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LAPORAN PEMAKAIAN DAN

( LP
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGA
KODE NAMA OBAT KELAS SATU-
TERAPI AN
1 2 3
1 Abate Pack/1000 gr
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs
4 Air untuk injeksi 25 ml ampul 25 ml
5 Air untuk irigasi lar inf 1000 ml 5 Botol
6 Akarbose tab 50 mg 6.2.4 ktk/100tab
7 Alkohol swab 29 Box
8 Alat suntik sekali pakai 1 ml 32 100/ktk
9 Alat Suntik Sekali pakai 10 ml 32 ktk
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak
11 Alat suntik sekali pakai 5 ml 32 100set/ktk
12 Albendasol tab 400 mg bok/100tb
13 Alkohol 70% 1 liter btl
14 Allupurinol 14.1 box
15 Alprazolam tablet 0,5 mg 21.2.4 tablet
16 Amblodipin 10 mg 32 box
17 Ambroxol tab 10 mg box
18 Aminofilin inj 24 mg/ml 26.2 Ampul
19 aminopilin tab 6.2.2 btl
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet
22 Amoksisilin sir kering 125 mg/ml btl
23 Amoksisilin tab 500mg dus/100tab
24
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
2ml dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet
200 mg + Magnesium Hidroksida 200 mg 6.2.1
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot
10.000 UI/g 32
29 anti rabies verorab bok

30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot


32
31 Antihemoroid 31 Supp
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab
34 Aplicators set
35 Asam askorbit (vitamin C) kaplet 50 mg bok
36 Asam assetilsalisilat(aspilet) Bok
37 Asam folat tab 1 mg 6.2.2 Botol
38 Asam mefenamat 32 b0k
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab
40 Asam traneksamat inj 100mg/ml 32 Ampul
41 Aseptik gel
42 Asiklovir krim 5% 6.2.2 Tube
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp
45 Attapugit tab650 mg dus/100tab
46 Bedak salisil serbuk 2 % 25.1 pot
47 Betafort syrup botol
48 Basitrasin salep tube
49 Betametason 0,1% kream 6.2.1 tube
50 Bisakodil supositoria 10mg dus/50sup
51 Bisakodil supositoria 5mg dus/6sup
52 Blood Lancet ktk/100pcs
53 Brondisal 2mg 32 Dus 10 strip
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs
62 Caviton 29 Set
63 Cefadroxil sirup bok
64 Cefatroxil 500mg kap 23.2 Bok
65 Cepotaksim inj 20.3 dus/10vial 1gr
66 Ciprofloxacin tab 25.1 b0k
67 CTm (klorfeniramina Maleat tab 4 mg) bok
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp
69 Deksametason tab 0,5 mg bok
70 Dektran larutan infus 70% btl
71 Diasepm larutan rektal 5
72 Diazepam tab 2 mg 6.4.2.2 Botol
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul
74 Digoksin tab 0,25mg dus/100tab
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp
77 Disposable meroaplicators
78 Domperidon suspensi 5mg/5ml botol 60ml
79 Domperidon tab dus/100tab
80 elastis perban 23.4 Roll
81 Epineprin inj ktk/100Amp
82 Etanol 70% 100ml 6.4.2.1 botol
83 Eritromisin ktk
84 Etil klorida semprot 100ml botol 100ml
85 ETSA 14.2 Set
86 Eugenol cairan 6.2.1 botol

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet


89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp
90 Fixomull stretch 15 cm x 5 m 14.2 Roll
91 Furosemid Ktk/100tab
Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium
92 sachet
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube
94 Gentian Violet Lrutan 1 % 32 Botol
95 Glass lonomer cemet ART 27.2 Set
96 Glibenklamid tab 5 mg 32 ktk/100tab
97 Glimepirid tab 1 mg ktk/100tab
98 Glimepirid tab 2 mg ktk/100tab
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab
100 glove non Steril l (hanskund) ktk
101 Glove non steril m (hanskund) ktk
102 Glove non steril S ktk
103 Glove Surgical no 7.0 ktk/50pcs
104 Glove Surgical no 7.5 ktk/50pcs
105 Glukosa larutan infus 5 % steril 31 botol
106 Griseofulvin tablet 125 mg 32 ktk/100tab
107 Haloperidol 5 mg bok
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab
109 Haloperidol tab 1,5 mg bok
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb
111 Handscrub 500cc+dispenser btl
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet
113 Hidrokortison krim 2,5 % 14.1 tube/5gr
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet
115 Ibuprofen sir 100 mg/5 ml botol
116 Ibuprofen tablet 400 mg pcs
117 Infus Set Anak pcs
118 Infus Set Dewasa (Tipe Y) pcs
119 iodium tes Botol 10 ml
120 Isosorbid Dinitrat tab 5mg 1.2 tablet
121 Kalsium glukonat inj i.v 10% 29 Tube
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet
123 Kapas 250 gram Pcs
124 Kapas berlemak 500gr 20.3 Bungkus
125 Kapsul kosong 23.2 tablet
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab
127 Karbamazepin tab 200 mg Ktk/100tab
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll
130 Kertas Puyer Obat bks
131 Kertas puyer pres 6.2.1 bks
132 Ketokonasol krim 2% 7.2 tube
133 Ketokonazol tab 200 mg 32 Dus 5 strip
134 Ketorolac inj 10 mg 25.1 Ampul/10amp
135 Kloramfenikol suspensi 26.3 botol/60ml
136 Kloramfenikol salep mata 1 % tube
137 Kloramfenikol tetes mata 0,5% 5 Botol
138 Kloramfenikol tetes telinga1% 13.1 Botol
139 kalsium hidroksida pasta
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab
141 Kodein 25.4 btl
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143 ktk/100tab
Trimetoprim 80 mg 20.2
144 Kotrimoksasol suspensi 5 botol/60ml
145 lar. HCl 0,1 N botol
146 Leukoplast 7,5 cmx4,5m 1.2 Roll
147 Lipron B Plek 18.4 ktk/100tab
148 Lisol btl 1000ml
149 Loperamid tab 2 mg Ktk/100tab
150 Loratadin tablet 10 mg 32 ktk / 100 tab
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon
153 Masker one med Kait 6.1.1 ktk/50tab
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml
156 Metformin tab 500mg ktk/100yab
157 Metil prednisolon tab 4mg dus/100tab
158 Metilergometrin inj 0,2 mg/ml 18.4 Ampul
159 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab
160 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet
161 Metronidazol tab 500 mg 1.2 ktk/100tab
162 Mikonazol krim/salep 2 % (Nitrat) 23.2 tube
163 MTD MB Dewasa/Obat TBC 6.2.1 paket
164 MTD MB Anak/Obat TBC 25.4 paket
165 Mineral mik
166 NaCL 0,9 % Botol
167 Nasal Oksigen bayi pcs
168 Nasal oxsigen Anak pcs
169 Nasal oxsigen dewasa pcs
170 Natriun diklofent tab 50 mg 32 ktk/50 tab
171 Natriun Metamizole inj bok
172 Nifedipin kaps 10 mg 17.1 ktk/100kaps
173 Nistatin tab Ktk
174 Nistatin Vagina
175 Novabion kapsul
176 Novadiar sirup 26.1 btl/60ml
177 Noza tablet
178 Nurse cap bok/50 pcs
179 Obat Batuk hitam ( OBH) 14.1 Botol
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
180 20mg,sorbitol sirup with chocolate flavour q.c botol 60ml
181 Objeck Glass Frosted Dus/72 pcs
182 Objeck Glss frosted/slide 10.1 Box/72 pcs
183 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram
184 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak
185 Oksitosin inj10UI mg Ampul/100amp
186 Omeprasol kaps 20 mg Kapsu/3srtip
187 Omeprazol injeksi 40mg/10ml dus 10 vial
188 Ondansentron inj 2 mg/ml ampul
189 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll
190 Papaverin tablet 40 mg 31 1000 tablet / botol
191 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml
192 Parasetamol tab 500mg ktk/100tab
193 pembalut gips 6.2.1 Roll
194 Pelester non women roll 15x15 Roll
195 penjepit tl pstUmbilical Cord klem seteril nilon pcs
196 Permetrin krim 5 %(skabimite) 14.1 Tube
197 phenobarbital inj 6.1.1 ktk/30amp
198 Pipet tetes panjang 6.2.2 pcs
199 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol
200 Pirantel pamoat tablet 125mg dus/100tab
201 Pirantel suspensi 125 mg/5 ml 6.2.1 botol
202 Piridoksi vit B6 tab 10mg dus/100tab
203 Piroksikam tab 10 mg 6.3 ktk/100tab
204 Plastik klip sedang (5x8 cm) pak/100buah
205 plastik klip sedang (6x10 cm) pak/100buah
206 Plesterin Non Woven Roll 20cmx5m btl 500ml
207 poli kateter no 18 9 pcs
208 poli kateter no 20 21.2.4 pcs
209 poli kateter no 22 6.2.1 pcs
210 poli kateter no 24 6.2.1 pcs
211 Pot Sputum 3 btl
212 Povidon Iodida Larutan 10 % 26.1 btl/300ml
213 Povidon iodion 10% 6.2.2 botol/60ml
214 Prednison tab 11.2 Btl 1000tab
215 Primakuin tab 15 mg 21.2.1 ktk/100tab
216 Propanolol tab 10 mg 28.1 ktk/100tab
217 Propiltiourasil tab 100mg 6.2.4 ktk/100tab
218 Ranitidin inj 25 mg/ml 6.2.4 Ampul
219 Ranitidin kaplet 6.2.1 b0k
220 RDT DBD Box/20 pcs
221 RDT MALARIA Box/20 pcs
222 Reagen ZN
223 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap
224 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap
225 Ringer Laktat Larutan 6.3 botol
226 Rivanol 6.2.1 bt t/100ml
227 Rivanol 0,1% Btl 300 ml
228 Salbutamol tab 4mg bok
229 Salbutamol tab 2mg ktk
230 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot
231 Sarung tangan obgyn/panjang bok
232 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab
233 Seftriakson serb inj 1000mg/ml 6.2.2 Vial
234 Setirizin sirup 5 mg/5 ml botol 60ml
235 Setirizin ta 10 mg 25.4 ktk/100 kaps
236 Sianokobalamin (vit b12) inj 500 mcg dus/100amp
237 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs
238 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs
239 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet
240 Spasi inj 25.1 ktk / 10amp
241 Spritus 14.1 botol
242 Strip asam urat btl/25strp
243 Strip Gula Darah Nesco Btl/25strip
244 Strip kolesterol Nesco bt
245 Tabung EDTA ktk/100 pcs
246 Test kehamilan Box/50 pcs
247 tetrakain hcl tetes mata 0,5 13.2 btl
248 Tetrasiklin kap 500mg dus/100kap
249 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul
250 Tiamin (vit b1) tab 50mg ktk 100 tb
251 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul
252 Turniquit 20.3 pcs
253 Uniflex 15 cm x 4,5 m Roll
254 Urine Bag standard steril 2L.t (T valve) 26.1 Buah
255 Vacu needle
256 Vagistin Suppositoria bok 10 sup
257 vit C ktk/100tab
258 Vitamin b complek ktk/100tb
259 Vitamin B12 tab Btl
260 Zinc sir 20mg/5ml botol 60 ml
261 Zinc tab dispersible 20mg dus/100tab
262 OAT Anak dus
263 OAT Dewasa dus

UMUM
JUMLAH KUNJUNGAN RESEP
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui
Kepala Puskesmas Mepanga

Ketut Cita, A.Md.Kep.


NIP : 19730615 199403 1 009
APORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

: PARIGI MOUTONG BULAN : JANUARI


: SULAWESI TENGAH TAHUN : 2018
STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAAN
AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES ASKES
4 5 6=(4+5) 7=(6-8) 8 9 10 11 12
10 10 - 10
1,000 1,000 10 990
970 970 - 970
380 380 18 362
57 57 - 57
4,350 4,350 100 4,250
35 35 2 33
5,070 5,070 200 4,870
787 787 - 787
9,080 9,080 465 8,615
1,570 1,570 200 1,370
900 900 - 900
51 51 4 47
5,000 5,000 1,500 3,500
78 78 69 9 1000
12430 12,430 750 11,680
14,300 14,300 1,600 12,700
438 438 - 438
3,200 3,200 500 2,700
3,975 3,975 - 3,975
5,130 5,130 1,210 3,920
487 487 87 400
15,500 15,500 2,600 12,900

1670 1,670 176 1,494

4,000 4,000 300 3,700

18800 18,800 2,350 16,450

215 215 58 157

357 357 45 312

- - -

262 262 - 262

580 580 12 568

640 640 - 640

5,100 5,100 - 5,100


- - -
33,200 33,200 1,250 31,950
250 250 250 2500
2,350 2,350 300 2,050
27000 27,000 1,650 25,350
3,200 3,200 300 2,900
513 513 20 493
30 30 1 29
95 95 7 88
850 850 - 850
190 190 10 180
800 800 12 788
171 171 171 -
477 477 67 410
357 357 45 312
340 340 300 40
197 197 47 150
360 360 6 354
14 14 2 12
700 700 700
25 25 - 25
887 887 - 887
390 390 6 384
480 480 13 467
1,120 1,120 59 1,061
1,890 1,890 60 1,830
1,280 1,280 50 1,230
836 836 36 800
1 1 - 1
520 520 24 496
2,000 2,000 700 1,300
277 277 7 270
13300 13,300 1,250 12,050
46,200 46,200 2,800 43,400
2,195 2,195 40 2,155
50,500 50,500 1,400 49,100
24 24 10 14
40 40 15 25
500 500 2 498
432 432 54 378
2,220 2,220 120 2,100
24 24 - 24
1,300 1,300 - 1,300
1 1 - 1
352 352 27 325
2,500 2,500 200 2,300
13 13 - 13
485 485 25 460
357 357 23 334
2,300 2,300 - 2,300
9 9 1 8
- - -
3 3 - 3

7,600 7,600 1,000 6,600

- - - 2000
505 505 62 443
2 2 - 2
3,700 3,700 400 3,300

4,660 4,660 300 4,360

264 264 13 251


159 159 - 159
1 1 - 1
8,050 8,050 400 7,650
5,200 5,200 600 4,600
5,000 5,000 - 5,000
26,200 26,200 600 25,600
13 13 5 8
10 10 - 10
10 10 1 9
740 740 40 700
820 820 95 725
532 532 14 518
2,600 2,600 250 2,350
570 570 - 570
200 200 - 200
450 450 90 360
1380 1,380 - 1,380
28 28 5 23
3,400 3,400 200 3,200
565 565 21 544
2,400 2,400 600 1,800
47 47 3 44
2,000 2,000 450 1,550
100 100 60 40
1,242 1,242 66 1,176
47 47 10 37
2,970 2,970 - 2,970
44 44 4 40
2,250 2,250 1,050 1,200 2000
242 242 6 236
36 36 6 30
2,950 2,950 - 2,950
6,400 6,400 1,000 5,400
2,280 2,280 - 2,280
39 39 4 35
300 300 50 250
1 1 - 1
4 4 - 4
829 829 19 810
2,000 2,000 150 1,850
500 500 35 465
130 130 22 108
5 5 5 150
30 30 10 20
70 70 17 53
1 1 - 1
880 880 - 880
- - - 100
5,750 5,750 750 5,000

14,550 14,550 250 14,300

1242 1,242 - 1,242


1 1 1 -
127 127 5 122
10,000 10,000 1,200 8,800
10 10 1 9
850 850 350 500
650 650 150 500 1000
71 71 - 71
80 80 - 80
34 34 4 30
150 150 - 150
- - - 100
12,950 12,950 700 12,250
2,800 2,800 900 1,900
1,800 1,800 45 1,755
500 500 150 350 1000
1,750 1,750 50 1,700
3,700 3,700 - 3,700
392 392 7 385
12 12 5 7 15
3 3 - 3 5
4 4 - 4
321 321 36 285
25 25 2 23
43 43 5 38
43 43 5 38
150 150 150 2000
65 65 10 55
2,400 2,400 100 2,300
750 750 100 650 2000
170 170 130 40 500
11,100 11,100 1,050 10,050
470 470 37 433
1,000 1,000 25 975
1 1 1
120 120 6 114
130 130 16 114
12 12 - 12
144 144 - 144
100 100 28 72
204 204 10 194
1,037 1,037 57 980
13,110 13,110 860 12,250
85 85 10 75
500 500 25 475
250 250 - 250
15,300 15,300 100 15,200
555 555 101 454
45,400 45,400 3,950 41,450
152 152 - 152
19 19 1 18
1,150 1,150 33 1,117
199 199 - 199
390 390 - 390
100 100 - 100
73 73 6 67
800 800 - 800
27 27 5 22
5,250 5,250 700 4,550
3,650 3,650 1,150 2,500
8 8 1 7
25 25 - 25
5 5 - 5
20 20 10 10
65 65 6 59
50 50 - 50
50 50 - 50
250 250 80 170
52 52 7 45
- - -
29,000 29,000 1,000 28,000
1,200 1,200 - 1,200
3,220 3,220 220 3,000
2,000 2,000 300 1,700
1,610 1,610 285 1,325
39300 39,300 1,250 38,050
1 1 - 1
7 7 - 7
10 10 - 10
1 1 1
- - -
803 803 207 596
30 30 20 10
116 116 1 115
3,000 3,000 100 2,900
700 700 700
517 517 13 504
421 421 3 418
600 600 500 100 1000
444 444 12 432
48 48 3 45
1,700 1,700 250 1,450
1,844 1,844 149 1,695
604 604 26 578
632 632 6 626
15270 15,270 1,110 14,160
15 15 15
- - - 10
18 18 5 13
18 18 6 12
30 30 11 19
2 2 1 1
475 475 175 300
37 37 - 37
800 800 50 750
- - -
900 900 900 2000
7 7 2 5 100
1 1 1 5
15 15 - 15
70 70 5 65
1 1 1
182 182 - 182
34,550 34,550 2,600 31,950
45,000 45,000 1,350 43,650
5,900 5,900 250 5,650
50 50 10 40
2,700 2,700 200 2,500
- - 5
- - 5

UMUM
ASKES JUMLAH
ASKES JUMLAH
TIDAK BAYAR

Sumber Agung ,Januari 2018


Petugas

Ni Ketut Suriati, A.Md.Far


NIP/NRPTT : 19790320 201001 2 001
PEMBERIAAN KET
APBD LAIN JML
13 14 15 16
nuari 2018

320 201001 2 001


LAPORAN PEMAKAIAN D

KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTO
KECAMATAN : MEPANGA PROPINSI : SULAWESI TEN
KODE NAMA OBAT KELAS SATU-
TERAPI AN
1 2 3
1 Abate Pack/1000 gr
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs
4 Air untuk injeksi 25 ml ampul 25 ml
5 Air untuk irigasi lar inf 1000 ml 5 Botol
6 Akarbose tab 50 mg 6.2.4 ktk/100tab
7 Alkohol swab 29 Box
8 Alat suntik sekali pakai 1 ml 32 100/ktk
9 Alat Suntik Sekali pakai 10 ml 32 ktk
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak
11 Alat suntik sekali pakai 5 ml 32 100set/ktk
12 Albendasol tab 400 mg bok/100tb
13 Alkohol 70% 1 liter btl
14 Allupurinol 14.1 box
15 Alprazolam tablet 0,5 mg 21.2.4 tablet
16 Amblodipin 10 mg 32 box
17 Ambroxol tab 10 mg box
18 Aminofilin inj 24 mg/ml 26.2 Ampul
19 aminopilin tab 6.2.2 btl
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet
22 Amoksisilin sir kering 125 mg/ml btl
23 Amoksisilin tab 500mg dus/100tab
24
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
2ml dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet
200 mg + Magnesium Hidroksida 200 mg 6.2.1
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot
10.000 UI/g 32
29 anti rabies verorab bok

30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot


32
31 Antihemoroid 31 Supp
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab
34 Aplicators set
35 Asam askorbit (vitamin C) kaplet 50 mg bok
36 Asam assetilsalisilat(aspilet) Bok
37 Asam folat tab 1 mg 6.2.2 Botol
38 Asam mefenamat 32 b0k
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab
40 Asam traneksamat inj 100mg/ml 32 Ampul
41 Aseptik gel
42 Asiklovir krim 5% 6.2.2 Tube
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp
45 Attapugit tab650 mg dus/100tab
46 Bedak salisil serbuk 2 % 25.1 pot
47 Betafort syrup botol
48 Basitrasin salep tube
49 Betametason 0,1% kream 6.2.1 tube
50 Bisakodil supositoria 10mg dus/50sup
51 Bisakodil supositoria 5mg dus/6sup
52 Blood Lancet ktk/100pcs
53 Brondisal 2mg 32 Dus 10 strip
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs
62 Caviton 29 Set
63 Cefadroxil sirup bok
64 Cefatroxil 500mg kap 23.2 Bok
65 Cepotaksim inj 20.3 dus/10vial 1gr
66 Ciprofloxacin tab 25.1 b0k
67 CTm (klorfeniramina Maleat tab 4 mg) bok
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp
69 Deksametason tab 0,5 mg bok
70 Dektran larutan infus 70% btl
71 Diasepm larutan rektal 5
72 Diazepam tab 2 mg 6.4.2.2 Botol
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul
74 Digoksin tab 0,25mg dus/100tab
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp
77 Disposable meroaplicators
78 Domperidon suspensi 5mg/5ml botol 60ml
79 Domperidon tab dus/100tab
80 elastis perban 23.4 Roll
81 Epineprin inj ktk/100Amp
82 Etanol 70% 100ml 6.4.2.1 botol
83 Eritromisin ktk
84 Etil klorida semprot 100ml botol 100ml
85 ETSA 14.2 Set
86 Eugenol cairan 6.2.1 botol

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet


89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp
90 Fixomull stretch 15 cm x 5 m 14.2 Roll
91 Furosemid Ktk/100tab
Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium
92 sachet
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube
94 Gentian Violet Lrutan 1 % 32 Botol
95 Glass lonomer cemet ART 27.2 Set
96 Glibenklamid tab 5 mg 32 ktk/100tab
97 Glimepirid tab 1 mg ktk/100tab
98 Glimepirid tab 2 mg ktk/100tab
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab
100 glove non Steril l (hanskund) ktk
101 Glove non steril m (hanskund) ktk
102 Glove non steril S ktk
103 Glove Surgical no 7.0 ktk/50pcs
104 Glove Surgical no 7.5 ktk/50pcs
105 Glukosa larutan infus 5 % steril 31 botol
106 Griseofulvin tablet 125 mg 32 ktk/100tab
107 Haloperidol 5 mg bok
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab
109 Haloperidol tab 1,5 mg bok
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb
111 Handscrub 500cc+dispenser btl
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet
113 Hidrokortison krim 2,5 % 14.1 tube/5gr
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet
115 Ibuprofen sir 100 mg/5 ml botol
116 Ibuprofen tablet 400 mg pcs
117 Infus Set Anak pcs
118 Infus Set Dewasa (Tipe Y) pcs
119 iodium tes Botol 10 ml
120 Isosorbid Dinitrat tab 5mg 1.2 tablet
121 Kalsium glukonat inj i.v 10% 29 Tube
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet
123 Kapas 250 gram Pcs
124 Kapas berlemak 500gr 20.3 Bungkus
125 Kapsul kosong 23.2 tablet
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab
127 Karbamazepin tab 200 mg Ktk/100tab
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll
130 Kertas Puyer Obat bks
131 Kertas puyer pres 6.2.1 bks
132 Ketokonasol krim 2% 7.2 tube
133 Ketokonazol tab 200 mg 32 Dus 5 strip
134 Ketorolac inj 10 mg 25.1 Ampul/10amp
135 Kloramfenikol suspensi 26.3 botol/60ml
136 Kloramfenikol salep mata 1 % tube
137 Kloramfenikol tetes mata 0,5% 5 Botol
138 Kloramfenikol tetes telinga1% 13.1 Botol
139 kalsium hidroksida pasta
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab
141 Kodein 25.4 btl
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143 ktk/100tab
Trimetoprim 80 mg 20.2
144 Kotrimoksasol suspensi 5 botol/60ml
145 lar. HCl 0,1 N botol
146 Leukoplast 7,5 cmx4,5m 1.2 Roll
147 Lipron B Plek 18.4 ktk/100tab
148 Lisol btl 1000ml
149 Loperamid tab 2 mg Ktk/100tab
150 Loratadin tablet 10 mg 32 ktk / 100 tab
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon
153 Masker one med Kait 6.1.1 ktk/50tab
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml
156 Metformin tab 500mg ktk/100yab
157 Metil prednisolon tab 4mg dus/100tab
158 Metilergometrin inj 0,2 mg/ml 18.4 Ampul
159 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab
160 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet
161 Metronidazol tab 500 mg 1.2 ktk/100tab
162 Mikonazol krim/salep 2 % (Nitrat) 23.2 tube
163 MTD MB Dewasa/kusta 6.2.1 paket
164 MTD MB Anak/kusta 25.4 paket
165 Mineral mik
166 NaCL 0,9 % Botol
167 Nasal Oksigen bayi pcs
168 Nasal oxsigen Anak pcs
169 Nasal oxsigen dewasa pcs
170 Natriun diklofent tab 50 mg 32 ktk/50 tab
171 Natriun Metamizole inj bok
172 Nifedipin kaps 10 mg 17.1 ktk/100kaps
173 Nistatin tab Ktk
174 Nistatin Vagina
175 Novabion kapsul
176 Novadiar sirup 26.1 btl/60ml
177 Noza tablet
178 Nurse cap bok/50 pcs
179 Obat Batuk hitam ( OBH) 14.1 Botol
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
180 20mg,sorbitol sirup with chocolate flavour q.c botol 60ml
181 Objeck Glass Frosted Dus/72 pcs
182 Objeck Glss frosted/slide 10.1 Box/72 pcs
183 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram
184 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak
185 Oksitosin inj10UI mg Ampul/100amp
186 Omeprasol kaps 20 mg Kapsu/3srtip
187 Omeprazol injeksi 40mg/10ml dus 10 vial
188 Ondansentron inj 2 mg/ml ampul
189 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll
190 Papaverin tablet 40 mg 31 1000 tablet / botol
191 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml
192 Parasetamol tab 500mg ktk/100tab
193 pembalut gips 6.2.1 Roll
194 Pelester non women roll 15x15 Roll
195 penjepit tl pstUmbilical Cord klem seteril nilon pcs
196 Permetrin krim 5 %(skabimite) 14.1 Tube
197 phenobarbital inj 6.1.1 ktk/30amp
198 Pipet tetes panjang 6.2.2 pcs
199 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol
200 Pirantel pamoat tablet 125mg dus/100tab
201 Pirantel suspensi 125 mg/5 ml 6.2.1 botol
202 Piridoksi vit B6 tab 10mg dus/100tab
203 Piroksikam tab 10 mg 6.3 ktk/100tab
204 Plastik klip sedang (5x8 cm) pak/100buah
205 plastik klip sedang (6x10 cm) pak/100buah
206 Plesterin Non Woven Roll 20cmx5m btl 500ml
207 poli kateter no 18 9 pcs
208 poli kateter no 20 21.2.4 pcs
209 poli kateter no 22 6.2.1 pcs
210 poli kateter no 24 6.2.1 pcs
211 Pot Sputum 3 btl
212 Povidon Iodida Larutan 10 % 26.1 btl/300ml
213 Povidon iodion 10% 6.2.2 botol/60ml
214 Prednison tab 11.2 Btl 1000tab
215 Primakuin tab 15 mg 21.2.1 ktk/100tab
216 Propanolol tab 10 mg 28.1 ktk/100tab
217 Propiltiourasil tab 100mg 6.2.4 ktk/100tab
218 Ranitidin inj 25 mg/ml 6.2.4 Ampul
219 Ranitidin kaplet 6.2.1 b0k
220 RDT DBD Box/20 pcs
221 RDT MALARIA Box/20 pcs
222 Reagen ZN
223 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap
224 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap
225 Ringer Laktat Larutan 6.3 botol
226 Rivanol 6.2.1 bt t/100ml
227 Rivanol 0,1% Btl 300 ml
228 Salbutamol tab 4mg bok
229 Salbutamol tab 2mg ktk
230 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot
231 Sarung tangan obgyn/panjang bok
232 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab
233 Seftriakson serb inj 1000mg/ml 6.2.2 Vial
234 Setirizin sirup 5 mg/5 ml botol 60ml
235 Setirizin ta 10 mg 25.4 ktk/100 kaps
236 Sianokobalamin (vit b12) inj 500 mcg dus/100amp
237 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs
238 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs
239 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet
240 Spasi inj 25.1 ktk / 10amp
241 Spritus 14.1 botol
242 Strip asam urat btl/25strp
243 Strip Gula Darah Nesco Btl/25strip
244 Strip kolesterol Nesco bt
245 Tabung EDTA ktk/100 pcs
246 Test kehamilan Box/50 pcs
247 tetrakain hcl tetes mata 0,5 13.2 btl
248 Tetrasiklin kap 500mg dus/100kap
249 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul
250 Tiamin (vit b1) tab 50mg ktk 100 tb
251 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul
252 Turniquit 20.3 pcs
253 Uniflex 15 cm x 4,5 m Roll
254 Urine Bag standard steril 2L.t (T valve) 26.1 Buah
255 Vacu needle
256 Vagistin Suppositoria bok 10 sup
257 vit C ktk/100tab
258 Vitamin b complek ktk/100tb
259 Vitamin B12 tab Btl
260 Zinc sir 20mg/5ml botol 60 ml
261 Zinc tab dispersible 20mg dus/100tab
262 OAT Anak dus
263 OAT Dewasa dus
264 Gloves surgical no.6,5 pasang
265 Gloves surgical no.8,0 pasang
266 Plesterin Non Woven Roll 5cmx5m Roll
267 Plesterin Non Women Roll 10cmx5m Roll
268 Ecodine 5 liter Botol 5000 ml
269 Arm Sling M pcs
270 Arm Sling L pcs
271 Reagen pemerisaan gol.darah paket
272 Strip Haemoglobin botol/25 strip
273 Haemoglobin test Buah

UMUM
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui
Kepala Puskesmas Mepanga

Ketut Cita, A.Md.Kep.


NIP : 19730615 199403 1 009
APORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

: PARIGI MOUTONG LAPORAN : Februari


: SULAWESI TENGAH TAHUN : 2018
STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAAN
AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES ASKES
4 5 6=(4+5) 7=(6-8) 8 9 10 11 12
10 10 10 -
990 990 10 980
970 970 - 970
362 362 18 344
57 57 - 57
4,250 4,250 - 4,250
33 33 3 30
4,870 4,870 270 4,600
787 787 - 787
8,615 8,615 675 7,940
1,370 1,370 210 1,160
900 900 100 800
47 47 27 20
3,500 3,500 1,000 2,500
9 9 9 -
11,680 11,680 630 11,050
12,700 12,700 2,100 10,600
438 438 102 336
2,700 2,700 - 2,700
3,975 3,975 100 3,875
18,920 18,920 2,520 16,400
400 400 65 335
12,900 12,900 3,000 9,900

1,494 1,494 84 1,410

3,700 3,700 200 3,500

16,450 16,450 2,850 13,600

157 157 57 100

312 312 117 195

- - 10
262 262 - 262

568 568 30 538

640 640 - 640

5,100 5,100 300 4,800


- -
31,950 31,950 1,900 30,050
500 500 300 200 2000
2,050 2,050 300 1,750
25,350 25,350 800 24,550
2,900 2,900 900 2,000
493 493 - 493
29 32 61 - 61
88 88 18 70
850 850 - 850
180 180 - 180
788 788 60 728
- - - -
410 410 69 341
312 312 117 195
300 300 15 285
150 150 - 150
354 354 - 354
12 15 27 3 24
- -
25 25 10 15
887 120 1,007 - 1,007
384 384 5 379
467 467 17 450
1,061 200 1,261 20 1,241
1,830 1,830 39 1,791
1,230 300 1,530 210 1,320
800 800 93 707
1 1 - 1
496 496 29 467
1,300 1,300 700 600 2500
270 270 6 264
12,050 12,050 2,050 10,000
43,400 43,400 2,800 40,600
2,155 2,155 135 2,020
49,100 49,100 1,000 48,100
14 14 - 14
25 25 - 25
498 498 10 488
378 378 63 315
2,100 2,100 600 1,500
24 24 - 24
1,300 1,300 - 1,300
1 1 - 1
325 325 16 309
2,300 2,300 100 2,200
13 13 - 13
460 460 - 460
334 334 42 292
2,300 2,300 - 2,300
8 8 2 6
- -
3 3 - 3

6,600 6,600 3,850 2,750


5000
- - 2500
443 443 63 380
2 2 - 2
3,300 3,300 350 2,950

4,360 4,360 - 4,360

251 251 16 235


159 159 9 150
1 1 - 1
7,650 7,650 150 7,500
4,600 4,600 300 4,300
5,000 5,000 50 4,950
25,600 25,600 2,450 23,150
8 25 33 - 33
10 25 35 2 33
9 9 4 5
700 700 - 700
725 725 160 565
518 518 101 417
2,350 2,350 500 1,850
570 570 100 470
200 200 - 200
360 360 70 290
1,380 1,380 680 700
23 23 5 18
3,200 3,200 - 3,200
544 544 36 508
1,800 1,800 600 1,200
44 44 5 39
1,550 1,550 500 1,050
40 40 40 - 250
1,176 150 1,326 376 950
37 37 - 37
2,970 2,970 200 2,770
40 40 5 35
1,200 1000 2,200 1,200 1,000
236 236 4 232
30 30 - 30
2,950 2,950 - 2,950
5,400 5,400 750 4,650
2,280 2,280 40 2,240
35 35 - 35
250 250 75 175
1 1 1 -
4 5 9 - 9
810 810 10 800
1,850 1,850 50 1,800
465 465 60 405
108 108 27 81
96 96 54 42 200
20 20 20 - 100
53 53 3 50
1 1 - 1
880 880 - 880
100 100 40 60
5,000 5,000 900 4,100

14,300 14,300 400 13,900

1,242 1,242 - 1,242


- - - -
122 122 12 110
8,800 8,800 1,200 7,600
9 9 4 5 20
500 500 500 - 1000
500 1000 1,500 300 1,200
71 71 - 71
80 80 - 80
30 30 4 26
150 150 10 140
- - 100
12,250 12,250 1,050 11,200
1,900 1,900 700 1,200
1,755 1,755 5 1,750
350 1,000 1,350 - 1,350
1,700 1,700 400 1,300
3,700 3,700 2,300 1,400
385 385 10 375
5 5 - 5
2 2 - 2
4 4 - 4
285 285 95 190
23 23 - 23
38 38 - 38
38 38 - 38
2,000 2,000 800 1,200 2000
55 55 10 45
2,300 2,300 200 2,100
650 500 1,150 100 1,050
40 40 10 30 200
10,050 10,050 1,550 8,500
433 433 17 416
975 975 165 810
- -
114 114 19 95
114 114 5 109
12 12 - 12
144 144 - 144
72 72 17 55 100
194 194 4 190
980 980 83 897
12,250 12,250 840 11,410
75 75 - 75
475 475 67 408
250 250 - 250
15,200 15,200 - 15,200
454 454 92 362
41,450 41,450 4,050 37,400
152 152 - 152
18 18 3 15
1,117 1,117 87 1,030
199 199 - 199
390 390 - 390
100 100 - 100
67 67 5 62
800 800 - 800
22 22 - 22
4,550 4,550 200 4,350
2,500 2,500 1,500 1,000 2500
7 9 16 - 16
25 10 35 11 24
5 5 - 5
10 10 - 10
59 59 29 30
50 50 20 30
50 50 - 50
170 170 50 120
45 45 6 39
- -
28,000 28,000 3,000 25,000
1,200 1,200 - 1,200
3,000 3,000 200 2,800
1,700 1,700 - 1,700
1,325 1,325 105 1,220
38,050 38,050 1,050 37,000
1 1 1 -
7 7 4 3
10 10 - 10
20 20 7 13
120 120 44 76
596 596 260 336
10 10 3 7
115 115 - 115
2,900 5,000 7,900 400 7,500
- -
504 504 - 504
418 418 - 418
100 100 100 - 2500
432 432 6 426
45 45 - 45
1,450 1,450 100 1,350
1,695 1,695 340 1,355
578 578 150 428
626 626 154 472
14,160 14,160 1,160 13,000
- -
- - 5
13 20 33 3 30
12 30 42 3 39
19 2 21 6 15
1 1 - 1
300 300 15 285
37 37 19 18
750 750 50 700
- -
2,000 2,000 900 1,100 1000
10 10 5 5 50
- - 5
15 15 - 15
65 65 15 50
1 1 1
182 182 20 162
31,950 31,950 1,900 30,050
43,650 43,650 950 42,700
5,650 5,650 1,450 4,200
40 40 - 40
2,500 2,500 5,000 - 5,000
- - 6
- - - 10
250 250 - 250
200 200 - 200
15 15 - 15
7 7 - 7
1 1 - 1
5 5 - 5
5 5 - 5
5 5 2 3
7 7 1 6
1 1 1 -

UMUM
ASKES JUMLAH
TIDAK BAYAR

Sumber Agung ,Februari 2018


Petugas

Ni Ketut Suriati, A.Md.Far


NIP/NRPTT : 19790320 201001 2 001
PEMBERIAAN KET
APBD LAIN JML
13 14 15 16
680 ED
bruari 2018

320 201001 2 001


LAPORAN PEMAKAIAN D

KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTO
KECAMATAN : MEPANGA PROPINSI : SULAWESI TEN
KODE NAMA OBAT KELAS SATU-
TERAPI AN
1 2 3
1 Abate Pack/1000 gr
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs
4 Air untuk injeksi 25 ml ampul 25 ml
5 Air untuk irigasi lar inf 1000 ml 5 Botol
6 Akarbose tab 50 mg 6.2.4 ktk/100tab
7 Alkohol swab 29 Box
8 Alat suntik sekali pakai 1 ml 32 100/ktk
9 Alat Suntik Sekali pakai 10 ml 32 ktk
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak
11 Alat suntik sekali pakai 5 ml 32 100set/ktk
12 Albendasol tab 400 mg bok/100tb
13 Alkohol 70% 1 liter btl
14 Allupurinol 14.1 box
15 Alprazolam tablet 0,5 mg 21.2.4 tablet
16 Amblodipin 10 mg 32 box
17 Ambroxol tab 10 mg box
18 Aminofilin inj 24 mg/ml 26.2 Ampul
19 aminopilin tab 6.2.2 btl
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet
22 Amoksisilin sir kering 125 mg/ml btl
23 Amoksisilin tab 500mg dus/100tab
24
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
2ml dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet
200 mg + Magnesium Hidroksida 200 mg 6.2.1
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot
10.000 UI/g 32
29 anti rabies verorab bok

30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot


32
31 Antihemoroid 31 Supp
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab
34 Aplicators set
35 Asam askorbit (vitamin C) kaplet 50 mg bok
36 Asam assetilsalisilat(aspilet) Bok
37 Asam folat tab 1 mg 6.2.2 Botol
38 Asam mefenamat 32 b0k
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab
40 Asam traneksamat inj 100mg/ml 32 Ampul
41 Aseptik gel
42 Asiklovir krim 5% 6.2.2 Tube
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp
45 Attapugit tab650 mg dus/100tab
46 Bedak salisil serbuk 2 % 25.1 pot
47 Betafort syrup botol
48 Basitrasin salep tube
49 Betametason 0,1% kream 6.2.1 tube
50 Bisakodil supositoria 10mg dus/50sup
51 Bisakodil supositoria 5mg dus/6sup
52 Blood Lancet ktk/100pcs
53 Brondisal 2mg 32 Dus 10 strip
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs
62 Caviton 29 Set
63 Cefadroxil sirup bok
64 Cefatroxil 500mg kap 23.2 Bok
65 Cepotaksim inj 20.3 dus/10vial 1gr
66 Ciprofloxacin tab 25.1 b0k
67 CTm (klorfeniramina Maleat tab 4 mg) bok
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp
69 Deksametason tab 0,5 mg bok
70 Dektran larutan infus 70% btl
71 Diasepm larutan rektal 5
72 Diazepam tab 2 mg 6.4.2.2 Botol
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul
74 Digoksin tab 0,25mg dus/100tab
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp
77 Disposable meroaplicators
78 Domperidon suspensi 5mg/5ml botol 60ml
79 Domperidon tab dus/100tab
80 elastis perban 23.4 Roll
81 Epineprin inj ktk/100Amp
82 Etanol 70% 100ml 6.4.2.1 botol
83 Eritromisin ktk
84 Etil klorida semprot 100ml botol 100ml
85 ETSA 14.2 Set
86 Eugenol cairan 6.2.1 botol

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet


89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp
90 Fixomull stretch 15 cm x 5 m 14.2 Roll
91 Furosemid Ktk/100tab
Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium
92 sachet
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube
94 Gentian Violet Lrutan 1 % 32 Botol
95 Glass lonomer cemet ART 27.2 Set
96 Glibenklamid tab 5 mg 32 ktk/100tab
97 Glimepirid tab 1 mg ktk/100tab
98 Glimepirid tab 2 mg ktk/100tab
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab
100 glove non Steril l (hanskund) ktk
101 Glove non steril m (hanskund) ktk
102 Glove non steril S ktk
103 Glove Surgical no 7.0 ktk/50pcs
104 Glove Surgical no 7.5 ktk/50pcs
105 Glukosa larutan infus 5 % steril 31 botol
106 Griseofulvin tablet 125 mg 32 ktk/100tab
107 Haloperidol 5 mg bok
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab
109 Haloperidol tab 1,5 mg bok
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb
111 Handscrub 500cc+dispenser btl
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet
113 Hidrokortison krim 2,5 % 14.1 tube/5gr
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet
115 Ibuprofen sir 100 mg/5 ml botol
116 Ibuprofen tablet 400 mg pcs
117 Infus Set Anak pcs
118 Infus Set Dewasa (Tipe Y) pcs
119 iodium tes Botol 10 ml
120 Isosorbid Dinitrat tab 5mg 1.2 tablet
121 Kalsium glukonat inj i.v 10% 29 Tube
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet
123 Kapas 250 gram Pcs
124 Kapas berlemak 500gr 20.3 Bungkus
125 Kapsul kosong 23.2 tablet
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab
127 Karbamazepin tab 200 mg Ktk/100tab
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll
130 Kertas Puyer Obat bks
131 Kertas puyer pres 6.2.1 bks
132 Ketokonasol krim 2% 7.2 tube
133 Ketokonazol tab 200 mg 32 Dus 5 strip
134 Ketorolac inj 10 mg 25.1 Ampul/10amp
135 Kloramfenikol suspensi 26.3 botol/60ml
136 Kloramfenikol salep mata 1 % tube
137 Kloramfenikol tetes mata 0,5% 5 Botol
138 Kloramfenikol tetes telinga1% 13.1 Botol
139 kalsium hidroksida pasta
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab
141 Kodein 25.4 btl
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143 ktk/100tab
Trimetoprim 80 mg 20.2
144 Kotrimoksasol suspensi 5 botol/60ml
145 lar. HCl 0,1 N botol
146 Leukoplast 7,5 cmx4,5m 1.2 Roll
147 Lipron B Plek 18.4 ktk/100tab
148 Lisol btl 1000ml
149 Loperamid tab 2 mg Ktk/100tab
150 Loratadin tablet 10 mg 32 ktk / 100 tab
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon
153 Masker one med Kait 6.1.1 ktk/50tab
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml
156 Metformin tab 500mg ktk/100yab
157 Metil prednisolon tab 4mg dus/100tab
158 Metilergometrin inj 0,2 mg/ml 18.4 Ampul
159 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab
160 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet
161 Metronidazol tab 500 mg 1.2 ktk/100tab
162 Mikonazol krim/salep 2 % (Nitrat) 23.2 tube
163 MTD MB Dewasa/kusta 6.2.1 paket
164 MTD MB Anak/kusta 25.4 paket
165 Mineral mik
166 NaCL 0,9 % Botol
167 Nasal Oksigen bayi pcs
168 Nasal oxsigen Anak pcs
169 Nasal oxsigen dewasa pcs
170 Natriun diklofent tab 50 mg 32 ktk/50 tab
171 Natriun Metamizole inj bok
172 Nifedipin kaps 10 mg 17.1 ktk/100kaps
173 Nistatin tab Ktk
174 Nistatin Vagina
175 Novabion kapsul
176 Novadiar sirup 26.1 btl/60ml
177 Noza tablet
178 Nurse cap bok/50 pcs
179 Obat Batuk hitam ( OBH) 14.1 Botol
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
180 20mg,sorbitol sirup with chocolate flavour q.c botol 60ml
181 Objeck Glass Frosted Dus/72 pcs
182 Objeck Glss frosted/slide 10.1 Box/72 pcs
183 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram
184 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak
185 Oksitosin inj10UI mg Ampul/100amp
186 Omeprasol kaps 20 mg Kapsu/3srtip
187 Omeprazol injeksi 40mg/10ml dus 10 vial
188 Ondansentron inj 2 mg/ml ampul
189 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll
190 Papaverin tablet 40 mg 31 1000 tablet / botol
191 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml
192 Parasetamol tab 500mg ktk/100tab
193 pembalut gips 6.2.1 Roll
194 Pelester non women roll 15x15 Roll
195 penjepit tl pstUmbilical Cord klem seteril nilon pcs
196 Permetrin krim 5 %(skabimite) 14.1 Tube
197 phenobarbital inj 6.1.1 ktk/30amp
198 Pipet tetes panjang 6.2.2 pcs
199 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol
200 Pirantel pamoat tablet 125mg dus/100tab
201 Pirantel suspensi 125 mg/5 ml 6.2.1 botol
202 Piridoksi vit B6 tab 10mg dus/100tab
203 Piroksikam tab 10 mg 6.3 ktk/100tab
204 Plastik klip sedang (5x8 cm) pak/100buah
205 plastik klip sedang (6x10 cm) pak/100buah
206 Plesterin Non Woven Roll 20cmx5m btl 500ml
207 poli kateter no 18 9 pcs
208 poli kateter no 20 21.2.4 pcs
209 poli kateter no 22 6.2.1 pcs
210 poli kateter no 24 6.2.1 pcs
211 Pot Sputum 3 btl
212 Povidon Iodida Larutan 10 % 26.1 btl/300ml
213 Povidon iodion 10% 6.2.2 botol/60ml
214 Prednison tab 11.2 Btl 1000tab
215 Primakuin tab 15 mg 21.2.1 ktk/100tab
216 Propanolol tab 10 mg 28.1 ktk/100tab
217 Propiltiourasil tab 100mg 6.2.4 ktk/100tab
218 Ranitidin inj 25 mg/ml 6.2.4 Ampul
219 Ranitidin kaplet 6.2.1 b0k
220 RDT DBD Box/20 pcs
221 RDT MALARIA Box/20 pcs
222 Reagen ZN
223 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap
224 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap
225 Ringer Laktat Larutan 6.3 botol
226 Rivanol 6.2.1 bt t/100ml
227 Rivanol 0,1% Btl 300 ml
228 Salbutamol tab 4mg bok
229 Salbutamol tab 2mg ktk
230 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot
231 Sarung tangan obgyn/panjang bok
232 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab
233 Seftriakson serb inj 1000mg/ml 6.2.2 Vial
234 Setirizin sirup 5 mg/5 ml botol 60ml
235 Setirizin ta 10 mg 25.4 ktk/100 kaps
236 Sianokobalamin (vit b12) inj 500 mcg dus/100amp
237 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs
238 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs
239 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet
240 Spasi inj 25.1 ktk / 10amp
241 Spritus 14.1 botol
242 Strip asam urat btl/25strp
243 Strip Gula Darah Nesco Btl/25strip
244 Strip kolesterol Nesco bt
245 Tabung EDTA ktk/100 pcs
246 Test kehamilan Box/50 pcs
247 tetrakain hcl tetes mata 0,5 13.2 btl
248 Tetrasiklin kap 500mg dus/100kap
249 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul
250 Tiamin (vit b1) tab 50mg ktk 100 tb
251 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul
252 Turniquit 20.3 pcs
253 Uniflex 15 cm x 4,5 m(elastis verban) Roll
254 Urine Bag standard steril 2L.t (T valve) 26.1 Buah
255 Vacu needle
256 Vagistin Suppositoria bok 10 sup
257 vit C ktk/100tab
258 Vitamin b complek ktk/100tb
259 Vitamin B12 tab Btl
260 Zinc sir 20mg/5ml botol 60 ml
261 Zinc tab dispersible 20mg dus/100tab
262 OAT Anak dus
263 OAT Dewasa dus
264 Gloves surgical no.6,5 pasang
265 Gloves surgical no.8,0 pasang
266 Plesterin Non Woven Roll 5cmx5m Roll
267 Plesterin Non Women Roll 10cmx5m Roll
268 Ecodine 5 liter Botol 5000 ml
269 Arm Sling M pcs
270 Arm Sling L pcs
271 Reagen pemerisaan gol.darah paket
272 Strip Haemoglobin botol/25 strip
273 Haemoglobin test Buah

UMUM
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui
Kepala Puskesmas Mepanga

Ketut Cita, A.Md.Kep.


NIP : 19730615 199403 1 009
APORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )

: PARIGI MOUTONG LAPORAN : Maret


: SULAWESI TENGAH TAHUN : 2018
STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMBERIAAN
AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES ASKES
4 5 6=(4+5) 7=(6-8) 8 9 10 11 12
- - - -
980 980 - 980
970 970 40 930
344 344 21 323
57 57 - 57
4,250 4,250 200 4,050
30 30 1 29
4,600 4,600 250 4,350
787 787 - 787
7,940 7,940 440 7,500
1,160 1,160 160 1,000
800 800 - 800
20 20 - 20
2,500 2,500 1,500 1,000 2000
- - - - 1000
11,050 11,050 660 10,390
10,600 10,600 1,900 8,700
336 336 8 328
2,700 2,700 200 2,500
3,875 3,875 - 3,875
16,400 16,400 1,310 15,090
335 335 71 264
9,900 9,900 3,150 6,750

1,410 1,410 114 1,296

3,500 3,500 500 3,000

13,600 13,600 2,850 10,750

100 100 59 41

195 195 25 170

- - 10

262 262 - 262

538 538 10 528

640 640 - 640

4,800 4,800 100 4,700


- - 2
30,050 30,050 1,900 28,150
200 500 700 400 300
1,750 1,750 500 1,250
24,550 24,550 3,350 21,200
2,000 2,000 200 1,800
493 493 50 443
61 32 93 36 57
70 70 16 54 150
850 850 200 650 1000
180 180 25 155
728 728 28 700
- - - -
341 341 51 290
195 195 25 170
285 285 45 240
150 150 - 150
354 354 - 354
24 24 3 21
- -
15 15 1 14
1,007 1,007 44 963
379 379 15 364
450 450 - 450
1,241 1,241 59 1,182
1,791 1,791 273 1,518
1,320 1,320 156 1,164
707 707 101 606
1 1 - 1
467 467 72 395
600 600 600 - 2500
264 264 164 100
10,000 10,000 - 10,000
40,600 40,600 3,300 37,300
2,020 2,020 100 1,920
48,100 48,100 2,600 45,500
14 14 14 - 20
25 25 5 20
488 488 58 430
315 315 29 286
1,500 1,500 100 1,400
24 24 - 24
1,300 1,300 - 1,300
1 1 - 1
309 309 9 300
2,200 2,200 650 1,550
13 13 - 13
460 460 10 450
292 292 22 270
2,300 2,300 - 2,300
6 6 1 5
- - 2
3 3 - 3

2,750 5,010 7,760 1,800 5,960

500 500 - 500


380 380 - 380
2 2 1 1
2,950 2,950 450 2,500

4,360 4,360 500 3,860

235 235 35 200


150 150 - 150
1 1 - 1
7,500 7,500 400 7,100
4,300 4,300 300 4,000
4,950 4,950 - 4,950
23,150 23,150 600 22,550
33 33 - 33
33 33 4 29
5 5 - 5
700 700 108 592
565 565 118 447
417 417 - 417
1,850 1,850 900 950
470 470 - 470
200 200 - 200
290 290 60 230
700 700 - 700
18 18 2 16
3,200 3,200 - 3,200
508 508 46 462
1,200 1,200 800 400 2500
39 39 3 36
1,050 1,050 1,050 - 2500
- 50 50 - 50
950 950 139 811
37 37 - 37
2,770 2,770 300 2,470
35 35 - 35
1,000 1,000 1,000 - 2500
232 232 2 230
30 30 1 29
2,950 2,950 - 2,950
4,650 4,650 1,250 3,400
2,240 2,240 10 2,230
35 35 2 33
175 175 67 108
- - - -
9 9 - 9
800 800 47 753
1,800 1,800 200 1,600
405 405 45 360
81 81 17 64 100
42 48 90 8 82
- 42 42 - 42
50 50 13 37
1 1 - 1
880 880 - 880
60 60 10 50
4,100 4,100 700 3,400

13,900 13,900 1,050 12,850

1,242 1,242 48 1,194


- - - -
110 110 11 99
7,600 7,600 2,300 5,300
5 5 2 3 10
- 1,000 1,000 - 1,000
1,200 1,200 150 1,050
71 71 - 71
80 80 - 80
26 26 10 16
140 140 5 135
- - 100
11,200 11,200 700 10,500
1,200 1,200 600 600 2500
1,750 1,750 - 1,750
1,350 1,350 150 1,200
1,300 1,300 100 1,200
1,400 1,400 800 600 2500
375 375 100 275
5 5 2 3
2 2 - 2
4 4 - 4
190 140 330 210 120
23 23 - 23
38 38 - 38
38 38 - 38
1,200 1,000 2,200 1,300 900
45 45 45 -
2,100 2,100 100 2,000
1,050 1,050 400 650
30 30 30 - 500
8,500 8,500 1,250 7,250
416 416 46 370
810 810 185 625
- -
95 95 8 87
109 109 18 91
12 12 - 12
144 144 - 144
55 25 80 11 69
190 190 20 170
897 897 57 840
11,410 11,410 790 10,620
75 75 - 75
408 408 146 262
250 250 - 250
15,200 15,200 - 15,200
362 362 153 209
37,400 37,400 4,100 33,300
152 152 - 152
15 15 3 12
1,030 1,030 13 1,017
199 199 15 184
390 390 - 390
100 100 - 100
62 62 - 62
800 800 250 550
22 22 12 10
4,350 4,350 1,100 3,250
1,000 500 1,500 550 950
16 16 2 14
24 24 1 23
5 5 - 5
10 10 - 10
30 30 - 30
50 50 - 50
50 50 30 20
120 120 50 70
39 39 20 19
- -
25,000 25,000 3,200 21,800
1,200 1,200 - 1,200
2,800 2,800 600 2,200
1,700 1,700 500 1,200
1,220 1,220 172 1,048
37,000 37,000 16,000 21,000
- - - -
3 3 - 3
10 10 - 10
13 13 - 13
76 76 1 75
336 200 536 406 130
7 7 - 7
115 115 6 109
7,500 7,500 850 6,650
- -
504 504 34 470
418 418 - 418
- - - - 2500
426 426 - 426
45 45 - 45
1,350 1,350 250 1,100
1,355 1,355 233 1,122
428 428 2 426
472 472 27 445
13,000 13,000 1,590 11,410
- -
- - 2
30 30 5 25
39 39 7 32
15 15 10 5
1 1 - 1
285 285 50 235
18 18 8 10
700 700 100 600
- -
1,100 1,000 2,100 1,400 700 2500
5 10 15 10 5 25
- -
15 15 - 15
50 50 - 50
1 1 1
162 162 60 102
30,050 30,050 1,900 28,150
42,700 42,700 1,600 41,100
4,200 4,200 2,000 2,200
40 40 10 30
5,000 5,000 200 4,800
6 6 3 3
- 9 9 - 9
250 250 - 250
200 200 - 200
15 15 2 13
7 7 - 7
1 1 - 1
5 5 - 5
5 5 - 5
3 3 - 3
6 6 - 6
- - - -

UMUM
ASKES JUMLAH
TIDAK BAYAR

Sumber Agung ,Maret 2018


Petugas

Ni Ketut Suriati, A.Md.Far


NIP/NRPTT : 19790320 201001 2 001
PEMBERIAAN KET
APBD LAIN JML
13 14 15 16
680 ED
aret 2018

320 201001 2 001


LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : April
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 980 980 - 980
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 930 930 - 930
4 Air untuk injeksi 25 ml ampul 25 ml 323 323 12 311
5 Air untuk irigasi lar inf 1000 ml 5 Botol 57 57 - 57
6 Akarbose tab 50 mg 6.2.4 ktk/100tab 4,050 4,050 300 3,750
7 Alkohol swab 29 Box 29 29 1 28
8 Alat suntik sekali pakai 1 ml 32 100/ktk 4,350 4,350 180 4,170
9 Alat Suntik Sekali pakai 10 ml 32 ktk 787 787 - 787
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 7,500 7,500 935 6,565
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 1,000 1,000 310 690
12 Albendasol tab 400 mg bok/100tb 800 800 - 800
13 Alkohol 70% 1 liter btl 20 20 - 20
14 Allupurinol 14.1 box 1,000 1,500 2,500 1,200 1,300 2000
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - - 1000
16 Amblodipin 10 mg 32 box 10,390 10,390 1,020 9,370
17 Ambroxol tab 10 mg box 8,700 8,700 1,700 7,000
18 Aminofilin inj 24 mg/ml 26.2 Ampul 328 328 - 328
19 aminopilin tab 6.2.2 btl 2,500 2,500 200 2,300
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,875 3,875 175 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 15,090 15,090 690 14,400
22 Amoksisilin sir kering 125 mg/ml btl 264 264 84 180
23 Amoksisilin tab 500mg dus/100tab 6,750 6,750 3,700 3,050
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 1,296 1,296 179 1,117
dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab 3,000 3,000 1,000 2,000
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet 10,750 10,750 2,650 8,100
200 mg + Magnesium Hidroksida 200 mg 6.2.1
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml 41 41 41 -
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 250
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot 170 170 - 170
10.000 UI/g 32
29 anti rabies verorab bok - - 10

30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 262 262 - 262
32
31 Antihemoroid 31 Supp 528 528 - 528
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 4,700 4,700 100 4,600
34 Aplicators set 2 2 - 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 28,150 28,150 2,050 26,100
36 Asam assetilsalisilat(aspilet) Bok 300 300 - 300 2500
37 Asam folat tab 1 mg 6.2.2 Botol 1,250 1,250 250 1,000
38 Asam mefenamat 32 b0k 21,200 21,200 2,500 18,700
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 2,800 2,800 - 2,800
40 Asam traneksamat inj 100mg/ml 32 Ampul 443 443 3 440
41 Aseptik gel 57 57 7 50
42 Asiklovir krim 5% 6.2.2 Tube 54 25 79 33 46 150
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 650 1000 1,650 - 1,650 1000
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 155 155 - 155
45 Attapugit tab650 mg dus/100tab 700 700 - 700
46 Bedak salisil serbuk 2 % 25.1 pot - - - -
47 Betafort syrup botol 290 290 30 260
48 Basitrasin salep tube 170 170 - 170
49 Betametason 0,1% kream 6.2.1 tube 240 240 51 189
50 Bisakodil supositoria 10mg dus/50sup 150 150 - 150
51 Bisakodil supositoria 5mg dus/6sup 354 354 - 354
52 Blood Lancet ktk/100pcs 21 21 2 19
53 Brondisal 2mg 32 Dus 10 strip - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 14 14 2 12
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 963 963 271 692
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 364 364 - 364
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 450 450 44 406
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 1,182 1,182 27 1,155
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 1,518 1,518 - 1,518
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 1,164 1,164 185 979
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 606 606 40 566
62 Caviton 29 Set 1 1 - 1
63 Cefadroxil sirup bok 395 395 32 363
64 Cefatroxil 500mg kap 23.2 Bok - - - - 2500
65 Cepotaksim inj 20.3 dus/10vial 1gr 100 100 - 100
66 Ciprofloxacin tab 25.1 b0k 10,000 10,000 - 10,000
67 CTm (klorfeniramina Maleat tab 4 mg) bok 37,300 37,300 3,300 34,000
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,920 1,920 40 1,880
69 Deksametason tab 0,5 mg bok 45,500 45,500 1,700 43,800
70 Dektran larutan infus 70% btl - - - - 20
71 Diasepm larutan rektal 5 20 20 - 20
72 Diazepam tab 2 mg 6.4.2.2 Botol 430 430 130 300
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 286 286 24 262
74 Digoksin tab 0,25mg dus/100tab 1,400 1,400 - 1,400
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab 24 24 - 24
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,300 1,300 - 1,300
77 Disposable meroaplicators 1 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 300 300 13 287
79 Domperidon tab dus/100tab 1,550 1,550 - 1,550
80 elastis perban 23.4 Roll 13 13 - 13
81 Epineprin inj ktk/100Amp 450 450 210 240
82 Etanol 70% 100ml 6.4.2.1 botol 270 270 45 225
83 Eritromisin ktk 2,300 2,300 - 2,300
84 Etil klorida semprot 100ml botol 100ml 5 5 2 3
85 ETSA 14.2 Set 2 2 - 2
86 Eugenol cairan 6.2.1 botol 3 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab 5,960 5,960 3,220 2,740

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 500 500 1,000 700 300 2500
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 380 380 158 222
90 Fixomull stretch 15 cm x 5 m 14.2 Roll 1 1 - 1
91 Furosemid Ktk/100tab 2,500 2,500 450 2,050

Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium


92 sachet 3,860 3,860 3,160 700
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube 200 200 2 198
94 Gentian Violet Lrutan 1 % 32 Botol 150 150 - 150
95 Glass lonomer cemet ART 27.2 Set 1 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 7,100 7,100 600 6,500
97 Glimepirid tab 1 mg ktk/100tab 4,000 4,000 400 3,600
98 Glimepirid tab 2 mg ktk/100tab 4,950 4,950 - 4,950
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 22,550 22,550 2,400 20,150
100 glove non Steril l (hanskund) ktk 33 33 5 28
101 Glove non steril m (hanskund) ktk 29 29 3 26
102 Glove non steril S ktk 5 5 1 4
103 Glove Surgical no 7.0 ktk/50pcs 592 592 39 553
104 Glove Surgical no 7.5 ktk/50pcs 447 447 47 400
105 Glukosa larutan infus 5 % steril 31 botol 417 417 - 417
106 Griseofulvin tablet 125 mg 32 ktk/100tab 950 950 950 - 2500
107 Haloperidol 5 mg bok 470 470 70 400
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 200 200 100 100
109 Haloperidol tab 1,5 mg bok 230 230 230 -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb 700 700 100 600
111 Handscrub 500cc+dispenser btl 16 16 6 10
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 3,200 3,200 - 3,200
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 462 462 21 441
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet 400 500 900 900 - 2500
115 Ibuprofen sir 100 mg/5 ml botol 36 36 6 30
116 Ibuprofen tablet 400 mg pcs - 2,000 2,000 350 1,650 1000
117 Infus Set Anak pcs 50 50 35 15 250
118 Infus Set Dewasa (Tipe Y) pcs 811 811 191 620
119 iodium tes Botol 10 ml 37 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 2,470 2,470 200 2,270
121 Kalsium glukonat inj i.v 10% 29 Tube 35 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet - 2500 2,500 600 1,900 1000
123 Kapas 250 gram Pcs 230 230 6 224
124 Kapas berlemak 500gr 20.3 Bungkus 29 29 - 29
125 Kapsul kosong 23.2 tablet 2,950 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 3,400 3,400 1,500 1,900
127 Karbamazepin tab 200 mg Ktk/100tab 2,230 2,230 230 2,000
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 33 33 3 30
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll 108 108 79 29 100
130 Kertas Puyer Obat bks - - - -
131 Kertas puyer pres 6.2.1 bks 9 9 - 9
132 Ketokonasol krim 2% 7.2 tube 753 753 33 720
133 Ketokonazol tab 200 mg 32 Dus 5 strip 1,600 1,600 100 1,500
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 360 360 74 286
135 Kloramfenikol suspensi 26.3 botol/60ml 64 50 114 16 98 100
136 Kloramfenikol salep mata 1 % tube 82 82 10 72
137 Kloramfenikol tetes mata 0,5% 5 Botol 42 42 7 35
138 Kloramfenikol tetes telinga1% 13.1 Botol 37 37 11 26
139 kalsium hidroksida pasta 1 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 880 880 180 700
141 Kodein 25.4 btl 50 50 50 - 500
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml 3,400 3,400 550 2,850
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 12,850 12,850 850 12,000
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 1,194 1,194 37 1,157
145 lar. HCl 0,1 N botol - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 99 99 4 95
147 Lipron B Plek 18.4 ktk/100tab 5,300 5,300 2,200 3,100
148 Lisol btl 1000ml 3 3 6 4 2 10
149 Loperamid tab 2 mg Ktk/100tab 1,000 1,000 300 700 1000
150 Loratadin tablet 10 mg 32 ktk / 100 tab 1,050 1,050 - 1,050
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon 71 71 71 -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon 80 80 - 80
153 Masker one med Kait 6.1.1 ktk/50tab 16 16 11 5
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 135 135 6 129
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - - 100
156 Metformin tab 500mg ktk/100yab 10,500 10,500 750 9,750
157 Metil prednisolon tab 4mg dus/100tab 600 1,500 2,100 600 1,500
158 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 1,750 1,750 10 1,740
159 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 1,200 1,200 - 1,200
160 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet 1,200 1,200 100 1,100
161 Metronidazol tab 500 mg 1.2 ktk/100tab 600 2,500 3,100 700 2,400
162 Mikonazol krim/salep 2 % (Nitrat) 23.2 tube 275 275 123 152
163 MTD MB Dewasa/kusta 6.2.1 paket 3 3 - 3
164 MTD MB Anak/kusta 25.4 paket 2 2 - 2
165 Mineral mik 4 4 - 4
166 NaCL 0,9 % Botol 120 300 420 100 320
167 Nasal Oksigen bayi pcs 23 23 1 22
168 Nasal oxsigen Anak pcs 38 38 1 37
169 Nasal oxsigen dewasa pcs 38 38 1 37
170 Natriun diklofent tab 50 mg 32 ktk/50 tab 900 900 900 - 2500
171 Natriun Metamizole inj bok - - - -
172 Nifedipin kaps 10 mg 17.1 ktk/100kaps 2,000 2,000 250 1,750
173 Nistatin tab Ktk 650 650 150 500 2500
174 Nistatin Vagina - 300 300 100 200 500
175 Novabion kapsul 7,250 7,250 1,450 5,800
176 Novadiar sirup 26.1 btl/60ml 370 370 22 348
177 Noza tablet 625 625 116 509
178 Nurse cap bok/50 pcs - -
179 Obat Batuk hitam ( OBH) 14.1 Botol 87 87 5 82
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
180 20mg,sorbitol sirup with chocolate flavour q.c 91 91 11 80
botol 60ml
181 Objeck Glass Frosted Dus/72 pcs 12 12 2 10
182 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 144 - 144
183 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 69 25 94 40 54 100
184 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak 170 170 9 161
185 Oksitosin inj10UI mg Ampul/100amp 840 840 40 800
186 Omeprasol kaps 20 mg Kapsu/3srtip 10,620 10,620 1,650 8,970
187 Omeprazol injeksi 40mg/10ml dus 10 vial 75 75 5 70
188 Ondansentron inj 2 mg/ml ampul 262 262 117 145
189 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 250 250 - 250
190 Papaverin tablet 40 mg 31 1000 tablet / botol 15,200 15,200 - 15,200
191 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml 209 209 105 104
192 Parasetamol tab 500mg ktk/100tab 33,300 33,300 5,000 28,300
193 pembalut gips 6.2.1 Roll 152 152 - 152
194 Pelester non women roll 15x15 Roll 12 12 - 12
195 penjepit tl pstUmbilical Cord klem seteril nilon pcs 1,017 1,017 13 1,004
196 Permetrin krim 5 %(skabimite) 14.1 Tube 184 184 - 184
197 phenobarbital inj 6.1.1 ktk/30amp 390 390 240 150
198 Pipet tetes panjang 6.2.2 pcs 100 100 - 100
199 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol 62 62 44 18
200 Pirantel pamoat tablet 125mg dus/100tab 550 550 100 450
201 Pirantel suspensi 125 mg/5 ml 6.2.1 botol 10 10 10 -
202 Piridoksi vit B6 tab 10mg dus/100tab 3,250 3,250 700 2,550
203 Piroksikam tab 10 mg 6.3 ktk/100tab 950 950 700 250 2500
204 Plastik klip sedang (5x8 cm) pak/100buah 14 14 1 13
205 plastik klip sedang (6x10 cm) pak/100buah 23 9 32 - 32
206 Plesterin Non Woven Roll 20cmx5m btl 500ml 5 5 1 4
207 poli kateter no 18 9 pcs 10 10 - 10
208 poli kateter no 20 21.2.4 pcs 30 30 - 30
209 poli kateter no 22 6.2.1 pcs 50 50 - 50
210 poli kateter no 24 6.2.1 pcs 20 20 - 20
211 Pot Sputum 3 btl 70 70 - 70
212 Povidon Iodida Larutan 10 % 26.1 btl/300ml 19 19 - 19
213 Povidon iodion 10% 6.2.2 botol/60ml - -
214 Prednison tab 11.2 Btl 1000tab 21,800 21,800 2,450 19,350
215 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 1,200 - 1,200
216 Propanolol tab 10 mg 28.1 ktk/100tab 2,200 2,200 - 2,200
217 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 1,200 1,200 - 1,200
218 Ranitidin inj 25 mg/ml 6.2.4 Ampul 1,048 1,048 296 752
219 Ranitidin kaplet 6.2.1 b0k 35,000 35,000 2,000 33,000
220 RDT DBD Box/20 pcs - - - - 1
221 RDT MALARIA Box/20 pcs 3 3 - 3
222 Reagen ZN 10 10 - 10
223 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 13 13 - 13
224 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 75 75 1 74
225 Ringer Laktat Larutan 6.3 botol 130 500 630 210 420
226 Rivanol 6.2.1 bt t/100ml 7 7 - 7
227 Rivanol 0,1% Btl 300 ml 109 109 5 104
228 Salbutamol tab 4mg bok 6,650 6,650 450 6,200
229 Salbutamol tab 2mg ktk - -
230 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 470 470 40 430
231 Sarung tangan obgyn/panjang bok 418 418 15 403
232 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - - - 2500
233 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 426 426 6 420
234 Setirizin sirup 5 mg/5 ml botol 60ml 45 45 - 45
235 Setirizin ta 10 mg 25.4 ktk/100 kaps 1,100 1,100 - 1,100
236 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 1,122 1,122 310 812
237 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 426 426 12 414
238 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 445 445 - 445
239 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 11,410 11,410 1,320 10,090
240 Spasi inj 25.1 ktk / 10amp - -
241 Spritus 14.1 botol - - 2
242 Strip asam urat btl/25strp 25 25 5 20
243 Strip Gula Darah Nesco Btl/25strip 32 32 2 30
244 Strip kolesterol Nesco bt 5 5 3 2 10
245 Tabung EDTA ktk/100 pcs 1 1 - 1
246 Test kehamilan Box/50 pcs 235 235 50 185
247 tetrakain hcl tetes mata 0,5 13.2 btl 10 10 - 10
248 Tetrasiklin kap 500mg dus/100kap 600 600 50 550
249 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul - -
250 Tiamin (vit b1) tab 50mg ktk 100 tb 700 2,000 2,700 1,850 850 2500
251 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul 5 30 35 19 16 25
252 Turniquit 20.3 pcs - -
253 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 15 - 15
254 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 50 50 - 50
255 Vacu needle 1 1 1
256 Vagistin Suppositoria bok 10 sup 102 102 - 102
257 vit C ktk/100tab 28,150 28,150 2,050 26,100
258 Vitamin b complek ktk/100tb 41,100 41,100 1,900 39,200
259 Vitamin B12 tab Btl 2,200 2,200 - 2,200
260 Zinc sir 20mg/5ml botol 60 ml 30 30 - 30
261 Zinc tab dispersible 20mg dus/100tab 4,800 4,800 100 4,700
262 OAT Anak dus 3 3 - 3 5
263 OAT Dewasa dus 9 9 5 4 10
264 Gloves surgical no.6,5 pasang 250 250 - 250
265 Gloves surgical no.8,0 pasang 200 200 - 200
266 Plesterin Non Woven Roll 5cmx5m Roll 13 13 - 13
267 Plesterin Non Women Roll 10cmx5m Roll 7 7 - 7
268 Ecodine 5 liter Botol 5000 ml 1 1 - 1
269 Arm Sling M pcs 5 5 - 5
270 Arm Sling L pcs 5 5 - 5
271 Reagen pemerisaan gol.darah paket 3 3 1 2
272 Strip Haemoglobin botol/25 strip 6 6 2 4
273 Haemoglobin test Buah - - - -
274 BCG 20 ds/Ampul vial 5 20 25 18 7
275 Polio 10 ds/vial Vial 24 20 44 29 15
276 DPT-HB-HIB 8 45 53 31 22
277 IPV 13 10 23 8 15
278 Hel.B 1 ds/Ads 50 30 80 22 58
279 Dcampak 10 ds/Vial 34 34 18 16
280 Td 10 ds/ vial 23 23 17 6
281 ADS 0,05 ml 100 100 30 70
282 ADS 0,5 ml 200 400 600 310 290
283 ADS 5 ml 150 150 30 120
- -
- -
- -

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Sumber Agung April


Mengetahui
Kepala Puskesmas Mepanga Petugas

Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far


NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16
ED
Ed
ED 240
Sumber Agung April 2018

Suriati, A.Md.Far
T : 19790320 201001 2 001
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : Mei
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 980 980 120 860
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 930 930 - 930
4 Air untuk injeksi 25 ml ampul 25 ml 311 311 5 306
5 Air untuk irigasi lar inf 1000 ml 5 Botol 57 57 - 57
6 Akarbose tab 50 mg 6.2.4 ktk/100tab 3,750 3,750 - 3,750
7 Alkohol swab 29 Box 28 28 14 14
8 Alat suntik sekali pakai 1 ml 32 100/ktk 4,170 4,170 300 3,870
9 Alat Suntik Sekali pakai 10 ml 32 ktk 787 787 - 787
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 6,565 6,565 865 5,700
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 690 690 140 550
12 Albendasol tab 400 mg bok/100tb 800 800 - 800
13 Alkohol 70% 1 liter btl 20 20 - 20
14 Allupurinol 14.1 box 1,300 2,000 3,300 1,100 2,200 2000
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - - 1000
16 Amblodipin 10 mg 32 box 9,370 9,370 1,670 7,700
17 Ambroxol tab 10 mg box 7,000 7,000 1,500 5,500
18 Aminofilin inj 24 mg/ml 26.2 Ampul 328 328 - 328
19 aminopilin tab 6.2.2 btl 2,300 2,300 100 2,200
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,700 3,700 - 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 14,400 14,400 1,350 13,050
22 Amoksisilin sir kering 125 mg/ml btl 180 180 84 96 250
23 Amoksisilin tab 500mg dus/100tab 3,050 3,050 3,050 - 3000
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 1,117 1,117 185 932
dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab 2,000 2,000 500 1,500 1000
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet 8,100 8,100 2,750 5,350
200 mg + Magnesium Hidroksida 200 mg 6.2.1
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml - 100 37 63
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 100 250
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot - -
10.000 UI/g 32
29 anti rabies verorab bok - - 10

30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 262 262 - 262
32
31 Antihemoroid 31 Supp 528 528 30 498
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 4,600 4,600 100 4,500
34 Aplicators set 2 2 - 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 26,100 26,100 3,700 22,400
36 Asam assetilsalisilat(aspilet) Bok 300 1,500 1,800 300 1,500
37 Asam folat tab 1 mg 6.2.2 Botol 1,000 1,000 100 900
38 Asam mefenamat 32 b0k 18,700 18,700 2,050 16,650
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 2,800 2,800 - 2,800
40 Asam traneksamat inj 100mg/ml 32 Ampul 440 440 15 425
41 Aseptik gel 50 50 7 43
42 Asiklovir krim 5% 6.2.2 Tube 46 46 - 46 150
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 1,650 1000 2,650 - 2,650
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 155 155 10 145
45 Attapugit tab650 mg dus/100tab 700 700 100 600
46 Bedak salisil serbuk 2 % 25.1 pot - - - -
47 Betafort syrup botol 260 260 75 185 150
48 Basitrasin salep tube 170 170 15 155
49 Betametason 0,1% kream 6.2.1 tube 189 189 72 117 150
50 Bisakodil supositoria 10mg dus/50sup 150 150 - 150
51 Bisakodil supositoria 5mg dus/6sup 354 354 - 354
52 Blood Lancet ktk/100pcs 19 19 2 17
53 Brondisal 2mg 32 Dus 10 strip - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 12 12 - 12
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 692 692 - 692
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 364 364 - 364
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 406 406 58 348
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 1,155 1,155 20 1,135
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 1,518 1,518 180 1,338
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 979 979 175 804
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 566 566 75 491
62 Caviton 29 Set 1 1 - 1
63 Cefadroxil sirup bok 363 363 16 347
64 Cefatroxil 500mg kap 23.2 Bok - - - - 2500
65 Cepotaksim inj 20.3 dus/10vial 1gr 100 100 8 92
66 Ciprofloxacin tab 25.1 b0k 10,000 10,000 - 10,000
67 CTm (klorfeniramina Maleat tab 4 mg) bok 34,000 34,000 3,300 30,700
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,880 1,880 210 1,670
69 Deksametason tab 0,5 mg bok 43,800 43,800 2,600 41,200
70 Dektran larutan infus 70% btl - - - - 20
71 Diasepm larutan rektal 5 20 20 10 10
72 Diazepam tab 2 mg 6.4.2.2 Botol 300 300 100 200
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 262 262 57 205
74 Digoksin tab 0,25mg dus/100tab 1,400 1,400 - 1,400
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab 24 24 - 24
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,300 1,300 - 1,300
77 Disposable meroaplicators 1 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 287 287 23 264
79 Domperidon tab dus/100tab 1,550 1,550 1,200 350 2500
80 elastis perban 23.4 Roll 13 13 - 13
81 Epineprin inj ktk/100Amp 440 440 - 440
82 Etanol 70% 100ml 6.4.2.1 botol 225 225 43 182
83 Eritromisin ktk 2,300 2,300 - 2,300
84 Etil klorida semprot 100ml botol 100ml 3 3 2 1 10
85 ETSA 14.2 Set 2 2 - 2
86 Eugenol cairan 6.2.1 botol 3 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab 2,740 2,500 5,240 1,900 3,340

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 300 300 150 150 2500
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 222 222 97 125
90 Fixomull stretch 15 cm x 5 m 14.2 Roll 1 1 - 1
91 Furosemid Ktk/100tab 2,050 2,050 150 1,900

Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium


92 sachet 700 700 - 700
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube 198 198 10 188
94 Gentian Violet Lrutan 1 % 32 Botol 207 207 - 207
95 Glass lonomer cemet ART 27.2 Set 1 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 6,500 6,500 500 6,000
97 Glimepirid tab 1 mg ktk/100tab 3,600 3,600 - 3,600
98 Glimepirid tab 2 mg ktk/100tab 4,950 4,950 - 4,950
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 20,150 20,150 2,400 17,750
100 glove non Steril l (hanskund) ktk 28 28 3 25
101 Glove non steril m (hanskund) ktk 26 26 - 26
102 Glove non steril S ktk 4 4 3 1
103 Glove Surgical no 7.0 ktk/50pcs 553 553 120 433
104 Glove Surgical no 7.5 ktk/50pcs 400 400 30 370
105 Glukosa larutan infus 5 % steril 31 botol 417 417 - 417
106 Griseofulvin tablet 125 mg 32 ktk/100tab - 1,500 1,500 - 1,500 2500
107 Haloperidol 5 mg bok 400 400 - 400
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 100 100 - 100
109 Haloperidol tab 1,5 mg bok - - - -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb 600 600 - 600
111 Handscrub 500cc+dispenser btl 10 10 9 1 20
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 3,200 3,200 300 2,900
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 441 441 61 380
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet - 500 500 50 450 2500
115 Ibuprofen sir 100 mg/5 ml botol 30 30 - 30
116 Ibuprofen tablet 400 mg pcs 1,650 1,650 400 1,250 2500
117 Infus Set Anak pcs 15 15 15 - 250
118 Infus Set Dewasa (Tipe Y) pcs 620 620 209 411
119 iodium tes Botol 10 ml 37 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 2,270 2,270 300 1,970
121 Kalsium glukonat inj i.v 10% 29 Tube 35 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet 1,900 1,900 850 1,050 2500
123 Kapas 250 gram Pcs 224 224 5 219
124 Kapas berlemak 500gr 20.3 Bungkus 29 29 - 29
125 Kapsul kosong 23.2 tablet 2,950 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 1,900 1,900 900 1,000
127 Karbamazepin tab 200 mg Ktk/100tab 2,000 2,000 2,000 - 1000
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 30 30 1 29
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll 29 29 29 - 100
130 Kertas Puyer Obat bks - - - -
131 Kertas puyer pres 6.2.1 bks 9 9 - 9
132 Ketokonasol krim 2% 7.2 tube 720 720 - 720
133 Ketokonazol tab 200 mg 32 Dus 5 strip 1,500 1,500 - 1,500
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 286 286 46 240
135 Kloramfenikol suspensi 26.3 botol/60ml 98 100 198 21 177
136 Kloramfenikol salep mata 1 % tube 72 72 27 45 200
137 Kloramfenikol tetes mata 0,5% 5 Botol 35 35 11 24 50
138 Kloramfenikol tetes telinga1% 13.1 Botol 26 26 15 11 50
139 kalsium hidroksida pasta 1 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 700 700 - 700
141 Kodein 25.4 btl - 500 500 100 400
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml 2,850 2,850 650 2,200
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 12,000 12,000 750 11,250
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 1,157 1,157 38 1,119
145 lar. HCl 0,1 N botol - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 95 95 6 89
147 Lipron B Plek 18.4 ktk/100tab 3,100 3,100 2,750 350 2500
148 Lisol btl 1000ml 2 4 6 2 4
149 Loperamid tab 2 mg Ktk/100tab 700 1,000 1,700 250 1,450
150 Loratadin tablet 10 mg 32 ktk / 100 tab 1,050 1,050 100 950
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon - - - -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon 80 80 - 80
153 Masker one med Kait 6.1.1 ktk/50tab 5 5 5 -
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 129 129 10 119
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - - 100
156 Metformin tab 500mg ktk/100yab 9,750 9,750 1,250 8,500
157 Metil prednisolon tab 4mg dus/100tab 1,500 1,500 850 650 2500
158 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 1,740 1,740 1,225 515
159 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 1,200 1,200 100 1,100
160 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet 1,100 1,100 100 1,000
161 Metronidazol tab 500 mg 1.2 ktk/100tab 2,400 2,400 600 1,800
162 Mikonazol krim/salep 2 % (Nitrat) 23.2 tube 152 152 - 152
163 MTD Kusta PB Dewasa
164 MTD kusta PB Anak
165 MTD MB Dewasa/kusta 6.2.1 paket 3 3 1 2
166 MTD MB Anak/kusta 25.4 paket 2 2 1 1
167 Mineral mik 4 4 - 4
168 NaCL 0,9 % Botol 320 320 260 60 200
169 Nasal Oksigen bayi pcs 22 22 - 22
170 Nasal oxsigen Anak pcs 37 37 - 37
171 Nasal oxsigen dewasa pcs 37 37 - 37
172 Natriun diklofent tab 50 mg 32 ktk/50 tab - 2,500 2,500 750 1,750 2500
173 Natriun Metamizole inj bok - - - -
174 Nifedipin kaps 10 mg 17.1 ktk/100kaps 1,750 1,750 350 1,400
175 Nistatin tab Ktk 500 400 900 150 750
176 Nistatin Vagina 200 200 20 180 500
177 Novabion kapsul 5,800 5,800 1,900 3,900
178 Novadiar sirup 26.1 btl/60ml 348 348 40 308
179 Noza tablet 509 509 52 457
180 Nurse cap bok/50 pcs - -
181 Obat Batuk hitam ( OBH) 14.1 Botol 82 82 21 61
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
182 20mg,sorbitol sirup with chocolate flavour q.c 80 80 14 66
botol 60ml
183 Objeck Glass Frosted Dus/72 pcs 10 10 - 10
184 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 144 - 144
185 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 54 50 104 15 89 100
186 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak 161 161 5 156
187 Oksitosin inj10UI mg Ampul/100amp 800 800 38 762
188 Omeprasol kaps 20 mg Kapsu/3srtip 8,970 8,970 1,110 7,860
189 Omeprazol injeksi 40mg/10ml dus 10 vial 70 70 - 70
190 Ondansentron inj 2 mg/ml ampul 145 145 50 95
191 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 250 250 5 245
192 Papaverin tablet 40 mg 31 1000 tablet / botol 15,200 15,200 1,000 14,200
193 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml 104 104 104 -
194 Parasetamol tab 500mg ktk/100tab 28,300 28,300 5,300 23,000
195 pembalut gips 6.2.1 Roll 152 152 - 152
196 Pelester non women roll 15x15 Roll 12 12 - 12
197 penjepit tl pstUmbilical Cord klem seteril nilon pcs 1,004 1,004 44 960
198 Permetrin krim 5 %(skabimite) 14.1 Tube 184 184 - 184
199 phenobarbital inj 6.1.1 ktk/30amp 150 150 30 120
200 Pipet tetes panjang 6.2.2 pcs 100 100 - 100
201 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol 18 18 - 18
202 Pirantel pamoat tablet 125mg dus/100tab 450 450 - 450
203 Pirantel suspensi 125 mg/5 ml 6.2.1 botol - - - -
204 Piridoksi vit B6 tab 10mg dus/100tab 2,550 2,550 900 1,650
205 Piroksikam tab 10 mg 6.3 ktk/100tab 250 250 250 - 2500
206 Plastik klip sedang (5x8 cm) pak/100buah 13 13 3 10
207 plastik klip sedang (6x10 cm) pak/100buah 32 32 1 31
208 Plesterin Non Woven Roll 20cmx5m btl 500ml 4 4 - 4
209 poli kateter no 18 9 pcs 10 10 - 10
210 poli kateter no 20 21.2.4 pcs 30 30 - 30
211 poli kateter no 22 6.2.1 pcs 50 50 - 50
212 poli kateter no 24 6.2.1 pcs 20 20 - 20
213 Pot Sputum 3 btl 70 70 40 30 250
214 Povidon Iodida Larutan 10 % 26.1 btl/300ml 19 19 2 17
215 Povidon iodion 10% 6.2.2 botol/60ml - -
216 Prednison tab 11.2 Btl 1000tab 19,350 19,350 2,400 16,950
217 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 1,200 - 1,200
218 Propanolol tab 10 mg 28.1 ktk/100tab 2,200 2,200 - 2,200
219 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 1,200 1,200 - 1,200
220 Ranitidin inj 25 mg/ml 6.2.4 Ampul 752 752 122 630
221 Ranitidin kaplet 6.2.1 b0k 33,000 33,000 2,100 30,900
222 RDT DBD Box/20 pcs - - - - 1
223 RDT MALARIA Box/20 pcs 3 3 - 3
224 Reagen ZN 10 10 - 10
225 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 13 13 - 13
226 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 74 74 2 72
227 Ringer Laktat Larutan 6.3 botol 420 200 620 340 280 500
228 Rivanol 6.2.1 bt t/100ml 7 7 - 7
229 Rivanol 0,1% Btl 300 ml 104 104 3 101
230 Salbutamol tab 4mg bok 6,200 6,200 300 5,900
231 Salbutamol tab 2mg ktk - -
232 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 430 430 10 420
233 Sarung tangan obgyn/panjang bok 403 403 2 401
234 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - - - 2500
235 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 420 420 24 396
236 Setirizin sirup 5 mg/5 ml botol 60ml 45 45 - 45
237 Setirizin ta 10 mg 25.4 ktk/100 kaps 1,100 1,100 200 900
238 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 812 812 187 625
239 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 414 414 47 367
240 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 445 445 35 410
241 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 10,090 10,090 1,190 8,900
242 Spasi inj 25.1 ktk / 10amp - -
243 Spritus 14.1 botol - - 2
244 Strip asam urat btl/25strp 20 20 1 19
245 Strip Gula Darah Nesco Btl/25strip 30 30 5 25
246 Strip kolesterol Nesco bt 2 2 2 - 10
247 Tabung EDTA ktk/100 pcs 1 1 - 1
248 Test kehamilan Box/50 pcs 185 185 148 37
249 tetrakain hcl tetes mata 0,5 13.2 btl 10 10 - 10
250 Tetrasiklin kap 500mg dus/100kap 550 550 50 500
251 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul - -
252 Tiamin (vit b1) tab 50mg ktk 100 tb 850 2,500 3,350 1,600 1,750
253 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul 16 30 46 16 30 25
254 Turniquit 20.3 pcs - - 10
255 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 15 - 15
256 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 50 50 - 50
257 Vacu needle 1 1 1
258 Vagistin Suppositoria bok 10 sup 102 102 - 102
259 vit C ktk/100tab 26,100 26,100 3,700 22,400
260 Vitamin b complek ktk/100tb 39,200 39,200 1,500 37,700
261 Vitamin B12 tab Btl 2,200 2,200 250 1,950
262 Zinc sir 20mg/5ml botol 60 ml 30 30 5 25
263 Zinc tab dispersible 20mg dus/100tab 4,700 4,700 400 4,300
264 OAT Anak dus 3 5 8 5 3
265 OAT Dewasa dus 4 10 14 10 4
266 Gloves surgical no.6,5 pasang 250 250 - 250
267 Gloves surgical no.8,0 pasang 200 200 - 200
268 Plesterin Non Woven Roll 5cmx5m Roll 13 13 - 13
269 Plesterin Non Women Roll 10cmx5m Roll 7 7 - 7
270 Ecodine 5 liter Botol 5000 ml 1 1 - 1
271 Arm Sling M pcs 5 5 - 5
272 Arm Sling L pcs 5 5 - 5
273 Reagen pemerisaan gol.darah paket 2 2 - 2
274 Strip Haemoglobin botol/25 strip 4 4 1 3
275 Haemoglobin test Buah - - - -
276 BCG 20 ds/Ampul vial 7 20 27 17 10
277 Polio 10 ds/vial Vial 15 30 45 36 9
278 DPT-HB-HIB 22 30 52 41 11
279 IPV 15 15 15 -
280 Hel.B 1 ds/Ads 58 20 78 23 55
281 Dcampak 10 ds/Vial 16 10 26 21 5
282 Td 10 ds/ vial 6 20 26 10 16
283 ADS 0,05 ml 70 - 70 70 -
284 ADS 0,5 ml 290 300 590 340 250
285 ADS 5 ml 120 120 40 80
286 Bisoprolol 1,000 1,000 300 700
287 Klorampenikol kap 2,500 2,500 500 2,000
288 OAT Dewasa kategori 2 - - 4

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Sumber Agung Mei


Mengetahui
Kepala Puskesmas Mepanga Petugas
Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far
NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16
Ed
Ed
Sumber Agung Mei 2018
Suriati, A.Md.Far
T : 19790320 201001 2 001
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : Juni
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 860 860 - 860
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 930 930 130 800
4 Air untuk injeksi 25 ml ampul 25 ml 306 306 3 303
5 Air untuk irigasi lar inf 1000 ml 5 Botol 57 57 - 57
6 Akarbose tab 50 mg 6.2.4 ktk/100tab 3,750 3,750 3,750 - 2000
7 Alkohol swab 29 Box 14 14 - 14
8 Alat suntik sekali pakai 1 ml 32 100/ktk 3,870 3,870 450 3,420
9 Alat Suntik Sekali pakai 10 ml 32 ktk 787 787 181 606
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 5,700 5,700 700 5,000 300
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 550 550 250 300
12 Albendasol tab 400 mg bok/100tb 800 800 - 800
13 Alkohol 70% 1 liter btl 20 20 - 20
14 Allupurinol 14.1 box 2,200 2,000 4,200 2,250 1,950 2000
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - -
16 Amblodipin 10 mg 32 box 7,700 7,700 420 7,280
17 Ambroxol tab 10 mg box 5,500 5,500 1,100 4,400
18 Aminofilin inj 24 mg/ml 26.2 Ampul 328 328 - 328
19 aminopilin tab 6.2.2 btl 2,200 2,200 - 2,200
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,700 3,700 - 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 13,050 13,050 570 12,480
22 Amoksisilin sir kering 125 mg/ml btl 96 96 61 35 200
23 Amoksisilin tab 500mg dus/100tab - 2,000 2,000 1,200 800 5000
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 932 932 253 679
dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab 1,500 1,000 2,500 100 2,400
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet 5,350 5,350 2,600 2,750
200 mg + Magnesium Hidroksida 200 mg 6.2.1
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml 63 313 226 87
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 250 200
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot - -
10.000 UI/g 32
29 anti rabies verorab bok - - 10

30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 262 262 - 262
32
31 Antihemoroid 31 Supp 498 498 - 498
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 4,500 4,500 500 4,000
34 Aplicators set 2 2 - 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 22,400 22,400 2,000 20,400
36 Asam assetilsalisilat(aspilet) Bok 1,500 1,500 3,000 1,600 1,400
37 Asam folat tab 1 mg 6.2.2 Botol 900 900 200 700
38 Asam mefenamat 32 b0k 16,650 16,650 1,000 15,650
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 2,800 2,800 - 2,800
40 Asam traneksamat inj 100mg/ml 32 Ampul 425 425 5 420
41 Aseptik gel 43 43 8 35
42 Asiklovir krim 5% 6.2.2 Tube 46 46 - 46
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 2,650 1000 3,650 1,000 2,650
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 145 145 - 145
45 Attapugit tab650 mg dus/100tab 600 600 - 600
46 Bedak salisil serbuk 2 % 25.1 pot - - - - 50
47 Betafort syrup botol 185 150 335 70 265
48 Basitrasin salep tube 155 155 - 155
49 Betametason 0,1% kream 6.2.1 tube 117 150 267 104 163
50 Bisakodil supositoria 10mg dus/50sup 150 150 - 150
51 Bisakodil supositoria 5mg dus/6sup 354 354 54 300
52 Blood Lancet ktk/100pcs 17 17 2 15
53 Brondisal 2mg 32 Dus 10 strip - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 12 12 - 12
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 1,070 1,070 24 1,046
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 364 364 12 352
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 348 348 - 348
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 1,135 1,135 255 880
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 1,338 1,338 148 1,190
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 804 804 120 684
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 491 491 60 431
62 Caviton 29 Set 1 1 - 1
63 Cefadroxil sirup bok 347 347 20 327
64 Cefatroxil 500mg kap 23.2 Bok - - - - 2000
65 Cepotaksim inj 20.3 dus/10vial 1gr 92 92 4 88
66 Ciprofloxacin tab 25.1 b0k 10,000 10,000 1,500 8,500
67 CTm (klorfeniramina Maleat tab 4 mg) bok 30,700 30,700 1,970 28,730
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,670 1,670 5 1,665
69 Deksametason tab 0,5 mg bok 41,200 41,200 1,100 40,100
70 Dektran larutan infus 70% btl - - - - -
71 Diasepm larutan rektal 5 10 10 7 3 50
72 Diazepam tab 2 mg 6.4.2.2 Botol 200 200 - 200
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 205 205 58 147 200
74 Digoksin tab 0,25mg dus/100tab 1,400 1,400 - 1,400
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab 24 24 - 24
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,300 1,300 - 1,300
77 Disposable meroaplicators 1 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 264 264 36 228 200
79 Domperidon tab dus/100tab 350 2,500 2,850 1,600 1,250
80 elastis perban 23.4 Roll 13 13 - 13
81 Epineprin inj ktk/100Amp 440 440 - 440
82 Etanol 70% 100ml 6.4.2.1 botol 182 182 9 173
83 Eritromisin ktk 2,300 2,300 - 2,300
84 Etil klorida semprot 100ml botol 100ml 1 10 11 8 3
85 ETSA 14.2 Set 2 2 - 2
86 Eugenol cairan 6.2.1 botol 3 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab 3,340 3,340 1,820 1,520
5000
88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 150 150 100 50 200
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 125 125 60 65 120
90 Fixomull stretch 15 cm x 5 m 14.2 Roll 1 1 1 -
91 Furosemid Ktk/100tab 1,900 1,900 500 1,400

Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium


92 sachet 700 700 150 550
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube 188 188 - 188
94 Gentian Violet Lrutan 1 % 32 Botol 207 207 9 198
95 Glass lonomer cemet ART 27.2 Set 1 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 6,000 6,000 600 5,400
97 Glimepirid tab 1 mg ktk/100tab 3,600 3,600 300 3,300
98 Glimepirid tab 2 mg ktk/100tab 4,950 4,950 - 4,950
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 17,750 17,750 1,150 16,600
100 glove non Steril l (hanskund) ktk 25 25 - 25 200
101 Glove non steril m (hanskund) ktk 26 26 1 25 200
102 Glove non steril S ktk 1 1 1 - 100
103 Glove Surgical no 7.0 ktk/50pcs 433 433 133 300
104 Glove Surgical no 7.5 ktk/50pcs 370 370 70 300
105 Glukosa larutan infus 5 % steril 31 botol 467 467 40 427
106 Griseofulvin tablet 125 mg 32 ktk/100tab 1,500 1,500 3,000 1,200 1,800
107 Haloperidol 5 mg bok 400 400 - 400
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 100 100 - 100
109 Haloperidol tab 1,5 mg bok - - - -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb 600 600 - 600
111 Handscrub 500cc+dispenser btl 1 1 1 - 100
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 2,900 2,900 - 2,900
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 380 380 21 359
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet 450 500 950 950 - 3000
115 Ibuprofen sir 100 mg/5 ml botol 30 30 10 20
116 Ibuprofen tablet 400 mg pcs 1,250 2,500 3,750 700 3,050
117 Infus Set Anak pcs - - - - 500
118 Infus Set Dewasa (Tipe Y) pcs 411 411 271 140
119 iodium tes Botol 10 ml 37 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 1,970 1,970 100 1,870
121 Kalsium glukonat inj i.v 10% 29 Tube 35 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet 1,050 2500 3,550 1,900 1,650
123 Kapas 250 gram Pcs 219 219 5 214
124 Kapas berlemak 500gr 20.3 Bungkus 29 29 1 28
125 Kapsul kosong 23.2 tablet 2,950 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 1,000 1,000 700 300 2000
127 Karbamazepin tab 200 mg Ktk/100tab - 1,000 1,000 100 900
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 29 29 4 25
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll - - - - 200
130 Kertas Puyer Obat bks 9 9 - 9
131 Kertas puyer pres 6.2.1 bks - - - -
132 Ketokonasol krim 2% 7.2 tube 720 720 25 695
133 Ketokonazol tab 200 mg 32 Dus 5 strip 1,500 1,500 100 1,400
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 240 240 80 160 300
135 Kloramfenikol suspensi 26.3 botol/60ml 177 100 277 128 149
136 Kloramfenikol salep mata 1 % tube 45 200 245 110 135
137 Kloramfenikol tetes mata 0,5% 5 Botol 24 50 74 2 72
138 Kloramfenikol tetes telinga1% 13.1 Botol 11 50 61 32 29 50
139 kalsium hidroksida pasta 1 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 700 700 100 600
141 Kodein 25.4 btl 400 500 900 500 400
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml 2,200 2,200 800 1,400
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 11,250 11,250 250 11,000
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 1,119 1,119 39 1,080
145 lar. HCl 0,1 N botol - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 89 89 5 84
147 Lipron B Plek 18.4 ktk/100tab 350 350 350 - 3000
148 Lisol btl 1000ml 4 4 8 4 4
149 Loperamid tab 2 mg Ktk/100tab 1,450 1,450 400 1,050
150 Loratadin tablet 10 mg 32 ktk / 100 tab 950 950 50 900
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon - - - -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon 80 80 - 80
153 Masker one med Kait 6.1.1 ktk/50tab - - - -
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 119 119 21 98
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - -
156 Metformin tab 500mg ktk/100yab 8,500 8,500 800 7,700
157 Metil prednisolon tab 4mg dus/100tab 650 2,500 3,150 2,250 900
158 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 515 515 315 200 100
159 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 1,100 1,100 - 1,100
160 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet 1,000 1,000 - 1,000
161 Metronidazol tab 500 mg 1.2 ktk/100tab 1,800 1,800 750 1,050
162 Mikonazol krim/salep 2 % (Nitrat) 23.2 tube 152 152 9 143
163 MTD kusta PB Deewasa paket - - - 5
164 MTD Kusta PB Anak paket - - - 5
165 MTD MB Dewasa/kusta 6.2.1 paket 2 2 - 2 5
166 MTD MB Anak/kusta 25.4 paket 1 1 - 1 5
167 Mineral mik 4 4 - 4
168 NaCL 0,9 % Botol 60 200 260 180 80 200
169 Nasal Oksigen bayi pcs 22 22 - 22
170 Nasal oxsigen Anak pcs 37 37 - 37
171 Nasal oxsigen dewasa pcs 37 37 4 33
172 Natriun diklofent tab 50 mg 32 ktk/50 tab 1,750 2,500 4,250 550 3,700
173 Natriun Metamizole inj bok - - - -
174 Nifedipin kaps 10 mg 17.1 ktk/100kaps 1,400 1,400 450 950
175 Nistatin tab Ktk 750 400 1,150 400 750
176 Nistatin Vagina 180 180 - 180
177 Novabion kapsul 3,900 3,900 1,850 2,050
178 Novadiar sirup 26.1 btl/60ml 308 308 33 275
179 Noza tablet 457 457 33 424 200
180 Nurse cap bok/50 pcs - -
181 Obat Batuk hitam ( OBH) 14.1 Botol 61 61 16 45 100
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
182 20mg,sorbitol sirup with chocolate flavour q.c 66 66 - 66
botol 60ml
183 Objeck Glass Frosted Dus/72 pcs 10 10 1 9
184 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 144 - 144
185 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 89 100 189 89 100
186 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak 156 156 156 - 200
187 Oksitosin inj10UI mg Ampul/100amp 762 762 87 675
188 Omeprasol kaps 20 mg Kapsu/3srtip 7,860 7,860 1,180 6,680
189 Omeprazol injeksi 40mg/10ml dus 10 vial 70 70 70 - 100
190 Ondansentron inj 2 mg/ml ampul 95 95 85 10 200
191 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 245 245 5 240
192 Papaverin tablet 40 mg 31 1000 tablet / botol 14,200 14,200 - 14,200
193 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml - - - - 500
194 Parasetamol tab 500mg ktk/100tab 23,000 23,000 4,900 18,100
195 pembalut gips 6.2.1 Roll 152 152 - 152
196 Pelester non women roll 15x15 Roll 12 12 3 9
197 penjepit tl pstUmbilical Cord klem seteril nilon pcs 960 960 270 690
198 Permetrin krim 5 %(skabimite) 14.1 Tube 184 184 - 184
199 phenobarbital inj 6.1.1 ktk/30amp 120 120 - 120
200 Pipet tetes panjang 6.2.2 pcs 100 100 - 100
201 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol - - - -
202 Pirantel pamoat tablet 125mg dus/100tab 450 450 - 450
203 Pirantel suspensi 125 mg/5 ml 6.2.1 botol 18 18 - 18
204 Piridoksi vit B6 tab 10mg dus/100tab 1,650 1,650 - 1,650
205 Piroksikam tab 10 mg 6.3 ktk/100tab - - - - 2500
206 Plastik klip sedang (5x8 cm) pak/100buah 10 10 1 9
207 plastik klip sedang (6x10 cm) pak/100buah 31 31 2 29
208 Plesterin Non Woven Roll 20cmx5m btl 500ml 4 4 - 4
209 poli kateter no 18 9 pcs 10 10 - 10
210 poli kateter no 20 21.2.4 pcs 30 30 - 30
211 poli kateter no 22 6.2.1 pcs 50 50 - 50
212 poli kateter no 24 6.2.1 pcs 20 20 - 20
213 Pot Sputum 3 btl 30 30 - 30 100
214 Povidon Iodida Larutan 10 % 26.1 btl/300ml 17 17 3 14
215 Povidon iodion 10% 6.2.2 botol/60ml - -
216 Prednison tab 11.2 Btl 1000tab 16,950 16,950 1,200 15,750
217 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 1,200 - 1,200
218 Propanolol tab 10 mg 28.1 ktk/100tab 2,200 2,200 300 1,900
219 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 1,200 1,200 - 1,200
220 Ranitidin inj 25 mg/ml 6.2.4 Ampul 630 630 185 445
221 Ranitidin kaplet 6.2.1 b0k 30,900 30,900 700 30,200
222 RDT DBD Box/20 pcs - - - - 1
223 RDT MALARIA Box/20 pcs 3 3 - 3
224 Reagen ZN 10 10 - 10
225 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 13 13 - 13
226 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 72 72 2 70
227 Ringer Laktat Larutan 6.3 botol 280 200 480 200 280 500
228 Rivanol 6.2.1 bt t/100ml 7 7 - 7
229 Rivanol 0,1% Btl 300 ml 101 101 2 99
230 Salbutamol tab 4mg bok 5,900 5,900 750 5,150
231 Salbutamol tab 2mg ktk - -
232 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 420 420 - 420
233 Sarung tangan obgyn/panjang bok 401 401 200 201
234 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - - - 1000
235 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 396 396 6 390
236 Setirizin sirup 5 mg/5 ml botol 60ml 45 45 - 45
237 Setirizin ta 10 mg 25.4 ktk/100 kaps 900 900 - 900
238 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 625 625 275 350
239 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 367 367 7 360
240 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 410 410 30 380
241 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 8,900 8,900 1,110 7,790
242 Spasi inj 25.1 ktk / 10amp - -
243 Spritus 14.1 botol - - 2
244 Strip asam urat btl/25strp 19 19 2 17
245 Strip Gula Darah Nesco Btl/25strip 25 25 3 22
246 Strip kolesterol Nesco bt - - - - 15
247 Tabung EDTA ktk/100 pcs 1 1 - 1
248 Test kehamilan Box/50 pcs 37 37 - 37 100
249 tetrakain hcl tetes mata 0,5 13.2 btl 10 10 - 10
250 Tetrasiklin kap 500mg dus/100kap 500 500 - 500
251 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul - -
252 Tiamin (vit b1) tab 50mg ktk 100 tb 1,750 2,500 4,250 3,850 400 2000
253 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul 30 25 55 35 20 120
254 Turniquit 20.3 pcs - - 10
255 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 15 - 15
256 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 50 50 - 50
257 Vacu needle 1 1 1
258 Vagistin Suppositoria bok 10 sup 102 102 - 102
259 vit C ktk/100tab 22,400 22,400 2,000 20,400
260 Vitamin b complek ktk/100tb 37,700 37,700 1,100 36,600
261 Vitamin B12 tab Btl 1,950 1,950 250 1,700
262 Zinc sir 20mg/5ml botol 60 ml 25 25 - 25
263 Zinc tab dispersible 20mg dus/100tab 4,300 4,300 100 4,200
264 OAT Anak dus 3 5 8 5 3 10
265 OAT Dewasa dus 4 2 6 4 2 10
266 Gloves surgical no.6,5 pasang 250 250 - 250
267 Gloves surgical no.8,0 pasang 200 200 - 200
268 Plesterin Non Woven Roll 5cmx5m Roll 13 13 - 13
269 Plesterin Non Women Roll 10cmx5m Roll 7 7 - 7
270 Ecodine 5 liter Botol 5000 ml 1 1 - 1
271 Arm Sling M pcs 5 5 - 5
272 Arm Sling L pcs 5 5 - 5
273 Reagen pemerisaan gol.darah paket 2 2 - 2
274 Strip Haemoglobin botol/25 strip 3 3 2 1 5
275 Haemoglobin test Buah - - - -
276 BCG 20 ds/Ampul vial 10 20 30 15 15 15
277 Polio 10 ds/vial Vial 9 30 39 19 20 20
278 DPT-HB-HIB 11 40 51 34 17 30
279 IPV - 20 20 11 9 10
280 Hel.B 1 ds/Ads 55 30 85 42 43 30
281 Dcampak 10 ds/Vial 5 20 25 16 9 15
282 Td 10 ds/ vial 16 10 26 3 23
283 ADS 0,05 ml - 100 100 40 60
284 ADS 0,5 ml 250 300 550 250 300
285 ADS 5 ml 80 80 40 40
286 Bisoprolol 700 1,000 1,700 1,000 700
287 Klorampenikol kap 2,000 2,500 4,500 3,000 1,500
288 OAT Dewasa kategori 2 - - 4

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Sumber Agung Juni 2018


Mengetahui
Kepala Puskesmas Mepanga Petugas
Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far
NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16
Ed
Ed
Agung Juni 2018
Suriati, A.Md.Far
T : 19790320 201001 2 001
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : Agustus pemakaia
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 860 860 - 860
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 800 800 - 800
4 Air untuk injeksi 25 ml ampul 25 ml 303 303 - 303
5 Air untuk irigasi lar inf 1000 ml 5 Botol 57 57 2 55
6 Akarbose tab 50 mg 6.2.4 ktk/100tab - 2,000 2,000 - 2,000
7 Alkohol swab 29 Box 14 14 4 10
8 Alat suntik sekali pakai 1 ml 32 100/ktk 3,420 3,420 130 3,290
9 Alat Suntik Sekali pakai 10 ml 32 ktk 606 606 - 606
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 5,000 300 5,300 695 4,605
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 300 300 170 130 500
12 Albendasol tab 400 mg bok/100tb 800 800 - 800
13 Alkohol 70% 1 liter btl 20 20 - 20
14 Allupurinol 14.1 box 1,950 1,950 1,050 900 2500
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - - 500
16 Amblodipin 10 mg 32 box 7,280 7,280 800 6,480
17 Ambroxol tab 10 mg box 4,400 4,400 2,050 2,350
18 Aminofilin inj 24 mg/ml 26.2 Ampul 328 328 - 328
19 aminopilin tab 6.2.2 btl 2,200 2,200 200 2,000
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,700 3,700 - 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 12,480 12,480 1,290 11,190
22 Amoksisilin sir kering 125 mg/ml btl 35 200 235 60 175 200
23 Amoksisilin tab 500mg dus/100tab 800 1,500 2,300 1,400 900 5000
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 679 679 80 599
dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab 2,400 2,400 600 1,800
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet 2,750 2,750 2,750 -
200 mg + Magnesium Hidroksida 200 mg 6.2.1 5000
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml 87 337 314 23
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 250 200
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot 130 130 - 130
10.000 UI/g 32
29 anti rabies verorab bok - - 10
30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 262 262 - 262
32
31 Antihemoroid 31 Supp 498 498 28 470
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 4,000 4,000 100 3,900
34 Aplicators set 2 2 - 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 20,400 20,400 8,300 12,100
36 Asam assetilsalisilat(aspilet) Bok 1,400 1,400 100 1,300
37 Asam folat tab 1 mg 6.2.2 Botol 700 700 - 700
38 Asam mefenamat 32 b0k 15,650 15,650 2,150 13,500
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 2,800 2,800 100 2,700
40 Asam traneksamat inj 100mg/ml 32 Ampul 420 420 220 200
41 Aseptik gel 35 35 22 13
42 Asiklovir krim 5% 6.2.2 Tube 46 46 9 37
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 2,650 2,650 - 2,650
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 145 145 - 145
45 Attapugit tab650 mg dus/100tab 600 600 - 600
46 Bedak salisil serbuk 2 % 25.1 pot - 30 30 5 25
47 Betafort syrup botol 265 265 76 189
48 Basitrasin salep tube 155 155 25 130
49 Betametason 0,1% kream 6.2.1 tube 163 163 62 101
50 Bisakodil supositoria 10mg dus/50sup 150 150 - 150
51 Bisakodil supositoria 5mg dus/6sup 354 354 - 354
52 Blood Lancet ktk/100pcs 15 15 2 13
53 Brondisal 2mg 32 Dus 10 strip - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 12 12 1 11
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 1,046 1,046 37 1,009
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 352 352 15 337
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 348 348 24 324
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 880 880 280 600
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 1,190 1,190 459 731
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 684 684 310 374
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 431 431 197 234
62 Caviton 29 Set 1 1 1 -
63 Cefadroxil sirup bok 327 327 16 311
64 Cefatroxil 500mg kap 23.2 Bok - - - - 2000
65 Cepotaksim inj 20.3 dus/10vial 1gr 88 88 - 88
66 Ciprofloxacin tab 25.1 b0k 8,500 8,500 2,250 6,250
67 CTm (klorfeniramina Maleat tab 4 mg) bok 28,730 28,730 2,730 26,000
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,665 1,665 85 1,580
69 Deksametason tab 0,5 mg bok 40,100 40,100 2,200 37,900
70 Dektran larutan infus 70% btl - - - - - 20
71 Diasepm larutan rektal 5 3 3 - 3 50
72 Diazepam tab 2 mg 6.4.2.2 Botol 200 200 - 200
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 147 150 297 83 214
74 Digoksin tab 0,25mg dus/100tab 1,400 1,400 - 1,400
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab 24 24 24 -
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,300 1,300 - 1,300
77 Disposable meroaplicators 1 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 228 228 33 195 200
79 Domperidon tab dus/100tab 1,250 1,500 2,750 450 2,300
80 elastis perban 23.4 Roll 13 13 1 12
81 Epineprin inj ktk/100Amp 440 440 10 430
82 Etanol 70% 100ml 6.4.2.1 botol 173 173 8 165
83 Eritromisin ktk 2,300 2,300 - 2,300
84 Etil klorida semprot 100ml botol 100ml 3 3 - 3
85 ETSA 14.2 Set 2 2 - 2
86 Eugenol cairan 6.2.1 botol 3 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab 1,520 5,600 7,120 1,520 5,600
2000
88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 50 500 550 - 550 2000
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 65 120 185 70 115
90 Fixomull stretch 15 cm x 5 m 14.2 Roll - - - -
91 Furosemid Ktk/100tab 1,400 1,400 250 1,150

Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium


92 sachet 550 550 220 330
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2 500
93 Gentamisin 1mg krim tube 188 188 24 164
94 Gentian Violet Lrutan 1 % 32 Botol 198 198 - 198
95 Glass lonomer cemet ART 27.2 Set 1 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 5,400 5,400 1,000 4,400
97 Glimepirid tab 1 mg ktk/100tab 3,300 3,300 50 3,250
98 Glimepirid tab 2 mg ktk/100tab 4,950 4,950 - 4,950
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 16,600 16,600 1,800 14,800
100 glove non Steril l (hanskund) ktk 25 25 13 12 200
101 Glove non steril m (hanskund) ktk 25 25 - 25 200
102 Glove non steril S ktk - - - - 100
103 Glove Surgical no 7.0 ktk/50pcs 300 300 20 280
104 Glove Surgical no 7.5 ktk/50pcs 300 300 105 195
105 Glukosa larutan infus 5 % steril 31 botol 427 427 20 407
106 Griseofulvin tablet 125 mg 32 ktk/100tab 1,800 1,800 650 1,150 2500
107 Haloperidol 5 mg bok 400 400 - 400
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 100 100 - 100
109 Haloperidol tab 1,5 mg bok - - - -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb 600 600 600 -
111 Handscrub 500cc+dispenser btl - - - - 100
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 2,900 2,900 - 2,900
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 359 359 44 315
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet - - - - 3000
115 Ibuprofen sir 100 mg/5 ml botol 20 20 2 18
116 Ibuprofen tablet 400 mg pcs 3,050 3,050 1,250 1,800
117 Infus Set Anak pcs - 50 50 20 30 500
118 Infus Set Dewasa (Tipe Y) pcs 140 150 290 200 90 500
119 iodium tes Botol 10 ml 37 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 1,870 1,870 - 1,870
121 Kalsium glukonat inj i.v 10% 29 Tube 35 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet 1,650 1,650 1,100 550 3000
123 Kapas 250 gram Pcs 214 214 2 212
124 Kapas berlemak 500gr 20.3 Bungkus 28 28 2 26
125 Kapsul kosong 23.2 tablet 2,950 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 300 2,000 2,300 400 1,900 2000
127 Karbamazepin tab 200 mg Ktk/100tab 900 900 - 900
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 25 25 4 21
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll - - - - 500
130 Kertas Puyer Obat bks - -
131 Kertas puyer pres 6.2.1 bks 9 9 1 8
132 Ketokonasol krim 2% 7.2 tube 695 695 - 695
133 Ketokonazol tab 200 mg 32 Dus 5 strip 1,400 1,400 250 1,150
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 160 160 10 150 150
135 Kloramfenikol suspensi 26.3 botol/60ml 149 149 21 128 200
136 Kloramfenikol salep mata 1 % tube 135 135 35 100
137 Kloramfenikol tetes mata 0,5% 5 Botol 72 72 10 62
138 Kloramfenikol tetes telinga1% 13.1 Botol 29 50 79 18 61
139 kalsium hidroksida pasta 1 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 600 600 - 600
141 Kodein 25.4 btl 400 400 - 400
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml 1,400 1,400 1,200 200 3000
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 11,000 11,000 1,600 9,400
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 1,080 1,080 605 475
145 lar. HCl 0,1 N botol - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 84 84 12 72
147 Lipron B Plek 18.4 ktk/100tab - - - - 3000
148 Lisol btl 1000ml 4 4 4 - 50
149 Loperamid tab 2 mg Ktk/100tab 1,050 1,050 600 450
150 Loratadin tablet 10 mg 32 ktk / 100 tab 900 900 100 800
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon - - - -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon 80 80 - 80
153 Masker one med Kait 6.1.1 ktk/50tab - - - -
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 98 98 19 79
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - - 100
156 Miniaspi aspilet -
157 Metformin tab 500mg ktk/100yab 7,700 7,700 900 6,800
158 Metil prednisolon tab 4mg dus/100tab 900 900 700 200 2000
159 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 200 400 600 - 600
160 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 1,100 1,100 300 800
161 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet 1,000 1,000 - 1,000
162 Metronidazol tab 500 mg 1.2 ktk/100tab 1,050 1,050 500 550 3000
163 Mikonazol krim/salep 2 % (Nitrat) tube 143 143 - 143
23.2
165 MTD MB Dewasa/kusta 6.2.1 paket 2 2 - 2
166 MTD MB Anak/kusta 25.4 paket 1 1 - 1
167 Mineral mik 4 4 - 4
168 NaCL 0,9 % Botol 80 500 580 140 440
169 Nasal Oksigen bayi pcs 22 22 1 21
170 Nasal oxsigen Anak pcs 37 37 1 36
171 Nasal oxsigen dewasa pcs 33 33 3 30
172 Natriun diklofent tab 50 mg 32 ktk/50 tab 3,700 3,700 1,600 2,100 1000
173 Natriun Metamizole inj bok - - - -
174 Nifedipin kaps 10 mg 17.1 ktk/100kaps 950 950 150 800
175 Nistatin tab Ktk 750 750 150 600 1000
176 Nistatin Vagina 180 180 40 140
177 Novabion kapsul 2,050 2,050 2,050 - 3000
178 Novadiar sirup 26.1 btl/60ml 275 275 52 223
179 Noza tablet 424 424 244 180 500
180 Nurse cap bok/50 pcs - -
181 Obat Batuk hitam ( OBH) 14.1 Botol 45 45 15 30 100
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
182 66 66 25 41
20mg,sorbitol sirup with chocolate flavour q.c botol 60ml 100
183 Objeck Glass Frosted Dus/72 pcs 9 9 - 9
184 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 144 - 144
185 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 100 100 50 50 250
186 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak - - - - 200
187 Oksitosin inj10UI mg Ampul/100amp 675 675 15 660
188 Omeprasol kaps 20 mg Kapsu/3srtip 6,680 6,680 950 5,730
189 Omeprazol injeksi 40mg/10ml dus 10 vial - 30 30 - 30
190 Ondansentron inj 2 mg/ml ampul 10 10 10 - 200
191 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 240 240 30 210
192 Papaverin tablet 40 mg 31 1000 tablet / botol 14,200 14,200 11,500 2,700
193 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml - 500 500 26 474
194 Parasetamol tab 500mg ktk/100tab 18,100 18,100 5,400 12,700
195 pembalut gips 6.2.1 Roll 152 152 - 152
196 Pelester non women roll 15x15 Roll 9 9 2 7
197 penjepit tl pstUmbilical Cord klem seteril nilon pcs 895 895 - 895
198 Permetrin krim 5 %(skabimite) 14.1 Tube 184 184 10 174
199 phenobarbital inj 6.1.1 ktk/30amp 120 120 - 120
200 Pipet tetes panjang 6.2.2 pcs 100 100 - 100
201 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol - - - -
202 Pirantel pamoat tablet 125mg dus/100tab 450 450 100 350 1000
203 Pirantel suspensi 125 mg/5 ml 6.2.1 botol 18 18 18 -
204 Piridoksi vit B6 tab 10mg dus/100tab 1,650 1,650 1,550 100 2000
205 Piroksikam tab 10 mg 6.3 ktk/100tab - - - - 2500
206 Plastik klip sedang (5x8 cm) pak/100buah 9 9 1 8
207 plastik klip sedang (6x10 cm) pak/100buah 29 29 5 24
208 Plesterin Non Woven Roll 20cmx5m btl 500ml 4 4 - 4
209 poli kateter no 18 9 pcs 10 10 - 10
210 poli kateter no 20 21.2.4 pcs 30 30 - 30
211 poli kateter no 22 6.2.1 pcs 50 50 - 50
212 poli kateter no 24 6.2.1 pcs 20 20 2 18
213 Pot Sputum 3 btl 30 100 130 - 130
214 Povidon Iodida Larutan 10 % 26.1 btl/300ml 14 14 9 5
215 Povidon iodion 10% 6.2.2 botol/60ml - -
216 Prednison tab 11.2 Btl 1000tab 15,750 15,750 500 15,250
217 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 1,200 - 1,200
218 Propanolol tab 10 mg 28.1 ktk/100tab 1,900 1,900 500 1,400
219 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 1,200 1,200 100 1,100
220 Ranitidin inj 25 mg/ml 6.2.4 Ampul 445 445 125 320
221 Ranitidin kaplet 6.2.1 b0k 30,200 30,200 2,200 28,000
222 RDT DBD Box/20 pcs - - - 1
223 RDT MALARIA Box/20 pcs 3 3 1 2
224 Reagen ZN 10 10 - 10
225 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 13 13 7 6
226 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 70 70 45 25
227 Ringer Laktat Larutan 6.3 botol 280 500 780 302 478
228 Rivanol 6.2.1 bt t/100ml 7 7 7
229 Rivanol 0,1% Btl 300 ml 99 99 10 89
230 Salbutamol tab 4mg bok 5,150 5,150 450 4,700
231 Salbutamol tab 2mg ktk - -
232 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 420 420 24 396
233 Sarung tangan obgyn/panjang bok 391 391 - 391
234 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - - - 1000
235 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 390 390 6 384
236 Setirizin sirup 5 mg/5 ml botol 60ml 45 45 - 45
237 Setirizin ta 10 mg 25.4 ktk/100 kaps 900 900 - 900
238 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 350 350 200 150 200
239 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 360 360 - 360
240 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 380 380 15 365
241 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 7,790 7,790 1,050 6,740
242 Spasi inj 25.1 ktk / 10amp - -
243 Spritus 14.1 botol - - 2
244 Strip asam urat btl/25strp 17 17 2 15
245 Strip Gula Darah Nesco Btl/25strip 22 22 4 18
246 Strip kolesterol Nesco bt - 5 5 1 4 15
247 Tabung EDTA ktk/100 pcs 1 1 - 1
248 Test kehamilan Box/50 pcs 37 37 - 37 100
249 tetrakain hcl tetes mata 0,5 13.2 btl 10 10 - 10
250 Tetrasiklin kap 500mg dus/100kap 500 500 100 400
251 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul - -
252 Tiamin (vit b1) tab 50mg ktk 100 tb 400 2,000 2,400 900 1,500 2000
253 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul 20 30 50 16 34 50
254 Turniquit 20.3 pcs - - 5
255 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 15 - 15
256 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 50 50 5 45
257 Vacu needle 1 1 1
258 Vagistin Suppositoria bok 10 sup 102 102 - 102
259 vit C ktk/100tab 20,400 20,400 8,300 12,100
260 Vitamin b complek ktk/100tb 36,600 36,600 2,400 34,200
261 Vitamin B12 tab Btl 1,700 1,700 900 800
262 Zinc sir 20mg/5ml botol 60 ml 25 25 - 25
263 Zinc tab dispersible 20mg dus/100tab 4,200 4,200 2,100 2,100
264 OAT Anak dus 3 7 10 - 10
265 OAT Dewasa dus 2 10 12 - 12
266 Gloves surgical no.6,5 pasang 250 250 - 250
267 Gloves surgical no.8,0 pasang 200 50 250 - 250
268 Plesterin Non Woven Roll 5cmx5m Roll 13 13 - 13
269 Plesterin Non Women Roll 10cmx5m Roll 7 7 1 6
270 Ecodine 5 liter Botol 5000 ml 1 1 - 1
271 Arm Sling M pcs 5 5 - 5
272 Arm Sling L pcs 5 5 - 5
273 Reagen pemerisaan gol.darah paket 2 2 - 2
274 Strip Haemoglobin botol/25 strip 1 4 5 - 5
275 Haemoglobin test Buah - - - -
276 BCG 20 ds/Ampul vial 15 10 25 19 6 20
277 Polio 10 ds/vial Vial 20 20 40 30 10 30
278 DPT-HB-HIB 17 30 47 42 5 40
279 IPV 9 10 19 8 11 10
280 Hel.B 1 ds/Ads 43 30 73 43 30 30
281 Dcampak 10 ds/Vial 9 10 19 17 2 30
282 Td 10 ds/ vial 23 - 23 11 12 10
283 ADS 0,05 ml 60 - 60 50 10 100
284 ADS 0,5 ml 300 200 500 500 - 500
285 ADS 5 ml 40 - 40 20 20
286 Bisoprolol 700 700 200 500 2000
287 Klorampenikol kap 1,500 2,500 4,000 2,500 1,500
288 OAT Dewasa kategori 2 - - 4

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui
Kepala Puskesmas Mepanga Petugas
Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far
NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
: Agustus pemakaian juli

PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16
Ed
Ed
Suriati, A.Md.Far
T : 19790320 201001 2 001
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : Agustus
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 860 860 10 850
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 800 800 15 785
4 Air untuk injeksi 25 ml ampul 25 ml 303 303 - 303
5 Air untuk irigasi lar inf 1000 ml 5 Botol 55 55 - 55
6 Akarbose tab 50 mg 6.2.4 ktk/100tab 2,000 2,000 2,000 -
7 Alkohol swab 29 Box 10 10 - 10
8 Alat suntik sekali pakai 1 ml 32 100/ktk 3,290 3,290 65 3,225
9 Alat Suntik Sekali pakai 10 ml 32 ktk 606 606 - 606
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 4,605 4,605 1,425 3,180
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 130 500 630 230 400
12 Albendasol tab 400 mg bok/100tb 800 800 100 700
13 Alkohol 70% 1 liter btl 20 20 6 14
14 Allupurinol 14.1 box 900 900 900 -
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - - 500
16 Amblodipin 10 mg 32 box 6,480 6,480 1,410 5,070
17 Ambroxol tab 10 mg box 2,350 2,350 1,950 400 5000
18 Aminofilin inj 24 mg/ml 26.2 Ampul 328 328 - 328
19 aminopilin tab 6.2.2 btl 2,000 2,000 - 2,000
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,700 3,700 - 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 11,190 11,190 1,530 9,660
22 Amoksisilin sir kering 125 mg/ml btl 175 200 375 85 290
23 Amoksisilin tab 500mg dus/100tab 900 1,500 2,400 2,400 - 5000
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 599 599 224 375
dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab 1,800 1,800 550 1,250
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet - 5,000 5,000 1,600 3,400
200 mg + Magnesium Hidroksida 200 mg 6.2.1
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml 23 23 23 -
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 200
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot 130 130 78 52
10.000 UI/g 32
29 anti rabies verorab bok - - 10
30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 262 262 - 262
32
31 Antihemoroid 31 Supp 470 470 - 470
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 3,900 3,900 200 3,700
34 Aplicators set 2 2 - 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 12,100 12,100 3,100 9,000
36 Asam assetilsalisilat(aspilet) Bok 1,300 1,300 500 800
37 Asam folat tab 1 mg 6.2.2 Botol 700 700 700 - 1000
38 Asam mefenamat 32 b0k 13,500 13,500 2,150 11,350
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 2,700 2,700 100 2,600
40 Asam traneksamat inj 100mg/ml 32 Ampul 200 200 10 190
41 Aseptik gel 13 13 3 10
42 Asiklovir krim 5% 6.2.2 Tube 37 37 18 19 200
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 2,650 2,650 50 2,600
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 145 145 - 145
45 Attapugit tab650 mg dus/100tab 600 600 50 550
46 Bedak salisil serbuk 2 % 25.1 pot 25 25 5 20
47 Betafort syrup botol 189 189 102 87 200
48 Basitrasin salep tube 130 130 78 52
49 Betametason 0,1% kream 6.2.1 tube 101 101 58 43
50 Bisakodil supositoria 10mg dus/50sup 150 150 - 150
51 Bisakodil supositoria 5mg dus/6sup 354 354 1 353
52 Blood Lancet ktk/100pcs 13 13 2 11
53 Brondisal 2mg 32 Dus 10 strip - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 11 11 4 7
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 1,009 1,009 29 980
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 337 337 22 315
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 324 324 - 324
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 600 600 - 600
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 731 731 - 731
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 374 374 4 370
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 234 234 - 234
62 Caviton 29 Set - - - -
63 Cefadroxil sirup bok 311 311 33 278
64 Cefatroxil 500mg kap 23.2 Bok - - - - 3000
65 Cepotaksim inj 20.3 dus/10vial 1gr 88 88 - 88
66 Ciprofloxacin tab 25.1 b0k 6,250 6,250 1,250 5,000
67 CTm (klorfeniramina Maleat tab 4 mg) bok 26,000 26,000 4,000 22,000
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,580 1,580 100 1,480
69 Deksametason tab 0,5 mg bok 37,900 37,900 2,600 35,300
70 Dektran larutan infus 70% btl - - - - - 20
71 Diasepm larutan rektal 5 3 3 3 - 50
72 Diazepam tab 2 mg 6.4.2.2 Botol 200 200 - 200
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 214 214 67 147
74 Digoksin tab 0,25mg dus/100tab 1,400 1,400 - 1,400
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab - - - -
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,300 1,300 - 1,300
77 Disposable meroaplicators 1 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 195 180 375 56 319
79 Domperidon tab dus/100tab 2,300 2,300 800 1,500
80 elastis perban 23.4 Roll 12 12 - 12
81 Epineprin inj ktk/100Amp 430 430 - 430
82 Etanol 70% 100ml 6.4.2.1 botol 165 165 15 150
83 Eritromisin ktk 2,300 2,300 300 2,000
84 Etil klorida semprot 100ml botol 100ml 3 3 1 2
85 ETSA 14.2 Set 2 2 - 2
86 Eugenol cairan 6.2.1 botol 3 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab 5,600 5,600 3,300 2,300

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 550 1000 1,550 200 1,350
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 115 115 40 75 200
90 Fixomull stretch 15 cm x 5 m 14.2 Roll - - - -
91 Furosemid Ktk/100tab 1,150 1,150 300 850 1000
Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium
92 sachet 330 1,430 40 1,390
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2 1100
93 Gentamisin 1mg krim tube 164 164 10 154
94 Gentian Violet Lrutan 1 % 32 Botol 198 198 - 198
95 Glass lonomer cemet ART 27.2 Set 1 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 4,400 4,400 400 4,000
97 Glimepirid tab 1 mg ktk/100tab 3,250 3,250 600 2,650
98 Glimepirid tab 2 mg ktk/100tab 4,950 4,950 - 4,950
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 14,800 14,800 1,500 13,300
100 glove non Steril l (hanskund) ktk 12 10 22 10 12
101 Glove non steril m (hanskund) ktk 25 10 35 2 33
102 Glove non steril S ktk - - - -
103 Glove Surgical no 7.0 ktk/50pcs 280 280 20 260
104 Glove Surgical no 7.5 ktk/50pcs 195 195 153 42
105 Glukosa larutan infus 5 % steril 31 botol 407 407 37 370
106 Griseofulvin tablet 125 mg 32 ktk/100tab 1,150 2,500 3,650 700 2,950
107 Haloperidol 5 mg bok 400 400 200 200
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 100 100 - 100
109 Haloperidol tab 1,5 mg bok - - - -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb - - - -
111 Handscrub 500cc+dispenser btl - 10 10 2 8
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 2,900 2,900 - 2,900
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 315 315 69 246
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet - - - - 3000
115 Ibuprofen sir 100 mg/5 ml botol 18 18 10 8
116 Ibuprofen tablet 400 mg pcs 1,800 1,800 1,650 150 5000
117 Infus Set Anak pcs 30 - 30 30 - 500
118 Infus Set Dewasa (Tipe Y) pcs 90 500 590 193 397
119 iodium tes Botol 10 ml 37 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 1,870 1,870 400 1,470
121 Kalsium glukonat inj i.v 10% 29 Tube 35 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet 550 3000 3,550 750 2,800 3000
123 Kapas 250 gram Pcs 212 212 1 211
124 Kapas berlemak 500gr 20.3 Bungkus 26 26 5 21
125 Kapsul kosong 23.2 tablet 2,950 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 1,900 2,000 3,900 700 3,200
127 Karbamazepin tab 200 mg Ktk/100tab 900 900 - 900
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 21 21 2 19
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll - - - - 500
130 Kertas Puyer Obat bks - -
131 Kertas puyer pres 6.2.1 bks 8 9 1 8
132 Ketokonasol krim 2% 7.2 tube 695 695 25 670
133 Ketokonazol tab 200 mg 32 Dus 5 strip 1,150 1,150 50 1,100
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 150 150 60 90 150
135 Kloramfenikol suspensi 26.3 botol/60ml 128 128 35 93
136 Kloramfenikol salep mata 1 % tube 100 100 36 64
137 Kloramfenikol tetes mata 0,5% 5 Botol 62 62 12 50
138 Kloramfenikol tetes telinga1% 13.1 Botol 61 61 26 35
139 kalsium hidroksida pasta 1 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 600 600 - 600
141 Kodein 25.4 btl 400 400 - 400
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml 200 200 200 - 3000
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 9,400 9,400 1,100 8,300
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 475 475 70 405
145 lar. HCl 0,1 N botol - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 72 72 6 66
147 Lipron B Plek 18.4 ktk/100tab - - - - 3000
148 Lisol btl 1000ml - - - - 50
149 Loperamid tab 2 mg Ktk/100tab 450 450 300 150 2000
150 Loratadin tablet 10 mg 32 ktk / 100 tab 800 800 550 250 1000
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon - - - -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon 80 80 - 80
153 Masker one med Kait 6.1.1 ktk/50tab - - - -
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 79 20 99 21 78
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - - 100
156 Miniaspi aspilet -
157 Metformin tab 500mg ktk/100yab 6,800 6,800 1,350 5,450
158 Metil prednisolon tab 4mg dus/100tab 200 2,000 2,200 300 1,900
159 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 600 600 - 600
160 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 800 800 - 800
161 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet 1,000 1,000 700 300
162 Metronidazol tab 500 mg 1.2 ktk/100tab 550 3,000 3,550 850 2,700

163 Mikonazol krim/salep 2 % (Nitrat) tube 143 143 10 133


23.2
165 MTD MB Dewasa/kusta 6.2.1 paket 2 2 - 2
166 MTD MB Anak/kusta 25.4 paket 1 1 - 1
167 Mineral mik 4 4 - 4
168 NaCL 0,9 % Botol 440 440 200 240
169 Nasal Oksigen bayi pcs 21 21 - 21
170 Nasal oxsigen Anak pcs 36 36 - 36
171 Nasal oxsigen dewasa pcs 30 30 - 30
172 Natriun diklofent tab 50 mg 32 ktk/50 tab 2,100 1,000 3,100 2,100 1,000 2000
173 Natriun Metamizole inj bok - - - -
174 Nifedipin kaps 10 mg 17.1 ktk/100kaps 800 800 200 600
175 Nistatin tab Ktk 600 600 50 550 1000
176 Nistatin Vagina 140 140 20 120
177 Novabion kapsul - 1,000 1,000 650 350 3000
178 Novadiar sirup 26.1 btl/60ml 223 223 65 158
179 Noza tablet 180 180 140 40 500
180 Nurse cap bok/50 pcs - -
181 Obat Batuk hitam ( OBH) 14.1 Botol 30 30 17 13 100
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
182 41 41 14 27
20mg,sorbitol sirup with chocolate flavour q.c botol 60ml 100
183 Objeck Glass Frosted Dus/72 pcs 9 9 - 9
184 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 144 - 144
185 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 50 50 4 46 250
186 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak - - - - 200
187 Oksitosin inj10UI mg Ampul/100amp 660 660 25 635
188 Omeprasol kaps 20 mg Kapsu/3srtip 5,730 5,730 1,530 4,200
189 Omeprazol injeksi 40mg/10ml dus 10 vial 30 30 60 30 30
190 Ondansentron inj 2 mg/ml ampul - - - - 200
191 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 210 210 20 190
192 Papaverin tablet 40 mg 31 1000 tablet / botol 2,700 2,700 - 2,700
193 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml 474 474 156 318
194 Parasetamol tab 500mg ktk/100tab 12,700 12,700 5,500 7,200
195 pembalut gips 6.2.1 Roll 152 152 - 152
196 Pelester non women roll 15x15 Roll 7 7 - 7
197 penjepit tl pstUmbilical Cord klem seteril nilon pcs 895 895 35 860
198 Permetrin krim 5 %(skabimite) 14.1 Tube 174 174 - 174
199 phenobarbital inj 6.1.1 ktk/30amp 120 120 - 120
200 Pipet tetes panjang 6.2.2 pcs 100 100 - 100
201 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol - - - -
202 Pirantel pamoat tablet 125mg dus/100tab 350 1,000 1,350 - 1,350
203 Pirantel suspensi 125 mg/5 ml 6.2.1 botol - - - -
204 Piridoksi vit B6 tab 10mg dus/100tab 100 2,000 2,100 300 1,800
205 Piroksikam tab 10 mg 6.3 ktk/100tab - - - - 2500
206 Plastik klip sedang (5x8 cm) pak/100buah 8 8 - 8
207 plastik klip sedang (6x10 cm) pak/100buah 24 24 1 23
208 Plesterin Non Woven Roll 20cmx5m btl 500ml 4 4 1 3
209 poli kateter no 18 9 pcs 10 10 5 5
210 poli kateter no 20 21.2.4 pcs 30 30 - 30
211 poli kateter no 22 6.2.1 pcs 50 50 10 40
212 poli kateter no 24 6.2.1 pcs 18 18 12 6
213 Pot Sputum 3 btl 130 130 - 130
214 Povidon Iodida Larutan 10 % 26.1 btl/300ml 5 5 5 - 50
215 Povidon iodion 10% 6.2.2 botol/60ml - - 50
216 Prednison tab 11.2 Btl 1000tab 15,250 15,250 1,400 13,850
217 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 1,200 - 1,200
218 Propanolol tab 10 mg 28.1 ktk/100tab 1,400 1,400 500 900
219 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 1,100 1,100 400 700 1000
220 Ranitidin inj 25 mg/ml 6.2.4 Ampul 320 320 150 170
221 Ranitidin kaplet 6.2.1 b0k 28,000 28,000 1,400 26,600
222 RDT DBD Box/20 pcs - - 1
223 RDT MALARIA Box/20 pcs 2 2 - 2
224 Reagen ZN 10 10 - 10
225 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 6 6 - 6
226 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 25 25 3 22
227 Ringer Laktat Larutan 6.3 botol 478 478 368 110 500
228 Rivanol 6.2.1 bt t/100ml - -
229 Rivanol 0,1% Btl 300 ml 89 89 2 87
230 Salbutamol tab 4mg bok 4,700 4,700 600 4,100
231 Salbutamol tab 2mg ktk - -
232 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 396 396 44 352
233 Sarung tangan obgyn/panjang bok 391 391 60 331
234 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - - 1000
235 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 384 384 150 234
236 Setirizin sirup 5 mg/5 ml botol 60ml 45 45 - 45
237 Setirizin ta 10 mg 25.4 ktk/100 kaps 900 900 100 800
238 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 150 200 350 223 127 200
239 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 360 360 - 360
240 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 365 365 8 357
241 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 6,740 6,740 1,310 5,430
242 Spasi inj 25.1 ktk / 10amp - -
243 Spritus 14.1 botol - - 2
244 Strip asam urat btl/25strp 15 15 3 12
245 Strip Gula Darah Nesco Btl/25strip 18 18 6 12
246 Strip kolesterol Nesco bt 4 5 9 6 3 15
247 Tabung EDTA ktk/100 pcs 1 1 - 1
248 Test kehamilan Box/50 pcs 37 37 - 37 100
249 tetrakain hcl tetes mata 0,5 13.2 btl 10 10 5 5
250 Tetrasiklin kap 500mg dus/100kap 400 400 200 200
251 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul - -
252 Tiamin (vit b1) tab 50mg ktk 100 tb 1,500 2,000 3,500 2,050 1,450 2000
253 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul 34 34 19 15 50
254 Turniquit 20.3 pcs - - 5
255 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 15 - 15
256 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 45 45 5 40
257 Vacu needle 1 1 1
258 Vagistin Suppositoria bok 10 sup 102 102 - 102
259 vit C ktk/100tab 12,100 12,100 3,100 9,000
260 Vitamin b complek ktk/100tb 34,200 34,200 3,800 30,400
261 Vitamin B12 tab Btl 800 800 450 350 1000
262 Zinc sir 20mg/5ml botol 60 ml 25 25 25 - 1000
263 Zinc tab dispersible 20mg dus/100tab 2,100 2,100 900 1,200
264 OAT Anak dus 10 10 - 10
265 OAT Dewasa dus 12 12 - 12
266 Gloves surgical no.6,5 pasang 250 250 - 250
267 Gloves surgical no.8,0 pasang 250 250 - 250
268 Plesterin Non Woven Roll 5cmx5m Roll 13 13 1 12
269 Plesterin Non Women Roll 10cmx5m Roll 6 6 - 6
270 Ecodine 5 liter Botol 5000 ml 1 1 1 -
271 Arm Sling M pcs 5 5 - 5
272 Arm Sling L pcs 5 5 - 5
273 Reagen pemerisaan gol.darah paket 2 2 - 2
274 Strip Haemoglobin botol/25 strip 5 5 1 4
275 Haemoglobin test Buah - - - -
276 BCG 20 ds/Ampul vial 6 15 21 16 5
277 Polio 10 ds/vial Vial 10 20 30 30 -
278 DPT-HB-HIB 5 17 22 22 -
279 IPV 11 9 20 20 -
280 Hel.B 1 ds/Ads 30 43 73 59 14
281 Dcampak 10 ds/Vial 2 9 11 4 7
282 Td 10 ds/ vial 12 - 12 - 12
283 ADS 0,05 ml 10 - 10 - 10
284 ADS 0,5 ml - - - - -
285 ADS 5 ml 20 - 20 20 -
286 Bisoprolol 500 500 - 500 2000
287 Klorampenikol kap 1,500 1,500 1,200 300 2000
288 OAT Dewasa kategori 2 - - 4
289 Stik HIV untuk ibu hamil beresiko 400

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui Sumber Agung Agustus 2018


Kepala Puskesmas Mepanga Petugas
Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far
NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
: Agustus

PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16

ED
Agung Agustus 2018
Suriati, A.Md.Far
T : 19790320 201001 2 001
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : September
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 850 850 10 840
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 785 785 - 785
4 Air untuk injeksi 25 ml ampul 25 ml 303 303 18 285
5 Air untuk irigasi lar inf 1000 ml 5 Botol 55 55 - 55
6 Akarbose tab 50 mg 6.2.4 ktk/100tab - - - -
7 Alkohol swab 29 Box 10 10 - 10
8 Alat suntik sekali pakai 1 ml 32 100/ktk 3,225 3,225 90 3,135
9 Alat Suntik Sekali pakai 10 ml 32 ktk 606 606 - 606
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 3,180 3,180 670 2,510
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 400 400 235 165
12 Albendasol tab 400 mg bok/100tb 700 700 - 700
13 Alkohol 70% 1 liter btl 14 14 4 10
14 Allupurinol 14.1 box - - - - 2500
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - - 500
16 Amblodipin 10 mg 32 box 5,070 5,070 1,200 3,870
17 Ambroxol tab 10 mg box 400 400 400 - 5000
18 Aminofilin inj 24 mg/ml 26.2 Ampul 328 328 - 328
19 aminopilin tab 6.2.2 btl 2,000 2,000 300 1,700
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,700 3,700 - 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 9,660 9,660 1,050 8,610
22 Amoksisilin sir kering 125 mg/ml btl 290 290 115 175
23 Amoksisilin tab 500mg dus/100tab - - - - 5000
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 375 375 135 240
dus/30 amp
25 Antalgin tab(Metampiron tab) dus/100tab 1,250 1,250 300 950 2500
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet 3,400 3,400 2,200 1,200
200 mg + Magnesium Hidroksida 200 mg 6.2.1
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml - - - -
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 500
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot 52 52 - 52
10.000 UI/g 32
29 anti rabies verorab bok - - 10
30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 262 262 - 262
32
31 Antihemoroid 31 Supp 470 470 30 440
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 3,700 3,700 400 3,300
34 Aplicators set 2 2 - 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 9,000 9,000 3,100 5,900
36 Asam assetilsalisilat(aspilet) Bok 800 800 - 800
37 Asam folat tab 1 mg 6.2.2 Botol - - - -
38 Asam mefenamat 32 b0k 11,350 11,350 2,050 9,300
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 2,600 2,600 1,700 900
40 Asam traneksamat inj 100mg/ml 32 Ampul 190 190 10 180
41 Aseptik gel 10 10 - 10
42 Asiklovir krim 5% 6.2.2 Tube 19 19 9 10 300
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 2,600 2,600 150 2,450
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 145 145 - 145
45 Attapugit tab650 mg dus/100tab 550 550 230 320
46 Bedak salisil serbuk 2 % 25.1 pot 20 20 10 10
47 Betafort syrup botol 87 87 87 - 300
48 Basitrasin salep tube 52 52 - 52
49 Betametason 0,1% kream 6.2.1 tube 43 43 12 31
50 Bisakodil supositoria 10mg dus/50sup 150 150 - 150
51 Bisakodil supositoria 5mg dus/6sup 353 353 - 353
52 Blood Lancet ktk/100pcs 11 11 1 10
53 Brondisal 2mg 32 Dus 10 strip - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 7 7 - 7
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 980 980 12 968
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 315 315 - 315
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 324 324 84 240
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 600 600 394 206
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 731 731 - 731
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 370 370 180 190
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 234 234 84 150
62 Caviton 29 Set - - - - 6
63 Cefadroxil sirup bok 278 278 15 263
64 Cefatroxil 500mg kap 23.2 Bok - - - - 3000
65 Cepotaksim inj 20.3 dus/10vial 1gr 88 88 - 88
66 Ciprofloxacin tab 25.1 b0k 5,000 5,000 1,250 3,750
67 CTm (klorfeniramina Maleat tab 4 mg) bok 22,000 22,000 2,350 19,650
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,480 1,480 30 1,450
69 Deksametason tab 0,5 mg bok 35,300 35,300 1,600 33,700
70 Dektran larutan infus 70% btl - - - - - 20
71 Diasepm larutan rektal 5 - - - - 50
72 Diazepam tab 2 mg 6.4.2.2 Botol 200 200 - 200
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 147 147 73 74
74 Digoksin tab 0,25mg dus/100tab 1,400 1,400 - 1,400
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab - - - -
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,300 1,300 100 1,200
77 Disposable meroaplicators 1 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 319 319 54 265
79 Domperidon tab dus/100tab 1,500 1,500 350 1,150
80 elastis perban 23.4 Roll 12 12 - 12
81 Epineprin inj ktk/100Amp 430 430 - 430
82 Etanol 70% 100ml 6.4.2.1 botol 150 150 16 134
83 Eritromisin ktk 2,000 2,000 - 2,000
84 Etil klorida semprot 100ml botol 100ml 2 2 1 1 20
85 ETSA 14.2 Set 2 2 - 2
86 Eugenol cairan 6.2.1 botol 3 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab 2,300 2,300 2,300 -


3000
88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 1,350 1,350 1,300 50
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 75 75 60 15
90 Fixomull stretch 15 cm x 5 m 14.2 Roll - - - -
91 Furosemid Ktk/100tab 850 850 450 400 1000
Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium
92 sachet 1,390 1,390 140 1,250
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube 154 154 - 154
94 Gentian Violet Lrutan 1 % 32 Botol 198 198 9 189
95 Glass lonomer cemet ART 27.2 Set 1 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 4,000 4,000 600 3,400
97 Glimepirid tab 1 mg ktk/100tab 2,650 2,650 300 2,350
98 Glimepirid tab 2 mg ktk/100tab 4,950 4,950 - 4,950
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 13,300 13,300 2,700 10,600
100 glove non Steril l (hanskund) ktk 12 12 9 3
101 Glove non steril m (hanskund) ktk 33 33 5 28
102 Glove non steril S ktk - - - -
103 Glove Surgical no 7.0 ktk/50pcs 260 260 115 145
104 Glove Surgical no 7.5 ktk/50pcs 42 42 42 -
105 Glukosa larutan infus 5 % steril 31 botol 370 370 - 370
106 Griseofulvin tablet 125 mg 32 ktk/100tab 2,950 2,950 500 2,450
107 Haloperidol 5 mg bok 200 200 - 200
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 100 100 - 100
109 Haloperidol tab 1,5 mg bok - - - -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb - - - -
111 Handscrub 500cc+dispenser btl 8 8 8 25
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 2,900 2,900 100 2,800
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 246 246 15 231
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet - - - - 3000
115 Ibuprofen sir 100 mg/5 ml botol 8 8 4 4 100
116 Ibuprofen tablet 400 mg pcs 150 150 150 - 5000
117 Infus Set Anak pcs - - - - - 500
118 Infus Set Dewasa (Tipe Y) pcs 397 397 262 135
119 iodium tes Botol 10 ml 37 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 1,470 1,470 570 900
121 Kalsium glukonat inj i.v 10% 29 Tube 35 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet 2,800 2,800 2,100 700
123 Kapas 250 gram Pcs 211 211 2 209
124 Kapas berlemak 500gr 20.3 Bungkus 21 21 3 18
125 Kapsul kosong 23.2 tablet 2,950 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 3,200 3,200 700 2,500
127 Karbamazepin tab 200 mg Ktk/100tab 900 900 - 900
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 19 19 2 17
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll - - - - 500
130 Kertas Puyer Obat bks - -
131 Kertas puyer pres 6.2.1 bks 8 9 1 8
132 Ketokonasol krim 2% 7.2 tube 670 670 - 670
133 Ketokonazol tab 200 mg 32 Dus 5 strip 1,100 1,100 500 600
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 90 90 40 50 150
135 Kloramfenikol suspensi 26.3 botol/60ml 93 93 33 60
136 Kloramfenikol salep mata 1 % tube 64 64 25 39 200
137 Kloramfenikol tetes mata 0,5% 5 Botol 50 50 10 40
138 Kloramfenikol tetes telinga1% 13.1 Botol 35 35 15 20
139 kalsium hidroksida pasta 1 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 600 600 - 600
141 Kodein 25.4 btl 400 400 - 400
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml - - - - 3000
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 8,300 8,300 1,200 7,100
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 405 405 68 337
145 lar. HCl 0,1 N botol - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 66 66 11 55
147 Lipron B Plek 18.4 ktk/100tab - - - - 3000
148 Lisol btl 1000ml - - - - 50
149 Loperamid tab 2 mg Ktk/100tab 150 150 150 - 2000
150 Loratadin tablet 10 mg 32 ktk / 100 tab 250 250 100 150
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon - - - -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon 80 80 80 -
153 Masker one med Kait 6.1.1 ktk/50tab - - - -
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 78 78 24 54
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - - 100
156 Miniaspi aspilet -
157 Metformin tab 500mg ktk/100yab 5,450 5,450 1,200 4,250
158 Metil prednisolon tab 4mg dus/100tab 1,900 1,900 900 1,000
159 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 600 600 300 300
160 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 800 800 100 700
161 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet 300 300 300 -
162 Metronidazol tab 500 mg 1.2 ktk/100tab 2,700 2,700 500 2,200

163 Mikonazol krim/salep 2 % (Nitrat) tube 133 133 50 83


23.2
165 MTD MB Dewasa/kusta 6.2.1 paket 2 2 - 2
166 MTD MB Anak/kusta 25.4 paket 1 1 - 1
167 Mineral mik 4 4 4
168 NaCL 0,9 % Botol 240 240 - 240
169 Nasal Oksigen bayi pcs 21 21 - 21
170 Nasal oxsigen Anak pcs 36 36 - 36
171 Nasal oxsigen dewasa pcs 30 30 - 30
172 Natriun diklofent tab 50 mg 32 ktk/50 tab 1,000 1,000 1,000 - 2000
173 Natriun Metamizole inj bok - - - -
174 Nifedipin kaps 10 mg 17.1 ktk/100kaps 600 600 200 400
175 Nistatin tab Ktk 550 550 200 350
176 Nistatin Vagina 120 120 30 90
177 Novabion kapsul 350 350 350 - 3000
178 Novadiar sirup 26.1 btl/60ml 158 158 62 96
179 Noza tablet 40 40 40 - 500
180 Nurse cap bok/50 pcs - -
181 Obat Batuk hitam ( OBH) 14.1 Botol 13 13 13 - 100
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
182 27 27 10 17
20mg,sorbitol sirup with chocolate flavour q.c botol 60ml 100
183 Objeck Glass Frosted Dus/72 pcs 9 9 - 9
184 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 144 - 144
185 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 46 46 6 40 250
186 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak - - - - 200
187 Oksitosin inj10UI mg Ampul/100amp 635 635 55 580
188 Omeprasol kaps 20 mg Kapsu/3srtip 4,200 4,200 1,860 2,340
189 Omeprazol injeksi 40mg/10ml dus 10 vial 30 30 - 30
190 Ondansentron inj 2 mg/ml ampul - - - - 200
191 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 190 190 70 120
192 Papaverin tablet 40 mg 31 1000 tablet / botol 2,700 2,700 1,000 1,700
193 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml 318 318 166 152
194 Parasetamol tab 500mg ktk/100tab 7,200 7,200 5,400 1,800
195 pembalut gips 6.2.1 Roll 152 152 - 152
196 Pelester non women roll 15x15 Roll 7 7 - 7
197 penjepit tl pstUmbilical Cord klem seteril nilon pcs 860 860 10 850
198 Permetrin krim 5 %(skabimite) 14.1 Tube 174 174 - 174
199 phenobarbital inj 6.1.1 ktk/30amp 120 120 - 120
200 Pipet tetes panjang 6.2.2 pcs 100 100 - 100
201 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol - - - -
202 Pirantel pamoat tablet 125mg dus/100tab 1,350 1,350 - 1,350
203 Pirantel suspensi 125 mg/5 ml 6.2.1 botol - - - -
204 Piridoksi vit B6 tab 10mg dus/100tab 1,800 1,800 1,000 800
205 Piroksikam tab 10 mg 6.3 ktk/100tab - - - - 2500
206 Plastik klip sedang (5x8 cm) pak/100buah 8 8 1 7
207 plastik klip sedang (6x10 cm) pak/100buah 23 23 10 13
208 Plesterin Non Woven Roll 20cmx5m btl 500ml 3 3 1 2
209 poli kateter no 18 9 pcs 5 5 - 5
210 poli kateter no 20 21.2.4 pcs 30 30 - 30
211 poli kateter no 22 6.2.1 pcs 40 40 - 40
212 poli kateter no 24 6.2.1 pcs 6 6 - 6
213 Pot Sputum 3 btl 130 130 - 130
214 Povidon Iodida Larutan 10 % 26.1 btl/300ml - - - -
215 Povidon iodion 10% 6.2.2 botol/60ml - -
216 Prednison tab 11.2 Btl 1000tab 13,850 13,850 1,450 12,400
217 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 1,200 - 1,200
218 Propanolol tab 10 mg 28.1 ktk/100tab 900 900 400 500
219 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 700 700 200 500 1000
220 Ranitidin inj 25 mg/ml 6.2.4 Ampul 170 170 165 5
221 Ranitidin kaplet 6.2.1 b0k 26,600 26,600 1,800 24,800
222 RDT DBD Box/20 pcs - - 1
223 RDT MALARIA Box/20 pcs 2 2 1 1
224 Reagen ZN 10 10 - 10
225 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 6 6 - 6
226 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 22 22 1 21
227 Ringer Laktat Larutan 6.3 botol 110 500 610 230 380
228 Rivanol 6.2.1 bt t/100ml - -
229 Rivanol 0,1% Btl 300 ml 87 87 15 72
230 Salbutamol tab 4mg bok 4,100 4,100 650 3,450
231 Salbutamol tab 2mg ktk - -
232 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 352 352 - 352
233 Sarung tangan obgyn/panjang bok 331 331 - 331
234 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - 1000
235 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 234 234 10 224
236 Setirizin sirup 5 mg/5 ml botol 60ml 45 45 - 45
237 Setirizin ta 10 mg 25.4 ktk/100 kaps 800 800 50 750
238 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 127 900 1,027 307 720
239 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 360 360 17 343
240 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 357 357 3 354
241 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 5,430 5,430 1,680 3,750
242 Spasi inj 25.1 ktk / 10amp - -
243 Spritus 14.1 botol - - 2
244 Strip asam urat btl/25strp 12 12 2 10
245 Strip Gula Darah Nesco Btl/25strip 12 12 6 6
246 Strip kolesterol Nesco bt 3 5 8 8 - 15
247 Tabung EDTA ktk/100 pcs 1 1 - 1
248 Test kehamilan Box/50 pcs 37 37 20 17 100
249 tetrakain hcl tetes mata 0,5 13.2 btl 5 5 5 -
250 Tetrasiklin kap 500mg dus/100kap 200 200 50 150
251 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul - -
252 Tiamin (vit b1) tab 50mg ktk 100 tb 1,450 1,450 1,450 - 2000
253 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul 15 15 15 - 50
254 Turniquit 20.3 pcs - - 5
255 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 15 - 15
256 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 40 40 - 40
257 Vacu needle 1 1 1
258 Vagistin Suppositoria bok 10 sup 102 102 102 -
259 vit C ktk/100tab 9,000 9,000 3,100 5,900
260 Vitamin b complek ktk/100tb 30,400 30,400 3,100 27,300
261 Vitamin B12 tab Btl 350 350 150 200
262 Zinc sir 20mg/5ml botol 60 ml - - - -
263 Zinc tab dispersible 20mg dus/100tab 1,200 1,200 200 1,000
264 OAT Anak dus 10 10 5 5
265 OAT Dewasa dus 12 12 - 12
266 Gloves surgical no.6,5 pasang 250 250 - 250
267 Gloves surgical no.8,0 pasang 250 250 - 250
268 Plesterin Non Woven Roll 5cmx5m Roll 12 12 - 12
269 Plesterin Non Women Roll 10cmx5m Roll 6 6 - 6
270 Ecodine 5 liter Botol 5000 ml - - - -
271 Arm Sling M pcs 5 5 - 5
272 Arm Sling L pcs 5 5 - 5
273 Reagen pemerisaan gol.darah paket 2 2 - 2
274 Strip Haemoglobin botol/25 strip 4 4 1 3
275 Haemoglobin test Buah - - - -
276 BCG 20 ds/Ampul vial 5 20 25 12 13 15
277 Polio 10 ds/vial Vial - 40 40 29 11 30
278 DPT-HB-HIB - 40 40 35 5 40
279 IPV - 10 10 10 - 20
280 Hel.B 1 ds/Ads 14 40 54 18 36 20
281 Dcampak 10 ds/Vial 7 20 27 14 13 15
282 Td 10 ds/ vial 14 10 24 10 14 10
283 ADS 0,05 ml 30 - 30 10 20
284 ADS 0,5 ml - - - - - 300
285 ADS 5 ml - - - - -
286 Bisoprolol 500 500 250 250
287 Klorampenikol kap 300 300 300 -
288 OAT Dewasa kategori 2 - - 4
289 Stik HIV untuk ibu hamil beresiko 400
290 Raund Diamond bur un gigi 5
291 Raund fissure bur un gigi 5

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR
Mengetahui Sumber Agung September 20
Kepala Puskesmas Mepanga Pengelola obat

Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far


NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
: September

PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16
ED
ED

ED
ED
Agung September 2018
ngelola obat

Suriati, A.Md.Far
T : 19790320 201001 2 001
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : Oktober
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 840 840 1 839
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 785 785 200 585
4 Air untuk injeksi 25 ml ampul 25 ml 285 60 345 12 333
5 Air untuk irigasi lar inf 1000 ml 5 Botol 55 55 10 45
6 Akarbose tab 50 mg 6.2.4 ktk/100tab - - - -
7 Alkohol swab 29 Box 10 35 45 - 45
8 Alat suntik sekali pakai 1 ml 32 100/ktk 3,135 200 3,335 195 3,140
9 Alat Suntik Sekali pakai 10 ml 32 ktk 606 100 706 - 706
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 2,510 500 3,010 810 2,200
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 165 300 465 120 345
12 Albendasol tab 400 mg bok/100tb 700 600 1,300 400 900
13 Alkohol 70% 1 liter btl 10 3 13 4 9
14 Allupurinol 14.1 box - 600 600 - 600 3000
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - - 500
16 Amblodipin 10 mg 32 box 3,870 3,870 1,140 2,730
17 Ambroxol tab 10 mg box - 2,000 2,000 600 1,400 5000
18 Aminofilin inj 24 mg/ml 26.2 Ampul 328 30 358 - 358
19 aminopilin tab 6.2.2 btl 1,700 1,700 500 1,200
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,700 3,700 - 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 8,610 300 8,910 1,730 7,180
22 Amoksisilin sir kering 125 mg/ml btl 175 200 375 145 230
23 Amoksisilin tab 500mg dus/100tab - 8,000 8,000 3,900 4,100 2500
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 240 300 540 270 270
dus/30 amp 300
25 Antalgin tab(Metampiron tab) dus/100tab 950 500 1,450 200 1,250
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet 1,200 3,500 4,700 3,550 1,150
200 mg + Magnesium Hidroksida 200 mg 6.2.1 10000
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml - 200 15 185
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 200
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot 52 127 25 102
10.000 UI/g 32 75
29 anti rabies verorab bok - - 10
30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 262 48 310 - 310
32
31 Antihemoroid 31 Supp 440 40 480 10 470
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 3,300 300 3,600 200 3,400
34 Aplicators set 2 2 - 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 5,900 14,000 19,900 3,250 16,650
36 Asam assetilsalisilat(aspilet) Bok 800 400 1,200 400 800
37 Asam folat tab 1 mg 6.2.2 Botol - 1,000 1,000 - 1,000
38 Asam mefenamat 32 b0k 9,300 2100 11,400 2,900 8,500
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 900 900 500 400
40 Asam traneksamat inj 100mg/ml 32 Ampul 180 5 185 - 185
41 Aseptik gel 10 10 4 6
42 Asiklovir krim 5% 6.2.2 Tube 10 100 110 10 100
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 2,450 2,450 300 2,150
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 145 100 245 - 245
45 Attapugit tab650 mg dus/100tab 320 1,300 1,620 180 1,440
46 Bedak salisil serbuk 2 % 25.1 pot 10 10 - 10
47 Betafort syrup botol - - - - 300
48 Basitrasin salep tube 52 52 52 -
49 Betametason 0,1% kream 6.2.1 tube 31 100 131 60 71
50 Bisakodil supositoria 10mg dus/50sup 150 50 200 15 185
51 Bisakodil supositoria 5mg dus/6sup 353 353 80 273
52 Blood Lancet ktk/100pcs 10 5 15 - 15
53 Brondisal 2mg 32 Dus 10 strip - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 7 35 42 5 37
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 968 72 1,040 47 993
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 315 36 351 6 345
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 240 36 276 24 252
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 206 200 406 6 400
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 731 200 931 31 900
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 190 200 390 140 250
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 150 200 350 190 160
62 Caviton 29 Set - - - - 6
63 Cefadroxil sirup bok 263 200 463 48 415
64 Cefatroxil 500mg kap 23.2 Bok - - - - 3000
65 Cepotaksim inj 20.3 dus/10vial 1gr 88 88 - 88
66 Ciprofloxacin tab 25.1 b0k 3,750 1000 4,750 1,750 3,000
67 CTm (klorfeniramina Maleat tab 4 mg) bok 19,650 20,000 39,650 4,450 35,200
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,450 300 1,750 85 1,665
69 Deksametason tab 0,5 mg bok 33,700 3,000 36,700 2,500 34,200
70 Dektran larutan infus 70% btl - - - - - 20
71 Diasepm larutan rektal 5 - - - -
72 Diazepam tab 2 mg 6.4.2.2 Botol 200 200 - 200
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 74 120 194 60 134 100
74 Digoksin tab 0,25mg dus/100tab 1,400 300 1,700 - 1,700
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab - 18 18 - 18
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,200 1,200 - 1,200
77 Disposable meroaplicators 1 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 265 150 415 13 402
79 Domperidon tab dus/100tab 1,150 300 1,450 750 700
80 elastis perban 23.4 Roll 12 12 - 12
81 Epineprin inj ktk/100Amp 430 430 30 400
82 Etanol 70% 100ml 6.4.2.1 botol 134 134 17 117
83 Eritromisin ktk 2,000 200 2,200 - 2,200
84 Etil klorida semprot 100ml botol 100ml 1 1 1 - 25
85 ETSA 14.2 Set 2 2 - 2
86 Eugenol cairan 6.2.1 botol 3 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab - 11,200 11,200 1,800 9,400

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 50 600 650 250 400 2500
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 15 450 465 45 420
90 Fixomull stretch 15 cm x 5 m 14.2 Roll - - - -
91 Furosemid Ktk/100tab 400 1,400 1,800 100 1,700

Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium


92 sachet 1,250 2,250 500 1,750
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2 1000
93 Gentamisin 1mg krim tube 154 59 213 17 196
94 Gentian Violet Lrutan 1 % 32 Botol 189 189 - 189
95 Glass lonomer cemet ART 27.2 Set 1 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 3,400 1,000 4,400 500 3,900
97 Glimepirid tab 1 mg ktk/100tab 2,350 500 2,850 750 2,100
98 Glimepirid tab 2 mg ktk/100tab 4,950 2,150 7,100 - 7,100
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 10,600 500 11,100 1,500 9,600
100 glove non Steril l (hanskund) ktk 3 7 10 1 9
101 Glove non steril m (hanskund) ktk 28 7 35 11 24
102 Glove non steril S ktk - 8 8 - 8
103 Glove Surgical no 7.0 ktk/50pcs 145 200 345 145 200
104 Glove Surgical no 7.5 ktk/50pcs - 200 200 - 200
105 Glukosa larutan infus 5 % steril 31 botol 370 200 570 20 550
106 Griseofulvin tablet 125 mg 32 ktk/100tab 2,450 2,200 4,650 1,050 3,600
107 Haloperidol 5 mg bok 200 200 - 200
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 100 100 - 100
109 Haloperidol tab 1,5 mg bok - - - -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb - - - -
111 Handscrub 500cc+dispenser btl - - 50
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 2,800 2,800 - 2,800
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 231 120 351 133 218
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet - 1000 1,000 550 450 3000
115 Ibuprofen sir 100 mg/5 ml botol 4 400 404 4 400
116 Ibuprofen tablet 400 mg pcs - - - - 5000
117 Infus Set Anak pcs - - - - - 500
118 Infus Set Dewasa (Tipe Y) pcs 135 200 335 200 135 500
119 iodium tes Botol 10 ml 37 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 900 300 1,200 - 1,200
121 Kalsium glukonat inj i.v 10% 29 Tube 35 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet 700 4000 4,700 950 3,750
123 Kapas 250 gram Pcs 209 10 219 - 219
124 Kapas berlemak 500gr 20.3 Bungkus 18 18 4 14
125 Kapsul kosong 23.2 tablet 2,950 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 2,500 1,500 4,000 1,550 2,450
127 Karbamazepin tab 200 mg Ktk/100tab 900 100 1,000 200 800
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 17 4 21 - 21
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll - - - - 500
130 Kertas Puyer Obat bks - -
131 Kertas puyer pres 6.2.1 bks 8 8 - 8
132 Ketokonasol krim 2% 7.2 tube 670 100 770 21 749
133 Ketokonazol tab 200 mg 32 Dus 5 strip 600 350 950 - 950
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 50 50 30 20 150
135 Kloramfenikol suspensi 26.3 botol/60ml 60 60 31 29 250
136 Kloramfenikol salep mata 1 % tube 39 240 279 128 151
137 Kloramfenikol tetes mata 0,5% 5 Botol 40 50 90 12 78
138 Kloramfenikol tetes telinga1% 13.1 Botol 20 25 45 2 43
139 kalsium hidroksida pasta 1 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 600 600 - 600
141 Kodein 25.4 btl 400 400 300 100
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml - 2,000 2,000 500 1,500 3000
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 7,100 6,000 13,100 2,050 11,050
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 337 100 437 82 355
145 lar. HCl 0,1 N botol - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 55 10 65 11 54
147 Lipron B Plek 18.4 ktk/100tab - - - - 3000
148 Lisol btl 1000ml - - - - 50
149 Loperamid tab 2 mg Ktk/100tab - 2,500 2,500 1,300 1,200 2000
150 Loratadin tablet 10 mg 32 ktk / 100 tab 150 150 50 100 2000
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon - - - -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon - 10 10 5 5
153 Masker one med Kait 6.1.1 ktk/50tab - 14 14 - 14
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 54 300 354 43 311
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - - 100
156 Miniaspi aspilet -
157 Metformin tab 500mg ktk/100yab 4,250 4,250 700 3,550
158 Metil prednisolon tab 4mg dus/100tab 1,000 8,000 9,000 1,100 7,900
159 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 300 300 600 20 580
160 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 700 1,300 2,000 50 1,950 1000
161 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet - 200 200 200 -
162 Metronidazol tab 500 mg 1.2 ktk/100tab 2,200 1,000 3,200 750 2,450

163 Mikonazol krim/salep 2 % (Nitrat) tube 83 203 23 180


23.2 120
165 MTD MB Dewasa/kusta 6.2.1 paket 2 2 - 2
166 MTD MB Anak/kusta 25.4 paket 1 1 - 1
167 Mineral mik - -
168 NaCL 0,9 % Botol 240 360 600 230 370
169 Nasal Oksigen bayi pcs 21 5 26 1 25
170 Nasal oxsigen Anak pcs 36 5 41 - 41
171 Nasal oxsigen dewasa pcs 30 5 35 - 35
172 Natriun diklofent tab 50 mg 32 ktk/50 tab - 1,000 1,000 1,000 - 5000
173 Natriun Metamizole inj bok - - - -
174 Nifedipin kaps 10 mg 17.1 ktk/100kaps 400 1,500 1,900 400 1,500
175 Nistatin tab Ktk 350 200 550 - 550
176 Nistatin Vagina 90 90 10 80 200
177 Novabion kapsul - - - - 3000
178 Novadiar sirup 26.1 btl/60ml 96 50 146 66 80
179 Noza tablet - - - - 500
180 Nurse cap bok/50 pcs - -
181 Obat Batuk hitam ( OBH) 14.1 Botol - 100 100 20 80 100
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
182 17 17 17 -
20mg,sorbitol sirup with chocolate flavour q.c botol 60ml 100
183 Objeck Glass Frosted Dus/72 pcs 9 9 - 9
184 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 144 - 144
185 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 40 100 140 34 106
186 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak - - - - 200
187 Oksitosin inj10UI mg Ampul/100amp 580 200 780 75 705
188 Omeprasol kaps 20 mg Kapsu/3srtip 2,340 1,380 3,720 2,050 1,670
189 Omeprazol injeksi 40mg/10ml dus 10 vial 30 30 60 3 57
190 Ondansentron inj 2 mg/ml ampul - - - - 200
191 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 120 120 75 45
192 Papaverin tablet 40 mg 31 1000 tablet / botol 1,700 100 1,800 - 1,800
193 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml 152 500 652 197 455
194 Parasetamol tab 500mg ktk/100tab 1,800 7,500 9,300 6,050 3,250 5000
195 pembalut gips 6.2.1 Roll 152 152 - 152
196 Pelester non women roll 15x15 Roll 7 7 1 6
197 penjepit tl pstUmbilical Cord klem seteril nilon pcs 850 850 40 810
198 Permetrin krim 5 %(skabimite) 14.1 Tube 174 20 194 - 194
199 phenobarbital inj 6.1.1 ktk/30amp 120 120 120 - 50
200 Pipet tetes panjang 6.2.2 pcs 100 100 - 100
201 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol - - - - 50
202 Pirantel pamoat tablet 125mg dus/100tab 1,350 700 2,050 150 1,900
203 Pirantel suspensi 125 mg/5 ml 6.2.1 botol - - - -
204 Piridoksi vit B6 tab 10mg dus/100tab 800 800 700 100 2500
205 Piroksikam tab 10 mg 6.3 ktk/100tab - - - - 3000
206 Plastik klip sedang (5x8 cm) pak/100buah 7 7 3 4 20
207 plastik klip sedang (6x10 cm) pak/100buah 13 13 1 12 10
208 Plesterin Non Woven Roll 20cmx5m btl 500ml 2 2 - 2
209 poli kateter no 18 9 pcs 5 5 10 2 8
210 poli kateter no 20 21.2.4 pcs 30 5 35 - 35
211 poli kateter no 22 6.2.1 pcs 40 40 - 40
212 poli kateter no 24 6.2.1 pcs 6 6 - 6
213 Pot Sputum 3 btl 130 130 30 100
214 Povidon Iodida Larutan 10 % 26.1 btl/300ml - 7 7 3 4 50
215 Povidon iodion 10% 6.2.2 botol/60ml - -
216 Prednison tab 11.2 Btl 1000tab 12,400 6,500 18,900 2,000 16,900
217 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 1,200 - 1,200
218 Propanolol tab 10 mg 28.1 ktk/100tab 500 500 500 - 2500
219 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 500 500 - 500 1000
220 Ranitidin inj 25 mg/ml 6.2.4 Ampul 5 200 205 160 45 500
221 Ranitidin kaplet 6.2.1 b0k 24,800 6600 31,400 1,300 30,100
222 RDT DBD Box/20 pcs - - 1
223 RDT MALARIA Box/20 pcs 1 1 - 1 1
224 Reagen ZN 10 10 - 10
225 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 6 6 - 6
226 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 21 21 1 20
227 Ringer Laktat Larutan 6.3 botol 380 700 1,080 780 300 300
228 Rivanol 6.2.1 bt t/100ml - -
229 Rivanol 0,1% Btl 300 ml 72 24 96 - 96
230 Salbutamol tab 4mg bok 3,450 400 3,850 350 3,500
231 Salbutamol tab 2mg ktk - -
232 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 352 48 400 200 200
233 Sarung tangan obgyn/panjang bok 331 7 338 81 257
234 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - 1000
235 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 224 20 244 24 220
236 Setirizin sirup 5 mg/5 ml botol 60ml 45 200 245 - 245
237 Setirizin ta 10 mg 25.4 ktk/100 kaps 750 3,000 3,750 400 3,350
238 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 720 200 920 250 670
239 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 343 36 379 24 355
240 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 354 36 390 24 366
241 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 3,750 3,000 6,750 1,340 5,410
242 Spasi inj 25.1 ktk / 10amp - -
243 Spritus 14.1 botol - - 2
244 Strip asam urat btl/25strp 10 3 13 1 12
245 Strip Gula Darah Nesco Btl/25strip 6 3 9 2 7
246 Strip kolesterol Nesco bt - 8 8 5 3 15
247 Tabung EDTA ktk/100 pcs 1 1 - 1
248 Test kehamilan Box/50 pcs 17 17 17 - 100
249 tetrakain hcl tetes mata 0,5 13.2 btl - - - -
250 Tetrasiklin kap 500mg dus/100kap 150 300 450 100 350
251 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul - -
252 Tiamin (vit b1) tab 50mg ktk 100 tb - 4,500 4,500 550 3,950 2000
253 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul - - - - 50
254 Turniquit 20.3 pcs - - 5
255 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 15 - 15
256 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 40 40 2 38
257 Vacu needle 1 1 1
258 Vagistin Suppositoria bok 10 sup - - - -
259 vit C ktk/100tab 5,900 14,000 19,900 3,250 16,650
260 Vitamin b complek ktk/100tb 27,300 9,400 36,700 3,200 33,500
261 Vitamin B12 tab Btl 200 2,500 2,700 950 1,750
262 Zinc sir 20mg/5ml botol 60 ml - 100 100 20 80
263 Zinc tab dispersible 20mg dus/100tab 1,000 2,200 3,200 100 3,100
264 OAT Anak dus 5 5 - 5
265 OAT Dewasa dus 12 12 3 9
266 Gloves surgical no.6,5 pasang 250 200 450 - 450
267 Gloves surgical no.8,0 pasang 250 250 - 250
268 Plesterin Non Woven Roll 5cmx5m Roll 12 5 17 - 17
269 Plesterin Non Women Roll 10cmx5m Roll 6 6 - 6
270 Ecodine 5 liter Botol 5000 ml - - - -
271 Arm Sling M pcs 5 5 - 5
272 Arm Sling L pcs 5 5 - 5
273 Reagen pemerisaan gol.darah paket 2 2 - 2
274 Strip Haemoglobin botol/25 strip 3 2 5 1 4
275 Haemoglobin test Buah - - - -
276 BCG 20 ds/Ampul vial 13 20 33 20 13 15
277 Polio 10 ds/vial Vial 11 40 51 40 11 30
278 DPT-HB-HIB 5 40 45 40 5 40
279 IPV - 10 10 10 - 20
280 Hel.B 1 ds/Ads 36 40 76 40 36 20
281 Dcampak 10 ds/Vial 13 20 33 20 13 15
282 Td 10 ds/ vial 14 10 24 10 14 10
283 ADS 0,05 ml 20 - 20 - 20
284 ADS 0,5 ml - - - - - 300
285 ADS 5 ml - - - - -
286 Bisoprolol 250 1,000 1,250 250 1,000
287 Klorampenikol kap 500 mg - 700 700 300 400
288 OAT Dewasa kategori 2 - - 4
289 Stik HIV untuk ibu hamil beresiko - - 400
290 Raund Diamond bur un gigi - - 5
291 Raund fissure bur un gigi - - 5
292 Diasepam inj 5 mg/ml Ampul 50 10 40
293 SARAYA alsof pure 500 ml Botol 24 24 - 24
294 Fokus Malaria pan/pf casette pcs 25 25 - 25
295 Dimenhidrinat tab 50 mg tablet 600 600 - 600
296 Eritromisin sirup kering 200 mg/5 ml Botol 120 120 - 120
297 Betahistin tablet/6 mg tablet 1,300 1,300 300 1,000
298 Kloranfenikol kap 250 mg Kapsul 1,000 1,000 250 750
299 Parasetamol drop 100 mg/ml Botol 15 15 5 10
300 N-asetil sistein kapsul 200 mg Kapsul 1,800 1,800 60 1,740
301 Metronidazol ovula 500 mg suppo 125 125 - 125
302 Bisakodil tablet 5 mg tablet 600 600 - 600
303 Ampisilin Serbuk inj 1000 mg Vial 70 70 3 67
304 Klindamisin kapsul 300 mg Kapsul 150 150 - 150
305 Polli catheter two way no.10 pcs 5 5 - 5
306 poli catheter two way no.12 pcs 5 5 - 5
307 poli catheter two way no.14 pcs 5 5 - 5
308 paper tape 2,5cmx 9,14 m roll 12 12 - 12
309 paper tape 7,5cmx 9,14 m roll 8 8 1 7
310 Povidon iodine 30 ml Botol 28 28 2 26
311 Bioplacenton tulle 10x10 bok/10 sachet 70 70 1 69
312 Leukoplast 2,5 cmx4,5m roll 10 10 - 10
313 Elastis perban (uniflex 7,5cmx4,5m) roll 4 4 - 4
314 Elastis perban (uniflex 10cmx4,5m) roll 4 4 - 4
315 Leukomed i.v. Flim bok/50 pcs 400 400 - 400
316 Pehakain inj 250

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui Sumber Agung Oktober 2018


Kepala Puskesmas Mepanga Pengelola obat

Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far


NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
: Oktober

PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16
Agung Oktober 2018
ngelola obat

Suriati, A.Md.Far
T : 19790320 201001 2 001
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : November
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 839 839 - 839
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 585 585 - 585
4 Air untuk injeksi 25 ml ampul 25 ml 333 333 5 328
5 Air untuk irigasi lar inf 1000 ml 5 Botol 45 45 5 40
6 Akarbose tab 50 mg 6.2.4 ktk/100tab - - - - 2500
7 Alkohol swab 29 Box 45 45 - 45
8 Alat suntik sekali pakai 1 ml 32 100/ktk 3,140 3,140 - 3,140
9 Alat Suntik Sekali pakai 10 ml 32 ktk 706 706 - 706
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 2,200 2,200 625 1,575
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 345 345 180 165 1000
12 Albendasol tab 400 mg bok/100tb 900 900 - 900 500
13 Alkohol 70% 1 liter btl 9 9 6 3 100
14 Allupurinol 14.1 box 600 600 600 - 5000
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - - 500
16 Amblodipin 10 mg 32 box 2,730 2,730 800 1,930
17 Ambroxol tab 10 mg box 1,400 1,400 1,400 - 5000
18 Aminofilin inj 24 mg/ml 26.2 Ampul 358 358 110 248
19 aminopilin tab 6.2.2 btl 1,200 1,200 - 1,200
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,700 3,700 - 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 7,180 7,180 2,560 4,620
22 Amoksisilin sir kering 125 mg/ml btl 230 230 130 100 250
23 Amoksisilin tab 500mg dus/100tab 4,100 4,100 3,700 400 5000
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 270 270 30 240
dus/30 amp 300
25 Antalgin tab(Metampiron tab) dus/100tab 1,250 1,250 750 500 3000
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet 1,150 1,150 1,150 -
200 mg + Magnesium Hidroksida 200 mg 6.2.1 10000
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml 185 185 2 183
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 300
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot 102 102 - 102
10.000 UI/g 32
29 anti rabies verorab bok - - 10
30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 310 310 - 310
32
31 Antihemoroid 31 Supp 470 470 - 470
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 3,400 3,400 - 3,400
34 Aplicators set 2 2 - 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 16,650 16,650 2,750 13,900
36 Asam assetilsalisilat(aspilet) Bok 800 800 300 500 2500
37 Asam folat tab 1 mg 6.2.2 Botol 1,000 1,000 100 900
38 Asam mefenamat 32 b0k 8,500 8,500 3,400 5,100
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 400 400 - 400 500
40 Asam traneksamat inj 100mg/ml 32 Ampul 185 185 - 185
41 Aseptik gel 6 6 4 2
42 Asiklovir krim 5% 6.2.2 Tube 100 100 3 97 250
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 2,150 2,150 50 2,100
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 245 245 - 245
45 Attapugit tab650 mg dus/100tab 1,440 1,440 170 1,270
46 Bedak salisil serbuk 2 % 25.1 pot 10 10 8 2 50
47 Betafort syrup botol - - - - 300
48 Basitrasin salep tube - - - -
49 Betametason 0,1% kream 6.2.1 tube 71 71 36 35 100
50 Bisakodil supositoria 10mg dus/50sup 185 185 22 163
51 Bisakodil supositoria 5mg dus/6sup 273 273 22 251
52 Blood Lancet ktk/100pcs 15 15 1 14
53 Brondisal 2mg 32 Dus 10 strip - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 37 37 7 30
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 993 993 10 983
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 345 345 7 338
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 252 252 24 228
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 400 670 1,070 11 1,059
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 900 227 1,127 - 1,127
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 250 250 130 120 500
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 160 160 60 100 500
62 Caviton 29 Set - - - - 6
63 Cefadroxil sirup bok 415 415 - 415
64 Cefatroxil 500mg kap 23.2 Bok - - - - 3000
65 Cepotaksim inj 20.3 dus/10vial 1gr 88 88 24 64
66 Ciprofloxacin tab 25.1 b0k 3,000 3,000 550 2,450
67 CTm (klorfeniramina Maleat tab 4 mg) bok 35,200 35,200 3,050 32,150
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,665 1,665 5 1,660
69 Deksametason tab 0,5 mg bok 34,200 34,200 2,800 31,400
70 Dektran larutan infus 70% btl - - - - 20
71 Diasepm larutan rektal 5 - - - -
72 Diazepam tab 2 mg 6.4.2.2 Botol 200 200 - 200
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 134 134 87 47 200
74 Digoksin tab 0,25mg dus/100tab 1,700 1,700 - 1,700
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab 18 18 - 18
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,200 1,200 200 1,000
77 Disposable meroaplicators 1 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 402 402 43 359
79 Domperidon tab dus/100tab 700 700 600 100 3000
80 elastis perban 23.4 Roll 12 12 - 12
81 Epineprin inj ktk/100Amp 400 400 5 395
82 Etanol 70% 100ml 6.4.2.1 botol 117 117 40 77
83 Eritromisin ktk 2,200 2,200 - 2,200
84 Etil klorida semprot 100ml botol 100ml - - - - 25
85 ETSA 14.2 Set 2 2 - 2
86 Eugenol cairan 6.2.1 botol 3 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab 9,400 9,400 4,300 5,100

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 400 400 400 - 2500
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 420 420 70 350
90 Fixomull stretch 15 cm x 5 m 14.2 Roll - - - -
91 Furosemid Ktk/100tab 1,700 1,700 900 800 1000
Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium
92 sachet 1,750 1,750 190 1,560
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube 196 196 5 191
94 Gentian Violet Lrutan 1 % 32 Botol 189 189 - 189
95 Glass lonomer cemet ART 27.2 Set 1 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 3,900 3,900 200 3,700
97 Glimepirid tab 1 mg ktk/100tab 2,100 2,100 200 1,900
98 Glimepirid tab 2 mg ktk/100tab 7,100 7,100 1,200 5,900
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 9,600 9,600 2,150 7,450
100 glove non Steril l (hanskund) ktk 9 9 1 8
101 Glove non steril m (hanskund) ktk 24 24 10 14
102 Glove non steril S ktk 8 8 - 8
103 Glove Surgical no 7.0 ktk/50pcs 200 200 - 200
104 Glove Surgical no 7.5 ktk/50pcs 200 200 8 192
105 Glukosa larutan infus 5 % steril 31 botol 550 550 - 550
106 Griseofulvin tablet 125 mg 32 ktk/100tab 3,600 3,600 450 3,150
107 Haloperidol 5 mg bok 200 200 - 200
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 100 100 - 100
109 Haloperidol tab 1,5 mg bok - - - -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb - - - -
111 Handscrub 500cc+dispenser btl - - 50
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 2,800 2,800 - 2,800
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 218 218 65 153
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet 450 450 200 250 3000
115 Ibuprofen sir 100 mg/5 ml botol 400 400 6 394
116 Ibuprofen tablet 400 mg pcs - - - - 5000
117 Infus Set Anak pcs - - - - 1000
118 Infus Set Dewasa (Tipe Y) pcs 135 135 135 - 1000
119 iodium tes Botol 10 ml 37 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 1,200 1,200 300 900
121 Kalsium glukonat inj i.v 10% 29 Tube 35 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet 3,750 3,750 1,450 2,300
123 Kapas 250 gram Pcs 219 219 3 216
124 Kapas berlemak 500gr 20.3 Bungkus 14 14 2 12
125 Kapsul kosong 23.2 tablet 2,950 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 2,450 2,450 1,250 1,200
127 Karbamazepin tab 200 mg Ktk/100tab 800 800 - 800
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 21 21 6 15
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll - - - - 500
130 Kertas Puyer Obat bks - -
131 Kertas puyer pres 6.2.1 bks 8 8 1 7
132 Ketokonasol krim 2% 7.2 tube 749 749 30 719
133 Ketokonazol tab 200 mg 32 Dus 5 strip 950 950 200 750
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 20 20 20 - 150
135 Kloramfenikol suspensi 26.3 botol/60ml 29 29 29 - 250
136 Kloramfenikol salep mata 1 % tube 151 151 28 123
137 Kloramfenikol tetes mata 0,5% 5 Botol 78 78 3 75
138 Kloramfenikol tetes telinga1% 13.1 Botol 43 43 12 31
139 kalsium hidroksida pasta 1 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 600 600 - 600
141 Kodein 25.4 btl 100 100 - 100
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml 1,500 1,500 650 850 3000
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 11,050 11,050 1,150 9,900
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 355 355 43 312
145 lar. HCl 0,1 N botol - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 54 54 7 47
147 Lipron B Plek 18.4 ktk/100tab - - - - 3000
148 Lisol btl 1000ml - - - - 50
149 Loperamid tab 2 mg Ktk/100tab 1,200 1,200 550 650 2000
150 Loratadin tablet 10 mg 32 ktk / 100 tab 100 100 - 100 2000
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon - - - -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon 5 5 - 5
153 Masker one med Kait 6.1.1 ktk/50tab 14 14 - 14
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 311 311 - 311
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - - 100
156 Miniaspi aspilet -
157 Metformin tab 500mg ktk/100yab 3,550 3,550 1,150 2,400
158 Metil prednisolon tab 4mg dus/100tab 7,900 7,900 1,000 6,900
159 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 580 580 5 575
160 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 1,950 1,950 50 1,900 1000
161 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet - - - - 1000
162 Metronidazol tab 500 mg 1.2 ktk/100tab 2,450 2,450 900 1,550

163 Mikonazol krim/salep 2 % (Nitrat) tube 180 180 24 156


23.2
165 MTD MB Dewasa/kusta 6.2.1 paket 2 2 - 2
166 MTD MB Anak/kusta 25.4 paket 1 1 - 1
167 Mineral mik - -
168 NaCL 0,9 % Botol 370 370 10 360
169 Nasal Oksigen bayi pcs 25 25 - 25
170 Nasal oxsigen Anak pcs 41 41 - 41
171 Nasal oxsigen dewasa pcs 35 35 - 35
172 Natriun diklofent tab 50 mg 32 ktk/50 tab - - - - 5000
173 Natriun Metamizole inj bok - - - -
174 Nifedipin kaps 10 mg 17.1 ktk/100kaps 1,500 1,500 200 1,300
175 Nistatin tab Ktk 550 550 150 400
176 Nistatin Vagina 80 80 50 30 200
177 Novabion kapsul - - - - 3000
178 Novadiar sirup 26.1 btl/60ml 80 80 50 30 300
179 Noza tablet - - - - 500
180 Nurse cap bok/50 pcs - -
181 Obat Batuk hitam ( OBH) 14.1 Botol 80 80 11 69 100
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
182 - - - -
20mg,sorbitol sirup with chocolate flavour q.c botol 60ml 100
183 Objeck Glass Frosted Dus/72 pcs 9 9 - 9
184 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 144 - 144
185 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 106 106 34 72
186 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak - - - - 200
187 Oksitosin inj10UI mg Ampul/100amp 705 705 35 670
188 Omeprasol kaps 20 mg Kapsu/3srtip 1,670 1,670 1,310 360 3000
189 Omeprazol injeksi 40mg/10ml dus 10 vial 57 57 3 54
190 Ondansentron inj 2 mg/ml ampul - - - - 200
191 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 45 45 30 15
192 Papaverin tablet 40 mg 31 1000 tablet / botol 1,800 1,800 - 1,800
193 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml 455 455 140 315
194 Parasetamol tab 500mg ktk/100tab 3,250 3,500 6,750 3,950 2,800 5000
195 pembalut gips 6.2.1 Roll 152 152 - 152
196 Pelester non women roll 15x15 Roll 6 6 - 6
197 penjepit tl pstUmbilical Cord klem seteril nilon pcs 810 810 40 770
198 Permetrin krim 5 %(skabimite) 14.1 Tube 194 194 - 194
199 phenobarbital inj 6.1.1 ktk/30amp - - - - 50
200 Pipet tetes panjang 6.2.2 pcs 100 100 - 100
201 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol - - - - 50
202 Pirantel pamoat tablet 125mg dus/100tab 1,900 1,900 - 1,900
203 Pirantel suspensi 125 mg/5 ml 6.2.1 botol - - - -
204 Piridoksi vit B6 tab 10mg dus/100tab 100 100 100 - 3000
205 Piroksikam tab 10 mg 6.3 ktk/100tab - - - - 5000
206 Plastik klip sedang (5x8 cm) pak/100buah 4 4 2 2 20
207 plastik klip sedang (6x10 cm) pak/100buah 12 12 2 10 10
208 Plesterin Non Woven Roll 20cmx5m btl 500ml 2 2 - 2
209 poli kateter no 18 9 pcs 8 8 6 2
210 poli kateter no 20 21.2.4 pcs 35 35 7 28
211 poli kateter no 22 6.2.1 pcs 40 40 5 35
212 poli kateter no 24 6.2.1 pcs 6 6 6 -
213 Pot Sputum 3 btl 100 100 - 100
214 Povidon Iodida Larutan 10 % 26.1 btl/300ml 4 4 2 2 50
215 Povidon iodion 10% 6.2.2 botol/60ml - -
216 Prednison tab 11.2 Btl 1000tab 16,900 16,900 3,150 13,750
217 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 1,200 1,200 - 2500
218 Propanolol tab 10 mg 28.1 ktk/100tab - - - - 2500
219 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 500 500 400 100 2500
220 Ranitidin inj 25 mg/ml 6.2.4 Ampul 45 45 45 - 500
221 Ranitidin kaplet 6.2.1 b0k 30,100 30,100 2,700 27,400
222 RDT DBD Box/20 pcs - - 1
223 RDT MALARIA Box/20 pcs 1 1 - 1 1
224 Reagen ZN 10 10 - 10
225 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 6 6 - 6
226 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 20 20 1 19
227 Ringer Laktat Larutan 6.3 botol 300 300 600 260 340 300
228 Rivanol 6.2.1 bt t/100ml - -
229 Rivanol 0,1% Btl 300 ml 96 96 - 96
230 Salbutamol tab 4mg bok 3,500 3,500 650 2,850
231 Salbutamol tab 2mg ktk - -
232 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 200 200 27 173
233 Sarung tangan obgyn/panjang bok 257 257 - 257
234 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - 1000
235 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 220 220 - 220
236 Setirizin sirup 5 mg/5 ml botol 60ml 245 245 - 245
237 Setirizin ta 10 mg 25.4 ktk/100 kaps 3,350 3,350 350 3,000
238 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 670 670 200 470
239 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 355 355 - 355
240 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 366 366 29 337
241 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 5,410 5,410 1,600 3,810
242 Spasi inj 25.1 ktk / 10amp - -
243 Spritus 14.1 botol - - 5
244 Strip asam urat btl/25strp 12 12 3 9 5
245 Strip Gula Darah Nesco Btl/25strip 7 7 5 2 10
246 Strip kolesterol Nesco bt 3 3 3 - 15
247 Tabung EDTA ktk/100 pcs 1 1 - 1
248 Test kehamilan Box/50 pcs - - - - 100
249 tetrakain hcl tetes mata 0,5 13.2 btl - - - -
250 Tetrasiklin kap 500mg dus/100kap 350 350 50 300
251 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul - -
252 Tiamin (vit b1) tab 50mg ktk 100 tb 3,950 3,950 3,950 - 5000
253 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul - - - - 250
254 Turniquit 20.3 pcs - - 5
255 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 15 - 15
256 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 38 38 5 33
257 Vacu needle 1 1 1
258 Vagistin Suppositoria bok 10 sup - - - -
259 vit C ktk/100tab - - - -
260 Vitamin b complek ktk/100tb 33,500 33,500 3,400 30,100
261 Vitamin B12 tab Btl 1,750 1,750 250 1,500
262 Zinc sir 20mg/5ml botol 60 ml 80 80 15 65
263 Zinc tab dispersible 20mg dus/100tab 3,100 3,100 100 3,000
264 OAT Anak dus 5 5 - 5
265 OAT Dewasa dus 9 9 1 8
266 Gloves surgical no.6,5 pasang 450 450 - 450
267 Gloves surgical no.8,0 pasang 250 250 50 200
268 Plesterin Non Woven Roll 5cmx5m Roll 17 17 1 16
269 Plesterin Non Women Roll 10cmx5m Roll 6 6 - 6
270 Ecodine 5 liter Botol 5000 ml - - - -
271 Arm Sling M pcs 5 5 - 5
272 Arm Sling L pcs 5 5 - 5
273 Reagen pemerisaan gol.darah paket 2 2 - 2
274 Strip Haemoglobin botol/25 strip 4 4 1 3
275 Haemoglobin test Buah - - - - 1
276 BCG 20 ds/Ampul vial 13 13 3 10 15
277 Polio 10 ds/vial Vial 11 11 1 10 30
278 DPT-HB-HIB 5 5 5 - 40
279 IPV - - - - 20
280 Hel.B 1 ds/Ads 36 36 36 - 20
281 Dcampak 10 ds/Vial 13 13 13 - 15
282 Td 10 ds/ vial 14 14 14 - 10
283 ADS 0,05 ml 20 20 - 20
284 ADS 0,5 ml 400 400 250 150 300
285 ADS 5 ml - - - -
286 Bisoprolol 1,000 1,000 300 700 250
287 Klorampenikol kap 500 mg 400 400 100 300
288 OAT Dewasa kategori 2 - - 4
289 Stik HIV untuk ibu hamil beresiko - - 400
290 Raund Diamond bur un gigi - - 5
291 Raund fissure bur un gigi - - 5
292 Diasepam inj 5 mg/ml Ampul 40 10 40
293 SARAYA alsof pure 500 ml Botol 24 24 - 24
294 Fokus Malaria pan/pf casette pcs 25 25 - 25
295 Dimenhidrinat tab 50 mg tablet 600 600 100 500
296 Eritromisin sirup kering 200 mg/5 ml Botol 120 120 - 120
297 Betahistin tablet/6 mg tablet 1,000 1,000 - 1,000
298 Kloranfenikol kap 250 mg Kapsul 750 750 500 250
299 Parasetamol drop 100 mg/ml Botol 10 10 5 5
300 N-asetil sistein kapsul 200 mg Kapsul 1,740 1,740 - 1,740
301 Metronidazol ovula 500 mg suppo 125 125 10 115
302 Bisakodil tablet 5 mg tablet 600 600 100 500
303 Ampisilin Serbuk inj 1000 mg Vial 67 67 - 67
304 Klindamisin kapsul 300 mg Kapsul 150 150 - 150
305 Polli catheter two way no.10 pcs 5 5 - 5
306 poli catheter two way no.12 pcs 5 5 - 5
307 poli catheter two way no.14 pcs 5 5 - 5
308 paper tape 2,5cmx 9,14 m roll 12 12 - 12
309 paper tape 7,5cmx 9,14 m roll 7 7 - 7
310 Povidon iodine 30 ml Botol 26 26 6 20
311 Bioplacenton tulle 10x10 bok/10 sachet 69 69 6 63
312 Leukoplast 2,5 cmx4,5m roll 10 10 - 10
313 Elastis perban (uniflex 7,5cmx4,5m) roll 4 4 - 4
314 Elastis perban (uniflex 10cmx4,5m) roll 4 4 - 4
315 Leukomed i.v. Flim bok/50 pcs 400 400 - 400
316 Pehakain inj 250

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui Sumber Agung Nonember 20


Kepala Puskesmas Mepanga Pengelola obat

Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far


NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
: November

PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16
Agung Nonember 2018
ngelola obat

Suriati, A.Md.Far
T : 19790320 201001 2 001
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( LPLPO )
KODE PUSKESMAS :
PUSKESMAS : MEPANGA KAB/KODYA : PARIGI MOUTONG LAPORAN : November
KECAMATAN : MEPANGA PROPINSI : SULAWESI TENGAH TAHUN : 2018
KODE NAMA OBAT KELAS SATU- STOK PENERI- PERSE- PEMA- SISA STOK PERMIN- PEMB
TERAPI AN AWAL MAAN DIAAN KAIAN STOK OPT. TAAN INPRES
1 2 3 4 5 6=(4+5) 7=(6-8) 8 9 10 11
1 Abate Pack/1000 gr - - - - -
2 Aesculap blades /carbon steel scalpel blades #15 27.1 Box/100pcs 839 - 839 - 839
3 Aesculap blades /carbon steel scalpel blades #23 27.1 Box/100pcs 585 - 585 - 585
4 Air untuk injeksi 25 ml ampul 25 ml 333 60 393 65 328
5 Air untuk irigasi lar inf 1000 ml 5 Botol 45 - 45 5 40
6 Akarbose tab 50 mg 6.2.4 ktk/100tab - 2,000 2,000 2,000 - 2500
7 Alkohol swab 29 Box 45 35 80 35 45
8 Alat suntik sekali pakai 1 ml 32 100/ktk 3,140 200 3,340 200 3,140
9 Alat Suntik Sekali pakai 10 ml 32 ktk 706 100 806 100 706
10 Alat suntik sekali pakai 3 ml 32 100 set / kotak 2,200 800 3,000 1,425 1,575
11 Alat suntik sekali pakai 5 ml 32 100set/ktk 345 800 1,145 980 165 1000
12 Albendasol tab 400 mg bok/100tb 900 600 1,500 600 900 500
13 Alkohol 70% 1 liter btl 9 3 12 9 3 100
14 Allupurinol 14.1 box 600 6,100 6,700 6,700 - 5000
15 Alprazolam tablet 0,5 mg 21.2.4 tablet - - - - - 500
16 Amblodipin 10 mg 32 box 2,730 - 2,730 800 1,930
17 Ambroxol tab 10 mg box 1,400 2,000 3,400 3,400 - 5000
18 Aminofilin inj 24 mg/ml 26.2 Ampul 358 30 388 140 248
19 aminopilin tab 6.2.2 btl 1,200 - 1,200 - 1,200
20 Amitriptilin tab salut 25 mg (HCL) 13.2 ktk/100tab 3,700 - 3,700 - 3,700
21 Amlodipin tablet 5 mg 6.1.1 ktk/30 tablet 7,180 300 7,480 2,860 4,620
22 Amoksisilin sir kering 125 mg/ml btl 230 600 830 730 100 250
23 Amoksisilin tab 500mg dus/100tab 4,100 13,000 17,100 16,700 400 5000
Anastetik lokal gigi kombinasi : lidokain hcl 2%+epineprin 1:80000 inj
24
2ml 270 300 570 330 240
dus/30 amp 300
25 Antalgin tab(Metampiron tab) dus/100tab 1,250 1,500 2,750 2,250 500 3000
Antasida DOEN I Tablet kunyah, kombinasi : Aluminium Hidroksida
26 ktk/100 tablet 1,150 8,500 9,650 9,650 -
200 mg + Magnesium Hidroksida 200 mg 6.2.1 10000
Antasida DOEN II suspensi, kombinasi : Aluminium Hidroksida 200
27 Btl 60 ml 185 800 985 802 183
mg/5ml + Magnesium Hidroksida 200 mg/5 ml 16.4 300
Anti Bakteri DOEN salep kombinasi : Basitrasin 500 IU/g + Polimiksin
28 pot 102 75 177 75 102
10.000 UI/g 32
29 anti rabies verorab bok - - - 10
30 Antifungi DONE salep,kombinasi : Asam Benzoat 6% Asam Salisilat 3% Pot 310 48 358 48 310
32
31 Antihemoroid 31 Supp 470 40 510 40 470
Antimalaria DOEN kombinasi : Pirimetamin 25 mg + Sulfadoksin 500
32 tablet 640 - 640 - 640
mg 1.2
33 Antimigrain kombinasi ergotamin 1mg kafein 50mg tab botol 100tab 3,400 300 3,700 300 3,400
34 Aplicators set 2 2 4 2 2
35 Asam askorbit (vitamin C) kaplet 50 mg bok 16,650 14,000 30,650 16,750 13,900
36 Asam assetilsalisilat(aspilet) Bok 800 4,400 5,200 4,700 500 2500
37 Asam folat tab 1 mg 6.2.2 Botol 1,000 1,000 2,000 1,100 900
38 Asam mefenamat 32 b0k 8,500 2,100 10,600 5,500 5,100
39 Asam tranekamat tab 500 mg 6.2.2 ktk/100tab 400 - 400 - 400 500
40 Asam traneksamat inj 100mg/ml 32 Ampul 185 5 190 5 185
41 Aseptik gel 6 64 70 68 2
42 Asiklovir krim 5% 6.2.2 Tube 100 125 225 128 97 250
43 Asiklovir tablet/kapsul/kaplet 400 mg 18.3 tablet 2,150 3,000 5,150 3,050 2,100
44 Atropin inj 0,25mg/ml(i.m./i.v/s.k) dus/ 100amp 245 100 345 100 245
45 Attapugit tab650 mg dus/100tab 1,440 1,300 2,740 1,470 1,270
46 Bedak salisil serbuk 2 % 25.1 pot 10 30 40 38 2 50
47 Betafort syrup botol - 150 150 150 - 300
48 Basitrasin salep tube - - - - -
49 Betametason 0,1% kream 6.2.1 tube 71 250 321 286 35 100
50 Bisakodil supositoria 10mg dus/50sup 185 50 235 72 163
51 Bisakodil supositoria 5mg dus/6sup 273 - 273 22 251
52 Blood Lancet ktk/100pcs 15 20 35 21 14
53 Brondisal 2mg 32 Dus 10 strip - - -
54 burnasin Perak Sulfadiazin krim 1% 6.4.2.2 amp 37 35 72 42 30
55 Catgut /Benang Bedah plain No.2/0 ,3/0 dg jarum 32 kotak / 24 pcs 993 192 1,185 202 983
56 Catgut Chromic 2/0- + jarum 1/2 GT 35 mm Box/12 pcs 345 36 381 43 338
57 Catgut Chromic 3/0 + jarum 1/2 GT 35 mm Box/12 pcs 252 36 288 60 228
58 Cathy IV.Cannula 18G/Abocat 32 Box/100pcs 400 1,070 1,470 411 1,059
59 Cathy IV.Cannula 20G/abocat 16.4 Box/100pcs 900 427 1,327 200 1,127
60 Cathy IV.Cannula 22G/abocat 6.4.2.2 Box/100pcs 250 500 750 630 120 500
61 Cathy IV.Cannula 24G/abocat 6.2.1 Box/100pcs 160 200 360 260 100 500
62 Caviton 29 Set - - - - - 6
63 Cefadroxil sirup bok 415 200 615 200 415
64 Cefatroxil 500mg kap 23.2 Bok - - - - - 3000
65 Cepotaksim inj 20.3 dus/10vial 1gr 88 - 88 24 64
66 Ciprofloxacin tab 25.1 b0k 3,000 1,000 4,000 1,550 2,450
67 CTm (klorfeniramina Maleat tab 4 mg) bok 35,200 20,000 55,200 23,050 32,150
68 Deksametason inj 5mg/ml(i.v/i.m) dus/100amp 1,665 300 1,965 305 1,660
69 Deksametason tab 0,5 mg bok 34,200 3,000 37,200 5,800 31,400
70 Dektran larutan infus 70% btl - - - - - 20
71 Diasepm larutan rektal 5 - - - - -
72 Diazepam tab 2 mg 6.4.2.2 Botol 200 - 200 - 200
73 Difenhidramin injeksi i.m. 10 mg/ml 11.2 ampul 134 270 404 357 47 200
74 Digoksin tab 0,25mg dus/100tab 1,700 300 2,000 300 1,700
75 Dihydroantemisin 40 mg + Piperaquin phosphate 320 mg 32 ktk/9 tab 18 18 36 18 18
76 Doksisiklin kapsul 100 mg 10.2 ktk/100kpp 1,200 - 1,200 200 1,000
77 Disposable meroaplicators 1 - 1 - 1
78 Domperidon suspensi 5mg/5ml botol 60ml 402 330 732 373 359
79 Domperidon tab dus/100tab 700 4,300 5,000 4,900 100 3000
80 elastis perban 23.4 Roll 12 - 12 - 12
81 Epineprin inj ktk/100Amp 400 - 400 5 395
82 Etanol 70% 100ml 6.4.2.1 botol 117 - 117 40 77
83 Eritromisin ktk 2,200 200 2,400 200 2,200
84 Etil klorida semprot 100ml botol 100ml - 10 10 10 - 25
85 ETSA 14.2 Set 2 2 4 2 2
86 Eugenol cairan 6.2.1 botol 3 - 3 - 3

87 FE(kombinasi tablet salut:Besi(ll)sulfat7H20200mg+asam folat0,25mg ktk/ 100tab 9,400 24,310 33,710 28,610 5,100

88 Fitomenadion (vit.K1) tablet salut gula 10 mg 5 tablet 400 3,100 3,500 3,500 - 2500
89 fitomenadion (vitamin K 1)inj 2mg/ml dus/ 30amp 420 570 990 640 350
90 Fixomull stretch 15 cm x 5 m 14.2 Roll - - - - -
91 Furosemid Ktk/100tab 1,700 1,400 3,100 2,300 800 1000
Garam Oralit I serbuk, kombinasi : Natrium klorida 0,52 g kalium
92 sachet 1,750 2,100 3,850 2,290 1,560
klorida 0,30 g Trinatrium sitrat dihidrat 0,58 g Glukosa Anhidrat 2,70 g
26.2
93 Gentamisin 1mg krim tube 196 59 255 64 191
94 Gentian Violet Lrutan 1 % 32 Botol 189 - 189 - 189
95 Glass lonomer cemet ART 27.2 Set 1 - 1 - 1
96 Glibenklamid tab 5 mg 32 ktk/100tab 3,900 1,000 4,900 1,200 3,700
97 Glimepirid tab 1 mg ktk/100tab 2,100 500 2,600 700 1,900
98 Glimepirid tab 2 mg ktk/100tab 7,100 2,150 9,250 3,350 5,900
99 Gliseril guaikolat tab 100mg 20.1 dus/100tab 9,600 500 10,100 2,650 7,450
100 glove non Steril l (hanskund) ktk 9 42 51 43 8
101 Glove non steril m (hanskund) ktk 24 42 66 52 14
102 Glove non steril S ktk 8 8 16 8 8
103 Glove Surgical no 7.0 ktk/50pcs 200 200 400 200 200
104 Glove Surgical no 7.5 ktk/50pcs 200 200 400 208 192
105 Glukosa larutan infus 5 % steril 31 botol 550 200 750 200 550
106 Griseofulvin tablet 125 mg 32 ktk/100tab 3,600 7,700 11,300 8,150 3,150
107 Haloperidol 5 mg bok 200 - 200 - 200
108 Haloperidol tab 0,5 mg 10.2 ktk/100tab 100 - 100 - 100
109 Haloperidol tab 1,5 mg bok - - - - -
110 Haloperidol tab 2 mg 6.2.2 ktk/100tb - - - - -
111 Handscrub 500cc+dispenser btl 10 10 10 50
112 Hidroklorotiazida (HCT) tablet 25 mg 1.2 ktk / 100 tablet 2,800 - 2,800 - 2,800
113 Hidrokortison krim 2,5 % 14.1 tube/5gr 218 120 338 185 153
114 Hyocine n-butilbromida tab 10 mg(skopma plus) 16.1.1 ktk / 100 tablet 450 2,500 2,950 2,700 250 3000
115 Ibuprofen sir 100 mg/5 ml botol 400 400 800 406 394
116 Ibuprofen tablet 400 mg pcs - 4,500 4,500 4,500 - 5000
117 Infus Set Anak pcs - 100 100 100 - 1000
118 Infus Set Dewasa (Tipe Y) pcs 135 1,000 1,135 1,135 - 1000
119 iodium tes Botol 10 ml 37 - 37 - 37
120 Isosorbid Dinitrat tab 5mg 1.2 tablet 1,200 300 1,500 600 900
121 Kalsium glukonat inj i.v 10% 29 Tube 35 - 35 - 35
122 Kalsium Laktat (Kalk) tab 500 mg 25.6 ktk/100 tablet 3,750 13,000 16,750 14,450 2,300
123 Kapas 250 gram Pcs 219 10 229 13 216
124 Kapas berlemak 500gr 20.3 Bungkus 14 - 14 2 12
125 Kapsul kosong 23.2 tablet 2,950 - 2,950 - 2,950
126 Kaptopril tablet scored 25 mg 14.1 ktk/100tab 2,450 5,500 7,950 6,750 1,200
127 Karbamazepin tab 200 mg Ktk/100tab 800 1,100 1,900 1,100 800
128 kasa hydrophil 40 x 80 cm/Kasa gulung 5 Roll 21 4 25 10 15
129 Kasa Kompres 16 x 16 steril (isi 16 lembar) Roll - - - - - 500
130 Kertas Puyer Obat bks - - -
131 Kertas puyer pres 6.2.1 bks 8 5 8 1 7
132 Ketokonasol krim 2% 7.2 tube 749 100 849 130 719
133 Ketokonazol tab 200 mg 32 Dus 5 strip 950 350 1,300 550 750
134 Ketorolac inj 10 mg 25.1 Ampul/10amp 20 - 20 20 - 150
135 Kloramfenikol suspensi 26.3 botol/60ml 29 250 279 279 - 250
136 Kloramfenikol salep mata 1 % tube 151 584 735 612 123
137 Kloramfenikol tetes mata 0,5% 5 Botol 78 142 220 145 75
138 Kloramfenikol tetes telinga1% 13.1 Botol 43 125 168 137 31
139 kalsium hidroksida pasta 1 - 1 - 1
140 Klorpromazin tab 25 mg 6.3 ktk/100 tab 600 - 600 - 600
141 Kodein 25.4 btl 100 1,100 1,200 1,100 100
142 Kombinasi: Multivitami + Analgrtik Tab botol 60ml 1,500 2,000 3,500 2,650 850 3000
Kotrimoksazol DOEN I (Dewasa) Kombinasi : Sulfametoksazol 400 mg +
143
Trimetoprim 80 mg ktk/100tab 11,050 6,000 17,050 7,150 9,900
20.2
144 Kotrimoksasol suspensi 5 botol/60ml 355 100 455 143 312
145 lar. HCl 0,1 N botol - - - - -
146 Leukoplast 7,5 cmx4,5m 1.2 Roll 54 10 64 17 47
147 Lipron B Plek 18.4 ktk/100tab - - - - - 3000
148 Lisol btl 1000ml - 11 11 11 - 50
149 Loperamid tab 2 mg Ktk/100tab 1,200 4,500 5,700 5,050 650 2000
150 Loratadin tablet 10 mg 32 ktk / 100 tab 100 1,000 1,100 1,000 100 2000
151 Magnesium Sulfat 20% - 25 ml 26.2 plakon - - - - -
152 Magnesium Sulfat 40% - 25 ml 26.2 plakon 5 10 15 10 5
153 Masker one med Kait 6.1.1 ktk/50tab 14 14 28 14 14
154 Masker one med tali ti on 6.2.1 Btl 1000 kaplet 311 320 631 320 311
155 Metampiron (antalgin) injeksi 250 mg 23.4 ktk / 30 ampul @ 2 ml - - - 100
156 Miniaspi aspilet - -
157 Metformin tab 500mg ktk/100yab 3,550 4,000 7,550 5,150 2,400
158 Metil prednisolon tab 4mg dus/100tab 7,900 10,000 17,900 11,000 6,900
159 Metilergometrin inj 0,2 mg/ml 18.4 Ampul 580 1,700 2,280 1,705 575
160 Metilergometrin tab salut 0,125 mg 22.1 ktk/100tab 1,950 1,300 3,250 1,350 1,900 1000
161 Metoklopramide tablet 10 mg 7.2 ktk / 100 tablet - 2,700 2,700 2,700 - 1000
162 Metronidazol tab 500 mg 1.2 ktk/100tab 2,450 4,000 6,450 4,900 1,550

163 Mikonazol krim/salep 2 % (Nitrat) tube 180 125 305 149 156
23.2
165 MTD MB Dewasa/kusta 6.2.1 paket 2 - 2 - 2
166 MTD MB Anak/kusta 25.4 paket 1 440 441 440 1
167 Mineral mik - - -
168 NaCL 0,9 % Botol 370 1,060 1,430 1,070 360
169 Nasal Oksigen bayi pcs 25 5 30 5 25
170 Nasal oxsigen Anak pcs 41 3,005 3,046 3,005 41
171 Nasal oxsigen dewasa pcs 35 5 40 5 35
172 Natriun diklofent tab 50 mg 32 ktk/50 tab - 7,000 7,000 7,000 - 5000
173 Natriun Metamizole inj bok - 500 500 500 -
174 Nifedipin kaps 10 mg 17.1 ktk/100kaps 1,500 1,800 3,300 2,000 1,300
175 Nistatin tab Ktk 550 1,000 1,550 1,150 400
176 Nistatin Vagina 80 - 80 50 30 200
177 Novabion kapsul - 1,000 1,000 1,000 - 3000
178 Novadiar sirup 26.1 btl/60ml 80 50 130 100 30 300
179 Noza tablet - - - - - 500
180 Nurse cap bok/50 pcs - - -
181 Obat Batuk hitam ( OBH) 14.1 Botol 80 100 180 111 69 100
Obat batuk sirup anak pct 130mgdexchlorpheniramine maleate 1mgthiocol
182 - - - - -
20mg,sorbitol sirup with chocolate flavour q.c botol 60ml 100
183 Objeck Glass Frosted Dus/72 pcs 9 50 59 50 9
184 Objeck Glss frosted/slide 10.1 Box/72 pcs 144 - 144 - 144
185 Oksitetrasiklin Hcl salep kulit 3% Tube 5gram 106 250 356 284 72
186 Oksitetrasiklin injeksi I.m. 50 mg/ml-10 ml 20.3 10 vial / kotak - - - - - 200
187 Oksitosin inj10UI mg Ampul/100amp 705 200 905 235 670
188 Omeprasol kaps 20 mg Kapsu/3srtip 1,670 1,380 3,050 2,690 360 3000
189 Omeprazol injeksi 40mg/10ml dus 10 vial 57 90 147 93 54
190 Ondansentron inj 2 mg/ml ampul - - - - - 200
191 Onemed Kasa Pembalut Hydrofil 4 m x 15 cm Roll 45 - 45 30 15
192 Papaverin tablet 40 mg 31 1000 tablet / botol 1,800 100 1,900 100 1,800
193 Parasetamol sirup120 mg / 5 ml 6.2.1 Btl 60 ml 455 1,000 1,455 1,140 315
194 Parasetamol tab 500mg ktk/100tab 3,250 11,000 14,250 11,450 2,800 5000
195 pembalut gips 6.2.1 Roll 152 - 152 - 152
196 Pelester non women roll 15x15 Roll 6 - 6 - 6
197 penjepit tl pstUmbilical Cord klem seteril nilon pcs 810 - 810 40 770
198 Permetrin krim 5 %(skabimite) 14.1 Tube 194 20 214 20 194
199 phenobarbital inj 6.1.1 ktk/30amp - - - - - 50
200 Pipet tetes panjang 6.2.2 pcs 100 - 100 - 100
201 Pirantel pamoat suspen scored 125 mg/5mg 6.3 Botol - - - - - 50
202 Pirantel pamoat tablet 125mg dus/100tab 1,900 1,700 3,600 1,700 1,900
203 Pirantel suspensi 125 mg/5 ml 6.2.1 botol - 500 500 500 -
204 Piridoksi vit B6 tab 10mg dus/100tab 100 2,009 2,109 2,109 - 3000
205 Piroksikam tab 10 mg 6.3 ktk/100tab - 19 19 19 - 5000
206 Plastik klip sedang (5x8 cm) pak/100buah 4 - 4 2 2 20
207 plastik klip sedang (6x10 cm) pak/100buah 12 - 12 2 10 10
208 Plesterin Non Woven Roll 20cmx5m btl 500ml 2 - 2 - 2
209 poli kateter no 18 9 pcs 8 5 13 11 2
210 poli kateter no 20 21.2.4 pcs 35 5 40 12 28
211 poli kateter no 22 6.2.1 pcs 40 - 40 5 35
212 poli kateter no 24 6.2.1 pcs 6 - 6 6 -
213 Pot Sputum 3 btl 100 100 200 100 100
214 Povidon Iodida Larutan 10 % 26.1 btl/300ml 4 7 11 9 2 50
215 Povidon iodion 10% 6.2.2 botol/60ml - - -
216 Prednison tab 11.2 Btl 1000tab 16,900 6,500 23,400 9,650 13,750
217 Primakuin tab 15 mg 21.2.1 ktk/100tab 1,200 - 1,200 1,200 - 2500
218 Propanolol tab 10 mg 28.1 ktk/100tab - - - - - 2500
219 Propiltiourasil tab 100mg 6.2.4 ktk/100tab 500 - 500 400 100 2500
220 Ranitidin inj 25 mg/ml 6.2.4 Ampul 45 200 245 245 - 500
221 Ranitidin kaplet 6.2.1 b0k 30,100 6,600 36,700 9,300 27,400
222 RDT DBD Box/20 pcs - - - 1
223 RDT MALARIA Box/20 pcs 1 - 1 - 1 1
224 Reagen ZN 10 - 10 - 10
225 Retinol (vitamin A)Kaps lunak 100.000UI Btl/50kap 6 700 706 700 6
226 Retinol(vitamin A)200.000IU Kapsul 32 Btl/50kap 20 - 20 1 19
227 Ringer Laktat Larutan 6.3 botol 300 2,400 2,700 2,360 340 300
228 Rivanol 6.2.1 bt t/100ml 5,000 5,000 5,000
229 Rivanol 0,1% Btl 300 ml 96 24 120 24 96
230 Salbutamol tab 4mg bok 3,500 400 3,900 1,050 2,850
231 Salbutamol tab 2mg ktk - - -
232 Salep 2-4,kombinasi: asam salisilat 2%+ belerang endap 4% 3 Pot 200 48 248 75 173
233 Sarung tangan obgyn/panjang bok 257 7 264 7 257
234 Sefiksim tab 100mg 6.4.2.1 ktk/50 tab - - - 1000
235 Seftriakson serb inj 1000mg/ml 6.2.2 Vial 220 20 240 20 220
236 Setirizin sirup 5 mg/5 ml botol 60ml 245 200 445 200 245
237 Setirizin ta 10 mg 25.4 ktk/100 kaps 3,350 3,000 6,350 3,350 3,000
238 Sianokobalamin (vit b12) inj 500 mcg dus/100amp 670 1,300 1,970 1,500 470
239 Silk3 /0 + jarum1/2 GT 35 mm Box/12 pcs 355 36 391 36 355
240 Silk 2/0 + jarum1/2 GT 35 mm Box/12 pcs 366 36 402 65 337
241 Simvastatin scored tablet 10 mg 26.1 ktk/100 tablet 5,410 3,000 8,410 4,600 3,810
242 Spasi inj 25.1 ktk / 10amp 20 20 20
243 Spritus 14.1 botol 30 30 30 5
244 Strip asam urat btl/25strp 12 5 17 8 9 5
245 Strip Gula Darah Nesco Btl/25strip 7 3 10 8 2 10
246 Strip kolesterol Nesco bt 3 23 26 26 - 15
247 Tabung EDTA ktk/100 pcs 1 - 1 - 1
248 Test kehamilan Box/50 pcs - - - - - 100
249 tetrakain hcl tetes mata 0,5 13.2 btl - - - - -
250 Tetrasiklin kap 500mg dus/100kap 350 5,300 5,650 5,350 300
251 Tetrasiklin kapsul/kaplet 250 mg 1.2 kapsul 50 50 50
252 Tiamin (vit b1) tab 50mg ktk 100 tb 3,950 13,500 17,450 17,450 - 5000
253 Tiamin (Vit.B1) inj 10mg/ml 18.2 Ampul - 85 85 85 - 250
254 Turniquit 20.3 pcs - - - 5
255 Uniflex 15 cm x 4,5 m(elastis verban) Roll 15 - 15 - 15
256 Urine Bag standard steril 2L.t (T valve) 26.1 Buah 38 - 38 5 33
257 Vacu needle 1 - 1 1
258 Vagistin Suppositoria bok 10 sup - - - - -
259 vit C ktk/100tab - 14,000 14,000 14,000 -
260 Vitamin b complek ktk/100tb 33,500 9,400 42,900 12,800 30,100
261 Vitamin B12 tab Btl 1,750 5,000 6,750 5,250 1,500
262 Zinc sir 20mg/5ml botol 60 ml 80 106 186 121 65
263 Zinc tab dispersible 20mg dus/100tab 3,100 2,209 5,309 2,309 3,000
264 OAT Anak dus 5 267 272 267 5
265 OAT Dewasa dus 9 222 231 223 8
266 Gloves surgical no.6,5 pasang 450 215 665 215 450
267 Gloves surgical no.8,0 pasang 250 57 307 107 200
268 Plesterin Non Woven Roll 5cmx5m Roll 17 #VALUE! #VALUE! #VALUE! 16
269 Plesterin Non Women Roll 10cmx5m Roll 6 5 11 5 6
270 Ecodine 5 liter Botol 5000 ml - 5 5 5 -
271 Arm Sling M pcs 5 5 10 5 5
272 Arm Sling L pcs 5 7 12 7 5
273 Reagen pemerisaan gol.darah paket 2 1 3 1 2
274 Strip Haemoglobin botol/25 strip 4 26 30 27 3
275 Haemoglobin test Buah - 20 20 20 - 1
276 BCG 20 ds/Ampul vial 13 #VALUE! #VALUE! #VALUE! 10 15
277 Polio 10 ds/vial Vial 11 190 201 191 10 30
278 DPT-HB-HIB 5 227 232 232 - 40
279 IPV - 59 59 59 - 20
280 Hel.B 1 ds/Ads 36 203 239 239 - 20
281 Dcampak 10 ds/Vial 13 89 102 102 - 15
282 Td 10 ds/ vial 14 450 464 464 - 10
283 ADS 0,05 ml 20 100 120 100 20
284 ADS 0,5 ml 1,200 1,200 1,050 150 300
285 ADS 5 ml - - - - -
286 Bisoprolol 1,000 3,000 4,000 3,300 700 250
287 Klorampenikol kap 500 mg 400 8,200 8,600 8,300 300
288 OAT Dewasa kategori 2 #VALUE! #VALUE! #VALUE! 4
289 Stik HIV untuk ibu hamil beresiko - - - 400
290 Raund Diamond bur un gigi #VALUE! #VALUE! #VALUE! 5
291 Raund fissure bur un gigi #VALUE! #VALUE! #VALUE! 5
292 Diasepam inj 5 mg/ml Ampul 40 50 10 40
293 SARAYA alsof pure 500 ml Botol 24 #VALUE! #VALUE! #VALUE! 24
294 Fokus Malaria pan/pf casette pcs 25 25 50 25 25
295 Dimenhidrinat tab 50 mg tablet 600 600 1,200 700 500
296 Eritromisin sirup kering 200 mg/5 ml Botol 120 120 240 120 120
297 Betahistin tablet/6 mg tablet 1,000 1,300 2,300 1,300 1,000
298 Kloranfenikol kap 250 mg Kapsul 750 1,000 1,750 1,500 250
299 Parasetamol drop 100 mg/ml Botol 10 15 25 20 5
300 N-asetil sistein kapsul 200 mg Kapsul 1,740 1,800 3,540 1,800 1,740
301 Metronidazol ovula 500 mg suppo 125 125 250 135 115
302 Bisakodil tablet 5 mg tablet 600 600 1,200 700 500
303 Ampisilin Serbuk inj 1000 mg Vial 67 70 137 70 67
304 Klindamisin kapsul 300 mg Kapsul 150 150 300 150 150
305 Polli catheter two way no.10 pcs 5 5 10 5 5
306 poli catheter two way no.12 pcs 5 5 10 5 5
307 poli catheter two way no.14 pcs 5 5 10 5 5
308 paper tape 2,5cmx 9,14 m roll 12 12 24 12 12
309 paper tape 7,5cmx 9,14 m roll 7 8 15 8 7
310 Povidon iodine 30 ml Botol 26 28 54 34 20
311 Bioplacenton tulle 10x10 bok/10 sachet 69 70 139 76 63
312 Leukoplast 2,5 cmx4,5m roll 10 10 20 10 10
313 Elastis perban (uniflex 7,5cmx4,5m) roll 4 4 8 4 4
314 Elastis perban (uniflex 10cmx4,5m) roll 4 4 8 4 4
315 Leukomed i.v. Flim bok/50 pcs 400 400 800 400 400
316 Pehakain inj - 250

UMUM
ASKES JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui Sumber Agung Nonember 20


Kepala Puskesmas Mepanga Pengelola obat

Ketut Cita, A.Md.Kep. Ni Ketut Suriati, A.Md.Far


NIP : 19730615 199403 1 009 NIP/NRPTT : 19790320 201001
: November

PEMBERIAAN KET
ASKES APBD LAIN JML
12 13 14 15 16
Agung Nonember 2018
ngelola obat

Suriati, A.Md.Far
T : 19790320 201001 2 001