BLUD PUSKESMAS SAIL

DAFTAR BIAYA BAHAN HABIS PAKAI + OBAT TAHUN 2016

SATUAN / HARGA OBAT +
NO NAMA OBAT VOLUME TOTAL HARGA
KEMASAN PPN 10 %
Analog insulin rapid acting inj 100 UI/ml,
1 vial/cartridge disposible/penfill cartridge (Insulin pen
0 93,880 -
Aspart (Analogue))
2 Anti asma oral tablet (teofillin 300 mg) tablet 200 1,213 242,660
3 Anti bakteri topikal untuk luka bakar tube 10 19,957 199,573
4 Anti epilepsi sirup botol 20 45,980 919,600
5 Anti fungi sirup untuk candidiasis botol 10 37,950 379,500
6 Anti inflamasi dan antipruritik lotio botol 100 16,500 1,650,000
7 Anti kejang rectal tube 40 19,364 774,576
8 Anti platelet tablet 300 171 51,150
9 Anti scabies krim tube 25 28,600 715,000
10 Anti spasmodik tablet tablet 200 1,331 266,200
11 Anti tetanus injeksi ampul 4 187,000 748,000
12 Anti tusif syr botol 500 8,800 4,400,000
13 Nasal dekongestan sirup botol 500 16,500 8,250,000
14 Anti vertigo/migrain tablet tablet 500 7,370 3,685,000
Antiparkinson doen tab komb (benserazid 25
15 tablet
mg, levodopa 100 mg) 100 1,733 173,250
16 Asam traneksamat tablet 100 2,200 220,000
17 Asam valproat SR 250 tablet 200 3,072 614,460
18 Atorvastatin 10 mg tablet 0 - -
19 Attapulgite tab 600 mg tablet 300 231 69,300
20 Bisakodil suppositoria supp 20 6,650 132,990
21 Bisakodil tab 5 mg tablet 50 725 36,249
22 Curcuma tab tablet 5000 440 2,200,000
23 Fitomenadion inj 2mg/ml (vit K infant inj) ampul 0 9,075 -
24 Fluoksetin tab 20 mg tablet 0 499 -
25 Gabapentin tab tablet 100 10,450 1,045,000
26 Gentamisin salep mata 0,3 % tube 95 2,926 277,970
27 Glikazide 80 mg tablet 121 277 33,541
28 Gliseril trinitrate sublingual tablet 0 1,733 -
29 Hormon induktor fertilitas tablet 0 13,640 -
30 Hormon progesteron / penguat kandungan tablet 34 3,025 102,850
31 Imunomodulator syrup botol 200 21,780 4,356,000
32 Imunomodulator tablet tablet 1000 2,481 2,480,500
33 Kloramfenicol tetes mata botol 200 12,725 2,544,960
34 Kalium Klorida Tablet 600 mg tablet 50 1,738 86,900
35 Ketamin inj 100mg/ml ampul 10 121,000 1,210,000
36 Lidokain jeli 2 % syrg 1 44,000 44,000
37 Metilergometrin maleat injeksi 0,2 mg-1ml ampul 0 3,025 -
38 Metronidazol supp 500 mg supp 10 3,542 35,420
Mukolitik, ekspektoran nasal dekongestan
39 botol
syrup 100 8,852 885,170
40 Mukolitik, ekspektoran nasal dekongestan tab tablet 2000 343 686,796
41 Multivitamin penambah nafsu makan tablet tablet 3500 708 2,477,475
42 Multivitamin + pelancar ASI tablet 300 1,650 495,000
Multivitamin sirup untuk penambah nafsu
43 botol
makan anak 500 12,100 6,050,000
44 Multivitamin untuk ibu hamil tablet 500 3,025 1,512,500
45 Natrium fusidat salep 20 mg/g tube 10 7,211 72,105
46 Noretisteron tablet 5 mg tablet 30 2,880 86,394
47 Obat batuk hitam plus analgetik botol 200 11,798 2,359,500
48 Obat diare, konstipasi, kembung (Syinbio) sacc 300 4,730 1,419,000
49 Oksimetazolin tetes hidung 0,025 % botol 10 31,821 318,208
50 Penghambat neuromuskular tablet 0 2,530 -
Penguat kontraksi uterus/uterotonik (Oxitosin
51 ampul
inj) 0 2,090 -
52 Polikresulen cairan botol 0 19,792 -
53 Relaksan uterus tablet 0 5,500 -
54 Salbutamol inhalasi/aerosol 100 mcg/dosis botol 0 73,632 -
55 Budesonide/formoterol inhahalasi botol 0 129,360 -
56 Tamsulosin tab Sr 0,4 mg tablet 0 7,480 -
57 Tetrakain HCl tetes mata 0,5 % botol 0 12,650 -
58 Jelli anti pembekuan darah tube 25 44,000 1,100,000
59 Jelli anti inflamasi tube 50 26,400 1,320,000
60 Ventolin nebuliser ampul 50 7,623 381,150
61 Budesonide nebuliser ampul 50 9,790 489,500
62 Vitamin B untuk syaraf (neuropati perifer) tablet 1500 2,090 3,135,000
63 Vitamin neurotropik tablet + vit E tablet 2500 1,234 3,085,500
64 Zink sirup 20 mg/5 ml botol 25 8,547 213,675
65 Zink drop 10 ml/ml botol 25 14,124 353,100
 Anastesi lokal gigi untuk pasien tensi
66 vial
tinggi/mevinor 150 12,100 1,815,000
67 Anastesi lokal gigi, citoject vial 300 3,465 1,039,500
68 Bahan Pengisi saluran akar kotak 2 600,875 1,201,750
69 Bahan Perawatan saluran akar/cresophein kotak 3 660,000 1,980,000
70 Bahan Resin Komposite kotak 6 360,525 2,163,150
 71 Bahan tambalan sementarar pot 4 189,750 759,000
72 Bonding + etching set 3 990,000 2,970,000
73 Devitalisasi pasta pot 2 170,775 341,550
74 Etil Klorida spray botol 20 189,750 3,795,000
75 Eugenol cairan botol 1 19,250 19,250
76 Filler kotak 0 205,700 -
77 Glass lanomer cement/ Fuji IX mini set 6 430,100 2,580,600
78 Reamer kotak 0 158,125 -
79 Semen seng fosfat set 3 88,725 266,175
80 papper poin 6 16,500 99,000
81 guttap perca 0 - -
82 Occo botol 3 110,000 330,000
83 Mata bur set 4 165,000 660,000
84 Alkohol Swabs kotak 40 11,000 440,000
85 Antiseptik cuci tangan tanpa bilas botol 50 72,114 3,605,690
86 Catgut 2/0 sach 72 32,267 2,323,200
87 Catgut 3/0 sach 72 35,021 2,521,530
88 Dissposible Syringe 1 ml pcs 100 1,694 169,400
89 Dissposible Syringe 3 ml pcs 100 1,053 105,270
90 Dissposible Syringe 5 ml pcs 100 1,319 131,890
91 Handschoen non steril No.7 set 100 524 52,360
92 Handschoen non steril No.7,5 set 100 524 52,360
93 Handschoen steril No. 8 set 0 - -
94 Handschoen steril No.7 set 200 5,423 1,084,600
95 Handschoen steril No.7,5 set 100 5,423 542,300
96 Infusion set Anak set 10 3,850 38,500
97 Infusion set Dewasa set 10 5,990 59,895
98 IV Catheter no 18 G pcs 10 9,191 91,905
99 IV Catheter No. 20 G pcs 10 9,191 91,905
100 IV Catheter No. 22 G pcs 10 9,191 91,905
101 Jarum extirpasi kotak 0 132,825 -
102 Kapas absorben 250 gram bks 0 27,651 -
103 Kasa hidrofil 36 y x 80 y rol 10 144,320 1,443,200
104 Kasa kompres 40y/40 cm bks 100 2,008 200,750
105 Kasa pembalut 2y x 80 cm rol 5 10,590 52,949
106 Kasa pembalut hidro 4y x 10 cm rol 200 2,593 518,540
107 Kasa steril 16 x 16 ktk 200 8,899 1,779,800
108 Masker Tie On set 3000 529 1,586,244
109 Needle carpule kotak 3 158,125 474,375
110 Plester berpori 5 cm x 5 m (Hypafic) rol 12 29,700 356,400
111 Plester kertas hipoalergenik uk 1 inci rol 12 22,000 264,000
112 Silk 3/0 ktk/12 24 16,648 399,553
113 Bisturi ktk/100 1 330,000 330,000
114 Dariantulle ktk/20 3 320,000 960,000
115 Oksigen 500 L tabung 12 50,000 600,000
116 masker Nebulizer GEA pediatrik 1173 buah 12 44,000 528,000
117 masker Nebulizer Adult 1172 buah 12 35,000 420,000
118 masker oksigen Adult buah 12 25,000 300,000
119 masker oksigen pediatrik buah 12 25,000 300,000
120 masker onemed buah 3000 800 2,400,000
121 masker N95 pcs 200 20,000 4,000,000
122 Silk 3/0 sachet 72 6,318 454,896
123 Spuit 10cc buah 5 1,800 9,000
124 Blood Lancet box 60 30,000 1,800,000
125 Spalk set 1 70,000 70,000
126 Doek lobang 30 cm x 30 cm box 3 240,000 720,000
127 Nelaton mateter semua ukuran kotak 1 90,000 90,000
128 H202 3 % botol 2 264,000 528,000
129 Larutan Klorin botol 30 12,000 360,000
130 Jelly KY botol 3 65,000 195,000
131 Pot salep buah 600 800 480,000
132 Plastik obat 8 x 13 cm kg 30 30,000 900,000
133 Strip glukosa box 36 390,000 14,040,000
134 Strip kolesterol box 24 455,000 10,920,000
135 Strip asam urat box 24 325,000 7,800,000
136 Strip HB box 8 528,000 4,224,000
137 Strip pregnancy box 4 130,000 520,000
138 Reagen golongan darah set 1 520,000 520,000
139 Strip Glukosa dan protein box 3 130,000 390,000
140 Strip Accu Check aktif glukosa botol 4 222,000 888,000
141 Metilen blue botol 1 54,000 54,000
142 Pot dahak box 3 339,200 1,017,600
143 Sputum kontainer buah 1 179,600 179,600
144 Tissue Labor bungkus 12 13,000 156,000
145 Intec box 1 1,500,000 1,500,000
146 Vikia box 2 625,000 1,250,000
147 Oncoprobe box 4 1,250,000 5,000,000
TOTAL Rp 166,787,314
KESMAS SAIL
BIS PAKAI + OBAT TAHUN 2016

JKN

-
242,660
199,573
919,600
379,500
1,650,000
774,576
51,150
715,000
266,200
748,000
4,400,000
8,250,000
3,685,000

173,250
220,000
614,460
-
69,300
132,990
36,249
2,200,000
-
-
1,045,000
277,970
33,541
-
-
102,850
4,356,000
2,480,500
2,544,960
86,900
1,210,000
44,000
-
35,420

885,170
686,796
2,477,475
495,000

6,050,000
1,512,500
72,105
86,394
2,359,500
1,419,000
318,208
-

-
-
-
-
-
-
-
1,100,000
1,320,000
381,150
489,500
3,135,000
3,085,500
213,675
353,100
1,815,000
1,039,500
1,201,750
1,980,000
2,163,150
 759,000
2,970,000
341,550
3,795,000
19,250
-
2,580,600
-
266,175
99,000
-
330,000
660,000
440,000
3,605,690
2,323,200
2,521,530
169,400
105,270
131,890
52,360
52,360
-
1,084,600
542,300
38,500
59,895
91,905
91,905
91,905
-
-
1,443,200
200,750
52,949
518,540
1,779,800
1,586,244
474,375
356,400
264,000
399,553
330,000
960,000
600,000
528,000
420,000
300,000
300,000
2,400,000
4,000,000
454,896
9,000
1,800,000
70,000
720,000
90,000
528,000
360,000
195,000
480,000
900,000
14,040,000
10,920,000
7,800,000
4,224,000
520,000
520,000
390,000
888,000
54,000
1,017,600
179,600
156,000
1,500,000
1,250,000
5,000,000
166,787,314
3600

4.0701754

12400

11979

12,100

6.5014577
 harga perkiraan sendiri

harga lama dari ifk

3,158

3,210

12,045