Data Puskesmas

1 Nama Puskesmas
Kecamatan
Alamat
2 Nama Kapala Puskesmas
NIP
Nomor Telepon
3 Nama Petugas Pengelola Obat
NIP
Nomor Telepon
4 Jumlah Kunjungan
2016
2017
2018
Dana yang Dialokasikan BPJS
 2017

SUKARAJA
SUKARAJA
Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
dr. H. Eddy Ramdhan
19660415 200604 1 011
81809343707
Winti Agustina, [Link]., Apt.
19800817 201001 2 017
81563113739

43585
38681

Rp. 450.533.544
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)
PUSKESMAS SUKARAJA PELAPORAN BULAN Januari
KECAMATAN SUKARAJA TAHUN 2017
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI STOK STOK PERMINT PEMBERIAN
OPTIMU
AWAL AAN AN AN AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
OBAT 0 0 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0 0 0
2 Allupurinol 100 mg Tablet Tab 0 0 0 0 0
3 Aloclair plus gel BOTOL 0 0 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0 0 0
5 Aminophylin tablet 200mg Tab 0 0 0 0 0
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0 0 0
7 Amlodipin 5 mg Tab 0 0 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0 0 0
20 Antiparkinson DOEN Tab 0 0 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0 0 0
28 Asiklovir Krem 5% tube 0 0 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0 0 0
35 Betahistin maleat Tab 0 0 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0 0 0
38 Captopril 12,5 mg Tab 0 0 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0 0 0
50 Domperidon Syrup BOTOL 0 0 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0 0 0
74 Haloperidol 5 mg Tab 0 0 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0 0 0
82 Kalsium alginate gel tube 0 0 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0 0 0
 91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0 0 0
104 Lidokain inj. 2% ampul 0 0 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0 0 0
111 Metilergometrin Maleat injeksi 0,200 mg - 1ml ampul 0 0 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0 0 0
113 Metilprednisolon tablet Tab 0 0 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0 0 0
118 Miconazol SK tube 0 0 0 0 0
119 Multivitamin sirup BOTOL 0 0 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0 0 0
129 Omeprazol 20mg Tab 0 0 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0 0 0
131 parasetamol drop BOTOL 0 0 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0 0 0
133 Parasetamol sirup BOTOL 0 0 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0 0 0
139 Probiokid kapsul 0 0 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0 0 0
160 Simvastatin 20 mg Tab 0 0 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0 0 0
0BAT PROGRAM HIV 0 0 0 0 0
1 EFAVIRENS tablet 0 0 0 0 0
2 HIVIRAL 0 0 0 0 0
3 NEVIRAL 0 0 0 0 0
4 ATRIPLA 0 0 0 0 0
5 TENOFAVIR 0 0 0 0 0
6 DUVIRAL 0 0 0 0 0
7 ZIDOVUDINE/ 0 0 0 0 0
PROGRAM KUSTA 0 0 0 0 0
1 MB DEWASA Tab 0 0 0 0 0
2 PB DEWASA Tab 0 0 0 0 0
3 MB ANAK Tab 0 0 0 0 0
PROGRAM TBC 0 0 0 0 0
1 OAT FDC Anak Tab 0 0 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0 0 0
PROGRAM IMUNISASI 0 0 0 0 0
1 VAKSIN BCG 0 0 0 0 0
 2 vaksin DPT-HB-Hib 0 0 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0 0 0
4 Vaksin CAMPAK 0 0 0 0 0
5 vaksin HB-O 0 0 0 0 0
6 Vaksin Td 0 0 0 0 0
7 Vaksin IPV 0 0 0 0 0
SERUM 0 0 0 0 0
1 ABU 0 0 0 0 0
2 ADS 0 0 0 0 0
3 ATS 0 0 0 0 0
4 RABIES 0 0 0 0 0
CAIRAN 0 0 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0 0 0
BHP 0 0 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0 0 0
4 Alkohol Swab box 0 0 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0 0 0
7 Bioplasenton tulle Pcs 0 0 0 0 0
8 bloodset Pcs 0 0 0 0 0
9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0 0 0
Handscoon Non Steril 0 0 0 0 0
15 Ukuran L Pcs 0 0 0 0 0
16 Ukuran M Pcs 0 0 0 0 0
17 Ukuran S Pcs 0 0 0 0 0
Handscoon steril 0 0 0 0 0
18 Ukuran 6.5 Pcs 0 0 0 0 0
19 Ukuran 7.0 Pcs 0 0 0 0 0
20 Ukuran 7.5 Pcs 0 0 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0 0 0
23 Infusion set anak Pcs 0 0 0 0 0
24 Infusion set dewasa Pcs 0 0 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0 0 0
28 Kapas 250 gr Pcs 0 0 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0 0 0
34 Masker Pcs 0 0 0 0 0
35 Plester Pcs 0 0 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0 0 0
40 Urine bag Pcs 0 0 0 0 0
BHP GIGI 0 0 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0 0 0
5 Formokresol Cairan BOTOL 0 0 0 0 0
 6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0 0 0
9 Lidokain gel BOTOL 0 0 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0 0 0
11 Mummifying Pasta Botol 0 0 0 0 0
12 Polikresulen cairan POT 0 0 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0 0 0
DESINFECTAN 0 0 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0 0 0
3 Gel untuk cateter Btl 0 0 0 0 0
4 Lisol 1 liter Btl 0 0 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 890 0 890 100
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 440 0 440 30
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
 52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
 Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN februari
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 730 0 0
0 0 0 0
0 0 0 0
410 410 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
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0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN maret
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN april
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN mei
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN juni
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN juli
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN agustus
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN september
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
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0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN oktober
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
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0 0 0 0
0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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0 0 0 0
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 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN STOK PENERIM PERSEDIA PEMAKAI
AWAL AAN AN AN
OBAT 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730
3 Aloclair plus gel BOTOL 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 0 410
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0
7 Amlodipin 5 mg Tab 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 0 0 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 0 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 0 0
14 Antasida Suspensi 60 ml BOTOL 0 0 0
15 Antasida DOEN tablet kombinasi Tab 0 0 0
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 0 0 0
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 0 0 0
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 0 0 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0
28 Asiklovir Krem 5% tube 0 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 0 0 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 0 0
36 Betametasone Krim 0.1% tube 0 0 0
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 0 0 0
39 Captopril tablet 25 mg Tab 0 0 0
40 Ciprofloksasin 500 mg tablet Tab 0 0 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 0 0 0
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
 82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 5 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid kapsul 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 4 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
 0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Pcs 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0
BAR PERMINTAAN OBAT (LPLPO)
PELAPORAN BULAN november
TAHUN 2017
.1 Km. 5 Desa Sukaraja
STOK STOK PERMINT PEMBERIAN
OPTIMU
AKHIR M AAN BPJS APBD PROGRAM LAIN2 JUMLAH
0 0 0 0
0 0 0 0
730 0 -730 0
0 0 0 0
0 0 0 0
410 0 -410 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0

0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
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0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

PUSKESMAS : CIJANGKAR LAPORAN BULAN : desember

KECAMATAN : CIJANGKAR TAHUN : 2018
ALAMAT : [Link] km12,5,desa cijangkar,[Link]
NO NAMA OBAT SATUAN STOK AWAL PENERIM PERSEDIAAN PEMAKAIAN STOK AKHIR STOK PERMINTAA
PEMBERIAN

AAN OPTIMUM N BPJS APBD PROGRAM LAIN2 JUMLAH

OBAT 0 0 0 0 0 0 0 0
1 Albendazol tablet 400 mg Tab 0 0 0 0 0 0 0 0
2 Allupurinol 100 mg Tablet Tab 730 0 730 0 730 0 -730 0
3 Aloclair plus gel BOTOL 0 0 0 0 0 0 0 0
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0 0 0 0 0 0
5 Aminophylin tablet 200mg Tab 470 0 470 20 450 450 0 0
6 Amitriptilin HCl tablet salut 25 mg Tab 0 0 0 0 0 0 0 0
7 Amlodipin 5 mg Tab 0 0 0 0 0 0 0 0
8 Amoksisilin kaplet 500 mg kaplet 2860 0 2860 2240 620 620 10,000 0
9 Amoksisilin kapsul 250 mg KAPSUL 0 0 0 0 0 0 2000 0
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 804 0 804 113 691 691 1000 0
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0 0 0 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0 0 0 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 500 0 500 60 140 140 0 0
14 Antasida Suspensi 60 ml BOTOL 190 0 190 32 158 158 100 0
15 Antasida DOEN tablet kombinasi Tab 19900 0 19900 1412 18,488 18,488 0 0
16 Anti Bakteri DOEN salep kombinasi tube 20 0 20 5 15 15 100 0
17 Anti fungi DOEN komb sk tube 0 0 0 0 0 0 0 0
18 Anti Hemoroid DOEN kombinasi supp 50 0 50 10 40 40 50 0
19 Antimigren DOEN kombinasi Tab 0 0 0 0 0 0 0 0
20 Antiparkinson DOEN Tab 2200 0 2200 260 1940 1940 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0 0 0 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0 0 0 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0 0 0 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 5850 0 5850 237 5613 5613 0 0
25 asam folat tablet 1 mg Tab 0 0 0 0 0 0 0 0
26 Asam mefenamat 500 mg kaplet 1550 0 1550 730 820 820 5000 0
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 0 0 0 0 0 0 0
28 Asiklovir Krem 5% tube 45 0 45 2 43 43 0 0
29 Asiklovir tablet 200 mg Tab 0 0 0 0 0 0 0 0
30 Asiklovir Tablet 400 mg Tab 0 0 0 0 0 0 1000 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0 0 0 0 0 0
33 Attalpugite tab 600 mg Tab 641 0 641 205 436 436 1000 0
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0 0 0 0 0 0
35 Betahistin maleat Tab 0 0 0 0 0 0 2000 0
36 Betametasone Krim 0.1% tube 51 0 51 37 14 14 100 0
37 Bisakodil Supp 10 mg supp 0 0 0 0 0 0 0 0
38 Captopril 12,5 mg Tab 0 0 0 0 0 0 0 0
39 Captopril tablet 25 mg Tab 100 0 100 100 0 0 2000 0
40 Ciprofloksasin 500 mg tablet Tab 650 0 650 150 500 500 1000 0
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0
42 Deksametasone tablet 0.5mg Tab 6850 0 6850 1841 5009 5009 5000 0
43 Diasepam 5 mg tablet Tab 0 0 0 0 0 0 400 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0 0 0 0 10 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0 0 0 0 5 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0 0 0 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0
48 Digoksin tablet 0,25 mg Tab 390 0 390 40 350 350 0 0
49 Doksisiklin 100 mg ampul 0 0 0 0 0 0 0 0
50 Domperidon Syrup BOTOL 90 0 90 12 78 78 0 0
51 Domperidon tablet 10 mg Tab 270 0 270 230 40 40 1000 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0 0 0 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0 0 0 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0 0 0 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0 0 0 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0 0 0 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0 0 0 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 550 0 550 50 500 500 1000 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0 0 0 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0 0 0 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0 0 0 0 500 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0 0 0 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0 0 0 0 1000 0
65 Garam oralit 200 ml air sachet 1950 0 1950 150 1800 1800 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0 0 0 0 0 0
67 Gentamisin tetes mata BOTOL 40 0 40 10 30 30 100 0
68 Glibenklamid tablet 5 mg Tab 900 0 900 150 750 750 1000 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0 0 0 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0 0 0 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 800 0 800 150 650 650 0 0
72 Haloperidol 0,5 mg tablet Tab 500 0 500 150 350 350 0 0
73 Haloperidol 1,5 mg tablet Tab 3000 0 3000 150 2850 2850 0 0
74 Haloperidol 5 mg Tab 2200 0 2200 200 2000 2000 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0 0 0 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0 0 0 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0 0 0 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0 0 0 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0 0 0 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0 0 0 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 350 0 350 50 300 300 300 0
82 Kalsium alginate gel tube 0 0 0 0 0 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0 0 0 0 0 0
84 Kalsium lakate (kalk) tablet Tab 2750 0 2750 270 2480 2480 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0 0 0 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0 0 0 0 0 0
87 Ketokonazol krim 2 % tube 10 0 10 10 0 0 200 0
88 Ketokonazol Tablet 200 mg Tab 100 0 100 100 0 0 2000 0
89 Klindamicin 300 mg KAPSUL 0 0 0 0 0 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0 0 0 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 2250 0 2250 450 1800 1800 1000 0
 92 Kloramfenikol salep kulit 2% (bufacetin) tube 30 0 30 16 4 4 100 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 24 0 24 20 4 4 100 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0 0 0 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 3500 0 3500 2091 1409 1409 10000 0
96 Klorpromazin HCL tablet 100 mg Tab 7000 0 7000 500 6500 6500 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0 0 0 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0 0 0 0 0 0
99 Kotrimoksazol forte tablet Tab 1290 0 1290 390 900 900 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 501 0 501 110 391 391 100 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0 0 0 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0 0 0 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0 0 0 0 0 0
104 Lidokain inj. 2% ampul 80 0 80 20 60 60 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0 0 0 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0 0 0 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0 0 0 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0 0 0 0 0 0
109 Metformin tablet 500 mg Tab 350 0 350 160 190 190 1000 0
110 metil dopa tab 250 mg Tab 0 0 0 0 0 0 0 0
111 Metilergometrin Maleat injeksi 0,200 mg - 1ml ampul 0 0 0 0 0 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 90 0 90 20 70 70 500 0
113 Metilprednisolon tablet Tab 200 0 200 110 90 90 1000 0
114 Metoklorpropamid tablet 5 mg Tab 100 0 100 100 0 0 1000 0
115 Metronidazol sirup 125mg/5ml BOTOL 90 0 90 6 84 84 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0 0 0 0 0 0
117 Metronidazol tablet 500 mg Tab 600 0 600 120 480 480 0 0
118 Miconazol SK tube 20 0 20 20 0 74 150 0
119 Multivitamin sirup BOTOL 0 0 0 0 0 0 100 0
120 Multivitamin Tablet Dewasa Tab 0 0 0 0 0 0 1000 0
121 Natrium bikarbonat tablet 500 mg Tab 1860 0 1860 160 1700 1700 0 0
122 Natrium Diklofenac 25 mg Tab 850 0 850 385 465 465 2000 0
123 Nifedifin tablet 10 mg Tab 0 0 0 0 0 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0 0 0 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0 0 0 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 115 0 115 60 55 55 200 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0 0 0 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 90 0 90 20 70 70 100 0
129 Omeprazol 20mg Tab 260 0 260 260 0 0 1000 0
130 Ondansentron tab 8 mg Tab 0 0 0 0 0 0 0 0
131 parasetamol drop BOTOL 0 0 0 0 0 0 0 0
132 Parasetamol kaplet 500 mg Tab 21800 0 21800 4671 17129 17129 10000 0
133 Parasetamol sirup BOTOL 250 0 250 104 146 146 200 0
134 Permetrin/scabimite krim 5 % tube 0 0 0 0 0 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0 0 0 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0 0 0 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 6640 0 6640 587 6053 6053 0 0
138 Prednison tablet 5 mg Tab 1550 0 1550 376 1174 1174 1000 0
139 Probiokid kapsul 0 0 0 0 0 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0 0 0 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0 0 0 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0 0 0 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 40 0 40 10 30 30 50 0
144 Ranitidin tablet 150 mg Tab 3450 0 3450 1825 1625 1625 10000 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0 0 0 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0 0 0 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0 0 0 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0 0 0 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0 0 0 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0 0 0 0 0 0
151 Salbutamol tablet 4 mg Tab 1449 0 1449 169 1280 1280 0 0
152 Salep 2 - 4 kombinasi tube 36 0 36 26 10 10 100 0
153 Salisil Bedak 2% - 50 gram tube 30 0 30 30 0 0 200 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0 0 0 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0 0 0 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0 0 0 0 0 0
157 Sertirizin tablet 10 mg Tab 139 0 139 139 0 0 2000 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0 0 0 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 2150 0 2150 560 1590 1590 0 0
160 Simvastatin 20 mg Tab 100 0 100 100 0 0 1000 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0 0 0 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0 0 0 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0 0 0 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0 0 0 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 300 0 300 300 0 0 5000 0
166 Triheksifenidil HCl 2 mg tablet Tab 7050 0 7050 1050 6000 6000 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0 0 0 0 0 0
168 Vitamin B komplek tablet Tab 3510 0 3510 2560 950 950 10000 0
169 Zink syrup 20 mg/5 ml BOTOL 60 0 60 30 30 30 100 0
170 Zink tablet disp 20 mg Tab 0 0 0 0 0 0 0 0
0BAT PROGRAM HIV 0 0 0 0 0 0 0 0
1 EFAVIRENS tablet 0 0 0 0 0 0 0 0
2 HIVIRAL 0 0 0 0 0 0 0 0
3 NEVIRAL 0 0 0 0 0 0 0 0
4 ATRIPLA 0 0 0 0 0 0 0 0
5 TENOFAVIR 0 0 0 0 0 0 0 0
6 DUVIRAL 0 0 0 0 0 0 0 0
7 ZIDOVUDINE/ 0 0 0 0 0 0 0 0
PROGRAM KUSTA 0 0 0 0 0 0 0 0
1 MB DEWASA Tab 0 0 0 0 0 0 0 0
2 PB DEWASA Tab 0 0 0 0 0 0 0 0
3 MB ANAK Tab 0 0 0 0 0 0 0 0
PROGRAM TBC 0 0 0 0 0 0 0 0
1 OAT FDC Anak Tab 0 0 0 0 0 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0 0 0 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0 0 0 0 0 0
PROGRAM IMUNISASI 0 0 0 0 0 0 0 0
1 VAKSIN BCG 0 0 0 0 0 0 0 0
2 vaksin DPT-HB-Hib 0 0 0 0 0 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0 0 0 0 0 0
 4 Vaksin CAMPAK 0 0 0 0 0 0 0 0
5 vaksin HB-O 0 0 0 0 0 0 0 0
6 Vaksin Td 0 0 0 0 0 0 0 0
7 Vaksin IPV 0 0 0 0 0 0 0 0
SERUM 0 0 0 0 0 0 0 0
1 ABU 30 0 30 5 25 25 0 0
2 ADS 0 0 0 0 0 0 0 0
3 ATS 9 0 9 3 6 6 0 0
4 RABIES 0 0 0 0 0 0 0 0
CAIRAN 0 0 0 0 0 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0 0 0 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0 0 0 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0 0 0 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 100 0 100 10 90 90 0 0
BHP 0 0 0 0 0 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 70 0 70 30 40 40 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0 0 0 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0 0 0 0 0 0
4 Alkohol Swab box 0 0 0 0 0 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0 0 0 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0 0 0 0 0 0
7 Bioplasenton tulle Pcs 0 0 0 0 0 0 0 0
8 bloodset Pcs 0 0 0 0 0 0 0 0
9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0 0 0 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0 0 0 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0 0 0 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0 0 0 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0 0 0 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0 0 0 0 0 0
Handscoon Non Steril 0 0 0 0 0 0 0 0
15 Ukuran L Pcs 200 0 200 100 100 100 500 0
16 Ukuran M Pcs 200 0 200 100 100 100 500 0
17 Ukuran S Pcs 200 0 200 100 100 100 500 0
 Handscoon steril 0 0 0 0 0 0 0 0
18 Ukuran 6.5 Pcs 0 0 0 0 0 0 0 0
19 Ukuran 7.0 Pcs 0 0 0 0 0 0 0 0
20 Ukuran 7.5 Pcs 0 0 0 0 0 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0 0 0 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0 0 0 0 0 0
23 Infusion set anak Pcs 0 0 0 0 0 0 0 0
24 Infusion set dewasa Pcs 130 0 130 30 100 100 0 0
25 IV Catheter G - 18 Pcs 50 0 50 0 50 50 100 0
26 IV Catheter G - 20 Pcs 50 0 50 0 50 50 0 0
27 IV Catheter G - 22 Pcs 0 0 0 0 0 0 0 0
28 Kapas 250 gr Pcs 0 0 0 0 0 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0 0 0 0 0 0
30 Kasa hidrofil 16x16 (steril) Pcs 20 0 20 5 15 15 0 0
31 Kasa Kompres 40/40 steril Pcs 20 0 20 20 0 0 100 0
32 Kasa Pembalut 2 m x 80 cm Pcs 1 0 1 0 1 1 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0 0 0 0 0 0
34 Masker Pcs 400 0 400 100 300 300 0 0
35 Plester Pcs 6 0 6 1 5 5 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0 0 0 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Pcs 0 0 0 0 0 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0 0 0 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0 0 0 0 0 0
40 Urine bag Pcs 0 0 0 0 0 0 0 0
BHP GIGI 0 0 0 0 0 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0 0 0 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0 0 0 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0 0 0 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0 0 0 0 0 0
5 Formokresol Cairan BOTOL 0 0 0 0 0 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0 0 0 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0 0 0 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0 0 0 0 0 0
 9 Lidokain gel BOTOL 0 0 0 0 0 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0 0 0 0 0 0
11 Mummifying Pasta Botol 0 0 0 0 0 0 0 0
12 Polikresulen cairan POT 0 0 0 0 0 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0 0 0 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0 0 0 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0 0 0 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0 0 0 0 0 0
DESINFECTAN 0 0 0 0 0 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0 0 0 0 0 0
2 Antiseptik Hand Scrub Btl 0 0 0 0 0 0 0 0
3 Gel untuk cateter Btl 0 0 0 0 0 0 0 0
4 Lisol 1 liter Btl 0 0 0 0 0 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0 0 0 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0 0 0 0 0 0
7 Rivanol larutan 0,1% - 330 cc Btl 0 0 0 0 0 0 0 0

Mengetahui Sukabumi, 03 Januari 2019

[Link] Puskesmas Cijangkar Pengelola Program

[Link] SUMIATI,SKM.,[Link] Ety Karyati

NIP: 19710108199003.2.001 NIP: 196309051993102001
 PERSEDIAAN OBAT DAN PERBEKALAN FARMASI
PUSKESMAS SUKARAJA PERIODE 31 desember
KECAMATAN SUKARAJA TAHUN 2017
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 Desa Sukaraja
NO NAMA OBAT SATUAN PERSEDIAAN HARGA JUMLAH HARGA
BPJS APBD PROGRAM LAIN2 JUMLAH SATUAN
OBAT
1 Albendazol tablet 400 mg Tab 0 0 0 0 0 390 0
2 Allopurinol 100 mg Tablet Tab 3900 4732 0 0 8632 89 768248
3 Aloclair plus gel BOTOL 0 26 0 0 26 80,000 2080000
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0 0 0 2,998 0
5 Aminophylin tablet 200mg Tab 0 0 0 0 0 91 0
6 Amitriptilin HCl tablet salut 25 mg Tab 464 564 0 0 1028 112 115136
7 Amlodipin 5 mg Tab 0 508 0 0 508 85 43180
8 Amoksisilin kaplet 500 mg kaplet 152455 8536 0 0 160991 190 30588290
9 Amoksisilin kapsul 250 mg KAPSUL 133445 2460 0 0 135905 180 24462900
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 399 0 0 399 1,881 750519
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0 0 0 4,045 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0 0 0 5,100 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 476 0 0 476 133 63308
14 Antasida Suspensi 60 ml BOTOL 500 377 0 0 877 1,923 1686471
15 Antasida DOEN tablet kombinasi Tab 123684 4283 0 0 127967 58 7422086
16 Anti Bakteri DOEN salep kombinasi tube 500 0 0 0 500 2,924 1462000
17 Anti fungi DOEN komb sk tube 480 20 0 0 500 4,323 2161500
18 Anti Hemoroid DOEN kombinasi supp 0 28 0 0 28 7,200 201600
19 Antimigren DOEN kombinasi Tab 0 0 0 0 0 167 0
20 Antiparkinson DOEN Tab 0 0 0 0 0 1,500 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0 0 0 38,999 0
22 Artesunate tablet (ACT) Tab 0 0 0 0 0 1,375 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0 0 0 92 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 5000 2193 0 0 7193 104 748072
25 asam folat tablet 1 mg Tab 20000 0 0 0 20000 84 1680000
26 Asam mefenamat 500 mg kaplet 10600 4968 0 0 15568 100 1556800
27 Asam Mefenamat Kapsul 250 mg KAPSUL 0 322 0 0 322 139 44758
28 Asiklovir Krim 5% tube 0 44 0 0 44 3,150 138600
29 Asiklovir tablet 200 mg Tab 35 2923 0 0 2958 240 709920
30 Asiklovir Tablet 400 mg Tab 2189 1794 0 0 3983 365 1453795
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0 1,265 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0 0 0 74 0
33 Attalpugite tab 600 mg Tab 1500 255 0 0 1755 142 249210
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0 0 0 10,700 0
35 Betahistin maleat Tab 0 276 0 0 276 149 41124
36 Betametasone Krim 0.1% tube 3000 26 0 0 3026 1,349 4082074
37 Bisakodil Supp 10 mg supp 0 0 0 0 0 5,800 0
38 Captopril 12,5 mg Tab 44814 11925 0 0 56739 62 3517818
39 Captopril tablet 25 mg Tab 34457 6028 0 0 40485 80 3238800
40 Ciprofloksasin 500 mg tablet Tab 5500 476 0 0 5976 240 1434240
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0 0 0 1,580 0
42 Deksametasone tablet 0.5mg Tab 91112 4180 0 0 95292 41 3906972
43 Diazepam 5 mg tablet Tab 0 0 0 0 0 103 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0 0 0 12,090 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0 0 0 132 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0 1,060 0
48 Digoksin tablet 0,25 mg Tab 210 677 0 0 887 104 92248
49 Doksisiklin 100 mg Tab 0 500 0 0 500 268 134000
50 Domperidon Syrup BOTOL 0 0 0 0 0 3,333 0
51 Domperidon tablet 10 mg Tab 0 0 0 0 0 95 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0 0 0 1,749 0
53 Erytromycin 250 mg KAPSUL 0 0 0 0 0 557 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0 0 0 6,150 0
55 Etambutol HCL 250 mg Tab 0 0 0 0 0 359 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0 0 0 152 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0 1,800 0
58 Fenobarbital tablet 30 mg Tab 0 80 0 0 80 165 13200
59 Fenofibrat kaps 100 mg KAPSUL 0 850 0 0 850 1,375 1168750
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0 0 0 350 0
 61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0 0 0 605 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 812 0 0 812 686 557032
63 Fitomenadion injeksi 2 mg/ml ampul 0 135 0 0 135 3,550 479250
64 Furosemid tablet 40 mg Tab 0 367 0 0 367 72 26424
65 Garam oralit 200 ml air sachet 3000 3458 0 0 6458 285 1840530
66 Gentamicin inj 40 mg//ml ampul 0 235 0 0 235 3,386 795710
67 Gentamisin tetes mata BOTOL 0 0 0 0 0 4,000 0
68 Glibenklamid tablet 5 mg Tab 0 2048 0 0 2048 56 114688
69 Gliseril Guayakolat tablet 100 mg Tab 0 1752 0 0 1752 341 597432
70 Gliserin guayakolat syrup BOTOL 0 0 0 0 0 8,107 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0 0 0 247 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0 0 0 56 0
73 Haloperidol 1,5 mg tablet Tab 16000 9455 0 0 25455 61 1552755
74 Haloperidol 5 mg Tab 0 0 0 0 0 69 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0 0 0 36 0
76 Hidrokortison krim 2,5 % tube 0 59 0 0 59 2,798 165082
77 Ibuprofen tablet 200 mg Tab 0 0 0 0 0 102 0
78 Ibuprofen tablet 400 mg Tab 0 2220 0 0 2220 111 246420
79 Isoniazid tablet 100 mg Tab 0 0 0 0 0 74 0
80 Isoniazid tablet 300 mg Tab 0 0 0 0 0 158 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 275 493 0 0 768 90 69120
82 Kalsium alginate gel tube 0 0 0 0 0 104,000 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 576 0 0 576 7,800 4492800
84 Kalsium laktat (kalk) tablet Tab 0 0 0 0 0 56 0
85 Karbamazepin tablet 200 mg Tab 240 1087 0 0 1327 245 325115
86 Karbogliserin Tetes Telinga 10% BOTOL 240 59 0 0 299 2,500 747500
87 Ketokonazol krim 2 % tube 3400 25 0 0 3425 2,595 8887875
88 Ketokonazol Tablet 200 mg Tab 23500 3128 0 0 26628 280 7455840
89 Klindamicin 300 mg KAPSUL 0 398 0 0 398 603 239994
90 Klopidogrel tab 75 mg Tab 0 0 0 0 0 1,650 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 1054 0 0 1054 250 263500
92 Kloramfenikol salep kulit 2% (bufacetin) tube 1024 11 0 0 1035 3,091 3199185
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 32 0 0 32 1,810 57920
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0 0 0 1,600 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 34000 8764 0 0 42764 37 1582268
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0 0 0 144 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0 0 0 1,100 0
98 Kodein HCl tablet 10 mg Tab 0 0 0 0 0 500 0
99 Kotrimoksazol forte tablet Tab 0 710 0 0 710 321 227910
100 Kotrimoksazol suspensi kombinasi BOTOL 0 68 0 0 68 2,120 144160
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0 0 0 670 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0 0 0 6,200 0
103 Lansoprazol 30 mg Tab 0 0 0 0 0 315 0
104 Lidokain inj. 2% ampul 300 27 0 0 327 1,111 363297
105 Lidokain komp. injeksi kombinasi ampul 570 18 0 0 588 1,937 1138956
106 Loratadin tab 10 mg Tab 0 0 0 0 0 123 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 896 0 0 896 2,630 2356480
108 Mebendazol tablet 100 mg Tab 0 0 0 0 0 2,630 0
109 Metformin tablet 500 mg Tab 0 2907 0 0 2907 94 273258
110 metil dopa tab 250 mg Tab 0 0 0 0 0 911 0
111 Metilergometrin Maleat injeksi 0,200 mg - 1ml ampul 0 838 0 0 838 2,849 2387462
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 89 0 0 89 154 13706
113 Metilprednisolon tablet Tab 0 0 0 0 0 194 0
114 Metoklorpropamid tablet 10 mg Tab 0 0 0 0 0 87 0
115 Metronidazol sirup 125 mg/5ml BOTOL 300 0 0 0 300 3,800 1140000
116 Metronidazol tablet 250 mg Tab 10000 200 0 0 10200 90 918000
117 Metronidazol tablet 500 mg Tab 15000 833 0 0 15833 113 1789129
118 Miconazol SK tube 0 56 0 0 56 3,000 168000
119 Multivitamin sirup BOTOL 0 154 0 0 154 8,720 1342880
120 Multivitamin Tablet Dewasa Tab 0 0 0 0 0 935 0
121 Natrium bikarbonat tablet 500 mg Tab 0 1890 0 0 1890 20 37800
122 Natrium Diklofenac 25 mg Tab 0 500 0 0 500 200 100000
123 Nifedifin tablet 10 mg Tab 0 6 0 0 6 99 594
124 Nistatin 100.000 IU/gram tablet vaginal supp 296 354 0 0 650 545 354250
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 200 0 0 200 640 128000
126 Obat batuk Hitam (OBH) BOTOL 0 94 0 0 94 1,430 134420
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0 0 0 1,675 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 1161 0 0 1161 1,900 2205900
129 Omeprazol 20mg Tab 2160 300 0 0 2460 140 344400
130 Ondansentron tab 8 mg Tab 0 0 0 0 0 440 0
131 parasetamol drop BOTOL 0 0 0 0 0 5,200 0
132 Parasetamol kaplet 500 mg Tab 110000 30932 0 0 140932 49 6905668
133 Parasetamol sirup BOTOL 2000 397 0 0 2397 1,010 2420970
134 Permetrin/scabimite krim 5 % tube 0 115 0 0 115 12,155 1397825
135 Pirantel Pamoat tablet 125 mg Tab 49 532 0 0 581 269 156289
136 Pirazinamid tablet 500 mg Tab 0 0 0 0 0 228 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 10000 428 0 0 10428 118 1230504
138 Prednison tablet 5 mg Tab 6000 1866 0 0 7866 76 597816
139 Probiokid Box 0 207 0 0 207 130,240 26959680
140 Propiltiourasil tablet 100 mg Tab 0 0 0 0 0 319 0
141 Propranolol HCl tablet 10 mg Tab 0 510 0 0 510 52 26520
142 Pyrazinamid tablet 500 mg Tab 0 0 0 0 0 228 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0 0 0 1,458 0
144 Ranitidin tablet 150 mg Tab 0 2488 0 0 2488 98 243824
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 1066 0 1066 260 277160
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 721 0 721 459 330939
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0 0 0 648 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0 0 0 660 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0 0 0 1,108 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0 0 0 6,600 0
151 Salbutamol tablet 2 mg Tab 0 494 0 0 494 78 38532
152 Salep 2 - 4 kombinasi tube 960 72 0 0 1032 2,527 2607864
153 Salisil Bedak 2% - 50 gram tube 500 800 0 0 1300 1,020 1326000
154 Sefadroksil Kapsul 500 mg KAPSUL 0 500 0 0 500 450 225000
155 Sefadroksil Syrup 250 mg BOTOL 500 120 0 0 620 5,895 3654900
156 Sefiksim kapsul 100 mg KAPSUL 0 1274 0 0 1274 750 955500
157 Setirizin tablet 10 mg Tab 0 721 0 0 721 96 69216
158 Setirizin sir 5 mg/ 5 ml BOTOL 240 0 0 0 240 2,850 684000
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0 0 0 51 0
160 Simvastatin 20 mg Tab 0 554 0 0 554 229 126866
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 114000 26085 0 0 140085 350 49029750
162 Teofilin tab 150 mg Tab 0 1000 0 0 1000 270 270000
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 2900 0 0 0 2900 148 429200
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 6000 300 0 0 6300 310 1953000
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 10000 1826 0 0 11826 82 969732
166 Triheksifenidil HCl 2 mg tablet Tab 16500 6519 0 0 23019 80 1841520
167 Vermox tablet (obat cacing) Tab 0 0 0 0 0 8,800 0
168 Vitamin B komplek tablet Tab 189688 2000 0 0 191688 107 20510616
169 Zink syrup 20 mg/5 ml BOTOL 0 57 0 0 57 4,789 272973
170 Zink tablet disp 20 mg Tab 0 1107 0 0 1107 473 523611
0BAT PROGRAM HIV
1 EFAVIRENS tablet 0 0 0 0 0 0 0
2 HIVIRAL 0 0 0 0 0 0 0
3 NEVIRAL 0 0 0 0 0 0 0
4 ATRIPLA 0 0 0 0 0 0 0
5 TENOFAVIR 0 0 0 0 0 0 0
6 DUVIRAL 0 0 0 0 0 0 0
7 ZIDOVUDINE/ 0 0 0 0 0 0 0
PROGRAM KUSTA
1 MB DEWASA Tab 0 0 0 0 0 0 0
2 PB DEWASA Tab 0 0 0 0 0 0 0
3 MB ANAK Tab 0 0 0 0 0 0 0
PROGRAM TBC
1 OAT FDC Anak Paket 0 0 25 0 25 223,583 5589575
2 OAT FDC Kategori 1 Paket 0 0 78 0 78 374,379 29201562
3 OAT/FDC KATEGORI II Tab 0 0 0 0 0 1,247,984 0
PROGRAM IMUNISASI
1 VAKSIN BCG 0 0 0 0 0 0 0
2 vaksin DPT-HB-Hib 0 0 0 0 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0 0 0 0 0
4 Vaksin CAMPAK 0 0 0 0 0 0 0
5 vaksin HB-O 0 0 0 0 0 0 0
6 Vaksin Td 0 0 0 0 0 0 0
7 Vaksin IPV 0 0 0 0 0 0 0
SERUM
1 ABU 0 0 0 0 0 462,000 0
2 ADS 0 0 0 0 0 0 0
 3 ATS 0 0 0 0 0 126,500 0
4 RABIES 0 0 0 0 0 0 0
CAIRAN
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 300 0 0 0 300 2,302 690600
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0 0 0 6,900 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 400 52 0 0 452 6,410 2897320
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 400 35 0 0 435 7,150 3110250
BHP
1 Alat suntik sekali pakai 1 ml Pcs 1965 1131 0 0 3096 990 3065040
2 Alat suntik sekali pakai 3 ml Pcs 3882 135 0 0 4017 792 3181464
3 Alat suntik sekali pakai 5 ml Pcs 1510 379 0 0 1889 979 1849331
4 Alkohol Swab box 0 5 0 0 5 10,000 50000
5 autodisable no 0,05 ml Pcs 0 400 0 0 400 1,354 541600
6 autodisable no. 0,5 ml Pcs 0 1100 0 0 1100 1,175 1292500
7 Bioplasenton tulle Pcs 0 0 0 0 0 104,000 0
8 bloodset Pcs 0 0 0 0 0 13,420 0
9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 45 0 0 0 45 5,583 251235
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 215 1100 0 0 1315 5,583 7341645
11 Cuticell Classic 10 cm x 10 cm Pcs 100 295 0 0 395 5,198 2053210
12 ECG/USG jelly 82gr Pcs 0 0 0 0 0 34,528 0
13 Folley Catheter 2 way no 16 Pcs 0 20 0 0 20 8,500 170000
14 Folley Catheter 2 way no 18 Pcs 70 20 0 0 90 8,500 765000
Handscoon Non Steril
15 Ukuran L Pcs 4880 90 0 0 4970 1,144 5685680
16 Ukuran M Pcs 10750 0 0 0 10750 1,144 12298000
17 Ukuran S Pcs 100 100 0 0 200 1,144 228800
Handscoon steril
18 Ukuran 6.5 Pcs 596 151 0 0 747 7,600 5677200
19 Ukuran 7.0 Pcs 962 0 0 0 962 7,600 7311200
20 Ukuran 7.5 Pcs 296 0 0 0 296 7,600 2249600
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0 0 0 850 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0 0 0 850 0
23 Infusion set anak Pcs 0 0 0 0 0 5,100 0
24 Infusion set dewasa Pcs 0 0 0 0 0 4,800 0
25 IV Catheter G - 18 Pcs 125 0 0 0 125 10,000 1250000
26 IV Catheter G - 20 Pcs 500 100 0 0 600 10,000 6000000
27 IV Catheter G - 22 Pcs 38 0 0 0 38 10,000 380000
28 Kapas 250 gr Pcs 539 3.5 0 0 542.5 28,530 15477525
29 Kapas Pembalut Absorben 1000 gr Pcs 0 2 0 0 2 107,193 214386
30 Kasa hidrofil 16x16 (steril) box 294 2 0 0 296 7,900 2338400
31 Kasa Kompres 40/40 steril Pcs 1880 85 0 0 1965 1,800 3537000
32 Kasa Pembalut 2 m x 80 cm Pcs 0 30 0 0 30 9,400 282000
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0 0 0 130,000 0
34 Masker Dus 136 0 0 0 136 24,000 3264000
35 Plester Pcs 100 43 0 0 143 12,076 1726868
36 Plester Polifix 5 cm x 1 m Pcs 50 0 0 0 50 7,370 368500
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Roll 100 24 0 0 124 27,830 3450920
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 1225 18 0 0 1243 14,000 17402000
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 1254 19 0 0 1273 13,616 17333168
40 Urine bag Pcs 25 0 0 0 25 3,000 75000
BHP GIGI
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0.25 0 0 0.25 38,200 9550
2 Etil Klorida Semprot BOTOL 0 0 0 0 0 103,000 0
3 Eugenol cairan - 10 ml BOTOL 0 3.5 0 0 3.5 16,667 58334.5
4 Fluor tablet 0,5 mg TAB 0 0 0 0 0 45 0
5 Formokresol Cairan BOTOL 0 0 0 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0 0 0 450 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0 0 0 390,000 0
8 Kalsium Hidroksida Pasta BOTOL 0 1 0 0 1 235,000 235000
9 Lidokain gel BOTOL 0 0 0 0 0 54,000 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 1 0 0 1 173,000 173000
11 Mummifying Pasta Botol 0 1 0 0 1 17,393 17393
12 Polikresulen cairan POT 0 0 0 0 0 92,000 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0 0 0 5,279 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 4.5 0 0 4.5 33,000 148500
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0 0 0 130,000 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 1.25 0 0 1.25 50,400 63000
DESINFECTAN
1 Alkohol 70% - 1000 ml Btl 24 2 0 0 26 25,000 650000
2 Antiseptik Hand Rub 500 ml Btl 150 85 0 0 235 608,000 142880000
3 Gel untuk cateter Btl 0 10 0 0 10 8,320 83200
4 Lisol 1 liter Btl 30 1 0 0 31 41,000 1271000
5 Povidon Iodida 500 ml Btl 100 11 0 0 111 3,700 410700
6 Povidon Iodida 60 ml Btl 500 36 0 0 536 14,203 7612808
7 Rivanol larutan 0,1% - 300 cc Btl 259 3 0 0 262 3,000 786000
Jumlah ( Rp. ) 594315200.5

Keterangan
Harga sudah sesuai dengan pengadaan Tahun 2017
 RENCANA KEBUTUHA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 D

NO NAMA OBAT SATUAN SISA STOK 30 PEMAKAIAN KEBUTUHAN 1

OKT RATA RATA TAHUN
OBAT
1 Albendazol tablet 400 mg Tab 0 0 0
2 Alopurinol 100 mg Tablet Tab 5427 316 3792
3 Aloclair plus gel BOTOL 27 0.1 1.2
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 3 36
6 Amitriptilin HCl tablet salut 25 mg Tab 1028 19 228
7 Amlodipin 5 mg Tab 0 273 3276
8 Amoksisilin kaplet 500 mg kaplet 165725 9690 116280
9 Amoksisilin kapsul 250 mg KAPSUL 141345 2941 35292
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 600 7200
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 80 960
14 Antasida Suspensi 60 ml BOTOL 431 11 132
15 Antasida DOEN tablet kombinasi Tab 136088 7690 92280
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 1 38 456
18 Anti Hemoroid DOEN kombinasi supp 4 13 156
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 4997 1977 23724
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 6452 1122 13464
27 Asam Mefenamat Kapsul 250 mg KAPSUL 422 2941 35292
28 Asiklovir Krim 5% tube 0 15 180
29 Asiklovir tablet 200 mg Tab 3687 147 1764
30 Asiklovir Tablet 400 mg Tab 4399 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 7 49 588
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 24 288
36 Betametasone Krim 0.1% tube 0 63 756
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 58137 1086 13032
39 Captopril tablet 25 mg Tab 41733 687 8244
40 Ciprofloksasin 500 mg tablet Tab 4613 29 348
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 103090 7208 86496
43 Diasepam 5 mg tablet Tab 0 0 0
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 0 0 0
49 Doksisiklin 100 mg ampul 0 0 0
50 Domperidon Syrup BOTOL 0 0 0
 51 Domperidon tablet 10 mg Tab 0 0 0
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 0 0 0
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 0 0 0
63 Fitomenadion injeksi 2 mg/ml ampul 0 0 0
64 Furosemid tablet 40 mg Tab 0 0 0
65 Garam oralit 200 ml air sachet 0 0 0
66 Gentamicin inj 40 mg//ml ampul 0 0 0
67 Gentamisin tetes mata BOTOL 0 0 0
68 Glibenklamid tablet 5 mg Tab 0 0 0
69 Gliseril Guayakolat tablet 100 mg Tab 0 0 0
70 Gliserin guayakolat syrup BOTOL 0 0 0
71 Griseofulvin tablet 125 mg, micronized Tab 0 0 0
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 0 0 0
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 0 0
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 0 0 0
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 0 0 0
82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 0 0 0
84 Kalsium lakate (kalk) tablet Tab 0 0 0
85 Karbamazepin tablet 200 mg Tab 0 0 0
86 Karbogliserin Tetes Telinga 10% BOTOL 0 0 0
87 Ketokonazol krim 2 % tube 0 0 0
88 Ketokonazol Tablet 200 mg Tab 0 0 0
89 Klindamicin 300 mg KAPSUL 0 0 0
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 0 0 0
92 Kloramfenikol salep kulit 2% (bufacetin) tube 0 0 0
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 0 0 0
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 0 0
96 Klorpromazin HCL tablet 100 mg Tab 0 0 0
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 0 0
100 Kotrimoksazol suspensi kombinasi BOTOL 0 0 0
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 0 0 0
105 Lidokain komp. injeksi kombinasi ampul 0 0 0
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 0 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 0 0 0
110 metil dopa tab 250 mg Tab 0 0 0
Metilergometrin Maleat injeksi 0,200 mg - 1ml
111 ampul 0 0 0
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 0 0 0
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 10 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 0 0 0
116 Metronidazol tablet 250 mg Tab 0 0 0
117 Metronidazol tablet 500 mg Tab 0 0 0
118 Miconazol SK tube 0 0 0
119 Multivitamin sirup BOTOL 0 0 0
120 Multivitamin Tablet Dewasa Tab 0 0 0
121 Natrium bikarbonat tablet 500 mg Tab 0 0 0
122 Natrium Diklofenac 25 mg Tab 0 0 0
123 Nifedifin tablet 10 mg Tab 0 0 0
124 Nistatin 100.000 IU/gram tablet vaginal supp 0 0 0
125 Nistatin tablet salut gula 500.000 IU/g Tab 0 0 0
126 Obat batuk Hitam (OBH) BOTOL 0 0 0
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 0 0 0
129 Omeprazol 20mg Tab 0 0 0
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 0 0
132 Parasetamol kaplet 500 mg Tab 0 0 0
133 Parasetamol sirup BOTOL 0 0 0
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 0 0 0
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 0 0
138 Prednison tablet 5 mg Tab 0 0 0
139 Probiokid Box 0 0 0
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 0 0 0
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 0 0 0
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 0 0 0
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 0 0 0
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 2 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 0 0
153 Salisil Bedak 2% - 50 gram tube 0 0 0
154 Sefadroksil Kapsul 500 mg KAPSUL 0 0 0
155 Sefadroksil Syrup 250 mg BOTOL 0 0 0
156 Sefiksim kapsul 100 mg KAPSUL 0 0 0
157 Sertirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 0 0 0
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 0 0 0
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 0 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 0 0 0
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 0 0
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 0 0
166 Triheksifenidil HCl 2 mg tablet Tab 0 0 0
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 0 0 0
169 Zink syrup 20 mg/5 ml BOTOL 0 0 0
170 Zink tablet disp 20 mg Tab 0 0 0
0BAT PROGRAM HIV 0 0 0
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA 0 0 0
1 MB DEWASA Tab 0 0 0
2 PB DEWASA Tab 0 0 0
3 MB ANAK Tab 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 0 0 0
2 OAT FDC Kategori 1 Tab 0 0 0
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI 0 0 0
1 VAKSIN BCG 0 0 0
2 vaksin DPT-HB-Hib 0 0 0
3 VAKSIN POLIO (b OPV) 0 0 0
4 Vaksin CAMPAK 0 0 0
5 vaksin HB-O 0 0 0
6 Vaksin Td 0 0 0
7 Vaksin IPV 0 0 0
SERUM 0 0 0
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN 0 0 0
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 0 0
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 0 0 0
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 0 0 0
BHP 0 0 0
1 Alat suntik sekali pakai 1 ml Pcs 0 0 0
2 Alat suntik sekali pakai 3 ml Pcs 0 0 0
3 Alat suntik sekali pakai 5 ml Pcs 0 0 0
4 Alkohol Swab box 0 0 0
5 autodisable no 0,05 ml Pcs 0 0 0
6 autodisable no. 0,5 ml Pcs 0 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 0 0 0
11 Cuticell Classic 10 cm x 10 cm Pcs 0 0 0
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) box 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Dus 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Roll 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Rub 500 ml Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 300 cc Btl 0 0 0

Keterangan
Harga sudah sesuai dengan pengadaan Tahun 2017
ANA KEBUTUHAN OBAT
TAHUN 2018

ya Sukaraja No.1 Km. 5 Desa Sukaraja

RENCANA PENGADAAN JUMLAH KETERSEDIAAN HARGA JUMLAH

UMUM BPJS OBAT SATUAN HARGA

1000 2000 3,000 #DIV/0! 390 1,170,000

4000 0 4,000 12.6582278481 89 356,000
0 0 0 0 80,000 0
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0 0 0 0 112 0
3000 10000 13,000 47.61904761905 85 1,105,000
80000 0 80,000 8.255933952528 190 15,200,000
20000 0 20,000 6.800408024481 180 3,600,000
1000 0 1,000 1.666666666667 1,881 1,881,000
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1000 2000 3,000 37.5 133 399,000
0 0 0 0 1,923 0
100000 0 100,000 13.00390117035 58 5,800,000
250 0 250 #DIV/0! 2,924 731,000
120 0 120 3.157894736842 4,323 518,760
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20000 0 20,000 29.11208151383 80 1,600,000
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0 #DIV/0! 6,150 0
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0 #DIV/0! 152 0
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720 #DIV/0! 3,550 2,556,000
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0 #DIV/0! 285 0
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480 #DIV/0! 4,000 1,920,000
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0 #DIV/0! 69 0
0 #DIV/0! 36 0
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240 #DIV/0! 1,600 384,000
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0 #DIV/0! 194 0
0 #DIV/0! 87 0
0 #DIV/0! 3,800 0
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0 #DIV/0! 113 0
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500 #DIV/0! 8,720 4,360,000
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300 #DIV/0! 5,200 1,560,000
0 #DIV/0! 49 0
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200 #DIV/0! 12,155 2,431,000
0 #DIV/0! 269 0
0 #DIV/0! 228 0
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10 #DIV/0! 130,240 1,302,400
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0 #DIV/0! 0 0
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0 #DIV/0! 0 0
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 RENCANA KEBUTUHA
PUSKESMAS SUKARAJA
KECAMATAN SUKARAJA
ALAMAT Jl. Raya Sukaraja No.1 Km. 5 D

NO NAMA OBAT SATUAN SISA STOK 30 PEMAKAIAN KEBUTUHAN 1

OKT RATA RATA TAHUN
OBAT
1 Albendazol tablet 400 mg Tab 0 0 0
2 Alopurinol 100 mg Tablet Tab 5427 316 3792
3 Aloclair plus gel BOTOL 27 0.1 1.2
4 Aminofillin inj 24 mg /ml-10ml ampul 0 0 0
5 Aminophylin tablet 200mg Tab 410 3 36
6 Amitriptilin HCl tablet salut 25 mg Tab 1028 19 228
7 Amlodipin 5 mg Tab 0 273 3276
8 Amoksisilin kaplet 500 mg kaplet 165725 9690 116280
9 Amoksisilin kapsul 250 mg KAPSUL 141345 2941 35292
10 Amoksisilin sirup kering 125 mg/5 ml BOTOL 0 600 7200
11 Amoksisilin sirup kering Forte 250 mg/5 ml BOTOL 0 0 0
12 ampisilin inj IM/IV 1000 mg/ml ampul 0 0 0
13 Antalgin (Metampiron) tablet 500 mg Tab 0 80 960
14 Antasida Suspensi 60 ml BOTOL 431 11 132
15 Antasida DOEN tablet kombinasi Tab 136088 7690 92280
16 Anti Bakteri DOEN salep kombinasi tube 0 0 0
17 Anti fungi DOEN komb sk tube 1 38 456
18 Anti Hemoroid DOEN kombinasi supp 4 13 156
19 Antimigren DOEN kombinasi Tab 0 0 0
20 Antiparkinson DOEN Tab 0 0 0
21 Artesunat serb inj 60 mg/ml ampul 0 0 0
22 Artesunate tablet (ACT) Tab 0 0 0
23 Asam Asetil Salisilat (Asetosal) tablet 80 mg Tab 0 0 0
24 Asam Askorbat (Vit.C) tablet 50 mg Tab 4997 1977 23724
25 asam folat tablet 1 mg Tab 0 0 0
26 Asam mefenamat 500 mg kaplet 6452 1122 13464
27 Asam Mefenamat Kapsul 250 mg KAPSUL 422 2941 35292
28 Asiklovir Krim 5% tube 0 15 180
29 Asiklovir tablet 200 mg Tab 3687 147 1764
30 Asiklovir Tablet 400 mg Tab 4399 0 0
31 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
32 Atropin Sulfat tablet 0,5 mg Tab 0 0 0
33 Attalpugite tab 600 mg Tab 7 49 588
34 Benzatin Benzil Penisilin inj.1.2 juta IU/vial ampul 0 0 0
35 Betahistin maleat Tab 0 24 288
36 Betametasone Krim 0.1% tube 0 63 756
37 Bisakodil Supp 10 mg supp 0 0 0
38 Captopril 12,5 mg Tab 58137 1086 13032
39 Captopril tablet 25 mg Tab 41733 687 8244
40 Ciprofloksasin 500 mg tablet Tab 4613 29 348
41 Deksametason injeksi 5 mg/ml - 1 ml ampul 0 0 0
42 Deksametasone tablet 0.5mg Tab 103090 7208 86496
43 Diasepam 5 mg tablet Tab 0 50 600
44 Diazepam Inj 5 ml/2ml ampul 0 0 0
45 Diazepam lar rektal 5mg/2,5ml tube 0 0 0
46 Dietilkarbamazin sitrat tablet 100 mg Tab 0 0 0
47 Difenhidramin HCl injeksi 10 mg/ml - 1 ml ampul 0 0 0
48 Digoksin tablet 0,25 mg Tab 802 25 300
49 Doksisiklin 100 mg ampul 400 0 0
50 Domperidon Syrup BOTOL 0 68 816
51 Domperidon tablet 10 mg Tab 0 10 120
52 Epinefrina (adrenalin) injeksi 0,1% - 1 ml ampul 0 0 0
53 Erytromycin 250 mg KAPSUL 0 0 0
54 Erytromycin syr 200mg/5 ml BOTOL 0 0 0
55 Etambutol HCL 250 mg Tab 0 0 0
56 Fenitoin Na kaps 100 mg KAPSUL 0 0 0
57 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
58 Fenobarbital tablet 30 mg Tab 0 0 0
59 Fenofibrat kaps 100 mg KAPSUL 880 2 24
60 Fenoksimetil Penisilina tablet 250 mg Tab 0 0 0
61 Fenoksimetil Penisilina tablet 500 mg Tab 0 0 0
62 Fitomenadion (Vit.K1) tablet salut 10 mg Tab 898 73 876
63 Fitomenadion injeksi 2 mg/ml ampul 150 29 348
64 Furosemid tablet 40 mg Tab 423 46 552
65 Garam oralit 200 ml air sachet 3144 285 3420
66 Gentamicin inj 40 mg//ml ampul 235 0 0
67 Gentamisin tetes mata BOTOL 40 15 180
68 Glibenklamid tablet 5 mg Tab 2192 93 1116
69 Gliseril Guayakolat tablet 100 mg Tab 0 900 10800
70 Gliserin guayakolat syrup BOTOL 0 10 120
71 Griseofulvin tablet 125 mg, micronized Tab 269 177 2124
72 Haloperidol 0,5 mg tablet Tab 0 0 0
73 Haloperidol 1,5 mg tablet Tab 9830 543 6516
74 Haloperidol 5 mg Tab 0 0 0
75 Hidroklorotiazid (HCT) tablet 25 mg Tab 0 0 0
76 Hidrokortison krim 2,5 % tube 0 29 348
77 Ibuprofen tablet 200 mg Tab 0 0 0
78 Ibuprofen tablet 400 mg Tab 17174 5923 71076
79 Isoniazid tablet 100 mg Tab 0 0 0
80 Isoniazid tablet 300 mg Tab 0 0 0
 81 Isosorbid Dinitrat 5 mg tablet sublingual Tab 773 68 816
82 Kalsium alginate gel tube 0 0 0
83 Kalsium Glukonat Inj 100 mg/ml ampul 576 0 0
84 Kalsium laktat (kalk) tablet Tab 2580 666 7992
85 Karbamazepin tablet 200 mg Tab 787 13 156
86 Karbogliserin Tetes Telinga 10% BOTOL 47 8 96
87 Ketokonazol krim 2 % tube 0 22 264
88 Ketokonazol Tablet 200 mg Tab 3448 270 3240
89 Klindamicin 300 mg KAPSUL 452 5 60
90 Klopidogrel tab 75 mg Tab 0 0 0
91 Kloramfenikol kapsul 500 mg KAPSUL 2237 788 9456
92 Kloramfenikol salep kulit 2% (bufacetin) tube 52 23 276
93 Kloramfenikol Salep Mata 1% - 3,5 gr BOTOL 39 41 492
94 Kloramfenikol Tetes Telinga 3% - 5 ml BOTOL 0 0 0
95 Klorfeniramin Maleat (CTM) tablet 4 mg Tab 0 4675 56100
96 Klorpromazin HCL tablet 100 mg Tab 0 40 480
97 Klorpromazin inj. 25 mg/ml ampul 0 0 0
98 Kodein HCl tablet 10 mg Tab 0 0 0
99 Kotrimoksazol forte tablet Tab 0 682 8184
100 Kotrimoksazol suspensi kombinasi BOTOL 35 47 564
101 Kuinin (Kina) tablet 200 mg Tab 0 0 0
102 Kuinin dihidroklorida inj 25 %-2 ml ampul 0 0 0
103 Lansoprazol 30 mg Tab 0 0 0
104 Lidokain inj. 2% ampul 110 43 516
105 Lidokain komp. injeksi kombinasi ampul 0 36 432
106 Loratadin tab 10 mg Tab 0 0 0
107 Magnesium Sulfat injeksi (IV) 40% - 25 ml ampul 896 0 0
108 Mebendazol tablet 100 mg Tab 0 0 0
109 Metformin tablet 500 mg Tab 2525 107 1284
110 metil dopa tab 250 mg Tab 53 37 444
111 Metilergometrin Maleat injeksi 0,200 mg - 1ml ampul 858 7 84
112 Metilergometrin Maleat tablet salut 0,125 mg Tab 406 56 672
113 Metilprednisolon tablet Tab 0 0 0
114 Metoklorpropamid tablet 10 mg Tab 0 0 0
115 Metronidazol sirup 125mg/5ml BOTOL 68 3 36
116 Metronidazol tablet 250 mg Tab 50 455 5460
117 Metronidazol tablet 500 mg Tab 0 260 3120
118 Miconazol SK tube 0 43 516
119 Multivitamin sirup BOTOL 146 63 756
120 Multivitamin Tablet Dewasa Tab 1400 952 11424
121 Natrium bikarbonat tablet 500 mg Tab 2376 63 756
122 Natrium Diklofenac 25 mg Tab 0 276 3312
123 Nifedifin tablet 10 mg Tab 21 60 720
124 Nistatin 100.000 IU/gram tablet vaginal supp 682 22 264
125 Nistatin tablet salut gula 500.000 IU/g Tab 200 8 96
126 Obat batuk Hitam (OBH) BOTOL 0 35 420
127 Oksitetrasiklin HCl salep 3% - 5 gram tube 0 0 0
128 Oksitosin injeksi 10 IU/ml - 1 ml ampul 928 64 768
129 Omeprazol 20mg Tab 0 84 1008
130 Ondansentron tab 8 mg Tab 0 0 0
131 parasetamol drop BOTOL 0 26 312
132 Parasetamol kaplet 500 mg Tab 5753 8602 103224
133 Parasetamol sirup BOTOL 0 209 2508
134 Permetrin/scabimite krim 5 % tube 0 0 0
135 Pirantel Pamoat tablet 125 mg Tab 479 88 1056
136 Pirazinamid tablet 500 mg Tab 0 0 0
137 Piridoksin HCl (Vit.B6) tablet 10 mg Tab 0 1205 14460
138 Prednison tablet 5 mg Tab 892 628 7536
139 Probiokid Box 26 1 12
140 Propiltiourasil tablet 100 mg Tab 0 0 0
141 Propranolol HCl tablet 10 mg Tab 510 9 108
142 Pyrazinamid tablet 500 mg Tab 0 0 0
143 Ranitidin Injeksi 25 mg/ml ampul 0 0 0
144 Ranitidin tablet 150 mg Tab 786 842 10104
145 Retinol (Vit.A) 100.000 IU kapsul KAPSUL 1096 139 1668
146 Retinol (Vit.A) 200.000 IU kapsul KAPSUL 910 874 10488
147 Rifampisin kapsul 300 mg KAPSUL 0 0 0
148 Rifampisin kapsul 450 mg KAPSUL 0 0 0
149 Rifampisin kapsul 600 mg KAPSUL 0 0 0
150 Salbutamol Cairan ih 0,1% BOTOL 0 0 0
151 Salbutamol tablet 2 mg Tab 0 0 0
152 Salep 2 - 4 kombinasi tube 0 33 396
153 Salisil Bedak 2% - 50 gram tube 864 65 780
154 Sefadroksil Kapsul 500 mg KAPSUL 0 60 720
155 Sefadroksil Syrup 250 mg BOTOL 152 27 324
156 Sefiksim kapsul 100 mg KAPSUL 1394 6 72
157 Setirizin tablet 10 mg Tab 0 0 0
158 Setirizin sir 5 mg/ 5 ml BOTOL 32 3 36
159 Sianokobalamin (Vitamin B12) 50 mg Tab 0 0 0
160 Simvastatin 20 mg Tab 54 177 2124
161 Tablet ferro fumarat 60mg as folat 0.400mg Tab 0 0 0
162 Teofilin tab 150 mg Tab 1000 0 0
163 Tetrasiklin HCl kapsul 250 mg KAPSUL 2078 500 6000
164 Tetrasiklin HCl kapsul 500 mg KAPSUL 0 145 1740
165 Tiamin HCl/Mononitrat (Vit.B1) tablet 50 mg Tab 0 950 11400
166 Triheksifenidil HCl 2 mg tablet Tab 2029 968 11616
167 Vermox tablet (obat cacing) Tab 0 0 0
168 Vitamin B komplek tablet Tab 198418 5337 64044
169 Zink syrup 20 mg/5 ml BOTOL 40 20 240
170 Zink tablet disp 20 mg Tab 3107 670 8040
 0BAT PROGRAM HIV
1 EFAVIRENS tablet 0 0 0
2 HIVIRAL 0 0 0
3 NEVIRAL 0 0 0
4 ATRIPLA 0 0 0
5 TENOFAVIR 0 0 0
6 DUVIRAL 0 0 0
7 ZIDOVUDINE/ 0 0 0
PROGRAM KUSTA
1 MB DEWASA Blister 0 0 0
2 PB DEWASA Blister 0 0 0
3 MB ANAK Blister 0 0 0
PROGRAM TBC 0 0 0
1 OAT FDC Anak Tab 17 1 12
2 OAT FDC Kategori 1 Tab 39 26 312
3 OAT/FDC KATEGORI II Tab 0 0 0
PROGRAM IMUNISASI
1 VAKSIN BCG 10 24 288
2 vaksin DPT-HB-Hib 46 46 552
3 VAKSIN POLIO (b OPV) 35 43 516
4 Vaksin CAMPAK 0 23 276
5 vaksin HB-O 51 30 360
6 Vaksin Td 42 26 312
7 Vaksin IPV 23 6 72
SERUM
1 ABU 0 0 0
2 ADS 0 0 0
3 ATS 0 0 0
4 RABIES 0 0 0
CAIRAN
1 Air untuk injeksi (Aqua pro injeksi) 20 ml BOTOL 0 4 48
2 Glukosa Larutan infus 5% steril 500 ml BOTOL 0 0 0
3 Natrium Klorida [Link] 0,9% steril - 500 ml BOTOL 57 7 84
4 Ringer Laktat larutan infus steril - 500 ml BOTOL 32 28 336
BHP
1 Alat suntik sekali pakai 1 ml Pcs 2842 99 1188
2 Alat suntik sekali pakai 3 ml Pcs 4142 123 1476
3 Alat suntik sekali pakai 5 ml Pcs 1812 192 2304
4 Alkohol Swab box 5 0.5 6
5 autodisable no 0,05 ml Pcs 400 0 0
6 autodisable no. 0,5 ml Pcs 900 0 0
7 Bioplasenton tulle Pcs 0 0 0
8 bloodset Pcs 0 0 0
 9 Catgut Chromic 2/0 + jarum 1/2 HR 26 mm Pcs 47 7 84
10 Catgut Chromic 3/0 + jarum 1/2 HR 26 mm Pcs 357 21 252
11 Cuticell Classic 10 cm x 10 cm Pcs 205 2 24
12 ECG/USG jelly 82gr Pcs 0 0 0
13 Folley Catheter 2 way no 16 Pcs 0 0 0
14 Folley Catheter 2 way no 18 Pcs 0 0 0
Handscoon Non Steril 0 0 0
15 Ukuran L Pcs 0 0 0
16 Ukuran M Pcs 0 0 0
17 Ukuran S Pcs 0 0 0
Handscoon steril 0 0 0
18 Ukuran 6.5 Pcs 0 0 0
19 Ukuran 7.0 Pcs 0 0 0
20 Ukuran 7.5 Pcs 0 0 0
21 ID Patient Adult/Dewasa Biru Pcs 0 0 0
22 ID Patient Adult/Dewasa Pink Pcs 0 0 0
23 Infusion set anak Pcs 0 0 0
24 Infusion set dewasa Pcs 0 0 0
25 IV Catheter G - 18 Pcs 0 0 0
26 IV Catheter G - 20 Pcs 0 0 0
27 IV Catheter G - 22 Pcs 0 0 0
28 Kapas 250 gr Pcs 0 0 0
29 Kapas Pembalut Absorben 1000 gr Pcs 0 0 0
30 Kasa hidrofil 16x16 (steril) box 0 0 0
31 Kasa Kompres 40/40 steril Pcs 0 0 0
32 Kasa Pembalut 2 m x 80 cm Pcs 0 0 0
33 kasa pembalut hydrofil 40 cm x 80 cm Pcs 0 0 0
34 Masker Dus 0 0 0
35 Plester Pcs 0 0 0
36 Plester Polifix 5 cm x 1 m Pcs 0 0 0
37 Policrepe Pembalut Elastis 7,5 cm x 4,55 m Roll 0 0 0
38 Silk 2/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
39 Silk 3/0 + jarum 1/2 GT 35 mm Pcs 0 0 0
40 Urine bag Pcs 0 0 0
BHP GIGI 0 0 0
1 Devitalisasi pasta (Non Arsen) BOTOL 0 0 0
2 Etil Klorida Semprot BOTOL 0 0 0
3 Eugenol cairan - 10 ml BOTOL 0 0 0
4 Fluor tablet 0,5 mg TAB 0 0 0
5 Formokresol Cairan BOTOL 0 0 0
6 Gentian Violet larutan 1% - 10 ml BOTOL 0 0 0
7 Glass Ionomer Cement (GC IX) BOTOL 0 0 0
8 Kalsium Hidroksida Pasta BOTOL 0 0 0
9 Lidokain gel BOTOL 0 0 0
10 Monoklorkamfer Mentol cairan (CHKM) BOTOL 0 0 0
11 Mummifying Pasta Botol 0 0 0
12 Polikresulen cairan POT 0 0 0
13 Semen Seng Fosfat serbuk dan cairan BUAH 0 0 0
14 Spons Gelatin Cubicles 1 x 1 x 1 cm POT 0 0 0
15 Temporary Stopping Fletcher serbuk & cairan BOTOL 0 0 0
16 Trikresol Formalin TKF Cairan 10ml BOTOL 0 0 0
DESINFECTAN 0 0 0
1 Alkohol 70% - 1000 ml Btl 0 0 0
2 Antiseptik Hand Rub 500 ml Btl 0 0 0
3 Gel untuk cateter Btl 0 0 0
4 Lisol 1 liter Btl 0 0 0
5 Povidon Iodida 500 ml Btl 0 0 0
6 Povidon Iodida 60 ml Btl 0 0 0
7 Rivanol larutan 0,1% - 300 cc Btl 0 0 0

Keterangan
Harga sudah sesuai dengan pengadaan Tahun 2017
ANA KEBUTUHAN OBAT
TAHUN 2018

ya Sukaraja No.1 Km. 5 Desa Sukaraja

RENCANA PENGADAAN JUMLAH KETERSEDIAAN HARGA JUMLAH

UMUM BPJS OBAT SATUAN HARGA

1000 2,000 3,000 #DIV/0! 390 1,170,000

4000 0 4,000 12.6582278481 89 356,000
0 0 0 0 80,000 0
0 0 0 #DIV/0! 2,998 0
1000 3,000 4,000 1333.333333333 91 364,000
0 0 0 0 112 0
3000 10,000 13,000 47.61904761905 85 1,105,000
80000 0 80,000 8.255933952528 190 15,200,000
20000 0 20,000 6.800408024481 180 3,600,000
1000 0 1,000 1.666666666667 1,881 1,881,000
0 0 0 #DIV/0! 4,045 0
0 0 0 #DIV/0! 5,100 0
1000 2,000 3,000 37.5 133 399,000
0 0 0 0 1,923 0
100000 0 100,000 13.00390117035 58 5,800,000
250 0 250 #DIV/0! 2,924 731,000
120 0 120 3.157894736842 4,323 518,760
200 500 700 53.84615384615 7,200 5,040,000
0 0 0 #DIV/0! 167 0
0 0 0 #DIV/0! 1,500 0
0 0 0 #DIV/0! 38,999 0
0 0 0 #DIV/0! 1,375 0
0 0 0 #DIV/0! 92 0
10000 0 10,000 5.058168942843 104 1,040,000
5000 0 5,000 #DIV/0! 84 420,000
10000 0 10,000 8.91265597148 100 1,000,000
0 0 0 0 139 0
200 500 700 46.66666666667 3,150 2,205,000
1000 3,000 4,000 27.21088435374 240 960,000
3000 2,000 5,000 #DIV/0! 365 1,825,000
0 0 0 #DIV/0! 1,265 0
0 0 0 #DIV/0! 74 0
500 0 500 10.20408163265 142 71,000
0 0 0 #DIV/0! 10,700 0
1000 0 1,000 41.66666666667 149 149,000
 250 0 250 3.968253968254 1,349 337,250
10 50 60 #DIV/0! 5,800 348,000
10000 0 10,000 9.208103130755 62 620,000
20000 0 20,000 29.11208151383 80 1,600,000
3000 30,000 33,000 1137.931034483 240 7,920,000
10 0 10 #DIV/0! 1,580 15,800
50000 0 50,000 6.936736958935 41 2,050,000
2000 3,000 5,000 100 103 515,000
30 0 30 #DIV/0! 0 0
5 20 25 #DIV/0! 12,090 302,250
0 0 0 #DIV/0! 132 0
30 0 30 #DIV/0! 1,060 31,800
500 2,000 2,500 100 104 260,000
0 0 0 #DIV/0! 268 0
400 500 900 13.23529411765 3,333 2,999,700
1000 5,000 6,000 600 95 570,000
60 0 60 #DIV/0! 1,749 104,940
0 0 0 #DIV/0! 557 0
0 0 0 #DIV/0! 6,150 0
0 0 0 #DIV/0! 359 0
0 0 0 #DIV/0! 152 0
0 0 0 #DIV/0! 1,800 0
100 0 100 #DIV/0! 165 16,500
0 5,000 5,000 2500 1,375 6,875,000
0 0 0 #DIV/0! 350 0
0 0 0 #DIV/0! 605 0
500 1,000 1,500 20.54794520548 686 1,029,000
240 720 960 33.10344827586 3,550 3,408,000
1000 3,000 4,000 86.95652173913 72 288,000
1000 0 1,000 3.508771929825 285 285,000
0 0 0 #DIV/0! 3,386 0
192 480 672 44.8 4,000 2,688,000
2000 5,000 7,000 75.2688172043 56 392,000
40000 100,000 140,000 155.5555555556 341 47,740,000
200 500 700 70 8,107 5,674,900
2000 10,000 12,000 67.79661016949 247 2,964,000
0 0 0 #DIV/0! 56 0
0 0 0 0 61 0
0 0 0 #DIV/0! 69 0
0 0 0 #DIV/0! 36 0
300 1,000 1,300 44.8275862069 2,798 3,637,400
0 0 0 #DIV/0! 102 0
30000 100,000 130,000 21.94833699139 111 14,430,000
400 0 400 #DIV/0! 74 29,600
0 0 0 #DIV/0! 158 0
 1000 2,000 3,000 44.11764705882 90 270,000
0 0 0 #DIV/0! 104,000 0
0 0 0 #DIV/0! 7,800 0
10000 20,000 30,000 45.04504504505 56 1,680,000
0 0 0 0 245 0
48 0 48 6 2,500 120,000
240 480 720 32.72727272727 2,595 1,868,400
1000 0 1,000 3.703703703704 280 280,000
0 0 0 0 603 0
0 0 0 #DIV/0! 1,650 0
4000 5,000 9,000 11.42131979695 250 2,250,000
120 0 120 5.217391304348 3,091 370,920
360 480 840 20.48780487805 1,810 1,520,400
120 240 360 #DIV/0! 1,600 576,000
40000 0 40,000 8.55614973262 37 1,480,000
3000 5,000 8,000 200 144 1,152,000
0 0 0 #DIV/0! 1,100 0
500 1,000 1,500 #DIV/0! 500 750,000
10000 0 10,000 14.66275659824 321 3,210,000
400 0 400 8.510638297872 2,120 848,000
0 0 0 #DIV/0! 670 0
0 0 0 #DIV/0! 6,200 0
0 0 0 #DIV/0! 315 0
300 0 300 6.976744186047 1,111 333,300
300 0 300 8.333333333333 1,937 581,100
0 0 0 #DIV/0! 123 0
0 0 0 #DIV/0! 2,630 0
0 0 0 #DIV/0! 2,630 0
1000 3,000 4,000 37.38317757009 94 376,000
1000 3,000 4,000 108.1081081081 911 3,644,000
0 0 0 0 2,849 0
1000 3,000 4,000 71.42857142857 154 616,000
0 0 0 #DIV/0! 194 0
0 0 0 #DIV/0! 87 0
100 0 100 33.33333333333 3,800 380,000
3000 0 3,000 6.593406593407 90 270,000
2000 0 2,000 7.692307692308 113 226,000
240 480 720 16.74418604651 3,000 2,160,000
200 500 700 11.11111111111 8,720 6,104,000
10000 10,000 20,000 21.00840336134 935 18,700,000
3000 0 3,000 47.61904761905 20 60,000
3000 3,000 6,000 21.73913043478 200 1,200,000
1000 2,500 3,500 58.33333333333 99 346,500
0 400 400 18.18181818182 545 218,000
0 0 0 0 640 0
 1000 2,000 3,000 85.71428571429 1,430 4,290,000
240 480 720 #DIV/0! 1,675 1,206,000
400 1,000 1,400 21.875 1,900 2,660,000
3000 0 3,000 35.71428571429 140 420,000
0 0 0 #DIV/0! 440 0
200 500 700 26.92307692308 5,200 3,640,000
50000 0 50,000 5.81260172053 49 2,450,000
800 0 800 3.827751196172 1,010 808,000
60 200 260 #DIV/0! 12,155 3,160,300
0 0 0 0 269 0
0 0 0 #DIV/0! 228 0
10000 0 10,000 8.298755186722 118 1,180,000
4000 7,000 11,000 17.51592356688 76 836,000
20 50 70 70 130,240 9,116,800
0 0 0 #DIV/0! 319 0
0 0 0 0 52 0
0 0 0 #DIV/0! 228 0
0 0 0 #DIV/0! 1,458 0
7000 10,000 17,000 20.19002375297 98 1,666,000
924 0 924 6.647482014388 260 240,240
9914 0 9,914 11.34324942792 459 4,550,526
0 0 0 #DIV/0! 648 0
0 0 0 #DIV/0! 660 0
0 0 0 #DIV/0! 1,108 0
10 0 10 #DIV/0! 6,600 66,000
1000 0 1,000 #DIV/0! 78 78,000
240 0 240 7.272727272727 2,527 606,480
0 0 0 0 1,020 0
5000 10,000 15,000 250 450 6,750,000
300 0 300 11.11111111111 5,895 1,768,500
0 0 0 0 750 0
2000 5,000 7,000 #DIV/0! 96 672,000
200 0 200 66.66666666667 2,850 570,000
0 0 0 #DIV/0! 51 0
2000 0 2,000 11.29943502825 229 458,000
295440 0 295,440 #DIV/0! 350 103,404,000
1000 2,000 3,000 #DIV/0! 270 810,000
3000 0 3,000 6 148 444,000
3000 5,000 8,000 55.1724137931 310 2,480,000
5000 0 5,000 5.263157894737 82 410,000
5000 0 5,000 5.165289256198 80 400,000
0 0 0 #DIV/0! 8,800 0
30000 0 30,000 5.621135469365 107 3,210,000
200 500 700 35 4,789 3,352,300
2000 5,000 7,000 10.44776119403 473 3,311,000
 0 0 0 #DIV/0! 0 0
0 0 0 #DIV/0! 0 0
0 0 0 #DIV/0! 0 0
0 0 0 #DIV/0! 0 0
0 0 0 #DIV/0! 0 0
0 0 0 #DIV/0! 0 0
0 0 0 #DIV/0! 0 0

12 0 12 #DIV/0! 0 0
6 0 6 #DIV/0! 0 0
12 0 12 #DIV/0! 0 0
0 0 #DIV/0! 0 0
20 0 20 20 223,583 4,471,660
160 0 160 6.153846153846 374,379 59,900,640
0 0 0 #DIV/0! 1,247,984 0

480 0 480 20 0 0
1080 0 1,080 23.47826086957 0 0
960 0 960 22.32558139535 0 0
480 0 480 20.86956521739 0 0
600 0 600 20 0 0
600 0 600 23.07692307692 0 0
240 0 240 40 0 0

12 0 12 #DIV/0! 462,000 5,544,000

12 0 12 #DIV/0! 0 0
12 0 12 #DIV/0! 126,500 1,518,000
96 0 96 #DIV/0! 0 0

100 0 100 25 2,302 230,200

0 0 0 #DIV/0! 6,900 0
140 200 340 48.57142857143 6,410 2,179,400
200 1000 1,200 42.85714285714 7,150 8,580,000

0 0 0 0 990 0
500 0 500 4.065040650407 792 396,000
300 0 300 1.5625 979 293,700
3 0 3 6 10,000 30,000
0 0 0 #DIV/0! 1,354 0
0 0 0 #DIV/0! 1,175 0
10 50 60 #DIV/0! 104,000 6,240,000
20 100 120 #DIV/0! 13,420 1,610,400
 0 0 0 0 5,583 0
120 0 120 5.714285714286 5,583 669,960
100 100 50 5,198 519,800
0 0 #DIV/0! 34,528 0
0 0 #DIV/0! 8,500 0
0 0 #DIV/0! 8,500 0
0 #DIV/0! 0 0
0 0 #DIV/0! 1,144 0
0 0 #DIV/0! 1,144 0
0 0 #DIV/0! 1,144 0
0 #DIV/0! 0 0
0 0 #DIV/0! 7,600 0
0 0 #DIV/0! 7,600 0
0 0 #DIV/0! 7,600 0
0 0 #DIV/0! 850 0
0 0 #DIV/0! 850 0
0 0 #DIV/0! 5,100 0
0 0 #DIV/0! 4,800 0
0 0 #DIV/0! 10,000 0
500 500 #DIV/0! 10,000 5,000,000
0 0 #DIV/0! 10,000 0
0 0 #DIV/0! 28,530 0
0 0 #DIV/0! 107,193 0
0 0 #DIV/0! 7,900 0
0 0 #DIV/0! 1,800 0
0 0 #DIV/0! 9,400 0
0 0 #DIV/0! 130,000 0
0 0 #DIV/0! 24,000 0
0 0 #DIV/0! 12,076 0
0 0 #DIV/0! 7,370 0
0 0 #DIV/0! 27,830 0
0 0 #DIV/0! 14,000 0
0 0 #DIV/0! 13,616 0
0 0 #DIV/0! 3,000 0
0 #DIV/0! 0 0
6 6 #DIV/0! 38,200 229,200
12 12 #DIV/0! 103,000 1,236,000
12 12 #DIV/0! 16,667 200,004
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