LPLPO

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT DAN PERBEKALAN KESEHATAN
(LPLPOPK)
PELAPOR (UPT PUSKESMAS/ INSTANSI)* : DAWE

KABUPATEN : KUDUS
PELAPORAN BULAN/ PERIODE : JANUARI 2016
PERMINTAAN BULAN/ PERIODE : FEBRUARI 2016
STOK PERMINT PEMBERIAN
STOK PENERIMA PERSEDIA PEMAKAIA SISA STOK OPTIMU
NO NAMA OBAT & PERBEKALAN KESEHATAN SATUAN AWAL AN AN N AAN APBN APBD I APBD II LAIN2 JML
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A SEDIAAN FARMASI
1 Albendazol suspensi 200 mg/5 ml Botol - - -
2 Albendazol Tablet 400 mg Tablet - - -
3 Allopurinol Tablet 100 mg Tablet - 500 500 74 426
4 Alopurinol tablet 300 mg Tablet - - -
5 Alprazolam Tablet 0.50 mg Tablet 100 100 100
6 Ambroksol Sirup 15 mg/ mL Botol - 50 50 4 46
7 Ambroksol Tablet 30 mg Tablet - 500 500 18 482
8 Aminofilin Injeksi 24 mg/mL Ampul 51 51 51 - 10
9 Aminofilin tablet 150 mg Tablet - - -
10 Aminofilin Tablet 200 mg Tablet - 2,000 2,000 2,000
11 Amitriptilin Tablet Salut 25 mg Tablet 600 600 600
12 Amlodipin tablet 10 mg Tablet - - -
13 Amlodipin Tablet 5 mg Tablet - 600 600 202 398 300
14 Ammonium Bituminosulfonat Salep 10 %/ichtiol Pot - 10 10 10
15 Amoksisilin + As. Klavulanat 625 mg tablet Tablet - - -
16 Amoksisilin Kapsul 250 mg Kapsul - - -
17 Amoksisilin Kapsul 500 mg Kapsul - 10,000 10,000 2,121 7,879 2000
18 Amoksisilin serbuk injeksi 1000 mg Vial - - -
19 Amoksisilin Suspensi Kering 125 mg/ 5 mL Botol - 120 120 18 102 60
20 Ampisilin Kaplet 500 mg Tablet - - - 500
21 Ampisilin Serbuk Injeksi 1000 mg/ Vial Vial 440 440 440
22 Ampisilin Serbuk Injeksi 500 mg/ Vial Vial - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
23 Ampisilin Suspensi Kering 125 mg/ 5 mL Botol - - -
24 Antasida DOEN I Tablet Kunyah Tablet - 5,000 5,000 5,000
25 Antasida DOEN II Suspensi Botol - 50 50 50
26 Anti Bakteri DOEN Salep Tube - 50 50 2 48
27 Anti Fungi DOEN Salep Pot - 24 24 24
28 Anti Haemoroid DOEN Suppositoria Supp - 20 20 20
29 Anti Malaria DOEN Tablet - - -
30 Anti Migren Tablet Tablet - - -
31 Artemisin + Piperaquin (DHP) Tablet - - -
32 Arterakine Tablet Tablet - - -
33 Artermeter Injeksi 80 mg/ mL Ampul - - -
34 Artesunate + Amodiaquin Injeksi Ampul - - -
35 Artesunate Injeksi 60 mg/ mL Ampul - - -
36 Artesunate Tablet Tablet - - -
37 Asam Folat Tablet 0.5 mg Tablet - - -
38 Asam Folat Tablet 1 mg Tablet 28,600 28,600 190 28,410
39 Asam Mefenamat Kapsul 250 mg Kapsul - - -
40 Asam Mefenamat Tablet Salut Selaput 500 mg Tablet - - -
41 Asam Nalidixic Tablet 500 mg Tablet - - -
42 Asam Traneksamat Injeksi 250 mg Ampul - - -
43 Asam Traneksamat Tablet 500 mg Tablet - - -
44 Asetosal Tablet 100 mg Tablet - - - 100
45 Asetosal Tablet 500 mg Tablet - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
47 Asiklovir Krim 5 % Tube - 25 25 5 20
48 Asiklovir tablet 200 mg Tablet - - -
49 Asiklovir Tablet 400 mg Tablet - 200 200 36 164
50 Atenolol Tablet 50 mg Tablet - - -
51 Atropin Sulfat Injeksi 0.25 mg/ mL Ampul 30 30 30
52 Atropin Sulfat Injeksi 1 mg/ mL Ampul - - -
53 Atropin Sulfat tablet 0,5 mg Tablet - - -
54 Benzatin Benzil Penisilin 1,2 juta IU/ vial Ampul - - -
55 Benzatin Benzil Penisilin 2,4 juta IU/vial Ampul - - -
56 Besi (II) Sulfat 7H20 Sirup 150 mg/5ml Botol - - -
57 Besi (II) Sulfat 7H20 Tablet Tablet - - -
58 Betahistin Mesilat tablet 6 mg Tablet - - - 100
59 Betametason Krim 0,1 % Tube - 50 50 2 48
60 Bisakodil Suppositoria 10 mg Supp - - -
61 Bisakodil Tablet 10 mg Tablet - - -
62 Bisakodil Tablet 5 mg Tablet - 100 100 100
63 Bisoprolol tablet 5 mg Tablet - - -
64 Bromheksin tablet 8 mg Tablet - - -
65 Cetirizin sirup 5 mg/5 ml Botol - - -
66 Cetirizine tablet 10 mg Kapsul - - -
67 Clobazam tablet 10 mg Tablet - - -
68 Clobetasol krim 0,05% Tube - - -
69 Dapson tablet 100 mg Tablet - - -
70 Deksametason Injeksi 5 mg/ mL Ampul - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
71 Deksametason Tablet 0.5 mg Tablet - - - 10000
72 Dekstrometorfan (HBr) Sirup 10 mg/5 mL Botol - - -
73 Dekstrometorfan (HBr) Tablet 15 mg Tablet - - -
74 Dextran Botol - - -
75 Diazepam Injeksi 5 mg/ mL Ampul 60 60 60
76 Diazepam Larutan Rektal 10 mg/mL Tube - - -
77 Diazepam Larutan Rektal 5 mg/ mL Tube - - -
78 Diazepam Tablet 2 mg Tablet 41 41 6 35
79 Diazepam Tablet 5 mg Tablet - - -
80 Dietilkarbamazin Sitrat tablet 100 mg Tablet - - -
81 Difenhidramin HCl Injeksi 10 mg/ mL Vial - - -
82 Digoksin Tablet 0.25 mg Tablet - - -
83 Diltiazem HCl Tablet 30 mg Tablet 100 100 100
84 Dimenhidrinat Tablet 50 mg Tablet - 500 500 47 453
85 Doksisiklin Kapsul 100 mg Kapsul 100 100 40 60
86 Domperidone Sirup 5 mg/ 5 mL Botol - 20 20 3 17
87 Domperidone Tablet 10 mg Tablet - 300 300 8 292
88 DUVIRAL Tablet Tablet - - -
89 EFAVERINS Tablet 200 mg Tablet - - -
90 Efedrin Tablet 25 mg Tablet - - -
91 Ekstraks Belladona tablet 10 mg Tablet - - -
92 Epinefrin/ Adrenalin Injeksi 0,1 % Ampul - - -
93 Eritromisin Kapsul 250 mg Kapsul - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
95 Eritromisin Sirup 200 mg/ 5 mL Botol - 20 20 20
96 Etambutol Tablet 250 mg Tablet - - -
97 Etambutol Tablet Salut 500 mg Tablet - - -
98 Famotidine Tablet 20 mg Tablet - - -
99 Famotidine tablet 40 mg Tablet - - -
100 Fenilbutason tablet 200 mg Tablet - - -
101 Fenitoin Natrium injeksi 50 mg/ml Ampul - - -
102 Fenitoin Natrium Kapsul 100 mg Kapsul - - -
104 Fenobarbital Injeksi 50 mg/ mL Ampul - - -
105 Fenobarbital tablet 100 mg Tablet - - -
106 Fenobarbital Tablet 30 mg Tablet 77 77 77
107 Fenoksimetil Penisilin tablet 250 mg Tablet - - -
109 Fenol Gliserol Tetes Telinga 10% Pot - - -
110 Flukonazol Kapsul 150 mg Kapsul - - -
111 Furosemid Injeksi 10 mg/ mL Ampul - - -
112 Furosemid Tablet 40 mg Tablet - - - 100
113 Gameksan Salep 1% / scabimit Pot - 20 20 2 18
114 Garam Oralit Serbuk Sachet 100 100 100
115 Gemfibrozil Kapsul 300 mg Kapsul - - -
116 Gemfibrozil tablet 600 mg Tablet - - -
117 Gentamisin Injeksi 10 mg/ mL Ampul - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
119 Gentamisin Salep Kulit 0.1% Tube - 25 25 5 20
120 Gentamisin Salep Mata 0,3 % Tube - - -
121 Gentamisin Tetes Mata 0,3 % Botol - - -
122 Gentian Violet Larutan 1 % Botol - - - 10
123 Glibenkamid Tablet 5 mg Tablet - 500 500 88 412
124 Glimepirid Tablet 1 mg Tablet - 500 500 500
125 Glimepirid Tablet 2 mg Tablet - - -
126 Glimepiride tablet 3 mg Tablet - - -
128 Glipizid Tablet 5 mg Tablet - - -
129 Gliquidon tablet 30 mg Tablet - - -
130 Gliseril Guaiakolat Tablet 100 mg Tablet - 7,000 7,000 1,061 5,939 4000
131 Gliserin Botol - - -
132 Glukosa larutan infus 10 % Botol - - -
133 Glukosa Larutan Infus 40% Botol - - -
134 Glukosa Larutan Infus 5 % Botol - - -
135 Griseofulvin Tablet 125 mg Tablet - - -
137 Haloperidol Tablet 0.5 mg Tablet - - -
139 Haloperidol tablet 5 mg Tablet 400 400 400
140 Hidroklortiazid (HCT) Tablet 25 mg Tablet 211 211 34 177
141 Hidrokortison Krim 1 % Tube - - - 25
142 Hidrokortison Krim 2,5 % Tube - - - 25
(LPLPOPK)

KABUPATEN : KUDUS
M
143 Hiosin Butilbromide Tablet 10 mg Tablet - - -
144 Ibuprofen Sirup 100 mg/ 5 mL Botol - - -
145 Ibuprofen Tablet 200 mg Tablet - 500 500 500
146 Ibuprofen Tablet 400 mg Tablet - - -
147 Iodiol kapsul lunak Kapsul - - -
148 Isoniazid (INH) Tablet 100 mg Tablet 1,000 1,000 1,000
149 Isoniazid (INH) Tablet 300 mg Tablet - 1,000 1,000 1,000
150 Isosorbid Dinitrat Tablet Sublingual 5 mg Tablet - 100 100 20 80 100
151 Itrakonazol Kapsul 100 mg Kapsul - - -
152 Kalium Diklofenak tablet 50 mg Tablet - - -
153 Kalium Permanganat (KMnO4) Pot - 20 20 20
154 Kalsium Glukonas Injeksi 10% Ampul - - -
155 Kalsium Laktat Tablet 500 mg Tablet - 2,000 2,000 260 1,740 1000
156 Kaptopril tablet 12,5 mg Tablet - - -
157 Kaptopril Tablet 25 mg Tablet - 1,000 1,000 111 889
158 Kaptopril tablet 50 mg Tablet - - -
159 Karbamazepin Tablet 200 mg Tablet - - -
160 Karbazokrom Injeksi 10 mg/ 2 mL Ampul - - -
161 Karbazokrom Tablet 10 mg Tablet 90 90 90
162 Karbon Aktif Tablet - - -
163 Ketokonazol Krim 2% ; 10 gram Tube - 25 25 4 21
164 Ketokonazol Krim 2% ; 15 gram Tube - - -
165 Ketokonazol Tablet 200 mg Tablet - - - 300
166 Ketoprofen injeksi 100 mg Ampul - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
167 Ketoprofen tablet 100 mg Tablet - - -
168 Ketorolac Injeksi 10 mg/ mL Ampul - - -
169 Ketorolac injeksi 30 mg Ampul - 24 24 12 12
170 Kina Injeksi 25% - 2 ml Ampul - - -
171 Kina Tablet 200 mg Tablet - - -
172 Klindamisin Kapsul 150 mg Kapsul - - -
174 Klomifen tablet 50 mg Tablet - - -
175 Klonidin tablet 0,15 mg Tablet - - -
176 Kloramfenikol Injeksi 1 gr Vial - - -
177 Kloramfenikol Kapsul 250 mg Kapsul - 500 500 81 419
178 Kloramfenikol Salep Mata 1 % Tube - 24 24 4 20 24
179 Kloramfenikol Suspensi 125 mg/ 5 mL Botol - - -
180 Kloramfenikol Tetes Mata 0,5 % Botol - 25 25 1 24
181 Kloramfenikol Tetes Telinga 3% Botol - 24 24 5 19 24
182 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet - 3,000 3,000 1,886 1,114 4000
183 Klorokuin Tablet 150 mg Tablet - - -
184 Klorokuin tablet 250 mg Tablet - - -
185 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) Ampul - - -
186 Klorpromazin injeksi i.m. 25 mg/ml (HCl) Ampul 3 3 3
187 Klorpromazin tablet salut 100 mg (HCl) Tablet - - -
188 Klorpromazin Tablet Salut 25 mg Tablet - - -
189 Kodein Tablet 10 mg Tablet - - -
190 Kodein tablet 15 mg Tablet - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
192 Kotrimoksazol DOEN I Tablet (Dewasa) Tablet - 1,000 1,000 143 857
193 Kotrimoksazol DOEN II Tablet (Anak) Tablet - - -
194 Kotrimoksazol Suspensi Botol - 100 100 30 70 50
195 Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg + Botol - - -
Trimetoprim 40 mg / 5 ml
196 Kuinin Injeksi 25% Ampul - - -
197 Lamivudine tablet 150 mg Tablet - - -
198 Lanzoprazol Kapsul 30 mg Kapsul - - -
199 Levofloksasin tablet 500 mg Tablet - - -
200 Lidokain Injeksi 2% Ampul - 50 50 10 40
201 Lidokain Injeksi 2% + Epinefrin 1 : 80.000 Ampul - 60 60 20 40
202 Linkomisin Kapsul 500 mg Kapsul - - - 180
203 Lisinopril tablet 10 mg Tablet - - -
205 Loperamid Tablet 2 mg Tablet - 200 200 32 168
206 Loratadin Tablet 10 mg Tablet - - -
207 Magnesium Sulfat Injeksi 20% Ampul - - -
209 MDT MB Anak Paket - - -
210 MDT MB Dewasa Paket - - -
211 MDT PB Anak Paket - - -
212 MDT PB Dewasa Paket - - -
213 Mebendazol sirup 100 mg / 5 ml Botol - - -
214 Mebendazole Tablet 100 mg Tablet - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
215 Meloksikam suppositoria Supp - - -
216 Meloksikam Tablet 15 mg Tablet - - -
217 Meloksikam Tablet 7.5 mg Tablet - - -
218 Metampiron Injeksi 250 mg Ampul - - -
219 Metampiron Tablet 500 mg Tablet - 9,000 9,000 1,163 7,837
220 Metformin HCl Tablet 500 mg Tablet - - - 500
221 Metformin HCl tablet 850 mg Tablet - - -
222 Metil Ergometrine Maleat Injeksi 0,2 mg/ mL Ampul - - -
223 Metil Ergometrine Maleat Tab Salut 0,125mg Tablet - - - 100
224 Metil Prednisolon Tablet 4 mg Tablet - - - 500
225 Metil Prednisolon Tablet 8 mg Tablet - - -
226 Metilprednisolon injeksi 500 mg Vial - - -
227 Metilprednisolon tablet 16 mg Tablet - - -
228 Metoklopramid Injeksi 5 mg/mL Ampul - - -
229 Metoklopramid Tablet 10 mg Tablet - - -
230 Metoklopramide tablet 5 mg Tablet - 500 500 500
231 Metronidazol infus 500 mg/100 ml Botol - - -
232 Metronidazol tablet 250 mg Tablet - - -
233 Metronidazol Tablet 500 mg Tablet - 1,000 1,000 62 938
234 Mikonazole Krim 2 % Tube - 24 24 24
235 Mineral Mix Sachet - - -
236 Momethason krim 0,1 % Tube - - -
237 Morfin injeksi 10 mg/ml Ampul - - -
238 Morfin tablet 10 mg Tablet - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
239 Natrium Bikarbonat Inj 0,83mEK/mL(Meylon) Ampul - - -
240 Natrium Bikarbonat Tablet 500 mg Tablet - - -
241 Natrium Diklofenak Tablet 25 mg Tablet - - -
242 Natrium Diklofenak Tablet 50 mg Tablet - 500 500 10 490
243 Natrium Klorida (NaCl) Larutan Infus 0,9% Botol - - -
244 Natrium Tiroksin 100 mcg Tablet - - -
245 NEVIRAPIN Tablet 200 mg Tablet - - -
246 Nifedipin Tablet 10 mg Tablet - - -
247 Nistatin Suspensi Drops 100.000 UI/ mL Botol - - -
248 Nistatin Tablet Salut 500.000 IU/gr Tablet - - -
249 Nistatin Vaginal Tablet 100.000 IU/gr Tablet - - -
250 OAT Kategori Anak (FDC Anak) Paket - - -
251 OAT Kategori Anak (Kombipak Anak) Paket - - -
252 OAT Kategori I Dewasa (FDC I Dewasa) Paket - - -
253 OAT Kategori I Dewasa (Kombipak I Dewasa) Paket - - -
254 OAT Kategori II Dewasa (FDC II Dewasa) Paket - 2 2 2 -
255 OAT Kategori II Dewasa(Kombipak II Dewasa) Paket - - -
256 OAT Kategori Sisipan (FDC Sisipan) Paket - - -
257 OAT Kategori Sisipan (Kombipak Sisipan) Paket - - -
258 Obat Batuk Hitam (OBH) ; 100 mL Botol - 150 150 14 136
259 Obat Batuk Hitam (OBH) ; 200 mL Botol - - -
260 Ofloxacin tablet 200 mg Tablet - - -
262 Oksitetrasiklin Salep Kulit 3% Tube - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
263 Oksitetrasiklin Salep Mata 1% Tube - - -
264 Oksitosin Injeksi 10 IU/ mL Ampul - 30 30 30 - 30
265 Omeprazol Kapsul 20 mg Kapsul - 600 600 600
266 Ondansetron Injeksi 4 mg/2 mL Ampul - - -
267 Ondansetron Tablet 4 mg Tablet - - -
268 Oseltamivir Tablet 75 mg Tablet - - -
269 Papaverin injeksi 40 mg/ml Ampul - - -
270 Papaverin Tablet 40 mg Tablet - 500 500 71 429
271 Paraformaldehide Tablet 1 gram Tablet - - -
272 Parasetamol Drops 60 mg/ 0.6 mL Botol - - -
273 Parasetamol Sirup 120 mg/5 mL Botol - 168 168 168
274 Parasetamol Tablet 100 mg Tablet - - -
275 Parasetamol Tablet 500 mg Tablet 2,000 10,000 12,000 2,438 9,562 5000
276 Perak Sulfadiazin Salep Tube - - -
277 Perfenazin tablet 4 mg (HCl) Tablet - - -
278 Petidin injeksi 50 mg/ml Ampul - - -
279 Piracetam injeksi 1 g/5 ml Ampul - - -
281 Piracetam tablet 1200 mg Tablet - - -
283 Piracetam Tablet 800 mg Tablet - - -
284 Pirantel Pamoat Tablet 125 mg Tablet 50 50 50
285 Pirantel Pamoat Tablet 250 mg Tablet - - -
286 Pirantel sirup 125 mg/5 ml Botol - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
287 Pirazinamid Tablet 500 mg Tablet - 500 500 500
288 Piroksikam Tablet 10 mg Tablet - - -
289 Piroksikam Tablet 20 mg Tablet - 500 500 224 276 500
290 Podofilin 25% Larutan Tinctur Botol - - -
291 Povidon Iodida Larutan 10% ; 1000 mL Botol - - -
292 Povidon Iodida Larutan 10% ; 30 mL Botol - - - 10
294 Povidon Iodida larutan 10%; 60 mL Botol - - -
295 Pravastatin tablet 20 mg Tablet - - -
296 Prednison Tablet 5 mg Tablet - 4,000 4,000 1,631 2,369 5000
297 Primakuin Tablet 15 mg Tablet - - -
298 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial Vial - - -
299 Propanolol Tablet 10 mg Tablet - - -
301 Propiltiourasil (PTU) Tablet 100 mg Tablet - - -
302 Ramipril tablet 2,5 mg Tablet - - -
303 Ramipril tablet 5 mg Tablet - - -
304 Ranitidin Injeksi 25 mg/ 2 mL Ampul - - -
305 Ranitidin Tablet 150 mg Tablet - 1,000 1,000 262 738 500
306 Reserpin tablet 0,25 mg Tablet - - -
307 Reserpine Tablet 0.10 mg Tablet - - -
308 Rifampisin Kapsul 300 mg Kapsul - 500 500 34 466
309 Rifampisin Kapsul 600 mg Kapsul - - -
310 Rifampisin Kapsul Salut 450 mg Kapsul - 300 300 83 217 200
(LPLPOPK)

KABUPATEN : KUDUS
M
311 Ringer Laktat (RL) Larutan Infus Botol 200 200 400 100 300 60
312 Risperidon tablet 1 mg Tablet - - -
314 Rivanol (Etakridin) Larutan 0.1% ; 300 mL Botol - - -
315 Salbutamol Tablet 2 mg Tablet - 600 600 600
316 Salbutamol Tablet 4 mg Tablet - - -
317 Salep 2-4 Pot - 24 24 24
318 Salisil Bedak 2 % ; 100 gram Pot - - -
319 Salisil Bedak 2 % ; 50 gram Pot - 30 30 1 29
320 Sefadroksil Kapsul 250 mg Kapsul - - -
321 Sefadroksil Kapsul 500 mg Kapsul - - - 500
322 Sefadroksil Suspensi Kering 125 mg/ 5 mg Botol - 50 50 4 46
323 Sefaleksin Kapsul 250 mg Tablet - - -
324 Sefaleksin Kapsul 500 mg Kapsul - - -
325 Sefiksim 400 mg + Azitromisin 1000 mg Paket - - -
326 Sefiksim Kapsul 100 mg Kapsul - - -
328 Sefiksim sirup kering 100 mg/ 5 ml Botol - - -
329 Sefotaksim Serbuk Injeksi 0,5 g/ Vial Vial - - -
330 Sefotaksim Serbuk Injeksi 1 g/ Vial Vial - - -
331 Seftazidim injeksi 1 g Vial - - -
332 Seftriakson Injeksi 1 gr Vial - - -
333 Serum ABU I Vial 1 1 1
334 Serum ATS 1500 IU Ampul 3 3 3
(LPLPOPK)

KABUPATEN : KUDUS
M
335 Simetidine Tablet 200 mg Tablet - - - 500
336 Simvastatin Tablet 10 mg Tablet - 100 100 13 87
337 Simvastatin Tablet 20 mg Tablet - - -
338 Simvastatin tablet 5 mg Tablet - - -
339 Siprofloksasin infus 2% Botol - - -
340 Siprofloksasin tablet 250 mg (sebagai HCl) Tablet - - -
341 Siprofloksasin Tablet 500 mg Tablet - 1,000 1,000 42 958
342 Spiramisin Tablet 500 mg Tablet - - -
343 Stavudin tablet 30 mg Botol - - -
344 Streptomisin Serbuk Injeksi 1000 mg/ mL Ampul - - -
345 Sulfasalazin tablet 500 mg Tablet - - -
346 Sulfasetamida Natrium tetes mata 15 % Botol - - -
347 Tambah Darah Tablet Kombinasi Sachet - - - 1000
348 Terbutalin Tablet 2.5 mg Tablet - - -
349 Tetrasiklin Kapsul 250 mg Kapsul - 500 500 500
350 Tetrasiklin Kapsul 500 mg Kapsul - 500 500 500
351 Tiamfenikol Kapsul 250 mg Kapsul - - -
352 Tiamfenikol Kapsul 500 mg Kapsul - - - 500
353 Tramadol Injeksi 50 mg/ mL Ampul - 20 20 20
354 Tramadol Kapsul 50 mg Kapsul - - -
355 Triamcinolon Asetonid Salep 1 mg Tube - - - 20
356 Triheksifenidil tablet 2 mg Tablet - - -
357 Vaksin BCG Vial - - -
358 Vaksin Campak Vial - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
359 Vaksin DPT - HB Vial - - -
360 Vaksin DT Vial - - -
361 Vaksin HBU Vial - - -
362 Vaksin Polio Vial - - -
363 Vaksin Td Vial - - -
364 Vaksin TT Vial - - -
365 Verapamil tablet 80 mg (HCl) Tablet - - -
366 Vitamin A Kapsul 100.000 IU Kapsul - 1,000 1,000 1,000 -
367 Vitamin A Kapsul 200.000 IU Kapsul - 21,300 21,300 21,300 -
368 Vitamin A Tablet 50.000 IU Tablet - - -
369 Vitamin B Kompleks Tablet Tablet - 6,000 6,000 980 5,020 1000
370 Vitamin B1 Injeksi 100 mg/ mL Vial - - -
371 Vitamin B1 Tablet 50 mg Tablet - 6,000 6,000 200 5,800
372 Vitamin B12 Injeksi 500 mcg Ampul 100 100 200 200
373 Vitamin B12 Tablet 50 mcg Tablet - 3,000 3,000 622 2,378
374 Vitamin B6 Tablet 10 mg Tablet - 5,000 5,000 441 4,559
375 Vitamin C tablet 100 mg Tablet - - -
377 Vitamin C Tablet 50 mg Tablet - 2,000 2,000 254 1,746 1000
378 Vitamin K Injeksi 10 mg/ mL Vial 510 510 510
379 Vitamin K Tablet 10 mg Tablet - - - 100
380 Vitamin K1 Injeksi 2 mg/ mL Ampul - 30 30 30
381 Vitamin K3 injeksi 10 mg/ml Ampul - - -
382 Zidovudin 300 mg + Lamivudine 150 mg Tablet Tablet - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
383 Zidovudin tablet 100 mg Kapsul - - -
384 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg Tablet - - -
385 Zinc Tablet 20 mg Tablet - - - 100
381 Anti Diare Non Spesifik Tablet - 900 900 70 830
(Attapulgit 700 mg dan Pektin 50 mg) - - -
382 Anti Flu Kombinasi Kaplet Tablet - - - 1500
(Parasetamol 500 mg, CTM 2 mg, PPA 12.5 mg) - - -
383 Anti Flu Kombinasi Sirup Botol - - - 60
384 Fluocinolone 0,25 mg + Neomisin Sulfat 5 mg Tube - 20 20 20
385 Gameksan + Asam Usnat Salep Tube - - -
386 HES 6% dalam 0.9% NaCl (BM 130,000) Botol - - -
387 Levertran Salep Pot - 10 10 10
388 Multivitamin Kombinasi Kaplet Tablet - - - 1000
(As.Folat 1 mg dan Besi (II) Fumarat 90 mg) - - -
389 Multivitamin Kombinasi Sirup Botol - - - 60
(DHA 32 mg, L-Lysin 200 mg) - - -
390 OAI Antihipertensi Kapsul Kapsul - - -
391 OAI Curcuma Xanthorizae Tablet 20 mg Tablet - - -
- - -
B PERBEKALAN KESEHATAN/ BAHAN PAKAI HABIS - - -
1 Alat Suntik Sekali Pakai 0.05 mL ADS Pcs - - -
3 Alat Suntik Sekali Pakai 1 mL Pcs - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
4 Alat Suntik Sekali Pakai 2.5 mL Pcs - - -
5 Alat Suntik Sekali Pakai 3 mL Pcs - 300 300 250 50 400
6 Alat Suntik Sekali Pakai 5 mL Pcs - 100 100 100 - 100
7 Alkohol 70 % Larutan 100 mL Botol - 10 10 10
8 Alkohol 70 % Larutan 1000 mL Botol - - - 1
9 Aqua Pro Injection ; 10 mL Vial - - -
10 Aqua Pro Injection ; 20 mL Vial - 20 20 20
11 Catgut 2/0 dengan Jarum Bedah PLAIN Pcs - 10 10 10
12 Catgut 3/0 dengan Jarum Bedah PLAIN Pcs - - - 10
13 Catgut Chromic 2/0 Roll Pcs - 1 1 1
14 Catgut Plain 3/0 Roll Pcs - - -
15 Folley Catheter No. 16 Pcs - - -
17 Handscoon No. 7.5 (Non Steril) Pcs - - -
18 Handscoon No. 7.5 (Steril) Pcs - - - 200
19 Handscoon No.7 (Non Steril) Pcs - - -
20 Handscoon No.7 (Steril) Pcs - - - 100
21 Hidrogen Peroksida Larutan 3% Botol - - -
22 Infus Set Anak Pcs - - -
23 Infus Set Dewasa Pcs - 100 100 100
24 IV Catheter No. 18 G Pcs - - - 50
25 IV Catheter No. 20 G Pcs - 50 50 50
(LPLPOPK)

KABUPATEN : KUDUS
M
28 Jarum Jahit No. 11 Pcs 2 2 1 1
29 Jarum No. 23 G Pcs - - -
34 Kapas 250 gram Pcs - 10 10 10
35 Kasa Hidrofil Steril Ukuran 16 x 16 Pcs - - - 5
36 Kasa Kompres 40/40 Steril Pcs - - -
37 Kasa Pembalut 2 m X 80 cm Pcs - 20 20 20
38 Kasa Pembalut 4 m X 15 cm Pcs - 50 50 50
39 Kasa Pembalut Elastic 3 Inchi Pcs - - -
41 Kasa Pembalut Hidrofil 4 m x 10 cm Pcs - - -
42 Kasa Pembalut Hidrofil 4 m x 5 cm Pcs - 100 100 100
43 Lisol (Kresol tersaponifikasi 50%) ; 1 L Botol - - -
44 Masker Pcs - 100 100 100
45 Minyak Emersi Botol - - -
46 Pelarut Vaksin BCG/ Polio Vial - - -
47 Plester 5 Yards x 2 Inchi Pcs - - - 6
48 Silk No. 3/0 (Roll) Pcs - - -
49 Silk No. 3/0 dengan Jarum Bedah Pcs - - - 10
50 Slide Pcs - - -
51 Transfusi Set Pcs - - - 25
(LPLPOPK)

KABUPATEN : KUDUS
M
52 Urine Bag Pcs - - -
- - -
C PERBEKALAN KESEHATAN/ BAHAN GIGI - - -
1 Air Raksa Dental Pcs - - -
2 Alvogyil/ Alveopaste Botol - - -
3 Articulating Paper Pcs - - -
4 Blade (ukuran : 11) Pcs - - -
5 Cocoa Butter Botol - - -
6 Cresophen Botol - - -
7 Dental Needle (Carpul) Pcs - - -
8 Devitalisasi Pasta (Non Arsen) Botol - 1 1 1 -
9 Etil Klorid Spray Botol - 2 2 2 -
10 Eugenol Cairan Botol - - -
11 Glass Ionomer Cement ART Botol - 1 1 1 -
12 Kalsium Hidroksida Pasta Botol - 1 1 1 -
13 Klorfenol Kamfer Menthol (CHKM) Botol - 1 1 1 -
14 Klorheksidin Larutan 0,2% Botol - - -
15 Mata Bur High Speed Pcs - - -
16 Matriks Band Pcs - - -
17 Mummifying Pasta Botol - - -
18 Obat Kumur Antiseptik Botol - - -
(Benzalkonium Klorida Kombinasi) - - -
19 OCO (Tooth Cleansing Tincture) Botol - 1 1 1 -
20 Selluloid Strip Pcs - - -
(LPLPOPK)

KABUPATEN : KUDUS
M
21 Semen Seng Fosfat serbuk & cairan Botol - - -
22 Silver Amalgam Serbuk Botol - - - 2
23 Spon Gelatin Steril (ukuran 10 x 10 x 10 mm) Pcs - - -
24 Temporary Filling Material Botol - 1 1 1 -
25 Temporary Stopping (Fletcher) serbuk&cairan Botol - 1 1 1 -
26 Topikal Anestesi Botol - - -
27 Trikresol Formalin (TKF) Cair Botol - - -
- - -
D PERBEKALAN KESEHATAN/ REAGEN - - -
1 Asam Hidroklorida 20% Cairan Botol - - -
2 Benedict Larutan ; 100 mL Botol - - -
3 HIV Reagent Pcs - - -
4 Metilen Blue Larutan Botol - - -
5 Turk Larutan ; 100 mL Botol - - -
6 Ziel Nielsen Larutan (1 Paket 3 Botol) Paket - - -
-
E LAIN-LAIN/ YG BELUM TERCANTUM - - -
1 LYCODRYL DMP SIRUP BTL - 72 72 5 67
2 ANTI DIARE / NEO KAOMINAL SIRUP BTL - 50 50 5 45
3 ADITUSIN tablet ( CTM + DMP ) Tablet - - -
4 FLUTOP C syrup BTL - - - 60
5 HALOPERIDOL INJEKSI AMP 3 3 3
(LPLPOPK)

KABUPATEN : KUDUS
M
UMUM BPJS JUML

JUMLAH KUNJUNGAN RESEP BAYAR GR
RAWAT JALAN 0
JUMLAH KUNJUNGAN INAP 0
JUMLAH KUNJUNGAN PONED 0
MENGETAHUI MENYETUJUI
an. KEPALA DINAS KESEHATAN KABUPATEN KUDUS KEPALA SEKSI FARMASI YANG MEMINTA/ PELAPOR
KEPALA BIDANG SUMBER DAYA KESEHATAN DAN PERBEKALAN KESEHATAN KEPALA UPT PUSKESMAS PENGELOLA OBAT PUSKESMAS
DAWE DAWE
SUKOLIYONO, SH, MM SIGIT JOKO RIYANTO, SKM .. RATNA PUSPITASARI, A.Md

NIP. 19631122 199303 1 005 NIP. 19631214 198212 1 001 NIP. 19830309 200501 2 006
KET
16
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
p. gizi
p. gizi
KET
KET
KET
KET
KET
(LPLPOPK)

KABUPATEN : KUDUS
PELAPORAN BULAN/ PERIODE : FEBRUARI 2016
PERMINTAAN BULAN/ PERIODE : MARET 2016
STOK PENERIM PERSEDIA PEMAKAI SISA STOK OPTIMU
NO NAMA OBAT & PERBEKALAN KESEHATAN SATUAN AWAL AAN AN AN AAN APBN APBD I APBD II LAIN2 JML
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A SEDIAAN FARMASI
3 Allopurinol Tablet 100 mg Tablet 426 426 366 60 800
6 Ambroksol Sirup 15 mg/ mL Botol 46 46 4 42
7 Ambroksol Tablet 30 mg Tablet 482 482 260 222 600
8 Aminofilin Injeksi 24 mg/mL Ampul - 60 60 60
10 Aminofilin Tablet 200 mg Tablet 2,000 2,000 2,000
13 Amlodipin Tablet 5 mg Tablet 398 300 698 411 287 600
14 Ammonium Bituminosulfonat Salep 10 %/ichtiol Pot 10 10 2 8
17 Amoksisilin Kapsul 500 mg Kapsul 7,879 7,879 6,494 1,385 14000
19 Amoksisilin Suspensi Kering 125 mg/ 5 mL Botol 102 160 262 112 150 120
20 Ampisilin Kaplet 500 mg Tablet - 1,000 1,000 24 976
23 Ampisilin Suspensi Kering 125 mg/ 5 mL Botol - - - 60
24 Antasida DOEN I Tablet Kunyah Tablet 5,000 5,000 317 4,683
25 Antasida DOEN II Suspensi Botol 50 50 19 31 20
26 Anti Bakteri DOEN Salep Tube 48 48 7 41
KABUPATEN : KUDUS
M
27 Anti Fungi DOEN Salep Pot 24 24 24
28 Anti Haemoroid DOEN Suppositoria Supp 20 20 8 12 20
38 Asam Folat Tablet 1 mg Tablet 28,410 28,410 22,516 5,894
40 Asam Mefenamat Tablet Salut Selaput 500 mg Tablet - - - 5000
41 Asam Nalidixic Tablet 500 mg Tablet - - -
47 Asiklovir Krim 5 % Tube 20 20 13 7 50
49 Asiklovir Tablet 400 mg Tablet 164 164 119 45 250
KABUPATEN : KUDUS
M
59 Betametason Krim 0,1 % Tube 48 48 29 19 72
60 Bisakodil Suppositoria 10 mg Supp - - -
62 Bisakodil Tablet 5 mg Tablet 100 100 100
70 Deksametason Injeksi 5 mg/ mL Ampul - - -
71 Deksametason Tablet 0.5 mg Tablet - 8,000 8,000 1,362 6,638 3000
75 Diazepam Injeksi 5 mg/ mL Ampul 60 60 60
77 Diazepam Larutan Rektal 5 mg/ mL Tube - 5 5 5
78 Diazepam Tablet 2 mg Tablet 35 35 35
82 Digoksin Tablet 0.25 mg Tablet - - -
84 Dimenhidrinat Tablet 50 mg Tablet 453 453 169 284 300
86 Domperidone Sirup 5 mg/ 5 mL Botol 17 17 2 15
87 Domperidone Tablet 10 mg Tablet 292 292 110 182 200
KABUPATEN : KUDUS
M
92 Epinefrin/ Adrenalin Injeksi 0,1 % Ampul - - - 10
93 Eritromisin Kapsul 250 mg Kapsul - - - 360
95 Eritromisin Sirup 200 mg/ 5 mL Botol 20 20 9 11 20
111 Furosemid Injeksi 10 mg/ mL Ampul - - -
112 Furosemid Tablet 40 mg Tablet - 100 100 100 100
113 Gameksan Salep 1% / scabimit Pot 18 18 9 9 15
119 Gentamisin Salep Kulit 0.1% Tube 20 20 20 - 48
KABUPATEN : KUDUS
M
122 Gentian Violet Larutan 1 % Botol - - - 10
123 Glibenkamid Tablet 5 mg Tablet 412 412 408 4 1000
124 Glimepirid Tablet 1 mg Tablet 500 500 500
130 Gliseril Guaiakolat Tablet 100 mg Tablet 5,939 5,939 3,463 2,476 6000
134 Glukosa Larutan Infus 5 % Botol - - -
140 Hidroklortiazid (HCT) Tablet 25 mg Tablet 177 177 22 155
145 Ibuprofen Tablet 200 mg Tablet 500 500 210 290 500
149 Isoniazid (INH) Tablet 300 mg Tablet 1,000 1,000 359 641 500
150 Isosorbid Dinitrat Tablet Sublingual 5 mg Tablet 80 100 180 57 123 100
KABUPATEN : KUDUS
M
153 Kalium Permanganat (KMnO4) Pot 20 20 20
155 Kalsium Laktat Tablet 500 mg Tablet 1,740 1,000 2,740 1,476 1,264 2000
157 Kaptopril Tablet 25 mg Tablet 889 889 239 650
163 Ketokonazol Krim 2% ; 10 gram Tube 21 21 11 10 20
165 Ketokonazol Tablet 200 mg Tablet - 300 300 20 280
169 Ketorolac injeksi 30 mg Ampul 12 12 12
177 Kloramfenikol Kapsul 250 mg Kapsul 419 419 387 32 1000
178 Kloramfenikol Salep Mata 1 % Tube 20 24 44 20 24 48
179 Kloramfenikol Suspensi 125 mg/ 5 mL Botol - - - 50
180 Kloramfenikol Tetes Mata 0,5 % Botol 24 24 23 1 50
181 Kloramfenikol Tetes Telinga 3% Botol 19 24 43 13 30 24
KABUPATEN : KUDUS
M
182 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet 1,114 1,114 1,114 - 8000
192 Kotrimoksazol DOEN I Tablet (Dewasa) Tablet 857 857 664 193 1500
194 Kotrimoksazol Suspensi Botol 70 100 170 71 99 100
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg +
195 Botol - - -
Trimetoprim 40 mg / 5 ml
198 Lanzoprazol Kapsul 30 mg Kapsul - - - 500
200 Lidokain Injeksi 2% Ampul 40 40 40
201 Lidokain Injeksi 2% + Epinefrin 1 : 80.000 Ampul 40 40 40
202 Linkomisin Kapsul 500 mg Kapsul - - - 180
205 Loperamid Tablet 2 mg Tablet 168 168 153 15 400
KABUPATEN : KUDUS
M
219 Metampiron Tablet 500 mg Tablet 7,837 7,837 3,627 4,210 4000
223 Metil Ergometrine Maleat Tab Salut 0,125mg Tablet - 100 100 100
225 Metil Prednisolon Tablet 8 mg Tablet - 500 500 500
230 Metoklopramide tablet 5 mg Tablet 500 500 500
233 Metronidazol Tablet 500 mg Tablet 938 938 210 728
234 Mikonazole Krim 2 % Tube 24 24 2 22
242 Natrium Diklofenak Tablet 50 mg Tablet 490 490 462 28 1000
243 Natrium Klorida (NaCl) Larutan Infus 0,9% Botol - 20 20 20 - 20
KABUPATEN : KUDUS
M
252 OAT Kategori I Dewasa (FDC I Dewasa) Paket - 10 10 10 -
253 OAT Kategori I Dewasa (Kombipak I Dewasa) Paket - 2 2 2 -
254 OAT Kategori II Dewasa (FDC II Dewasa) Paket - - -
258 Obat Batuk Hitam (OBH) ; 100 mL Botol 136 136 121 15 250
262 Oksitetrasiklin Salep Kulit 3% Tube - - - 25
264 Oksitosin Injeksi 10 IU/ mL Ampul - 30 30 20 10 30
265 Omeprazol Kapsul 20 mg Kapsul 600 600 202 398 90
266 Ondansetron Injeksi 4 mg/2 mL Ampul - - -
270 Papaverin Tablet 40 mg Tablet 429 429 291 138 500
272 Parasetamol Drops 60 mg/ 0.6 mL Botol - - - 50
273 Parasetamol Sirup 120 mg/5 mL Botol 168 168 64 104 120
KABUPATEN : KUDUS
M
287 Pirazinamid Tablet 500 mg Tablet 500 500 500
288 Piroksikam Tablet 10 mg Tablet - - - 500
289 Piroksikam Tablet 20 mg Tablet 276 500 776 215 561 600
294 Povidon Iodida larutan 10%; 60 mL Botol - - - 10
296 Prednison Tablet 5 mg Tablet 2,369 5,000 7,369 1,810 5,559
305 Ranitidin Tablet 150 mg Tablet 738 500 1,238 538 700 600
KABUPATEN : KUDUS
M
308 Rifampisin Kapsul 300 mg Kapsul 466 466 52 414
310 Rifampisin Kapsul Salut 450 mg Kapsul 217 200 417 273 144 500
311 Ringer Laktat (RL) Larutan Infus Botol 300 100 400 20 380
315 Salbutamol Tablet 2 mg Tablet 600 600 600
317 Salep 2-4 Pot 24 24 18 6 24
319 Salisil Bedak 2 % ; 50 gram Pot 29 29 11 18 20
322 Sefadroksil Suspensi Kering 125 mg/ 5 mg Botol 46 46 8 38
334 Serum ATS 1500 IU Ampul 3 3 1 2
336 Simvastatin Tablet 10 mg Tablet 87 87 53 34 200
KABUPATEN : KUDUS
M
341 Siprofloksasin Tablet 500 mg Tablet 958 958 128 830
349 Tetrasiklin Kapsul 250 mg Kapsul 500 500 500
350 Tetrasiklin Kapsul 500 mg Kapsul 500 500 200 300
353 Tramadol Injeksi 50 mg/ mL Ampul 20 20 20
366 Vitamin A Kapsul 100.000 IU Kapsul - - -
KABUPATEN : KUDUS
M
369 Vitamin B Kompleks Tablet Tablet 5,020 5,020 3,634 1,386 6000
371 Vitamin B1 Tablet 50 mg Tablet 5,800 5,800 372 5,428
373 Vitamin B12 Tablet 50 mcg Tablet 2,378 2,378 1,949 429 4000
374 Vitamin B6 Tablet 10 mg Tablet 4,559 4,559 2,001 2,558 2000
377 Vitamin C Tablet 50 mg Tablet 1,746 1,000 2,746 2,003 743 4000
378 Vitamin K Injeksi 10 mg/ mL Vial 510 510 510 -
379 Vitamin K Tablet 10 mg Tablet - 300 300 300
380 Vitamin K1 Injeksi 2 mg/ mL Ampul 30 1,000 1,030 1,030
385 Zinc Tablet 20 mg Tablet - 500 500 500
381 Anti Diare Non Spesifik Tablet 830 830 347 483 450
384 Fluocinolone 0,25 mg + Neomisin Sulfat 5 mg Tube 20 20 20
387 Levertran Salep Pot 10 10 10
KABUPATEN : KUDUS
M
(DHA 32 mg, L-Lysin 200 mg) - - -
- - -
5 Alat Suntik Sekali Pakai 3 mL Pcs 50 400 450 11 439
6 Alat Suntik Sekali Pakai 5 mL Pcs - 200 200 200
7 Alkohol 70 % Larutan 100 mL Botol 10 10 2 8
10 Aqua Pro Injection ; 20 mL Vial 20 20 20
11 Catgut 2/0 dengan Jarum Bedah PLAIN Pcs 10 10 5 5 20
13 Catgut Chromic 2/0 Roll Pcs 1 1 1
17 Handscoon No. 7.5 (Non Steril) Pcs - - - 300
19 Handscoon No.7 (Non Steril) Pcs - - - 200
22 Infus Set Anak Pcs - - -
23 Infus Set Dewasa Pcs 100 100 10 90
25 IV Catheter No. 20 G Pcs 50 50 50
KABUPATEN : KUDUS
M
28 Jarum Jahit No. 11 Pcs 1 1 1
34 Kapas 250 gram Pcs 10 10 10
35 Kasa Hidrofil Steril Ukuran 16 x 16 Pcs - 10 10 10
37 Kasa Pembalut 2 m X 80 cm Pcs 20 20 20
42 Kasa Pembalut Hidrofil 4 m x 5 cm Pcs 100 100 100
44 Masker Pcs 100 100 100
45 Minyak Emersi Botol - 1 1 1 -
47 Plester 5 Yards x 2 Inchi Pcs - 6 6 6
49 Silk No. 3/0 dengan Jarum Bedah Pcs - 10 10 10
50 Slide Pcs - - -
52 Urine Bag Pcs - - -
- - -
KABUPATEN : KUDUS
M
8 Devitalisasi Pasta (Non Arsen) Botol - - -
9 Etil Klorid Spray Botol - - - 3
11 Glass Ionomer Cement ART Botol - - -
12 Kalsium Hidroksida Pasta Botol - - -
13 Klorfenol Kamfer Menthol (CHKM) Botol - - -
19 OCO (Tooth Cleansing Tincture) Botol - - -
22 Silver Amalgam Serbuk Botol - 2 2 2 - 2
24 Temporary Filling Material Botol - - -
25 Temporary Stopping (Fletcher) serbuk&cairan Botol - - -
- - -
KABUPATEN : KUDUS
M
-
1 LYCODRYL DMP SIRUP BTL 67 67 53 14 144
2 ANTI DIARE / NEO KAOMINAL SIRUP BTL 45 45 5 40
UMUM BPJS JUML

RAWAT JALAN 0
JUMLAH KUNJUNGAN INAP 7 6 13
JUMLAH KUNJUNGAN PONED 8 8
DAWE DAWE
SUKOLIYONO, SH, MM SIGIT JOKO RIYANTO, SKM .. RATNA PUSPITASARI, A.Md

NIP. 19631122 199303 1 005 NIP. 19631214 198212 1 001 NIP. 19830309 200501 2 006
KET
16
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
p. gizi
p. gizi
KET
KET
KET
KET
KET
(LPLPOPK)

KABUPATEN : KUDUS
PELAPORAN BULAN/ PERIODE : MARET 2016
PERMINTAAN BULAN/ PERIODE : APRIL 2016
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A SEDIAAN FARMASI
3 Allopurinol Tablet 100 mg Tablet 60 800 860 284 576 400
4 Alopurinol tablet 300 mg Tablet - - - 500
6 Ambroksol Sirup 15 mg/ mL Botol 42 42 41 1 100
7 Ambroksol Tablet 30 mg Tablet 222 600 822 822 - 1500
8 Aminofilin Injeksi 24 mg/mL Ampul 60 60 60
10 Aminofilin Tablet 200 mg Tablet 2,000 2,000 40 1,960
12 Amlodipin tablet 10 mg Tablet - - - 400
13 Amlodipin Tablet 5 mg Tablet 287 600 887 344 543 240
14 Ammonium Bituminosulfonat Salep 10 %/ichtio Pot 8 8 2 6 5
17 Amoksisilin Kapsul 500 mg Kapsul 1,385 15,000 16,385 4,904 11,481 10000
20 Ampisilin Kaplet 500 mg Tablet 976 976 937 39 2000
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
24 Antasida DOEN I Tablet Kunyah Tablet 4,683 4,683 1,965 2,718 3000
25 Antasida DOEN II Suspensi Botol 31 60 91 25 66 50
27 Anti Fungi DOEN Salep Pot 24 24 5 19
28 Anti Haemoroid DOEN Suppositoria Supp 12 20 32 11 21 20
30 Anti Migren Tablet Tablet - - - 200
40 Asam Mefenamat Tablet Salut Selaput 500 mg Tablet - 5,000 5,000 80 4,920
41 Asam Nalidixic Tablet 500 mg Tablet - - - 200
43 Asam Traneksamat Tablet 500 mg Tablet - - - 100
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
60 Bisakodil Suppositoria 10 mg Supp - - - 20
70 Deksametason Injeksi 5 mg/ mL Ampul - - - 50
71 Deksametason Tablet 0.5 mg Tablet 6,638 4,000 10,638 4,185 6,453 5000
75 Diazepam Injeksi 5 mg/ mL Ampul 60 60 60 -
77 Diazepam Larutan Rektal 5 mg/ mL Tube 5 5 5
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
81 Difenhidramin HCl Injeksi 10 mg/ mL Vial - - - 60
82 Digoksin Tablet 0.25 mg Tablet - - - 100
84 Dimenhidrinat Tablet 50 mg Tablet 284 300 584 175 409 200
85 Doksisiklin Kapsul 100 mg Kapsul 36 36 36
86 Domperidone Sirup 5 mg/ 5 mL Botol 15 15 11 4 30
87 Domperidone Tablet 10 mg Tablet 182 200 382 135 247 200
92 Epinefrin/ Adrenalin Injeksi 0,1 % Ampul - 100 100 5 95
95 Eritromisin Sirup 200 mg/ 5 mL Botol 11 20 31 2 29
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
109 Fenol Gliserol Tetes Telinga 10% Pot - - - 10
111 Furosemid Injeksi 10 mg/ mL Ampul - - - 20
112 Furosemid Tablet 40 mg Tablet 100 100 200 2 198
119 Gentamisin Salep Kulit 0.1% Tube - 50 50 3 47
122 Gentian Violet Larutan 1 % Botol - - -
123 Glibenkamid Tablet 5 mg Tablet 4 1,000 1,004 204 800 300
124 Glimepirid Tablet 1 mg Tablet 500 500 10 490
130 Gliseril Guaiakolat Tablet 100 mg Tablet 2,476 6,000 8,476 3,658 4,818 6000
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
132 Glukosa larutan infus 10 % Botol - - - 20
133 Glukosa Larutan Infus 40% Botol - - - 10
134 Glukosa Larutan Infus 5 % Botol - 40 40 20 20 40
140 Hidroklortiazid (HCT) Tablet 25 mg Tablet 155 155 80 75 1000
144 Ibuprofen Sirup 100 mg/ 5 mL Botol - - - 60
145 Ibuprofen Tablet 200 mg Tablet 290 500 790 101 689 200
146 Ibuprofen Tablet 400 mg Tablet - - - 300
149 Isoniazid (INH) Tablet 300 mg Tablet 641 500 1,141 398 743 500
150 Isosorbid Dinitrat Tablet Sublingual 5 mg Tablet 123 100 223 23 200
157 Kaptopril Tablet 25 mg Tablet 650 650 352 298 1000
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
165 Ketokonazol Tablet 200 mg Tablet 280 280 25 255
172 Klindamisin Kapsul 150 mg Kapsul - - - 200
177 Kloramfenikol Kapsul 250 mg Kapsul 32 1,000 1,032 367 665 1000
182 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet - - - 10000
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
189 Kodein Tablet 10 mg Tablet - - - 50
192 Kotrimoksazol DOEN I Tablet (Dewasa) Tablet 193 2,000 2,193 454 1,739 500
194 Kotrimoksazol
Kotrimoksazol Suspensi
Suspensi komb: Botol 99 100 199 71 128 100
195 Sulfametoksazol 200 mg + Trimetoprim 40 mg Botol - - -
196 /Kuinin
5 ml Injeksi 25% Ampul - - -
200 Lidokain Injeksi 2% Ampul 40 40 40
201 Lidokain Injeksi 2% + Epinefrin 1 : 80.000 Ampul 40 40 20 20 60
202 Linkomisin Kapsul 500 mg Kapsul - - -
206 Loratadin Tablet 10 mg Tablet - 500 500 12 488
207 Magnesium Sulfat Injeksi 20% Ampul - - - 2
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
217 Meloksikam Tablet 7.5 mg Tablet - - - 100
219 Metampiron Tablet 500 mg Tablet 4,210 4,000 8,210 4,286 3,924 6000
222 Metil Ergometrine Maleat Injeksi 0,2 mg/ mL Ampul - - - 2
223 Metil Ergometrine Maleat Tab Salut 0,125mg Tablet 100 100 100
225 Metil Prednisolon Tablet 8 mg Tablet 500 500 500
233 Metronidazol Tablet 500 mg Tablet 728 728 192 536 300
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
242 Natrium Diklofenak Tablet 50 mg Tablet 28 1,000 1,028 301 727 500
243 Natrium Klorida (NaCl) Larutan Infus 0,9% Botol - 20 20 10 10 40
246 Nifedipin Tablet 10 mg Tablet - - - 100
258 Obat Batuk Hitam (OBH) ; 100 mL Botol 15 250 265 110 155 150
264 Oksitosin Injeksi 10 IU/ mL Ampul 10 20 30 10 20 10
265 Omeprazol Kapsul 20 mg Kapsul 398 600 998 218 780 150
266 Ondansetron Injeksi 4 mg/2 mL Ampul - - - 20
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
267 Ondansetron Tablet 4 mg Tablet - - - 200
270 Papaverin Tablet 40 mg Tablet 138 500 638 202 436 400
273 Parasetamol Sirup 120 mg/5 mL Botol 104 168 272 122 150 120
287 Pirazinamid Tablet 500 mg Tablet 500 500 66 434 100
289 Piroksikam Tablet 20 mg Tablet 561 600 1,161 406 755 300
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
296 Prednison Tablet 5 mg Tablet 5,559 5,559 2,599 2,960 3000
311 Ringer Laktat (RL) Larutan Infus Botol 380 380 100 280
315 Salbutamol Tablet 2 mg Tablet 600 600 200 400 300
317 Salep 2-4 Pot 6 24 30 10 20 24
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
322 Sefadroksil Suspensi Kering 125 mg/ 5 mg Botol 38 38 13 25 50
329 Sefotaksim Serbuk Injeksi 0,5 g/ Vial Vial - - - 20
330 Sefotaksim Serbuk Injeksi 1 g/ Vial Vial - - - 20
334 Serum ATS 1500 IU Ampul 2 2 2 -
341 Siprofloksasin Tablet 500 mg Tablet 830 830 592 238 1300
347 Tambah Darah Tablet Kombinasi Sachet - - -
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
350 Tetrasiklin Kapsul 500 mg Kapsul 300 300 108 192 500
355 Triamcinolon Asetonid Salep 1 mg Tube - - -
369 Vitamin B Kompleks Tablet Tablet 1,386 6,800 8,186 2,992 5,194 3000
371 Vitamin B1 Tablet 50 mg Tablet 5,428 5,428 184 5,244
373 Vitamin B12 Tablet 50 mcg Tablet 429 4,000 4,429 998 3,431 1000
374 Vitamin B6 Tablet 10 mg Tablet 2,558 2,000 4,558 2,254 2,304 4000
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
377 Vitamin C Tablet 50 mg Tablet 743 4,000 4,743 2,664 2,079 6000
378 Vitamin K Injeksi 10 mg/ mL Vial - - -
379 Vitamin K Tablet 10 mg Tablet 300 300 300
380 Vitamin K1 Injeksi 2 mg/ mL Ampul 1,030 1,030 1,030
Zidovudin tablet 300 mg + Lamivudine tablet
384 Tablet - - -
150 mg
385 Zinc Tablet 20 mg Tablet 500 500 10 490
381 Anti Diare Non Spesifik Tablet 483 600 1,083 214 869 300
384 Fluocinolone 0,25 mg + Neomisin Sulfat 5 mg Tube 20 20 1 19
387 Levertran Salep Pot 10 10 10
(DHA 32 mg, L-Lysin 200 mg) - - -
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
- - -
5 Alat Suntik Sekali Pakai 3 mL Pcs 439 439 7 432
6 Alat Suntik Sekali Pakai 5 mL Pcs 200 200 200
7 Alkohol 70 % Larutan 100 mL Botol 8 8 3 5 15
11 Catgut 2/0 dengan Jarum Bedah PLAIN Pcs 5 5 5
12 Catgut 3/0 dengan Jarum Bedah PLAIN Pcs - - -
13 Catgut Chromic 2/0 Roll Pcs 1 1 1
14 Catgut Plain 3/0 Roll Pcs - - - 2
22 Infus Set Anak Pcs - - - 100
23 Infus Set Dewasa Pcs 90 90 30 60 100
25 IV Catheter No. 20 G Pcs 50 50 20 30 50
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
26 IV Catheter No. 22 G Pcs 50 50 20 30 50
35 Kasa Hidrofil Steril Ukuran 16 x 16 Pcs 10 10 3 7 5
44 Masker Pcs 100 100 100
47 Plester 5 Yards x 2 Inchi Pcs 6 6 2 4 5
49 Silk No. 3/0 dengan Jarum Bedah Pcs 10 10 10
50 Slide Pcs - - -
52 Urine Bag Pcs - - - 10
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
- - -
9 Etil Klorid Spray Botol - 3 3 2 1 5
11 Glass Ionomer Cement ART Botol - - - 1
12 Kalsium Hidroksida Pasta Botol - - - 1
13 Klorfenol Kamfer Menthol (CHKM) Botol - - - 1
22 Silver Amalgam Serbuk Botol - 2 2 2
24 Temporary Filling Material Botol - - - 1
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
25 Temporary Stopping (Fletcher) serbuk&cairan Botol - - - 1
27 Trikresol Formalin (TKF) Cair Botol - - - 1
- - -
-
1 LYCODRYL DMP SIRUP BTL 14 14 14 - 120
2 ANTI DIARE / NEO KAOMINAL SIRUP BTL 40 40 5 35 10
HANDSCOON non steril M 100 100 100
HANDSCOON non steril S 200 200 100 100
UMUM BPJS JUML

RAWAT JALAN 0
KABUPATEN : KUDUS
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
DAWE DAWE
SUKOLIYONO, SH, MM SIGIT JOKO RIYANTO, SKM DARSONO, SKM RATNA PUSPITASARI, A.Md
NIP. 19631122 199303 1 005 NIP. 19631214 198212 1 001 NIP : 19680312 198903 1 006 NIP. 19830309 200501 2 006
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
KET
16
p. gizi
p. gizi
KET
16
KET
16
KET
16
KET
16
KET
16
(LPLPOPK)

KABUPATEN : KUDUS
PELAPORAN BULAN/ PERIODE : APRIL 2016
PERMINTAAN BULAN/ PERIODE : MEI 2016
NO NAMA OBAT & PERBEKALAN KESEHATAN SATUAN STOK PENERIM PERSEDIA PEMAKAI SISA STOK OPTIMU
AWAL AAN AN AN AAN APBN APBD I APBD II LAIN2 JML
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A SEDIAAN FARMASI
3 Allopurinol Tablet 100 mg Tablet 576 200 776 293 483 800
4 Alopurinol tablet 300 mg Tablet - - - 500
6 Ambroksol Sirup 15 mg/ mL Botol 1 50 51 51
7 Ambroksol Tablet 30 mg Tablet - 1,500 1,500 199 1,301
12 Amlodipin tablet 10 mg Tablet - - - 400
13 Amlodipin Tablet 5 mg Tablet 543 600 1,143 292 851 600
14 Ammonium Bituminosulfonat Salep 10 %/ichtio Pot 6 5 11 11
20 Ampisilin Kaplet 500 mg Tablet 39 2,000 2,039 42 1,997
24 Antasida DOEN I Tablet Kunyah Tablet 2,718 2,000 4,718 2,626 2,092 6500
25 Antasida DOEN II Suspensi Botol 66 60 126 4 122 50
KABUPATEN : KUDUS
M
26 Anti Bakteri DOEN Salep Tube 37 37 12 25 25
27 Anti Fungi DOEN Salep Pot 19 19 4 15 24
28 Anti Haemoroid DOEN Suppositoria Supp 21 10 31 11 20 20
30 Anti Migren Tablet Tablet - - - 200
40 Asam Mefenamat Tablet Salut Selaput 500 mg Tablet 4,920 4,920 410 4,510
41 Asam Nalidixic Tablet 500 mg Tablet - 200 200 200
43 Asam Traneksamat Tablet 500 mg Tablet - - - 100
KABUPATEN : KUDUS
M
60 Bisakodil Suppositoria 10 mg Supp - 6 6 6
62 Bisakodil Tablet 5 mg Tablet 100 100 4 96
70 Deksametason Injeksi 5 mg/ mL Ampul - 100 100 100
75 Diazepam Injeksi 5 mg/ mL Ampul - - -
81 Difenhidramin HCl Injeksi 10 mg/ mL Vial - - - 60
82 Digoksin Tablet 0.25 mg Tablet - 100 100 100
84 Dimenhidrinat Tablet 50 mg Tablet 409 200 609 273 336 500
KABUPATEN : KUDUS
M
86 Domperidone Sirup 5 mg/ 5 mL Botol 4 30 34 2 32
87 Domperidone Tablet 10 mg Tablet 247 200 447 71 376 200
92 Epinefrin/ Adrenalin Injeksi 0,1 % Ampul 95 95 7 88
95 Eritromisin Sirup 200 mg/ 5 mL Botol 29 29 2 27
109 Fenol Gliserol Tetes Telinga 10% Pot - - - 10
111 Furosemid Injeksi 10 mg/ mL Ampul - 25 25 25 20
112 Furosemid Tablet 40 mg Tablet 198 198 26 172 100
114 Garam Oralit Serbuk Sachet 100 100 14 86
KABUPATEN : KUDUS
M
119 Gentamisin Salep Kulit 0.1% Tube 47 47 21 26 50
130 Gliseril Guaiakolat Tablet 100 mg Tablet 4,818 2,000 6,818 4,536 2,282 14000
132 Glukosa larutan infus 10 % Botol - - - 20
133 Glukosa Larutan Infus 40% Botol - - - 10
134 Glukosa Larutan Infus 5 % Botol 20 55 75 35 40 60
140 Hidroklortiazid (HCT) Tablet 25 mg Tablet 75 75 75 - 1000
143 Hiosin Butilbromide Tablet 10 mg Tablet - - - 200
145 Ibuprofen Tablet 200 mg Tablet 689 200 889 132 757 200
KABUPATEN : KUDUS
M
146 Ibuprofen Tablet 400 mg Tablet - - - 300
149 Isoniazid (INH) Tablet 300 mg Tablet 743 500 1,243 356 887 500
150 Isosorbid Dinitrat Tablet Sublingual 5 mg Tablet 200 200 5 195
153 Kalium Permanganat (KMnO4) Pot 20 20 9 11 20
154 Kalsium Glukonas Injeksi 10% Ampul - 2 2 2
157 Kaptopril Tablet 25 mg Tablet 298 1,000 1,298 353 945 500
165 Ketokonazol Tablet 200 mg Tablet 255 255 80 175 100
KABUPATEN : KUDUS
M
177 Kloramfenikol Kapsul 250 mg Kapsul 665 1,000 1,665 459 1,206 500
189 Kodein Tablet 10 mg Tablet - 100 100 100
192 Kotrimoksazol DOEN I Tablet (Dewasa) Tablet 1,739 500 2,239 524 1,715 500
194 Kotrimoksazol
Suspensi komb: Botol 128 100 228 60 168 100
195 Sulfametoksazol 200 mg + Trimetoprim 40 mg Botol - - -
196 /Kuinin
5 ml Injeksi 25% Ampul - - -
200 Lidokain Injeksi 2% Ampul 40 40 20 20 100
201 Lidokain Injeksi 2% + Epinefrin 1 : 80.000 Ampul 20 40 60 20 40 80
KABUPATEN : KUDUS
M
206 Loratadin Tablet 10 mg Tablet 488 488 111 377 200
207 Magnesium Sulfat Injeksi 20% Ampul - 2 2 2 -
217 Meloksikam Tablet 7.5 mg Tablet - - - 100
219 Metampiron Tablet 500 mg Tablet 3,924 6,000 9,924 3,365 6,559 3000
222 Metil Ergometrine Maleat Injeksi 0,2 mg/ mL Ampul - - - 2
225 Metil Prednisolon Tablet 8 mg Tablet 500 500 48 452
230 Metoklopramide tablet 5 mg Tablet 500 500 77 423
233 Metronidazol Tablet 500 mg Tablet 536 300 836 466 370 1200
234 Mikonazole Krim 2 % Tube 21 21 4 17 25
KABUPATEN : KUDUS
M
242 Natrium Diklofenak Tablet 50 mg Tablet 727 500 1,227 560 667 1000
243 Natrium Klorida (NaCl) Larutan Infus 0,9% Botol 10 40 50 50 40
246 Nifedipin Tablet 10 mg Tablet - - - 100
258 Obat Batuk Hitam (OBH) ; 100 mL Botol 155 150 305 248 57 850
264 Oksitosin Injeksi 10 IU/ mL Ampul 20 10 30 30 - 200
265 Omeprazol Kapsul 20 mg Kapsul 780 300 1,080 316 764 300
KABUPATEN : KUDUS
M
266 Ondansetron Injeksi 4 mg/2 mL Ampul - 20 20 20
267 Ondansetron Tablet 4 mg Tablet - - - 200
270 Papaverin Tablet 40 mg Tablet 436 100 536 222 314 600
273 Parasetamol Sirup 120 mg/5 mL Botol 150 168 318 149 169 260
284 Pirantel Pamoat Tablet 125 mg Tablet 50 50 2 48
287 Pirazinamid Tablet 500 mg Tablet 434 100 534 35 499
289 Piroksikam Tablet 20 mg Tablet 755 300 1,055 394 661 300
294 Povidon Iodida larutan 10%; 60 mL Botol - - - 10
KABUPATEN : KUDUS
M
296 Prednison Tablet 5 mg Tablet 2,960 3,000 5,960 2,328 3,632 3000
305 Ranitidin Tablet 150 mg Tablet 600 1,000 1,600 490 1,110 1000
311 Ringer Laktat (RL) Larutan Infus Botol 280 260 540 220 320 240
315 Salbutamol Tablet 2 mg Tablet 400 300 700 206 494 300
317 Salep 2-4 Pot 20 24 44 9 35
322 Sefadroksil Suspensi Kering 125 mg/ 5 mg Botol 25 50 75 8 67
KABUPATEN : KUDUS
M
329 Sefotaksim Serbuk Injeksi 0,5 g/ Vial Vial - - - 20
330 Sefotaksim Serbuk Injeksi 1 g/ Vial Vial - - - 20
333 Serum ABU I Vial 1 1 1 -
334 Serum ATS 1500 IU Ampul - - - 3
341 Siprofloksasin Tablet 500 mg Tablet 238 1,000 1,238 479 759 500
350 Tetrasiklin Kapsul 500 mg Kapsul 192 500 692 70 622
KABUPATEN : KUDUS
M
369 Vitamin B Kompleks Tablet Tablet 5,194 6,800 11,994 3,422 8,572 6000
373 Vitamin B12 Tablet 50 mcg Tablet 3,431 1,000 4,431 877 3,554 1000
374 Vitamin B6 Tablet 10 mg Tablet 2,304 3,000 5,304 1,940 3,364 3000
377 Vitamin C Tablet 50 mg Tablet 2,079 3,000 5,079 3,035 2,044 9000
379 Vitamin K Tablet 10 mg Tablet 300 300 300 - 1000
380 Vitamin K1 Injeksi 2 mg/ mL Ampul 1,030 1,030 1,030
Zidovudin tablet 300 mg + Lamivudine tablet
384 Tablet - - -
150 mg
KABUPATEN : KUDUS
M
381 Anti Diare Non Spesifik Tablet 869 300 1,169 321 848 750
384 Fluocinolone 0,25 mg + Neomisin Sulfat 5 mg Tube 19 19 5 14 20
387 Levertran Salep Pot 10 10 3 7 5
388 Multivitamin Kombinasi Kaplet Tablet - 500 500 500
(DHA 32 mg, L-Lysin 200 mg) - - -
- - -
7 Alkohol 70 % Larutan 100 mL Botol 5 5 3 2 15
11 Catgut 2/0 dengan Jarum Bedah PLAIN Pcs 5 5 2 3 20
KABUPATEN : KUDUS
M
13 Catgut Chromic 2/0 Roll Pcs 1 1 1 - 2
22 Infus Set Anak Pcs - 100 100 100
23 Infus Set Dewasa Pcs 60 60 60 - 300
25 IV Catheter No. 20 G Pcs 30 30 30 - 100
26 IV Catheter No. 22 G Pcs 30 30 30 - 100
34 Kapas 250 gram Pcs 10 10 1 9
35 Kasa Hidrofil Steril Ukuran 16 x 16 Pcs 7 10 17 17
37 Kasa Pembalut 2 m X 80 cm Pcs 20 20 7 13
KABUPATEN : KUDUS
M
44 Masker Pcs 100 100 100 100
47 Plester 5 Yards x 2 Inchi Pcs 4 6 10 2 8
48 Silk No. 3/0 (Roll) Pcs - - - 2
49 Silk No. 3/0 dengan Jarum Bedah Pcs 10 10 10 - 50
50 Slide Pcs - - -
52 Urine Bag Pcs - 10 10 10
- - -
9 Etil Klorid Spray Botol 1 2 3 3
11 Glass Ionomer Cement ART Botol - 1 1 1 -
12 Kalsium Hidroksida Pasta Botol - 1 1 1 -
13 Klorfenol Kamfer Menthol (CHKM) Botol - 1 1 1 -
KABUPATEN : KUDUS
M
22 Silver Amalgam Serbuk Botol 2 2 2 -
24 Temporary Filling Material Botol - 1 1 1 -
25 Temporary Stopping (Fletcher) serbuk&cairan Botol - 1 1 1 -
- - -
-
1 LYCODRYL DMP SIRUP BTL - - - 120
HANDSCOON non steril M 100 100 100 - 400
HANDSCOON non steril S 100 100 100 - 400
UMUM BPJS JUML

KABUPATEN : KUDUS
M
RAWAT JALAN 0
DAWE DAWE
NIP. 19631122 199303 1 005 NIP. 19631214 198212 1 001 NIP : 19680312 198903 1 006 NIP. 19830309 200501 2 006
KET
16
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
p. gizi
p. gizi
KET
KET
KET
KET
(LPLPOPK)

KABUPATEN : KUDUS
PELAPORAN BULAN/ PERIODE : MEI 2016
PERMINTAAN BULAN/ PERIODE : JUNI 2016
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
A SEDIAAN FARMASI
3 Allopurinol Tablet 100 mg Tablet 483 800 1,283 400 883
6 Ambroksol Sirup 15 mg/ mL Botol 51 51 51 -
7 Ambroksol Tablet 30 mg Tablet 1,301 1,301 701 600
8 Aminofilin Injeksi 24 mg/mL Ampul 60 60 30 30
13 Amlodipin Tablet 5 mg Tablet 851 600 1,451 341 1,110
14 Ammonium Bituminosulfonat Salep 10 %/ichtiol Pot 11 11 1 10
17 Amoksisilin Kapsul 500 mg Kapsul 4,124 20,000 24,124 4,023 20,101
19 Amoksisilin Suspensi Kering 125 mg/ 5 mL Botol 208 600 808 197 611
20 Ampisilin Kaplet 500 mg Tablet 1,997 1,997 1,252 745
21 Ampisilin Serbuk Injeksi 1000 mg/ Vial Vial 440 440 30 410
24 Antasida DOEN I Tablet Kunyah Tablet 2,092 5,000 7,092 3,008 4,084
25 Antasida DOEN II Suspensi Botol 122 122 11 111
26 Anti Bakteri DOEN Salep Tube 25 50 75 2 73
KABUPATEN : KUDUS
M
27 Anti Fungi DOEN Salep Pot 15 24 39 2 37
28 Anti Haemoroid DOEN Suppositoria Supp 20 20 40 40
40 Asam Mefenamat Tablet Salut Selaput 500 mg Tablet 4,510 4,510 780 3,730
41 Asam Nalidixic Tablet 500 mg Tablet 200 200 200
KABUPATEN : KUDUS
M
58 Betahistin Mesilat tablet 6 mg Tablet - - -
60 Bisakodil Suppositoria 10 mg Supp 6 6 6
70 Deksametason Injeksi 5 mg/ mL Ampul 100 100 10 90
71 Deksametason Tablet 0.5 mg Tablet 5,050 12,000 17,050 2,380 14,670
82 Digoksin Tablet 0.25 mg Tablet 100 100 100
84 Dimenhidrinat Tablet 50 mg Tablet 336 500 836 136 700
KABUPATEN : KUDUS
M
92 Epinefrin/ Adrenalin Injeksi 0,1 % Ampul 88 88 78 10
111 Furosemid Injeksi 10 mg/ mL Ampul 25 25 50 25 25
112 Furosemid Tablet 40 mg Tablet 172 100 272 272
KABUPATEN : KUDUS
M
119 Gentamisin Salep Kulit 0.1% Tube 26 26 20 6
130 Gliseril Guaiakolat Tablet 100 mg Tablet 2,282 14,000 16,282 3,254 13,028
134 Glukosa Larutan Infus 5 % Botol 40 60 100 20 80
140 Hidroklortiazid (HCT) Tablet 25 mg Tablet - - -
141 Hidrokortison Krim 1 % Tube - - -
142 Hidrokortison Krim 2,5 % Tube - - -
145 Ibuprofen Tablet 200 mg Tablet 757 500 1,257 40 1,217
KABUPATEN : KUDUS
M
149 Isoniazid (INH) Tablet 300 mg Tablet 887 500 1,387 1,387
153 Kalium Permanganat (KMnO4) Pot 11 20 31 31
154 Kalsium Glukonas Injeksi 10% Ampul 2 2 2
155 Kalsium Laktat Tablet 500 mg Tablet 2,064 3,000 5,064 729 4,335
157 Kaptopril Tablet 25 mg Tablet 945 500 1,445 207 1,238
165 Ketokonazol Tablet 200 mg Tablet 175 100 275 175 100
169 Ketorolac injeksi 30 mg Ampul 12 12 5 7
KABUPATEN : KUDUS
M
177 Kloramfenikol Kapsul 250 mg Kapsul 1,206 1,000 2,206 386 1,820
178 Kloramfenikol Salep Mata 1 % Tube 85 24 109 16 93
181 Kloramfenikol Tetes Telinga 3% Botol 42 24 66 12 54
182 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet - - -
189 Kodein Tablet 10 mg Tablet 100 100 100
192 Kotrimoksazol DOEN I Tablet (Dewasa) Tablet 1,715 500 2,215 433 1,782
194 Kotrimoksazol Suspensi Botol 168 100 268 15 253
Kotrimoksazol Suspensi komb: Sulfametoksazol
195 Botol - - -
200 mg + Trimetoprim 40 mg / 5 ml
200 Lidokain Injeksi 2% Ampul 20 20 20 -
201 Lidokain Injeksi 2% + Epinefrin 1 : 80.000 Ampul 40 40 30 10
206 Loratadin Tablet 10 mg Tablet 377 377 377 -
KABUPATEN : KUDUS
M
219 Metampiron Tablet 500 mg Tablet 6,559 3,000 9,559 222 9,337
220 Metformin HCl Tablet 500 mg Tablet - - -
225 Metil Prednisolon Tablet 8 mg Tablet 452 452 10 442
233 Metronidazol Tablet 500 mg Tablet 370 1,200 1,570 120 1,450
KABUPATEN : KUDUS
M
242 Natrium Diklofenak Tablet 50 mg Tablet 667 1,000 1,667 417 1,250
243 Natrium Klorida (NaCl) Larutan Infus 0,9% Botol 50 40 90 10 80
258 Obat Batuk Hitam (OBH) ; 100 mL Botol 57 750 807 33 774
262 Oksitetrasiklin Salep Kulit 3% Tube - - -
264 Oksitosin Injeksi 10 IU/ mL Ampul - - -
265 Omeprazol Kapsul 20 mg Kapsul 764 300 1,064 314 750
266 Ondansetron Injeksi 4 mg/2 mL Ampul 20 20 10 10
KABUPATEN : KUDUS
M
270 Papaverin Tablet 40 mg Tablet 314 1,000 1,314 164 1,150
275 Parasetamol Tablet 500 mg Tablet 8,703 21,000 29,703 6,086 23,617
287 Pirazinamid Tablet 500 mg Tablet 499 499 499
289 Piroksikam Tablet 20 mg Tablet 661 661 111 550
296 Prednison Tablet 5 mg Tablet 3,632 3,632 2,532 1,100
KABUPATEN : KUDUS
M
305 Ranitidin Tablet 150 mg Tablet 1,110 1,000 2,110 610 1,500
310 Rifampisin Kapsul Salut 450 mg Kapsul 521 300 821 321 500
311 Ringer Laktat (RL) Larutan Infus Botol 320 500 820 140 680
317 Salep 2-4 Pot 35 35 17 18
KABUPATEN : KUDUS
M
333 Serum ABU I Vial - - -
334 Serum ATS 1500 IU Ampul - - -
335 Simetidine Tablet 200 mg Tablet - - -
341 Siprofloksasin Tablet 500 mg Tablet 759 500 1,259 559 700
347 Tambah Darah Tablet Kombinasi Sachet - - -
KABUPATEN : KUDUS
M
369 Vitamin B Kompleks Tablet Tablet 8,572 6,800 15,372 2,010 13,362
371 Vitamin B1 Tablet 50 mg Tablet 1,344 13,000 14,344 872 13,472
372 Vitamin B12 Injeksi 500 mcg Ampul 172 172 172
373 Vitamin B12 Tablet 50 mcg Tablet 3,554 1,000 4,554 686 3,868
374 Vitamin B6 Tablet 10 mg Tablet 3,364 3,000 6,364 873 5,491
377 Vitamin C Tablet 50 mg Tablet 2,044 7,000 9,044 1,385 7,659
379 Vitamin K Tablet 10 mg Tablet - 1,000 1,000 1,000
380 Vitamin K1 Injeksi 2 mg/ mL Ampul 1,030 1,030 1,030 -
Zidovudin tablet 300 mg + Lamivudine tablet 150
384 Tablet - - -
mg
381 Anti Diare Non Spesifik Tablet 848 750 1,598 198 1,400
KABUPATEN : KUDUS
M
382 Anti Flu Kombinasi Kaplet Tablet - - -
383 Anti Flu Kombinasi Sirup Botol - - -
387 Levertran Salep Pot 7 10 17 17
388 Multivitamin Kombinasi Kaplet Tablet 500 500 1,000 30 970
389 Multivitamin Kombinasi Sirup Botol - - -
(DHA 32 mg, L-Lysin 200 mg) - - -
- - -
7 Alkohol 70 % Larutan 100 mL Botol 2 2 2
8 Alkohol 70 % Larutan 1000 mL Botol - - -
10 Aqua Pro Injection ; 20 mL Vial 20 20 8 12
11 Catgut 2/0 dengan Jarum Bedah PLAIN Pcs 3 3 3 -
13 Catgut Chromic 2/0 Roll Pcs - - -
KABUPATEN : KUDUS
M
18 Handscoon No. 7.5 (Steril) Pcs - - -
20 Handscoon No.7 (Steril) Pcs - - -
22 Infus Set Anak Pcs 100 100 20 80
23 Infus Set Dewasa Pcs - - -
24 IV Catheter No. 18 G Pcs - - -
35 Kasa Hidrofil Steril Ukuran 16 x 16 Pcs 17 17 17
KABUPATEN : KUDUS
M
44 Masker Pcs 100 100 100
47 Plester 5 Yards x 2 Inchi Pcs 8 8 8 -
49 Silk No. 3/0 dengan Jarum Bedah Pcs - - -
50 Slide Pcs - - -
51 Transfusi Set Pcs - - -
52 Urine Bag Pcs 10 10 10
- - -
9 Etil Klorid Spray Botol 3 5 8 8
KABUPATEN : KUDUS
M
22 Silver Amalgam Serbuk Botol - - -
- - -
-
1 LYCODRYL DMP SIRUP BTL - - -
2 ANTI DIARE / NEO KAOMINAL SIRUP BTL 30 30 30
4 FLUTOP C syrup BTL - - -
6 HANDSCOON non steril M - - -
7 HANDSCOON non steril S - - -
8 TES YODIUM - 102 102 102 -
UMUM BPJS JUML

KABUPATEN : KUDUS
M
RAWAT JALAN
JUMLAH KUNJUNGAN INAP
JUMLAH KUNJUNGAN PONED
DAWE DAWE
NIP. 19631122 199303 1 005 NIP. 19631214 198212 1 001 NIP : 19680312 198903 1 006 NIP. 19830309 200501 2 006
KET
16
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
KET
poned
KET
KET
KET
KET
gizi
(LPLPOPK)

KABUPATEN : KUDUS
PELAPORAN BULAN/ PERIODE : JUNI 2016
PERMINTAAN BULAN/ PERIODE : JULI 2016
NO NAMA OBAT & PERBEKALAN KESEHATAN SATUAN AWAL AAN AN AN AAN APBN APBD I APBD II LAIN2
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14
A SEDIAAN FARMASI
6 Ambroksol Sirup 15 mg/ mL Botol - - -
7 Ambroksol Tablet 30 mg Tablet 600 600 600 -
13 Amlodipin Tablet 5 mg Tablet 1,110 1,110 240 870 *
14 Ammonium Bituminosulfonat Salep 10 %/ichtiol Pot 10 10 10
19 Amoksisilin Suspensi Kering 125 mg/ 5 mL Botol 611 611 156 455
20 Ampisilin Kaplet 500 mg Tablet 745 745 567 178 500
24 Antasida DOEN I Tablet Kunyah Tablet 4,084 4,084 1,603 2,481 2000
KABUPATEN : KUDUS
STOK STOK PERMINT
PENERIM PERSEDIA PEMAKAI SISA STOK OPTIMU PEMBERIAN
M
27 Anti Fungi DOEN Salep Pot 37 37 2 35
28 Anti Haemoroid DOEN Suppositoria Supp 40 40 40
40 Asam Mefenamat Tablet Salut Selaput 500 mg Tablet 3,730 3,730 3,730 - *
47 Asiklovir Krim 5 % Tube 64 64 7 57
KABUPATEN : KUDUS
STOK STOK PERMINT
M
69 Dapson tablet 100 mg Tablet - - - 100
70 Deksametason Injeksi 5 mg/ mL Ampul 90 90 90
71 Deksametason Tablet 0.5 mg Tablet 14,670 14,670 6,853 7,817 6000
82 Digoksin Tablet 0.25 mg Tablet 100 100 100
84 Dimenhidrinat Tablet 50 mg Tablet 700 700 50 650
KABUPATEN : KUDUS
STOK STOK PERMINT
M
87 Domperidone Tablet 10 mg Tablet 400 400 400
92 Epinefrin/ Adrenalin Injeksi 0,1 % Ampul 10 10 10
106 Fenobarbital Tablet 30 mg Tablet 77 77 10 67
111 Furosemid Injeksi 10 mg/ mL Ampul 25 25 25
112 Furosemid Tablet 40 mg Tablet 272 272 62 210
113 Gameksan Salep 1% / scabimit Pot 10 10 10 - 30
114 Garam Oralit Serbuk Sachet 86 86 20 66
KABUPATEN : KUDUS
STOK STOK PERMINT
M
119 Gentamisin Salep Kulit 0.1% Tube 6 6 6 - 25
123 Glibenkamid Tablet 5 mg Tablet 900 900 100 800
130 Gliseril Guaiakolat Tablet 100 mg Tablet 13,028 13,028 1,912 11,116 8000
134 Glukosa Larutan Infus 5 % Botol 80 80 80
145 Ibuprofen Tablet 200 mg Tablet 1,217 1,217 17 1,200
KABUPATEN : KUDUS
STOK STOK PERMINT
M
149 Isoniazid (INH) Tablet 300 mg Tablet 1,387 1,387 137 1,250
155 Kalsium Laktat Tablet 500 mg Tablet 4,335 4,335 804 3,531
157 Kaptopril Tablet 25 mg Tablet 1,238 1,238 338 900 500
165 Ketokonazol Tablet 200 mg Tablet 100 100 100 - 300
KABUPATEN : KUDUS
STOK STOK PERMINT
M
177 Kloramfenikol Kapsul 250 mg Kapsul 1,820 1,820 220 1,600
178 Kloramfenikol Salep Mata 1 % Tube 93 93 32 61 24
181 Kloramfenikol Tetes Telinga 3% Botol 54 54 9 45
192 Kotrimoksazol DOEN I Tablet (Dewasa) Tablet 1,782 1,782 254 1,528
194 Kotrimoksazol Suspensi Botol 253 253 84 169
Kotrimoksazol Suspensi komb: Sulfametoksazol
195 Botol - - -
200 mg + Trimetoprim 40 mg / 5 ml
200 Lidokain Injeksi 2% Ampul - - - 100
205 Loperamid Tablet 2 mg Tablet 540 540 40 500
KABUPATEN : KUDUS
STOK STOK PERMINT
M
219 Metampiron Tablet 500 mg Tablet 9,337 9,337 522 8,815
225 Metil Prednisolon Tablet 8 mg Tablet 442 442 442
230 Metoklopramide tablet 5 mg Tablet 423 423 23 400
233 Metronidazol Tablet 500 mg Tablet 1,450 1,450 400 1,050 300
KABUPATEN : KUDUS
STOK STOK PERMINT
M
242 Natrium Diklofenak Tablet 50 mg Tablet 1,250 1,250 1,000 250 1500
243 Natrium Klorida (NaCl) Larutan Infus 0,9% Botol 80 80 80
258 Obat Batuk Hitam (OBH) ; 100 mL Botol 774 774 145 629
264 Oksitosin Injeksi 10 IU/ mL Ampul - - - 100
265 Omeprazol Kapsul 20 mg Kapsul 750 750 180 570
KABUPATEN : KUDUS
STOK STOK PERMINT
M
266 Ondansetron Injeksi 4 mg/2 mL Ampul 10 10 10
270 Papaverin Tablet 40 mg Tablet 1,150 1,150 150 1,000
275 Parasetamol Tablet 500 mg Tablet 23,617 23,617 7,795 15,822 5000
287 Pirazinamid Tablet 500 mg Tablet 499 499 99 400
289 Piroksikam Tablet 20 mg Tablet 550 550 350 200 500
KABUPATEN : KUDUS
STOK STOK PERMINT
M
296 Prednison Tablet 5 mg Tablet 1,100 1,100 1,100 - 2000
304 Ranitidin Injeksi 25 mg/ 2 mL Ampul - - - 60
305 Ranitidin Tablet 150 mg Tablet 1,500 1,500 600 900 500
310 Rifampisin Kapsul Salut 450 mg Kapsul 500 500 250 250 500
315 Salbutamol Tablet 2 mg Tablet 700 700 150 550
317 Salep 2-4 Pot 18 18 6 12 24
319 Salisil Bedak 2 % ; 50 gram Pot 48 48 4 44
KABUPATEN : KUDUS
STOK STOK PERMINT
M
333 Serum ABU I Vial - - - 1
334 Serum ATS 1500 IU Ampul - - - 3
336 Simvastatin Tablet 10 mg Tablet 400 400 100 300
341 Siprofloksasin Tablet 500 mg Tablet 700 700 700 - 1500
353 Tramadol Injeksi 50 mg/ mL Ampul 20 20 10 10
KABUPATEN : KUDUS
STOK STOK PERMINT
M
369 Vitamin B Kompleks Tablet Tablet 13,362 13,362 2,431 10,931
371 Vitamin B1 Tablet 50 mg Tablet 13,472 13,472 1,084 12,388
373 Vitamin B12 Tablet 50 mcg Tablet 3,868 3,868 1,052 2,816 1000
377 Vitamin C Tablet 50 mg Tablet 7,659 7,659 1,178 6,481
379 Vitamin K Tablet 10 mg Tablet 1,000 1,000 40 960
380 Vitamin K1 Injeksi 2 mg/ mL Ampul - - -
Zidovudin tablet 300 mg + Lamivudine tablet 150
384 Tablet - - -
mg
KABUPATEN : KUDUS
STOK STOK PERMINT
M
381 Anti Diare Non Spesifik Tablet 1,400 1,400 362 1,038 600
382 Anti Flu Kombinasi Kaplet Tablet - - -
383 Anti Flu Kombinasi Sirup Botol - - -
388 Multivitamin Kombinasi Kaplet Tablet 970 970 20 950
(DHA 32 mg, L-Lysin 200 mg) - - -
- - -
7 Alkohol 70 % Larutan 100 mL Botol 2 2 2 - 20
KABUPATEN : KUDUS
STOK STOK PERMINT
M
13 Catgut Chromic 2/0 Roll Pcs - - - 1
22 Infus Set Anak Pcs 80 80 80
23 Infus Set Dewasa Pcs - - - 200
KABUPATEN : KUDUS
STOK STOK PERMINT
M
44 Masker Pcs 100 100 100
47 Plester 5 Yards x 2 Inchi Pcs - - - 6
48 Silk No. 3/0 (Roll) Pcs - - - 1
49 Silk No. 3/0 dengan Jarum Bedah Pcs - - - 10
50 Slide Pcs - - -
- - -
9 Etil Klorid Spray Botol 8 8 8
KABUPATEN : KUDUS
STOK STOK PERMINT
M
- - -
-
4 FLUTOP C syrup BTL - - -
8 TES YODIUM - - -
UMUM BPJS JUML

KABUPATEN : KUDUS
STOK STOK PERMINT
M
RAWAT JALAN
DAWE DAWE
SUKOLIYONO, SH, MM SIGIT JOKO RIYANTO, SKM DARSONO, SKM.MM RATNA PUSPITASARI, A.Md
NIP. 19631122 199303 1 005 NIP. 19631214 198212 1 001 NIP : 19680312 198903 1 006 NIP. 19830309 200501 2 006
PEMBERIAN
KET
JML
15 16
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
poned
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PENGELOLA OBAT PUSKESMAS

DAWE
RATNA PUSPITASARI, A.Md

NIP. 19830309 200501 2 006
(LPLPOPK)

KABUPATEN : KUDUS
PELAPORAN BULAN/ PERIODE : JULI 2016
PERMINTAAN BULAN/ PERIODE : AGUSTUS 2016
M
1 2 3 4 5 6 7 8 9 10 11 12 13 14
A SEDIAAN FARMASI
6 Ambroksol Sirup 15 mg/ mL Botol - - -
7 Ambroksol Tablet 30 mg Tablet - - -
13 Amlodipin Tablet 5 mg Tablet 870 870 379 491 500
14 Ammonium Bituminosulfonat Salep 10 %/ichtiol Pot 10 10 10
19 Amoksisilin Suspensi Kering 125 mg/ 5 mL Botol 455 455 132 323 60
20 Ampisilin Kaplet 500 mg Tablet 178 1,000 1,178 1,178
24 Antasida DOEN I Tablet Kunyah Tablet 2,481 2,000 4,481 1,537 2,944 1000
KABUPATEN : KUDUS
M
27 Anti Fungi DOEN Salep Pot 35 35 35
28 Anti Haemoroid DOEN Suppositoria Supp 40 40 3 37
40 Asam Mefenamat Tablet Salut Selaput 500 mg Tablet - 4,500 4,500 706 3,794
47 Asiklovir Krim 5 % Tube 57 57 5 52
49 Asiklovir Tablet 400 mg Tablet 170 100 270 75 195 200
KABUPATEN : KUDUS
M
62 Bisakodil Tablet 5 mg Tablet 96 96 8 88
70 Deksametason Injeksi 5 mg/ mL Ampul 90 90 90
82 Digoksin Tablet 0.25 mg Tablet 100 100 20 80
84 Dimenhidrinat Tablet 50 mg Tablet 650 650 169 481
KABUPATEN : KUDUS
M
86 Domperidone Sirup 5 mg/ 5 mL Botol 24 24 24
92 Epinefrin/ Adrenalin Injeksi 0,1 % Ampul 10 10 10
106 Fenobarbital Tablet 30 mg Tablet 67 67 10 57
111 Furosemid Injeksi 10 mg/ mL Ampul 25 25 25 -
112 Furosemid Tablet 40 mg Tablet 210 210 210
113 Gameksan Salep 1% / scabimit Pot - - -
KABUPATEN : KUDUS
M
119 Gentamisin Salep Kulit 0.1% Tube - - - 50
123 Glibenkamid Tablet 5 mg Tablet 800 800 172 628
124 Glimepirid Tablet 1 mg Tablet 320 320 170 150 400
130 Gliseril Guaiakolat Tablet 100 mg Tablet 11,116 11,116 2,279 8,837
134 Glukosa Larutan Infus 5 % Botol 80 80 60 20
145 Ibuprofen Tablet 200 mg Tablet 1,200 1,200 1,200
KABUPATEN : KUDUS
M
149 Isoniazid (INH) Tablet 300 mg Tablet 1,250 1,250 282 968
150 Isosorbid Dinitrat Tablet Sublingual 5 mg Tablet 150 150 49 101 100
153 Kalium Permanganat (KMnO4) Pot 31 31 8 23
155 Kalsium Laktat Tablet 500 mg Tablet 3,531 3,531 912 2,619 1000
157 Kaptopril Tablet 25 mg Tablet 900 500 1,400 246 1,154
163 Ketokonazol Krim 2% ; 10 gram Tube 10 25 35 13 22 25
165 Ketokonazol Tablet 200 mg Tablet - 300 300 75 225
KABUPATEN : KUDUS
M
177 Kloramfenikol Kapsul 250 mg Kapsul 1,600 1,600 70 1,530
181 Kloramfenikol Tetes Telinga 3% Botol 45 45 15 30 24
182 Klorfeniramin Maleat (CTM) Tablet 4 mg Tablet - - -
192 Kotrimoksazol DOEN I Tablet (Dewasa) Tablet 1,528 1,528 463 1,065 1000
194 Kotrimoksazol Suspensi Botol 169 169 30 139
Kotrimoksazol Suspensi komb: Sulfametoksazol 200
195 Botol - - -
mg + Trimetoprim 40 mg / 5 ml
200 Lidokain Injeksi 2% Ampul - - - 100
205 Loperamid Tablet 2 mg Tablet 500 500 110 390
KABUPATEN : KUDUS
M
206 Loratadin Tablet 10 mg Tablet - - - 500
219 Metampiron Tablet 500 mg Tablet 8,815 8,815 1,440 7,375
220 Metformin HCl Tablet 500 mg Tablet - - -
225 Metil Prednisolon Tablet 8 mg Tablet 442 442 442 - 1000
233 Metronidazol Tablet 500 mg Tablet 1,050 300 1,350 309 1,041
KABUPATEN : KUDUS
M
242 Natrium Diklofenak Tablet 50 mg Tablet 250 2,000 2,250 596 1,654 1000
243 Natrium Klorida (NaCl) Larutan Infus 0,9% Botol 80 80 80
258 Obat Batuk Hitam (OBH) ; 100 mL Botol 629 629 85 544
264 Oksitosin Injeksi 10 IU/ mL Ampul - - - 100
265 Omeprazol Kapsul 20 mg Kapsul 570 570 409 161 1000
KABUPATEN : KUDUS
M
266 Ondansetron Injeksi 4 mg/2 mL Ampul 10 10 10
270 Papaverin Tablet 40 mg Tablet 1,000 1,000 142 858
284 Pirantel Pamoat Tablet 125 mg Tablet 48 48 10 38
287 Pirazinamid Tablet 500 mg Tablet 400 400 23 377
289 Piroksikam Tablet 20 mg Tablet 200 200 200 - 500
KABUPATEN : KUDUS
M
296 Prednison Tablet 5 mg Tablet - - - 1000
304 Ranitidin Injeksi 25 mg/ 2 mL Ampul - - - 60
317 Salep 2-4 Pot 12 24 36 7 29
319 Salisil Bedak 2 % ; 50 gram Pot 44 44 8 36
KABUPATEN : KUDUS
M
333 Serum ABU I Vial - - -
334 Serum ATS 1500 IU Ampul - - -
335 Simetidine Tablet 200 mg Tablet - - -
336 Simvastatin Tablet 10 mg Tablet 300 300 34 266
341 Siprofloksasin Tablet 500 mg Tablet - 1,500 1,500 52 1,448
KABUPATEN : KUDUS
M
369 Vitamin B Kompleks Tablet Tablet 10,931 10,931 2,078 8,853
371 Vitamin B1 Tablet 50 mg Tablet 12,388 12,388 12,388
372 Vitamin B12 Injeksi 500 mcg Ampul 162 162 162
373 Vitamin B12 Tablet 50 mcg Tablet 2,816 1,000 3,816 928 2,888 1000
374 Vitamin B6 Tablet 10 mg Tablet 3,307 2,000 5,307 1,075 4,232
377 Vitamin C Tablet 50 mg Tablet 6,481 6,481 1,637 4,844
379 Vitamin K Tablet 10 mg Tablet 960 960 960
380 Vitamin K1 Injeksi 2 mg/ mL Ampul - - -
KABUPATEN : KUDUS
M
381 Anti Diare Non Spesifik Tablet 1,038 600 1,638 164 1,474 300
385 Gameksan + Asam Usnat Salep Tube - - - 25
388 Multivitamin Kombinasi Kaplet Tablet 950 950 950
389 Multivitamin Kombinasi Sirup Botol - - -
(DHA 32 mg, L-Lysin 200 mg) - - -
- - -
10 Aqua Pro Injection ; 20 mL Vial 12 12 3 9
KABUPATEN : KUDUS
M
13 Catgut Chromic 2/0 Roll Pcs - - - 3
22 Infus Set Anak Pcs 80 80 80
23 Infus Set Dewasa Pcs - - - 300
27 IV Catheter No. 24 G Pcs 50 50 50 -
42 Kasa Pembalut Hidrofil 4 m x 5 cm Pcs 100 100 10 90
KABUPATEN : KUDUS
M
44 Masker Pcs 100 100 100
47 Plester 5 Yards x 2 Inchi Pcs - 6 6 2 4
48 Silk No. 3/0 (Roll) Pcs - - - 3
49 Silk No. 3/0 dengan Jarum Bedah Pcs - - -
50 Slide Pcs - - -
- - -
9 Etil Klorid Spray Botol 8 8 8
KABUPATEN : KUDUS
M
- - -
-
8 TES YODIUM - - -
UMUM BPJS JUML

KABUPATEN : KUDUS
M
RAWAT JALAN
DAWE DAWE
SUKOLIYONO, SH, MM SIGIT JOKO RIYANTO, SKM DARSONO, SKM.MM RATNA PUSPITASARI, A.Md
NIP. 19631122 199303 1 005 NIP. 19631214 198212 1 001 NIP : 19680312 198903 1 006 NIP. 19830309 200501 2 006
PEMBERIAN
KET
JML
15 16
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
poned
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PEMBERIAN
KET
JML
PENGELOLA OBAT PUSKESMAS

DAWE
RATNA PUSPITASARI, A.Md

NIP. 19830309 200501 2 006
PENERIMAAN TAHUN 2016 DARI IFK
NO NAMA OBAT & PERBEKALAN KESEHATAN JAN FEB MAR APR
1 2 3 4 5 6
A SEDIAAN FARMASI
1 Albendazol suspensi 200 mg/5 ml - - - -
2 Albendazol Tablet 400 mg - - - -
3 Allopurinol Tablet 100 mg 500 - 800 200
4 Alopurinol tablet 300 mg - - - -
5 Alprazolam Tablet 0.50 mg - - - -
6 Ambroksol Sirup 15 mg/ mL 50 - - 50
7 Ambroksol Tablet 30 mg 500 - 600 1,500
8 Aminofilin Injeksi 24 mg/mL - 60 - -
9 Aminofilin tablet 150 mg - - - -
10 Aminofilin Tablet 200 mg 2,000 - - -
11 Amitriptilin Tablet Salut 25 mg - - - -
12 Amlodipin tablet 10 mg - - - -
13 Amlodipin Tablet 5 mg 600 300 600 600
14 Ammonium Bituminosulfonat Salep 10 %/ichtiol 10 - - 5
15 Amoksisilin + As. Klavulanat 625 mg tablet - - - -
16 Amoksisilin Kapsul 250 mg - - - -
17 Amoksisilin Kapsul 500 mg 10,000 - 15,000 -
18 Amoksisilin serbuk injeksi 1000 mg - - - -
19 Amoksisilin Suspensi Kering 125 mg/ 5 mL 120 160 120 360
20 Ampisilin Kaplet 500 mg - 1,000 - 2,000
21 Ampisilin Serbuk Injeksi 1000 mg/ Vial - - - -
22 Ampisilin Serbuk Injeksi 500 mg/ Vial - - - -
23 Ampisilin Suspensi Kering 125 mg/ 5 mL - - - -
24 Antasida DOEN I Tablet Kunyah 5,000 - - 2,000
25 Antasida DOEN II Suspensi 50 - 60 60
26 Anti Bakteri DOEN Salep 50 - - -
27 Anti Fungi DOEN Salep 24 - - -
28 Anti Haemoroid DOEN Suppositoria 20 - 20 10
29 Anti Malaria DOEN - - - -
30 Anti Migren Tablet - - - -
31 Artemisin + Piperaquin (DHP) - - - -
32 Arterakine Tablet - - - -
33 Artermeter Injeksi 80 mg/ mL - - - -
34 Artesunate + Amodiaquin Injeksi - - - -
35 Artesunate Injeksi 60 mg/ mL - - - -
36 Artesunate Tablet - - - -
37 Asam Folat Tablet 0.5 mg - - - -
38 Asam Folat Tablet 1 mg - - - -
39 Asam Mefenamat Kapsul 250 mg - - - -
40 Asam Mefenamat Tablet Salut Selaput 500 mg - - 5,000 -
41 Asam Nalidixic Tablet 500 mg - - - 200
42 Asam Traneksamat Injeksi 250 mg - - - -
43 Asam Traneksamat Tablet 500 mg - - - -
44 Asetosal Tablet 100 mg - - - -
47 Asiklovir Krim 5 % 25 - 50 -
48 Asiklovir tablet 200 mg - - - -
49 Asiklovir Tablet 400 mg 200 - 200 -
50 Atenolol Tablet 50 mg - - - -
51 Atropin Sulfat Injeksi 0.25 mg/ mL - - - -
52 Atropin Sulfat Injeksi 1 mg/ mL - - - -
53 Atropin Sulfat tablet 0,5 mg - - - -
54 Benzatin Benzil Penisilin 1,2 juta IU/ vial - - - -
55 Benzatin Benzil Penisilin 2,4 juta IU/vial - - - -
56 Besi (II) Sulfat 7H20 Sirup 150 mg/5ml - - - -
57 Besi (II) Sulfat 7H20 Tablet - - - -
58 Betahistin Mesilat tablet 6 mg - - - -
59 Betametason Krim 0,1 % 50 - 100 -
60 Bisakodil Suppositoria 10 mg - - - 6
61 Bisakodil Tablet 10 mg - - - -
62 Bisakodil Tablet 5 mg 100 - - -
63 Bisoprolol tablet 5 mg - - - -
64 Bromheksin tablet 8 mg - - - -
65 Cetirizin sirup 5 mg/5 ml - - - -
66 Cetirizine tablet 10 mg - - - -
67 Clobazam tablet 10 mg - - - -
68 Clobetasol krim 0,05% - - - -
69 Dapson tablet 100 mg - - - -
70 Deksametason Injeksi 5 mg/ mL - - - 100
71 Deksametason Tablet 0.5 mg - 8,000 4,000 4,000
72 Dekstrometorfan (HBr) Sirup 10 mg/5 mL - - - -
73 Dekstrometorfan (HBr) Tablet 15 mg - - - -
74 Dextran - - - -
75 Diazepam Injeksi 5 mg/ mL - - - -
76 Diazepam Larutan Rektal 10 mg/mL - - - -
77 Diazepam Larutan Rektal 5 mg/ mL - 5 - -
78 Diazepam Tablet 2 mg - - - -
79 Diazepam Tablet 5 mg - - - -
80 Dietilkarbamazin Sitrat tablet 100 mg - - - -
81 Difenhidramin HCl Injeksi 10 mg/ mL - - - -
82 Digoksin Tablet 0.25 mg - - - 100
83 Diltiazem HCl Tablet 30 mg - - - -
84 Dimenhidrinat Tablet 50 mg 500 - 300 200
85 Doksisiklin Kapsul 100 mg - - - -
86 Domperidone Sirup 5 mg/ 5 mL 20 - - 30
87 Domperidone Tablet 10 mg 300 - 200 200
88 DUVIRAL Tablet - - - -
89 EFAVERINS Tablet 200 mg - - - -
90 Efedrin Tablet 25 mg - - - -
91 Ekstraks Belladona tablet 10 mg - - - -
92 Epinefrin/ Adrenalin Injeksi 0,1 % - - 100 -
93 Eritromisin Kapsul 250 mg - - - -
94 Eritromisin Kapsul 500 mg - - - -
95 Eritromisin Sirup 200 mg/ 5 mL 20 - 20 -
96 Etambutol Tablet 250 mg - - - -
97 Etambutol Tablet Salut 500 mg - - - -
98 Famotidine Tablet 20 mg - - - -
99 Famotidine tablet 40 mg - - - -
100 Fenilbutason tablet 200 mg - - - -
101 Fenitoin Natrium injeksi 50 mg/ml - - - -
102 Fenitoin Natrium Kapsul 100 mg - - - -
103 Fenitoin Natrium Kapsul 30 mg - - - -
104 Fenobarbital Injeksi 50 mg/ mL - - - -
105 Fenobarbital tablet 100 mg - - - -
106 Fenobarbital Tablet 30 mg - - - -
107 Fenoksimetil Penisilin tablet 250 mg - - - -
108 Fenoksimetil Penisilin tablet 500 mg - - - -
109 Fenol Gliserol Tetes Telinga 10% - - - -
110 Flukonazol Kapsul 150 mg - - - -
111 Furosemid Injeksi 10 mg/ mL - - - 25
112 Furosemid Tablet 40 mg - 100 100 -
113 Gameksan Salep 1% / scabimit 20 - 10 -
114 Garam Oralit Serbuk - - - -
115 Gemfibrozil Kapsul 300 mg - - - -
116 Gemfibrozil tablet 600 mg - - - -
117 Gentamisin Injeksi 10 mg/ mL - - - -
118 Gentamisin Injeksi 40 mg/ mL - - - -
119 Gentamisin Salep Kulit 0.1% 25 - 50 -
120 Gentamisin Salep Mata 0,3 % - - - -
121 Gentamisin Tetes Mata 0,3 % - - - -
122 Gentian Violet Larutan 1 % - - - -
123 Glibenkamid Tablet 5 mg 500 - 1,000 -
124 Glimepirid Tablet 1 mg 500 - - -
125 Glimepirid Tablet 2 mg - - - -
126 Glimepiride tablet 3 mg - - - -
127 Glimepiride tablet 4 mg - - - -
128 Glipizid Tablet 5 mg - - - -
129 Gliquidon tablet 30 mg - - - -
130 Gliseril Guaiakolat Tablet 100 mg 7,000 - 6,000 2,000
131 Gliserin - - - -
132 Glukosa larutan infus 10 % - - - -
133 Glukosa Larutan Infus 40% - - - -
134 Glukosa Larutan Infus 5 % - - 40 55
135 Griseofulvin Tablet 125 mg - - - -
136 Griseofulvin Tablet 250 mg - - - -
137 Haloperidol Tablet 0.5 mg - - - -
138 Haloperidol Tablet 1.5 mg - - - -
139 Haloperidol tablet 5 mg - - - -
140 Hidroklortiazid (HCT) Tablet 25 mg - - - -
141 Hidrokortison Krim 1 % - - - -
142 Hidrokortison Krim 2,5 % - - - -
143 Hiosin Butilbromide Tablet 10 mg - - - -
144 Ibuprofen Sirup 100 mg/ 5 mL - - - -
145 Ibuprofen Tablet 200 mg 500 - 500 200
146 Ibuprofen Tablet 400 mg - - - -
147 Iodiol kapsul lunak - - - -
148 Isoniazid (INH) Tablet 100 mg - - - -
149 Isoniazid (INH) Tablet 300 mg 1,000 - 500 500
150 Isosorbid Dinitrat Tablet Sublingual 5 mg 100 100 100 -
151 Itrakonazol Kapsul 100 mg - - - -
152 Kalium Diklofenak tablet 50 mg - - - -
153 Kalium Permanganat (KMnO4) 20 - - -
154 Kalsium Glukonas Injeksi 10% - - - 2
155 Kalsium Laktat Tablet 500 mg 2,000 1,000 2,000 2,000
156 Kaptopril tablet 12,5 mg - - - -
157 Kaptopril Tablet 25 mg 1,000 - - 1,000
158 Kaptopril tablet 50 mg - - - -
159 Karbamazepin Tablet 200 mg - - - -
160 Karbazokrom Injeksi 10 mg/ 2 mL - - - -
161 Karbazokrom Tablet 10 mg - - - -
162 Karbon Aktif - - - -
163 Ketokonazol Krim 2% ; 10 gram 25 - 25 -
164 Ketokonazol Krim 2% ; 15 gram - - - -
165 Ketokonazol Tablet 200 mg - 300 - -
166 Ketoprofen injeksi 100 mg - - - -
167 Ketoprofen tablet 100 mg - - - -
168 Ketorolac Injeksi 10 mg/ mL - - - -
169 Ketorolac injeksi 30 mg 24 - - -
170 Kina Injeksi 25% - 2 ml - - - -
171 Kina Tablet 200 mg - - - -
172 Klindamisin Kapsul 150 mg - - - -
173 Klindamisin Kapsul 300 mg - - - -
174 Klomifen tablet 50 mg - - - -
175 Klonidin tablet 0,15 mg - - - -
176 Kloramfenikol Injeksi 1 gr - - - -
177 Kloramfenikol Kapsul 250 mg 500 - 1,000 1,000
178 Kloramfenikol Salep Mata 1 % 24 24 48 48
179 Kloramfenikol Suspensi 125 mg/ 5 mL - - - -
180 Kloramfenikol Tetes Mata 0,5 % 25 - 100 -
181 Kloramfenikol Tetes Telinga 3% 24 24 24 24
182 Klorfeniramin Maleat (CTM) Tablet 4 mg 3,000 - - -
183 Klorokuin Tablet 150 mg - - - -
184 Klorokuin tablet 250 mg - - - -
185 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) - - - -
186 Klorpromazin injeksi i.m. 25 mg/ml (HCl) - - - -
187 Klorpromazin tablet salut 100 mg (HCl) - - - -
188 Klorpromazin Tablet Salut 25 mg - - - -
189 Kodein Tablet 10 mg - - - 100
190 Kodein tablet 15 mg - - - -
191 Kodein Tablet 20 mg - - - -
192 Kotrimoksazol DOEN I Tablet (Dewasa) 1,000 - 2,000 500
193 Kotrimoksazol DOEN II Tablet (Anak) - - - -
194 Kotrimoksazol Suspensi 100 100 100 100
Kotrimoksazol Suspensi komb: Sulfametoksazol 200 mg
195 - - - -
+ Trimetoprim 40 mg / 5 ml
196 Kuinin Injeksi 25% - - - -
197 Lamivudine tablet 150 mg - - - -
198 Lanzoprazol Kapsul 30 mg - - - -
199 Levofloksasin tablet 500 mg - - - -
200 Lidokain Injeksi 2% 50 - - -
201 Lidokain Injeksi 2% + Epinefrin 1 : 80.000 60 - - 40
202 Linkomisin Kapsul 500 mg - - - -
203 Lisinopril tablet 10 mg - - - -
204 Lisinopril tablet 5 mg - - - -
205 Loperamid Tablet 2 mg 200 - 400 -
206 Loratadin Tablet 10 mg - - 500 -
207 Magnesium Sulfat Injeksi 20% - - - 2
208 Magnesium Sulfat Injeksi 40% - - - -
209 MDT MB Anak - - - -
210 MDT MB Dewasa - - - -
211 MDT PB Anak - - - -
212 MDT PB Dewasa - - - -
213 Mebendazol sirup 100 mg / 5 ml - - - -
214 Mebendazole Tablet 100 mg - - - -
215 Meloksikam suppositoria - - - -
216 Meloksikam Tablet 15 mg - - - -
217 Meloksikam Tablet 7.5 mg - - - -
218 Metampiron Injeksi 250 mg - - - -
219 Metampiron Tablet 500 mg 9,000 - 4,000 6,000
220 Metformin HCl Tablet 500 mg - - - -
221 Metformin HCl tablet 850 mg - - - -
222 Metil Ergometrine Maleat Injeksi 0,2 mg/ mL - - - -
223 Metil Ergometrine Maleat Tab Salut 0,125mg - 100 - -
224 Metil Prednisolon Tablet 4 mg - - - -
225 Metil Prednisolon Tablet 8 mg - 500 - -
226 Metilprednisolon injeksi 500 mg - - - -
227 Metilprednisolon tablet 16 mg - - - -
228 Metoklopramid Injeksi 5 mg/mL - - - -
229 Metoklopramid Tablet 10 mg - - - -
230 Metoklopramide tablet 5 mg 500 - - -
231 Metronidazol infus 500 mg/100 ml - - - -
232 Metronidazol tablet 250 mg - - - -
233 Metronidazol Tablet 500 mg 1,000 - - 300
234 Mikonazole Krim 2 % 24 - - -
235 Mineral Mix - - - -
236 Momethason krim 0,1 % - - - -
237 Morfin injeksi 10 mg/ml - - - -
238 Morfin tablet 10 mg - - - -
239 Natrium Bikarbonat Inj 0,83mEK/mL(Meylon) - - - -
240 Natrium Bikarbonat Tablet 500 mg - - - -
241 Natrium Diklofenak Tablet 25 mg - - - -
242 Natrium Diklofenak Tablet 50 mg 500 - 1,000 500
243 Natrium Klorida (NaCl) Larutan Infus 0,9% - 20 20 40
244 Natrium Tiroksin 100 mcg - - - -
245 NEVIRAPIN Tablet 200 mg - - - -
246 Nifedipin Tablet 10 mg - - - -
247 Nistatin Suspensi Drops 100.000 UI/ mL - - - -
248 Nistatin Tablet Salut 500.000 IU/gr - - - -
249 Nistatin Vaginal Tablet 100.000 IU/gr - - - -
250 OAT Kategori Anak (FDC Anak) - - - -
251 OAT Kategori Anak (Kombipak Anak) - - - -
252 OAT Kategori I Dewasa (FDC I Dewasa) - 10 - -
253 OAT Kategori I Dewasa (Kombipak I Dewasa) - 2 - -
254 OAT Kategori II Dewasa (FDC II Dewasa) 2 - - -
255 OAT Kategori II Dewasa(Kombipak II Dewasa) - - - -
256 OAT Kategori Sisipan (FDC Sisipan) - - - -
257 OAT Kategori Sisipan (Kombipak Sisipan) - - - -
258 Obat Batuk Hitam (OBH) ; 100 mL 150 - 250 150
259 Obat Batuk Hitam (OBH) ; 200 mL - - - -
260 Ofloxacin tablet 200 mg - - - -
261 Ofloxacin tablet 400 mg - - - -
262 Oksitetrasiklin Salep Kulit 3% - - - -
263 Oksitetrasiklin Salep Mata 1% - - - -
264 Oksitosin Injeksi 10 IU/ mL 30 30 20 10
265 Omeprazol Kapsul 20 mg 600 - 600 300
266 Ondansetron Injeksi 4 mg/2 mL - - - 20
267 Ondansetron Tablet 4 mg - - - -
268 Oseltamivir Tablet 75 mg - - - -
269 Papaverin injeksi 40 mg/ml - - - -
270 Papaverin Tablet 40 mg 500 - 500 100
271 Paraformaldehide Tablet 1 gram - - - -
272 Parasetamol Drops 60 mg/ 0.6 mL - - - -
273 Parasetamol Sirup 120 mg/5 mL 168 - 168 168
274 Parasetamol Tablet 100 mg - - - -
275 Parasetamol Tablet 500 mg 10,000 5,000 10,000 10,000
276 Perak Sulfadiazin Salep - - - -
277 Perfenazin tablet 4 mg (HCl) - - - -
278 Petidin injeksi 50 mg/ml - - - -
279 Piracetam injeksi 1 g/5 ml - - - -
280 Piracetam injeksi 3 g/15 ml - - - -
281 Piracetam tablet 1200 mg - - - -
282 Piracetam tablet 400 mg - - - -
283 Piracetam Tablet 800 mg - - - -
284 Pirantel Pamoat Tablet 125 mg - - - -
285 Pirantel Pamoat Tablet 250 mg - - - -
286 Pirantel sirup 125 mg/5 ml - - - -
287 Pirazinamid Tablet 500 mg 500 - - 100
288 Piroksikam Tablet 10 mg - - - -
289 Piroksikam Tablet 20 mg 500 500 600 300
290 Podofilin 25% Larutan Tinctur - - - -
291 Povidon Iodida Larutan 10% ; 1000 mL - - - -
294 Povidon Iodida larutan 10%; 60 mL - - - -
295 Pravastatin tablet 20 mg - - - -
296 Prednison Tablet 5 mg 4,000 5,000 - 3,000
297 Primakuin Tablet 15 mg - - - -
298 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial - - - -
299 Propanolol Tablet 10 mg - - - -
300 Propanolol Tablet 40 mg - - - -
301 Propiltiourasil (PTU) Tablet 100 mg - - - -
302 Ramipril tablet 2,5 mg - - - -
303 Ramipril tablet 5 mg - - - -
304 Ranitidin Injeksi 25 mg/ 2 mL - - - -
305 Ranitidin Tablet 150 mg 1,000 500 600 1,000
306 Reserpin tablet 0,25 mg - - - -
307 Reserpine Tablet 0.10 mg - - - -
308 Rifampisin Kapsul 300 mg 500 - - -
309 Rifampisin Kapsul 600 mg - - - -
310 Rifampisin Kapsul Salut 450 mg 300 200 500 500
311 Ringer Laktat (RL) Larutan Infus 200 100 - 260
312 Risperidon tablet 1 mg - - - -
313 Risperidon tablet 2 mg - - - -
314 Rivanol (Etakridin) Larutan 0.1% ; 300 mL - - - -
315 Salbutamol Tablet 2 mg 600 - - 300
316 Salbutamol Tablet 4 mg - - - -
317 Salep 2-4 24 - 24 24
318 Salisil Bedak 2 % ; 100 gram - - - -
319 Salisil Bedak 2 % ; 50 gram 30 - 20 -
320 Sefadroksil Kapsul 250 mg - - - -
321 Sefadroksil Kapsul 500 mg - - - -
322 Sefadroksil Suspensi Kering 125 mg/ 5 mg 50 - - 50
323 Sefaleksin Kapsul 250 mg - - - -
324 Sefaleksin Kapsul 500 mg - - - -
325 Sefiksim 400 mg + Azitromisin 1000 mg - - - -
326 Sefiksim Kapsul 100 mg - - - -
327 Sefiksim Kapsul 100 mg - - - -
328 Sefiksim sirup kering 100 mg/ 5 ml - - - -
329 Sefotaksim Serbuk Injeksi 0,5 g/ Vial - - - -
330 Sefotaksim Serbuk Injeksi 1 g/ Vial - - - -
331 Seftazidim injeksi 1 g - - - -
332 Seftriakson Injeksi 1 gr - - - -
333 Serum ABU I - - - -
334 Serum ATS 1500 IU - - - -
335 Simetidine Tablet 200 mg - - - -
336 Simvastatin Tablet 10 mg 100 - 200 -
337 Simvastatin Tablet 20 mg - - - -
338 Simvastatin tablet 5 mg - - - -
339 Siprofloksasin infus 2% - - - -
340 Siprofloksasin tablet 250 mg (sebagai HCl) - - - -
341 Siprofloksasin Tablet 500 mg 1,000 - - 1,000
342 Spiramisin Tablet 500 mg - - - -
343 Stavudin tablet 30 mg - - - -
344 Streptomisin Serbuk Injeksi 1000 mg/ mL - - - -
345 Sulfasalazin tablet 500 mg - - - -
346 Sulfasetamida Natrium tetes mata 15 % - - - -
347 Tambah Darah Tablet Kombinasi - - - -
348 Terbutalin Tablet 2.5 mg - - - -
349 Tetrasiklin Kapsul 250 mg 500 - - -
350 Tetrasiklin Kapsul 500 mg 500 - - 500
351 Tiamfenikol Kapsul 250 mg - - - -
352 Tiamfenikol Kapsul 500 mg - - - -
353 Tramadol Injeksi 50 mg/ mL 20 - - -
354 Tramadol Kapsul 50 mg - - - -
355 Triamcinolon Asetonid Salep 1 mg - - - -
356 Triheksifenidil tablet 2 mg - - - -
357 Vaksin BCG - - - -
358 Vaksin Campak - - - -
359 Vaksin DPT - HB - - - -
360 Vaksin DT - - - -
361 Vaksin HBU - - - -
362 Vaksin Polio - - - -
363 Vaksin Td - - - -
364 Vaksin TT - - - -
365 Verapamil tablet 80 mg (HCl) - - - -
366 Vitamin A Kapsul 100.000 IU 1,000 - - -
367 Vitamin A Kapsul 200.000 IU 21,300 - - -
368 Vitamin A Tablet 50.000 IU - - - -
369 Vitamin B Kompleks Tablet 6,000 - 6,800 6,800
370 Vitamin B1 Injeksi 100 mg/ mL - - - -
371 Vitamin B1 Tablet 50 mg 6,000 - - -
372 Vitamin B12 Injeksi 500 mcg 100 - - -
373 Vitamin B12 Tablet 50 mcg 3,000 - 4,000 1,000
374 Vitamin B6 Tablet 10 mg 5,000 - 2,000 3,000
375 Vitamin C tablet 100 mg - - - -
376 Vitamin C tablet 250 mg - - - -
377 Vitamin C Tablet 50 mg 2,000 1,000 4,000 3,000
378 Vitamin K Injeksi 10 mg/ mL - - - -
379 Vitamin K Tablet 10 mg - 300 - -
380 Vitamin K1 Injeksi 2 mg/ mL 30 1,000 - -
381 Vitamin K3 injeksi 10 mg/ml - - - -
382 Zidovudin 300 mg + Lamivudine 150 mg Tablet - - - -
383 Zidovudin tablet 100 mg - - - -
384 Zidovudin tablet 300 mg + Lamivudine tablet 150 mg - - - -
385 Zinc Tablet 20 mg - 500 - -
381 Anti Diare Non Spesifik 900 - 600 300
(Attapulgit 700 mg dan Pektin 50 mg) - - - -
382 Anti Flu Kombinasi Kaplet - - - -
(Parasetamol 500 mg, CTM 2 mg, PPA 12.5 mg) - - - -
383 Anti Flu Kombinasi Sirup - - - -
(Parasetamol 500 mg, CTM 2 mg, PPA 12.5 mg) - - - -
384 Fluocinolone 0,25 mg + Neomisin Sulfat 5 mg 20 - - -
385 Gameksan + Asam Usnat Salep - - - -
386 HES 6% dalam 0.9% NaCl (BM 130,000) - - - -
387 Levertran Salep 10 - - -
388 Multivitamin Kombinasi Kaplet - - - 500
(As.Folat 1 mg dan Besi (II) Fumarat 90 mg) - - - -
389 Multivitamin Kombinasi Sirup - - - -
(DHA 32 mg, L-Lysin 200 mg) - - - -
390 OAI Antihipertensi Kapsul - - - -
391 OAI Curcuma Xanthorizae Tablet 20 mg - - - -
- - - -
B PERBEKALAN KESEHATAN/ BAHAN PAKAI HABIS - - - -
1 Alat Suntik Sekali Pakai 0.05 mL ADS - - - -
2 Alat Suntik Sekali Pakai 0.5 mL ADS - - - -
3 Alat Suntik Sekali Pakai 1 mL - - - -
4 Alat Suntik Sekali Pakai 2.5 mL - - - -
5 Alat Suntik Sekali Pakai 3 mL 300 400 - -
6 Alat Suntik Sekali Pakai 5 mL 100 200 - -
7 Alkohol 70 % Larutan 100 mL 10 - - -
8 Alkohol 70 % Larutan 1000 mL - - - -
9 Aqua Pro Injection ; 10 mL - - - -
10 Aqua Pro Injection ; 20 mL 20 - - -
11 Catgut 2/0 dengan Jarum Bedah PLAIN 10 - - -
12 Catgut 3/0 dengan Jarum Bedah PLAIN - - - -
13 Catgut Chromic 2/0 Roll 1 - - -
14 Catgut Plain 3/0 Roll - - - -
15 Folley Catheter No. 16 - - - -
16 Folley Catheter No. 18 - - - -
17 Handscoon No. 7.5 (Non Steril) - - - -
18 Handscoon No. 7.5 (Steril) - - - -
19 Handscoon No.7 (Non Steril) - - - -
20 Handscoon No.7 (Steril) - - - -
21 Hidrogen Peroksida Larutan 3% - - - -
22 Infus Set Anak - - - 100
23 Infus Set Dewasa 100 - - -
24 IV Catheter No. 18 G - - - -
25 IV Catheter No. 20 G 50 - - -
28 Jarum Jahit No. 11 - - - -
29 Jarum No. 23 G - - - -
30 Jarum No. 24 G - - - -
31 Jarum No. 25 G - - - -
32 Jarum No. 26 G - - - -
33 Jarum No. 27 G - - - -
34 Kapas 250 gram 10 - - -
35 Kasa Hidrofil Steril Ukuran 16 x 16 - 10 - 10
36 Kasa Kompres 40/40 Steril - - - -
37 Kasa Pembalut 2 m X 80 cm 20 - - -
38 Kasa Pembalut 4 m X 15 cm 50 - - -
39 Kasa Pembalut Elastic 3 Inchi - - - -
40 Kasa Pembalut Elastic 4 Inchi - - - -
41 Kasa Pembalut Hidrofil 4 m x 10 cm - - - -
42 Kasa Pembalut Hidrofil 4 m x 5 cm 100 - - -
43 Lisol (Kresol tersaponifikasi 50%) ; 1 L - - - -
44 Masker 100 - - -
45 Minyak Emersi - 1 - -
46 Pelarut Vaksin BCG/ Polio - - - -
47 Plester 5 Yards x 2 Inchi - 6 - 6
48 Silk No. 3/0 (Roll) - - - -
49 Silk No. 3/0 dengan Jarum Bedah - 10 - -
50 Slide - - - -
51 Transfusi Set - - - -
52 Urine Bag - - - 10
- - - -
C PERBEKALAN KESEHATAN/ BAHAN GIGI - - - -
1 Air Raksa Dental - - - -
2 Alvogyil/ Alveopaste - - - -
3 Articulating Paper - - - -
4 Blade (ukuran : 11) - - - -
5 Cocoa Butter - - - -
6 Cresophen - - - -
7 Dental Needle (Carpul) - - - -
8 Devitalisasi Pasta (Non Arsen) 1 - - -
9 Etil Klorid Spray 2 - 3 2
10 Eugenol Cairan - - - -
11 Glass Ionomer Cement ART 1 - - 1
12 Kalsium Hidroksida Pasta 1 - - 1
13 Klorfenol Kamfer Menthol (CHKM) 1 - - 1
14 Klorheksidin Larutan 0,2% - - - -
15 Mata Bur High Speed - - - -
16 Matriks Band - - - -
17 Mummifying Pasta - - - -
18 Obat Kumur Antiseptik - - - -
(Benzalkonium Klorida Kombinasi) - - - -
19 OCO (Tooth Cleansing Tincture) 1 - - -
20 Selluloid Strip - - - -
21 Semen Seng Fosfat serbuk & cairan - - - -
22 Silver Amalgam Serbuk - 2 2 -
23 Spon Gelatin Steril (ukuran 10 x 10 x 10 mm) - - - -
24 Temporary Filling Material 1 - - 1
25 Temporary Stopping (Fletcher) serbuk&cairan 1 - - 1
26 Topikal Anestesi - - - -
27 Trikresol Formalin (TKF) Cair - - - -
- - - -
D PERBEKALAN KESEHATAN/ REAGEN - - - -
1 Asam Hidroklorida 20% Cairan - - - -
2 Benedict Larutan ; 100 mL - - - -
3 HIV Reagent - - - -
4 Metilen Blue Larutan - - - -
5 Turk Larutan ; 100 mL - - - -
6 Ziel Nielsen Larutan (1 Paket 3 Botol) - - - -
- - - -
E LAIN-LAIN/ YG BELUM TERCANTUM - - - -
1 LYCODRYL DMP SIRUP 72 - - -
2 ANTI DIARE / NEO KAOMINAL SIRUP 50 - - -
3 ADITUSIN tablet ( CTM + DMP ) - - - -
4 FLUTOP C syrup - - - -
5 HALOPERIDOL INJEKSI - - - -
6 HANDSCOON non steril M - - 100 -
7 HANDSCOON non steril S - - 200 -
8 TES YODIUM - - - -
MEI JUN JUL JUMLAH
7 8 9 10
- - - -
- - - -
800 - - 2,300
- - - -
- - - -
- - - 100
- - - 2,600
- - - 60
- - - -
- - - 2,000
- - - -
- - - -
600 - - 2,700
- - - 15
- - - -
- - - -
20,000 - - 45,000
- - - -
600 - - 1,360
- - 1,000 4,000
- - - -
- - - -
- - - -
5,000 - 2,000 14,000
- - - 170
50 - - 100
24 - - 48
20 - - 70
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - 4,500 9,500
- - - 200
- - - -
- - - -
- - - -
- - - -
- - - -
50 - - 125
- - - -
200 - 100 700
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
50 - 25 225
- - - 6
- - - -
- - - 100
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 100
12,000 - 4,000 32,000
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 5
- - - -
- - - -
- - - -
- - - -
- - - 100
- - - -
500 - - 1,500
- - - -
- - - 50
200 - - 900
- - - -
- - - -
- - - -
- - - -
- - - 100
- - - -
- - - -
- - - 40
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
25 - - 50
100 - - 300
10 - - 40
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 75
- - - -
- - - -
- - - -
500 - - 2,000
- - - 500
- - - -
- - - -
- - - -
- - - -
- - - -
14,000 - - 29,000
- - - -
- - - -
- - - -
60 - - 155
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
500 - - 1,700
- - - -
- - - -
- - - -
500 - - 2,500
- - - 300
- - - -
- - - -
20 - - 40
- - - 2
3,000 - - 10,000
- - - -
500 - 500 3,000
- - - -
- - - -
- - - -
- - - -
- - - -
25 - 25 100
- - - -
100 - 300 700
- - - -
- - - -
- - - -
- - - 24
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
1,000 - - 3,500
24 - 24 192
- - - -
25 - 100 250
24 - - 120
- - - 3,000
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 100
- - - -
- - - -
500 - - 4,000
- - - -
100 - - 500
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 50
- 60 60 220
- - - -
- - - -
- - - -
300 - - 900
- - - 500
- - - 2
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
3,000 - - 22,000
- - - -
- - - -
- - - -
- - - 100
- - - -
- - - 500
- - - -
- - - -
- - - -
- - - -
- - - 500
- - - -
- - - -
1,200 - 300 2,800
24 - - 48
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
1,000 - 2,000 5,000
40 - - 120
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 10
- - - 2
- - - 2
- - - -
- - - -
- - - -
750 - - 1,300
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 90
300 - - 1,800
- - - 20
- - - -
- - - -
- - - -
1,000 - - 2,100
- - - -
- - - -
336 - 84 924
- - - -
21,000 - 5,000 61,000
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 600
- - - -
- - - 1,900
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 12,000
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
1,000 - 500 4,600
- - - -
- - - -
- - - 500
- - - -
300 - 500 2,300
500 - - 1,060
- - - -
- - - -
- - - -
300 - - 1,200
- - - -
- - 24 96
- - - -
40 - - 90
- - - -
- - - -
- - - 100
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
300 - - 600
- - - -
- - - -
- - - -
- - - -
500 - 1,500 4,000
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 500
- - - 1,000
- - - -
- - - -
- - - 20
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 1,000
- - - 21,300
- - - -
6,800 - - 26,400
- - - -
13,000 - - 19,000
- - - 100
1,000 - 1,000 10,000
3,000 - 2,000 15,000
- - - -
- - - -
7,000 - - 17,000
- - - -
1,000 - - 1,300
- - - 1,030
- - - -
- - - -
- - - -
- - - -
- - - 500
750 - 600 3,150
- - - -
- - - -
- - - -
- - - -
- - - -
20 - - 40
- - - -
- - - -
10 - - 20
500 - - 1,000
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
100 - - 800
- - - 300
- - - 10
- - - -
- - - -
- - - 20
- - - 10
- - - -
- - - 1
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 100
- - - 100
- - - -
- - - 50
- - - 50
- - - 50
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 10
- - - 20
- - - -
- - - 20
- - - 50
- - - -
- - - -
- - - -
- - - 100
- - - -
- - - 100
- - - 1
- - - -
- - 6 18
- - - -
- - - 10
- - - -
- - - -
- - - 10
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - -
- - - 1
5 - - 12
- - - -
- - - 2
- - - 2
- - - 2
- - - -
- - - -
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- - - -
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102 - - 102
PEMAKAIAN TAHUN 2016 DARI IFK
NO NAMA OBAT & PERBEKALAN KESEHATAN JAN FEB MAR APR MEI
1 2 3 4 5 6 7
A SEDIAAN FARMASI
1 Albendazol suspensi 200 mg/5 ml - - - - -
2 Albendazol Tablet 400 mg - - - - -
3 Allopurinol Tablet 100 mg 74 366 284 293 400
4 Alopurinol tablet 300 mg - - - - -
5 Alprazolam Tablet 0.50 mg - - - - -
6 Ambroksol Sirup 15 mg/ mL 4 4 41 - 51
7 Ambroksol Tablet 30 mg 18 260 822 199 701
8 Aminofilin Injeksi 24 mg/mL 51 - - - 30
9 Aminofilin tablet 150 mg - - - - -
10 Aminofilin Tablet 200 mg - - 40 111 36
11 Amitriptilin Tablet Salut 25 mg - - - - -
12 Amlodipin tablet 10 mg - - - - -
13 Amlodipin Tablet 5 mg 202 411 344 292 341
14 Ammonium Bituminosulfonat Salep 10 %/ichti - 2 2 - 1
15 Amoksisilin + As. Klavulanat 625 mg tablet - - - - -
16 Amoksisilin Kapsul 250 mg - - - - -
17 Amoksisilin Kapsul 500 mg 2,121 6,494 4,904 7,357 4,023
18 Amoksisilin serbuk injeksi 1000 mg - - - - -
19 Amoksisilin Suspensi Kering 125 mg/ 5 mL 18 112 169 253 197
20 Ampisilin Kaplet 500 mg - 24 937 42 1,252
21 Ampisilin Serbuk Injeksi 1000 mg/ Vial - - - - 30
22 Ampisilin Serbuk Injeksi 500 mg/ Vial - - - - -
23 Ampisilin Suspensi Kering 125 mg/ 5 mL - - - - -
24 Antasida DOEN I Tablet Kunyah - 317 1,965 2,626 3,008
25 Antasida DOEN II Suspensi - 19 25 4 11
26 Anti Bakteri DOEN Salep 2 7 4 12 2
27 Anti Fungi DOEN Salep - - 5 4 2
28 Anti Haemoroid DOEN Suppositoria - 8 11 11 -
29 Anti Malaria DOEN - - - - -
30 Anti Migren Tablet - - - - -
31 Artemisin + Piperaquin (DHP) - - - - -
32 Arterakine Tablet - - - - -
33 Artermeter Injeksi 80 mg/ mL - - - - -
34 Artesunate + Amodiaquin Injeksi - - - - -
1 2 3 4 5 6 7
35 Artesunate Injeksi 60 mg/ mL - - - - -
36 Artesunate Tablet - - - - -
37 Asam Folat Tablet 0.5 mg - - - - -
38 Asam Folat Tablet 1 mg 190 22,516 304 140 120
39 Asam Mefenamat Kapsul 250 mg - - - - -
40 Asam Mefenamat Tablet Salut Selaput 500 mg - - 80 410 780
41 Asam Nalidixic Tablet 500 mg - - - - -
42 Asam Traneksamat Injeksi 250 mg - - - - -
43 Asam Traneksamat Tablet 500 mg - - - - -
44 Asetosal Tablet 100 mg - - - - -
47 Asiklovir Krim 5 % 5 13 13 18 12
48 Asiklovir tablet 200 mg - - - - -
49 Asiklovir Tablet 400 mg 36 119 45 88 112
50 Atenolol Tablet 50 mg - - - - -
51 Atropin Sulfat Injeksi 0.25 mg/ mL - - - - -
52 Atropin Sulfat Injeksi 1 mg/ mL - - - - -
53 Atropin Sulfat tablet 0,5 mg - - - - -
54 Benzatin Benzil Penisilin 1,2 juta IU/ vial - - - - -
55 Benzatin Benzil Penisilin 2,4 juta IU/vial - - - - -
56 Besi (II) Sulfat 7H20 Sirup 150 mg/5ml - - - - -
57 Besi (II) Sulfat 7H20 Tablet - - - - -
58 Betahistin Mesilat tablet 6 mg - - - - -
59 Betametason Krim 0,1 % 2 29 17 26 2
60 Bisakodil Suppositoria 10 mg - - - - -
61 Bisakodil Tablet 10 mg - - - - -
62 Bisakodil Tablet 5 mg - - - 4 -
63 Bisoprolol tablet 5 mg - - - - -
64 Bromheksin tablet 8 mg - - - - -
65 Cetirizin sirup 5 mg/5 ml - - - - -
66 Cetirizine tablet 10 mg - - - - -
67 Clobazam tablet 10 mg - - - - -
68 Clobetasol krim 0,05% - - - - -
69 Dapson tablet 100 mg - - - - -
70 Deksametason Injeksi 5 mg/ mL - - - - 10
71 Deksametason Tablet 0.5 mg - 1,362 4,185 5,403 2,380
72 Dekstrometorfan (HBr) Sirup 10 mg/5 mL - - - - -
73 Dekstrometorfan (HBr) Tablet 15 mg - - - - -
74 Dextran - - - - -
75 Diazepam Injeksi 5 mg/ mL - - 60 - -
76 Diazepam Larutan Rektal 10 mg/mL - - - - -
1 2 3 4 5 6 7
77 Diazepam Larutan Rektal 5 mg/ mL - - - - -
78 Diazepam Tablet 2 mg 6 - 6 - 6
79 Diazepam Tablet 5 mg - - - - -
80 Dietilkarbamazin Sitrat tablet 100 mg - - - - -
81 Difenhidramin HCl Injeksi 10 mg/ mL - - - - -
82 Digoksin Tablet 0.25 mg - - - - -
83 Diltiazem HCl Tablet 30 mg - - - - -
84 Dimenhidrinat Tablet 50 mg 47 169 175 273 136
85 Doksisiklin Kapsul 100 mg 40 24 - - -
86 Domperidone Sirup 5 mg/ 5 mL 3 2 11 2 4
87 Domperidone Tablet 10 mg 8 110 135 71 176
88 DUVIRAL Tablet - - - - -
89 EFAVERINS Tablet 200 mg - - - - -
90 Efedrin Tablet 25 mg - - - - -
91 Ekstraks Belladona tablet 10 mg - - - - -
92 Epinefrin/ Adrenalin Injeksi 0,1 % - - 5 7 78
93 Eritromisin Kapsul 250 mg - - - - -
94 Eritromisin Kapsul 500 mg - - - - -
95 Eritromisin Sirup 200 mg/ 5 mL - 9 2 2 11
96 Etambutol Tablet 250 mg - - - - -
97 Etambutol Tablet Salut 500 mg - - - - -
98 Famotidine Tablet 20 mg - - - - -
99 Famotidine tablet 40 mg - - - - -
100 Fenilbutason tablet 200 mg - - - - -
101 Fenitoin Natrium injeksi 50 mg/ml - - - - -
102 Fenitoin Natrium Kapsul 100 mg - - - - -
103 Fenitoin Natrium Kapsul 30 mg - - - - -
104 Fenobarbital Injeksi 50 mg/ mL - - - - -
105 Fenobarbital tablet 100 mg - - - - -
106 Fenobarbital Tablet 30 mg - - - - -
107 Fenoksimetil Penisilin tablet 250 mg - - - - -
108 Fenoksimetil Penisilin tablet 500 mg - - - - -
109 Fenol Gliserol Tetes Telinga 10% - - - - -
110 Flukonazol Kapsul 150 mg - - - - -
111 Furosemid Injeksi 10 mg/ mL - - - - 25
112 Furosemid Tablet 40 mg - - 2 26 -
113 Gameksan Salep 1% / scabimit 2 9 4 10 5
114 Garam Oralit Serbuk - - - 14 -
115 Gemfibrozil Kapsul 300 mg - - - - -
116 Gemfibrozil tablet 600 mg - - - - -
117 Gentamisin Injeksi 10 mg/ mL - - - - -
118 Gentamisin Injeksi 40 mg/ mL - - - - -
1 2 3 4 5 6 7
119 Gentamisin Salep Kulit 0.1% 5 20 3 21 20
120 Gentamisin Salep Mata 0,3 % - - - - -
121 Gentamisin Tetes Mata 0,3 % - - - - -
122 Gentian Violet Larutan 1 % - - - - -
123 Glibenkamid Tablet 5 mg 88 408 204 306 94
124 Glimepirid Tablet 1 mg - - 10 90 50
125 Glimepirid Tablet 2 mg - - - - -
126 Glimepiride tablet 3 mg - - - - -
127 Glimepiride tablet 4 mg - - - - -
128 Glipizid Tablet 5 mg - - - - -
129 Gliquidon tablet 30 mg - - - - -
130 Gliseril Guaiakolat Tablet 100 mg 1,061 3,463 3,658 4,536 3,254
131 Gliserin - - - - -
132 Glukosa larutan infus 10 % - - - - -
133 Glukosa Larutan Infus 40% - - - - -
134 Glukosa Larutan Infus 5 % - - 20 35 20
135 Griseofulvin Tablet 125 mg - - - - -
136 Griseofulvin Tablet 250 mg - - - - -
137 Haloperidol Tablet 0.5 mg - - - - -
138 Haloperidol Tablet 1.5 mg - - - - -
139 Haloperidol tablet 5 mg - - - - -
140 Hidroklortiazid (HCT) Tablet 25 mg 34 22 80 75 -
141 Hidrokortison Krim 1 % - - - - -
142 Hidrokortison Krim 2,5 % - - - - -
143 Hiosin Butilbromide Tablet 10 mg - - - - -
144 Ibuprofen Sirup 100 mg/ 5 mL - - - - -
145 Ibuprofen Tablet 200 mg - 210 101 132 40
146 Ibuprofen Tablet 400 mg - - - - -
147 Iodiol kapsul lunak - - - - -
148 Isoniazid (INH) Tablet 100 mg - - - - -
149 Isoniazid (INH) Tablet 300 mg - 359 398 356 -
150 Isosorbid Dinitrat Tablet Sublingual 5 mg 20 57 23 5 20
151 Itrakonazol Kapsul 100 mg - - - - -
152 Kalium Diklofenak tablet 50 mg - - - - -
153 Kalium Permanganat (KMnO4) - - - 9 -
154 Kalsium Glukonas Injeksi 10% - - - - -
155 Kalsium Laktat Tablet 500 mg 260 1,476 1,656 1,544 729
156 Kaptopril tablet 12,5 mg - - - - -
157 Kaptopril Tablet 25 mg 111 239 352 353 207
158 Kaptopril tablet 50 mg - - - - -
159 Karbamazepin Tablet 200 mg - - - - -
160 Karbazokrom Injeksi 10 mg/ 2 mL - - - - -
1 2 3 4 5 6 7
161 Karbazokrom Tablet 10 mg - - - - -
162 Karbon Aktif - - - - -
163 Ketokonazol Krim 2% ; 10 gram 4 11 9 12 14
164 Ketokonazol Krim 2% ; 15 gram - - - - -
165 Ketokonazol Tablet 200 mg - 20 25 80 175
166 Ketoprofen injeksi 100 mg - - - - -
167 Ketoprofen tablet 100 mg - - - - -
168 Ketorolac Injeksi 10 mg/ mL - - - - -
169 Ketorolac injeksi 30 mg 12 - - - 5
170 Kina Injeksi 25% - 2 ml - - - - -
171 Kina Tablet 200 mg - - - - -
172 Klindamisin Kapsul 150 mg - - - - -
173 Klindamisin Kapsul 300 mg - - - - -
174 Klomifen tablet 50 mg - - - - -
175 Klonidin tablet 0,15 mg - - - - -
176 Kloramfenikol Injeksi 1 gr - - - - -
177 Kloramfenikol Kapsul 250 mg 81 387 367 459 386
178 Kloramfenikol Salep Mata 1 % 4 20 20 15 16
179 Kloramfenikol Suspensi 125 mg/ 5 mL - - - - -
180 Kloramfenikol Tetes Mata 0,5 % 1 23 9 26 42
181 Kloramfenikol Tetes Telinga 3% 5 13 17 19 12
182 Klorfeniramin Maleat (CTM) Tablet 4 mg 1,886 1,114 - - -
183 Klorokuin Tablet 150 mg - - - - -
184 Klorokuin tablet 250 mg - - - - -
185 Klorpromazin injeksi i.m 5 mg/ml - 2 ml (HCl) - - - - -
186 Klorpromazin injeksi i.m. 25 mg/ml (HCl) - - - - -
187 Klorpromazin tablet salut 100 mg (HCl) - - - - -
188 Klorpromazin Tablet Salut 25 mg - - - - -
189 Kodein Tablet 10 mg - - - - -
190 Kodein tablet 15 mg - - - - -
191 Kodein Tablet 20 mg - - - - -
192 Kotrimoksazol DOEN I Tablet (Dewasa) 143 664 454 524 433
193 Kotrimoksazol DOEN II Tablet (Anak) - - - - -
194 Kotrimoksazol
Suspensi komb: 30 71 71 60 15
195 Sulfametoksazol 200 mg + Trimetoprim 40 - - - - -
196 mg / 5 Injeksi
Kuinin ml 25% - - - - -
197 Lamivudine tablet 150 mg - - - - -
198 Lanzoprazol Kapsul 30 mg - - - - -
199 Levofloksasin tablet 500 mg - - - - -
200 Lidokain Injeksi 2% 10 - - 20 20
201 Lidokain Injeksi 2% + Epinefrin 1 : 80.000 20 - 20 20 30
202 Linkomisin Kapsul 500 mg - - - - -
1 2 3 4 5 6 7
203 Lisinopril tablet 10 mg - - - - -
204 Lisinopril tablet 5 mg - - - - -
205 Loperamid Tablet 2 mg 32 153 88 58 29
206 Loratadin Tablet 10 mg - - 12 111 377
207 Magnesium Sulfat Injeksi 20% - - - 2 -
208 Magnesium Sulfat Injeksi 40% - - - - -
209 MDT MB Anak - - - - -
210 MDT MB Dewasa - - - - -
211 MDT PB Anak - - - - -
212 MDT PB Dewasa - - - - -
213 Mebendazol sirup 100 mg / 5 ml - - - - -
214 Mebendazole Tablet 100 mg - - - - -
215 Meloksikam suppositoria - - - - -
216 Meloksikam Tablet 15 mg - - - - -
217 Meloksikam Tablet 7.5 mg - - - - -
218 Metampiron Injeksi 250 mg - - - - -
219 Metampiron Tablet 500 mg 1,163 3,627 4,286 3,365 222
220 Metformin HCl Tablet 500 mg - - - - -
221 Metformin HCl tablet 850 mg - - - - -
222 Metil Ergometrine Maleat Injeksi 0,2 mg/ mL - - - - -
223 Metil Ergometrine Maleat Tab Salut 0,125mg - - - - -
224 Metil Prednisolon Tablet 4 mg - - - - -
225 Metil Prednisolon Tablet 8 mg - - - 48 10
226 Metilprednisolon injeksi 500 mg - - - - -
227 Metilprednisolon tablet 16 mg - - - - -
228 Metoklopramid Injeksi 5 mg/mL - - - - -
229 Metoklopramid Tablet 10 mg - - - - -
230 Metoklopramide tablet 5 mg - - - 77 -
231 Metronidazol infus 500 mg/100 ml - - - - -
232 Metronidazol tablet 250 mg - - - - -
233 Metronidazol Tablet 500 mg 62 210 192 466 120
234 Mikonazole Krim 2 % - 2 1 4 6
235 Mineral Mix - - - - -
236 Momethason krim 0,1 % - - - - -
237 Morfin injeksi 10 mg/ml - - - - -
238 Morfin tablet 10 mg - - - - -
239 Natrium Bikarbonat Inj 0,83mEK/mL(Meylon) - - - - -
240 Natrium Bikarbonat Tablet 500 mg - - - - -
241 Natrium Diklofenak Tablet 25 mg - - - - -
242 Natrium Diklofenak Tablet 50 mg 10 462 301 560 417
243 Natrium Klorida (NaCl) Larutan Infus 0,9% - 20 10 - 10
244 Natrium Tiroksin 100 mcg - - - - -
1 2 3 4 5 6 7
245 NEVIRAPIN Tablet 200 mg - - - - -
246 Nifedipin Tablet 10 mg - - - - -
247 Nistatin Suspensi Drops 100.000 UI/ mL - - - - -
248 Nistatin Tablet Salut 500.000 IU/gr - - - - -
249 Nistatin Vaginal Tablet 100.000 IU/gr - - - - -
250 OAT Kategori Anak (FDC Anak) - - - - -
251 OAT Kategori Anak (Kombipak Anak) - - - - -
252 OAT Kategori I Dewasa (FDC I Dewasa) - 10 - - -
253 OAT Kategori I Dewasa (Kombipak I Dewasa) - 2 - - -
254 OAT Kategori II Dewasa (FDC II Dewasa) 2 - - - -
255 OAT Kategori II Dewasa(Kombipak II Dewasa) - - - - -
256 OAT Kategori Sisipan (FDC Sisipan) - - - - -
257 OAT Kategori Sisipan (Kombipak Sisipan) - - - - -
258 Obat Batuk Hitam (OBH) ; 100 mL 14 121 110 248 33
259 Obat Batuk Hitam (OBH) ; 200 mL - - - - -
260 Ofloxacin tablet 200 mg - - - - -
261 Ofloxacin tablet 400 mg - - - - -
262 Oksitetrasiklin Salep Kulit 3% - - - - -
263 Oksitetrasiklin Salep Mata 1% - - - - -
264 Oksitosin Injeksi 10 IU/ mL 30 20 10 30 -
265 Omeprazol Kapsul 20 mg - 202 218 316 314
266 Ondansetron Injeksi 4 mg/2 mL - - - - 10
267 Ondansetron Tablet 4 mg - - - - -
268 Oseltamivir Tablet 75 mg - - - - -
269 Papaverin injeksi 40 mg/ml - - - - -
270 Papaverin Tablet 40 mg 71 291 202 222 164
271 Paraformaldehide Tablet 1 gram - - - - -
272 Parasetamol Drops 60 mg/ 0.6 mL - - - - -
273 Parasetamol Sirup 120 mg/5 mL - 64 122 149 48
274 Parasetamol Tablet 100 mg - - - - -
275 Parasetamol Tablet 500 mg 2,438 7,898 8,607 9,354 6,086
276 Perak Sulfadiazin Salep - - - - -
277 Perfenazin tablet 4 mg (HCl) - - - - -
278 Petidin injeksi 50 mg/ml - - - - -
279 Piracetam injeksi 1 g/5 ml - - - - -
280 Piracetam injeksi 3 g/15 ml - - - - -
281 Piracetam tablet 1200 mg - - - - -
282 Piracetam tablet 400 mg - - - - -
283 Piracetam Tablet 800 mg - - - - -
284 Pirantel Pamoat Tablet 125 mg - - - 2 -
285 Pirantel Pamoat Tablet 250 mg - - - - -
286 Pirantel sirup 125 mg/5 ml - - - - -
1 2 3 4 5 6 7
287 Pirazinamid Tablet 500 mg - - 66 35 -
288 Piroksikam Tablet 10 mg - - - - -
289 Piroksikam Tablet 20 mg 224 215 406 394 111
290 Podofilin 25% Larutan Tinctur - - - - -
291 Povidon Iodida Larutan 10% ; 1000 mL - - - - -
294 Povidon Iodida larutan 10%; 60 mL - - - - -
295 Pravastatin tablet 20 mg - - - - -
296 Prednison Tablet 5 mg 1,631 1,810 2,599 2,328 2,532
297 Primakuin Tablet 15 mg - - - - -
298 Prokain Benzil Penisilin G. injeksi 3 jt IU/vial - - - - -
299 Propanolol Tablet 10 mg - - - - -
300 Propanolol Tablet 40 mg - - - - -
301 Propiltiourasil (PTU) Tablet 100 mg - - - - -
302 Ramipril tablet 2,5 mg - - - - -
303 Ramipril tablet 5 mg - - - - -
304 Ranitidin Injeksi 25 mg/ 2 mL - - - - -
305 Ranitidin Tablet 150 mg 262 538 700 490 610
306 Reserpin tablet 0,25 mg - - - - -
307 Reserpine Tablet 0.10 mg - - - - -
308 Rifampisin Kapsul 300 mg 34 52 62 25 127
309 Rifampisin Kapsul 600 mg - - - - -
310 Rifampisin Kapsul Salut 450 mg 83 273 316 307 321
311 Ringer Laktat (RL) Larutan Infus 100 20 100 220 140
312 Risperidon tablet 1 mg - - - - -
313 Risperidon tablet 2 mg - - - - -
314 Rivanol (Etakridin) Larutan 0.1% ; 300 mL - - - - -
315 Salbutamol Tablet 2 mg - - 200 206 94
316 Salbutamol Tablet 4 mg - - - - -
317 Salep 2-4 - 18 10 9 17
318 Salisil Bedak 2 % ; 100 gram - - - - -
319 Salisil Bedak 2 % ; 50 gram 1 11 7 15 8
320 Sefadroksil Kapsul 250 mg - - - - -
321 Sefadroksil Kapsul 500 mg - - - - -
322 Sefadroksil Suspensi Kering 125 mg/ 5 mg 4 8 13 8 19
323 Sefaleksin Kapsul 250 mg - - - - -
324 Sefaleksin Kapsul 500 mg - - - - -
325 Sefiksim 400 mg + Azitromisin 1000 mg - - - - -
326 Sefiksim Kapsul 100 mg - - - - -
327 Sefiksim Kapsul 100 mg - - - - -
328 Sefiksim sirup kering 100 mg/ 5 ml - - - - -
1 2 3 4 5 6 7
329 Sefotaksim Serbuk Injeksi 0,5 g/ Vial - - - - -
330 Sefotaksim Serbuk Injeksi 1 g/ Vial - - - - -
331 Seftazidim injeksi 1 g - - - - -
332 Seftriakson Injeksi 1 gr - - - - -
333 Serum ABU I - - - 1 -
334 Serum ATS 1500 IU - 1 2 - -
335 Simetidine Tablet 200 mg - - - - -
336 Simvastatin Tablet 10 mg 13 53 9 88 37
337 Simvastatin Tablet 20 mg - - - - -
338 Simvastatin tablet 5 mg - - - - -
339 Siprofloksasin infus 2% - - - - -
340 Siprofloksasin tablet 250 mg (sebagai HCl) - - - - -
341 Siprofloksasin Tablet 500 mg 42 128 592 479 559
342 Spiramisin Tablet 500 mg - - - - -
343 Stavudin tablet 30 mg - - - - -
344 Streptomisin Serbuk Injeksi 1000 mg/ mL - - - - -
345 Sulfasalazin tablet 500 mg - - - - -
346 Sulfasetamida Natrium tetes mata 15 % - - - - -
347 Tambah Darah Tablet Kombinasi - - - - -
348 Terbutalin Tablet 2.5 mg - - - - -
349 Tetrasiklin Kapsul 250 mg - - - - -
350 Tetrasiklin Kapsul 500 mg - 200 108 70 122
351 Tiamfenikol Kapsul 250 mg - - - - -
352 Tiamfenikol Kapsul 500 mg - - - - -
353 Tramadol Injeksi 50 mg/ mL - - - - -
354 Tramadol Kapsul 50 mg - - - - -
355 Triamcinolon Asetonid Salep 1 mg - - - - -
356 Triheksifenidil tablet 2 mg - - - - -
357 Vaksin BCG - - - - -
358 Vaksin Campak - - - - -
359 Vaksin DPT - HB - - - - -
360 Vaksin DT - - - - -
361 Vaksin HBU - - - - -
362 Vaksin Polio - - - - -
363 Vaksin Td - - - - -
364 Vaksin TT - - - - -
365 Verapamil tablet 80 mg (HCl) - - - - -
366 Vitamin A Kapsul 100.000 IU 1,000 - - - -
367 Vitamin A Kapsul 200.000 IU 21,300 - - - -
368 Vitamin A Tablet 50.000 IU - - - - -
369 Vitamin B Kompleks Tablet 980 3,634 2,992 3,422 2,010
370 Vitamin B1 Injeksi 100 mg/ mL - - - - -
1 2 3 4 5 6 7
371 Vitamin B1 Tablet 50 mg 200 372 184 3,900 872
372 Vitamin B12 Injeksi 500 mcg - 11 7 10 -
373 Vitamin B12 Tablet 50 mcg 622 1,949 998 877 686
374 Vitamin B6 Tablet 10 mg 441 2,001 2,254 1,940 873
375 Vitamin C tablet 100 mg - - - - -
376 Vitamin C tablet 250 mg - - - - -
377 Vitamin C Tablet 50 mg 254 2,003 2,664 3,035 1,385
378 Vitamin K Injeksi 10 mg/ mL - 510 - - -
379 Vitamin K Tablet 10 mg - - - 300 -
380 Vitamin K1 Injeksi 2 mg/ mL - - - - 1,030
381 Vitamin K3 injeksi 10 mg/ml - - - - -
382 Zidovudin 300 mg + Lamivudine 150 mg Tablet - - - - -
383 Zidovudin tablet 100 mg - - - - -
384 Zidovudin tablet 300 mg + Lamivudine tablet - - - - -
150 mg
385 Zinc Tablet 20 mg - - 10 135 75
381 Anti Diare Non Spesifik 70 347 214 321 198
(Attapulgit 700 mg dan Pektin 50 mg) - - - - -
382 Anti Flu Kombinasi Kaplet - - - - -
(Parasetamol 500 mg, CTM 2 mg, PPA 12.5 mg - - - - -
383 Anti Flu Kombinasi Sirup - - - - -
(Parasetamol 500 mg, CTM 2 mg, PPA 12.5 mg - - - - -
384 Fluocinolone 0,25 mg + Neomisin Sulfat 5 mg - - 1 5 -
385 Gameksan + Asam Usnat Salep - - - - -
386 HES 6% dalam 0.9% NaCl (BM 130,000) - - - - -
387 Levertran Salep - - - 3 -
388 Multivitamin Kombinasi Kaplet - - - - 30
(As.Folat 1 mg dan Besi (II) Fumarat 90 mg) - - - - -
389 Multivitamin Kombinasi Sirup - - - - -
(DHA 32 mg, L-Lysin 200 mg) - - - - -
390 OAI Antihipertensi Kapsul - - - - -
391 OAI Curcuma Xanthorizae Tablet 20 mg - - - - -
- - - - -
B PERBEKALAN KESEHATAN/ BAHAN PAKAI HAB - - - - -
1 Alat Suntik Sekali Pakai 0.05 mL ADS - - - - -
2 Alat Suntik Sekali Pakai 0.5 mL ADS - - - - -
3 Alat Suntik Sekali Pakai 1 mL - - - - -
4 Alat Suntik Sekali Pakai 2.5 mL - - - - -
5 Alat Suntik Sekali Pakai 3 mL 250 11 7 60 50
6 Alat Suntik Sekali Pakai 5 mL 100 - - - 30
7 Alkohol 70 % Larutan 100 mL - 2 3 3 -
8 Alkohol 70 % Larutan 1000 mL - - - - -
9 Aqua Pro Injection ; 10 mL - - - - -
1 2 3 4 5 6 7
10 Aqua Pro Injection ; 20 mL - - - - 8
11 Catgut 2/0 dengan Jarum Bedah PLAIN - 5 - 2 3
12 Catgut 3/0 dengan Jarum Bedah PLAIN - - - - -
13 Catgut Chromic 2/0 Roll - - - 1 -
14 Catgut Plain 3/0 Roll - - - - -
15 Folley Catheter No. 16 - - - - -
16 Folley Catheter No. 18 - - - - -
17 Handscoon No. 7.5 (Non Steril) - - - - -
18 Handscoon No. 7.5 (Steril) - - - - -
19 Handscoon No.7 (Non Steril) - - - - -
20 Handscoon No.7 (Steril) - - - - -
21 Hidrogen Peroksida Larutan 3% - - - - -
22 Infus Set Anak - - - - 20
23 Infus Set Dewasa - 10 30 60 -
24 IV Catheter No. 18 G - - - - -
25 IV Catheter No. 20 G - - 20 30 -
26 IV Catheter No. 22 G - - 20 30 -
27 IV Catheter No. 24 G - - - - -
28 Jarum Jahit No. 11 1 - - - -
29 Jarum No. 23 G - - - - -
30 Jarum No. 24 G - - - - -
31 Jarum No. 25 G - - - - -
32 Jarum No. 26 G - - - - -
33 Jarum No. 27 G - - - - -
34 Kapas 250 gram - - - 1 -
35 Kasa Hidrofil Steril Ukuran 16 x 16 - - 3 - -
36 Kasa Kompres 40/40 Steril - - - - -
37 Kasa Pembalut 2 m X 80 cm - - - 7 1
38 Kasa Pembalut 4 m X 15 cm - - - - -
39 Kasa Pembalut Elastic 3 Inchi - - - - -
40 Kasa Pembalut Elastic 4 Inchi - - - - -
41 Kasa Pembalut Hidrofil 4 m x 10 cm - - - - -
42 Kasa Pembalut Hidrofil 4 m x 5 cm - - - - -
43 Lisol (Kresol tersaponifikasi 50%) ; 1 L - - - - -
44 Masker - - - - -
45 Minyak Emersi - 1 - - -
46 Pelarut Vaksin BCG/ Polio - - - - -
47 Plester 5 Yards x 2 Inchi - - 2 2 8
48 Silk No. 3/0 (Roll) - - - - -
49 Silk No. 3/0 dengan Jarum Bedah - - - 10 -
50 Slide - - - - -
51 Transfusi Set - - - - -
1 2 3 4 5 6 7
52 Urine Bag - - - - -
- - - - -
C PERBEKALAN KESEHATAN/ BAHAN GIGI - - - - -
1 Air Raksa Dental - - - - -
2 Alvogyil/ Alveopaste - - - - -
3 Articulating Paper - - - - -
4 Blade (ukuran : 11) - - - - -
5 Cocoa Butter - - - - -
6 Cresophen - - - - -
7 Dental Needle (Carpul) - - - - -
8 Devitalisasi Pasta (Non Arsen) 1 - - - -
9 Etil Klorid Spray 2 - 2 - -
10 Eugenol Cairan - - - - -
11 Glass Ionomer Cement ART 1 - - 1 -
12 Kalsium Hidroksida Pasta 1 - - 1 -
13 Klorfenol Kamfer Menthol (CHKM) 1 - - 1 -
14 Klorheksidin Larutan 0,2% - - - - -
15 Mata Bur High Speed - - - - -
16 Matriks Band - - - - -
17 Mummifying Pasta - - - - -
18 Obat Kumur Antiseptik - - - - -
(Benzalkonium Klorida Kombinasi) - - - - -
19 OCO (Tooth Cleansing Tincture) 1 - - - -
20 Selluloid Strip - - - - -
21 Semen Seng Fosfat serbuk & cairan - - - - -
22 Silver Amalgam Serbuk - 2 - 2 -
23 Spon Gelatin Steril (ukuran 10 x 10 x 10 mm) - - - - -
24 Temporary Filling Material 1 - - 1 -
25 Temporary Stopping (Fletcher) serbuk&cairan 1 - - 1 -
26 Topikal Anestesi - - - - -
27 Trikresol Formalin (TKF) Cair - - - - -
- - - - -
D PERBEKALAN KESEHATAN/ REAGEN - - - - -
1 Asam Hidroklorida 20% Cairan - - - - -
2 Benedict Larutan ; 100 mL - - - - -
3 HIV Reagent - - - - -
4 Metilen Blue Larutan - - - - -
5 Turk Larutan ; 100 mL - - - - -
6 Ziel Nielsen Larutan (1 Paket 3 Botol) - - - - -
- - - - -
E LAIN-LAIN/ YG BELUM TERCANTUM - - - - -
1 LYCODRYL DMP SIRUP 5 53 14 - -
1 2 3 4 5 6 7
2 ANTI DIARE / NEO KAOMINAL SIRUP 5 5 5 5 -
3 ADITUSIN tablet ( CTM + DMP ) - - - - -
4 FLUTOP C syrup - - - - -
5 HALOPERIDOL INJEKSI - - - - -
6 HANDSCOON non steril M - - - 100 -
7 HANDSCOON non steril S - - 100 100 -
8 TES YODIUM - - - - 102
JUN JUL JUMLAH
8 9 10
- - -
- - -
283 296 1,996
- - -
- - -
- - 100
600 - 2,600
- - 81
- - -
140 100 427
- - -
- - -
240 379 2,209
- - 5
- - -
- - -
5,501 5,750 36,150
- - -
156 132 1,037
567 - 2,822
- - 30
- - -
- - -
1,603 1,537 11,056
15 11 85
10 5 42
2 - 13
- 3 33
- - -
- - -
- - -
- - -
- - -
- - -
JUN JUL JUMLAH
8 9 10
- - -
- - -
- - -
120 10 23,400
- - -
3,730 706 5,706
- - -
- - -
- - -
- - -
- - -
- - -
7 5 73
- - -
30 75 505
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
40 16 132
- - -
- - -
- 8 12
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 10
6,853 3,995 24,178
- - -
- - -
- - -
- - 60
- - -
JUN JUL JUMLAH
8 9 10
- - -
- - 18
- - -
- - -
- - -
- 20 20
- - -
50 169 1,019
- 10 74
4 - 26
- 115 615
- - -
- - -
- - -
- - -
- - 90
- - -
- - -
1 1 26
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
10 10 20
- - -
- - -
- - -
- - -
- 25 50
62 - 90
10 - 40
20 - 34
- - -
- - -
- - -
- - -
JUN JUL JUMLAH
8 9 10
6 - 75
- - -
- - -
- - -
100 172 1,372
30 170 350
- - -
- - -
- - -
- - -
- - -
1,912 2,279 20,163
- - -
- - -
- - -
- 60 135
- - -
- - -
- - -
- - -
- - -
- - 211
- - -
- - -
- - -
- - -
17 - 500
- - -
- - -
- - -
137 282 1,532
25 49 199
- - -
- - -
- 8 17
- - -
804 912 7,381
- - -
338 246 1,846
- - -
- - -
- - -
JUN JUL JUMLAH
8 9 10
- - -
- - -
15 13 78
- - -
100 75 475
- - -
- - -
- - -
- - 17
- - -
- - -
- - -
- - -
- - -
- - -
- - -
220 70 1,970
32 34 141
- - -
48 2 151
9 15 90
- - 3,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
254 463 2,935
- - -
84 30 361
- - -
- - -
- - -
- - -
- - -
- - 50
12 20 122
- - -
JUN JUL JUMLAH
8 9 10
- - -
- - -
40 110 510
- - 500
- - 2
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
522 1,440 14,625
- - -
- - -
- - -
- - -
- - -
- 442 500
- - -
- - -
- - -
- - -
23 - 100
- - -
- - -
400 309 1,759
9 11 33
- - -
- - -
- - -
- - -
- - -
- - -
- - -
1,000 596 3,346
- - 40
- - -
JUN JUL JUMLAH
8 9 10
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 10
- - 2
- - 2
- - -
- - -
- - -
145 85 756
- - -
- - -
- - -
- - -
- - -
- - 90
180 409 1,639
- - 10
- - -
- - -
- - -
150 142 1,242
- - -
- - -
118 44 545
- - -
7,795 5,329 47,507
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- 10 12
- - -
- - -
JUN JUL JUMLAH
8 9 10
99 23 223
- - -
350 200 1,900
- - -
- - -
- - -
- - -
- - -
- - -
1,100 - 12,000
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
600 650 3,850
- - -
- - -
30 34 364
- - -
250 226 1,776
180 120 880
- - -
- - -
- - -
150 156 806
- - -
6 7 67
- - -
4 8 54
- - -
- - -
3 4 59
- - -
- - -
- - -
- - -
- - -
- - -
JUN JUL JUMLAH
8 9 10
- - -
- - -
- - -
- - -
- - 1
- - 3
- - -
100 34 334
- - -
- - -
- - -
- - -
700 52 2,552
- - -
- - -
- - -
- - -
- - -
- - -
- - -
20 - 20
- 8 508
- - -
- - -
10 - 10
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 1,000
- - 21,300
- - -
2,431 2,078 17,547
- - -
JUN JUL JUMLAH
8 9 10
1,084 - 6,612
10 - 38
1,052 928 7,112
2,184 1,075 10,768
- - -
- - -
1,178 1,637 12,156
- - 510
40 - 340
- - 1,030
- - -
- - -
- - -
- - -
70 8 298
362 164 1,676
- - -
- - -
- - -
- - -
- - -
12 1 19
- - -
- - -
1 3 7
20 - 50
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
82 55 515
20 - 150
2 - 10
- - -
- - -
JUN JUL JUMLAH
8 9 10
- 3 11
- - 10
- - -
- - 1
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 20
- - 100
- - -
- - 50
- - 50
- 50 50
- - 1
- - -
- - -
- - -
- - -
- - -
- - 1
10 - 13
- - -
- - 8
2 5 7
- - -
- - -
- - -
- 10 10
- - -
- - -
- - 1
- - -
- 2 14
- - -
- - 10
- - -
- - -
JUN JUL JUMLAH
8 9 10
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 1
- - 4
- - -
- - 2
- - 2
- - 2
- - -
- - -
- - -
- - -
- - -
- - -
- - 1
- - -
- - -
- - 4
- - -
- - 2
- - 2
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - -
- - 72
JUN JUL JUMLAH
8 9 10
3 5 28
- - -
- - -
- - -
- - 100
- - 200
- - 102

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UMUM BPJS JUML

SUKOLIYONO, SH, MM SIGIT JOKO RIYANTO, SKM .. RATNA PUSPITASARI, A.Md

PELAPOR (UPT PUSKESMAS/ INSTANSI)* : DAWE

UMUM BPJS JUML

SUKOLIYONO, SH, MM SIGIT JOKO RIYANTO, SKM .. RATNA PUSPITASARI, A.Md

PELAPOR (UPT PUSKESMAS/ INSTANSI)* : DAWE

UMUM BPJS JUML

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UMUM BPJS JUML

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UMUM BPJS JUML

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PENGELOLA OBAT PUSKESMAS

RATNA PUSPITASARI, A.Md

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UMUM BPJS JUML

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RATNA PUSPITASARI, A.Md

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