - ml OKSITOSIK

162 Metilergometrin maleat(Metilergometrin) tab.salut 0,125 mg OKSITOSIK

163 Mineral Mix SUPLEMEN GIZI
164 Natrium Tiroksin ANTITIROID
165 Oksitoksin in 10 IU/ml- 1 ml OKSITOSIK
166 Retinol (VIT A) Kapsul 200.000 IU VITAMIN dan MINERAL
167 Retinol tab 100.000 IU VITAMIN dan MINERAL
Tablet Tambah darah kombinasi : Besi II Sulfat 200 mg +
168 Asam folat 0.25 mg ANTIANEMI
PROGRAM YANKES
169 Amitriptilina HCl tablet salut 25 mg OBAT PSIKOSIS
170 Diazepam inj 5 mg/ml-2 ml OBAT PSIKOSIS
171 Diazepam Rectal 10 mg/2,5 ml OBAT PSIKOSIS
172 Diazepam Rectal 5 mg/2,5 ml OBAT PSIKOSIS
173 Diazepam tablet 2 mg OBAT PSIKOSIS
174 Fenitoin Natrium kapsul 100 mg OBAT PSIKOSIS
175 Fenobarbital tablet 30 mg OBAT PSIKOSIS
176 Haloperidol 5 mg OBAT PSIKOSIS
177 Haloperidol tablet 1,5 mg OBAT PSIKOSIS
178 Karbamazepin tablet 200 mg OBAT PSIKOSIS
179 Klorpropmazin HCl tablet salut 100 mg OBAT PSIKOSIS
180 Resperidon 2 mg OBAT PSIKOSIS
181 Flufenazin inj 25mg/ml (Sikzonoate) OBAT PSIKOSIS
182 Triheksifenidil HCl tablet 2 mg OBAT PSIKOSIS
183 Caviton (Citodur) OBAT GIGI
184 Devitalisasi Pasta (D Pulp) OBAT GIGI
185 Endometason OBAT GIGI
186 Eugenol Cairan OBAT GIGI
187 Formokresol Cair OBAT GIGI
188 Glass Ionomer Cement (GC IX) OBAT GIGI
189 Kalsium hidroksida pasta (Calcidor) OBAT GIGI
190 Monoklorkamfer mentol cairan OBAT GIGI
191 Mummifying Pasta OBAT GIGI
192 Natrium Hipoklorid OBAT GIGI
193 Semen seng fosfat serbuk cairan (Dorident) OBAT GIGI
PROGRAM P2
194 ADS 0.05 ml BAHAN HABIS PAKAI PROGRAM
195 ADS 0.5 ml BAHAN HABIS PAKAI PROGRAM
196 ADS 5 ml BAHAN HABIS PAKAI PROGRAM
197 Azithromisin tablet 500 mg IMS
198 Dehidroartemisin+Piperaquin ANTIMALARIA
199 Doksisilin 100 mg ANTIMALARIA
200 Fluconazol 150 mg IMS
201 Kina Inj 26 % 2 ml ANTIMALARIA
202 Kina Tablet 222 mg ANTIMALARIA
203 Klindanmycin 300 mg IMS
204 Masker N-95 BAHAN HABIS PAKAI PROGRAM
205 MB Anak ANTILEPRA
206 MB Dewasa ANTILEPRA
207 OAT FDC Katagori 1 ANTITUBERKULOSIS
208 OAT FDC Katagori 2 ANTITUBERKULOSIS
209 OAT Kategori Anak ANTITUBERKULOSIS
210 OAT Kombipak Kat I ANTITUBERKULOSIS
211 OAT Sisipan ANTITUBERKULOSIS
212 PB Anak ANTILEPRA
213 PB Dewasa ANTILEPRA
214 Primakuin ANTIMALARIA
215 Safety box BAHAN HABIS PAKAI PROGRAM
216 Sefiksime + Azitromisin IMS
217 Serum anti tetanus inj 1500 IU/vial (ATS) VAKSIN dan SERUM
218 Serum antibisa ular Polivalen inj 5 ml (SABU) I VAKSIN dan SERUM
219 Vaksin Rabies VAKSIN dan SERUM
220 Vaksin BCG + Pelarut VAKSIN dan SERUM
221 Vaksin DPT-HB VAKSIN dan SERUM
222 Vaksin Polio + Dropper VAKSIN dan SERUM
223 Vaksin Campak + Pelarut VAKSIN dan SERUM
224 Vaksin Uniject VAKSIN dan SERUM
225 Vaksin TT VAKSIN dan SERUM
226 Vaksin Td VAKSIN dan SERUM
227 Vaksin DT VAKSIN dan SERUM
REAGEN
228 Rapid Test 1 HIV REAGENT
229 Rapid Test 2 HIV REAGENT
230 Rapid test 3 HIV REAGENT
231 Rapid Test Syphilis REAGENT
232 RPR Syphilis REAGENT
233 Rapid Test Malaria REAGENT
LAIN-LAIN
234 Ambroxol
235 Betahistin
236 H2O2 1000ml 3%
237 Hibicet 100ml
238 Bayclin 500ml
239 Sarung tangan Ukuran S
240 Ambroxol syrup
241 Metronidazol syrup
242
243
244
245
246
247
248
249
250
JUMLAH TOTAL
 KOLOM WARNA MERAH
JANGAN DIGANGGU

HARGA SATUAN 2015 PEMAKAIAN TAHUN 2015

SATUAN
E
SURVEY JAN FEB MAR APR MEI JUN
KATALOG

Tablet 86.00 196 92 103 200 82 201

Ampul 3,822.00
Tablet 90.00 3 70 8 43
Tablet 187.00 354 291 110 389 367 380
Kaplet 272.00 9,309 819 9,205 9,555 7,967 8,166
Botol 2,445.00 184 203 172 160 188 195
Botol 5,800.00
Tablet
Tablet 75.00 6,054 5,785 6,031 6,423 4,822 5,911
Botol 2,100.00 37 30 45 69 40 46
Tablet 3,045.00 6 12 20 6 12
Tablet 2,516.00 22 59 32 32
Pot 2,750.00 8 19 17 12 17
Tablet 135.00 23 3 9 6 30 42
Vial 2,030.00 61 52 52 60 46 60
Tablet 116.00 13 126 146 162 15
Tablet
Tablet 95.00 1,482 1,861 476 856 621 820
Tablet 112.00 1,520 2,477 1,600 1,751 1,913 2,000
Tube 3,073.50 10 2 18 15 15 13
Tablet 345.00 45 7 5 36
Tablet 190.00 361 443 321 435 353 256
Ampul 1,350.00 5
Vial 13,400.00
Tube 1,520.00 123 137 70 80 120 120
Tablet 121.00 1,902 1,827 1,673 1,000 600 773
Ampul 1,580.00 200 272 175 189 174 177
Tablet 68.00 6,201 3,246
Tablet 594.00 257 400 400 478 561 600
Botol 11,985.00 16 27 30 30 4 14
Botol 14,524.00
Ampul 1,054.00 5 8 15 5 15
Tablet 97.00 10 16 10
Tablet 104.00 10 10
Botol 3,333.00 10 7 19 17 17 18
Tablet 167.00 45 174 280 237 102
Tablet
Ampul 8,100.00 4 2 2
Tablet 497.00 249
Botol 2,550.00 1
Botol
Botol 21,500.00 3 4 5 3 2 1
Botol 165,000.00 2 2 3 4 4
Tablet 510.00 21 291 219
Tablet 634.00 117
Tablet 85.00 43 5 28 66 84 178
Sachet 285.00 107 100 185 50 24
Ampul 3,399.00 20 10 9 11 15 15
Tube 1,842.58 33 96 117 104 171
Botol 1,210.00 2 1 11 10 10
Tablet 56.00 152 225 147 276 231 193
Tablet 62.20 4,932 4,476 7,838 6,710 4,777
Fls 5,200.00
Tablet 219.00 12 10 103 130 40
Tablet 149.00 33
Tube 2,798.00 27 41 44 64 106
Tablet 299.20
Tablet 149.00 913 1,287 2,531 1,949 1,159 1,783
Tablet 88.00 3
Tablet 70.00 2,093 3,229 2,489 1,224 1,356
Tablet 80.00 1,715 1,912 2,261 3,001 1,608 2,106
Botol 2,042.00 4 10
Tablet 100.00
Tablet 300.00 6
Kapsul 273.74 584 1,713 1,587 1,587 981 1,052
Tube 1,600.00 33 50 44 48 21 7
Botol 3,680.00
Botol 5,500.00 35 49 51 68 68 78
Tube 2,090.00 17 29 41 49 26
Tablet 51.00 7,891 8,350 11,190 7,847 7,403 8,343
Botol 2,145.00 172 180 163 147 52 114
Tablet 149.00 1,172 1,711 1,235 1,231 1,047 918
Tablet
Ampul 1,363.00 100 98 162 140 106
Botol 41,000.00 3 3 2 2
Tablet 112.50 60 92 148 162 45 166
Tablet 300.00
Ampul 5,500.00
Tablet 160.00 434 720 400 498 403 339
Tube 3,000.00 6 20 12 52
Botol 11,700.00 45 68 35 46 7
Kaplet 914.00 405 595 628 626 100
Tablet 51.70 1,394 974 1,494 906 1,512 530
Tablet 200.00 549 707 786 446 393
Fls 4,700.00 26 29 28 39 29 20
Tablet 640.00 10 17
Tablet 480.00 6 5 2 12 14 6
Botol 5,796.00 45 86 86 35 63
Tube 2,772.00 63 52 41 41 37
Flacon
Tube 1,829.68 52 68 41 49 71 41
Kapsul 211.00 55 88 42 32 60 44
Botol 1,438.00 361 394 463 399 401 374
Tablet 89.00 24,154 21,993 20,235 22,488 18,652 18,627
Tube 11,475.00 2 28 10 20 36 27
Tablet 1,292.30
Tablet 110.00 2,824 1,777 2,195 1,522 1,083
Botol 2,163.00 2 1 3 2
Botol 14,203.00 2 2 1 2 2 4
Tablet 87.52 525 875 1,527 3,879 4,779
Tablet 106.00 19 19 20 42
Tablet 319.00
Ampul 1,140.00 137 260 193 170 169 183
Tablet 120.00 1,924 2,260 2,226 2,668 1,317 2,697
Fls 5,200.00 376 458 502 541 288 375
Ampul 6,600.00 3 13 2 7 38 2
Tablet 105.97 350 318 209 211 321 303
Pot 2,000.00 40 40 40 57 42 54
Kotak 1,250.00 83 103 120 69 72
Botol 4,746.00 2 40 36 28 46
Kapsul 509.00 473 519 696 723 516 544
Vial 2,950.00 100 87 52 38 10 30
Vial 3,300.00 160 209 162 183 130 93
Ampul 1,078.00
Tablet 169.00 70 109 15 165 121
Kaplet 255.00 275 482 358 341 313 235
Kapsul 148.00 896 1,604 606 606 576 403
Kapsul 300.00 100 154 100 100
Kapsul 615.59 293
Ampul 767.00 30 15
Tablet 54.54 3,020 5,992 1,980
Ampul 2,395.00 14
Tablet 304.56 10 10 10
Tablet 107.00 7,670 1,436 4,580 4,083 4,703
Tablet 473.00 252 241 192 168 109 160

Set 650.00 153 349 101 130 51

Set 650.00 1,143 994 1,331 1,306 840 1,165
Set 750.00 332 31 61 272 157 10
Buah 770.00 3 3 5 13 15
Buah 3,600.00 5 3
Roll 5,583.33 36 4
Roll 5,583.33 23 25 2 37 36 35
pcs 8,000.00 3 4 10 10 14
Kantong 3,500.00 48 15 19 28 39 29
Kantong 3,200.00 79 115 124 110 86 73
set 7,472.00 1 1
set 7,472.00 81 68 74 102 66 63
set 7,472.00 12 41 35 18 33
set 7,472.00 56 56 51 61 39 41
pcs 2,291.67 1 2 1 2 4
pcs 2,291.67 1 2 1 4
Roll 12,500.00 4 5 5 4 2 3
Roll 7,700.00 16 26 25 29 40 28
Lembar 362.50 20 20 10 26 16 20
Roll 1,500.00 74 70 90 78 40 50
Roll 750.00 13 2 30 20
Roll 8,438.00 55 30 22 88 49 58
set 330.00 50 90 80 120 100 120
Roll 15,730.00 4 6 5 7 7 7
Set 325.00 300 430 300 470 400 700
Set 4,180.00 50 43 57 20 50 57
Buah 125.00 474 642 798 637 637 534
Sachet 3,055.56 26 35 37 56 36 35
buah 3,000.00 2 4 5 11 5

Tablet 338.00 3 1
Ampul 3,417.00 3
Ampul
Botol 5,806.00
Botol 6,050.00
Botol 6,050.00
Ampul 2,750.00 24 20 12 28 11 25
Tablet 154.00 120 100 118 170 40
Sachet 2,450.00
Tablet 1,550.00
Ampul 2,200.00 24 40 33 23 40
Kapsul 459.00 650
Kapsul 260.00 3,850
Tablet 50.00

Tablet 112.00
Ampul 4,180.00 5 2
tube 16,748.00 1 1 1 2 1 10
tube 11,525.00 5 2 11
Tablet 45.00 92 18 200 150 118
Kapsul 133.00 50 249
Tablet 220.00 90 145 125 40 65
Tablet 96.00
Tablet 69.00 150 210 240 230 275 310
Tablet 245.00 45 60 280 230 390 280
Tablet 144.00 36 137 260 195 207
Tablet 1,008.00 230 234 210
Ampul 55,000.00
Tablet 235.50 150 200 260 230 345 385
Botol 165,000.00 1
Botol 148,500.00 1
Botol 566,500.00 1
Botol 16,667.00 1 1
Botol 40,700.00 1
Botol 715,000.00 1
Pot 137,500.00 1
Botol 40,700.00 1
Botol
Botol 55,000.00 1
Pot 187,000.00 1

pcs 1,997.00 101 889 393

pcs 1,450.00 794 109 400
pcs 2,050.00 306 100
Tablet 4,500.00
Kotak 35,472.00
Tablet 270.00
Tablet 22,000.00
Ampul 6,200.00
Tablet 670.00
Tablet 553.00
buah 7,425.00
Blister 14,862.00
Blister 20,906.00
Paket 359,900.00 5 6
Paket 1,199,990.00 1
paket 214,900.00 8 1 2
paket 288,200.00
Tablet 160,000.00
Blister 6,539.00
Blister 6,539.00
Tablet 108.99
pcs 18,625.00
Kotak 33,000.00
Ampul 126,500.00 10 3 7
Ampul 473,000.00 2 2
Ampul 78,500.00 3 3
Paket 55,506.00 30 31 47 18 50
Vial 63,930.00 30 90 80 70 70 40
Paket 18,997.00 64 70 80 70 20
Paket 26,895.00 32 33 50 43 30 45
Vial 19,096.00 104 33 103 68
Vial 14,201.00 33 102 46 24 10 27
Vial 16,181.00
Vial 17,105.00

Sachet 20,232.00
Sachet 24,495.00
Sachet 22,200.20
Sachet 27,710.00
Sachet 7,875.00
Sachet 7,875.00

Tablet 150
Tablet 170
Botol 90000
Botol 60000
Botol 5000
Bok 42000
Botol 5,100
Botol 4200
TAHUN 2015 JUMLAH RATA-RATA KEBUTUHAN THN 2016 MET
PEMAKAIAN KEKOSO PEMAKAIAN
10 BULAN NGAN PER BLN
JUL AGUST SEPT OKT TAHUN 2015 (… BLN) TAHUN 2015 12 BULAN BUFFER
10%
83 61 109 98 1,225 - 123 1,470 147
- 10 - - -
93 146 363 4 61 726 73
383 389 127 212 3,002 - 300 3,602 360
7,456 7,594 8,171 6,897 75,139 - 7,514 90,167 9,017
142 185 80 120 1,629 - 163 1,955 195

3,343 4,857 6,179 5,689 55,094 - 5,509 66,113 6,611

20 41 50 40 418 - 42 502 50
12 10 10 88 2 11 132 13
24 31 44 30 274 2 34 411 41
24 97 4 16 194 19
113 4 19 226 23
50 57 65 70 573 - 57 688 69
29 100 30 621 2 78 932 93

763 819 1,061 1,167 9,926 - 993 11,911 1,191

1,700 1,000 800 800 15,561 - 1,556 18,673 1,867
7 12 16 13 121 - 12 145 15
66 165 60 60 444 1 49 592 59
305 398 300 454 3,626 - 363 4,351 435
5 9 5 60 6
4 6 10 8 5 60 6
81 119 30 88 968 - 97 1,162 116
7,775 4 1,296 15,550 1,555
80 40 160 180 1,647 - 165 1,976 198
500 200 10,147 6 2,537 30,441 3,044
300 2,996 3 428 5,136 514
18 6 20 165 1 18 220 22
- 10 - - -
20 25 93 3 13 159 16
30 66 6 17 198 20
12 32 7 11 128 13
6 19 16 5 134 13 161 16
114 134 206 133 1,425 1 158 1,900 190

5 5 5 23 4 4 46 5
86 335 8 168 2,010 201
1 2 8 1 12 1

3 5 3 5 34 - 3 41 4
3 2 2 22 2 3 33 3
 531 7 177 2,124 212
30 70 160 200 577 5 115 1,385 138
14 3 124 60 605 - 61 726 73
125 100 691 3 99 1,185 118
10 15 20 25 150 - 15 180 18
82 140 104 75 922 1 102 1,229 123
10 7 8 59 2 7 89 9
159 186 108 177 1,854 - 185 2,225 222
4,949 4,673 2,695 1,000 42,050 1 4,672 56,067 5,607
- 10 - - -
60 50 70 475 2 59 713 71
112 145 8 73 870 87
48 64 394 3 56 675 68
- 10 - - -
768 1,072 2,382 2,318 16,162 - 1,616 19,394 1,939
3 9 3 36 4
1,094 1,171 877 1,992 15,525 1 1,725 20,700 2,070
1,260 1,364 629 2,905 18,761 - 1,876 22,513 2,251
15 9 7 45 5 9 108 11
- 10 - - -
20 26 8 13 156 16
1,064 1,251 1,080 1,080 11,979 - 1,198 14,375 1,437
10 15 24 48 300 - 30 360 36
- 10 - - -
66 30 79 524 1 58 699 70
162 5 32 389 39
8,454 11,402 7,890 6,110 84,880 - 8,488 101,856 10,186
79 118 136 164 1,325 - 133 1,590 159
815 1,033 1,236 980 11,378 - 1,138 13,654 1,365

97 107 130 130 1,070 1 119 1,427 143

2 2 2 6 22 2 3 33 3
182 855 3 122 1,466 147
- 10 - - -
- 10 - - -
200 500 490 3,984 1 443 5,312 531
61 32 26 49 258 2 32 387 39
10 34 245 3 35 420 42
500 2,854 4 476 5,708 571
703 1,097 1,640 1,868 12,118 - 1,212 14,542 1,454
536 600 1,164 1,030 6,211 - 621 7,453 745
28 20 23 26 268 - 27 322 32
13 20 10 70 5 14 168 17
3 10 20 12 90 - 9 108 11
85 58 97 100 655 1 73 873 87
45 71 78 75 503 1 56 671 67

20 48 78 52 520 - 52 624 62
20 40 54 12 447 - 45 536 54
359 477 262 544 4,034 - 403 4,841 484
10,204 10,000 8,000 8,000 162,353 - 16,235 194,824 19,482
25 18 20 34 220 - 22 264 26
- 9 - - -
1,376 1,940 1,560 1,986 16,263 1 1,807 21,684 2,168
3 3 14 4 2 28 3
5 3 4 25 1 3 33 3
1,000 12,585 4 2,098 25,170 2,517
100 6 25 300 30
- 10 - - -
50 10 1,172 2 147 1,758 176
1,678 1,870 2,154 18,794 1 2,088 25,059 2,506
235 302 310 370 3,757 - 376 4,508 451
5 10 10 10 100 - 10 120 12
200 360 240 235 2,747 - 275 3,296 330
35 120 42 48 518 - 52 622 62
40 60 44 76 667 1 74 889 89
6 28 128 148 462 1 51 616 62
447 484 2,900 2,831 10,133 - 1,013 12,160 1,216
30 40 33 40 460 - 46 552 55
50 168 40 50 1,245 - 125 1,494 149
20 12 32 8 16 192 19
480 5 96 1,152 115
309 426 230 300 3,269 - 327 3,923 392
360 300 1,200 1,200 7,751 - 775 9,301 930
146 200 230 1,030 3 147 1,766 177
293 9 293 3,516 352
10 20 75 6 19 225 23
2,000 1,000 13,992 5 2,798 33,581 3,358
14 9 14 168 17
20 50 6 13 150 15
3,923 4,977 4,000 5,420 40,792 1 4,532 54,389 5,439
63 1,185 2 148 1,778 178

200 200 200 1,384 2 173 2,076 208

980 932 1,086 1,120 10,897 - 1,090 13,076 1,308
60 330 300 300 1,853 - 185 2,224 222
5 10 8 62 2 8 93 9
1 9 7 3 36 4
20 21 23 104 5 21 250 25
33 32 29 26 278 - 28 334 33
7 9 8 14 79 1 9 105 11
35 30 32 43 318 - 32 382 38
65 43 50 82 827 - 83 992 99
2 4 7 1 16 2
63 64 50 80 711 - 71 853 85
40 40 43 45 307 1 34 409 41
46 33 20 45 448 - 45 538 54
2 4 16 3 2 27 3
2 4 14 4 2 28 3
1 2 4 30 1 3 40 4
45 36 35 36 316 - 32 379 38
50 40 202 2 25 303 30
35 58 80 575 1 64 767 77
5 10 80 4 13 160 16
20 82 78 65 547 - 55 656 66
120 120 160 960 1 107 1,280 128
 7 7 5 55 1 6 73 7
365 400 405 300 4,070 - 407 4,884 488
50 150 477 2 60 716 72
580 546 343 450 5,641 - 564 6,769 677
35 47 35 33 375 - 38 450 45
12 15 7 14 75 1 8 100 10

23 27 7 9 108 11
4 7 8 4 42 4

- 10 - - -
- 10 - - -
- 10 - - -
5 10 20 155 1 17 207 21
80 80 100 80 888 1 99 1,184 118
- 10 - - -
- 10 - - -
100 15 5 30 310 1 34 413 41
750 1,400 8 700 8,400 840
3,200 7,050 8 3,525 42,300 4,230
100 100 9 100 1,200 120

- 9 - - -
5 4 4 20 5 4 48 5
1 17 3 2 29 3
2 3 3 3 29 3 4 50 5
20 110 40 30 778 1 86 1,037 104
120 300 719 6 180 2,157 216
465 5 93 1,116 112
- 10 - - -
250 385 360 450 2,860 - 286 3,432 343
260 260 340 300 2,445 - 245 2,934 293
280 300 360 240 2,015 1 224 2,687 269
40 150 80 944 4 157 1,888 189
- 10 - - -
400 405 330 400 3,105 - 311 3,726 373
1 9 1 12 1
1 9 1 12 1
1 9 1 12 1
2 8 1 12 1
1 9 1 12 1
1 9 1 12 1
1 9 1 12 1
1 9 1 12 1

1 9 1 12 1
1 9 1 12 1

100 200 200 1,883 4 314 3,766 377

300 600 950 300 3,453 3 493 5,919 592
100 200 706 6 177 2,118 212
 - 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
2 2 4 19 5 4 46 5
1 2 8 1 12 1
11 7 4 44 4
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
5 1 1 27 4 5 54 5
1 6 1 12 5 2 29 3
1 5 1 13 5 3 31 3
35 42 40 43 336 1 37 448 45
57 60 60 40 597 - 60 716 72
50 40 50 40 484 1 54 645 65
45 49 123 45 495 - 50 594 59
2 25 335 4 56 670 67
34 25 45 346 1 38 461 46
- 10 - - -
- 10 - - -

- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -

- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
- 10 - - -
 739,939,172.81
1. Volume kebutuhan 1 tahun yang sudah
dibuat di samping kiri (Kolom V), dipecah
volumenya berdasarkan sumber dananya,
BUTUHAN THN 2016 METODE KONSUMSI antara JKN (Kolom Y) dan Dinkes (kolom SUMBER DANA JKN
AA).
2. Sumber dana JKN hanya digunakan untuk
obat yang ada di daftar e katalog (kolom E).
JUMLAH NILAI VOLUME

1,617 139,062.00 1600

- -
799 71,874.00 700
3,963 741,013.68 3900
99,183 26,977,906.56 99000
2,150 5,257,434.60 2150
1200

72,724 5,454,306.00 72700

552 1,158,696.00 550
145 442,134.00 145
452 1,137,483.60 400
213 586,850.00 213
249 33,561.00 200
756 1,535,410.80 700
1,025 118,859.40 800

13,102 1,244,720.40 7500

20,541 2,300,538.24 20500
160 490,899.42 100
651 224,664.00 500
4,786 909,400.80 4500
66 89,100.00 20
66 884,400.00 60
1,278 1,942,195.20 1000
17,105 2,069,705.00 1700
2,174 3,434,983.20 2000
33,485 2,276,986.80 30000
5,650 3,355,862.40 5650
242 2,900,370.00 300
- -
175 184,841.49 75
218 21,126.60
141 14,643.20
177 589,541.04 100
2,090 349,030.00 2000

51 409,860.00 30
2,211 1,098,867.00 1200
13 33,660.00

45 964,920.00 30
36 5,989,500.00 30
 2,336 1,191,564.00 1500
1,523 965,759.52 1500
799 67,881.00 300
1,303 371,363.14 700
198 673,002.00 150
1,352 2,491,659.51 1000
97 117,793.50 60
2,447 137,047.68 2000
61,673 3,836,081.33 50000
- -
784 171,641.25 500
957 142,593.00 700
743 2,078,834.06 700
7,000 2,094,400.00 7000
21,334 3,178,742.16 21000
40 3,484.80 30
22,770 1,593,900.00 22000
24,765 1,981,161.60 24000
119 242,589.60 100
- -
172 51,480.00 50
15,812 4,328,453.53 15000
396 633,600.00 200
1,500 5,520,000.00 1500
769 4,226,933.33 500
428 893,851.20 300
112,042 5,714,121.60 112000
1,749 3,751,605.00 1500
15,019 2,237,825.04 15000

1,569 2,139,001.33 1500

36 1,488,300.00 30
1,612 181,382.14 1500
40,000 12,000,000.00 35000
6,000 33,000,000.00 3000
5,843 934,912.00 5000
426 1,277,100.00 300
462 5,405,400.00 462
6,279 5,738,823.20 8000
15,996 826,980.79 15000
8,199 1,639,704.00 8000
354 1,662,672.00 350
185 118,272.00 170
119 57,024.00 100
961 5,568,024.00 950
738 2,044,996.80 700

686 1,255,892.35 686

590 124,498.44 500
5,325 7,657,177.44 5300
214,306 19,073,230.44 240000
290 3,332,340.00 400
- -
23,852 2,623,764.00 22000
31 66,620.40 30
37 520,776.67 30
27,687 2,423,027.81 27000
330 34,980.00
- -
1,934 2,204,532.00 1700
27,565 3,307,744.00 27000
4,959 25,788,048.00 4950
132 871,200.00 100
3,626 384,251.46 3500
684 1,367,520.00 600
978 1,222,833.33 900
678 3,215,889.60 1000
13,376 6,808,160.04 13000
607 1,791,240.00 600
1,643 5,423,220.00 1600
211 227,673.60 150
1,267 214,156.80 1200
4,315 1,100,345.40 4000
10,231 1,514,235.36 10000
1,942 582,685.71 1700
3,868 2,380,842.99 3000
248 189,832.50 140
36,939 2,014,708.08 35000
185 442,596.00 85
165 50,252.40 200
59,828 6,401,624.53 59000
1,955 924,833.25 1600

2,284 1,484,340.00 2000

14,384 9,349,626.00 14000
2,446 1,834,470.00 2000
102 78,771.00 60
40 142,560.00 10
275 1,532,960.00 200
367 2,048,860.00 300
116 926,933.33 100
420 1,469,160.00 300
1,092 3,493,248.00 800
18 131,507.20 10
939 7,012,621.44 900
450 3,364,392.53 400
591 4,418,641.92 500
30 69,142.96 20
31 70,583.44 20
44 550,000.00 20
417 3,211,824.00 400
333 120,821.25 300
843 1,265,000.00 600
176 132,000.00 100
722 6,092,573.52 300
1,408 464,640.00 1408
 81 1,268,886.67 70
5,372 1,746,030.00 4000
787 3,289,869.00 500
7,446 930,765.00 5000
495 1,512,500.00 300
110 330,000.00 80

119 40,154.40
46 157,865.40 40

- -
- -
- -
227 625,166.67 227

1,302 200,569.60
1302
- -
- -
455 1,000,266.67 400
9,240 4,241,160.00 9240
46,530 12,097,800.00 24000

1,320 66,000.00

- -
53 220,704.00 50
32 536,893.03 32
55 630,252.86 50
1,141 51,348.00 1141
2,373 315,569.10 2000
1,228 270,072.00 1000
400 38,400.00 400
3,775 260,488.80 3775
3,227 790,713.00 3227
2,955 425,568.00 2955
2,077 2,093,414.40 1500
- -
4,099 965,220.30 4000
13 2,178,000.00
13 1,960,200.00
13 7,477,800.00
13 220,004.40
13 537,240.00
13 9,438,000.00
13 1,815,000.00
13 537,240.00

13 726,000.00
13 2,468,400.00

4,143 8,272,772.20 2000

6,511 9,441,488.57 3500
2,330 4,776,090.00 1500
 - -
- -
- -
- -
- -
- -
- -
- -
- -
- -
50 18,052,584.00 20
13 15,839,868.00 7
48 10,401,160.00 12
- -
- -
- -
- -
- -
- -
- -
59 7,514,100.00 25
32 14,984,640.00 25
34 2,694,120.00 30
493 27,353,356.80 400
788 50,376,840.00 700
710 13,485,337.07 700
653 17,573,193.00 600
737 14,073,752.00 600
507 7,206,534.13 450
- -
- -

- -
- -
- -
- -
- -
- -

70,000 10,500,000.00 1. Untuk obat yang dibutuhkan di luar obat

4,000 680,000.00 daftar di atas, silahkan diisikan di nomor
urut 234 dst, dengan memperhatikan jenis
12 1,080,000.00
obat yang diatur dalam Fornas PPK 1,
40 2,400,000.00 efisiensi, serta rasionalitas
50 250,000.00 pengobatannya.
700 29,400,000.00 2. Harga obatnya silahkan dicari di harga e
5,000 25,500,000.00 katalog atau survey
8,000 33,600,000.00
-
-
-
-
-
-
 -
-
-
739,939,172.81
 Diisi berdasarkan perkiraan
288,930,745.33 TOTAL alokasi dana obat dari #VALUE!
(288,930,745.33) penerimaan kapitasi JKN
(termasuk SILPA)

SUMBER DANA JKN PENGADAAN DINKES

NILAI (Rp) VOLUME NILAI (Rp)

137,600.00 17 1,462.00
- #VALUE!
63,000.00 99 8,874.00
729,300.00 63 11,713.68
26,928,000.00 183 49,906.56
5,256,750.00 -
4,640,000.00

5,452,500.00 24 1,806.00
1,155,000.00 2 3,696.00
441,525.00 0 609.00
1,006,400.00 400 1,006,400.00
250 687,500.00
27,000.00 -
1,421,000.00 56 114,410.80
92,800.00 225 26,059.40

712,500.00 5,602 532,220.40

2,296,000.00 41 4,538.24
60 183,549.42
172,500.00 151 52,164.00
855,000.00 286 54,400.80
27,000.00 46 62,100.00
804,000.00 40 536,000.00
1,520,000.00 278 422,195.20
3,000 363,000.00
3,160,000.00 300 474,000.00
2,040,000.00 3,485 236,986.80
3,000 1,782,000.00
200 2,397,000.00
- - -
79,050.00 100 105,791.49
- 218 21,126.60
- 141 14,643.20
333,300.00 77 256,241.04
334,000.00 90 15,030.00

243,000.00 21 166,860.00
596,400.00 1,011 502,467.00
- 13 33,660.00

645,000.00 15 319,920.00
6 1,039,500.00
 765,000.00 836 426,564.00
951,000.00 23 14,759.52
25,500.00 499 42,381.00
199,500.00 603 171,863.14
509,850.00 48 163,152.00
1,352 2,491,168.16
37 45,193.50
112,000.00 447 25,047.68
40,000 2,488,000.00
- - -
109,500.00 284 62,141.25
104,300.00 257 38,293.00
1,958,600.00 43 120,234.06
2,094,400.00 - -
3,129,000.00 334 49,742.16
2,640.00 10 844.80
1,540,000.00 770 53,900.00
1,920,000.00 765 61,161.60
204,200.00 19 38,389.60
- -
15,000.00 122 36,480.00
812 222,353.53
320,000.00 196 313,600.00
5,520,000.00 - -
769 4,229,500.00
428 894,520.00
5,610,000.00 42 2,121.60
3,217,500.00 249 534,105.00
2,235,000.00 19 2,825.04

2,044,500.00 69 94,501.33
1,230,000.00 6 258,300.00
168,750.00 112 12,632.14
10,500,000.00 5,000 1,500,000.00
3,000 16,500,000.00
800,000.00 843 134,912.00
900,000.00 126 377,100.00
50 585,000.00
3,000 2,742,000.00
996 51,480.79
1,600,000.00 199 39,704.00
1,645,000.00 4 17,672.00
108,800.00 15 9,472.00
48,000.00 19 9,024.00
11 61,824.00
38 104,596.80

0 731.87
105,500.00 90 18,998.44
7,621,400.00 25 35,777.44
21,360,000.00 15,000 1,335,000.00
4,590,000.00 200 2,295,000.00
- -
 2,420,000.00 1,852 203,764.00
64,890.00 10 21,630.00
426,090.00 7 94,686.67
687 60,122.81
- 330 34,980.00
- - -
1,938,000.00 234 266,532.00
3,240,000.00 565 67,744.00
25,740,000.00 9 48,048.00
660,000.00 32 211,200.00
3,626 384,247.22
1,200,000.00 84 167,520.00
1,125,000.00 78 97,833.33
4,746,000.00 400 1,898,400.00
6,617,000.00 376 191,160.04
1,770,000.00 7 21,240.00
5,280,000.00 43 143,220.00
161,700.00 61 65,973.60
202,800.00 67 11,356.80
1,020,000.00 600 153,000.00
1,480,000.00 231 34,235.36
510,000.00 242 72,685.71
3,868 2,381,089.23
108 82,452.50
35,000 1,908,958.33
203,575.00 100 239,021.00
235 71,571.60
6,313,000.00 828 88,624.53
756,800.00 355 168,033.25

1,300,000.00 284 184,340.00

9,100,000.00 384 249,626.00
1,500,000.00 446 334,470.00
42 32,571.00
36,000.00 30 106,560.00
1,116,666.67 75 416,293.33
1,675,000.00 67 373,860.00
800,000.00 16 126,933.33
1,050,000.00 120 419,160.00
2,560,000.00 292 933,248.00
74,720.00 8 56,787.20
6,724,800.00 39 287,821.44
2,988,800.00 50 375,592.53
91 682,641.92
10 23,309.56
11 24,750.04
250,000.00 24 300,000.00
3,080,000.00 17 131,824.00
108,750.00 33 12,071.25
900,000.00 243 365,000.00
75,000.00 76 57,000.00
2,531,400.00 422 3,561,173.52
464,640.00 - -
 11 167,786.67
1,300,000.00 1,372 446,030.00
2,090,000.00 287 1,199,869.00
2,446 305,765.00
916,666.67 195 595,833.33
240,000.00 30 90,000.00

- 119 40,154.40
136,680.00 6 21,185.40

- -
- -
- -
624,250.00 0 916.67
200,508.00 61.60
0
- -
- - -
880,000.00 55 120,266.67
4,241,160.00 - -
6,240,000.00 22,530 5,857,800.00
- 66,000.00
1,320

- - -
209,000.00 3 11,704.00
535,936.00 0 957.03
576,250.00 5 54,002.86
51,345.00 0 3.00
266,000.00 373 49,569.10
220,000.00 228 50,072.00
38,400.00 - -
260,488.00 0 13.80
790,615.00 0 98.00
425,520.00 0 48.00
1,512,000.00 577 581,414.40
- - -
99 23,220.30
13 2,178,000.00
13 1,960,200.00
13 7,477,800.00
- 13 220,004.40
13 537,240.00
13 9,438,000.00
13 1,815,000.00
13 537,240.00

13 726,000.00
13 2,468,400.00

2,143 4,278,772.20
3,011 4,366,488.57
830 1,701,090.00
 - -
- -
- -
- -
- -
- -
- -
- -
- -
- -
7,198,000.00 30 10,854,584.00
8,399,930.00 6 7,439,938.00
2,578,800.00 36 7,822,360.00
- - -
- - -
- -
- -
- -
1,000 18,625,000.00
- -
34 4,351,600.00
7 3,159,640.00
2,355,000.00 4 339,120.00
93 5,162,058.00
88 5,625,840.00
10 187,437.07
53 1,436,193.00
137 2,616,152.00
57 816,084.13
- -
- -

- -
- -
- -
- -
- -
- -

70,000 10,500,000.00
4,000 680,000.00
12 1,080,000.00
40 2,400,000.00
50 250,000.00
700 29,400,000.00
5,000 25,500,000.00
8,000 33,600,000.00
- -
- -
- -
- -
- -
- -
 - -
- -
- -
288,930,745.33 #VALUE!
47391.493
###
 RENCANA KEBUTUHAN OBAT
PUSKESMAS WANARAJA
TAHUN 2016

RATA-RATA RENCANA PENGADAAN RENCANA PENGADAAN

HARGA SATUAN (Rp) KEBUTUHAN 1 THN
NO NAMA OBAT SATUAN PEMAKAIAN PER SUMBER DANA JKN PENGELOLAAN DINKES
E KATALOG SURVEY BLN VOLUME NILAI VOLUME NILAI VOLUME NILAI
1 Alopurinol tablet 100 mg Tablet 86.00 - 122.50 1,617.00 139,062.00 1,600.00 137,600.00 17.00 1,462.00
2 Aminofilin Inj 24 mg/ml-10 ml Ampul 3,822.00 - - - - - - #VALUE!
3 Aminofilin Tablet 200 mg Tablet 90.00 - 60.50 798.60 71,874.00 700.00 63,000.00 98.60 8,874.00
4 Amlodipin tablet 5 mg Tablet 187.00 - 300.20 3,962.64 741,013.68 3,900.00 729,300.00 62.64 11,713.68
5 Amoksisilin Kaplet 500 mg Kaplet 272.00 - 7,513.90 99,183.48 26,977,906.56 99,000.00 26,928,000.00 183.48 49,906.56
6 Amoksisilin Sirup Kering 125 mg/5 ml Botol 2,445.00 - 162.90 2,150.28 5,257,434.60 2,150.00 5,256,750.00 - -
7 Amoksisilin Sirup Kering Forte 250 mg/5 ml Botol - 5,800.00 - - - 1,200.00 4,640,000.00 - -
8 Antalgin (Metampiron) Tablet 500 mg Tablet - - - - - - - - -
9 Antasida DOEN I Tablet Kunyah Tablet 75.00 - 5,509.40 72,724.08 5,454,306.00 72,700.00 5,452,500.00 24.08 1,806.00
10 Antasida II Suspensi 60 ml Botol 2,100.00 - 41.80 551.76 1,158,696.00 550.00 1,155,000.00 1.76 3,696.00
11 Anti Hemmoroid DOEN Tablet 3,045.00 - 11.00 145.20 442,134.00 145.00 441,525.00 0.20 609.00
12 Antibakteri DOEN Tablet 2,516.00 - 34.25 452.10 1,137,483.60 400.00 1,006,400.00 400.00 1,006,400.00
13 Antifungi DOEN kombinasi Pot - 2,750.00 16.17 213.40 586,850.00 213.00 - 250.00 687,500.00
14 Antimigren DOEN Tablet 135.00 - 18.83 248.60 33,561.00 200.00 27,000.00 - -
15 Aqua Pro Injeksi steril bebas pirogen- 20 ml Vial 2,030.00 - 57.30 756.36 1,535,410.80 700.00 1,421,000.00 56.36 114,410.80
16 Asam Asetilsalisilat Tablet 100 mg (Asetosal) Tablet 116.00 - 77.63 1,024.65 118,859.40 800.00 92,800.00 224.65 26,059.40
17 Asam Asetilsalisilat Tablet 80 mg (Asetosal) Tablet - - - - - - - - -
18 Asam Askorbat (VIT C) Tablet 50 mg Tablet 95.00 - 992.60 13,102.32 1,244,720.40 7,500.00 712,500.00 5,602.32 532,220.40
19 Asam Mefenamat kaplet 500 mg Tablet 112.00 - 1,556.10 20,540.52 2,300,538.24 20,500.00 2,296,000.00 40.52 4,538.24
20 Asiklovir Krim 5%/5g Tube - 3,073.50 12.10 159.72 490,899.42 100.00 - 59.72 183,549.42
21 Asiklovir Tablet 400 mg Tablet 345.00 - 49.33 651.20 224,664.00 500.00 172,500.00 151.20 52,164.00
22 Atapulgit tablet 600 mg (Puralex) Tablet 190.00 - 362.60 4,786.32 909,400.80 4,500.00 855,000.00 286.32 54,400.80
23 Atropin Sulfat injeksi 0,25 mg/ml-1 ml Ampul 1,350.00 - 5.00 66.00 89,100.00 20.00 27,000.00 46.00 62,100.00
24 Benzatin Benzil Penisilin Inj 2,4 juta IU/vial Vial 13,400.00 - 5.00 66.00 884,400.00 60.00 804,000.00 40.00 536,000.00
25 Betametason Krim 0.1 % Tube 1,520.00 - 96.80 1,277.76 1,942,195.20 1,000.00 1,520,000.00 277.76 422,195.20
26 Bromheksin Tablet 8 mg Tablet - 121.00 1,295.83 17,105.00 2,069,705.00 1,700.00 - 3,000.00 363,000.00
27 Deksametason inj 5 mg/ml-1 ml Ampul 1,580.00 - 164.70 2,174.04 3,434,983.20 2,000.00 3,160,000.00 300.00 474,000.00
28 Deksametason Tablet 0,5 mg Tablet 68.00 - 2,536.75 33,485.10 2,276,986.80 30,000.00 2,040,000.00 3,485.10 236,986.80
29 Dekstrometorfan tablet kombinasi Tablet - 594.00 428.00 5,649.60 3,355,862.40 5,650.00 - 3,000.00 1,782,000.00
30 Dektrometorfan sirup kombinasi Botol - 11,985.00 18.33 242.00 2,900,370.00 300.00 - 200.00 2,397,000.00
31 Dextrose Inj 40% Botol 14,524.00 - - - - - - - -
32 Difenhidramin inj 10 mg/ml Ampul 1,054.00 - 13.29 175.37 184,841.49 75.00 79,050.00 100.37 105,791.49
33 Digoksin tablet 0,25 mg Tablet 97.00 - 16.50 217.80 21,126.60 - - 217.80 21,126.60
34 Dimenhidrinat Tablet 50 mg Tablet 104.00 - 10.67 140.80 14,643.20 - - 140.80 14,643.20
35 Domperidon Suspensi 5mg/5ml Botol 3,333.00 - 13.40 176.88 589,541.04 100.00 333,300.00 76.88 256,241.04
36 Domperidon Tablet 10 mg Tablet 167.00 - 158.33 2,090.00 349,030.00 2,000.00 334,000.00 90.00 15,030.00
37 Efedrin HCl tablet 25 mg Tablet - - - - - - - - -
38 Epinefrina HCl/Bitartrat(Adrenalin) inj 0,1 %-1ml Ampul 8,100.00 - 3.83 50.60 409,860.00 30.00 243,000.00 20.60 166,860.00
39 Eritromisin Kapsul 250 mg Tablet 497.00 - 167.50 2,211.00 1,098,867.00 1,200.00 596,400.00 1,011.00 502,467.00
40 Etakridin Larutan 0,1 % Botol 2,550.00 - 1.00 13.20 33,660.00 - - 13.20 33,660.00
41 Etanol 70 %- 100 ml Botol - - - - - - - - -
42 Etanol 70 %- 1000 ml Botol 21,500.00 - 3.40 44.88 964,920.00 30.00 645,000.00 14.88 319,920.00
43 Etil Klorida Spray Botol - 165,000.00 2.75 36.30 5,989,500.00 30.00 - 6.30 1,039,500.00
44 Fenoksimetil Penisilin tablet 500 mg Tablet 510.00 - 177.00 2,336.40 1,191,564.00 1,500.00 765,000.00 836.40 426,564.00
45 Fitomenadion(Vit K1) tablet salut gula 10 mg Tablet 634.00 - 115.40 1,523.28 965,759.52 1,500.00 951,000.00 23.28 14,759.52
46 Furosemid tablet 40 mg Tablet 85.00 - 60.50 798.60 67,881.00 300.00 25,500.00 498.60 42,381.00
 RATA-RATA RENCANA PENGADAAN RENCANA PENGADAAN
HARGA SATUAN (Rp) KEBUTUHAN 1 THN
NO NAMA OBAT SATUAN PEMAKAIAN PER SUMBER DANA JKN PENGELOLAAN DINKES
E KATALOG SURVEY BLN VOLUME NILAI VOLUME NILAI VOLUME NILAI
47 Garam Oralit I Serbuk Sachet 285.00 - 98.71 1,303.03 371,363.14 700.00 199,500.00 603.03 171,863.14
48 Gentamisin Injeksi 40 mg/ml (Sulfat) Ampul 3,399.00 - 15.00 198.00 673,002.00 150.00 509,850.00 48.00 163,152.00
49 Gentamisin Salep Kulit 0,1% Tube - 1,842.58 102.44 1,352.27 2,491,659.51 1,000.00 - 1,352.00 2,491,168.16
50 Gentian violet larutan 1 %-10 ml Botol - 1,210.00 7.38 97.35 117,793.50 60.00 - 37.35 45,193.50
51 Glibenklamid tablet 5 mg Tablet 56.00 - 185.40 2,447.28 137,047.68 2,000.00 112,000.00 447.28 25,047.68
52 Gliseril Guaiakolat Tablet 100 mg Tablet - 62.20 4,672.22 61,673.33 3,836,081.33 50,000.00 - 40,000.00 2,488,000.00
53 Glukosa Laruran infus 5% steril-500 ml Fls 5,200.00 - - - - - - - -
54 Griseofulvin tablet 125 mg micronized Tablet 219.00 - 59.38 783.75 171,641.25 500.00 109,500.00 283.75 62,141.25
55 Hidroklortiazid (HCT) tablet 25 mg Tablet 149.00 - 72.50 957.00 142,593.00 700.00 104,300.00 257.00 38,293.00
56 Hidrokortison krim 2,5 % Tube 2,798.00 - 56.29 742.97 2,078,834.06 700.00 1,958,600.00 42.97 120,234.06
57 Hyoscine-n-butilbromide Tablet 10 mg Tablet 299.20 - - 7,000.00 2,094,400.00 7,000.00 2,094,400.00 - -
58 Ibuprofen tablet 400 mg Tablet 149.00 - 1,616.20 21,333.84 3,178,742.16 21,000.00 3,129,000.00 333.84 49,742.16
59 Isosorbid dinitrat tablet sublingual 5 mg Tablet 88.00 - 3.00 39.60 3,484.80 30.00 2,640.00 9.60 844.80
60 Kalsium Laktat (Kalk) tablet 500 mg Tablet 70.00 - 1,725.00 22,770.00 1,593,900.00 22,000.00 1,540,000.00 770.00 53,900.00
61 Kaptropil 25 mg Tablet 80.00 - 1,876.10 24,764.52 1,981,161.60 24,000.00 1,920,000.00 764.52 61,161.60
62 Karbogliserin Tetes telinga 10 % Botol 2,042.00 - 9.00 118.80 242,589.60 100.00 204,200.00 18.80 38,389.60
63 Karbon Aktif Tablet - 100.00 - - - - - - -
64 Ketokonazol Tablet 200 mg Tablet 300.00 - 13.00 171.60 51,480.00 50.00 15,000.00 121.60 36,480.00
65 Kloramfenikol kapsul 250 mg Kapsul - 273.74 1,197.90 15,812.28 4,328,453.53 15,000.00 - 812.28 222,353.53
66 Kloramfenikol salep mata 1 % Tube 1,600.00 - 30.00 396.00 633,600.00 200.00 320,000.00 196.00 313,600.00
67 Kloramfenikol syrup 125 mg/5 ml Botol 3,680.00 - - 1,500.00 5,520,000.00 1,500.00 5,520,000.00 - -
68 Kloramfenikol Tetes Mata 0.5% Botol - 5,500.00 58.22 768.53 4,226,933.33 500.00 - 769.00 4,229,500.00
69 Kloramfenikol Tetes telinga 3 % Tube - 2,090.00 32.40 427.68 893,851.20 300.00 - 428.00 894,520.00
70 Klorfenarimin maleat (CTM) tablet 4 mg Tablet 51.00 - 8,488.00 112,041.60 5,714,121.60 112,000.00 5,610,000.00 41.60 2,121.60
71 Kotrimoksazol Susp:Sulf 200+Trim 40 mg/5 ml Botol 2,145.00 - 132.50 1,749.00 3,751,605.00 1,500.00 3,217,500.00 249.00 534,105.00
72 Kotrimoksazol Tab Dws:Sulf 400+Trim 80 mg Tablet 149.00 - 1,137.80 15,018.96 2,237,825.04 15,000.00 2,235,000.00 18.96 2,825.04
73 Kotrimoksazol Tab Ped:Sulf 100 + Trim 20 mg Tablet - - - - - - - - -
74 Lidokain inj Komp : Lidokain %+ Epinefrin 1 : 80000-2 ml Ampul 1,363.00 - 118.89 1,569.33 2,139,001.33 1,500.00 2,044,500.00 69.33 94,501.33
75 Lisol Botol 41,000.00 - 2.75 36.30 1,488,300.00 30.00 1,230,000.00 6.30 258,300.00
76 Metformin HCl Tablet 500 mg Tablet 112.50 - 122.14 1,612.29 181,382.14 1,500.00 168,750.00 112.29 12,632.14
77 Metilprednisolon 4 mg Tablet 300.00 - - 40,000.00 12,000,000.00 35,000.00 10,500,000.00 5,000.00 1,500,000.00
78 Ondansetron inj 4 mg/2 ml Ampul - 5,500.00 - 6,000.00 33,000,000.00 3,000.00 - 3,000.00 16,500,000.00
79 Metronidazol tablet 500 mg Tablet 160.00 - 442.67 5,843.20 934,912.00 5,000.00 800,000.00 843.20 134,912.00
80 Mikonazol Krim/Salep 2% Tube 3,000.00 - 32.25 425.70 1,277,100.00 300.00 900,000.00 125.70 377,100.00
81 Multivitamin + DHA + Lysin (Truvit) Botol - 11,700.00 35.00 462.00 5,405,400.00 462.00 - 50.00 585,000.00
82 Multivitamin + Mineral (Selviplex) Kaplet - 914.00 475.67 6,278.80 5,738,823.20 8,000.00 - 3,000.00 2,742,000.00
83 Natrium Bikarbonat tablet 500 mg Tablet - 51.70 1,211.80 15,995.76 826,980.79 15,000.00 - 995.76 51,480.79
84 Natrium Diklofenak Tablet 50 mg Tablet 200.00 - 621.10 8,198.52 1,639,704.00 8,000.00 1,600,000.00 198.52 39,704.00
85 Natrium Klorida Larutan Infus 0,9% Fls 4,700.00 - 26.80 353.76 1,662,672.00 350.00 1,645,000.00 3.76 17,672.00
86 Nistatin tablet salut gula 500.000 IU/g Tablet 640.00 - 14.00 184.80 118,272.00 170.00 108,800.00 14.80 9,472.00
87 Nistatin tablet vaginal 100.000 IU/g Tablet 480.00 - 9.00 118.80 57,024.00 100.00 48,000.00 18.80 9,024.00
88 Obat batuk Hitam (OBH) Cairan -100 ml Botol - 5,796.00 72.78 960.67 5,568,024.00 950.00 - 10.67 61,824.00
89 Oksitetrasiklin HCl 1 % Salep mata Tube - 2,772.00 55.89 737.73 2,044,996.80 700.00 - 37.73 104,596.80
90 Oksitetrasiklin HCl inj i.m 50 mg/ml-10 ml Flacon - - - - - - - - -
91 Oksitetrasiklin HCl Salep Kulit 3 % Tube - 1,829.68 52.00 686.40 1,255,892.35 686.00 - 0.40 731.87
92 Omeprazol kapsul 20 mg Kapsul 211.00 - 44.70 590.04 124,498.44 500.00 105,500.00 90.04 18,998.44
93 Parasetamol sirup 120 mg / 5ml Botol 1,438.00 - 403.40 5,324.88 7,657,177.44 5,300.00 7,621,400.00 24.88 35,777.44
94 Parasetamol tablet 500 mg Tablet 89.00 - 16,235.30 214,305.96 19,073,230.44 240,000.00 21,360,000.00 15,000.00 1,335,000.00
95 Permetrin krim 5% (Scabimite) Tube 11,475.00 - 22.00 290.40 3,332,340.00 400.00 4,590,000.00 200.00 2,295,000.00
96 Piracetam Tablet 1200 mg Tablet - 1,292.30 - - - - - - -
97 Piridoksin HCl (Vit B6) tablet 10 mg Tablet 110.00 - 1,807.00 23,852.40 2,623,764.00 22,000.00 2,420,000.00 1,852.40 203,764.00
 RATA-RATA RENCANA PENGADAAN RENCANA PENGADAAN
HARGA SATUAN (Rp) KEBUTUHAN 1 THN
NO NAMA OBAT SATUAN PEMAKAIAN PER SUMBER DANA JKN PENGELOLAAN DINKES
E KATALOG SURVEY BLN VOLUME NILAI VOLUME NILAI VOLUME NILAI
98 Povidon Iodiada 10 %-30 ml Botol 2,163.00 - 2.33 30.80 66,620.40 30.00 64,890.00 10.00 21,630.00
99 Povidon Iodiada 10 %-300 ml Botol 14,203.00 - 2.78 36.67 520,776.67 30.00 426,090.00 6.67 94,686.67
100 Prednison tablet 5 mg Tablet - 87.52 2,097.50 27,687.00 2,423,027.81 27,000.00 - 687.00 60,122.81
101 Propanolol HCl tablet 40 mg Tablet 106.00 - 25.00 330.00 34,980.00 - - 330.00 34,980.00
102 Propiltiourasil tablet 100 mg Tablet 319.00 - - - - - - - -
103 Ranitidin Injeksi 25 mg/ml Ampul 1,140.00 - 146.50 1,933.80 2,204,532.00 1,700.00 1,938,000.00 233.80 266,532.00
104 Ranitidin Tablet 150 mg Tablet 120.00 - 2,088.22 27,564.53 3,307,744.00 27,000.00 3,240,000.00 564.53 67,744.00
105 Ringer Laktat Larutan Infus Steril Fls 5,200.00 - 375.70 4,959.24 25,788,048.00 4,950.00 25,740,000.00 9.24 48,048.00
106 Salbutamol 2,5 mg/2,5 ml NaCl Ampul 6,600.00 - 10.00 132.00 871,200.00 100.00 660,000.00 32.00 211,200.00
107 Salbutamol tablet 4 mg Tablet - 105.97 274.70 3,626.04 384,251.46 3,500.00 - 3,626.00 384,247.22
108 Salep 2-4 kombinasi : as.asal 2 % + Bel. 4 % Pot 2,000.00 - 51.80 683.76 1,367,520.00 600.00 1,200,000.00 83.76 167,520.00
109 Salisil Bedak 2 % - 50 gram Kotak 1,250.00 - 74.11 978.27 1,222,833.33 900.00 1,125,000.00 78.27 97,833.33
110 Sefadroksil syrup 125 mg/5 ml Botol 4,746.00 - 51.33 677.60 3,215,889.60 1,000.00 4,746,000.00 400.00 1,898,400.00
111 Sefadroxil Kapsul 500 mg Kapsul 509.00 - 1,013.30 13,375.56 6,808,160.04 13,000.00 6,617,000.00 375.56 191,160.04
112 Sefotaksim Injeksi 1 g Vial 2,950.00 - 46.00 607.20 1,791,240.00 600.00 1,770,000.00 7.20 21,240.00
113 Seftriaxon Injeksi 1 g Vial 3,300.00 - 124.50 1,643.40 5,423,220.00 1,600.00 5,280,000.00 43.40 143,220.00
114 Sianokobalamin (Vit B12 ) inj 500 mcg/ml-1ml Ampul 1,078.00 - 16.00 211.20 227,673.60 150.00 161,700.00 61.20 65,973.60
115 Simvastatin 10 mg Tablet 169.00 - 96.00 1,267.20 214,156.80 1,200.00 202,800.00 67.20 11,356.80
116 Siprofloksasin (HCl) Kaplet 500 mg Kaplet 255.00 - 326.90 4,315.08 1,100,345.40 4,000.00 1,020,000.00 600.00 153,000.00
117 Tetrasiklin Kapsul 250 mg Kapsul 148.00 - 775.10 10,231.32 1,514,235.36 10,000.00 1,480,000.00 231.32 34,235.36
118 Tetrasiklin Kapsul 500 mg Kapsul 300.00 - 147.14 1,942.29 582,685.71 1,700.00 510,000.00 242.29 72,685.71
119 Tiamfenikol Kapsul 500 mg Kapsul - 615.59 293.00 3,867.60 2,380,842.99 3,000.00 - 3,868.00 2,381,089.23
120 Tiamin HCL (Vit B1) inj 100 mg/ml-1ml Ampul - 767.00 18.75 247.50 189,832.50 140.00 - 107.50 82,452.50
121 Tiamin HCL (Vit B1) tablet 50 mg Tablet - 54.54 2,798.40 36,938.88 2,014,708.08 35,000.00 - 35,000.00 1,908,958.33
122 Tramadol Injeksi 50 mg/ml Ampul 2,395.00 - 14.00 184.80 442,596.00 85.00 203,575.00 99.80 239,021.00
123 Tramadol Kapsul 50 mg Tablet - 304.56 12.50 165.00 50,252.40 200.00 - 235.00 71,571.60
124 Vitamin B Kompleks tablet Tablet 107.00 - 4,532.44 59,828.27 6,401,624.53 59,000.00 6,313,000.00 828.27 88,624.53
125 Zinc Tablet 20 mg Tablet 473.00 - 148.13 1,955.25 924,833.25 1,600.00 756,800.00 355.25 168,033.25
ALKES HABIS PAKAI
126 Alat Suntik Sekali Pakai 1ml Set 650.00 - 173.00 2,283.60 1,484,340.00 2,000.00 1,300,000.00 283.60 184,340.00
127 Alat Suntik Sekali Pakai 2,5 ml / 3 ml Set 650.00 - 1,089.70 14,384.04 9,349,626.00 14,000.00 9,100,000.00 384.04 249,626.00
128 Alat Suntik Sekali Pakai 5 ml Set 750.00 - 185.30 2,445.96 1,834,470.00 2,000.00 1,500,000.00 445.96 334,470.00
129 Bisturi Buah - 770.00 7.75 102.30 78,771.00 60.00 - 42.30 32,571.00
130 Blood set Buah 3,600.00 - 3.00 39.60 142,560.00 10.00 36,000.00 29.60 106,560.00
131 Catgut/Benang Bedah No.2/0 dengan jarum bedah Roll 5,583.33 - 20.80 274.56 1,532,960.00 200.00 1,116,666.67 74.56 416,293.33
132 Catgut/Benang Bedah No.3/0 dengan jarum bedah Roll 5,583.33 - 27.80 366.96 2,048,860.00 300.00 1,675,000.00 66.96 373,860.00
133 Folley Catheter pcs 8,000.00 - 8.78 115.87 926,933.33 100.00 800,000.00 15.87 126,933.33
134 Infusion set anak Kantong 3,500.00 - 31.80 419.76 1,469,160.00 300.00 1,050,000.00 119.76 419,160.00
135 Infusion set dewasa Kantong 3,200.00 - 82.70 1,091.64 3,493,248.00 800.00 2,560,000.00 291.64 933,248.00
136 IV Catheter No.18 set 7,472.00 - 1.33 17.60 131,507.20 10.00 74,720.00 7.60 56,787.20
137 IV Catheter No.20 set 7,472.00 - 71.10 938.52 7,012,621.44 900.00 6,724,800.00 38.52 287,821.44
138 IV Catheter No.22 set 7,472.00 - 34.11 450.27 3,364,392.53 400.00 2,988,800.00 50.27 375,592.53
139 IV Catheter No.24 set 7,472.00 - 44.80 591.36 4,418,641.92 500.00 91.36 682,641.92
140 Jarum kulit (GT) pcs - 2,291.67 2.29 30.17 69,142.96 20.00 - 10.17 23,309.56
141 Jarum otot (GR) pcs - 2,291.67 2.33 30.80 70,583.44 20.00 - 10.80 24,750.04
142 Kapas Pembalut/absorben 250 mg Roll 12,500.00 - 3.33 44.00 550,000.00 20.00 250,000.00 24.00 300,000.00
143 Kasa Hidrofil 2x80 Roll 7,700.00 - 31.60 417.12 3,211,824.00 400.00 3,080,000.00 17.12 131,824.00
144 Kasa Hidrofil Steril 16 X 16 Lembar 362.50 - 25.25 333.30 120,821.25 300.00 108,750.00 33.30 12,071.25
145 Kasa Pembalut Hidrofil 4 X 10 cm Roll 1,500.00 - 63.89 843.33 1,265,000.00 600.00 900,000.00 243.33 365,000.00
146 Kasa Pembalut hidrofil 4 x 5 cm Roll 750.00 - 13.33 176.00 132,000.00 100.00 75,000.00 76.00 57,000.00
147 Kassa Pembalut elastic 4 inchi Roll 8,438.00 - 54.70 722.04 6,092,573.52 300.00 2,531,400.00 422.04 3,561,173.52
 RATA-RATA RENCANA PENGADAAN RENCANA PENGADAAN
HARGA SATUAN (Rp) KEBUTUHAN 1 THN
NO NAMA OBAT SATUAN PEMAKAIAN PER SUMBER DANA JKN PENGELOLAAN DINKES
E KATALOG SURVEY BLN VOLUME NILAI VOLUME NILAI VOLUME NILAI
148 Masker set 330.00 - 106.67 1,408.00 464,640.00 1,408.00 464,640.00 - -
149 Plester 5 yard x 2 inch Roll - 15,730.00 6.11 80.67 1,268,886.67 70.00 - 10.67 167,786.67
150 Sarung Tangan non steril Set 325.00 - 407.00 5,372.40 1,746,030.00 4,000.00 1,300,000.00 1,372.40 446,030.00
151 Sarung Tangan steril Set 4,180.00 - 59.63 787.05 3,289,869.00 500.00 2,090,000.00 287.05 1,199,869.00
152 Sendok Obat Buah - 125.00 564.10 7,446.12 930,765.00 5,000.00 - 2,446.12 305,765.00
153 Silk (Benang Bedah Sutera) No3/0 dengan jarum bedah Sachet 3,055.56 - 37.50 495.00 1,512,500.00 300.00 916,666.67 195.00 595,833.33
154 Urin Bag buah 3,000.00 - 8.33 110.00 330,000.00 80.00 240,000.00 30.00 90,000.00
PROGRAM KESGA
155 Albendazol Tablet 338.00 - 9.00 118.80 40,154.40 - - 118.80 40,154.40
156 Fitomenadion(Vit K1) inj 2 mg/ml Ampul 3,417.00 - 3.50 46.20 157,865.40 40.00 136,680.00 6.20 21,185.40
157 Fitomenadion(Vit K1) inj 10 mg/ml Ampul - - - - - - - - -
158 Iodin test Botol - 5,806.00 - - - - - - -
159 Magnesium sulfat inj(IV) 20 % Botol - 6,050.00 - - - - - - -
160 Magnesium sulfat inj(IV) 40 % Botol - 6,050.00 - - - - - - -
161 Metilergomatrin maleat inj 0,200 mg - ml Ampul 2,750.00 - 17.22 227.33 625,166.67 227.00 624,250.00 0.33 916.67
162 Metilergometrin maleat(Metilergometrin) tab.salut 0,125 mg Tablet 154.00 - 98.67 1,302.40 200,569.60 1,302.00 200,508.00 0.40 61.60
163 Mineral Mix Sachet - 2,450.00 - - - - - - -
164 Natrium Tiroksin Tablet 1,550.00 - - - - - - - -
165 Oksitoksin in 10 IU/ml- 1 ml Ampul 2,200.00 - 34.44 454.67 1,000,266.67 400.00 880,000.00 54.67 120,266.67
166 Retinol (VIT A) Kapsul 200.000 IU Kapsul 459.00 - 700.00 9,240.00 4,241,160.00 9,240.00 4,241,160.00 - -
167 Retinol tab 100.000 IU Kapsul 260.00 - 3,525.00 46,530.00 12,097,800.00 24,000.00 6,240,000.00 22,530.00 5,857,800.00
168 Tablet Tambah darah kombinasi : Besi II Sulfat 200 mg + Tablet 50.00 - 100.00 1,320.00 66,000.00 - - 1,320.00 66,000.00
Asam folat 0.25 mg
PROGRAM YANKES
169 Amitriptilina HCl tablet salut 25 mg Tablet 112.00 - - - - - - - -
170 Diazepam inj 5 mg/ml-2 ml Ampul 4,180.00 - 4.00 52.80 220,704.00 50.00 209,000.00 2.80 11,704.00
171 Diazepam Rectal 10 mg/2,5 ml tube 16,748.00 - 2.43 32.06 536,893.03 32.00 535,936.00 0.06 957.03
172 Diazepam Rectal 5 mg/2,5 ml tube 11,525.00 - 4.14 54.69 630,252.86 50.00 576,250.00 4.69 54,002.86
173 Diazepam tablet 2 mg Tablet 45.00 - 86.44 1,141.07 51,348.00 1,141.00 51,345.00 0.07 3.00
174 Fenitoin Natrium kapsul 100 mg Kapsul 133.00 - 179.75 2,372.70 315,569.10 2,000.00 266,000.00 372.70 49,569.10
175 Fenobarbital tablet 30 mg Tablet 220.00 - 93.00 1,227.60 270,072.00 1,000.00 220,000.00 227.60 50,072.00
176 Haloperidol 5 mg Tablet 96.00 - - 400.00 38,400.00 400.00 38,400.00 - -
177 Haloperidol tablet 1,5 mg Tablet 69.00 - 286.00 3,775.20 260,488.80 3,775.00 260,488.00 0.20 13.80
178 Karbamazepin tablet 200 mg Tablet 245.00 - 244.50 3,227.40 790,713.00 3,227.00 790,615.00 0.40 98.00
179 Klorpropmazin HCl tablet salut 100 mg Tablet 144.00 - 223.89 2,955.33 425,568.00 2,955.00 425,520.00 0.33 48.00
180 Resperidon 2 mg Tablet 1,008.00 - 157.33 2,076.80 2,093,414.40 1,500.00 1,512,000.00 576.80 581,414.40
181 Flufenazin inj 25mg/ml (Sikzonoate) Ampul 55,000.00 - - - - - - - -
182 Triheksifenidil HCl tablet 2 mg Tablet - 235.50 310.50 4,098.60 965,220.30 4,000.00 - 98.60 23,220.30
183 Caviton (Citodur) Botol - 165,000.00 1.00 13.20 2,178,000.00 - - 13.20 2,178,000.00
184 Devitalisasi Pasta (D Pulp) Botol - 148,500.00 1.00 13.20 1,960,200.00 - - 13.20 1,960,200.00
185 Endometason Botol - 566,500.00 1.00 13.20 7,477,800.00 - - 13.20 7,477,800.00
186 Eugenol Cairan Botol 16,667.00 - 1.00 13.20 220,004.40 - - 13.20 220,004.40
187 Formokresol Cair Botol - 40,700.00 1.00 13.20 537,240.00 - - 13.20 537,240.00
188 Glass Ionomer Cement (GC IX) Botol - 715,000.00 1.00 13.20 9,438,000.00 - - 13.20 9,438,000.00
189 Kalsium hidroksida pasta (Calcidor) Pot - 137,500.00 1.00 13.20 1,815,000.00 - - 13.20 1,815,000.00
190 Monoklorkamfer mentol cairan Botol - 40,700.00 1.00 13.20 537,240.00 - - 13.20 537,240.00
191 Mummifying Pasta Botol - - - - - - - - -
192 Natrium Hipoklorid Botol - 55,000.00 1.00 13.20 726,000.00 - - 13.20 726,000.00
193 Semen seng fosfat serbuk cairan (Dorident) Pot - 187,000.00 1.00 13.20 2,468,400.00 - - 13.20 2,468,400.00
PROGRAM P2
194 ADS 0.05 ml pcs - 1,997.00 313.83 4,142.60 8,272,772.20 2,000.00 - 2,142.60 4,278,772.20
 RATA-RATA RENCANA PENGADAAN RENCANA PENGADAAN
HARGA SATUAN (Rp) KEBUTUHAN 1 THN
NO NAMA OBAT SATUAN PEMAKAIAN PER SUMBER DANA JKN PENGELOLAAN DINKES
E KATALOG SURVEY BLN VOLUME NILAI VOLUME NILAI VOLUME NILAI
195 ADS 0.5 ml pcs - 1,450.00 493.29 6,511.37 9,441,488.57 3,500.00 - 3,011.37 4,366,488.57
196 ADS 5 ml pcs - 2,050.00 176.50 2,329.80 4,776,090.00 1,500.00 - 829.80 1,701,090.00
197 Azithromisin tablet 500 mg Tablet - 4,500.00 - - - - - - -
198 Dehidroartemisin+Piperaquin Kotak - 35,472.00 - - - - - - -
199 Doksisilin 100 mg Tablet - 270.00 - - - - - - -
200 Fluconazol 150 mg Tablet - 22,000.00 - - - - - - -
201 Kina Inj 26 % 2 ml Ampul - 6,200.00 - - - - - - -
202 Kina Tablet 222 mg Tablet - 670.00 - - - - - - -
203 Klindanmycin 300 mg Tablet - 553.00 - - - - - - -
204 Masker N-95 buah - 7,425.00 - - - - - - -
205 MB Anak Blister - 14,862.00 - - - - - - -
206 MB Dewasa Blister - 20,906.00 - - - - - - -
207 OAT FDC Katagori 1 Paket 359,900.00 - 3.80 50.16 18,052,584.00 20.00 7,198,000.00 30.16 10,854,584.00
208 OAT FDC Katagori 2 Paket 1,199,990.00 - 1.00 13.20 15,839,868.00 7.00 8,399,930.00 6.20 7,439,938.00
209 OAT Kategori Anak paket 214,900.00 - 3.67 48.40 10,401,160.00 12.00 2,578,800.00 36.40 7,822,360.00
210 OAT Kombipak Kat I paket 288,200.00 - - - - - - - -
211 OAT Sisipan Tablet 160,000.00 - - - - - - - -
212 PB Anak Blister - 6,539.00 - - - - - - -
213 PB Dewasa Blister - 6,539.00 - - - - - - -
214 Primakuin Tablet - 108.99 - - - - - - -
215 Safety box pcs - 18,625.00 - - - - - 1,000.00 18,625,000.00
216 Sefiksime + Azitromisin Kotak - 33,000.00 - - - - - - -
217 Serum anti tetanus inj 1500 IU/vial (ATS) Ampul - 126,500.00 4.50 59.40 7,514,100.00 25.00 - 34.40 4,351,600.00
218 Serum antibisa ular Polivalen inj 5 ml (SABU) I Ampul - 473,000.00 2.40 31.68 14,984,640.00 25.00 - 6.68 3,159,640.00
219 Vaksin Rabies Ampul 78,500.00 - 2.60 34.32 2,694,120.00 30.00 2,355,000.00 4.32 339,120.00
220 Vaksin BCG + Pelarut Paket - 55,506.00 37.33 492.80 27,353,356.80 400.00 - 93.00 5,162,058.00
221 Vaksin DPT-HB Vial - 63,930.00 59.70 788.00 50,376,840.00 700.00 - 88.00 5,625,840.00
222 Vaksin Polio + Dropper Paket - 18,997.00 53.78 709.87 13,485,337.07 700.00 - 9.87 187,437.07
223 Vaksin Campak + Pelarut Paket - 26,895.00 49.50 653.40 17,573,193.00 600.00 - 53.40 1,436,193.00
224 Vaksin Uniject Vial - 19,096.00 55.83 737.00 14,073,752.00 600.00 - 137.00 2,616,152.00
225 Vaksin TT Vial - 14,201.00 38.44 507.47 7,206,534.13 450.00 - 57.47 816,084.13
226 Vaksin Td Vial - 16,181.00 - - - - - - -
227 Vaksin DT Vial - 17,105.00 - - - - - - -
REAGEN
228 Rapid Test 1 HIV Sachet - 20,232.00 - - - - - - -
229 Rapid Test 2 HIV Sachet - 24,495.00 - - - - - - -
230 Rapid test 3 HIV Sachet - 22,200.20 - - - - - - -
231 Rapid Test Syphilis Sachet - 27,710.00 - - - - - - -
232 RPR Syphilis Sachet - 7,875.00 - - - - - - -
233 Rapid Test Malaria Sachet - 7,875.00 - - - - - - -
LAIN-LAIN
234 Ambroxol Tablet - 150.00 - 70,000.00 10,500,000.00 - - 70,000.00 10,500,000.00
235 Betahistin Tablet - 170.00 - 4,000.00 680,000.00 - - 4,000.00 680,000.00
236 H2O2 1000ml 3% Botol - 90,000.00 - 12.00 1,080,000.00 - - 12.00 1,080,000.00
237 Hibicet 100ml Botol - 60,000.00 - 40.00 2,400,000.00 - - 40.00 2,400,000.00
238 Bayclin 500ml Botol - 5,000.00 - 50.00 250,000.00 - - 50.00 250,000.00
239 Sarung tangan Ukuran S Bok - 42,000.00 - 700.00 29,400,000.00 - - 700.00 29,400,000.00
240 Ambroxol syrup Botol - 5,100.00 - 5,000.00 25,500,000.00 - - 5,000.00 25,500,000.00
241 Metronidazol syrup Botol - 4,200.00 - 8,000.00 33,600,000.00 - - 8,000.00 33,600,000.00
242 - - - - - - - - - - -
243 - - - - - - - - - - -
 RATA-RATA RENCANA PENGADAAN RENCANA PENGADAAN
HARGA SATUAN (Rp) KEBUTUHAN 1 THN
NO NAMA OBAT SATUAN PEMAKAIAN PER SUMBER DANA JKN PENGELOLAAN DINKES
E KATALOG SURVEY BLN VOLUME NILAI VOLUME NILAI VOLUME NILAI
244 - - - - - - - - - - -
245 - - - - - - - - - - -
246 - - - - - - - - - - -
247 - - - - - - - - - - -
248 - - - - - - - - - - -
249 - - - - - - - - - - -
250 - - - - - - - - - - -
JUMLAH TOTAL 739,939,172.81 - -

Garut, 2 Desember 2015

Kepala Puskesmas Wanaraja

dr. H. Indra Hisyam Saptarina

NIP. 19740419 200604 1 011
 DATA KUNJUNGAN PASIEN DAN DATA RESEP
PUSKESMAS WANARAJA
TAHUN 2015

JAN FEB MAR APR MEI JUN

URAIAN
NO PUSKESMAS UMUM BPJS JUMLAH UMUM BPJS JUMLAH UMUM BPJS JUMLAH UMUM BPJS JUMLAH UMUM BPJS JUMLAH UMUM BPJS JUMLAH

1 KUNJUNGAN PASIEN PKM 2015 - - - - - -

RAWAT JALAN

KUNJUNGAN RESEP 1,147 740 1,887 1,111 635 1,746 1,284 658 1,942 1,295 808 2,103 1,154 667 1,821 1,159 553 1,712

R/ (ITEM) OBAT 3,461 2,235 5,696 3,369 1,931 5,300 3,888 3,888 4,017 2,480 6,497 3,534 2,046 5,580 3,535 1,695 5,230

R/ (ITEM) OBAT GENERIK 3,412 2,229 5,641 3,201 1,929 5,130 3,732 3,732 3,928 2,418 6,346 3,478 1,998 5,476 3,487 1,663 5,150

RAWAT INAP

KUNJUNGAN RESEP 30 37 67 28 40 68 37 37 74 46 39 85 23 30 53 16 33 49

R/ (ITEM) OBAT 90 111 201 85 120 205 112 111 223 139 117 256 69 90 159 48 98 146

R/ (ITEM) OBAT GENERIK 89 111 200 82 119 201 112 110 222 138 117 255 69 90 159 47 98 145

JUL AGUS SEPT OKT NOP DES

URAIAN
UMUM BPJS JUMLAH UMUM BPJS JUMLAH UMUM BPJS JUMLAH UMUM BPJS JUMLAH UMUM BPJS JUMLAH UMUM BPJS JUMLAH

KUNJUNGAN PASIEN PKM 2015 - - - - - -

RAWAT JALAN

KUNJUNGAN RESEP 1,020 495 1,515 1,261 463 1,724 1,283 454 1,737 1,391 528 1,919 1,154 667 1,821 1,159 553 1,712

R/ (ITEM) OBAT 3,079 1,511 4,590 3,819 1,589 5,408 3,895 1,362 5,257 4,199 1,584 5,783 3,534 2,046 5,580 3,535 1,695 5,230

R/ (ITEM) OBAT GENERIK 3,060 1,487 4,547 3,776 1,371 5,147 3,866 1,339 5,205 4,176 1,559 5,735 3,478 1,998 5,476 3,487 1,663 5,150

RAWAT INAP

KUNJUNGAN RESEP 16 36 52 18 36 54 36 20 56 30 42 72 23 30 53 16 33 49

R/ (ITEM) OBAT 49 108 157 55 108 163 108 62 170 90 125 215 69 90 159 48 98 146

R/ (ITEM) OBAT GENERIK 48 108 156 55 102 157 108 61 169 89 125 214 69 90 159 47 98 145

JUMLAH
URAIAN
UMUM BPJS JUMLAH

KUNJUNGAN PASIEN PKM 2015 - - -

RAWAT JALAN

KUNJUNGAN RESEP 12,105 6,001 18,106

R/ (ITEM) OBAT 36,796 18,480 55,276

R/ (ITEM) OBAT GENERIK 36,116 15,998 52,114

RAWAT INAP

KUNJUNGAN RESEP 280 350 630

R/ (ITEM) OBAT 962 1,238 2,200

R/ (ITEM) OBAT GENERIK 953 1,229 2,182

Garut, 2 Desember 2015

Kepala Puskesmas Wanaraja

dr. H. Indra Hisyam Saptarina

NIP. 19740419 200604 1 011
 PROFIL DATA
PUSKESMAS WANARAJA
TAHUN 2015 (S.D OKT)

NO URAIAN JUMLAH
1 Jumlah penduduk 50454
2 Jumlah peserta BPJS 22931
3 Jumlah Ibu hamil 166
4 Jumlah ibu bersalin 98
5 Jumlah ibu nifas 98
6 Jumlah Bayi lahir 98
7 Jumlah bayi 6-11 bln 720
8 Jumlah bayi 1- 59 bln 2440
9 Jumlah gizi buruk 1
10 Jumlah murid kelas 1 SD 856
11 Jumlah murid SD 5537
12 Jumlah usila 60+ 3224
13 Jumlah kasus malaria
14 Jumlah kasus kusta
15 Jumlah kasus HIV
16 Jumlah kasus AIDS
17 Jumlah kasus IMS 12
18 Jumlah kasus TB 755
19 Jumlah kasus jiwa 88

Garut, 2 Desember 2015

Kepala Puskesmas Wanaraja

dr. H. Indra Hisyam Saptarina

NIP. 19740419 200604 1 011