MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN

PERIODE JANUARI 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan % Kepatuhan
Obat Non Formularium yang dituliskan
Formularium RS Formularium Nasional ditelaah Formularium RS Formularium Nasional
1 57 35 58 98.28 60.34 Laviplex 1
2 154 100 157 98.09 63.69 Imboost kids 1, Pibaksin zalf 1, Cendo Fenicol
eye drop 1

3 125 99 139 89.93 71.22 Voltaren 1, Imboost kids 8, Nutridink 1,

Mediamer B6 1, Noremi 1, Calc 95 1, Silex 1
4 104 78 108 96.30 72.22 Imboost kids 3, Apialys syr 1
5 63 43 63 100.00 68.25 -

Imboost forte 1, Sulfas Atropin tab 1,

6 203 156 212 95.75 73.58 Fluomethalone 1, Uricran 1, Itrakonazol 1,
Caladin 1, Glaupen 1, Kenalog 1, Nebacetin
powder 1

7 170 114 180 94.44 63.33 Flamar gel 1, Sangobion 1, Aspart K, Respimer
baby 1, Tempra syr 1, Imboost kids 3, Primolut 1,
Hp-Pro 1

8 194 152 197 98.48 77.16

Multivitamin 1, Imboost kids 1, Lactacyd liq 1
9 189 156 193 97.93 80.83 Imboost kids 2, Irbensartan 2
10 142 98 151 94.04 64.90 Primolut 2, CaCO3, Vit E 1, Imboost kids 3
11 145 100 152 95.39 65.79 Sirplus simplex 1, Imboost kids 4, Imboost forte
1, Isoprinosine syr 1
12 66 51 66 100.00 77.27 -
13 202 152 204 99.02 74.51 PK 1, Magtral 1
14 185 125 190 97.37 65.79 Primolut 1, Imboost kids 1, Respimer nasal baby
1, Neurodex 2
15 191 133 192 99.48 69.27 Interlac
16 191 151 192 99.48 78.65 RG Choline tab 1
17 179 138 182 98.35 75.82 Respimer nasal baby 1, Imboost kids 1, Acyclovir
syr 1
18 112 88 112 100.00 78.57 -
19 90 66 90 100.00 73.33 -
20 199 140 205 97.07 68.29 Imboost kids 3, Uricran 1, Fluometholone 1,
Aquamaris baby 1
21 173 133 176 98.30 75.57 Imboost kids 2, Vit D 1
22 191 130 193 98.96 67.36 Betadin gargle 1, Imunos kids 1
23 205 125 206 99.51 60.68 Sirup Simplex 1,
24 81 67 87 93.10 77.01 Caviplex 1, Sterimer nasal baby 1, Hemabion 1,
Stimuno 1, Imboost kids 2
25 75 49 75 100.00 65.33 -
26 75 51 80 93.75 63.75 Ferlin syr 1, Ranitidin syr 1, Praxion 1, Kaolin
pectin syr 1, Primadex 1
27 229 165 237 96.62 69.62 Imboost kids 6, Vit E 1, Neurodex 1,
28 219 153 220 99.55 69.55 Imboost kids 1
Sterimer nasal baby 1, Primolut 1, Lisinopril
1, Fluometholone 1, Imboost kids 2,
29 186 122 196 94.90 62.24
Itrakunazole 1, Lacidofil 1, Vivity 1,
Lotio Caladin 1
30 269 185 269 100.00 68.77 -
31 155 106 159 97.48 66.67 Imboost kids 2, Polisilen 1, Scabimed 1
Total % Kepatuhan formularium 97.47 69.98
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE FEBRUARI 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan % Kepatuhan
Obat Non Formularium yang dituliskan
Formularium RS Formularium Nasional ditelaah Formularium RS Formularium Nasional
1 125 95 127 98.43 74.80 Imboost kids 1, Glucophage 1
2 88 63 89 98.88 70.79 Imunos 1
3 206 150 207 99.52 72.46 Albendazol 1

4 189 183 194 97.42 94.33 Digenta zalf 1, Sirplus simplex 1, Transpulmin 1,
Respirator nasal 1, Imboost kids 1
5 192 135 194 98.97 69.59 Imboost kids 2
6 186 134 193 96.37 69.43 Imboost 4, Respimer 2, Mebo salep 1

Imboost kids 5, CaCo3 1, Betadin gargle 1,

7 153 128 168 91.07 76.19 Alpara 1, Vit C 500 1, Sterimer nasal 2, Lactafar
1, Transpulmin 1, Sirplus simplex 1, Erdostein syr
1
Scabimed 1, Nasacort 2, Transpulmin 2, Imboost
8 111 80 117 94.87 68.38 kids 1, Respimer nasal 3, Glucophage xr 1,
Isprinol 1
9 95 63 98 96.94 64.29 Permethrin 1, Neurobion 1, Apialys syr 1

10 229 156 238 96.22 65.55 Imboost kids 2, Isprinol 2, Co-Amoxiclav 1,

Isoprinosin 1, Matovit 1, Optimax 1, C. Pitalmic 1
11 216 154 223 96.86 69.06 Imboost kids 4, Otilen 2, Rebamipid 1

12 180 136 187 96.26 72.73 Bubuk PK 1, Pioglitazone 1, Glaupen ed 1,

Imboost kids 1, Respimer 1, Rhinofed 1, Otilen 1
13 114 155 220 51.82 70.45 Imboost kids 3, FG Throces 1, Pioglitazone 1,
Sterimer 1
14 207 146 211 98.10 69.19 Microlac 1, Imboost kids 1, Sangobion 1, Apialys
syr 1
15 168 105 173 97.11 60.69 Imboost kids 4, Insto 1
16 93 71 94 98.94 75.53 Apialys syr 1
 Sirplus simplex 3, Imboost kids 4, Lactacyd baby
17 223 151 236 94.49 63.98 1, Vitrolenta 1, Sterimer nasal 1, Neurodex 1,
Floragyn 1, FG Troches 1

18 208 149 217 95.85 68.66 Primolut 1, Apialys syr 1, Imboost kids 2, Aspar-K
1, Glaupen ed 1, Rebamipid 1, Univit syr 2

Glaupen ed 4, Ibuprofen syr 1, Bubuk PK 1,

19 177 156 189 93.65 82.54 Imboost kids 2, Sirplus simplex 1, Imunped 1,
Lacidofil 1, C.Fenikol 1
20 199 166 207 96.14 80.19
Imboost kids 5, C.Fenikol 1, Catgae 1, Lacidofil 1,
21 181 145 183 98.91 79.23 Imboost kids 2
22 136 110 143 95.10 76.92 Imboost kids 5, Microlac 1, Counterpain 1
23 89 74 89 100.00 83.15 -
24 172 148 184 93.48 80.43 Interlac drop 1, Imboost kids 6, Herocyn bedak
1, Neurobion 3, Atopic cream 1
25 163 100 168 97.02 59.52 Imboost kids 3, Polisilane 2
26 235 8 243 96.71 3.29 Eye Vit 1, Imboost kids 6, Sterimer 1
Imboost 4, Nasal breathy 1, Otilen 1, Ranitidine
27 183 11 189 96.83 5.82 syr 1, Glucophage XR 1, Folamil 1, Duphaston 1,
Vit
Vit D3
E 1,1,Kenalog
Activedorabase
1 1, Harnal 1, Imboost
28 190 8 194 97.94 4.12 kids 4
29 149 15 150 99.33 10.00 Griseofuluin 1
Total % Kepatuhan formularium 95.28 63.49
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE MARET 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan % Kepatuhan
Obat Non Formularium yang dituliskan
Formularium RS Formularium Nasional ditelaah Formularium RS Formularium Nasional
1 80 60 80 100.00 75.00 -
2 218 165 224 97.32 73.66 Imboost kids 1, Actived 2, Lacidofil 1, Vivity 1,
Breathy 1
3 244 199 251 97.21 79.28 Atived 1, Imboost kids 4, Apialys syr 2
4 228 121 234 97.44 51.71 Retivit 1, Irbesartan 2, Glaupen ED 1, Respimer 1,
Imboost kids 1
5 203 124 213 95.31 58.22
Imboost kids 7, Rebamipid 1, Rhinos 1, Interlac 1
6 232 155 234 99.15 66.24 Analsik 1, Tempra 1
7 159 121 160 99.38 75.63 Tanapres 1
8 71 58 73 97.26 79.45 Sanadryl 1, Neurobion 1

9 236 219 245 96.33 89.39 Rhinos 1, Isprinol 1, Imboost 1, Isprinol 1, Retivit
2, Neurobion 1, Primolut 1, Bubuk PK 1
10 246 157 249 98.80 63.05 Sirplus simplex 1, CaCO3 1, Ibuprofen syr 1
11 191 133 192 99.48 69.27 Imboost force 1
Imboost kids 7, Sirplus simplex 1, Rhinos 1,
12 198 145 213 92.96 68.08 Aminophilin tab 1, Sterimer 1, Ambeven 1, HP
Pro 1, Apialys syr 1, Sangobion 1
13 208 178 214 97.20 83.18 Imboost kids 3, Sterimer 2, Pioglitazon 1
14 144 118 146 98.63 80.82 Rhinofed 1, Sangobion 1
15 99 68 101 98.02 67.33 Burnazin salp 1, Imboost kids 1
16 225 121 230 97.83 52.61 Rhinos 3, Imboost kids 1, Renovit 1
17 230 120 235 97.87 51.06 Imboost kids 4, Sanadryl 1
18 213 127 216 98.61 58.80 Glaupen ED 1, Imboost kids 1, Rhinofed 1
19 225 124 231 97.40 53.68 Imboost kids 2, Sirplus simplex 1, Rhinos 1,
Rebamipid 1, L-bio 1
20 193 127 199 96.98 63.82 Glaupen ED 1, Tebokan 1, Imboost kids 2,
Sterimer 1, Snecta 1
21 143 114 146 97.95 78.08 Imboost kids 2, Rebamipid 1
22 60 38 60 100.00 63.33 -
23 176 110 184 95.65 59.78 Imboost kids 4, Rhinofed 1, Lacidofil 1, Breathy 1,
Sanadryl 1, Polysilane 1
24 186 112 190 97.89 58.95 Sterimer 1, Polysilane 1, Imboost kids 1, Primolut
1
25 62 55 62 100.00 88.71 -
26 199 107 199 100.00 53.77 -
27 155 117 156 99.36 75.00 Dystonia 1
28 100 75 100 100.00 75.00 -
29 67 49 67 100.00 73.13 -
30 124 114 127 97.64 89.76 Bubuk pk 1, Theragran 1, Primadex 1
31 117 111 120 97.50 92.50 Amoxiclav 1, Herbeser 1, Isoprinosin 1
Total % Kepatuhan formularium 98.04 69.94
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE APRIL 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan % Kepatuhan
Obat Non Formularium yang dituliskan
Formularium RS Formularium Nasional ditelaah Formularium RS Formularium Nasional
1 119 100 121 98.35 82.64 Imboost kids 2
2 128 92 129 99.22 71.32 Urispas 1
3 135 96 137 98.54 70.07 Lipiton 1, Tebokan 1
4 90 78 91 98.90 85.71 Isoprinosin 1
5 48 38 49 97.96 77.55 Urivit syr 1
6 136 116 142 95.77 81.69 Vit E 1, Apialys syr 1, Becefat syr 1, Polynel 1,
Polysilane 1, Retivit 1
7 133 98 135 98.52 72.59 Imboost kids 1, Polysilane 1
8 115 100 116 99.14 86.21 Sanadrin 1
9 146 111 147 99.32 75.51 CaCO3
10 52 40 53 98.11 75.47 Isoprinosin 1
11 87 77 88 98.86 87.50 Apialys syr 1
12 38 30 38 100.00 78.95 -
13 125 112 129 96.90 86.82 Dulcolax supp 1, Polysilane 1, Rebamipid 1,
CaCO3, Ambeven 1
14 128 98 129 99.22 75.97 Sterimer nasal 1
15 138 100 141 97.87 70.92 Cavit D3 1, Becom-z 1, Ferlin syr 1
16 138 102 141 97.87 72.34 Rebamipid 1, Callusol 1, Polysilane
17 105 80 105 100.00 76.19 -
18 97 55 99 97.98 55.56 Claritromicin 1, Folamil 1
19 47 25 47 100.00 53.19 -
20 143 99 143 100.00 69.23 -
21 109 98 110 99.09 89.09 Polysilane 1
22 98 65 98 100.00 66.33 -
23 110 100 110 100.00 90.91 -
24 93 75 95 97.89 78.95 Gom 1, Imunped 1
25 69 59 69 100.00 85.51 -
26 32 18 35 91.43 51.43 isoprinosin 1, Rebamipid 1
27 94 88 96 97.92 91.67 Imboost kids 1, Pk 1
28 113 97 113 100.00 85.84 -
29 102 95 105 97.14 90.48 Amoxiclav 1, Imunped 1, Caladin lot 1
30 103 87 104 99.04 83.65 Herocyn bedak 1
Total % Kepatuhan formularium 98.50 77.31
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE MEI 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan % Kepatuhan
Obat Non Formularium yang dituliskan
Formularium RS Formularium Nasional ditelaah Formularium RS Formularium Nasional
1 32 25 32 100.00 78.13 -
2 63 55 63 100.00 87.30 -
3 35 24 37 94.59 64.86 Apialys syr 2
4 93 88 93 100.00 94.62 -
5 137 113 137 100.00 82.48 -
6 128 120 128 100.00 93.75 -
7 40 21 40 100.00 52.50 -
8 103 87 105 98.10 82.86 Onbrez 1, CaCO 1
9 54 35 56 96.43 62.50 Apialys syr 1, Pedialite syr 1
10 35 29 35 100.00 82.86 -
11 106 99 108 98.15 91.67 Caladin lot, Zamed
12 120 100 122 98.36 81.97 CaCO3, Ambeven
13 121 100 124 97.58 80.65 Glaupen ED, Amoxiclave, JF Sulfur
14 88 70 89 98.88 78.65 Becom C
15 98 68 102 96.08 66.67 Sanbe Tears ED, Imboost syr, Sirplus,
Rebamipid 2
16 74 60 75 98.67 80.00 Ambeven
17 38 30 38 100.00 78.95 -
18 99 90 106 93.40 84.91 Sirplus 1, Primolut 1, Oscipit 1, Bcom C 2,
Imboost syr 1, Polysilane 1
19 122 98 122 100.00 80.33 -
20 94 78 99 94.95 78.79 Vit E, HP-Pro, Sisterol, Curvit, Primolut
21 28 20 29 96.55 68.97 Coconut oil
22 94 78 95 98.95 82.11 Imunped
23 77 60 78 98.72 76.92 Imboost force
24 60 44 60 100.00 73.33 -
25 54 49 54 100.00 90.74 -
26 137 112 138 99.28 81.16 Microginum
27 109 83 113 96.46 73.45 Imunped, Praxion, Imboost, Uricran
28 102 80 104 98.08 76.92 Tempra, Primolut
29 98 62 99 98.99 62.63 Glaupen ED
30 86 72 86 100.00 83.72 -
31 23 12 24 95.83 50.00 Caviplex
Total % Kepatuhan formularium 95.23 75.95 -
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE JUNI 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan % Kepatuhan Formularium
Formularium RS Formularium Nasional ditelaah Formularium RS Nasional Obat Non Formularium yang dituliskan

1 46 41 48 95.83 85.42 Selkom C 1, Neurobion 1

2 136 109 139 97.84 78.42 Curcuma plus 1, Hemobion 1, Zegavit 1
3 146 125 152 96.05 82.24 Curcuma plus 4, Imunos 1, Neurobion 1
4 136 114 138 98.55 82.61 Curvit 1, Tempra 1
5 125 104 128 97.66 81.25 Celebrex, Ferlin, Anoxi
6 76 78 112 67.86 69.64 Co Amox, Folamil Genio
7 34 36 42 80.95 85.71 Caladin Lot, Caviplex
8 110 111 129 85.27 86.05 FG Throces
9 126 98 130 96.92 75.38 HP Pro, Rebamipid, Transpulmin BB, CaCO3
10 109 101 113 96.46 89.38 Renivit 2, Genta salep mata, Isprinol syr
11 160 131 161 99.38 81.37 Lisinopril
12 129 104 129 100.00 80.62 -
13 86 65 87 98.85 74.71 Imboost syr
14 42 40 43 97.67 93.02 Milmor
15 124 97 128 96.88 75.78 Ambeven, Pisane, Folamil Genio, Vometa

16 125 87 132 94.70 65.91 Celebrex, Tebokan, Co Amox, Imboost kids, Nebacetin,
Irbensartan, Recolfar

17 105 84 112 93.75 75.00 Polysilane, Retivit, Interlac, Rebamipid, Apialys syr,
Desoximetason krim, Vometa drop
18 124 101 125 99.20 80.80 Viaqra
19 156 68 156 100.00 43.59 Polysilane, Ambeven
20 89 17 91 97.80 18.68 Scabimed, Caviplex
21 112 107 112 100.00 95.54 -
22 111 90 112 99.11 80.36 Cal 95
23 105 105 107 98.13 98.13 Primolut, Co Amox
24 122 100 124 98.39 80.65 Curvit, Polynel
25 107 78 109 98.17 71.56 Rebamipid, Esthero
26 107 58 108 99.07 53.70 Co Amox
27 83 27 85 97.65 31.76 Pregabalin, Rebamipid
28 33 30 33 100.00 90.91 -
29 106 93 108 98.15 86.11 Betadin gargle, Irbesartan
30 97 76 97 100.00 78.35 -
Total % Kepatuhan formularium 96.01 75.75
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE JULI 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan
Formularium RS Formularium Nasional ditelaah Formularium RS

1 114 101 122 93.44

2 125 89 126 99.21
3 134 111 134 100.00
4 116 94 117 99.15
5 30 27 30 100.00
6 112 90 118 94.92
7 139 104 142 97.89
8 156 139 159 98.11
9 105 86 109 96.33
10 115 105 117 98.29
11 94 64 95 98.95
12 58 50 58 100.00
13 124 105 126 98.41
14 138 104 140 98.57
15 138 127 139 99.28
16 130 113 132 98.48
17 86 78 89 96.63
18 83 70 86 96.51
19 15 10 16 93.75
20 145 126 147 98.64
21 118 89 121 97.52
22 101 73 102 99.02
23 110 82 110 100.00
24 102 82 104 98.08
25 47 42 48 97.92
26 25 22 25 100.00
27 145 127 147 98.64
28 104 81 104 100.00
29 135 118 138 97.83
30 115 90 117 98.29
31 34 31 34 100.00
Total % Kepatuhan formularium 98.19
MULARIUM RSUD MATRAMAN
ULI 2020

oring kepatuhan

% Kepatuhan Formularium
Obat Non Formularium yang dituliskan
Nasional

82.79 Retivit 3, Glaupen ed 2, Bubuk PK 1, Apialys

syr 1
70.63 Lactacyd baby liq 1
82.84 -
80.34 Rebamipid 1
90.00 -
76.27 Retivit 2, Co-Amoxi 1, Bufaco orabase 1,
Ferlin 1, Folamil 1
73.24 Caviplex 1, Vitrolenta 1, Eye vit 1
87.42 Tempra drop 1, Kenacord 1, Minosep 1
78.90 Vit D, CaCO3, Amoxiclav, Rebamipid
89.74 Imboost, Rebamipid
67.37 Lactacyd
86.21 -
83.33 Imboost, Neurobion
74.29 Imboost 2
91.37 Retivit
85.61 Anvoner, Caviplex
87.64 Cal 95, Claneksi
81.40 Neurobion, Gastrucid, Gom
62.50 Microlax supp
85.71 Bubuk Pk, Retivit
73.55 Jf sulfur 2, Imboost
71.57 Retivit
74.55 -
78.85 Celebrex 2
87.50 Scabimed
88.00 -
86.39 Lactacyd, Norit
77.88 -
85.51 Neurobion, Imboost, Microgest
76.92 Cal 95, Imunped
91.18 -
80.95
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE AGUSTUS 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan
Formularium RS Formularium Nasional ditelaah Formularium RS
1 83 73 83 100.00
2 30 25 30 100.00
3 153 139 154 99.35
4 137 113 139 98.56
5 101 90 104 97.12
6 152 129 155 98.06
7 99 83 101 98.02
8 94 69 97 96.91
9 39 35 39 100.00
10 143 131 149 95.97

11 176 139 178 98.88

12 132 106 139 94.96

13 133 111 133 100.00
14 130 98 130 100.00
15 96 80 98 97.96
16 46 41 48 95.83
17 35 32 37 94.59
18 196 159 197 99.49
19 148 133 154 96.10
20 56 50 56 100.00
21 130 109 132 98.48
22 108 94 109 99.08
23 36 32 38 94.74
24 153 138 156 98.08
25 177 152 179 98.88
26 99 75 105 94.29
27 136 108 136 100.00
28 107 96 110 97.27
29 90 66 91 98.90
30 36 36 40 90.00
31 137 115 139 98.56
Total % Kepatuhan formularium 97.72
ORMULARIUM RSUD MATRAMAN
AGUSTUS 2020

nitoring kepatuhan

% Kepatuhan Formularium
Obat Non Formularium yang dituliskan
Nasional
87.95 -
83.33 -
90.26 Bubuk pk
81.29 Aspar K, Sangobion
86.54 Retivit 3
Pantoprazol tab, Inpepsa, Rebamipid, Dexteem
83.23
plus
82.18 Eyefresh, Dulcolac syr
71.13 Microlac, Vit E 2
89.74 -
87.92 Co Amoxiclav 3, Retivit, Rebamipid 2
78.09
Aspar K, Neurobion
76.26 Eyefresh, Retivit, Infantrim, Imboost syr 2, CaCO3,
Co Amoxiclav
83.46 -
75.38 -
81.63 Kenalog, Vit E, Vit D3 1000
85.42 Vit E, Renalit, Univit
86.49 Isprinol, Vit E
80.71 Aspar K
86.36 Imboost force 2, Eyefresh, Retivit, Linkomisin syr
89.29 -
82.58 Imboost, Garamycin
86.24 Imunped
84.21 Boraginol, Neurobion inj
88.46 Polysilane, Zegavit, Ambeven
84.92 Polysilane, Rebamipid
71.43 Retivit 4, Co Amoxiclav, Floragyn
79.41 -
87.27 Retivit 2, Imunped
72.53 Co Amoxiclav
90.00 Ambeven, Vit E 400 IU, Imunped, Rebamipid
82.73 Eyefresh, C. Polynel
83.12
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE SEPTEMBER 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan
Formularium RS Formularium Nasional ditelaah Formularium RS

1 152 132 153 99.35

2 113 106 121 93.39
3 152 124 153 99.35
4 110 101 114 96.49
5 91 74 92 98.91
6 33 29 33 100.00
7 150 134 150 100.00
8 159 147 161 98.76
9 96 85 98 97.96
10 121 94 125 96.80
11 125 103 125 100.00
12 108 80 109 99.08
13 49 47 50 98.00
14 145 130 145 100.00
15 156 141 160 97.50

16 109 99 114 95.61

17 102 88 103 99.03
18 124 108 125 99.20
19 81 66 82 98.78
20 46 46 47 97.87
21 147 136 153 96.08
22 124 115 126 98.41
23 123 101 128 96.09
24 134 126 134 100.00
25 91 83 93 97.85
26 62 61 67 92.54
27 29 25 30 96.67
28 116 99 119 97.48
29 160 128 163 98.16
30 123 115 129 95.35
Total % Kepatuhan formularium 97.82
3402
 ARIUM RSUD MATRAMAN
BER 2020

g kepatuhan

% Kepatuhan
Obat Non Formularium yang dituliskan
Formularium Nasional

86.27 Vit D3 1000 IU

87.60 Flumekholon, Retivit 2, Vit E, Betadin Gargle,
Polynel, Glaupen ED
81.05 Rebamipid
88.60 Cal 95, Retivit plus, CoAmox, Rebamipid
80.43 Smecta
87.88 -
89.33 -
91.30 Retivit, Vitrolenta, Smecta
86.73 Imboost syr, Aspar K
75.20 Rebamipid, Lisinopril 2, Vit D3 1000 IU, Vit E
400 IU
82.40 -
73.39 Combantrin
94.00 Vectrin
89.66
88.13 Imboost syr, Vitrolenta, Curviplex tab,
Scabiad
86.84 Candistatin, Celebrex, Fulidic acid, Vit E,
CoAmox
85.44 Fluimucil
86.40 Ultracet
80.49 Vit E 400 IU
97.87 Pedyalite
88.89 Vit E 400 IU, Vit D3 1000, AsparK, PK,
Sterimer, Betadin gargle, CoAmox
91.27 Natacimin, Imboost syr
78.91 Retivit 2, Lactacyd liq, Celebrex, AsparK
94.03
89.25 Obat Cacing, Vit E
91.04 Polysilane, Folamil, Cavit D3, Maltofer,
Imboost syr, Vit E, Etabion
83.33 Vit D3, Vit E
83.19 Glaupen, Glauplus, Cygest
78.53 C. Asthenof, Retivit, Smecta
89.15 Retivit, Polynel, Vitrolenta, Aspar-K,
Glauplus, Ferrin
86.22
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE OKTOBER 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan
Formularium RS Formularium Nasional ditelaah Formularium RS
1 155 128 157 98.73
2 96 69 98 97.96
3 102 90 106 96.23
4 20 19 22 90.91
5 120 108 127 94.49
6 115 80 116 99.14
7 133 118 133 100.00
8 130 107 131 99.24
9 94 84 96 97.92
10 66 55 67 98.51
11 30 26 30 100.00
12 77 72 78 98.72

13 65 56 68 95.59

14 55 49 55 100.00
15 78 67 79 98.73
16 29 25 29 100.00
17 94 84 96 97.92
18 18 16 18 100.00
19 170 145 174 97.70
20 182 163 183 99.45
21 117 87 118 99.15
22 135 109 137 98.54
23 103 86 105 98.10
24 82 65 84 97.62
25 43 37 43 100.00
26 62 48 65 95.38
27 147 133 147 100.00
28 124 115 124 100.00
29 42 38 42 100.00
30 77 71 80 96.25
31 79 72 80 98.75
Total % Kepatuhan formularium 98.21
FORMULARIUM RSUD MATRAMAN
OKTOBER 2020

onitoring kepatuhan
% Kepatuhan
Obat Non Formularium yang dituliskan
Formularium Nasional
81.53 Sangobion, Rebamipid
70.41 Isoprinosin, Retivit
84.91 Pregabalin, Cygest 400mg, Vit E, Vit D3
86.36 Vit E, Rebamipid
85.04 Retivit, Amoxiclav, Sanorin gargle, Vit D3
68.97 Sterimer
88.72 -
81.68 VIP Albumin
87.50 Zink oint, Rebamipid
82.09 Folamil genio
86.67 -
92.31 CaCO3
Spasminal, Ericaf, Celestamin, Metamizol inj, Neurobion
82.35
inj
89.09 -
84.81 Antrain inj
86.21 -
87.50 Folamil genio, Polysilane
88.89 -
83.33 Glaupen, Gastrucid, Cygest, Dibekacin
89.07 Transofix
73.73 Vit D3, Vit E
79.56 Transpulmin balsem, Celebrex
81.90 Glaupen, Aspar K
77.38 Recansa, Scabimit
86.05 -
73.85 Neurobion, Celebrex, Folamil Genio
90.48 -
92.74 -
90.48 -
88.75 Imboost syr 2, Dexa salep 1
90.00 Folamil Genio, Cygest
84.08
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE NOVEMBER 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan
Formularium RS Formularium Nasional ditelaah Formularium RS

1 36 28 37 97.30
2 140 125 144 97.22
3 173 148 174 99.43
4 152 140 155 98.06
5 135 116 137 98.54
6 105 97 109 96.33
7 98 81 99 98.99
8 46 39 47 97.87
9 134 125 137 97.81
10 176 148 181 97.24
11 165 145 168 98.21
12 249 229 252 98.81
13 134 117 137 97.81
14 76 71 79 96.20
15 57 50 57 100.00
16 116 96 121 95.87
17 172 150 173 99.42
18 160 139 162 98.77
19 168 139 170 98.82
20 146 120 152 96.05
21 117 98 118 99.15
22 42 38 42 100.00
23 184 156 189 97.35
24 164 144 168 97.62

25 123 115 129 95.35

26 124 97 126 98.41
27 137 114 139 98.56
28 123 112 124 99.19
29 36 33 36 100.00
30 137 118 143 95.80
Total % Kepatuhan formularium 98.01
ULARIUM RSUD MATRAMAN
MBER 2020

ing kepatuhan

% Kepatuhan
Formularium Nasional Obat Non Formularium yang dituliskan

75.68 Isprinol syr

86.81 Bubuk PK, Vit D3, Vit E, Caviplex
85.06 Rebamipid
90.32 Aspar K, NACL kaps, Rebamipid
84.67 Co-Amox, Becombiyon
88.99 Glaupen, Polysilane, Spasminal, Isoprinol
81.82 CaCO3
82.98 Vit E, Vit D
91.24 Aspar K, Retivit
81.77 Aspar K, Co-Amoxiclav, Becombion, Betadin
Gargle
86.31 Zegavit, Retivit
90.87 Cygest, Celebrex, Sterimar Nasal Spray
85.40 Isoprinosin, Cotri Forte, Nacl kaps
89.87 Folamil, Rebamipid, Cygest 400
87.72 -
79.34 AsparK, Celebrex, Sanorin, Uricran
86.71 Caladin
85.80 Vit E 250 IU, Chloramfecort
81.76 Sirplus syr, CaCO3
78.95 Avodart, Fc-Throces, Polysilane, Celebrex,
Amoxiclav, Counterpain
83.05 Vit D
90.48 -
82.54 Flukonazol inj, Retivit, Glaupen ED
85.71
Univit syr, Glaupen ED, Vit D, Vit E, Rebamipid
89.15 Retivit, Glaupen ED, AsparK, Univit syr,
Amoxiclav
76.98 Celebrex, Combantrin
82.01 Glaupen ED
90.32 Valacyclovir, Zegavit
91.67 -
82.52 Retivit, Celebrex, Vit E, Vit D
85.22
 MONITORING KEPATUHAN FORMULARIUM RSUD MATRAMAN
PERIODE DESEMBER 2020

Monitoring kepatuhan
Tanggal Total Resep Sesuai Total Resep Sesuai Total resep yg % Kepatuhan
Formularium RS Formularium Nasional ditelaah Formularium RS
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ARIUM RSUD MATRAMAN
ER 2020

kepatuhan
% Kepatuhan Obat Non Formularium yang
Formularium Nasional dituliskan
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Laporan Indikator mutu rumah sakit
Indiaktor : Pemberian Pelayanan Informasi Obat (PIO) kepada pasien rawat jalan dengan diagnosa Diabetes Mellitus (DM) sebesar 100%
Sat kerja : Farmasi
Tahun : 2019

Juli Agustus September Oktober Mei Juni

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