NILAI PERSEDIAAN ALKES UNIT IGD

KODE RUMAH SAKIT :

RUMAH SAKIT : RUMAH SAKIT TIPE D
KECAMATAN : KEMAYORAN
KOTA ADMINISTRASI : JAKARTA PUSAT
PROPINSI : DKI JAKARTA
BULAN : Dec-21
KETERANGAN : IGD COVID

No. NAMA ALKES SATUAN STOK AWAL PENERIMAAN PERSEDIAAN ROBIN SELISIH PEMAKAIAN

1 LIDOCAIN Ampul 5 5 -
2 ATROPINE Ampul 5 - 5 -
3 EPINEPHRINE Ampul 10 6 16 6
4 DIAZEPAM Ampul 6 6 -
5 DOPAMINE Ampul 5 - 5 -
6 NOVALGIN Ampul - - -
7 TRAMADOL Ampul - - -
8 ONDANCENTRON Ampul 5 10 15 10
9 RANITIDIN Ampul 5 8 13 8
10 KCL INJ 25 ML BTL 25 ML 3 4 7 4
11 DEXAMETHASONE Ampul 2 2 4 2
12 FUROSEMIDE 20mg Ampul - - -
13 KERTAS EKG 210X25 ROL 3 1 4 1
14 DYPHENIDRAMINE Ampul - - -
15 AMINOPHYLIN Ampul 2 1 3 1
16 STESOLID SUPP 5mg Tube 2 1 3 1
17 STESOLID SUPP 10mg Tube 2 2 4 2
18 PROFENID SUPP Strip 2 2 -
19 D40 / DEXTROSE 25ml 2 2 -
20 VENTOLIN NEBULE pulf 5 5 -
21 ELEKTRODA EKG PCS 5 12 17 12
DEWASA
22 PCT DROP 100mg Botol 3 3 -
 23 PCT SYR 120mg Botol 2 2 -
24 GENTAMICIN ZALF Tube 2 2 -
25 CEFOTAXIME 1g Vial - - -
26 CEFTRIAXONE 1gr Vial - - -
27 CLOPIDOGREL 75mg Tab 10 3 13 3
28 ASPILET 80mg Tab 10 4 14 4
29 ISDN 5mg Tab 10 10 -
30 CAPTOPRIL 25mg Tab 10 10 -
31 AMLODIPINE 5mg Tab 10 10 -
32 AMLODIPINE 10mg Tab 10 10 -
33 SARUNG TANGAN PSG 10 2 12 2
STERIL NO. 6,5
34 PCT TAB 500mg Tab 10 10 -
35 OMEPRAZOL 40 MG VIAL - - -
INJ
36 USG JELLY botol 3 1 4 1
37 SURGICAL BLADES / BISTUR Pcs 100 100 -
38 AQUAPRO INJEKSI Pcs 5 5 -
39 MICROPORE 2cm Pcs 5 5 10 5
40 ALCOHOL SWAB pcs 100 250 350 250
41 ALCOHOL CAIR btl 3 3 -
42 SPUIT 1cc Pcs 5 5 -
43 SPUIT 2,5cc Pcs 5 - 5 -
44 SPUIT 5cc Pcs 5 5 10 5
45 SPUIT 10cc Pcs 5 5 10 5
46 SPUIT 20cc Pcs 5 5 -
47 SPUIT 50cc Pcs 5 - 5 -
48 SILK BRAIDED 3/0 Pcs 25 25 -
49 SILK BRAIDED 4/0 Pcs 5 5 -
50 CATGUT CROMIC 3/0 Pcs 5 5 -
ONEMED
(623) URINE BAG Pcs 2 2 -
52 FOLEY CATH NO.10 Pcs 6 6 -
53 FOLEY CATH NO.12 Pcs 6 6 -
54 FOLEY CATH NO.16 Pcs 2 2 -
55 FOLEY CATH NO.18 Pcs - - -
56 NGT NO.3 Pcs 3 3 -
57 NGT NO.5 Pcs 3 3 -
58 NGT NO.6 Pcs 3 3 -
59 NGT NO.8 Pcs 5 5 -
60 NGT NO.10 Pcs 3 3 -
61 NGT NO.12 Pcs 3 3 -
62 NGT NO.14 Pcs 3 3 -
63 NGT NO. 16 pcs 2 2 -
64 BETHADINE CAIR Botol 3 3 -
65 UNDERPADS Pcs - - -
66 KASA GULUNG BESAR Pcs 2 2 -
67 KASA STERIL 10x10 Pcs - - -
68 TEGADERM Pcs 5 5 -
69 ABOCATH NO.18 Pcs 2 10 12 10
70 ABOCATH NO.20 Pcs 2 2 -
71 ABOCATH NO.22 Pcs 2 2 -
72 ABOCATH NO.24 Pcs 2 6 8 6
73 ABOCATH NO.26 Pcs 2 2 -
74 CAIRAN GLUKOSA 5% Botol 5 5 -
75 CAIRAN GLUKOSA 10% Botol - - -
76 CAIRAN KA-EN 3B Botol 2 2 -
77 CAIRAN NaCL 0,9% Botol 5 5 -
78 CAIRAN RINGER LAKTAT Botol 2 2 -
79 CAIRAN ASERING Botol 5 5 -
80 WING / 3 WAY STOPCOCK Pcs 3 3 -
81 DARYANT-TULLE Pcs 10 10 -
82 NASAL CANUL BAYI Pcs 5 3 8 3
83 NASAL CANUL ANAK Pcs - - -
84 NASAL CANUL DEWASA Pcs - 10 10 10
85 SIMPLE MASK DEWASA Pcs 2 2 4 2
86 SIMPLE MASK PEDIATRIK Pcs 2 2 4 2
87 MASKER NEBU ANAK Pcs 5 5 -
88 MASKER NEBU DEWASA Pcs 3 3 -
89 GUEDEL 40mm Pcs 1 1 -
90 GUEDEL 50mm Pcs 1 1 -
91 GUEDEL 60mm Pcs 1 1 -
92 GUEDEL 70mm Pcs 1 1 -
 93 GUEDEL 80mm Pcs 1 1 -
94 GUEDEL 90mm Pcs 1 1 -
95 GUEDEL 100mm Pcs 1 1 -
96 GUEDEL 110mm Pcs 2 - 2 -
97 ETT no.8 Pcs 2 2 -
98 ETT no.7,5 Pcs 4 4 -
99 ETT no.7 Pcs 4 4 -
100 ETT no.6,5 Pcs 4 4 -
101 ETT no.5 Pcs 2 2 -
102 ETT no.4,5 Pcs 2 2 -
103 ETT no.3,5 Pcs 4 4 -
104 HANSCOON pak 3 3 -
105 SAVETY BOX pcs 3 3 -
106 KATETER TIP pcs 10 10 -
107 MASKER BOX @ 50 3 3 -
PCS
BTL
108 Parasetamol drips (inf 2 2 -
109 FOLEY CATETER NO.8 Pcs 3 3 -
110 FOLEY CATETER NO.2 Pcs 1 1 -
111 FOLEY CATETER NO.1 Pcs 1 1 -
112 CAIRAN GLUKOSA 40% 25ml 2 2 -
INFUSION SET
113 INFUSION SET ANAK
DEWASA
Pcs 2 2 -
114 ( MAKROSET ) Pcs 3 6 9 6
115 NGT NO. 18 Pcs 2 2 -
116 KAEN 1 B BTL 2 - 2 -
117 VALISANBE/ Ampul - - -
DIAZEPAM INJ
118 FENTANYL Ampul - - -
119 MIDAZOLAM Ampul - - -
120 MORFINA Ampul - - -
121 VORTRAN pcs - - -
122 Masker N95 pcs - - -
123 NRM dewasa pcs 3 7 10 7
124 NRM anak pcs 5 2 7 2

BULAN INI 623 370

BULAN KEMARIN 623

Mengetahui
Ka. Seksi Keperawatan dan Penunjang Medis

Dini Utami Ningrum, Apt, MPH.

NIP. 198710282011012014
 NILAI ROBIN
STOK HARGA
ROBIN SELISIH PERSEDIAA
AKHIR SATUAN
N
5 319 1,595 1,595
5 1,230 6,150 6,150
10 2,204 22,040 22,040
6 27 162 162
5 14,300 71,500 71,500
- 10,500 - -
- 1,710 - -
5 1,254 6,270 6,270
5 2,040 10,200 10,200
3 3,100 9,300 9,300
2 1,600 3,200 3,200
- 24,700 - -
3 148,800 446,400 446,400
- 1,260 - -
2 4,582 9,164 9,164
2 11,525 23,050 23,050
2 16,748 33,496 33,496
2 2,470 4,940 4,940
2 13,400 26,800 26,800
5 5,000 25,000 25,000
5 3,833 19,167 19,167
3 6,857 20,572 20,572
 2 1,438 2,876 2,876
2 4,000 8,000 8,000
- 13,200 - -
- 10,000 - -
10 4,080 40,800 40,800
10 178 1,780 1,780
10 92 920 920
10 84 840 840
10 187 1,870 1,870
10 330 3,300 3,300
10 12,925 129,250 129,250
10 2,100 21,000 21,000
- 17,000 - -
3 12,584 37,752 37,752
100 1,008 100,800 100,800
5 6,000 30,000 30,000
5 50,820 254,100 254,100
100 100 10,000 10,000
3 25,000 75,000 75,000
5 1,614 8,070 8,070
5 1,300 6,500 6,500
5 1,300 6,500 6,500
5 8,030 40,150 40,150
5 18,000 90,000 90,000
5 20,000 100,000 100,000
25 3,056 76,400 76,400
5 3,056 15,280 15,280
5 5,600 28,000 28,000
2 3,000 6,000 6,000
6 35,200 211,200 211,200
6 12,200 73,200 73,200
2 12,200 24,400 24,400
- 12,500 - -
3 8,841 26,523 26,523
3 8,841 26,523 26,523
3 42,350 127,050 127,050
5 42,350 211,750 211,750
3 7,700 23,100 23,100
3 7,370 22,110 22,110
3 7,370 22,110 22,110
2 42,350 84,700 84,700
3 - - -
- 7,800 - -
2 105,000 210,000 210,000
- 18,610 - -
5 2,250 11,250 11,250
2 2,000 4,000 4,000
2 2,000 4,000 4,000
2 2,000 4,000 4,000
2 1,650 3,300 3,300
2 2,000 4,000 4,000
5 6,900 34,500 34,500
- 7,500 - -
2 10,000 20,000 20,000
5 6,410 32,049 32,049
2 7,150 14,300 14,300
5 9,275 46,375 46,375
3 2,645 7,935 7,935
10 3,650 36,500 36,500
5 5,900 29,500 29,500
- 5,900 - -
- 5,900 - -
2 23,650 47,300 47,300
2 23,650 47,300 47,300
5 14,400 72,000 72,000
3 25,777 77,331 77,331
1 12,575 12,575 12,575
1 12,575 12,575 12,575
1 12,575 12,575 12,575
1 12,575 12,575 12,575
 1 12,575 12,575 12,575
1 12,600 12,600 12,600
1 12,600 12,600 12,600
2 12,600 25,200 25,200
2 254,000 508,000 508,000
4 254,000 1,016,000 1,016,000
4 254,000 1,016,000 1,016,000
4 254,000 1,016,000 1,016,000
2 254,000 508,000 508,000
2 254,000 508,000 508,000
4 254,000 1,016,000 1,016,000
3 18,000 54,000 54,000
3 15,715 47,146 47,146
10 12,000 120,000 120,000
3 396 1,188 1,188
2 12,950 25,900 25,900
3 12,200 36,600 36,600
1 12,500 12,500 12,500
1 12,200 12,200 12,200
2 7,821 15,642 15,642
2 17,670 35,340 35,340
3 14,740 44,220 44,220
2 7,370 14,740 14,740
2 9,000 18,000 18,000
- 14,410 -
- 397,100 - -
- 4,125 - -
- 10,505 - -
- 1,408,000 - -
- 17,783 - -
3 15,700 47,100 47,100
5 15,700 78,500 78,500

623
 623

9,656,850 9,656,850

Pengurus Barang

Ngadini
NIP. 1966073198032002
 NILAI PERSEDIAAN ALKES UNIT IGD

KODE RUMAH SAKIT :

RUMAH SAKIT : RUMAH SAKIT TIPE D
KECAMATAN : KEMAYORAN
KOTA ADMINISTRASI : JAKARTA PUSAT
PROPINSI : DKI JAKARTA
BULAN : JANUARI
KETERANGAN : IGD COVID

No. NAMA ALKES SATUAN STOK AWAL PENERIMAAN PERSEDIAAN ROBIN SELISIH PEMAKAIAN

1 LIDOCAIN Ampul 5 5 10 5
2 ATROPINE Ampul 5 3 8 3
3 EPINEPHRINE Ampul 10 5 15 5
4 DIAZEPAM Ampul 6 6 12 6
5 DOPAMINE Ampul 5 1 6 1
6 NOVALGIN Ampul - - -
7 TRAMADOL Ampul - - -
8 ONDANCENTRON Ampul 5 10 15 10
9 RANITIDIN Ampul 5 8 13 8
10 KCL INJ 25 ML BTL 25 ML 3 4 7 4
11 DEXAMETHASONE Ampul 2 2 4 2
12 FUROSEMIDE 20mg Ampul - 2 2 2
13 KERTAS EKG 210X25 ROL 3 2 5 2
14 DYPHENIDRAMINE Ampul - 2 2 2
15 AMINOPHYLIN Ampul 2 1 3 1
16 STESOLID SUPP 5mg Tube 2 2 4 2
17 STESOLID SUPP 10mg Tube 2 2 4 2
18 PROFENID SUPP Strip 2 - 2 -
19 D40 / DEXTROSE 25ml 2 2 -
20 VENTOLIN NEBULE pulf 5 5 -
21 ELEKTRODA EKG DEWASA PCS 5 10 15 10
22 PCT DROP 100mg Botol 3 3 -
 23 PCT SYR 120mg Botol 2 2 -
24 GENTAMICIN ZALF Tube 2 5 7 5
25 CEFOTAXIME 1g Vial - - -
26 CEFTRIAXONE 1gr Vial - - -
27 CLOPIDOGREL 75mg Tab 10 3 13 3
28 ASPILET 80mg Tab 10 4 14 4
29 ISDN 5mg Tab 10 2 12 2
30 CAPTOPRIL 25mg Tab 10 5 15 5
31 AMLODIPINE 5mg Tab 10 3 13 3
32 AMLODIPINE 10mg Tab 10 4 14 4
33 SARUNG TANGAN XS PSG 10 9 19 9
STERIL NO. 6,5
34 PCT TAB 500mg Tab 10 10 -
35 OMEPRAZOL 40 MG INJ VIAL - - -
36 USG JELLY botol 3 1 4 1
37 SURGICAL BLADES / BISTURI Pcs 100 100 -
38 AQUAPRO INJEKSI Pcs 5 5 -
39 MICROPORE 2cm Pcs 5 5 10 5
40 ALCOHOL SWAB pcs 100 2,000 2,100 2,000
41 ALCOHOL CAIR btl 3 3 -
42 SPUIT 1cc Pcs 5 100 105 100
43 SPUIT 3 cc Pcs 5 100 105 100
44 SPUIT 5cc Pcs 5 5 10 5
45 SPUIT 10cc Pcs 5 5 10 5
46 SPUIT 20cc Pcs 5 5 -
47 SPUIT 50cc Pcs 5 - 5 -
48 SILK BRAIDED 3/0 Pcs 25 25 -
49 SILK BRAIDED 4/0 Pcs 5 5 -
50 CATGUT CROMIC 3/0 Pcs 5 5 -
ONEMED
(623) URINE BAG Pcs 2 2 -
52 FOLEY CATH NO.10 Pcs 6 6 -
53 FOLEY CATH NO.12 Pcs 6 6 -
54 FOLEY CATH NO.16 Pcs 2 2 -
55 FOLEY CATH NO.18 Pcs - - -
56 NGT NO.3 Pcs 3 3 -
57 NGT NO.5 Pcs 3 3 -
58 NGT NO.6 Pcs 3 3 -
59 NGT NO.8 Pcs 5 5 -
60 NGT NO.10 Pcs 3 3 -
61 NGT NO.12 Pcs 3 3 -
62 NGT NO.14 Pcs 3 3 -
63 NGT NO. 16 pcs 2 2 -
64 BETHADINE CAIR Botol 3 3 -
65 UNDERPADS Pcs - - -
66 KASA GULUNG BESAR Pcs 2 2 -
67 KASA STERIL 10x10 Pcs - - -
68 TEGADERM Pcs 5 5 -
69 ABOCATH NO.18 Pcs 2 10 12 10
70 ABOCATH NO.20 Pcs 2 2 -
71 ABOCATH NO.22 Pcs 2 2 -
72 ABOCATH NO.24 Pcs 2 6 8 6
73 ABOCATH NO.26 Pcs 2 2 -
74 CAIRAN GLUKOSA 5% Botol 5 5 -
75 CAIRAN GLUKOSA 10% Botol - - -
76 CAIRAN KA-EN 3B Botol 2 2 -
77 CAIRAN NaCL 0,9% Botol 5 5 -
78 CAIRAN RINGER LAKTAT Botol 2 2 -
79 CAIRAN ASERING Botol 5 5 -
80 WING / 3 WAY STOPCOCK Pcs 3 3 -
81 DARYANT-TULLE Pcs 10 10 -
82 NASAL CANUL BAYI Pcs 5 3 8 3
83 NASAL CANUL ANAK Pcs - - -
84 NASAL CANUL DEWASA Pcs - 10 10 10
85 SIMPLE MASK DEWASA Pcs 2 2 4 2
86 SIMPLE MASK PEDIATRIK Pcs 2 2 4 2
87 MASKER NEBU ANAK Pcs 5 5 -
88 MASKER NEBU DEWASA Pcs 3 3 -
89 GUEDEL 40mm Pcs 1 1 -
90 GUEDEL 50mm Pcs 1 1 -
91 GUEDEL 60mm Pcs 1 1 -
92 GUEDEL 70mm Pcs 1 1 -
 93 GUEDEL 80mm Pcs 1 1 -
94 GUEDEL 90mm Pcs 1 1 -
95 GUEDEL 100mm Pcs 1 1 -
96 GUEDEL 110mm Pcs 2 - 2 -
97 ETT no.8 Pcs 2 2 -
98 ETT no.7,5 Pcs 4 4 -
99 ETT no.7 Pcs 4 4 -
100 ETT no.6,5 Pcs 4 4 -
101 ETT no.5 Pcs 2 2 -
102 ETT no.4,5 Pcs 2 2 -
103 ETT no.3,5 Pcs 4 4 -
104 HANSCOON pak 3 3 -
105 SAVETY BOX pcs 3 27 30 27
106 KATETER TIP pcs 10 10 -
107 MASKER HIJAB BOX @ 50 3 14 17 14
PCS
BTL
108 Parasetamol drips (infus) 1000 2 2 -
109 FOLEY CATETER NO.8 Pcs 3 2 5 2
110 FOLEY CATETER NO.20 Pcs 1 1 -
111 FOLEY CATETER NO.14 Pcs 1 1 -
112 CAIRAN GLUKOSA 40% 25ml 2 2 -
113 INFUSION SET ANAK
INFUSION SET DEWASA
Pcs 2 2 -
114 ( MAKROSET ) Pcs 3 6 9 6
115 NGT NO. 18 Pcs 2 3 5 3
116 KAEN 1 B BTL 2 - 2 -
117 VALISANBE/ DIAZEPAM INJ Ampul - - -
118 FENTANYL Ampul - - -
119 MIDAZOLAM Ampul - - -
120 MORFINA Ampul - - -
121 VORTRAN pcs - - -
122 Masker N95 pcs - 15 15 15
123 NRM dewasa pcs 3 7 10 7
124 NRM anak pcs 5 2 7 2

BULAN INI 623

BULAN KEMARIN 623

Mengetahui
Ka. Seksi Keperawatan dan Penunjang Medis

Dini Utami Ningrum, Apt, MPH.

NIP. 198710282011012014
 STOK HARGA NILAI ROBIN
ROBIN SELISIH
AKHIR SATUAN PERSEDIAAN

5 319 1,595 1,595

5 1,230 6,150 6,150
10 2,204 22,040 22,040
6 27 162 162
5 14,300 71,500 71,500
- 10,500 - -
- 1,710 - -
5 1,254 6,270 6,270
5 2,040 10,200 10,200
3 3,100 9,300 9,300
2 1,600 3,200 3,200
- 24,700 - -
3 148,800 446,400 446,400
- 1,260 - -
2 4,582 9,164 9,164
2 11,525 23,050 23,050
2 16,748 33,496 33,496
2 2,470 4,940 4,940
2 13,400 26,800 26,800
5 5,000 25,000 25,000
5 3,833 19,167 19,167
3 6,857 20,572 20,572
 2 1,438 2,876 2,876
2 4,000 8,000 8,000
- 13,200 - -
- 10,000 - -
10 4,080 40,800 40,800
10 178 1,780 1,780
10 92 920 920
10 84 840 840
10 187 1,870 1,870
10 330 3,300 3,300
10 134,999 1,349,990 1,349,990
10 2,100 21,000 21,000
- 17,000 - -
3 12,584 37,752 37,752
100 1,008 100,800 100,800
5 6,000 30,000 30,000
5 50,820 254,100 254,100
100 145 14,500 14,500
3 25,000 75,000 75,000
5 1,361 6,805 6,805
5 1,121 5,605 5,605
5 1,300 6,500 6,500
5 8,030 40,150 40,150
5 18,000 90,000 90,000
5 20,000 100,000 100,000
25 3,056 76,400 76,400
5 3,056 15,280 15,280
5 5,600 28,000 28,000
2 3,000 6,000 6,000
6 35,200 211,200 211,200
6 12,200 73,200 73,200
2 12,200 24,400 24,400
- 12,500 - -
3 8,841 26,523 26,523
3 8,841 26,523 26,523
3 42,350 127,050 127,050
5 42,350 211,750 211,750
3 7,700 23,100 23,100
3 7,370 22,110 22,110
3 7,370 22,110 22,110
2 42,350 84,700 84,700
3 - - -
- 7,800 - -
2 105,000 210,000 210,000
- 18,610 - -
5 2,250 11,250 11,250
2 2,000 4,000 4,000
2 2,000 4,000 4,000
2 2,000 4,000 4,000
2 1,650 3,300 3,300
2 2,000 4,000 4,000
5 6,900 34,500 34,500
- 7,500 - -
2 10,000 20,000 20,000
5 6,410 32,049 32,049
2 7,150 14,300 14,300
5 9,275 46,375 46,375
3 2,645 7,935 7,935
10 3,650 36,500 36,500
5 5,900 29,500 29,500
- 5,900 - -
- 5,900 - -
2 23,650 47,300 47,300
2 23,650 47,300 47,300
5 14,400 72,000 72,000
3 25,777 77,331 77,331
1 12,575 12,575 12,575
1 12,575 12,575 12,575
1 12,575 12,575 12,575
1 12,575 12,575 12,575
 1 12,575 12,575 12,575
1 12,600 12,600 12,600
1 12,600 12,600 12,600
2 12,600 25,200 25,200
2 254,000 508,000 508,000
4 254,000 1,016,000 1,016,000
4 254,000 1,016,000 1,016,000
4 254,000 1,016,000 1,016,000
2 254,000 508,000 508,000
2 254,000 508,000 508,000
4 254,000 1,016,000 1,016,000
3 18,000 54,000 54,000
3 14,630 43,890 43,890
10 12,000 120,000 120,000
3 79,618 238,854 238,854
2 12,950 25,900 25,900
3 12,200 36,600 36,600
1 12,500 12,500 12,500
1 12,200 12,200 12,200
2 7,821 15,642 15,642
2 17,670 35,340 35,340
3 14,740 44,220 44,220
2 7,370 14,740 14,740
2 9,000 18,000 18,000
- 14,410 -
- 397,100 - -
- 4,125 - -
- 10,505 - -
- 1,408,000 - -
- 13,200 - -
3 15,700 47,100 47,100
5 15,700 78,500 78,500

623
 623

11,114,340 11,114,340

Pengurus Barang

Ngadini
NIP. 1966073198032002
 NILAI PERSEDIAAN ALKES UNIT IGD

KODE RUMAH SAKIT :

RUMAH SAKIT : RUMAH SAKIT TIPE D
KECAMATAN : KEMAYORAN
KOTA ADMINISTRASI : JAKARTA PUSAT
PROPINSI : DKI JAKARTA
BULAN : FEBRUARI
KETERANGAN : IGD COVID

No. NAMA ALKES SATUAN STOK AWAL PENERIMAAN PERSEDIAAN ROBIN SELISIH PEMAKAIAN

1 LIDOCAIN Ampul 5 5
2 ATROPINE Ampul 5 5
3 EPINEPHRINE Ampul 10 10
4 DIAZEPAM Ampul 6 6
5 DOPAMINE Ampul 5 5
6 NOVALGIN Ampul - -
7 TRAMADOL Ampul - -
8 ONDANCENTRON Ampul 5 5
9 RANITIDIN Ampul 5 5
10 KCL INJ 25 ML BTL 25 ML 3 3
11 DEXAMETHASONE Ampul 2 2
12 FUROSEMIDE 20mg Ampul - -
13 KERTAS EKG 210X25 ROL 3 3
14 DYPHENIDRAMINE Ampul - -
15 AMINOPHYLIN Ampul 2 2
16 STESOLID SUPP 5mg Tube 2 2
17 STESOLID SUPP 10mg Tube 2 2
18 PROFENID SUPP Strip 2 2
19 D40 / DEXTROSE 25ml 2 2
20 VENTOLIN NEBULE pulf 5 5
21 ELEKTRODA EKG DEWASA PCS 5 5
22 PCT DROP 100mg Botol 3 3
 23 PCT SYR 120mg Botol 2 2
24 GENTAMICIN ZALF Tube 2 2
25 CEFOTAXIME 1g Vial - -
26 CEFTRIAXONE 1gr Vial - -
27 CLOPIDOGREL 75mg Tab 10 10
28 ASPILET 80mg Tab 10 10
29 ISDN 5mg Tab 10 10
30 CAPTOPRIL 25mg Tab 10 10
31 AMLODIPINE 5mg Tab 10 10
32 AMLODIPINE 10mg Tab 10 10
33 SARUNG TANGAN XS PSG 10 5 15 5
STERIL NO. 6,5
34 PCT TAB 500mg Tab 10 10
35 OMEPRAZOL 40 MG INJ VIAL - -
36 USG JELLY botol 3 3
37 SURGICAL BLADES / BISTURI Pcs 100 100
38 AQUAPRO INJEKSI Pcs 5 5
39 MICROPORE 2cm Pcs 5 3 8 3
40 ALCOHOL SWAB pcs 100 100 200 100
41 ALCOHOL CAIR btl 3 3
42 SPUIT 1cc Pcs 5 5
43 SPUIT 3 cc Pcs 5 5
44 SPUIT 5cc Pcs 5 5
45 SPUIT 10cc Pcs 5 5
46 SPUIT 20cc Pcs 5 5
47 SPUIT 50cc Pcs 5 5
48 SILK BRAIDED 3/0 Pcs 25 25
49 SILK BRAIDED 4/0 Pcs 5 5
50 CATGUT CROMIC 3/0 Pcs 5 5
ONEMED
(623) URINE BAG Pcs 2 2
52 FOLEY CATH NO.10 Pcs 6 6
53 FOLEY CATH NO.12 Pcs 6 6
54 FOLEY CATH NO.16 Pcs 2 2
55 FOLEY CATH NO.18 Pcs - -
56 NGT NO.3 Pcs 3 3
57 NGT NO.5 Pcs 3 3
58 NGT NO.6 Pcs 3 3
59 NGT NO.8 Pcs 5 5
60 NGT NO.10 Pcs 3 3
61 NGT NO.12 Pcs 3 3
62 NGT NO.14 Pcs 3 3
63 NGT NO. 16 pcs 2 2
64 BETHADINE CAIR Botol 3 3 6 3
65 UNDERPADS Pcs - -
66 KASA GULUNG BESAR Pcs 2 2
67 KASA STERIL 10x10 Pcs - -
68 TEGADERM Pcs 5 5
69 ABOCATH NO.18 Pcs 2 2
70 ABOCATH NO.20 Pcs 2 2
71 ABOCATH NO.22 Pcs 2 2
72 ABOCATH NO.24 Pcs 2 2
73 ABOCATH NO.26 Pcs 2 2
74 CAIRAN GLUKOSA 5% Botol 5 5
75 CAIRAN GLUKOSA 10% Botol - -
76 CAIRAN KA-EN 3B Botol 2 2
77 CAIRAN NaCL 0,9% Botol 5 5
78 CAIRAN RINGER LAKTAT Botol 2 2
79 CAIRAN ASERING Botol 5 5
80 WING / 3 WAY STOPCOCK Pcs 3 3
81 DARYANT-TULLE Pcs 10 10
82 NASAL CANUL BAYI Pcs 5 5
83 NASAL CANUL ANAK Pcs - -
84 NASAL CANUL DEWASA Pcs - -
85 SIMPLE MASK DEWASA Pcs 2 2
86 SIMPLE MASK PEDIATRIK Pcs 2 2
87 MASKER NEBU ANAK Pcs 5 5
88 MASKER NEBU DEWASA Pcs 3 3
89 GUEDEL 40mm Pcs 1 1
90 GUEDEL 50mm Pcs 1 1
91 GUEDEL 60mm Pcs 1 1
92 GUEDEL 70mm Pcs 1 1
 93 GUEDEL 80mm Pcs 1 1
94 GUEDEL 90mm Pcs 1 1
95 GUEDEL 100mm Pcs 1 1
96 GUEDEL 110mm Pcs 2 2
97 ETT no.8 Pcs 2 2
98 ETT no.7,5 Pcs 4 4
99 ETT no.7 Pcs 4 4
100 ETT no.6,5 Pcs 4 4
101 ETT no.5 Pcs 2 2
102 ETT no.4,5 Pcs 2 2
103 ETT no.3,5 Pcs 4 4
104 HANSCOON pak 3 3
105 SAVETY BOX pcs 3 2 5 2
106 KATETER TIP pcs 10 10
107 MASKER HIJAB BOX @ 50 3 5 8 5
PCS
BTL
108 Parasetamol drips (infus) 1000 2 2
109 FOLEY CATETER NO.8 Pcs 3 3
110 FOLEY CATETER NO.20 Pcs 1 1
111 FOLEY CATETER NO.14 Pcs 1 1
112 CAIRAN GLUKOSA 40% 25ml 2 2
113 INFUSION SET ANAK
INFUSION SET DEWASA
Pcs 2 2
114 ( MAKROSET ) Pcs 3 3
115 NGT NO. 18 Pcs 2 2
116 KAEN 1 B BTL 2 2
117 VALISANBE/ DIAZEPAM INJ Ampul - -
118 FENTANYL Ampul - -
119 MIDAZOLAM Ampul - -
120 MORFINA Ampul - -
121 VORTRAN pcs - -
122 Masker N95 pcs - 10 10 10
123 NRM dewasa pcs 3 3
124 NRM anak pcs 5 5

751 128
BULAN INI 623
BULAN KEMARIN 623

Mengetahui
Ka. Seksi Keperawatan dan Penunjang Medis

Dini Utami Ningrum, Apt, MPH.

NIP. 198710282011012014
 STOK HARGA NILAI ROBIN
ROBIN SELISIH
AKHIR SATUAN PERSEDIAAN

5 319 1,595 1,595

5 1,230 6,150 6,150
10 2,204 22,040 22,040
6 27 162 162
5 14,300 71,500 71,500
- 10,500 - -
- 1,710 - -
5 1,254 6,270 6,270
5 2,040 10,200 10,200
3 3,100 9,300 9,300
2 1,600 3,200 3,200
- 24,700 - -
3 148,800 446,400 446,400
- 1,260 - -
2 4,582 9,164 9,164
2 11,525 23,050 23,050
2 16,748 33,496 33,496
2 2,470 4,940 4,940
2 13,400 26,800 26,800
5 5,000 25,000 25,000
5 3,833 19,167 19,167
3 6,857 20,572 20,572
 2 1,438 2,876 2,876
2 4,000 8,000 8,000
- 13,200 - -
- 10,000 - -
10 4,080 40,800 40,800
10 178 1,780 1,780
10 92 920 920
10 84 840 840
10 187 1,870 1,870
10 330 3,300 3,300
10 134,999 1,349,990 1,349,990
10 2,100 21,000 21,000
- 17,000 - -
3 12,584 37,752 37,752
100 1,008 100,800 100,800
5 6,000 30,000 30,000
5 50,820 254,100 254,100
100 145 14,500 14,500
3 25,000 75,000 75,000
5 1,361 6,805 6,805
5 1,121 5,605 5,605
5 1,300 6,500 6,500
5 8,030 40,150 40,150
5 18,000 90,000 90,000
5 20,000 100,000 100,000
25 3,056 76,400 76,400
5 3,056 15,280 15,280
5 5,600 28,000 28,000
2 3,000 6,000 6,000
6 35,200 211,200 211,200
6 12,200 73,200 73,200
2 12,200 24,400 24,400
- 12,500 - -
3 8,841 26,523 26,523
3 8,841 26,523 26,523
3 42,350 127,050 127,050
5 42,350 211,750 211,750
3 7,700 23,100 23,100
3 7,370 22,110 22,110
3 7,370 22,110 22,110
2 42,350 84,700 84,700
3 - - -
- 7,800 - -
2 105,000 210,000 210,000
- 18,610 - -
5 2,250 11,250 11,250
2 2,000 4,000 4,000
2 2,000 4,000 4,000
2 2,000 4,000 4,000
2 1,650 3,300 3,300
2 2,000 4,000 4,000
5 6,900 34,500 34,500
- 7,500 - -
2 10,000 20,000 20,000
5 6,410 32,049 32,049
2 7,150 14,300 14,300
5 9,275 46,375 46,375
3 2,645 7,935 7,935
10 3,650 36,500 36,500
5 5,900 29,500 29,500
- 5,900 - -
- 5,900 - -
2 23,650 47,300 47,300
2 23,650 47,300 47,300
5 14,400 72,000 72,000
3 25,777 77,331 77,331
1 12,575 12,575 12,575
1 12,575 12,575 12,575
1 12,575 12,575 12,575
1 12,575 12,575 12,575
 1 12,575 12,575 12,575
1 12,600 12,600 12,600
1 12,600 12,600 12,600
2 12,600 25,200 25,200
2 254,000 508,000 508,000
4 254,000 1,016,000 1,016,000
4 254,000 1,016,000 1,016,000
4 254,000 1,016,000 1,016,000
2 254,000 508,000 508,000
2 254,000 508,000 508,000
4 254,000 1,016,000 1,016,000
3 18,000 54,000 54,000
3 14,630 43,890 43,890
10 12,000 120,000 120,000
3 79,618 238,854 238,854
2 12,950 25,900 25,900
3 12,200 36,600 36,600
1 12,500 12,500 12,500
1 12,200 12,200 12,200
2 7,821 15,642 15,642
2 17,670 35,340 35,340
3 14,740 44,220 44,220
2 7,370 14,740 14,740
2 9,000 18,000 18,000
- 14,410 -
- 397,100 - -
- 4,125 - -
- 10,505 - -
- 1,408,000 - -
- 13,200 - -
3 15,700 47,100 47,100
5 15,700 78,500 78,500

623
 623

11,114,340 11,114,340

Pengurus Barang

Ngadini
NIP. 1966073198032002
 NILAI PERSEDIAAN ALKES UNIT IGD

KODE RUMAH SAKIT :

RUMAH SAKIT : RUMAH SAKIT TIPE D
KECAMATAN : KEMAYORAN
KOTA ADMINISTRASI : JAKARTA PUSAT
PROPINSI : DKI JAKARTA
BULAN : MARET
KETERANGAN : IGD COVID

No. NAMA ALKES SATUAN STOK AWAL PENERIMAAN PERSEDIAAN ROBIN SELISIH

1 LIDOCAIN Ampul 5 - 5
2 ATROPINE Ampul 5 - 5
3 EPINEPHRINE Ampul 10 - 10
4 DIAZEPAM Ampul 6 - 6
5 DOPAMINE Ampul 5 - 5
6 NOVALGIN Ampul - - -
7 TRAMADOL Ampul - - -
8 ONDANCENTRON Ampul 5 10 15
9 RANITIDIN Ampul 5 10 15
10 KCL INJ 25 ML BTL 25 ML 3 2 5
11 DEXAMETHASONE Ampul 2 2 4
12 FUROSEMIDE 20mg Ampul - 2 2
13 KERTAS EKG 210X25 ROL 3 2 5
14 DYPHENIDRAMINE Ampul - - -
15 AMINOPHYLIN Ampul 2 - 2
16 STESOLID SUPP 5mg Tube 2 2 4
17 STESOLID SUPP 10mg Tube 2 2 4
18 PROFENID SUPP Strip 2 2 4
19 D40 / DEXTROSE 25ml 2 2 4
20 VENTOLIN NEBULE pulf 5 2 7
21 ELEKTRODA EKG DEWASA PCS 5 5 10
22 PCT DROP 100mg Botol 3 - 3
 23 PCT SYR 120mg Botol 2 - 2
24 GENTAMICIN ZALF Tube 2 3 5
25 CEFOTAXIME 1g Vial - - -
26 CEFTRIAXONE 1gr Vial - - -
27 CLOPIDOGREL 75mg Tab 10 5 15
28 ASPILET 80mg Tab 10 5 15
29 ISDN 5mg Tab 10 5 15
30 CAPTOPRIL 25mg Tab 10 5 15
31 AMLODIPINE 5mg Tab 10 5 15
32 AMLODIPINE 10mg Tab 10 5 15
33 SARUNG TANGAN STERIL NO. 6,5 PSG 10 3 13
34 PCT TAB 500mg Tab 10 5 15
35 OMEPRAZOL 40 MG INJ VIAL - - -
36 USG JELLY botol 3 3 6
37 SURGICAL BLADES / BISTURI Pcs 100 50 150
38 AQUAPRO INJEKSI Pcs 5 5 10
39 MICROPORE 2cm Pcs 5 20 25
40 ALCOHOL SWAB pcs 100 300 400
41 ALCOHOL CAIR btl 3 3 6
42 SPUIT 1cc Pcs 5 100 105
43 SPUIT 3 cc Pcs 5 200 205
44 SPUIT 5cc Pcs 5 50 55
45 SPUIT 10cc Pcs 5 30 35
46 SPUIT 20cc Pcs 5 5 10
47 SPUIT 50cc Pcs 5 3 8
48 SILK BRAIDED 3/0 Pcs 25 5 30
49 SILK BRAIDED 4/0 Pcs 5 10 15
50 CATGUT CROMIC 3/0 ONEMED Pcs 5 5 10
(1,246) URINE BAG Pcs 2 2 4
52 FOLEY CATH NO.10 Pcs 6 3 9
53 FOLEY CATH NO.12 Pcs 6 3 9
54 FOLEY CATH NO.16 Pcs 2 - 2
55 FOLEY CATH NO.18 Pcs - - -
56 NGT NO.3 Pcs 3 3 6
57 NGT NO.5 Pcs 3 2 5
58 NGT NO.6 Pcs 3 - 3
59 NGT NO.8 Pcs 5 - 5
60 NGT NO.10 Pcs 3 3 6
61 NGT NO.12 Pcs 3 2 5
62 NGT NO.14 Pcs 3 3 6
63 NGT NO. 16 pcs 2 5 7
64 BETHADINE CAIR Botol 3 3 6
65 UNDERPADS Pcs - 3 3
66 KASA GULUNG BESAR Pcs 2 3 5
67 KASA STERIL 10x10 Pcs - 5 5
68 TEGADERM Pcs 5 3 8
69 ABOCATH NO.18 Pcs 2 3 5
70 ABOCATH NO.20 Pcs 2 3 5
71 ABOCATH NO.22 Pcs 2 3 5
72 ABOCATH NO.24 Pcs 2 5 7
73 ABOCATH NO.26 Pcs 2 5 7
74 CAIRAN GLUKOSA 5% Botol 5 5 10
75 CAIRAN GLUKOSA 10% Botol - 2 2
76 CAIRAN KA-EN 3B Botol 2 3 5
77 CAIRAN NaCL 0,9% Botol 5 5 10
78 CAIRAN RINGER LAKTAT Botol 2 5 7
79 CAIRAN ASERING Botol 5 - 5
80 WING / 3 WAY STOPCOCK Pcs 3 - 3
81 DARYANT-TULLE Pcs 10 - 10
82 NASAL CANUL BAYI Pcs 5 - 5
83 NASAL CANUL ANAK Pcs - - -
84 NASAL CANUL DEWASA Pcs - - -
85 SIMPLE MASK DEWASA Pcs 2 - 2
86 SIMPLE MASK PEDIATRIK Pcs 2 - 2
87 MASKER NEBU ANAK Pcs 5 - 5
88 MASKER NEBU DEWASA Pcs 3 - 3
89 GUEDEL 40mm Pcs 1 - 1
90 GUEDEL 50mm Pcs 1 - 1
91 GUEDEL 60mm Pcs 1 - 1
92 GUEDEL 70mm Pcs 1 - 1
 93 GUEDEL 80mm Pcs 1 - 1
94 GUEDEL 90mm Pcs 1 - 1
95 GUEDEL 100mm Pcs 1 - 1
96 GUEDEL 110mm Pcs 2 - 2
97 ETT no.8 Pcs 2 - 2
98 ETT no.7,5 Pcs 4 - 4
99 ETT no.7 Pcs 4 - 4
100 ETT no.6,5 Pcs 4 - 4
101 ETT no.5 Pcs 2 - 2
102 ETT no.4,5 Pcs 2 - 2
103 ETT no.3,5 Pcs 4 - 4
104 HANSCOON pak 3 120 123
105 SAVETY BOX pcs 3 20 23
106 KATETER TIP pcs 10 5 15
107 MASKER HIJAB BOX @ 50 3 20 23
PCS
BTL
108 Parasetamol drips (infus) 1000 mg/100 mL 2 - 2
109 FOLEY CATETER NO.8 Pcs 3 3 6
110 FOLEY CATETER NO.20 Pcs 1 1 2
111 FOLEY CATETER NO.14 Pcs 1 - 1
112 CAIRAN GLUKOSA 40% 25ml 2 1 3
113 INFUSION SET ANAK
INFUSION SET DEWASA ( MAKROSET
Pcs 2 2 4
114 ) Pcs 3 2 5
115 NGT NO. 18 Pcs 2 2 4
116 KAEN 1 B BTL 2 - 2
117 VALISANBE/ DIAZEPAM INJ Ampul - - -
118 FENTANYL Ampul - - -
119 MIDAZOLAM Ampul - - -
120 MORFINA Ampul - - -
121 VORTRAN pcs - - -
122 Masker N95 pcs - 80 80
123 NRM dewasa pcs 3 2 5
124 NRM anak pcs 5 2 7
623

BULAN INI 1,246

BULAN KEMARIN 623

Mengetahui
Ka. Seksi Keperawatan dan Penunjang Medis

Dini Utami Ningrum, Apt, MPH.

NIP. 198710282011012014
 STOK HARGA NILAI ROBIN
PEMAKAIAN ROBIN SELISIH
AKHIR SATUAN PERSEDIAAN

- 5 319 1,595 1,595

- 5 1,230 6,150 6,150
- 10 2,204 22,040 22,040
- 6 27 162 162
- 5 14,300 71,500 71,500
- - 10,500 - -
- - 1,710 - -
10 5 1,254 6,270 6,270
10 5 2,040 10,200 10,200
2 3 3,100 9,300 9,300
2 2 1,600 3,200 3,200
2 - 24,700 - -
2 3 148,800 446,400 446,400
- - 1,260 - -
- 2 4,582 9,164 9,164
2 2 11,525 23,050 23,050
2 2 16,748 33,496 33,496
2 2 2,470 4,940 4,940
2 2 13,400 26,800 26,800
2 5 5,000 25,000 25,000
5 5 3,833 19,167 19,167
- 3 6,857 20,572 20,572
 - 2 1,438 2,876 2,876
3 2 4,000 8,000 8,000
- - 13,200 - -
- - 10,000 - -
5 10 4,080 40,800 40,800
5 10 178 1,780 1,780
5 10 92 920 920
5 10 84 840 840
5 10 187 1,870 1,870
5 10 330 3,300 3,300
3 10 134,999 1,349,990 1,349,990
5 10 2,100 21,000 21,000
- - 17,000 - -
3 3 12,584 37,752 37,752
50 100 1,008 100,800 100,800
5 5 6,000 30,000 30,000
20 5 50,820 254,100 254,100
300 100 145 14,500 14,500
3 3 25,000 75,000 75,000
100 5 1,361 6,805 6,805
200 5 1,121 5,605 5,605
50 5 1,300 6,500 6,500
30 5 8,030 40,150 40,150
5 5 18,000 90,000 90,000
3 5 20,000 100,000 100,000
5 25 3,056 76,400 76,400
10 5 3,056 15,280 15,280
5 5 5,600 28,000 28,000
2 2 3,000 6,000 6,000
3 6 35,200 211,200 211,200
3 6 12,200 73,200 73,200
- 2 12,200 24,400 24,400
- - 12,500 - -
3 3 8,841 26,523 26,523
2 3 8,841 26,523 26,523
- 3 42,350 127,050 127,050
- 5 42,350 211,750 211,750
3 3 7,700 23,100 23,100
2 3 7,370 22,110 22,110
3 3 7,370 22,110 22,110
5 2 42,350 84,700 84,700
3 3 - - -
3 - 7,800 - -
3 2 105,000 210,000 210,000
5 - 18,610 - -
3 5 2,250 11,250 11,250
3 2 2,000 4,000 4,000
3 2 2,000 4,000 4,000
3 2 2,000 4,000 4,000
5 2 1,650 3,300 3,300
5 2 2,000 4,000 4,000
5 5 6,900 34,500 34,500
2 - 7,500 - -
3 2 10,000 20,000 20,000
5 5 6,410 32,049 32,049
5 2 7,150 14,300 14,300
- 5 9,275 46,375 46,375
- 3 2,645 7,935 7,935
- 10 3,650 36,500 36,500
- 5 5,900 29,500 29,500
- - 5,900 - -
- - 5,900 - -
- 2 23,650 47,300 47,300
- 2 23,650 47,300 47,300
- 5 14,400 72,000 72,000
- 3 25,777 77,331 77,331
- 1 12,575 12,575 12,575
- 1 12,575 12,575 12,575
- 1 12,575 12,575 12,575
- 1 12,575 12,575 12,575
 - 1 12,575 12,575 12,575
- 1 12,600 12,600 12,600
- 1 12,600 12,600 12,600
- 2 12,600 25,200 25,200
- 2 254,000 508,000 508,000
- 4 254,000 1,016,000 1,016,000
- 4 254,000 1,016,000 1,016,000
- 4 254,000 1,016,000 1,016,000
- 2 254,000 508,000 508,000
- 2 254,000 508,000 508,000
- 4 254,000 1,016,000 1,016,000
120 3 18,000 54,000 54,000
20 3 14,630 43,890 43,890
5 10 12,000 120,000 120,000
20 3 79,618 238,854 238,854
- 2 12,950 25,900 25,900
3 3 12,200 36,600 36,600
1 1 12,500 12,500 12,500
- 1 12,200 12,200 12,200
1 2 7,821 15,642 15,642
2 2 17,670 35,340 35,340
2 3 14,740 44,220 44,220
2 2 7,370 14,740 14,740
- 2 9,000 18,000 18,000
- - 14,410 -
- - 397,100 - -
- - 4,125 - -
- - 10,505 - -
- - 1,408,000 - -
80 - 13,200 - -
2 3 15,700 47,100 47,100
2 5 15,700 78,500 78,500

623
 623

11,114,340 11,114,340

Pengurus Barang

Ngadini
NIP. 1966073198032002
 NILAI PERSEDIAAN ALKES UNIT IGD

KODE RUMAH SAKIT :

RUMAH SAKIT : RUMAH SAKIT TIPE D
KECAMATAN : KEMAYORAN
KOTA ADMINISTRASI : JAKARTA PUSAT
PROPINSI : DKI JAKARTA
BULAN : MARET
KETERANGAN : IGD COVID

No. NAMA ALKES SATUAN STOK AWAL PENERIMAAN PERSEDIAAN ROBIN SELISIH

1 LIDOCAIN Ampul 5 - 5
2 ATROPINE Ampul 5 - 5
3 EPINEPHRINE Ampul 10 - 10
4 DIAZEPAM Ampul 6 - 6
5 DOPAMINE Ampul 5 - 5
6 NOVALGIN Ampul - - -
7 TRAMADOL Ampul - - -
8 ONDANCENTRON Ampul 5 - 5
9 RANITIDIN Ampul 5 - 5
10 KCL INJ 25 ML BTL 25 ML 3 - 3
11 DEXAMETHASONE Ampul 2 - 2
12 FUROSEMIDE 20mg Ampul - - -
13 KERTAS EKG 210X25 ROL 3 2 5
14 DYPHENIDRAMINE Ampul - - -
15 AMINOPHYLIN Ampul 2 - 2
16 STESOLID SUPP 5mg Tube 2 - 2
17 STESOLID SUPP 10mg Tube 2 - 2
18 PROFENID SUPP Strip 2 - 2
19 D40 / DEXTROSE 25ml 2 - 2
20 VENTOLIN NEBULE pulf 5 - 5
21 ELEKTRODA EKG DEWASA PCS 5 - 5
22 PCT DROP 100mg Botol 3 - 3
23 PCT SYR 120mg Botol 2 - 2
24 GENTAMICIN ZALF Tube 2 - 2
25 CEFOTAXIME 1g Vial - - -
26 CEFTRIAXONE 1gr Vial - - -
27 CLOPIDOGREL 75mg Tab 10 - 10
28 ASPILET 80mg Tab 10 - 10
29 ISDN 5mg Tab 10 - 10
30 CAPTOPRIL 25mg Tab 10 - 10
31 AMLODIPINE 5mg Tab 10 - 10
32 AMLODIPINE 10mg Tab 10 - 10
SARUNG TANGAN STERIL NO. PSG
33 6,5 10
10 -
34 PCT TAB 500mg Tab 10 - 10
35 OMEPRAZOL 40 MG INJ VIAL - - -
36 USG JELLY botol 3 2 5
37 SURGICAL BLADES / BISTURI Pcs 100 - 100
38 AQUAPRO INJEKSI Pcs 5 - 5
39 MICROPORE 2cm Pcs 5 20 25
40 ALCOHOL SWAB pcs 100 300 400
41 ALCOHOL CAIR btl 3 3 6
42 SPUIT 1cc Pcs 5 100 105
43 SPUIT 3 cc Pcs 5 200 205
44 SPUIT 5cc Pcs 5 - 5
45 SPUIT 10cc Pcs 5 - 5
46 SPUIT 20cc Pcs 5 - 5
47 SPUIT 50cc Pcs 5 - 5
48 SILK BRAIDED 3/0 Pcs 25 - 25
49 SILK BRAIDED 4/0 Pcs 5 - 5
CATGUT CROMIC 3/0 ONEMED
50 - 5
Pcs 5
(135) URINE BAG Pcs 2 - 2
52 FOLEY CATH NO.10 Pcs 6 - 6
53 FOLEY CATH NO.12 Pcs 6 - 6
54 FOLEY CATH NO.16 Pcs 2 - 2
55 FOLEY CATH NO.18 Pcs - - -
56 NGT NO.3 Pcs 3 - 3
57 NGT NO.5 Pcs 3 - 3
58 NGT NO.6 Pcs 3 - 3
59 NGT NO.8 Pcs 5 - 5
60 NGT NO.10 Pcs 3 - 3
61 NGT NO.12 Pcs 3 - 3
62 NGT NO.14 Pcs 3 - 3
63 NGT NO. 16 pcs 2 - 2
64 BETHADINE CAIR Botol 3 2 5
65 UNDERPADS Pcs - - -
66 KASA GULUNG BESAR Pcs 2 - 2
67 KASA STERIL 10x10 Pcs - - -
68 TEGADERM Pcs 5 - 5
69 ABOCATH NO.18 Pcs 2 - 2
70 ABOCATH NO.20 Pcs 2 - 2
71 ABOCATH NO.22 Pcs 2 - 2
72 ABOCATH NO.24 Pcs 2 - 2
73 ABOCATH NO.26 Pcs 2 - 2
74 CAIRAN GLUKOSA 5% Botol 5 - 5
75 CAIRAN GLUKOSA 10% Botol - - -
76 CAIRAN KA-EN 3B Botol 2 - 2
77 CAIRAN NaCL 0,9% Botol 5 - 5
78 CAIRAN RINGER LAKTAT Botol 2 - 2
79 CAIRAN ASERING Botol 5 - 5
80 WING / 3 WAY STOPCOCK Pcs 3 - 3
81 DARYANT-TULLE Pcs 10 - 10
82 NASAL CANUL BAYI Pcs 5 - 5
 83 NASAL CANUL ANAK Pcs - - -
84 NASAL CANUL DEWASA Pcs - - -
85 SIMPLE MASK DEWASA Pcs 2 - 2
86 SIMPLE MASK PEDIATRIK Pcs 2 - 2
87 MASKER NEBU ANAK Pcs 5 - 5
88 MASKER NEBU DEWASA Pcs 3 - 3
89 GUEDEL 40mm Pcs 1 - 1
90 GUEDEL 50mm Pcs 1 - 1
91 GUEDEL 60mm Pcs 1 - 1
92 GUEDEL 70mm Pcs 1 - 1
93 GUEDEL 80mm Pcs 1 - 1
94 GUEDEL 90mm Pcs 1 - 1
95 GUEDEL 100mm Pcs 1 - 1
96 GUEDEL 110mm Pcs 2 - 2
97 ETT no.8 Pcs 2 - 2
98 ETT no.7,5 Pcs 4 - 4
99 ETT no.7 Pcs 4 - 4
100 ETT no.6,5 Pcs 4 - 4
101 ETT no.5 Pcs 2 - 2
102 ETT no.4,5 Pcs 2 - 2
103 ETT no.3,5 Pcs 4 - 4
104 HANSCOON pak 3 12 15
105 SAVETY BOX pcs 3 10 13
106 KATETER TIP pcs 10 - 10
107 MASKER HIJAB BOX @ 50 3 6 9
PCS
BTL
108 Parasetamol drips (infus) 1000 mg/ 2 - 2
109 FOLEY CATETER NO.8 Pcs 3 - 3
110 FOLEY CATETER NO.20 Pcs 1 - 1
111 FOLEY CATETER NO.14 Pcs 1 - 1
112 CAIRAN GLUKOSA 40% 25ml 2 - 2
113 INFUSION SET ANAK Pcs 2 - 2

114 INFUSION SET DEWASA - 3

( MAKROSET ) Pcs 3
115 NGT NO. 18 Pcs 2 - 2
116 KAEN 1 B BTL 2 - 2
117 VALISANBE/ DIAZEPAM INJ Ampul - - -
118 FENTANYL Ampul - - -
119 MIDAZOLAM Ampul - - -
120 MORFINA Ampul - - -
121 VORTRAN pcs - - -
122 Masker N95 pcs - - -
123 NRM dewasa pcs 3 - 3
124 NRM anak pcs 5 - 5
-
623 657 1,280
BULAN INI 135
BULAN KEMARIN 623

Mengetahui
Ka. Seksi Keperawatan dan Penunjang Medis

Dini Utami Ningrum, Apt, MPH.

NIP. 198710282011012014
GD

STOK HARGA NILAI ROBIN

PEMAKAIAN ROBIN SELISIH
AKHIR SATUAN PERSEDIAAN

5 - 319 - -
5 - 1,230 - -
10 - 2,204 - -
6 - 27 - -
5 - 14,300 - -
- - 10,500 - -
- - 1,710 - -
5 - 1,254 - -
5 - 2,040 - -
3 - 3,100 - -
2 - 1,600 - -
- - 24,700 - -
2 3 148,800 446,400 446,400
- - 1,260 - -
2 - 4,582 - -
2 - 11,525 - -
2 - 16,748 - -
2 - 2,470 - -
2 - 13,400 - -
 5 - 5,000 - -
- 5 3,833 19,167 19,167
3 - 6,857 - -
2 - 1,438 - -
2 - 4,000 - -
- - 13,200 - -
- - 10,000 - -
10 - 4,080 - -
10 - 178 - -
10 - 92 - -
10 - 84 - -
10 - 187 - -
10 - 330 - -

10 - -
134,999 -
10 - 2,100 - -
- - 17,000 - -
2 3 12,584 37,752 37,752
100 - 1,008 - -
5 - 6,000 - -
20 5 50,820 254,100 254,100
300 100 145 14,500 14,500
3 3 25,000 75,000 75,000
100 5 1,361 6,805 6,805
200 5 1,121 5,605 5,605
5 - 1,300 - -
5 - 8,030 - -
5 - 18,000 - -
5 - 20,000 - -
25 - 3,056 - -
5 - 3,056 - -

5 - 5,600 -
-
2 - 3,000 - -
6 - 35,200 - -
6 - 12,200 - -
2 - 12,200 - -
- - 12,500 - -
3 - 8,841 - -
3 - 8,841 - -
3 - 42,350 - -
5 - 42,350 - -
3 - 7,700 - -
3 - 7,370 - -
3 - 7,370 - -
2 - 42,350 - -
2 3 - - -
- - 7,800 - -
2 - 105,000 - -
- - 18,610 - -
5 - 2,250 - -
2 - 2,000 - -
2 - 2,000 - -
2 - 2,000 - -
2 - 1,650 - -
2 - 2,000 - -
5 - 6,900 - -
- - 7,500 - -
2 - 10,000 - -
5 - 6,410 - -
2 - 7,150 - -
5 - 9,275 - -
3 - 2,645 - -
10 - 3,650 - -
5 - 5,900 - -
 - - 5,900 - -
- - 5,900 - -
2 - 23,650 - -
2 - 23,650 - -
5 - 14,400 - -
3 - 25,777 - -
1 - 12,575 - -
1 - 12,575 - -
1 - 12,575 - -
1 - 12,575 - -
1 - 12,575 - -
1 - 12,600 - -
1 - 12,600 - -
2 - 12,600 - -
2 - 254,000 - -
4 - 254,000 - -
4 - 254,000 - -
4 - 254,000 - -
2 - 254,000 - -
2 - 254,000 - -
4 - 254,000 - -
12 3 18,000 54,000 54,000
10 3 14,630 43,890 43,890
10 - 12,000 - -
6 3 79,618 238,854 238,854
2 - 12,950 - -
3 - 12,200 - -
1 - 12,500 - -
1 - 12,200 - -
2 - 7,821 - -
2 - 17,670 - -

3 - 14,740 -
-
 2 - 7,370 - -
2 - 9,000 - -
- - 14,410 -
- - 397,100 - -
- - 4,125 - -
- - 10,505 - -
- - 1,408,000 - -
- - 13,200 - -
3 - 15,700 - -
5 - 15,700 - -

1,139
141
141

1,196,073 1,196,073

Pengurus Barang

Ngadini
NIP. 1966073198032002
 NILAI PERSEDIAAN ALKES UNIT IGD

KODE RUMAH SAKIT :

RUMAH SAKIT : RUMAH SAKIT TIPE D
KECAMATAN : KEMAYORAN
KOTA ADMINISTRASI : JAKARTA PUSAT
PROPINSI : DKI JAKARTA
BULAN : mei 2022
KETERANGAN : IGD COVID

No. NAMA ALKES SATUAN STOK AWAL PENERIMAAN PERSEDIAAN ROBIN SELISIH

1 LIDOCAIN Ampul - - -
2 ATROPINE Ampul - - -
3 EPINEPHRINE Ampul - - -
4 DIAZEPAM Ampul - - -
5 DOPAMINE Ampul - - -
6 NOVALGIN Ampul - - -
7 TRAMADOL Ampul - - -
8 ONDANCENTRON Ampul - - -
9 RANITIDIN Ampul - - -
10 KCL INJ 25 ML BTL 25 ML - - -
11 DEXAMETHASONE Ampul - - -
12 FUROSEMIDE 20mg Ampul - - -
13 KERTAS EKG 210X25 ROL 3 2 5
14 DYPHENIDRAMINE Ampul - - -
15 AMINOPHYLIN Ampul - - -
16 STESOLID SUPP 5mg Tube - - -
17 STESOLID SUPP 10mg Tube - - -
18 PROFENID SUPP Strip - - -
19 D40 / DEXTROSE 25ml - - -
20 VENTOLIN NEBULE pulf - - -
21 ELEKTRODA EKG DEWASA PCS 5 - 5
22 PCT DROP 100mg Botol - - -
 23 PCT SYR 120mg Botol - - -
24 GENTAMICIN ZALF Tube - - -
25 CEFOTAXIME 1g Vial - - -
26 CEFTRIAXONE 1gr Vial - - -
27 CLOPIDOGREL 75mg Tab - - -
28 ASPILET 80mg Tab - - -
29 ISDN 5mg Tab - - -
30 CAPTOPRIL 25mg Tab - - -
31 AMLODIPINE 5mg Tab - - -
32 AMLODIPINE 10mg Tab - - -
33 SARUNG TANGAN STERIL NO. 6,5 PSG - - -
34 PCT TAB 500mg Tab - - -
35 OMEPRAZOL 40 MG INJ VIAL - - -
36 USG JELLY botol 3 3 6
37 SURGICAL BLADES / BISTURI Pcs - - -
38 AQUAPRO INJEKSI Pcs - - -
39 MICROPORE 2cm Pcs 5 20 25
40 ALCOHOL SWAB pcs 100 300 400
41 ALCOHOL CAIR btl 3 3 6
42 SPUIT 1cc Pcs 5 100 105
43 SPUIT 3 cc Pcs 5 200 205
44 SPUIT 5cc Pcs - - -
45 SPUIT 10cc Pcs - - -
46 SPUIT 20cc Pcs - - -
47 SPUIT 50cc Pcs - - -
48 SILK BRAIDED 3/0 Pcs - - -
49 SILK BRAIDED 4/0 Pcs - - -
50 CATGUT CROMIC 3/0 ONEMED Pcs - - -
(141) URINE BAG Pcs - - -
52 FOLEY CATH NO.10 Pcs - - -
53 FOLEY CATH NO.12 Pcs - - -
54 FOLEY CATH NO.16 Pcs - - -
55 FOLEY CATH NO.18 Pcs - - -
56 NGT NO.3 Pcs - - -
57 NGT NO.5 Pcs - - -
58 NGT NO.6 Pcs - - -
59 NGT NO.8 Pcs - - -
60 NGT NO.10 Pcs - - -
61 NGT NO.12 Pcs - - -
62 NGT NO.14 Pcs - - -
63 NGT NO. 16 pcs - - -
64 BETHADINE CAIR Botol 3 3 6
65 UNDERPADS Pcs - - -
66 KASA GULUNG BESAR Pcs - - -
67 KASA STERIL 10x10 Pcs - - -
68 TEGADERM Pcs - - -
69 ABOCATH NO.18 Pcs - - -
70 ABOCATH NO.20 Pcs - - -
71 ABOCATH NO.22 Pcs - - -
72 ABOCATH NO.24 Pcs - - -
73 ABOCATH NO.26 Pcs - - -
74 CAIRAN GLUKOSA 5% Botol - - -
75 CAIRAN GLUKOSA 10% Botol - - -
76 CAIRAN KA-EN 3B Botol - - -
77 CAIRAN NaCL 0,9% Botol - - -
78 CAIRAN RINGER LAKTAT Botol - - -
79 CAIRAN ASERING Botol - - -
80 WING / 3 WAY STOPCOCK Pcs - - -
81 DARYANT-TULLE Pcs - - -
82 NASAL CANUL BAYI Pcs - - -
83 NASAL CANUL ANAK Pcs - - -
84 NASAL CANUL DEWASA Pcs - - -
85 SIMPLE MASK DEWASA Pcs - - -
86 SIMPLE MASK PEDIATRIK Pcs - - -
87 MASKER NEBU ANAK Pcs - - -
88 MASKER NEBU DEWASA Pcs - - -
89 GUEDEL 40mm Pcs - - -
90 GUEDEL 50mm Pcs - - -
91 GUEDEL 60mm Pcs - - -
92 GUEDEL 70mm Pcs - - -
 93 GUEDEL 80mm Pcs - - -
94 GUEDEL 90mm Pcs - - -
95 GUEDEL 100mm Pcs - - -
96 GUEDEL 110mm Pcs - - -
97 ETT no.8 Pcs - - -
98 ETT no.7,5 Pcs - - -
99 ETT no.7 Pcs - - -
100 ETT no.6,5 Pcs - - -
101 ETT no.5 Pcs - - -
102 ETT no.4,5 Pcs - - -
103 ETT no.3,5 Pcs - - -
104 HANSCOON pak 3 120 123
105 SAVETY BOX pcs 3 20 23
106 KATETER TIP pcs - - -
107 MASKER HIJAB BOX @ 50 3 20 23
PCS
BTL
108 Parasetamol drips (infus) 1000 mg/100 mL - - -
109 FOLEY CATETER NO.8 Pcs - - -
110 FOLEY CATETER NO.20 Pcs - - -
111 FOLEY CATETER NO.14 Pcs - - -
112 CAIRAN GLUKOSA 40% 25ml - - -
113 INFUSION SET ANAK
INFUSION SET DEWASA ( MAKROSET
Pcs - - -
114 ) Pcs - - -
115 NGT NO. 18 Pcs - - -
116 KAEN 1 B BTL - - -
117 VALISANBE/ DIAZEPAM INJ Ampul - - -
118 FENTANYL Ampul - - -
119 MIDAZOLAM Ampul - - -
120 MORFINA Ampul - - -
121 VORTRAN pcs - - -
122 Masker N95 pcs - - -
123 NRM dewasa pcs - - -
124 NRM anak pcs - - -
141

BULAN INI 141

BULAN KEMARIN 142

Mengetahui
Ka. Seksi Keperawatan dan Penunjang Medis

Dini Utami Ningrum, Apt, MPH.

NIP. 198710282011012014
 STOK HARGA NILAI ROBIN
PEMAKAIAN ROBIN SELISIH
AKHIR SATUAN PERSEDIAAN

- - 319 - -
- - 1,230 - -
- - 2,204 - -
- - 27 - -
- - 14,300 - -
- - 10,500 - -
- - 1,710 - -
- - 1,254 - -
- - 2,040 - -
- - 3,100 - -
- - 1,600 - -
- - 24,700 - -
2 3 148,800 446,400 446,400
- - 1,260 - -
- - 4,582 - -
- - 11,525 - -
- - 16,748 - -
- - 2,470 - -
- - 13,400 - -
- - 5,000 - -
- 5 3,833 19,167 19,167
- - 6,857 - -
 - - 1,438 - -
- - 4,000 - -
- - 13,200 - -
- - 10,000 - -
- - 4,080 - -
- - 178 - -
- - 92 - -
- - 84 - -
- - 187 - -
- - 330 - -
- - 134,999 - -
- - 2,100 - -
- - 17,000 - -
3 3 12,584 37,752 37,752
- - 1,008 - -
- - 6,000 - -
20 5 50,820 254,100 254,100
300 100 145 14,500 14,500
3 3 25,000 75,000 75,000
100 5 1,361 6,805 6,805
200 5 1,121 5,605 5,605
- - 1,300 - -
- - 8,030 - -
- - 18,000 - -
- - 20,000 - -
- - 3,056 - -
- - 3,056 - -
- - 5,600 - -
- - 3,000 - -
- - 35,200 - -
- - 12,200 - -
- - 12,200 - -
- - 12,500 - -
- - 8,841 - -
- - 8,841 - -
- - 42,350 - -
- - 42,350 - -
- - 7,700 - -
- - 7,370 - -
- - 7,370 - -
- - 42,350 - -
3 3 - - -
- - 7,800 - -
- - 105,000 - -
- - 18,610 - -
- - 2,250 - -
- - 2,000 - -
- - 2,000 - -
- - 2,000 - -
- - 1,650 - -
- - 2,000 - -
- - 6,900 - -
- - 7,500 - -
- - 10,000 - -
- - 6,410 - -
- - 7,150 - -
- - 9,275 - -
- - 2,645 - -
- - 3,650 - -
- - 5,900 - -
- - 5,900 - -
- - 5,900 - -
- - 23,650 - -
- - 23,650 - -
- - 14,400 - -
- - 25,777 - -
- - 12,575 - -
- - 12,575 - -
- - 12,575 - -
- - 12,575 - -
 - - 12,575 - -
- - 12,600 - -
- - 12,600 - -
- - 12,600 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
120 3 18,000 54,000 54,000
20 3 14,630 43,890 43,890
- - 12,000 - -
20 3 79,618 238,854 238,854
- - 12,950 - -
- - 12,200 - -
- - 12,500 - -
- - 12,200 - -
- - 7,821 - -
- - 17,670 - -
- - 14,740 - -
- - 7,370 - -
- - 9,000 - -
- - 14,410 -
- - 397,100 - -
- - 4,125 - -
- - 10,505 - -
- - 1,408,000 - -
- - 13,200 - -
- - 15,700 - -
- - 15,700 - -
141
 1,196,073 1,196,073

Pengurus Barang

Ngadini
NIP. 1966073198032002
 NILAI PERSEDIAAN ALKES UN

KODE RUMAH SAKIT :

RUMAH SAKIT : RUMAH SAKIT TIPE D
KECAMATAN : KEMAYORAN
KOTA ADMINISTRASI : JAKARTA PUSAT
PROPINSI : DKI JAKARTA
BULAN : Jun-22
KETERANGAN : IGD COVID

No. NAMA ALKES SATUAN STOK AWAL PENERIMAAN

1 LIDOCAIN Ampul -
2 ATROPINE Ampul - -
3 EPINEPHRINE Ampul - -
4 DIAZEPAM Ampul - -
5 DOPAMINE Ampul - -
6 NOVALGIN Ampul - -
7 TRAMADOL Ampul - -
8 ONDANCENTRON Ampul - -
9 RANITIDIN Ampul - -
10 KCL INJ 25 ML BTL 25 ML - -
11 DEXAMETHASONE Ampul - -
12 FUROSEMIDE 20mg Ampul - -
13 KERTAS EKG 210X25 ROL 3 2
14 DYPHENIDRAMINE Ampul - -
15 AMINOPHYLIN Ampul - -
16 STESOLID SUPP 5mg Tube - -
17 STESOLID SUPP 10mg Tube - -
18 PROFENID SUPP Strip - -
19 D40 / DEXTROSE 25ml - -
20 VENTOLIN NEBULE pulf - -
21 ELEKTRODA EKG DEWASA PCS 5 10
22 PCT DROP 100mg Botol - -
23 PCT SYR 120mg Botol - -
24 GENTAMICIN ZALF Tube - -
25 CEFOTAXIME 1g Vial - -
26 CEFTRIAXONE 1gr Vial - -
27 CLOPIDOGREL 75mg Tab - -
28 ASPILET 80mg Tab - -
29 ISDN 5mg Tab - -
30 CAPTOPRIL 25mg Tab - -
31 AMLODIPINE 5mg Tab - -
32 AMLODIPINE 10mg Tab - -
33 SARUNG TANGAN STERIL NO. 6,5 PSG - -
34 PCT TAB 500mg Tab - -
 35 OMEPRAZOL 40 MG INJ VIAL - -
36 USG JELLY botol 3 3
37 SURGICAL BLADES / BISTURI Pcs - -
38 AQUAPRO INJEKSI Pcs - -
39 MICROPORE 2cm Pcs 5 15
40 ALCOHOL SWAB pcs 100 200
41 ALCOHOL CAIR btl 3 2
42 SPUIT 1cc Pcs 5 50
43 SPUIT 3 cc Pcs 5 50
44 SPUIT 5cc Pcs - -
45 SPUIT 10cc Pcs - -
46 SPUIT 20cc Pcs - -
47 SPUIT 50cc Pcs - -
48 SILK BRAIDED 3/0 Pcs - -
49 SILK BRAIDED 4/0 Pcs - -
50 CATGUT CROMIC 3/0 ONEMED Pcs - -
(141) URINE BAG Pcs - -
52 FOLEY CATH NO.10 Pcs - -
53 FOLEY CATH NO.12 Pcs - -
54 FOLEY CATH NO.16 Pcs - -
55 FOLEY CATH NO.18 Pcs - -
56 NGT NO.3 Pcs - -
57 NGT NO.5 Pcs - -
58 NGT NO.6 Pcs - -
59 NGT NO.8 Pcs - -
60 NGT NO.10 Pcs - -
61 NGT NO.12 Pcs - -
62 NGT NO.14 Pcs - -
63 NGT NO. 16 pcs - -
64 BETHADINE CAIR Botol 3 2
65 UNDERPADS Pcs - -
66 KASA GULUNG BESAR Pcs - -
67 KASA STERIL 10x10 Pcs - -
68 TEGADERM Pcs - -
69 ABOCATH NO.18 Pcs - -
70 ABOCATH NO.20 Pcs - -
71 ABOCATH NO.22 Pcs - -
72 ABOCATH NO.24 Pcs - -
73 ABOCATH NO.26 Pcs - -
74 CAIRAN GLUKOSA 5% Botol - -
75 CAIRAN GLUKOSA 10% Botol - -
76 CAIRAN KA-EN 3B Botol - -
77 CAIRAN NaCL 0,9% Botol - -
78 CAIRAN RINGER LAKTAT Botol - -
79 CAIRAN ASERING Botol - -
80 WING / 3 WAY STOPCOCK Pcs - -
81 DARYANT-TULLE Pcs - -
82 NASAL CANUL BAYI Pcs - -
 83 NASAL CANUL ANAK Pcs - -
84 NASAL CANUL DEWASA Pcs - -
85 SIMPLE MASK DEWASA Pcs - -
86 SIMPLE MASK PEDIATRIK Pcs - -
87 MASKER NEBU ANAK Pcs - -
88 MASKER NEBU DEWASA Pcs - -
89 GUEDEL 40mm Pcs - -
90 GUEDEL 50mm Pcs - -
91 GUEDEL 60mm Pcs - -
92 GUEDEL 70mm Pcs - -
93 GUEDEL 80mm Pcs - -
94 GUEDEL 90mm Pcs - -
95 GUEDEL 100mm Pcs - -
96 GUEDEL 110mm Pcs - -
97 ETT no.8 Pcs - -
98 ETT no.7,5 Pcs - -
99 ETT no.7 Pcs - -
100 ETT no.6,5 Pcs - -
101 ETT no.5 Pcs - -
102 ETT no.4,5 Pcs - -
103 ETT no.3,5 Pcs - -
104 HANSCOON pak 3 15
105 SAVETY BOX pcs 3 10
106 KATETER TIP pcs - -
107 MASKER HIJAB BOX @ 50 3 15
PCS
BTL
108 Parasetamol drips (infus) 1000 mg/100 mL - -
109 FOLEY CATETER NO.8 Pcs - -
110 FOLEY CATETER NO.20 Pcs - -
111 FOLEY CATETER NO.14 Pcs - -
112 CAIRAN GLUKOSA 40% 25ml - -
113 INFUSION SET ANAK
INFUSION SET DEWASA ( MAKROSET
Pcs - -
114 ) Pcs - -
115 NGT NO. 18 Pcs - -
116 KAEN 1 B BTL - -
117 VALISANBE/ DIAZEPAM INJ Ampul - -
118 FENTANYL Ampul - -
119 MIDAZOLAM Ampul - -
120 MORFINA Ampul - -
121 VORTRAN pcs - -
122 Masker N95 pcs - -
123 NRM dewasa pcs - -
124 NRM anak pcs - -
141 374

BULAN INI 141

BULAN KEMARIN 141
Mengetahui
Ka. Seksi Keperawatan dan Penunjang Medis

Dini Utami Ningrum, Apt, MPH.

NIP. 198710282011012014
NILAI PERSEDIAAN ALKES UNIT IGD
STOK
PERSEDIAAN ROBIN SELISIH PEMAKAIAN
AKHIR
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
5 2
- -
- -
- -
- -
- -
- -
- -
15 10
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
HARGA
ROBIN SELISIH
SATUAN
- 319
- 1,230
- 2,204
- 27
- 14,300
- 10,500
- 1,710
- 1,254
- 2,040
- 3,100
- 1,600
- 24,700
3 148,800
- 1,260
- 4,582
- 11,525
- 16,748
- 2,470
- 13,400
- 5,000
5 3,833
- 6,857
- 1,438
- 4,000
- 13,200
- 10,000
- 4,080
- 178
- 92
- 84
- 187
- 330
- 134,999
- 2,100
 - - - 17,000
6 3 3 12,584
- - - 1,008
- - - 6,000
20 15 5 50,820
300 200 100 145
5 2 3 25,000
55 50 5 1,361
55 50 5 1,121
- - - 1,300
- - - 8,030
- - - 18,000
- - - 20,000
- - - 3,056
- - - 3,056
- - - 5,600
- - - 3,000
- - - 35,200
- - - 12,200
- - - 12,200
- - - 12,500
- - - 8,841
- - - 8,841
- - - 42,350
- - - 42,350
- - - 7,700
- - - 7,370
- - - 7,370
- - - 42,350
5 2 3 -
- - - 7,800
- - - 105,000
- - - 18,610
- - - 2,250
- - - 2,000
- - - 2,000
- - - 2,000
- - - 1,650
- - - 2,000
- - - 6,900
- - - 7,500
- - - 10,000
- - - 6,410
- - - 7,150
- - - 9,275
- - - 2,645
- - - 3,650
- - - 5,900
 - - - 5,900
- - - 5,900
- - - 23,650
- - - 23,650
- - - 14,400
- - - 25,777
- - - 12,575
- - - 12,575
- - - 12,575
- - - 12,575
- - - 12,575
- - - 12,600
- - - 12,600
- - - 12,600
- - - 254,000
- - - 254,000
- - - 254,000
- - - 254,000
- - - 254,000
- - - 254,000
- - - 254,000
18 15 3 18,000
13 10 3 14,630
- - - 12,000
18 15 3 79,618
- - - 12,950
- - - 12,200
- - - 12,500
- - - 12,200
- - - 7,821
- - - 17,670
- - - 14,740
- - - 7,370
- - - 9,000
- - - 14,410
- - - 397,100
- - - 4,125
- - - 10,505
- - - 1,408,000
- - - 13,200
- - - 15,700
- - - 15,700
374 141
Pengurus Barang

Ngadini
NIP. 1966073198032002
 NILAI ROBIN
PERSEDIAAN

- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
446,400 446,400
- -
- -
- -
- -
- -
- -
- -
19,167 19,167
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
 - -
37,752 37,752
- -
- -
254,100 254,100
14,500 14,500
75,000 75,000
6,805 6,805
5,605 5,605
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
 - -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
- -
54,000 54,000
43,890 43,890
- -
238,854 238,854
- -
- -
- -
- -
- -
- -
- -
- -
- -
-
- -
- -
- -
- -
- -
- -
- -

1,196,073 1,196,073
 NILAI PERSEDIAAN ALKES UNIT IGD

KODE RUMAH SAKIT :

RUMAH SAKIT : RUMAH SAKIT TIPE D
KECAMATAN : KEMAYORAN
KOTA ADMINISTRASI : JAKARTA PUSAT
PROPINSI : DKI JAKARTA
BULAN : mei 2022
KETERANGAN : IGD COVID

No. NAMA ALKES SATUAN STOK AWALPENERIMAAN

PERSEDIAAN ROBIN SELISIH

1 LIDOCAIN Ampul - - -
2 ATROPINE Ampul - - -
3 EPINEPHRINE Ampul - - -
4 DIAZEPAM Ampul - - -
5 DOPAMINE Ampul - - -
6 NOVALGIN Ampul - - -
7 TRAMADOL Ampul - - -
8 ONDANCENTRON Ampul - - -
9 RANITIDIN Ampul - - -
KCL INJ 25 ML BTL 25
10 ML - - -

11 DEXAMETHASONE Ampul - - -
12 FUROSEMIDE 20mg Ampul - - -
13 KERTAS EKG 210X25 ROL 3 2 5
14 DYPHENIDRAMINE Ampul - - -
15 AMINOPHYLIN Ampul - - -
16 STESOLID SUPP 5mg Tube - - -
17 STESOLID SUPP 10mg Tube - - -
18 PROFENID SUPP Strip - - -
19 D40 / DEXTROSE 25ml - - -
20 VENTOLIN NEBULE pulf - - -
ELEKTRODA EKG PCS
DEWASA
21 5
5 -
22 PCT DROP 100mg Botol - - -
23 PCT SYR 120mg Botol - - -
24 GENTAMICIN ZALF Tube - - -
25 CEFOTAXIME 1g Vial - - -
26 CEFTRIAXONE 1gr Vial - - -
27 CLOPIDOGREL 75mg Tab - - -
28 ASPILET 80mg Tab - - -
29 ISDN 5mg Tab - - -
 30 CAPTOPRIL 25mg Tab - - -
31 AMLODIPINE 5mg Tab - - -
32 AMLODIPINE 10mg Tab - - -
SARUNG TANGAN PSG
STERIL NO. 6,5
33 -
- -
34 PCT TAB 500mg Tab - - -
OMEPRAZOL 40 MG VIAL
INJ
35 -
- -
USG JELLY botol
36 6
3 3
37 SURGICAL BLADES / BISTURI Pcs - - -
38 AQUAPRO INJEKSI Pcs - - -
39 MICROPORE 2cm Pcs 5 20 25
40 ALCOHOL SWAB pcs 100 300 400
41 ALCOHOL CAIR btl 3 3 6
42 SPUIT 1cc Pcs 5 100 105
43 SPUIT 3 cc Pcs 5 200 205
44 SPUIT 5cc Pcs - - -
45 SPUIT 10cc Pcs - - -
46 SPUIT 20cc Pcs - - -
47 SPUIT 50cc Pcs - - -
48 SILK BRAIDED 3/0 Pcs - - -
49 SILK BRAIDED 4/0 Pcs - - -
CATGUT CROMIC 3/0
ONEMED
50 - -
Pcs -
(141) URINE BAG Pcs - - -
52 FOLEY CATH NO.10 Pcs - - -
53 FOLEY CATH NO.12 Pcs - - -
54 FOLEY CATH NO.16 Pcs - - -
55 FOLEY CATH NO.18 Pcs - - -
56 NGT NO.3 Pcs - - -
57 NGT NO.5 Pcs - - -
58 NGT NO.6 Pcs - - -
59 NGT NO.8 Pcs - - -
60 NGT NO.10 Pcs - - -
61 NGT NO.12 Pcs - - -
62 NGT NO.14 Pcs - - -
63 NGT NO. 16 pcs - - -
64 BETHADINE CAIR Botol 3 3 6
65 UNDERPADS Pcs - - -
66 KASA GULUNG BESAR Pcs - - -
67 KASA STERIL 10x10 Pcs - - -
 68 TEGADERM Pcs - - -
69 ABOCATH NO.18 Pcs - - -
70 ABOCATH NO.20 Pcs - - -
71 ABOCATH NO.22 Pcs - - -
72 ABOCATH NO.24 Pcs - - -
73 ABOCATH NO.26 Pcs - - -
74 CAIRAN GLUKOSA 5% Botol - - -
75 CAIRAN GLUKOSA 10% Botol - - -
76 CAIRAN KA-EN 3B Botol - - -
77 CAIRAN NaCL 0,9% Botol - - -
78 CAIRAN RINGER LAKTAT Botol - - -
79 CAIRAN ASERING Botol - - -
80 WING / 3 WAY STOPCOCK Pcs - - -
81 DARYANT-TULLE Pcs - - -
82 NASAL CANUL BAYI Pcs - - -
83 NASAL CANUL ANAK Pcs - - -
84 NASAL CANUL DEWASA Pcs - - -
85 SIMPLE MASK DEWASA Pcs - - -
86 SIMPLE MASK PEDIATRIK Pcs - - -
87 MASKER NEBU ANAK Pcs - - -
88 MASKER NEBU DEWASA Pcs - - -
89 GUEDEL 40mm Pcs - - -
90 GUEDEL 50mm Pcs - - -
91 GUEDEL 60mm Pcs - - -
92 GUEDEL 70mm Pcs - - -
93 GUEDEL 80mm Pcs - - -
94 GUEDEL 90mm Pcs - - -
95 GUEDEL 100mm Pcs - - -
96 GUEDEL 110mm Pcs - - -
97 ETT no.8 Pcs - - -
98 ETT no.7,5 Pcs - - -
99 ETT no.7 Pcs - - -
100 ETT no.6,5 Pcs - - -
101 ETT no.5 Pcs - - -
102 ETT no.4,5 Pcs - - -
103 ETT no.3,5 Pcs - - -
104 HANSCOON pak 3 120 123
105 SAVETY BOX pcs 3 20 23
106 KATETER TIP pcs - - -
MASKER HIJAB BOX @ 50
107 20 23
PCS 3
108 Parasetamol drips (infus BTL - - -
109 FOLEY CATETER NO.8 Pcs - - -
110 FOLEY CATETER NO.20 Pcs - - -
111 FOLEY CATETER NO.14 Pcs - - -
112 CAIRAN GLUKOSA 40% 25ml - - -
 INFUSION SET ANAK
113 - -
Pcs -

114 - -

INFUSION SET
DEWASA ( MAKROSET ) Pcs -
NGT NO. 18
115 -
Pcs - -
116 KAEN 1 B BTL - - -
VALISANBE/ DIAZEPAM
INJ
117 -

Ampul - -
FENTANYL Ampul
118 -
- -
119 MIDAZOLAM Ampul - - -
120 MORFINA Ampul - - -
121 VORTRAN pcs - - -

122 Masker N95 pcs - -

-
123 NRM dewasa pcs - - -
124 NRM anak pcs - - -
141

BULAN INI 141

BULAN KEMARIN 141

Mengetahui
Ka. Seksi Keperawatan dan Penunjang Medis

Dini Utami Ningrum, Apt, MPH.

NIP. 198710282011012014
ES UNIT IGD

STOK HARGA NILAI ROBIN

PEMAKAIAN ROBIN SELISIH
AKHIR SATUAN PERSEDIAAN
- - 319 - -
- - 1,230 - -
- - 2,204 - -
- - 27 - -
- - 14,300 - -
- - 10,500 - -
- - 1,710 - -
- - 1,254 - -
- - 2,040 - -

- - 3,100 -
-
- - 1,600 - -
- - 24,700 - -
2 3 148,800 446,400 446,400
- - 1,260 - -
- - 4,582 - -
- - 11,525 - -
- - 16,748 - -
- - 2,470 - -
- - 13,400 - -
- - 5,000 - -

- 5 3,833 19,167
19,167
- - 6,857 - -
- - 1,438 - -
- - 4,000 - -
- - 13,200 - -
- - 10,000 - -
- - 4,080 - -
- - 178 - -
- - 92 - -
 - - 84 - -
- - 187 - -
- - 330 - -

- - -
134,999 -
- - 2,100 - -

- - 17,000 -
-

3 3 37,752
12,584 37,752
- - 1,008 - -
- - 6,000 - -
20 5 50,820 254,100 254,100
300 100 145 14,500 14,500
3 3 25,000 75,000 75,000
100 5 1,361 6,805 6,805
200 5 1,121 5,605 5,605
- - 1,300 - -
- - 8,030 - -
- - 18,000 - -
- - 20,000 - -
- - 3,056 - -
- - 3,056 - -

- - 5,600 -
-
- - 3,000 - -
- - 35,200 - -
- - 12,200 - -
- - 12,200 - -
- - 12,500 - -
- - 8,841 - -
- - 8,841 - -
- - 42,350 - -
- - 42,350 - -
- - 7,700 - -
- - 7,370 - -
- - 7,370 - -
- - 42,350 - -
3 3 - - -
- - 7,800 - -
- - 105,000 - -
- - 18,610 - -
 - - 2,250 - -
- - 2,000 - -
- - 2,000 - -
- - 2,000 - -
- - 1,650 - -
- - 2,000 - -
- - 6,900 - -
- - 7,500 - -
- - 10,000 - -
- - 6,410 - -
- - 7,150 - -
- - 9,275 - -
- - 2,645 - -
- - 3,650 - -
- - 5,900 - -
- - 5,900 - -
- - 5,900 - -
- - 23,650 - -
- - 23,650 - -
- - 14,400 - -
- - 25,777 - -
- - 12,575 - -
- - 12,575 - -
- - 12,575 - -
- - 12,575 - -
- - 12,575 - -
- - 12,600 - -
- - 12,600 - -
- - 12,600 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
- - 254,000 - -
120 3 18,000 54,000 54,000
20 3 14,630 43,890 43,890
- - 12,000 - -

20 3 79,618 238,854
238,854
- - 12,950 - -
- - 12,200 - -
- - 12,500 - -
- - 12,200 - -
- - 7,821 - -
- - 17,670 -
-

- - 14,740 -

- - -
7,370 -
- - 9,000 - -

- 14,410 -

- - -
397,100 -
- - 4,125 - -
- - 10,505 - -
- - 1,408,000 - -

- - 13,200 -
-
- - 15,700 - -
- - 15,700 - -
141

1,196,073 1,196,073

Pengurus Barang

Ngadini
NIP. 1966073198032002