LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MATAKO PELAPORAN BLN/PERIODE : AGUSTUS 2020

KECAMATAN : TOJO BARAT PERMINTAAN BLN/PERIODE : SEPTEMBER 2020
KABUPATEN : TOJO UNA UNA
PROPINSI : SULAWESI TENGAH

Stok Peneri- Perse- Pema- Stok Permin- Pemberian

NO Nama Obat/Alkes/BMHP Satuan Awal maan diaan kaian Akhir taan APBD I APBD II Program Lain- Jumlah KET
lain
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Abbocath 18 Piece 50 50 0 50
2 Abbocath 20 Piece 70 70 0 70
3 Abbocath 22 Piece 140 140 0 140
4 Abbocath 24 Piece 72 72 0 72
5 Acyclovir cream Tube 40 40 0 40
6 Acyclovir tablet 200 mg Tab 1,000 1,000 2,000 0 2,000
7 Acyclovir tablet 400 mg Tab 2,100 2,100 0 2,100
8 Ailin tetes mata Botol 0 0 0 0
9 AIC Now + Sistem 20'S Box 0 0 0 0
10 Alat Autochek Unit 0 0 0 0
11 Alat Pemeriksa HB Buah 0 0 0 0
12 Alat suntik sekali pakai 1 ml Piece 500 500 0 500
13 Alat suntik sekali pakai 10 ml Piece 200 200 0 200
14 Alat suntik sekali pakai 3 ml Piece 250 250 0 250
15 Alat suntik sekali pakai 5 ml Piece 600 600 0 600
16 Albendazol 400 mg Tab 0 0 0 0
17 Alcohol Swab CHG + 0,5 % Box 1 1 0 1
18 Alletrol Tetes Mata Botol 0 0 0 0
19 Allopurinol Tab 100 mg Tab 2,200 2,200 800 1,400
20 Allopurinol Tab 300 mg Tab 0 0 0 0
21 Alprazolam Tablet 0,5 mg Tab 500 500 300 200
22 Alprazolam Tablet 1 mg Tab 0 0 0 0
23 Ambroxol 30 mg Tab 1,200 1,200 0 1,200
24 Ambroxol syr Botol 30 30 0 30
25 Aminofilin inj 24 mg/ml Ampul 30 30 0 30
26 Amitriptilin Tablet Salut 25 mg Tab 1,400 1,400 100 1,300
27 Amlodipin Tablet 10 mg Tab 510 510 0 510
28 Amlodipin Tablet 5 mg Tab 600 600 0 600
29 Amoksisilin Kapsul 500 mg Tab 200 1,000 1,200 800 400
30 Amoxycillin Syrup 125 mg / 5 ml Botol 0 0 0 0
31 Amoxycillin Syrup 250 mg / 5 ml Botol 60 60 0 60
32 Ampicilin 500 mg Tab 200 200 0 200
33 Ampicilin syr Botol 0 0 0 0
34 Analog Long Insulin 100 IU Pen Pen 0 0 0 0
35 Antalgin 500 mg Tab 0 0 0 0
36 Antalgin Injeksi Ampul 0 0 0 0
37 Antasida DOEN I tablet kunyah Tab 0 0 0 0
38 Antasida Doen Syrup Botol 300 300 0 300
39 Antihemoroid Supp 90 90 0 90
40 Antimalaria Tab 0 0 0 0
41 Antiseptik Hand Rub 10 Btl @ 500 ml Botol 54 54 0 54
42 Antrain Injeksi Ampul 0 0 0 0
43 Aqua pro Injeksi 20 ml Ampul 46 46 0 46
44 Arkine Tab 3,000 3,000 750 2,250
45 Asam Askorbat Tablet 50 mg Tab 7,700 7,700 2,700 5,000
46 Asam Folat tablet 1 mg Tab 0 0 0 0
47 Asam Mefenamat kaplet 500 mg Kap 9,600 9,600 0 9,600
48 Asam Traneksamat 250 mg Ampul 15 15 0 15
49 Asam Valproat Syrup Botol 0 0 0 0
50 Asetosal Tablet 80 mg Tab 0 0 0 0
51 Atropin inj 0,25 mg / ml Ampul 20 20 0 20
52 Betahistin Tablet 6 mg Tab 100 100 0 100
53 Betametason Krim 0,1 %/Skizon Tube 0 0 0 0
54 Biocombin Injk/Farbion Injeksi Ampul 0 0 0 0
55 Bionemi Kaps Kapsul 0 0 0 0
56 Bisoprolol Tablet 5 mg Tab 50 50 0 50
57 Blood Lancents Buah 4 4 0 4
58 Buscopan Injeksi/Skopamin Ampul 0 0 0 0
59 Candesartan 8 mg Tab 0 0 0 0
60 Captopril Tablet 12,5 mg Tab 100 100 0 100
61 Captopril Tablet 25 mg Tab 500 500 100 400
62 Catapres Injeksi Ampul 70 70 0 70
63 Cathejell Lidocain 2 % & CHG 0,05 % Ampul 3 3 0 3
64 Catqut Chromic 2/0 75 C + Jarum 1/2 30 M R Box 0 0 0 0
65 Catqut Chromic 2/0 HR 20 MM Sachet 0 0 0 0
66 Catqut Chromic 3/0 75 C + Jarum 1/2 37 M R Box 1 1 0 1
67 Catqut Plain 2/0 HR 37 MM Sachet 1 1 0 1
68 Catqut Plain 3/0 HR 26 MM Sachet 1 1 0 1
69 Catqut Plain 4/0 100 M Roll 0 0 0 0
70 Cefadroxil kapsul 500 mg Kap 3,500 3,500 500 3,000
71 Cefadroxil Syrup 125 mg/ 5 ml Botol 160 160 0 160
72 Cimetidin Tab 0 0 0 0
73 Colcitine 0,5 mg Tab 810 810 0 810
74 Clobazam Tab 0 0 0 0
75 Clonidine 0,15 mg Tab 100 100 0 100
76 Clopidogrel 75 mg Tab 0 0 0 0
77 Combivent UDV Vial 0 0 0 0
78 Curcuma Tab 0 0 0 0
79 Deksametason Injeksi i.v/i.m 5 mg/ml Ampul 555 555 75 480
80 Deksametason Tablet 0,5 mg Tab 0 0 0 0
81 Diazepam Tablet 2 mg Tab 4,100 4,100 200 3,900
82 Diazepam injeksi 5 mg / ml Ampul 20 20 0 20
83 Diazepam larutan rektal 10 mg/2,5 ml Tube 0 0 0 0
84 Diazepam Tablet 5 mg Tab 0 0 0 0
85 Digoksin 0,25 mg Tab 0 0 0 0
86 Diltiazem HCL tablet 30 mg Tab 0 0 0 0
87 Dimenhidrinat tab 50 mg Tab 1,300 1,300 0 1,300
88 Diphenhidramin Injeksi 10 mg/ml Ampul 60 60 30 30
89 Diuvar Injeksi Ampul 5 5 0 5
90 Doksisiklin Kapsul 100 mg Kap 1,000 1,000 0 1,000
91 Domperidon suspensi 5 mg / 5 ml Botol 0 0 0 0
92 Domperidon tablet 10 mg Tab 1,900 1,900 400 1,500
93 Dulcolax 5 mg/Bisacodyl 5 mg Tab 0 0 0 0
94 Dulcolax Suppo anak Supp 31 31 0 31
95 Dumin Rectal Supp 0 0 0 0
96 Eflin Tab 200 200 0 200
97 Enbatic Cream Tube 0 0 0 0
98 Epinefrin Inj. i.v.s.k/i.m 1 mg/ml Ampul 180 180 0 180
99 Ergotamin tab 1 mg Tab 0 0 0 0
100 Eritromisin Kapsul 500 mg Kap 1,000 1,000 0 1,000
101 Erladerm-N Tube 0 0 0 0
102 Erlemicetin Tetes Telinga Botol 0 0 0 0
103 Erlemicetin Tetes Mata Botol 0 0 0 0
104 Etakridin Botol 8 8 0 8
105 Etambutol tablet salut 500 mg Tab 0 0 0 0
106 Etanol 70% 1 Liter Botol 0 0 0 0
107 Etanol 70% 300 ml Botol 0 0 0 0
108 Etilklorida Botol 0 0 0 0
109 Folley Catheter 3 - 5 ml / cc - 10 fr Piece 14 14 0 14
110 Folley Catheter 3 - 5 ml / cc - 16 fr Piece 32 32 0 32
111 Folley Catheter 3 - 5 ml / cc - 18 fr Piece 10 10 0 10
112 Folley Catheter 3 - 5 ml / cc - 22 fr Piece 0 0 0 0
113 Furosemid tab 40 mg Tab 1,200 1,200 200 1,000
114 Gabapentin Tablet 300 mg Kap 0 0 0 0
115 Garam Oralit Sachet 1,400 1,400 0 1,400
116 Gemfibrozil Kapsul 300 mg Kap 600 600 0 600
117 Gentalex Krim Tube 160 160 0 160
118 Gentamisin Inj. 40 mg/ml Ampul 0 0 0 0
119 Gentamisin Salep Tube 0 0 0 0
120 Gention Violet Botol 19 19 0 19
121 Glibenklamid tab 5 mg Tab 0 0 0 0
122 Glimepiride 2 mg Tab 900 900 600 300
123 Gliseril Guaiacolat 100 mg Tab 0 0 0 0
124 Gliserin lar 50 % Botol 54 54 0 54
125 Glukosa Lar. Infus 5 % Steril Botol 60 60 0 60
126 Griseofulvin tablet 125 mg Tab 5,400 5,400 0 5,400
127 Griseofulvin tablet 500 mg Tab 700 700 0 700
128 Halloperidol 0,5 mg Tab 500 500 0 500
129 Halloperidol 1,5 mg Tab 4,900 4,900 300 4,600
130 Halloperidol 5 mg Tab 500 500 0 500
131 Handscond Genekolog Psg 160 160 0 160
132 Handscond No. 7 Steril Psg 200 200 0 200
133 Handscond No. 7,5 Steril Psg 1,100 1,100 0 1,100
134 Handscond Non Steril (M) Psg 2,200 2,200 0 2,200
135 Handscond Non Steril ((L) Psg 4,500 4,500 0 4,500
136 Hemafort Tab 0 0 0 0
137 Hidroklortiazid tablet 25 mg Tab 0 0 0 0
138 Hidrokortison krim 2,5 % Tube 96 96 0 96
139 Ibuprofen syrup 200 mg/5 ml Botol 130 130 0 130
140 Ibuprofen tablet 400 mg Tab 0 0 0 0
141 Ichtiyol Pot 16 16 0 16
142 Infusion Set Anak Buah 968 968 0 968
143 Infusion Set Dewasa Buah 48 48 0 48
144 Iodina test Botol 0 0 0 0
145 Isoniazid Tablet Tab 0 0 0 0
146 Isosorbid Dinitrat tab 5 mg Tab 700 700 200 500
147 Kalsium Glukonat Inj i.v 10 % Ampul 73 73 0 73
148 Kalsium Lactat Tablet 500 mg Tab 3,800 3,800 400 3,400
149 Kanamicin inj Vial 50 50 0 50
150 Kaotin Syrup Botol 0 0 0 0
151 Kapas Pembalut 250 mg Roll 25 25 0 25
152 Karbamazepin Kaplet 200 mg Kap 7,300 7,300 1,100 6,200
153 Kasa hydrofil Steril 16x16 cm Dos 0 0 0 0
154 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0
155 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0
156 Kertas USG Rol 10 10 0 10
157 Ketokonazole krim 2 % Tube 275 275 0 275
158 Ketokonazole tablet 200 mg Tab 5,100 5,100 0 5,100
159 Kloramphenicol Kapsul 250 mg/Novachlor Kap 5,700 5,700 0 5,700
160 Kloramphenicol salep mata 1 % Tube 96 96 0 96
161 Kloramphenicol Suspensi 125mg/5ml Botol 19 19 0 19
162 Kloramphenicol tetes mata 0,5 % Botol 0 0 0 0
163 Klorfenilamin Maleat tablet 4 mg Tab 1,500 1,500 0 1,500
164 Klorpromazin Injeksi salut 25 mg/ml Ampul 0 0 0 0
165 Klorpromazin Tab Salut 25 mg Tab 0 0 0 0
166 Klorpromazin Tablet salut 100 mg Tab 400 400 0 400
167 Kodein tablet 10 mg Tab 300 300 0 300
168 Kolicgon Tab 0 0 0 0
169 Kotrimoksazole Tablet 480 mg Tab 5,500 5,500 0 5,500
170 Kotrimoxazol Suspensi Botol 0 0 0 0
171 Kutoin 100 mg Tab 0 0 0 0
172 Lancet For Fine Touch Dos 4 4 0 4
173 Larutan PK Pot 0 0 0 0
174 Larutan H2O2 Botol 4 4 0 4
175 Lidocain HCL 2% Injeksi Ampul 2,230 2,230 0 2,230
176 Lidocain Injeksi 2% + Epinefrin 1 : 8000 - 2 ml Ampul 30 30 0 30
177 Lisol Botol 0 0 0 0
178 Loperamid Tablet 2 Mg Tab 100 100 0 100
179 Loratadin 10 mg Tab 2,800 2,800 100 2,700
180 Masker Earloop Psg 0 0 0 0
181 Masker Karet Psg 0 0 0 0
182 Masker N95 Box 0 0 0 0
183 Masker Tali Dos 0 0 0 0
184 Meloksikam 15 mg Tab 0 0 0 0
185 Metergin Inj Vial 0 0 0 0
186 Metformin HCL Tablet 500 mg Tab 1,600 1,600 0 1,600
187 Metilergometrin inj 0,2 mg / ml Ampul 290 290 0 290
188 Metilergometrin Tablet 0,125 mg Tab 2,200 2,200 0 2,200
189 Metilprednisolon Tablet 4 mg Tab 500 500 0 500
190 Metilprednisolon tablet 8 mg Tab 0 0 0 0
191 Metoklopramide Injeksi Ampul 10 10 0 10
192 Metoklopramide Sirup 5 mg/5 ml Botol 0 0 0 0
193 Metoklopramide Tablet 10 mg Tab 1,000 1,000 0 1,000
194 Metolon Inj Ampul 0 0 0 0
195 Metronidazol tablet 500 mg Tab 400 400 0 400
196 MgSO4 inj 20% - 25 ml Botol 81 81 0 81
197 MgSO4 inj 20% - 25 ml Botol 0 0 0 0
198 MgSO4 inj 40% - 25 ml Botol 24 24 0 24
199 Mikonazole Salep 2% Tube 96 96 0 96
200 Mix Insulin Flexpen / Catridge Pen 0 0 0 0
201 Mucotussan Tab 0 0 0 0
202 Multivitamin Seven Seas Botol 128 128 0 128
203 My Jelli 83 Gram Tube 0 0 0 0
204 Nacl 0,9% Botol 40 40 0 40
205 Natrium Diklofenak 25 mg Tab 3,600 3,600 600 3,000
206 Needle No.23 Pcs 0 0 0 0
207 Neurovit E Kotak 400 400 200 200
208 Nifedipin tablet 20 mg Tab 100 100 0 100
209 Nistatin Tablet salut 100.000 IU/g Tab 420 420 0 420
210 Nistatin Tablet salut 500.000 IU/g Tab 200 200 0 200
211 Novadiar Syrup Botol 140 140 0 140
212 Novapyron/Neurotropic Plus Tab 0 0 0 0
213 Novazon Tab 0 0 0 0
214 Novo Twist Box 8 8 0 8
215 Novorapid Pen 0 0 0 0
216 OAT FDC Kategori 1 Paket 8 8 0 8
217 OAT FDC Kategori Anak Paket 3 3 0 3
218 OAT FDC Kategori Anak Paket 0 0 0 0
219 OAT FDC Kategori FDC Kategori Sisipan Paket 0 0 0 0
220 OAT FDC Kategori II Paket 2 2 0 2
221 OBH Botol 105 105 0 105
222 Oksitetrasiklin salep kulit 3% Tube 115 115 0 115
223 Oksitetrasiklin salep mata 1% Tube 0 0 0 0
224 Oksitosin inj 10 UI/ml Ampul 200 200 0 200
225 Omeprazol Tablet 20 mg Kapsul 0 0 0 0
226 Ondancentron 8 mg Ampul 64 64 0 64
227 Oxybiotic Inj Vial 0 0 0 0
228 Papaverin 40 mg Tab 0 0 0 0
229 Paracetamol syrup 120 mg / 5 ml Botol 0 0 0 0
230 Parasetamol Kaplet 500 mg Tab 0 0 0 0
231 Pehacain Inj Ampul 0 0 0 0
232 Pehatrim Forte Tab 0 0 0 0
233 Phenol Gliserol Tetes Telinga Botol 20 20 0 20
234 Phitomenadion inj i.m 2 mg / ml Ampul 120 120 0 120
235 Phitomenadion tablet 10 mg Tab 1,500 1,500 0 1,500
236 Piracetam 400 mg Tab 700 700 0 700
237 Piracetam inj 3g/15ml Ampul 10 10 0 10
238 Pirantel Tablet 125 mg Tab 0 0 0 0
239 Piridoksin inj 100 mg/ml Ampul 0 0 0 0
240 Piridoksin Tablet 10 mg Tab 0 0 0 0
241 Piroksicam 20 mg Tab 0 0 0 0
242 Pisau bedah Box 20 20 0 20
243 Pisau bedah 21 Set 0 0 0 0
244 Plano test Buah 23 23 0 23
245 Plester 7,5cm x 4,5m Rol 60 60 0 60
246 Plesterin Bulat Non Woven Box 41 41 0 41
247 Poligyp 5 cm x 2,7 m Roll 19 19 0 19
248 Pot sputum Pot 0 0 0 0
249 Povidon Iodida larutan 10% 60 ml Botol 38 38 0 38
250 Prednison tablet Tab 5,700 5,700 1,200 4,500
251 Primakuin Tablet 15 mg Tab 1,000 1,000 0 1,000
252 Promavit Kapsul Kapsul 0 0 0 0
253 Propanolol tablet 10 mg Tab 600 600 300 300
254 Propilteurasil 100 Mg Tab 100 100 0 100
255 Ramipril Tablet 5 mg Tab 0 0 0 0
256 Ranitidin Injeksi 25 mg/ml Ampul 100 100 13 87
257 Ranitidin Tablet 150 mg Tab 700 700 0 700
258 RDT DBD Pcs 4 4 0 4
259 RDT malaria Pcs 0 0 0 0
260 Retinol (Vitamin A) 100.000 IU Kapsul 20 20 0 20
261 Retinol (Vitamin A) 200.000 IU Botol 7 7 0 7
262 Rifampisin tablet 450 mg Kapsul 0 0 0 0
263 Rifampisin tablet 600 mg Kaplet 0 0 0 0
264 Ringer Laktat Larutan Infus Botol 620 620 0 620
265 Risperidon 2 mg Tab 0 0 0 0
266 Salbutamol 2 mg Tab 0 0 0 0
267 Salbutamol 4 mg Tab 6,700 6,700 500 6,200
268 Salep 2-4 Pot 45 45 0 45
269 Salisil Bedak serbuk 2% Box 180 180 0 180
270 Selediar Tab 0 0 0 0
271 Selesbion Tab 0 500 500 0 500
272 Selkom C Kap 0 0 0 0
273 Selviplex Kap 0 0 0 0
274 Serum ATS Botol 0 0 0 0
275 Setirizin sirup 5 mg/5ml Botol 33 33 0 33
276 Setrizin Tablet 10 mg Tab 0 0 0 0
277 Sianokobalamin injeksi 500 mcg Ampul 170 170 0 170
278 Scopamin 10 mg Tab 1,200 1,200 0 1,200
279 Sidiadryl Inj Vial 0 0 0 0
280 Silk 3/0 100 M Roll 0 0 0 0
281 Silk 3/0 75 C + Jarum 1/2 17 M R Box 0 0 0 0
282 Silk 4/0 100 M Roll 0 0 0 0
283 Silk Black 2/0 DS 30 MM Sachet 0 0 0 0
284 Silk Black 3/0 DS 30 MM Sachet 0 0 0 0
285 Simvastatin 10 mg Tab 0 0 0 0
286 Sianokobalamin Tab 0 0 0 0
287 Simvastatin 20 mg Tab 500 1,000 1,500 900 600
288 Siprofloksasin Tablet 500 mg Tab 8,800 8,800 0 8,800
289 Soldextam Tab 0 0 0 0
290 Solvita Plus Syrup Botol 0 0 0 0
291 Spasmolit Tab 0 0 0 0
292 Spironolacton 25 mg Tab 0 0 0 0
293 Stesolid 5 mg Tube 0 0 0 0
294 Stik Asam Urat Autochek Botol 3 3 0 3
295 Stik Asam Urat Benecheck Box 0 0 0 0
296 Stik Gula Darah Autochek Box 0 0 0 0
297 Stik Gula Darah Benecheck Box 0 0 0 0
298 Stik Kolesterol Autochek Botol 0 0 0 0
299 Stik Kolesterol Benecheck Botol 0 0 0 0
300 Stik Pemerksaan HB Botol 1 1 0 1
301 Sulfadoxine Pyrimehamine 250 mg Tab 400 400 0 400
302 Tablet Tambah Darah Sachet 0 0 0 0
303 Tablet Tambah Darah Tab 0 0 0 0
304 Tetrasiklin kapsul 500 mg kap 1,200 1,200 0 1,200
305 Termorex Drops Botol 0 0 0 0
306 Thiamin 50 mg Tab 750 750 0 750
307 Thiamin inj Ampul 0 0 0 0
308 Tramadol 50 mg Tab 0 0 0 0
309 Truvit Syrup Botol 3 3 0 3
310 Urin bag Pcs 10 10 0 10
311 Urin bag Pcs 0 0 0 0
312 USG Gel 250 ml Botol 0 0 0 0
313 Vastigo Tab 0 0 0 0
314 Ventolin Nebulizer Ampul 40 40 0 40
315 Verorab Vial 0 0 0 0
316 Vitamin B Kompleks Tablet Tab 700 700 0 700
317 Vitamin B Kompleks Injeksi Vial 0 0 0 0
318 Wing needle No.23 Pcs 0 0 0 0
319 Zinc Syrup Botol 180 180 0 180
320 Zink Tablet 20 mg Tab 0 0 0 0
321 Leukoplast Roll 0 0 0 0
322 Nystatin Drop Botol 76 76 0 76
323 Paracetamol Drops Botol 0 0 0 0
324 Dopamet Tab 50 50 0 50
325 Acetylcystein Tab 0 0 0 0
326 Aspar-K Tab 0 0 0 0
327 New Antides Tab 3,100 3,100 0 3,100
328 Atrovent Botol 2 2 0 2
329 Mometasone Tube 25 25 0 25
330 Soft U cream Tube 62 62 0 62
331 Paracetamol Infus Botol 50 50 0 50
332 Metronidazol Infus Botol 10 10 0 10
333 Clozapine 25 mg Tab 1,050 1,050 450 600
334 Clorpromazine Injeksi Ampul 0 0 0 0
335 Sanbe Tears Botol 1 1 0 1
336 Pantocain Botol 0 0 0 0
337 Caterlent Botol 3 3 0 3
338 Scopamin Ampul 10 10 0 10
339 Omeprazole Injek 40 mg Ampul 14 14 0 14
340 Guaifeesin 100 mg Tab 800 1,000 1,800 1,200 600
341 Depakote Botol 100 100 0 100
342 Phenobarbital Inj Ampul 28 28 0 28
343 Furosemide Inj Ampul 0 0 0 0
344 Elasti Perban 7,5 cm x 4,5 cm Buah 8 8 0 8
345 Medigibs Buah 19 19 0 19
346 Nasal Oksigen ( selang O2) Buah 0 0 0 0
347 Slide Microscope Buah 169 169 0 169
348 One step anti HIV 1/2 Test Btl 2 2 0 2
349 Alat suntik sekali pakai 20ml Buah 0 0 0 0
350 Iliadin tetes hidung anak Botol 4 4 0 4
351 cendo Xytrol Botol 15 15 0 15
352 Primpen Botol 740 740 0 740
353 Aqua Gell Tube 15 15 0 15
354 Alkohon 1 liter 70% Botol 10 10 0 10
355 Spritus Botol 1 1 0 1
356 Emercin oil Botol 3 3 0 3
357 Gemsa Buah 2 2 0 2
358 Mitela Buah 1 1 0 1
359 Metanol Botol 3 3 0 3
360 Gliserin 100 ml Botol 55 55 0 55
361 Adalat 20 mg Tab 450 450 30 420
362 Atrofastatin 20 mg Tab 360 360 120 240
363 Asam Traneksamat 500 mg Tab 100 100 0 100
364 Loremide Tab 100 100 0 100
365 Vomistop Tab 60 60 0 60
366 Tagadem Buah 19 19 0 19
367 Blood Lancents Buah 1,000 1,000 0 1,000
368 Farsifen 400 mg Tablet 300 300 0 300
369 Miniaspi 80 mg Tablet 900 900 0 900
370 Pritagesic Tablet 100 100 0 100
371 Ovtelis 20 mg Tablet 300 300 0 300
372 Novagesic 500 mg Tablet 5,600 5,600 5,400 200
373 Faridexon 0,5 mg Tablet 0 0 0 0
374 Abbocath 26 Pcs 7 7 0 7
375 Valium 5 mg Tablet 0 0 0 0
376 Oxygen Nasal Canula Anak Pcs 2 2 0 2
377 Penjepit Tali Pusat Pcs 0 0 0 0
378 Sotatic Ampul 5 5 0 5
379 Yusimox 125mg/5 ml Botol 360 360 0 360
380 Handsoon Non Steril (S) Pcs 900 900 0 900
381 Cavicur Tablet 200 200 0 200
382 Prix 25 mg Tablet 0 0 0 0
383 Patrin 250 mg Tablet 580 580 20 560
384 Grafalin 2 mg Tablet 400 400 0 400
385 Phenitoin Injeksi Ampul 10 10 0 10
386 Diazepam 2 Mg Tablet 200 200 0 200
387 Twist Lancet 28 G Pcs 1,300 1,300 0 1,300
388 Easy Touch Boold Glukose Pcs 0 0 0 0
389 Easy Touch Urid Acid Pcs 4 4 0 4
390 Easy Touch Cholesterol Ampul 0 0 0 0
391 Ovtelis 10 mg Tablet 100 100 0 100
392 Underpads Pcs 20 20 0 20
393 Stik Urinalysis Pcs 100 100 0 100
394 Novagesic Syr Botol 0 0 0 0
395 Siobion Tablet 0 0 0 0
396 Diatabs Tablet 1,400 1,400 0 1,400
397 Repas 400 mg Tablet 9,900 9,900 0 9,900
398 Farizol 500 mg Tablet 5,000 5,000 0 5,000
399 Diazepam 5 mg Tablet 180 180 0 180
400 Pritanol 300 mg Tablet 2,600 2,600 800 1,800
401 Novadium Tablet 500 500 0 500
402 Nasal Oksigen ukuran Xs Pcs 10 10 0 10
403 Nasal Oksigen Ukuran S Pcs 10 10 0 10
404 Scobutrin Tablet 100 100 0 100
405 Floxigra 500 mg Tablet 100 100 0 100
406 Eritromisin Syr Botol 50 50 0 50
407 Amoxcicilin 250 mg Tablet 1,000 1,000 200 800
408 Trihexylphenidyl Hcl 2 mg Tablet 1,500 1,500 0 1,500

JAMKESDA BPJS
JUMLAH KUNJUNGAN RESEP
 Mengetahui/Menyetujui Yang Menyerahkan Yang Memohon Yang Menerima
Kepala Seksi Kefarmasian Penanggung Jawab
Gudang Farmasi

Sahrul, SKM Arini Priyanti Kandupi. S.Farm., Apt Megawati Ranindi, S.Tr.Keb Nur Mufida Saenda,S.Farm
Nip. 19820714 200502 1 002 Nip. 19820403 200804 2 002 Nip. 19730708 199303 2 004
 LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MATAKO PELAPORAN BLN/PERIODE : JULI 2020

KECAMATAN : TOJO BARAT PERMINTAAN BLN/PERIODE : AGUSTUS 2020
KABUPATEN : TOJO UNA UNA
PROPINSI : SULAWESI TENGAH

Stok Peneri- Perse- Pema- Stok Permin- Pemberian

NO Nama Obat/Alkes/BMHP Satuan Awal maan diaan kaian Akhir taan APBD I APBD II Program Lain- Jumlah KET
lain
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Abbocath 18 Piece 160 160 110 50
2 Abbocath 20 Piece 150 150 80 70
3 Abbocath 22 Piece 140 140 0 140
4 Abbocath 24 Piece 82 82 10 72
5 Acyclovir cream Tube 40 40 0 40
6 Acyclovir tablet 200 mg Tab 1,000 1,000 0 1,000
7 Acyclovir tablet 400 mg Tab 2,100 2,100 0 2,100
8 Ailin tetes mata Botol 0 0 0 0
9 AIC Now + Sistem 20'S Box 0 0 0 0
10 Alat Autochek Unit 0 0 0 0
11 Alat Pemeriksa HB Buah 0 0 0 0
12 Alat suntik sekali pakai 1 ml Piece 500 500 0 500
13 Alat suntik sekali pakai 10 ml Piece 200 200 0 200
14 Alat suntik sekali pakai 3 ml Piece 250 250 0 250
15 Alat suntik sekali pakai 5 ml Piece 600 600 0 600
16 Albendazol 400 mg Tab 0 0 0 0
17 Alcohol Swab CHG + 0,5 % Box 1 1 0 1
18 Alletrol Tetes Mata Botol 0 0 0 0
19 Allopurinol Tab 100 mg Tab 2,200 2,200 0 2,200
20 Allopurinol Tab 300 mg Tab 0 0 0 0
21 Alprazolam Tablet 0,5 mg Tab 500 500 0 500
22 Alprazolam Tablet 1 mg Tab 0 0 0 0
23 Ambroxol 30 mg Tab 1,200 1,200 0 1,200
24 Ambroxol syr Botol 30 30 0 30
25 Aminofilin inj 24 mg/ml Ampul 30 30 0 30
26 Amitriptilin Tablet Salut 25 mg Tab 1,400 1,400 0 1,400
27 Amlodipin Tablet 10 mg Tab 510 510 0 510
28 Amlodipin Tablet 5 mg Tab 600 600 0 600
29 Amoksisilin Kapsul 500 mg Tab 2,600 2,600 2,400 200
30 Amoxycillin Syrup 125 mg / 5 ml Botol 0 0 0 0
31 Amoxycillin Syrup 250 mg / 5 ml Botol 60 60 0 60
32 Ampicilin 500 mg Tab 200 200 0 200
33 Ampicilin syr Botol 0 0 0 0
34 Analog Long Insulin 100 IU Pen Pen 0 0 0 0
35 Antalgin 500 mg Tab 0 0 0 0
36 Antalgin Injeksi Ampul 0 0 0 0
37 Antasida DOEN I tablet kunyah Tab 0 0 0 0
38 Antasida Doen Syrup Botol 300 300 0 300
39 Antihemoroid Supp 90 90 0 90
40 Antimalaria Tab 0 0 0 0
41 Antiseptik Hand Rub 10 Btl @ 500 ml Botol 54 54 0 54
42 Antrain Injeksi Ampul 0 0 0 0
43 Aqua pro Injeksi 20 ml Ampul 46 46 0 46
44 Arkine Tab 3,000 3,000 0 3,000
45 Asam Askorbat Tablet 50 mg Tab 7,700 7,700 0 7,700
46 Asam Folat tablet 1 mg Tab 0 0 0 0
47 Asam Mefenamat kaplet 500 mg Kap 9,600 9,600 0 9,600
48 Asam Traneksamat 250 mg Ampul 15 15 0 15
49 Asam Valproat Syrup Botol 0 0 0 0
50 Asetosal Tablet 80 mg Tab 0 0 0 0
51 Atropin inj 0,25 mg / ml Ampul 20 20 0 20
52 Betahistin Tablet 6 mg Tab 100 100 0 100
53 Betametason Krim 0,1 %/Skizon Tube 0 0 0 0
54 Biocombin Injk/Farbion Injeksi Ampul 0 0 0 0
55 Bionemi Kaps Kapsul 0 0 0 0
56 Bisoprolol Tablet 5 mg Tab 50 50 0 50
57 Blood Lancents Buah 4 4 0 4
58 Buscopan Injeksi/Skopamin Ampul 0 0 0 0
59 Candesartan 8 mg Tab 0 0 0 0
60 Captopril Tablet 12,5 mg Tab 100 100 0 100
61 Captopril Tablet 25 mg Tab 500 500 0 500
62 Catapres Injeksi Ampul 70 70 0 70
63 Cathejell Lidocain 2 % & CHG 0,05 % Ampul 3 3 0 3
64 Catqut Chromic 2/0 75 C + Jarum 1/2 30 M R Box 0 0 0 0
65 Catqut Chromic 2/0 HR 20 MM Sachet 0 0 0 0
66 Catqut Chromic 3/0 75 C + Jarum 1/2 37 M R Box 1 1 0 1
67 Catqut Plain 2/0 HR 37 MM Sachet 1 1 0 1
68 Catqut Plain 3/0 HR 26 MM Sachet 1 1 0 1
69 Catqut Plain 4/0 100 M Roll 0 0 0 0
70 Cefadroxil kapsul 500 mg Kap 3,500 3,500 0 3,500
71 Cefadroxil Syrup 125 mg/ 5 ml Botol 160 160 0 160
72 Cimetidin Tab 0 0 0 0
73 Colcitine 0,5 mg Tab 810 810 0 810
74 Clobazam Tab 0 0 0 0
75 Clonidine 0,15 mg Tab 100 100 0 100
76 Clopidogrel 75 mg Tab 0 0 0 0
77 Combivent UDV Vial 0 0 0 0
78 Curcuma Tab 0 0 0 0
79 Deksametason Injeksi i.v/i.m 5 mg/ml Ampul 555 555 0 555
80 Deksametason Tablet 0,5 mg Tab 0 0 0 0
81 Diazepam Tablet 2 mg Tab 4,100 4,100 0 4,100
82 Diazepam injeksi 5 mg / ml Ampul 20 20 0 20
83 Diazepam larutan rektal 10 mg/2,5 ml Tube 0 0 0 0
84 Diazepam Tablet 5 mg Tab 0 0 0 0
85 Digoksin 0,25 mg Tab 0 0 0 0
86 Diltiazem HCL tablet 30 mg Tab 0 0 0 0
87 Dimenhidrinat tab 50 mg Tab 1,300 1,300 0 1,300
88 Diphenhidramin Injeksi 10 mg/ml Ampul 60 60 0 60
89 Diuvar Injeksi Ampul 5 5 0 5
90 Doksisiklin Kapsul 100 mg Kap 1,000 1,000 0 1,000
91 Domperidon suspensi 5 mg / 5 ml Botol 0 0 0 0
92 Domperidon tablet 10 mg Tab 1,900 1,900 0 1,900
93 Dulcolax 5 mg/Bisacodyl 5 mg Tab 0 0 0 0
94 Dulcolax Suppo anak Supp 31 31 0 31
95 Dumin Rectal Supp 0 0 0 0
96 Eflin Tab 200 200 0 200
97 Enbatic Cream Tube 0 0 0 0
98 Epinefrin Inj. i.v.s.k/i.m 1 mg/ml Ampul 180 180 0 180
99 Ergotamin tab 1 mg Tab 0 0 0 0
100 Eritromisin Kapsul 500 mg Kap 1,000 1,000 0 1,000
101 Erladerm-N Tube 0 0 0 0
102 Erlemicetin Tetes Telinga Botol 0 0 0 0
103 Erlemicetin Tetes Mata Botol 0 0 0 0
104 Etakridin Botol 8 8 0 8
105 Etambutol tablet salut 500 mg Tab 0 0 0 0
106 Etanol 70% 1 Liter Botol 0 0 0 0
107 Etanol 70% 300 ml Botol 0 0 0 0
108 Etilklorida Botol 0 0 0 0
109 Folley Catheter 3 - 5 ml / cc - 10 fr Piece 14 14 0 14
110 Folley Catheter 3 - 5 ml / cc - 16 fr Piece 32 32 0 32
111 Folley Catheter 3 - 5 ml / cc - 18 fr Piece 10 10 0 10
112 Folley Catheter 3 - 5 ml / cc - 22 fr Piece 0 0 0 0
113 Furosemid tab 40 mg Tab 1,200 1,200 0 1,200
114 Gabapentin Tablet 300 mg Kap 0 0 0 0
115 Garam Oralit Sachet 1,400 1,400 0 1,400
116 Gemfibrozil Kapsul 300 mg Kap 600 600 0 600
117 Gentalex Krim Tube 160 160 0 160
118 Gentamisin Inj. 40 mg/ml Ampul 0 0 0 0
119 Gentamisin Salep Tube 0 0 0 0
120 Gention Violet Botol 19 19 0 19
121 Glibenklamid tab 5 mg Tab 0 0 0 0
122 Glimepiride 2 mg Tab 900 900 0 900
123 Gliseril Guaiacolat 100 mg Tab 0 0 0 0
124 Gliserin lar 50 % Botol 54 54 0 54
125 Glukosa Lar. Infus 5 % Steril Botol 60 60 0 60
126 Griseofulvin tablet 125 mg Tab 5,400 5,400 0 5,400
127 Griseofulvin tablet 500 mg Tab 700 700 0 700
128 Halloperidol 0,5 mg Tab 500 500 0 500
129 Halloperidol 1,5 mg Tab 4,900 4,900 0 4,900
130 Halloperidol 5 mg Tab 500 500 0 500
131 Handscond Genekolog Psg 160 160 0 160
132 Handscond No. 7 Steril Psg 200 200 0 200
133 Handscond No. 7,5 Steril Psg 1,100 1,100 0 1,100
134 Handscond Non Steril (M) Psg 3,300 3,300 1,100 2,200
135 Handscond Non Steril ((L) Psg 5,400 5,400 900 4,500
136 Hemafort Tab 0 0 0 0
137 Hidroklortiazid tablet 25 mg Tab 0 0 0 0
138 Hidrokortison krim 2,5 % Tube 96 96 0 96
139 Ibuprofen syrup 200 mg/5 ml Botol 183 183 53 130
140 Ibuprofen tablet 400 mg Tab 0 0 0 0
141 Ichtiyol Pot 16 16 0 16
142 Infusion Set Anak Buah 968 968 0 968
143 Infusion Set Dewasa Buah 48 48 0 48
144 Iodina test Botol 0 0 0 0
145 Isoniazid Tablet Tab 0 0 0 0
146 Isosorbid Dinitrat tab 5 mg Tab 700 700 0 700
147 Kalsium Glukonat Inj i.v 10 % Ampul 73 73 0 73
148 Kalsium Lactat Tablet 500 mg Tab 3,800 3,800 0 3,800
149 Kanamicin inj Vial 50 50 0 50
150 Kaotin Syrup Botol 0 0 0 0
151 Kapas Pembalut 250 mg Roll 25 25 0 25
152 Karbamazepin Kaplet 200 mg Kap 7,300 7,300 0 7,300
153 Kasa hydrofil Steril 16x16 cm Dos 0 0 0 0
154 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0
155 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0
156 Kertas USG Rol 10 10 0 10
157 Ketokonazole krim 2 % Tube 275 275 0 275
158 Ketokonazole tablet 200 mg Tab 5,100 5,100 0 5,100
159 Kloramphenicol Kapsul 250 mg/Novachlor Kap 5,700 5,700 0 5,700
160 Kloramphenicol salep mata 1 % Tube 96 96 0 96
161 Kloramphenicol Suspensi 125mg/5ml Botol 19 19 0 19
162 Kloramphenicol tetes mata 0,5 % Botol 0 0 0 0
163 Klorfenilamin Maleat tablet 4 mg Tab 1,500 1,500 0 1,500
164 Klorpromazin Injeksi salut 25 mg/ml Ampul 0 0 0 0
165 Klorpromazin Tab Salut 25 mg Tab 0 0 0 0
166 Klorpromazin Tablet salut 100 mg Tab 400 400 0 400
167 Kodein tablet 10 mg Tab 300 300 0 300
168 Kolicgon Tab 0 0 0 0
169 Kotrimoksazole Tablet 480 mg Tab 5,500 5,500 0 5,500
170 Kotrimoxazol Suspensi Botol 0 0 0 0
171 Kutoin 100 mg Tab 0 0 0 0
172 Lancet For Fine Touch Dos 4 4 0 4
173 Larutan PK Pot 0 0 0 0
174 Larutan H2O2 Botol 4 4 0 4
175 Lidocain HCL 2% Injeksi Ampul 2,230 2,230 0 2,230
176 Lidocain Injeksi 2% + Epinefrin 1 : 8000 - 2 ml Ampul 30 30 0 30
177 Lisol Botol 0 0 0 0
178 Loperamid Tablet 2 Mg Tab 100 100 0 100
179 Loratadin 10 mg Tab 3,400 3,400 600 2,800
180 Masker Earloop Psg 0 0 0 0
181 Masker Karet Psg 0 0 0 0
182 Masker N95 Box 0 0 0 0
183 Masker Tali Dos 0 0 0 0
184 Meloksikam 15 mg Tab 0 0 0 0
185 Metergin Inj Vial 0 0 0 0
186 Metformin HCL Tablet 500 mg Tab 1,600 1,600 0 1,600
187 Metilergometrin inj 0,2 mg / ml Ampul 290 290 0 290
188 Metilergometrin Tablet 0,125 mg Tab 2,200 2,200 0 2,200
189 Metilprednisolon Tablet 4 mg Tab 1,000 1,000 500 500
190 Metilprednisolon tablet 8 mg Tab 0 0 0 0
191 Metoklopramide Injeksi Ampul 10 10 0 10
192 Metoklopramide Sirup 5 mg/5 ml Botol 0 0 0 0
193 Metoklopramide Tablet 10 mg Tab 1,000 1,000 0 1,000
194 Metolon Inj Ampul 0 0 0 0
195 Metronidazol tablet 500 mg Tab 400 400 0 400
196 MgSO4 inj 20% - 25 ml Botol 81 81 0 81
197 MgSO4 inj 20% - 25 ml Botol 0 0 0 0
198 MgSO4 inj 40% - 25 ml Botol 24 24 0 24
199 Mikonazole Salep 2% Tube 96 96 0 96
200 Mix Insulin Flexpen / Catridge Pen 0 0 0 0
201 Mucotussan Tab 0 0 0 0
202 Multivitamin Seven Seas Botol 128 128 0 128
203 My Jelli 83 Gram Tube 0 0 0 0
204 Nacl 0,9% Botol 40 40 0 40
205 Natrium Diklofenak 25 mg Tab 3,600 3,600 0 3,600
206 Needle No.23 Pcs 0 0 0 0
207 Neurovit E Kotak 0 500 500 100 400
208 Nifedipin tablet 20 mg Tab 100 100 0 100
209 Nistatin Tablet salut 100.000 IU/g Tab 420 420 0 420
210 Nistatin Tablet salut 500.000 IU/g Tab 200 200 0 200
211 Novadiar Syrup Botol 140 140 0 140
212 Novapyron/Neurotropic Plus Tab 0 0 0 0
213 Novazon Tab 0 0 0 0
214 Novo Twist Box 8 8 0 8
215 Novorapid Pen 0 0 0 0
216 OAT FDC Kategori 1 Paket 8 8 0 8
217 OAT FDC Kategori Anak Paket 3 3 0 3
218 OAT FDC Kategori Anak Paket 0 0 0 0
219 OAT FDC Kategori FDC Kategori Sisipan Paket 0 0 0 0
220 OAT FDC Kategori II Paket 2 2 0 2
221 OBH Botol 120 120 15 105
222 Oksitetrasiklin salep kulit 3% Tube 115 115 0 115
223 Oksitetrasiklin salep mata 1% Tube 0 0 0 0
224 Oksitosin inj 10 UI/ml Ampul 200 200 0 200
225 Omeprazol Tablet 20 mg Kapsul 0 0 0 0
226 Ondancentron 8 mg Ampul 64 64 0 64
227 Oxybiotic Inj Vial 0 0 0 0
228 Papaverin 40 mg Tab 0 0 0 0
229 Paracetamol syrup 120 mg / 5 ml Botol 0 0 0 0
230 Parasetamol Kaplet 500 mg Tab 0 0 0 0
231 Pehacain Inj Ampul 0 0 0 0
232 Pehatrim Forte Tab 0 0 0 0
233 Phenol Gliserol Tetes Telinga Botol 20 20 0 20
234 Phitomenadion inj i.m 2 mg / ml Ampul 120 120 0 120
235 Phitomenadion tablet 10 mg Tab 1,500 1,500 0 1,500
236 Piracetam 400 mg Tab 700 700 0 700
237 Piracetam inj 3g/15ml Ampul 10 10 0 10
238 Pirantel Tablet 125 mg Tab 0 0 0 0
239 Piridoksin inj 100 mg/ml Ampul 0 0 0 0
240 Piridoksin Tablet 10 mg Tab 0 0 0 0
241 Piroksicam 20 mg Tab 0 0 0 0
242 Pisau bedah Box 20 20 0 20
243 Pisau bedah 21 Set 0 0 0 0
244 Plano test Buah 23 23 0 23
245 Plester 7,5cm x 4,5m Rol 60 60 0 60
246 Plesterin Bulat Non Woven Box 41 41 0 41
247 Poligyp 5 cm x 2,7 m Roll 19 19 0 19
248 Pot sputum Pot 0 0 0 0
249 Povidon Iodida larutan 10% 60 ml Botol 38 38 0 38
250 Prednison tablet Tab 5,700 5,700 0 5,700
251 Primakuin Tablet 15 mg Tab 1,000 1,000 0 1,000
252 Promavit Kapsul Kapsul 0 0 0 0
253 Propanolol tablet 10 mg Tab 600 600 0 600
254 Propilteurasil 100 Mg Tab 200 200 100 100
255 Ramipril Tablet 5 mg Tab 0 0 0 0
256 Ranitidin Injeksi 25 mg/ml Ampul 100 100 0 100
257 Ranitidin Tablet 150 mg Tab 700 700 0 700
258 RDT DBD Pcs 4 4 0 4
259 RDT malaria Pcs 0 0 0 0
260 Retinol (Vitamin A) 100.000 IU Kapsul 20 20 0 20
261 Retinol (Vitamin A) 200.000 IU Botol 7 7 0 7
262 Rifampisin tablet 450 mg Kapsul 0 0 0 0
263 Rifampisin tablet 600 mg Kaplet 0 0 0 0
264 Ringer Laktat Larutan Infus Botol 620 620 0 620
265 Risperidon 2 mg Tab 0 0 0 0
266 Salbutamol 2 mg Tab 0 0 0 0
267 Salbutamol 4 mg Tab 6,700 6,700 0 6,700
268 Salep 2-4 Pot 45 45 0 45
269 Salisil Bedak serbuk 2% Box 180 180 0 180
270 Selediar Tab 0 0 0 0
271 Selesbion Tab 0 500 500 500 0
272 Selkom C Kap 0 0 0 0
273 Selviplex Kap 0 0 0 0
274 Serum ATS Botol 0 0 0 0
275 Setirizin sirup 5 mg/5ml Botol 33 33 0 33
276 Setrizin Tablet 10 mg Tab 0 0 0 0
277 Sianokobalamin injeksi 500 mcg Ampul 170 170 0 170
278 Scopamin 10 mg Tab 1,200 1,200 0 1,200
279 Sidiadryl Inj Vial 0 0 0 0
280 Silk 3/0 100 M Roll 0 0 0 0
281 Silk 3/0 75 C + Jarum 1/2 17 M R Box 0 0 0 0
282 Silk 4/0 100 M Roll 0 0 0 0
283 Silk Black 2/0 DS 30 MM Sachet 0 0 0 0
284 Silk Black 3/0 DS 30 MM Sachet 0 0 0 0
285 Simvastatin 10 mg Tab 0 0 0 0
286 Sianokobalamin Tab 0 0 0 0
287 Simvastatin 20 mg Tab 500 500 0 500
288 Siprofloksasin Tablet 500 mg Tab 8,800 8,800 0 8,800
289 Soldextam Tab 0 0 0 0
290 Solvita Plus Syrup Botol 0 0 0 0
291 Spasmolit Tab 0 0 0 0
292 Spironolacton 25 mg Tab 0 0 0 0
293 Stesolid 5 mg Tube 0 0 0 0
294 Stik Asam Urat Autochek Botol 3 3 0 3
295 Stik Asam Urat Benecheck Box 0 0 0 0
296 Stik Gula Darah Autochek Box 0 0 0 0
297 Stik Gula Darah Benecheck Box 0 0 0 0
298 Stik Kolesterol Autochek Botol 0 0 0 0
299 Stik Kolesterol Benecheck Botol 0 0 0 0
300 Stik Pemerksaan HB Botol 1 1 0 1
301 Sulfadoxine Pyrimehamine 250 mg Tab 400 400 0 400
302 Tablet Tambah Darah Sachet 0 0 0 0
303 Tablet Tambah Darah Tab 0 0 0 0
304 Tetrasiklin kapsul 500 mg kap 1,200 1,200 0 1,200
305 Termorex Drops Botol 0 0 0 0
306 Thiamin 50 mg Tab 750 750 0 750
307 Thiamin inj Ampul 0 0 0 0
308 Tramadol 50 mg Tab 0 0 0 0
309 Truvit Syrup Botol 3 3 0 3
310 Urin bag Pcs 10 10 0 10
311 Urin bag Pcs 0 0 0 0
312 USG Gel 250 ml Botol 0 0 0 0
313 Vastigo Tab 0 0 0 0
314 Ventolin Nebulizer Ampul 40 40 0 40
315 Verorab Vial 0 0 0 0
316 Vitamin B Kompleks Tablet Tab 700 700 0 700
317 Vitamin B Kompleks Injeksi Vial 0 0 0 0
318 Wing needle No.23 Pcs 0 0 0 0
319 Zinc Syrup Botol 180 180 0 180
320 Zink Tablet 20 mg Tab 0 0 0 0
321 Leukoplast Roll 0 0 0 0
322 Nystatin Drop Botol 76 76 0 76
323 Paracetamol Drops Botol 0 0 0 0
324 Dopamet Tab 50 50 0 50
325 Acetylcystein Tab 0 0 0 0
326 Aspar-K Tab 0 0 0 0
327 New Antides Tab 3,100 3,100 0 3,100
328 Atrovent Botol 2 2 0 2
329 Mometasone Tube 25 25 0 25
330 Soft U cream Tube 62 62 0 62
331 Paracetamol Infus Botol 50 50 0 50
332 Metronidazol Infus Botol 10 10 0 10
333 Clozapine Tab 1,050 1,050 0 1,050
334 Clorpromazine Injeksi Ampul 0 0 0 0
335 Sanbe Tears Botol 1 1 0 1
336 Pantocain Botol 0 0 0 0
337 Caterlent Botol 3 3 0 3
338 Scopamin Ampul 10 10 0 10
339 Omeprazole Injek 40 mg Ampul 14 14 0 14
340 Guaifeesin 100 mg Tab 800 800 0 800
341 Depakote Botol 100 100 0 100
342 Phenobarbital Inj Ampul 28 28 0 28
343 Furosemide Inj Ampul 0 0 0 0
344 Elasti Perban 7,5 cm x 4,5 cm Buah 8 8 0 8
345 Medigibs Buah 19 19 0 19
346 Nasal Oksigen ( selang O2) Buah 0 0 0 0
347 Slide Microscope Buah 169 169 0 169
348 One step anti HIV 1/2 Test Btl 2 2 0 2
349 Alat suntik sekali pakai 20ml Buah 0 0 0 0
350 Iliadin tetes hidung anak Botol 4 4 0 4
351 cendo Xytrol Botol 15 15 0 15
352 Primpen Botol 740 740 0 740
353 Aqua Gell Tube 15 15 0 15
354 Alkohon 1 liter 70% Botol 10 10 0 10
355 Spritus Botol 1 1 0 1
356 Emercin oil Botol 3 3 0 3
357 Gemsa Buah 2 2 0 2
358 Mitela Buah 1 1 0 1
359 Metanol Botol 3 3 0 3
360 Gliserin 100 ml Botol 55 55 0 55
361 Adalat 20 mg Tab 450 450 0 450
362 Atrofastatin 20 mg Tab 480 480 120 360
363 Asam Traneksamat 500 mg Tab 100 100 0 100
364 Loremide Tab 100 100 0 100
365 Vomistop Tab 60 60 0 60
366 Tagadem Buah 19 19 0 19
367 Blood Lancents Buah 1,000 1,000 0 1,000
368 Farsifen 400 mg Tablet 300 300 0 300
369 Miniaspi 80 mg Tablet 900 900 0 900
370 Pritagesic Tablet 100 100 0 100
371 Ovtelis 20 mg Tablet 300 300 0 300
372 Novagesic 500 mg Tablet 5,600 5,600 0 5,600
373 Faridexon 0,5 mg Tablet 200 200 200 0
374 Abbocath 26 Pcs 7 7 0 7
375 Valium 5 mg Tablet 0 0 0 0
376 Oxygen Nasal Canula Anak Pcs 2 2 0 2
377 Penjepit Tali Pusat Pcs 0 0 0 0
378 Sotatic Ampul 5 5 0 5
379 Yusimox 125mg/5 ml Botol 360 360 0 360
380 Handsoon Non Steril (S) Pcs 1,900 1,900 1,000 900
381 Cavicur Tablet 200 200 0 200
382 Prix 25 mg Tablet 800 800 800 0
383 Patrin 250 mg Tablet 580 580 0 580
384 Grafalin 2 mg Tablet 400 400 0 400
385 Phenitoin Injeksi Ampul 10 10 0 10
386 Diazepam 2 Mg Tablet 200 200 0 200
387 Twist Lancet 28 G Pcs 1,300 1,300 0 1,300
388 Easy Touch Boold Glukose Pcs 0 0 0 0
389 Easy Touch Urid Acid Pcs 4 4 0 4
390 Easy Touch Cholesterol Ampul 0 0 0 0
391 Ovtelis 10 mg Tablet 100 100 0 100
392 Underpads Pcs 20 20 0 20
393 Stik Urinalysis Pcs 100 100 0 100
394 Novagesic Syr Botol 60 60 60 0
395 Siobion Tablet 300 300 300 0
396 Diatabs Tablet 1,400 1,400 0 1,400
397 Repas 400 mg Tablet 9,900 9,900 0 9,900
398 Farizol 500 mg Tablet 5,000 5,000 0 5,000
399 Diazepam 5 mg Tablet 180 180 0 180
400 Pritanol 300 mg Tablet 2,600 2,600 0 2,600
401 Novadium Tablet 500 500 0 500
402 Nasal Oksigen ukuran Xs Pcs 10 10 0 10
403 Nasal Oksigen Ukuran S Pcs 10 10 0 10
404 Scobutrin Tablet 300 300 200 100
405 Floxigra 500 mg Tablet 100 100 0 100
406 Eritromisin Syr Botol 50 50 0 50
407 Amoxcicilin 250 mg Tablet 1,000 1,000 0 1,000
408 Trihexylphenidyl Hcl 2 mg Tablet 1,500 1,500 0 1,500

JAMKESDA BPJS
JUMLAH KUNJUNGAN RESEP
 Mengetahui/Menyetujui Yang Menyerahkan Yang Memohon Yang Menerima
Kepala Seksi Kefarmasian Penanggung Jawab
Gudang Farmasi

Sahrul, SKM Arini Priyanti Kandupi. S.Farm., Apt Megawati Ranindi, S.Tr.Keb Nur Mufida Saenda,S.Farm
Nip. 19820714 200502 1 002 Nip. 19820403 200804 2 002 Nip. 19730708 199303 2 004
 LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MATAKO PELAPORAN BLN/PERIODE : JUNI 2020

KECAMATAN : TOJO BARAT PERMINTAAN BLN/PERIODE : JULI 2020
KABUPATEN : TOJO UNA UNA
PROPINSI : SULAWESI TENGAH

Stok Peneri- Perse- Pema- Stok Permin- Pemberian

NO Nama Obat/Alkes/BMHP Satuan Awal maan diaan kaian Akhir taan APBD I APBD II Program Lain- Jumlah KET
lain
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Abbocath 18 Piece 160 160 0 160
2 Abbocath 20 Piece 150 150 0 150
3 Abbocath 22 Piece 140 140 0 140
4 Abbocath 24 Piece 82 82 0 82
5 Acyclovir cream Tube 40 40 0 40
6 Acyclovir tablet 200 mg Tab 1,000 1,000 0 1,000
7 Acyclovir tablet 400 mg Tab 2,100 2,100 0 2,100
8 Ailin tetes mata Botol 0 0 0 0
9 AIC Now + Sistem 20'S Box 0 0 0 0
10 Alat Autochek Unit 0 0 0 0
11 Alat Pemeriksa HB Buah 0 0 0 0
12 Alat suntik sekali pakai 1 ml Piece 500 500 0 500
13 Alat suntik sekali pakai 10 ml Piece 200 200 0 200
14 Alat suntik sekali pakai 3 ml Piece 250 250 0 250
15 Alat suntik sekali pakai 5 ml Piece 600 600 0 600
16 Albendazol 400 mg Tab 0 0 0 0
17 Alcohol Swab CHG + 0,5 % Box 1 1 0 1
18 Alletrol Tetes Mata Botol 0 0 0 0
19 Allopurinol Tab 100 mg Tab 2,200 2,200 0 2,200
20 Allopurinol Tab 300 mg Tab 0 0 0 0
21 Alprazolam Tablet 0,5 mg Tab 500 500 0 500
22 Alprazolam Tablet 1 mg Tab 0 0 0 0
23 Ambroxol 30 mg Tab 1,200 1,200 0 1,200
24 Ambroxol syr Botol 30 30 0 30
25 Aminofilin inj 24 mg/ml Ampul 30 30 0 30
26 Amitriptilin Tablet Salut 25 mg Tab 1,400 1,400 0 1,400
27 Amlodipin Tablet 10 mg Tab 510 510 0 510
28 Amlodipin Tablet 5 mg Tab 600 600 0 600
29 Amoksisilin Kapsul 500 mg Tab 2,600 2,600 0 2,600
30 Amoxycillin Syrup 125 mg / 5 ml Botol 0 0 0 0
31 Amoxycillin Syrup 250 mg / 5 ml Botol 60 60 0 60
32 Ampicilin 500 mg Tab 200 200 0 200
33 Ampicilin syr Botol 0 0 0 0
34 Analog Long Insulin 100 IU Pen Pen 0 0 0 0
35 Antalgin 500 mg Tab 0 0 0 0
36 Antalgin Injeksi Ampul 0 0 0 0
37 Antasida DOEN I tablet kunyah Tab 0 0 0 0
38 Antasida Doen Syrup Botol 300 300 0 300
39 Antihemoroid Supp 90 90 0 90
40 Antimalaria Tab 0 0 0 0
41 Antiseptik Hand Rub 10 Btl @ 500 ml Botol 54 54 0 54
42 Antrain Injeksi Ampul 0 0 0 0
43 Aqua pro Injeksi 20 ml Ampul 46 46 0 46
44 Arkine Tab 3,000 3,000 0 3,000
45 Asam Askorbat Tablet 50 mg Tab 7,700 7,700 0 7,700
46 Asam Folat tablet 1 mg Tab 0 0 0 0
47 Asam Mefenamat kaplet 500 mg Kap 9,600 9,600 0 9,600
48 Asam Traneksamat 250 mg Ampul 15 15 0 15
49 Asam Valproat Syrup Botol 0 0 0 0
50 Asetosal Tablet 80 mg Tab 0 0 0 0
51 Atropin inj 0,25 mg / ml Ampul 20 20 0 20
52 Betahistin Tablet 6 mg Tab 100 100 0 100
53 Betametason Krim 0,1 %/Skizon Tube 0 0 0 0
54 Biocombin Injk/Farbion Injeksi Ampul 0 0 0 0
55 Bionemi Kaps Kapsul 0 0 0 0
56 Bisoprolol Tablet 5 mg Tab 50 50 0 50
57 Blood Lancents Buah 4 4 0 4
58 Buscopan Injeksi/Skopamin Ampul 0 0 0 0
59 Candesartan 8 mg Tab 0 0 0 0
60 Captopril Tablet 12,5 mg Tab 100 100 0 100
61 Captopril Tablet 25 mg Tab 500 500 0 500
62 Catapres Injeksi Ampul 70 70 0 70
63 Cathejell Lidocain 2 % & CHG 0,05 % Ampul 3 3 0 3
64 Catqut Chromic 2/0 75 C + Jarum 1/2 30 M R Box 0 0 0 0
65 Catqut Chromic 2/0 HR 20 MM Sachet 0 0 0 0
66 Catqut Chromic 3/0 75 C + Jarum 1/2 37 M R Box 1 1 0 1
67 Catqut Plain 2/0 HR 37 MM Sachet 1 1 0 1
68 Catqut Plain 3/0 HR 26 MM Sachet 1 1 0 1
69 Catqut Plain 4/0 100 M Roll 0 0 0 0
70 Cefadroxil kapsul 500 mg Kap 3,500 3,500 0 3,500
71 Cefadroxil Syrup 125 mg/ 5 ml Botol 160 160 0 160
72 Cimetidin Tab 0 0 0 0
73 Colcitine 0,5 mg Tab 810 810 0 810
74 Clobazam Tab 0 0 0 0
75 Clonidine 0,15 mg Tab 100 100 0 100
76 Clopidogrel 75 mg Tab 0 0 0 0
77 Combivent UDV Vial 0 0 0 0
78 Curcuma Tab 0 0 0 0
79 Deksametason Injeksi i.v/i.m 5 mg/ml Ampul 555 555 0 555
80 Deksametason Tablet 0,5 mg Tab 0 0 0 0
81 Diazepam Tablet 2 mg Tab 4,100 4,100 0 4,100
82 Diazepam injeksi 5 mg / ml Ampul 20 20 0 20
83 Diazepam larutan rektal 10 mg/2,5 ml Tube 0 0 0 0
84 Diazepam Tablet 5 mg Tab 0 0 0 0
85 Digoksin 0,25 mg Tab 0 0 0 0
86 Diltiazem HCL tablet 30 mg Tab 0 0 0 0
87 Dimenhidrinat tab 50 mg Tab 1,300 1,300 0 1,300
88 Diphenhidramin Injeksi 10 mg/ml Ampul 60 60 0 60
89 Diuvar Injeksi Ampul 5 5 0 5
90 Doksisiklin Kapsul 100 mg Kap 1,000 1,000 0 1,000
91 Domperidon suspensi 5 mg / 5 ml Botol 0 0 0 0
92 Domperidon tablet 10 mg Tab 1,900 1,900 0 1,900
93 Dulcolax 5 mg/Bisacodyl 5 mg Tab 0 0 0 0
94 Dulcolax Suppo anak Supp 31 31 0 31
95 Dumin Rectal Supp 0 0 0 0
96 Eflin Tab 200 200 0 200
97 Enbatic Cream Tube 0 0 0 0
98 Epinefrin Inj. i.v.s.k/i.m 1 mg/ml Ampul 180 180 0 180
99 Ergotamin tab 1 mg Tab 0 0 0 0
100 Eritromisin Kapsul 500 mg Kap 1,000 1,000 0 1,000
101 Erladerm-N Tube 0 0 0 0
102 Erlemicetin Tetes Telinga Botol 0 0 0 0
103 Erlemicetin Tetes Mata Botol 0 0 0 0
104 Etakridin Botol 8 8 0 8
105 Etambutol tablet salut 500 mg Tab 0 0 0 0
106 Etanol 70% 1 Liter Botol 0 0 0 0
107 Etanol 70% 300 ml Botol 0 0 0 0
108 Etilklorida Botol 0 0 0 0
109 Folley Catheter 3 - 5 ml / cc - 10 fr Piece 14 14 0 14
110 Folley Catheter 3 - 5 ml / cc - 16 fr Piece 32 32 0 32
111 Folley Catheter 3 - 5 ml / cc - 18 fr Piece 10 10 0 10
112 Folley Catheter 3 - 5 ml / cc - 22 fr Piece 0 0 0 0
113 Furosemid tab 40 mg Tab 1,200 1,200 0 1,200
114 Gabapentin Tablet 300 mg Kap 0 0 0 0
115 Garam Oralit Sachet 1,400 1,400 0 1,400
116 Gemfibrozil Kapsul 300 mg Kap 600 600 0 600
117 Gentalex Krim Tube 160 160 0 160
118 Gentamisin Inj. 40 mg/ml Ampul 0 0 0 0
119 Gentamisin Salep Tube 0 0 0 0
120 Gention Violet Botol 19 19 0 19
121 Glibenklamid tab 5 mg Tab 0 0 0 0
122 Glimepiride 2 mg Tab 900 900 0 900
123 Gliseril Guaiacolat 100 mg Tab 0 0 0 0
124 Gliserin lar 50 % Botol 54 54 0 54
125 Glukosa Lar. Infus 5 % Steril Botol 60 60 0 60
126 Griseofulvin tablet 125 mg Tab 5,400 5,400 0 5,400
127 Griseofulvin tablet 500 mg Tab 700 700 0 700
128 Halloperidol 0,5 mg Tab 500 500 0 500
129 Halloperidol 1,5 mg Tab 4,900 4,900 0 4,900
130 Halloperidol 5 mg Tab 500 500 0 500
131 Handscond Genekolog Psg 160 160 0 160
132 Handscond No. 7 Steril Psg 200 200 0 200
133 Handscond No. 7,5 Steril Psg 1,100 1,100 0 1,100
134 Handscond Non Steril (M) Psg 3,600 3,600 300 3,300
135 Handscond Non Steril ((L) Psg 5,500 5,500 100 5,400
136 Hemafort Tab 0 0 0 0
137 Hidroklortiazid tablet 25 mg Tab 0 0 0 0
138 Hidrokortison krim 2,5 % Tube 96 96 0 96
139 Ibuprofen syrup 200 mg/5 ml Botol 183 183 0 183
140 Ibuprofen tablet 400 mg Tab 0 0 0 0
141 Ichtiyol Pot 16 16 0 16
142 Infusion Set Anak Buah 968 968 0 968
143 Infusion Set Dewasa Buah 48 48 0 48
144 Iodina test Botol 0 0 0 0
145 Isoniazid Tablet Tab 0 0 0 0
146 Isosorbid Dinitrat tab 5 mg Tab 700 700 0 700
147 Kalsium Glukonat Inj i.v 10 % Ampul 73 73 0 73
148 Kalsium Lactat Tablet 500 mg Tab 3,800 3,800 0 3,800
149 Kanamicin inj Vial 50 50 0 50
150 Kaotin Syrup Botol 0 0 0 0
151 Kapas Pembalut 250 mg Roll 25 25 0 25
152 Karbamazepin Kaplet 200 mg Kap 7,300 7,300 0 7,300
153 Kasa hydrofil Steril 16x16 cm Dos 0 0 0 0
154 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0
155 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0
156 Kertas USG Rol 10 10 0 10
157 Ketokonazole krim 2 % Tube 275 275 0 275
158 Ketokonazole tablet 200 mg Tab 5,100 5,100 0 5,100
159 Kloramphenicol Kapsul 250 mg/Novachlor Kap 5,700 5,700 0 5,700
160 Kloramphenicol salep mata 1 % Tube 96 96 0 96
161 Kloramphenicol Suspensi 125mg/5ml Botol 19 19 0 19
162 Kloramphenicol tetes mata 0,5 % Botol 0 0 0 0
163 Klorfenilamin Maleat tablet 4 mg Tab 1,500 1,500 0 1,500
164 Klorpromazin Injeksi salut 25 mg/ml Ampul 0 0 0 0
165 Klorpromazin Tab Salut 25 mg Tab 0 0 0 0
166 Klorpromazin Tablet salut 100 mg Tab 400 400 0 400
167 Kodein tablet 10 mg Tab 300 300 0 300
168 Kolicgon Tab 0 0 0 0
169 Kotrimoksazole Tablet 480 mg Tab 5,500 5,500 0 5,500
170 Kotrimoxazol Suspensi Botol 0 0 0 0
171 Kutoin 100 mg Tab 0 0 0 0
172 Lancet For Fine Touch Dos 4 4 0 4
173 Larutan PK Pot 0 0 0 0
174 Larutan H2O2 Botol 4 4 0 4
175 Lidocain HCL 2% Injeksi Ampul 2,230 2,230 0 2,230
176 Lidocain Injeksi 2% + Epinefrin 1 : 8000 - 2 ml Ampul 30 30 0 30
177 Lisol Botol 0 0 0 0
178 Loperamid Tablet 2 Mg Tab 100 100 0 100
179 Loratadin 10 mg Tab 3,400 3,400 0 3,400
180 Masker Earloop Psg 0 0 0 0
181 Masker Karet Psg 0 0 0 0
182 Masker N95 Box 0 0 0 0
183 Masker Tali Dos 0 0 0 0
184 Meloksikam 15 mg Tab 0 0 0 0
185 Metergin Inj Vial 0 0 0 0
186 Metformin HCL Tablet 500 mg Tab 1,800 1,800 200 1,600
187 Metilergometrin inj 0,2 mg / ml Ampul 290 290 0 290
188 Metilergometrin Tablet 0,125 mg Tab 2,200 2,200 0 2,200
189 Metilprednisolon Tablet 4 mg Tab 1,200 1,200 200 1,000
190 Metilprednisolon tablet 8 mg Tab 0 0 0 0
191 Metoklopramide Injeksi Ampul 10 10 0 10
192 Metoklopramide Sirup 5 mg/5 ml Botol 0 0 0 0
193 Metoklopramide Tablet 10 mg Tab 1,000 1,000 0 1,000
194 Metolon Inj Ampul 0 0 0 0
195 Metronidazol tablet 500 mg Tab 400 400 0 400
196 MgSO4 inj 20% - 25 ml Botol 81 81 0 81
197 MgSO4 inj 20% - 25 ml Botol 0 0 0 0
198 MgSO4 inj 40% - 25 ml Botol 24 24 0 24
199 Mikonazole Salep 2% Tube 96 96 0 96
200 Mix Insulin Flexpen / Catridge Pen 0 0 0 0
201 Mucotussan Tab 0 0 0 0
202 Multivitamin Seven Seas Botol 130 130 2 128
203 My Jelli 83 Gram Tube 0 0 0 0
204 Nacl 0,9% Botol 40 40 0 40
205 Natrium Diklofenak 25 mg Tab 3,600 3,600 0 3,600
206 Needle No.23 Pcs 0 0 0 0
207 Neurovit E Kotak 0 0 0 0
208 Nifedipin tablet 20 mg Tab 100 100 0 100
209 Nistatin Tablet salut 100.000 IU/g Tab 420 420 0 420
210 Nistatin Tablet salut 500.000 IU/g Tab 200 200 0 200
211 Novadiar Syrup Botol 140 140 0 140
212 Novapyron/Neurotropic Plus Tab 0 0 0 0
213 Novazon Tab 0 0 0 0
214 Novo Twist Box 8 8 0 8
215 Novorapid Pen 0 0 0 0
216 OAT FDC Kategori 1 Paket 8 8 0 8
217 OAT FDC Kategori Anak Paket 3 3 0 3
218 OAT FDC Kategori Anak Paket 0 0 0 0
219 OAT FDC Kategori FDC Kategori Sisipan Paket 0 0 0 0
220 OAT FDC Kategori II Paket 2 2 0 2
221 OBH Botol 130 130 10 120
222 Oksitetrasiklin salep kulit 3% Tube 115 115 0 115
223 Oksitetrasiklin salep mata 1% Tube 0 0 0 0
224 Oksitosin inj 10 UI/ml Ampul 200 200 0 200
225 Omeprazol Tablet 20 mg Kapsul 0 0 0 0
226 Ondancentron 8 mg Ampul 64 64 0 64
227 Oxybiotic Inj Vial 0 0 0 0
228 Papaverin 40 mg Tab 0 0 0 0
229 Paracetamol syrup 120 mg / 5 ml Botol 0 0 0 0
230 Parasetamol Kaplet 500 mg Tab 0 0 0 0
231 Pehacain Inj Ampul 0 0 0 0
232 Pehatrim Forte Tab 0 0 0 0
233 Phenol Gliserol Tetes Telinga Botol 20 20 0 20
234 Phitomenadion inj i.m 2 mg / ml Ampul 120 120 0 120
235 Phitomenadion tablet 10 mg Tab 1,500 1,500 0 1,500
236 Piracetam 400 mg Tab 700 700 0 700
237 Piracetam inj 3g/15ml Ampul 10 10 0 10
238 Pirantel Tablet 125 mg Tab 0 0 0 0
239 Piridoksin inj 100 mg/ml Ampul 0 0 0 0
240 Piridoksin Tablet 10 mg Tab 0 0 0 0
241 Piroksicam 20 mg Tab 0 0 0 0
242 Pisau bedah Box 20 20 0 20
243 Pisau bedah 21 Set 0 0 0 0
244 Plano test Buah 23 23 0 23
245 Plester 7,5cm x 4,5m Rol 60 60 0 60
246 Plesterin Bulat Non Woven Box 41 41 0 41
247 Poligyp 5 cm x 2,7 m Roll 19 19 0 19
248 Pot sputum Pot 0 0 0 0
249 Povidon Iodida larutan 10% 60 ml Botol 38 38 0 38
250 Prednison tablet Tab 5,700 5,700 0 5,700
251 Primakuin Tablet 15 mg Tab 1,000 1,000 0 1,000
252 Promavit Kapsul Kapsul 0 0 0 0
253 Propanolol tablet 10 mg Tab 600 600 0 600
254 Propilteurasil 100 Mg Tab 200 200 0 200
255 Ramipril Tablet 5 mg Tab 0 0 0 0
256 Ranitidin Injeksi 25 mg/ml Ampul 100 100 0 100
257 Ranitidin Tablet 150 mg Tab 700 700 0 700
258 RDT DBD Pcs 4 4 0 4
259 RDT malaria Pcs 0 0 0 0
260 Retinol (Vitamin A) 100.000 IU Kapsul 20 20 0 20
261 Retinol (Vitamin A) 200.000 IU Botol 7 7 0 7
262 Rifampisin tablet 450 mg Kapsul 0 0 0 0
263 Rifampisin tablet 600 mg Kaplet 0 0 0 0
264 Ringer Laktat Larutan Infus Botol 640 640 20 620
265 Risperidon 2 mg Tab 0 0 0 0
266 Salbutamol 2 mg Tab 0 0 0 0
267 Salbutamol 4 mg Tab 6,700 6,700 0 6,700
268 Salep 2-4 Pot 45 45 0 45
269 Salisil Bedak serbuk 2% Box 180 180 0 180
270 Selediar Tab 0 0 0 0
271 Selesbion Tab 0 0 0 0
272 Selkom C Kap 0 0 0 0
273 Selviplex Kap 0 0 0 0
274 Serum ATS Botol 0 0 0 0
275 Setirizin sirup 5 mg/5ml Botol 33 33 0 33
276 Setrizin Tablet 10 mg Tab 0 0 0 0
277 Sianokobalamin injeksi 500 mcg Ampul 170 170 0 170
278 Scopamin 10 mg Tab 1,200 1,200 0 1,200
279 Sidiadryl Inj Vial 0 0 0 0
280 Silk 3/0 100 M Roll 0 0 0 0
281 Silk 3/0 75 C + Jarum 1/2 17 M R Box 0 0 0 0
282 Silk 4/0 100 M Roll 0 0 0 0
283 Silk Black 2/0 DS 30 MM Sachet 0 0 0 0
284 Silk Black 3/0 DS 30 MM Sachet 0 0 0 0
285 Simvastatin 10 mg Tab 0 0 0 0
286 Sianokobalamin Tab 0 0 0 0
287 Simvastatin 20 mg Tab 500 500 0 500
288 Siprofloksasin Tablet 500 mg Tab 8,800 8,800 0 8,800
289 Soldextam Tab 0 0 0 0
290 Solvita Plus Syrup Botol 0 0 0 0
291 Spasmolit Tab 0 0 0 0
292 Spironolacton 25 mg Tab 0 0 0 0
293 Stesolid 5 mg Tube 0 0 0 0
294 Stik Asam Urat Autochek Botol 3 3 0 3
295 Stik Asam Urat Benecheck Box 0 0 0 0
296 Stik Gula Darah Autochek Box 0 0 0 0
297 Stik Gula Darah Benecheck Box 0 0 0 0
298 Stik Kolesterol Autochek Botol 0 0 0 0
299 Stik Kolesterol Benecheck Botol 0 0 0 0
300 Stik Pemerksaan HB Botol 1 1 0 1
301 Sulfadoxine Pyrimehamine 250 mg Tab 400 400 0 400
302 Tablet Tambah Darah Sachet 0 0 0 0
303 Tablet Tambah Darah Tab 0 0 0 0
304 Tetrasiklin kapsul 500 mg kap 1,200 1,200 0 1,200
305 Termorex Drops Botol 0 0 0 0
306 Thiamin 50 mg Tab 750 750 0 750
307 Thiamin inj Ampul 0 0 0 0
308 Tramadol 50 mg Tab 0 0 0 0
309 Truvit Syrup Botol 3 3 0 3
310 Urin bag Pcs 10 10 0 10
311 Urin bag Pcs 0 0 0 0
312 USG Gel 250 ml Botol 0 0 0 0
313 Vastigo Tab 0 0 0 0
314 Ventolin Nebulizer Ampul 40 40 0 40
315 Verorab Vial 0 0 0 0
316 Vitamin B Kompleks Tablet Tab 700 700 0 700
317 Vitamin B Kompleks Injeksi Vial 0 0 0 0
318 Wing needle No.23 Pcs 0 0 0 0
319 Zinc Syrup Botol 180 180 0 180
320 Zink Tablet 20 mg Tab 0 0 0 0
321 Leukoplast Roll 0 0 0 0
322 Nystatin Drop Botol 76 76 0 76
323 Paracetamol Drops Botol 0 0 0 0
324 Dopamet Tab 150 150 100 50
325 Acetylcystein Tab 0 0 0 0
326 Aspar-K Tab 0 0 0 0
327 New Antides Tab 3,100 3,100 0 3,100
328 Atrovent Botol 2 2 0 2
329 Mometasone Tube 25 25 0 25
330 Soft U cream Tube 62 62 0 62
331 Paracetamol Infus Botol 50 50 0 50
332 Metronidazol Infus Botol 10 10 0 10
333 Clozapine Tab 1,050 1,050 0 1,050
334 Clorpromazine Injeksi Ampul 0 0 0 0
335 Sanbe Tears Botol 1 1 0 1
336 Pantocain Botol 0 0 0 0
337 Caterlent Botol 3 3 0 3
338 Scopamin Ampul 10 10 0 10
339 Omeprazole Injek 40 mg Ampul 14 14 0 14
340 Guaifeesin 100 mg Tab 800 800 0 800
341 Depakote Botol 100 100 0 100
342 Phenobarbital Inj Ampul 28 28 0 28
343 Furosemide Inj Ampul 0 0 0 0
344 Elasti Perban 7,5 cm x 4,5 cm Buah 8 8 0 8
345 Medigibs Buah 19 19 0 19
346 Nasal Oksigen ( selang O2) Buah 0 0 0 0
347 Slide Microscope Buah 169 169 0 169
348 One step anti HIV 1/2 Test Btl 2 2 0 2
349 Alat suntik sekali pakai 20ml Buah 0 0 0 0
350 Iliadin tetes hidung anak Botol 4 4 0 4
351 cendo Xytrol Botol 15 15 0 15
352 Primpen Botol 740 740 0 740
353 Aqua Gell Tube 15 15 0 15
354 Alkohon 1 liter 70% Botol 10 10 0 10
355 Spritus Botol 1 1 0 1
356 Emercin oil Botol 3 3 0 3
357 Gemsa Buah 2 2 0 2
358 Mitela Buah 1 1 0 1
359 Metanol Botol 3 3 0 3
360 Gliserin 100 ml Botol 55 55 0 55
361 Adalat 20 mg Tab 450 450 0 450
362 Atrofastatin 20 mg Tab 540 540 60 480
363 Asam Traneksamat 500 mg Tab 100 100 0 100
364 Loremide Tab 100 100 0 100
365 Vomistop Tab 60 60 0 60
366 Tagadem Buah 19 19 0 19
367 Blood Lancents Buah 1,000 1,000 0 1,000
368 Farsifen 400 mg Tablet 300 300 0 300
369 Miniaspi 80 mg Tablet 900 900 0 900
370 Pritagesic Tablet 100 100 0 100
371 Ovtelis 20 mg Tablet 300 300 0 300
372 Novagesic 500 mg Tablet 5,800 5,800 200 5,600
373 Faridexon 0,5 mg Tablet 700 700 500 200
374 Abbocath 26 Pcs 7 7 0 7
375 Valium 5 mg Tablet 0 0 0 0
376 Oxygen Nasal Canula Anak Pcs 2 2 0 2
377 Penjepit Tali Pusat Pcs 0 0 0 0
378 Sotatic Ampul 5 5 0 5
379 Yusimox 125mg/5 ml Botol 360 360 0 360
380 Handsoon Non Steril (S) Pcs 2,100 2,100 200 1,900
381 Cavicur Tablet 200 200 0 200
382 Prix 25 mg Tablet 1,000 1,000 200 800
383 Patrin 250 mg Tablet 580 580 0 580
384 Grafalin 2 mg Tablet 400 400 0 400
385 Phenitoin Injeksi Ampul 10 10 0 10
386 Diazepam 2 Mg Tablet 200 200 0 200
387 Twist Lancet 28 G Pcs 1,300 1,300 0 1,300
388 Easy Touch Boold Glukose Pcs 0 0 0 0
389 Easy Touch Urid Acid Pcs 4 4 0 4
390 Easy Touch Cholesterol Ampul 0 0 0 0
391 Ovtelis 10 mg Tablet 100 100 0 100
392 Underpads Pcs 20 20 0 20
393 Stik Urinalysis Pcs 100 100 0 100
394 Novagesic Syr Botol 60 60 0 60
395 Siobion Tablet 300 300 0 300
396 Diatabs Tablet 1,400 1,400 0 1,400
397 Repas 400 mg Tablet 9,900 9,900 0 9,900
398 Farizol 500 mg Tablet 5,000 5,000 0 5,000
399 Diazepam 5 mg Tablet 180 180 0 180
400 Pritanol 300 mg Tablet 2,600 2,600 0 2,600
401 Novadium Tablet 500 500 0 500
402 Nasal Oksigen ukuran Xs Pcs 10 10 0 10
403 Nasal Oksigen Ukuran S Pcs 10 10 0 10
404 Scobutrin Tablet 300 300 0 300
405 Floxigra 500 mg Tablet 100 100 0 100
406 Eritromisin Syr Botol 50 50 0 50
407 Amoxcicilin 250 mg Tablet 1,000 1,000 0 1,000
408 Trihexylphenidyl Hcl 2 mg Tablet 1,500 1,500 0 1,500

JAMKESDA BPJS
JUMLAH KUNJUNGAN RESEP
 Mengetahui/Menyetujui Yang Menyerahkan Yang Memohon Yang Menerima
Kepala Seksi Kefarmasian Penanggung Jawab
Gudang Farmasi

Sahrul, SKM Arini Priyanti Kandupi. S.Farm., Apt Megawati Ranindi, S.Tr.Keb Nur Mufida Saenda,S.Farm
Nip. 19820714 200502 1 002 Nip. 19820403 200804 2 002 Nip. 19730708 199303 2 004
 LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MATAKO PELAPORAN BLN/PERIODE : MEI 2020

KECAMATAN : TOJO BARAT PERMINTAAN BLN/PERIODE : JUNI 2020
KABUPATEN : TOJO UNA UNA
PROPINSI : SULAWESI TENGAH

Stok Peneri- Perse- Pema- Stok Permin- Pemberian

NO Nama Obat/Alkes/BMHP Satuan Awal maan diaan kaian Akhir taan APBD I APBD II Program Lain- Jumlah KET
lain
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Abbocath 18 Piece 80 80 160 0 160
2 Abbocath 20 Piece 50 100 150 0 150
3 Abbocath 22 Piece 140 0 140 0 140
4 Abbocath 24 Piece 80 2 82 0 82
5 Acyclovir cream Tube 73 0 73 33 40
6 Acyclovir tablet 200 mg Tab 500 500 1,000 0 1,000
7 Acyclovir tablet 400 mg Tab 2,600 200 2,800 700 2,100
8 Ailin tetes mata Botol 0 0 0 0 0
9 AIC Now + Sistem 20'S Box 0 0 0 0 0
10 Alat Autochek Unit 0 0 0 0 0
11 Alat Pemeriksa HB Buah 0 0 0 0 0
12 Alat suntik sekali pakai 1 ml Piece 300 200 500 0 500
13 Alat suntik sekali pakai 10 ml Piece 200 0 200 0 200
14 Alat suntik sekali pakai 3 ml Piece 100 200 300 50 250
15 Alat suntik sekali pakai 5 ml Piece 300 300 600 0 600
16 Albendazol 400 mg Tab 0 0 0 0 0
17 Alcohol Swab CHG + 0,5 % Box 1 0 1 0 1
18 Alletrol Tetes Mata Botol 0 0 0 0 0
19 Allopurinol Tab 100 mg Tab 2,800 0 2,800 600 2,200
20 Allopurinol Tab 300 mg Tab 0 0 0 0 0
21 Alprazolam Tablet 0,5 mg Tab 500 0 500 0 500
22 Alprazolam Tablet 1 mg Tab 0 0 0 0 0
23 Ambroxol 30 mg Tab 1,900 0 1,900 700 1,200
24 Ambroxol syr Botol 30 0 30 0 30
25 Aminofilin inj 24 mg/ml Ampul 30 0 30 0 30
26 Amitriptilin Tablet Salut 25 mg Tab 1,000 400 1,400 0 1,400
27 Amlodipin Tablet 10 mg Tab 510 0 510 0 510
28 Amlodipin Tablet 5 mg Tab 300 1,800 2,100 1,500 600
29 Amoksisilin Kapsul 500 mg Tab 4,800 1,000 5,800 3,200 2,600
30 Amoxycillin Syrup 125 mg / 5 ml Botol 0 0 0 0 0
31 Amoxycillin Syrup 250 mg / 5 ml Botol 0 60 60 0 60
32 Ampicilin 500 mg Tab 200 0 200 0 200
33 Ampicilin syr Botol 0 0 0 0 0
34 Analog Long Insulin 100 IU Pen Pen 0 0 0 0 0
35 Antalgin 500 mg Tab 0 0 0 0 0
36 Antalgin Injeksi Ampul 0 0 0 0 0
37 Antasida DOEN I tablet kunyah Tab 0 0 0 0 0
38 Antasida Doen Syrup Botol 0 300 300 0 300
39 Antihemoroid Supp 300 0 300 210 90
40 Antimalaria Tab 0 0 0 0 0
41 Antiseptik Hand Rub 10 Btl @ 500 ml Botol 54 0 54 0 54
42 Antrain Injeksi Ampul 0 0 0 0 0
43 Aqua pro Injeksi 20 ml Ampul 26 20 46 0 46
44 Arkine Tab 3,000 0 3,000 0 3,000
45 Asam Askorbat Tablet 50 mg Tab 5,800 5,000 10,800 3,100 7,700
46 Asam Folat tablet 1 mg Tab 0 0 0 0 0
47 Asam Mefenamat kaplet 500 mg Kap 11,300 0 11,300 1,700 9,600
48 Asam Traneksamat 250 mg Ampul 15 0 15 0 15
49 Asam Valproat Syrup Botol 0 0 0 0 0
50 Asetosal Tablet 80 mg Tab 0 0 0 0 0
51 Atropin inj 0,25 mg / ml Ampul 20 0 20 0 20
52 Betahistin Tablet 6 mg Tab 100 0 100 0 100
53 Betametason Krim 0,1 %/Skizon Tube 0 0 0 0 0
54 Biocombin Injk/Farbion Injeksi Ampul 0 0 0 0 0
55 Bionemi Kaps Kapsul 0 0 0 0 0
56 Bisoprolol Tablet 5 mg Tab 50 0 50 0 50
57 Blood Lancents Buah 4 0 4 0 4
58 Buscopan Injeksi/Skopamin Ampul 0 0 0 0 0
59 Candesartan 8 mg Tab 0 0 0 0 0
60 Captopril Tablet 12,5 mg Tab 100 0 100 0 100
61 Captopril Tablet 25 mg Tab 500 0 500 0 500
62 Catapres Injeksi Ampul 70 0 70 0 70
63 Cathejell Lidocain 2 % & CHG 0,05 % Ampul 3 0 3 0 3
64 Catqut Chromic 2/0 75 C + Jarum 1/2 30 M R Box 0 0 0 0 0
65 Catqut Chromic 2/0 HR 20 MM Sachet 0 0 0 0 0
66 Catqut Chromic 3/0 75 C + Jarum 1/2 37 M R Box 1 0 1 0 1
67 Catqut Plain 2/0 HR 37 MM Sachet 1 0 1 0 1
68 Catqut Plain 3/0 HR 26 MM Sachet 1 0 1 0 1
69 Catqut Plain 4/0 100 M Roll 0 0 0 0 0
70 Cefadroxil kapsul 500 mg Kap 4,300 0 4,300 800 3,500
71 Cefadroxil Syrup 125 mg/ 5 ml Botol 160 0 160 0 160
72 Cimetidin Tab 0 0 0 0 0
73 Colcitine 0,5 mg Tab 810 0 810 0 810
74 Clobazam Tab 0 0 0 0 0
75 Clonidine 0,15 mg Tab 100 0 100 0 100
76 Clopidogrel 75 mg Tab 0 0 0 0 0
77 Combivent UDV Vial 0 0 0 0 0
78 Curcuma Tab 0 0 0 0 0
79 Deksametason Injeksi i.v/i.m 5 mg/ml Ampul 505 50 555 0 555
80 Deksametason Tablet 0,5 mg Tab 0 0 0 0 0
81 Diazepam Tablet 2 mg Tab 4,100 0 4,100 0 4,100
82 Diazepam injeksi 5 mg / ml Ampul 0 20 20 0 20
83 Diazepam larutan rektal 10 mg/2,5 ml Tube 0 0 0 0 0
84 Diazepam Tablet 5 mg Tab 0 0 0 0 0
85 Digoksin 0,25 mg Tab 0 0 0 0 0
86 Diltiazem HCL tablet 30 mg Tab 0 0 0 0 0
87 Dimenhidrinat tab 50 mg Tab 1,000 300 1,300 0 1,300
88 Diphenhidramin Injeksi 10 mg/ml Ampul 50 60 110 50 60
89 Diuvar Injeksi Ampul 5 0 5 0 5
90 Doksisiklin Kapsul 100 mg Kap 1,000 0 1,000 0 1,000
91 Domperidon suspensi 5 mg / 5 ml Botol 0 0 0 0 0
92 Domperidon tablet 10 mg Tab 2,700 300 3,000 1,100 1,900
93 Dulcolax 5 mg/Bisacodyl 5 mg Tab 0 0 0 0 0
94 Dulcolax Suppo anak Supp 31 0 31 0 31
95 Dumin Rectal Supp 0 0 0 0 0
96 Eflin Tab 200 0 200 0 200
97 Enbatic Cream Tube 0 0 0 0 0
98 Epinefrin Inj. i.v.s.k/i.m 1 mg/ml Ampul 80 100 180 0 180
99 Ergotamin tab 1 mg Tab 0 0 0 0 0
100 Eritromisin Kapsul 500 mg Kap 1,000 0 1,000 0 1,000
101 Erladerm-N Tube 0 0 0 0 0
102 Erlemicetin Tetes Telinga Botol 0 0 0 0 0
103 Erlemicetin Tetes Mata Botol 0 0 0 0 0
104 Etakridin Botol 8 0 8 0 8
105 Etambutol tablet salut 500 mg Tab 0 0 0 0 0
106 Etanol 70% 1 Liter Botol 0 0 0 0 0
107 Etanol 70% 300 ml Botol 0 0 0 0 0
108 Etilklorida Botol 0 0 0 0 0
109 Folley Catheter 3 - 5 ml / cc - 10 fr Piece 14 0 14 0 14
110 Folley Catheter 3 - 5 ml / cc - 16 fr Piece 32 0 32 0 32
111 Folley Catheter 3 - 5 ml / cc - 18 fr Piece 10 0 10 0 10
112 Folley Catheter 3 - 5 ml / cc - 22 fr Piece 0 0 0 0 0
113 Furosemid tab 40 mg Tab 1,000 200 1,200 0 1,200
114 Gabapentin Tablet 300 mg Kap 0 0 0 0 0
115 Garam Oralit Sachet 1,400 0 1,400 0 1,400
116 Gemfibrozil Kapsul 300 mg Kap 600 0 600 0 600
117 Gentalex Krim Tube 160 0 160 0 160
118 Gentamisin Inj. 40 mg/ml Ampul 0 0 0 0 0
119 Gentamisin Salep Tube 0 0 0 0 0
120 Gention Violet Botol 19 0 19 0 19
121 Glibenklamid tab 5 mg Tab 0 0 0 0 0
122 Glimepiride 2 mg Tab 900 0 900 0 900
123 Gliseril Guaiacolat 100 mg Tab 0 0 0 0 0
124 Gliserin lar 50 % Botol 54 0 54 0 54
125 Glukosa Lar. Infus 5 % Steril Botol 60 0 60 0 60
126 Griseofulvin tablet 125 mg Tab 5,400 0 5,400 0 5,400
127 Griseofulvin tablet 500 mg Tab 700 0 700 0 700
128 Halloperidol 0,5 mg Tab 500 0 500 0 500
129 Halloperidol 1,5 mg Tab 3,400 1,500 4,900 0 4,900
130 Halloperidol 5 mg Tab 0 500 500 0 500
131 Handscond Genekolog Psg 160 0 160 0 160
132 Handscond No. 7 Steril Psg 0 200 200 0 200
133 Handscond No. 7,5 Steril Psg 900 200 1,100 0 1,100
134 Handscond Non Steril (M) Psg 4,400 0 4,400 800 3,600
135 Handscond Non Steril ((L) Psg 6,000 0 6,000 500 5,500
136 Hemafort Tab 0 0 0 0 0
137 Hidroklortiazid tablet 25 mg Tab 0 0 0 0 0
138 Hidrokortison krim 2,5 % Tube 96 48 144 48 96
139 Ibuprofen syrup 200 mg/5 ml Botol 225 0 225 42 183
140 Ibuprofen tablet 400 mg Tab 0 0 0 0 0
141 Ichtiyol Pot 16 0 16 0 16
142 Infusion Set Anak Buah 968 0 968 0 968
143 Infusion Set Dewasa Buah 48 0 48 0 48
144 Iodina test Botol 0 0 0 0 0
145 Isoniazid Tablet Tab 0 0 0 0 0
146 Isosorbid Dinitrat tab 5 mg Tab 400 300 700 0 700
147 Kalsium Glukonat Inj i.v 10 % Ampul 63 10 73 0 73
148 Kalsium Lactat Tablet 500 mg Tab 4,500 0 4,500 700 3,800
149 Kanamicin inj Vial 50 0 50 0 50
150 Kaotin Syrup Botol 0 0 0 0 0
151 Kapas Pembalut 250 mg Roll 25 0 25 0 25
152 Karbamazepin Kaplet 200 mg Kap 4,300 3,000 7,300 0 7,300
153 Kasa hydrofil Steril 16x16 cm Dos 0 0 0 0 0
154 Kasa pembalut hydrofil 40x80 cm Roll 0 1 1 1 0
155 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0 0
156 Kertas USG Rol 10 0 10 0 10
157 Ketokonazole krim 2 % Tube 225 100 325 50 275
158 Ketokonazole tablet 200 mg Tab 5,100 100 5,200 100 5,100
159 Kloramphenicol Kapsul 250 mg/Novachlor Kap 6,000 0 6,000 300 5,700
160 Kloramphenicol salep mata 1 % Tube 24 96 120 24 96
161 Kloramphenicol Suspensi 125mg/5ml Botol 19 0 19 0 19
162 Kloramphenicol tetes mata 0,5 % Botol 0 0 0 0 0
163 Klorfenilamin Maleat tablet 4 mg Tab 1,600 2,000 3,600 2,100 1,500
164 Klorpromazin Injeksi salut 25 mg/ml Ampul 0 0 0 0 0
165 Klorpromazin Tab Salut 25 mg Tab 0 0 0 0 0
166 Klorpromazin Tablet salut 100 mg Tab 200 200 400 0 400
167 Kodein tablet 10 mg Tab 0 300 300 0 300
168 Kolicgon Tab 0 0 0 0 0
169 Kotrimoksazole Tablet 480 mg Tab 5,500 0 5,500 0 5,500
170 Kotrimoxazol Suspensi Botol 0 0 0 0 0
171 Kutoin 100 mg Tab 0 0 0 0 0
172 Lancet For Fine Touch Dos 4 0 4 0 4
173 Larutan PK Pot 0 0 0 0 0
174 Larutan H2O2 Botol 4 0 4 0 4
175 Lidocain HCL 2% Injeksi Ampul 2,200 30 2,230 0 2,230
176 Lidocain Injeksi 2% + Epinefrin 1 : 8000 - 2 ml Ampul 30 0 30 0 30
177 Lisol Botol 0 0 0 0 0
178 Loperamid Tablet 2 Mg Tab 100 0 100 0 100
179 Loratadin 10 mg Tab 600 3,000 3,600 200 3,400
180 Masker Earloop Psg 0 0 0 0 0
181 Masker Karet Psg 0 0 0 0 0
182 Masker N95 Box 0 0 0 0 0
183 Masker Tali Dos 0 0 0 0 0
184 Meloksikam 15 mg Tab 0 0 0 0 0
185 Metergin Inj Vial 0 0 0 0 0
186 Metformin HCL Tablet 500 mg Tab 700 3,000 3,700 1,900 1,800
187 Metilergometrin inj 0,2 mg / ml Ampul 190 100 290 0 290
188 Metilergometrin Tablet 0,125 mg Tab 1,900 300 2,200 0 2,200
189 Metilprednisolon Tablet 4 mg Tab 1,400 0 1,400 200 1,200
190 Metilprednisolon tablet 8 mg Tab 0 0 0 0 0
191 Metoklopramide Injeksi Ampul 10 0 10 0 10
192 Metoklopramide Sirup 5 mg/5 ml Botol 0 0 0 0 0
193 Metoklopramide Tablet 10 mg Tab 700 500 1,200 200 1,000
194 Metolon Inj Ampul 0 0 0 0 0
195 Metronidazol tablet 500 mg Tab 400 0 400 0 400
196 MgSO4 inj 20% - 25 ml Botol 51 30 81 0 81
197 MgSO4 inj 20% - 25 ml Botol 0 0 0 0 0
198 MgSO4 inj 40% - 25 ml Botol 4 20 24 0 24
199 Mikonazole Salep 2% Tube 0 96 96 0 96
200 Mix Insulin Flexpen / Catridge Pen 0 0 0 0 0
201 Mucotussan Tab 0 0 0 0 0
202 Multivitamin Seven Seas Botol 130 0 130 0 130
203 My Jelli 83 Gram Tube 0 0 0 0 0
204 Nacl 0,9% Botol 10 40 50 10 40
205 Natrium Diklofenak 25 mg Tab 4,750 0 4,750 1,150 3,600
206 Needle No.23 Pcs 0 0 0 0 0
207 Neurovit E Kotak 0 0 0 0 0
208 Nifedipin tablet 20 mg Tab 100 0 100 0 100
209 Nistatin Tablet salut 100.000 IU/g Tab 220 200 420 0 420
210 Nistatin Tablet salut 500.000 IU/g Tab 200 0 200 0 200
211 Novadiar Syrup Botol 140 0 140 0 140
212 Novapyron/Neurotropic Plus Tab 0 0 0 0 0
213 Novazon Tab 0 0 0 0 0
214 Novo Twist Box 8 0 8 0 8
215 Novorapid Pen 0 0 0 0 0
216 OAT FDC Kategori 1 Paket 4 4 8 0 8
217 OAT FDC Kategori Anak Paket 1 2 3 0 3
218 OAT FDC Kategori Anak Paket 0 0 0 0 0
219 OAT FDC Kategori FDC Kategori Sisipan Paket 0 0 0 0 0
220 OAT FDC Kategori II Paket 1 1 2 0 2
221 OBH Botol 130 0 130 0 130
222 Oksitetrasiklin salep kulit 3% Tube 115 0 115 0 115
223 Oksitetrasiklin salep mata 1% Tube 0 0 0 0 0
224 Oksitosin inj 10 UI/ml Ampul 100 100 200 0 200
225 Omeprazol Tablet 20 mg Kapsul 0 0 0 0 0
226 Ondancentron 8 mg Ampul 64 0 64 0 64
227 Oxybiotic Inj Vial 0 0 0 0 0
228 Papaverin 40 mg Tab 0 0 0 0 0
229 Paracetamol syrup 120 mg / 5 ml Botol 0 0 0 0 0
230 Parasetamol Kaplet 500 mg Tab 0 0 0 0 0
231 Pehacain Inj Ampul 0 0 0 0 0
232 Pehatrim Forte Tab 0 0 0 0 0
233 Phenol Gliserol Tetes Telinga Botol 20 0 20 0 20
234 Phitomenadion inj i.m 2 mg / ml Ampul 120 0 120 0 120
235 Phitomenadion tablet 10 mg Tab 1,600 200 1,800 300 1,500
236 Piracetam 400 mg Tab 700 0 700 0 700
237 Piracetam inj 3g/15ml Ampul 10 0 10 0 10
238 Pirantel Tablet 125 mg Tab 0 0 0 0 0
239 Piridoksin inj 100 mg/ml Ampul 0 0 0 0 0
240 Piridoksin Tablet 10 mg Tab 0 0 0 0 0
241 Piroksicam 20 mg Tab 0 0 0 0 0
242 Pisau bedah Box 20 0 20 0 20
243 Pisau bedah 21 Set 0 0 0 0 0
244 Plano test Buah 13 10 23 0 23
245 Plester 7,5cm x 4,5m Rol 60 0 60 0 60
246 Plesterin Bulat Non Woven Box 41 0 41 0 41
247 Poligyp 5 cm x 2,7 m Roll 19 0 19 0 19
248 Pot sputum Pot 0 0 0 0 0
249 Povidon Iodida larutan 10% 60 ml Botol 38 0 38 0 38
250 Prednison tablet Tab 6,800 300 7,100 1,400 5,700
251 Primakuin Tablet 15 mg Tab 800 1,000 1,800 800 1,000
252 Promavit Kapsul Kapsul 0 0 0 0 0
253 Propanolol tablet 10 mg Tab 100 500 600 0 600
254 Propilteurasil 100 Mg Tab 200 200 400 200 200
255 Ramipril Tablet 5 mg Tab 0 0 0 0 0
256 Ranitidin Injeksi 25 mg/ml Ampul 128 0 128 28 100
257 Ranitidin Tablet 150 mg Tab 700 0 700 0 700
258 RDT DBD Pcs 4 0 4 0 4
259 RDT malaria Pcs 0 0 0 0 0
260 Retinol (Vitamin A) 100.000 IU Kapsul 10 10 20 0 20
261 Retinol (Vitamin A) 200.000 IU Botol 3 4 7 0 7
262 Rifampisin tablet 450 mg Kapsul 0 0 0 0 0
263 Rifampisin tablet 600 mg Kaplet 0 0 0 0 0
264 Ringer Laktat Larutan Infus Botol 287 400 687 47 640
265 Risperidon 2 mg Tab 0 0 0 0 0
266 Salbutamol 2 mg Tab 0 0 0 0 0
267 Salbutamol 4 mg Tab 6,700 0 6,700 0 6,700
268 Salep 2-4 Pot 45 0 45 0 45
269 Salisil Bedak serbuk 2% Box 156 30 186 6 180
270 Selediar Tab 0 0 0 0 0
271 Selesbion Tab 0 0 0 0 0
272 Selkom C Kap 0 0 0 0 0
273 Selviplex Kap 0 0 0 0 0
274 Serum ATS Botol 0 0 0 0 0
275 Setirizin sirup 5 mg/5ml Botol 35 0 35 2 33
276 Setrizin Tablet 10 mg Tab 0 0 0 0 0
277 Sianokobalamin injeksi 500 mcg Ampul 170 0 170 0 170
278 Scopamin 10 mg Tab 1,200 0 1,200 0 1,200
279 Sidiadryl Inj Vial 0 0 0 0 0
280 Silk 3/0 100 M Roll 0 0 0 0 0
281 Silk 3/0 75 C + Jarum 1/2 17 M R Box 0 0 0 0 0
282 Silk 4/0 100 M Roll 0 0 0 0 0
283 Silk Black 2/0 DS 30 MM Sachet 0 0 0 0 0
284 Silk Black 3/0 DS 30 MM Sachet 0 0 0 0 0
285 Simvastatin 10 mg Tab 0 0 0 0 0
286 Sianokobalamin Tab 0 0 0 0 0
287 Simvastatin 20 mg Tab 0 500 500 0 500
288 Siprofloksasin Tablet 500 mg Tab 9,100 0 9,100 300 8,800
289 Soldextam Tab 0 0 0 0 0
290 Solvita Plus Syrup Botol 0 0 0 0 0
291 Spasmolit Tab 0 0 0 0 0
292 Spironolacton 25 mg Tab 0 0 0 0 0
293 Stesolid 5 mg Tube 0 0 0 0 0
294 Stik Asam Urat Autochek Botol 3 0 3 0 3
295 Stik Asam Urat Benecheck Box 0 0 0 0 0
296 Stik Gula Darah Autochek Box 0 0 0 0 0
297 Stik Gula Darah Benecheck Box 0 0 0 0 0
298 Stik Kolesterol Autochek Botol 0 0 0 0 0
299 Stik Kolesterol Benecheck Botol 0 0 0 0 0
300 Stik Pemerksaan HB Botol 1 0 1 0 1
301 Sulfadoxine Pyrimehamine 250 mg Tab 400 0 400 0 400
302 Tablet Tambah Darah Sachet 0 0 0 0 0
303 Tablet Tambah Darah Tab 0 0 0 0 0
304 Tetrasiklin kapsul 500 mg kap 1,200 0 1,200 0 1,200
305 Termorex Drops Botol 0 0 0 0 0
306 Thiamin 50 mg Tab 750 0 750 0 750
307 Thiamin inj Ampul 0 0 0 0 0
308 Tramadol 50 mg Tab 0 0 0 0 0
309 Truvit Syrup Botol 3 0 3 0 3
310 Urin bag Pcs 10 0 10 0 10
311 Urin bag Pcs 0 0 0 0 0
312 USG Gel 250 ml Botol 0 0 0 0 0
313 Vastigo Tab 0 0 0 0 0
314 Ventolin Nebulizer Ampul 40 0 40 0 40
315 Verorab Vial 0 0 0 0 0
316 Vitamin B Kompleks Tablet Tab 700 0 700 0 700
317 Vitamin B Kompleks Injeksi Vial 0 0 0 0 0
318 Wing needle No.23 Pcs 0 0 0 0 0
319 Zinc Syrup Botol 180 100 280 100 180
320 Zink Tablet 20 mg Tab 0 0 0 0 0
321 Leukoplast Roll 0 0 0 0 0
322 Nystatin Drop Botol 76 0 76 0 76
323 Paracetamol Drops Botol 0 0 0 0 0
324 Dopamet Tab 150 0 150 0 150
325 Acetylcystein Tab 0 0 0 0 0
326 Aspar-K Tab 0 0 0 0 0
327 New Antides Tab 3,100 0 3,100 0 3,100
328 Atrovent Botol 2 0 2 0 2
329 Mometasone Tube 25 0 25 0 25
330 Soft U cream Tube 62 0 62 0 62
331 Paracetamol Infus Botol 50 0 50 0 50
332 Metronidazol Infus Botol 0 10 10 0 10
333 Clozapine Tab 1,050 0 1,050 0 1,050
334 Clorpromazine Injeksi Ampul 0 0 0 0 0
335 Sanbe Tears Botol 1 0 1 0 1
336 Pantocain Botol 0 0 0 0 0
337 Caterlent Botol 3 0 3 0 3
338 Scopamin Ampul 10 0 10 0 10
339 Omeprazole Injek 40 mg Ampul 19 0 19 5 14
340 Guaifeesin 100 mg Tab 1,700 0 1,700 900 800
341 Depakote Botol 100 0 100 0 100
342 Phenobarbital Inj Ampul 28 0 28 0 28
343 Furosemide Inj Ampul 0 0 0 0 0
344 Elasti Perban 7,5 cm x 4,5 cm Buah 8 0 8 0 8
345 Medigibs Buah 19 0 19 0 19
346 Nasal Oksigen ( selang O2) Buah 0 0 0 0 0
347 Slide Microscope Buah 169 0 169 0 169
348 One step anti HIV 1/2 Test Btl 2 0 2 0 2
349 Alat suntik sekali pakai 20ml Buah 0 0 0 0 0
350 Iliadin tetes hidung anak Botol 4 0 4 0 4
351 cendo Xytrol Botol 15 0 15 0 15
352 Primpen Botol 750 0 750 10 740
353 Aqua Gell Tube 18 0 18 3 15
354 Alkohon 1 liter 70% Botol 10 0 10 0 10
355 Spritus Botol 1 0 1 0 1
356 Emercin oil Botol 3 0 3 0 3
357 Gemsa Buah 2 0 2 0 2
358 Mitela Buah 1 0 1 0 1
359 Metanol Botol 3 0 3 0 3
360 Gliserin 100 ml Botol 55 0 55 0 55
361 Adalat 20 mg Tab 450 0 450 0 450
362 Atrofastatin 20 mg Tab 630 0 630 90 540
363 Asam Traneksamat 500 mg Tab 200 0 200 100 100
364 Loremide Tab 100 0 100 0 100
365 Vomistop Tab 60 0 60 0 60
366 Tagadem Buah 19 0 19 0 19
367 Blood Lancents Buah 1,000 0 1,000 0 1,000
368 Farsifen 400 mg Tablet 300 0 300 0 300
369 Miniaspi 80 mg Tablet 600 300 900 0 900
370 Pritagesic Tablet 100 0 100 0 100
371 Ovtelis 20 mg Tablet 300 0 300 0 300
372 Novagesic 500 mg Tablet 8,200 100 8,300 2,500 5,800
373 Faridexon 0,5 mg Tablet 1,900 0 1,900 1,200 700
374 Abbocath 26 Pcs 7 0 7 0 7
375 Valium 5 mg Tablet 0 0 0 0 0
376 Oxygen Nasal Canula Anak Pcs 2 0 2 0 2
377 Penjepit Tali Pusat Pcs 0 0 0 0 0
378 Sotatic Ampul 5 0 5 0 5
379 Yusimox 125mg/5 ml Botol 365 0 365 5 360
380 Handsoon Non Steril (S) Pcs 3,000 0 3,000 900 2,100
381 Cavicur Tablet 200 0 200 0 200
382 Prix 25 mg Tablet 1,300 0 1,300 300 1,000
383 Patrin 250 mg Tablet 330 300 630 50 580
384 Grafalin 2 mg Tablet 500 100 600 200 400
385 Phenitoin Injeksi Ampul 10 0 10 0 10
386 Diazepam 2 Mg Tablet 200 0 200 0 200
387 Twist Lancet 28 G Pcs 1,200 100 1,300 0 1,300
388 Easy Touch Boold Glukose Pcs 0 0 0 0 0
389 Easy Touch Urid Acid Pcs 4 0 4 0 4
390 Easy Touch Cholesterol Ampul 0 0 0 0 0
391 Ovtelis 10 mg Tablet 100 0 100 0 100
392 Underpads Pcs 20 0 20 0 20
393 Stik Urinalysis Pcs 100 0 100 0 100
394 Novagesic Syr Botol 60 0 60 0 60
395 Siobion Tablet 300 0 300 0 300
396 Diatabs Tablet 1,500 0 1,500 100 1,400
397 Repas 400 mg Tablet 5,400 6,000 11,400 1,500 9,900
398 Farizol 500 mg Tablet 5,000 0 5,000 0 5,000
399 Diazepam 5 mg Tablet 180 0 180 0 180
400 Pritanol 300 mg Tablet 3,100 0 3,100 500 2,600
401 Novadium Tablet 500 0 500 0 500
402 Nasal Oksigen ukuran Xs Pcs 10 0 10 0 10
403 Nasal Oksigen Ukuran S Pcs 10 0 10 0 10
404 Scobutrin Tablet 300 0 300 0 300
405 Floxigra 500 mg Tablet 0 100 100 0 100
406 Eritromisin Syr Botol 0 50 50 0 50
407 Amoxcicilin 250 mg Tablet 0 1,000 1,000 0 1,000
408 Trihexylphenidyl Hcl 2 mg Tablet 0 1,500 1,500 0 1,500

JAMKESDA BPJS
JUMLAH KUNJUNGAN RESEP
 Mengetahui/Menyetujui Yang Menyerahkan Yang Memohon Yang Menerima
Kepala Seksi Kefarmasian Penanggung Jawab
Gudang Farmasi

Sahrul, SKM Arini Priyanti Kandupi. S.Farm., Apt Megawati Ranindi, S.Tr.Keb Nur Mufida Saenda,S.Farm
Nip. 19820714 200502 1 002 Nip. 19820403 200804 2 002 Nip. 19730708 199303 2 004
 LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MATAKO PELAPORAN BLN/PERIODE : APRIL 2020

KECAMATAN : TOJO BARAT PERMINTAAN BLN/PERIODE : MEI 2020
KABUPATEN : TOJO UNA UNA
PROPINSI : SULAWESI TENGAH

Stok Peneri- Perse- Pema- Stok Permin- Pemberian

NO Nama Obat/Alkes/BMHP Satuan Awal maan diaan kaian Akhir taan APBD I APBD II Program Lain- Jumlah KET
lain
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Abbocath 18 Piece 80 0 80 0 80
2 Abbocath 20 Piece 50 0 50 0 50
3 Abbocath 22 Piece 140 0 140 0 140
4 Abbocath 24 Piece 80 0 80 0 80
5 Acyclovir cream Tube 73 0 73 0 73
6 Acyclovir tablet 200 mg Tab 500 0 500 0 500
7 Acyclovir tablet 400 mg Tab 2,600 0 2,600 0 2,600
8 Ailin tetes mata Botol 0 0 0 0 0
9 AIC Now + Sistem 20'S Box 0 0 0 0 0
10 Alat Autochek Unit 0 0 0 0 0
11 Alat Pemeriksa HB Buah 0 0 0 0 0
12 Alat suntik sekali pakai 1 ml Piece 300 0 300 0 300
13 Alat suntik sekali pakai 10 ml Piece 200 0 200 0 200
14 Alat suntik sekali pakai 3 ml Piece 100 0 100 0 100
15 Alat suntik sekali pakai 5 ml Piece 300 0 300 0 300
16 Albendazol 400 mg Tab 0 0 0 0 0
17 Alcohol Swab CHG + 0,5 % Box 1 0 1 0 1
18 Alletrol Tetes Mata Botol 0 0 0 0 0
19 Allopurinol Tab 100 mg Tab 3,000 0 3,000 200 2,800
20 Allopurinol Tab 300 mg Tab 0 0 0 0 0
21 Alprazolam Tablet 0,5 mg Tab 500 0 500 0 500
22 Alprazolam Tablet 1 mg Tab 0 0 0 0 0
23 Ambroxol 30 mg Tab 2,300 0 2,300 400 1,900
24 Ambroxol syr Botol 60 0 60 30 30
25 Aminofilin inj 24 mg/ml Ampul 30 0 30 0 30
26 Amitriptilin Tablet Salut 25 mg Tab 1,000 0 1,000 1,000
27 Amlodipin Tablet 10 mg Tab 1,620 0 1,620 1,110 510
28 Amlodipin Tablet 5 mg Tab 300 0 300 0 300
29 Amoksisilin Kapsul 500 mg Tab 6,200 0 6,200 1,400 4,800
30 Amoxycillin Syrup 125 mg / 5 ml Botol 0 0 0 0 0
31 Amoxycillin Syrup 250 mg / 5 ml Botol 0 0 0 0 0
32 Ampicilin 500 mg Tab 200 0 200 0 200
33 Ampicilin syr Botol 0 0 0 0 0
34 Analog Long Insulin 100 IU Pen Pen 0 0 0 0 0
35 Antalgin 500 mg Tab 0 0 0 0 0
36 Antalgin Injeksi Ampul 0 0 0 0 0
37 Antasida DOEN I tablet kunyah Tab 0 0 0 0 0
38 Antasida Doen Syrup Botol 0 0 0 0 0
39 Antihemoroid Supp 300 0 300 0 300
40 Antimalaria Tab 0 0 0 0 0
41 Antiseptik Hand Rub 10 Btl @ 500 ml Botol 54 0 54 0 54
42 Antrain Injeksi Ampul 0 0 0 0 0
43 Aqua pro Injeksi 20 ml Ampul 26 0 26 0 26
44 Arkine Tab 3,000 0 3,000 0 3,000
45 Asam Askorbat Tablet 50 mg Tab 7,300 0 7,300 1,500 5,800
46 Asam Folat tablet 1 mg Tab 0 0 0 0 0
47 Asam Mefenamat kaplet 500 mg Kap 12,700 0 12,700 1,400 11,300
48 Asam Traneksamat 250 mg Ampul 15 0 15 0 15
49 Asam Valproat Syrup Botol 5 0 5 5 0 ED 5
50 Asetosal Tablet 80 mg Tab 0 0 0 0 0
51 Atropin inj 0,25 mg / ml Ampul 20 0 20 0 20
52 Betahistin Tablet 6 mg Tab 100 0 100 0 100
53 Betametason Krim 0,1 %/Skizon Tube 0 0 0 0 0
54 Biocombin Injk/Farbion Injeksi Ampul 0 0 0 0 0
55 Bionemi Kaps Kapsul 0 0 0 0 0
56 Bisoprolol Tablet 5 mg Tab 150 0 150 100 50
57 Blood Lancents Buah 4 0 4 0 4
58 Buscopan Injeksi/Skopamin Ampul 0 0 0 0 0
59 Candesartan 8 mg Tab 0 0 0 0 0
60 Captopril Tablet 12,5 mg Tab 100 0 100 0 100
61 Captopril Tablet 25 mg Tab 500 0 500 0 500
62 Catapres Injeksi Ampul 70 0 70 0 70
63 Cathejell Lidocain 2 % & CHG 0,05 % Ampul 3 0 3 0 3
64 Catqut Chromic 2/0 75 C + Jarum 1/2 30 M R Box 0 0 0 0 0
65 Catqut Chromic 2/0 HR 20 MM Sachet 0 0 0 0 0
66 Catqut Chromic 3/0 75 C + Jarum 1/2 37 M R Box 1 0 1 0 1
67 Catqut Plain 2/0 HR 37 MM Sachet 1 0 1 0 1
68 Catqut Plain 3/0 HR 26 MM Sachet 1 0 1 0 1
69 Catqut Plain 4/0 100 M Roll 0 0 0 0 0
70 Cefadroxil kapsul 500 mg Kap 4,800 0 4,800 500 4,300
71 Cefadroxil Syrup 125 mg/ 5 ml Botol 184 0 184 24 160
72 Cimetidin Tab 0 0 0 0 0
73 Colcitine 0,5 mg Tab 810 0 810 0 810
74 Clobazam Tab 0 0 0 0 0
75 Clonidine 0,15 mg Tab 100 0 100 0 100
76 Clopidogrel 75 mg Tab 0 0 0 0 0
77 Combivent UDV Vial 0 0 0 0 0
78 Curcuma Tab 0 0 0 0 0
79 Deksametason Injeksi i.v/i.m 5 mg/ml Ampul 520 0 520 15 505
80 Deksametason Tablet 0,5 mg Tab 0 0 0 0 0
81 Diazepam Tablet 2 mg Tab 4,100 0 4,100 0 4,100
82 Diazepam injeksi 5 mg / ml Ampul 7 0 7 7 0 20 ED 7
83 Diazepam larutan rektal 10 mg/2,5 ml Tube 0 0 0 0 0
84 Diazepam Tablet 5 mg Tab 0 0 0 0 0
85 Digoksin 0,25 mg Tab 0 0 0 0 0
86 Diltiazem HCL tablet 30 mg Tab 0 0 0 0 0
87 Dimenhidrinat tab 50 mg Tab 1,000 0 1,000 0 1,000
88 Diphenhidramin Injeksi 10 mg/ml Ampul 50 0 50 0 50
89 Diuvar Injeksi Ampul 5 0 5 0 5
90 Doksisiklin Kapsul 100 mg Kap 1,000 0 1,000 0 1,000
91 Domperidon suspensi 5 mg / 5 ml Botol 28 0 28 28 0
92 Domperidon tablet 10 mg Tab 2,700 0 2,700 0 2,700
93 Dulcolax 5 mg/Bisacodyl 5 mg Tab 0 0 0 0 0
94 Dulcolax Suppo anak Supp 31 0 31 0 31
95 Dumin Rectal Supp 0 0 0 0 0
96 Eflin Tab 500 0 500 300 200
97 Enbatic Cream Tube 51 0 51 51 0
98 Epinefrin Inj. i.v.s.k/i.m 1 mg/ml Ampul 80 0 80 0 80
99 Ergotamin tab 1 mg Tab 0 0 0 0 0
100 Eritromisin Kapsul 500 mg Kap 1,000 0 1,000 0 1,000
101 Erladerm-N Tube 0 0 0 0 0
102 Erlemicetin Tetes Telinga Botol 0 0 0 0 0
103 Erlemicetin Tetes Mata Botol 0 0 0 0 0
104 Etakridin Botol 8 0 8 0 8
105 Etambutol tablet salut 500 mg Tab 0 0 0 0 0
106 Etanol 70% 1 Liter Botol 0 0 0 0 0
107 Etanol 70% 300 ml Botol 0 0 0 0 0
108 Etilklorida Botol 0 0 0 0 0
109 Folley Catheter 3 - 5 ml / cc - 10 fr Piece 14 0 14 0 14
110 Folley Catheter 3 - 5 ml / cc - 16 fr Piece 32 0 32 0 32
111 Folley Catheter 3 - 5 ml / cc - 18 fr Piece 10 0 10 0 10
112 Folley Catheter 3 - 5 ml / cc - 22 fr Piece 0 0 0 0 0
113 Furosemid tab 40 mg Tab 1,000 0 1,000 0 1,000
114 Gabapentin Tablet 300 mg Kap 0 0 0 0 0
115 Garam Oralit Sachet 1,400 0 1,400 0 1,400
116 Gemfibrozil Kapsul 300 mg Kap 600 0 600 0 600
117 Gentalex Krim Tube 372 0 372 212 160
118 Gentamisin Inj. 40 mg/ml Ampul 0 0 0 0 0
119 Gentamisin Salep Tube 0 0 0 0 0
120 Gention Violet Botol 19 0 19 0 19
121 Glibenklamid tab 5 mg Tab 0 0 0 0 0
122 Glimepiride 2 mg Tab 900 0 900 0 900
123 Gliseril Guaiacolat 100 mg Tab 0 0 0 0 0
124 Gliserin lar 50 % Botol 54 0 54 0 54
125 Glukosa Lar. Infus 5 % Steril Botol 60 0 60 0 60
126 Griseofulvin tablet 125 mg Tab 5,400 0 5,400 0 5,400
127 Griseofulvin tablet 500 mg Tab 700 0 700 0 700
128 Halloperidol 0,5 mg Tab 500 0 500 0 500
129 Halloperidol 1,5 mg Tab 3,400 0 3,400 0 3,400
130 Halloperidol 5 mg Tab 0 0 0 0 0
131 Handscond Genekolog Psg 160 0 160 0 160
132 Handscond No. 7 Steril Psg 0 0 0 0 0
133 Handscond No. 7,5 Steril Psg 900 0 900 0 900
134 Handscond Non Steril (M) Psg 5,800 0 5,800 1,400 4,400
135 Handscond Non Steril ((L) Psg 7,100 0 7,100 1,100 6,000
136 Hemafort Tab 0 0 0 0 0
137 Hidroklortiazid tablet 25 mg Tab 0 0 0 0 0
138 Hidrokortison krim 2,5 % Tube 96 0 96 0 96
139 Ibuprofen syrup 200 mg/5 ml Botol 280 0 280 55 225
140 Ibuprofen tablet 400 mg Tab 0 0 0 0 0
141 Ichtiyol Pot 16 0 16 0 16
142 Infusion Set Anak Buah 968 0 968 0 968
143 Infusion Set Dewasa Buah 48 0 48 0 48
144 Iodina test Botol 0 0 0 0 0
145 Isoniazid Tablet Tab 0 0 0 0 0
146 Isosorbid Dinitrat tab 5 mg Tab 400 0 400 0 400
147 Kalsium Glukonat Inj i.v 10 % Ampul 63 0 63 0 63
148 Kalsium Lactat Tablet 500 mg Tab 4,900 0 4,900 400 4,500
149 Kanamicin inj Vial 50 0 50 0 50
150 Kaotin Syrup Botol 0 0 0 0 0
151 Kapas Pembalut 250 mg Roll 25 0 25 0 25
152 Karbamazepin Kaplet 200 mg Kap 4,300 0 4,300 0 4,300
153 Kasa hydrofil Steril 16x16 cm Dos 2 0 2 2 0
154 Kasa pembalut hydrofil 40x80 cm Roll 6 0 6 6 0
155 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0 0
156 Kertas USG Rol 10 0 10 0 10
157 Ketokonazole krim 2 % Tube 225 0 225 0 225
158 Ketokonazole tablet 200 mg Tab 5,100 0 5,100 0 5,100
159 Kloramphenicol Kapsul 250 mg/Novachlor Kap 6,500 0 6,500 500 6,000
160 Kloramphenicol salep mata 1 % Tube 24 0 24 0 24
161 Kloramphenicol Suspensi 125mg/5ml Botol 39 0 39 20 19
162 Kloramphenicol tetes mata 0,5 % Botol 0 0 0 0 0
163 Klorfenilamin Maleat tablet 4 mg Tab 200 2,000 2,200 600 1,600
164 Klorpromazin Injeksi salut 25 mg/ml Ampul 0 0 0 0 0
165 Klorpromazin Tab Salut 25 mg Tab 0 0 0 0 0
166 Klorpromazin Tablet salut 100 mg Tab 200 0 200 0 200
167 Kodein tablet 10 mg Tab 0 0 0 0 0
168 Kolicgon Tab 0 0 0 0 0
169 Kotrimoksazole Tablet 480 mg Tab 5,500 0 5,500 0 5,500
170 Kotrimoxazol Suspensi Botol 419 0 419 419 0 ED 419
171 Kutoin 100 mg Tab 100 0 100 100 0
172 Lancet For Fine Touch Dos 4 0 4 0 4
173 Larutan PK Pot 0 0 0 0 0
174 Larutan H2O2 Botol 4 0 4 0 4
175 Lidocain HCL 2% Injeksi Ampul 2,200 0 2,200 0 2,200
176 Lidocain Injeksi 2% + Epinefrin 1 : 8000 - 2 ml Ampul 30 0 30 0 30
177 Lisol Botol 12 0 12 12 0
178 Loperamid Tablet 2 Mg Tab 100 0 100 0 100
179 Loratadin 10 mg Tab 800 0 800 200 600
180 Masker Earloop Psg 0 0 0 0 0
181 Masker Karet Psg 0 0 0 0 0
182 Masker N95 Box 1 0 1 1 0
183 Masker Tali Dos 3 0 3 3 0
184 Meloksikam 15 mg Tab 0 0 0 0 0
185 Metergin Inj Vial 0 0 0 0 0
186 Metformin HCL Tablet 500 mg Tab 200 1,000 1,200 500 700
187 Metilergometrin inj 0,2 mg / ml Ampul 190 0 190 0 190
188 Metilergometrin Tablet 0,125 mg Tab 1,900 0 1,900 0 1,900
189 Metilprednisolon Tablet 4 mg Tab 1,600 0 1,600 200 1,400
190 Metilprednisolon tablet 8 mg Tab 0 0 0 0 0
191 Metoklopramide Injeksi Ampul 10 0 10 0 10
192 Metoklopramide Sirup 5 mg/5 ml Botol 0 0 0 0 0
193 Metoklopramide Tablet 10 mg Tab 900 0 900 200 700
194 Metolon Inj Ampul 0 0 0 0 0
195 Metronidazol tablet 500 mg Tab 400 0 400 0 400
196 MgSO4 inj 20% - 25 ml Botol 51 0 51 0 51
197 MgSO4 inj 20% - 25 ml Botol 0 0 0 0 0
198 MgSO4 inj 40% - 25 ml Botol 4 0 4 0 4
199 Mikonazole Salep 2% Tube 0 0 0 0 0
200 Mix Insulin Flexpen / Catridge Pen 0 0 0 0 0
201 Mucotussan Tab 0 0 0 0 0
202 Multivitamin Seven Seas Botol 230 0 230 100 130
203 My Jelli 83 Gram Tube 0 0 0 0 0
204 Nacl 0,9% Botol 20 0 20 10 10
205 Natrium Diklofenak 25 mg Tab 5,150 0 5,150 400 4,750
206 Needle No.23 Pcs 0 0 0 0 0
207 Neurovit E Kotak 0 0 0 0 0
208 Nifedipin tablet 20 mg Tab 100 0 100 0 100
209 Nistatin Tablet salut 100.000 IU/g Tab 220 0 220 0 220
210 Nistatin Tablet salut 500.000 IU/g Tab 200 0 200 0 200
211 Novadiar Syrup Botol 150 0 150 10 140
212 Novapyron/Neurotropic Plus Tab 0 0 0 0 0
213 Novazon Tab 0 0 0 0 0
214 Novo Twist Box 8 0 8 0 8
215 Novorapid Pen 5 0 5 5 0
216 OAT FDC Kategori 1 Paket 0 4 4 0 4
217 OAT FDC Kategori Anak Paket 1 2 3 2 1
218 OAT FDC Kategori Anak Paket 0 0 0 0 0
219 OAT FDC Kategori FDC Kategori Sisipan Paket 0 0 0 0 0
220 OAT FDC Kategori II Paket 2 1 3 2 1
221 OBH Botol 160 0 160 30 130
222 Oksitetrasiklin salep kulit 3% Tube 115 0 115 0 115
223 Oksitetrasiklin salep mata 1% Tube 0 0 0 0 0
224 Oksitosin inj 10 UI/ml Ampul 100 0 100 0 100
225 Omeprazol Tablet 20 mg Kapsul 0 0 0 0 0
226 Ondancentron 8 mg Ampul 64 0 64 0 64
227 Oxybiotic Inj Vial 0 0 0 0 0
228 Papaverin 40 mg Tab 0 0 0 0 0
229 Paracetamol syrup 120 mg / 5 ml Botol 0 0 0 0 0
230 Parasetamol Kaplet 500 mg Tab 0 0 0 0 0
231 Pehacain Inj Ampul 0 0 0 0 0
232 Pehatrim Forte Tab 0 0 0 0 0
233 Phenol Gliserol Tetes Telinga Botol 20 0 20 0 20
234 Phitomenadion inj i.m 2 mg / ml Ampul 120 0 120 0 120
235 Phitomenadion tablet 10 mg Tab 1,600 0 1,600 0 1,600
236 Piracetam 400 mg Tab 800 0 800 100 700
237 Piracetam inj 3g/15ml Ampul 10 0 10 0 10
238 Pirantel Tablet 125 mg Tab 0 0 0 0 0
239 Piridoksin inj 100 mg/ml Ampul 0 0 0 0 0
240 Piridoksin Tablet 10 mg Tab 0 0 0 0 0
241 Piroksicam 20 mg Tab 0 0 0 0 0
242 Pisau bedah Box 20 0 20 0 20
243 Pisau bedah 21 Set 0 0 0 0 0
244 Plano test Buah 13 0 13 0 13
245 Plester 7,5cm x 4,5m Rol 60 0 60 0 60
246 Plesterin Bulat Non Woven Box 41 0 41 0 41
247 Poligyp 5 cm x 2,7 m Roll 19 0 19 0 19
248 Pot sputum Pot 0 0 0 0 0
249 Povidon Iodida larutan 10% 60 ml Botol 38 0 38 0 38
250 Prednison tablet Tab 7,000 0 7,000 200 6,800
251 Primakuin Tablet 15 mg Tab 800 0 800 0 800
252 Promavit Kapsul Kapsul 0 0 0 0 0
253 Propanolol tablet 10 mg Tab 100 0 100 0 100
254 Propilteurasil 100 Mg Tab 200 0 200 0 200
255 Ramipril Tablet 5 mg Tab 0 0 0 0 0
256 Ranitidin Injeksi 25 mg/ml Ampul 138 0 138 10 128
257 Ranitidin Tablet 150 mg Tab 700 0 700 0 700
258 RDT DBD Pcs 4 0 4 0 4
259 RDT malaria Pcs 0 0 0 0 0
260 Retinol (Vitamin A) 100.000 IU Kapsul 10 0 10 0 10
261 Retinol (Vitamin A) 200.000 IU Botol 3 0 3 0 3
262 Rifampisin tablet 450 mg Kapsul 0 0 0 0 0
263 Rifampisin tablet 600 mg Kaplet 0 0 0 0 0
264 Ringer Laktat Larutan Infus Botol 287 0 287 0 287
265 Risperidon 2 mg Tab 0 0 0 0 0
266 Salbutamol 2 mg Tab 0 0 0 0 0
267 Salbutamol 4 mg Tab 7,100 0 7,100 400 6,700
268 Salep 2-4 Pot 45 0 45 0 45
269 Salisil Bedak serbuk 2% Box 180 0 180 24 156
270 Selediar Tab 0 0 0 0 0
271 Selesbion Tab 0 0 0 0 0
272 Selkom C Kap 0 0 0 0 0
273 Selviplex Kap 200 0 200 200 0
274 Serum ATS Botol 0 0 0 0 0
275 Setirizin sirup 5 mg/5ml Botol 70 0 70 35 35
276 Setrizin Tablet 10 mg Tab 0 0 0 0 0
277 Sianokobalamin injeksi 500 mcg Ampul 170 0 170 0 170
278 Scopamin 10 mg Tab 1,200 0 1,200 0 1,200
279 Sidiadryl Inj Vial 0 0 0 0 0
280 Silk 3/0 100 M Roll 0 0 0 0 0
281 Silk 3/0 75 C + Jarum 1/2 17 M R Box 0 0 0 0 0
282 Silk 4/0 100 M Roll 0 0 0 0 0
283 Silk Black 2/0 DS 30 MM Sachet 0 0 0 0 0
284 Silk Black 3/0 DS 30 MM Sachet 0 0 0 0 0
285 Simvastatin 10 mg Tab 0 0 0 0 0
286 Sianokobalamin Tab 0 0 0 0 0
287 Simvastatin 20 mg Tab 0 0 0 0 0
288 Siprofloksasin Tablet 500 mg Tab 9,100 0 9,100 0 9,100
289 Soldextam Tab 0 0 0 0 0
290 Solvita Plus Syrup Botol 0 0 0 0 0
291 Spasmolit Tab 0 0 0 0 0
292 Spironolacton 25 mg Tab 0 0 0 0 0
293 Stesolid 5 mg Tube 0 0 0 0 0
294 Stik Asam Urat Autochek Botol 3 0 3 0 3
295 Stik Asam Urat Benecheck Box 0 0 0 0 0
296 Stik Gula Darah Autochek Box 0 0 0 0 0
297 Stik Gula Darah Benecheck Box 0 0 0 0 0
298 Stik Kolesterol Autochek Botol 0 0 0 0 0
299 Stik Kolesterol Benecheck Botol 0 0 0 0 0
300 Stik Pemerksaan HB Botol 1 0 1 0 1
301 Sulfadoxine Pyrimehamine 250 mg Tab 400 0 400 0 400
302 Tablet Tambah Darah Sachet 6,330 0 6,330 10,650 4,320
303 Tablet Tambah Darah Tab 0 0 0 0 0
304 Tetrasiklin kapsul 500 mg kap 1,200 0 1,200 0 1,200
305 Termorex Drops Botol 0 0 0 0 0
306 Thiamin 50 mg Tab 750 0 750 0 750
307 Thiamin inj Ampul 0 0 0 0 0
308 Tramadol 50 mg Tab 0 0 0 0 0
309 Truvit Syrup Botol 80 0 80 77 3
310 Urin bag Pcs 10 0 10 0 10
311 Urin bag Pcs 0 0 0 0 0
312 USG Gel 250 ml Botol 0 0 0 0 0
313 Vastigo Tab 0 0 0 0 0
314 Ventolin Nebulizer Ampul 40 0 40 0 40
315 Verorab Vial 0 0 0 0 0
316 Vitamin B Kompleks Tablet Tab 700 0 700 0 700
317 Vitamin B Kompleks Injeksi Vial 0 0 0 0 0
318 Wing needle No.23 Pcs 0 0 0 0 0
319 Zinc Syrup Botol 185 0 185 5 180
320 Zink Tablet 20 mg Tab 0 0 0 0 0
321 Leukoplast Roll 0 0 0 0 0
322 Nystatin Drop Botol 76 0 76 0 76
323 Paracetamol Drops Botol 0 0 0 0 0
324 Dopamet Tab 150 0 150 0 150
325 Acetylcystein Tab 0 0 0 0 0
326 Aspar-K Tab 0 0 0 0 0
327 New Antides Tab 3,100 0 3,100 0 3,100
328 Atrovent Botol 2 0 2 0 2
329 Mometasone Tube 25 0 25 0 25
330 Soft U cream Tube 62 0 62 0 62
331 Paracetamol Infus Botol 50 0 50 0 50
332 Metronidazol Infus Botol 0 0 0 0 0
333 Clozapine Tab 1,050 0 1,050 0 1,050
334 Clorpromazine Injeksi Ampul 0 0 0 0 0
335 Sanbe Tears Botol 1 0 1 0 1
336 Pantocain Botol 0 0 0 0 0
337 Caterlent Botol 3 0 3 0 3
338 Scopamin Ampul 10 0 10 0 10
339 Omeprazole Injek 40 mg Ampul 19 0 19 0 19
340 Guaifeesin 100 mg Tab 2,800 0 2,800 1,100 1,700
341 Depakote Botol 100 0 100 0 100
342 Phenobarbital Inj Ampul 28 0 28 0 28
343 Furosemide Inj Ampul 0 0 0 0 0
344 Elasti Perban 7,5 cm x 4,5 cm Buah 8 0 8 0 8
345 Medigibs Buah 19 0 19 0 19
346 Nasal Oksigen ( selang O2) Buah 0 0 0 0 0
347 Slide Microscope Buah 169 0 169 0 169
348 One step anti HIV 1/2 Test Btl 2 0 2 0 2
349 Alat suntik sekali pakai 20ml Buah 0 0 0 0 0
350 Iliadin tetes hidung anak Botol 4 0 4 0 4
351 cendo Xytrol Botol 15 0 15 0 15
352 Primpen Botol 900 0 900 150 750
353 Aqua Gell Tube 18 0 18 0 18
354 Alkohon 1 liter 70% Botol 20 0 20 10 10
355 Spritus Botol 1 0 1 0 1
356 Emercin oil Botol 3 0 3 0 3
357 Gemsa Buah 2 0 2 0 2
358 Mitela Buah 1 0 1 0 1
359 Metanol Botol 3 0 3 0 3
360 Gliserin 100 ml Botol 55 0 55 0 55
361 Adalat 20 mg Tab 450 0 450 0 450
362 Atrofastatin 20 mg Tab 630 0 630 0 630
363 Asam Traneksamat 500 mg Tab 200 0 200 0 200
364 Loremide Tab 100 0 100 0 100
365 Vomistop Tab 60 0 60 0 60
366 Tagadem Buah 19 0 19 0 19
367 Blood Lancents Buah 1,000 0 1,000 0 1,000
368 Farsifen 400 mg Tablet 300 0 300 0 300
369 Miniaspi 80 mg Tablet 600 0 600 0 600
370 Pritagesic Tablet 500 0 500 400 100
371 Ovtelis 20 mg Tablet 300 0 300 0 300
372 Novagesic 500 mg Tablet 9,900 0 9,900 1,700 8,200
373 Faridexon 0,5 mg Tablet 2,800 0 2,800 900 1,900
374 Abbocath 26 Pcs 7 0 7 0 7
375 Valium 5 mg Tablet 0 0 0 0 0
376 Oxygen Nasal Canula Anak Pcs 2 0 2 0 2
377 Penjepit Tali Pusat Pcs 0 0 0 0 0
378 Sotatic Ampul 5 0 5 0 5
379 Yusimox 125mg/5 ml Botol 390 0 390 25 365
380 Handsoon Non Steril (S) Pcs 3,000 0 3,000 0 3,000
381 Cavicur Tablet 300 0 300 100 200
382 Prix 25 mg Tablet 1,300 0 1,300 0 1,300
383 Patrin 250 mg Tablet 370 0 370 40 330
384 Grafalin 2mg Tablet 1,000 0 1,000 500 500
385 Phenitoin Injeksi Ampul 10 0 10 0 10
386 Diazepam 2 Mg Tablet 200 0 200 0 200
387 Twist Lancet 28 G Pcs 1,200 0 1,200 0 1,200
388 Easy Touch Boold Glukose Pcs 0 0 0 0 0
389 Easy Touch Urid Acid Pcs 4 0 4 0 4
390 Easy Touch Cholesterol Ampul 0 0 0 0 0
391 Ovtelis 10 mg Tablet 100 0 100 0 100
392 Underpads Pcs 20 0 20 0 20
393 Stik Urinalysis Pcs 100 0 100 0 100
394 Novagesic Syr Botol 60 0 60 0 60
395 Siobion Tablet 300 0 300 0 300
396 Diatabs Tablet 1,500 0 1,500 0 1,500
397 Repas 400 mg Tablet 6,300 0 6,300 900 5,400
398 Farizol 500 mg Tablet 5,000 0 5,000 0 5,000
399 Diazepam 5 mg Tablet 180 0 180 0 180
400 Pritanol 300 mg Tablet 3,200 0 3,200 100 3,100
401 Novadium Tablet 500 0 500 0 500
402 Nasal Oksigen ukuran Xs Pcs 10 0 10 0 10
403 Nasal Oksigen Ukuran S Pcs 10 0 10 0 10
404 Scobutrin Tablet 500 0 500 200 300
405 0 0 0 0 0

JAMKESDA BPJS
JUMLAH KUNJUNGAN RESEP
 Mengetahui/Menyetujui Yang Menyerahkan Yang Memohon Yang Menerima
Kepala Seksi Kefarmasian Penanggung Jawab
Gudang Farmasi

Sahrul, SKM Arini Priyanti Kandupi. S.Farm., Apt Megawati Ranindi, S.Tr.Keb Nur Mufida Saenda,S.Farm
Nip. 19820714 200502 1 002 Nip. 19820403 200804 2 002 Nip. 19730708 199303 2 004
 LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MATAKO PELAPORAN BLN/PERIODE : MARET 2020

KECAMATAN : TOJO BARAT PERMINTAAN BLN/PERIODE : APRIL 2020
KABUPATEN : TOJO UNA UNA
PROPINSI : SULAWESI TENGAH

Stok Peneri- Perse- Pema- Stok Permin- Pemberian

NO Nama Obat/Alkes/BMHP Satuan Awal maan diaan kaian Akhir taan APBD I APBD II Program Lain- Jumlah KET
lain
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Abbocath 18 Piece 30 50 80 0 80
2 Abbocath 20 Piece 0 50 50 0 50
3 Abbocath 22 Piece 140 0 140 0 140
4 Abbocath 24 Piece 80 0 80 0 80
5 Acyclovir cream Tube 73 0 73 0 73
6 Acyclovir tablet 200 mg Tab 500 0 500 0 500
7 Acyclovir tablet 400 mg Tab 2,100 500 2,600 0 2,600
8 Ailin tetes mata Botol 0 0 0 0 0
9 AIC Now + Sistem 20'S Box 0 0 0 0 0
10 Alat Autochek Unit 0 0 0 0 0
11 Alat Pemeriksa HB Buah 0 0 0 0 0
12 Alat suntik sekali pakai 1 ml Piece 300 0 300 0 300
13 Alat suntik sekali pakai 10 ml Piece 200 0 200 0 200
14 Alat suntik sekali pakai 3 ml Piece 300 0 300 200 100
15 Alat suntik sekali pakai 5 ml Piece 300 0 300 0 300
16 Albendazol 400 mg Tab 0 0 0 0 0
17 Alcohol Swab CHG + 0,5 % Box 1 0 1 0 1
18 Alletrol Tetes Mata Botol 0 0 0 0 0
19 Allopurinol Tab 100 mg Tab 4,600 0 4,600 1,600 3,000
20 Allopurinol Tab 300 mg Tab 0 0 0 0 0
21 Alprazolam Tablet 0,5 mg Tab 500 0 500 0 500
22 Alprazolam Tablet 1 mg Tab 0 0 0 0 0
23 Ambroxol 30 mg Tab 2,600 0 2,600 300 2,300
24 Ambroxol syr Botol 60 0 60 0 60
25 Aminofilin inj 24 mg/ml Ampul 30 0 30 0 30
26 Amitriptilin Tablet Salut 25 mg Tab 0 1,000 1,000 0 1,000
27 Amlodipin Tablet 10 mg Tab 2,040 480 2,520 900 1,620
28 Amlodipin Tablet 5 mg Tab 0 300 300 0 300
29 Amoksisilin Kapsul 500 mg Tab 5,300 2,000 7,300 1,100 6,200
30 Amoxycillin Syrup 125 mg / 5 ml Botol 0 0 0 0 0
31 Amoxycillin Syrup 250 mg / 5 ml Botol 0 0 0 0 0
32 Ampicilin 500 mg Tab 200 0 200 0 200
33 Ampicilin syr Botol 0 0 0 0 0
34 Analog Long Insulin 100 IU Pen Pen 0 0 0 0 0
35 Antalgin 500 mg Tab 0 0 0 0 0
36 Antalgin Injeksi Ampul 0 0 0 0 0
37 Antasida DOEN I tablet kunyah Tab 0 0 0 0 0
38 Antasida Doen Syrup Botol 0 0 0 0 0
39 Antihemoroid Supp 300 0 300 0 300
40 Antimalaria Tab 0 0 0 0 0
41 Antiseptik Hand Rub 10 Btl @ 500 ml Botol 54 0 54 0 54
42 Antrain Injeksi Ampul 0 0 0 0 0
43 Aqua pro Injeksi 20 ml Ampul 0 26 26 0 26
44 Arkine Tab 3,000 0 3,000 0 3,000
45 Asam Askorbat Tablet 50 mg Tab 9,500 0 9,500 2,200 7,300
46 Asam Folat tablet 1 mg Tab 0 0 0 0 0
47 Asam Mefenamat kaplet 500 mg Kap 13,800 0 13,800 1,100 12,700
48 Asam Traneksamat 250 mg Ampul 15 0 15 0 15
49 Asam Valproat Syrup Botol 5 0 5 0 5
50 Asetosal Tablet 80 mg Tab 0 0 0 0 0
51 Atropin inj 0,25 mg / ml Ampul 20 0 20 0 20
52 Betahistin Tablet 6 mg Tab 200 0 200 100 100
53 Betametason Krim 0,1 %/Skizon Tube 0 0 0 0 0
54 Biocombin Injk/Farbion Injeksi Ampul 0 0 0 0 0
55 Bionemi Kaps Kapsul 0 0 0 0 0
56 Bisoprolol Tablet 5 mg Tab 50 100 150 0 150
57 Blood Lancents Buah 4 0 4 0 4
58 Buscopan Injeksi/Skopamin Ampul 0 0 0 0 0
59 Candesartan 8 mg Tab 0 0 0 0 0
60 Captopril Tablet 12,5 mg Tab 300 0 300 200 100
61 Captopril Tablet 25 mg Tab 0 500 500 0 500
62 Catapres Injeksi Ampul 70 0 70 0 70
63 Cathejell Lidocain 2 % & CHG 0,05 % Ampul 3 0 3 0 3
64 Catqut Chromic 2/0 75 C + Jarum 1/2 30 M R Box 0 0 0 0 0
65 Catqut Chromic 2/0 HR 20 MM Sachet 0 0 0 0 0
66 Catqut Chromic 3/0 75 C + Jarum 1/2 37 M R Box 1 0 1 0 1
67 Catqut Plain 2/0 HR 37 MM Sachet 1 0 1 0 1
68 Catqut Plain 3/0 HR 26 MM Sachet 1 0 1 0 1
69 Catqut Plain 4/0 100 M Roll 0 0 0 0 0
70 Cefadroxil kapsul 500 mg Kap 4,800 0 4,800 0 4,800
71 Cefadroxil Syrup 125 mg/ 5 ml Botol 84 100 184 0 184
72 Cimetidin Tab 0 0 0 0 0
73 Colcitine 0,5 mg Tab 810 0 810 0 810
74 Clobazam Tab 0 0 0 0 0
75 Clonidine 0,15 mg Tab 100 0 100 0 100
76 Clopidogrel 75 mg Tab 0 0 0 0 0
77 Combivent UDV Vial 0 0 0 0 0
78 Curcuma Tab 0 0 0 0 0
79 Deksametason Injeksi i.v/i.m 5 mg/ml Ampul 520 0 520 0 520
80 Deksametason Tablet 0,5 mg Tab 0 0 0 0 0
81 Diazepam Tablet 2 mg Tab 4,100 0 4,100 0 4,100
82 Diazepam injeksi 5 mg / ml Ampul 7 0 7 0 7
83 Diazepam larutan rektal 10 mg/2,5 ml Tube 0 0 0 0 0
84 Diazepam Tablet 5 mg Tab 0 0 0 0 0
85 Digoksin 0,25 mg Tab 0 0 0 0 0
86 Diltiazem HCL tablet 30 mg Tab 0 0 0 0 0
87 Dimenhidrinat tab 50 mg Tab 1,000 0 1,000 0 1,000
88 Diphenhidramin Injeksi 10 mg/ml Ampul 50 0 50 0 50
89 Diuvar Injeksi Ampul 5 0 5 0 5
90 Doksisiklin Kapsul 100 mg Kap 1,000 0 1,000 0 1,000
91 Domperidon suspensi 5 mg / 5 ml Botol 28 0 28 0 28
92 Domperidon tablet 10 mg Tab 2,700 0 2,700 0 2,700
93 Dulcolax 5 mg/Bisacodyl 5 mg Tab 0 0 0 0 0
94 Dulcolax Suppo anak Supp 31 0 31 0 31
95 Dumin Rectal Supp 0 0 0 0 0
96 Eflin Tab 600 0 600 100 500
97 Enbatic Cream Tube 51 0 51 0 51
98 Epinefrin Inj. i.v.s.k/i.m 1 mg/ml Ampul 80 0 80 0 80
99 Ergotamin tab 1 mg Tab 0 0 0 0 0
100 Eritromisin Kapsul 500 mg Kap 1,000 0 1,000 0 1,000
101 Erladerm-N Tube 0 0 0 0 0
102 Erlemicetin Tetes Telinga Botol 0 0 0 0 0
103 Erlemicetin Tetes Mata Botol 0 0 0 0 0
104 Etakridin Botol 8 0 8 0 8
105 Etambutol tablet salut 500 mg Tab 0 0 0 0 0
106 Etanol 70% 1 Liter Botol 0 0 0 0 0
107 Etanol 70% 300 ml Botol 0 0 0 0 0
108 Etilklorida Botol 0 0 0 0 0
109 Folley Catheter 3 - 5 ml / cc - 10 fr Piece 14 0 14 0 14
110 Folley Catheter 3 - 5 ml / cc - 16 fr Piece 32 0 32 0 32
111 Folley Catheter 3 - 5 ml / cc - 18 fr Piece 10 0 10 0 10
112 Folley Catheter 3 - 5 ml / cc - 22 fr Piece 0 0 0 0 0
113 Furosemid tab 40 mg Tab 1,000 0 1,000 0 1,000
114 Gabapentin Tablet 300 mg Kap 0 0 0 0 0
115 Garam Oralit Sachet 1,400 0 1,400 0 1,400
116 Gemfibrozil Kapsul 300 mg Kap 500 100 600 0 600
117 Gentalex Krim Tube 372 0 372 0 372
118 Gentamisin Inj. 40 mg/ml Ampul 0 0 0 0 0
119 Gentamisin Salep Tube 0 0 0 0 0
120 Gention Violet Botol 19 0 19 0 19
121 Glibenklamid tab 5 mg Tab 0 0 0 0 0
122 Glimepiride 2 mg Tab 1,100 0 1,100 200 900
123 Gliseril Guaiacolat 100 mg Tab 0 0 0 0 0
124 Gliserin lar 50 % Botol 54 0 54 0 54
125 Glukosa Lar. Infus 5 % Steril Botol 60 0 60 0 60
126 Griseofulvin tablet 125 mg Tab 5,400 0 5,400 0 5,400
127 Griseofulvin tablet 500 mg Tab 700 0 700 0 700
128 Halloperidol 0,5 mg Tab 500 0 500 0 500
129 Halloperidol 1,5 mg Tab 3,400 0 3,400 0 3,400
130 Halloperidol 5 mg Tab 0 0 0 0 0
131 Handscond Genekolog Psg 160 0 160 0 160
132 Handscond No. 7 Steril Psg 0 0 0 0 0
133 Handscond No. 7,5 Steril Psg 900 0 900 0 900
134 Handscond Non Steril (M) Psg 5,900 0 5,900 100 5,800
135 Handscond Non Steril ((L) Psg 7,500 0 7,500 400 7,100
136 Hemafort Tab 0 0 0 0 0
137 Hidroklortiazid tablet 25 mg Tab 0 0 0 0 0
138 Hidrokortison krim 2,5 % Tube 96 0 96 0 96
139 Ibuprofen syrup 200 mg/5 ml Botol 240 50 290 10 280
140 Ibuprofen tablet 400 mg Tab 0 0 0 0 0
141 Ichtiyol Pot 4 12 16 0 16
142 Infusion Set Anak Buah 968 0 968 0 968
143 Infusion Set Dewasa Buah 48 0 48 0 48
144 Iodina test Botol 0 0 0 0 0
145 Isoniazid Tablet Tab 0 0 0 0 0
146 Isosorbid Dinitrat tab 5 mg Tab 400 0 400 0 400
147 Kalsium Glukonat Inj i.v 10 % Ampul 63 0 63 0 63
148 Kalsium Lactat Tablet 500 mg Tab 6,600 0 6,600 1,700 4,900
149 Kanamicin inj Vial 50 0 50 0 50
150 Kaotin Syrup Botol 0 0 0 0 0
151 Kapas Pembalut 250 mg Roll 25 0 25 0 25
152 Karbamazepin Kaplet 200 mg Kap 4,400 0 4,400 100 4,300
153 Kasa hydrofil Steril 16x16 cm Dos 1 3 4 2 2
154 Kasa pembalut hydrofil 40x80 cm Roll 6 0 6 0 6
155 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0 0
156 Kertas USG Rol 10 0 10 0 10
157 Ketokonazole krim 2 % Tube 225 0 225 0 225
158 Ketokonazole tablet 200 mg Tab 5,200 0 5,200 100 5,100
159 Kloramphenicol Kapsul 250 mg/Novachlor Kap 6,500 0 6,500 0 6,500
160 Kloramphenicol salep mata 1 % Tube 24 0 24 0 24
161 Kloramphenicol Suspensi 125mg/5ml Botol 39 0 39 0 39
162 Kloramphenicol tetes mata 0,5 % Botol 0 0 0 0 0
163 Klorfenilamin Maleat tablet 4 mg Tab 1,500 500 2,000 1,800 200
164 Klorpromazin Injeksi salut 25 mg/ml Ampul 0 0 0 0 0
165 Klorpromazin Tab Salut 25 mg Tab 0 0 0 0 0
166 Klorpromazin Tablet salut 100 mg Tab 200 0 200 0 200
167 Kodein tablet 10 mg Tab 0 0 0 0 0
168 Kolicgon Tab 0 0 0 0 0
169 Kotrimoksazole Tablet 480 mg Tab 5,500 0 5,500 0 5,500
170 Kotrimoxazol Suspensi Botol 419 0 419 0 419
171 Kutoin 100 mg Tab 400 0 400 300 100
172 Lancet For Fine Touch Dos 4 0 4 0 4
173 Larutan PK Pot 0 0 0 0 0
174 Larutan H2O2 Botol 4 0 4 0 4
175 Lidocain HCL 2% Injeksi Ampul 2,200 0 2,200 0 2,200
176 Lidocain Injeksi 2% + Epinefrin 1 : 8000 - 2 ml Ampul 30 0 30 0 30
177 Lisol Botol 12 0 12 0 12
178 Loperamid Tablet 2 Mg Tab 100 0 100 0 100
179 Loratadin 10 mg Tab 100 1,000 1,100 300 800
180 Masker Earloop Psg 0 0 0 0 0
181 Masker Karet Psg 0 0 0 0 0
182 Masker N95 Box 1 1 2 1 1
183 Masker Tali Dos 0 10 10 7 3
184 Meloksikam 15 mg Tab 0 0 0 0 0
185 Metergin Inj Vial 0 0 0 0 0
186 Metformin HCL Tablet 500 mg Tab 600 0 600 400 200
187 Metilergometrin inj 0,2 mg / ml Ampul 190 0 190 0 190
188 Metilergometrin Tablet 0,125 mg Tab 1,900 0 1,900 0 1,900
189 Metilprednisolon Tablet 4 mg Tab 1,600 0 1,600 0 1,600
190 Metilprednisolon tablet 8 mg Tab 0 0 0 0 0
191 Metoklopramide Injeksi Ampul 10 0 10 0 10
192 Metoklopramide Sirup 5 mg/5 ml Botol 0 0 0 0 0
193 Metoklopramide Tablet 10 mg Tab 900 0 900 0 900
194 Metolon Inj Ampul 0 0 0 0 0
195 Metronidazol tablet 500 mg Tab 400 0 400 0 400
196 MgSO4 inj 20% - 25 ml Botol 51 0 51 0 51
197 MgSO4 inj 20% - 25 ml Botol 0 0 0 0 0
198 MgSO4 inj 40% - 25 ml Botol 4 0 4 0 4
199 Mikonazole Salep 2% Tube 24 0 24 24 0
200 Mix Insulin Flexpen / Catridge Pen 0 0 0 0 0
201 Mucotussan Tab 0 0 0 0 0
202 Multivitamin Seven Seas Botol 250 0 250 20 230
203 My Jelli 83 Gram Tube 0 0 0 0 0
204 Nacl 0,9% Botol 20 0 20 0 20
205 Natrium Diklofenak 25 mg Tab 5,150 0 5,150 0 5,150
206 Needle No.23 Pcs 0 0 0 0 0
207 Neurovit E Kotak 0 0 0 0 0
208 Nifedipin tablet 20 mg Tab 100 0 100 0 100
209 Nistatin Tablet salut 100.000 IU/g Tab 220 0 220 0 220
210 Nistatin Tablet salut 500.000 IU/g Tab 200 0 200 0 200
211 Novadiar Syrup Botol 50 100 150 0 150
212 Novapyron/Neurotropic Plus Tab 0 0 0 0 0
213 Novazon Tab 0 0 0 0 0
214 Novo Twist Box 8 0 8 0 8
215 Novorapid Pen 5 0 5 0 5
216 OAT FDC Kategori 1 Paket 0 0 0 0 0
217 OAT FDC Kategori Anak Paket 1 0 1 0 1
218 OAT FDC Kategori Anak Paket 0 0 0 0 0
219 OAT FDC Kategori FDC Kategori Sisipan Paket 0 0 0 0 0
220 OAT FDC Kategori II Paket 2 0 2 0 2
221 OBH Botol 70 100 170 10 160
222 Oksitetrasiklin salep kulit 3% Tube 65 50 115 0 115
223 Oksitetrasiklin salep mata 1% Tube 0 0 0 0 0
224 Oksitosin inj 10 UI/ml Ampul 100 0 100 0 100
225 Omeprazol Tablet 20 mg Kapsul 0 0 0 0 0
226 Ondancentron 8 mg Ampul 64 0 64 0 64
227 Oxybiotic Inj Vial 0 0 0 0 0
228 Papaverin 40 mg Tab 0 0 0 0 0
229 Paracetamol syrup 120 mg / 5 ml Botol 0 0 0 0 0
230 Parasetamol Kaplet 500 mg Tab 0 0 0 0 0
231 Pehacain Inj Ampul 0 0 0 0 0
232 Pehatrim Forte Tab 0 0 0 0 0
233 Phenol Gliserol Tetes Telinga Botol 20 0 20 0 20
234 Phitomenadion inj i.m 2 mg / ml Ampul 120 0 120 0 120
235 Phitomenadion tablet 10 mg Tab 1,700 0 1,700 100 1,600
236 Piracetam 400 mg Tab 900 0 900 100 800
237 Piracetam inj 3g/15ml Ampul 0 10 10 0 10
238 Pirantel Tablet 125 mg Tab 0 0 0 0 0
239 Piridoksin inj 100 mg/ml Ampul 0 0 0 0 0
240 Piridoksin Tablet 10 mg Tab 0 0 0 0 0
241 Piroksicam 20 mg Tab 0 0 0 0 0
242 Pisau bedah Box 20 0 20 0 20
243 Pisau bedah 21 Set 0 0 0 0 0
244 Plano test Buah 13 0 13 0 13
245 Plester 7,5cm x 4,5m Rol 60 0 60 0 60
246 Plesterin Bulat Non Woven Box 41 0 41 0 41
247 Poligyp 5 cm x 2,7 m Roll 19 0 19 0 19
248 Pot sputum Pot 0 0 0 0 0
249 Povidon Iodida larutan 10% 60 ml Botol 38 0 38 0 38
250 Prednison tablet Tab 9,000 0 9,000 2,000 7,000
251 Primakuin Tablet 15 mg Tab 700 100 800 0 800
252 Promavit Kapsul Kapsul 0 0 0 0 0
253 Propanolol tablet 10 mg Tab 0 100 100 0 100
254 Propilteurasil 100 Mg Tab 0 200 200 0 200
255 Ramipril Tablet 5 mg Tab 0 0 0 0 0
256 Ranitidin Injeksi 25 mg/ml Ampul 55 100 155 17 138
257 Ranitidin Tablet 150 mg Tab 2,000 0 2,000 1,300 700
258 RDT DBD Pcs 4 0 4 0 4
259 RDT malaria Pcs 0 0 0 0 0
260 Retinol (Vitamin A) 100.000 IU Kapsul 10 0 10 0 10
261 Retinol (Vitamin A) 200.000 IU Botol 3 0 3 0 3
262 Rifampisin tablet 450 mg Kapsul 0 0 0 0 0
263 Rifampisin tablet 600 mg Kaplet 0 0 0 0 0
264 Ringer Laktat Larutan Infus Botol 60 300 360 73 287
265 Risperidon 2 mg Tab 0 0 0 0 0
266 Salbutamol 2 mg Tab 0 0 0 0 0
267 Salbutamol 4 mg Tab 7,400 0 7,400 300 7,100
268 Salep 2-4 Pot 45 0 45 0 45
269 Salisil Bedak serbuk 2% Box 90 96 186 6 180
270 Selediar Tab 0 0 0 0 0
271 Selesbion Tab 0 0 0 0 0
272 Selkom C Kap 0 500 500 500 0
273 Selviplex Kap 200 0 200 0 200
274 Serum ATS Botol 0 0 0 0 0
275 Setirizin sirup 5 mg/5ml Botol 80 0 80 10 70
276 Setrizin Tablet 10 mg Tab 0 0 0 0 0
277 Sianokobalamin injeksi 500 mcg Ampul 80 100 180 10 170
278 Scopamin 10 mg Tab 1,200 0 1,200 0 1,200
279 Sidiadryl Inj Vial 3 0 3 3 0
280 Silk 3/0 100 M Roll 0 0 0 0 0
281 Silk 3/0 75 C + Jarum 1/2 17 M R Box 0 0 0 0 0
282 Silk 4/0 100 M Roll 0 0 0 0 0
283 Silk Black 2/0 DS 30 MM Sachet 0 0 0 0 0
284 Silk Black 3/0 DS 30 MM Sachet 0 0 0 0 0
285 Simvastatin 10 mg Tab 0 0 0 0 0
286 Sianokobalamin Tab 0 0 0 0 0
287 Simvastatin 20 mg Tab 0 0 0 0 0
288 Siprofloksasin Tablet 500 mg Tab 9,100 0 9,100 0 9,100
289 Soldextam Tab 0 0 0 0 0
290 Solvita Plus Syrup Botol 0 0 0 0 0
291 Spasmolit Tab 0 0 0 0 0
292 Spironolacton 25 mg Tab 0 0 0 0 0
293 Stesolid 5 mg Tube 0 0 0 0 0
294 Stik Asam Urat Autochek Botol 3 0 3 0 3
295 Stik Asam Urat Benecheck Box 0 0 0 0 0
296 Stik Gula Darah Autochek Box 0 0 0 0 0
297 Stik Gula Darah Benecheck Box 0 0 0 0 0
298 Stik Kolesterol Autochek Botol 0 0 0 0 0
299 Stik Kolesterol Benecheck Botol 0 0 0 0 0
300 Stik Pemerksaan HB Botol 1 0 1 0 1
301 Sulfadoxine Pyrimehamine 250 mg Tab 500 0 500 100 400
302 Tablet Tambah Darah Sachet 2,010 4,320 6,330 0 6,330
303 Tablet Tambah Darah Tab 0 0 0 0 0
304 Tetrasiklin kapsul 500 mg kap 1,200 0 1,200 0 1,200
305 Termorex Drops Botol 0 0 0 0 0
306 Thiamin 50 mg Tab 750 0 750 0 750
307 Thiamin inj Ampul 0 0 0 0 0
308 Tramadol 50 mg Tab 0 0 0 0 0
309 Truvit Syrup Botol 80 0 80 0 80
310 Urin bag Pcs 10 0 10 0 10
311 Urin bag Pcs 0 0 0 0 0
312 USG Gel 250 ml Botol 0 0 0 0 0
313 Vastigo Tab 0 0 0 0 0
314 Ventolin Nebulizer Ampul 40 0 40 0 40
315 Verorab Vial 0 0 0 0 0
316 Vitamin B Kompleks Tablet Tab 700 0 700 0 700
317 Vitamin B Kompleks Injeksi Vial 0 0 0 0 0
318 Wing needle No.23 Pcs 0 0 0 0 0
319 Zinc Syrup Botol 130 100 230 45 185
320 Zink Tablet 20 mg Tab 0 0 0 0 0
321 Leukoplast Roll 0 0 0 0 0
322 Nystatin Drop Botol 76 0 76 0 76
323 Paracetamol Drops Botol 0 0 0 0 0
324 Dopamet Tab 150 0 150 0 150
325 Acetylcystein Tab 0 0 0 0 0
326 Aspar-K Tab 0 0 0 0 0
327 New Antides Tab 3,100 0 3,100 0 3,100
328 Atrovent Botol 2 0 2 2
329 Mometasone Tube 25 0 25 0 25
330 Soft U cream Tube 62 0 62 0 62
331 Paracetamol Infus Botol 50 0 50 0 50
332 Metronidazol Infus Botol 0 0 0 0 0
333 Clozapine Tab 1,050 0 1,050 0 1,050
334 Clorpromazine Injeksi Ampul 0 0 0 0 0
335 Sanbe Tears Botol 1 0 1 0 1
336 Pantocain Botol 0 0 0 0 0
337 Caterlent Botol 3 0 3 0 3
338 Scopamin Ampul 10 0 10 0 10
339 Omeprazole Injek 40 mg Ampul 19 0 19 0 19
340 Guaifeesin 100 mg Tab 3,900 0 3,900 1,100 2,800
341 Depakote Botol 100 0 100 0 100
342 Phenobarbital Inj Ampul 28 0 28 0 28
343 Furosemide Inj Ampul 0 0 0 0 0
344 Elasti Perban 7,5 cm x 4,5 cm Buah 8 0 8 0 8
345 Medigibs Buah 19 0 19 0 19
346 Nasal Oksigen ( selang O2) Buah 0 0 0 0 0
347 Slide Microscope Buah 169 0 169 0 169
348 One step anti HIV 1/2 Test Btl 2 0 2 0 2
349 Alat suntik sekali pakai 20ml Buah 0 0 0 0 0
350 Iliadin tetes hidung anak Botol 4 0 4 0 4
351 cendo Xytrol Botol 20 0 20 5 15
352 Primpen Botol 900 0 900 0 900
353 Aqua Gell Tube 18 0 18 0 18
354 Alkohon 1 liter 70% Botol 10 10 20 0 20
355 Spritus Botol 1 0 1 0 1
356 Emercin oil Botol 3 0 3 0 3
357 Gemsa Buah 2 0 2 0 2
358 Mitela Buah 1 0 1 0 1
359 Metanol Botol 3 0 3 0 3
360 Gliserin 100 ml Botol 55 0 55 0 55
361 Adalat 20 mg Tab 450 0 450 0 450
362 Atrofastatin 20 mg Tab 1,110 0 1,110 480 630
363 Asam Traneksamat 500 mg Tab 200 0 200 0 200
364 Loremide Tab 100 0 100 0 100
365 Vomistop Tab 60 0 60 0 60
366 Tagadem Buah 19 0 19 0 19
367 Blood Lancents Buah 1,000 0 1,000 0 1,000
368 Farsifen 400 mg Tablet 300 0 300 0 300
369 Miniaspi 80 mg Tablet 100 500 600 0 600
370 Pritagesic Tablet 0 500 500 0 500
371 Ovtelis 20 mg Tablet 0 500 500 200 300
372 Novagesic 500 mg Tablet 10,600 0 10,600 700 9,900
373 Faridexon 0,5 mg Tablet 3,600 0 3,600 800 2,800
374 Abbocath 26 Pcs 7 0 7 0 7
375 Valium 5 mg Tablet 0 0 0 0 0
376 Oxygen Nasal Canula Anak Pcs 2 0 2 0 2
377 Penjepit Tali Pusat Pcs 80 0 80 80 0
378 Sotatic Ampul 5 0 5 0 5
379 Yusimox 125mg/5 ml Botol 380 100 480 90 390
380 Handsoon Non Steril (S) Pcs 3,000 0 3,000 0 3,000
381 Cavicur Tablet 300 0 300 0 300
382 Prix 25 mg Tablet 1,800 0 1,800 500 1,300
383 Patrin 250 mg Tablet 380 0 380 10 370
384 Grafalin 2mg Tablet 1,000 0 1,000 0 1,000
385 Phenitoin Injeksi Ampul 10 0 10 0 10
386 Diazepam 2 Mg Tablet 200 0 200 0 200
387 Twist Lancet 28 G Pcs 1,200 0 1,200 0 1,200
388 Easy Touch Boold Glukose Pcs 0 0 0 0 0
389 Easy Touch Urid Acid Pcs 4 0 4 0 4
390 Easy Touch Cholesterol Ampul 0 0 0 0 0
391 Ovtelis 10 mg Tablet 100 0 100 0 100
392 Underpads Pcs 20 0 20 0 20
393 Stik Urinalysis Pcs 100 0 100 0 100
394 Novagesic Syr Botol 160 0 160 100 60
395 Siobion Tablet 300 0 300 0 300
396 Diatabs Tablet 1,500 0 1,500 0 1,500
397 Repas 400 mg Tablet 7,300 0 7,300 1,000 6,300
398 Farizol 500 mg Tablet 5,000 0 5,000 0 5,000
399 Diazepam 5 mg Tablet 180 0 180 0 180
400 Pritanol 300 mg Tablet 3,400 0 3,400 200 3,200
401 Novadium Tablet 0 500 500 0 500
402 Nasal Oksigen ukuran Xs Pcs 0 10 10 0 10
403 Nasal Oksigen Ukuran S Pcs 0 10 10 0 10
404 Scobutrin Tablet 0 500 500 0 500
405 0 0 0 0 0

JAMKESDA BPJS
JUMLAH KUNJUNGAN RESEP
 Mengetahui/Menyetujui Yang Menyerahkan Yang Memohon Yang Menerima
Kepala Seksi Kefarmasian Penanggung Jawab
Gudang Farmasi

Sahrul, SKM Arini Priyanti Kandupi. S.Farm., Apt Megawati Ranindi, S.Tr.Keb Nur Mufida Saenda,S.Farm
Nip. 19820714 200502 1 002 Nip. 19820403 200804 2 002 Nip. 19730708 199303 2 004
 LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MATAKO PELAPORAN BLN/PERIODE : FEBRUARI 2020

KECAMATAN : TOJO BARAT PERMINTAAN BLN/PERIODE : MARET 2020
KABUPATEN : TOJO UNA UNA
PROPINSI : SULAWESI TENGAH

Stok Peneri- Perse- Pema- Stok Permin- Pemberian

NO Nama Obat/Alkes/BMHP Satuan Awal maan diaan kaian Akhir taan APBD I APBD II Program Lain- Jumlah KET
lain
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Abbocath 18 Piece 30 0 30 0 30
2 Abbocath 20 Piece 0 0 0 0 0
3 Abbocath 22 Piece 140 0 140 0 140
4 Abbocath 24 Piece 80 0 80 0 80
5 Acyclovir cream Tube 73 0 73 0 73
6 Acyclovir tablet 200 mg Tab 500 0 500 0 500
7 Acyclovir tablet 400 mg Tab 2,100 0 2,100 0 2,100
8 Ailin tetes mata Botol 0 0 0 0 0
9 AIC Now + Sistem 20'S Box 0 0 0 0 0
10 Alat Autochek Unit 0 0 0 0 0
11 Alat Pemeriksa HB Buah 0 0 0 0 0
12 Alat suntik sekali pakai 1 ml Piece 400 0 400 100 300
13 Alat suntik sekali pakai 10 ml Piece 200 0 200 0 200
14 Alat suntik sekali pakai 3 ml Piece 100 400 500 200 300
15 Alat suntik sekali pakai 5 ml Piece 200 300 500 200 300
16 Albendazol 400 mg Tab 0 0 0 0 0
17 Alcohol Swab CHG + 0,5 % Box 3 0 3 2 1
18 Alletrol Tetes Mata Botol 0 0 0 0 0
19 Allopurinol Tab 100 mg Tab 4,800 0 4,800 200 4,600
20 Allopurinol Tab 300 mg Tab 0 0 0 0 0
21 Alprazolam Tablet 0,5 mg Tab 500 0 500 0 500
22 Alprazolam Tablet 1 mg Tab 0 0 0 0 0
23 Ambroxol 30 mg Tab 3,000 0 3,000 400 2,600
24 Ambroxol syr Botol 108 0 108 48 60
25 Aminofilin inj 24 mg/ml Ampul 30 0 30 0 30
26 Amitriptilin Tablet Salut 25 mg Tab 1,300 0 1,300 1,300 0 1,300 ED
27 Amlodipin Tablet 10 mg Tab 570 2,070 2,640 600 2,040
28 Amlodipin Tablet 5 mg Tab 0 0 0 0 0
29 Amoksisilin Kapsul 500 mg Tab 8,600 0 8,600 3,300 5,300
30 Amoxycillin Syrup 125 mg / 5 ml Botol 0 0 0 0 0
31 Amoxycillin Syrup 250 mg / 5 ml Botol 0 0 0 0 0
32 Ampicilin 500 mg Tab 200 0 200 0 200
33 Ampicilin syr Botol 0 0 0 0 0
34 Analog Long Insulin 100 IU Pen Pen 0 0 0 0 0
35 Antalgin 500 mg Tab 0 0 0 0 0
36 Antalgin Injeksi Ampul 0 0 0 0 0
37 Antasida DOEN I tablet kunyah Tab 0 0 0 0 0
38 Antasida Doen Syrup Botol 0 0 0 0 0
39 Antihemoroid Supp 300 0 300 0 300
40 Antimalaria Tab 47 0 0 0 0
41 Antiseptik Hand Rub 10 Btl @ 500 ml Botol 54 0 54 0 54
42 Antrain Injeksi Ampul 0 0 0 0 0
43 Aqua pro Injeksi 20 ml Ampul 0 0 0 0 0
44 Arkine Tab 3,250 0 3,250 250 3,000
45 Asam Askorbat Tablet 50 mg Tab 9,500 0 9,500 0 9,500
46 Asam Folat tablet 1 mg Tab 0 0 0 0 0
47 Asam Mefenamat kaplet 500 mg Kap 17,000 0 17,000 3,200 13,800
48 Asam Traneksamat 250 mg Ampul 15 0 15 0 15
49 Asam Valproat Syrup Botol 5 0 5 0 5
50 Asetosal Tablet 80 mg Tab 0 0 0 0 0
51 Atropin inj 0,25 mg / ml Ampul 20 0 20 0 20
52 Betahistin Tablet 6 mg Tab 200 0 200 0 200
53 Betametason Krim 0,1 %/Skizon Tube 0 0 0 0 0
54 Biocombin Injk/Farbion Injeksi Ampul 30 0 30 30 0
55 Bionemi Kaps Kapsul 0 0 0 0 0
56 Bisoprolol Tablet 5 mg Tab 50 0 50 0 50
57 Blood Lancents Buah 4 0 4 0 4
58 Buscopan Injeksi/Skopamin Ampul 0 0 0 0 0
59 Candesartan 8 mg Tab 0 0 0 0 0
60 Captopril Tablet 12,5 mg Tab 400 0 400 100 300
61 Captopril Tablet 25 mg Tab 0 0 0 0 0
62 Catapres Injeksi Ampul 70 0 70 0 70
63 Cathejell Lidocain 2 % & CHG 0,05 % Ampul 3 0 3 0 3
64 Catqut Chromic 2/0 75 C + Jarum 1/2 30 M R Box 10 0 0 0 0
65 Catqut Chromic 2/0 HR 20 MM Sachet 0 0 0 0 0
66 Catqut Chromic 3/0 75 C + Jarum 1/2 37 M R Box 1 0 1 0 1
67 Catqut Plain 2/0 HR 37 MM Sachet 1 0 1 0 1
68 Catqut Plain 3/0 HR 26 MM Sachet 1 0 1 0 1
69 Catqut Plain 4/0 100 M Roll 0 0 0 0 0
70 Cefadroxil kapsul 500 mg Kap 4,800 0 4,800 0 4,800
71 Cefadroxil Syrup 125 mg/ 5 ml Botol 0 100 100 16 84
72 Cimetidin Tab 0 0 0 0 0
73 Colcitine 0,5 mg Tab 960 0 960 150 810
74 Clobazam Tab 0 0 0 0 0
75 Clonidine 0,15 mg Tab 100 0 100 0 100
76 Clopidogrel 75 mg Tab 0 0 0 0 0
77 Combivent UDV Vial 0 0 0 0 0
78 Curcuma Tab 100 0 100 100 0
79 Deksametason Injeksi i.v/i.m 5 mg/ml Ampul 560 0 560 40 520
80 Deksametason Tablet 0,5 mg Tab 0 0 0 0 0
81 Diazepam Tablet 2 mg Tab 4,200 0 4,200 100 4,100
82 Diazepam injeksi 5 mg / ml Ampul 11 0 11 4 7
83 Diazepam larutan rektal 10 mg/2,5 ml Tube 0 0 0 0 0
84 Diazepam Tablet 5 mg Tab 0 0 0 0 0
85 Digoksin 0,25 mg Tab 0 0 0 0 0
86 Diltiazem HCL tablet 30 mg Tab 0 0 0 0 0
87 Dimenhidrinat tab 50 mg Tab 1,000 0 1,000 0 1,000
88 Diphenhidramin Injeksi 10 mg/ml Ampul 90 0 90 40 50
89 Diuvar Injeksi Ampul 5 0 5 0 5
90 Doksisiklin Kapsul 100 mg Kap 1,000 0 1,000 0 1,000
91 Domperidon suspensi 5 mg / 5 ml Botol 38 0 38 10 28
92 Domperidon tablet 10 mg Tab 2,800 0 2,800 100 2,700
93 Dulcolax 5 mg/Bisacodyl 5 mg Tab 0 0 0 0 0
94 Dulcolax Suppo anak Supp 31 0 31 0 31
95 Dumin Rectal Supp 0 0 0 0 0
96 Eflin Tab 1,000 0 1,000 400 600
97 Enbatic Cream Tube 90 0 90 39 51
98 Epinefrin Inj. i.v.s.k/i.m 1 mg/ml Ampul 80 0 80 0 80
99 Ergotamin tab 1 mg Tab 0 0 0 0 0
100 Eritromisin Kapsul 500 mg Kap 1,000 0 1,000 0 1,000
101 Erladerm-N Tube 0 0 0 0 0
102 Erlemicetin Tetes Telinga Botol 0 0 0 0 0
103 Erlemicetin Tetes Mata Botol 0 0 0 0 0
104 Etakridin Botol 8 0 8 0 8
105 Etambutol tablet salut 500 mg Tab 0 0 0 0 0
106 Etanol 70% 1 Liter Botol 0 0 0 0 0
107 Etanol 70% 300 ml Botol 0 0 0 0 0
108 Etilklorida Botol 0 0 0 0 0
109 Folley Catheter 3 - 5 ml / cc - 10 fr Piece 14 0 14 0 14
110 Folley Catheter 3 - 5 ml / cc - 16 fr Piece 32 0 32 0 32
111 Folley Catheter 3 - 5 ml / cc - 18 fr Piece 10 0 10 0 10
112 Folley Catheter 3 - 5 ml / cc - 22 fr Piece 0 0 0 0 0
113 Furosemid tab 40 mg Tab 1,000 0 1,000 0 1,000
114 Gabapentin Tablet 300 mg Kap 0 0 0 0 0
115 Garam Oralit Sachet 1,400 0 1,400 0 1,400
116 Gemfibrozil Kapsul 300 mg Kap 500 0 500 0 500
117 Gentalex Krim Tube 420 0 420 48 372
118 Gentamisin Inj. 40 mg/ml Ampul 0 0 0 0 0
119 Gentamisin Salep Tube 0 0 0 0 0
120 Gention Violet Botol 24 0 24 5 19
121 Glibenklamid tab 5 mg Tab 0 0 0 0 0
122 Glimepiride 2 mg Tab 600 500 1,100 0 1,100
123 Gliseril Guaiacolat 100 mg Tab 0 0 0 0 0
124 Gliserin lar 50 % Botol 54 0 54 0 54
125 Glukosa Lar. Infus 5 % Steril Botol 60 0 60 0 60
126 Griseofulvin tablet 125 mg Tab 5,600 0 5,600 200 5,400
127 Griseofulvin tablet 500 mg Tab 700 0 700 0 700
128 Halloperidol 0,5 mg Tab 500 0 500 0 500
129 Halloperidol 1,5 mg Tab 3,400 0 3,400 0 3,400
130 Halloperidol 5 mg Tab 0 0 0 0 0
131 Handscond Genekolog Psg 160 0 160 0 160
132 Handscond No. 7 Steril Psg 0 0 0 0 0
133 Handscond No. 7,5 Steril Psg 900 0 900 0 900
134 Handscond Non Steril (M) Psg 6,000 0 6,000 100 5,900
135 Handscond Non Steril ((L) Psg 7,600 0 7,600 100 7,500
136 Hemafort Tab 0 0 0 0 0
137 Hidroklortiazid tablet 25 mg Tab 0 0 0 0 0
138 Hidrokortison krim 2,5 % Tube 168 0 168 72 96
139 Ibuprofen syrup 200 mg/5 ml Botol 295 0 295 55 240
140 Ibuprofen tablet 400 mg Tab 0 0 0 0 0
141 Ichtiyol Pot 4 0 4 0 4
142 Infusion Set Anak Buah 973 0 973 5 968
143 Infusion Set Dewasa Buah 100 0 100 52 48
144 Iodina test Botol 12 0 12 12 0
145 Isoniazid Tablet Tab 0 0 0 0 0
146 Isosorbid Dinitrat tab 5 mg Tab 400 0 400 0 400
147 Kalsium Glukonat Inj i.v 10 % Ampul 63 0 63 0 63
148 Kalsium Lactat Tablet 500 mg Tab 7,700 0 7,700 1,100 6,600
149 Kanamicin inj Vial 50 0 50 0 50
150 Kaotin Syrup Botol 0 0 0 0 0
151 Kapas Pembalut 250 mg Roll 28 0 28 3 25
152 Karbamazepin Kaplet 200 mg Kap 4,600 0 4,600 200 4,400
153 Kasa hydrofil Steril 16x16 cm Dos 4 0 4 3 1
154 Kasa pembalut hydrofil 40x80 cm Roll 6 0 6 0 6
155 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0 0
156 Kertas USG Rol 10 0 10 0 10
157 Ketokonazole krim 2 % Tube 300 0 300 75 225
158 Ketokonazole tablet 200 mg Tab 5,200 0 5,200 0 5,200
159 Kloramphenicol Kapsul 250 mg/Novachlor Kap 6,900 0 6,900 400 6,500
160 Kloramphenicol salep mata 1 % Tube 48 0 48 24 24
161 Kloramphenicol Suspensi 125mg/5ml Botol 39 0 39 0 39
162 Kloramphenicol tetes mata 0,5 % Botol 0 0 0 0 0
163 Klorfenilamin Maleat tablet 4 mg Tab 1,500 0 1,500 0 1,500
164 Klorpromazin Injeksi salut 25 mg/ml Ampul 0 0 0 0 0
165 Klorpromazin Tab Salut 25 mg Tab 0 0 0 0 0
166 Klorpromazin Tablet salut 100 mg Tab 500 0 500 300 200
167 Kodein tablet 10 mg Tab 0 0 0 0 0
168 Kolicgon Tab 0 0 0 0 0
169 Kotrimoksazole Tablet 480 mg Tab 5,500 0 5,500 0 5,500
170 Kotrimoxazol Suspensi Botol 419 0 419 0 419
171 Kutoin 100 mg Tab 400 0 400 0 400
172 Lancet For Fine Touch Dos 4 0 4 0 4
173 Larutan PK Pot 0 0 0 0 0
174 Larutan H2O2 Botol 4 0 4 0 4
175 Lidocain HCL 2% Injeksi Ampul 2,638 0 2,638 438 2,200
176 Lidocain Injeksi 2% + Epinefrin 1 : 8000 - 2 ml Ampul 30 0 30 0 30
177 Lisol Botol 12 0 12 0 12
178 Loperamid Tablet 2 Mg Tab 100 0 100 0 100
179 Loratadin 10 mg Tab 400 0 400 300 100
180 Masker Earloop Psg 0 0 0 0 0
181 Masker Karet Psg 50 0 50 50 0
182 Masker N95 Box 1 0 1 0 1
183 Masker Tali Dos 200 0 200 200 0
184 Meloksikam 15 mg Tab 0 0 0 0 0
185 Metergin Inj Vial 0 0 0 0 0
186 Metformin HCL Tablet 500 mg Tab 1,600 0 1,600 1,000 600
187 Metilergometrin inj 0,2 mg / ml Ampul 190 0 190 0 190
188 Metilergometrin Tablet 0,125 mg Tab 1,900 0 1,900 0 1,900
189 Metilprednisolon Tablet 4 mg Tab 2,000 0 2,000 400 1,600
190 Metilprednisolon tablet 8 mg Tab 0 0 0 0 0
191 Metoklopramide Injeksi Ampul 10 0 10 0 10
192 Metoklopramide Sirup 5 mg/5 ml Botol 0 0 0 0 0
193 Metoklopramide Tablet 10 mg Tab 1,100 0 1,100 200 900
194 Metolon Inj Ampul 0 0 0 0 0
195 Metronidazol tablet 500 mg Tab 400 0 400 0 400
196 MgSO4 inj 20% - 25 ml Botol 51 0 51 0 51
197 MgSO4 inj 20% - 25 ml Botol 0 0 0 0 0
198 MgSO4 inj 40% - 25 ml Botol 4 0 4 0 4
199 Mikonazole Salep 2% Tube 24 0 24 0 24
200 Mix Insulin Flexpen / Catridge Pen 0 0 0 0 0
201 Mucotussan Tab 0 0 0 0 0
202 Multivitamin Seven Seas Botol 250 0 250 0 250
203 My Jelli 83 Gram Tube 0 0 0 0 0
204 Nacl 0,9% Botol 80 0 80 60 20
205 Natrium Diklofenak 25 mg Tab 5,650 0 5,650 500 5,150
206 Needle No.23 Pcs 0 0 0 0 0
207 Neurovit E Kotak 0 0 0 0 0
208 Nifedipin tablet 20 mg Tab 100 0 100 0 100
209 Nistatin Tablet salut 100.000 IU/g Tab 220 0 220 0 220
210 Nistatin Tablet salut 500.000 IU/g Tab 200 0 200 0 200
211 Novadiar Syrup Botol 60 0 60 10 50
212 Novapyron/Neurotropic Plus Tab 0 0 0 0 0
213 Novazon Tab 0 0 0 0 0
214 Novo Twist Box 8 0 8 0 8
215 Novorapid Pen 5 0 5 0 5
216 OAT FDC Kategori 1 Paket 0 0 0 0 0
217 OAT FDC Kategori Anak Paket 1 0 1 0 1
218 OAT FDC Kategori Anak Paket 0 0 0 0 0
219 OAT FDC Kategori FDC Kategori Sisipan Paket 0 0 0 0 0
220 OAT FDC Kategori II Paket 4 0 4 2 2
221 OBH Botol 110 0 110 40 70
222 Oksitetrasiklin salep kulit 3% Tube 75 0 75 10 65
223 Oksitetrasiklin salep mata 1% Tube 0 0 0 0 0
224 Oksitosin inj 10 UI/ml Ampul 100 0 100 0 100
225 Omeprazol Tablet 20 mg Kapsul 0 0 0 0 0
226 Ondancentron 8 mg Ampul 64 0 64 0 64
227 Oxybiotic Inj Vial 0 0 0 0 0
228 Papaverin 40 mg Tab 0 0 0 0 0
229 Paracetamol syrup 120 mg / 5 ml Botol 0 0 0 0 0
230 Parasetamol Kaplet 500 mg Tab 0 0 0 0 0
231 Pehacain Inj Ampul 0 0 0 0 0
232 Pehatrim Forte Tab 0 0 0 0 0
233 Phenol Gliserol Tetes Telinga Botol 20 0 20 0 20
234 Phitomenadion inj i.m 2 mg / ml Ampul 120 0 120 0 120
235 Phitomenadion tablet 10 mg Tab 1,800 0 1,800 100 1,700
236 Piracetam 400 mg Tab 1,000 0 1,000 100 900
237 Piracetam inj 3g/15ml Ampul 0 0 0 0 0
238 Pirantel Tablet 125 mg Tab 0 0 0 0 0
239 Piridoksin inj 100 mg/ml Ampul 0 0 0 0 0
240 Piridoksin Tablet 10 mg Tab 0 0 0 0 0
241 Piroksicam 20 mg Tab 0 0 0 0 0
242 Pisau bedah Box 40 0 40 20 20
243 Pisau bedah 21 Set 0 0 0 0 0
244 Plano test Buah 13 0 13 0 13
245 Plester 7,5cm x 4,5m Rol 60 0 60 0 60
246 Plesterin Bulat Non Woven Box 41 0 41 0 41
247 Poligyp 5 cm x 2,7 m Roll 19 0 19 0 19
248 Pot sputum Pot 0 0 0 0 0
249 Povidon Iodida larutan 10% 60 ml Botol 70 0 70 32 38
250 Prednison tablet Tab 9,000 0 9,000 0 9,000
251 Primakuin Tablet 15 mg Tab 700 0 700 0 700
252 Promavit Kapsul Kapsul 0 0 0 0 0
253 Propanolol tablet 10 mg Tab 0 0 0 0 0
254 Propilteurasil 100 Mg Tab 200 0 200 200 0
255 Ramipril Tablet 5 mg Tab 0 0 0 0 0
256 Ranitidin Injeksi 25 mg/ml Ampul 100 0 100 45 55
257 Ranitidin Tablet 150 mg Tab 0 2,500 2,500 500 2,000
258 RDT DBD Pcs 5 0 5 1 4
259 RDT malaria Pcs 3 0 3 3 0
260 Retinol (Vitamin A) 100.000 IU Kapsul 10 0 10 0 10
261 Retinol (Vitamin A) 200.000 IU Botol 4 0 4 1 3
262 Rifampisin tablet 450 mg Kapsul 0 0 0 0 0
263 Rifampisin tablet 600 mg Kaplet 0 0 0 0 0
264 Ringer Laktat Larutan Infus Botol 180 0 180 120 60
265 Risperidon 2 mg Tab 0 0 0 0 0
266 Salbutamol 2 mg Tab 0 0 0 0 0
267 Salbutamol 4 mg Tab 7,700 0 7,700 300 7,400
268 Salep 2-4 Pot 63 0 63 18 45
269 Salisil Bedak serbuk 2% Box 130 0 130 40 90
270 Selediar Tab 0 0 0 0 0
271 Selesbion Tab 0 0 0 0 0
272 Selkom C Kap 0 0 0 0 0
273 Selviplex Kap 1,000 0 1,000 800 200
274 Serum ATS Botol 0 0 0 0 0
275 Setirizin sirup 5 mg/5ml Botol 100 0 100 20 80
276 Setrizin Tablet 10 mg Tab 100 0 100 100 0
277 Sianokobalamin injeksi 500 mcg Ampul 100 0 100 20 80
278 Scopamin 10 mg Tab 1,800 0 1,800 600 1,200
279 Sidiadryl Inj Vial 5 0 5 2 3
280 Silk 3/0 100 M Roll 0 0 0 0 0
281 Silk 3/0 75 C + Jarum 1/2 17 M R Box 0 0 0 0 0
282 Silk 4/0 100 M Roll 0 0 0 0 0
283 Silk Black 2/0 DS 30 MM Sachet 0 0 0 0 0
284 Silk Black 3/0 DS 30 MM Sachet 0 0 0 0 0
285 Simvastatin 10 mg Tab 330 0 330 330 0
286 Sianokobalamin Tab 0 0 0 0 0
287 Simvastatin 20 mg Tab 0 0 0 0 0
288 Siprofloksasin Tablet 500 mg Tab 9,100 0 9,100 0 9,100
289 Soldextam Tab 0 0 0 0 0
290 Solvita Plus Syrup Botol 0 0 0 0 0
291 Spasmolit Tab 0 0 0 0 0
292 Spironolacton 25 mg Tab 0 0 0 0 0
293 Stesolid 5 mg Tube 0 0 0 0 0
294 Stik Asam Urat Autochek Botol 3 0 3 0 3
295 Stik Asam Urat Benecheck Box 0 0 0 0 0
296 Stik Gula Darah Autochek Box 0 0 0 0 0
297 Stik Gula Darah Benecheck Box 0 0 0 0 0
298 Stik Kolesterol Autochek Botol 0 0 0 0 0
299 Stik Kolesterol Benecheck Botol 0 0 0 0 0
300 Stik Pemerksaan HB Botol 1 0 1 0 1
301 Sulfadoxine Pyrimehamine 250 mg Tab 500 0 500 0 500
302 Tablet Tambah Darah Sachet 2,010 0 2,010 0 2,010
303 Tablet Tambah Darah Tab 0 0 0 0 0
304 Tetrasiklin kapsul 500 mg kap 1,200 0 1,200 0 1,200
305 Termorex Drops Botol 0 0 0 0 0
306 Thiamin 50 mg Tab 1,000 0 1,000 250 750
307 Thiamin inj Ampul 610 0 610 610 0 610 ED
308 Tramadol 50 mg Tab 0 0 0 0 0
309 Truvit Syrup Botol 106 0 160 80 80
310 Urin bag Pcs 10 0 10 0 10
311 Urin bag Pcs 0 0 0 0 0
312 USG Gel 250 ml Botol 0 0 0 0 0
313 Vastigo Tab 0 0 0 0 0
314 Ventolin Nebulizer Ampul 40 0 40 0 40
315 Verorab Vial 0 0 0 0 0
316 Vitamin B Kompleks Tablet Tab 700 0 700 0 700
317 Vitamin B Kompleks Injeksi Vial 219 0 219 219 0 219 ED
318 Wing needle No.23 Pcs 0 0 0 0 0
319 Zinc Syrup Botol 130 0 130 0 130
320 Zink Tablet 20 mg Tab 0 0 0 0 0
321 Leukoplast Roll 0 0 0 0 0
322 Nystatin Drop Botol 76 0 76 0 76
323 Paracetamol Drops Botol 0 0 0 0 0
324 Dopamet Tab 150 0 150 0 150
325 Acetylcystein Tab 1,680 0 1,680 1,680 0 1,680 ED
326 Aspar-K Tab 0 0 0 0 0
327 New Antides Tab 3,500 0 3,500 400 3,100
328 Atrovent Botol 9 0 9 7 2
329 Mometasone Tube 25 0 25 0 25
330 Soft U cream Tube 75 0 75 13 62
331 Paracetamol Infus Botol 50 0 50 0 50
332 Metronidazol Infus Botol 4 0 4 4 0 4 ED
333 Clozapine Tab 1,050 0 1,050 0 1,050
334 Clorpromazine Injeksi Ampul 0 0 0 0 0
335 Sanbe Tears Botol 1 0 1 0 1
336 Pantocain Botol 0 0 0 0 0
337 Caterlent Botol 3 0 3 0 3
338 Scopamin Ampul 10 0 10 0 10
339 Omeprazole Injek 40 mg Ampul 19 0 19 0 19
340 Guaifeesin 100 mg Tab 5,900 0 5,900 2,000 3,900
341 Depakote Botol 100 0 100 0 100
342 Phenobarbital Inj Ampul 28 0 28 0 28
343 Furosemide Inj Ampul 0 0 0 0 0
344 Elasti Perban 7,5 cm x 4,5 cm Buah 8 0 8 0 8
345 Medigibs Buah 19 0 19 0 19
346 Nasal Oksigen ( selang O2) Buah 0 0 0 0 0
347 Slide Microscope Buah 169 0 169 0 169
348 One step anti HIV 1/2 Test Btl 2 0 2 0 2
349 Alat suntik sekali pakai 20ml Buah 0 0 0 0 0
350 Iliadin tetes hidung anak Botol 4 0 4 0 4
351 cendo Xytrol Botol 29 0 29 9 20
352 Primpen Botol 900 0 900 0 900
353 Aqua Gell Tube 18 0 18 0 18
354 Alkohon 1 liter 70% Botol 13 0 13 3 10
355 Spritus Botol 1 0 1 0 1
356 Emercin oil Botol 3 0 3 0 3
357 Gemsa Buah 2 0 2 0 2
358 Mitela Buah 1 0 1 0 1
359 Metanol Botol 3 0 3 0 3
360 Gliserin 100 ml Botol 55 0 55 0 55
361 Adalat 20 mg Tab 450 0 450 0 450
362 Atrofastatin 20 mg Tab 690 1,200 1,890 780 1,110
363 Asam Traneksamat 500 mg Tab 200 0 200 0 200
364 Loremide Tab 100 0 100 0 100
365 Vomistop Tab 60 0 60 0 60
366 Tagadem Buah 19 0 19 0 19
367 Blood Lancents Buah 1,000 0 1,000 0 1,000
368 Farsifen 400 mg Tablet 300 0 300 0 300
369 Miniaspi 80 mg Tablet 100 0 100 0 100
370 Pritagesic Tablet 100 0 100 100 0
371 Ovtelis 20 mg Tablet 100 0 100 100 0
372 Novagesic 500 mg Tablet 13,300 0 13,300 2,700 10,600
373 Faridexon 0,5 mg Tablet 4,500 0 4,500 900 3,600
374 Abbocath 26 Pcs 10 0 10 3 7
375 Valium 5 mg Tablet 7 0 7 7 0
376 Oxygen Nasal Canula Anak Pcs 2 0 2 0 2
377 Penjepit Tali Pusat Pcs 80 0 80 0 80
378 Sotatic Ampul 10 0 10 5 5
379 Yusimox 125mg/5 ml Botol 380 0 380 0 380
380 Handsoon Non Steril (S) Pcs 3,000 0 3,000 0 3,000
381 Cavicur Tablet 300 0 300 0 300
382 Prix 25 mg Tablet 2,500 0 2,500 700 1,800
383 Patrin 250 mg Tablet 500 0 500 120 380
384 Grafalin 2mg Tablet 1,000 0 1,000 0 1,000
385 Phenitoin Injeksi Ampul 10 0 10 0 10
386 Diazepam 2 Mg Tablet 200 0 200 0 200
387 Twist Lancet 28 G Pcs 1,800 0 1,800 600 1,200
388 Easy Touch Boold Glukose Pcs 8 0 8 8 0
389 Easy Touch Urid Acid Pcs 10 0 10 6 4
390 Easy Touch Cholesterol Ampul 11 0 11 11 0
391 Ovtelis 10 mg Tablet 100 0 100 0 100
392 Underpads Pcs 20 0 20 0 20
393 Stik Urinalysis Pcs 100 0 100 0 100
394 Novagesic Syr Botol 160 0 160 0 160
395 Siobion Tablet 1,000 0 1,000 700 300
396 Diatabs Tablet 1,500 0 1,500 0 1,500
397 Repas 400 mg Tablet 10,000 0 10,000 2,700 7,300
398 Farizol 500 mg Tablet 5,000 0 5,000 0 5,000
399 Diazepam 5 mg Tablet 180 0 180 0 180
400 Pritanol 300 mg Tablet 4,000 0 4,000 600 3,400
401
402
403
404
405

JAMKESDA BPJS
JUMLAH KUNJUNGAN RESEP
 Mengetahui/Menyetujui Yang Menyerahkan Yang Memohon Yang Menerima
Kepala Seksi Kefarmasian Penanggung Jawab
Gudang Farmasi

Sahrul, SKM Arini Priyanti Kandupi. S.Farm., Apt Megawati Ranindi, S.Tr.Keb Nur Mufida Saenda,S.Farm
Nip. 19820714 200502 1 002 Nip. 19820403 200804 2 002 Nip. 19730708 199303 2 004
 LAPORAN PEMAKAIAN DAN LEMBARAN PERMINTAAN OBAT (LPLPO)

PUSKESMAS : MATAKO PELAPORAN BLN/PERIODE : JANUARI 2020

KECAMATAN : TOJO BARAT PERMINTAAN BLN/PERIODE : FEBRUARI 2020
KABUPATEN : TOJO UNA UNA
PROPINSI : SULAWESI TENGAH

Stok Peneri- Perse- Pema- Stok Permin- Pemberian

NO Nama Obat/Alkes/BMHP Satuan Awal maan diaan kaian Akhir taan APBD I APBD II Program Lain- Jumlah KET
lain
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Abbocath 18 Piece 80 0 80 50 30 100
2 Abbocath 20 Piece 0 0 0 0 0 100
3 Abbocath 22 Piece 230 0 230 90 140
4 Abbocath 24 Piece 80 0 80 0 80
5 Acyclovir cream Tube 73 0 73 0 73
6 Acyclovir tablet 200 mg Tab 500 0 500 0 500
7 Acyclovir tablet 400 mg Tab 2,100 0 2,100 0 2,100
8 Ailin tetes mata Botol 0 0 0 0 0
9 AIC Now + Sistem 20'S Box 0 0 0 0 0
10 Alat Autochek Unit 0 0 0 0 0
11 Alat Pemeriksa HB Buah 0 0 0 0 0 1
12 Alat suntik sekali pakai 1 ml Piece 400 0 400 0 400
13 Alat suntik sekali pakai 10 ml Piece 200 0 200 0 200
14 Alat suntik sekali pakai 3 ml Piece 200 0 200 100 100 500
15 Alat suntik sekali pakai 5 ml Piece 200 0 200 0 200 100
16 Albendazol 400 mg Tab 0 0 0 0 0
17 Alcohol Swab CHG + 0,5 % Box 3 0 3 0 3
18 Alletrol Tetes Mata Botol 0 0 0 0 0
19 Allopurinol Tab 100 mg Tab 4,800 0 4,800 0 4,800
20 Allopurinol Tab 300 mg Tab 0 0 0 0 0
21 Alprazolam Tablet 0,5 mg Tab 0 0 0 0 0
22 Alprazolam Tablet 1 mg Tab 0 0 0 0 0
23 Ambroxol 30 mg Tab 3,000 0 3,000 0 3,000
24 Ambroxol syr Botol 108 0 108 0 108
25 Aminofilin inj 24 mg/ml Ampul 30 0 30 0 30
26 Amitriptilin Tablet Salut 25 mg Tab 1,300 0 1,300 0 1,300 1,000
27 Amlodipin Tablet 10 mg Tab 570 0 570 0 570 2,000
28 Amlodipin Tablet 5 mg Tab 0 0 0 0 0
29 Amoksisilin Kapsul 500 mg Tab 8,600 0 8,600 0 8,600 2,000
30 Amoxycillin Syrup 125 mg / 5 ml Botol 0 0 0 0 0 100
31 Amoxycillin Syrup 250 mg / 5 ml Botol 0 0 0 0 0
32 Ampicilin 500 mg Tab 200 0 200 0 200
33 Ampicilin syr Botol 0 0 0 0 0
34 Analog Long Insulin 100 IU Pen Pen 0 0 0 0 0
35 Antalgin 500 mg Tab 0 0 0 0 0
36 Antalgin Injeksi Ampul 0 0 0 0 0
37 Antasida DOEN I tablet kunyah Tab 0 0 0 0 0 2,000
38 Antasida Doen Syrup Botol 0 0 0 0 0 200
39 Antihemoroid Supp 300 0 300 0 300
40 Antimalaria Tab 47 0 47 0 47
41 Antiseptik Hand Rub 10 Btl @ 500 ml Botol 54 0 54 0 54 100
42 Antrain Injeksi Ampul 0 0 0 0 0
43 Aqua pro Injeksi 20 ml Ampul 0 0 0 0 0 50
44 Arkine Tab 3,500 0 3,500 250 3,250
45 Asam Askorbat Tablet 50 mg Tab 10,500 0 10,500 1,000 9,500
46 Asam Folat tablet 1 mg Tab 0 0 0 0 0 1,000
47 Asam Mefenamat kaplet 500 mg Kap 17,000 0 17,000 0 17,000
48 Asam Traneksamat 250 mg Ampul 15 0 15 0 15
49 Asam Valproat Syrup Botol 5 0 5 0 5
50 Asetosal Tablet 80 mg Tab 0 0 0 0 0
51 Atropin inj 0,25 mg / ml Ampul 20 0 20 0 20
52 Betahistin Tablet 6 mg Tab 300 0 300 100 200 500
53 Betametason Krim 0,1 %/Skizon Tube 0 0 0 0 0
54 Biocombin Injk/Farbion Injeksi Ampul 0 30 30 0 30
55 Bionemi Kaps Kapsul 0 0 0 0 0
56 Bisoprolol Tablet 5 mg Tab 50 0 50 0 50
57 Blood Lancents Buah 4 0 4 0 4
58 Buscopan Injeksi/Skopamin Ampul 0 0 0 0 0 50
59 Candesartan 8 mg Tab 0 0 0 0 0
60 Captopril Tablet 12,5 mg Tab 400 0 400 0 400
61 Captopril Tablet 25 mg Tab 0 0 0 0 0 1,000
62 Catapres Injeksi Ampul 70 0 70 0 70
63 Cathejell Lidocain 2 % & CHG 0,05 % Ampul 3 0 3 0 3
64 Catqut Chromic 2/0 75 C + Jarum 1/2 30 M R Box 10 0 10 0 10
65 Catqut Chromic 2/0 HR 20 MM Sachet 0 0 0 0 0
66 Catqut Chromic 3/0 75 C + Jarum 1/2 37 M R Box 1 0 1 0 1
67 Catqut Plain 2/0 HR 37 MM Sachet 1 0 1 0 1
68 Catqut Plain 3/0 HR 26 MM Sachet 1 0 1 0 1
69 Catqut Plain 4/0 100 M Roll 0 0 0 0 0
70 Cefadroxil kapsul 500 mg Kap 4,800 0 4,800 0 4,800
71 Cefadroxil Syrup Botol 0 0 0 0 0 100
72 Cimetidin Tab 0 0 0 0 0
73 Colcitine 0,5 mg Tab 960 0 960 0 960
74 Clobazam Tab 0 0 0 0 0
75 Clonidine 0,15 mg Tab 100 0 100 0 100
76 Clopidogrel 75 mg Tab 0 0 0 0 0
77 Combivent UDV Vial 0 0 0 0 0
78 Curcuma Tab 100 0 100 0 100
79 Deksametason Injeksi i.v/i.m 5 mg/ml Ampul 560 0 560 0 560
80 Deksametason Tablet 0,5 mg Tab 0 0 0 0 0
81 Diazepam Tablet 2 mg Tab 4,400 0 4,400 200 4,200
82 Diazepam injeksi 5 mg / ml Ampul 11 0 11 0 11
83 Diazepam larutan rektal 10 mg/2,5 ml Tube 0 0 0 0 0
84 Diazepam Tablet 5 mg Tab 0 0 0 0 0
85 Digoksin 0,25 mg Tab 0 0 0 0 0
86 Diltiazem HCL tablet 30 mg Tab 0 0 0 0 0
87 Dimenhidrinat tab 50 mg Tab 1,000 0 1,000 0 1,000
88 Diphenhidramin Injeksi 10 mg/ml Ampul 90 0 90 0 90
89 Diuvar Injeksi Ampul 5 0 5 0 5
90 Doksisiklin Kapsul 100 mg Kap 1,000 0 1,000 0 1,000
91 Domperidon suspensi 5 mg / 5 ml Botol 38 0 38 0 38
92 Domperidon tablet 10 mg Tab 2,800 0 2,800 0 2,800
93 Dulcolax 5 mg/Bisacodyl 5 mg Tab 0 0 0 0 0
94 Dulcolax Suppo anak Supp 31 0 31 0 31
95 Dumin Rectal Supp 0 0 0 0 0
96 Eflin Tab 0 1,000 1,000 0 1,000
97 Enbatic Cream Tube 90 0 90 0 90
98 Epinefrin Inj. i.v.s.k/i.m 1 mg/ml Ampul 80 0 80 0 80
99 Ergotamin tab 1 mg Tab 0 0 0 0 0
100 Eritromisin Kapsul 500 mg Kap 1,000 0 1,000 0 1,000
101 Erladerm-N Tube 0 0 0 0 0
102 Erlemicetin Tetes Telinga Botol 0 0 0 0 0
103 Erlemicetin Tetes Mata Botol 0 0 0 0 0
104 Etakridin Botol 8 0 8 0 8 50
105 Etambutol tablet salut 500 mg Tab 0 0 0 0 0
106 Etanol 70% 1 Liter Botol 0 0 0 0 0 50
107 Etanol 70% 300 ml Botol 0 0 0 0 0
108 Etilklorida Botol 1 0 1 1 0 10
109 Folley Catheter 3 - 5 ml / cc - 10 fr Piece 14 0 14 0 14
110 Folley Catheter 3 - 5 ml / cc - 16 fr Piece 32 0 32 0 32
111 Folley Catheter 3 - 5 ml / cc - 18 fr Piece 10 0 10 0 10
112 Folley Catheter 3 - 5 ml / cc - 22 fr Piece 0 0 0 0 0
113 Furosemid tab 40 mg Tab 1,000 0 1,000 0 1,000
114 Gabapentin Tablet 300 mg Kap 0 0 0 0 0
115 Garam Oralit Sachet 1,400 0 1,400 0 1,400
116 Gemfibrozil Kapsul 300 mg Kap 500 0 500 0 500
117 Gentalex Krim Tube 420 0 420 0 420
118 Gentamisin Inj. 40 mg/ml Ampul 0 0 0 0 0
119 Gentamisin Salep Tube 0 0 0 0 0
120 Gention Violet Botol 24 0 24 0 24
121 Glibenklamid tab 5 mg Tab 0 0 0 0 0
122 Glimepiride 2 mg Tab 600 0 600 0 600
123 Gliseril Guaiacolat 100 mg Tab 0 0 0 0 0
124 Gliserin lar 50 % Botol 54 0 54 0 54
125 Glukosa Lar. Infus 5 % Steril Botol 60 0 60 0 60
126 Griseofulvin tablet 125 mg Tab 5,600 0 5,600 0 5,600
127 Griseofulvin tablet 500 mg Tab 700 0 700 0 700
128 Halloperidol 0,5 mg Tab 500 0 500 0 500
129 Halloperidol 1,5 mg Tab 3,400 0 3,400 0 3,400
130 Halloperidol 5 mg Tab 0 0 0 0 0
131 Handscond Genekolog Psg 160 0 160 0 160
132 Handscond No. 7 Steril Psg 0 0 0 0 0
133 Handscond No. 7,5 Steril Psg 900 0 900 0 900
134 Handscond Non Steril (M) Psg 6,000 0 6,000 0 6,000
135 Handscond Non Steril ((L) Psg 7,600 0 7,600 0 7,600
136 Hemafort Tab 0 0 0 0 0
137 Hidroklortiazid tablet 25 mg Tab 0 0 0 0 0
138 Hidrokortison krim 2,5 % Tube 168 0 168 0 168
139 Ibuprofen syrup 200 mg/5 ml Botol 308 0 308 13 295
140 Ibuprofen tablet 400 mg Tab 0 0 0 0 0
141 Ichtiyol Pot 4 0 4 0 4
142 Infusion Set Anak Buah 973 0 973 0 973
143 Infusion Set Dewasa Buah 100 0 100 0 100
144 Iodina test Botol 12 0 12 0 12
145 Isoniazid Tablet Tab 0 0 0 0 0
146 Isosorbid Dinitrat tab 5 mg Tab 400 0 400 0 400
147 Kalsium Glukonat Inj i.v 10 % Ampul 63 0 63 0 63
148 Kalsium Lactat Tablet 500 mg Tab 8,000 0 8,000 300 7,700
149 Kanamicin inj Vial 50 0 50 0 50
150 Kaotin Syrup Botol 0 0 0 0 0
151 Kapas Pembalut 250 mg Roll 34 0 34 6 28
152 Karbamazepin Kaplet 200 mg Kap 4,600 0 4,600 0 4,600
153 Kasa hydrofil Steril 16x16 cm Dos 4 0 4 0 4
154 Kasa pembalut hydrofil 40x80 cm Roll 6 0 6 0 6
155 Kasa pembalut hydrofil 40x80 cm Roll 0 0 0 0 0
156 Kertas USG Rol 10 0 10 0 10
157 Ketokonazole krim 2 % Tube 300 0 300 0 300
158 Ketokonazole tablet 200 mg Tab 5,200 0 5,200 0 5,200
159 Kloramphenicol Kapsul 250 mg/Novachlor Kap 6,900 0 6,900 0 6,900
160 Kloramphenicol salep mata 1 % Tube 48 0 48 0 48
161 Kloramphenicol Suspensi 125mg/5ml Botol 39 0 39 0 39
162 Kloramphenicol tetes mata 0,5 % Botol 0 0 0 0 0
163 Klorfenilamin Maleat tablet 4 mg Tab 2,100 0 2,100 600 1,500
164 Klorpromazin Injeksi salut 25 mg/ml Ampul 0 0 0 0 0
165 Klorpromazin Tab Salut 25 mg Tab 0 0 0 0 0
166 Klorpromazin Tablet salut 100 mg Tab 500 0 500 0 500
167 Kodein tablet 10 mg Tab 0 0 0 0 0
168 Kolicgon Tab 0 0 0 0 0
169 Kotrimoksazole Tablet 480 mg Tab 5,500 0 5,500 0 5,500
170 Kotrimoxazol Suspensi Botol 419 0 419 0 419
171 Kutoin 100 mg Tab 600 0 600 200 400
172 Lancet For Fine Touch Dos 4 0 4 0 4
173 Larutan PK Pot 0 0 0 0 0
174 Larutan H2O2 Botol 4 0 4 0 4
175 Lidocain HCL 2% Injeksi Ampul 2,638 0 2,638 0 2,638
176 Lidocain Injeksi 2% + Epinefrin 1 : 8000 - 2 ml Ampul 30 0 30 0 30
177 Lisol Botol 12 0 12 0 12
178 Loperamid Tablet 2 Mg Tab 100 0 100 0 100
179 Loratadin 10 mg Tab 400 0 400 0 400
180 Masker Earloop Psg 0 0 0 0 0
181 Masker Karet Psg 50 0 50 0 50
182 Masker N95 Box 1 0 1 0 1
183 Masker Tali Dos 200 0 200 0 200
184 Meloksikam 15 mg Tab 0 0 0 0 0
185 Metergin Inj Vial 0 0 0 0 0
186 Metformin HCL Tablet 500 mg Tab 1,600 0 1,600 0 1,600
187 Metilergometrin inj 0,2 mg / ml Ampul 190 0 190 0 190
188 Metilergometrin Tablet 0,125 mg Tab 1,900 0 1,900 0 1,900
189 Metilprednisolon Tablet 4 mg Tab 2,000 0 2,000 0 2,000
190 Metilprednisolon tablet 8 mg Tab 0 0 0 0 0
191 Metoklopramide Injeksi Ampul 10 0 10 0 10
192 Metoklopramide Sirup 5 mg/5 ml Botol 0 0 0 0 0
193 Metoklopramide Tablet 10 mg Tab 1,100 0 1,100 0 1,100
194 Metolon Inj Ampul 0 0 0 0 0
195 Metronidazol tablet 500 mg Tab 400 0 400 0 400
196 MgSO4 inj 20% - 25 ml Botol 51 0 51 0 51
197 MgSO4 inj 20% - 25 ml Botol 0 0 0 0 0
198 MgSO4 inj 40% - 25 ml Botol 4 0 4 0 4
199 Mikonazole Salep 2% Tube 24 0 24 0 24
200 Mix Insulin Flexpen / Catridge Pen 0 0 0 0 0
201 Mucotussan Tab 0 0 0 0 0
202 Multivitamin Seven Seas Botol 250 0 250 0 250
203 My Jelli 83 Gram Tube 0 0 0 0 0
204 Nacl 0,9% Botol 80 0 80 0 80
205 Natrium Diklofenak 25 mg Tab 5,650 0 5,650 0 5,650
206 Needle No.23 Pcs 0 0 0 0 0
207 Neurovit E Kotak 0 0 0 0 0
208 Nifedipin tablet 20 mg Tab 100 0 100 0 100
209 Nistatin Tablet salut 100.000 IU/g Tab 220 0 220 0 220
210 Nistatin Tablet salut 500.000 IU/g Tab 200 0 200 0 200
211 Novadiar Syrup Botol 60 0 60 0 60
212 Novapyron/Neurotropic Plus Tab 0 0 0 0 0
213 Novazon Tab 0 0 0 0 0
214 Novo Twist Box 8 0 8 0 8
215 Novorapid Pen 5 0 5 0 5
216 OAT FDC Kategori 1 Paket 0 0 0 0 0
217 OAT FDC Kategori Anak Paket 1 0 1 0 1
218 OAT FDC Kategori Anak Paket 0 0 0 0 0
219 OAT FDC Kategori FDC Kategori Sisipan Paket 0 0 0 0 0
220 OAT FDC Kategori II Paket 4 0 4 0 4
221 OBH Botol 110 0 110 0 110
222 Oksitetrasiklin salep kulit 3% Tube 75 0 75 0 75
223 Oksitetrasiklin salep mata 1% Tube 0 0 0 0 0
224 Oksitosin inj 10 UI/ml Ampul 100 0 100 0 100
225 Omeprazol Tablet 20 mg Kapsul 0 0 0 0 0
226 Ondancentron 8 mg Ampul 64 0 64 0 64
227 Oxybiotic Inj Vial 0 0 0 0 0
228 Papaverin 40 mg Tab 0 0 0 0 0
229 Paracetamol syrup 120 mg / 5 ml Botol 0 0 0 0 0
230 Parasetamol Kaplet 500 mg Tab 0 0 0 0 0
231 Pehacain Inj Ampul 0 0 0 0 0
232 Pehatrim Forte Tab 0 0 0 0 0
233 Phenol Gliserol Tetes Telinga Botol 20 0 20 0 20
234 Phitomenadion inj i.m 2 mg / ml Ampul 120 0 120 0 120
235 Phitomenadion tablet 10 mg Tab 1,800 0 1,800 0 1,800
236 Piracetam 400 mg Tab 1,000 0 1,000 0 1,000
237 Piracetam inj 3g/15ml Ampul 0 0 0 0 0
238 Pirantel Tablet 125 mg Tab 0 0 0 0 0
239 Piridoksin inj 100 mg/ml Ampul 0 0 0 0 0
240 Piridoksin Tablet 10 mg Tab 0 0 0 0 0
241 Piroksicam 20 mg Tab 0 0 0 0 0
242 Pisau bedah Box 40 0 40 0 40
243 Pisau bedah 21 Set 0 0 0 0 0
244 Plano test Buah 13 0 13 0 13
245 Plester 7,5cm x 4,5m Rol 60 0 60 0 60
246 Plesterin Bulat Non Woven Box 41 0 41 0 41
247 Poligyp 5 cm x 2,7 m Roll 19 0 19 0 19
248 Pot sputum Pot 0 0 0 0 0
249 Povidon Iodida larutan 10% 60 ml Botol 70 0 70 0 70
250 Prednison tablet Tab 9,000 0 9,000 0 9,000
251 Primakuin Tablet 15 mg Tab 700 0 700 0 700
252 Promavit Kapsul Kapsul 0 0 0 0 0
253 Propanolol tablet 10 mg Tab 0 0 0 0 0
254 Propilteurasil 100 Mg Tab 200 0 200 0 200
255 Ramipril Tablet 5 mg Tab 0 0 0 0 0
256 Ranitidin Injeksi 25 mg/ml Ampul 100 0 100 0 100
257 Ranitidin Tablet 150 mg Tab 0 0 0 0 0
258 RDT DBD Pcs 5 0 5 0 5
259 RDT malaria Pcs 3 0 3 0 3
260 Retinol (Vitamin A) 100.000 IU Kapsul 12 0 12 2 10
261 Retinol (Vitamin A) 200.000 IU Botol 14 0 14 10 4
262 Rifampisin tablet 450 mg Kapsul 0 0 0 0 0
263 Rifampisin tablet 600 mg Kaplet 0 0 0 0 0
264 Ringer Laktat Larutan Infus Botol 180 0 180 0 180
265 Risperidon 2 mg Tab 0 0 0 0 0
266 Salbutamol 2 mg Tab 0 0 0 0 0
267 Salbutamol 4 mg Tab 7,700 0 7,700 0 7,700
268 Salep 2-4 Pot 63 0 63 0 63
269 Salisil Bedak serbuk 2% Box 130 0 130 0 130
270 Selediar Tab 0 0 0 0 0
271 Selesbion Tab 0 0 0 0 0
272 Selkom C Kap 0 0 0 0 0 5,000
273 Selviplex Kap 1,000 0 1,000 0 1,000
274 Serum ATS Botol 0 0 0 0 0
275 Setirizin sirup 5 mg/5ml Botol 100 0 100 0 100
276 Setrizin Tablet 10 mg Tab 100 0 100 0 100
277 Sianokobalamin injeksi 500 mcg Ampul 100 0 100 0 100
278 Scopamin 10 mg Tab 2,000 0 2,000 200 1,800
279 Sidiadryl Inj Vial 5 0 5 0 5
280 Silk 3/0 100 M Roll 0 0 0 0 0
281 Silk 3/0 75 C + Jarum 1/2 17 M R Box 0 0 0 0 0
282 Silk 4/0 100 M Roll 0 0 0 0 0
283 Silk Black 2/0 DS 30 MM Sachet 0 0 0 0 0
284 Silk Black 3/0 DS 30 MM Sachet 0 0 0 0 0
285 Simvastatin 10 mg Tab 480 0 480 150 330
286 Sianokobalamin Tab 0 0 0 0 0
287 Simvastatin 20 mg Tab 0 0 0 0 0
288 Siprofloksasin Tablet 500 mg Tab 9,100 0 9,100 0 9,100
289 Soldextam Tab 0 0 0 0 0
290 Solvita Plus Syrup Botol 0 0 0 0 0
291 Spasmolit Tab 0 0 0 0 0
292 Spironolacton 25 mg Tab 0 0 0 0 0
293 Stesolid 5 mg Tube 0 0 0 0 0
294 Stik Asam Urat Autochek Botol 3 0 3 0 3
295 Stik Asam Urat Benecheck Box 0 0 0 0 0 5
296 Stik Gula Darah Autochek Box 0 0 0 0 0 5
297 Stik Gula Darah Benecheck Box 0 0 0 0 0 5
298 Stik Kolesterol Autochek Botol 0 0 0 0 0 5
299 Stik Kolesterol Benecheck Botol 0 0 0 0 0 5
300 Stik Pemerksaan HB Botol 1 0 1 0 1 5
301 Sulfadoxine Pyrimehamine 250 mg Tab 500 0 500 0 500
302 Tablet Tambah Darah Sachet 2,010 0 2,010 0 2,010 5,000
303 Tablet Tambah Darah Tab 0 0 0 0 0
304 Tetrasiklin kapsul 500 mg kap 1,260 0 1,260 60 1,200
305 Termorex Drops Botol 0 0 0 0 0
306 Thiamin 50 mg Tab 1,500 0 1,500 500 1,000
307 Thiamin inj Ampul 610 0 610 0 610
308 Tramadol 50 mg Tab 0 0 0 0 0
309 Truvit Syrup Botol 106 0 106 0 106
310 Urin bag Pcs 10 0 10 0 10
311 Urin bag Pcs 0 0 0 0 0
312 USG Gel 250 ml Botol 0 0 0 0 0
313 Vastigo Tab 0 0 0 0 0
314 Ventolin Nebulizer Ampul 40 0 40 0 40
315 Verorab Vial 0 0 0 0 0
316 Vitamin B Kompleks Tablet Tab 1,000 0 1,000 300 700
317 Vitamin B Kompleks Injeksi Vial 219 0 219 0 219
318 Wing needle No.23 Pcs 0 0 0 0 0
319 Zinc Syrup Botol 130 0 130 0 130
320 Zink Tablet 20 mg Tab 0 0 0 0 0 2,000
321 Leukoplast Roll 0 0 0 0 0
322 Nystatin Drop Botol 76 0 76 0 76
323 Paracetamol Drops Botol 0 0 0 0 0
324 Dopamet Tab 150 0 150 0 150
325 Acetylcystein Tab 1,680 0 1,680 0 1,680
326 Aspar-K Tab 0 0 0 0 0
327 New Antides Tab 3,500 0 3,500 0 3,500
328 Atrovent Botol 9 0 9 0 9
329 Mometasone Tube 25 0 25 0 25
330 Soft U cream Tube 75 0 75 0 75
331 Paracetamol Infus Botol 50 0 50 0 50
332 Metronidazol Infus Botol 4 0 4 0 4
333 Clozapine Tab 1,050 0 1,050 0 1,050
334 Clorpromazine Injeksi Ampul 0 0 0 0 0
335 Sanbe Tears Botol 1 0 1 0 1
336 Pantocain Botol 0 0 0 0 0
337 Caterlent Botol 3 0 3 0 3
338 Scopamin Ampul 10 0 10 0 10
339 Omeprazole Injek 40 mg Ampul 19 0 19 0 19
340 Guaifeesin 100 mg Tab 6,600 0 6,600 700 5,900 1,000
341 Depakote Botol 100 0 100 0 100
342 Phenobarbital Inj Ampul 28 0 28 0 28
343 Furosemide Inj Ampul 0 0 0 0 0
344 Elasti Perban 7,5 cm x 4,5 cm Buah 8 0 8 0 8
345 Medigibs Buah 19 0 19 0 19
346 Nasal Oksigen ( selang O2) Buah 0 0 0 0 0 10
347 Slide Microscope Buah 169 0 169 0 169
348 One step anti HIV 1/2 Test Btl 2 0 2 0 2
349 Alat suntik sekali pakai 20ml Buah 0 0 0 0 0
350 Iliadin tetes hidung anak Botol 4 0 4 0 4
351 cendo Xytrol Botol 29 0 29 0 29
352 Primpen Botol 900 0 900 0 900
353 Aqua Gell Tube 18 0 18 0 18
354 Alkohon 1 liter 70% Botol 14 0 14 1 13
355 Spritus Botol 1 0 1 0 1
356 Emercin oil Botol 3 0 3 0 3
357 Gemsa Buah 2 0 2 0 2
358 Mitela Buah 1 0 1 0 1
359 Metanol Botol 3 0 3 0 3
360 Gliserin 100 ml Botol 55 0 55 0 55
361 Adalat 20 mg Tab 450 0 450 0 450
362 Atrofastatin 20 mg Tab 690 0 690 0 690
363 Asam Traneksamat 500 mg Tab 200 0 200 0 200
364 Loremide Tab 100 0 100 0 100
365 Vomistop Tab 60 0 60 0 60
366 Tagadem Buah 19 0 19 0 19
367 Blood Lancents Buah 1000 0 1,000 0 1,000
368 Farsifen 400 mg Tablet 300 0 300 0 300
369 Miniaspi 80 mg Tablet 100 0 100 0 100
370 Pritagesic Tablet 200 0 200 100 100
371 Ovtelis 20 mg Tablet 200 0 200 100 100
372 Novagesic 500 mg Tablet 14000 0 14,000 700 13,300
373 Faridexon 0,5 mg Tablet 4500 0 4,500 0 4,500
374 Abbocath 26 Pcs 10 0 10 0 10
375 Valium 5 mg Tablet 7 0 7 0 7
376 Oxygen Nasal Canula Anak Pcs 2 0 2 0 2
377 Penjepit Tali Pusat Pcs 80 0 80 0 80
378 Sotatic Ampul 10 0 10 0 10
379 Yusimox 125mg/5 ml Botol 380 0 380 0 380
380 Handsoon Non Steril (S) Pcs 3000 0 3,000 0 3,000
381 Cavicur Tablet 300 0 300 0 300
382 Prix 25 mg Tablet 2500 0 2,500 0 2,500
383 Patrin 250 mg Tablet 530 0 530 30 500
384 Grafalin 2mg Tablet 1000 0 1,000 0 1,000
385 Phenitoin Injeksi Ampul 10 0 10 0 10
386 Diazepam 2 Mg Tablet 200 0 200 0 200
387 Twist Lancet 28 G Pcs 1800 0 1,800 0 1,800
388 Easy Touch Boold Glukose Pcs 8 0 8 0 8
389 Easy Touch Urid Acid Pcs 10 0 10 0 10
390 Easy Touch Cholesterol Ampul 11 0 11 0 11
391 Ovtelis 10 mg Tablet 100 0 100 0 100
392 Underpads Pcs 20 0 20 0 20
393 Stik Urinalysis Pcs 100 0 100 0 100
394 Novagesic Syr Botol 160 0 160 0 160
395 Siobion Tablet 1000 0 1,000 0 1,000
396 Diatabs Tablet 1500 0 1,500 0 1,500
397 Repas 400 mg Tablet 10000 0 10,000 0 10,000
398 Farizol 500 mg Tablet 5000 0 5,000 0 5,000
399 Diazepam 5 mg Tablet 200 0 200 20 180
400
401
402
403
404
405

JAMKESDA BPJS
JUMLAH KUNJUNGAN RESEP
 Mengetahui/Menyetujui Yang Menyerahkan Yang Memohon Yang Menerima
Kepala Seksi Kefarmasian Penanggung Jawab
Gudang Farmasi

Sahrul, SKM Arini Priyanti Kandupi. S.Farm., Maspa Lapui, SKM Nur Mufida Saenda,S.Farm
Nip. 19820714 200502 1 002 Nip. 19820403 200804 2 002 Nip. 19800828 200502 2 007