PEMAKAIAN KEBUTUHAN X KEBUTUHAN

NO NAMA OBAT
PERBULAN BUFFER DALAM SETAHUN
1 Amlodipine 5 mg 2,000 30,000 30,000
2 Amoksisilin 500 mg 8,000 120,000 120,000
Antasida kombinasi tablet
3 8,000 120,000 120,000
kunyah
4 Asam Askorbat (Vit C) 2,500 37,500 37,500
5 Asam Mefenamat 500 mg 5,000 75,000 75,000
6 Gentamycin Salep Mata 50 750 750
7 Gentamycin Tetes Mata 50 750 750
8 Ibuprofen 400 mg 3,000 45,000 45,000
10 Kotri Syrup 125/5mg 100 1,500 1,500
11 N-Asetil Sistein 200mg 6,000 90,000 90,000
Paracetamol Syrup
12 100 1,500 1,500
125mg/5mg
13 Prednison 5 mg 5,000 75,000 75,000
14 Ranitidin 150mg 7,000 105,000 105,000
15 Salep 2-4 100 1,500 1,500

16 Ciprofloxacin 500 mg 3,000 45,000 45,000

17 Allopurinol 300mg 300 4500 4500
18 Asiklovir tab 400mg 30 450 450
19 Betahistin Melistat tab 50 750 750
20 Cefadroxil 500 Mg 1,000 15,000 15,000
21 Cotrimoksazole 480 mg 1,000 15,000 15,000
22 Deksametason tab 5000 75000 75000
23 Domperidon 10 mg 500 7,500 7,500
24 Glibenklamid tab 300 4500 4500
25 Kalsium laktat tab 500 7500 7500
26 Kaptopril tab 100 1500 1500
27 Klorfeniramin tablet 4 mg 8,000 120,000 120,000
28 Metformin 500 mg 1,000 15,000 15,000
29 Metronidazole 500 mg 1,000 15,000 15,000
30 Natrium Diklofenak tab 1000 15000 15000
31 Neo Diaform tab 2000 30000 30000
32 Nifedipine 10 mg 100 1,500 1,500
Nistatin tab vaginal 100.000
33 10 150 150
IU
34 Omeprazole 20 mg 3,000 45,000 45,000
35 Paracetamol 500 mg 20,000 300,000 300,000
36 Phytomenadione Tab 10 mg 100 1,500 1,500
37 Piridoksin (vitamin B6) tab 1500 22500 22500
 38 Simvastatin tab 300 4500 4500
39 Tiamin (vitamin B1) tab 1000 15000 15000
40 Tetrasiklin 500mg 100 1500 1500
41 Vitamin Bcomplex 6,000 90,000 90,000
42 Hemoroid Supp 100 1500 1500
43 Anti Fungsi kombinasi salep 30 450 450
44 Bedak Salisil serb 100 1500 1500
45 Betametason krim 100 1500 1500
46 Etil Klorida 2 30 30
47 Fenol Gliserol 20 300 300
48 Hidrokortison krim 50 750 750
49 Ketoconazole krim 10 150 150
50 Kloramfenikol salep 50 750 750
51 Kloramfenikol Tetes Telinga 20 300 300
52 Mikonazol krim 30 450 450
53 Povidon Iodida larutan 10 150 150
54 Oxytocin Injeksi 10IU/Ml 20 300 300
55 Lidocain HCl 2% 30 450 450
Lidokain injeksi 2 %
56 ( HCL ) + epinefrin 1 : 30 450 450
80.000-2 ml
Serum anti bisa ular I inj
57 1 15 15
(i.m./i.v.)
Vit K (Phytomenadione) 10
58 30 450 450
mg Injeksi
59 Serum antitetanus (A.T.S) 1 15 15
Alat suntik sekali pakai 1 ml
60 10 150 150
+ jarum
Alat suntik sekali pakai 10
61 2 30 30
ml + jarum
Alat suntik sekali pakai 3 ml
62 100 1500 1,500
+ jarum
Alat suntik sekali pakai 5 ml
63 20 300 300
+ jarum
Catgut Chromic/benang
64 12 180 180
bedah no. 2/0 + jarum
Catgut Chromic/benang
65 12 180 180
bedah no. 3/0 + jarum

66 Foley Catheter 2 way No. 16 2 30 30

67 Foley Catheter 2 way No. 18 2 30 30
68 Infusion set anak 10 150 150
69 Infusion set dewasa 30 450 450
70 IV catheter no 18 G 20 300 300
71 IV catheter no 20 G 20 300 300
72 IV catheter no 22 G 20 300 300
73 IV catheter no 24 G 20 300 300
Sarung Tangan Pendek non
74 5 75 75
steril ukuran L
Sarung Tangan Pendek non
75 10 150 150
steril ukuran M
Sarung Tangan Pendek non
76 10 150 150
steril ukuran S
77 Selang Oksigen 5 75 75
78 Selang Oksigen 1 15 15
Silk( Benang Bedah Sutera)
79 15 225 225
No 2/0
 KEBUTUHAN
SISA AKHIR TAHUN
BELANJA JKN
10,032 19,968
25,000 95,000
- 120,000
58,000 - 20,500
- 75,000
- 750
- 750
9,000 36,000
100 1,400
58,000 32,000
300 1,200
- 75,000
- 105,000
- 1,500

- 45,000
2500 2000
50 400
800 - 50
- 15,000
- 15,000
0 75000
- 7,500
1200 3300
0 7500
800 700
17,000 103,000
3,000 12,000
1,500 13,500
0 15000
15000 15000
500 1,000
0 150
- 45,000
40,000 260,000
300 1,200
75000 -52500
 0 4500
21000 -6000
0 1500
35,000 55,000
200 1300
150 300
200 1300
100 1400
- 30
0 300
750
100 50
50 700
50 250
100 350
25 125
50 250
90 360

10 440

1 14

25 425
1 14
100 50

0 30

0 1,500

200 100

100 80

120 60

0 30
 0 30
150
120 330
0 300
30 270
20 280
0 300
15 60

120 30

25 125
0 75
0 15
50 175