Daftar Permintaan Obat JKN

Puskesmas Tumbang Rahuyan April 2019

NO NAMA SATUAN HARGA PERMINTAAN TOTAL MERK

OBAT

1 Nistatin Tablet 950 200 190.000 pharos

500.000 IU
2 Kalsium laktat Tablet 60 3.000 180.000 mercifarma
3 Tramadol inj Ampul 1017 200 203.400 mercifarma
4 Cefixime 100 capsule 2395 300 718.500 Kimia
mg farma
5 Cetirizine botol 3035 300 910.500 rama
syrup
6 Cefadroxil botol 4086 300 1.225.80 Holi
syrp 125 0 pharma
7 Metilprednisol vial 11.449 20 228.980 phapros
on inj
8 Prednisone tablet 74 2.000 148.000 Holi
pharma
9 Gentamicin ed botol 5098 100 509.800 erela
0.3 %
10 Carbamazepin tablet 188 500 94.000 Holi
e pharma
11 Ketorolac inj ampul 1.100 100 110.000 ethika
12 Lansoprazol capsule 343 2.000 686.000 ifars
30 mg
13 Omeprazole 30 capsule 143 3.000 429.000 nova
mg
14 Lidocain inj ampul 1386 100 138.600 phapros
2%
15 Povidon iodine botol 60.000 5 300.000 Kimia
farma
16 Sucralfat botol 7.789 100 778.900 meprofarm
suspense 500
mg/5 ml
17 Vit B com tablet 141 5.000 705.000 Marin
7.556.480
18 Gentamisin inj ampul 4.211 50 210.550 indofarma
40 mg
19 Gliseril tablet 235 1.000 235.000 Kimia
guacolat farma
20 Miconazol tube 4.097 72 294.984 Kimia
krim farma
21 Metilprednisol tablet 143 1.000 143.000 yarindo
on 4 mg
22 Ranitidine 150 tablet 105 2.000 210.000 dexamedica
mg
23 Kotrimoksazol botol 2.115 100 211.500 mersifarma
240 mg
24 ciprofloksasin tablet 1.175 500 587.500 Kimia
500 mg farma
25 B6 ( tablet 148 1.000 148.000 Kimia
piridoksin) farma
26 Captopril 25 tablet 85 5.000 425.000 pertiwi
mg
27 Loratadin 10 Tablet 150 2.000 300.000 hexpharm
mg
28 Natrium tablet 154 3.000 462.000 pharos
diclofenac 25
mg
29 Natrium tablet 450 2.000 900.000 Kimia
diclofenac 50 farma
mg
30 Ibuprofen 400 tablet 123 3.000 369.000 phytokemo
mg
31 Ondansentron tablet 42 3.000 126.000 indofarma
8 mg
32 Amlodipine 5 tablet 80 5.000 500.000 Tempo scan
mg pasific
33 Ctm 4 mg tablet 25 2.000 50.000 nova
34 Levofloksasin tablet 1154 100 115.400 Kimia
500 mg farma
35 Metoclopramid tablet 83 1.000 83.000 Kimia
e farma
36 Metronidazole botol 4.200 100 420.000 phitokemo
syrp 125 mg
37 Metronidazole tablet 134 2.000 268.000 Phitokemo
38 Ranitidine ampul 1.320 200 264.000 Kimia
injeksi farma
39 Salbutamol 2 tablet 64 1.000 64.000 Kimia
mg farma
40 Cefadroxil 500 capsule 495 200 990.000 otto
mg
41 Cefadroxil 250 botol 5.538 100 553.800 rama
mg
42 Cefixim syrp botol 6.681 50 334.050 ifars
100 mg
43 Cetirizin 10 tablet 98 2.000 196.000 rama
mg
44 Cyanocobalam tablet 49 3.000 147.000 Kimia
in 500 farma
45 Ecosol RL Infus 7.150 20 143.000 pharos
46 Paracetamol botol 7.979 25 199.475 indofarma
drop
47 Dextrose 10% infus 7.500 5 37.500 widatra
48 KAEN 3B Infus 11.314 5 56.570 otsuka
49 Omeprazole vial 11.868 10 118.680 darya
inj
50 Betahistin 6 tablet 119 500 59.500 dexamedica
mg
51 Ergotamine tablet 206 500 103.000 Kimia
farma
52 acetylcystein tablet 431 1.000 431.000 Indofarma

53 Nitral gliserid tablet 1.585 50 79.250 -

54 Nacl infus 50
Total 17.391.4
39
 Daftar Permintaan BHP JKN
Puskesmas Tumbang Rahuyan April 2019

NO NAMA BARANG HARGA PERMINTAAN TOTAL

1 air injeksi 20 ml 2860 50 143.000
2 spuit 3 cc 854 1.500 1.281.000
3 spuit 5 cc 905 1.500 1.357.000
4 spuit 10 cc 1.103 200 220.600
5 cat gut crom 33.538 20 670.760
6 cat gut plain 34.004 20 680.080
7 cateter 16 7.561 10 75.610
8 cateter 18 7.561 10 75.610
9 hc steril 7.5 9.680 100 968.000
10 hc non steril 7.5 7.000 100 700.000
11 hc non steril 8 7.000 100 700.000
12 hipafix 5 x 5 39.217 10 392.170
13 infus set anak 8.400 30 252.000
14 infus set dewasa 5.096 50 254.800
15 iv cat 20 6.270 20 125.400
16 iv cat 22 6.270 20 125.400
17 iv cat 24 6.270 20 125.400
18 kapas 500 25.410 20 508.200
19 kapas hydro 4 x 15 3.990 30 119.700
20 kasa steril 16 x 16 7.370 50 368.000
21 kasa hydro 2 x 80 9.870 30 296.100
22 plaster uk 5 x 4.5 12.700 50 635.000
23 alkohol swab 100 2.000 200.000
24 ngt 18 4.346 10 43.460
25 urine bag 4.290 10 42.900
26 masker
27 ky jelly
total 9.950.590