JKD September

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
( L P L P O)
KODE PUSKESMAS :
PUSKESMAS : BARANTI NO :
KECAMATAN : BARANTI TGL : BULAN DESEMBER
KABUPATEN : SIDENRENG RAPPANG TAHUN 2 0 1 6
PROPINSI : SULAWESI SELATAN
NO. NAMA OBAT SATU STOK PENERI PERSE PEMA SISA STOK PERMIN SUMBER DANA HARGA JUMLAH
JMLH
SATUAN HARGA
KET
( URUT NAMA ) AN AWAL MAAN DIAAN KAIAN STOK OPT TAAN DAK/11 DAK/13 DAK/14 DAK/15 DAK/16 PROGRAM BANTUAN
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
1 IV Catheter Gea No. 18 set 0 0 0 5,203 0
5 Ansell Steril 6 1/2 psg 0 0 0 7,500 0
6 Ansell Steril 7 psg 0 0 0 7,500 0
7 Ansell Steri 7 1/2 psg 0 0 0 7,500 0
8 Alat suntik sekali pakai 1 ml set 0 0 0 748 0
11 Albendasol tablet 400 mg tablet 0 0 0 425 0
12 Alupurinol tablet 100 mg tablet 39 39 39 0 95 0
13 Ambroxol sirup 15 mg/ml Botol 0 0 0 5,000 0
14 Ambroxol tablet tablet 0 0 0 196 0
15 Aminofilin tablet 200 mg tablet 0 0 0 86 0
16 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 3,349 0
17 Amitriptilin HCI tablet salut 25 mg tablet 0 0 0 165 0
18 Amoksisilin sirup kering 125 mg/5 ml Botol 0 0 0 0 2,200 0
19 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 4,147 0
20 Amoksisilin kapsul 250 mg Kapsul 0 0 0 207 0
21 Amoksisilin kaplet 500 mg kaplet 121 121 121 0 233 0
22 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 4,600 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
23 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 0 190 0
24 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 1,500 0
25 Antasida DOEN tablet kombinasi tablet 100 100 200 200 0 64 0
26 Antasida DOEN suspensi Botol 0 0 0 2,106 0
27 Antihemoroid DOEN kombinasi suppos 0 0 0 3,502 0
28 Antifungi DOEN kombinasi pot 0 0 0 4,782 0
29 Antibakteri DOEN salep Kombinasi tube 0 0 0 2,767 0
30 Antimigrain DOEN kombinasi tablet 0 0 0 149 0
31 Aqua pro injeksi steril, bebas pirogen ampul 0 0 0 5,800 0
32 Asam Askorbat (Vit C) tablet 50 mg tablet 130 200 330 330 0 120 0
33 Asam Folat tablet 0 0 0 68 0
34 Asam Mefenamat tablet 500 mg tablet 130 130 130 0 0 113 0
35 Asiklovir 200 mg tablet 0 0 0 272 0
37 Asiklovir krim 5% tube 0 0 0 3,600 0
38 Asetosal tablet 100 mg tablet 0 0 0 110 0
39 Attalpulgit tablet 0 0 0 173 0
40 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 1,672 0
41 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 75 0
42 Betametason krim 0.1 % tube 0 0 0 1,435 0
43 Catgut/benang bedah no .2/0 sak 0 0 0 33,925 0
45 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 1,740 0
46 Deksametason tablet 0,5 mg tablet 800 800 800 0 48 0
47 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 2,578 0
48 Diazepam tablet 2 mg tablet 0 0 0 134 0
50 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 0 104 0
51 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 1,354 0
52 Digoksin tablet 0,25 mg tablet 0 0 0 108 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
53 Doksisilin kapsul 100 mg kapsul 0 0 0 309 0
54 Domperidom suspensi Botol 0 0 0 3,180 0
55 Efedrin HCI tablet 25 mg tablet 0 0 0 56 0
56 Ekstrak Belladon tablet 10 mg tablet 0 0 0 42 0
57 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 8,910 0
58 Etakridin (Rivanol) larutan 0,1 % botol 0 0 0 3,600 0
59 E t a n o l 70 % 100 ml botol 0 0 0 2,625 0
60 Etil klorida semprot botol 0 0 0 115,500 0
61 Eugenol cairan botol 0 0 0 18,333 0
62 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 1,980 0
63 Fenobarbital tablet 30 mg tablet 0 0 0 74 0
64 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 m ampul 0 0 0 3,754 0
65 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 0 0 0 796 0
66 Foly Catheter No. 18 pcs 0 0 0 9,200 0
68 Furosemid tablet 40 mg tablet 0 0 0 84 0
69 Garam Oralit untuk 200 ml Air sak 0 0 0 274 0
70 Gentamicin inj 40mg/ml ampul 0 0 0 3,545 0
71 Gentian Violet larutan 1 % botol 0 0 0 3,500 0
72 Glass lonomer Cement (GC IX ) botol 0 0 0 434,500 0
73 Glibenklamid tablet 5 mg tablet 0 100 100 100 0 100 0
74 Guafenisin tablet tablet 0 0 0 120 0
75 Glukosa larutan infus 5 % steril botol 0 0 0 6,900 0
76 Grisefulvin tablet 125 mg (Micronized) tablet 0 0 0 475 0
77 Haloperidol tablet 1,5 mg tablet 0 0 0 74 0
78 Haloperidol tablet 2 mg tablet 0 0 0 134 0
79 Hidroklorotiazid (HCT) tablet 25 mg tablet 0 0 0 171 0
80 Hidrokortison krim 2,5 % tube 0 0 0 2,812 0
81 Ibuprofen suspensi 100 mg/5 ml botol 0 0 0 8,000 0
82 Ibuprofen tablet 200 mg tablet 0 0 0 111 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
83 Ibuprofen tablet 400 mg tablet 80 300 380 380 0 133 0
84 Infusion set anak set 0 0 0 4,025 0
85 Infusion set dewasa set 0 0 0 3,680 0
86 Isoniazid tablet 100 mg tablet 0 0 0 82 0
87 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 0 98 0
88 Kalsium Glukonat inj 10% ampul 0 0 0 999 0
89 Kalsium Hidroksida pasta tube 0 0 0 266,200 0
90 Kalsium laktat (Kalk) tablet 500 mg tablet 0 200 200 200 0 69 0
91 Kapas pembalut / Absorben 250 gram bungkus 0 0 0 14,375 0
92 Kaptopril 12,5 mg tablet 110 200 310 310 0 69 0
93 Kaptopril 25 mg tablet 0 200 200 200 0 150 0
94 Karbamazepin tablet 200 mg tablet 0 0 0 306 0
95 Kasa pembalut Hidrofil 4 m x 10 cm rol 0 0 0 1,725 0
96 Kasa pembalut elastis 3 inch rol 0 0 0 7,700 0
97 Ketokonazol krim 2% tube 0 0 0 6,000 0
98 Ketokonazol tablet 200 mg tablet 0 0 0 240 0
99 Kloramfenikol kapsul 250 mg kapsul 0 0 0 560 0
100 Kloramfenikol salep mata 1 % tube 0 0 0 1,850 0
101 Kloramfenikol tetes telinga 3 % botol 0 0 0 7,500 0
102 Klorfeniramin maleat tablet 4 mg tablet 0 0 0 45 0
103 Klorokuin tablet 150 mg tablet 0 0 0 112 0
104 Klorfenol Kamfer Menthol botol 0 0 0 60,500 0
105 Klorpromazin HCI injeksi 5 mg/ml - 2 ml ampul 0 0 0 1,045 0
106 Klorpromazin HCI tablet salut 100 mg tablet 0 0 0 179 0
108 Kotrimoksazol tablet 480 mg tablet 180 180 180 0 158 0
109 Kotrimoksazol Suspensi 240 mg/ 5 ml botol 4 4 4 0 2,225 0
110 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 125 0
111 Larutan mengandung elektrolit botol 0 0 0 9,275 0
112 Lidokain komp. injeksi - 2 ml ampul 0 0 0 2,122 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
113 Lisol, mengandung kresol tersabun 50 % botol 0 0 0 49,200 0
114 Loratadine tablet 0 0 0 149 0
115 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml vial 0 0 0 3,200 0
117 Masker Kain lembar 0 0 0 506 0
118 Mata Pisau No. 15 pcs 0 0 0 3,300 0
119 Mata Pisau No. 20 pcs 0 0 0 3,300 0
120 Metilergometrin maleat tablet salut 0,125 mg tablet 0 0 0 133 0
121 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0 2,684 0
122 Metilprednisolon tablet 4 mg tablet 0 0 0 200 0
123 Metformin Hcl 500 mg tablet 0 0 0 115 0
124 Metoklopramida 10 mg tablet 0 0 0 100 0
125 Metoklopramida injeksi 5 mg / ml tablet 0 0 0 6,000 0
126 Metronidazol tablet 250 mg tablet 0 0 0 98 0
128 Mineral Mix sak 0 0 0 2,450 0
129 Mummifying pasta botol 0 0 0 193,600 0
130 Natrium diklofenak 50 mg tablet 38 38 38 0 161 0
131 Natrium klorida larutan infus 0,9 % steril botol 0 0 0 6,410 0
132 Nifedipin 10 mg tablet 0 0 0 123 0
133 Nistatin tablet vagina 100.000 IU / g tablet 0 0 0 602 0
134 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 0 0 704 0
135 Obat anti Tuberklosis kategori FDC I paket 0 0 0 413,984 0
136 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 1,317,000 0
137 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 236,500 0
138 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 4,000 0
139 Ofloksasin tablet 400 mg tablet 0 0 0 636 0
140 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 1,869 0
141 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 3,000 0
142 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 0 0 1,900 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
143 Parasetamol drops botol 0 0 0 5,980 0
144 Parasetamol sirup 120 mg / 5 ml botol 0 0 0 1,535 0
145 Parasetamol tablet 500 mg tablet 0 0 0 0 58 0
146 Permetrin krim 5% tube 0 0 0 12,155 0
147 Pirantel pamoat tablet 125 mg tablet 0 0 0 318 0
148 Pirantel suspensi botol 0 0 0 16,000 0
149 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 0 0 136 0
150 Piroksikam 20 mg kapsul 0 0 0 200 0
151 Plester 5 yards x 2 inch rol 0 0 0 12,076 0
152 Prednison tablet 5 mg tablet 0 0 0 175 0
153 Primakuin tablet 15 mg tablet 0 0 0 120 0
154 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 9,908 0
155 Propiltiourasil tablet 100 mg tablet 0 0 0 320 0
156 Propranolol HCI tablet 40 mg tablet 0 0 0 69 0
157 Ranitidin tablet 150 mg tablet 0 0 0 115 0
158 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 1,600 0
159 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 0 0 327 0
161 Reagensia ZN paket 0 0 0 270,000 0
162 Ringer Laktat larutan infus steril botol 0 0 0 7,150 0
163 Salbutamol tablet 2 mg tablet 60 60 60 0 90 0
164 Salep 2 - 4 kombinasi pot 0 0 0 2,797 0
165 Salisil bedak 2 % botol 0 0 0 1,066 0
166 Sefadroksil 500 mg kapsul 0 0 0 557 0
167 Semen seng fosfat serbuk dan cairan botol 0 0 0 102,850 0
168 Setrizin tablet 10 mg tablet 0 0 0 154 0
169 Setrizin syrup botol 0 0 0 7,756 0
170 Sianokorbalamin (Vit.B 12) 500 mcg tablet 0 0 0 58 0
171 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 1,226 0
172 Simetidine 200 mg tablet 0 0 0 190 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
173 Simvastatin 10 mg tablet 0 0 0 135 0
174 Silk (benang Bedah Sutera) No. 3 / 0 set 0 0 0 20,825 0
175 Siprofloksasin tablet 500 mg tablet 0 0 0 298 0
176 Sulfasetamida natrium tetes mata 15 % botol 0 0 0 3,549 0
177 Tablet tambah darah kombinasi tablet 0 0 0 297 0
178 Taburia kotak 0 0 0 18,150 0
179 Temporary stopping (Fletcher) set 0 0 0 37,400 0
180 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 0 162 0
182 Tiamfenikol 500 mg kapsul 0 0 0 1,320 0
183 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 1,600 0
184 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 0 200 200 200 0 91 0
185 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 97 0
186 Urine Bag pcs 0 0 0 3,450 0
187 Vaksin Rabies vero set 0 0 0 700,000 0
188 Vitamin B kompleks tablet tablet 0 0 0 132 0
189 Yodium povidon larutan 10 % 300 ml botol 0 0 0 21,600 0
191 Zinc syrup botol 0 0 0 8,140 0
192 Zinc Tablet tablet 0 0 0 592 0
193 Pot Sputum pot 0 0 0 2,730 0
194 Salbutamol 4 mg tablet 0 0 0 88 0
195 Domperidom tablet tablet 0 0 0 410 0
196 Omeprazole 20 mg kapsul 0 0 0 800 0
197 Glimepiride 1 mg tablet 0 0 0 220 0
199 Loperamide 2 mg tablet 0 0 0 90 0
200 Miconazole Krim Tube 0 0 0 3,737 0
201 Allpurinol tablet 300 mg tablet 0 0 0 244 0
202 Amlodipine 5 mg tablet 0 0 0 105 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
204 Bisakodil 5 mg supp suppos 0 0 0 5,670 0
206 Diazepam rectal 5mg/2,5 ml tube 0 0 0 12,749 0
207 Kloramfenikol susp 125mg/5 ml tablet 0 0 0 4,000 0
209 Haloperidol inj 50 mg/ml ampul 0 0 0 91,667 0
210 Alat Suntik sekali pakai 0,05 ml set 0 0 0 1,650 0
212 Spironolakton tablet 100 mg tablet 0 0 0 878 0
213 Alat Suntik sekali pakai 10 ml set 0 0 0 1,064 0
214 Kloramfenikol salep Kulit 2% tube 0 0 0 3,409 0
215 Umbilical Cord pcs 0 0 0 3,163 0
216 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 1,030 0
217 Vaksin Jerap Tetanus vial 0 0 0 14,498 0
218 Alkohol Swab kotak 0 0 0 115 0
219 Blood Lancet 26G kotak 0 0 0 160 0
222 Sarung Tangan Examination S pcs 0 0 0 410 0
223 Sarung Tangan Examination M pcs 0 0 0 410 0
224 Sarung Tangan Examination L pcs 0 0 0 410 0
225 U-Pad steril 60 cm x 90 cm pcs 0 0 0 8,770 0
226 Plester 7,5 cm x 4,5 m rol 0 0 0 35,532 0
227 Anagens Syrup Botol 0 0 0 19,800 0
228 Fervital Kapsul kapsul 0 0 0 861 0
229 OBH Itral Syrup Botol 0 0 0 16,698 0
230 Wicold kapsul 0 0 0 792 0
231 Kasa hidrofil 40 x 80 cm roll 0 0 0 120,750 0
232 Rapid Test VIKIA HIV 1/2 kit 0 0 0 487,500 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
233 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 14,344 0
234 Benecheck plus Glucose test strip 50's box 0 0 0 156,072 0
235 Benecheck plus Cholesterol test strip 50's box 0 0 0 234,238 0
236 Benecheck plus Uric test strip 50's box 0 0 0 129,210 0
237 Kloramfenikol tetes mata 1 % botol 0 0 0 7,500 0
238 Betahistin maleat 24 mg tablet 0 0 0 1,100 0
239 Multivitamin (Lycalvit) syrup botol 0 0 0 34,000 0
TOTAL 0
(LPLPO)
KODE PUSKESMAS : 101
KECAMATAN : BARANTI TGL : BULAN JULI
KABUPATEN : SIDENRENG RAPPANG TAHUN 2017
PROPENSI : SULAWESI SELATAN
SATU STOK PENER PERSE PEMA SISA STOK PERMIN SUMBER DANA HARGA
NO. NAMA OBAT JMLH JUMLAH HARGA KET
AN AWAL MAAN DIAAN KAIAN STOK OPT SATUAN
TAAN DAK/11 DAK/12 DAK/13 DAK/14 DAK/15 DAK/16 BANTUAN PROGRAM
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set 278 0 278 7 271 271 271 5,203 1,410,013
2 IV Catheter Gea No. 20 set 108 100 208 37 171 171 100 171 4,370 747,270
5 Ansell Steril 6 1/2 psg 384 0 384 34 350 350 350 7,500 2,625,000
6 Ansell Steril 7 psg 413 0 413 4 409 409 409 7,500 3,067,500
7 Ansell Steri 7 1/2 psg 288 0 288 57 231 231 231 7,500 1,732,500
8 Alat Suntik sekali pakai 0,05 ml set 0 1000 1000 0 1000 1000 1,000 1,650 1,650,000
9 Alat Suntik sekali pakai 0,5 ml set 738 1000 1738 210 1528 1528 1,528 1,240 1,894,720
10 Alat suntik sekali pakai 1 ml set 5686 0 5686 30 5656 5656 5,656 748 4,230,688
13 Alat Suntik sekali pakai 10 ml set 200 0 200 0 200 200 200 1,064 212,800
14 Albendasol tablet 400 mg tablet 0 0 0 0 0 0 0 425 0
15 Alkohol Swab kotak 200 0 200 0 200 200 200 115 23,000
16 Alupurinol tablet 100 mg tablet 1290 0 1290 377 913 913 913 95 86,735
17 Allpurinol tablet 300 mg tablet 40 0 40 0 40 40 40 244 9,760
18 Ambroxol sirup 15 mg/ml Botol 148 0 148 24 124 124 124 5,500 682,000 Des
19 Ambroxol tablet tablet 810 0 810 390 420 420 3,000 420 216 90,720 Des
20 Aminofilin tablet 200 mg tablet 0 0 0 0 0 0 0 86 0

21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 6 0 6 0 6 6 6 3,349 20,094
22 Amitriptilin HCI tablet salut 25 mg tablet 1000 0 1000 0 1000 1000 1,000 165 165,000
23 Amlodipine 5 mg tablet 0 0 0 0 0 0 0 105 0

25 Amoksisilin sirup kering 125 mg/5 ml Botol 185 0 185 51 134 134 100 134 2,200 294,800
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 37 0 37 0 37 37 37 4,147 153,439
27 Amoksisilin kapsul 250 mg Kapsul 6373 0 6373 316 6057 6057 6,057 207 1,253,799
28 Amoksisilin kaplet 500 mg kaplet 19780 0 19780 3588 16192 16192 15,000 16,192 233 3,772,736
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0 0 0 0 4,600 0
30 Anagens Syrup Botol 23 0 23 0 23 23 23 19,800 455,400
31 Antalgin (Metampiron) tablet 500 mg Tablet 1730 0 1730 0 1730 1730 1,730 209 361,570 Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0 0 0 0 1,500 0
33 Antasida DOEN tablet kombinasi tablet 13120 0 13120 1655 11465 11465 10,000 11,465 64 733,760
34 Antasida DOEN suspensi Botol 79 0 79 36 43 43 100 43 2,106 90,558
35 Antihemoroid DOEN kombinasi suppos 61 0 61 48 13 13 50 13 3,502 45,526
36 Antifungi DOEN kombinasi pot 24 0 24 0 24 24 24 4,782 114,768
37 Antibakteri DOEN salep Kombinasi tube 0 0 0 0 0 0 0 2,767 0
38 Antimigrain DOEN kombinasi tablet 215 0 215 194 21 21 21 149 3,129
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0 0 0 0 5,800 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 12966 0 12966 5452 7514 7514 14,000 7,514 120 901,680
41 Asam Folat tablet 1490 0 1490 280 1210 1210 2,000 1,210 68 82,280
42 Asam Mefenamat tablet 500 mg tablet 10630 0 10630 2158 8472 8472 5,000 8,472 122 1,033,584 Des
43 Asiklovir 200 mg tablet 574 0 574 44 530 530 530 272 144,160
45 Asiklovir krim 5% tablet 25 0 25 0 25 25 25 25 3,960 99,000 Des
46 Asetosal tablet 100 mg tabet 100 0 100 0 100 100 100 110 11,000
47 Attalpulgit tablet 0 0 0 0 0 0 0 173 0 EXP
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 8 0 8 0 8 8 8 1,672 13,376
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 0 0 0 0 75 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0 0 0 0 156,072 0

51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 0 0 0 234,238 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0 0 0 0 129,210 0
53 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 1,000 0 1,210 0 Des
54 Betametason krim 0.1 % tube 47 100 147 9 138 138 100 138 1,435 198,030
55 Bisakodil 5 mg supp suppos 10 0 10 0 10 10 12 10 5,670 56,700
56 Bisakodil 10 mg supp suppos 8 0 8 11 -3 -3 12 -3 5,800 -17,400
57 Blood Lancet 26G kotak 50 0 50 200 -150 -150 500 -150 160 -24,000
58 Catgut/benang bedah no .2/0 pcs 0 0 0 0 0 0 0 33,925 0
59 Catgut/benang bedah no .3/0 pcs 151 72 223 17 206 206 206 6,421 1,322,726
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 28 0 28 0 28 28 28 1,740 48,720
61 Deksametason tablet 0,5 mg tablet 12851 0 12851 1542 11309 11309 11,309 48 542,832
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 0 10 0 2,578 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0 0 0 5 0 12,749 0
64 Diazepam tablet 2 mg tablett 0 0 0 0 0 0 1,000 0 134 0
65 Diazepam tablet 5 mg tablet 0 0 0 0 0 0 0 65 0
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 0 0 0 0 0 104 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 30 0 30 0 30 30 30 1,354 40,620 EXP
68 Digoksin tablet 0,25 mg tablet 100 0 100 0 100 100 100 108 10,800
69 Doksisilin kapsul 100 mg Kapsul 0 0 0 0 0 0 0 309 0
70 Domperidom suspensi Botol 24 30 54 8 46 46 100 46 3,180 146,280
71 Domperidom tablet tablet 300 0 300 36 264 264 264 451 0 Jan
72 Efedrin HCI tablet 25 mg tablet 0 0 0 0 0 0 0 56 0
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 0 0 0 5,000 0 42 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 0 10 0 8,910 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 9 0 9 3 6 6 10 6 3,600 21,600
76 E t a n o l 70 % 100 ml Botol 203 0 203 8 195 195 195 2,625 511,875
77 Etil klorida semprot Botol 0 0 0 0 0 0 0 115,500 0
78 Eugenol cairan botol 0 0 0 0 0 0 0 18,333 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 29 0 29 0 29 29 29 1,980 57,420
80 Fenobarbital tablet 30 mg tablet 0 0 0 0 0 0 0 74 0
81 Fervital Kapsul kapsul 3290 0 3290 770 2520 2520 3,000 2,520 861 2,169,720
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 124 0 124 79 45 45 90 45 3,754 168,930 EXP
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 322 0 322 24 298 298 298 796 237,208
84 Foly Catheter No. 18 pcs 9 0 9 1 8 8 8 9,200 73,600

86 Furosemid tablet 40 mg tablet 103 0 103 2 101 101 300 101 84 8,484
87 Garam Oralit untuk 200 ml Air sak 960 0 960 399 561 561 1,000 561 274 153,714
88 Gentamicin inj 40mg/ml Ampul 25 0 25 0 25 25 25 3,545 88,625 EXP
89 Gentian Violet larutan 1 % Botol 7 0 7 0 7 7 7 3,850 26,950 Jan
90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 0 0 0 434,500 0
91 Glibenklamid tablet 5 mg tablet 3045 0 3045 121 2924 2924 2,924 110 321,640 Des
92 Glimepiride 1 mg tablet 200 0 200 10 190 190 190 220 41,800
94 Guaiafenesin Tablet tablet 13555 0 13555 2952 10603 10603 5,000 10,603 132 1,399,596 Des
95 Glukosa larutan infus 5 % steril Botol 105 0 105 26 79 79 79 6,900 545,100
96 Grisefulvin tablet 125 mg (Micronized) tablet 2100 0 2100 105 1995 1995 1,995 523 1,042,388 Des
97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 0 1,000 0 76 0 Des
98 Haloperidol tablet 2 mg tablet 0 0 0 0 0 0 0 134 0
99 Haloperidol inj 50 mg/ml ampul 0 0 0 0 0 0 0 91,667 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 662 0 662 310 352 352 1,000 352 171 60,192
101 Hidrokortison krim 2,5 % tube 15 100 115 4 111 111 111 2,812 312,132
102 Ibuprofen suspensi 100 mg/5 ml Botol 13 0 13 0 13 13 13 8,000 104,000
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 0 0 0 0 8,800 0 Des
104 Ibuprofen tablet 200 mg tablet 2863 3000 5863 1142 4721 4721 5,000 4,721 111 524,031
105 Ibuprofen tablet 400 mg tablet 1035 0 1035 160 875 875 875 133 116,375
106 Infusion set anak pcs 96 0 96 12 84 84 50 84 4,025 338,100
107 Infusion set dewasa pcs 177 50 227 85 142 142 200 142 3,680 522,560
108 Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 0 82 0
109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 0 0 0 0 0 98 0
110 Kalsium Glukonat inj 10% ampul 0 0 0 0 0 0 0 999 0
111 Kalsium Hidroksida pasta buah 0 0 0 0 0 0 0 266,200 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 7796 0 7796 1130 6666 6666 10,000 6,666 69 459,954
113 Kapas pembalut 250 gram buah 8 0 8 4 4 4 10 4 14,375 57,500
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 0 0 0 0 0 31,372 0
115 Kapas pembalut / Absorben 1000 gram bungkus 2 0 2 0 2 2 2 62,744 125,488
116 Kaptopril 12,5 mg tablet 2132 0 2132 376 1756 1756 3,000 1,756 69 121,164
117 Kaptopril 25 mg tablet 800 0 800 0 800 800 5,000 800 165 132,000 Des
118 Karbamazepin tablet 200 mg tablet 0 0 0 0 0 0 0 306 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1398 0 1398 21 1377 1377 1,377 1,725 2,375,325
120 Kasa hidrofil 40 x 80 cm roll 2 7 9 1 8 8 8 120,750 966,000
121 Kasa pembalut elastis 3 inch roll 10 0 10 0 10 10 10 7,700 77,000
122 Ketokonazol krim 2% tube 26 0 26 0 26 26 100 26 6,600 171,600 Des
123 Ketokonazol tablet 200 mg tablet 500 0 500 30 470 470 470 264 124,080 Des
124 Kloramfenikol kapsul 250 mg Kapsul 479 0 479 358 121 121 121 616 74,536 Des
125 Kloramfenikol susp 125mg/5 ml Botol 101 0 101 5 96 96 96 4,000 384,000
126 Kloramfenikol salep mata 1 % tube 25 0 25 3 22 22 100 22 1,850 40,700
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 50 0 8,250 0 Des
128 Kloramfenikol salep Kulit 2% tube 16 0 16 10 6 6 6 3,409 20,454
129 Kloramfenikol tetes telinga 3 % Botol 14 0 14 0 14 14 14 8,250 115,500 Des
130 Klorfeniramin maleat tablet 4 mg tablet 9960 0 9960 2394 7566 7566 5,000 7,566 45 340,470
131 Klorokuin tablet 150 mg tablet 0 0 0 0 0 0 0 112 0
132 Klorfenol Kamfer Menthol Botol 0 0 0 0 0 0 0 60,500 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0 0 0 0 1,045 0 EXP
134 Klorpromazin HCI tablet salut 100 mg tablet 0 0 0 0 0 0 1,000 0 179 0
135 Klorpromazin HCI tablet salut 25 mg tablet 0 0 0 570 -570 -570 -570 170 -96,900
136 Kotrimoksazol tablet 480 mg tablet 2918 0 2918 554 2364 2364 5,000 2,364 158 373,512
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 148 0 148 15 133 133 50 133 2,225 295,925
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 0 390 0 390 390 390 138 53,625 Jan
139 Larutan mengandung elektrolit botol 78 0 78 4 74 74 74 9,275 686,350
140 Lidokain komp. injeksi - 2 ml ampul 67 0 67 1 66 66 66 2,122 140,052
141 Lisol 1 liter Botol 4 0 4 0 4 4 4 49,200 196,800
142 Loperamide 2 mg tablet 0 0 0 0 0 0 0 90 0
143 Loratadine 10 mg tablet 450 0 450 0 450 450 450 149 67,050
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 0 0 0 1,694 0 Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 6 0 6 0 6 6 6 2,143 12,858 Des
146 Masker Kain pcs 791 0 791 406 385 385 1,000 385 506 194,810
147 Mata Pisau No. 15 pcs 89 0 89 0 89 89 89 3,300 293,700
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
149 Metilergometrin maleat tablet salut 0,125 mg tablet 0 0 0 0 0 0 0 133 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 91 0 91 0 91 91 91 2,684 244,244
151 Metilprednisolon tablet 4 mg tablet 1000 0 1000 200 800 800 800 200 160,000
152 Metformin Hcl 500 mg tablet 1100 0 1100 301 799 799 799 115 91,885
153 Metoklopramida 10 mg tablet 0 1000 1000 73 927 927 927 100 92,700
154 Metoklopramida injeksi 5 mg / ml vial 45 0 45 8 37 37 37 6,600 244,200 Jan
155 Metronidazol tablet 250 mg tablet 0 0 0 0 0 0 0 98 0
156 Metronidazol tablet 500 mg tablet 4228 0 4228 372 3856 3856 3,856 140 539,840
157 Miconazole Krim tube 63 0 63 10 53 53 48 53 3,737 198,061
158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 47 0 47 8 39 39 39 37,400 1,458,600 Des
160 Mummifying pasta buah 0 0 0 0 0 0 0 193,600 0
161 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0 0 161 0
162 Natrium klorida larutan infus 0,9 % steril Botol 71 60 131 67 64 64 100 64 6,410 410,240
163 Nifedipin 10 mg tablet 102 0 102 30 72 72 300 72 123 8,856
164 Nistatin tablet vagina 100.000 IU / g ovula 87 0 87 80 7 7 7 602 4,214
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 0 0 0 0 0 0 704 0
166 Obat anti Tuberklosis kategori FDC I paket 1 5 6 0 6 6 6 413,984 2,483,904
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 0 0 1,317,000 0 Des
168 Obat anti Tuberklosis kategori FDC Anak paket 1 0 1 0 1 1 1 236,500 236,500
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0 0 4,400 0 Des
170 OBH Itral Syrup Botol 13 0 13 4 9 9 9 16,698 150,282

171 Ofloksasin tablet 400 mg tablet 0 0 0 0 0 0 0 636 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0 0 0 100 0 1,869 0
173 Oksitetrasiklin HCI salep mata 1 % tube 25 0 25 0 25 25 100 25 3,300 82,500 Des
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 265 0 265 0 265 265 265 1,900 503,500
175 Omeprazole 20 mg kapsul 460 0 460 40 420 420 600 420 880 0 Jan
176 Parasetamol drops Botol 136 0 136 38 98 98 98 7,350 720,300 Des
177 Parasetamol sirup 120 mg / 5 ml Botol 57 200 257 116 141 141 200 141 1,119 157,779 Des
178 Parasetamol tablet 500 mg tablet 12384 10000 22384 7781 14603 14603 20,000 14,603 145 2,117,435 Des
179 Pehacain injeksi botol 78 200 278 81 197 197 200 197 4,400 866,800 Des
180 Permetrin krim 5% tube 6 0 6 0 6 6 6 12,155 72,930
181 Pirantel pamoat tablet 125 mg tablet 249 0 249 131 118 118 200 118 318 37,524 EXP
182 Pirantel suspensi 10 ml botol 0 0 0 1 -1 -1 -1 17,600 -17,600 EXP
183 Pirantel suspensin 60 ml Botol 9 0 9 0 9 9 9 9,100 81,900 Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 15950 0 15950 1442 14508 14508 14,508 136 1,973,088
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 100 0 100 0 100 100 100 1,030 103,000
186 Piroksikam 20 mg tablet 14 0 14 10 4 4 300 4 220 880 Des
187 Plester 2,5 cm x 4 m rol 15 0 15 1 14 14 14 12,076 169,064
188 Plester 7,5 cm x 4 m rol 16 0 16 5 11 11 11 35,532 390,852
189 Pot Sputum pcs 265 0 265 0 265 265 265 3,190 0 Des
190 Prednison tablet 5 mg tablet 2200 3000 5200 2330 2870 2870 5,000 2,870 193 553,910 Jan
191 Primakuin tablet 15 mg tablet 0 0 0 0 0 0 0 120 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 30 0 30 0 30 30 30 9,908 297,240
193 Propiltiourasil tablet 100 mg tablet 900 0 900 220 680 680 680 320 217,600
194 Propranolol HCI tablet 40 mg tablet 300 0 300 0 300 300 300 69 20,700
195 Ranitidin tablet 150 mg tablet 400 1000 1400 348 1052 1052 1,052 132 138,864 Des
196 Ranitidin injeksi 25 mg/2 ml ampul 20 0 20 16 4 4 4 1,600 6,400
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0 0 525,000 0 Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 0 0 0 0 14,344 0
199 Reagensia ZN botol 0 10 10 0 10 10 10 270,000 2,700,000
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 0 0 0 0 0 0 327 0
202 Ringer Laktat larutan infus steril Botol 25 440 465 129 336 336 336 7,150 2,402,400
203 Salbutamol tablet 2 mg tablet 692 0 692 154 538 538 1,000 538 99 53,262 Des
204 Salbutamol 4 mg tablet 200 0 200 0 200 200 200 88 17,600
205 Salep 2 - 4 kombinasi pot 58 0 58 1 57 57 48 57 2,797 159,429

206 Salisil bedak 2 % pot 83 0 83 29 54 54 100 54 1,066 57,564
207 Sarung Tangan Examination S pcs 795 0 795 912 -117 -117 1,000 -117 410 -47,970
208 Sarung Tangan Examination M pcs 0 1000 1000 500 500 500 1,000 500 410 205,000
209 Sarung Tangan Examination L pcs 800 0 800 500 300 300 1,000 300 410 123,000
210 Sefadroksil 500 mg kapsul 2000 0 2000 204 1796 1796 1,796 557 1,000,372
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 0 0 0 102,850 0
212 Setrizin tablet 10 mg tablet 0 0 0 0 0 0 0 154 0
213 Setrizin syrup Botol 67 0 67 3 64 64 64 7,756 496,384
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 5790 0 5790 240 5550 5550 5,550 58 321,900
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 140 0 140 0 140 140 140 1,226 171,640
216 Simetidine 200 mg tablet 2000 0 2000 0 2000 2000 2,000 209 418,000 Jan
217 Simvastatin 10 mg tablet 0 900 900 120 780 780 780 135 105,300
218 Simvastatin 20 mg tablet 0 0 0 0 0 0 0 252 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 78 0 78 19 59 59 59 20,825 1,228,675
220 Siprofloksasin tablet 500 mg tablet 710 500 1210 377 833 833 1,000 833 298 248,234
221 Spironolakton tablet 100 mg tablet 100 0 100 0 100 100 100 878 87,800
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0 0 0 0 3,549 0
223 Tablet tambah darah kombinasi tablet 9753 0 9753 2170 7583 7583 30,000 7,583 327 2,477,366 Des
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
225 Temporary stopping (Fletcher) buah 0 0 0 0 0 0 0 37,400 0
226 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 0 0 0 0 0 162 0
227 Tetrasiklin HCI kapsul 500 mg kapsul 500 0 500 40 460 460 460 325 149,500
228 Tiamfenikol 500 mg kapsul 160 0 160 30 130 130 300 130 1,452 188,760 Jan
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 30 0 30 0 30 30 30 1,760 52,800 Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 14445 0 14445 1206 13239 13239 13,239 91 1,204,749
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 0 0 0 1,000 0 97 0
232 Umbilical Cord kotak 99 0 99 8 91 91 100 91 3,163 287,833
233 U-Pad steril 60 cm x 90 cm pcs 19 20 39 13 26 26 50 26 8,770 228,020
234 Urine Bag set 11 0 11 0 11 11 10 11 3,450 37,950
235 Vaksin Jerap Tetanus vial 64 0 64 6 58 58 58 14,498 840,884
236 Vaksin Rabies vero kuur 12 0 12 0 12 12 12 700,000 8,400,000

237 Vitamin B kompleks tablet tablet 26613 0 26613 3252 23361 23361 5,000 23,361 132 3,083,652
238 Wicold kapsul kapsul 660 0 660 80 580 580 3,000 580 792 459,360
239 Yodium povidon larutan 10 % 60 ml Botol 41 0 41 6 35 35 35 7,040 246,400
240 Yodium povidon larutan 10 % 300 ml Botol 12 0 12 3 9 9 10 9 21,600 194,400
241 Zinc syrup Botol 0 0 0 0 0 0 0 8,140 0
242 Zinc Tablet tablet 5202 0 5202 220 4982 4982 4,982 592 2,949,344
TOTAL 98,563,578
jumlah resep
Jenis kunjungan jumlahpasien
generik NON GENERIK UNIT JAMKESDA JKN TOTAL
Jamkesda 904 2707 PELAYANAN Jml pasien Jml R/ Jml pasien Jml R/ Jml pasien Jml R/
JKN 641 1900 pustu simpo 37 114 16 50
Lain - lain pustu tonrong 37 106
pustu trong rijang 115 333
Kunjungan Rawat Inap pkesdes sipodeceng
Jamkesda 109 323 pkesdes baranti
JKN 7 18 pkesdes passeno
Lain - lain 11 23 pkesdes trong
pkesdes trong rijang
pkesdes duampanua
usila
posbindu
TOTAL 1672 4971 TOTAL 189 553 16 50 0 0

Mengetahui
Kepala Puskesmas Barant Pengelola obat Pkm Barant
dr Hj Ulianti Murniaty,S.Farm
NIP.197908072007012013 NIP : 198212112009012006

( L P L P O ) JKD
KODE PUSKESMAS :
PUSKESMAS : POSKESDES TONRONG RIJANG NO :
KECAMATAN : TGL :31-10-2017 BULAN 10
SATU STOK PENER PERSE PEMA SISA STOK PERMIN SUMBER DANA HARGA JUMLAH
NO. NAMA OBAT JMLH
SATUAN HARGA KET
AN AWAL MAAN DIAAN KAIAN STOK OPT TAAN DAK/11 DAK/12 DAK/13 DAK/14 DAK/15 DAK/16 BANTUAN PROGRAM
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set 5 0 5 0 5 0 5,203 0
3 IV Catheter Gea No. 22 set 0 5,203 0
5 Ansell Steril 6 1/2 psg 0 7,500 0
6 Ansell Steril 7 psg 0 7,500 0
7 Ansell Steri 7 1/2 psg 8 0 8 2 6 0 7,500 0
8 Alat Suntik sekali pakai 0,05 ml set 0 1,650 0
9 Alat Suntik sekali pakai 0,5 ml set 10 0 10 2 8 0 1,240 0
10 Alat suntik sekali pakai 1 ml set 87 0 87 0 87 0 748 0
13 Alat Suntik sekali pakai 10 ml set 0 1,064 0
14 Albendasol tablet 400 mg tablet 0 425 0
15 Alkohol Swab kotak 0 115 0
16 Alupurinol tablet 100 mg tablet 0 95 0
17 Allpurinol tablet 300 mg tablet 0 244 0
18 Ambroxol sirup 15 mg/ml Botol 0 5,500 0 Des
19 Ambroxol tablet tablet 0 216 0 Des
20 Aminofilin tablet 200 mg tablet 0 86 0

NO. NAMA OBAT JMLH SATUAN HARGA KET
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 3,349 0
22 Amitriptilin HCI tablet salut 25 mg tablet 0 165 0
23 Amlodipine 5 mg tablet 0 105 0
25 Amoksisilin sirup kering 125 mg/5 ml Botol 1 0 1 1 0 0 2,200 0
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 4,147 0
27 Amoksisilin kapsul 250 mg Kapsul 0 207 0
28 Amoksisilin kaplet 500 mg kaplet 380 0 380 80 300 0 233 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 4,600 0
30 Anagens Syrup Botol 0 19,800 0

31 Antalgin (Metampiron) tablet 500 mg Tablet 0 209 0 Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 1,500 0
33 Antasida DOEN tablet kombinasi tablet 130 0 130 0 130 0 64 0
34 Antasida DOEN suspensi Botol 0 2,106 0
35 Antihemoroid DOEN kombinasi suppos 0 3,502 0
36 Antifungi DOEN kombinasi pot 0 4,782 0
37 Antibakteri DOEN salep Kombinasi tube 0 2,767 0
38 Antimigrain DOEN kombinasi tablet 0 149 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 5,800 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 0 0 0 0 0 0 120 0
41 Asam Folat tablet 200 0 200 20 180 0 68 0
42 Asam Mefenamat tablet 500 mg tablet 270 0 270 50 220 0 113 0 Des
43 Asiklovir 200 mg tablet 0 272 0
45 Asiklovir krim 5% tablet 0 3,960 0 Des
46 Asetosal tablet 100 mg tabet 0 110 0
47 Attalpulgit tablet 0 173 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 1,672 0
49 Atropin Sulfat tablet 0,5 mg tablet 0 75 0
50 Benecheck plus Glucose test strip 50's box 0 156,072 0
51 Benecheck plus Cholesterol test strip 50's box 0 234,238 0
52 Benecheck plus Uric test strip 50's box 0 129,210 0
53 Betahistin maleat 24 mg tablet 0 1,210 0 Des
54 Betametason krim 0.1 % tube 0 1,435 0

55 Bisakodil 5 mg supp suppos 0 5,670 0
57 Blood Lancet 26G kotak 0 160 0

58 Catgut/benang bedah no .2/0 pcs 0 33,925 0
59 Catgut/benang bedah no .3/0 pcs 5 0 5 0 5 0 6,421 0
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 1,740 0
61 Deksametason tablet 0,5 mg tablet 80 0 80 70 10 0 48 0
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 2,578 0
63 Diazepam rectal 5mg/2,5 ml buah 0 12,749 0
64 Diazepam tablet 2 mg tablett 0 134 0
65 Diazepam tablet 5 mg tablet 0 65 0
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 104 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 1,354 0
68 Digoksin tablet 0,25 mg tablet 0 108 0
69 Doksisilin kapsul 100 mg Kapsul 0 309 0

70 Domperidom suspensi Botol 0 3,180 0
71 Domperidom tablet tablet 0 451 0 Jan

72 Efedrin HCI tablet 25 mg tablet 0 56 0
73 Ekstrak Belladon tablet 10 mg tablet 0 42 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 8,910 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 0 3,600 0
76 E t a n o l 70 % 100 ml Botol 6 0 6 0 6 0 2,625 0
77 Etil klorida semprot Botol 0 115,500 0
78 Eugenol cairan botol 0 18,333 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 1,980 0
80 Fenobarbital tablet 30 mg tablet 0 74 0
81 Fervital Kapsul kapsul 20 0 20 20 0 0 861 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 4 0 4 0 4 0 3,754 0 EXP
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 0 796 0
84 Foly Catheter No. 18 pcs 0 9,200 0
86 Furosemid tablet 40 mg tablet 0 84 0
87 Garam Oralit untuk 200 ml Air sak 38 0 38 18 20 0 274 0
88 Gentamicin inj 40mg/ml Ampul 0 3,545 0 EXP
89 Gentian Violet larutan 1 % Botol 0 3,850 0 Jan

90 Glass lonomer Cement (GC IX ) buah 0 434,500 0
91 Glibenklamid tablet 5 mg tablet 0 110 0 Des
92 Glimepiride 1 mg tablet 0 220 0

94 Guaiafenesin Tablet tablet 0 132 0 Des
95 Glukosa larutan infus 5 % steril Botol 0 6,900 0
96 Grisefulvin tablet 125 mg (Micronized) tablet 0 523 0 Des

97 Haloperidol tablet 1,5 mg tablet 0 76 0 Des
98 Haloperidol tablet 2 mg tablet 0 134 0
99 Haloperidol inj 50 mg/ml ampul 0 91,667 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 0 171 0
101 Hidrokortison krim 2,5 % tube 4 0 4 2 2 0 2,812 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 8,000 0
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 8,800 0 Des

104 Ibuprofen tablet 200 mg tablet 300 0 300 20 280 0 111 0
106 Infusion set anak pcs 0 4,025 0
107 Infusion set dewasa pcs 6 0 6 0 6 0 3,680 0
108 Isoniazid tablet 100 mg tablet 0 82 0

109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 98 0
110 Kalsium Glukonat inj 10% ampul 0 999 0
111 Kalsium Hidroksida pasta buah 0 266,200 0
113 Kapas pembalut 250 gram buah 0 14,375 0
114 Kapas pembalut / Absorben 500 gram bungkus 0 31,372 0
116 Kaptopril 12,5 mg tablet 0 69 0
117 Kaptopril 25 mg tablet 0 165 0 Des
118 Karbamazepin tablet 200 mg tablet 0 306 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 30 0 30 5 25 0 1,725 0
120 Kasa hidrofil 40 x 80 cm roll 0 120,750 0
121 Kasa pembalut elastis 3 inch roll 0 7,700 0
122 Ketokonazol krim 2% tube 0 6,600 0 Des
123 Ketokonazol tablet 200 mg tablet 0 264 0 Des
124 Kloramfenikol kapsul 250 mg Kapsul 0 616 0 Des
125 Kloramfenikol susp 125mg/5 ml Botol 0 4,000 0
126 Kloramfenikol salep mata 1 % tube 3 0 3 1 2 0 1,850 0
127 Kloramfenikol tetes mata 1 % botol 0 8,250 0 Des
128 Kloramfenikol salep Kulit 2% tube 0 3,409 0
129 Kloramfenikol tetes telinga 3 % Botol 0 8,250 0 Des
130 Klorfeniramin maleat tablet 4 mg tablet 0 45 0
131 Klorokuin tablet 150 mg tablet 0 112 0
132 Klorfenol Kamfer Menthol Botol 0 60,500 0

133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 1,045 0
134 Klorpromazin HCI tablet salut 100 mg tablet 0 179 0

136 Kotrimoksazol tablet 480 mg tablet 20 0 20 10 10 0 158 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 3 0 3 0 3 0 2,225 0
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 138 0 Jan

139 Larutan mengandung elektrolit botol 0 9,275 0
140 Lidokain komp. injeksi - 2 ml ampul 11 0 11 1 10 0 2,122 0
141 Lisol 1 liter Botol 0 49,200 0
142 Loperamide 2 mg tablet 0 90 0
143 Loratadine 10 mg tablet 0 149 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 1,694 0 Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 2,143 0 Des
146 Masker Kain pcs 55 0 55 5 50 0 506 0
147 Mata Pisau No. 15 pcs 0 3,300 0

149 Metilergometrin maleat tablet salut 0,125 mg tablet 0 133 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 2,684 0
151 Metilprednisolon tablet 4 mg tablet 0 200 0
152 Metformin Hcl 500 mg tablet 0 115 0
153 Metoklopramida 10 mg tablet 0 100 0
154 Metoklopramida injeksi 5 mg / ml vial 0 6,600 0 Jan

155 Metronidazol tablet 250 mg tablet 0 98 0
156 Metronidazol tablet 500 mg tablet 190 0 190 0 190 0 140 0
157 Miconazole Krim tube 0 3,737 0
158 Mineral Mix sak 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 4 0 4 0 4 0 37,400 0 Des
160 Mummifying pasta buah 0 193,600 0
161 Natrium diklofenak 50 mg tablet 0 161 0
162 Natrium klorida larutan infus 0,9 % steril Botol 6 0 6 0 6 0 6,410 0 EXP
163 Nifedipin 10 mg tablet 0 123 0
164 Nistatin tablet vagina 100.000 IU / g ovula 0 602 0
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 704 0
166 Obat anti Tuberklosis kategori FDC I paket 0 413,984 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 1,317,000 0
168 Obat anti Tuberklosis kategori FDC Anak paket 0 236,500 0
169 Obat Batuk Hitam (O.B.H) cairan botol 0 4,400 0
170 OBH Itral Syrup Botol 0 16,698 0
171 Ofloksasin tablet 400 mg tablet 0 636 0

172 Oksitetrasiklin HCI salep kulit 3 % tube 0 1,869 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 3,300 0
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 1,900 0

175 Omeprazole 20 mg kapsul 0 880 0 Jan
176 Parasetamol drops Botol 4 0 4 4 0 0 5,980 0 Des
177 Parasetamol sirup 120 mg / 5 ml Botol 5 0 5 5 0 0 1,119 0 Des
178 Parasetamol tablet 500 mg tablet 350 0 350 200 150 0 145 0 Des
179 Pehacain injeksi botol 0 4,400 0 Des
180 Permetrin krim 5% tube 0 12,155 0
181 Pirantel pamoat tablet 125 mg tablet 0 318 0
182 Pirantel suspensi 10 ml botol 0 17,600 0 Jan
183 Pirantel suspensin 60 ml Botol 0 9,100 0 Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 136 0
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 1,030 0
186 Piroksikam 20 mg tablet 0 220 0 Des

187 Plester 2,5 cm x 4 m rol 1 0 1 0 1 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 35,532 0
189 Pot Sputum pcs 0 3,190 0 Des
190 Prednison tablet 5 mg tablet 0 193 0 Jan

191 Primakuin tablet 15 mg tablet 0 120 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 9,908 0
193 Propiltiourasil tablet 100 mg tablet 0 320 0
194 Propranolol HCI tablet 40 mg tablet 0 69 0
195 Ranitidin tablet 150 mg tablet 0 115 0 Des
196 Ranitidin injeksi 25 mg/2 ml ampul 0 1,600 0
197 Rapid Test VIKIA HIV 1/2 kit 0 525,000 0 Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 14,344 0
199 Reagensia ZN botol 0 270,000 0
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 327 0
202 Ringer Laktat larutan infus steril Botol 3 5 8 0 8 0 7,150 0 EXP
203 Salbutamol tablet 2 mg tablet 0 99 0 Des
204 Salbutamol 4 mg tablet 0 88 0
205 Salep 2 - 4 kombinasi pot 4 0 4 0 4 0 2,797 0
206 Salisil bedak 2 % pot 4 0 4 1 3 0 1,066 0
207 Sarung Tangan Examination S pcs 0 410 0
208 Sarung Tangan Examination M pcs 0 0 0 0 0 0 410 0
209 Sarung Tangan Examination L pcs 0 410 0
210 Sefadroksil 500 mg kapsul 0 557 0

211 Semen seng fosfat serbuk dan cairan buah 0 102,850 0
212 Setrizin tablet 10 mg tablet 0 154 0
213 Setrizin syrup Botol 0 7,756 0

214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 230 0 230 20 210 0 58 0
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 1,226 0
216 Simetidine 200 mg tablet 0 209 0 Jan

217 Simvastatin 10 mg tablet 0 135 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 5 0 5 0 5 0 20,825 0
220 Siprofloksasin tablet 500 mg tablet 0 298 0
221 Spironolakton tablet 100 mg tablet 0 878 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 3,549 0
223 Tablet tambah darah kombinasi tablet 430 0 430 400 30 0 327 0 Des
224 Taburia kotak 0 18,150 0
225 Temporary stopping (Fletcher) buah 0 37,400 0

226 Tetrasiklin HCI kapsul 250 mg kapsul 0 162 0
228 Tiamfenikol 500 mg kapsul 0 1,452 0 Jan

229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 1,760 0 Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 460 0 460 80 380 0 91 0
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 97 0
232 Umbilical Cord kotak 8 0 8 0 8 0 3,163 0
233 U-Pad steril 60 cm x 90 cm pcs 4 0 4 0 4 0 8,770 0
234 Urine Bag set 0 3,450 0
235 Vaksin Jerap Tetanus vial 1 0 1 1 0 0 14,498 0
236 Vaksin Rabies vero kuur 0 700,000 0
237 Vitamin B kompleks tablet tablet 250 0 250 160 90 0 132 0
238 Wicold kapsul kapsul 0 0 0 0 0 0 792 0
239 Yodium povidon larutan 10 % 60 ml Botol 0 0 0 0 0 0 7,040 0
241 Zinc syrup Botol 0 8,140 0
242 Zinc Tablet tablet 100 0 100 10 90 0 592 0 EXP

TOTAL 0
###
JENIS KUNJUNGAN JUMLAH PASIEN JUMLAH RESEP UNIT JAMKESDA JKN TOTAL
Jamkesda GENERIK NON GENERIK PELAYANAN Jml pasien Jml R/ Jml pasien Jml R/ Jml pasien Jml R/
JKN
Lain - lain
Kunjungan Rawat Inap

Jamkesda
JKN
Lain - lain
TOTAL TOTAL
IF Dinas Kesehatan Kasie Farmasi
Kab.Sidenreng Rappang Kab.Sidenreng Rappang
(Bedo Sari Anton,S.Si.,Apt.,M.Kes )
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
(LPLPO)
KODE PUSKESMAS :
PUSKESMAS : POSKESDES PASSENO NO :
KECAMATAN : BARANTI TGL : 31 okt 2017 BULAN 10
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set 1 1 0 1 1 1 5,203 5,203
3 IV Catheter Gea No. 22 set 0 0 0 0 5,203 0
5 Ansell Steril 6 1/2 psg 0 0 0 0 7,500 0
6 Ansell Steril 7 psg 12 12 1 11 11 10 11 7,500 82,500
7 Ansell Steri 7 1/2 psg 9 9 0 9 9 9 7,500 67,500
8 Alat Suntik sekali pakai 0,05 ml set 0 0 0 0 1,650 0
9 Alat Suntik sekali pakai 0,5 ml set 24 24 7 17 17 20 17 1,240 21,080
10 Alat suntik sekali pakai 1 ml set 185 185 1 184 184 184 748 137,632
13 Alat Suntik sekali pakai 10 ml set 0 0 0 0 1,064 0
14 Albendasol tablet 400 mg tablet 0 0 0 0 425 0
15 Alkohol Swab kotak 0 0 0 0 115 0
17 Allpurinol tablet 300 mg tablet 0 0 0 0 244 0
18 Ambroxol sirup 15 mg/ml Botol 0 0 0 0 5,500 0 Des
19 Ambroxol tablet tablet 0 0 0 0 216 0 Des
20 Aminofilin tablet 200 mg tablet 0 0 0 0 86 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 0 3,349 0
22 Amitriptilin HCI tablet salut 25 mg tablet 0 0 0 0 165 0
23 Amlodipine 5 mg tablet 0 0 0 0 105 0
25 Amoksisilin sirup kering 125 mg/5 ml Botol 10 10 3 7 7 5 7 2,200 15,400
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 4,147 0
27 Amoksisilin kapsul 250 mg Kapsul 0 0 0 0 207 0
28 Amoksisilin kaplet 500 mg kaplet 1017 1017 160 857 857 200 857 233 199,681
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0 4,600 0
30 Anagens Syrup Botol 0 0 0 0 19,800 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
31 Antalgin (Metampiron) tablet 500 mg Tablet 280 280 0 280 280 280 209 58,520 Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0 1,500 0
33 Antasida DOEN tablet kombinasi tablet 900 900 30 870 870 870 64 55,680
34 Antasida DOEN suspensi Botol 0 0 0 0 2,106 0
35 Antihemoroid DOEN kombinasi suppos 0 0 0 0 3,502 0
36 Antifungi DOEN kombinasi pot 0 0 0 0 4,782 0
37 Antibakteri DOEN salep Kombinasi tube 0 0 0 0 2,767 0
38 Antimigrain DOEN kombinasi tablet 0 0 0 0 149 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0 5,800 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 451 451 442 9 9 1,000 9 120 1,080
41 Asam Folat tablet 160 160 90 70 70 500 70 68 4,760
42 Asam Mefenamat tablet 500 mg tablet 735 735 95 640 640 640 113 72,320 Des
43 Asiklovir 200 mg tablet 0 0 0 0 272 0
45 Asiklovir krim 5% tablet 0 0 0 0 3,960 0 Des
46 Asetosal tablet 100 mg tabet 0 0 0 0 110 0
47 Attalpulgit tablet 0 0 0 0 173 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 1,672 0
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 0 75 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0 156,072 0
51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 234,238 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0 129,210 0
53 Betahistin maleat 24 mg tablet 0 0 0 0 1,210 0 Des
54 Betametason krim 0.1 % tube 9 9 0 9 9 9 1,435 12,915
55 Bisakodil 5 mg supp suppos 0 0 0 0 5,670 0
57 Blood Lancet 26G kotak 0 0 0 0 160 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
58 Catgut/benang bedah no .2/0 pcs 0 0 0 0 33,925 0
59 Catgut/benang bedah no .3/0 pcs 12 12 1 11 11 11 6,421 70,631
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 0 1,740 0
61 Deksametason tablet 0,5 mg tablet 768 768 179 589 589 200 589 48 28,272
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 2,578 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0 12,749 0
64 Diazepam tablet 2 mg tablett 0 0 0 0 134 0
65 Diazepam tablet 5 mg tablet 0 0 0 0 65 0
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 0 0 104 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 1,354 0
68 Digoksin tablet 0,25 mg tablet 0 0 0 0 108 0
69 Doksisilin kapsul 100 mg Kapsul 0 0 0 0 309 0
70 Domperidom suspensi Botol 0 0 0 0 3,180 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
71 Domperidom tablet tablet 0 0 0 0 451 0 Jan

72 Efedrin HCI tablet 25 mg tablet 0 0 0 0 56 0
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 0 42 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 8,910 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 0 0 0 0 3,600 0
76 E t a n o l 70 % 100 ml Botol 7 7 1 6 6 6 2,625 15,750
77 Etil klorida semprot Botol 0 0 0 0 115,500 0
78 Eugenol cairan botol 0 0 0 0 18,333 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 1,980 0
80 Fenobarbital tablet 30 mg tablet 0 0 0 0 74 0
81 Fervital Kapsul kapsul 560 560 60 500 500 500 861 430,500
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 4 4 1 3 3 10 3 3,754 11,262
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 0 0 0 0 796 0
84 Foly Catheter No. 18 pcs 0 0 0 0 9,200 0
86 Furosemid tablet 40 mg tablet 0 0 0 0 84 0
87 Garam Oralit untuk 200 ml Air sak 46 46 12 34 34 50 34 274 9,316
88 Gentamicin inj 40mg/ml Ampul 0 0 0 0 3,545 0
89 Gentian Violet larutan 1 % Botol 0 0 0 0 3,850 0 Jan

90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 434,500 0
91 Glibenklamid tablet 5 mg tablet 0 0 0 0 110 0 Des
92 Glimepiride 1 mg tablet 0 0 0 0 220 0
94 Guaiafenesin Tablet tablet 0 0 0 1,000 0 132 0 Des
95 Glukosa larutan infus 5 % steril Botol 2 2 0 2 2 2 6,900 13,800
96 Grisefulvin tablet 125 mg (Micronized) tablet 0 0 0 0 523 0 Des
97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 76 0 Des

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
98 Haloperidol tablet 2 mg tablet 0 0 0 0 134 0
99 Haloperidol inj 50 mg/ml ampul 0 0 0 0 91,667 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 0 0 0 0 171 0
101 Hidrokortison krim 2,5 % tube 0- 0 0 0 0 0 2,812 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 0 0 0 8,000 0
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 0 8,800 0 Des
104 Ibuprofen tablet 200 mg tablet 200 200 200 200 200 111 22,200
105 Ibuprofen tablet 400 mg tablet 240 240 60 180 180 180 133 23,940
106 Infusion set anak pcs 0 0 0 0 4,025 0
107 Infusion set dewasa pcs 9 9 0 9 9 9 3,680 33,120
108 Isoniazid tablet 100 mg tablet 0 0 0 0 82 0
109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 0 0 98 0
110 Kalsium Glukonat inj 10% ampul 0 0 0 0 999 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
111 Kalsium Hidroksida pasta buah 0 0 0 0 266,200 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 570 570 150 420 420 500 420 69 28,980
113 Kapas pembalut 250 gram buah 0 0 0 0 14,375 0
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 0 0 31,372 0
116 Kaptopril 12,5 mg tablet 0 0 0 0 69 0
117 Kaptopril 25 mg tablet 0 0 0 0 165 0 Des
118 Karbamazepin tablet 200 mg tablet 0 0 0 0 306 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 30 30 10 20 20 50 20 1,725 34,500
120 Kasa hidrofil 40 x 80 cm roll 0 0 0 0 120,750 0
121 Kasa pembalut elastis 3 inch roll 0 0 0 0 7,700 0
122 Ketokonazol krim 2% tube 0 0 0 0 6,600 0 Des
123 Ketokonazol tablet 200 mg tablet 0 0 0 0 264 0 Des
124 Kloramfenikol kapsul 250 mg Kapsul 0 0 0 0 616 0 Des
125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0 0 4,000 0
126 Kloramfenikol salep mata 1 % tube 2 2 1 1 1 5 1 1,850 1,850
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 8,250 0 Des
128 Kloramfenikol salep Kulit 2% tube 0 0 0 0 3,409 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 8,250 0 Des
130 Klorfeniramin maleat tablet 4 mg tablet 1000 1000 60 940 940 940 45 42,300
131 Klorokuin tablet 150 mg tablet 0 0 0 0 112 0
132 Klorfenol Kamfer Menthol Botol 0 0 0 0 60,500 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0 1,045 0
134 Klorpromazin HCI tablet salut 100 mg tablet 0 0 0 0 179 0
136 Kotrimoksazol tablet 480 mg tablet 665 665 30 635 635 635 158 100,330
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 15 15 0 15 15 15 2,225 33,375

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 138 0 Jan

139 Larutan mengandung elektrolit botol 0 0 0 0 9,275 0
140 Lidokain komp. injeksi - 2 ml ampul 0 0 0 0 2,122 0
141 Lisol 1 liter Botol 1 1 0 1 1 1 49,200 49,200
142 Loperamide 2 mg tablet 0 0 0 0 90 0
143 Loratadine 10 mg tablet 0 0 0 0 149 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 1,694 0 Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0 0 2,143 0 Des
146 Masker Kain pcs 0 0 0 0 506 0
147 Mata Pisau No. 15 pcs 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 3,300 0
149 Metilergometrin maleat tablet salut 0,125 mg tablet 0 0 0 0 133 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0 0 2,684 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
151 Metilprednisolon tablet 4 mg tablet 0 0 0 0 200 0
152 Metformin Hcl 500 mg tablet 0 0 0 0 115 0
153 Metoklopramida 10 mg tablet 0 0 0 0 100 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0 6,600 0 Jan

155 Metronidazol tablet 250 mg tablet 0 0 0 0 98 0
156 Metronidazol tablet 500 mg tablet 200 200 20 180 180 180 140 25,200
157 Miconazole Krim tube 0 0 0 0 3,737 0
158 Mineral Mix sak 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 4 4 1 3 3 10 3 37,400 112,200 Des
160 Mummifying pasta buah 0 0 0 0 193,600 0
162 Natrium klorida larutan infus 0,9 % steril Botol 0 0 0 0 6,410 0
163 Nifedipin 10 mg tablet 0 0 0 0 123 0
164 Nistatin tablet vagina 100.000 IU / g ovula 0 0 0 0 602 0
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 0 0 0 704 0
166 Obat anti Tuberklosis kategori FDC I paket 0 0 0 0 413,984 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 1,317,000 0 Des
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 0 236,500 0
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 4,400 0 Des
170 OBH Itral Syrup Botol 0 0 0 0 16,698 0
171 Ofloksasin tablet 400 mg tablet 0 0 0 0 636 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0 1,869 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 10 0 3,300 0 Des
175 Omeprazole 20 mg kapsul 0 0 0 0 880 0 Jan
176 Parasetamol drops Botol 5 5 5 0 0 10 0 5,980 0 Des
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 0 1,119 0 Des

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
178 Parasetamol tablet 500 mg tablet 618 618 166 452 452 500 452 145 65,540 Des
179 Pehacain injeksi botol 0 0 0 0 4,400 0 Des
180 Permetrin krim 5% tube 0 0 0 0 12,155 0
181 Pirantel pamoat tablet 125 mg tablet 25 25 0 25 25 25 318 7,950
182 Pirantel suspensi 10 ml botol 0 0 0 0 17,600 0 Jan
183 Pirantel suspensin 60 ml Botol 0 0 0 0 9,100 0 Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 0 0 0 136 0
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 0 1,030 0
186 Piroksikam 20 mg tablet 0 0 0 0 220 0 Des
187 Plester 2,5 cm x 4 m rol 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 3,190 0 Des
190 Prednison tablet 5 mg tablet 195 195 0 195 195 195 193 37,635 Jan
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
191 Primakuin tablet 15 mg tablet 0 0 0 0 120 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 0 9,908 0
193 Propiltiourasil tablet 100 mg tablet 0 0 0 0 320 0
194 Propranolol HCI tablet 40 mg tablet 0 0 0 0 69 0
195 Ranitidin tablet 150 mg tablet 0 0 0 0 115 0 Des
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 0 1,600 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 525,000 0 Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 0 14,344 0
199 Reagensia ZN botol 0 0 0 0 270,000 0
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 0 0 0 327 0
202 Ringer Laktat larutan infus steril Botol 5 5 0 5 5 5 7,150 35,750
203 Salbutamol tablet 2 mg tablet 0 0 0 0 99 0 Des
204 Salbutamol 4 mg tablet 0 0 0 0 88 0
205 Salep 2 - 4 kombinasi pot 0 0 0 0 2,797 0
206 Salisil bedak 2 % pot 9 9 1 8 8 8 1,066 8,528
207 Sarung Tangan Examination S pcs 72 72 4 68 68 68 410 27,880
208 Sarung Tangan Examination M pcs 0 0 0 0 410 0
209 Sarung Tangan Examination L pcs 0 0 0 0 410 0
210 Sefadroksil 500 mg kapsul 0 0 0 0 557 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 102,850 0
212 Setrizin tablet 10 mg tablet 0 0 0 0 154 0
213 Setrizin syrup Botol 0 0 0 0 7,756 0
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 420 420 100 320 320 300 320 58 18,560
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 0 1,226 0
216 Simetidine 200 mg tablet 0 0 0 0 209 0 Jan

217 Simvastatin 10 mg tablet 0 0 0 0 135 0
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 0 0 0 20,825 0
220 Siprofloksasin tablet 500 mg tablet 0 0 0 0 298 0
221 Spironolakton tablet 100 mg tablet 0 0 0 0 878 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0 3,549 0
223 Tablet tambah darah kombinasi tablet 85 85 40 45 45 900 45 327 14,702 Des
224 Taburia kotak 0 0 0 0 18,150 0
225 Temporary stopping (Fletcher) buah 0 0 0 0 37,400 0
226 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 0 0 162 0
228 Tiamfenikol 500 mg kapsul 0 0 0 0 1,452 0 Jan

229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 1,760 0 Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 0 0 0 0 91 0
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 0 97 0
232 Umbilical Cord kotak 7 7 1 6 6 10 6 3,163 18,978
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 5 0 8,770 0
234 Urine Bag set 0 0 0 0 3,450 0
235 Vaksin Jerap Tetanus vial 4 4 1 3 3 3 14,498 43,494
236 Vaksin Rabies vero kuur 0 0 0 0 700,000 0
237 Vitamin B kompleks tablet tablet 333 333 82 251 251 500 251 132 33,132
238 Wicold kapsul kapsul 100 100 0 100 100 200 100 792 79,200
239 Yodium povidon larutan 10 % 60 ml Botol 0 0 0 0 7,040 0
241 Zinc syrup Botol 0 0 0 0 8,140 0
242 Zinc Tablet tablet 100 100 10 90 90 200 90 592 53,280
243 Samcobion tablet 420 420 310 110 110 900 110
TOTAL ###
###
JKN
Lain - lain
Jamkesda
JKN
Lain - lain
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
(LPLPO)
KODE PUSKESMAS :
POSKESDES : SIPODECENG NO :
KECAMATAN : TGL :31 oktober 2017 BULAN 10
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
2 IV Catheter Gea No. 20 set 2 2 0 2 0 4,370 0
6 Ansell Steril 7 psg 10 10 3 7 0 7,500 0
7 Ansell Steri 7 1/2 psg 9 9 2 7 0 7,500 0
9 Alat Suntik sekali pakai 0,5 ml set 47 47 9 38 0 1,240 0
10 Alat suntik sekali pakai 1 ml set 145 145 2 143 0 748 0

25 Amoksisilin sirup kering 125 mg/5 ml Botol 9 9 3 6 0 2,200 0
28 Amoksisilin kaplet 500 mg kaplet 470 470 25 445 0 233 0

33 Antasida DOEN tablet kombinasi tablet 230 230 230 0 64 0
41 Asam Folat tablet 210 210 0 210 0 68 0
42 Asam Mefenamat tablet 500 mg tablet 610 610 0 610 0 113 0 Des
43 Asiklovir 200 mg tablet 0 0 272 0
45 Asiklovir krim 5% tablet 0 0 3,960 0 Des
46 Asetosal tablet 100 mg tabet 0 0 110 0
47 Attalpulgit tablet 0 0 173 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 1,672 0
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 75 0
50 Benecheck plus Glucose test strip 50's box 0 0 156,072 0
51 Benecheck plus Cholesterol test strip 50's box 0 0 234,238 0
52 Benecheck plus Uric test strip 50's box 0 0 129,210 0
53 Betahistin maleat 24 mg tablet 0 0 1,210 0 Des
54 Betametason krim 0.1 % tube 0 0 1,435 0

55 Bisakodil 5 mg supp suppos 0 0 5,670 0
57 Blood Lancet 26G kotak 0 0 160 0

58 Catgut/benang bedah no .2/0 pcs 0 0 33,925 0
59 Catgut/benang bedah no .3/0 pcs 10 10 2 8 0 6,421 0
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 1,740 0
61 Deksametason tablet 0,5 mg tablet 640 640 50 590 0 48 0
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 2,578 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 12,749 0
64 Diazepam tablet 2 mg tablett 0 0 134 0
65 Diazepam tablet 5 mg tablet 0 0 65 0
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 104 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 1,354 0
68 Digoksin tablet 0,25 mg tablet 0 0 108 0
69 Doksisilin kapsul 100 mg Kapsul 0 0 309 0
70 Domperidom suspensi Botol 0 0 3,180 0

71 Domperidom tablet tablet 0 0 451 0 Jan

72 Efedrin HCI tablet 25 mg tablet 0 0 56 0
73 Ekstrak Belladon tablet 10 mg tablet 0 0 42 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 8,910 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 0 0 3,600 0
76 E t a n o l 70 % 100 ml Botol 4 4 1 3 0 2,625 0
77 Etil klorida semprot Botol 0 0 115,500 0
78 Eugenol cairan botol 0 0 18,333 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 1,980 0
80 Fenobarbital tablet 30 mg tablet 0 0 74 0
81 Fervital Kapsul kapsul 230 230 140 90 0 861 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 3,754 0
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 0 0 796 0
84 Foly Catheter No. 18 pcs 0 0 9,200 0
86 Furosemid tablet 40 mg tablet 0 0 84 0
87 Garam Oralit untuk 200 ml Air sak 40 40 21 19 0 274 0
88 Gentamicin inj 40mg/ml Ampul 0 0 3,545 0
89 Gentian Violet larutan 1 % Botol 0 0 3,850 0 Jan

90 Glass lonomer Cement (GC IX ) buah 0 0 434,500 0
91 Glibenklamid tablet 5 mg tablet 0 0 110 0 Des
92 Glimepiride 1 mg tablet 0 0 220 0
94 Guaiafenesin Tablet tablet 0 0 132 0 Des

95 Glukosa larutan infus 5 % steril Botol 1 1 1 0 6,900 0
96 Grisefulvin tablet 125 mg (Micronized) tablet 0 0 523 0 Des
97 Haloperidol tablet 1,5 mg tablet 0 0 76 0 Des

98 Haloperidol tablet 2 mg tablet 0 0 134 0
99 Haloperidol inj 50 mg/ml ampul 0 0 91,667 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 0 0 171 0
101 Hidrokortison krim 2,5 % tube 0 0 2,812 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 0 8,000 0
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 8,800 0 Des
106 Infusion set anak pcs 0 0 4,025 0
107 Infusion set dewasa pcs 8 8 0 8 0 3,680 0
108 Isoniazid tablet 100 mg tablet 0 0 82 0
109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 98 0
110 Kalsium Glukonat inj 10% ampul 0 0 999 0

111 Kalsium Hidroksida pasta buah 0 0 266,200 0
113 Kapas pembalut 250 gram buah 0 0 14,375 0
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 31,372 0
116 Kaptopril 12,5 mg tablet 0 0 69 0
117 Kaptopril 25 mg tablet 0 0 165 0 Des
118 Karbamazepin tablet 200 mg tablet 0 0 306 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 35 35 5 30 0 1,725 0
120 Kasa hidrofil 40 x 80 cm roll 0 0 120,750 0
121 Kasa pembalut elastis 3 inch roll 0 0 7,700 0
122 Ketokonazol krim 2% tube 0 0 6,600 0 Des
123 Ketokonazol tablet 200 mg tablet 0 0 264 0 Des
124 Kloramfenikol kapsul 250 mg Kapsul 0 0 616 0 Des
125 Kloramfenikol susp 125mg/5 ml Botol 0 0 4,000 0
126 Kloramfenikol salep mata 1 % tube 0 0 1,850 0
127 Kloramfenikol tetes mata 1 % botol 0 0 8,250 0 Des
128 Kloramfenikol salep Kulit 2% tube 0 0 3,409 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 8,250 0 Des
130 Klorfeniramin maleat tablet 4 mg tablet 0 0 45 0
131 Klorokuin tablet 150 mg tablet 0 0 112 0
132 Klorfenol Kamfer Menthol Botol 0 0 60,500 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 1,045 0
134 Klorpromazin HCI tablet salut 100 mg tablet 0 0 179 0

136 Kotrimoksazol tablet 480 mg tablet 680 680 30 650 0 158 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 8 8 2 6 0 2,225 0

138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 138 0 Jan

139 Larutan mengandung elektrolit botol 0 0 9,275 0
140 Lidokain komp. injeksi - 2 ml ampul 12 12 2 10 0 2,122 0
141 Lisol 1 liter Botol 0 0 49,200 0
142 Loperamide 2 mg tablet 0 0 90 0
143 Loratadine 10 mg tablet 0 0 149 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 1,694 0 Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 2,143 0 Des
146 Masker Kain pcs 0 506 0
147 Mata Pisau No. 15 pcs 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 3,300 0
149 Metilergometrin maleat tablet salut 0,125 mg tablet 0 0 133 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 2,684 0

151 Metilprednisolon tablet 4 mg tablet 0 0 200 0
152 Metformin Hcl 500 mg tablet 0 0 115 0
153 Metoklopramida 10 mg tablet 0 0 100 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 6,600 0 Jan

155 Metronidazol tablet 250 mg tablet 0 0 98 0
156 Metronidazol tablet 500 mg tablet 220 220 20 200 0 140 0
157 Miconazole Krim tube 0 0 3,737 0
158 Mineral Mix sak 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 3 3 0 3 eks 3 0 37,400 0 Des
160 Mummifying pasta buah 0 0 193,600 0
161 Natrium diklofenak 50 mg tablet 0 0 161 0
162 Natrium klorida larutan infus 0,9 % steril Botol 4 4 0 4 0 6,410 0
163 Nifedipin 10 mg tablet 0 0 123 0
164 Nistatin tablet vagina 100.000 IU / g ovula 0 0 602 0
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 0 704 0
166 Obat anti Tuberklosis kategori FDC I paket 0 0 413,984 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 1,317,000 0 Des
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 236,500 0
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 4,400 0 Des
170 OBH Itral Syrup Botol 0 0 16,698 0
171 Ofloksasin tablet 400 mg tablet 0 0 636 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 1,869 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 3,300 0 Des
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 0 1,900 0

175 Omeprazole 20 mg kapsul 0 0 880 0 Jan
176 Parasetamol drops Botol 4 4 2 2 0 5,980 0 Des
177 Parasetamol sirup 120 mg / 5 ml Botol 6 6 5 1 0 1,119 0 Des

178 Parasetamol tablet 500 mg tablet 939 939 220 719 0 145 0 Des
179 Pehacain injeksi botol 0 0 4,400 0 Des
180 Permetrin krim 5% tube 0 0 12,155 0
181 Pirantel pamoat tablet 125 mg tablet 0 0 318 0
182 Pirantel suspensi 10 ml botol 0 0 17,600 0 Jan
183 Pirantel suspensin 60 ml Botol 0 0 9,100 0 Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 518 518 77 441 0 136 0
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 1,030 0
186 Piroksikam 20 mg tablet 0 0 220 0 Des
187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 35,532 0
189 Pot Sputum pcs 0 0 3,190 0 Des
190 Prednison tablet 5 mg tablet 0 0 193 0 Jan

191 Primakuin tablet 15 mg tablet 0 0 120 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 9,908 0
193 Propiltiourasil tablet 100 mg tablet 0 0 320 0
194 Propranolol HCI tablet 40 mg tablet 0 0 69 0
195 Ranitidin tablet 150 mg tablet 0 0 115 0 Des
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 1,600 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 525,000 0 Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 14,344 0
199 Reagensia ZN botol 0 0 270,000 0
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 0 327 0
202 Ringer Laktat larutan infus steril Botol 7 7 0 7 0 7,150 0
203 Salbutamol tablet 2 mg tablet 0 0 99 0 Des
204 Salbutamol 4 mg tablet 0 0 88 0
205 Salep 2 - 4 kombinasi pot 0 2,797 0
206 Salisil bedak 2 % pot 0 0 0 1,066 0
207 Sarung Tangan Examination S pcs 0 0 410 0
208 Sarung Tangan Examination M pcs 0 0 410 0
209 Sarung Tangan Examination L pcs 0 0 410 0
210 Sefadroksil 500 mg kapsul 0 0 557 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 102,850 0
212 Setrizin tablet 10 mg tablet 0 0 154 0
213 Setrizin syrup Botol 0 0 7,756 0
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 0 0 58 0

215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 1,226 0
216 Simetidine 200 mg tablet 0 0 209 0 Jan

217 Simvastatin 10 mg tablet 0 0 135 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 0 20,825 0
220 Siprofloksasin tablet 500 mg tablet 0 0 298 0
221 Spironolakton tablet 100 mg tablet 0 0 878 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 3,549 0
223 Tablet tambah darah kombinasi tablet 0 327 0 Des
224 Taburia kotak 0 0 18,150 0
225 Temporary stopping (Fletcher) buah 0 0 37,400 0
226 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 162 0
228 Tiamfenikol 500 mg kapsul 0 0 1,452 0 Jan

229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 1,760 0 Jan
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 97 0
232 Umbilical Cord kotak 15 15 2 13 0 3,163 0
234 Urine Bag set 0 0 3,450 0
235 Vaksin Jerap Tetanus vial 8 8 1 7 0 14,498 0
236 Vaksin Rabies vero kuur 0 0 700,000 0
237 Vitamin B kompleks tablet tablet 982 982 62 920 0 132 0
238 Wicold kapsul kapsul 0 0 0 0 0 792 0
239 Yodium povidon larutan 10 % 60 ml Botol 0 0 7,040 0
240 Yodium povidon larutan 10 % 300 ml Botol 0 0 0 0 0 21,600 0
241 Zinc syrup Botol 0 0 8,140 0
242 Zinc Tablet tablet 100 100 0 100 eks 500 0 592 0
TOTAL 0
###
GENERIK
NON GENERIK
Jamkesda 42 126 126 PELAYANAN Jml pasien Jml R/ Jml pasien Jml R/ Jml pasien Jml R/
JKN
Lain - lain
Jamkesda
JKN
Lain - lain
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
SE
KODE PUSKESMAS :
PUSKESMAS : SIMPO NO :
KECAMATAN : BARANTI TGL :31-10-2017 BULAN OKTOBER
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set 0 0 5,203 0
5 Ansell Steril 6 1/2 psg 0 0 7,500 0
6 Ansell Steril 7 psg 0 0 7,500 0
7 Ansell Steri 7 1/2 psg 5 5 2 3 0 7,500 0
8 Alat Suntik sekali pakai 0,05 ml set 0 0 1,650 0
10 Alat suntik sekali pakai 1 ml set 0 0 748 0
13 Alat Suntik sekali pakai 10 ml set 0 0 1,064 0
14 Albendasol tablet 400 mg tablet 0 0 425 0
15 Alkohol Swab kotak 0 0 115 0
16 Alupurinol tablet 100 mg tablet 0 0 95 0
17 Allpurinol tablet 300 mg tablet 0 0 244 0
18 Ambroxol sirup 15 mg/ml Botol 0 0 5,500 0 Des
19 Ambroxol tablet tablet 0 0 216 0 Des
20 Aminofilin tablet 200 mg tablet 0 0 86 0

21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 3,349 0
22 Amitriptilin HCI tablet salut 25 mg tablet 0 0 165 0
23 Amlodipine 5 mg tablet 0 0 105 0
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 4,147 0
27 Amoksisilin kapsul 250 mg Kapsul 280 280 30 250 0 207 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 4,600 0

31 Antalgin (Metampiron) tablet 500 mg Tablet 370 370 370 0 209 0 Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 1,500 0
34 Antasida DOEN suspensi Botol 0 0 2,106 0
35 Antihemoroid DOEN kombinasi suppos 0 0 3,502 0
36 Antifungi DOEN kombinasi pot 0 0 4,782 0
37 Antibakteri DOEN salep Kombinasi tube 0 0 2,767 0
38 Antimigrain DOEN kombinasi tablet 0 0 149 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 5,800 0
41 Asam Folat tablet 0 0 68 0




76 E t a n o l 70 % 100 ml Botol 0 0 2,625 0
81 Fervital Kapsul kapsul 150 150 150 0 861 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 0 3,754 0


95 Glukosa larutan infus 5 % steril Botol 0 0 6,900 0
96 Grisefulvin tablet 125 mg (Micronized) tablet 80 80 80 100 0 523 0 Des

101 Hidrokortison krim 2,5 % tube 10 10 10 0 2,812 0
105 Ibuprofen tablet 400 mg tablet 0 0 133 0
107 Infusion set dewasa pcs 0 0 3,680 0

112 Kalsium laktat (Kalk) tablet 500 mg tablet 0 0 69 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 0 0 1,725 0
130 Klorfeniramin maleat tablet 4 mg tablet 130 130 60 70 500 0 45 0

137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 10 10 2 8 0 2,225 0 EXP


140 Lidokain komp. injeksi - 2 ml ampul 0 0 2,122 0
146 Masker Kain pcs 43 43 43 0 506 0
147 Mata Pisau No. 15 pcs 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 3,300 0


159 Multivitamin (Lycalvit) syrup botol 0 0 37,400 0 Des
162 Natrium klorida larutan infus 0,9 % steril Botol 0 0 6,410 0
170 OBH Itral Syrup Botol 3 3 3 0 10 0 16,698 0

176 Parasetamol drops Botol 0 0 5,980 0 Des

184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 270 270 60 210 300 0 136 0
187 Plester 2,5 cm x 4 m rol 1 1 1 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 35,532 0
190 Prednison tablet 5 mg tablet 190 190 70 120 200 0 193 0 Jan
202 Ringer Laktat larutan infus steril Botol 0 0 7,150 0
205 Salep 2 - 4 kombinasi pot 0 0 2,797 0
206 Salisil bedak 2 % pot 5 5 5 0 1,066 0


223 Tablet tambah darah kombinasi tablet 0 0 327 0 Des

232 Umbilical Cord kotak 0 0 3,163 0
233 U-Pad steril 60 cm x 90 cm pcs 0 0 8,770 0
234 Urine Bag set 0 0 3,450 0
235 Vaksin Jerap Tetanus vial 0 0 14,498 0
242 Zinc Tablet tablet 0 0 592 0

TOTAL 0
###
Jamkesda 27 41
JKN 23 67
Jamkesda
JKN
Lain - lain
TOTAL 50 TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
EXP
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
(LPLPO)
KECAMATAN : BARANTI TGL : BULAN 12
PROVINSI : SULAWESI SELATAN
TAAN DAK/11 DAK/12 DAK/13 DAK/14 DAK/15 DAK/16 DAK/17 BANTUAN PROGRAM
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
5 Ansell Steril 6 1/2 psg 300 0 300 0 300 300 300 7333.7 2,200,110
6 Ansell Steril 7 psg 172 0 172 8 164 164 164 7333.7 1,202,727
7 Ansell Steri 7 1/2 psg 174 0 174 7 167 167 167 7333.7 1,224,728
8 Alat Suntik sekali pakai 0,05 ml set 900 0 900 0 900 900 900 1517.72307 1,365,951
9 Alat Suntik sekali pakai 0,5 ml set 75 0 75 8 67 67 67 1374,375 92,083,125
10 Alat suntik sekali pakai 1 ml set 5,396 0 5,396 43 5,353 5,353 5,353 748 4,004,044
12 Alat suntik sekali pakai 5 ml set 1,039 0 1,039 14 1,025 1,025 1,025 863 884,575
15 Alkohol Swab kotak 200 0 200 0 200 200 200 114.95 22,990
16 Alupurinol tablet 100 mg tablet 1,545 0 1,545 110 1,435 1,435 1,435 95 136,325
17 Allpurinol tablet 300 mg tablet 0 0 0 0 0 0 0 244 0
18 Ambroxol sirup 15 mg/ml Botol 71 0 71 4 67 67 67 5,500 368,500
19 Ambroxol tablet tablet 0 0 0 0 0 0 5,000 0 216 0

22 Amitriptilin HCI tablet salut 25 mg tablet 1,000 0 1,000 0 1,000 1,000 1,000 165 165,000
23 Amlodipine 5 mg tablet 1,470 0 1,470 326 1,144 1,144 1,144 90 102,960

27 Amoksisilin kapsul 250 mg Kapsul 4,090 0 4,090 510 3,580 3,580 3,580 207 741,060
28 Amoksisilin kaplet 500 mg kaplet 33,464 0 33,464 4550 28,914 28,914 28,914 233 6,736,962
31 Antalgin (Metampiron) tablet 500 mg Tablet 1,570 0 1,570 0 1,570 1,570 1,570 209 328,130
33 Antasida DOEN tablet kombinasi tablet 14,028 0 14,028 1319 12,709 12,709 12,709 59 749,831
35 Antihemoroid DOEN kombinasi suppos 61 0 61 22 39 39 39 3,502 136,578
36 Antifungi DOEN kombinasi pot 24 0 24 24 0 0 0 4,782 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 21,653 0 21,653 5697 15,956 15,956 15,956 120 1,914,720
41 Asam Folat tablet 1,290 0 1,290 245 1,045 1,045 500 1,045 68 71,060
42 Asam Mefenamat tablet 500 mg tablet 15,164 0 15,164 2369 12,795 12,795 12,795 102 1,305,090
45 Asiklovir krim 5% tablet 9 0 9 8 1 1 25 1 3,960 3,960
47 Attalpulgit tablet 0 0 0 0 0 0 0 173 0

53 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 0 1,210 0
54 Betametason krim 0.1 % tube 247 0 247 2 245 245 245 1,435 351,575
55 Bisakodil 5 mg supp suppos 6 0 6 0 6 6 6 5,670 34,020
56 Bisakodil 10 mg supp suppos 6 0 6 6 0 0 0 5,800 0
57 Blood Lancet 26G kotak 300 0 300 0 300 300 300 167.42 50,226
59 Catgut/benang bedah no .3/0 pcs 196 0 196 22 174 174 174 7929,16666 #VALUE!
61 Deksametason tablet 0,5 mg tablet 10,334 0 10,334 1782 8,552 8,552 8,552 45 384,840
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 0 0 2,578 0
63 Diazepam rectal 5mg/2,5 ml buah 3 0 3 0 3 3 3 12,749 38,247
64 Diazepam tablet 2 mg tablett 0 0 0 0 0 0 0 134 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 30 0 30 0 30 30 30 1,354 40,620
70 Domperidom suspensi Botol 61 0 61 13 48 48 48 3,180 152,640
71 Domperidom tablet tablet 652 0 652 0 652 652 652 133 0
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 0 0 0 0 42 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 0 0 8,910 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 16 0 16 1 15 15 15 3,600 54,000
76 E t a n o l 70 % 100 ml Botol 121 0 121 23 98 98 98 2,625 257,250
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0 0 0 2,265 0
81 Fervital Kapsul kapsul 2,315 0 2,315 110 2,205 2,205 1,000 2,205 860.64 1,897,711

86 Furosemid tablet 40 mg tablet 369 0 369 55 314 314 314 91 28,574
87 Garam Oralit untuk 200 ml Air sak 1,273 0 1,273 161 1,112 1,112 1,112 274 304,688
88 Gentamicin inj 40mg/ml Ampul 25 0 25 0 25 25 25 3,545 88,625
89 Gentian Violet larutan 1 % Botol 5 0 5 0 5 5 5 3,850 19,250
91 Glibenklamid tablet 5 mg tablet 2,505 0 2,505 30 2,475 2,475 2,475 110 272,250
92 Glimepiride 1 mg tablet 74 0 74 74 0 0 0 220 0
94 Guaiafenesin Tablet tablet 11,026 0 11,026 2418 8,608 8,608 10,000 8,608 132 1,136,256
96 Grisefulvin tablet 125 mg (Micronized) tablet 1,390 0 1,390 470 920 920 920 263 241,960
97 Haloperidol tablet 1,5 mg tablet 400 0 400 400 0 0 500 0 74 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 1,116 0 1,116 0 1,116 1,116 1,116 171 190,836
104 Ibuprofen tablet 200 mg tablet 18,917 0 18,917 1057 17,860 17,860 17,860 111 1,982,460
106 Infusion set anak pcs 152 0 152 12 140 140 140 2913.3 407,862
107 Infusion set dewasa pcs 453 0 453 20 433 433 433 6622,2 #VALUE!
110 Kalsium Glukonat inj 10% ampul 0 0 0 0 0 0 0 9,955 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 10,490 0 10,490 1570 8,920 8,920 8,920 69 615,480
113 Kapas pembalut 250 gram buah 14 0 14 2 12 12 12 14,366 172,392
116 Kaptopril 12,5 mg tablet 4,990 0 4,990 103 4,887 4,887 4,887 69 337,203
117 Kaptopril 25 mg tablet 5,722 0 5,722 627 5,095 5,095 5,095 86 438,170
118 Karbamazepin tablet 200 mg tablet 2,000 0 2,000 10 1,990 1,990 1,990 306 608,940
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1,224 0 1,224 74 1,150 1,150 1,150 1723.7 1,982,255
122 Ketokonazol krim 2% tube 102 0 102 15 87 87 87 2,790 242,730
123 Ketokonazol tablet 200 mg tablet 340 200 540 0 540 540 540 264 142,560
124 Kloramfenikol kapsul 250 mg Kapsul 0 0 0 0 0 0 0 616 0
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 0 1,850 0
128 Kloramfenikol salep Kulit 2% tube 0 0 0 0 0 0 0 3,409 0
129 Kloramfenikol tetes telinga 3 % Botol 11 0 11 0 11 11 11 8,250 90,750
130 Klorfeniramin maleat tablet 4 mg tablet 12,565 0 12,565 1280 11,285 11,285 5,000 11,285 45 507,825
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 30 0 30 1 29 29 29 1,425 41,325
134 Klorpromazin HCI tablet salut 100 mg tablet 0 0 0 0 0 0 0 179 0
136 Kotrimoksazol tablet 480 mg tablet 8,670 0 8,670 664 8,006 8,006 8,006 158 1,264,948
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 142 0 142 14 128 128 128 2,225 284,800
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 0 390 0 390 390 390 137.5 53,625
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 0 0 0 1,694 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 6 0 6 0 6 6 6 3,650 21,900
146 Masker Kain pcs 802 0 802 363 439 439 500 439 805 353,395
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 90 0 90 90 0 0 0 2,684 0
151 Metilprednisolon tablet 4 mg tablet 780 400 1,180 0 1,180 1,180 1,180 200 236,000
152 Metformin Hcl 500 mg tablet 1,348 0 1,348 200 1,148 1,148 1,148 115 132,020
153 Metoklopramida 10 mg tablet 590 0 590 290 300 300 500 300 100 30,000
154 Metoklopramida injeksi 5 mg / ml vial 22 0 22 200 -178 -178 -178 3,904 -694,912
156 Metronidazol tablet 500 mg tablet 5,064 0 5,064 1136 3,928 3,928 5,000 3,928 140 549,920
157 Miconazole Krim tube 38 0 38 11 27 27 27 3,737 100,899
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0
159 Multivitamin (Lycalvit) syrup botol 13 0 13 9 4 4 4 37,400 149,600 EXP
161 Natrium diklofenak 50 mg tablet 2,900 0 2,900 422 2,478 2,478 2,478 161 398,958
162 Natrium klorida larutan infus 0,9 % steril Botol 186 0 186 35 151 151 151 6,410 967,910
163 Nifedipin 10 mg tablet 310 0 310 10 300 300 300 123 36,900
166 Obat anti Tuberklosis kategori FDC I paket 4 0 4 4 0 0 0 413,984 0
167 Obat anti Tuberklosis kategori FDC 2 paket 1 0 1 0 1 1 1 1,379,984 1,379,984
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0 0 4,400 0

172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0 0 0 0 1,869 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 0 0 0 3,300 0
175 Omeprazole 20 mg kapsul 300 0 300 150 150 150 300 150 148 0
176 Parasetamol drops Botol 114 0 114 27 87 87 87 5,980 520,260
177 Parasetamol sirup 120 mg / 5 ml Botol 25 0 25 11 14 14 14 1,119 15,666
178 Parasetamol tablet 500 mg tablet 27,567 0 27,567 7975 19,592 19,592 10,000 19,592 58 1,136,336
179 Pehacain injeksi botol 165 0 165 76 89 89 89 4,400 391,600
181 Pirantel pamoat tablet 125 mg tablet 271 0 271 20 251 251 251 318 79,818
182 Pirantel suspensi 10 ml botol 4 0 4 4 0 0 0 17,600 0
183 Pirantel suspensin 60 ml Botol 0 0 0 0 0 0 0 9,100 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 9,003 0 9,003 2398 6,605 6,605 5,000 6,605 136 898,280
186 Piroksikam 20 mg tablet 0 0 0 0 0 0 0 220 0
187 Plester 2,5 cm x 4 m rol 22 0 22 0 22 22 22 12,076 265,672
188 Plester 7,5 cm x 4 m rol 17 0 17 2 15 15 15 35,532 532,980
189 Pot Sputum pcs 58 0 58 18 40 40 40 3137.2 0
190 Prednison tablet 5 mg tablet 10,360 0 10,360 1557 8,803 8,803 8,803 85 748,255
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 0 0 0 0 9,908 0
193 Propiltiourasil tablet 100 mg tablet 10 0 10 10 0 0 500 0 320 0
195 Ranitidin tablet 150 mg tablet 4,882 0 4,882 892 3,990 3,990 3,990 115 458,850
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0 0 525,000 0
199 Reagensia ZN botol 0 0 0 0 0 0 0 276,600 0
202 Ringer Laktat larutan infus steril Botol 337 0 337 95 242 242 100 242 7,150 1,730,300
203 Salbutamol tablet 2 mg tablet 1,508 0 1,508 150 1,358 1,358 1,358 68 92,344
205 Salep 2 - 4 kombinasi pot 107 0 107 5 102 102 102 2,797 285,294
206 Salisil bedak 2 % pot 204 0 204 90 114 114 114 1,066 121,524
207 Sarung Tangan Examination S pcs 63 300 363 0 363 363 363 531.3 192,862
208 Sarung Tangan Examination M pcs 1,500 0 1,500 1100 400 400 400 531.3 212,520
209 Sarung Tangan Examination L pcs 1,090 0 1,090 110 980 980 980 531.3 520,674
210 Sefadroksil 500 mg kapsul 1,232 0 1,232 186 1,046 1,046 1,046 557 582,622
212 Setrizin tablet 10 mg tablet 0 0 0 0 0 0 1,000 0 154 0
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 4,295 0 4,295 439 3,856 3,856 3,856 58 223,648
216 Simetidine 200 mg tablet 2,000 0 2,000 0 2,000 2,000 2,000 209 418,000
217 Simvastatin 10 mg tablet 1,170 0 1,170 200 970 970 970 135 130,950
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 46 0 46 8 38 38 100 38 4124.8366 156,744
220 Siprofloksasin tablet 500 mg tablet 1,827 0 1,827 120 1,707 1,707 1,707 298 508,686
223 Tablet tambah darah kombinasi tablet 3,663 0 3,663 1900 1,763 1,763 5,000 1,763 410 722,830
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
228 Tiamfenikol 500 mg kapsul 360 0 360 0 360 360 360 1,452 522,720
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 30 0 30 0 30 30 30 1,760 52,800
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 12,225 0 12,225 3155 9,070 9,070 10,000 9,070 91 825,370
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 0 0 0 0 97 0
232 Umbilical Cord kotak 212 0 212 8 204 204 204 1494.9 304,960
233 U-Pad steril 60 cm x 90 cm pcs 90 0 90 10 80 80 30 80 8768.1 701,448
234 Urine Bag set 16 0 16 1 15 15 15 3,432 51,480
236 Vaksin Rabies vero kuur 0 0 0 0 0 0 10 0 174499,6 #VALUE!

237 Vitamin B kompleks tablet tablet 38,753 0 38,753 2228 36,525 36,525 36,525 132 4,821,300
239 Yodium povidon larutan 10 % 60 ml Botol 32 0 32 2 30 30 30 4438.5 133,155
241 Zinc syrup Botol 30 0 30 0 30 30 30 16,478 494,340
242 Zinc Tablet tablet 3,519 0 3,519 180 3,339 3,339 3,339 592 1,976,688
243 Paper Tape 2,5 x 9,14 Rol 4 0 4 0 4 4 4 9372.5 37,490
244 Paper Tape 7,5 x 9,14 Rol 2 0 2 0 2 2 2 25127,5 50,255
245 Zidovudine 150 mg Btl 1,700 0
246 Lomivudine 150 mg Btl 4,255 0
247 Efavirenz 600 mg Btl 7,331 0
248 Nepirapine 200 mg Btl 3,080 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 3,058 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 11894.3 0
251 TenoFovir 300 mg Btl 6,475 0
252 Tenof EM Btl 12,449 0
253 Samcobion Tablet 4,480 0 4,480 180 4,300 4,300 4,300 989.659 4,255,534
254 Spironolakton tablet 25 mg Tablet 314 0
255 Lytacur Sirup Btl 14,300 0
256 Susu Produgen Kotak 40,700 0
TOTAL 88,998,322
jumlah resep
Jamkesda PELAYANAN Jml pasien Jml R/ Jml pasien Jml R/ Jml pasien Jml R/
JKN pustu simpo
Lain - lain pustu tonrong
pustu trong rijang
Jamkesda pkesdes baranti
JKN pkesdes passeno
Lain - lain pkesdes trong
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
TAAN DAK/11 DAK/12 DAK/13 DAK/14 DAK/15 DAK/16 DAK/17 BANTUANPROGRAM
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
3 IV Catheter Gea No. 22 set 131 0 131 119 12 12 12 7,076 84,912
5 Ansell Steril 6 1/2 psg -80 0 -80 99 -179 -179 -179 7333.7 -1,312,732
6 Ansell Steril 7 psg 51 0 51 90 -39 -39 -39 7333.7 -286,014
7 Ansell Steri 7 1/2 psg 324 0 324 107 217 217 217 7333.7 1,591,413
8 Alat Suntik sekali pakai 0,05 ml set 500 0 500 100 400 400 400 1517.72307 607,089
9 Alat Suntik sekali pakai 0,5 ml set 8 0 8 15 -7 -7 -7 1374,375 -9,620,625
11 Alat suntik sekali pakai 3 ml set 802 0 802 80 722 722 722 748 540,056
18 Ambroxol sirup 15 mg/ml Botol 0 0 0 0 0 0 0 5,500 0
19 Ambroxol tablet tablet -1 0 -1 0 -1 -1 -1 216 -216

21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 0 0 0 0 3,349 0
24 Amlodipine 10 mg tablet -5 0 -5 5 -10 -10 -10 163 -1,630
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 0 0 0 4,147 0
27 Amoksisilin kapsul 250 mg Kapsul 1,670 0 1,670 1010 660 660 660 207 136,620
30 Anagens Syrup Botol 5 0 5 5 0 0 0 19,800 0
31 Antalgin (Metampiron) tablet 500 mg Tablet -40 0 -40 0 -40 -40 -40 209 -8,360
34 Antasida DOEN suspensi Botol 127 0 127 43 84 84 84 2,098 176,232
40 Asam Askorbat (Vit C) tablet 50 mg tablet 9,301 0 9,301 9275 26 26 26 120 3,120
42 Asam Mefenamat tablet 500 mg tablet 7,423 0 7,423 2545 4,878 4,878 4,878 102 497,556
45 Asiklovir krim 5% tablet 0 0 0 0 0 0 0 3,960 0

57 Blood Lancet 26G kotak 0 0 0 0 0 0 0 167.42 0
58 Catgut/benang bedah no .2/0 pcs -5 0 -5 0 -5 -5 -5 7928,333 -39,641,665
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 10 0 10 0 10 10 10 1,913 19,130
71 Domperidom tablet tablet 500 0 500 0 500 500 500 133 66,500
76 E t a n o l 70 % 100 ml Botol 123 0 123 2 121 121 121 2,625 317,625
81 Fervital Kapsul kapsul 180 0 180 0 180 180 180 860.64 154,915

94 Guaiafenesin Tablet tablet 7,675 0 7,675 4255 3,420 3,420 3,420 132 451,440
95 Glukosa larutan infus 5 % steril Botol 215 0 215 0 215 215 215 6,900 1,483,500
96 Grisefulvin tablet 125 mg (Micronized) tablet 3,190 0 3,190 115 3,075 3,075 3,075 263 808,725
97 Haloperidol tablet 1,5 mg tablet 2,000 0 2,000 0 2,000 2,000 2,000 74 148,000
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 494 0 494 0 494 494 494 171 84,474
103 Ibuprofen suspensi 200 mg/5 ml Botol -1 0 -1 1 -2 -2 -2 8,800 -17,600
104 Ibuprofen tablet 200 mg tablet 9,705 0 9,705 1105 8,600 8,600 8,600 111 954,600
108 Isoniazid tablet 100 mg tablet -115 0 -115 90 -205 -205 -205 82 -16,810
114 Kapas pembalut / Absorben 500 gram bungkus -1 0 -1 2 -3 -3 -3 31,372 -94,116
117 Kaptopril 25 mg tablet 2,033 0 2,033 2050 -17 -17 -17 80 -1,360
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 729 0 729 27 702 702 702 1723.7 1,210,037
122 Ketokonazol krim 2% tube 8 0 8 17 -9 -9 -9 2,790 -25,110
130 Klorfeniramin maleat tablet 4 mg tablet 9,917 0 9,917 420 9,497 9,497 9,497 45 427,365
136 Kotrimoksazol tablet 480 mg tablet 2,542 0 2,542 1589 953 953 953 158 150,574
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 0 390 0 390 390 390 137.5 53,625 Exp
140 Lidokain komp. injeksi - 2 ml ampul 35 0 35 185 -150 -150 35 2,122 74,270
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0 0 0 0 0 3,650 0
146 Masker Kain pcs 1,758 0 1,758 637 1,121 1,121 1,121 506 567,226
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
149 Metilergometrin maleat tablet salut 0,125 mg tablet 500 0 500 0 500 500 500 245 122,500
151 Metilprednisolon tablet 4 mg tablet 1,220 0 1,220 60 1,160 1,160 1,160 139 161,240
153 Metoklopramida 10 mg tablet -23 0 -23 84 -107 -107 -107 100 -10,700
154 Metoklopramida injeksi 5 mg / ml vial 47 0 47 0 47 47 47 3,904 183,488
155 Metronidazol tablet 250 mg tablet 440 0 440 80 360 360 360 98 35,280
156 Metronidazol tablet 500 mg tablet 1,803 0 1,803 747 1,056 1,056 1,056 140 147,840
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0
159 Multivitamin (Lycalvit) syrup botol -1 0 -1 0 -1 -1 -1 37,400 -37,400 EXP
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 0 0 1,379,984 0
170 OBH Itral Syrup Botol 0 0 0 0 0 0 0 16,698 0

171 Ofloksasin tablet 400 mg tablet 100 0 100 0 100 100 100 636 63,600
175 Omeprazole 20 mg kapsul -60 0 -60 30 -90 -90 -90 148 -13,320
176 Parasetamol drops Botol 0 0 0 0 0 0 0 5,980 0
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 0 0 0 0 1,119 0
178 Parasetamol tablet 500 mg tablet 33,003 0 33,003 12149 20,854 20,854 20,854 58 1,209,532
179 Pehacain injeksi botol 0 0 0 0 0 0 0 4,400 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 13,672 0 13,672 2813 10,859 10,859 10,859 136 1,476,824
187 Plester 2,5 cm x 4 m rol 15 0 15 5 10 10 10 12,076 120,760
188 Plester 7,5 cm x 4 m rol 18 0 18 1 17 17 17 35,532 604,044
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial -3 0 -3 0 -3 -3 -3 9,908 -29,724
193 Propiltiourasil tablet 100 mg tablet 0 0 0 0 0 0 0 320 0
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 0 0 0 0 1,600 0
202 Ringer Laktat larutan infus steril Botol 209 0 209 78 131 131 131 7,150 936,650
203 Salbutamol tablet 2 mg tablet 166 0 166 149 17 17 17 68 1,156

207 Sarung Tangan Examination S pcs 0 0 0 0 0 0 0 531.3 0
208 Sarung Tangan Examination M pcs 0 0 0 0 0 0 0 531.3 0
209 Sarung Tangan Examination L pcs 0 0 0 0 0 0 0 496,1 #VALUE!

210 Sefadroksil 500 mg kapsul 660 0 660 60 600 600 600 557 334,200
212 Setrizin tablet 10 mg tablet 1,000 0 1,000 0 1,000 1,000 1,000 154 154,000
213 Setrizin syrup Botol -24 0 -24 0 -24 -24 -24 7,756 -186,144
217 Simvastatin 10 mg tablet 1,800 0 1,800 0 1,800 1,800 1,800 135 243,000
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 84 0 84 0 84 84 84 4124.8366 346,486
223 Tablet tambah darah kombinasi tablet 17,034 0 17,034 940 16,094 16,094 16,094 410 6,598,540
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul -320 0 -320 0 -320 -320 -320 1,760 -563,200
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 3,771 0 3,771 560 3,211 3,211 3,211 91 292,201
233 U-Pad steril 60 cm x 90 cm pcs 7 0 7 0 7 7 7 8.769,9 #VALUE!
234 Urine Bag set 9 0 9 0 9 9 9 3,432 30,888
235 Vaksin Jerap Tetanus vial 0 0 0 0 0 0 0 14,498 0
236 Vaksin Rabies vero kuur -300 0 -300 0 -300 -300 -300 174499,6 #VALUE!
238 Wicold kapsul kapsul 0 0 0 0 0 0 0 792 0
240 Yodium povidon larutan 10 % 300 ml Botol 13 0 13 0 13 13 13 21,593 280,709 EXP
241 Zinc syrup Botol 13 0 13 0 13 13 13 16,478 214,214
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 0 5 5 5 9372.5 46,863
244 Paper Tape 7,5 x 9,14 Rol 2 0 2 0 2 2 2 25127,5 #VALUE!
245 Zidovudine 150 mg Btl 0 0 0 1,700 0
246 Lomivudine 150 mg Btl 0 0 0 4,255 0
247 Efavirenz 600 mg Btl 0 0 0 7,331 0
248 Nepirapine 200 mg Btl 0 0 0 3,080 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0 3,058 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0 11894.3 0
251 TenoFovir 300 mg Btl 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 12,449 0
253 Samcobion Tablet 0 0 0 0 0 0 0 989.659 0
254 Spironolakton tablet 25 mg Tablet 0 0 0 314 0
255 Lytacur Sirup Btl 120 0 0 0 120 14,300 1,716,000
256 Susu Produgen Kotak 0 0 0 40,700 0
TOTAL 4,346,717
jumlah resep
JKN pustu simpo

pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
5 Ansell Steril 6 1/2 psg 23 0 23 103 -80 -80 -80 7333.7 -586,696
6 Ansell Steril 7 psg 132 0 132 81 51 51 51 7333.7 374,019
7 Ansell Steri 7 1/2 psg 438 0 438 114 324 324 324 7333.7 2,376,119
16 Alupurinol tablet 100 mg tablet 0 2000 2,000 0 2,000 2,000 2,000 95 190,000
19 Ambroxol tablet tablet -1 0 -1 0 -1 -1 -1 216 -216

24 Amlodipine 10 mg tablet 0 0 0 5 -5 -5 -5 163 -815
31 Antalgin (Metampiron) tablet 500 mg Tablet -20 0 -20 20 -40 -40 -40 209 -8,360

76 E t a n o l 70 % 100 ml Botol 127 0 127 4 123 123 123 2,625 322,875

94 Guaiafenesin Tablet tablet 2,092 10000 12,092 4417 7,675 7,675 7,675 132 1,013,100
97 Haloperidol tablet 1,5 mg tablet 0 2000 2,000 0 2,000 2,000 2,000 74 148,000
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 1 -1 -1 -1 8,800 -8,800
114 Kapas pembalut / Absorben 500 gram bungkus 1 0 1 2 -1 -1 -1 31,372 -31,372
116 Kaptopril 12,5 mg tablet 140 5000 5,140 293 4,847 4,847 4,847 69 334,443
120 Kasa hidrofil 40 x 80 cm roll 2 10 12 3 9 9 9 120,750 1,086,750
136 Kotrimoksazol tablet 480 mg tablet 3,771 0 3,771 1229 2,542 2,542 2,542 158 401,636
146 Masker Kain pcs 401 2000 2,401 643 1,758 1,758 1,758 506 889,548
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
152 Metformin Hcl 500 mg tablet 1,235 0 1,235 529 706 706 706 115 81,190
153 Metoklopramida 10 mg tablet 61 0 61 84 -23 -23 -23 100 -2,300
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0 1 -1 -1 -1 37,400 -37,400 EXP

175 Omeprazole 20 mg kapsul -30 0 -30 30 -60 -60 -60 148 -8,880
182 Pirantel suspensi 10 ml botol 10 0 10 5 5 5 5 17,600 88,000
187 Plester 2,5 cm x 4 m rol 21 0 21 6 15 15 15 12,076 181,140
188 Plester 7,5 cm x 4 m rol -1 20 19 1 18 18 18 35,532 639,576
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
190 Prednison tablet 5 mg tablet 435 5000 5,435 457 4,978 4,978 4,978 85 423,130
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial -3 0 -3 0 -3 -3 -3 9,908 -29,724


212 Setrizin tablet 10 mg tablet 0 1000 1,000 0 1,000 1,000 1,000 154 154,000
213 Setrizin syrup Botol 26 0 26 50 -24 -24 -24 7,756 -186,144
217 Simvastatin 10 mg tablet 0 1800 1,800 0 1,800 1,800 1,800 135 243,000
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 30 0 30 350 -320 -320 -320 1,760 -563,200
234 Urine Bag set 9 0 9 0 9 9 9 3,432 30,888
236 Vaksin Rabies vero kuur 0 0 0 300 -300 -300 -300 174499,6 #VALUE!
241 Zinc syrup Botol 13 0 13 0 13 13 13 16,478 214,214
242 Zinc Tablet tablet 1,210 0 1,210 360 850 850 850 592 503,200
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 0 5 5 5 9372.5 46,863
247 Efavirenz 600 mg Btl 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 12,449 0
TOTAL 16,478,921
jumlah resep
JKN pustu simpo

pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
5 Ansell Steril 6 1/2 psg 120 0 120 97 23 23 23 7333.7 168,675
7 Ansell Steri 7 1/2 psg 551 0 551 113 438 438 438 7333.7 3,212,161
16 Alupurinol tablet 100 mg tablet 0 0 0 0 0 0 0 95 0
19 Ambroxol tablet tablet 0 0 0 1 -1 -1 -1 216 -216

31 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 0 20 -20 -20 -20 209 -4,180

58 Catgut/benang bedah no .2/0 pcs 0 0 0 5 -5 -5 -5 7928,333 -39,641,665
76 E t a n o l 70 % 100 ml Botol 131 0 131 4 127 127 127 2,625 333,375

97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 0 0 74 0
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 0 0 0 0 8,800 0
108 Isoniazid tablet 100 mg tablet 65 0 65 90 -25 -25 -25 82 -2,050
116 Kaptopril 12,5 mg tablet 393 0 393 253 140 140 140 69 9,660
146 Masker Kain pcs 1,033 0 1,033 632 401 401 401 506 202,906
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 0 37,400 0 EXP

175 Omeprazole 20 mg kapsul 0 0 0 30 -30 -30 -30 148 -4,440
178 Parasetamol tablet 500 mg tablet 24,239 0 24,239 12462 11,777 11,777 11,777 58 683,066
187 Plester 2,5 cm x 4 m rol 25 0 25 4 21 21 21 12,076 253,596
188 Plester 7,5 cm x 4 m rol 0 0 0 1 -1 -1 -1 35,532 -35,532
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
190 Prednison tablet 5 mg tablet 972 0 972 537 435 435 435 85 36,975
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 3 -3 -3 -3 9,908 -29,724


224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 12 0 12 3 9 9 9 3,432 30,888
236 Vaksin Rabies vero kuur 0 0 0 0 0 0 0 174499,6 #VALUE!

241 Zinc syrup Botol 13 0 13 0 13 13 13 16,478 214,214
242 Zinc Tablet tablet 1,260 0 1,260 50 1,210 1,210 1,210 592 716,320
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 0 5 5 5 9372.5 46,863
247 Efavirenz 600 mg Btl 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 12,449 0
TOTAL 64,118,466
jumlah resep
JKN pustu simpo

pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 566 0 566 15 551 551 551 7333.7 4,040,869
11 Alat suntik sekali pakai 3 ml set 1,385 0 1,385 442 943 943 943 748 705,364
19 Ambroxol tablet tablet 0 0 0 0 0 0 0 216 0

31 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 0 0 0 0 0 209 0
35 Antihemoroid DOEN kombinasi suppos 28 0 28 28 28 28 3,502 98,056

76 E t a n o l 70 % 100 ml Botol 135 0 135 4 131 131 131 2,625 343,875

87 Garam Oralit untuk 200 ml Air sak 91 1000 1,091 307 784 784 784 275 215,600
97 Haloperidol tablet 1,5 mg tablet 1,100 0 1,100 1100 0 0 0 74 0
108 Isoniazid tablet 100 mg tablet 90 0 90 25 65 65 65 82 5,330
116 Kaptopril 12,5 mg tablet 3,380 0 3,380 2987 393 393 393 69 27,117
121 Kasa pembalut elastis 3 inch roll 7 7 0 7 7 7 7,700 53,900
146 Masker Kain pcs 90 1000 1,090 57 1,033 1,033 1,033 506 522,698
147 Mata Pisau No. 15 pcs 84 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
151 Metilprednisolon tablet 4 mg tablet 640 1000 1,640 300 1,340 1,340 1,340 139 186,260
152 Metformin Hcl 500 mg tablet 500 2000 2,500 736 1,764 1,764 1,764 115 202,860
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0
162 Natrium klorida larutan infus 0,9 % steril Botol 186 186 20 166 166 166 6,410 1,064,060

175 Omeprazole 20 mg kapsul 90 0 90 90 0 0 0 148 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 477 14000 14,477 2132 12,345 12,345 12,345 136 1,678,920
187 Plester 2,5 cm x 4 m rol 25 0 25 0 25 25 25 12,076 301,900
188 Plester 7,5 cm x 4 m rol 1 0 1 1 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
190 Prednison tablet 5 mg tablet 395 3000 3,395 2423 972 972 972 85 82,620
195 Ranitidin tablet 150 mg tablet 60 5000 5,060 468 4,592 4,592 4,592 115 528,080

209 Sarung Tangan Examination L pcs 40 0 40 40 0 0 0 531.3 0

210 Sefadroksil 500 mg kapsul 0 1000 1,000 247 753 753 753 557 419,421
212 Setrizin tablet 10 mg tablet 0 1000 1,000 540 460 460 460 154 70,840
223 Tablet tambah darah kombinasi tablet 0 21600 21,600 710 20,890 20,890 20,890 410 8,564,900
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 12 0 12 0 12 12 12 3,432 41,184

241 Zinc syrup Botol 26 0 26 13 13 13 13 16,478 214,214
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 0 5 5 5 9372.5 46,863
247 Efavirenz 600 mg Btl 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 12,449 0
TOTAL 78,028,596
jumlah resep
JKN pustu simpo

pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 646 0 646 80 566 566 566 7333.7 4,150,874
9 Alat Suntik sekali pakai 0,5 ml set 26 0 26 1 25 25 1,000 25 1374,375 34,359,375
16 Alupurinol tablet 100 mg tablet 40 0 40 0 40 40 5,000 40 95 3,800
18 Ambroxol sirup 15 mg/ml Botol 2 0 2 1 1 1 200 1 5,500 5,500

23 Amlodipine 5 mg tablet 0 0 0 0 0 0 10,000 0 90 0

27 Amoksisilin kapsul 250 mg Kapsul 2,160 0 2,160 400 1,760 1,760 1,000 1,760 207 364,320
28 Amoksisilin kaplet 500 mg kaplet 15,574 0 15,574 4950 10,624 10,624 50,000 10,624 233 2,475,392
33 Antasida DOEN tablet kombinasi tablet 5,105 0 5,105 1572 3,533 3,533 5,000 3,533 59 208,447
34 Antasida DOEN suspensi Botol 50 0 50 50 0 0 200 0 2,106 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 11,801 0 11,801 4119 7,682 7,682 10,000 7,682 120 921,840
41 Asam Folat tablet 80 0 80 60 20 20 1,000 20 68 1,360
42 Asam Mefenamat tablet 500 mg tablet 4,578 0 4,578 1340 3,238 3,238 10,000 3,238 102 330,276

63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0 0 0 0 12,749 0
76 E t a n o l 70 % 100 ml Botol 135 0 135 0 135 135 135 2,625 354,375
81 Fervital Kapsul kapsul 420 0 420 190 230 230 5,000 230 860.64 197,947
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 100 0 100 6 94 94 300 94 796 74,824
84 Foly Catheter No. 18 pcs 0 0 0 0 0 0 10 0 13,970 0
85 Foly Catheter No. 20 pcs 0 0 0 3 -3 -3 10 -3 13,970 -41,910

95 Glukosa larutan infus 5 % steril Botol 66 0 66 53 13 13 200 13 6,900 89,700
101 Hidrokortison krim 2,5 % tube 71 0 71 6 65 65 200 65 2,812 182,780
120 Kasa hidrofil 40 x 80 cm roll 1 0 1 1 0 0 0 120,736 0
135 Klorpromazin HCI tablet salut 25 mg tablet -40 0 -40 0 -40 -40 -40 170 -6,800
146 Masker Kain pcs 593 0 593 503 90 90 90 805 72,450
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
151 Metilprednisolon tablet 4 mg tablet 100 0 100 100 0 0 0 200 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0 0 0 0 3,904 0
157 Miconazole Krim tube 0 0 0 0 0 0 0 3,737 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0
161 Natrium diklofenak 50 mg tablet 2,030 0 2,030 1190 840 840 840 161 135,240
162 Natrium klorida larutan infus 0,9 % steril Botol 193 0 193 7 186 186 186 6,410 1,192,260

175 Omeprazole 20 mg kapsul 90 0 90 30 60 60 60 148 8,880
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 3,348 0 3,348 2871 477 477 477 136 64,872
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 100 0 100 0 100 100 10,000 100 1,040 104,000
187 Plester 2,5 cm x 4 m rol 25 0 25 0 25 25 25 12,076 301,900
188 Plester 7,5 cm x 4 m rol 8 0 8 7 1 1 20 1 35,532 35,532
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
190 Prednison tablet 5 mg tablet 1,335 0 1,335 940 395 395 395 85 33,575
195 Ranitidin tablet 150 mg tablet 830 0 830 560 270 270 5,000 270 115 31,050
202 Ringer Laktat larutan infus steril Botol 72 0 72 72 0 0 400 0 7,150 0

207 Sarung Tangan Examination S pcs 32 0 32 4 28 28 1,000 28 531.3 14,876
208 Sarung Tangan Examination M pcs 0 0 0 0 0 0 1,000 0 531.3 0
209 Sarung Tangan Examination L pcs 66 0 66 6 60 60 1,000 60 531.3 31,878

210 Sefadroksil 500 mg kapsul 89 0 89 0 89 89 1,000 89 557 49,573
211 Semen seng fosfat serbuk dan cairan buah -10 0 -10 0 -10 -10 -10 102,850 -1,028,500
212 Setrizin tablet 10 mg tablet 345 0 345 0 345 345 1,000 345 154 53,130
223 Tablet tambah darah kombinasi tablet 2,210 0 2,210 2210 0 0 5,000 0 410 0
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
233 U-Pad steril 60 cm x 90 cm pcs 7 0 7 0 7 7 7 8768.1 61,377
234 Urine Bag set -44 0 -44 0 -44 -44 -44 3,432 -151,008

241 Zinc syrup Botol -50 0 -50 3 -53 -53 -53 16,478 -873,334
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 0 5 5 5 9372.5 46,863
247 Efavirenz 600 mg Btl 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 12,449 0
255 Lytacur Sirup Btl 54 0 17 0 37 14,300 529,100
TOTAL 48,501,022
jumlah resep
JKN pustu simpo

pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
4 IV Catheter Gea No. 24 set 181 0 181 18 163 163 200 163 8,515 1,387,945
7 Ansell Steri 7 1/2 psg 646 0 646 0 646 646 646 7333.7 4,737,570

23 Amlodipine 5 mg tablet 0 1500 1,500 0 0 0 10,000 0 90 0

31 Antalgin (Metampiron) tablet 500 mg Tablet 280 0 280 844 -564 -564 -564 209 -117,876
40 Asam Askorbat (Vit C) tablet 50 mg tablet 17,505 0 17,505 5704 11,801 11,801 10,000 11,801 120 1,416,120
42 Asam Mefenamat tablet 500 mg tablet 6,628 0 6,628 2050 4,578 4,578 10,000 4,578 102 466,956

76 E t a n o l 70 % 100 ml Botol 135 0 135 0 135 135 135 2,625 354,375
81 Fervital Kapsul kapsul 420 0 420 0 420 420 5,000 420 860.64 361,469
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 100 0 100 0 100 100 300 100 796 79,600

119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1,037 0 1,037 48 989 989 989 1723.7 1,704,739
135 Klorpromazin HCI tablet salut 25 mg tablet -20 0 -20 20 -40 -40 -40 170 -6,800
146 Masker Kain pcs 90 1000 1,090 497 593 593 593 805 477,365
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
157 Miconazole Krim tube 6 0 6 40 -34 -34 -34 3,737 -127,058
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

178 Parasetamol tablet 500 mg tablet 10,569 16,800 27,369 7841 19,528 19,528 19,528 58 1,132,624
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 8,255 0 8,255 4907 3,348 3,348 3,348 136 455,328
187 Plester 2,5 cm x 4 m rol 32 0 32 7 25 25 25 12,076 301,900
188 Plester 7,5 cm x 4 m rol 10 0 10 2 8 8 8 35,532 284,256
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
195 Ranitidin tablet 150 mg tablet 1,980 0 1,980 1150 830 830 5,000 830 115 95,450
202 Ringer Laktat larutan infus steril Botol 37 200 237 165 72 72 400 72 7,150 514,800

207 Sarung Tangan Examination S pcs 48 0 48 16 32 32 1,000 32 531.3 17,002
208 Sarung Tangan Examination M pcs 0 0 0 0 0 0 1,000 0 531.3 0
209 Sarung Tangan Examination L pcs 76 0 76 10 66 66 1,000 66 531.3 35,066

210 Sefadroksil 500 mg kapsul 479 0 479 390 89 89 1,000 89 557 49,573
211 Semen seng fosfat serbuk dan cairan buah -5 0 -5 5 -10 -10 -10 102,850 -1,028,500
212 Setrizin tablet 10 mg tablet 965 0 965 620 345 345 1,000 345 154 53,130
223 Tablet tambah darah kombinasi tablet 3,930 0 3,930 1720 2,210 2,210 2,210 410 906,100
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set -44 0 -44 0 -44 -44 -44 3,432 -151,008

241 Zinc syrup Botol -50 0 -50 0 -50 -50 -50 16,478 -823,900
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 30 5 5 5 9372.5 46,863
247 Efavirenz 600 mg Btl 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 12,449 0
253 Samcobion Tablet 970 0 970 880 90 90 90 989.659 89,069
255 Lytacur Sirup Btl 81 0 27 0 54 14,300 772,200
TOTAL 60,115,184
jumlah resep
JKN pustu simpo

pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 674 0 674 28 646 646 646 7333.7 4,737,570

23 Amlodipine 5 mg tablet 1,267 0 1,267 0 1,267 1,267 10,000 1,267 90 114,030

24 Amlodipine 10 mg tablet 374 0 374 0 374 374 5,000 374 163 60,962
31 Antalgin (Metampiron) tablet 500 mg Tablet 1,124 0 1,124 844 280 280 280 209 58,520

58 Catgut/benang bedah no .2/0 pcs 0 0 0 5 -5 -5 -5 7928,333 -39,641,665
76 E t a n o l 70 % 100 ml Botol 145 0 145 10 135 135 135 2,625 354,375

94 Guaiafenesin Tablet tablet 12,695 0 12,695 3489 9,206 9,206 9,206 132 1,215,192
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 1,143 0 1,143 188 955 955 955 171 163,305
108 Isoniazid tablet 100 mg tablet 0 0 0 10 -10 -10 -10 82 -820
135 Klorpromazin HCI tablet salut 25 mg tablet 0 0 0 20 -20 -20 -20 170 -3,400
146 Masker Kain pcs 625 0 625 535 90 90 90 805 72,450
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

187 Plester 2,5 cm x 4 m rol 35 0 35 3 32 32 32 12,076 386,432
188 Plester 7,5 cm x 4 m rol 14 0 14 4 10 10 10 35,532 355,320
189 Pot Sputum pcs 100 0 100 100 0 0 0 3137.2 0

209 Sarung Tangan Examination L pcs 76 0 76 0 76 76 76 531.3 40,379

211 Semen seng fosfat serbuk dan cairan buah 0 0 0 5 -5 -5 -5 102,850 -514,250
212 Setrizin tablet 10 mg tablet 970 0 970 5 965 965 965 154 148,610
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 30 0 30 70 -40 -40 -40 1,760 -70,400
234 Urine Bag set 16 0 16 60 -44 -44 -44 3,432 -151,008

241 Zinc syrup Botol 30 0 30 80 -50 -50 -50 16,478 -823,900
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 30 5 5 5 9372.5 46,863
247 Efavirenz 600 mg Btl 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 12,449 0
TOTAL 71,518,190
jumlah resep
JKN pustu simpo

pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 167 0 167 22 145 145 145 7333.7 1,063,387

23 Amlodipine 5 mg tablet 1,144 0 1,144 814 330 330 330 90 29,700

34 Antasida DOEN suspensi Botol 108 0 108 108 0 0 0 2,106 0
41 Asam Folat tablet 1,045 0 1,045 200 845 845 845 68 57,460

76 E t a n o l 70 % 100 ml Botol 98 0 98 25 73 73 73 2,625 191,625
81 Fervital Kapsul kapsul 2,205 0 2,205 1375 830 830 830 860.64 714,331

87 Garam Oralit untuk 200 ml Air sak 1,112 0 1,112 297 815 815 815 274 223,310
96 Grisefulvin tablet 125 mg (Micronized) tablet 920 0 920 110 810 810 810 263 213,030
146 Masker Kain pcs 439 0 439 282 157 157 157 805 126,385
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
151 Metilprednisolon tablet 4 mg tablet 1,210 0 1,210 480 730 730 730 200 146,000
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

187 Plester 2,5 cm x 4 m rol 22 0 22 5 17 17 17 12,076 205,292
188 Plester 7,5 cm x 4 m rol 15 0 15 6 9 9 9 35,532 319,788
189 Pot Sputum pcs 40 0 40 7 33 33 33 3137.2 103,528

209 Sarung Tangan Examination L pcs 980 0 980 500 480 480 480 531.3 255,024
220 Siprofloksasin tablet 500 mg tablet 1,162 0 1,162 764 398 398 398 298 118,604
223 Tablet tambah darah kombinasi tablet 1,240 0 1,240 840 400 400 400 410 164,000
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 16 0 16 0 16 16 16 3,432 54,912

241 Zinc syrup Botol 30 0 30 0 30 30 30 16,478 494,340
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 0 5 5 5 9372.5 46,863
245 Zidovudine 150 mg Btl 0 0 1,700 0
246 Lomivudine 150 mg Btl 0 0 4,255 0
247 Efavirenz 600 mg Btl 0 0 7,331 0
248 Nepirapine 200 mg Btl 0 0 3,080 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 3,058 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 11894.3 0
251 TenoFovir 300 mg Btl 0 0 6,475 0
252 Tenof EM Btl 0 0 12,449 0
254 Spironolakton tablet 25 mg Tablet 0 0 314 0
255 Lytacur Sirup Btl 38 24 38 38 14,300 543,400
256 Susu Produgen Kotak 0 0 40,700 0
TOTAL 66,193,714
jumlah resep
JKN pustu simpo

pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 174 0 174 7 167 167 167 7333.7 1,224,728


41 Asam Folat tablet 1,290 0 1,290 245 1,045 1,045 500 1,045 68 71,060
45 Asiklovir krim 5% tablet 9 0 9 8 1 1 25 1 3,960 3,960

76 E t a n o l 70 % 100 ml Botol 121 0 121 23 98 98 98 2,625 257,250
81 Fervital Kapsul kapsul 2,315 0 2,315 110 2,205 2,205 1,000 2,205 860.64 1,897,711

94 Guaiafenesin Tablet tablet 11,026 0 11,026 2418 8,608 8,608 10,000 8,608 132 1,136,256
96 Grisefulvin tablet 125 mg (Micronized) tablet 1,390 0 1,390 470 920 920 920 263 241,960
97 Haloperidol tablet 1,5 mg tablet 400 0 400 400 0 0 500 0 74 0
109 Isosorbid Dinitrat tablet subligual 5 mg tablet 43 0 43 0 43 43 43 95 4,085
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 0 390 0 390 390 390 137.5 53,625
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 6 0 6 0 6 6 6 3,650 21,900
146 Masker Kain pcs 802 0 802 363 439 439 500 439 805 353,395
147 Mata Pisau No. 15 pcs 84 0 84 0 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
153 Metoklopramida 10 mg tablet 590 0 590 290 300 300 500 300 100 30,000
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

175 Omeprazole 20 mg kapsul 300 0 300 150 150 150 300 150 148 22,200
178 Parasetamol tablet 500 mg tablet 27,567 0 27,567 7975 19,592 19,592 10,000 19,592 58 1,136,336
187 Plester 2,5 cm x 4 m rol 22 0 22 0 22 22 22 12,076 265,672
188 Plester 7,5 cm x 4 m rol 17 0 17 2 15 15 15 35,532 532,980
189 Pot Sputum pcs 58 0 58 18 40 40 40 3137.2 125,488
193 Propiltiourasil tablet 100 mg tablet 10 0 10 10 0 0 500 0 320 0
208 Sarung Tangan Examination M pcs 1,500 0 1,500 1100 400 400 400 531.3 212,520
209 Sarung Tangan Examination L pcs 1,090 0 1,090 110 980 980 980 531.3 520,674
210 Sefadroksil 500 mg kapsul 1,089 0 1,089 186 903 903 903 557 502,971
212 Setrizin tablet 10 mg tablet 0 0 0 0 0 0 1,000 0 154 0
223 Tablet tambah darah kombinasi tablet 3,140 0 3,140 1900 1,240 1,240 5,000 1,240 410 508,400
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 17 0 17 1 16 16 16 3,432 54,912
236 Vaksin Rabies vero kuur 5 0 5 5 0 0 10 0 174499,6 #VALUE!

241 Zinc syrup Botol 30 0 30 0 30 30 30 16,478 494,340
243 Paper Tape 2,5 x 9,14 Rol 5 0 5 0 5 5 5 9372.5 46,863
245 Zidovudine 150 mg Btl 0 1,700 0
246 Lomivudine 150 mg Btl 0 4,255 0
247 Efavirenz 600 mg Btl 0 7,331 0
248 Nepirapine 200 mg Btl 0 3,080 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 3,058 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 11894.3 0
251 TenoFovir 300 mg Btl 0 6,475 0
252 Tenof EM Btl 0 12,449 0
254 Spironolakton tablet 25 mg Tablet 0 314 0
255 Lytacur Sirup Btl 38 38 38 14,300 543,400
256 Susu Produgen Kotak 0 40,700 0
TOTAL 83,005,374
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

LAPORAN KEGIATAN MUTASI OBAT
PADA PUSKESMAS BARANTI
STOK AWAL PENERIMAAN PENGELUARAN

Pustu Pustu Pustu Pksdes Pksdes Pksdes PkesdesPkesdes Pksdes Pustu Pustu Pustu Pksdes Pksdes Pksdes Pkesdes Pksdes Pkesdes Pustu Pustu Pustu Pksdes
NO NAMA OBAT Satuan
GUDANG Apotk Gudang Apotk TOTAL Gudang Apotk
simpo Trong T.Rjang Barant Trong T.Rjang 2panua Paseno spdeceng TOTAL simpo Trong T.Rjang Barant Trong T.Rjang 2panua passeno sipodec simpo Trong T.Rjang Barant
1 IV Catheter Gea No. 18 100 0 0 0 0 17 21 10 2 16 12 187 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6
5 Ansell Steril 6 1/2 5 0 0 0 0 0 0 0 0 0 18 23 300 0 0 0 0 0 0 0 0 0 0 0 0 0 95 0 0 0 0
6 Ansell Steril 7 79 0 0 0 10 0 0 6 0 21 16 132 162 0 0 0 0 0 0 0 0 0 0 0 0 0 71 0 0 0 0
7 Ansell Steri 7 1/2 400 0 2 5 0 15 8 0 5 5 0 566 145 0 0 0 0 0 0 0 0 0 0 0 0 0 93 0 3 0 15
8 Alat Suntik sekali pakai 0,05 ml 600 0 0 0 0 0 0 0 0 0 0 600 900 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0
9 Alat Suntik sekali pakai 0,5 ml 0 0 0 0 0 0 8 0 0 2 15 25 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Alat suntik sekali pakai 1 ml 4,332 0 0 0 50 22 67 75 36 178 190 4950 5355 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20
11 Alat suntik sekali pakai 3 ml 582 0 0 16 50 43 61 19 0 77 21 869 2093 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 10
12 Alat suntik sekali pakai 5 ml 937 0 0 19 0 0 10 7 0 5 4 986 1011 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 3
13 Alat Suntik sekali pakai 10 ml 157 0 0 0 0 0 0 0 0 0 0 157 161 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0
14 Albendasol tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Alkohol Swab 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Alupurinol tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 1180 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0

17 Allpurinol tablet 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ambroxol sirup 15 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ambroxol tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
20 Aminofilin tablet 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Amitriptilin HCI tablet salut 25 mg 1,000 0 0 0 0 0 0 0 0 0 0 1000 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Amlodipine 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Amlodipine 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 1350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml 108 0 5 6 4 9 0 8 5 12 11 168 169 0 0 0 0 0 0 0 0 0 0 0 0 0 42 1 2 6 0
26 Amoksisilin sirup kering forte 250 mg/5 ml 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Amoksisilin kapsul 250 mg 1,000 30 80 410 0 0 0 70 40 0 0 1630 3270 0 0 0 0 0 0 0 0 0 0 0 0 0 900 20 90 0 0
28 Amoksisilin kaplet 500 mg 18,400 200 670 590 170 810 750 200 770 722 1,173 24455 24706 0 0 0 0 0 0 0 0 0 0 0 0 0 2370 230 120 330 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Anagens Syrup 3 0 3 0 0 4 0 0 0 0 0 10 24 0 0 0 0 0 0 0 0 0 0 0 0 0 4 2 0 0 0
31 Antalgin (Metampiron) tablet 500 mg 0 0 0 0 0 80 0 0 0 280 0 360 1494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20
32 Antalgin injeksi 250 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Antasida DOEN tablet kombinasi 1,700 30 500 275 330 300 450 170 400 460 500 5115 10934 0 0 0 0 0 0 0 0 0 0 0 0 0 812 130 40 170 70
34 Antasida DOEN suspensi 73 0 0 0 0 0 0 0 0 0 0 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37 0 0 3 0
35 Antihemoroid DOEN kombinasi 23 0 0 0 0 0 0 0 0 0 0 23 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 Antifungi DOEN kombinasi 22 0 0 0 0 0 0 0 0 0 0 22 24 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0
37 Antibakteri DOEN salep Kombinasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Antimigrain DOEN kombinasi 300 43 0 0 0 0 0 0 0 0 0 343 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg 9,300 62 230 510 0 314 100 250 60 292 935 12053 10344 0 0 0 0 0 0 0 0 0 0 0 0 0 8388 250 140 0 70
41 Asam Folat 200 100 0 0 0 0 0 0 0 0 0 300 845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Asam Mefenamat tablet 500 mg 6,000 110 560 545 160 250 450 130 640 450 608 9903 10387 0 0 0 0 0 0 0 0 0 0 0 0 0 1950 60 60 240 30
43 Asiklovir 200 mg 0 10 0 0 0 0 0 0 0 0 0 10 300 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0
44 Asiklovir 400 mg 150 0 0 0 0 0 0 0 0 0 0 150 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Asiklovir krim 5% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Asetosal tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Attalpulgit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml 3 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Atropin Sulfat tablet 0,5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Betahistin maleat 24 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Betametason krim 0.1 % 134 20 0 0 0 0 0 0 0 3 0 157 237 0 0 0 0 0 0 0 0 0 0 0 0 0 4 0 0 0 0
55 Bisakodil 5 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Bisakodil 10 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Blood Lancet 26G 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Catgut/benang bedah no .2/0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5
59 Catgut/benang bedah no .3/0 40 0 0 0 0 2 3 4 0 5 8 62 161 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0
60 Deksametason injeksi 5 mlg/ml - 1 ml 25 0 0 0 0 0 0 0 0 0 0 25 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Deksametason tablet 0,5 mg 2,400 300 230 860 200 216 150 390 360 447 564 6117 6967 0 0 0 0 0 0 0 0 0 0 0 0 0 1983 60 30 0 0
62 Diazepam injeksi 5 mg/ml - 2 ml 10 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml -1 0 0 0 0 0 0 0 0 0 0 -1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
64 Diazepam tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Diazepam tablet 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml 30 0 0 0 0 0 0 0 0 0 0 30 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Digoksin tablet 0,25 mg 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Doksisilin kapsul 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Domperidom suspensi 24 0 0 0 3 0 0 0 0 0 0 27 29 0 0 0 0 0 0 0 0 0 0 0 0 0 26 0 0 3 0
71 Domperidom tablet 500 0 0 0 0 0 0 0 0 0 0 500 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Efedrin HCI tablet 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ekstrak Belladon tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % 6 0 1 1 0 0 1 0 0 0 0 10 14 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
76 E t a n o l 70 % 100 ml 64 0 0 0 0 2 2 2 0 3 0 73 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
77 Etil klorida semprot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Eugenol cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Fenobarbital tablet 30 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Fervital Kapsul 0 0 150 0 0 0 30 0 0 0 0 180 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml 23 0 0 0 0 16 8 0 0 7 11 65 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg 300 46 0 0 0 0 0 0 0 0 0 346 30 0 0 0 0 0 0 0 0 0 0 0 0 0 18 0 0 0 0
84 Foly Catheter No. 18 10 0 0 0 0 0 0 0 0 0 0 10 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Foly Catheter No. 20 8 0 0 0 0 0 0 0 0 0 0 8 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
86 Furosemid tablet 40 mg 0 65 0 0 0 0 0 0 0 0 0 65 297 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0
87 Garam Oralit untuk 200 ml Air 400 90 0 25 0 32 12 35 45 35 41 715 815 0 0 0 0 0 0 0 0 0 0 0 0 0 10 22 10 0 4
95 Gentamicin inj 40mg/ml 25 0 0 0 0 0 0 0 0 0 0 25 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Gentian Violet larutan 1 % 5 0 0 0 0 0 0 0 0 0 0 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Glass lonomer Cement (GC IX ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Glibenklamid tablet 5 mg 1,700 155 0 0 0 0 0 0 0 0 0 1855 2445 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0

92 Glimepiride 1 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Glimepiride 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Guaiafenesin Tablet 1,000 110 420 115 0 280 30 0 100 537 0 2592 5349 0 0 0 0 0 0 0 0 0 0 0 0 0 3998 150 65 0 0
95 Glukosa larutan infus 5 % steril 200 0 0 0 0 0 8 5 0 2 0 215 69 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
96 Grisefulvin tablet 125 mg (Micronized) 2,500 0 0 720 0 20 0 0 0 0 0 3240 810 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 10
97 Haloperidol tablet 1,5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Haloperidol tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
99 Haloperidol inj 50 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Hidroklorotiazid (HCT) tablet 25 mg 400 94 0 0 0 0 0 0 0 0 0 494 1149 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
101 Hidrokortison krim 2,5 % 120 20 7 9 0 0 2 9 0 0 0 167 19 0 0 0 0 0 0 0 0 0 0 0 0 0 4 3 1 0 0
102 Ibuprofen suspensi 100 mg/5 ml 24 0 8 0 0 0 5 6 0 0 0 43 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0
103 Ibuprofen suspensi 200 mg/5 ml 0 0 0 0 0 2 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
104 Ibuprofen tablet 200 mg 6,000 100 630 1200 450 630 500 200 310 425 400 10845 16430 0 0 0 0 0 0 0 0 0 0 0 0 0 610 160 40 50 0
105 Ibuprofen tablet 400 mg 0 0 0 0 0 0 140 0 0 0 0 140 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Infusion set anak 147 0 0 0 0 0 0 0 0 0 0 147 119 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0
107 Infusion set dewasa 123 0 0 0 3 6 9 5 1 9 11 167 274 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 4
108 Isoniazid tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0
109 Isosorbid Dinitrat tablet subligual 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
110 Kalsium Glukonat inj 10% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
111 Kalsium Hidroksida pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg 1,400 124 0 0 150 280 130 200 250 80 350 2964 5344 0 0 0 0 0 0 0 0 0 0 0 0 0 1036 0 0 50 20
113 Kapas pembalut 250 gram 1 0 0 0 0 0 0 0 0 0 0 1 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
114 Kapas pembalut / Absorben 500 gram 1 0 0 0 0 0 0 0 0 0 0 1 3 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0
115 Kapas pembalut / Absorben 1000 gram 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
116 Kaptopril 12,5 mg 0 0 0 0 140 0 0 0 0 0 0 140 4484 0 0 0 0 0 0 0 0 0 0 0 0 0 193 0 0 60 0

117 Kaptopril 25 mg 900 183 0 0 0 0 0 0 0 0 0 1083 4401 0 0 0 0 0 0 0 0 0 0 0 0 0 2050 0 0 0 0
118 Karbamazepin tablet 200 mg 1,900 ### 0 0 0 0 0 0 0 0 0 3880 1980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm 600 0 0 29 0 0 50 0 0 50 50 779 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0
120 Kasa hidrofil 40 x 80 cm 2 0 0 0 0 0 0 0 0 0 0 2 4 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0
121 Kasa pembalut elastis 3 inch 7 0 0 0 0 0 0 0 0 0 0 7 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
122 Ketokonazol krim 2% 0 25 0 0 0 0 0 0 0 0 0 25 81 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0
123 Ketokonazol tablet 200 mg 500 90 0 0 0 0 0 0 0 0 0 590 150 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0
124 Kloramfenikol kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
125 Kloramfenikol susp 125mg/5 ml 77 0 0 0 0 0 0 0 0 0 0 77 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
126 Kloramfenikol salep mata 1 % 24 23 0 0 0 0 5 1 5 6 0 64 99 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
127 Kloramfenikol tetes mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Kloramfenikol salep Kulit 2% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
129 Kloramfenikol tetes telinga 3 % 9 0 0 0 0 0 0 0 0 0 0 9 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Klorfeniramin maleat tablet 4 mg 2,900 183 330 0 300 0 620 390 270 654 160 5807 7663 0 0 0 0 0 0 0 0 0 0 0 0 0 0 150 0 200 0
131 Klorokuin tablet 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
132 Klorfenol Kamfer Menthol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml 29 0 0 0 0 0 0 0 0 0 0 29 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
134 Klorpromazin HCI tablet salut 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
135 Klorpromazin HCI tablet salut 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kotrimoksazol tablet 480 mg 1,600 76 200 440 0 490 300 0 200 445 60 3811 7168 0 0 0 0 0 0 0 0 0 0 0 0 0 979 10 20 0 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml 3 0 1 0 0 6 1 2 0 11 4 28 98 0 0 0 0 0 0 0 0 0 0 0 0 0 7 1 0 0 0
138 Kotrimoksazol Pediatrik tablet 120 mg 390 0 0 0 0 0 0 0 0 0 0 390 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 Larutan mengandung elektrolit 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
140 Lidokain komp. injeksi - 2 ml 60 0 0 10 5 2 5 13 10 0 0 105 117 0 0 0 0 0 0 0 0 0 0 0 0 0 170 0 0 5 0
141 Lisol 1 liter 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

142 Loperamide 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
143 Loratadine 10 mg 450 0 0 0 0 0 0 0 0 0 0 450 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Masker Kain 200 0 0 29 0 35 0 10 40 47 0 361 157 0 0 0 0 0 0 0 0 0 0 0 0 0 600 0 2 0 15
147 Mata Pisau No. 15 84 0 0 0 0 0 0 0 0 0 0 84 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Mata Pisau No. 20 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Metilergometrin maleat tablet salut 0,125 mg 500 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
151 Metilprednisolon tablet 4 mg 500 140 0 0 0 0 0 0 0 0 0 640 730 0 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0
152 Metformin Hcl 500 mg 1,100 135 0 0 0 0 0 0 0 0 0 1235 820 0 0 0 0 0 0 0 0 0 0 0 0 0 529 0 0 0 0
153 Metoklopramida 10 mg 0 145 0 0 0 0 0 0 0 0 0 145 300 0 0 0 0 0 0 0 0 0 0 0 0 0 84 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml 47 0 0 0 0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
155 Metronidazol tablet 250 mg 0 0 0 0 0 0 0 0 260 0 0 260 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
156 Metronidazol tablet 500 mg 900 20 0 0 50 210 360 130 260 120 490 2540 2804 0 0 0 0 0 0 0 0 0 0 0 0 0 657 0 0 50 40
157 Miconazole Krim 0 17 0 0 0 0 0 0 0 0 0 17 27 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0
158 Mineral Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Multivitamin (Lycalvit) syrup 0 0 0 0 0 0 1 5 0 0 0 6 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Mummifying pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Natrium diklofenak 50 mg 3,000 190 0 0 0 0 0 0 0 0 0 3190 1424 0 0 0 0 0 0 0 0 0 0 0 0 0 410 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril 120 0 0 1 0 3 8 8 10 0 5 155 126 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0
163 Nifedipin 10 mg 0 100 0 0 0 0 0 0 0 0 0 100 300 0 0 0 0 0 0 0 0 0 0 0 0 0 65 0 0 0 0
164 Nistatin tablet vagina 100.000 IU / g 70 0 0 0 0 0 0 0 0 0 0 70 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 Nistatin vaginal tablet salut 500.000 IU/g 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Obat anti Tuberklosis kategori FDC I 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

168 Obat anti Tuberklosis kategori FDC 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Obat anti Tuberklosis kategori FDC Anak 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
170 Obat Batuk Hitam (O.B.H) cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
171 OBH Itral Syrup 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
172 Ofloksasin tablet 400 mg 100 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep kulit 3 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
174 Oksitetrasiklin HCI salep mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
175 Oksitosin injeksi 10 IU / ml - 1 ml 80 0 0 0 10 0 4 9 6 8 0 117 210 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0
176 Omeprazole 20 mg 90 0 0 0 0 0 0 0 0 0 0 90 30 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0 0 0 0
177 Parasetamol drops 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
178 Parasetamol sirup 120 mg / 5 ml 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
179 Parasetamol tablet 500 mg 6,000 706 530 790 400 188 410 640 700 703 610 11677 9030 0 0 0 0 0 0 0 0 0 0 0 0 0 10834 380 110 300 70
180 Pehacain injeksi 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
181 Permetrin krim 5% 6 0 0 0 0 0 0 0 0 0 0 6 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 Pirantel pamoat tablet 125 mg 0 90 0 0 0 6 0 0 0 0 0 96 239 0 0 0 0 0 0 0 0 0 0 0 0 0 28 0 0 0 0
183 Pirantel suspensi 10 ml 10 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0
184 Pirantel suspensin 60 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
185 Piridoksin HCI (Vit. B6 ) tablet 10 mg 8,200 300 220 0 0 0 0 300 0 0 485 9505 2660 0 0 0 0 0 0 0 0 0 0 0 0 0 2613 50 0 0 0
186 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Piroksikam 20 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
188 Plester 2,5 cm x 4 m 15 0 -1 0 0 2 1 2 1 0 1 21 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 1
189 Plester 7,5 cm x 4 m -1 0 0 0 0 0 0 0 0 0 0 -1 9 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
190 Pot Sputum 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
191 Prednison tablet 5 mg 0 0 70 130 80 0 0 0 0 155 0 435 5984 0 0 0 0 0 0 0 0 0 0 0 0 0 367 150 0 20 0
192 Primakuin tablet 15 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Prokain benzil penisilin injeksi 3 Juta IU / vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0
194 Propiltiourasil tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
195 Propranolol HCI tablet 40 mg 300 0 0 0 0 0 0 0 0 0 0 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 Ranitidin tablet 150 mg 4,000 140 0 0 0 50 0 0 0 0 0 4190 3280 0 0 0 0 0 0 0 0 0 0 0 0 0 392 0 0 0 10
197 Ranitidin injeksi 25 mg/2 ml 0 0 0 0 0 0 0 0 0 0 0 0 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
198 Rapid Test VIKIA HIV 1/2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Rapid Test SD Bioline HIV 1/2 3.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
200 Reagensia ZN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
201 Retinol (Vitamin A) kapsul 100.000 IU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Retinol (Vitamin A) kapsul 200.000 IU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 Ringer Laktat larutan infus steril 220 0 0 0 0 1 5 9 10 5 4 254 87 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0 0 0 4
204 Salbutamol tablet 2 mg 0 100 0 75 0 100 60 30 0 0 0 365 1192 0 0 0 0 0 0 0 0 0 0 0 0 0 129 0 10 0 0
205 Salbutamol 4 mg 190 0 0 0 170 0 0 0 0 0 0 360 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 30 0
206 Salep 2 - 4 kombinasi 52 0 0 0 8 2 3 6 0 0 0 71 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1
207 Salisil bedak 2 % 14 0 4 0 0 4 3 2 0 7 1 35 79 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
208 Sarung Tangan Examination S 0 0 0 0 0 0 0 0 0 20 0 20 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Sarung Tangan Examination M 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
210 Sarung Tangan Examination L 0 0 0 0 0 0 0 0 0 0 0 0 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
211 Sefadroksil 500 mg 600 0 0 0 60 0 0 0 0 0 0 660 702 0 0 0 0 0 0 0 0 0 0 0 0 0 53 0 0 40 0

212 Semen seng fosfat serbuk dan cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
213 Setrizin tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 460 0 0 0 0
214 Setrizin syrup 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
215 Sianokorbalamin (Vit.B 12) 500 mcg 600 0 0 0 50 240 120 50 450 0 0 1510 3118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 60
216 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml 140 0 0 0 0 0 0 0 0 0 0 140 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
217 Simetidine 200 mg 900 110 0 0 0 0 0 0 0 0 0 1010 1800 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
218 Simvastatin 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 317 0 0 0 0 0 0 0 0 0 0 0 0 0 360 0 0 0 0
219 Simvastatin 20 mg 150 26 0 0 0 0 0 0 0 0 0 176 0 0 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0
220 Silk (benang Bedah Sutera) No. 3 / 0 3 0 0 0 0 0 5 5 0 0 0 13 22 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0 0 0 0
221 Siprofloksasin tablet 500 mg 3,100 30 0 0 0 0 0 0 0 0 0 3130 398 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0
222 Spironolakton tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
223 Sulfasetamida natrium tetes mata 15 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 Tablet tambah darah kombinasi 17,670 54 0 0 300 120 0 60 180 50 0 18434 400 0 0 0 0 0 0 0 0 0 0 0 0 0 1216 0 0 20 180
225 Taburia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 Temporary stopping (Fletcher) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
227 Tetrasiklin HCI kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
228 Tetrasiklin HCI kapsul 500 mg 400 0 0 0 0 0 0 0 0 0 0 400 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 Tiamfenikol 500 mg 200 20 0 0 0 0 0 0 0 0 0 220 320 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
230 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml 30 0 0 0 0 0 0 0 0 0 0 30 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg 1,800 231 140 720 360 220 0 460 500 0 430 4861 3556 0 0 0 0 0 0 0 0 0 0 0 0 0 3299 330 90 140 0
232 Triheksifenidil Hidroklorida tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Umbilical Cord 0 0 0 0 0 0 1 6 3 10 7 27 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234 U-Pad steril 60 cm x 90 cm 0 0 0 0 0 0 0 0 1 0 6 7 39 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0
235 Urine Bag 9 0 0 0 0 0 0 0 0 0 0 9 16 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0 0 0 0
236 Vaksin Jerap Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
237 Vaksin Rabies vero 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Vitamin B kompleks tablet 11,100 330 690 995 300 148 600 360 260 256 670 15709 28428 0 0 0 0 0 0 0 0 0 0 0 0 0 2510 230 190 200 60
239 Wicold kapsul 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
240 Yodium povidon larutan 10 % 60 ml 9 0 3 0 0 3 1 0 0 0 0 16 23 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
241 Yodium povidon larutan 10 % 300 ml 2 0 0 0 0 0 1 0 0 0 0 3 4 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0
242 Zinc syrup 8 0 0 0 0 0 0 0 5 0 0 13 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
243 Zinc Tablet 300 60 0 0 0 140 220 140 100 240 10 1210 2520 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
244 Paper Tape 2,5 x 9,14 5 0 0 0 0 0 0 0 0 0 0 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Paper Tape 7,5 x 9,14 2 0 0 0 0 0 0 0 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Zidovudine 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
246 Lomivudine 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Efavirenz 600 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
248 Nipirapine 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
249 ZDV + 3 TC+ NVP Ped Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
250 TDF +3TC+EFV (300/300/600) Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Tenofovir 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
252 Tenof EM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
253 samcobion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
254 Spironolakton tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
255 lytacur sirup 112 2 0 0 0 0 0 4 0 10 0 128 14 0 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0
256 Susu Produgen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0
0 0
Mengetahui
Kepala Puskesmas Baranti
BULAN 7
TAHUN 2018
PENGELUARAN SISA STOCK
Pksdes Pksdes Pkesdes Pkesdes Pksdes 115 Pustu Pustu Pustu Pksdes Pksdes Pksdes Pkesdes Pksdes Pkesdes
TOTAL Apotk TOTAL
Trong T.Rjangduampanuapassenosipodeceng simpo Trong T.Rjang Barant Trong T.Rijang 2panua passeno sipodecen
115
0 1 2 0 0 9 15 100 0 0 0 0 11 21 10 3 16 12 179
0 0 0 0 0 37 80 167 0 0 0 0 4 9 5 5 5 4 231
0 0 0 0 0 121 92 123 0 0 0 0 9 0 0 0 0 0 132
0 0 0 0 0 5 18 292 0 0 0 0 0 0 0 24 0 0 316
0 0 0 0 2 97 0 5 0 0 0 0 0 0 0 0 0 18 120
0 2 0 4 0 77 242 79 0 0 0 10 0 0 6 0 21 16 132
2 0 0 0 0 113 61 400 0 2 5 0 15 8 0 5 5 0 551
0 0 0 0 0 100 0 600 0 0 0 0 0 0 0 0 0 0 700
2 0 0 12 0 14 17 0 0 0 0 0 30 12 0 0 2 0 25
3 2 5 1 0 31 112 4,364 0 0 0 50 14 67 75 36 178 190 4974
5 4 0 8 29 74 129 582 0 0 16 50 43 61 19 0 77 21 869
0 0 0 0 0 20 8 900 0 0 19 0 17 10 7 5 5 4 982
0 0 0 0 0 2 0 157 0 0 0 0 0 0 0 0 0 0 157
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 1,000 0 0 0 0 0 0 0 0 0 0 1000
0 0 0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 976 0 0 0 0 0 0 0 0 0 0 0 0
0 2 0 0 1 54 30 108 0 5 6 4 9 0 8 5 12 11 168
0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0
0 10 0 0 0 1020 320 1,000 30 80 410 0 0 0 70 40 0 0 1630
60 100 150 110 45 3515 2930 18,400 200 670 590 170 810 750 200 770 722 1,173 24455
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 6 4 3 0 3 0 0 4 0 0 0 0 0 10
0 0 0 0 0 20 370 0 0 0 0 0 80 0 0 0 280 0 360
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 30 100 30 104 1536 2069 1,700 30 500 275 330 300 450 170 400 460 500 5115
0 0 0 0 0 40 44 73 0 0 0 6 0 0 0 0 0 0 79
0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 27
0 0 0 0 0 2 0 22 0 0 0 0 0 0 0 0 0 0 22
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 20 300 43 0 0 0 0 0 0 0 0 0 343
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 50 0 241 0 9189 3953 9,300 62 230 510 0 314 100 250 60 292 935 12053
0 0 0 0 0 0 375 200 100 0 0 0 0 0 0 0 0 0 300
50 70 0 80 10 2550 1392 6,000 110 560 545 160 250 450 130 640 450 608 9903
0 0 0 0 0 30 0 0 10 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 150 0 0 0 0 0 0 0 0 0 0 150
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 5 12 134 20 0 0 0 0 0 0 0 3 0 157
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 5 0 0 0 0 0 0 -3 0 0 0 0 0 -3
0 0 0 1 0 31 19 40 0 0 0 0 0 3 4 0 5 8 60
0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 25
50 110 70 126 0 2429 1387 2,400 300 230 860 200 216 150 390 360 447 564 6117
0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 -1 0 0 0 0 0 0 0 0 0 0 -1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 30
0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 29 16 24 0 0 0 3 0 0 0 0 0 0 27
0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 500
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 1 6 0 1 1 0 0 1 0 0 0 0 10
2 1 0 0 0 4 28 64 0 0 0 0 2 2 2 0 3 0 73
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 0 0 0 0 30 390 0 0 150 0 0 0 30 0 0 0 0 180
1 0 0 1 0 6 9 23 0 0 0 0 16 8 0 0 7 11 65 -3
0 0 0 0 0 18 30 300 46 0 0 0 0 0 0 0 0 0 346
0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 0 25 3 0 65 0 0 0 0 0 0 0 0 0 65
6 15 0 11 9 87 281 400 90 0 25 0 32 12 35 45 35 41 715
0 0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 25
0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 45 10 1,700 155 0 0 0 0 0 0 0 0 0 1855

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 0 170 122 0 4555 2654 1,000 110 420 115 0 280 30 0 100 537 0 2592
0 0 0 0 0 0 10 200 0 0 0 0 0 8 5 0 2 0 215
0 0 0 0 0 60 150 2,500 0 0 720 0 20 0 0 0 0 0 3240
0 0 0 0 0 0 120 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 6 400 94 0 0 0 0 0 0 0 0 0 494
0 0 0 0 0 8 14 120 20 7 9 0 0 2 9 0 0 0 167
0 4 0 0 0 6 9 24 0 8 0 0 0 0 6 0 0 0 49
0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2
0 100 40 15 0 1015 520 6,000 100 630 1200 450 630 500 200 310 425 400 10845
0 0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 140
0 0 0 0 0 3 15 147 0 0 0 0 0 0 0 10 0 0 157
0 1 0 0 0 29 9 123 0 0 0 3 6 9 5 1 9 11 167
0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 100 70 110 150 1586 1211 1,400 124 0 0 150 280 130 200 250 80 350 2964
0 0 0 0 0 0 2 1 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 2 0 1 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 253 76 0 0 0 0 140 0 0 0 0 0 0 140

0 0 0 0 0 2050 709 900 183 0 0 0 0 0 0 0 0 0 1083
0 0 0 0 0 0 0 1,900 1980 0 0 0 0 0 0 0 0 0 3880
10 0 5 0 0 17 27 600 0 0 29 0 0 50 0 0 50 50 779
0 0 0 0 0 3 2 2 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 0 17 6 0 25 0 0 0 0 0 0 0 0 0 25
0 0 0 0 0 10 190 500 90 0 0 0 0 0 0 0 0 0 590
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 77 0 0 0 0 0 0 0 0 0 0 77
1 4 0 3 0 8 20 24 23 0 0 0 0 5 1 5 6 0 64
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 9 0 0 2 0 0 0 0 0 0 0 11
50 110 0 90 0 600 2548 2,900 183 330 0 300 0 620 390 270 654 160 5807
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 29
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 10 20 30 140 1229 405 1,600 76 190 440 0 490 300 210 200 445 60 4011
1 1 0 0 1 11 4 3 0 9 0 0 6 1 2 0 11 4 36
0 0 0 0 0 0 0 390 0 0 0 0 0 0 0 0 0 0 390
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 176 37 60 0 0 10 5 2 5 13 10 0 0 105
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 450
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 2 10 3 0 632 532 200 0 0 29 0 35 0 10 40 47 0 90
0 0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 84
0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 500
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 60 30 500 140 0 0 0 0 0 0 0 0 0 640
0 0 0 0 0 529 290 1,100 135 0 0 0 0 0 0 0 0 0 1235
0 0 0 0 0 84 0 0 100 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 47 0 0 0 0 0 0 0 0 0 0 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 260
0 10 0 0 30 787 290 900 20 0 0 50 210 360 130 0 120 490 2280
0 0 0 0 0 2 31 0 17 0 0 0 0 0 0 0 0 0 17
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 410 836 3,000 190 0 0 0 0 0 0 0 0 0 3190
0 0 0 0 1 31 49 100 0 0 1 0 3 8 8 10 0 5 135
0 0 0 0 0 65 14 0 100 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 70
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 1 2 1 0 30 4 80 0 0 0 10 0 4 9 6 8 0 117
0 0 0 0 0 30 90 90 0 0 0 0 0 0 0 0 0 0 90
0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0
60 160 150 108 290 12462 7420 6,000 706 530 790 400 188 410 640 700 703 610 11677
0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 0 28 39 0 62 0 0 0 6 0 0 0 0 0 68
0 0 0 0 0 5 0 10 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 100 0 0 77 2840 2161 8,200 300 220 0 0 0 0 300 0 0 485 9505
0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 4 2 15 0 -1 0 0 2 1 2 1 0 1 21
0 0 0 0 0 1 4 -1 0 0 0 0 0 0 0 0 0 0 -1
0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 537 2881 0 0 70 130 80 0 0 0 0 155 0 435
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 300
0 0 0 0 0 402 980 4,000 140 0 0 0 50 0 0 0 0 0 4190
0 0 0 0 0 0 28 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 75 67 120 0 0 0 0 1 5 9 10 5 4 154
20 0 0 0 0 159 222 0 100 0 75 0 100 60 30 0 0 0 365
0 0 0 0 0 30 0 190 0 0 0 170 0 0 0 0 0 0 360
0 0 0 0 0 3 8 52 0 0 0 8 2 3 6 0 0 0 71
0 0 0 0 0 1 26 14 0 4 0 0 4 3 2 0 7 1 35
0 0 0 4 0 4 14 0 0 0 0 0 0 0 0 0 20 0 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 404 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 93 220 600 92 0 0 60 0 0 0 0 0 0 752
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0
20 50 50 0 0 230 140 600 0 0 0 50 240 120 50 450 0 0 1510
0 0 0 0 0 0 0 140 0 0 0 0 0 0 0 0 0 0 140
0 0 0 0 0 0 0 900 110 0 0 0 0 0 0 0 0 0 1010
0 0 0 0 0 360 407 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 24 0 150 26 0 0 0 0 0 0 0 0 0 176
0 0 0 0 0 8 17 3 0 0 0 0 0 5 5 0 0 0 13
0 0 0 0 0 100 398 3,100 30 0 0 0 0 0 0 0 0 0 3130
0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
200 180 120 290 270 2476 1600 17,670 54 0 0 10 120 0 60 180 50 0 18144
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 400
0 0 0 0 0 0 40 200 20 0 0 0 0 0 0 0 0 0 220
0 0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 30
0 40 0 0 160 4059 2867 1,800 231 140 720 360 220 0 460 500 0 430 4861
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 1 2 1 0 6 12 0 0 0 0 0 0 1 6 3 10 7 27
0 0 0 0 0 10 4 0 0 0 0 0 0 0 0 0 0 6 17
0 0 0 0 0 3 0 9 0 0 0 0 0 0 0 0 0 0 9
0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 140 150 201 180 3901 2935 11,100 330 690 995 300 148 600 360 260 256 670 15709
0 0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 2 2 9 0 3 0 0 3 1 0 0 0 0 16
0 0 0 0 0 1 7 2 0 0 0 0 0 1 0 0 0 0 3
0 0 0 0 0 0 0 8 0 0 0 0 0 0 0 5 0 0 13
0 20 0 10 20 50 206 300 60 0 0 0 140 220 140 100 240 10 1210
0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 0 0 8 17 112 2 0 0 0 0 0 4 0 10 0 128
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0
18 0
Pengelola Obat Pkm Baranti


Pustu Pustu Pustu Pksdes Pksdes Pksdes PkesdesPkesdes Pksdes Pustu Pustu Pustu Pksdes Pksdes Pksdes Pkesdes Pksdes Pkesdes Pustu Pustu Pustu Pksdes Pksdes
NO NAMA OBAT Satuan
simpo Trong T.Rjang Barant Trong T.Rjang 2panua Paseno spdeceng TOTAL simpo Trong T.Rjang Barant Trong T.Rjang 2panua passeno sipodec simpo Trong T.Rjang Barant Trong
2 IV Catheter Gea No. 20 15 0 0 0 0 8 9 5 0 5 4 46 99 200 0 0 0 0 0 0 0 0 0 0 200 0 15 0 0 0 0 0
5 Ansell Steril 6 1/2 250 0 0 0 0 0 0 0 0 0 0 250 300 0 0 0 0 0 0 0 0 0 0 20 0 0 130 0 0 0 0 0
6 Ansell Steril 7 296 0 0 0 0 0 0 0 0 15 0 311 162 0 0 0 0 10 0 0 10 0 10 20 0 0 96 0 0 0 0 0
7 Ansell Steri 7 1/2 538 0 2 11 0 0 2 3 1 9 0 566 145 0 0 0 0 0 30 10 0 5 0 0 0 0 0 0 3 0 0 4
8 Alat Suntik sekali pakai 0,05 ml 700 0 0 0 0 0 0 0 0 0 0 700 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik sekali pakai 0,5 ml 0 0 0 0 0 0 8 0 0 2 15 25 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 Alat suntik sekali pakai 1 ml 4,400 28 0 0 0 12 73 79 51 181 190 5014 5355 0 0 0 0 50 30 0 0 0 0 0 0 0 228 0 0 0 8 3
11 Alat suntik sekali pakai 3 ml 1,100 50 0 16 0 46 71 8 0 87 7 1385 2093 0 0 0 0 50 30 0 20 0 0 50 0 0 400 0 0 0 23 5
12 Alat suntik sekali pakai 5 ml 937 0 0 19 0 0 12 9 0 5 4 986 1011 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2
13 Alat Suntik sekali pakai 10 ml 159 0 0 0 0 0 0 0 0 0 0 159 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Albendasol tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Alkohol Swab 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Alupurinol tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 1180 0 0 0 0 0 0 0 0 0 0 0 0 40 0 0 0 0 0 0

17 Allpurinol tablet 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 500 0 500 0 0 0 0 0
18 Ambroxol sirup 15 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 61 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ambroxol tablet 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Aminofilin tablet 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Amitriptilin HCI tablet salut 25 mg 1,000 0 0 0 0 0 0 0 0 0 0 1000 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Amlodipine 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Amlodipine 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 1350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml 65 1 7 8 0 9 0 0 0 2 5 97 169 200 0 0 0 10 0 0 10 5 10 10 200 0 71 1 0 0 0 0
26 Amoksisilin sirup kering forte 250 mg/5 ml 30 0 0 0 0 0 0 0 0 0 0 30 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Amoksisilin kapsul 250 mg 1,100 30 110 350 0 0 0 140 30 0 0 1760 3270 1000 0 0 200 0 0 0 0 0 0 0 1000 0 0 0 50 0 0 0
28 Amoksisilin kaplet 500 mg 7,300 170 1,030 310 0 900 360 130 30 362 1,032 11624 24706 20000 0 0 500 500 0 500 300 1000 200 300 20000 0 3200 130 100 0 90 50
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Anagens Syrup 8 0 5 0 0 4 0 0 0 0 0 17 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
31 Antalgin (Metampiron) tablet 500 mg 0 0 0 0 0 0 0 0 0 280 0 280 1494 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Antasida DOEN tablet kombinasi 900 88 200 335 0 90 550 0 200 520 650 3533 10934 5000 0 500 0 500 300 0 300 500 0 0 5000 0 1546 70 20 0 20 50
34 Antasida DOEN suspensi 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 9 0 0 0 0 0 0 200 0 90 0 0 0 0 0
35 Antihemoroid DOEN kombinasi 28 0 0 0 0 0 0 0 0 0 0 28 28 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
36 Antifungi DOEN kombinasi 24 0 0 0 0 0 0 0 0 0 0 24 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Antibakteri DOEN salep Kombinasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Antimigrain DOEN kombinasi 300 43 0 0 0 0 0 0 0 0 0 343 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg 5,300 150 610 360 0 424 200 0 0 103 535 7682 10344 14000 0 0 500 0 0 0 0 0 500 400 14000 0 240 130 110 0 40 50
41 Asam Folat 0 0 0 0 0 0 0 20 0 0 0 20 845 500 0 0 0 0 0 0 0 0 0 0 500 0 200 0 0 0 0 0
42 Asam Mefenamat tablet 500 mg 0 0 620 675 0 290 550 60 30 360 653 3238 10387 10000 0 0 0 400 0 0 200 500 200 0 10000 0 430 0 70 0 10 50
43 Asiklovir 200 mg 100 40 0 0 0 0 0 0 0 0 0 140 300 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0
44 Asiklovir 400 mg 200 0 0 0 0 0 0 0 0 0 0 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0
45 Asiklovir krim 5% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Asetosal tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Attalpulgit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml 3 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Atropin Sulfat tablet 0,5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Betahistin maleat 24 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Betametason krim 0.1 % 200 0 0 0 0 0 0 0 0 4 0 204 237 0 0 0 0 0 0 0 0 0 0 0 0 0 42 0 0 0 0 0
55 Bisakodil 5 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Bisakodil 10 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Blood Lancet 26G 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Catgut/benang bedah no .2/0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 Catgut/benang bedah no .3/0 24 7 0 0 0 5 4 5 0 7 8 60 161 72 0 0 0 0 0 0 0 0 0 0 72 0 36 0 0 0 3 1
60 Deksametason injeksi 5 mlg/ml - 1 ml 25 0 0 0 0 0 0 0 0 0 0 25 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Deksametason tablet 0,5 mg 2,100 150 70 900 0 76 237 0 10 73 564 4180 6967 5000 0 300 0 200 200 0 500 500 500 0 5000 0 377 80 10 0 60 37
62 Diazepam injeksi 5 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 5 0 3 0 0 0 0 0
64 Diazepam tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Diazepam tablet 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml 30 0 0 0 0 0 0 0 0 0 0 30 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Digoksin tablet 0,25 mg 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Doksisilin kapsul 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Domperidom suspensi 20 1 0 0 0 0 0 0 0 0 0 21 29 100 0 0 0 6 0 0 0 0 0 0 100 0 65 0 0 0 0 0
71 Domperidom tablet 500 120 0 0 0 0 0 0 0 0 0 620 600 0 0 0 0 0 0 0 0 0 0 0 0 0 120 0 0 0 0 0
72 Efedrin HCI tablet 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ekstrak Belladon tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % 8 0 0 1 0 0 1 0 0 0 0 10 14 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 E t a n o l 70 % 100 ml 85 0 1 0 0 3 5 5 0 4 0 103 73 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1
77 Etil klorida semprot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Eugenol cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Fenobarbital tablet 30 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Fervital Kapsul 0 0 150 0 0 0 80 0 0 0 0 230 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml 53 22 0 0 0 0 6 2 0 9 8 100 134 0 0 0 0 0 20 5 0 0 0 5 0 0 22 0 0 0 0 2
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg 0 94 0 0 0 0 0 0 0 0 0 94 30 300 0 0 0 0 0 0 0 0 0 0 300 0 30 0 0 0 0 0
84 Foly Catheter No. 18 0 0 0 0 0 0 0 0 0 0 0 0 2 10 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0
85 Foly Catheter No. 20 0 0 0 0 0 0 0 0 0 0 0 0 6 10 0 0 0 0 0 0 0 0 0 0 10 0 2 0 0 0 0 0
86 Furosemid tablet 40 mg 0 179 0 0 0 0 0 0 0 0 0 179 297 0 0 0 0 0 0 0 0 0 0 0 0 0 89 0 0 0 0 0
87 Garam Oralit untuk 200 ml Air 0 0 22 40 0 19 0 0 0 10 0 91 815 1000 0 0 0 0 20 18 50 50 50 50 1000 0 270 0 5 0 3 0
95 Gentamicin inj 40mg/ml 25 0 0 0 0 0 0 0 0 0 0 25 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Gentian Violet larutan 1 % 5 0 0 0 0 0 0 0 0 0 0 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Glass lonomer Cement (GC IX ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Glibenklamid tablet 5 mg 2,000 45 0 0 0 0 0 0 0 0 0 2045 2445 0 0 0 0 0 0 0 0 0 0 0 0 0 145 0 0 0 0 0

92 Glimepiride 1 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Glimepiride 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Guaiafenesin Tablet 1,200 40 190 220 0 280 120 0 40 659 0 2749 5349 5000 0 0 0 0 0 0 0 200 0 0 5000 0 782 120 40 0 0 40
95 Glukosa larutan infus 5 % steril 25 68 0 0 0 0 8 5 0 2 0 108 69 200 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0
96 Grisefulvin tablet 125 mg (Micronized) 3,000 90 0 280 0 30 0 0 0 0 0 3400 810 0 0 0 500 0 0 0 0 0 0 0 0 0 90 0 10 0 0 0
97 Haloperidol tablet 1,5 mg 1,100 0 0 0 0 0 0 0 0 0 0 1100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1100 0 0 0 0 0
98 Haloperidol tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
99 Haloperidol inj 50 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Hidroklorotiazid (HCT) tablet 25 mg 800 119 0 0 0 0 0 0 0 0 0 919 1149 0 0 0 0 0 0 0 0 0 0 0 0 0 425 0 0 0 0 0
101 Hidrokortison krim 2,5 % 0 0 10 0 0 0 3 4 0 0 0 17 19 192 0 0 10 0 0 0 5 0 0 0 192 0 43 0 0 0 0 1
102 Ibuprofen suspensi 100 mg/5 ml 52 0 0 0 0 0 0 0 0 0 0 52 74 0 0 10 0 0 0 5 10 0 0 0 0 0 11 0 0 0 0 0
103 Ibuprofen suspensi 200 mg/5 ml 0 0 0 0 0 2 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
104 Ibuprofen tablet 200 mg 10,300 0 860 1240 0 630 500 150 50 210 450 14390 16430 0 0 0 0 500 0 0 300 200 300 0 0 0 2120 70 0 0 0 0
105 Ibuprofen tablet 400 mg 0 0 0 0 0 0 140 0 0 0 0 140 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Infusion set anak 150 16 0 0 0 0 0 0 0 0 0 166 119 0 0 0 0 0 0 0 0 0 0 0 0 0 16 0 0 0 0 0
107 Infusion set dewasa 150 119 0 0 0 11 9 6 -2 9 11 313 274 0 0 0 0 3 0 0 0 0 0 0 0 0 114 0 0 0 1 0
108 Isoniazid tablet 100 mg 0 90 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 25 0 0 0 0 0
109 Isosorbid Dinitrat tablet subligual 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
110 Kalsium Glukonat inj 10% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
111 Kalsium Hidroksida pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg 5,200 94 0 0 0 150 220 0 -30 300 0 5934 5344 0 0 0 0 200 300 0 0 500 0 500 0 0 1204 0 0 0 150 40
113 Kapas pembalut 250 gram 3 0 0 0 0 0 0 0 0 0 0 3 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
114 Kapas pembalut / Absorben 500 gram 3 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
115 Kapas pembalut / Absorben 1000 gram 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
116 Kaptopril 12,5 mg 3,300 80 0 0 0 0 0 0 0 0 0 3380 4484 0 0 0 0 200 0 0 0 0 0 0 0 0 2987 0 0 0 0 0

117 Kaptopril 25 mg 1,700 0 0 0 0 0 0 0 0 0 0 1700 4401 3000 0 0 0 0 0 0 0 0 0 0 3000 0 1567 0 0 0 0 0
118 Karbamazepin tablet 200 mg 0 ### 0 0 0 0 0 0 0 0 0 1980 1980 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm 600 0 0 33 0 0 60 20 0 50 50 813 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0
120 Kasa hidrofil 40 x 80 cm 0 0 0 0 0 0 0 0 0 0 0 0 4 5 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0
121 Kasa pembalut elastis 3 inch 7 0 0 0 0 0 0 0 0 0 0 7 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
122 Ketokonazol krim 2% 25 22 0 0 0 0 0 0 0 0 0 47 81 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0 0 0 0
123 Ketokonazol tablet 200 mg 650 0 0 0 0 0 0 0 0 0 0 650 150 0 0 0 0 0 0 0 0 0 0 0 0 0 250 0 0 0 0 0
124 Kloramfenikol kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
125 Kloramfenikol susp 125mg/5 ml 78 0 0 0 0 0 0 0 0 0 0 78 80 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
126 Kloramfenikol salep mata 1 % 82 6 0 0 0 0 4 0 8 9 0 109 99 0 0 0 0 0 0 5 5 5 0 0 0 0 34 0 0 0 0 3
127 Kloramfenikol tetes mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Kloramfenikol salep Kulit 2% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
129 Kloramfenikol tetes telinga 3 % 9 0 0 0 0 0 0 0 0 0 0 9 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Klorfeniramin maleat tablet 4 mg 1,300 60 20 0 0 0 770 0 0 444 160 2754 7663 5000 0 500 0 500 0 0 600 500 300 0 5000 0 877 40 0 0 0 100
131 Klorokuin tablet 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
132 Klorfenol Kamfer Menthol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml 29 0 0 0 0 0 0 0 0 0 0 29 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
134 Klorpromazin HCI tablet salut 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
135 Klorpromazin HCI tablet salut 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kotrimoksazol tablet 480 mg 2,600 120 200 220 0 500 0 240 230 531 340 4981 7168 0 0 0 0 0 0 0 0 0 0 0 0 0 45 20 20 0 10 40
137 Kotrimoksazol Suspensi 240 mg/ 5 ml 22 0 1 0 0 6 2 3 0 11 3 48 98 0 0 0 0 0 0 0 0 0 0 5 0 0 7 0 0 0 0 0
138 Kotrimoksazol Pediatrik tablet 120 mg 390 0 0 0 0 0 0 0 0 0 0 390 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 Larutan mengandung elektrolit 0 0 0 0 0 0 0 0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 14 0 0 0 0 0
140 Lidokain komp. injeksi - 2 ml 0 14 0 10 0 4 0 7 0 0 0 35 117 300 0 0 0 10 0 5 10 10 0 0 300 0 49 0 0 0 2 0
141 Lisol 1 liter 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

142 Loperamide 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
143 Loratadine 10 mg 450 0 0 0 0 0 0 0 0 0 0 450 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Masker Kain 0 0 0 32 0 13 0 15 0 0 0 60 157 1000 0 0 0 0 50 0 0 50 100 0 1000 0 30 0 1 0 13 0
147 Mata Pisau No. 15 84 0 0 0 0 0 0 0 0 0 0 84 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Mata Pisau No. 20 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Metilergometrin maleat tablet salut 0,125 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 500 0 0 0 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
151 Metilprednisolon tablet 4 mg 0 0 0 0 0 0 0 0 0 0 0 0 730 1000 0 0 0 0 0 0 0 0 0 0 1000 0 300 0 0 0 0 0
152 Metformin Hcl 500 mg 600 40 0 0 0 0 0 0 0 0 0 640 820 2000 0 0 0 0 0 0 0 0 0 0 2000 0 736 0 0 0 0 0
153 Metoklopramida 10 mg 400 100 0 0 0 0 0 0 0 0 0 500 300 0 0 0 0 0 0 0 0 0 0 0 0 0 355 0 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 50 0 3 0 0 0 0 0
155 Metronidazol tablet 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0
156 Metronidazol tablet 500 mg 2,400 90 0 0 0 300 360 170 0 120 520 3960 2804 0 0 0 0 100 0 0 0 0 0 0 0 0 553 0 0 0 50 0
157 Miconazole Krim 0 0 0 0 0 0 0 0 0 0 0 0 27 24 0 0 0 0 0 0 0 0 0 0 24 0 5 0 0 0 0 0
158 Mineral Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Multivitamin (Lycalvit) syrup 0 0 0 0 0 0 1 0 1 0 0 2 3 0 0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0
160 Mummifying pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Natrium diklofenak 50 mg 1,150 60 0 0 0 0 0 0 0 0 0 1210 1424 2800 0 0 0 0 0 0 0 0 0 0 2800 0 410 0 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril 130 0 0 1 0 3 8 8 0 0 6 156 126 0 0 0 0 0 0 0 10 0 0 0 20 0 0 0 0 0
163 Nifedipin 10 mg 200 10 0 0 0 0 0 0 0 0 0 210 300 0 0 0 0 0 0 0 0 0 0 0 0 0 45 0 0 0 0 0
164 Nistatin tablet vagina 100.000 IU / g 70 0 0 0 0 0 0 0 0 0 0 70 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 Nistatin vaginal tablet salut 500.000 IU/g 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Obat anti Tuberklosis kategori FDC I 10 0 0 0 0 0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

168 Obat anti Tuberklosis kategori FDC 2 2 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Obat anti Tuberklosis kategori FDC Anak 3 0 0 0 0 0 0 0 0 0 0 3 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
170 Obat Batuk Hitam (O.B.H) cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
171 OBH Itral Syrup 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
172 Ofloksasin tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep kulit 3 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
174 Oksitetrasiklin HCI salep mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
175 Oksitosin injeksi 10 IU / ml - 1 ml 130 0 0 0 0 0 0 2 0 10 0 142 210 0 0 0 0 10 0 5 0 10 0 0 0 0 0 0 0 0 0 0
176 Omeprazole 20 mg 90 0 0 0 0 0 0 0 0 0 0 90 30 0 0 0 0 0 0 0 0 0 0 0 0 0 90 0 0 0 0 0
177 Parasetamol drops 13 0 0 0 0 0 0 0 0 0 0 13 53 0 0 0 0 0 0 0 0 0 0 0 0 0 13 0 0 0 0 0
178 Parasetamol sirup 120 mg / 5 ml 0 0 0 0 0 0 0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
179 Parasetamol tablet 500 mg 6,700 140 0 0 0 368 500 0 120 361 0 8189 9030 16800 0 1000 1000 700 0 0 1000 1000 500 900 16800 0 120 90 0 0 110 30
180 Pehacain injeksi 0 0 0 0 0 0 0 0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
181 Permetrin krim 5% 6 0 0 0 0 0 0 0 0 0 0 6 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 Pirantel pamoat tablet 125 mg 100 90 0 0 0 6 0 0 0 0 0 196 239 0 0 0 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0
183 Pirantel suspensi 10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 20 0 5 0 0 0 0 0
184 Pirantel suspensin 60 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
185 Piridoksin HCI (Vit. B6 ) tablet 10 mg 0 0 280 0 0 0 0 0 0 0 197 477 2660 14000 0 0 0 0 0 0 400 0 0 500 14000 0 1987 10 0 0 0 0
186 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Piroksikam 20 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
188 Plester 2,5 cm x 4 m 23 0 1 0 0 0 1 0 0 0 1 26 17 0 0 0 0 2 3 0 2 1 0 0 0 0 0 0 0 0 0 0
189 Plester 7,5 cm x 4 m 1 0 0 0 0 0 0 0 0 0 0 1 9 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
190 Pot Sputum 0 0 0 0 0 0 0 0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
191 Prednison tablet 5 mg 0 0 80 160 0 0 0 0 0 155 0 395 5984 3000 0 200 0 100 0 0 0 0 0 0 3000 0 2333 60 30 0 0 0
192 Primakuin tablet 15 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Prokain benzil penisilin injeksi 3 Juta IU / vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
194 Propiltiourasil tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
195 Propranolol HCI tablet 40 mg 300 0 0 0 0 0 0 0 0 0 0 300 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 Ranitidin tablet 150 mg 0 0 0 0 0 60 0 0 0 0 0 60 3280 5000 0 0 0 0 0 0 0 0 0 0 5000 0 468 0 0 0 0 0
197 Ranitidin injeksi 25 mg/2 ml 20 0 0 0 0 0 0 0 0 0 0 20 78 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0
198 Rapid Test VIKIA HIV 1/2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Rapid Test SD Bioline HIV 1/2 3.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
200 Reagensia ZN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
201 Retinol (Vitamin A) kapsul 100.000 IU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Retinol (Vitamin A) kapsul 200.000 IU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 Ringer Laktat larutan infus steril 120 19 0 0 0 7 5 5 0 5 4 165 87 400 0 0 0 0 0 0 5 5 0 0 400 0 304 0 0 0 2 0
204 Salbutamol tablet 2 mg 400 75 0 85 0 100 90 50 0 0 0 800 1192 0 0 0 0 0 0 0 0 0 0 0 0 0 191 0 0 0 0 10
205 Salbutamol 4 mg 190 0 0 0 0 0 0 0 0 0 0 190 200 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0
206 Salep 2 - 4 kombinasi 70 0 0 0 0 4 0 1 0 0 0 75 92 0 0 0 0 10 0 3 5 0 0 0 0 0 2 0 0 0 1 0
207 Salisil bedak 2 % 15 0 4 0 0 4 3 2 0 7 1 36 79 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
208 Sarung Tangan Examination S 0 0 0 0 0 0 0 0 0 28 0 28 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Sarung Tangan Examination M 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
210 Sarung Tangan Examination L 0 0 0 0 0 0 40 0 0 0 0 40 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 46
211 Sefadroksil 500 mg 0 92 0 0 0 0 0 0 0 0 0 92 702 1000 0 0 0 100 0 0 0 0 0 0 1000 0 247 0 0 0 0 0

212 Semen seng fosfat serbuk dan cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
213 Setrizin tablet 10 mg 0 50 0 0 0 0 0 0 0 0 0 50 0 1000 0 0 0 0 0 0 0 0 0 0 1000 0 540 0 0 0 0 0
214 Setrizin syrup 29 14 0 0 0 0 0 0 0 0 0 43 24 0 0 0 0 0 0 0 0 0 0 0 0 0 17 0 0 0 0 0
215 Sianokorbalamin (Vit.B 12) 500 mcg 1,600 0 0 0 0 300 170 40 200 0 0 2310 3118 0 0 0 0 100 0 0 100 500 0 0 0 0 410 0 0 0 0 30
216 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml 140 0 0 0 0 0 0 0 0 0 0 140 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
217 Simetidine 200 mg 1,500 0 0 0 0 0 0 0 0 0 0 1500 1800 0 0 0 0 0 0 0 0 0 0 0 0 0 790 0 0 0 0 0
218 Simvastatin 10 mg 1,140 0 0 0 0 0 0 0 0 0 0 1140 317 0 0 0 0 0 0 0 0 0 0 0 0 0 780 0 0 0 0 0
219 Simvastatin 20 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 300 0 100 0 0 0 0 0
220 Silk (benang Bedah Sutera) No. 3 / 0 24 43 0 0 0 0 5 5 0 0 0 77 22 0 0 0 0 0 0 0 0 0 0 0 0 0 55 0 0 0 0 0
221 Siprofloksasin tablet 500 mg 1,300 90 0 0 0 0 0 0 0 0 0 1390 398 2000 0 0 0 0 0 0 0 0 0 0 2000 0 160 0 0 0 0 0
222 Spironolakton tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
223 Sulfasetamida natrium tetes mata 15 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 Tablet tambah darah kombinasi 0 0 0 0 0 0 0 0 0 0 0 0 400 21600 0 0 0 300 300 300 270 300 600 270 21600 0 410 0 0 0 0 10
225 Taburia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 Temporary stopping (Fletcher) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
227 Tetrasiklin HCI kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
228 Tetrasiklin HCI kapsul 500 mg 400 0 0 0 0 0 0 0 0 0 0 400 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 Tiamfenikol 500 mg 200 60 0 0 0 0 0 0 0 0 0 260 320 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0
230 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml 30 0 0 0 0 0 0 0 0 0 0 30 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg 0 90 0 340 0 220 0 0 240 0 270 1160 3556 10000 0 500 500 500 0 0 500 500 0 400 10000 0 2600 30 30 0 0 0
232 Triheksifenidil Hidroklorida tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Umbilical Cord 35 0 0 0 0 0 5 9 0 12 7 68 174 0 0 0 0 0 0 0 0 0 0 0 0 0 35 0 0 0 0 2
234 U-Pad steril 60 cm x 90 cm 0 0 0 0 0 0 0 1 1 0 6 8 39 10 0 0 0 0 0 0 0 0 0 0 10 0 10 0 0 0 0 0
235 Urine Bag 12 0 0 0 0 0 0 0 0 0 0 12 16 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
236 Vaksin Jerap Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
237 Vaksin Rabies vero 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238 Vitamin B kompleks tablet 18,100 150 90 275 0 288 690 100 150 587 440 20870 28428 0 0 1000 1000 500 0 0 500 500 0 500 0 0 1460 170 90 0 80 50
239 Wicold kapsul 0 0 0 0 0 0 0 0 0 0 0 0 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
240 Yodium povidon larutan 10 % 60 ml 10 0 1 0 0 3 1 0 0 0 1 16 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
241 Yodium povidon larutan 10 % 300 ml 4 0 0 0 0 0 1 0 0 0 0 5 4 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0
242 Zinc syrup 26 0 0 0 0 0 0 0 0 0 0 26 30 0 0 0 0 0 0 0 0 5 0 0 0 0 13 0 0 0 10 0
243 Zinc Tablet 700 102 0 0 0 150 220 180 0 170 40 1562 2520 0 0 0 0 0 0 0 0 0 100 0 0 0 250 0 0 0 0 0
244 Paper Tape 2,5 x 9,14 5 0 0 0 0 0 0 0 0 0 0 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Paper Tape 7,5 x 9,14 2 0 0 0 0 0 0 0 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Zidovudine 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
246 Lomivudine 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Efavirenz 600 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
248 Nipirapine 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
249 ZDV + 3 TC+ NVP Ped Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
250 TDF +3TC+EFV (300/300/600) Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Tenofovir 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
252 Tenof EM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
253 samcobion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
254 Spironolakton tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
255 lytacur sirup 36 0 0 0 0 0 0 0 0 1 0 37 14 100 0 0 0 0 0 0 5 0 10 0 100 0 0 0 0 0 0 0
256 Susu Produgen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 0
20 0
Mengetahui
BULAN 6
TAHUN 2018
Pksdes Pkesdes Pkesdes Pksdes 115 Pustu Pustu Pustu Pksdes Pksdes Pksdes Pkesdes Pksdes Pkesdes
TOTAL Apotk TOTAL
T.Rjangduampanuapassenosipodeceng simpo Trong T.Rjang Barant Trong T.Rijang 2panua passeno sipodecen
115
1 3 0 0 8 15 100 0 0 0 0 17 10 2 16 12 179
0 0 0 0 15 80 200 0 0 0 0 4 9 5 0 5 4 231
0 0 0 0 42 92 160 0 0 0 0 9 0 0 0 0 0 169
0 0 0 0 38 18 292 0 0 0 0 0 0 0 0 0 0 292
0 0 0 0 130 0 5 0 0 0 0 0 0 0 0 0 18 120
2 0 0 4 102 242 79 0 0 0 10 0 0 6 0 21 16 132
3 1 4 0 15 61 400 0 2 5 0 15 8 0 5 5 0 551
0 0 0 0 0 0 600 0 0 0 0 0 0 0 0 0 0 700
0 0 0 0 0 17 0 0 0 0 0 0 8 0 0 2 15 25
2 10 2 0 253 112 4,332 0 0 0 50 22 67 75 36 178 190 4950
5 0 2 7 442 129 582 0 0 16 50 43 61 19 0 77 21 869
2 0 0 0 4 8 937 0 0 19 0 0 10 7 0 5 4 982
0 0 0 0 0 0 157 0 0 0 0 0 0 0 0 0 0 157
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 230 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1,000 0 0 0 0 0 0 0 0 0 0 1000
0 0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 976 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 75 30 108 0 5 6 4 9 0 8 5 12 11 168
0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 0 0
60 0 0 0 110 320 1,000 30 80 410 0 0 0 70 40 0 0 1630
130 200 30 114 4044 2930 18,400 200 670 590 170 810 750 200 770 722 1,173 24455
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 4 3 0 3 0 0 4 0 0 0 0 0 10
0 0 0 0 0 370 0 0 0 0 0 80 0 0 0 280 0 360
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 0 30 46 1882 2069 1,700 30 500 275 330 300 450 170 400 460 500 5115
0 0 0 0 90 44 73 0 0 0 0 0 0 0 0 0 0 73
0 0 0 0 1 0 23 0 0 0 0 0 0 0 0 0 0 27
0 0 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 22
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 20 300 43 0 0 0 0 0 0 0 0 0 343
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 70 0 640 3953 9,300 62 230 510 0 314 100 250 60 292 935 12053
20 0 0 0 220 375 200 100 0 0 0 0 0 0 0 0 0 300
60 100 30 35 785 1392 6,000 110 560 545 160 250 450 130 640 450 608 9903
0 0 0 0 100 0 0 10 0 0 0 0 0 0 0 0 0 10
0 0 0 0 50 0 150 0 0 0 0 0 0 0 0 0 0 150
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 42 12 134 20 0 0 0 0 0 0 0 3 0 157
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1 0 1 0 42 19 40 0 0 0 0 2 3 4 0 5 8 62
0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 25
0 70 0 0 634 1387 2,400 300 230 860 200 216 150 390 360 447 564 6117
0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 3 0 -1 0 0 0 0 0 0 0 0 0 0 -1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 30
0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 65 16 24 0 0 0 3 0 0 0 0 0 0 27
0 0 0 0 120 0 500 0 0 0 0 0 0 0 0 0 0 500
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 6 0 1 1 0 0 1 0 0 0 0 10
2 0 1 0 4 28 64 0 0 0 0 2 2 2 0 3 0 73
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 20 390 0 0 150 0 0 0 30 0 0 0 0 180
2 0 1 2 29 9 23 0 0 0 0 16 8 0 0 7 11 65 -3
0 0 0 0 30 30 300 46 0 0 0 0 0 0 0 0 0 346
0 0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 2 0 8 0 0 0 0 0 0 0 0 0 0 8
0 0 0 0 89 3 0 65 0 0 0 0 0 0 0 0 0 65
0 15 14 0 307 281 400 90 0 25 0 32 12 35 45 35 41 715
0 0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 25
0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 145 10 1,700 155 0 0 0 0 0 0 0 0 0 1855

0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 120 0 0 1102 2654 1,000 110 420 115 0 280 30 0 100 537 0 2592
0 0 0 0 0 10 200 0 0 0 0 0 8 5 0 2 0 215
0 0 0 0 100 150 2,500 0 0 720 0 20 0 0 0 0 0 3240
0 0 0 0 1100 120 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 425 6 400 94 0 0 0 0 0 0 0 0 0 494
0 0 0 0 44 14 120 20 7 9 0 0 2 9 0 0 0 167
0 0 0 0 11 9 24 0 8 0 0 0 5 6 0 0 0 49
0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2
150 80 70 50 2540 520 6,000 100 630 1200 450 630 500 200 310 425 400 10845
0 0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 140
0 0 0 0 16 15 147 0 0 0 0 0 0 0 0 0 0 147
0 2 0 0 117 9 123 0 0 0 3 6 9 5 1 9 11 167
0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 180 110 0 1684 1211 1,400 124 0 0 150 280 130 200 250 80 350 2964
0 0 0 0 0 2 1 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 2987 76 0 0 0 0 140 0 0 0 0 0 0 140

0 0 0 0 1567 709 900 183 0 0 0 0 0 0 0 0 0 1083
0 0 0 0 10 0 1,900 1980 0 0 0 0 0 0 0 0 0 3880
10 5 0 0 17 27 600 0 0 29 0 0 50 0 0 50 50 779
0 0 0 0 0 2 2 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 7
0 0 0 0 5 6 0 25 0 0 0 0 0 0 0 0 0 25
0 0 0 0 250 190 500 90 0 0 0 0 0 0 0 0 0 590
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 1 77 0 0 0 0 0 0 0 0 0 0 77
0 0 0 0 37 20 24 23 0 0 0 0 5 1 5 6 0 64
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 9
100 230 0 0 1347 2548 2,900 183 330 0 300 0 620 390 270 654 160 5807
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 29
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 20 40 140 335 405 1,600 76 200 440 490 300 0 200 445 60 3811
0 0 0 3 10 4 3 0 1 0 0 6 1 2 0 11 4 28
0 0 0 0 0 0 390 0 0 0 0 0 0 0 0 0 0 390
0 0 0 0 14 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 54 37 60 0 0 10 5 2 5 13 10 0 0 105
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 450
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 10 0 0 57 532 200 0 0 29 0 35 0 10 40 47 0 90
0 0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 84
0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 500 0 0 0 0 0 0 0 0 0 0 500
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 300 30 500 140 0 0 0 0 0 0 0 0 0 640
0 0 0 0 736 290 1,100 135 0 0 0 0 0 0 0 0 0 1235
0 0 0 0 355 0 0 145 0 0 0 0 0 0 0 0 0 145
0 0 0 0 3 0 47 0 0 0 0 0 0 0 0 0 0 47
0 0 0 0 0 0 0 0 0 0 0 0 0 0 260 0 0 260
30 0 0 0 633 290 900 20 0 0 50 210 360 130 260 120 490 2540
0 0 0 0 5 31 0 17 0 0 0 0 0 0 0 0 0 17
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 0 0 6
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 410 836 3,000 190 0 0 0 0 0 0 0 0 0 3190
0 0 0 0 20 49 120 0 0 1 0 3 8 8 10 0 5 155
0 0 0 0 45 14 0 100 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 70
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 2 1 0 5 4 80 0 0 0 10 0 4 9 6 8 0 117
0 0 0 0 90 90 90 0 0 0 0 0 0 0 0 0 0 90
0 0 0 0 13 10 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0
200 150 50 0 750 7420 6,000 706 530 790 400 188 410 640 700 703 610 11677
0 0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 100 39 0 90 0 0 0 6 0 0 0 0 0 96
0 0 0 0 5 0 10 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 135 2132 2161 8,200 300 220 0 0 0 0 300 0 0 485 9505
0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 15 0 -1 0 0 2 1 2 1 0 1 21
0 0 0 0 1 4 -1 0 0 0 0 0 0 0 0 0 0 -1
0 0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 2423 2881 0 0 70 130 80 0 0 0 0 155 0 435
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 300
0 0 0 0 468 980 4,000 140 0 0 0 50 0 0 0 0 0 4190
0 0 0 0 20 28 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 306 67 220 0 0 0 0 1 5 9 10 5 4 254
20 0 0 0 221 222 0 100 0 75 0 100 60 30 0 0 0 365
0 0 0 0 0 0 190 0 0 0 170 0 0 0 0 0 0 360
0 0 0 0 3 8 52 0 0 0 8 2 3 6 0 0 0 71
0 0 0 0 0 26 14 0 4 0 0 4 3 2 0 7 1 35
0 0 4 0 4 14 0 0 0 0 0 0 0 0 0 20 0 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 46 404 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 247 220 600 0 0 0 60 0 0 0 0 0 0 660
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 17 10 0 0 0 0 0 0 0 0 0 0 0 0
40 0 0 0 480 140 600 60 0 0 50 240 120 50 450 0 0 1570
0 0 0 0 0 0 140 60 0 0 0 0 0 0 0 0 0 200
0 0 0 0 790 0 900 110 0 0 0 0 0 0 0 0 0 1010
0 0 0 0 780 407 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 100 0 150 26 0 0 0 0 0 0 0 0 0 176
0 0 0 0 55 17 3 0 0 0 0 0 5 5 0 0 0 13
0 0 0 0 160 398 3,100 30 0 0 0 0 0 0 0 0 0 3130
0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 0 260 0 710 1600 17,670 54 0 0 300 120 0 60 180 50 0 18434
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 400 0 0 0 0 0 0 0 0 0 0 400
0 0 0 0 20 40 200 20 0 0 0 0 0 0 0 0 0 220
0 0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 30
0 0 0 80 2740 2867 1,800 231 140 720 360 220 0 460 500 0 430 4861
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
2 0 1 0 40 12 0 0 0 0 0 0 1 6 3 10 7 27
1 0 0 0 11 4 0 0 0 0 0 0 0 0 1 0 6 17
0 0 0 0 0 0 9 0 0 0 0 0 0 0 0 0 0 9
0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 90 130 90 2260 2935 11,100 330 690 995 300 148 600 360 260 256 670 15709
0 0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 9 0 3 0 0 3 1 0 0 0 0 16
0 0 0 0 1 7 2 0 0 0 0 0 1 0 0 0 0 3
0 0 0 0 23 0 8 0 0 0 0 0 0 0 5 0 0 13
20 0 20 20 310 206 300 60 0 0 0 140 220 140 100 240 10 1210
0 0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 17 112 2 0 0 0 0 0 4 0 10 0 128
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0
8 0


Pustu Pustu Pustu Pksdes Pksdes Pksdes PkesdesPkesdes Pksdes Pustu Pustu Pustu Pksdes Pksdes Pksdes Pkesdes Pksdes Pkesdes Pustu Pustu Pustu Pksdes Pksdes Pksdes
NO NAMA OBAT Satuan
simpo Trong T.Rjang Barant Trong T.Rjang 2panua Paseno spdeceng TOTAL simpo Trong T.Rjang Barant Trong T.Rjang 2panua passeno sipodec simpo Trong T.Rjang Barant Trong T.Rjang
1 IV Catheter Gea No. 18 115 0 0 0 0 7 21 12 11 16 12 194 225 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0
5 Ansell Steril 6 1/2 250 0 0 0 0 0 0 0 0 0 0 250 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
6 Ansell Steril 7 300 0 0 0 1 0 0 0 0 15 3 319 162 0 0 0 0 0 0 0 0 0 0 0 0 104 104 0 0 0 0 0 0
7 Ansell Steri 7 1/2 500 0 0 12 0 0 2 4 3 11 0 532 145 0 0 0 0 0 0 0 0 0 0 0 0 70 70 2 1 0 0 3 1
8 Alat Suntik sekali pakai 0,05 ml 900 0 0 0 0 0 0 0 0 0 0 900 900 0 0 0 0 0 0 0 0 0 0 0 0 200 200 0 0 0 0 0 0
9 Alat Suntik sekali pakai 0,5 ml 0 0 0 0 0 0 8 0 0 5 13 26 55 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0
10 Alat suntik sekali pakai 1 ml 4600 0 0 0 0 18 78 79 66 181 192 5214 5355 0 0 0 0 0 0 0 0 0 0 0 0 178 178 0 0 0 6 5 0
13 Alat Suntik sekali pakai 10 ml 157 0 0 0 0 0 0 0 0 0 0 157 161 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 Albendasol tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Alkohol Swab 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
16 Alupurinol tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 1180 0 0 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0

17 Allpurinol tablet 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ambroxol sirup 15 mg/ml 0 0 0 0 1 1 0 0 0 0 0 2 61 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0
19 Ambroxol tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Aminofilin tablet 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Amitriptilin HCI tablet salut 25 mg 1000 0 0 0 0 0 0 0 0 0 0 1000 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Amlodipine 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 330 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Amlodipine 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 1350 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml 85 13 9 10 0 10 0 0 0 3 8 138 169 0 0 0 0 0 0 0 0 0 0 0 0 82 82 2 2 0 1 1 0
26 Amoksisilin sirup kering forte 250 mg/5 ml 32 0 0 0 0 0 0 0 0 0 0 32 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Amoksisilin kapsul 250 mg 1400 61 170 380 0 0 0 170 40 0 0 2221 3270 0 0 0 0 0 0 0 0 0 0 0 0 731 731 60 30 0 0 0 30
28 Amoksisilin kaplet 500 mg 10300 140 1140 520 0 970 430 250 587 682 1132 16151 24706 0 0 0 0 0 0 0 0 0 0 0 0 5310 5310 110 210 0 70 50 120
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Anagens Syrup 6 0 5 0 0 4 0 0 0 0 0 15 24 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0
31 Antalgin (Metampiron) tablet 500 mg 0 0 0 0 0 0 0 0 0 280 0 280 1494 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Antasida DOEN tablet kombinasi 2200 10 350 395 0 160 610 80 0 630 720 5155 10934 0 0 0 0 0 0 0 0 0 0 0 0 2222 2222 150 60 0 70 30 80
34 Antasida DOEN suspensi 50 0 0 0 0 0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0 50 50 0 0 0 0 0 0
35 Antihemoroid DOEN kombinasi 28 0 0 0 0 0 0 0 0 0 0 28 28 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
36 Antifungi DOEN kombinasi 24 0 0 0 0 0 0 0 0 0 0 24 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
37 Antibakteri DOEN salep Kombinasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Antimigrain DOEN kombinasi 300 43 0 0 0 0 0 0 0 0 0 343 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg 8500 98 760 460 0 464 280 40 260 1011 575 12448 10344 0 0 0 0 0 0 0 0 0 0 0 0 6448 6448 150 100 0 40 70 40
41 Asam Folat 0 0 0 0 0 0 0 0 0 0 0 0 845 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 60
42 Asam Mefenamat tablet 500 mg 900 0 640 715 0 320 580 100 280 665 653 4853 10387 0 0 0 0 0 0 0 0 0 0 0 0 2500 2500 20 40 0 30 0 40
43 Asiklovir 200 mg 200 0 0 0 0 0 0 0 0 0 0 200 300 0 0 0 0 0 0 0 0 0 0 0 0 60 60 0 0 0 0 0 0
44 Asiklovir 400 mg 200 0 0 0 0 0 0 0 0 0 0 200 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Asiklovir krim 5% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Asetosal tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Attalpulgit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml 3 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Atropin Sulfat tablet 0,5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Betahistin maleat 24 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Betametason krim 0.1 % 200 0 0 0 0 0 0 0 0 6 0 206 237 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
55 Bisakodil 5 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Bisakodil 10 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Blood Lancet 26G 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Catgut/benang bedah no .2/0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0 0
59 Catgut/benang bedah no .3/0 72 0 0 0 0 0 4 5 0 8 9 98 161 0 0 0 0 0 0 0 0 0 0 0 0 41 41 0 0 0 0 1 0
60 Deksametason injeksi 5 mlg/ml - 1 ml 25 0 0 0 0 0 0 0 0 0 0 25 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
61 Deksametason tablet 0,5 mg 3700 105 90 900 0 100 287 60 70 379 604 6295 6967 0 0 0 0 0 0 0 0 0 0 0 0 2455 2455 20 0 0 3 30 60
62 Diazepam injeksi 5 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
64 Diazepam tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Diazepam tablet 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml 30 0 0 0 0 0 0 0 0 0 0 30 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Digoksin tablet 0,25 mg 100 0 0 0 0 0 0 0 0 0 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Doksisilin kapsul 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Domperidom suspensi 29 1 0 0 6 0 0 0 0 0 0 36 29 0 0 0 0 0 0 0 0 0 0 0 0 30 30 0 0 0 0 0 0
71 Domperidom tablet 600 0 0 0 0 0 0 0 0 0 0 600 600 0 0 0 0 0 0 0 0 0 0 0 0 250 250 0 0 0 0 0 0
72 Efedrin HCI tablet 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ekstrak Belladon tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % 8 0 1 1 0 0 1 0 0 0 0 11 14 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 0 0 0 0
76 E t a n o l 70 % 100 ml 90 0 0 0 0 3 5 5 0 4 0 107 73 0 0 0 0 0 0 0 0 0 0 0 0 26 26 0 0 0 0 2 0
77 Etil klorida semprot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Eugenol cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Fenobarbital tablet 30 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Fervital Kapsul 0 0 150 0 0 0 80 0 0 0 0 230 830 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml 94 0 0 0 0 0 7 2 0 10 8 121 134 0 0 0 0 0 0 0 0 0 0 0 0 19 19 0 0 0 0 2 0
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg 100 0 0 0 0 0 0 0 0 0 0 100 30 0 0 0 0 0 0 0 0 0 0 0 0 6 6 0 0 0 0 0 0
84 Foly Catheter No. 18 0 0 0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Foly Catheter No. 20 3 0 0 0 0 0 0 0 0 0 0 3 6 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0
86 Furosemid tablet 40 mg 200 59 0 0 0 0 0 0 0 0 0 259 297 0 0 0 0 0 0 0 0 0 0 0 0 80 80 0 0 0 0 0 0
87 Garam Oralit untuk 200 ml Air 0 0 22 40 11 31 0 0 15 15 0 134 815 0 0 0 0 0 0 0 0 0 0 0 0 100 100 60 0 0 12 0 0
95 Gentamicin inj 40mg/ml 25 0 0 0 0 0 0 0 0 0 0 25 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Gentian Violet larutan 1 % 5 0 0 0 0 0 0 0 0 0 0 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Glass lonomer Cement (GC IX ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Glibenklamid tablet 5 mg 2000 45 0 0 100 0 0 0 0 0 0 2145 2445 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

92 Glimepiride 1 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Glimepiride 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Guaiafenesin Tablet 3400 95 250 260 0 300 150 70 300 809 0 5634 5349 0 0 0 0 0 0 0 0 0 0 0 0 4655 4655 0 40 0 20 70 70
95 Glukosa larutan infus 5 % steril 45 8 0 0 0 0 8 5 0 2 0 68 69 0 0 0 0 0 0 0 0 0 0 0 0 28 28 0 0 0 0 0 0
96 Grisefulvin tablet 125 mg (Micronized) 3000 100 0 300 60 30 0 0 0 0 0 3490 810 0 0 0 0 0 0 0 0 0 0 0 0 10 10 0 20 0 0 0 0
97 Haloperidol tablet 1,5 mg 1100 160 0 0 0 0 0 0 0 0 0 1260 0 0 0 0 0 0 0 0 0 0 0 0 0 160 160 0 0 0 0 0 0
98 Haloperidol tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
99 Haloperidol inj 50 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Hidroklorotiazid (HCT) tablet 25 mg 1000 107 0 0 0 0 0 0 0 0 0 1107 1149 0 0 0 0 0 0 0 0 0 0 0 0 188 188 0 0 0 0 0 0
101 Hidrokortison krim 2,5 % 0 0 10 0 4 0 5 4 0 0 0 23 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
102 Ibuprofen suspensi 100 mg/5 ml 0 0 0 0 0 0 0 0 0 0 0 0 74 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
103 Ibuprofen suspensi 200 mg/5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
104 Ibuprofen tablet 200 mg 10300 15 940 1280 0 630 500 300 230 520 460 15175 16430 0 0 0 0 0 0 0 0 0 0 0 0 0 0 80 60 0 0 0 150
105 Ibuprofen tablet 400 mg 0 0 0 0 0 0 140 0 0 0 0 140 160 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Infusion set anak 150 18 0 0 0 0 0 0 10 0 0 178 119 0 0 0 0 0 0 0 0 0 0 0 0 2 2 0 0 0 0 0 0
107 Infusion set dewasa 200 94 0 0 0 12 9 6 5 9 11 346 274 0 0 0 0 0 0 0 0 0 0 0 0 25 25 0 0 0 1 0 0
108 Isoniazid tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 10 10 0 0 0 0 0 0
109 Isosorbid Dinitrat tablet subligual 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
110 Kalsium Glukonat inj 10% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
111 Kalsium Hidroksida pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg 6400 108 0 0 130 350 290 0 180 700 310 8468 5344 0 0 0 0 0 0 0 0 0 0 0 0 1215 1215 0 0 0 100 60 0
113 Kapas pembalut 250 gram 2 0 0 0 0 1 0 0 0 0 0 3 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
114 Kapas pembalut / Absorben 500 gram 3 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
115 Kapas pembalut / Absorben 1000 gram 1 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
116 Kaptopril 12,5 mg 3800 124 0 0 0 0 0 0 0 0 0 3924 4484 0 0 0 0 0 0 0 0 0 0 0 0 544 544 0 0 0 0 0 0

117 Kaptopril 25 mg 2000 115 0 0 0 0 0 0 0 0 0 2115 4401 0 0 0 0 0 0 0 0 0 0 0 0 415 415 0 0 0 0 0 0
118 Karbamazepin tablet 200 mg 1900 80 0 0 0 0 0 0 0 0 0 1980 1980 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm 650 0 0 34 0 0 60 30 15 50 50 889 1085 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 10
120 Kasa hidrofil 40 x 80 cm 1 0 0 0 0 0 0 0 0 0 0 1 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 Kasa pembalut elastis 3 inch 7 0 0 0 0 0 0 0 0 0 0 7 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
122 Ketokonazol krim 2% 50 0 0 0 0 0 0 0 0 0 0 50 81 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0
123 Ketokonazol tablet 200 mg 650 10 0 0 200 0 0 0 0 0 0 860 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
124 Kloramfenikol kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
125 Kloramfenikol susp 125mg/5 ml 78 0 0 0 0 0 0 0 0 0 0 78 80 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
126 Kloramfenikol salep mata 1 % 82 39 0 0 0 0 5 0 0 10 0 136 99 0 0 0 0 0 0 0 0 0 0 0 0 33 33 0 0 0 0 2 0
127 Kloramfenikol tetes mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Kloramfenikol salep Kulit 2% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
129 Kloramfenikol tetes telinga 3 % 9 0 0 2 0 0 0 0 0 0 0 11 11 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Klorfeniramin maleat tablet 4 mg 3300 140 140 0 0 0 820 0 230 615 220 5465 7663 0 0 0 0 0 0 0 0 0 0 0 0 2080 2080 120 0 0 0 50 0
131 Klorokuin tablet 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
132 Klorfenol Kamfer Menthol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml 29 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
134 Klorpromazin HCI tablet salut 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
135 Klorpromazin HCI tablet salut 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0 0
136 Kotrimoksazol tablet 480 mg 7168 0 0 0 0 0 0 0 0 0 0 0 0 130 130 0 10 0 0 20 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml 98 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 2
138 Kotrimoksazol Pediatrik tablet 120 mg 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 Larutan mengandung elektrolit 24 0 0 0 0 0 0 0 0 0 0 0 0 8 8 0 0 0 0 0 0
140 Lidokain komp. injeksi - 2 ml 117 0 0 0 0 0 0 0 0 0 0 0 0 86 86 0 0 0 2 0 0
141 Lisol 1 liter 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

142 Loperamide 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
143 Loratadine 10 mg 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Masker Kain 157 0 0 0 0 0 0 0 0 0 0 0 0 500 500 0 1 0 5 0 5
147 Mata Pisau No. 15 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Mata Pisau No. 20 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Metilergometrin maleat tablet salut 0,125 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
151 Metilprednisolon tablet 4 mg 730 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
152 Metformin Hcl 500 mg 820 0 0 0 0 0 0 0 0 0 0 0 0 220 220 0 0 0 0 0 0
153 Metoklopramida 10 mg 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
155 Metronidazol tablet 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
156 Metronidazol tablet 500 mg 2804 0 0 0 0 0 0 0 0 0 0 0 0 300 300 0 0 0 40 0 0
157 Miconazole Krim 27 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
158 Mineral Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Multivitamin (Lycalvit) syrup 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
160 Mummifying pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Natrium diklofenak 50 mg 1424 0 0 0 0 0 0 0 0 0 0 0 0 1270 1270 0 0 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril 126 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
163 Nifedipin 10 mg 300 0 0 0 0 0 0 0 0 0 0 0 0 43 43 0 0 0 0 0 0
164 Nistatin tablet vagina 100.000 IU / g 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 Nistatin vaginal tablet salut 500.000 IU/g 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Obat anti Tuberklosis kategori FDC I 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

168 Obat anti Tuberklosis kategori FDC 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Obat anti Tuberklosis kategori FDC Anak 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
170 Obat Batuk Hitam (O.B.H) cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
171 OBH Itral Syrup 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
172 Ofloksasin tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep kulit 3 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
174 Oksitetrasiklin HCI salep mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
175 Oksitosin injeksi 10 IU / ml - 1 ml 210 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
176 Omeprazole 20 mg 30 0 0 0 0 0 0 0 0 0 0 0 0 30 30 0 0 0 0 0 0
177 Parasetamol drops 53 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0
178 Parasetamol sirup 120 mg / 5 ml 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
179 Parasetamol tablet 500 mg 9030 0 0 0 0 0 0 0 0 0 0 0 0 460 460 100 0 0 110 100 0
180 Pehacain injeksi 67 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
181 Permetrin krim 5% 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
182 Pirantel pamoat tablet 125 mg 239 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
183 Pirantel suspensi 10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
184 Pirantel suspensin 60 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
185 Piridoksin HCI (Vit. B6 ) tablet 10 mg 2660 0 0 0 0 0 0 0 0 0 0 0 0 2776 2776 20 0 0 0 0 0
186 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Piroksikam 20 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
188 Plester 2,5 cm x 4 m 17 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 1 0
189 Plester 7,5 cm x 4 m 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
190 Pot Sputum 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
191 Prednison tablet 5 mg 5984 0 0 0 0 0 0 0 0 0 0 0 0 800 800 110 30 0 0 0 0
192 Primakuin tablet 15 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

193 Prokain benzil penisilin injeksi 3 Juta IU / vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
194 Propiltiourasil tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
195 Propranolol HCI tablet 40 mg 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 Ranitidin tablet 150 mg 3280 0 0 0 0 0 0 0 0 0 0 0 0 300 300 0 0 0 20 0 0
197 Ranitidin injeksi 25 mg/2 ml 78 0 0 0 0 0 0 0 0 0 0 0 0 6 6 0 0 0 0 0 0
198 Rapid Test VIKIA HIV 1/2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Rapid Test SD Bioline HIV 1/2 3.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
200 Reagensia ZN 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
201 Retinol (Vitamin A) kapsul 100.000 IU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Retinol (Vitamin A) kapsul 200.000 IU 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 Ringer Laktat larutan infus steril 87 0 0 0 0 0 0 0 0 0 0 0 0 81 81 0 0 0 1 0 0
204 Salbutamol tablet 2 mg 1192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 20 0 0 0 0
205 Salbutamol 4 mg 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
206 Salep 2 - 4 kombinasi 92 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
207 Salisil bedak 2 % 79 0 0 0 0 0 0 0 0 0 0 0 0 21 21 0 0 0 2 0 0
208 Sarung Tangan Examination S 62 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Sarung Tangan Examination M 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
210 Sarung Tangan Examination L 480 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
211 Sefadroksil 500 mg 702 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 3 0

212 Semen seng fosfat serbuk dan cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
213 Setrizin tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214 Setrizin syrup 24 0 0 0 0 0 0 0 0 0 0 0 0 18 18 0 0 0 0 0 0
215 Sianokorbalamin (Vit.B 12) 500 mcg 3118 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
216 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
217 Simetidine 200 mg 1800 0 0 0 0 0 0 0 0 0 0 0 0 190 190 0 0 0 0 0 0
218 Simvastatin 10 mg 317 0 0 0 0 0 0 0 0 0 0 0 0 610 610 0 0 0 0 0 0
219 Simvastatin 20 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 70 0
220 Silk (benang Bedah Sutera) No. 3 / 0 22 0 0 0 0 0 0 0 0 0 0 0 0 17 17 0 0 0 0 0 0
221 Siprofloksasin tablet 500 mg 398 0 0 0 0 0 0 0 0 0 0 0 0 420 420 0 0 0 0 0 0
222 Spironolakton tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
223 Sulfasetamida natrium tetes mata 15 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224 Tablet tambah darah kombinasi 400 0 0 0 0 0 0 0 0 0 0 0 0 1980 1980 0 0 0 0 0 0
225 Taburia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226 Temporary stopping (Fletcher) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
227 Tetrasiklin HCI kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
228 Tetrasiklin HCI kapsul 500 mg 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229 Tiamfenikol 500 mg 320 0 0 0 0 0 0 0 0 0 0 0 0 20 20 0 0 0 0 0 0
230 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg 3556 0 0 0 0 0 0 0 0 0 0 0 0 2390 2390 70 0 0 0 0 0
232 Triheksifenidil Hidroklorida tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233 Umbilical Cord 174 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
234 U-Pad steril 60 cm x 90 cm 39 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235 Urine Bag 16 0 0 0 0 0 0 0 0 0 0 0 0 4 4 0 0 0 0 0 0
236 Vaksin Jerap Tetanus 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
237 Vaksin Rabies vero 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 50 0
238 Vitamin B kompleks tablet 28428 0 0 0 0 0 0 0 0 0 0 0 0 1480 1480 150 0 0 0 0 0
239 Wicold kapsul 60 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
240 Yodium povidon larutan 10 % 60 ml 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
241 Yodium povidon larutan 10 % 300 ml 4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
242 Zinc syrup 30 0 0 0 0 0 0 0 0 0 0 0 0 3 3 0 0 0 0 0 0
243 Zinc Tablet 2520 0 0 0 0 0 0 0 0 0 0 0 0 250 250 0 0 0 0 0 0
244 Paper Tape 2,5 x 9,14 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0
245 Paper Tape 7,5 x 9,14 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
245 Zidovudine 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
246 Lomivudine 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Efavirenz 600 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
248 Nipirapine 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
249 ZDV + 3 TC+ NVP Ped Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
250 TDF +3TC+EFV (300/300/600) Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Tenofovir 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
252 Tenof EM 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
253 samcobion 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
254 Spironolakton tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
255 lytacur sirup 14 0 0 0 0 0 0 0 0 0 0 0 0 14 14 0 0 0 0 0 0
256 Susu Produgen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui
BULAN 5
TAHUN 2018
Pkesdes Pkesdes Pksdes 115 Pustu Pustu Pustu Pksdes Pksdes Pksdes Pkesdes Pksdes Pkesdes
TOTAL Apotk TOTAL
duampanuapassenosipodeceng simpo Trong T.Rjang Barant Trong T.Rijang 2panua passeno sipodece
115
2 0 0 3 15 115 0 0 0 0 6 21 12 0 16 12 194
0 0 0 8 80 15 0 0 0 0 8 9 5 0 5 4 45
0 0 0 6 92 0 2 0 0 0 13 0 0 0 0 0 15
0 0 0 22 18 100 33 0 0 0 2 0 0 0 0 0 135
0 0 0 0 0 250 0 0 0 0 0 0 0 0 0 0 250
0 0 4 108 242 296 0 0 0 0 0 0 0 0 15 0 311
3 2 0 82 61 538 0 2 11 0 0 2 3 1 9 0 566
0 0 0 200 0 700 0 0 0 0 0 0 0 0 0 0 700
0 0 0 3 17 0 0 0 0 0 0 8 0 0 2 15 25
7 0 2 198 112 4,400 28 0 0 0 12 73 79 0 181 190 4963
0 2 5 69 129 1,100 50 0 16 0 46 71 8 0 87 7 1385
0 0 0 3 8 937 0 0 19 0 0 12 9 0 5 4 986
0 0 0 0 0 159 0 0 0 0 0 0 0 0 0 0 159
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 100 230 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 40 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1,000 0 0 0 0 0 0 0 0 0 0 1000
0 0 0 0 563 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 976 0 0 0 0 0 0 0 0 0 0 0 0
0 1 3 92 30 65 1 7 8 0 9 0 0 0 2 5 97
0 0 0 0 5 30 0 0 0 0 0 0 0 0 0 0 30
0 0 0 851 320 1,100 30 110 350 0 0 0 140 30 0 0 1760
130 80 100 6180 2930 7,300 170 1,030 310 0 900 360 130 30 362 1,032 11624
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 4 8 0 5 0 0 4 0 0 0 0 0 17
0 0 0 0 370 0 0 0 0 0 0 0 0 0 280 0 280
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 60 70 2742 2069 900 88 200 335 0 90 550 0 200 520 650 3533
0 0 0 50 44 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 23 0 0 0 0 0 0 0 0 0 0 23
0 0 0 0 0 24 0 0 0 0 0 0 0 0 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 20 300 43 0 0 0 0 0 0 0 0 0 343
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
200 261 40 7349 3953 5,300 150 610 360 0 424 200 0 0 103 535 7682
0 0 0 60 375 0 0 0 0 0 0 0 20 0 0 0 20
40 30 0 2700 1392 0 0 620 675 0 290 550 60 30 360 653 3238
0 0 0 60 0 100 40 0 0 0 0 0 0 0 0 0 140
0 0 0 0 0 200 0 0 0 0 0 0 0 0 0 0 200
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 1 0 1 12 200 0 0 0 0 0 0 0 0 4 0 204
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 5 0 0 0 0 0 0 5 0 0 0 0 0 5
0 1 1 44 19 24 7 0 0 0 0 4 5 0 7 8 55
0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 25
70 116 40 2794 1387 2,100 150 70 900 0 76 237 0 10 73 564 4180
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 30
0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 30 16 20 1 0 0 0 0 0 0 0 0 0 21
0 0 0 250 0 500 120 0 0 0 0 0 0 0 0 0 620
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 1 8 0 0 1 0 0 1 0 0 0 0 10
0 0 0 28 28 85 0 1 0 0 3 5 5 0 4 0 103
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 20 390 0 0 150 0 0 0 80 0 0 0 0 230
0 1 0 22 9 53 22 0 0 0 0 6 2 0 9 8 100 -3
0 0 0 6 30 0 94 0 0 0 0 0 0 0 0 0 94
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 80 3 0 179 0 0 0 0 0 0 0 0 0 179
5 5 0 182 281 0 0 22 40 0 19 0 0 0 10 0 91
0 0 0 0 0 25 0 0 0 0 0 0 0 0 0 0 25
0 0 0 0 0 5 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 10 2,000 45 0 0 0 0 0 0 0 0 0 2045
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
110 86 0 5051 2654 1,200 40 190 220 0 280 120 0 40 659 0 2749
0 0 0 28 10 25 68 0 0 0 0 8 5 0 2 0 108
0 0 0 30 150 3,000 90 0 280 0 30 0 0 0 0 0 3400
0 0 0 160 120 1,100 0 0 0 0 0 0 0 0 0 0 1100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 188 6 800 119 0 0 0 0 0 0 0 0 0 919
0 0 0 0 14 0 0 10 0 0 0 3 4 0 0 0 17
0 0 0 1 9 52 0 0 0 0 0 0 0 0 0 0 52
0 0 0 0 0 0 0 0 0 0 2 0 0 0 0 0 2
0 10 10 310 520 10,300 0 860 1240 0 630 500 150 50 210 450 14390
0 0 0 0 0 0 0 0 0 0 0 140 0 0 0 0 140
0 0 0 2 15 150 16 0 0 0 0 0 0 0 0 0 166
2 0 0 28 9 150 119 0 0 0 11 9 6 -2 9 11 313
0 0 0 10 0 0 90 0 0 0 0 0 0 0 0 0 90
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
180 150 0 1705 1211 5,200 94 0 0 0 150 220 0 -30 300 0 5934
0 0 0 0 2 -1 0 0 0 0 0 0 0 0 0 0 -1
0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1
0 0 0 544 76 3,300 80 0 0 0 0 0 0 0 0 0 3380

0 0 0 415 709 1,700 0 0 0 0 0 0 0 0 0 0 1700
0 0 0 0 0 0 1980 0 0 0 0 0 0 0 0 0 1980
5 0 0 16 27 600 0 0 33 0 0 60 20 0 50 50 813
0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 7
0 0 0 3 6 25 22 0 0 0 0 0 0 0 0 0 47
0 0 0 0 190 650 0 0 0 0 0 0 0 0 0 0 650
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 78 0 0 0 0 0 0 0 0 0 0 78
0 0 0 35 20 82 6 0 0 0 0 4 0 8 9 0 109
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 9 0 0 2 0 0 0 0 0 0 0 11
230 61 60 2601 2548 1,300 60 20 0 0 0 770 0 0 444 160 2754
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 29 0 0 0 0 0 0 0 0 0 0 29
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0 0
20 10 25 215 405 2,600 120 200 480 0 500 340 240 0 515 340 5335
0 0 2 7 4 22 0 1 0 0 6 2 3 0 11 3 48
0 0 0 0 0 390 0 0 0 0 0 0 0 0 0 0 390
0 0 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 88 37 0 14 0 10 0 4 0 7 0 0 0 35
0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 450 0 0 0 0 0 0 0 0 0 0 450
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
10 0 0 521 532 0 0 0 32 0 13 0 15 0 0 0 90
0 0 0 0 0 84 0 0 0 0 0 0 0 0 0 0 84
0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 30 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 220 290 600 40 0 0 0 0 0 0 0 0 0 640
0 0 0 0 0 400 100 0 0 0 0 0 0 0 0 0 500
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 10 10 360 290 2,400 90 0 0 0 300 360 170 0 120 520 3960
0 0 0 0 31 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 0 0 0 1 0 1 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1270 836 1,150 60 0 0 0 0 0 0 0 0 0 1210
0 0 0 0 49 0 0 0 1 0 3 8 8 0 0 6 26
0 0 0 43 14 200 10 0 0 0 0 0 0 0 0 0 210
0 0 0 0 0 70 0 0 0 0 0 0 0 0 0 0 70
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 10 0 0 0 0 0 0 0 0 0 0 10
0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 4 130 0 0 0 0 0 0 2 0 10 0 142
0 0 0 30 90 90 0 0 0 0 0 0 0 0 0 0 90
0 0 0 3 10 13 0 0 0 0 0 0 0 0 0 0 13
0 0 0 0 3 0 0 0 0 0 0 0 0 0 0 0 0
150 128 31 1079 7420 6,700 140 0 0 0 368 500 0 120 361 0 8189
0 0 0 0 67 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 6 0 0 0 0 0 0 0 0 0 0 6
0 0 0 0 39 100 90 0 0 0 6 0 0 0 0 0 196
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 75 2871 2161 0 0 280 0 0 0 0 0 0 0 197 477
0 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 2 2 23 0 1 0 0 0 1 0 0 0 1 26
0 0 0 0 4 1 0 0 0 0 0 0 0 0 0 0 1
0 0 0 0 33 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 940 2881 0 0 80 160 0 0 0 0 0 155 0 395
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 300 0 0 0 0 0 0 0 0 0 0 300
0 0 0 320 980 0 0 0 0 0 60 0 0 0 0 0 60
0 0 0 6 28 20 0 0 0 0 0 0 0 0 0 0 20
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 82 67 140 19 0 0 0 7 5 5 0 5 4 185
0 0 0 20 222 400 75 0 85 0 100 90 50 0 0 0 800
0 0 0 0 0 190 0 0 0 0 0 0 0 0 0 0 190
0 0 0 2 8 70 0 0 0 0 4 0 1 0 0 0 75
0 0 0 23 26 15 0 4 0 0 4 3 2 0 7 1 36
0 4 0 4 14 0 0 0 0 0 0 0 0 0 28 0 28
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 404 0 0 0 0 0 0 40 0 0 0 0 40
0 0 0 3 220 0 92 0 0 0 0 0 0 0 0 0 92
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 30 0 50 0 0 0 0 0 0 0 0 0 50
0 0 0 18 10 29 14 0 0 0 0 0 0 0 0 0 43
0 0 0 0 140 1,600 50 0 0 0 300 170 40 200 0 0 2360
0 0 0 0 0 140 50 0 0 0 0 0 0 0 0 0 190
0 0 0 190 0 1,500 50 0 0 0 0 0 0 0 0 0 1550
0 0 0 610 407 1,140 0 0 0 0 0 0 0 0 0 0 1140
0 0 0 70 0 0 50 0 0 0 0 0 0 0 0 0 50
0 0 0 17 17 24 43 0 0 0 0 5 5 0 0 0 77
0 0 0 420 398 1,300 90 0 0 0 0 0 0 0 0 0 1390
0 0 0 0 0 100 50 0 0 0 0 0 0 0 0 0 150
0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 50
0 0 0 1980 1600 0 50 0 0 0 0 0 0 0 0 0 50
0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 50
0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 50
0 0 0 0 0 0 50 0 0 0 0 0 0 0 0 0 50
0 0 0 0 0 400 50 0 0 0 0 0 0 0 0 0 450
0 0 0 20 40 200 60 0 0 0 0 0 0 0 0 0 260
0 0 0 0 0 30 50 0 0 0 0 0 0 0 0 0 80
0 0 0 2460 2867 0 90 0 340 0 220 0 0 240 0 270 1160
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1 12 35 0 0 0 0 0 5 9 0 12 7 68
0 0 0 0 4 0 0 0 0 0 0 0 1 1 0 6 8
0 0 0 4 0 12 0 0 0 0 0 0 0 0 0 0 12
0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 50 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 1630 2935 18,100 150 90 275 0 288 690 100 150 587 440 20870
0 0 0 0 40 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 2 10 0 1 0 0 3 1 0 0 0 1 16
0 0 0 0 7 4 0 0 0 0 0 1 0 0 0 0 5
0 0 0 3 0 26 0 0 0 0 0 0 0 0 0 0 26
0 0 0 250 206 700 102 0 0 0 150 220 180 0 170 40 1562
0 0 0 1 0 5 0 0 0 0 0 0 0 0 0 0 5
0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 0 2
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 14 17 36 0 0 0 0 0 0 0 0 1 0 37
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

(LPLPO)
PUSKESMAS : BARANTI NO :001/ JKD-Posk TR.RJG/I/2018
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
3 IV Catheter Gea No. 22 set 0 0 0 0 0 0 0 8,050 0
5 Ansell Steril 6 1/2 psg 0 0 0 0 0 0 0 7333.7 0
6 Ansell Steril 7 psg 0 0 0 0 0 0 0 7333.7 0
7 Ansell Steri 7 1/2 psg 12 0 12 6 6 6 10 6 7333.7 44,002
8 Alat Suntik sekali pakai 0,05 ml set 0 0 0 0 0 0 0 1517.72307 0
9 Alat Suntik sekali pakai 0,5 ml set 4 0 4 3 1 1 10 1 1374,375 1,374,375
11 Alat suntik sekali pakai 3 ml set 12 0 12 8 4 4 20 4 748 2,992
12 Alat suntik sekali pakai 5 ml set 3 0 3 2 1 1 10 1 863 863
13 Alat Suntik sekali pakai 10 ml set 0 0 0 0 0 0 0 1,353 0
15 Alkohol Swab kotak 0 0 0 0 0 0 0 114.95 0

22 Amitriptilin HCI tablet salut 25 mg tablet 0 0 0 0 0 0 0 165 0
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 0 0 0 0 4,147 0
27 Amoksisilin kapsul 250 mg Kapsul 0 0 0 0 0 0 200 0 207 0
33 Antasida DOEN tablet kombinasi tablet 510 0 510 120 390 390 390 59 23,010
35 Antihemoroid DOEN kombinasi suppos 0 0 0 0 0 0 0 3,502 0
38 Antimigrain DOEN kombinasi tablet 0 0 0 0 0 0 0 149 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 0 0 0 0 0 0 1,000 0 120 0
42 Asam Mefenamat tablet 500 mg tablet 520 0 520 190 330 330 330 102 33,660
43 Asiklovir 200 mg tablet 0 0 0 0 0 0 0 272 0
46 Asetosal tablet 100 mg tabet 0 0 0 0 0 0 0 153 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 1,672 0

54 Betametason krim 0.1 % tube 0 0 0 0 0 0 0 1,435 0

59 Catgut/benang bedah no .3/0 pcs 4 0 4 2 2 2 5 2 7929,16666 #VALUE!
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 0 0 0 0 1,740 0
61 Deksametason tablet 0,5 mg tablet 390 0 390 170 220 220 200 220 45 9,900
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 1,354 0
68 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0 0 108 0
70 Domperidom suspensi Botol 0 0 0 0 0 0 0 3,180 0
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 0 0 0 300 0 42 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 0 0 0 0 0 0 0 3,600 0
76 E t a n o l 70 % 100 ml Botol 5 0 5 3 2 2 5 2 2,625 5,250
81 Fervital Kapsul kapsul 160 0 160 60 100 100 200 100 860.64 86,064
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 0 0 0 0 0 0 0 796 0
84 Foly Catheter No. 18 pcs 0 0 0 0 0 0 0 13,970 0

86 Furosemid tablet 40 mg tablet 0 0 0 0 0 0 0 91 0
88 Gentamicin inj 40mg/ml Ampul 0 0 0 0 0 0 0 3,545 0
89 Gentian Violet larutan 1 % Botol 0 0 0 0 0 0 0 3,850 0
91 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0 0 110 0
94 Guaiafenesin Tablet tablet 360 0 360 160 200 200 300 200 132 26,400
95 Glukosa larutan infus 5 % steril Botol 0 0 0 0 0 0 5 0 6,900 0
96 Grisefulvin tablet 125 mg (Micronized) tablet 0 0 0 0 0 0 0 263 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 0 0 0 0 0 0 0 171 0
101 Hidrokortison krim 2,5 % tube 0 0 0 0 0 0 5 0 2,812 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 1 0 1 1 0 0 5 0 2,560 0
105 Ibuprofen tablet 400 mg tablet 0 0 0 0 0 0 0 133 0
106 Infusion set anak pcs 0 0 0 0 0 0 0 2913.3 0
107 Infusion set dewasa pcs 5 0 5 3 2 2 5 2 6622,2 #VALUE!
112 Kalsium laktat (Kalk) tablet 500 mg tablet 820 0 820 820 0 0 0 69 0
113 Kapas pembalut 250 gram buah 0 0 0 0 0 0 0 14,366 0
116 Kaptopril 12,5 mg tablet 0 0 0 0 0 0 0 69 0

117 Kaptopril 25 mg tablet 0 0 0 0 0 0 0 86 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 20 0 20 20 0 0 50 0 1723.7 0
121 Kasa pembalut elastis 3 inch roll 0 0 0 0 0 0 0 7,700 0
122 Ketokonazol krim 2% tube 0 0 0 0 0 0 0 2,790 0
123 Ketokonazol tablet 200 mg tablet 0 0 0 0 0 0 0 264 0
125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0 0 0 0 0 4,000 0
126 Kloramfenikol salep mata 1 % tube 0 0 0 0 0 0 0 1,850 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 0 0 0 8,250 0
130 Klorfeniramin maleat tablet 4 mg tablet 300 0 300 300 0 0 1,000 0 45 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0 0 0 0 1,425 0
136 Kotrimoksazol tablet 480 mg tablet 300 0 300 0 300 300 300 158 47,400
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 0 0 0 137.5 0
139 Larutan mengandung elektrolit botol 0 0 0 0 0 0 0 9,275 0
140 Lidokain komp. injeksi - 2 ml ampul 9 0 9 3 6 6 5 6 2,122 12,732
141 Lisol 1 liter Botol 0 0 0 0 0 0 0 49,192 0
143 Loratadine 10 mg tablet 0 0 0 0 0 0 0 149 0

146 Masker Kain pcs 40 0 40 5 35 35 35 805 28,175
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
152 Metformin Hcl 500 mg tablet 0 0 0 0 0 0 0 115 0
153 Metoklopramida 10 mg tablet 0 0 0 0 0 0 0 100 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0
163 Nifedipin 10 mg tablet 0 0 0 0 0 0 0 123 0
164 Nistatin tablet vagina 100.000 IU / g ovula 0 0 0 0 0 0 0 602 0
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 0 0 0 0 236,500 0
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0 5 0 4,400 0

174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 10 0 10 4 6 6 10 6 1,900 11,400
176 Parasetamol drops Botol 7 0 7 4 3 3 5 3 5,980 17,940
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 0 0 0 10 0 1,119 0
178 Parasetamol tablet 500 mg tablet 710 0 710 330 380 380 300 380 58 22,040
180 Permetrin krim 5% tube 0 0 0 0 0 0 0 12,155 0
181 Pirantel pamoat tablet 125 mg tablet 0 0 0 0 0 0 0 318 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 0 0 0 0 0 0 136 0
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 0 0 0 0 1,040 0
187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 0 1 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
190 Prednison tablet 5 mg tablet 0 0 0 0 0 0 0 85 0
194 Propranolol HCI tablet 40 mg tablet 0 0 0 0 0 0 0 69 0
195 Ranitidin tablet 150 mg tablet 0 0 0 0 0 0 0 115 0
203 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0 100 0 68 0
204 Salbutamol 4 mg tablet 0 0 0 0 0 0 0 88 0
205 Salep 2 - 4 kombinasi pot 2 0 2 2 0 0 5 0 2,797 0

206 Salisil bedak 2 % pot 1 0 1 1 0 0 5 0 1,066 0

210 Sefadroksil 500 mg kapsul 0 0 0 0 0 0 0 557 0
213 Setrizin syrup Botol 0 0 0 0 0 0 0 7,756 0
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 120 0 120 40 80 80 200 80 58 4,640
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 0 0 0 0 1,226 0
216 Simetidine 200 mg tablet 0 0 0 0 0 0 0 209 0
220 Siprofloksasin tablet 500 mg tablet 0 0 0 0 0 0 0 298 0
221 Spironolakton tablet 100 mg tablet 0 0 0 0 0 0 0 878 0
223 Tablet tambah darah kombinasi tablet 500 0 500 300 200 200 500 200 410 82,000
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
228 Tiamfenikol 500 mg kapsul 0 0 0 0 0 0 0 1,452 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 0 0 0 1,760 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 250 0 250 60 190 190 190 91 17,290
232 Umbilical Cord kotak 7 0 7 4 3 3 20 3 1494.9 4,485
233 U-Pad steril 60 cm x 90 cm pcs 2 0 2 2 0 0 10 0 8768.1 0
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0
235 Vaksin Jerap Tetanus vial 0 0 0 0 0 0 5 0 14,498 0

238 Wicold kapsul kapsul 0 0 0 0 0 0 300 0 792 0
239 Yodium povidon larutan 10 % 60 ml Botol 0 0 0 0 0 0 0 4438.5 0
240 Yodium povidon larutan 10 % 300 ml Botol 0 0 0 0 0 0 1 0 21,593 0
241 Zinc syrup Botol 0 0 0 0 0 0 0 16,478 0
242 Zinc Tablet tablet 270 0 270 270 0 0 200 0 592 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
245 Zidovudine 150 mg Btl 0 0 0 0 0 0 0 1,700 0
246 Lomivudine 150 mg Btl 0 0 0 0 0 0 0 4,255 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
248 Nepirapine 200 mg Btl 0 0 0 0 0 0 0 3,080 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0 0 0 0 0 3,058 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0 0 0 0 0 11894.3 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
254 Spironolakton tablet 25 mg Tablet 0 0 0 0 0 0 0 314 0
255 Lytacur Sirup Btl 0 0 0 0 0 0 0 14,300 0
256 Susu Produgen Kotak 0 0 0 0 0 0 0 40,700 0
TOTAL 1,058,603
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
dr Hj Ulianti Nenni Triani, Amd.Keb
NIP.197908072007012013 NIP : 198212112009012006

LAPORAN GUDANG OBAT PKM BARANTI
Periode : Juni 2018
PUSTU PUSTU PUSTU PS

KAMAR brsali poli PS T PS PS
NO NAMA OBAT STOCK AWAL PENERIMAAN JUMLAH UGD RRI PKIA LAB DLL SIMPO TONRO TR PS Brt PS Trong RIJANG SIPODECE
OBAT n gigi 2PANUA PASSENO
NG RIJANG NG
1 IV Catheter Gea No. 18 100 0 100 0 0 0 0 0 0 0 0 0 0
2 IV Catheter Gea No. 20 134 0 134 33 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
5 Ansell Steril 6 1/2 -90 0 -90 95 0 0 0 0 0 0 0 0 0 0
6 Ansell Steril 7 8 0 8 71 0 0 0 0 0 0 0 0 0 0
7 Ansell Steri 7 1/2 307 0 307 93 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik sekali pakai 0,05 ml 500 0 500 100 0 0 0 0 0 0 0 0 0
10 Alat suntik sekali pakai 1 ml 4364 0 4364 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik sekali pakai 10 ml 155 0 155 2 0 0 0 0 0 0 0 0 0
14 Albendasol tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Alkohol Swab 100 0 100 0 0 0 0 0 0 0 0 0 0
16 Alupurinol tablet 100 mg 1400 0 1400 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
17 Allpurinol tablet 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
18 Ambroxol sirup 15 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ambroxol tablet 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Aminofilin tablet 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Amitriptilin HCI tablet salut 25 mg 1000 0 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
23 Amlodipine 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
24 Amlodipine 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml 66 0 66 42 0 0 0 0 0 0 0 0 0
26 Amoksisilin sirup kering forte 250 mg/5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
27 Amoksisilin kapsul 250 mg 1500 0 1500 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

28 Amoksisilin kaplet 500 mg 16200 0 16200 2200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Anagens Syrup -1 0 -1 4 0 0 0 0 0 0 0 0 0
31 Antalgin (Metampiron) tablet 500 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Antasida DOEN tablet kombinasi 1700 0 1700 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
34 Antasida DOEN suspensi 136 0 136 37 0 0 0 0 0 0 0 0 0
35 Antihemoroid DOEN kombinasi 23 0 23 0 0 0 0 0 0 0 0 0 0
36 Antifungi DOEN kombinasi 20 0 20 2 0 0 0 0 0 0 0 0 0
37 Antibakteri DOEN salep Kombinasi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Antimigrain DOEN kombinasi 300 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg 8000 0 8000 8300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
41 Asam Folat 100 0 100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
42 Asam Mefenamat tablet 500 mg 4100 0 4100 1900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
43 Asiklovir 200 mg 500 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
44 Asiklovir 400 mg 150 0 150 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
45 Asiklovir krim 5% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Asetosal tablet 100 mg 100 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
47 Attalpulgit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml 3 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
49 Atropin Sulfat tablet 0,5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Betahistin maleat 24 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Betametason krim 0.1 % 134 0 134 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
55 Bisakodil 5 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Bisakodil 10 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Blood Lancet 26G 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Catgut/benang bedah no .2/0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
59 Catgut/benang bedah no .3/0 130 0 130 30 0 0 0 0 0 0 0 0 0
60 Deksametason injeksi 5 mlg/ml - 1 ml 25 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

61 Deksametason tablet 0,5 mg 10300 0 10300 2100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
62 Diazepam injeksi 5 mg/ml - 2 ml 10 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
64 Diazepam tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Diazepam tablet 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml 30 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
68 Digoksin tablet 0,25 mg 100 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
69 Doksisilin kapsul 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Domperidom suspensi 98 0 98 26 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
71 Domperidom tablet 200 0 200 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
72 Efedrin HCI tablet 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ekstrak Belladon tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % 5 0 5 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
76 E t a n o l 70 % 100 ml 32 0 32 32 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
77 Etil klorida semprot 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Eugenol cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Fenobarbital tablet 30 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Fervital Kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml 23 0 23 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg 110 0 110 280 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
84 Foly Catheter No. 18 10 0 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
85 Foly Catheter No. 20 8 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
86 Furosemid tablet 40 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
87 Garam Oralit untuk 200 ml Air 300 0 300 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
88 Gentamicin inj 40mg/ml 25 0 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
89 Gentian Violet larutan 1 % 5 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
90 Glass lonomer Cement (GC IX ) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Glibenklamid tablet 5 mg 1600 0 1600 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
92 Glimepiride 1 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Glimepiride 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Guaiafenesin Tablet 7000 0 7000 4000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
95 Glukosa larutan infus 5 % steril 200 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
96 Grisefulvin tablet 125 mg (Micronized) 2500 0 2500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
97 Haloperidol tablet 1,5 mg 2000 0 2000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
98 Haloperidol tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
99 Haloperidol inj 50 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Hidroklorotiazid (HCT) tablet 25 mg 400 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
101 Hidrokortison krim 2,5 % 288 0 288 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
102 Ibuprofen suspensi 100 mg/5 ml 24 0 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
103 Ibuprofen suspensi 200 mg/5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
104 Ibuprofen tablet 200 mg 5400 0 5400 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
105 Ibuprofen tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
106 Infusion set anak 144 0 144 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
107 Infusion set dewasa 99 0 99 24 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
108 Isoniazid tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
109 Isosorbid Dinitrat tablet subligual 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
110 Kalsium Glukonat inj 10% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
111 Kalsium Hidroksida pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg 10400 0 10400 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
113 Kapas pembalut 250 gram 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
114 Kapas pembalut / Absorben 500 gram 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
115 Kapas pembalut / Absorben 1000 gram 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
116 Kaptopril 12,5 mg 4300 0 4300 700 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
117 Kaptopril 25 mg 1800 0 1800 2100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
118 Karbamazepin tablet 200 mg 1900 0 1900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm 600 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
120 Kasa hidrofil 40 x 80 cm 9 0 9 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
121 Kasa pembalut elastis 3 inch 7 0 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
122 Ketokonazol krim 2% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
123 Ketokonazol tablet 200 mg 400 0 400 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
124 Kloramfenikol kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
125 Kloramfenikol susp 125mg/5 ml 77 0 77 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
126 Kloramfenikol salep mata 1 % 192 0 192 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

127 Kloramfenikol tetes mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
128 Kloramfenikol salep Kulit 2% 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
129 Kloramfenikol tetes telinga 3 % 9 0 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
130 Klorfeniramin maleat tablet 4 mg 7900 0 7900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
131 Klorokuin tablet 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
132 Klorfenol Kamfer Menthol 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml 29 0 29 0 0 0 0 0 0 0 Dec-99 0 0 0 0 0 0 0 0 0

134 Klorpromazin HCI tablet salut 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
135 Klorpromazin HCI tablet salut 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
136 Kotrimoksazol tablet 480 mg 600 0 600 1000 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml 96 0 96 7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
138 Kotrimoksazol Pediatrik tablet 120 mg 390 0 390 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
139 Larutan mengandung elektrolit 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
140 Lidokain komp. injeksi - 2 ml 70 0 70 170 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
141 Lisol 1 liter 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
142 Loperamide 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
143 Loratadine 10 mg 450 0 450 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Masker Kain 1600 0 1600 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
147 Mata Pisau No. 15 84 0 84 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
148 Mata Pisau No. 20 100 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
149 Metilergometrin maleat tablet salut 0,125 mg 500 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
151 Metilprednisolon tablet 4 mg 300 0 300 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
152 Metformin Hcl 500 mg 600 0 600 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
153 Metoklopramida 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml 47 0 47 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
155 Metronidazol tablet 250 mg 500 0 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
156 Metronidazol tablet 500 mg 400 0 400 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
157 Miconazole Krim 77 0 77 19 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
158 Mineral Mix 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Multivitamin (Lycalvit) syrup 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Mummifying pasta 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Natrium diklofenak 50 mg 5200 0 5200 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril 100 0 130 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
163 Nifedipin 10 mg 200 0 200 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
164 Nistatin tablet vagina 100.000 IU / g 70 0 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
165 Nistatin vaginal tablet salut 500.000 IU/g 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Obat anti Tuberklosis kategori FDC I 0 0 0 0 0 0 0 0 0 0 0 0 0

167 Obat anti Tuberklosis kategori FDC 2 0 0 0 0 0 0 0 0 0 0 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak 0 0 0 0 0 0 0 0 0 0 0 0 0
169 Obat Batuk Hitam (O.B.H) cairan 0 0 0 0 0 0 0 0 0 0 0 0 0
170 OBH Itral Syrup 0 0 0 0 0 0 0 0 0 0 0 0 0
171 Ofloksasin tablet 400 mg 100 0 100 0 0 0 0 0 0 0 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
174 Oksitosin injeksi 10 IU / ml - 1 ml 55 0 55 25 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
175 Omeprazole 20 mg 90 0 90 90 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
176 Parasetamol drops 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
177 Parasetamol sirup 120 mg / 5 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
178 Parasetamol tablet 500 mg 28200 0 28200 11400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
179 Pehacain injeksi 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
180 Permetrin krim 5% 6 0 6 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
181 Pirantel pamoat tablet 125 mg 0 0 0 0 0 0 0 0 0 0 Dec-99 0 0 0 0 0 0 0 0 0
182 Pirantel suspensi 10 ml 5 0 5 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
183 Pirantel suspensin 60 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg 12600 0 12600 2600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml 100 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

186 Piroksikam 20 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Plester 2,5 cm x 4 m 15 0 15 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
188 Plester 7,5 cm x 4 m 19 0 19 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
189 Pot Sputum 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
190 Prednison tablet 5 mg 4800 0 4800 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
191 Primakuin tablet 15 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Propiltiourasil tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
194 Propranolol HCI tablet 40 mg 300 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
195 Ranitidin tablet 150 mg 3500 0 3500 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
196 Ranitidin injeksi 25 mg/2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
197 Rapid Test VIKIA HIV 1/2 0 0 0 0 0 0 0 0 0 0 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Reagensia ZN 0 0 0 0 0 0 0 0 0 0 0 0 0
200 Retinol (Vitamin A) kapsul 100.000 IU 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Ringer Laktat larutan infus steril 150 0 150 70 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
203 Salbutamol tablet 2 mg -100 0 -100 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
204 Salbutamol 4 mg 190 0 190 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
205 Salep 2 - 4 kombinasi 52 0 52 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
206 Salisil bedak 2 % 13 0 13 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
207 Sarung Tangan Examination S 0 0 0 0 0 0 0 0 0 0 0 0 0
208 Sarung Tangan Examination M 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Sarung Tangan Examination L 0 0 0 0 0 0 0 0 0 0 0 0 0

Sefadroksil 500 mg 600 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
210
Semen seng fosfat serbuk dan cairan 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
211
Setrizin tablet 10 mg 600 0 600 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
212
Setrizin syrup 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
213
Sianokorbalamin (Vit.B 12) 500 mcg 600 0 600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
214
Sianokorbalamin (Vit.B 12) inj. 500 mg / ml 140 0 140 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
215
Simetidine 200 mg 900 0 900 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
216
Simvastatin 10 mg 1440 0 1440 360 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
217
Simvastatin 20 mg 1600 0 1600 50 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
218
Silk (benang Bedah Sutera) No. 3 / 0 67 0 67 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
219
Siprofloksasin tablet 500 mg 3100 0 3100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
220
Spironolakton tablet 100 mg 100 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
221
Sulfasetamida natrium tetes mata 15 % 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
222
Tablet tambah darah kombinasi 16430 0 16430 1240 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
223
Taburia 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
224
Temporary stopping (Fletcher) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
225
Tetrasiklin HCI kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
226
Tetrasiklin HCI kapsul 500 mg 400 0 400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
227
Tiamfenikol 500 mg 200 0 200 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
228
Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml 30 0 30 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
229
Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg -1600 0 -1600 3400 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
230
Triheksifenidil Hidroklorida tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
231
Umbilical Cord 100 0 100 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
232
U-Pad steril 60 cm x 90 cm -10 0 -10 10 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
233
Urine Bag 9 0 9 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
234
Vaksin Jerap Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
235
Vaksin Rabies vero 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
236
Vitamin B kompleks tablet 8500 0 8500 2600 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
237
Wicold kapsul 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
238
Yodium povidon larutan 10 % 60 ml 8 0 8 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
239
Yodium povidon larutan 10 % 300 ml 11 0 11 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
240
Zinc syrup 8 0 8 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
241
Zinc Tablet 300 0 300 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
242
Paper Tape 2,5 x 9,14 5 0 5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
243
Paper Tape 7,5 x 9,14 2 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
244
Zidovudine 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
245
Lomivudine 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
246
Efavirenz 600 mg
247 0 0 0 0 0 0 0 0 0 0 0 0 0
248 Nipirapine 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
249 ZDV + 3 TC+ NVP Ped Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0
250 TDF +3TC+EFV (300/300/600) Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Tenofovir 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0

252 Tenof EM 0 0 0 0 0 0 0 0 0 0 0 0 0
253 samcobion 0 0 0 0 0 0 0 0 0 0 0 0 0
254 Spironolakton tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
255 lytacur sirup 112 0 112 9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
256 Susu Produgen 0 0 0 0 0 0 0 0 0 0 0 0 0
257 xylocaine spray 3 0 3 0 0 0 0 0 0 0 0 0 0
258 zink drop 18 0 18 0 0 0 0 0 0 0 0 0 0
Mengetahi
POSBIN harga
USILA TOTAL SISA ket jumlah harga KET
DU satuan
0 100
0 0 33 101
0 0 117 123
0 0 3 286
95 -185
71 -63
93 214
100 400
0 0
0 4364
18 546
17 866
2 153
0 0
0 100
0 0 600 800
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0 exp
0 0 0 1000
0 0 0 0
0 0 0 0
42 24
0 0 0 0 exp
0 0 500 1000
0 0 2200 14000
0 0 0 0
4 -5
0 0 0 0
0 0 0 0
0 0 600 1700
37 99
0 23
2 18
0 0 0 0
0 0 0 300
0 0 0 0
0 0 8300 -300
0 0 100 0
0 0 1900 2200
0 0 0 500
0 0 0 150
0 0 0 0
0 0 0 100
0 0 0 0
0 0 0 3
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 134
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
30 100
0 0 0 25
0 0 2100 8200
0 0 0 10
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 30
0 0 0 100
0 0 0 0
0 0 26 72
0 0 300 -100
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1 4
0 0 32 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 23
0 0 280 -170
0 0 0 10
0 0 0 8
0 0 0 0
0 0 100 200
0 0 0 25
0 0 0 5
0 0 0 0
0 0 100 1500
0 0 0 0
0 0 0 0
0 0 4000 3000
0 0 0 200
0 0 0 2500
0 0 0 2000
0 0 0 0
0 0 0 0
0 0 0 400
0 0 24 264
0 0 0 24
0 0 0 0
0 0 600 4800
0 0 0 0
0 0 3 141
0 0 24 75
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 0
0 0 1000 9400
0 0 1 -1
0 0 1 -1
0 0 1 -1
0 0 700 3600
0 0 2100 -300
0 0 0 1900
0 0 0 600
0 0 3 6
0 0 0 7
0 0 0 0
0 0 100 300
0 0 0 0
0 0 0 77
0 0 0 192
0 0 0 0
0 0 0 0
0 0 0 9
0 0 0 7900
0 0 0 0
0 0 0 0
0 0 0 29
0 0 0 0
0 0 0 0
0 0 1000 -400
0 0 7 89
0 0 0 390
0 0 0 0
0 0 170 -100
0 0 0 0
0 0 0 0
0 0 0 450
0 0 0 0
0 0 0 0 exp
0 0 600 1000
0 0 0 84
0 0 0 100
0 0 0 500
0 0 0 0
0 0 200 100
0 0 500 100
0 0 0 0
0 0 0 47
0 0 0 500
0 0 500 -100
0 0 19 58
0 0 0 0
0 0 0 0
0 0 0 0
0 0 600 4600
0 0 30 100
0 0 100 100
0 0 0 70
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 100
0 0 0 0
0 0 0 0
0 0 25 30
0 0 Jan-00 90
0 0 0 0
0 0 0 0
0 0 11400 16800
0 0 0 0
0 0 0 6
0 0 0 0
0 0 5 0
0 0 0 0
0 0 2600 10000
0 0 0 100
0 0 0 0
0 0 0 15
0 0 1 18
0 0 0 0
0 0 200 4600
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 300
0 0 500 3000
0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0 70 80
0 0 100 -200
0 0 0 190
0 0 0 52
0 0 1 12
0 0
0 0
0 0
0 0 0 600
0 0 0 0
0 0 400 200
0 0 0 0
0 0 0 600
0 0 0 140
0 0 0 900
0 0 360 1080
0 0 50 1550
0 0 8 59
0 0 0 3100
0 0 0 100
0 0 0 0
0 0 1240 15190
0 0 0 0
0 0 0 0
0 0 0 0
0 0 0 400
0 0 0 200
0 0 0 30
0 0 3400 -5000
0 0 0 0
0 0 0 100
0 0 10 -20
0 0 3 9
0 0 0 0
0 0 0 0
0 0 2600 5900
0 0 0 0
0 0 1 7
0 0 1 10 Exp Jan-18
0 0 0 8
0 0 0 300
0 0 0 5
0 0 0 2
0 0
0 0
0 0 9 112
3
18
Pengelola Obat Puskesmas baranti

LAPORAN SISA STOCK OBAT PKM BARANTI
Periode : Juni 2018
KMAR UGD KIA pkia POLI LAB DLL AMBUL Pustu Pustu Pustu PDS PDS PDS
GUDANG PDS PDS PDS D2PANU
NO NAMA OBAT TR. SPDECE TRONG TR. PSSENO
OBAT OBAT GIGI AN SIMPO TRONG Rijang BRT NG Rijang A
1 IV Catheter Gea No. 18 100 0 0 0 0 11 12 21 10 16 3

5 Ansell Steril 6 1/2 5 0 0 0 0 0 18 0 0 0 0
6 Ansell Steril 7 79 0 0 0 10 0 16 0 6 21 0
7 Ansell Steri 7 1/2 400 0 2 5 0 15 0 8 0 5 5
8 Alat Suntik sekali pakai 0,05 ml 600 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik sekali pakai 0,5 ml 0 0 0 0 0 30 0 12 0 0 0
10 Alat suntik sekali pakai 1 ml 4,364 0 0 0 50 14 190 67 75 178 36
11 Alat suntik sekali pakai 3 ml 582 0 0 16 50 43 21 61 19 77 0
12 Alat suntik sekali pakai 5 ml 900 0 0 19 0 17 4 10 7 5 5
13 Alat Suntik sekali pakai 10 ml 157 0 0 0 0 0 0 0 0 0 0
14 Albendasol tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0
15 Alkohol Swab 100 0 0 0 0 0 0 0 0 0 0
16 Alupurinol tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0
17 Allpurinol tablet 300 mg 0 0 0 0 0 0 0 0 0 0 0
18 Ambroxol sirup 15 mg/ml 0 0 0 0 0 0 0 0 0 0 0
19 Ambroxol tablet 0 0 0 0 0 0 0 0 0 0 0
20 Aminofilin tablet 200 mg 0 0 0 0 0 0 0 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml 0 0 0 0 0 0 0 0 0 0 0
22 Amitriptilin HCI tablet salut 25 mg 1,000 0 0 0 0 0 0 0 0 0 0
23 Amlodipine 5 mg 0 0 0 0 0 0 0 0 0 0 0
24 Amlodipine 10 mg 0 0 0 0 0 0 0 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml 108 0 5 6 4 9 11 0 8 12 5
26 Amoksisilin sirup kering forte 250 mg/5 ml 0 0 0 0 0 0 0 0 0 0 0
27 Amoksisilin kapsul 250 mg 1,000 30 80 410 0 0 0 0 70 0 40
28 Amoksisilin kaplet 500 mg 18,400 200 670 590 170 810 1,173 750 200 722 770
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg 0 0 0 0 0 0 0 0 0 0 0
30 Anagens Syrup 3 0 3 0 0 4 0 0 0 0 0
31 Antalgin (Metampiron) tablet 500 mg 0 0 0 0 0 80 0 0 0 280 0
32 Antalgin injeksi 250 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0
33 Antasida DOEN tablet kombinasi 1,700 30 500 275 330 300 500 450 170 460 400
34 Antasida DOEN suspensi 73 0 0 0 6 0 0 0 0 0 0
35 Antihemoroid DOEN kombinasi 23 0 0 0 0 0 0 0 0 0 0
36 Antifungi DOEN kombinasi 22 0 0 0 0 0 0 0 0 0 0
37 Antibakteri DOEN salep Kombinasi 0 0 0 0 0 0 0 0 0 0 0
38 Antimigrain DOEN kombinasi 300 43 0 0 0 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen 0 0 0 0 0 0 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg 9,300 62 230 510 0 314 935 100 250 292 60
41 Asam Folat 200 100 0 0 0 0 0 0 0 0 0
42 Asam Mefenamat tablet 500 mg 6,000 110 560 545 160 250 608 450 130 450 640
43 Asiklovir 200 mg 0 10 0 0 0 0 0 0 0 0 0
44 Asiklovir 400 mg 150 0 0 0 0 0 0 0 0 0 0
45 Asiklovir krim 5% 0 0 0 0 0 0 0 0 0 0 0
46 Asetosal tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0
47 Attalpulgit 0 0 0 0 0 0 0 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml 3 0 0 0 0 0 0 0 0 0 0
49 Atropin Sulfat tablet 0,5 mg 0 0 0 0 0 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's 0 0 0 0 0 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's 0 0 0 0 0 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's 0 0 0 0 0 0 0 0 0 0 0
53 Betahistin maleat 24 mg 0 0 0 0 0 0 0 0 0 0 0
54 Betametason krim 0.1 % 134 20 0 0 0 0 0 0 0 3 0
55 Bisakodil 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
56 Bisakodil 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
57 Blood Lancet 26G 0 0 0 0 0 0 0 0 0 0 0
58 Catgut/benang bedah no .2/0 0 0 0 0 0 -3 0 0 0 0 0
59 Catgut/benang bedah no .3/0 40 0 0 0 0 0 8 3 4 5 0
60 Deksametason injeksi 5 mlg/ml - 1 ml 25 0 0 0 0 0 0 0 0 0 0
61 Deksametason tablet 0,5 mg 2,400 300 230 860 200 216 564 150 390 447 360
62 Diazepam injeksi 5 mg/ml - 2 ml 10 0 0 0 0 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml -1 0 0 0 0 0 0 0 0 0 0
64 Diazepam tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0
65 Diazepam tablet 5 mg 0 0 0 0 0 0 0 0 0 0 0
66 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml 30 0 0 0 0 0 0 0 0 0 0
68 Digoksin tablet 0,25 mg 100 0 0 0 0 0 0 0 0 0 0
69 Doksisilin kapsul 100 mg 0 0 0 0 0 0 0 0 0 0 0
70 Domperidom suspensi 24 0 0 0 3 0 0 0 0 0 0
71 Domperidom tablet 500 0 0 0 0 0 0 0 0 0 0
72 Efedrin HCI tablet 25 mg 0 0 0 0 0 0 0 0 0 0 0
73 Ekstrak Belladon tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml 0 0 0 0 0 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % 6 0 1 1 0 0 0 1 0 0 0
76 E t a n o l 70 % 100 ml 64 0 0 0 0 2 0 2 2 3 0
77 Etil klorida semprot 0 0 0 0 0 0 0 0 0 0 0
78 Eugenol cairan 0 0 0 0 0 0 0 0 0 0 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0
80 Fenobarbital tablet 30 mg 0 0 0 0 0 0 0 0 0 0 0
81 Fervital Kapsul 0 0 150 0 0 0 0 30 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml 23 0 0 0 0 16 11 8 0 7 0
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg 300 46 0 0 0 0 0 0 0 0 0
84 Foly Catheter No. 18 10 0 0 0 0 0 0 0 0 0 0
85 Foly Catheter No. 20 8 0 0 0 0 0 0 0 0 0 0
86 Furosemid tablet 40 mg 0 65 0 0 0 0 0 0 0 0 0
87 Garam Oralit untuk 200 ml Air 400 90 0 25 0 32 41 12 35 35 45
88 Gentamicin inj 40mg/ml 25 0 0 0 0 0 0 0 0 0 0
89 Gentian Violet larutan 1 % 5 0 0 0 0 0 0 0 0 0 0
90 Glass lonomer Cement (GC IX ) 0 0 0 0 0 0 0 0 0 0 0
91 Glibenklamid tablet 5 mg 1,700 155 0 0 0 0 0 0 0 0 0
92 Glimepiride 1 mg 0 0 0 0 0 0 0 0 0 0 0
93 Glimepiride 2 mg 0 0 0 0 0 0 0 0 0 0 0
94 Guaiafenesin Tablet 1,000 110 420 115 0 280 0 30 0 537 100
95 Glukosa larutan infus 5 % steril 200 0 0 0 0 0 0 8 5 2 0
96 Grisefulvin tablet 125 mg (Micronized) 2,500 0 0 720 0 20 0 0 0 0 0
97 Haloperidol tablet 1,5 mg 0 0 0 0 0 0 0 0 0 0 0
98 Haloperidol tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0
99 Haloperidol inj 50 mg/ml 0 0 0 0 0 0 0 0 0 0 0
100 Hidroklorotiazid (HCT) tablet 25 mg 400 94 0 0 0 0 0 0 0 0 0
101 Hidrokortison krim 2,5 % 120 20 7 9 0 0 0 2 9 0 0
102 Ibuprofen suspensi 100 mg/5 ml 24 0 8 0 0 0 0 0 6 0 0
103 Ibuprofen suspensi 200 mg/5 ml 0 0 0 0 0 2 0 0 0 0 0
104 Ibuprofen tablet 200 mg 6,000 100 630 1200 450 630 400 500 200 425 310
105 Ibuprofen tablet 400 mg 0 0 0 0 0 0 0 140 0 0 0
106 Infusion set anak 147 0 0 0 0 0 0 0 0 0 10
107 Infusion set dewasa 123 0 0 0 3 6 11 9 5 9 1
108 Isoniazid tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0
109 Isosorbid Dinitrat tablet subligual 5 mg 0 0 0 0 0 0 0 0 0 0 0
110 Kalsium Glukonat inj 10% 0 0 0 0 0 0 0 0 0 0 0
111 Kalsium Hidroksida pasta 0 0 0 0 0 0 0 0 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg 1,400 124 0 0 150 280 350 130 200 80 250
113 Kapas pembalut 250 gram 1 0 0 0 0 0 0 0 0 0 0
114 Kapas pembalut / Absorben 500 gram 1 0 0 0 0 0 0 0 0 0 0
115 Kapas pembalut / Absorben 1000 gram 1 0 0 0 0 0 0 0 0 0 0
116 Kaptopril 12,5 mg 0 0 0 0 140 0 0 0 0 0 0
117 Kaptopril 25 mg 900 183 0 0 0 0 0 0 0 0 0
118 Karbamazepin tablet 200 mg 1,900 1980 0 0 0 0 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm 600 0 0 29 0 0 50 50 0 50 0
120 Kasa hidrofil 40 x 80 cm 2 0 0 0 0 0 0 0 0 0 0
121 Kasa pembalut elastis 3 inch 7 0 0 0 0 0 0 0 0 0 0
122 Ketokonazol krim 2% 0 25 0 0 0 0 0 0 0 0 0
123 Ketokonazol tablet 200 mg 500 90 0 0 0 0 0 0 0 0 0
124 Kloramfenikol kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0
125 Kloramfenikol susp 125mg/5 ml 77 0 0 0 0 0 0 0 0 0 0
126 Kloramfenikol salep mata 1 % 24 23 0 0 0 0 0 5 1 6 5
127 Kloramfenikol tetes mata 1 % 0 0 0 0 0 0 0 0 0 0 0
128 Kloramfenikol salep Kulit 2% 0 0 0 0 0 0 0 0 0 0 0
129 Kloramfenikol tetes telinga 3 % 9 0 0 2 0 0 0 0 0 0 0
130 Klorfeniramin maleat tablet 4 mg 2,900 183 330 0 300 0 160 620 390 654 270
131 Klorokuin tablet 150 mg 0 0 0 0 0 0 0 0 0 0 0
132 Klorfenol Kamfer Menthol 0 0 0 0 0 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml 29 0 0 0 0 0 0 0 0 0 0
134 Klorpromazin HCI tablet salut 100 mg 0 0 0 0 0 0 0 0 0 0 0
135 Klorpromazin HCI tablet salut 25 mg 0 0 0 0 0 0 0 0 0 0 0
136 Kotrimoksazol tablet 480 mg 1,600 76 190 440 0 490 60 300 210 445 200
137 Kotrimoksazol Suspensi 240 mg/ 5 ml 3 0 9 0 0 6 4 1 2 11 0
138 Kotrimoksazol Pediatrik tablet 120 mg 390 0 0 0 0 0 0 0 0 0 0
139 Larutan mengandung elektrolit 0 0 0 0 0 0 0 0 0 0 0
140 Lidokain komp. injeksi - 2 ml 60 0 0 10 5 2 0 5 13 0 10
141 Lisol 1 liter 0 0 0 0 0 0 0 0 0 1 0
142 Loperamide 2 mg 0 0 0 0 0 0 0 0 0 0 0
143 Loratadine 10 mg 450 0 0 0 0 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0
146 Masker Kain 200 0 0 29 0 35 0 0 10 47 40
147 Mata Pisau No. 15 84 0 0 0 0 0 0 0 0 0 0
148 Mata Pisau No. 20 100 0 0 0 0 0 0 0 0 0 0
149 Metilergometrin maleat tablet salut 0,125 mg 500 0 0 0 0 0 0 0 0 0 0
150Metilergometrin maleat injeksi 0.200 mg - 1 ml 0 0 0 0 0 0 0 0 0 0 0
151 Metilprednisolon tablet 4 mg 500 140 0 0 0 0 0 0 0 0 0
152 Metformin Hcl 500 mg 1,100 135 0 0 0 0 0 0 0 0 0
153 Metoklopramida 10 mg 0 100 0 0 0 0 0 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml 47 0 0 0 0 0 0 0 0 0 0
155 Metronidazol tablet 250 mg 0 0 0 0 0 0 0 0 0 0 260
156 Metronidazol tablet 500 mg 900 20 0 0 50 210 490 360 130 120 0
157 Miconazole Krim 0 17 0 0 0 0 0 0 0 0 0
158 Mineral Mix 0 0 0 0 0 0 0 0 0 0 0
159 Multivitamin (Lycalvit) syrup 0 0 0 0 0 0 0 1 5 0 0
160 Mummifying pasta 0 0 0 0 0 0 0 0 0 0 0
161 Natrium diklofenak 50 mg 3,000 190 0 0 0 0 0 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril 100 0 0 1 0 3 5 8 8 0 10
163 Nifedipin 10 mg 0 100 0 0 0 0 0 0 0 0 0
164 Nistatin tablet vagina 100.000 IU / g 70 0 0 0 0 0 0 0 0 0 0
165 Nistatin vaginal tablet salut 500.000 IU/g 0 0 0 0 0 0 0 0 0 0 0
166 Obat anti Tuberklosis kategori FDC I 0 0 0 0 0 0 0 0 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 0 0 0 0 0 0 0 0 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak 0 0 0 0 0 0 0 0 0 0 0
169 Obat Batuk Hitam (O.B.H) cairan 0 0 0 0 0 0 0 0 0 0 0
170 OBH Itral Syrup 0 0 0 0 0 0 0 0 0 0 0
171 Ofloksasin tablet 400 mg 100 0 0 0 0 0 0 0 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % 0 0 0 0 0 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % 0 0 0 0 0 0 0 0 0 0 0
174 Oksitosin injeksi 10 IU / ml - 1 ml 80 0 0 0 10 0 0 4 9 8 6
175 Omeprazole 20 mg 90 0 0 0 0 0 0 0 0 0 0
176 Parasetamol drops 0 0 0 0 0 0 0 0 0 0 0
177 Parasetamol sirup 120 mg / 5 ml 0 0 0 0 0 0 0 0 0 0 0
178 Parasetamol tablet 500 mg 6,000 706 530 790 400 188 610 410 640 703 700
179 Pehacain injeksi 0 0 0 0 0 0 0 0 0 0 0
180 Permetrin krim 5% 6 0 0 0 0 0 0 0 0 0 0
181 Pirantel pamoat tablet 125 mg 0 62 0 0 0 6 0 0 0 0 0
182 Pirantel suspensi 10 ml 10 0 0 0 0 0 0 0 0 0 0
183 Pirantel suspensin 60 ml 0 0 0 0 0 0 0 0 0 0 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg 8,200 300 220 0 0 0 485 0 300 0 0
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml 100 0 0 0 0 0 0 0 0 0 0
186 Piroksikam 20 mg 0 0 0 0 0 0 0 0 0 0 0
187 Plester 2,5 cm x 4 m 15 0 -1 0 0 2 1 1 2 0 1
188 Plester 7,5 cm x 4 m -1 0 0 0 0 0 0 0 0 0 0
189 Pot Sputum 0 0 0 0 0 0 0 0 0 0 0
190 Prednison tablet 5 mg 0 0 70 130 80 0 0 0 0 155 0
191 Primakuin tablet 15 mg 0 0 0 0 0 0 0 0 0 0 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial 0 0 0 0 0 0 0 0 0 0 0
193 Propiltiourasil tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0
194 Propranolol HCI tablet 40 mg 300 0 0 0 0 0 0 0 0 0 0
195 Ranitidin tablet 150 mg 4,000 140 0 0 0 50 0 0 0 0 0
196 Ranitidin injeksi 25 mg/2 ml 0 0 0 0 0 0 0 0 0 0 0
197 Rapid Test VIKIA HIV 1/2 0 0 0 0 0 0 0 0 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 0 0 0 0 0 0 0 0 0 0 0
199 Reagensia ZN 0 0 0 0 0 0 0 0 0 0 0
200 Retinol (Vitamin A) kapsul 100.000 IU 0 0 0 0 0 0 0 0 0 0 0
201 Retinol (Vitamin A) kapsul 200.000 IU 0 0 0 0 0 0 0 0 0 0 0
202 Ringer Laktat larutan infus steril 120 0 0 0 0 1 4 5 9 5 10
203 Salbutamol tablet 2 mg 0 100 0 75 0 100 0 60 30 0 0
204 Salbutamol 4 mg 190 0 0 0 170 0 0 0 0 0 0
205 Salep 2 - 4 kombinasi 52 0 0 0 8 2 0 3 6 0 0
206 Salisil bedak 2 % 14 0 4 0 0 4 1 3 2 7 0
207 Sarung Tangan Examination S 0 0 0 0 0 0 0 0 0 20 0
208 Sarung Tangan Examination M 0 0 0 0 0 0 0 0 0 0 0
209 Sarung Tangan Examination L 0 0 0 0 0 0 0 0 0 0 0
210 Sefadroksil 500 mg 600 0 0 0 60 0 0 0 0 0 0
211 Semen seng fosfat serbuk dan cairan 0 0 0 0 0 0 0 0 0 0 0
212 Setrizin tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0
213 Setrizin syrup 0 0 0 0 0 0 0 0 0 0 0
214 Sianokorbalamin (Vit.B 12) 500 mcg 600 0 0 0 50 240 0 120 50 0 450
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml 140 0 0 0 0 0 0 0 0 0 0
216 Simetidine 200 mg 900 110 0 0 0 0 0 0 0 0 0
217 Simvastatin 10 mg 0 0 0 0 0 0 0 0 0 0 0
218 Simvastatin 20 mg 150 26 0 0 0 0 0 0 0 0 0
219 Silk (benang Bedah Sutera) No. 3 / 0 3 0 0 0 0 0 0 5 5 0 0
220 Siprofloksasin tablet 500 mg 3,100 30 0 0 0 0 0 0 0 0 0
221 Spironolakton tablet 100 mg 100 0 0 0 0 0 0 0 0 0 0
222 Sulfasetamida natrium tetes mata 15 % 0 0 0 0 0 0 0 0 0 0 0
223 Tablet tambah darah kombinasi 17,670 54 0 0 10 120 0 0 60 50 180
224 Taburia 0 0 0 0 0 0 0 0 0 0 0
225 Temporary stopping (Fletcher) 0 0 0 0 0 0 0 0 0 0 0
226 Tetrasiklin HCI kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0
227 Tetrasiklin HCI kapsul 500 mg 400 0 0 0 0 0 0 0 0 0 0
228 Tiamfenikol 500 mg 200 20 0 0 0 0 0 0 0 0 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml 30 0 0 0 0 0 0 0 0 0 0
230Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg 1,800 231 140 720 360 220 430 0 460 0 500
231 Triheksifenidil Hidroklorida tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0
232 Umbilical Cord 0 0 0 0 0 0 7 1 6 10 3
233 U-Pad steril 60 cm x 90 cm 0 0 0 0 0 0 6 0 0 0 0
234 Urine Bag 9 0 0 0 0 0 0 0 0 0 0
235 Vaksin Jerap Tetanus 0 0 0 0 0 0 0 0 0 0 0
236 Vaksin Rabies vero 0 0 0 0 0 0 0 0 0 0 0
237 Vitamin B kompleks tablet 11,100 330 690 995 300 148 670 600 360 256 260
238 Wicold kapsul 0 0 0 0 0 0 0 0 0 0 0
239 Yodium povidon larutan 10 % 60 ml 9 0 3 0 0 3 0 1 0 0 0
240 Yodium povidon larutan 10 % 300 ml 2 0 0 0 0 0 0 1 0 0 0
241 Zinc syrup 8 0 0 0 0 0 0 0 0 0 5
242 Zinc Tablet 300 60 0 0 0 140 10 220 140 240 100
243 Paper Tape 2,5 x 9,14 5 0 0 0 0 0 0 0 0 0 0
244 Paper Tape 7,5 x 9,14 2 0 0 0 0 0 0 0 0 0 0
245 Zidovudine 100 mg 0 0 0 0 0 0 0 0 0 0 0
246 Lomivudine 150 mg 0 0 0 0 0 0 0 0 0 0 0
247 Efavirenz 600 mg 0 0 0 0 0 0 0 0 0 0 0
248 Nipirapine 200 mg 0 0 0 0 0 0 0 0 0 0 0
249 ZDV + 3 TC+ NVP Ped Triple FDC 0 0 0 0 0 0 0 0 0 0 0
250 TDF +3TC+EFV (300/300/600) Triple FDC 0 0 0 0 0 0 0 0 0 0 0
251 Tenofovir 300 mg 0 0 0 0 0 0 0 0 0 0 0
252 Tenof EM 0 0 0 0 0 0 0 0 0 0 0
253 samcobion 0 0 0 0 0 0 0 0 0 0 0
254 Spironolakton tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0
255 lytacur sirup 112 2 0 0 0 0 0 0 4 10 0
256 Susu Produgen 0 0 0 0 0 0 0 0 0 0 0
3 0
8 0
Mengetahui
a Puskesmas Baranti Pengelola Obat Puskesmas Baranti
USILA POSBIN TOTAL
DU
186
199
132
316
23
132
566
700
26
5214
869
967
157
0
100
0
0
0
0
0
0
1000
0
0
168
0
1630
24455
0
10
360
0
5115
79
23
22
0
343
0
12053
300
9903
10
150
0
100
0
3
0
0
0
0
0
157
0
0
0
-3
60
25
6117
10
-1
0
0
0
30
100
0
27
500
0
0
0
9
73
0
0
0
0
180
65
346
10
8
65
715
25
5
0
1855
0
0
2592
215
3240
0
0
0
494
167
38
2
10845
140
157
167
0
0
0
0
2964
1
1
1
140
1083
3880
779
2
7
25
590
0
77
64
0
0
11
5807
0
0
29
0
0
4011
36
390 exp
0
105
1
0
450
0
0
361
84
100
500
0
640
1235
100
47
260
2280
17
0
0
0
3190
135
100
70
0
0
0
0
0
0
100
0
0
117
90
0
0
11677
0
6
68
10
0
9505
100
0
21
-1
0
435
0
0
0
300
4190
0
0
0
0
0
0
154
365
360
71
35
20
0
0
660
0
0
0
1510
140
1010
0
176
13
3130
100
0
0
0
0
0
400
220
30
4861
0
68
7
9
4
0
15709
0
16
3
13
1210
5
2
0
0
0
0
0
0
0
0
0
0
128
0
3
18
Baranti
LAPORAN OBAT PKM BARANTI
Periode : Juni 2018
NO NAMA OBAT stok awal penerimaan pemakaian sisa KET
1 IV Catheter Gea No. 18 0 0 0 0
3 IV Catheter Gea No. 22 0 117 119 -2
5 Ansell Steril 6 1/2 0 95 95 0
6 Ansell Steril 7 0 71 71 0
7 Ansell Steri 7 1/2 0 93 93 0
8 Alat Suntik sekali pakai 0,05 ml 0 100 100 0
9 Alat Suntik sekali pakai 0,5 ml 0 0 0 0
10 Alat suntik sekali pakai 1 ml 0 0 0 0
13 Alat Suntik sekali pakai 10 ml 0 2 2 0
14 Albendasol tablet 400 mg 0 0 0 0
15 Alkohol Swab 0 0 0 0
16 Alupurinol tablet 100 mg 0 600 0 600
17 Allpurinol tablet 300 mg 0 0 0 0
18 Ambroxol sirup 15 mg/ml 0 0 0 0
19 Ambroxol tablet 0 0 0 0
20 Aminofilin tablet 200 mg 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml 0 0 0 0
22 Amitriptilin HCI tablet salut 25 mg 0 0 0 0
23 Amlodipine 5 mg 0 0 0 0
24 Amlodipine 10 mg 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml 0 42 42 0
26 Amoksisilin sirup kering forte 250 mg/5 ml 0 0 0 0
27 Amoksisilin kapsul 250 mg 30 500 900 -370
28 Amoksisilin kaplet 500 mg 200 2200 2370 30

29 Ampisilin serbuk injeksi i.m/i.v 1000 mg 0 0 0 0
30 Anagens Syrup 0 4 4 0
31 Antalgin (Metampiron) tablet 500 mg 0 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml 0 0 0 0
33 Antasida DOEN tablet kombinasi 30 600 812 -182
34 Antasida DOEN suspensi 0 37 37 0
35 Antihemoroid DOEN kombinasi 0 0 0 0
36 Antifungi DOEN kombinasi 0 2 2 0
37 Antibakteri DOEN salep Kombinasi 0 0 0 0
38 Antimigrain DOEN kombinasi 43 0 0 43
39 Aqua pro injeksi steril, bebas pirogen 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg 62 8300 8388 -26
41 Asam Folat 100 100 0 200
42 Asam Mefenamat tablet 500 mg 110 1900 1950 60
43 Asiklovir 200 mg 10 0 30 10
44 Asiklovir 400 mg 0 0 0 0
45 Asiklovir krim 5% 0 0 0 0
46 Asetosal tablet 100 mg 0 0 0 0
47 Attalpulgit 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml 0 0 0 0
49 Atropin Sulfat tablet 0,5 mg 0 0 0 0
50 Benecheck plus Glucose test strip 50's 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's 0 0 0 0
52 Benecheck plus Uric test strip 50's 0 0 0 0
53 Betahistin maleat 24 mg 0 0 0 0
54 Betametason krim 0.1 % 20 0 4 16
55 Bisakodil 5 mg supp 0 0 0 0
56 Bisakodil 10 mg supp 0 0 0 0
57 Blood Lancet 26G 0 0 0 0
58 Catgut/benang bedah no .2/0 0 0 0 0
59 Catgut/benang bedah no .3/0 0 30 30 0
60 Deksametason injeksi 5 mlg/ml - 1 ml 0 0 0 0

61 Deksametason tablet 0,5 mg 300 2100 1983 417
62 Diazepam injeksi 5 mg/ml - 2 ml 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml 0 0 0 0
64 Diazepam tablet 2 mg 0 0 0 0
65 Diazepam tablet 5 mg 0 0 0 0
66 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml 0 0 0 0
68 Digoksin tablet 0,25 mg 0 0 0 0
69 Doksisilin kapsul 100 mg 0 0 0 0
70 Domperidom suspensi 0 26 26 0
71 Domperidom tablet 0 300 0 0
72 Efedrin HCI tablet 25 mg 0 0 0 0
73 Ekstrak Belladon tablet 10 mg 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % 0 1 1 0
76 E t a n o l 70 % 100 ml 0 32 0 32
77 Etil klorida semprot 0 0 0 0
78 Eugenol cairan 0 0 0 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml 0 0 0 0
80 Fenobarbital tablet 30 mg 0 0 0 0
81 Fervital Kapsul 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml 0 0 0 0
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg 46 280 18 46
84 Foly Catheter No. 18 0 0 0 0
85 Foly Catheter No. 20 0 0 0 0
86 Furosemid tablet 40 mg 65 0 25 40
87 Garam Oralit untuk 200 ml Air 90 100 10 180
88 Gentamicin inj 40mg/ml 0 0 0 0
89 Gentian Violet larutan 1 % 0 0 0 0
90 Glass lonomer Cement (GC IX ) 0 0 0 0
91 Glibenklamid tablet 5 mg 155 100 45 210
92 Glimepiride 1 mg 0 0 0 0
93 Glimepiride 2 mg 0 0 0 0
94 Guaiafenesin Tablet 110 4000 3998 112
95 Glukosa larutan infus 5 % steril 0 0 0 0
96 Grisefulvin tablet 125 mg (Micronized) 0 0 0 0
97 Haloperidol tablet 1,5 mg 0 0 0 0
98 Haloperidol tablet 2 mg 0 0 0 0
99 Haloperidol inj 50 mg/ml 0 0 0 0
100 Hidroklorotiazid (HCT) tablet 25 mg 94 0 0 94
101 Hidrokortison krim 2,5 % 20 24 4 40
102 Ibuprofen suspensi 100 mg/5 ml 0 0 0 0
103 Ibuprofen suspensi 200 mg/5 ml 0 0 0 0
104 Ibuprofen tablet 200 mg 100 600 610 100
105 Ibuprofen tablet 400 mg 0 0 0 0
106 Infusion set anak 0 3 3 0
107 Infusion set dewasa 0 24 24 0
108 Isoniazid tablet 100 mg 0 0 90 0
109 Isosorbid Dinitrat tablet subligual 5 mg 0 0 0 0
110 Kalsium Glukonat inj 10% 0 0 0 0
111 Kalsium Hidroksida pasta 0 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg 124 1000 1036 124
113 Kapas pembalut 250 gram 0 1 0 1
114 Kapas pembalut / Absorben 500 gram 0 1 2 -1
115 Kapas pembalut / Absorben 1000 gram 0 1 0 1
116 Kaptopril 12,5 mg 0 700 193 507
117 Kaptopril 25 mg 183 2100 2050 233
118 Karbamazepin tablet 200 mg 1980 0 0 1980
119 Kasa pembalut Hidrofil 4 m x 10 cm 0 0 0 0
120 Kasa hidrofil 40 x 80 cm 0 3 3 0
121 Kasa pembalut elastis 3 inch 0 0 0 0
122 Ketokonazol krim 2% 25 0 17 8
123 Ketokonazol tablet 200 mg 90 100 10 90
124 Kloramfenikol kapsul 250 mg 0 0 0 0

125 Kloramfenikol susp 125mg/5 ml 0 0 0 0
126 Kloramfenikol salep mata 1 % 23 0 0 23
127 Kloramfenikol tetes mata 1 % 0 0 0 0
128 Kloramfenikol salep Kulit 2% 0 0 0 0
129 Kloramfenikol tetes telinga 3 % 0 0 0 0
130 Klorfeniramin maleat tablet 4 mg 183 0 0 183
131 Klorokuin tablet 150 mg 0 0 0 0
132 Klorfenol Kamfer Menthol 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml 0 0 0 0
134 Klorpromazin HCI tablet salut 100 mg 0 0 0 0
135 Klorpromazin HCI tablet salut 25 mg 0 0 0 0
136 Kotrimoksazol tablet 480 mg 76 1000 979 97
137 Kotrimoksazol Suspensi 240 mg/ 5 ml 0 7 7 0
138 Kotrimoksazol Pediatrik tablet 120 mg 0 0 0 0
139 Larutan mengandung elektrolit 0 0 0 0
140 Lidokain komp. injeksi - 2 ml 0 170 170 0
141 Lisol 1 liter 0 0 0 0
142 Loperamide 2 mg 0 0 0 0
143 Loratadine 10 mg 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml 0 0 0 0
146 Masker Kain 0 600 600 0
147 Mata Pisau No. 15 0 0 0 0
148 Mata Pisau No. 20 0 0 0 0
149 Metilergometrin maleat tablet salut 0,125 mg 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml 0 0 0 0
151 Metilprednisolon tablet 4 mg 140 200 60 140
152 Metformin Hcl 500 mg 135 500 529 106
153 Metoklopramida 10 mg 100 0 84 100
154 Metoklopramida injeksi 5 mg / ml 0 0 0 0
155 Metronidazol tablet 250 mg 0 0 0 0
156 Metronidazol tablet 500 mg 20 500 657 -137

157 Miconazole Krim 17 19 2 17
158 Mineral Mix 0 0 0 0
159 Multivitamin (Lycalvit) syrup 0 0 0 0 EXP
160 Mummifying pasta 0 0 0 0
161 Natrium diklofenak 50 mg 190 600 410 380
162 Natrium klorida larutan infus 0,9 % steril 0 30 30 0
163 Nifedipin 10 mg 100 100 65 135
164 Nistatin tablet vagina 100.000 IU / g 0 0 0 0
165 Nistatin vaginal tablet salut 500.000 IU/g 0 0 0 0
166 Obat anti Tuberklosis kategori FDC I 0 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 0 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak 0 0 0 0
169 Obat Batuk Hitam (O.B.H) cairan 0 0 0 0
170 OBH Itral Syrup 0 0 0 0
171 Ofloksasin tablet 400 mg 0 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % 0 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % 0 0 0 0
174 Oksitosin injeksi 10 IU / ml - 1 ml 0 25 25 0
175 Omeprazole 20 mg 0 90 30 0
176 Parasetamol drops 0 0 0 0
177 Parasetamol sirup 120 mg / 5 ml 0 0 0 0
178 Parasetamol tablet 500 mg 706 11400 10834 1272
179 Pehacain injeksi 0 0 0 0
180 Permetrin krim 5% 0 0 0 0
181 Pirantel pamoat tablet 125 mg 62 0 28 62
182 Pirantel suspensi 10 ml 0 5 5 0
183 Pirantel suspensin 60 ml 0 0 0 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg 300 2600 2613 287
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml 0 0 0 0
186 Piroksikam 20 mg 0 0 0 0
187 Plester 2,5 cm x 4 m 0 0 0 0
188 Plester 7,5 cm x 4 m 0 1 1 0

189 Pot Sputum 0 0 0 0
190 Prednison tablet 5 mg 0 200 367 -167
191 Primakuin tablet 15 mg 0 0 0 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial 0 0 0 0
193 Propiltiourasil tablet 100 mg 0 0 0 0
194 Propranolol HCI tablet 40 mg 0 0 0 0
195 Ranitidin tablet 150 mg 140 500 392 248
196 Ranitidin injeksi 25 mg/2 ml 0 0 0 0
197 Rapid Test VIKIA HIV 1/2 0 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 0 0 0 0
199 Reagensia ZN 0 0 0 0
200 Retinol (Vitamin A) kapsul 100.000 IU 0 0 0 0
201 Retinol (Vitamin A) kapsul 200.000 IU 0 0 0 0
202 Ringer Laktat larutan infus steril 0 70 70 0
203 Salbutamol tablet 2 mg 100 100 129 71
204 Salbutamol 4 mg 0 0 0 0
205 Salep 2 - 4 kombinasi 0 0 0 0
206 Salisil bedak 2 % 0 1 1 0
207 Sarung Tangan Examination S 0 0 0 0
208 Sarung Tangan Examination M 0 0 0 0
209 Sarung Tangan Examination L 0 0 0 0
210 Sefadroksil 500 mg 0 0 53 -53
211 Semen seng fosfat serbuk dan cairan 0 0 0 0
212 Setrizin tablet 10 mg 0 400 460 -60
213 Setrizin syrup 0 0 0 0
214 Sianokorbalamin (Vit.B 12) 500 mcg 0 0 0 0
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml 0 0 0 0
216 Simetidine 200 mg 110 0 0 110
217 Simvastatin 10 mg 0 360 360 0
218 Simvastatin 20 mg 26 50 24 26
219 Silk (benang Bedah Sutera) No. 3 / 0 0 8 8 0
220 Siprofloksasin tablet 500 mg 30 0 100 -70

221 Spironolakton tablet 100 mg 0 0 0 0
222 Sulfasetamida natrium tetes mata 15 % 0 0 0 0
223 Tablet tambah darah kombinasi 54 1240 1216 54
224 Taburia 0 0 0 0
225 Temporary stopping (Fletcher) 0 0 0 0
226 Tetrasiklin HCI kapsul 250 mg 0 0 0 0
227 Tetrasiklin HCI kapsul 500 mg 0 0 0 0
228 Tiamfenikol 500 mg 20 0 0 20
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml 0 0 0 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg 231 3400 3299 332
231 Triheksifenidil Hidroklorida tablet 2 mg 0 0 0 0
232 Umbilical Cord 0 0 0 0
233 U-Pad steril 60 cm x 90 cm 0 10 10 0
234 Urine Bag 0 3 3 0
235 Vaksin Jerap Tetanus 0 0 0 0
236 Vaksin Rabies vero 0 0 0 0
237 Vitamin B kompleks tablet 330 2600 2510 420
238 Wicold kapsul 0 0 0 0
239 Yodium povidon larutan 10 % 60 ml 0 1 1 0
240 Yodium povidon larutan 10 % 300 ml 0 1 1 0
241 Zinc syrup 0 0 0 0
242 Zinc Tablet 60 0 0 60
243 Paper Tape 2,5 x 9,14 0 0 0 0
244 Paper Tape 7,5 x 9,14 0 0 0 0
245 Zidovudine 100 mg 0 0 0 0
246 Lomivudine 150 mg 0 0 0 0
247 Efavirenz 600 mg 0 0 0 0
248 Nipirapine 200 mg 0 0 0 0
249 ZDV + 3 TC+ NVP Ped Triple FDC 0 0 0 0
250 TDF +3TC+EFV (300/300/600) Triple FDC 0 0 0 0
251 Tenofovir 300 mg 0 0 0 0
252 Tenof EM 0 0 0 0
253 samcobion 0 0 0 0
254 Spironolakton tablet 100 mg 0 0 0 0
255 lytacur sirup 2 9 7 4
256 Susu Produgen 0 0 0 0
257 xylocain spray 0 0 0
258 zink drop 0 0 0
Mengetahui
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
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0
0
0
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0
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0
0
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0
0
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LAPORAN OBAT PKM BARANTI
Periode : Juni 2018
NO NAMA OBAT STOCK AWAL PENERIMAAN JUMLAH KAMAR OBAT P SIMPO P TONRONG P TR RJG PS Brt PS Trong PS T RIJANG PS 2PANUA PS PASSENO PS SIPODECENG
2 IV Catheter Gea No. 20 -60 0 -60 33 0 0 50 0 0 0 0 0 0
5 Ansell Steril 6 1/2 147 0 147 95 0 0 0 0 0 0 0 0 4
6 Ansell Steril 7 115 0 115 71 0 0 3 0 0 3 0 3 10
7 Ansell Steri 7 1/2 443 0 443 93 0 2 0 5 7 0 0 0 0
9 Alat Suntik sekali pakai 0,5 ml -3 0 -3 0 0 0 0 10 5 0 0 0 0
13 Alat Suntik sekali pakai 10 ml 157 0 157 2 0 0 0 0 0 0 0 0 0
14 Albendasol tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
15 Alkohol Swab 100 0 100 0 0 0 0 0 0 0 0 0 0
16 Alupurinol tablet 100 mg 2000 0 2000 0 0 0 0 0 0 0 0 0 0
17 Allpurinol tablet 300 mg -500 0 -500 0 0 0 0 0 0 0 0 0 0
18 Ambroxol sirup 15 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0
19 Ambroxol tablet 0 0 0 0 0 0 0 0 0 0 0 0 0
20 Aminofilin tablet 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
22 Amitriptilin HCI tablet salut 25 mg 1000 0 1000 0 0 0 0 0 0 0 0 0 0
23 Amlodipine 5 mg -1500 0 -1500 0 0 0 0 0 0 0 0 0 0
24 Amlodipine 10 mg -5 0 -5 0 0 0 5 0 0 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml -98 0 -98 42 2 2 4 0 0 1 0 2 0
26 Amoksisilin sirup kering forte 250 mg/5 ml 32 0 32 0 0 0 0 0 0 0 0 0 0
27 Amoksisilin kapsul 250 mg 970 0 970 900 30 60 0 0 0 20 0 0 0
28 Amoksisilin kaplet 500 mg 1304 0 1304 2370 140 220 170 0 20 80 120 85 95
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
30 Anagens Syrup 3 0 3 4 1 0 0 0 0 0 0 0 0
31 Antalgin (Metampiron) tablet 500 mg 1104 0 1104 0 0 0 0 0 0 0 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
33 Antasida DOEN tablet kombinasi 4051 0 4051 812 120 60 330 40 20 30 100 10 20
34 Antasida DOEN suspensi 69 0 69 37 0 0 6 0 0 0 0 0 0
35 Antihemoroid DOEN kombinasi 48 0 48 0 0 0 0 0 0 0 0 0 0
36 Antifungi DOEN kombinasi 22 0 22 2 0 0 0 0 0 0 0 0 0
37 Antibakteri DOEN salep Kombinasi 0 0 0 0 0 0 0 0 0 0 0 0 0
38 Antimigrain DOEN kombinasi 343 0 343 0 0 0 0 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen 0 0 0 0 0 0 0 0 0 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg 1071 0 1071 8388 110 90 0 314 60 40 0 178 95
41 Asam Folat -450 0 -450 0 0 0 0 0 0 0 0 0 0
42 Asam Mefenamat tablet 500 mg -1437 0 -1437 1950 10 65 80 10 30 130 240 10 20
43 Asiklovir 200 mg 520 0 520 30 0 0 0 0 0 0 0 0 0
44 Asiklovir 400 mg 150 0 150 0 0 0 0 0 0 0 0 0 0
45 Asiklovir krim 5% 0 0 0 0 0 0 0 0 0 0 0 0 0
46 Asetosal tablet 100 mg 100 0 100 0 0 0 0 0 0 0 0 0 0
47 Attalpulgit 0 0 0 0 0 0 0 0 0 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml 3 0 3 0 0 0 0 0 0 0 0 0 0
49 Atropin Sulfat tablet 0,5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's 0 0 0 0 0 0 0 0 0 0 0 0 0
53 Betahistin maleat 24 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
54 Betametason krim 0.1 % 158 0 158 4 0 0 0 0 0 0 0 2 0
55 Bisakodil 5 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0
56 Bisakodil 10 mg supp 0 0 0 0 0 0 0 0 0 0 0 0 0
57 Blood Lancet 26G 0 0 0 0 0 0 0 0 0 0 0 0 0
58 Catgut/benang bedah no .2/0 -8 0 -8 0 0 0 0 0 0 0 0 0 0
59 Catgut/benang bedah no .3/0 113 0 113 30 0 0 0 0 2 0 0 1 3
60 Deksametason injeksi 5 mlg/ml - 1 ml 25 0 25 0 0 0 0 0 0 0 0 0 0

61 Deksametason tablet 0,5 mg 9944 0 9944 1983 90 30 0 80 0 50 100 101 10
62 Diazepam injeksi 5 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml -3 0 -3 0 0 0 0 0 0 0 0 0 0
64 Diazepam tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
65 Diazepam tablet 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
66 Dietilkarbamazin Sitrat tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml 30 0 30 0 0 0 0 0 0 0 0 0 0
68 Digoksin tablet 0,25 mg 100 0 100 0 0 0 0 0 0 0 0 0 0
69 Doksisilin kapsul 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
70 Domperidom suspensi 6 0 6 26 0 0 3 0 0 0 0 0 0
71 Domperidom tablet 300 0 300 0 0 0 0 0 0 0 0 0 0
72 Efedrin HCI tablet 25 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
73 Ekstrak Belladon tablet 10 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % 10 0 10 1 0 0 0 0 0 0 0 0 0
76 E t a n o l 70 % 100 ml 86 0 86 0 0 0 0 1 1 0 0 0 0
77 Etil klorida semprot 0 0 0 0 0 0 0 0 0 0 0 0 0
78 Eugenol cairan 0 0 0 0 0 0 0 0 0 0 0 0 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
80 Fenobarbital tablet 30 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
81 Fervital Kapsul 20 0 20 0 0 0 0 0 0 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml 57 0 57 0 0 0 0 3 1 0 0 1 3
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg 216 0 216 18 0 0 0 0 0 0 0 0 0
84 Foly Catheter No. 18 8 0 8 0 0 0 0 0 0 0 0 0 0
85 Foly Catheter No. 20 12 0 12 0 0 0 0 0 0 0 0 0 0
86 Furosemid tablet 40 mg 65 0 65 25 0 0 0 0 0 0 0 0 0
87 Garam Oralit untuk 200 ml Air -436 0 -436 10 0 0 0 10 0 10 25 6 18
88 Gentamicin inj 40mg/ml 25 0 25 0 0 0 0 0 0 0 0 0 0
89 Gentian Violet larutan 1 % 5 0 5 0 0 0 0 0 0 0 0 0 0
90 Glass lonomer Cement (GC IX ) 0 0 0 0 0 0 0 0 0 0 0 0 0
91 Glibenklamid tablet 5 mg 2005 0 2005 45 0 0 0 0 0 0 0 0 0
92 Glimepiride 1 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
93 Glimepiride 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
94 Guaiafenesin Tablet 5179 0 5179 3998 90 70 0 0 20 0 0 77 0
95 Glukosa larutan infus 5 % steril 20 0 20 0 0 0 0 0 0 0 0 0 0
96 Grisefulvin tablet 125 mg (Micronized) 2930 0 2930 0 0 105 0 10 0 0 0 0 0
97 Haloperidol tablet 1,5 mg 2000 0 2000 0 0 0 0 0 0 0 0 0 0
98 Haloperidol tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
99 Haloperidol inj 50 mg/ml 0 0 0 0 0 0 0 0 0 0 0 0 0
100 Hidroklorotiazid (HCT) tablet 25 mg 494 0 494 0 0 0 0 0 0 0 0 0 0
101 Hidrokortison krim 2,5 % 122 0 122 4 0 2 0 0 0 1 0 0 0
102 Ibuprofen suspensi 100 mg/5 ml 46 0 46 0 3 0 0 0 1 1 0 0 0
103 Ibuprofen suspensi 200 mg/5 ml -1 0 -1 0 0 0 0 1 0 0 0 0 0
104 Ibuprofen tablet 200 mg 56731 0 56731 610 90 40 200 20 0 30 100 15 0
105 Ibuprofen tablet 400 mg 550 0 550 0 0 0 0 0 20 0 0 0 0
106 Infusion set anak 157 0 157 3 0 0 0 0 0 0 0 0 0
107 Infusion set dewasa 166 0 166 24 0 0 0 0 0 0 0 1 2
108 Isoniazid tablet 100 mg -25 0 -25 90 0 0 0 0 0 0 0 0 0
109 Isosorbid Dinitrat tablet subligual 5 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
110 Kalsium Glukonat inj 10% 0 0 0 0 0 0 0 0 0 0 0 0 0
111 Kalsium Hidroksida pasta 0 0 0 0 0 0 0 0 0 0 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg 12303 0 12303 1036 0 0 0 100 40 200 80 10 130
113 Kapas pembalut 250 gram 8 0 8 0 0 0 0 0 0 0 0 0 0
114 Kapas pembalut / Absorben 500 gram 1 0 1 2 0 0 0 0 0 0 0 0 0
115 Kapas pembalut / Absorben 1000 gram 1 0 1 0 0 0 0 0 0 0 0 0 0
116 Kaptopril 12,5 mg 5100 0 5100 193 0 0 140 0 0 0 0 0 0
117 Kaptopril 25 mg 1203 0 1203 2050 0 0 0 0 0 0 0 0 0
118 Karbamazepin tablet 200 mg 1980 0 1980 0 0 0 0 0 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm 921 0 921 0 0 2 0 0 0 0 0 0 25
120 Kasa hidrofil 40 x 80 cm 12 0 12 3 0 0 0 0 0 0 0 0 0
121 Kasa pembalut elastis 3 inch 7 0 7 0 0 0 0 0 0 0 0 0 0
122 Ketokonazol krim 2% 15 0 15 17 0 0 0 0 0 0 0 0 0
123 Ketokonazol tablet 200 mg 800 0 800 10 0 0 0 0 0 0 0 0 0
124 Kloramfenikol kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0

125 Kloramfenikol susp 125mg/5 ml 78 0 78 0 0 0 0 0 0 0 0 0 0
126 Kloramfenikol salep mata 1 % 235 0 235 0 0 0 0 0 1 0 1 1 0
127 Kloramfenikol tetes mata 1 % -9 0 -9 0 0 0 0 0 0 0 0 0 0
128 Kloramfenikol salep Kulit 2% 0 0 0 0 0 0 0 0 0 0 0 0 0
129 Kloramfenikol tetes telinga 3 % 11 0 11 0 0 0 0 0 0 0 0 0 0
130 Klorfeniramin maleat tablet 4 mg 6032 0 6032 0 90 0 40 0 20 90 120 40 20
131 Klorokuin tablet 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
132 Klorfenol Kamfer Menthol 0 0 0 0 0 0 0 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml 29 0 29 0 0 0 0 0 0 0 0 0 0
134 Klorpromazin HCI tablet salut 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
135 Klorpromazin HCI tablet salut 25 mg -20 0 -20 0 0 0 0 0 0 0 0 0 0
136 Kotrimoksazol tablet 480 mg 3611 0 3611 979 20 0 0 30 10 10 70 435 35
137 Kotrimoksazol Suspensi 240 mg/ 5 ml 143 0 143 7 1 0 0 0 0 0 0 1 0
138 Kotrimoksazol Pediatrik tablet 120 mg 390 0 390 0 0 0 0 0 0 0 0 0 0
139 Larutan mengandung elektrolit 0 0 0 0 0 0 0 0 0 0 0 0 0
140 Lidokain komp. injeksi - 2 ml -103 0 -103 170 0 0 5 1 0 1 5 0 3
141 Lisol 1 liter 1 0 1 0 0 0 0 0 0 0 0 0 0
142 Loperamide 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
143 Loratadine 10 mg 450 0 450 0 0 0 0 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
146 Masker Kain 396 0 396 600 0 2 0 10 0 2 20 3 0
147 Mata Pisau No. 15 84 0 84 0 0 0 0 0 0 0 0 0 0
148 Mata Pisau No. 20 100 0 100 0 0 0 0 0 0 0 0 0 0
149 Metilergometrin maleat tablet salut 0,125 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
151 Metilprednisolon tablet 4 mg -185 0 -185 60 0 0 0 0 0 0 0 0 0
152 Metformin Hcl 500 mg -765 0 -765 529 0 0 0 0 0 0 0 0 0
153 Metoklopramida 10 mg 361 0 361 84 0 0 0 0 0 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml -3 0 -3 0 0 0 0 0 0 0 0 0 0
155 Metronidazol tablet 250 mg 440 0 440 0 0 0 0 0 0 0 80 0 0
156 Metronidazol tablet 500 mg 2510 0 2510 657 0 0 20 30 10 10 0 0 20

157 Miconazole Krim 131 0 131 2 0 0 0 0 0 0 0 0 0
158 Mineral Mix 0 0 0 0 0 0 0 0 0 0 0 0 0
159 Multivitamin (Lycalvit) syrup 0 0 0 0 0 0 0 0 0 0 0 0 0
160 Mummifying pasta 0 0 0 0 0 0 0 0 0 0 0 0 0
161 Natrium diklofenak 50 mg 3190 0 3190 410 0 0 0 0 0 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril 53 0 53 30 0 0 0 0 0 0 5 0 0
163 Nifedipin 10 mg 400 0 400 65 0 0 0 0 0 0 0 0 0
164 Nistatin tablet vagina 100.000 IU / g 70 0 70 0 0 0 0 0 0 0 0 0 0
165 Nistatin vaginal tablet salut 500.000 IU/g 0 0 0 0 0 0 0 0 0 0 0 0 0
166 Obat anti Tuberklosis kategori FDC I 10 0 10 0 0 0 0 0 0 0 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 2 0 2 0 0 0 0 0 0 0 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak 3 0 3 0 0 0 0 0 0 0 0 0 0
169 Obat Batuk Hitam (O.B.H) cairan 0 0 0 0 0 0 0 0 0 0 0 0 0
170 OBH Itral Syrup -2 0 -2 0 0 0 0 0 0 0 0 0 0
171 Ofloksasin tablet 400 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % 0 0 0 0 0 0 0 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % 0 0 0 0 0 0 0 0 0 0 0 0 0
174 Oksitosin injeksi 10 IU / ml - 1 ml 164 0 164 25 0 0 0 0 2 0 1 1 0
175 Omeprazole 20 mg 40 0 40 30 0 0 0 0 0 0 0 0 0
176 Parasetamol drops 2 0 2 0 0 0 0 0 0 0 0 0 0
177 Parasetamol sirup 120 mg / 5 ml 2 0 2 0 0 0 0 0 0 0 0 0 0
178 Parasetamol tablet 500 mg 23393 0 23393 10834 250 145 110 70 30 130 210 130 240
179 Pehacain injeksi 0 0 0 0 0 0 0 0 0 0 0 0 0
180 Permetrin krim 5% 6 0 6 0 0 0 0 0 0 0 0 0 0
181 Pirantel pamoat tablet 125 mg 69 0 69 28 0 0 0 0 0 0 0 0 0
182 Pirantel suspensi 10 ml -10 0 -10 5 0 0 0 0 0 0 0 0 0
183 Pirantel suspensin 60 ml 0 0 0 0 0 0 0 0 0 0 0 0 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg 3010 0 3010 2613 100 0 0 0 30 40 0 0 30
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml 100 0 100 0 0 0 0 0 0 0 0 0 0
186 Piroksikam 20 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
187 Plester 2,5 cm x 4 m 23 0 23 0 0 1 2 1 0 0 0 0 1
188 Plester 7,5 cm x 4 m 32 0 32 1 0 0 0 0 0 0 0 0 0

189 Pot Sputum 100 0 100 0 0 0 0 0 0 0 0 0 0
190 Prednison tablet 5 mg 4543 0 4543 367 10 10 80 0 0 0 0 10 0
191 Primakuin tablet 15 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial 0 0 0 0 0 0 0 0 0 0 0 0 0
193 Propiltiourasil tablet 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
194 Propranolol HCI tablet 40 mg 300 0 300 0 0 0 0 0 0 0 0 0 0
195 Ranitidin tablet 150 mg -670 0 -670 392 0 0 0 0 0 0 0 0 0
196 Ranitidin injeksi 25 mg/2 ml 14 0 14 0 0 0 0 0 0 0 0 0 0
197 Rapid Test VIKIA HIV 1/2 0 0 0 0 0 0 0 0 0 0 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 0 0 0 0 0 0 0 0 0 0 0 0 0
199 Reagensia ZN 0 0 0 0 0 0 0 0 0 0 0 0 0
202 Ringer Laktat larutan infus steril -346 0 -346 70 0 0 0 0 0 0 5 1 2
203 Salbutamol tablet 2 mg 285 0 285 129 0 0 0 10 10 0 0 0 0
204 Salbutamol 4 mg 182 0 182 0 0 0 150 0 0 0 0 0 0
205 Salep 2 - 4 kombinasi 77 0 77 0 0 0 2 1 0 0 0 0 0
206 Salisil bedak 2 % 39 0 39 1 0 0 0 1 0 0 0 0 0
207 Sarung Tangan Examination S 12 0 12 0 0 0 0 0 0 0 0 0 0
208 Sarung Tangan Examination M 0 0 0 0 0 0 0 0 0 0 0 0 0
209 Sarung Tangan Examination L -6 0 -6 0 0 0 0 0 0 0 0 0 0
210 Sefadroksil 500 mg -460 0 -460 53 0 0 60 0 0 0 0 0 0
211 Semen seng fosfat serbuk dan cairan 0 0 0 0 0 0 0 0 0 0 0 0 0
212 Setrizin tablet 10 mg 0 0 0 460 0 0 0 0 0 0 0 0 0
213 Setrizin syrup 0 0 0 0 0 0 0 0 0 0 0 0 0
214 Sianokorbalamin (Vit.B 12) 500 mcg 1640 0 1640 0 0 0 50 40 20 0 130 0 0
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml 140 0 140 0 0 0 0 0 0 0 0 0 0
216 Simetidine 200 mg 1010 0 1010 0 0 0 0 0 0 0 0 0 0
217 Simvastatin 10 mg 1820 0 1820 360 0 0 0 0 0 0 0 0 0
218 Simvastatin 20 mg 1376 0 1376 24 0 0 0 0 0 0 0 0 0
219 Silk (benang Bedah Sutera) No. 3 / 0 90 0 90 8 0 0 0 0 0 0 0 0 0
220 Siprofloksasin tablet 500 mg 1130 0 1130 100 0 0 0 0 0 0 0 0 0

222 Sulfasetamida natrium tetes mata 15 % 0 0 0 0 0 0 0 0 0 0 0 0 0
223 Tablet tambah darah kombinasi -2569 0 -2569 1216 0 0 30 20 200 180 0 260 250
224 Taburia 0 0 0 0 0 0 0 0 0 0 0 0 0
225 Temporary stopping (Fletcher) 0 0 0 0 0 0 0 0 0 0 0 0 0
226 Tetrasiklin HCI kapsul 250 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
227 Tetrasiklin HCI kapsul 500 mg 400 0 400 0 0 0 0 0 0 0 0 0 0
228 Tiamfenikol 500 mg 220 0 220 0 0 0 0 0 0 0 0 0 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml 30 0 30 0 0 0 0 0 0 0 0 0 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg -5719 0 -5719 3299 10 190 10 80 0 70 150 0 50
231 Triheksifenidil Hidroklorida tablet 2 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
232 Umbilical Cord 212 0 212 0 0 0 0 0 2 0 0 1 3
233 U-Pad steril 60 cm x 90 cm 23 0 23 10 0 0 0 0 0 0 0 0 0
234 Urine Bag 5 0 5 3 0 0 0 0 0 0 0 0 0
235 Vaksin Jerap Tetanus 5 0 5 0 0 0 0 0 0 0 0 0 0
236 Vaksin Rabies vero 0 0 0 0 0 0 0 0 0 0 0 0 0
237 Vitamin B kompleks tablet 18288 0 18288 2510 220 200 0 48 50 90 110 133 145
238 Wicold kapsul 20 0 20 0 0 0 0 0 0 0 0 0 0
239 Yodium povidon larutan 10 % 60 ml 19 0 19 1 0 0 0 0 0 0 0 0 0
240 Yodium povidon larutan 10 % 300 ml 25 0 25 1 0 0 0 0 0 0 0 0 0
241 Zinc syrup 13 0 13 0 0 0 0 0 0 0 0 0 0
242 Zinc Tablet 1060 0 1060 0 0 0 0 20 0 120 0 0 0
243 Paper Tape 2,5 x 9,14 5 0 5 0 0 0 0 0 0 0 0 0 0
244 Paper Tape 7,5 x 9,14 2 0 2 0 0 0 0 0 0 0 0 0 0
245 Zidovudine 100 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
246 Lomivudine 150 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
247 Efavirenz 600 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
248 Nipirapine 200 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
249 ZDV + 3 TC+ NVP Ped Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0
250 TDF +3TC+EFV (300/300/600) Triple FDC 0 0 0 0 0 0 0 0 0 0 0 0 0
251 Tenofovir 300 mg 0 0 0 0 0 0 0 0 0 0 0 0 0
252 Tenof EM 0 0 0 0 0 0 0 0 0 0 0 0 0
253 samcobion 650 0 650 0 0 0 0 0 0 0 0 0 0
255 lytacur sirup 35 0 35 7 0 0 0 0 0 0 0 0 0
256 Susu Produgen 0 0 0 0 0 0 0 0 0 0 0 0
Mengetahui
USILA POSBINDU TOTAL SISA KET
15 173 210
83 -143 76
119 -40 28
3 111 183
99 48 250
90 25 420
107 336 646
100 500 900
15 -18 36
20 4887 #VALUE!
80 319 1476
21 925 984
2 155 159
0 0 0
0 100 100
0 2000 140
0 -500 0
0 0 6
0 0 0
0 0 0
0 0 0
0 1000 1000
0 -1500 0
5 -10 0
53 -151 188
0 32 32
1010 -40 2363
3300 -1996 18990

0 0 0
5 -2 16
0 1104 280
0 0 0
1542 2509 7036
43 26 50
0 48 48
2 20 24
0 0 0
0 343 343
0 0 0
9275 -8204 17505
0 -450 380
2545 -3982 6628
30 490 200
0 150 200
0 0 0
0 100 100
0 0 0
0 3 3
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
6 152 214
0 0 0
0 0 0
0 0 0
0 -8 0
36 77 118
0 25 25
2444 7500 7141
0 0 0
0 -3 0
0 0 0
0 0 0
0 0 0
0 30 30
0 100 100
0 0 0
29 -23 57
0 300 800
0 0 0
0 0 0
0 0 0
1 9 12
2 84 135
0 0 0
0 0 0
0 0 0
0 0 0
0 20 420
8 49 124
18 198 100
0 8 0
0 12 3
25 40 271
79 -515 294
0 25 25
0 5 5
0 0 0
45 1960 2245
0 0 0
0 0 440
4255 924 9206
0 20 99
115 2815 3620
0 2000 1760
0 0 0
0 0 0
0 494 1139
7 115 77
5 41 60
1 -2 0
1105 55626 14460
20 530 140
3 154 191
27 139 371
90 -115 100
0 0 0
0 0 0
0 0 0
1596 10707 9388
0 8 5
2 -1 3
0 1 1
333 4767 4166
2050 -847 2595
0 1980 1980
27 894 1010
3 9 4
0 7 7
17 -2 78
10 790 850
0 0 0
0 78 78
3 232 173
0 -9 0
0 0 0
0 11 9
420 5612 9045
0 0 0
0 0 0
0 29 29
0 0 0
0 -20 0
1589 2022 5800
9 134 88
0 390 390
0 0 20
185 -288 26
0 1 1
0 0 0
0 450 450
0 0 0
0 0 0
637 -241 90
0 84 84
0 100 100
0 0 0
0 0 0
60 -245 100
529 -1294 1100
84 277 800
0 -3 0
80 360 0
747 1763 4920

2 129 6
0 0 0
0 0 0 EXP
0 0 0
410 2780 3380
35 18 33
65 335 253
0 70 70
0 0 0
0 10 10
0 2 2
0 3 3
0 0 0
0 -2 1
0 0 0
0 0 0
0 0 0
29 135 178
30 10 180
0 2 33
0 2 1
12149 11244 10569
0 0 0
0 6 6
28 41 100
5 -15 0
0 0 0
2813 197 8255
0 100 100
0 0 0
5 18 32
1 31 10
0 100 0
477 4066 4315
0 0 0
0 0 0
0 0 0
0 300 300
392 -1062 1050
0 14 35
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
78 -424 37
149 136 765
150 32 190
3 74 84
2 37 103
0 12 48
0 0 0
0 -6 66
113 -573 92
0 0 0
460 -460 350
0 0 64
240 1400 2958
0 140 140
0 1010 1800
360 1460 2100
24 1352 0
8 82 96
100 1030 2190

0 100 100
0 0 0
2156 -4725 3930
0 0 0
0 0 0
0 0 0
0 400 400
0 220 260
0 30 30
3859 -9578 7455
0 0 0
6 206 160
10 13 30
3 2 12
0 5 7
0 0 0
3506 14782 25812
0 20 20
1 18 20
1 24 14
0 13 29
140 920 2072
0 5 5
0 2 2
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 650 970
0 0 0
7 28 81
0 #VALUE! 0
Pengelola Obat Puskesmas Baranti

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0 0 7333.7 0
9 Alat Suntik sekali pakai 0,5 ml set 15 0 15 15 0 0 0 1374,375 0

27 Amoksisilin kapsul 250 mg Kapsul 0 0 0 0 0 0 0 207 0
28 Amoksisilin kaplet 500 mg kaplet 1,032 300 1,332 114 1,218 1,218 1,218 233 283,794
40 Asam Askorbat (Vit C) tablet 50 mg tablet 535 400 935 0 935 935 935 120 112,200
41 Asam Folat tablet 0 0 0 0 0 0 0 68 0


76 E t a n o l 70 % 100 ml Botol 0 0 0 0 0 0 0 2,625 0
81 Fervital Kapsul kapsul 0 0 0 0 0 0 0 860.64 0


94 Guaiafenesin Tablet tablet 0 0 0 0 0 0 0 132 0
95 Glukosa larutan infus 5 % steril Botol 0 0 0 0 0 0 0 6,900 0
101 Hidrokortison krim 2,5 % tube 0 0 0 0 0 0 0 2,812 0

119 Kasa pembalut Hidrofil 4 m x 10 cm roll 50 0 50 0 50 50 50 1723.7 86,185
130 Klorfeniramin maleat tablet 4 mg tablet 160 0 160 0 160 160 160 45 7,200
140 Lidokain komp. injeksi - 2 ml ampul 0 0 0 0 0 0 0 2,122 0

146 Masker Kain pcs 0 0 0 0 0 0 0 805 0
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 0 0 0 0 0 0 1,900 0
178 Parasetamol tablet 500 mg tablet 0 900 900 0 900 900 900 58 52,200
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 197 500 697 135 562 562 562 136 76,432
187 Plester 2,5 cm x 4 m rol 1 0 1 0 1 1 1 12,076 12,076
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
203 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0 0 68 0
205 Salep 2 - 4 kombinasi pot 0 0 0 0 0 0 0 2,797 0


214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 0 0 0 0 0 0 0 58 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 0 0 0 0 0 0 4124.8366 0
223 Tablet tambah darah kombinasi tablet 0 270 270 0 270 270 270 410 110,700
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0

240 Yodium povidon larutan 10 % 300 ml Botol 0 0 0 0 0 0 0 21,593 0
241 Zinc syrup Botol 0 0 0 0 0 0 0 16,478 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
TOTAL 2,176,551
jumlah resep
JKN pustu simpo
pustu trong rijang
Kunjungan Rawat Inap pkesdes sipodeceng 46
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
1 IV Catheter Gea No. 18 set 2 0 2 2 0 0 10 0 8,050 0
7 Ansell Steri 7 1/2 psg 7 0 7 5 2 2 15 2 7333.7 14,667

25 Amoksisilin sirup kering 125 mg/5 ml Botol 10 0 10 10 0 0 0 2,200 0
27 Amoksisilin kapsul 250 mg Kapsul 140 0 140 20 120 120 120 207 24,840
41 Asam Folat tablet 0 0 0 0 0 0 500 0 68 0
42 Asam Mefenamat tablet 500 mg tablet 0 0 0 0 0 0 1,000 0 102 0
43 Asiklovir 200 mg tablet 0 0 0 0 0 0 300 0 272 0
45 Asiklovir krim 5% tablet 0 0 0 0 0 0 10 0 3,960 0


58 Catgut/benang bedah no .2/0 pcs 0 0 0 0 0 0 10 0 7928,333 0
61 Deksametason tablet 0,5 mg tablet 410 0 410 410 0 0 500 0 45 0
76 E t a n o l 70 % 100 ml Botol 0 0 0 0 0 0 0 2,625 0
81 Fervital Kapsul kapsul 290 0 290 290 0 0 1,000 0 860.64 0

82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 6 0 6 0 6 6 5 6 4,167 25,002

94 Guaiafenesin Tablet tablet 1,000 0 1,000 300 700 700 700 132 92,400
112 Kalsium laktat (Kalk) tablet 500 mg tablet 320 0 320 320 0 0 1,000 0 69 0

126 Kloramfenikol salep mata 1 % tube 4 0 4 4 0 0 10 0 1,850 0
128 Kloramfenikol salep Kulit 2% tube 0 0 0 0 0 0 10 0 3,409 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 0 0 5 0 8,250 0
130 Klorfeniramin maleat tablet 4 mg tablet 800 0 800 300 500 500 500 500 45 22,500
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 0 0 0 0 0 0 0 2,225 0
140 Lidokain komp. injeksi - 2 ml ampul 0 0 0 0 0 0 5 0 2,122 0

146 Masker Kain pcs 70 0 70 20 50 50 50 805 40,250
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
156 Metronidazol tablet 500 mg tablet 520 0 520 520 0 0 200 0 140 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 15 0 37,400 0 EXP
162 Natrium klorida larutan infus 0,9 % steril Botol 0 0 0 0 0 0 0 6,410 0

176 Parasetamol drops Botol 7 0 7 7 0 0 10 0 5,980 0
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 0 0 0 15 0 1,119 0
178 Parasetamol tablet 500 mg tablet 930 0 930 430 500 500 1,000 500 58 29,000
187 Plester 2,5 cm x 4 m rol 1 0 1 1 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
202 Ringer Laktat larutan infus steril Botol 0 0 0 0 0 0 10 0 7,150 0

206 Salisil bedak 2 % pot 0 0 0 0 0 0 0 1,066 0

214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 0 0 0 0 0 0 500 0 58 0
223 Tablet tambah darah kombinasi tablet 0 0 0 0 0 0 0 410 0
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 0 0 0 0 0 0 500 0 91 0
232 Umbilical Cord kotak 4 0 4 0 4 4 10 4 1494.9 5,980
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0

237 Vitamin B kompleks tablet tablet 930 0 930 330 600 600 500 600 132 79,200
238 Wicold kapsul kapsul 0 0 0 0 0 0 1,000 0 792 0
241 Zinc syrup Botol 0 0 0 0 0 0 10 0 16,478 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 2 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
253 Samcobion Tablet 0 0 0 0 0 0 1,000 0 989.659 0
255 Lytacur Sirup Btl 0 0 0 0 0 0 10 0 14,300 0
TOTAL 1,131,888
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
Kepala Puskesmas Barant Bidan Desa/Kel
dr Hj Ulianti Devy Silvia Nika Idris, Amd.Keb
NIP.197908072007012013
(LPLPO)
PUSKESMAS : BARANTI NO 001/JKD-Posk.PSN/I/2018
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
5 Ansell Steril 6 1/2 psg 0 0 0 0 0 7333.7 0
6 Ansell Steril 7 psg 11 11 0 11 11 11 7333.7 80,671
7 Ansell Steri 7 1/2 psg 18 18 3 15 15 15 7333.7 110,006
8 Alat Suntik sekali pakai 0,05 ml set 0 0 0 0 1517.72307 0
9 Alat Suntik sekali pakai 0,5 ml set 10 10 1 9 9 9 1374,375 12,369,375
11 Alat suntik sekali pakai 3 ml set 93 93 93 93 93 748 69,564
15 Alkohol Swab kotak 0 0 0 0 114.95 0
18 Ambroxol sirup 15 mg/ml Botol 0 0 0 0 5,500 0
19 Ambroxol tablet tablet 0 0 0 0 216 0

25 Amoksisilin sirup kering 125 mg/5 ml Botol 8 8 0 8 8 8 2,200 17,600
28 Amoksisilin kaplet 500 mg kaplet 1,057 1,057 120 937 937 937 233 218,321
31 Antalgin (Metampiron) tablet 500 mg Tablet 280 280 0 280 280 280 209 58,520
40 Asam Askorbat (Vit C) tablet 50 mg tablet 784 784 210 574 574 574 120 68,880
41 Asam Folat tablet 180 180 50 130 130 130 68 8,840
42 Asam Mefenamat tablet 500 mg tablet 460 460 80 380 380 380 102 38,760
45 Asiklovir krim 5% tablet 0 0 0 0 3,960 0

53 Betahistin maleat 24 mg tablet 0 0 0 0 1,210 0

57 Blood Lancet 26G kotak 0 0 0 0 167.42 0
59 Catgut/benang bedah no .3/0 pcs 10 10 0 10 10 10 7929,16666 #VALUE!
61 Deksametason tablet 0,5 mg tablet 847 847 150 697 697 697 45 31,365
71 Domperidom tablet tablet 0 0 0 0 133 0
76 E t a n o l 70 % 100 ml Botol 5 5 0 5 5 5 2,625 13,125
81 Fervital Kapsul kapsul 360 360 40 320 320 320 860.64 275,405
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 12 12 0 12 12 12 4,167 50,004

87 Garam Oralit untuk 200 ml Air sak 48 48 8 40 40 40 274 10,960
89 Gentian Violet larutan 1 % Botol 0 0 0 0 3,850 0
91 Glibenklamid tablet 5 mg tablet 0 0 0 0 110 0
94 Guaiafenesin Tablet tablet 1,000 1,000 74 926 926 926 132 122,232
96 Grisefulvin tablet 125 mg (Micronized) tablet 0 0 0 0 263 0
97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 74 0
106 Infusion set anak pcs 0 0 0 0 2913.3 0
107 Infusion set dewasa pcs 9 9 0 9 9 9 6622,2 #VALUE!
110 Kalsium Glukonat inj 10% ampul 0 0 0 0 9,955 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 610 610 120 490 490 490 69 33,810

117 Kaptopril 25 mg tablet 0 0 0 0 86 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 70 70 0 70 70 70 1723.7 120,659
122 Ketokonazol krim 2% tube 0 0 0 0 2,790 0
123 Ketokonazol tablet 200 mg tablet 0 0 0 0 264 0
124 Kloramfenikol kapsul 250 mg Kapsul 0 0 0 0 616 0
126 Kloramfenikol salep mata 1 % tube 11 11 0 11 11 11 1,850 20,350
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 1,850 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 8,250 0
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 137.5 0

144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 1,694 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0 0 3,650 0
146 Masker Kain pcs 0 0 0 0 805 0
147 Mata Pisau No. 15 pcs 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 3,300 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0 3,904 0
158 Mineral Mix sak 0 0 0 0 2726.9 0
159 Multivitamin (Lycalvit) syrup botol 2 2 2 0 0 0 37,400 0 EXP
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 1,379,984 0
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 4,400 0

173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 3,300 0
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 12 12 0 12 12 12 1,900 22,800
175 Omeprazole 20 mg kapsul 0 0 0 0 148 0
176 Parasetamol drops Botol 4 4 2 2 2 2 5,980 11,960
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 0 1,119 0
178 Parasetamol tablet 500 mg tablet 1,111 1,111 78 1,033 1,033 1,033 58 59,914
179 Pehacain injeksi botol 0 0 0 0 4,400 0
182 Pirantel suspensi 10 ml botol 0 0 0 0 17,600 0
183 Pirantel suspensin 60 ml Botol 0 0 0 0 9,100 0
186 Piroksikam 20 mg tablet 0 0 0 0 220 0
187 Plester 2,5 cm x 4 m rol 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 3137.2 0
190 Prednison tablet 5 mg tablet 175 175 0 175 175 175 85 14,875
195 Ranitidin tablet 150 mg tablet 0 0 0 0 115 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 525,000 0

207 Sarung Tangan Examination S pcs 62 62 0 62 62 62 531.3 32,941
208 Sarung Tangan Examination M pcs 0 0 0 0 531.3 0
209 Sarung Tangan Examination L pcs 0 0 0 0 531.3 0

214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 248 248 150 98 98 98 58 5,684
216 Simetidine 200 mg tablet 0 0 0 0 209 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 0 0 0 4124.8366 0
223 Tablet tambah darah kombinasi tablet 0 0 0 0 410 0
224 Taburia kotak 0 0 0 0 18,150 0
228 Tiamfenikol 500 mg kapsul 0 0 0 0 1,452 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 1,760 0
232 Umbilical Cord kotak 15 15 0 15 15 15 1494.9 22,424
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0 8768.1 0
234 Urine Bag set 0 0 0 0 3,432 0
236 Vaksin Rabies vero kuur 0 0 0 0 174499,6 #VALUE!

237 Vitamin B kompleks tablet tablet 1,065 1,065 94 971 971 971 132 128,172
238 Wicold kapsul kapsul 70 70 10 60 60 60 792 47,520
239 Yodium povidon larutan 10 % 60 ml Botol 0 0 0 0 4438.5 0
241 Zinc syrup Botol 0 0 0 0 16,478 0
242 Zinc Tablet tablet 200 200 20 180 180 180 592 106,560
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 25127,5 0
245 Zidovudine 150 mg Btl 0 0 0 0 1,700 0
246 Lomivudine 150 mg Btl 0 0 0 0 4,255 0
247 Efavirenz 600 mg Btl 0 0 0 0 7,331 0
248 Nepirapine 200 mg Btl 0 0 0 0 3,080 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0 0 3,058 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0 0 11894.3 0
251 TenoFovir 300 mg Btl 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 12,449 0
253 Samcobion Tablet 0 0 0 0 989.659 0
254 Spironolakton tablet 25 mg Tablet 0 0 0 0 314 0
255 Lytacur Sirup Btl 0 0 0 0 14,300 0
256 Susu Produgen Kotak 0 0 0 0 40,700 0
TOTAL 2,537,812
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
dr Hj Ulianti Zaenab, Amd.Keb
NIP.197908072007012013 NIP :
(LPLPO)
PUSKESMAS : BARANTI NO 001/JKD-Posk BRT/I/2018
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0 10 0 7333.7 0
9 Alat Suntik sekali pakai 0,5 ml set 0 0 0 0 0 0 10 0 1374,375 0
12 Alat suntik sekali pakai 5 ml set 5 0 5 4 1 1 10 1 863 863

25 Amoksisilin sirup kering 125 mg/5 ml Botol 0 0 0 0 0 0 5 0 2,200 0
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 0 0 0 0 4,147 0
27 Amoksisilin kapsul 250 mg Kapsul 0 0 0 0 0 0 200 0 207 0
28 Amoksisilin kaplet 500 mg kaplet 1,027 0 1,027 347 680 680 680 233 158,440


59 Catgut/benang bedah no .3/0 pcs 7 0 7 5 2 2 5 2 7929,16666 #VALUE!
61 Deksametason tablet 0,5 mg tablet 42 0 42 0 42 42 200 42 45 1,890
76 E t a n o l 70 % 100 ml Botol 5 0 5 3 2 2 5 2 2,625 5,250
81 Fervital Kapsul kapsul 170 0 170 70 100 100 200 100 860.64 86,064

87 Garam Oralit untuk 200 ml Air sak 0 0 0 0 0 0 0 274 0
94 Guaiafenesin Tablet tablet 0 0 0 0 0 0 300 0 132 0
95 Glukosa larutan infus 5 % steril Botol 0 0 0 0 0 0 5 0 6,900 0
101 Hidrokortison krim 2,5 % tube 0 0 0 0 0 0 5 0 2,812 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 0 0 0 0 0 5 0 2,560 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 470 0 470 470 0 0 0 69 0

119 Kasa pembalut Hidrofil 4 m x 10 cm roll 0 0 0 0 0 0 50 0 1723.7 0
130 Klorfeniramin maleat tablet 4 mg tablet 0 0 0 0 0 0 1,000 0 45 0

146 Masker Kain pcs 40 0 40 5 35 35 35 805 28,175
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 0 0 0 0 0 10 0 1,900 0
176 Parasetamol drops Botol 9 0 9 6 3 3 5 3 5,980 17,940
177 Parasetamol sirup 120 mg / 5 ml Botol 3 0 3 0 3 3 10 3 1,119 3,357
178 Parasetamol tablet 500 mg tablet 720 0 720 340 380 380 300 380 58 22,040
187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 0 1 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0
203 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0 100 0 68 0
205 Salep 2 - 4 kombinasi pot 4 0 4 4 0 0 5 0 2,797 0

206 Salisil bedak 2 % pot 6 0 6 6 0 0 5 0 1,066 0

214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 230 0 230 150 80 80 200 80 58 4,640
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 0 0 0 0 0 5 0 4124.8366 0
223 Tablet tambah darah kombinasi tablet 330 0 330 130 200 200 500 200 410 82,000
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
232 Umbilical Cord kotak 0 0 0 0 0 0 20 0 1494.9 0
233 U-Pad steril 60 cm x 90 cm pcs 11 0 11 11 0 0 10 0 8768.1 0
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0
235 Vaksin Jerap Tetanus vial 0 0 0 0 0 0 5 0 14,498 0

238 Wicold kapsul kapsul 0 0 0 0 0 0 300 0 792 0
240 Yodium povidon larutan 10 % 300 ml Botol 0 0 0 0 0 0 1 0 21,593 0
241 Zinc syrup Botol 0 0 0 0 0 0 0 16,478 0
242 Zinc Tablet tablet 180 0 180 180 0 0 200 0 592 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
TOTAL 890,876
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
PUSKESMAS : BARANTI NO :001/JKD-posk SPD/i/2018
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 5 0 5 5 0 0 0 7333.7 0
11 Alat suntik sekali pakai 3 ml set 18 0 18 18 0 0 0 748 0



76 E t a n o l 70 % 100 ml Botol 3 0 3 3 0 0 0 2,625 0

82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 4,167 0


130 Klorfeniramin maleat tablet 4 mg tablet 0 0 0 0 0 0 0 45 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 4 0 4 4 0 0 0 2,225 0

146 Masker Kain pcs 0 0 0 0 0 0 0 805 0
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

178 Parasetamol tablet 500 mg tablet 300 0 300 300 0 0 0 58 0

187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0


224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 85 0 85 85 0 0 0 91 0
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0

241 Zinc syrup Botol 0 0 0 0 0 0 0 16,478 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
TOTAL 1,072,250
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
dr Hj Ulianti Marlina, Amd.Keb
NIP.197908072007012013
(LPLPO)
PUSKESMAS : BARANTI NO 001/ JKD-Posk TRG/I/2018
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
5 Ansell Steril 6 1/2 psg 0 7333.7 0
6 Ansell Steril 7 psg 0 7333.7 0
7 Ansell Steri 7 1/2 psg 8 0 8 0 7333.7 0
8 Alat Suntik sekali pakai 0,05 ml set 0 1517.72307 0
10 Alat suntik sekali pakai 1 ml set 86 0 86 0 748 0
15 Alkohol Swab kotak 0 114.95 0
18 Ambroxol sirup 15 mg/ml Botol 0 5,500 0
19 Ambroxol tablet tablet 0 216 0

28 Amoksisilin kaplet 500 mg kaplet 630 50 580 0 233 0
31 Antalgin (Metampiron) tablet 500 mg Tablet 0 209 0
33 Antasida DOEN tablet kombinasi tablet 720 20 700 0 59 0
41 Asam Folat tablet 0 68 0
42 Asam Mefenamat tablet 500 mg tablet 640 40 600 0 102 0
45 Asiklovir krim 5% tablet 0 3,960 0

53 Betahistin maleat 24 mg tablet 0 1,210 0

57 Blood Lancet 26G kotak 0 167.42 0
59 Catgut/benang bedah no .3/0 pcs 6 0 6 0 7929,16666 #VALUE!
71 Domperidom tablet tablet 0 133 0
76 E t a n o l 70 % 100 ml Botol 3 0 3 5 0 2,625 0
81 Fervital Kapsul kapsul 210 90 120 200 0 860.64 0

82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 4,167 0

87 Garam Oralit untuk 200 ml Air sak 0 274 0
88 Gentamicin inj 40mg/ml Ampul 0 3,545 0
89 Gentian Violet larutan 1 % Botol 0 3,850 0
91 Glibenklamid tablet 5 mg tablet 0 110 0
94 Guaiafenesin Tablet tablet 300 0 132 0
95 Glukosa larutan infus 5 % steril Botol 5 2 3 5 0 6,900 0
96 Grisefulvin tablet 125 mg (Micronized) tablet 0 263 0
97 Haloperidol tablet 1,5 mg tablet 0 74 0
104 Ibuprofen tablet 200 mg tablet 500 0 500 0 111 0
106 Infusion set anak pcs 0 2913.3 0
107 Infusion set dewasa pcs 4 0 4 3 0 6622,2 #VALUE!
110 Kalsium Glukonat inj 10% ampul 0 9,955 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 520 70 450 0 69 0


117 Kaptopril 25 mg tablet 0 86 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 10 0 10 50 0 1723.7 0
122 Ketokonazol krim 2% tube 0 2,790 0
123 Ketokonazol tablet 200 mg tablet 0 264 0
124 Kloramfenikol kapsul 250 mg Kapsul 0 616 0
126 Kloramfenikol salep mata 1 % tube 10 0 10 0 1,850 0
127 Kloramfenikol tetes mata 1 % botol 0 1,850 0
129 Kloramfenikol tetes telinga 3 % Botol 0 8,250 0
130 Klorfeniramin maleat tablet 4 mg tablet 1,000 30 970 0 45 0
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 137.5 0

144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 1,694 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 3,650 0
154 Metoklopramida injeksi 5 mg / ml vial 0 3,904 0
158 Mineral Mix sak 0 2726.9 0
159 Multivitamin (Lycalvit) syrup botol 3 0 3 0 37,400 0 EXP
169 Obat Batuk Hitam (O.B.H) cairan botol 5 0 4,400 0

175 Omeprazole 20 mg kapsul 0 148 0
176 Parasetamol drops Botol 5 0 5,980 0
177 Parasetamol sirup 120 mg / 5 ml Botol 3 3 0 10 0 1,119 0

179 Pehacain injeksi botol 0 4,400 0
181 Pirantel pamoat tablet 125 mg tablet 12 12 0 0 318 0 EXP
182 Pirantel suspensi 10 ml botol 0 17,600 0
183 Pirantel suspensin 60 ml Botol 0 9,100 0
186 Piroksikam 20 mg tablet 0 220 0
187 Plester 2,5 cm x 4 m rol 1 0 1 1 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 35,532 0
189 Pot Sputum pcs 0 3137.2 0
190 Prednison tablet 5 mg tablet 0 85 0
195 Ranitidin tablet 150 mg tablet 0 115 0
197 Rapid Test VIKIA HIV 1/2 kit 0 525,000 0
203 Salbutamol tablet 2 mg tablet 100 0 68 0

207 Sarung Tangan Examination S pcs 0 531.3 0
208 Sarung Tangan Examination M pcs 0 531.3 0
209 Sarung Tangan Examination L pcs 80 0 80 0 531.3 0

214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 140 0 140 100 0 58 0
216 Simetidine 200 mg tablet 0 209 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 6 0 6 0 4124.8366 0
223 Tablet tambah darah kombinasi tablet 80 80 0 500 0 410 0
228 Tiamfenikol 500 mg kapsul 0 1,452 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 1,760 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 0 91 0
232 Umbilical Cord kotak 11 0 11 0 1494.9 0
233 U-Pad steril 60 cm x 90 cm pcs 10 0 8768.1 0
236 Vaksin Rabies vero kuur 0 174499,6 #VALUE!

237 Vitamin B kompleks tablet tablet 1,000 70 930 0 132 0
238 Wicold kapsul kapsul 100 0 792 0
239 Yodium povidon larutan 10 % 60 ml Botol 1 0 1 0 4438.5 0
242 Zinc Tablet tablet 160 0 160 200 0 592 0 100 EXF
243 Paper Tape 2,5 x 9,14 Rol 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 25127,5 0
245 Zidovudine 150 mg Btl 0 1,700 0
246 Lomivudine 150 mg Btl 0 4,255 0
247 Efavirenz 600 mg Btl 0 7,331 0
248 Nepirapine 200 mg Btl 0 3,080 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 3,058 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 11894.3 0
251 TenoFovir 300 mg Btl 0 6,475 0
252 Tenof EM Btl 0 12,449 0
253 Samcobion Tablet 0 989.659 0
255 Lytacur Sirup Btl 0 14,300 0
256 Susu Produgen Kotak 0 40,700 0
TOTAL 0
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
Kepala Puskesmas Barant Bidan desa/Kel
dr Hj Ulianti Aulia Ekawati, S.ST
NIP.197908072007012013
(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 0 5 5 0 5 5 5 7333.7 36,669

28 Amoksisilin kaplet 500 mg kaplet 862 500 1,362 70 1,292 1,292 1,292 233 301,036


76 E t a n o l 70 % 100 ml Botol 0 0 0 0 0 0 0 2,625 0

82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 5 5 5 0 0 0 4,167 0



146 Masker Kain pcs 0 0 0 0 0 0 0 805 0
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

187 Plester 2,5 cm x 4 m rol 0 1 1 0 1 1 1 12,076 12,076
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0


224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0

241 Zinc syrup Botol 0 0 0 0 0 0 0 16,478 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
TOTAL 1,974,493
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KODE PUSKESMAS :
PUSKESMAS : Baranti NO :
KECAMATAN : Baranti TGL 30-Nov-17 BULAN November
SATU STOK PENER PERSE PEMA SISA STOK PERMIN SUMBER DANA JUMLAH
NO. NAMA OBAT JMLH HARGA SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
4 IV Catheter Gea No. 24 set 2 2 0 2 2 5,203 10,406
5 Ansell Steril 6 1/2 psg 0 0 0 0 0 7,500 0
6 Ansell Steril 7 psg 2 2 1 1 1 7,500 7,500
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 7,500 0
11 Alat suntik sekali pakai 3 ml set 89 89 29 60 51 748 38,148
13 Alat Suntik sekali pakai 10 ml set 0 0 0 0 0 1,064 0
14 Albendasol tablet 400 mg tablet 0 0 0 0 0 425 0
15 Alkohol Swab kotak 0 0 0 0 0 115 0
16 Alupurinol tablet 100 mg tablet 100 100 60 40 40 95 3,800
17 Allpurinol tablet 300 mg tablet 0 0 0 0 0 244 0
18 Ambroxol sirup 15 mg/ml Botol 4 4 2 2 2 5,500 11,000 Des
19 Ambroxol tablet tablet 0 0 0 0 0 216 0 Des

20 Aminofilin tablet 200 mg tablet 0 0 0 0 0 86 0
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 0 0 3,349 0
22 Amitriptilin HCI tablet salut 25 mg tablet 0 0 0 0 0 165 0
23 Amlodipine 5 mg tablet 0 0 0 0 0 105 0
25 Amoksisilin sirup kering 125 mg/5 ml Botol 18 18 10 8 8 2,200 17,600
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 0 4,147 0
28 Amoksisilin kaplet 500 mg kaplet 572 1000 1572 510 1,062 1,062 233 247,446
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0 0 4,600 0
30 Anagens Syrup Botol 0 0 0 0 0 19,800 0

31 Antalgin (Metampiron) tablet 500 mg Tablet 40 40 40 0 0 209 0 Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0 0 1,500 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 0 1000 1000 0 1000 1,000 120 120,000
43 Asiklovir 200 mg tablet 0 0 0 0 0 272 0
45 Asiklovir krim 5% tablet 1 1 0 1 1 3,960 3,960 Des
46 Asetosal tablet 100 mg tabet 0 0 0 0 0 110 0
47 Attalpulgit tablet 0 0 0 0 0 173 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0 1,672 0
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 0 0 75 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0 0 156,072 0
51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 0 234,238 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0 0 129,210 0
53 Betahistin maleat 24 mg tablet 0 0 0 0 0 1,210 0 Des

54 Betametason krim 0.1 % tube 13 13 13 0 0 1,435 0
55 Bisakodil 5 mg supp suppos 0 0 0 0 0 5,670 0
56 Bisakodil 10 mg supp suppos 0 0 0 0 0 5,800 0

57 Blood Lancet 26G kotak 0 0 0 0 0 160 0
59 Catgut/benang bedah no .3/0 pcs 3 3 0 3 3 6,421 19,263
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 0 0 1,740 0
61 Deksametason tablet 0,5 mg tablet 839 839 460 379 379 48 18,192
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 2,578 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0 0 12,749 0
64 Diazepam tablet 2 mg tablett 0 0 0 0 0 134 0
65 Diazepam tablet 5 mg tablet 0 0 0 0 0 65 0
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 0 0 0 104 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0 1,354 0
68 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 108 0
69 Doksisilin kapsul 100 mg Kapsul 0 0 0 0 0 309 0
70 Domperidom suspensi Botol 0 0 0 0 0 3,180 0

71 Domperidom tablet tablet 0 0 0 0 0 451 0 Jan

72 Efedrin HCI tablet 25 mg tablet 0 0 0 0 0 56 0
73 Ekstrak Belladon tablet 10 mg tablet 100 100 0 100 100 42 4,200 2017
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 8,910 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 1 1 1 0 0 3,600 0
76 E t a n o l 70 % 100 ml Botol 2 2 2 0 0 2,625 0
77 Etil klorida semprot Botol 0 0 0 0 0 115,500 0
78 Eugenol cairan botol 0 0 0 0 0 18,333 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0 1,980 0
80 Fenobarbital tablet 30 mg tablet 0 0 0 0 0 74 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 0 0 0 0 3,754 0
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 0 100 796 79,600
84 Foly Catheter No. 18 pcs 0 0 0 0 0 9,200 0
85 Foly Catheter No. 20 pcs 0 0 0 0 0 9,200 0
86 Furosemid tablet 40 mg tablet 0 0 0 0 0 84 0
88 Gentamicin inj 40mg/ml Ampul 0 0 0 0 0 3,545 0
89 Gentian Violet larutan 1 % Botol 2 2 2 0 0 3,850 0 Jan

90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 0 434,500 0
91 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 110 0 Des
92 Glimepiride 1 mg tablet 0 0 0 0 0 220 0

94 Guaiafenesin Tablet tablet 560 1000 1560 380 1,180 1,180 132 155,760 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 60 60 20 40 40 523 20,900 Des

97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 76 0 Des
98 Haloperidol tablet 2 mg tablet 0 0 0 0 0 134 0
99 Haloperidol inj 50 mg/ml ampul 0 0 0 0 0 91,667 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 0 0 0 0 0 171 0
101 Hidrokortison krim 2,5 % tube 0 0 0 0 0 2,812 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 0 0 0 0 8,000 0
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 0 0 8,800 0 Des
104 Ibuprofen tablet 200 mg tablet 0 1000 1000 0 1,000 1,000 111 111,000
106 Infusion set anak pcs 1 1 0 1 1 4,025 4,025
108 Isoniazid tablet 100 mg tablet 0 0 0 0 0 82 0
109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 0 0 0 98 0
110 Kalsium Glukonat inj 10% ampul 0 0 0 0 0 999 0

111 Kalsium Hidroksida pasta buah 0 0 0 0 0 266,200 0
113 Kapas pembalut 250 gram buah 0 0 0 0 0 14,375 0
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 0 0 0 31,372 0
115 Kapas pembalut / Absorben 1000 gram bungkus 0 0 0 0 0 62,744 0
117 Kaptopril 25 mg tablet 0 0 0 0 0 165 0 Des
118 Karbamazepin tablet 200 mg tablet 0 0 0 0 0 306 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 0 50 50 0 50 50 1,725 86,250
120 Kasa hidrofil 40 x 80 cm roll 0 0 0 0 0 120,750 0
121 Kasa pembalut elastis 3 inch roll 0 0 0 0 0 7,700 0
122 Ketokonazol krim 2% tube 0 0 0 0 0 6,600 0 Des
123 Ketokonazol tablet 200 mg tablet 0 0 0 0 0 264 0 Des
124 Kloramfenikol kapsul 250 mg Kapsul 0 0 0 0 0 616 0 Des
125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0 0 0 4,000 0
126 Kloramfenikol salep mata 1 % tube 0 0 0 0 0 1,850 0
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 8,250 0 Des
128 Kloramfenikol salep Kulit 2% tube 0 0 0 0 0 3,409 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 0 8,250 0 Des
130 Klorfeniramin maleat tablet 4 mg tablet 670 1000 1670 389 1,281 1,281 45 57,645
131 Klorokuin tablet 150 mg tablet 0 0 0 0 0 112 0
132 Klorfenol Kamfer Menthol Botol 0 0 0 0 0 60,500 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0 0 1,045 0

134 Klorpromazin HCI tablet salut 100 mg tablet 0 0 0 0 0 179 0
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 0 138 0 Jan

139 Larutan mengandung elektrolit botol 0 0 0 0 0 9,275 0
141 Lisol 1 liter Botol 0 0 0 0 0 49,200 0
142 Loperamide 2 mg tablet 0 0 0 0 0 90 0
143 Loratadine 10 mg tablet 0 0 0 0 0 149 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 0 1,694 0 Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0 0 0 2,143 0 Des
146 Masker Kain pcs 0 0 0 0 0 506 0
147 Mata Pisau No. 15 pcs 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 3,300 0
149 Metilergometrin maleat tablet salut 0,125 mg tablet 0 0 0 0 0 133 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0 0 0 2,684 0

151 Metilprednisolon tablet 4 mg tablet 100 100 0 100 100 200 20,000
153 Metoklopramida 10 mg tablet 100 100 0 100 100 100 10,000
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0 0 6,600 0 Jan

156 Metronidazol tablet 500 mg tablet 300 300 300 360 140 50,400
157 Miconazole Krim tube 0 0 0 0 0 3,737 0
158 Mineral Mix sak 0 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 37,400 0 Des
160 Mummifying pasta buah 0 0 0 0 0 193,600 0
161 Natrium diklofenak 50 mg tablet 0 0 0 0 0 161 0
163 Nifedipin 10 mg tablet 0 0 0 0 0 123 0
164 Nistatin tablet vagina 100.000 IU / g ovula 0 0 0 0 0 602 0
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 0 0 0 0 704 0
166 Obat anti Tuberklosis kategori FDC I paket 0 0 0 0 0 413,984 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 1,317,000 0 Des
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 0 0 236,500 0
169 Obat Batuk Hitam (O.B.H) cairan botol 0 3 4,400 13,200 Des
170 OBH Itral Syrup Botol 3 3 0 3 0 16,698 0
171 Ofloksasin tablet 400 mg tablet 0 0 0 0 0 636 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0 0 1,869 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 0 3,300 0 Des

174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 0 0 0 0 1,900 0
175 Omeprazole 20 mg kapsul 0 0 0 0 0 880 0 Jan

178 Parasetamol tablet 500 mg tablet 270 1000 1270 250 1,020 1,020 145 147,900 Des
180 Permetrin krim 5% tube 0 0 0 0 0 12,155 0
181 Pirantel pamoat tablet 125 mg tablet 20 20 0 20 20 318 6,360
182 Pirantel suspensi 10 ml botol 0 0 0 0 0 17,600 0 Jan
183 Pirantel suspensin 60 ml Botol 0 0 0 0 0 9,100 0 Des
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 0 0 1,030 0
186 Piroksikam 20 mg tablet 0 0 0 0 0 220 0 Des
187 Plester 2,5 cm x 4 m rol 0 1 12,076 12,076
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 3,190 0 Des
190 Prednison tablet 5 mg tablet 0 0 0 0 0 193 0 Jan

191 Primakuin tablet 15 mg tablet 0 0 0 0 0 120 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 0 0 9,908 0
193 Propiltiourasil tablet 100 mg tablet 60 60 60 0 0 320 0
194 Propranolol HCI tablet 40 mg tablet 0 0 0 0 0 69 0
195 Ranitidin tablet 150 mg tablet 100 100 0 100 100 115 11,500 Des
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 0 0 1,600 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 525,000 0 Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 0 0 14,344 0
199 Reagensia ZN botol 0 0 0 0 0 270,000 0
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 0 0 0 0 327 0
203 Salbutamol tablet 2 mg tablet 140 140 50 90 90 99 8,910 Des
204 Salbutamol 4 mg tablet 0 0 0 0 0 88 0
205 Salep 2 - 4 kombinasi pot 2 2 2 0 0 2,797 0
206 Salisil bedak 2 % pot 3 3 0 3 3 1,066 3,198
207 Sarung Tangan Examination S pcs 0 0 0 0 0 410 0
208 Sarung Tangan Examination M pcs 0 0 0 0 0 410 0
209 Sarung Tangan Examination L pcs 0 0 0 0 0 410 0
210 Sefadroksil 500 mg kapsul 0 0 0 0 0 557 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 0 102,850 0
212 Setrizin tablet 10 mg tablet 0 0 0 0 0 154 0
213 Setrizin syrup Botol 4 4 0 4 4 7,756 31,024

215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 0 0 1,226 0
216 Simetidine 200 mg tablet 0 0 0 0 0 209 0 Jan

217 Simvastatin 10 mg tablet 0 0 0 0 0 135 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 2 20,825 41,650
220 Siprofloksasin tablet 500 mg tablet 0 0 0 0 0 298 0
221 Spironolakton tablet 100 mg tablet 0 0 0 0 0 878 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0 0 3,549 0
223 Tablet tambah darah kombinasi tablet 3 327 980 Des
224 Taburia kotak 0 0 0 0 0 18,150 0
225 Temporary stopping (Fletcher) buah 0 0 0 0 0 37,400 0
226 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 0 0 0 162 0
228 Tiamfenikol 500 mg kapsul 0 0 0 0 0 1,452 0 Jan

229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 0 1,760 0 Jan
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 0 0 97 0
234 Urine Bag set 0 0 0 0 0 3,450 0
236 Vaksin Rabies vero kuur 0 0 0 0 0 700,000 0
237 Vitamin B kompleks tablet tablet 218 1000 1218 208 1,010 1,000 132 132,000
239 Yodium povidon larutan 10 % 60 ml Botol 2 2 0 2 3 7,040 21,120
241 Zinc syrup Botol 0 0 0 0 0 8,140 0
242 Zinc Tablet tablet 0 0 0 0 592 0

TOTAL 1,758,418
6,293,488
Jamkesda 128 GENERIK NON GENERIK PELAYANAN Jml pasien Jml R/ Jml pasien Jml R/ Jml pasien Jml R/
JKN 5
Lain - lain
Jamkesda 0
JKN 0
Lain - lain
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
(LPLPO)
KODE PUSKESMAS :
KECAMATAN : BARANTI TGL : 30-Dec-17 BULAN 12
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
6 Ansell Steril 7 psg 11 11 0 11 11 11 7,500 82,500
7 Ansell Steri 7 1/2 psg 18 18 0 18 18 18 7,500 135,000
9 Alat Suntik sekali pakai 0,5 ml set 12 12 2 10 10 10 1,240 12,400

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
28 Amoksisilin kaplet 500 mg kaplet 1167 1167 110 1057 1057 1,057 233 246,281

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
41 Asam Folat tablet 210 210 30 180 180 180 68 12,240

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

76 E t a n o l 70 % 100 ml Botol 6 6 1 5 5 5 2,625 13,125

94 Guaiafenesin Tablet tablet 1000 1000 0 1000 1000 1,000 132 132,000 Des

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
101 Hidrokortison krim 2,5 % tube 3 3 0 3 3 3 2,812 8,436

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

146 Masker Kain pcs 0 0 0 0 506 0
147 Mata Pisau No. 15 pcs 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 3,300 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

158 Mineral Mix sak 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit/Liracur) syrup botol 7 7 4 3 3 3 37,400 112,200 Des
162 Natrium klorida larutan infus 0,9 % steril Botol 2 2 0 2 2 2 6,410 12,820
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 3,300 0 Des
176 Parasetamol drops Botol 9 9 5 4 4 4 5,980 23,920 Des

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
178 Parasetamol tablet 500 mg tablet 1290 1290 179 1111 1111 1,111 145 161,095 Des
187 Plester 2,5 cm x 4 m rol 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 35,532 0
190 Prednison tablet 5 mg tablet 195 195 20 175 175 175 193 33,775 Jan
NO. NAMA OBAT JMLH
SATUAN HARGA
KET

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
224 Taburia kotak 0 0 0 0 18,150 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
232 Umbilical Cord kotak 15 15 0 15 15 15 3,163 47,445
233 U-Pad steril 60 cm x 90 cm pcs 10 10 0 10 10 10 8,770 87,700
234 Urine Bag set 0 0 0 0 3,450 0
237 Vitamin B kompleks tablet tablet 1109 1109 44 1065 1065 1,065 132 140,580
240 Yodium povidon larutan 10 % 300 ml Botol 1 1 0 1 1 1 21,600 21,600
241 Zinc syrup Botol 0 0 0 0 8,140 0
242 Zinc Tablet tablet 240 240 40 200 200 200 592 118,400
243 Samcobion tablet 670 670 170 500 500 500

TOTAL ###
###
JKN
Lain - lain
Jamkesda
JKN
Lain - lain
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
( L P L P O ) JKD
KODE PUSKESMAS :
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 12 0 12 0 12 0 7,500 0






76 E t a n o l 70 % 100 ml Botol 5 0 5 0 5 0 2,625 0


94 Guaiafenesin Tablet tablet 480 0 480 120 360 0 132 0 Des

102 Ibuprofen suspensi 100 mg/5 ml Botol 5 0 5 4 1 0 8,000 0


112 Kalsium laktat (Kalk) tablet 500 mg tablet 850 0 850 30 820 0 69 0



146 Masker Kain pcs 45 0 45 5 40 0 506 0



174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 10 0 10 0 10 0 1,900 0


187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 35,532 0







TOTAL 0
###
JKN
Lain - lain

Jamkesda
JKN
Lain - lain
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
(LPLPO)
KODE PUSKESMAS :
KECAMATAN : TGL :31 desember 2017 BULAN 12
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 5 5 5 5 0 7,500 0






76 E t a n o l 70 % 100 ml Botol 3 3 0 3 0 2,625 0



104 Ibuprofen tablet 200 mg tablet 0 111 0




147 Mata Pisau No. 15 pcs 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 3,300 0




187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 35,532 0

206 Salisil bedak 2 % pot 4 4 1 3 0 1,066 0


223 Tablet tambah darah kombinasi tablet 900 900 580 320 0 327 0 Des

234 Urine Bag set 0 0 3,450 0
242 Zinc Tablet tablet 100 100 0 100 0 592 0

TOTAL 0
###
GENERIK
NON GENERIK
JKN
Lain - lain
Jamkesda
JKN
Lain - lain
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
(LPLPO)
KODE PUSKESMAS :
PUSKESMAS : Baranti NO :
KECAMATAN : Baranti TGL 31 12-2017 BULADesember
KABUPATEN : SIDENRENG RAPPANG TAHU2 0 1 7
SATU STOK PENER PERSE PEMA SISA STOK PERMIN SUMBER DANA JML HARGA JUMLAH
NO. NAMA OBAT KET
AN AWAL MAAN DIAAN KAIAN STOK OPT TAAN DAK/11DAK/12 DAK/13 DAK/14DAK/15DAK/16 BANTUAN PROGRAM H SATUAN HARGA
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
4 IV Catheter Gea No. 24 set 2 2 0 2 2 5,203 10,406
6 Ansell Steril 7 psg 1 1 0 1 1 7,500 7,500
7 Ansell Steri 7 1/2 psg 0 0 7,500 0
11 Alat suntik sekali pakai 3 ml set 51 51 748 38,148
16 Alupurinol tablet 100 mg tablet 40 40 40 0 0 95 0
18 Ambroxol sirup 15 mg/ml Botol 2 2 1 1 1 5,500 5,500 Des 5000

19 Ambroxol tablet tablet 0 0 216 0 Des 196
NO. NAMA OBAT KET
25 Amoksisilin sirup kering 125 mg/5 ml Botol 8 8 7 1 1 2,200 2,200
27 Amoksisilin kapsul 250 mg Kapsul 0 0 207 0
28 Amoksisilin kaplet 500 mg kaplet 1062 1062 480 582 582 233 135,606
30 Anagens Syrup Botol 0 0 19,800 0

NO. NAMA OBAT KET
31 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 209 0 Des 190

35 Antihemoroid DOEN kombinasi suppos 0 0 0 0 0 3,502 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 1000 1000 210 790 790 120 94,800
42 Asam Mefenamat tablet 500 mg tablet 847 847 160 687 687 113 77,631 Des 122
45 Asiklovir krim 5% tablet 1 1 0 1 1 3,960 3,960 Des 3600

54 Betametason krim 0.1 % tube 0 0 0 0 0 1,435 0

NO. NAMA OBAT KET
59 Catgut/benang bedah no .3/0 pcs 3 3 0 3 3 6,421 19,263

NO. NAMA OBAT KET
71 Domperidom tablet tablet 0 451 0 Jan 133


75 Etakridin (Rivanol) larutan 0,1 % Botol 1 1 1 0 0 3,600 0
76 E t a n o l 70 % 100 ml Botol 0 2,625 0
81 Fervital Kapsul kapsul 0 861 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 m ampul 0 3,754 0
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 tablet 0 796 0 EXD
87 Garam Oralit untuk 200 ml Air sak 31 31 0 31 31 274 8,494
88 Gentamicin inj 40mg/ml Ampul 0 3,545 0
89 Gentian Violet larutan 1 % Botol 0 0 0 0 3,850 0 Jan 3500

94 Guaiafenesin Tablet tablet 1180 1180 440 740 800 132 105,600 Des

NO. NAMA OBAT KET
97 Haloperidol tablet 1,5 mg tablet 0 76 0 Des 74

101 Hidrokortison krim 2,5 % tube 0 0 0 0 0 2,812 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 8,000 0 8000

103 Ibuprofen suspensi 200 mg/5 ml Botol 0 8,800 0 Des 8000
106 Infusion set anak pcs 0 0 0 0 0 4,025 0

NO. NAMA OBAT KET
112 Kalsium laktat (Kalk) tablet 500 mg tablet 500 500 100 400 400 69 27,600
126 Kloramfenikol salep mata 1 % tube 0 1,850 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 0 8,250 0 Des
130 Klorfeniramin maleat tablet 4 mg tablet 1320 1320 340 980 980 45 44,100
136 Kotrimoksazol tablet 480 mg tablet 500 500 260 240 240 158 37,920
NO. NAMA OBAT KET
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 0 138 0 Jan 125

140 Lidokain komp. injeksi - 2 ml ampul 0 2,122 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 1,694 0 Des 3200

145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 2,143 0 Des 3650
149 Metilergometrin maleat tablet salut 0,125 tablet 0 133 0
150 Metilergometrin maleat injeksi 0.200 mg - 1ampul 0 2,684 0

NO. NAMA OBAT KET
151 Metilprednisolon tablet 4 mg tablet 100 100 0 100 100 200 20,000
153 Metoklopramida 10 mg tablet 100 100 0 100 100 100 10,000
154 Metoklopramida injeksi 5 mg / ml vial 0 6,600 0 Jan 6000

156 Metronidazol tablet 500 mg tablet 60 60 10 50 50 140 7,000
157 Miconazole Krim tube 0 0 0 0 0 3,737 0
159 Multivitamin (Lycalvit) syrup botol 5 5 2 3 3 37,400 112,200 Des
167 Obat anti Tuberklosis kategori FDC 2 paket 0 ### 0 Des 1319900
173 Oksitetrasiklin HCI salep mata 1 % tube 0 3,300 0 Des
175 Omeprazole 20 mg kapsul 0 880 0 Jan 221

176 Parasetamol drops Botol 0 5,980 0 Des 7,350
NO. NAMA OBAT KET
178 Parasetamol tablet 500 mg tablet 1020 1020 360 660 660 145 95,700 Des 58
179 Pehacain injeksi botol 9 9 2 7 7 4,400 30,800 Des
181 Pirantel pamoat tablet 125 mg tablet 16 16 4 12 12 318 3,816
187 Plester 2,5 cm x 4 m rol 1 1 1 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 35,532 0
190 Prednison tablet 5 mg tablet 0 193 0 Jan 175

NO. NAMA OBAT KET
192 Prokain benzil penisilin injeksi 3 Juta IU / via vial 0 9,908 0
193 Propiltiourasil tablet 100 mg tablet 40 40 10 30 30 320 9,600
195 Ranitidin tablet 150 mg tablet 100 100 100 0 0 115 0 Des 132
197 Rapid Test VIKIA HIV 1/2 kit 0 525,000 0 Des 487500
203 Salbutamol tablet 2 mg tablet 90 90 70 20 20 99 1,980 Des
206 Salisil bedak 2 % pot 3 3 1 2 2 1,066 2,132
208 Sarung Tangan Examination M pcs 0 410 0
213 Setrizin syrup Botol 4 4 1 3 3 7,756 23,268
216 Simetidine 200 mg tablet 0 209 0 Jan 190

NO. NAMA OBAT KET
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 2 2 1 1 1 20,825 20,825
228 Tiamfenikol 500 mg kapsul 0 1,452 0 Jan 1320

229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ampul 0 1,760 0 Jan 1600
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 5 tablet 0 0 0 0 0 91 0
NO. NAMA OBAT KET
232 Umbilical Cord kotak 0 3,163 0
233 U-Pad steril 60 cm x 90 cm pcs 0 8,770 0
235 Vaksin Jerap Tetanus vial 0 14,498 0
236 Vaksin Rabies vero kuur 280 700,000 ###
238 Wicold kapsul kapsul 0 792 0
239 Yodium povidon larutan 10 % 60 ml Botol 0 7,040 0
242 Zinc Tablet tablet 0 592 0

TOTAL ###
###
UNIT
JENIS KUNJUNGAN JUMLAH PASIEN JUMLAH RESEP JAMKESDA JKN TOTAL
PELAYANAN Jml pasienJml R/ Jml pasien
Jamkesda 128 GENERI NON GENERIK Jml R/Jml pasienJml R/
JKN 5
Lain - lain
Jamkesda 0
JKN 0
Lain - lain
NO. NAMA OBAT KET
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

KODE PUSKESMAS :
KECAMATAN : BARANTI TGL :30-12-2017 BULAN DESEMBER
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 3 3 3 0 7,500 0






76 E t a n o l 70 % 100 ml Botol 0 0 2,625 0




130 Klorfeniramin maleat tablet 4 mg tablet 520 520 50 470 0 45 0



146 Masker Kain pcs 0 0 0 0 506 0
147 Mata Pisau No. 15 pcs 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 3,300 0




187 Plester 2,5 cm x 4 m rol 1 1 1 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 35,532 0
190 Prednison tablet 5 mg tablet 350 350 70 280 0 193 0 Jan




234 Urine Bag set 0 0 3,450 0

TOTAL 0
###
Jamkesda 20 55
JKN 10 27
Jamkesda
JKN
Lain - lain
TOTAL 30 TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
EXP
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
KODE PUSKESMAS :
KECAMATAN : BARANTI TGL :30-11-2017 BULAN NOVEMBER
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 3 3 3 0 7,500 0






76 E t a n o l 70 % 100 ml Botol 0 0 2,625 0





137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 8 8 8 0 2,225 0 EXP


146 Masker Kain pcs 43 43 43 0 0 506 0
147 Mata Pisau No. 15 pcs 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 3,300 0




187 Plester 2,5 cm x 4 m rol 1 1 1 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 35,532 0
190 Prednison tablet 5 mg tablet 120 300 420 70 350 0 193 0 Jan



234 Urine Bag set 0 0 3,450 0

TOTAL 0
###
Jamkesda 19 58
JKN 25 75
Jamkesda
JKN
Lain - lain
TOTAL 44 TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
EXP
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
( L P L P O ) JKD
KODE PUSKESMAS :
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 6 10 16 4 12 0 7,500 0






76 E t a n o l 70 % 100 ml Botol 6 0 6 1 5 0 2,625 0


94 Guaiafenesin Tablet tablet 0 500 500 20 480 0 132 0 Des

102 Ibuprofen suspensi 100 mg/5 ml Botol 0 7 7 2 5 0 8,000 0





146 Masker Kain pcs 50 0 50 5 45 0 506 0





187 Plester 2,5 cm x 4 m rol 1 0 1 1 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 35,532 0






sancobion kapsul tablet 700 700 700

TOTAL 0
###
JKN
Lain - lain
Jamkesda
JKN
Lain - lain
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
(LPLPO)
KODE PUSKESMAS :
KECAMATAN : TGL :30 november 2017 BULAN 11
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 7 7 2 5 0 7,500 0

30 Anagens Syrup Botol 0 0 19,800 0

31 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 209 0 Des




76 E t a n o l 70 % 100 ml Botol 3 3 0 3 0 2,625 0







146 Masker Kain pcs 0 0 506 0
147 Mata Pisau No. 15 pcs 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 3,300 0




187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 35,532 0

206 Salisil bedak 2 % pot 0 0 1,066 0


223 Tablet tambah darah kombinasi tablet 900 900 900 0 327 0 Des

234 Urine Bag set 0 0 3,450 0
sancobion kapsul table 500 500 500 0

TOTAL 0
###
GENERIK
NON GENERIK
JKN
Lain - lain

Jamkesda
JKN
Lain - lain
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
(LPLPO)
KODE PUSKESMAS :
KECAMATAN : BARANTI TGL : 30-Nov-17 BULAN 11
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
6 Ansell Steril 7 psg 11 0 11 0 11 11 11 7,500 82,500
7 Ansell Steri 7 1/2 psg 9 10 19 1 18 18 18 7,500 135,000

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
28 Amoksisilin kaplet 500 mg kaplet 857 500 1357 190 1167 1167 1,167 233 271,911

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
31 Antalgin (Metampiron) tablet 500 mg Tablet 280 0 280 0 280 280 280 209 58,520 Des
42 Asam Mefenamat tablet 500 mg tablet 640 0 640 80 560 560 560 113 63,280 Des

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
59 Catgut/benang bedah no .3/0 pcs 11 0 11 1 10 10 10 6,421 64,210

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

76 E t a n o l 70 % 100 ml Botol 6 0 6 0 6 6 6 2,625 15,750
81 Fervital Kapsul kapsul 500 300 800 440 360 360 360 861 309,960

94 Guaiafenesin Tablet tablet 1000 1000 0 1000 1000 1,000 132 132,000 Des

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
107 Infusion set dewasa pcs 9 0 9 0 9 9 9 3,680 33,120

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 20 50 70 0 70 70 70 1,725 120,750

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

146 Masker Kain pcs 0 0 0 0 506 0
147 Mata Pisau No. 15 pcs 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 3,300 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

158 Mineral Mix sak 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit/Liracur) syrup botol 3 3 1 2 2 2 37,400 74,800 Des

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
178 Parasetamol tablet 500 mg tablet 452 1000 1452 162 1290 1290 1,290 145 187,050 Des
187 Plester 2,5 cm x 4 m rol 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 35,532 0
190 Prednison tablet 5 mg tablet 195 0 195 0 195 195 195 193 37,635 Jan
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
207 Sarung Tangan Examination S pcs 68 0 68 6 62 62 62 410 25,420

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
223 Tablet tambah darah kombinasi tablet 45 0 45 15 30 30 30 327 9,801 Des
224 Taburia kotak 0 0 0 0 18,150 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0 8,770 0
234 Urine Bag set 0 0 0 0 3,450 0
237 Vitamin B kompleks tablet tablet 251 1000 1251 142 1109 1109 1,109 132 146,388
239 Yodium povidon larutan 10 % 60 ml Botol 1 1 1 1 1 7,040 7,040
241 Zinc syrup Botol 0 0 0 0 8,140 0
243 Samcobion tablet 420 700 1120 1120 0 0 0

TOTAL ###
###
JKN
Lain - lain
Jamkesda
JKN
Lain - lain
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 196 0 196 22 174 174 174 7,500 1,305,000
16 Alupurinol tablet 100 mg tablet 945 1000 1,945 400 1,545 1,545 1,545 95 146,775
19 Ambroxol tablet tablet 0 0 0 0 0 0 0 216 0 Des

23 Amlodipine 5 mg tablet 0 1500 1,500 30 1,470 1,470 1,470 105 154,350

24 Amlodipine 10 mg tablet 0 1500 1,500 20 1,480 1,480 1,480 163 241,240
31 Antalgin (Metampiron) tablet 500 mg Tablet 1,670 0 1,670 100 1,570 1,570 1,570 209 328,130 Des
41 Asam Folat tablet 1,420 0 1,420 130 1,290 1,290 1,290 68 87,720
42 Asam Mefenamat tablet 500 mg tablet 12,369 5000 17,369 2205 15,164 15,164 15,164 122 1,850,008 Des
45 Asiklovir krim 5% tablet 19 0 19 10 9 9 9 3,960 35,640 Des

53 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 0 1,210 0 Des
57 Blood Lancet 26G kotak 300 0 300 0 300 300 300 160 48,000
76 E t a n o l 70 % 100 ml Botol 126 0 126 5 121 121 121 2,625 317,625
81 Fervital Kapsul kapsul 3,735 0 3,735 1420 2,315 2,315 2,315 861 1,993,215
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 88 90 178 8 170 170 170 3,754 638,180 EXP

91 Glibenklamid tablet 5 mg tablet 2,565 0 2,565 60 2,505 2,505 2,505 110 275,550 Des
94 Guaiafenesin Tablet tablet 10,240 5000 15,240 4214 11,026 11,026 11,026 132 1,455,432 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 1,538 0 1,538 148 1,390 1,390 1,390 523 726,275 Des
97 Haloperidol tablet 1,5 mg tablet 0 500 500 100 400 400 400 76 30,400 Des
103 Ibuprofen suspensi 200 mg/5 ml Botol 13 0 13 0 13 13 13 8,800 114,400 Des
106 Infusion set anak pcs 152 0 152 0 152 152 152 4,025 611,800
107 Infusion set dewasa pcs 301 200 501 48 453 453 453 3,680 1,667,040
116 Kaptopril 12,5 mg tablet 0 5000 5,000 10 4,990 4,990 4,990 69 344,310
117 Kaptopril 25 mg tablet 4,301 3000 7,301 1579 5,722 5,722 5,722 165 944,130 Des
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1,256 0 1,256 32 1,224 1,224 1,224 1,725 2,111,400
122 Ketokonazol krim 2% tube 2 100 102 0 102 102 102 6,600 673,200 Des
124 Kloramfenikol kapsul 250 mg Kapsul 0 0 0 0 0 0 0 616 0 Des
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 0 8,250 0 Des
146 Masker Kain pcs 1,106 0 1,106 304 802 802 802 506 405,812
147 Mata Pisau No. 15 pcs 89 0 89 5 84 84 84 3,300 277,200
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
152 Metformin Hcl 500 mg tablet 585 1000 1,585 237 1,348 1,348 1,348 115 155,020
158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0
161 Natrium diklofenak 50 mg tablet 0 3000 3,000 100 2,900 2,900 2,900 161 466,900
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 70 0 70 0 70 70 70 704 49,280
167 Obat anti Tuberklosis kategori FDC 2 paket 0 1 1 0 1 1 1 1,317,000 1,317,000 Des

173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 0 0 0 3,300 0 Des
175 Omeprazole 20 mg kapsul 30 300 330 30 300 300 300 880 0 Jan
177 Parasetamol sirup 120 mg / 5 ml Botol 35 0 35 10 25 25 25 1,119 27,975 Des
178 Parasetamol tablet 500 mg tablet 16,884 20000 36,884 9317 27,567 27,567 27,567 145 3,997,215 Des
179 Pehacain injeksi botol 200 0 200 35 165 165 165 4,400 726,000 Des
181 Pirantel pamoat tablet 125 mg tablet 313 0 313 42 271 271 271 318 86,178 EXP
182 Pirantel suspensi 10 ml botol 6 0 6 2 4 4 4 17,600 70,400 EXP
183 Pirantel suspensin 60 ml Botol 0 0 0 0 0 0 0 9,100 0 Des
186 Piroksikam 20 mg tablet 0 0 0 0 0 0 0 220 0 Des
187 Plester 2,5 cm x 4 m rol 14 10 24 2 22 22 22 12,076 265,672
188 Plester 7,5 cm x 4 m rol 12 10 22 5 17 17 17 35,532 604,044
190 Prednison tablet 5 mg tablet 4,276 10000 14,276 3916 10,360 10,360 10,360 193 1,999,480 Jan
195 Ranitidin tablet 150 mg tablet 278 5000 5,278 396 4,882 4,882 4,882 132 644,424 Des
203 Salbutamol tablet 2 mg tablet 1,193 500 1,693 185 1,508 1,508 1,508 99 149,292 Des
208 Sarung Tangan Examination M pcs 500 1000 1,500 0 1,500 1,500 1,500 410 615,000
209 Sarung Tangan Examination L pcs 800 1000 1,800 710 1,090 1,090 1,090 410 446,900
216 Simetidine 200 mg tablet 2,000 0 2,000 0 2,000 2,000 2,000 209 418,000 Jan
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 11 36 47 1 46 46 46 20,825 957,950
220 Siprofloksasin tablet 500 mg tablet 827 1000 1,827 0 1,827 1,827 1,827 298 544,446
223 Tablet tambah darah kombinasi tablet 3,708 0 3,708 45 3,663 3,663 3,663 327 1,196,702 Des
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
228 Tiamfenikol 500 mg kapsul 360 0 360 0 360 360 360 1,452 522,720 Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 2,850 10000 12,850 625 12,225 12,225 12,225 91 1,112,475
233 U-Pad steril 60 cm x 90 cm pcs 94 0 94 4 90 90 90 8,770 789,300
234 Urine Bag set 16 0 16 0 16 16 16 3,450 55,200
236 Vaksin Rabies vero kuur 0 0 0 0 0 0 0 700,000 0

241 Zinc syrup Botol 30 0 30 0 30 30 30 8,140 244,200
243 Paper Tape 2,5 x 9,14 Rol 4 0 4 4 4 4 592 2,368
244 Paper Tape 7,5 x 9,14 Rol 2 0 2 0 2 2 2 592 1,184
245 samcobion Tablet 5,600 0 5,600 1120 4,480 4,480 4,480 592 2,652,160
TOTAL 104,610,890
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 208 0 208 12 196 196 196 7,500 1,470,000
9 Alat Suntik sekali pakai 0,5 ml set 1,411 0 1,411 819 592 592 592 1,240 734,080
16 Alupurinol tablet 100 mg tablet 600 500 1,100 155 945 945 1,000 945 95 89,775
19 Ambroxol tablet tablet 180 0 180 10 170 170 3,000 170 216 36,720 Des


31 Antalgin (Metampiron) tablet 500 mg Tablet 1,670 0 1,670 60 1,610 1,610 1,610 209 336,490 Des
38 Antimigrain DOEN kombinasi tablet 100 200 300 0 300 300 200 300 149 44,700
40 Asam Askorbat (Vit C) tablet 50 mg tablet 18,418 0 18,418 5599 12,819 12,819 14,400 12,819 120 1,538,280
41 Asam Folat tablet 1,640 0 1,640 220 1,420 1,420 1,420 68 96,560
42 Asam Mefenamat tablet 500 mg tablet 14,135 0 14,135 1766 12,369 12,369 5,000 12,369 122 1,509,018 Des

53 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 1,000 0 1,210 0 Des
59 Catgut/benang bedah no .3/0 pcs 134 0 134 16 118 118 94 118 6,421 757,678
61 Deksametason tablet 0,5 mg tablet 8,552 0 8,552 1349 7,203 7,203 5,000 7,203 48 345,744
64 Diazepam tablet 2 mg tablett 0 0 0 0 0 0 1,000 0 134 0
65 Diazepam tablet 5 mg tablet 0 0 0 0 0 0 65 0
71 Domperidom tablet tablet 164 300 464 112 352 352 300 352 451 0 Jan
76 E t a n o l 70 % 100 ml Botol 152 0 152 26 126 126 126 2,625 330,750
77 Etil klorida semprot Botol 0 0 0 0 0 0 10 0 115,500 0
81 Fervital Kapsul kapsul 4,500 0 4,500 765 3,735 3,735 3,735 861 3,215,835
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 89 0 89 1 88 88 100 88 3,754 330,352 EXP

87 Garam Oralit untuk 200 ml Air sak 1,425 0 1,425 344 1,081 1,081 500 1,081 274 296,194
91 Glibenklamid tablet 5 mg tablet 2,755 0 2,755 190 2,565 2,565 2,565 110 282,150 Des
94 Guaiafenesin Tablet tablet 14,839 0 14,839 4599 10,240 10,240 5,000 10,240 132 1,351,680 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 1,784 0 1,784 246 1,538 1,538 1,538 523 803,605 Des
97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 0 500 0 76 0 Des
102 Ibuprofen suspensi 100 mg/5 ml Botol 63 0 63 53 10 10 200 10 8,000 80,000
104 Ibuprofen tablet 200 mg tablet 10,520 0 10,520 550 9,970 9,970 10,000 9,970 111 1,106,670
107 Infusion set dewasa pcs 318 0 318 17 301 301 200 301 3,680 1,107,680
112 Kalsium laktat (Kalk) tablet 500 mg tablet 7,390 0 7,390 650 6,740 6,740 5,000 6,740 69 465,060
116 Kaptopril 12,5 mg tablet 147 0 147 147 0 0 5,000 0 69 0

117 Kaptopril 25 mg tablet 5,000 0 5,000 699 4,301 4,301 5,000 4,301 165 709,665 Des
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1,307 0 1,307 51 1,256 1,256 1,256 1,725 2,166,600
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 30 0 30 0 30 30 30 1,045 31,350 EXP
135 Klorpromazin HCI tablet salut 25 mg tablet 1,430 0 1,430 1000 430 430 2,000 430 170 73,100
146 Masker Kain pcs 1,492 0 1,492 386 1,106 1,106 1,106 506 559,636
147 Mata Pisau No. 15 pcs 89 0 89 0 89 89 89 3,300 293,700
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
152 Metformin Hcl 500 mg tablet 690 300 990 405 585 585 1,000 585 115 67,275
158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0
161 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0 10,000 0 161 0
166 Obat anti Tuberklosis kategori FDC I paket 2 5 7 4 3 3 5 3 413,984 1,241,952
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 0 1 0 1,317,000 0 Des

176 Parasetamol drops Botol 55 0 55 43 12 12 100 12 7,350 88,200 Des
178 Parasetamol tablet 500 mg tablet 26,486 0 26,486 9602 16,884 16,884 20,000 16,884 145 2,448,180 Des
187 Plester 2,5 cm x 4 m rol 11 10 21 7 14 14 10 14 12,076 169,064
188 Plester 7,5 cm x 4 m rol 8 10 18 6 12 12 10 12 35,532 426,384
190 Prednison tablet 5 mg tablet 7,513 0 7,513 3237 4,276 4,276 10,000 4,276 193 825,268 Jan
193 Propiltiourasil tablet 100 mg tablet 400 0 400 119 281 281 1,000 281 320 89,920
195 Ranitidin tablet 150 mg tablet 940 0 940 662 278 278 5,000 278 132 36,696 Des
203 Salbutamol tablet 2 mg tablet 1,199 0 1,199 96 1,103 1,103 500 1,103 99 109,197 Des
208 Sarung Tangan Examination M pcs 0 500 500 0 500 500 1,000 500 410 205,000
209 Sarung Tangan Examination L pcs 1,300 0 1,300 500 800 800 1,000 800 410 328,000
216 Simetidine 200 mg tablet 2,000 0 2,000 0 2,000 2,000 2,000 209 418,000 Jan
217 Simvastatin 10 mg tablet 570 0 570 0 570 570 600 570 135 76,950
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 14 36 50 0 50 50 48 50 20,825 1,041,250
220 Siprofloksasin tablet 500 mg tablet 1,342 0 1,342 0 1,342 1,342 1,000 1,342 298 399,916
223 Tablet tambah darah kombinasi tablet 4,438 0 4,438 1233 3,205 3,205 3,205 327 1,047,074 Des
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 20 0 20 0 20 20 20 3,450 69,000
236 Vaksin Rabies vero kuur 0 0 0 0 0 0 0 700,000 0

237 Vitamin B kompleks tablet tablet 31,705 0 31,705 2468 29,237 29,237 5,000 29,237 132 3,859,284
241 Zinc syrup Botol 30 0 30 0 30 30 30 8,140 244,200
243 Paper Tape 2,5 x 9,14 Rol 4 0 4 4 4 4 592 2,368
244 Paper Tape 7,5 x 9,14 Rol 2 0 2 0 2 2 2 592 1,184
245 samcobion Tablet 5,600 0 5,600 0 5,600 5,600 5,600 592 3,315,200
TOTAL 85,879,616
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set 267 0 267 #REF! #REF! #REF! #REF! 5,203 #REF!
2 IV Catheter Gea No. 20 set 170 0 170 #REF! #REF! #REF! 100 #REF! 4,370 #REF!
5 Ansell Steril 6 1/2 psg 300 0 300 #REF! #REF! #REF! #REF! 7,500 #REF!
6 Ansell Steril 7 psg 250 0 250 #REF! #REF! #REF! #REF! 7,500 #REF!
7 Ansell Steri 7 1/2 psg 208 0 208 #REF! #REF! #REF! #REF! 7,500 #REF!
8 Alat Suntik sekali pakai 0,05 ml set 900 0 900 #REF! #REF! #REF! #REF! 1,650 #REF!
9 Alat Suntik sekali pakai 0,5 ml set 1,411 0 1,411 #REF! #REF! #REF! #REF! 1,240 #REF!
10 Alat suntik sekali pakai 1 ml set 5,532 0 5,532 #REF! #REF! #REF! #REF! 748 #REF!
13 Alat Suntik sekali pakai 10 ml set 198 0 198 #REF! #REF! #REF! #REF! 1,064 #REF!
14 Albendasol tablet 400 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 425 #REF!
15 Alkohol Swab kotak 200 0 200 #REF! #REF! #REF! #REF! 115 #REF!
16 Alupurinol tablet 100 mg tablet 600 500 1,100 #REF! #REF! #REF! 1,000 #REF! 95 #REF!
17 Allpurinol tablet 300 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 244 #REF!
18 Ambroxol sirup 15 mg/ml Botol 99 0 99 #REF! #REF! #REF! #REF! 5,500 #REF! Des
19 Ambroxol tablet tablet 180 0 180 #REF! #REF! #REF! 3,000 #REF! 216 #REF! Des
20 Aminofilin tablet 200 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 86 #REF!

21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 6 0 6 #REF! #REF! #REF! #REF! 3,349 #REF!
22 Amitriptilin HCI tablet salut 25 mg tablet 1,000 0 1,000 #REF! #REF! #REF! #REF! 165 #REF!
23 Amlodipine 5 mg tablet 0 0 0 #REF! #REF! #REF! 5,000 #REF! 105 #REF!

24 Amlodipine 10 mg tablet 0 0 0 #REF! #REF! #REF! 5,000 #REF! 163 #REF!
25 Amoksisilin sirup kering 125 mg/5 ml Botol 231 0 231 #REF! #REF! #REF! 200 #REF! 2,200 #REF!
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 37 0 37 #REF! #REF! #REF! #REF! 4,147 #REF!
27 Amoksisilin kapsul 250 mg Kapsul 4,910 0 4,910 #REF! #REF! #REF! #REF! 207 #REF!
28 Amoksisilin kaplet 500 mg kaplet 32,744 0 32,744 #REF! #REF! #REF! 10,000 #REF! 233 #REF!
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 #REF! #REF! #REF! #REF! 4,600 #REF!
30 Anagens Syrup Botol 23 0 23 #REF! #REF! #REF! #REF! 19,800 #REF!
31 Antalgin (Metampiron) tablet 500 mg Tablet 1,730 0 1,730 #REF! #REF! #REF! #REF! 209 #REF! Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 #REF! #REF! #REF! #REF! 1,500 #REF!
33 Antasida DOEN tablet kombinasi tablet 7,490 0 7,490 #REF! #REF! #REF! 10,000 #REF! 64 #REF!
34 Antasida DOEN suspensi Botol 210 0 210 #REF! #REF! #REF! #REF! 2,106 #REF!
35 Antihemoroid DOEN kombinasi suppos 88 0 88 #REF! #REF! #REF! #REF! 3,502 #REF!
36 Antifungi DOEN kombinasi pot 24 0 24 #REF! #REF! #REF! #REF! 4,782 #REF!
37 Antibakteri DOEN salep Kombinasi tube 0 0 0 #REF! #REF! #REF! #REF! 2,767 #REF!
38 Antimigrain DOEN kombinasi tablet 100 200 300 #REF! #REF! #REF! 200 #REF! 149 #REF!
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 #REF! #REF! #REF! #REF! 5,800 #REF!
40 Asam Askorbat (Vit C) tablet 50 mg tablet 18,418 0 18,418 #REF! #REF! #REF! 14,400 #REF! 120 #REF!
41 Asam Folat tablet 1,640 0 1,640 #REF! #REF! #REF! #REF! 68 #REF!
42 Asam Mefenamat tablet 500 mg tablet 14,135 0 14,135 #REF! #REF! #REF! 5,000 #REF! 122 #REF! Des
43 Asiklovir 200 mg tablet 470 0 470 #REF! #REF! #REF! #REF! 272 #REF!
45 Asiklovir krim 5% tablet 25 0 25 #REF! #REF! #REF! 100 #REF! 3,960 #REF! Des
46 Asetosal tablet 100 mg tabet 100 0 100 #REF! #REF! #REF! #REF! 110 #REF!
47 Attalpulgit tablet 0 0 0 #REF! #REF! #REF! #REF! 173 #REF! EXP
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 8 0 8 #REF! #REF! #REF! #REF! 1,672 #REF!
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 75 #REF!
50 Benecheck plus Glucose test strip 50's box 0 0 0 #REF! #REF! #REF! #REF! 156,072 #REF!
51 Benecheck plus Cholesterol test strip 50's box 0 0 0 #REF! #REF! #REF! #REF! 234,238 #REF!
52 Benecheck plus Uric test strip 50's box 0 0 0 #REF! #REF! #REF! #REF! 129,210 #REF!
53 Betahistin maleat 24 mg tablet 0 0 0 #REF! #REF! #REF! 1,000 #REF! 1,210 #REF! Des
54 Betametason krim 0.1 % tube 280 0 280 #REF! #REF! #REF! #REF! 1,435 #REF!
55 Bisakodil 5 mg supp suppos 18 0 18 #REF! #REF! #REF! #REF! 5,670 #REF!
56 Bisakodil 10 mg supp suppos 9 10 19 #REF! #REF! #REF! 10 #REF! 5,800 #REF!
57 Blood Lancet 26G kotak 300 0 300 #REF! #REF! #REF! #REF! 160 #REF!
58 Catgut/benang bedah no .2/0 pcs 0 0 0 #REF! #REF! #REF! #REF! 33,925 #REF!
59 Catgut/benang bedah no .3/0 pcs 134 0 134 #REF! #REF! #REF! 94 #REF! 6,421 #REF!
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 28 0 28 #REF! #REF! #REF! #REF! 1,740 #REF!
61 Deksametason tablet 0,5 mg tablet 8,552 0 8,552 #REF! #REF! #REF! 5,000 #REF! 48 #REF!
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 #REF! #REF! #REF! 5 #REF! 2,578 #REF!
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 #REF! #REF! #REF! 5 #REF! 12,749 #REF!
64 Diazepam tablet 2 mg tablett 0 0 0 #REF! #REF! #REF! 1,000 #REF! 134 #REF!
65 Diazepam tablet 5 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 65 #REF!
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 104 #REF!
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 30 0 30 #REF! #REF! #REF! #REF! 1,354 #REF! EXP
68 Digoksin tablet 0,25 mg tablet 100 0 100 #REF! #REF! #REF! #REF! 108 #REF!
69 Doksisilin kapsul 100 mg Kapsul 0 0 0 #REF! #REF! #REF! #REF! 309 #REF!
70 Domperidom suspensi Botol 104 0 104 #REF! #REF! #REF! #REF! 3,180 #REF!
71 Domperidom tablet tablet 164 300 464 #REF! #REF! #REF! 300 #REF! 451 0 Jan
72 Efedrin HCI tablet 25 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 56 #REF!
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 #REF! #REF! #REF! 1,000 #REF! 42 #REF!
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 #REF! #REF! #REF! #REF! 8,910 #REF!
75 Etakridin (Rivanol) larutan 0,1 % Botol 15 5 20 #REF! #REF! #REF! #REF! 3,600 #REF!
76 E t a n o l 70 % 100 ml Botol 152 0 152 #REF! #REF! #REF! #REF! 2,625 #REF!
77 Etil klorida semprot Botol 0 0 0 #REF! #REF! #REF! 10 #REF! 115,500 #REF!
78 Eugenol cairan botol 0 0 0 #REF! #REF! #REF! #REF! 18,333 #REF!
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 #REF! #REF! #REF! #REF! 1,980 #REF!
80 Fenobarbital tablet 30 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 74 #REF!
81 Fervital Kapsul kapsul 4,500 0 4,500 #REF! #REF! #REF! #REF! 861 #REF!
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 89 0 89 #REF! #REF! #REF! 100 #REF! 3,754 #REF! EXP
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 170 0 170 #REF! #REF! #REF! #REF! 796 #REF!
84 Foly Catheter No. 18 pcs 6 0 6 #REF! #REF! #REF! #REF! 9,200 #REF!
86 Furosemid tablet 40 mg tablet 384 0 384 #REF! #REF! #REF! #REF! 84 #REF!
87 Garam Oralit untuk 200 ml Air sak 1,425 0 1,425 #REF! #REF! #REF! 500 #REF! 274 #REF!
88 Gentamicin inj 40mg/ml Ampul 25 0 25 #REF! #REF! #REF! #REF! 3,545 #REF! EXP
89 Gentian Violet larutan 1 % Botol 7 0 7 #REF! #REF! #REF! #REF! 3,850 #REF! Jan
90 Glass lonomer Cement (GC IX ) buah 0 0 0 #REF! #REF! #REF! #REF! 434,500 #REF!
91 Glibenklamid tablet 5 mg tablet 2,755 0 2,755 #REF! #REF! #REF! #REF! 110 #REF! Des
92 Glimepiride 1 mg tablet 190 0 190 #REF! #REF! #REF! #REF! 220 #REF!
94 Guaiafenesin Tablet tablet 14,839 0 14,839 #REF! #REF! #REF! 5,000 #REF! 132 #REF! Des
95 Glukosa larutan infus 5 % steril Botol 73 0 73 #REF! #REF! #REF! 60 #REF! 6,900 #REF!
96 Grisefulvin tablet 125 mg (Micronized) tablet 1,784 0 1,784 #REF! #REF! #REF! #REF! 523 #REF! Des
97 Haloperidol tablet 1,5 mg tablet 0 0 0 #REF! #REF! #REF! 500 #REF! 76 #REF! Des
98 Haloperidol tablet 2 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 134 #REF!
99 Haloperidol inj 50 mg/ml ampul 0 0 0 #REF! #REF! #REF! #REF! 91,667 #REF!
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 1,637 0 1,637 #REF! #REF! #REF! #REF! 171 #REF!
101 Hidrokortison krim 2,5 % tube 71 0 71 #REF! #REF! #REF! #REF! 2,812 #REF!
102 Ibuprofen suspensi 100 mg/5 ml Botol 63 0 63 #REF! #REF! #REF! 200 #REF! 8,000 #REF!
103 Ibuprofen suspensi 200 mg/5 ml Botol 13 0 13 #REF! #REF! #REF! #REF! 8,800 #REF! Des
104 Ibuprofen tablet 200 mg tablet 10,520 0 10,520 #REF! #REF! #REF! 10,000 #REF! 111 #REF!
105 Ibuprofen tablet 400 mg tablet 583 0 583 #REF! #REF! #REF! #REF! 133 #REF!
106 Infusion set anak pcs 152 0 152 #REF! #REF! #REF! #REF! 4,025 #REF!
107 Infusion set dewasa pcs 318 0 318 #REF! #REF! #REF! 200 #REF! 3,680 #REF!
108 Isoniazid tablet 100 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 82 #REF!
109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 98 #REF!
110 Kalsium Glukonat inj 10% ampul 0 0 0 #REF! #REF! #REF! #REF! 999 #REF!
111 Kalsium Hidroksida pasta buah 0 0 0 #REF! #REF! #REF! #REF! 266,200 #REF!
112 Kalsium laktat (Kalk) tablet 500 mg tablet 7,390 0 7,390 #REF! #REF! #REF! 5,000 #REF! 69 #REF!
113 Kapas pembalut 250 gram buah 14 0 14 #REF! #REF! #REF! #REF! 14,375 #REF!
114 Kapas pembalut / Absorben 500 gram bungkus 3 0 3 #REF! #REF! #REF! #REF! 31,372 #REF!
116 Kaptopril 12,5 mg tablet 147 0 147 #REF! #REF! #REF! 5,000 #REF! 69 #REF!
117 Kaptopril 25 mg tablet 5,000 0 5,000 #REF! #REF! #REF! 5,000 #REF! 165 #REF! Des
118 Karbamazepin tablet 200 mg tablet 2,000 0 2,000 #REF! #REF! #REF! #REF! 306 #REF!
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1,307 0 1,307 #REF! #REF! #REF! #REF! 1,725 #REF!
120 Kasa hidrofil 40 x 80 cm roll 6 0 6 #REF! #REF! #REF! #REF! 120,750 #REF!
121 Kasa pembalut elastis 3 inch roll 10 0 10 #REF! #REF! #REF! #REF! 7,700 #REF!
122 Ketokonazol krim 2% tube 2 0 2 #REF! #REF! #REF! 100 #REF! 6,600 #REF! Des
123 Ketokonazol tablet 200 mg tablet 350 0 350 #REF! #REF! #REF! #REF! 264 #REF! Des
124 Kloramfenikol kapsul 250 mg Kapsul 0 0 0 #REF! #REF! #REF! #REF! 616 #REF! Des
125 Kloramfenikol susp 125mg/5 ml Botol 90 0 90 #REF! #REF! #REF! #REF! 4,000 #REF!
126 Kloramfenikol salep mata 1 % tube 54 0 54 #REF! #REF! #REF! 100 #REF! 1,850 #REF!
127 Kloramfenikol tetes mata 1 % botol 0 0 0 #REF! #REF! #REF! #REF! 8,250 #REF! Des
128 Kloramfenikol salep Kulit 2% tube 0 0 0 #REF! #REF! #REF! #REF! 3,409 #REF!
129 Kloramfenikol tetes telinga 3 % Botol 13 0 13 #REF! #REF! #REF! #REF! 8,250 #REF! Des
130 Klorfeniramin maleat tablet 4 mg tablet 13,898 0 13,898 #REF! #REF! #REF! 5,000 #REF! 45 #REF!
131 Klorokuin tablet 150 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 112 #REF!
132 Klorfenol Kamfer Menthol Botol 0 0 0 #REF! #REF! #REF! #REF! 60,500 #REF!
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 30 0 30 #REF! #REF! #REF! #REF! 1,045 #REF! EXP
134 Klorpromazin HCI tablet salut 100 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 179 #REF!
135 Klorpromazin HCI tablet salut 25 mg tablet 1,430 0 1,430 #REF! #REF! #REF! 2,000 #REF! 170 #REF!
136 Kotrimoksazol tablet 480 mg tablet 9,374 0 9,374 #REF! #REF! #REF! #REF! 158 #REF!
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 193 0 193 #REF! #REF! #REF! #REF! 2,225 #REF!
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 0 390 #REF! #REF! #REF! #REF! 138 #REF! Jan
139 Larutan mengandung elektrolit botol 60 0 60 #REF! #REF! #REF! #REF! 9,275 #REF!
140 Lidokain komp. injeksi - 2 ml ampul 53 0 53 #REF! #REF! #REF! #REF! 2,122 #REF!
141 Lisol 1 liter Botol 3 0 3 #REF! #REF! #REF! #REF! 49,200 #REF!
142 Loperamide 2 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 90 #REF!
143 Loratadine 10 mg tablet 450 0 450 #REF! #REF! #REF! #REF! 149 #REF!
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 #REF! #REF! #REF! #REF! 1,694 #REF! Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 6 0 6 #REF! #REF! #REF! #REF! 2,143 #REF! Des
146 Masker Kain pcs 1,492 0 1,492 #REF! #REF! #REF! #REF! 506 #REF!
147 Mata Pisau No. 15 pcs 89 0 89 #REF! #REF! #REF! #REF! 3,300 #REF!
149 Metilergometrin maleat tablet salut 0,125 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 133 #REF!
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0 #REF! #REF! #REF! #REF! 2,684 #REF!
151 Metilprednisolon tablet 4 mg tablet 800 0 800 #REF! #REF! #REF! #REF! 200 #REF!
152 Metformin Hcl 500 mg tablet 690 300 990 #REF! #REF! #REF! 1,000 #REF! 115 #REF!
153 Metoklopramida 10 mg tablet 800 0 800 #REF! #REF! #REF! #REF! 100 #REF!
154 Metoklopramida injeksi 5 mg / ml vial 24 0 24 #REF! #REF! #REF! #REF! 6,600 #REF! Jan
155 Metronidazol tablet 250 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 98 #REF!
156 Metronidazol tablet 500 mg tablet 2,890 0 2,890 #REF! #REF! #REF! 3,000 #REF! 140 #REF!
157 Miconazole Krim tube 70 0 70 #REF! #REF! #REF! #REF! 3,737 #REF!
158 Mineral Mix sak 0 0 0 #REF! #REF! #REF! #REF! 2,450 #REF!
159 Multivitamin (Lycalvit) syrup botol 29 0 29 #REF! #REF! #REF! #REF! 37,400 #REF! Des
160 Mummifying pasta buah 0 0 0 #REF! #REF! #REF! #REF! 193,600 #REF!
161 Natrium diklofenak 50 mg tablet 0 0 0 #REF! #REF! #REF! 10,000 #REF! 161 #REF!
162 Natrium klorida larutan infus 0,9 % steril Botol 162 100 262 #REF! #REF! #REF! #REF! 6,410 #REF!
163 Nifedipin 10 mg tablet 342 0 342 #REF! #REF! #REF! #REF! 123 #REF!
164 Nistatin tablet vagina 100.000 IU / g ovula 7 0 7 #REF! #REF! #REF! #REF! 602 #REF!
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 0 0 #REF! #REF! #REF! #REF! 704 #REF!
166 Obat anti Tuberklosis kategori FDC I paket 2 5 7 #REF! #REF! #REF! 5 #REF! 413,984 #REF!
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 #REF! #REF! #REF! 1 #REF! 1,317,000 #REF! Des
168 Obat anti Tuberklosis kategori FDC Anak paket 1 0 1 #REF! #REF! #REF! #REF! 236,500 #REF!
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 #REF! #REF! #REF! #REF! 4,400 #REF! Des
170 OBH Itral Syrup Botol 9 20 29 #REF! #REF! #REF! #REF! 16,698 #REF!
171 Ofloksasin tablet 400 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 636 #REF!
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 #REF! #REF! #REF! #REF! 1,869 #REF!
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 #REF! #REF! #REF! #REF! 3,300 #REF! Des
175 Omeprazole 20 mg kapsul 60 0 60 #REF! #REF! #REF! 300 #REF! 880 0 Jan
176 Parasetamol drops Botol 55 0 55 #REF! #REF! #REF! 100 #REF! 7,350 #REF! Des
177 Parasetamol sirup 120 mg / 5 ml Botol 132 0 132 #REF! #REF! #REF! 200 #REF! 1,119 #REF! Des
178 Parasetamol tablet 500 mg tablet 26,486 0 26,486 #REF! #REF! #REF! 20,000 #REF! 145 #REF! Des
179 Pehacain injeksi botol 315 0 315 #REF! #REF! #REF! 100 #REF! 4,400 #REF! Des
180 Permetrin krim 5% tube 6 0 6 #REF! #REF! #REF! #REF! 12,155 #REF!
181 Pirantel pamoat tablet 125 mg tablet 321 0 321 #REF! #REF! #REF! #REF! 318 #REF! EXP
182 Pirantel suspensi 10 ml botol 8 0 8 #REF! #REF! #REF! #REF! 17,600 #REF! EXP
183 Pirantel suspensin 60 ml Botol 0 0 0 #REF! #REF! #REF! #REF! 9,100 #REF! Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 8,378 0 8,378 #REF! #REF! #REF! 10,000 #REF! 136 #REF!
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 100 0 100 #REF! #REF! #REF! #REF! 1,030 #REF!
186 Piroksikam 20 mg tablet 0 0 0 #REF! #REF! #REF! 300 #REF! 220 #REF! Des
187 Plester 2,5 cm x 4 m rol 11 10 21 #REF! #REF! #REF! 10 #REF! 12,076 #REF!
188 Plester 7,5 cm x 4 m rol 8 10 18 #REF! #REF! #REF! 10 #REF! 35,532 #REF!
189 Pot Sputum pcs 223 0 223 #REF! #REF! #REF! #REF! 3,190 0 Des
190 Prednison tablet 5 mg tablet 7,513 0 7,513 #REF! #REF! #REF! 10,000 #REF! 193 #REF! Jan
191 Primakuin tablet 15 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 120 #REF!
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 #REF! #REF! #REF! #REF! 9,908 #REF!
193 Propiltiourasil tablet 100 mg tablet 400 0 400 #REF! #REF! #REF! 1,000 #REF! 320 #REF!
194 Propranolol HCI tablet 40 mg tablet 300 0 300 #REF! #REF! #REF! #REF! 69 #REF!
195 Ranitidin tablet 150 mg tablet 940 0 940 #REF! #REF! #REF! 5,000 #REF! 132 #REF! Des
196 Ranitidin injeksi 25 mg/2 ml ampul 100 0 100 #REF! #REF! #REF! #REF! 1,600 #REF!
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 #REF! #REF! #REF! #REF! 525,000 #REF! Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 #REF! #REF! #REF! #REF! 14,344 #REF!
199 Reagensia ZN botol 0 0 0 #REF! #REF! #REF! #REF! 270,000 #REF!
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 0 0 #REF! #REF! #REF! #REF! 327 #REF!
202 Ringer Laktat larutan infus steril Botol 388 0 388 #REF! #REF! #REF! 300 #REF! 7,150 #REF!
203 Salbutamol tablet 2 mg tablet 1,199 0 1,199 #REF! #REF! #REF! 500 #REF! 99 #REF! Des
204 Salbutamol 4 mg tablet 200 0 200 #REF! #REF! #REF! #REF! 88 #REF!
205 Salep 2 - 4 kombinasi pot 112 0 112 #REF! #REF! #REF! #REF! 2,797 #REF!
206 Salisil bedak 2 % pot 193 0 193 #REF! #REF! #REF! 100 #REF! 1,066 #REF!
207 Sarung Tangan Examination S pcs 472 0 472 #REF! #REF! #REF! #REF! 410 #REF!
208 Sarung Tangan Examination M pcs 0 500 500 #REF! #REF! #REF! 1,000 #REF! 410 #REF!
209 Sarung Tangan Examination L pcs 1,300 0 1,300 #REF! #REF! #REF! 1,000 #REF! 410 #REF!
210 Sefadroksil 500 mg kapsul 1,500 0 1,500 #REF! #REF! #REF! #REF! 557 #REF!
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 #REF! #REF! #REF! #REF! 102,850 #REF!
212 Setrizin tablet 10 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 154 #REF!
213 Setrizin syrup Botol 62 0 62 #REF! #REF! #REF! #REF! 7,756 #REF!
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 4,910 0 4,910 #REF! #REF! #REF! #REF! 58 #REF!
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 140 0 140 #REF! #REF! #REF! #REF! 1,226 #REF!
216 Simetidine 200 mg tablet 2,000 0 2,000 #REF! #REF! #REF! #REF! 209 #REF! Jan
217 Simvastatin 10 mg tablet 570 0 570 #REF! #REF! #REF! 600 #REF! 135 #REF!
218 Simvastatin 20 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 252 #REF!
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 29 36 65 #REF! #REF! #REF! 48 #REF! 20,825 #REF!
220 Siprofloksasin tablet 500 mg tablet 1,342 0 1,342 #REF! #REF! #REF! 1,000 #REF! 298 #REF!
221 Spironolakton tablet 100 mg tablet 100 0 100 #REF! #REF! #REF! #REF! 878 #REF!
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 #REF! #REF! #REF! #REF! 3,549 #REF!
223 Tablet tambah darah kombinasi tablet 4,438 0 4,438 #REF! #REF! #REF! #REF! 327 #REF! Des
224 Taburia kotak 0 0 0 #REF! #REF! #REF! #REF! 18,150 #REF!
225 Temporary stopping (Fletcher) buah 0 0 0 #REF! #REF! #REF! #REF! 37,400 #REF!
226 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 0 #REF! #REF! #REF! #REF! 162 #REF!
228 Tiamfenikol 500 mg kapsul 370 0 370 #REF! #REF! #REF! #REF! 1,452 #REF! Jan
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 30 0 30 #REF! #REF! #REF! #REF! 1,760 #REF! Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 6,114 0 6,114 #REF! #REF! #REF! 10,000 #REF! 91 #REF!
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 97 #REF!
232 Umbilical Cord kotak 218 0 218 #REF! #REF! #REF! #REF! 3,163 #REF!
233 U-Pad steril 60 cm x 90 cm pcs 94 0 94 #REF! #REF! #REF! #REF! 8,770 #REF!
234 Urine Bag set 20 0 20 #REF! #REF! #REF! #REF! 3,450 #REF!
235 Vaksin Jerap Tetanus vial 46 0 46 #REF! #REF! #REF! #REF! 14,498 #REF!
236 Vaksin Rabies vero kuur 0 0 0 #REF! #REF! #REF! #REF! 700,000 #REF!
237 Vitamin B kompleks tablet tablet 31,705 0 31,705 #REF! #REF! #REF! 5,000 #REF! 132 #REF!
238 Wicold kapsul kapsul 350 0 350 #REF! #REF! #REF! 10,000 #REF! 792 #REF!
239 Yodium povidon larutan 10 % 60 ml Botol 33 0 33 #REF! #REF! #REF! #REF! 7,040 #REF!
241 Zinc syrup Botol 30 0 30 #REF! #REF! #REF! #REF! 8,140 #REF!
242 Zinc Tablet tablet 3,835 0 3,835 #REF! #REF! #REF! #REF! 592 #REF!
243 Paper Tape 2,5 x 9,14 Rol 4 0 4 #REF! #REF! #REF! #REF! 592 #REF!
244 Paper Tape 7,5 x 9,14 Rol 2 0 2 #REF! #REF! #REF! #REF! 592 #REF!
245 samcobion Tablet 5,600 0 5,600 #REF! #REF! #REF! #REF! 592 #REF!
TOTAL #REF!
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN SEPTEMBER
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 265 0 265 57 208 208 208 7,500 1,560,000
9 Alat Suntik sekali pakai 0,5 ml set 1,621 0 1621 210 1411 1411 1,411 1,240 1,749,640
10 Alat suntik sekali pakai 1 ml set 5,562 0 5562 30 5532 5532 5,532 748 4,137,936
12 Alat suntik sekali pakai 5 ml set 1,081 0 1081 7 1074 1074 1,074 863 926,862
16 Alupurinol tablet 100 mg tablet 977 0 977 377 600 600 500 600 95 57,000
19 Ambroxol tablet tablet 180 0 180 390 -210 -210 500 -210 216 -45,360 Des

22 Amitriptilin HCI tablet salut 25 mg tablet 1,000 0 1000 0 1000 1000 1,000 165 165,000

27 Amoksisilin kapsul 250 mg Kapsul 5,226 0 5226 316 4910 4910 4,910 207 1,016,370
28 Amoksisilin kaplet 500 mg kaplet 26,332 10000 36332 3588 32744 32744 32,744 233 7,629,352
31 Antalgin (Metampiron) tablet 500 mg Tablet 1,730 0 1730 0 1730 1730 1,730 209 361,570 Des
33 Antasida DOEN tablet kombinasi tablet 9,145 0 9145 1655 7490 7490 7,490 64 479,360
40 Asam Askorbat (Vit C) tablet 50 mg tablet 16,870 7000 23870 5452 18418 18418 18,418 120 2,210,160
41 Asam Folat tablet 1,920 0 1920 280 1640 1640 1,640 68 111,520
42 Asam Mefenamat tablet 500 mg tablet 11,993 4300 16293 2158 14135 14135 14,135 122 1,724,470 Des

61 Deksametason tablet 0,5 mg tablet 10,094 0 10094 1542 8552 8552 8,552 48 410,496
76 E t a n o l 70 % 100 ml Botol 160 0 160 8 152 152 152 2,625 399,000
81 Fervital Kapsul kapsul 5,270 0 5270 770 4500 4500 4,500 861 3,874,500

87 Garam Oralit untuk 200 ml Air sak 1,329 500 1829 399 1430 1430 1,430 274 391,820
91 Glibenklamid tablet 5 mg tablet 2,876 0 2876 121 2755 2755 2,755 110 303,050 Des
94 Guaiafenesin Tablet tablet 12,791 5000 17791 2952 14839 14839 14,839 132 1,958,748 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 1,889 0 1889 105 1784 1784 1,784 523 932,140 Des
97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 0 0 76 0 Des
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 1,447 500 1947 310 1637 1637 1,637 171 279,927
102 Ibuprofen suspensi 100 mg/5 ml Botol 50 50 0 50 50 50 8,000 400,000
103 Ibuprofen suspensi 200 mg/5 ml Botol 13 0 13 0 13 13 13 8,800 114,400 Des
104 Ibuprofen tablet 200 mg tablet 8,662 3000 11662 1142 10520 10520 10,520 111 1,167,720
112 Kalsium laktat (Kalk) tablet 500 mg tablet 3,520 5000 8520 1130 7390 7390 7,390 69 509,910
116 Kaptopril 12,5 mg tablet 523 0 523 376 147 147 500 147 69 10,143
117 Kaptopril 25 mg tablet 0 5000 5000 0 5000 5000 5,000 165 825,000 Des
118 Karbamazepin tablet 200 mg tablet 2,000 0 2000 0 2000 2000 2,000 306 612,000
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1,328 0 1328 21 1307 1307 1,307 1,725 2,254,575
130 Klorfeniramin maleat tablet 4 mg tablet 11,292 5000 16292 2394 13898 13898 13,898 45 625,410
135 Klorpromazin HCI tablet salut 25 mg tablet 2,000 0 2000 570 1430 1430 1,430 170 243,100
136 Kotrimoksazol tablet 480 mg tablet 6,968 3000 9968 554 9414 9414 9,414 158 1,487,412
146 Masker Kain pcs 1,398 500 1898 406 1492 1492 1,492 506 754,952
147 Mata Pisau No. 15 pcs 89 0 89 0 89 89 89 3,300 293,700
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
151 Metilprednisolon tablet 4 mg tablet 1,000 0 1000 200 800 800 800 200 160,000
152 Metformin Hcl 500 mg tablet 691 300 991 301 690 690 300 690 115 79,350
156 Metronidazol tablet 500 mg tablet 3,262 0 3262 372 2890 2890 2,890 140 404,600
158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0
166 Obat anti Tuberklosis kategori FDC I paket 2 0 2 0 2 2 5 2 413,984 827,968
170 OBH Itral Syrup Botol 13 0 13 4 9 9 20 9 16,698 150,282

178 Parasetamol tablet 500 mg tablet 24,267 10000 34267 7781 26486 26486 26,486 145 3,840,470 Des
179 Pehacain injeksi botol 296 100 396 81 315 315 315 4,400 1,386,000 Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 9,820 0 9820 1442 8378 8378 8,378 136 1,139,408
187 Plester 2,5 cm x 4 m rol 12 0 12 1 11 11 10 11 12,076 132,836
188 Plester 7,5 cm x 4 m rol 13 0 13 5 8 8 10 8 35,532 284,256
190 Prednison tablet 5 mg tablet 4,843 5000 9843 2330 7513 7513 7,513 193 1,450,009 Jan
193 Propiltiourasil tablet 100 mg tablet 620 0 620 220 400 400 200 400 320 128,000
195 Ranitidin tablet 150 mg tablet 1,200 0 1200 348 852 852 852 132 112,464 Des
197 Rapid Test VIKIA HIV 1/2 kit 16 0 16 0 16 16 16 525,000 8,400,000 Des
203 Salbutamol tablet 2 mg tablet 1,353 0 1353 154 1199 1199 1,199 99 118,701 Des
207 Sarung Tangan Examination S pcs 1,084 300 1384 912 472 472 472 410 193,520
208 Sarung Tangan Examination M pcs 500 0 500 500 0 0 500 0 410 0
209 Sarung Tangan Examination L pcs 1,600 300 1900 500 1400 1400 1,400 410 574,000
210 Sefadroksil 500 mg kapsul 1,704 0 1704 204 #REF! #REF! #REF! 557 #REF!
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 #REF! #REF! #REF! 102,850 #REF!
212 Setrizin tablet 10 mg tablet 0 0 0 0 #REF! #REF! #REF! 154 #REF!
213 Setrizin syrup Botol 65 0 65 3 #REF! #REF! #REF! 7,756 #REF!
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 5,090 0 5090 240 #REF! #REF! #REF! 58 #REF!
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 140 0 140 0 #REF! #REF! #REF! 1,226 #REF!
216 Simetidine 200 mg tablet 2,000 0 2000 0 #REF! #REF! #REF! 209 #REF! Jan
217 Simvastatin 10 mg tablet 690 0 690 120 #REF! #REF! #REF! 135 #REF!
218 Simvastatin 20 mg tablet 0 0 0 0 #REF! #REF! #REF! 252 #REF!
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 51 0 51 19 #REF! #REF! 50 #REF! 20,825 #REF!
220 Siprofloksasin tablet 500 mg tablet 1,219 500 1719 377 #REF! #REF! #REF! 298 #REF!
221 Spironolakton tablet 100 mg tablet 100 0 100 0 #REF! #REF! #REF! 878 #REF!
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0 #REF! #REF! #REF! 3,549 #REF!
223 Tablet tambah darah kombinasi tablet 6,608 0 6608 2180 #REF! #REF! #REF! 327 #REF! Des
224 Taburia kotak 0 0 0 0 #REF! #REF! #REF! 18,150 #REF!
225 Temporary stopping (Fletcher) buah 0 0 0 0 #REF! #REF! #REF! 37,400 #REF!
226 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 0 0 #REF! #REF! #REF! 162 #REF!
227 Tetrasiklin HCI kapsul 500 mg kapsul 440 0 440 40 #REF! #REF! #REF! 325 #REF!
228 Tiamfenikol 500 mg kapsul 400 0 400 30 #REF! #REF! #REF! 1,452 #REF! Jan
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 30 0 30 0 #REF! #REF! #REF! 1,760 #REF! Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 7,120 0 7120 1206 #REF! #REF! #REF! 91 #REF!
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 0 #REF! #REF! #REF! 97 #REF!
232 Umbilical Cord kotak 178 50 228 8 #REF! #REF! #REF! 3,163 #REF!
233 U-Pad steril 60 cm x 90 cm pcs 77 30 107 13 #REF! #REF! #REF! 8,770 #REF!
234 Urine Bag set 20 0 20 0 #REF! #REF! #REF! 3,450 #REF!
235 Vaksin Jerap Tetanus vial 52 0 52 6 #REF! #REF! #REF! 14,498 #REF!
236 Vaksin Rabies vero kuur 9 0 9 0 #REF! #REF! #REF! 700,000 #REF!
237 Vitamin B kompleks tablet tablet 29,957 5000 34957 3252 #REF! #REF! #REF! 132 #REF!
238 Wicold kapsul kapsul 430 0 430 80 #REF! #REF! #REF! 792 #REF!
239 Yodium povidon larutan 10 % 60 ml Botol 39 0 39 6 #REF! #REF! #REF! 7,040 #REF!
240 Yodium povidon larutan 10 % 300 ml Botol 18 5 23 2 #REF! #REF! #REF! 21,600 #REF!
241 Zinc syrup Botol 0 30 30 0 #REF! #REF! #REF! 8,140 #REF!
242 Zinc Tablet tablet 4,055 0 4055 220 #REF! #REF! #REF! 592 #REF!
243 Paper Tape 2,5 x 9,14 Rol 4 0 4 0 #REF! #REF! #REF! 592 #REF!
244 Paper Tape 7,5 x 9,14 Rol 2 0 2 0 #REF! #REF! #REF! 592 #REF!
245 samcobion Tablet 3,000 3000 6000 400 #REF! #REF! #REF! 592 #REF!
TOTAL #REF!
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
dr Hj Ulianti Hapsa Useng
NIP.197908072007012013 NIP : 198012152010012003

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN SEPTEMBER
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 163 0 163 57 106 106 106 7,500 795,000
9 Alat Suntik sekali pakai 0,5 ml set 1,341 0 1341 210 1131 1131 1,131 1,240 1,402,440
12 Alat suntik sekali pakai 5 ml set 1,071 0 1071 7 1064 1064 1,064 863 918,232
16 Alupurinol tablet 100 mg tablet 677 500 1177 377 800 800 500 800 95 76,000
19 Ambroxol tablet tablet 180 0 180 390 -210 -210 500 -210 216 -45,360 Des

22 Amitriptilin HCI tablet salut 25 mg tablet 1,000 0 1000 0 1000 1000 1,000 165 165,000

27 Amoksisilin kapsul 250 mg Kapsul 5,226 0 5226 316 4910 4910 4,910 207 1,016,370
28 Amoksisilin kaplet 500 mg kaplet 29,932 0 29932 3588 26344 26344 26,344 233 6,138,152
31 Antalgin (Metampiron) tablet 500 mg Tablet 1,630 0 1630 0 1630 1630 1,630 209 340,670 Des
33 Antasida DOEN tablet kombinasi tablet 6,945 0 6945 1655 5290 5290 5,290 64 338,560
40 Asam Askorbat (Vit C) tablet 50 mg tablet 17,770 0 17770 5452 12318 12318 12,318 120 1,478,160
41 Asam Folat tablet 1,120 0 1120 280 840 840 840 68 57,120
42 Asam Mefenamat tablet 500 mg tablet 13,093 0 13093 2158 10935 10935 10,935 122 1,334,070 Des

61 Deksametason tablet 0,5 mg tablet 7,694 0 7694 1542 6152 6152 6,152 48 295,296
76 E t a n o l 70 % 100 ml Botol 143 0 143 8 135 135 135 2,625 354,375
81 Fervital Kapsul kapsul 3,670 0 3670 770 2900 2900 2,900 861 2,496,900

87 Garam Oralit untuk 200 ml Air sak 1,559 0 1559 399 1160 1160 1,160 274 317,840
91 Glibenklamid tablet 5 mg tablet 2,876 0 2876 121 2755 2755 2,755 110 303,050 Des
94 Guaiafenesin Tablet tablet 14,391 0 14391 2952 11439 11439 11,439 132 1,509,948 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 1,489 0 1489 105 1384 1384 1,384 523 723,140 Des
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 1,647 0 1647 310 1337 1337 1,337 171 228,627
104 Ibuprofen tablet 200 mg tablet 9,362 0 9362 1142 8220 8220 8,220 111 912,420
112 Kalsium laktat (Kalk) tablet 500 mg tablet 8,120 0 8120 1130 6990 6990 6,990 69 482,310
116 Kaptopril 12,5 mg tablet 523 0 523 376 147 147 500 147 69 10,143
117 Kaptopril 25 mg tablet 5,000 0 5000 0 5000 5000 5,000 165 825,000 Des
118 Karbamazepin tablet 200 mg tablet 2,000 0 2000 0 2000 2000 2,000 306 612,000
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1,213 0 1213 21 1192 1192 1,192 1,725 2,056,200
130 Klorfeniramin maleat tablet 4 mg tablet 11,992 0 11992 2394 9598 9598 9,598 45 431,910
135 Klorpromazin HCI tablet salut 25 mg tablet 1,300 0 1300 570 730 730 730 170 124,100
136 Kotrimoksazol tablet 480 mg tablet 8,168 0 8168 554 7614 7614 7,614 158 1,203,012
146 Masker Kain pcs 1,348 0 1348 406 942 942 942 506 476,652
147 Mata Pisau No. 15 pcs 89 0 89 0 89 89 89 3,300 293,700
148 Mata Pisau No. 20 pcs 100 0 100 0 100 100 100 3,300 330,000
156 Metronidazol tablet 500 mg tablet 2,662 0 2662 372 2290 2290 2,290 140 320,600
158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0
166 Obat anti Tuberklosis kategori FDC I paket 2 5 7 0 7 7 5 7 413,984 2,897,888

177 Parasetamol sirup 120 mg / 5 ml Botol 73 0 73 116 -43 -43 100 -43 1,119 -48,117 Des
178 Parasetamol tablet 500 mg tablet 23,267 0 23267 7781 15486 15486 15,486 145 2,245,470 Des
179 Pehacain injeksi botol 316 0 316 81 235 235 235 4,400 1,034,000 Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 8,020 0 8020 1442 6578 6578 6,578 136 894,608
187 Plester 2,5 cm x 4 m rol 9 10 19 1 18 18 10 18 12,076 217,368
188 Plester 7,5 cm x 4 m rol 8 10 18 5 13 13 10 13 35,532 461,916
190 Prednison tablet 5 mg tablet 7,343 0 7343 2330 5013 5013 5,013 193 967,509 Jan
195 Ranitidin tablet 150 mg tablet 600 0 600 348 252 252 252 132 33,264 Des
197 Rapid Test VIKIA HIV 1/2 kit 16 0 16 0 16 16 16 525,000 8,400,000 Des
203 Salbutamol tablet 2 mg tablet 1,153 0 1153 154 999 999 999 99 98,901 Des

207 Sarung Tangan Examination S pcs 384 0 384 912 -528 -528 -528 410 -216,480
208 Sarung Tangan Examination M pcs 0 500 500 500 0 0 500 0 410 0
209 Sarung Tangan Examination L pcs 1,300 0 1300 500 800 800 800 410 328,000
210 Sefadroksil 500 mg kapsul 1,604 0 1604 204 1400 1400 1,400 557 779,800
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 4,690 0 4690 240 4450 4450 4,450 58 258,100
216 Simetidine 200 mg tablet 2,000 0 2000 0 2000 2000 2,000 209 418,000 Jan
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 39 36 75 19 56 56 50 56 20,825 1,166,200
220 Siprofloksasin tablet 500 mg tablet 1,419 0 1419 377 1042 1042 1,042 298 310,516
223 Tablet tambah darah kombinasi tablet 5,538 0 5538 2180 3358 3358 3,358 327 1,097,059 Des
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 4,420 0 4420 1206 3214 3214 3,214 91 292,474
234 Urine Bag set 20 0 20 0 20 20 20 3,450 69,000

237 Vitamin B kompleks tablet tablet 29,857 0 29857 3252 26605 26605 26,605 132 3,511,860
238 Wicold kapsul kapsul 30 0 30 80 -50 -50 -50 792 -39,600
241 Zinc syrup Botol 30 0 30 0 30 30 30 8,140 244,200
242 Zinc Tablet tablet 3,455 0 3455 220 3235 3235 3,235 592 1,915,120
243 Paper Tape 2,5 x 9,14 Rol 4 0 4 0 4 4 4 592 2,368
244 Paper Tape 7,5 x 9,14 Rol 2 0 2 0 2 2 2 592 1,184
245 samcobion Tablet 3,700 0 3700 400 3300 3300 3,300 592 1,953,600
TOTAL 98,303,540
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
dr Hj Ulianti Hapsa Useng
NIP.197908072007012013 NIP : 198012152010012003

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN JUNI
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set 279 279 1 278 278 278 5,203 1,446,434
5 Ansell Steril 6 1/2 psg 384 384 0 384 384 384 7,500 2,880,000
6 Ansell Steril 7 psg 464 464 51 413 413 413 7,500 3,097,500
7 Ansell Steri 7 1/2 psg 348 348 60 288 288 288 7,500 2,160,000
10 Alat suntik sekali pakai 1 ml set 5716 5716 30 5686 5686 5,686 748 4,253,128
13 Alat Suntik sekali pakai 10 ml set 200 200 0 200 200 200 1,064 212,800
14 Albendasol tablet 400 mg tablet 0 0 0 0 0 0 425 0
15 Alkohol Swab kotak 200 200 0 200 200 200 115 23,000
16 Alupurinol tablet 100 mg tablet 1611 1611 321 1290 1290 1,290 95 122,550
17 Allpurinol tablet 300 mg tablet 130 130 90 40 40 40 244 9,760
18 Ambroxol sirup 15 mg/ml Botol 168 168 20 148 148 148 5,500 814,000 Des
19 Ambroxol tablet tablet 1160 1160 350 810 810 810 216 174,960 Des
20 Aminofilin tablet 200 mg tablet 0 0 0 0 0 0 86 0

21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 6 6 0 6 6 6 3,349 20,094
22 Amitriptilin HCI tablet salut 25 mg tablet 1000 1000 0 1000 1000 1,000 165 165,000

26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 40 40 3 37 37 37 4,147 153,439
27 Amoksisilin kapsul 250 mg Kapsul 6853 6853 480 6373 6373 6,373 207 1,319,211
28 Amoksisilin kaplet 500 mg kaplet 22065 22065 2285 19780 19780 19,780 233 4,608,740
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0 0 0 4,600 0
30 Anagens Syrup Botol 23 23 0 23 23 23 19,800 455,400
31 Antalgin (Metampiron) tablet 500 mg Tablet 1730 1730 0 1730 1730 1,730 209 361,570 Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0 0 0 1,500 0
33 Antasida DOEN tablet kombinasi tablet 15068 15068 1948 13120 13120 13,120 64 839,680
34 Antasida DOEN suspensi Botol 88 88 9 79 79 79 2,106 166,374
35 Antihemoroid DOEN kombinasi suppos 77 77 16 61 61 61 3,502 213,622
36 Antifungi DOEN kombinasi pot 24 24 0 24 24 24 4,782 114,768
37 Antibakteri DOEN salep Kombinasi tube 0 0 0 0 0 0 2,767 0
38 Antimigrain DOEN kombinasi tablet 215 215 0 215 215 215 149 32,035
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0 0 0 5,800 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 17043 17043 4077 12966 12966 12,966 120 1,555,920
41 Asam Folat tablet 1660 1660 170 1490 1490 1,490 68 101,320
42 Asam Mefenamat tablet 500 mg tablet 12124 12124 1494 10630 10630 10,630 122 1,296,860 Des
43 Asiklovir 200 mg tablet 590 590 16 574 574 574 272 156,128
45 Asiklovir krim 5% tablet 25 25 0 25 25 25 3,960 99,000 Des
46 Asetosal tablet 100 mg tabet 100 100 0 100 100 100 110 11,000
47 Attalpulgit tablet 0 0 0 0 0 0 173 0 EXP
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 8 8 0 8 8 8 1,672 13,376
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 0 0 0 75 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0 0 0 156,072 0

51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 0 0 234,238 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0 0 0 129,210 0

55 Bisakodil 5 mg supp suppos 16 16 6 10 10 10 5,670 56,700
57 Blood Lancet 26G kotak 50 50 0 50 50 50 160 8,000
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 28 28 0 28 28 28 1,740 48,720
61 Deksametason tablet 0,5 mg tablet 14886 14886 2035 12851 12851 12,851 48 616,848
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 0 2,578 0
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 0 0 0 0 104 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 30 30 0 30 30 30 1,354 40,620 EXP
68 Digoksin tablet 0,25 mg tablet 100 100 0 100 100 100 108 10,800
69 Doksisilin kapsul 100 mg Kapsul 0 0 0 0 0 0 309 0
71 Domperidom tablet tablet 300 300 0 300 300 300 451 0 Jan
72 Efedrin HCI tablet 25 mg tablet 0 0 0 0 0 0 56 0
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 0 0 0 42 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 0 8,910 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 10 10 1 9 9 9 3,600 32,400
76 E t a n o l 70 % 100 ml Botol 225 225 22 203 203 203 2,625 532,875
77 Etil klorida semprot Botol 0 0 0 0 0 0 115,500 0
78 Eugenol cairan botol 0 0 0 0 0 0 18,333 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 29 29 0 29 29 29 1,980 57,420
80 Fenobarbital tablet 30 mg tablet 0 0 0 0 0 0 74 0
81 Fervital Kapsul kapsul 3860 3860 570 3290 3290 3,290 861 2,832,690
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 154 154 30 124 124 124 3,754 465,496 EXP
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 332 332 10 322 322 322 796 256,312
84 Foly Catheter No. 18 pcs 9 9 0 9 9 9 9,200 82,800

86 Furosemid tablet 40 mg tablet 114 114 11 103 103 103 84 8,652
88 Gentamicin inj 40mg/ml Ampul 25 25 0 25 25 25 3,545 88,625 EXP
89 Gentian Violet larutan 1 % Botol 7 7 0 7 7 7 3,850 26,950 Jan
90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 0 0 434,500 0
91 Glibenklamid tablet 5 mg tablet 3120 3120 75 3045 3045 3,045 110 334,950 Des
92 Glimepiride 1 mg tablet 210 210 10 200 200 200 220 44,000
94 Guaiafenesin Tablet tablet 14950 14950 1395 13555 13555 13,555 132 1,789,260 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 2164 2164 64 2100 2100 2,100 523 1,097,250 Des
97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 0 76 0 Des
98 Haloperidol tablet 2 mg tablet 0 0 0 0 0 0 134 0
99 Haloperidol inj 50 mg/ml ampul 0 0 0 0 0 0 91,667 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 769 769 107 662 662 662 171 113,202
102 Ibuprofen suspensi 100 mg/5 ml Botol 16 16 3 13 13 13 8,000 104,000
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 0 0 0 8,800 0 Des
104 Ibuprofen tablet 200 mg tablet 3848 3848 985 2863 2863 3,000 2,863 111 317,793
105 Ibuprofen tablet 400 mg tablet 1115 1115 80 1035 1035 1,035 133 137,655
106 Infusion set anak pcs 96 96 0 96 96 96 4,025 386,400
108 Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 82 0
109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 0 0 0 0 98 0
110 Kalsium Glukonat inj 10% ampul 0 0 0 0 0 0 999 0
111 Kalsium Hidroksida pasta buah 0 0 0 0 0 0 266,200 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 9624 9624 1828 7796 7796 3,000 7,796 69 537,924
113 Kapas pembalut 250 gram buah 8 8 0 8 8 8 14,375 115,000
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 0 0 0 0 31,372 0
115 Kapas pembalut / Absorben 1000 gram bungkus 2 2 0 2 2 2 62,744 125,488
116 Kaptopril 12,5 mg tablet 2387 2387 255 2132 2132 2,132 69 147,108
117 Kaptopril 25 mg tablet 2176 2176 1376 800 800 3,000 800 165 132,000 Des
118 Karbamazepin tablet 200 mg tablet 0 0 0 0 0 0 306 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1442 1442 44 1398 1398 1,398 1,725 2,411,550
121 Kasa pembalut elastis 3 inch roll 10 10 0 10 10 10 7,700 77,000
123 Ketokonazol tablet 200 mg tablet 500 500 0 500 500 500 264 132,000 Des
124 Kloramfenikol kapsul 250 mg Kapsul 480 480 1 479 479 479 616 295,064 Des
125 Kloramfenikol susp 125mg/5 ml Botol 102 102 1 101 101 101 4,000 404,000
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 8,250 0 Des
128 Kloramfenikol salep Kulit 2% tube 22 22 6 16 16 16 3,409 54,544
129 Kloramfenikol tetes telinga 3 % Botol 14 14 0 14 14 14 8,250 115,500 Des
130 Klorfeniramin maleat tablet 4 mg tablet 11300 11300 1340 9960 9960 9,960 45 448,200
131 Klorokuin tablet 150 mg tablet 0 0 0 0 0 0 112 0
132 Klorfenol Kamfer Menthol Botol 0 0 0 0 0 0 60,500 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0 0 0 1,045 0 EXP
134 Klorpromazin HCI tablet salut 100 mg tablet 0 0 0 0 0 0 179 0
136 Kotrimoksazol tablet 480 mg tablet 3672 3672 754 2918 2918 2,918 158 461,044
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 390 0 390 390 390 138 53,625 Jan
139 Larutan mengandung elektrolit botol 78 78 0 78 78 78 9,275 723,450
140 Lidokain komp. injeksi - 2 ml ampul 72 72 5 67 67 67 2,122 142,174
142 Loperamide 2 mg tablet 65 65 65 0 0 0 90 0
143 Loratadine 10 mg tablet 450 450 0 450 450 450 149 67,050
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 0 0 1,694 0 Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 6 6 0 6 6 6 2,143 12,858 Des
146 Masker Kain pcs 1155 1155 364 791 791 791 506 400,246
147 Mata Pisau No. 15 pcs 89 89 0 89 89 89 3,300 293,700
148 Mata Pisau No. 20 pcs 100 100 0 100 100 100 3,300 330,000
149 Metilergometrin maleat tablet salut 0,125 mg tablet 0 0 0 0 0 0 133 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 91 91 0 91 91 91 2,684 244,244
151 Metilprednisolon tablet 4 mg tablet 1000 1000 0 1000 1000 1,000 200 200,000
152 Metformin Hcl 500 mg tablet 1390 1390 290 1100 1100 1,100 115 126,500
153 Metoklopramida 10 mg tablet 0 0 0 0 0 1,000 0 100 0
154 Metoklopramida injeksi 5 mg / ml vial 49 49 4 45 45 45 6,600 297,000 Jan
156 Metronidazol tablet 500 mg tablet 4538 4538 310 4228 4228 4,228 140 591,920
157 Miconazole Krim tube 82 82 19 63 63 63 3,737 235,431
158 Mineral Mix sak 0 0 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 61 61 14 47 47 47 37,400 1,757,800 Des
160 Mummifying pasta buah 0 0 0 0 0 0 193,600 0
161 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0 161 0
163 Nifedipin 10 mg tablet 112 112 10 102 102 102 123 12,546
164 Nistatin tablet vagina 100.000 IU / g ovula 90 90 3 87 87 87 602 52,374
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 0 0 0 0 0 704 0
166 Obat anti Tuberklosis kategori FDC I paket 1 1 0 1 1 4 1 413,984 413,984
168 Obat anti Tuberklosis kategori FDC Anak paket 1 1 0 1 1 1 236,500 236,500
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0 4,400 0 Des
170 OBH Itral Syrup Botol 13 13 0 13 13 13 16,698 217,074

171 Ofloksasin tablet 400 mg tablet 0 0 0 0 0 0 636 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0 0 0 1,869 0
173 Oksitetrasiklin HCI salep mata 1 % tube 25 25 0 25 25 25 3,300 82,500 Des
175 Omeprazole 20 mg kapsul 600 600 140 460 460 460 880 0 Jan
178 Parasetamol tablet 500 mg tablet 18676 18676 6292 12384 12384 10,000 12,384 145 1,795,680 Des
180 Permetrin krim 5% tube 6 6 0 6 6 6 12,155 72,930
181 Pirantel pamoat tablet 125 mg tablet 253 253 4 249 249 249 318 79,182 EXP
182 Pirantel suspensi 10 ml botol 0 0 0 0 0 0 17,600 0 EXP
183 Pirantel suspensin 60 ml Botol 9 9 0 9 9 9 9,100 81,900 Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 17425 17425 1475 15950 15950 15,950 136 2,169,200
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 100 100 0 100 100 100 1,030 103,000
186 Piroksikam 20 mg tablet 90 90 76 14 14 14 220 3,080 Des
187 Plester 2,5 cm x 4 m rol 20 20 5 15 15 15 12,076 181,140
188 Plester 7,5 cm x 4 m rol 20 20 4 16 16 16 35,532 568,512
189 Pot Sputum pcs 286 286 21 265 265 265 3,190 0 Des
190 Prednison tablet 5 mg tablet 4039 4039 1839 2200 2200 3,000 2,200 193 424,600 Jan
191 Primakuin tablet 15 mg tablet 0 0 0 0 0 0 120 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 30 30 0 30 30 30 9,908 297,240
193 Propiltiourasil tablet 100 mg tablet 1152 1152 252 900 900 900 320 288,000
194 Propranolol HCI tablet 40 mg tablet 300 300 0 300 300 300 69 20,700
195 Ranitidin tablet 150 mg tablet 730 730 330 400 400 1,000 400 132 52,800 Des
196 Ranitidin injeksi 25 mg/2 ml ampul 30 30 10 20 20 20 1,600 32,000
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0 525,000 0 Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 0 0 0 14,344 0
199 Reagensia ZN botol 0 0 0 0 0 0 270,000 0
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 0 0 0 0 0 327 0
203 Salbutamol tablet 2 mg tablet 882 882 190 692 692 692 99 68,508 Des
204 Salbutamol 4 mg tablet 200 200 0 200 200 200 88 17,600
205 Salep 2 - 4 kombinasi pot 58 58 0 58 58 58 2,797 162,226

208 Sarung Tangan Examination M pcs 500 500 500 0 0 1,000 0 410 0
209 Sarung Tangan Examination L pcs 1000 1000 200 800 800 800 410 328,000
210 Sefadroksil 500 mg kapsul 2000 2000 0 2000 2000 2,000 557 1,114,000
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 0 0 102,850 0
212 Setrizin tablet 10 mg tablet 0 0 0 0 0 0 154 0
213 Setrizin syrup Botol 72 72 5 67 67 67 7,756 519,652
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 6020 6020 230 5790 5790 5,790 58 335,820
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 140 140 0 140 140 140 1,226 171,640
216 Simetidine 200 mg tablet 2000 2000 0 2000 2000 2,000 209 418,000 Jan
218 Simvastatin 20 mg tablet 30 30 30 0 0 0 252 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 84 84 6 78 78 78 20,825 1,624,350
220 Siprofloksasin tablet 500 mg tablet 856 856 146 710 710 500 710 298 211,580
221 Spironolakton tablet 100 mg tablet 100 100 0 100 100 100 878 87,800
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0 0 0 3,549 0
223 Tablet tambah darah kombinasi tablet 12013 12013 2260 9753 9753 9,753 327 3,186,305 Des
224 Taburia kotak 0 0 0 0 0 0 18,150 0
225 Temporary stopping (Fletcher) buah 0 0 0 0 0 0 37,400 0
226 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 0 0 0 0 162 0
227 Tetrasiklin HCI kapsul 500 mg kapsul 500 500 0 500 500 500 325 162,500
228 Tiamfenikol 500 mg kapsul 190 190 30 160 160 160 1,452 232,320 Jan
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 30 30 0 30 30 30 1,760 52,800 Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 16355 16355 1910 14445 14445 14,445 91 1,314,495
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 0 0 0 97 0
234 Urine Bag set 12 12 1 11 11 11 3,450 37,950
236 Vaksin Rabies vero kuur 12 12 0 12 12 12 700,000 8,400,000

237 Vitamin B kompleks tablet tablet 28380 28380 1767 26613 26613 26,613 132 3,512,916
241 Zinc syrup Botol 0 0 0 0 0 0 8,140 0
242 Zinc Tablet tablet 5501 5501 299 5202 5202 5,202 592 3,079,584
43358
TOTAL 95,699,745
jumlah resep
JKN 440 1377 pustu simpo 29 82 11 30 112
Lain - lain 3 9 pustu tonrong 39 98 98
pustu trong rijang 114 339 339
Jamkesda 99 294 pkesdes baranti 0
JKN 5 12 pkesdes passeno 0
Lain - lain pkesdes trong 0
pkesdes trong rijang 0
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 182 519 11 0 549

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

( L P L P O ) JKD
KODE PUSKESMAS :
KECAMATAN : TGL :31-8-2017 BULAN AGUSTUS
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0 7,500 0






76 E t a n o l 70 % 100 ml Botol 2 0 2 0 2 0 2,625 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 4 0 4 0 4 0 3,754 0


94 Guaiafenesin Tablet tablet 0 132 0 Des






146 Masker Kain pcs 15 0 15 5 10 0 506 0





187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 35,532 0







TOTAL 0
###
JKN
Lain - lain

Jamkesda
JKN
Lain - lain
TOTAL TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
(LPLPO)
KODE PUSKESMAS :
KECAMATAN : TGL :31 AGUSTUS 2017 BULAN 8
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 1 1 1 0 0 7,500 0






76 E t a n o l 70 % 100 ml Botol 5 5 1 4 0 2,625 0



107 Infusion set dewasa pcs 8 8 8 0 3,680 0




147 Mata Pisau No. 15 pcs 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 3,300 0




187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 35,532 0




233 U-Pad steril 60 cm x 90 cm pcs 5 5 5 0 8,770 0
234 Urine Bag set 0 0 3,450 0

TOTAL 0
###
GENERIK
NON GENERIK
JKN
Lain - lain
Jamkesda
JKN
Lain - lain
TOTAL TOTAL

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
(LPLPO)
KODE PUSKESMAS :
KECAMATAN : BARANTI TGL : 31-Aug-17 BULAN 8
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
6 Ansell Steril 7 psg 6 6 3 3 3 3 7,500 22,500
7 Ansell Steri 7 1/2 psg 1 1 1 0 0 0 7,500 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
28 Amoksisilin kaplet 500 mg kaplet 282 282 145 137 137 137 233 31,921

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
54 Betametason krim 0.1 % tube 0 0 0 0 1,435 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

76 E t a n o l 70 % 100 ml Botol 9 9 1 8 8 8 2,625 21,000

94 Guaiafenesin Tablet tablet 0 0 0 0 132 0 Des

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
126 Kloramfenikol salep mata 1 % tube 0 0 0 0 1,850 0
130 Klorfeniramin maleat tablet 4 mg tablet 0 0 0 0 45 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

146 Masker Kain pcs 0 0 0 0 506 0
147 Mata Pisau No. 15 pcs 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 3,300 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

158 Mineral Mix sak 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 2 2 0 2 2 2 37,400 74,800 Des
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 0 0 0 1,900 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
178 Parasetamol tablet 500 mg tablet 350 350 106 244 244 244 145 35,380 Des
187 Plester 2,5 cm x 4 m rol 0 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 35,532 0
190 Prednison tablet 5 mg tablet 0 0 0 0 193 0 Jan

NO. NAMA OBAT JMLH
SATUAN HARGA
KET

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
223 Tablet tambah darah kombinasi tablet 515 515 250 265 265 265 327 86,576 Des
224 Taburia kotak 0 0 0 0 18,150 0

NO. NAMA OBAT JMLH
SATUAN HARGA
KET
233 U-Pad steril 60 cm x 90 cm pcs 3 3 1 2 2 2 8,770 17,540
234 Urine Bag set 0 0 0 0 3,450 0
237 Vitamin B kompleks tablet tablet 604 604 141 463 463 463 132 61,116
241 Zinc syrup Botol 0 0 0 0 8,140 0

TOTAL ###
###
JKN
Lain - lain
Jamkesda
JKN
Lain - lain
TOTAL TOTAL
NO. NAMA OBAT JMLH
SATUAN HARGA
KET
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
KODE PUSKESMAS :
KECAMATAN : BARANTI TGL :31-8-2017 BULAN AGUSTUS
NO. NAMA OBAT JMLH
SATUAN HARGA KET
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 0 5 5 0 7,500 0






76 E t a n o l 70 % 100 ml Botol 0 0 2,625 0
87 Garam Oralit untuk 200 ml Air sak 70 70 6 64 EXP 0 274 0







146 Masker Kain pcs 45 45 2 43 0 506 0
147 Mata Pisau No. 15 pcs 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 3,300 0




187 Plester 2,5 cm x 4 m rol 1 1 1 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 35,532 0




234 Urine Bag set 0 0 3,450 0

TOTAL 0
###
Jamkesda 21 59
JKN 14 43
Jamkesda
JKN
Lain - lain
TOTAL 35 TOTAL
NIP. NIP : 19780301 200502 2 009

5000
196
190
122
3600
133
3500
74
8000
8000
125
3200
3650
6000
1319900
221
7,350
58
175
132
487500
190
1320
1600
(LPLPO)
KECAMATAN : BARANTI TGL : BULAN JUNI
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set 279 279 #REF! #REF! #REF! #REF! 5,203 #REF!
2 IV Catheter Gea No. 20 set 145 145 #REF! #REF! #REF! 100 #REF! 4,370 #REF!
5 Ansell Steril 6 1/2 psg 384 384 #REF! #REF! #REF! #REF! 7,500 #REF!
6 Ansell Steril 7 psg 464 464 #REF! #REF! #REF! #REF! 7,500 #REF!
7 Ansell Steri 7 1/2 psg 348 348 #REF! #REF! #REF! #REF! 7,500 #REF!
8 Alat Suntik sekali pakai 0,05 ml set 0 0 #REF! #REF! #REF! 100 #REF! 1,650 #REF!
9 Alat Suntik sekali pakai 0,5 ml set 745 745 #REF! #REF! #REF! #REF! 1,240 #REF!
10 Alat suntik sekali pakai 1 ml set 5716 5716 #REF! #REF! #REF! #REF! 748 #REF!
13 Alat Suntik sekali pakai 10 ml set 200 200 #REF! #REF! #REF! #REF! 1,064 #REF!
14 Albendasol tablet 400 mg tablet 0 0 #REF! #REF! #REF! #REF! 425 #REF!
15 Alkohol Swab kotak 200 200 #REF! #REF! #REF! #REF! 115 #REF!
16 Alupurinol tablet 100 mg tablet 1611 1611 #REF! #REF! #REF! #REF! 95 #REF!
17 Allpurinol tablet 300 mg tablet 130 130 #REF! #REF! #REF! #REF! 244 #REF!
18 Ambroxol sirup 15 mg/ml Botol 168 168 #REF! #REF! #REF! #REF! 5,500 #REF! Des
19 Ambroxol tablet tablet 1160 1160 #REF! #REF! #REF! #REF! 216 #REF! Des
20 Aminofilin tablet 200 mg tablet 0 0 #REF! #REF! #REF! #REF! 86 #REF!

21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 6 6 #REF! #REF! #REF! #REF! 3,349 #REF!
22 Amitriptilin HCI tablet salut 25 mg tablet 1000 1000 #REF! #REF! #REF! #REF! 165 #REF!
23 Amlodipine 5 mg tablet 2 2 #REF! #REF! #REF! 900 #REF! 105 #REF!

24 Amlodipine 10 mg tablet 90 90 #REF! #REF! #REF! 900 #REF! 163 #REF!
25 Amoksisilin sirup kering 125 mg/5 ml Botol 210 210 #REF! #REF! #REF! #REF! 2,200 #REF!
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 40 40 #REF! #REF! #REF! #REF! 4,147 #REF!
27 Amoksisilin kapsul 250 mg Kapsul 6853 6853 #REF! #REF! #REF! #REF! 207 #REF!
28 Amoksisilin kaplet 500 mg kaplet 22065 22065 #REF! #REF! #REF! #REF! 233 #REF!
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 #REF! #REF! #REF! #REF! 4,600 #REF!
30 Anagens Syrup Botol 23 23 #REF! #REF! #REF! #REF! 19,800 #REF!
31 Antalgin (Metampiron) tablet 500 mg Tablet 1730 1730 #REF! #REF! #REF! #REF! 209 #REF! Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 #REF! #REF! #REF! #REF! 1,500 #REF!
33 Antasida DOEN tablet kombinasi tablet 15068 15068 #REF! #REF! #REF! #REF! 64 #REF!
34 Antasida DOEN suspensi Botol 88 88 #REF! #REF! #REF! #REF! 2,106 #REF!
35 Antihemoroid DOEN kombinasi suppos 77 77 #REF! #REF! #REF! #REF! 3,502 #REF!
36 Antifungi DOEN kombinasi pot 24 24 #REF! #REF! #REF! #REF! 4,782 #REF!
37 Antibakteri DOEN salep Kombinasi tube 0 0 #REF! #REF! #REF! #REF! 2,767 #REF!
38 Antimigrain DOEN kombinasi tablet 215 215 #REF! #REF! #REF! #REF! 149 #REF!
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 #REF! #REF! #REF! #REF! 5,800 #REF!
40 Asam Askorbat (Vit C) tablet 50 mg tablet 17043 17043 #REF! #REF! #REF! #REF! 120 #REF!
41 Asam Folat tablet 1660 1660 #REF! #REF! #REF! #REF! 68 #REF!
42 Asam Mefenamat tablet 500 mg tablet 12124 12124 #REF! #REF! #REF! #REF! 122 #REF! Des
43 Asiklovir 200 mg tablet 590 590 #REF! #REF! #REF! #REF! 272 #REF!
44 Asiklovir 400 mg tablet 200 200 #REF! #REF! #REF! #REF! 381 #REF!
45 Asiklovir krim 5% tablet 25 25 #REF! #REF! #REF! #REF! 3,960 #REF! Des
46 Asetosal tablet 100 mg tabet 100 100 #REF! #REF! #REF! #REF! 110 #REF!
47 Attalpulgit tablet 0 0 #REF! #REF! #REF! #REF! 173 #REF! EXP
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 8 8 #REF! #REF! #REF! #REF! 1,672 #REF!
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 #REF! #REF! #REF! #REF! 75 #REF!
50 Benecheck plus Glucose test strip 50's box 0 0 #REF! #REF! #REF! #REF! 156,072 #REF!
51 Benecheck plus Cholesterol test strip 50's box 0 0 #REF! #REF! #REF! #REF! 234,238 #REF!
52 Benecheck plus Uric test strip 50's box 0 0 #REF! #REF! #REF! #REF! 129,210 #REF!
53 Betahistin maleat 24 mg tablet 0 0 #REF! #REF! #REF! 500 #REF! 1,210 #REF! Des
54 Betametason krim 0.1 % tube 51 51 #REF! #REF! #REF! 100 #REF! 1,435 #REF!
55 Bisakodil 5 mg supp suppos 16 16 #REF! #REF! #REF! #REF! 5,670 #REF!
56 Bisakodil 10 mg supp suppos 12 12 #REF! #REF! #REF! #REF! 5,800 #REF!
57 Blood Lancet 26G kotak 50 50 #REF! #REF! #REF! #REF! 160 #REF!
58 Catgut/benang bedah no .2/0 pcs 0 0 #REF! #REF! #REF! #REF! 33,925 #REF!
59 Catgut/benang bedah no .3/0 pcs 201 201 #REF! #REF! #REF! 72 #REF! 6,421 #REF!
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 28 28 #REF! #REF! #REF! #REF! 1,740 #REF!
61 Deksametason tablet 0,5 mg tablet 14886 14886 #REF! #REF! #REF! #REF! 48 #REF!
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 #REF! #REF! #REF! #REF! 2,578 #REF!
63 Diazepam rectal 5mg/2,5 ml buah 0 0 #REF! #REF! #REF! 5 #REF! 12,749 #REF!
64 Diazepam tablet 2 mg tablett 0 0 #REF! #REF! #REF! 500 #REF! 134 #REF!
65 Diazepam tablet 5 mg tablet 0 0 #REF! #REF! #REF! #REF! 65 #REF!
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 #REF! #REF! #REF! #REF! 104 #REF!
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 30 30 #REF! #REF! #REF! #REF! 1,354 #REF! EXP
68 Digoksin tablet 0,25 mg tablet 100 100 #REF! #REF! #REF! #REF! 108 #REF!
69 Doksisilin kapsul 100 mg Kapsul 0 0 #REF! #REF! #REF! #REF! 309 #REF!
70 Domperidom suspensi Botol 33 33 #REF! #REF! #REF! 30 #REF! 3,180 #REF!
71 Domperidom tablet tablet 300 300 #REF! #REF! #REF! #REF! 451 0 Jan
72 Efedrin HCI tablet 25 mg tablet 0 0 #REF! #REF! #REF! #REF! 56 #REF!
73 Ekstrak Belladon tablet 10 mg tablet 0 0 #REF! #REF! #REF! #REF! 42 #REF!
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 #REF! #REF! #REF! #REF! 8,910 #REF!
75 Etakridin (Rivanol) larutan 0,1 % Botol 10 10 #REF! #REF! #REF! #REF! 3,600 #REF!
76 E t a n o l 70 % 100 ml Botol 225 225 #REF! #REF! #REF! #REF! 2,625 #REF!
77 Etil klorida semprot Botol 0 0 #REF! #REF! #REF! #REF! 115,500 #REF!
78 Eugenol cairan botol 0 0 #REF! #REF! #REF! #REF! 18,333 #REF!
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 29 29 #REF! #REF! #REF! #REF! 1,980 #REF!
80 Fenobarbital tablet 30 mg tablet 0 0 #REF! #REF! #REF! #REF! 74 #REF!
81 Fervital Kapsul kapsul 3860 3860 #REF! #REF! #REF! #REF! 861 #REF!
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 154 154 #REF! #REF! #REF! #REF! 3,754 #REF! EXP
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 332 332 #REF! #REF! #REF! #REF! 796 #REF!
84 Foly Catheter No. 18 pcs 9 9 #REF! #REF! #REF! #REF! 9,200 #REF!
85 Foly Catheter No. 20 pcs 7 7 #REF! #REF! #REF! #REF! 9,200 #REF!
86 Furosemid tablet 40 mg tablet 114 114 #REF! #REF! #REF! #REF! 84 #REF!
87 Garam Oralit untuk 200 ml Air sak 1356 1356 #REF! #REF! #REF! #REF! 274 #REF!
88 Gentamicin inj 40mg/ml Ampul 25 25 #REF! #REF! #REF! #REF! 3,545 #REF! EXP
89 Gentian Violet larutan 1 % Botol 7 7 #REF! #REF! #REF! #REF! 3,850 #REF! Jan
90 Glass lonomer Cement (GC IX ) buah 0 0 #REF! #REF! #REF! #REF! 434,500 #REF!
91 Glibenklamid tablet 5 mg tablet 3120 3120 #REF! #REF! #REF! #REF! 110 #REF! Des
92 Glimepiride 1 mg tablet 210 210 #REF! #REF! #REF! #REF! 220 #REF!
93 Glimepiride 2 mg tablet 100 100 #REF! #REF! #REF! #REF! 297 #REF!
94 Guaiafenesin Tablet tablet 14950 14950 #REF! #REF! #REF! #REF! 132 #REF! Des
95 Glukosa larutan infus 5 % steril Botol 106 106 #REF! #REF! #REF! #REF! 6,900 #REF!
96 Grisefulvin tablet 125 mg (Micronized) tablet 2164 2164 #REF! #REF! #REF! #REF! 523 #REF! Des
97 Haloperidol tablet 1,5 mg tablet 0 0 #REF! #REF! #REF! #REF! 76 #REF! Des
98 Haloperidol tablet 2 mg tablet 0 0 #REF! #REF! #REF! #REF! 134 #REF!
99 Haloperidol inj 50 mg/ml ampul 0 0 #REF! #REF! #REF! #REF! 91,667 #REF!
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 769 769 #REF! #REF! #REF! #REF! 171 #REF!
101 Hidrokortison krim 2,5 % tube 16 16 #REF! #REF! #REF! 100 #REF! 2,812 #REF!
102 Ibuprofen suspensi 100 mg/5 ml Botol 16 16 #REF! #REF! #REF! #REF! 8,000 #REF!
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 #REF! #REF! #REF! #REF! 8,800 #REF! Des
104 Ibuprofen tablet 200 mg tablet 3848 3848 #REF! #REF! #REF! 3,000 #REF! 111 #REF!
105 Ibuprofen tablet 400 mg tablet 1115 1115 #REF! #REF! #REF! #REF! 133 #REF!
106 Infusion set anak pcs 96 96 #REF! #REF! #REF! #REF! 4,025 #REF!
107 Infusion set dewasa pcs 248 248 #REF! #REF! #REF! 50 #REF! 3,680 #REF!
108 Isoniazid tablet 100 mg tablet 0 0 #REF! #REF! #REF! #REF! 82 #REF!
109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 #REF! #REF! #REF! #REF! 98 #REF!
110 Kalsium Glukonat inj 10% ampul 0 0 #REF! #REF! #REF! #REF! 999 #REF!
111 Kalsium Hidroksida pasta buah 0 0 #REF! #REF! #REF! #REF! 266,200 #REF!
112 Kalsium laktat (Kalk) tablet 500 mg tablet 9624 9624 #REF! #REF! #REF! 3,000 #REF! 69 #REF!
113 Kapas pembalut 250 gram buah 8 8 #REF! #REF! #REF! #REF! 14,375 #REF!
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 #REF! #REF! #REF! #REF! 31,372 #REF!
115 Kapas pembalut / Absorben 1000 gram bungkus 2 2 #REF! #REF! #REF! #REF! 62,744 #REF!
116 Kaptopril 12,5 mg tablet 2387 2387 #REF! #REF! #REF! #REF! 69 #REF!
117 Kaptopril 25 mg tablet 2176 2176 #REF! #REF! #REF! 3,000 #REF! 165 #REF! Des
118 Karbamazepin tablet 200 mg tablet 0 0 #REF! #REF! #REF! #REF! 306 #REF!
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 1442 1442 #REF! #REF! #REF! #REF! 1,725 #REF!
120 Kasa hidrofil 40 x 80 cm roll 6 6 #REF! #REF! #REF! 7 #REF! 120,750 #REF!
121 Kasa pembalut elastis 3 inch roll 10 10 #REF! #REF! #REF! #REF! 7,700 #REF!
122 Ketokonazol krim 2% tube 55 55 #REF! #REF! #REF! 25 #REF! 6,600 #REF! Des
123 Ketokonazol tablet 200 mg tablet 500 500 #REF! #REF! #REF! #REF! 264 #REF! Des
124 Kloramfenikol kapsul 250 mg Kapsul 480 480 #REF! #REF! #REF! #REF! 616 #REF! Des
125 Kloramfenikol susp 125mg/5 ml Botol 102 102 #REF! #REF! #REF! #REF! 4,000 #REF!
126 Kloramfenikol salep mata 1 % tube 39 39 #REF! #REF! #REF! #REF! 1,850 #REF!
127 Kloramfenikol tetes mata 1 % botol 0 0 #REF! #REF! #REF! #REF! 8,250 #REF! Des
128 Kloramfenikol salep Kulit 2% tube 22 22 #REF! #REF! #REF! #REF! 3,409 #REF!
129 Kloramfenikol tetes telinga 3 % Botol 14 14 #REF! #REF! #REF! #REF! 8,250 #REF! Des
130 Klorfeniramin maleat tablet 4 mg tablet 11300 11300 #REF! #REF! #REF! #REF! 45 #REF!
131 Klorokuin tablet 150 mg tablet 0 0 #REF! #REF! #REF! #REF! 112 #REF!
132 Klorfenol Kamfer Menthol Botol 0 0 #REF! #REF! #REF! #REF! 60,500 #REF!
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 #REF! #REF! #REF! #REF! 1,045 #REF! EXP
134 Klorpromazin HCI tablet salut 100 mg tablet 0 0 #REF! #REF! #REF! #REF! 179 #REF!
135 Klorpromazin HCI tablet salut 25 mg tablet 0 0 #REF! #REF! #REF! #REF! 170 #REF!
136 Kotrimoksazol tablet 480 mg tablet 3672 3672 #REF! #REF! #REF! #REF! 158 #REF!
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 165 165 #REF! #REF! #REF! #REF! 2,225 #REF!
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 390 #REF! #REF! #REF! #REF! 138 #REF! Jan
139 Larutan mengandung elektrolit botol 78 78 #REF! #REF! #REF! #REF! 9,275 #REF!
140 Lidokain komp. injeksi - 2 ml ampul 72 72 #REF! #REF! #REF! #REF! 2,122 #REF!
141 Lisol 1 liter Botol 4 4 #REF! #REF! #REF! #REF! 49,200 #REF!
142 Loperamide 2 mg tablet 65 65 #REF! #REF! #REF! #REF! 90 #REF!
143 Loratadine 10 mg tablet 450 450 #REF! #REF! #REF! #REF! 149 #REF!
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 #REF! #REF! #REF! #REF! 1,694 #REF! Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 6 6 #REF! #REF! #REF! #REF! 2,143 #REF! Des
146 Masker Kain pcs 1155 1155 #REF! #REF! #REF! #REF! 506 #REF!
147 Mata Pisau No. 15 pcs 89 89 #REF! #REF! #REF! #REF! 3,300 #REF!
148 Mata Pisau No. 20 pcs 100 100 #REF! #REF! #REF! #REF! 3,300 #REF!
149 Metilergometrin maleat tablet salut 0,125 mg tablet 0 0 #REF! #REF! #REF! #REF! 133 #REF!
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 91 91 #REF! #REF! #REF! #REF! 2,684 #REF!
151 Metilprednisolon tablet 4 mg tablet 1000 1000 #REF! #REF! #REF! #REF! 200 #REF!
152 Metformin Hcl 500 mg tablet 1390 1390 #REF! #REF! #REF! #REF! 115 #REF!
153 Metoklopramida 10 mg tablet 0 0 #REF! #REF! #REF! 1,000 #REF! 100 #REF!
154 Metoklopramida injeksi 5 mg / ml vial 49 49 #REF! #REF! #REF! #REF! 6,600 #REF! Jan
155 Metronidazol tablet 250 mg tablet 0 0 #REF! #REF! #REF! #REF! 98 #REF!
156 Metronidazol tablet 500 mg tablet 4538 4538 #REF! #REF! #REF! #REF! 140 #REF!
157 Miconazole Krim tube 82 82 #REF! #REF! #REF! #REF! 3,737 #REF!
158 Mineral Mix sak 0 0 #REF! #REF! #REF! #REF! 2,450 #REF!
159 Multivitamin (Lycalvit) syrup botol 61 61 #REF! #REF! #REF! #REF! 37,400 #REF! Des
160 Mummifying pasta buah 0 0 #REF! #REF! #REF! #REF! 193,600 #REF!
161 Natrium diklofenak 50 mg tablet 0 0 #REF! #REF! #REF! #REF! 161 #REF!
162 Natrium klorida larutan infus 0,9 % steril Botol 130 130 #REF! #REF! #REF! 60 #REF! 6,410 #REF!
163 Nifedipin 10 mg tablet 112 112 #REF! #REF! #REF! #REF! 123 #REF!
164 Nistatin tablet vagina 100.000 IU / g ovula 90 90 #REF! #REF! #REF! #REF! 602 #REF!
165 Nistatin vaginal tablet salut 500.000 IU/g tablet 0 0 #REF! #REF! #REF! #REF! 704 #REF!
166 Obat anti Tuberklosis kategori FDC I paket 1 1 #REF! #REF! #REF! 4 #REF! 413,984 #REF!
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 #REF! #REF! #REF! 1 #REF! 1,317,000 #REF! Des
168 Obat anti Tuberklosis kategori FDC Anak paket 1 1 #REF! #REF! #REF! #REF! 236,500 #REF!
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 #REF! #REF! #REF! #REF! 4,400 #REF! Des
170 OBH Itral Syrup Botol 13 13 #REF! #REF! #REF! #REF! 16,698 #REF!
171 Ofloksasin tablet 400 mg tablet 0 0 #REF! #REF! #REF! #REF! 636 #REF!
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 #REF! #REF! #REF! #REF! 1,869 #REF!
173 Oksitetrasiklin HCI salep mata 1 % tube 25 25 #REF! #REF! #REF! #REF! 3,300 #REF! Des
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 271 271 #REF! #REF! #REF! #REF! 1,900 #REF!
175 Omeprazole 20 mg kapsul 600 600 #REF! #REF! #REF! #REF! 880 0 Jan
176 Parasetamol drops Botol 163 163 #REF! #REF! #REF! #REF! 7,350 #REF! Des
177 Parasetamol sirup 120 mg / 5 ml Botol 150 150 #REF! #REF! #REF! 180 #REF! 1,119 #REF! Des
178 Parasetamol tablet 500 mg tablet 18676 18676 #REF! #REF! #REF! 10,000 #REF! 145 #REF! Des
179 Pehacain injeksi botol 111 111 #REF! #REF! #REF! 100 #REF! 4,400 #REF! Des
180 Permetrin krim 5% tube 6 6 #REF! #REF! #REF! #REF! 12,155 #REF!
181 Pirantel pamoat tablet 125 mg tablet 253 253 #REF! #REF! #REF! #REF! 318 #REF! EXP
182 Pirantel suspensi 10 ml botol 0 0 #REF! #REF! #REF! #REF! 17,600 #REF! EXP
183 Pirantel suspensin 60 ml Botol 9 9 #REF! #REF! #REF! #REF! 9,100 #REF! Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 17425 17425 #REF! #REF! #REF! #REF! 136 #REF!
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 100 100 #REF! #REF! #REF! #REF! 1,030 #REF!
186 Piroksikam 20 mg tablet 90 90 #REF! #REF! #REF! #REF! 220 #REF! Des
187 Plester 2,5 cm x 4 m rol 20 20 #REF! #REF! #REF! #REF! 12,076 #REF!
188 Plester 7,5 cm x 4 m rol 20 20 #REF! #REF! #REF! #REF! 35,532 #REF!
189 Pot Sputum pcs 286 286 #REF! #REF! #REF! #REF! 3,190 0 Des
190 Prednison tablet 5 mg tablet 4039 4039 #REF! #REF! #REF! 3,000 #REF! 193 #REF! Jan
191 Primakuin tablet 15 mg tablet 0 0 #REF! #REF! #REF! #REF! 120 #REF!
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 30 30 #REF! #REF! #REF! #REF! 9,908 #REF!
193 Propiltiourasil tablet 100 mg tablet 1152 1152 #REF! #REF! #REF! #REF! 320 #REF!
194 Propranolol HCI tablet 40 mg tablet 300 300 #REF! #REF! #REF! #REF! 69 #REF!
195 Ranitidin tablet 150 mg tablet 730 730 #REF! #REF! #REF! 1,000 #REF! 132 #REF! Des
196 Ranitidin injeksi 25 mg/2 ml ampul 30 30 #REF! #REF! #REF! #REF! 1,600 #REF!
197 Rapid Test VIKIA HIV 1/2 kit 0 0 #REF! #REF! #REF! #REF! 525,000 #REF! Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 #REF! #REF! #REF! #REF! 14,344 #REF!
199 Reagensia ZN botol 0 0 #REF! #REF! #REF! #REF! 270,000 #REF!
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul 0 0 #REF! #REF! #REF! #REF! 327 #REF!
201 Retinol (Vitamin A) kapsul 200.000 IU kapsul 0 0 #REF! #REF! #REF! #REF! 505 #REF!
202 Ringer Laktat larutan infus steril Botol 81 81 #REF! #REF! #REF! 340 #REF! 7,150 #REF!
203 Salbutamol tablet 2 mg tablet 882 882 #REF! #REF! #REF! #REF! 99 #REF! Des
204 Salbutamol 4 mg tablet 200 200 #REF! #REF! #REF! #REF! 88 #REF!
205 Salep 2 - 4 kombinasi pot 58 58 #REF! #REF! #REF! #REF! 2,797 #REF!
206 Salisil bedak 2 % pot 107 107 #REF! #REF! #REF! #REF! 1,066 #REF!
207 Sarung Tangan Examination S pcs 996 996 #REF! #REF! #REF! #REF! 410 #REF!
208 Sarung Tangan Examination M pcs 500 500 #REF! #REF! #REF! 1,000 #REF! 410 #REF!
209 Sarung Tangan Examination L pcs 1000 1000 #REF! #REF! #REF! #REF! 410 #REF!
210 Sefadroksil 500 mg kapsul 2000 2000 #REF! #REF! #REF! #REF! 557 #REF!
211 Semen seng fosfat serbuk dan cairan buah 0 0 #REF! #REF! #REF! #REF! 102,850 #REF!
212 Setrizin tablet 10 mg tablet 0 0 #REF! #REF! #REF! #REF! 154 #REF!
213 Setrizin syrup Botol 72 72 #REF! #REF! #REF! #REF! 7,756 #REF!
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 6020 6020 #REF! #REF! #REF! #REF! 58 #REF!
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 140 140 #REF! #REF! #REF! #REF! 1,226 #REF!
216 Simetidine 200 mg tablet 2000 2000 #REF! #REF! #REF! #REF! 209 #REF! Jan
217 Simvastatin 10 mg tablet 150 150 #REF! #REF! #REF! 900 #REF! 135 #REF!
218 Simvastatin 20 mg tablet 30 30 #REF! #REF! #REF! #REF! 252 #REF!
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 84 84 #REF! #REF! #REF! #REF! 20,825 #REF!
220 Siprofloksasin tablet 500 mg tablet 856 856 #REF! #REF! #REF! 500 #REF! 298 #REF!
221 Spironolakton tablet 100 mg tablet 100 100 #REF! #REF! #REF! #REF! 878 #REF!
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 #REF! #REF! #REF! #REF! 3,549 #REF!
223 Tablet tambah darah kombinasi tablet 12013 12013 #REF! #REF! #REF! #REF! 327 #REF! Des
224 Taburia kotak 0 0 #REF! #REF! #REF! #REF! 18,150 #REF!
225 Temporary stopping (Fletcher) buah 0 0 #REF! #REF! #REF! #REF! 37,400 #REF!
226 Tetrasiklin HCI kapsul 250 mg kapsul 0 0 #REF! #REF! #REF! #REF! 162 #REF!
227 Tetrasiklin HCI kapsul 500 mg kapsul 500 500 #REF! #REF! #REF! #REF! 325 #REF!
228 Tiamfenikol 500 mg kapsul 190 190 #REF! #REF! #REF! #REF! 1,452 #REF! Jan
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 30 30 #REF! #REF! #REF! #REF! 1,760 #REF! Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 16355 16355 #REF! #REF! #REF! #REF! 91 #REF!
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 #REF! #REF! #REF! #REF! 97 #REF!
232 Umbilical Cord kotak 107 107 #REF! #REF! #REF! #REF! 3,163 #REF!
233 U-Pad steril 60 cm x 90 cm pcs 39 39 #REF! #REF! #REF! 20 #REF! 8,770 #REF!
234 Urine Bag set 12 12 #REF! #REF! #REF! #REF! 3,450 #REF!
235 Vaksin Jerap Tetanus vial 73 73 #REF! #REF! #REF! #REF! 14,498 #REF!
236 Vaksin Rabies vero kuur 12 12 #REF! #REF! #REF! #REF! 700,000 #REF!
237 Vitamin B kompleks tablet tablet 28380 28380 #REF! #REF! #REF! #REF! 132 #REF!
238 Wicold kapsul kapsul 738 738 #REF! #REF! #REF! #REF! 792 #REF!
239 Yodium povidon larutan 10 % 60 ml Botol 42 42 #REF! #REF! #REF! #REF! 7,040 #REF!
240 Yodium povidon larutan 10 % 300 ml Botol 15 15 #REF! #REF! #REF! #REF! 21,600 #REF!
241 Zinc syrup Botol 0 0 #REF! #REF! #REF! #REF! 8,140 #REF!
242 Zinc Tablet tablet 5501 5501 #REF! #REF! #REF! #REF! 592 #REF!
#REF!
TOTAL #REF!
jumlah resep
JKN 440 1377 pustu simpo 29 82 11 30 112
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 182 519 11 0 549

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN APRIL
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set #REF! 0 #REF! #REF! #REF! #REF! #REF! 5,203 #REF!
2 IV Catheter Gea No. 20 set #REF! 0 #REF! #REF! #REF! #REF! 50 #REF! 4,370 #REF!
3 IV Catheter Gea No. 22 set #REF! 0 #REF! #REF! #REF! #REF! 50 #REF! 5,203 #REF!
4 IV Catheter Gea No. 24 set #REF! 0 #REF! #REF! #REF! #REF! #REF! 5,203 #REF!
5 Ansell Steril 6 1/2 psg #REF! 0 #REF! #REF! #REF! #REF! #REF! 7,500 #REF!
6 Ansell Steril 7 psg #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 7,500 #REF!
7 Ansell Steri 7 1/2 psg #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 7,500 #REF!
8 Alat Suntik sekali pakai 0,05 ml set #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,650 #REF!
9 Alat Suntik sekali pakai 0,5 ml set #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,240 #REF!
10 Alat suntik sekali pakai 1 ml set #REF! 0 #REF! #REF! #REF! #REF! #REF! 748 #REF!
11 Alat suntik sekali pakai 3 ml set 4598 0 4598 #REF! #REF! #REF! #REF! 748 #REF!
12 Alat suntik sekali pakai 5 ml set #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 863 #REF!
13 Alat Suntik sekali pakai 10 ml set #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,064 #REF!
14 Albendasol tablet 400 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 425 #REF!
15 Alkohol Swab kotak #REF! 0 #REF! #REF! #REF! #REF! #REF! 115 #REF!
16 Alupurinol tablet 100 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 95 #REF!
17 Allpurinol tablet 300 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 244 #REF!
18 Ambroxol sirup 15 mg/ml Botol #REF! 0 #REF! #REF! #REF! #REF! 150 #REF! 5,500 #REF! Des
19 Ambroxol tablet tablet #REF! 0 #REF! #REF! #REF! #REF! 1,500 #REF! 216 #REF! Des
20 Aminofilin tablet 200 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 86 #REF!
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,349 #REF!
22 Amitriptilin HCI tablet salut 25 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 165 #REF!
23 Amlodipine 5 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 105 #REF!
24 Amlodipine 10 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 163 #REF!
25 Amoksisilin sirup kering 125 mg/5 ml Botol #REF! 0 #REF! #REF! #REF! #REF! 150 #REF! 2,200 #REF!
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 4,147 #REF!
27 Amoksisilin kapsul 250 mg Kapsul #REF! 0 #REF! #REF! #REF! #REF! 5,000 #REF! 207 #REF!
28 Amoksisilin kaplet 500 mg kaplet #REF! 0 #REF! #REF! #REF! #REF! 20,000 #REF! 233 #REF!
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial #REF! 0 #REF! #REF! #REF! #REF! #REF! 4,600 #REF!
30 Anagens Syrup Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 19,800 #REF!
31 Antalgin (Metampiron) tablet 500 mg Tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 209 #REF! Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,500 #REF!
33 Antasida DOEN tablet kombinasi tablet #REF! 0 #REF! #REF! #REF! #REF! 10,000 #REF! 64 #REF!
34 Antasida DOEN suspensi Botol #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 2,106 #REF!
35 Antihemoroid DOEN kombinasi suppos #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 3,502 #REF!
36 Antifungi DOEN kombinasi pot #REF! 0 #REF! #REF! #REF! #REF! #REF! 4,782 #REF!
37 Antibakteri DOEN salep Kombinasi tube #REF! 0 #REF! #REF! #REF! #REF! #REF! 2,767 #REF!
38 Antimigrain DOEN kombinasi tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 149 #REF!
39 Aqua pro injeksi steril, bebas pirogen vial #REF! 0 #REF! #REF! #REF! #REF! 5 #REF! 5,800 #REF!
40 Asam Askorbat (Vit C) tablet 50 mg tablet #REF! 3000 #REF! #REF! #REF! #REF! 10,000 #REF! 120 #REF!
41 Asam Folat tablet #REF! 0 #REF! #REF! #REF! #REF! 1,500 #REF! 68 #REF!
42 Asam Mefenamat tablet 500 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 10,000 #REF! 122 #REF! Des
43 Asiklovir 200 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 272 #REF!
44 Asiklovir 400 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 200 #REF! 381 #REF!
45 Asiklovir krim 5% tablet #REF! 0 #REF! #REF! #REF! #REF! 25 #REF! 3,960 #REF! Des
46 Asetosal tablet 100 mg tabet #REF! 0 #REF! #REF! #REF! #REF! #REF! 110 #REF!
47 Attalpulgit tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 173 #REF! EXP
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,672 #REF!
49 Atropin Sulfat tablet 0,5 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 500 #REF! 75 #REF!
50 Benecheck plus Glucose test strip 50's box #REF! 0 #REF! #REF! #REF! #REF! 2 #REF! 156,072 #REF!
51 Benecheck plus Cholesterol test strip 50's box #REF! 0 #REF! #REF! #REF! #REF! 2 #REF! 234,238 #REF!
52 Benecheck plus Uric test strip 50's box #REF! 0 #REF! #REF! #REF! #REF! 2 #REF! 129,210 #REF!
53 Betahistin maleat 24 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 1,210 #REF! Des
54 Betametason krim 0.1 % tube #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 1,435 #REF!
55 Bisakodil 5 mg supp suppos #REF! 0 #REF! #REF! #REF! #REF! 12 #REF! 5,670 #REF!
56 Bisakodil 10 mg supp suppos #REF! 0 #REF! #REF! #REF! #REF! 12 #REF! 5,800 #REF!
57 Blood Lancet 26G kotak #REF! 0 #REF! #REF! #REF! #REF! #REF! 160 #REF!
58 Catgut/benang bedah no .2/0 pcs #REF! 0 #REF! #REF! #REF! #REF! #REF! 33,925 #REF!
59 Catgut/benang bedah no .3/0 pcs #REF! 0 #REF! #REF! #REF! #REF! 96 #REF! 6,421 #REF!
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,740 #REF!
61 Deksametason tablet 0,5 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 5,000 #REF! 48 #REF!
62 Diazepam injeksi 5 mg/ml - 2 ml ampul #REF! 0 #REF! #REF! #REF! #REF! 10 #REF! 2,578 #REF!
63 Diazepam rectal 5mg/2,5 ml buah #REF! 0 #REF! #REF! #REF! #REF! 5 #REF! 12,749 #REF!
64 Diazepam tablet 2 mg tablett #REF! 0 #REF! #REF! #REF! #REF! 500 #REF! 134 #REF!
65 Diazepam tablet 5 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 65 #REF!
66 Dietilkarbamazin Sitrat tablet 100 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 104 #REF!
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul #REF! 0 #REF! #REF! #REF! #REF! 30 #REF! 1,354 #REF! EXP
68 Digoksin tablet 0,25 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 108 #REF!
69 Doksisilin kapsul 100 mg Kapsul #REF! 0 #REF! #REF! #REF! #REF! #REF! 309 #REF!
70 Domperidom suspensi Botol #REF! 0 #REF! 5 #REF! #REF! #REF! 3,180 #REF!
71 Domperidom tablet tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 451 0 Jan
72 Efedrin HCI tablet 25 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 56 #REF!
73 Ekstrak Belladon tablet 10 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,500 #REF! 42 #REF!
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul #REF! 0 #REF! #REF! #REF! #REF! 5 #REF! 8,910 #REF!
75 Etakridin (Rivanol) larutan 0,1 % Botol 3 0 3 #REF! #REF! #REF! 10 #REF! 3,600 #REF!
76 E t a n o l 70 % 100 ml Botol #REF! 100 #REF! #REF! #REF! #REF! 100 #REF! 2,625 #REF!
77 Etil klorida semprot Botol #REF! 0 #REF! #REF! #REF! #REF! 5 #REF! 115,500 #REF!
78 Eugenol cairan botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 18,333 #REF!
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,980 #REF!
80 Fenobarbital tablet 30 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 74 #REF!
81 Fervital Kapsul kapsul #REF! 0 #REF! #REF! #REF! #REF! 3,000 #REF! 861 #REF!
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul #REF! 0 #REF! #REF! #REF! #REF! 250 #REF! 3,754 #REF! EXP
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 796 #REF!
84 Foly Catheter No. 18 pcs #REF! 0 #REF! #REF! #REF! #REF! #REF! 9,200 #REF!
85 Foly Catheter No. 20 pcs #REF! 0 #REF! #REF! #REF! #REF! #REF! 9,200 #REF!
86 Furosemid tablet 40 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 84 #REF!
87 Garam Oralit untuk 200 ml Air sak #REF! 0 #REF! #REF! #REF! #REF! 500 #REF! 274 #REF!
88 Gentamicin inj 40mg/ml Ampul #REF! 0 #REF! #REF! #REF! #REF! 25 #REF! 3,545 #REF! EXP
89 Gentian Violet larutan 1 % Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,850 #REF! Jan
90 Glass lonomer Cement (GC IX ) buah #REF! 0 #REF! #REF! #REF! #REF! 1 #REF! 434,500 #REF!
91 Glibenklamid tablet 5 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 500 #REF! 110 #REF! Des
92 Glimepiride 1 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 220 #REF!
93 Glimepiride 2 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 297 #REF!
94 Guaiafenesin Tablet tablet #REF! 0 #REF! #REF! #REF! #REF! 10,000 #REF! 132 #REF! Des
95 Glukosa larutan infus 5 % steril Botol #REF! 0 #REF! #REF! #REF! #REF! 40 #REF! 6,900 #REF!
96 Grisefulvin tablet 125 mg (Micronized) tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 523 #REF! Des
97 Haloperidol tablet 1,5 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 76 #REF! Des
98 Haloperidol tablet 2 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 134 #REF!
99 Haloperidol inj 50 mg/ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 91,667 #REF!
100 Hidroklorotiazid (HCT) tablet 25 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 171 #REF!
101 Hidrokortison krim 2,5 % tube 23 0 23 #REF! #REF! #REF! 100 #REF! 2,812 #REF!
102 Ibuprofen suspensi 100 mg/5 ml Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 8,000 #REF!
103 Ibuprofen suspensi 200 mg/5 ml Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 8,800 #REF! Des
104 Ibuprofen tablet 200 mg tablet #REF! 1000 #REF! #REF! #REF! #REF! 3,000 #REF! 111 #REF!
105 Ibuprofen tablet 400 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 2,000 #REF! 133 #REF!
106 Infusion set anak pcs #REF! 0 #REF! #REF! #REF! #REF! 50 #REF! 4,025 #REF!
107 Infusion set dewasa pcs #REF! 50 #REF! #REF! #REF! #REF! 200 #REF! 3,680 #REF!
108 Isoniazid tablet 100 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 82 #REF!
109 Isosorbid Dinitrat tablet subligual 5 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 98 #REF!
110 Kalsium Glukonat inj 10% ampul #REF! 0 #REF! #REF! #REF! #REF! 25 #REF! 999 #REF!
111 Kalsium Hidroksida pasta buah #REF! 0 #REF! #REF! #REF! #REF! 1 #REF! 266,200 #REF!
112 Kalsium laktat (Kalk) tablet 500 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 10,000 #REF! 69 #REF!
113 Kapas pembalut 250 gram buah #REF! 0 #REF! #REF! #REF! #REF! #REF! 14,375 #REF!
114 Kapas pembalut / Absorben 500 gram bungkus #REF! 0 #REF! #REF! #REF! #REF! #REF! 31,372 #REF!
115 Kapas pembalut / Absorben 1000 gram bungkus #REF! 0 #REF! #REF! #REF! #REF! #REF! 62,744 #REF!
116 Kaptopril 12,5 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 69 #REF!
117 Kaptopril 25 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 2,000 #REF! 165 #REF! Des
118 Karbamazepin tablet 200 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 306 #REF!
119 Kasa pembalut Hidrofil 4 m x 10 cm roll #REF! 0 #REF! #REF! #REF! #REF! 900 #REF! 1,725 #REF!
120 Kasa hidrofil 40 x 80 cm roll #REF! 0 #REF! #REF! #REF! #REF! 15 #REF! 120,750 #REF!
121 Kasa pembalut elastis 3 inch roll #REF! 0 #REF! #REF! #REF! #REF! #REF! 7,700 #REF!
122 Ketokonazol krim 2% tube #REF! 0 #REF! #REF! #REF! #REF! 36 #REF! 6,600 #REF! Des
123 Ketokonazol tablet 200 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 264 #REF! Des
124 Kloramfenikol kapsul 250 mg Kapsul #REF! 0 #REF! #REF! #REF! #REF! #REF! 616 #REF! Des
125 Kloramfenikol susp 125mg/5 ml Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 4,000 #REF!
126 Kloramfenikol salep mata 1 % tube #REF! 0 #REF! #REF! #REF! #REF! 120 #REF! 1,850 #REF!
128 Kloramfenikol salep Kulit 2% tube #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,409 #REF!
129 Kloramfenikol tetes telinga 3 % Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 8,250 #REF! Des
130 Klorfeniramin maleat tablet 4 mg tablet #REF! 3000 #REF! #REF! #REF! #REF! 5,000 #REF! 45 #REF!
131 Klorokuin tablet 150 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 112 #REF!
132 Klorfenol Kamfer Menthol Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 60,500 #REF!
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,045 #REF! EXP
134 Klorpromazin HCI tablet salut 100 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 179 #REF!
135 Klorpromazin HCI tablet salut 25 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 170 #REF!
136 Kotrimoksazol tablet 480 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 158 #REF!
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 2,225 #REF!
138 Kotrimoksazol Pediatrik tablet 120 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 138 #REF! Jan
139 Larutan mengandung elektrolit botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 9,275 #REF!
140 Lidokain komp. injeksi - 2 ml ampul #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 2,122 #REF!
141 Lisol 1 liter Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 49,200 #REF!
142 Loperamide 2 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 90 #REF!
143 Loratadine 10 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 149 #REF!
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,694 #REF! Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol #REF! 0 #REF! #REF! #REF! #REF! 5 #REF! 2,143 #REF! Des
146 Masker Kain pcs #REF! 0 #REF! #REF! #REF! #REF! #REF! 506 #REF!
147 Mata Pisau No. 15 pcs #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,300 #REF!
148 Mata Pisau No. 20 pcs #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,300 #REF!
149 Metilergometrin maleat tablet salut 0,125 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 133 #REF!
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 2,684 #REF!
151 Metilprednisolon tablet 4 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 200 #REF!
152 Metformin Hcl 500 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 500 #REF! 115 #REF!
153 Metoklopramida 10 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 100 #REF!
154 Metoklopramida injeksi 5 mg / ml vial #REF! 0 #REF! #REF! #REF! #REF! #REF! 6,600 #REF! Jan
155 Metronidazol tablet 250 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 98 #REF!
156 Metronidazol tablet 500 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,500 #REF! 140 #REF!
157 Miconazole Krim tube #REF! 0 #REF! #REF! #REF! #REF! 48 #REF! 3,737 #REF!
158 Mineral Mix sak #REF! 0 #REF! #REF! #REF! #REF! #REF! 2,450 #REF!
159 Multivitamin (Lycalvit) syrup botol #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 37,400 #REF! Des
160 Mummifying pasta buah #REF! 0 #REF! #REF! #REF! #REF! #REF! 193,600 #REF!
161 Natrium diklofenak 50 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 750 #REF! 161 #REF!
162 Natrium klorida larutan infus 0,9 % steril Botol #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 6,410 #REF!
163 Nifedipin 10 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 123 #REF!
164 Nistatin tablet vagina 100.000 IU / g ovula #REF! 0 #REF! #REF! #REF! #REF! #REF! 602 #REF!
165 Nistatin vaginal tablet salut 500.000 IU/g tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 704 #REF!
166 Obat anti Tuberklosis kategori FDC I paket #REF! 0 #REF! #REF! #REF! #REF! #REF! 413,984 #REF!
167 Obat anti Tuberklosis kategori FDC 2 paket #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,317,000 #REF! Des
168 Obat anti Tuberklosis kategori FDC Anak paket #REF! 0 #REF! #REF! #REF! #REF! #REF! 236,500 #REF!
169 Obat Batuk Hitam (O.B.H) cairan botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 4,400 #REF! Des
170 OBH Itral Syrup Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 16,698 #REF!
171 Ofloksasin tablet 400 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 636 #REF!
172 Oksitetrasiklin HCI salep kulit 3 % tube #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 1,869 #REF!
173 Oksitetrasiklin HCI salep mata 1 % tube #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,300 #REF! Des
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,900 #REF!
175 Omeprazole 20 mg kapsul #REF! 0 #REF! #REF! #REF! #REF! #REF! 880 0 Jan
176 Parasetamol drops Botol #REF! 0 #REF! #REF! #REF! #REF! 150 #REF! 7,350 #REF! Des
177 Parasetamol sirup 120 mg / 5 ml Botol #REF! 0 #REF! #REF! #REF! #REF! 200 #REF! 1,119 #REF! Des
178 Parasetamol tablet 500 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 20,000 #REF! 145 #REF! Des
179 Pehacain injeksi botol #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 4,400 #REF! Des
180 Permetrin krim 5% tube #REF! 0 #REF! #REF! #REF! #REF! #REF! 12,155 #REF!
181 Pirantel pamoat tablet 125 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 318 #REF! EXP
182 Pirantel suspensi 10 ml botol 0 0 0 0 0 17,600 0 EXP
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet #REF! 3000 #REF! #REF! #REF! #REF! 15,000 #REF! 136 #REF!
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,030 #REF!
186 Piroksikam 20 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 220 #REF! Des
187 Plester 2,5 cm x 4 m rol #REF! 0 #REF! #REF! #REF! #REF! #REF! 12,076 #REF!
188 Plester 7,5 cm x 4 m rol #REF! 0 #REF! #REF! #REF! #REF! 20 #REF! 35,532 #REF!
190 Prednison tablet 5 mg tablet #REF! 3000 #REF! #REF! #REF! #REF! 3,000 #REF! 193 #REF! Jan
191 Primakuin tablet 15 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 120 #REF!
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial #REF! 0 #REF! #REF! #REF! #REF! #REF! 9,908 #REF!
193 Propiltiourasil tablet 100 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 500 #REF! 320 #REF!
194 Propranolol HCI tablet 40 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 69 #REF!
195 Ranitidin tablet 150 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 132 #REF! Des
196 Ranitidin injeksi 25 mg/2 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,600 #REF!
197 Rapid Test VIKIA HIV 1/2 kit #REF! 0 #REF! #REF! #REF! #REF! #REF! 525,000 #REF! Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test #REF! 0 #REF! #REF! #REF! #REF! #REF! 14,344 #REF!
199 Reagensia ZN botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 270,000 #REF!
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul #REF! 0 #REF! #REF! #REF! #REF! #REF! 327 #REF!
201 Retinol (Vitamin A) kapsul 200.000 IU kapsul #REF! 0 #REF! #REF! #REF! #REF! #REF! 505 #REF!
202 Ringer Laktat larutan infus steril Botol #REF! 0 #REF! #REF! #REF! #REF! 300 #REF! 7,150 #REF!
203 Salbutamol tablet 2 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 500 #REF! 99 #REF! Des
204 Salbutamol 4 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 88 #REF!
205 Salep 2 - 4 kombinasi pot #REF! 0 #REF! #REF! #REF! #REF! 48 #REF! 2,797 #REF!
206 Salisil bedak 2 % pot #REF! 0 #REF! #REF! #REF! #REF! 100 #REF! 1,066 #REF!
207 Sarung Tangan Examination S pcs #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 410 #REF!
208 Sarung Tangan Examination M pcs #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 410 #REF!
209 Sarung Tangan Examination L pcs #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 410 #REF!
210 Sefadroksil 500 mg kapsul #REF! 0 #REF! #REF! #REF! #REF! #REF! 557 #REF!
211 Semen seng fosfat serbuk dan cairan buah #REF! 0 #REF! #REF! #REF! #REF! 1 #REF! 102,850 #REF!
212 Setrizin tablet 10 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 154 #REF!
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet #REF! 0 #REF! 260 #REF! #REF! 5,000 #REF! 58 #REF!
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,226 #REF!
216 Simetidine 200 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 209 #REF! Jan
217 Simvastatin 10 mg tablet #REF! 600 #REF! #REF! #REF! #REF! 300 #REF! 135 #REF!
218 Simvastatin 20 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 252 #REF!
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs #REF! 12 #REF! #REF! #REF! #REF! 48 #REF! 20,825 #REF!
220 Siprofloksasin tablet 500 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 298 #REF!
221 Spironolakton tablet 100 mg tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 878 #REF!
222 Sulfasetamida natrium tetes mata 15 % Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,549 #REF!
223 Tablet tambah darah kombinasi tablet #REF! 0 #REF! #REF! #REF! #REF! #REF! 327 #REF! Des
224 Taburia kotak #REF! 0 #REF! #REF! #REF! #REF! #REF! 18,150 #REF!
225 Temporary stopping (Fletcher) buah #REF! 0 #REF! #REF! #REF! #REF! #REF! 37,400 #REF!
226 Tetrasiklin HCI kapsul 250 mg kapsul #REF! 0 #REF! #REF! #REF! #REF! #REF! 162 #REF!
227 Tetrasiklin HCI kapsul 500 mg kapsul #REF! 0 #REF! #REF! #REF! #REF! #REF! 325 #REF!
228 Tiamfenikol 500 mg kapsul #REF! 100 #REF! #REF! #REF! #REF! 200 #REF! 1,452 #REF! Jan
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul #REF! 0 #REF! #REF! #REF! #REF! #REF! 1,760 #REF! Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet #REF! 3000 #REF! #REF! #REF! #REF! 15,000 #REF! 91 #REF!
231 Triheksifenidil Hidroklorida tablet 2 mg tablet #REF! 0 #REF! #REF! #REF! #REF! 1,000 #REF! 97 #REF!
232 Umbilical Cord kotak #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,163 #REF!
233 U-Pad steril 60 cm x 90 cm pcs #REF! 0 #REF! #REF! #REF! #REF! 50 #REF! 8,770 #REF!
234 Urine Bag set #REF! 0 #REF! #REF! #REF! #REF! #REF! 3,450 #REF!
235 Vaksin Jerap Tetanus vial #REF! 0 #REF! #REF! #REF! #REF! #REF! 14,498 #REF!
236 Vaksin Rabies vero kuur #REF! 0 #REF! #REF! #REF! #REF! #REF! 700,000 #REF!
237 Vitamin B kompleks tablet tablet #REF! 0 #REF! #REF! #REF! #REF! 15,000 #REF! 132 #REF!
238 Wicold kapsul kapsul #REF! 0 #REF! #REF! #REF! #REF! 3,000 #REF! 792 #REF!
239 Yodium povidon larutan 10 % 60 ml Botol #REF! 0 #REF! #REF! #REF! #REF! #REF! 7,040 #REF!
240 Yodium povidon larutan 10 % 300 ml Botol #REF! 0 #REF! #REF! #REF! #REF! 15 #REF! 21,600 #REF!
241 Zinc syrup Botol #REF! 0 #REF! #REF! #REF! #REF! 60 #REF! 8,140 #REF!
242 Zinc Tablet tablet #REF! 0 #REF! #REF! #REF! #REF! 3,000 #REF! 592 #REF!
TOTAL #REF!
jumlah resep
JKN 440 1377 pustu simpo 29 82 11 30 112
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 182 519 11 0 549

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN MEI
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
16 Alupurinol tablet 100 mg tablet 654 1000 1654 #REF! #REF! #REF! #REF! 95 #REF!
19 Ambroxol tablet tablet 0 1500 1500 #REF! #REF! #REF! #REF! 216 #REF! Des

22 Amitriptilin HCI tablet salut 25 mg tablet 1000 0 1000 #REF! #REF! #REF! #REF! 165 #REF!
23 Amlodipine 5 mg tablet 304 0 304 #REF! #REF! #REF! #REF! 105 #REF!
25 Amoksisilin sirup kering 125 mg/5 ml Botol 93 150 243 #REF! #REF! #REF! #REF! 2,200 #REF!
27 Amoksisilin kapsul 250 mg Kapsul 2333 5000 7333 #REF! #REF! #REF! #REF! 207 #REF!
28 Amoksisilin kaplet 500 mg kaplet 6781 20000 26781 #REF! #REF! #REF! #REF! 233 #REF!
31 Antalgin (Metampiron) tablet 500 mg Tablet 1740 0 1740 #REF! #REF! #REF! #REF! 209 #REF! Des
33 Antasida DOEN tablet kombinasi tablet 7333 10000 17333 #REF! #REF! #REF! #REF! 64 #REF!
38 Antimigrain DOEN kombinasi tablet 224 0 224 #REF! #REF! #REF! #REF! 149 #REF!
40 Asam Askorbat (Vit C) tablet 50 mg tablet 6566 14000 20566 #REF! #REF! #REF! #REF! 120 #REF!
41 Asam Folat tablet 200 1500 1700 #REF! #REF! #REF! #REF! 68 #REF!
42 Asam Mefenamat tablet 500 mg tablet 3673 10000 13673 #REF! #REF! #REF! #REF! 122 #REF! Des
45 Asiklovir krim 5% tablet 25 0 25 #REF! #REF! #REF! #REF! 3,960 #REF! Des
53 Betahistin maleat 24 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 1,210 #REF! Des
61 Deksametason tablet 0,5 mg tablet 11563 5000 16563 #REF! #REF! #REF! #REF! 48 #REF!
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 #REF! #REF! #REF! #REF! 2,578 #REF!
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 #REF! #REF! #REF! #REF! 12,749 #REF!
64 Diazepam tablet 2 mg tablett 0 0 0 #REF! #REF! #REF! #REF! 134 #REF!
71 Domperidom tablet tablet 300 0 300 #REF! #REF! #REF! #REF! 451 0 Jan
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 42 #REF!
77 Etil klorida semprot Botol 0 0 0 #REF! #REF! #REF! #REF! 115,500 #REF!
81 Fervital Kapsul kapsul 1390 3000 4390 #REF! #REF! #REF! #REF! 861 #REF!
87 Garam Oralit untuk 200 ml Air sak 1138 500 1638 #REF! #REF! #REF! #REF! 274 #REF!
91 Glibenklamid tablet 5 mg tablet 2700 500 3200 #REF! #REF! #REF! #REF! 110 #REF! Des
94 Guaiafenesin Tablet tablet 5000 10000 15000 #REF! #REF! #REF! #REF! 132 #REF! Des
95 Glukosa larutan infus 5 % steril Botol 80 40 120 #REF! #REF! #REF! #REF! 6,900 #REF!
96 Grisefulvin tablet 125 mg (Micronized) tablet 1260 1000 2260 #REF! #REF! #REF! #REF! 523 #REF! Des
97 Haloperidol tablet 1,5 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 76 #REF! Des
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 530 300 830 #REF! #REF! #REF! #REF! 171 #REF!
102 Ibuprofen suspensi 100 mg/5 ml Botol 24 0 24 #REF! #REF! #REF! #REF! 8,000 #REF!
107 Infusion set dewasa pcs 140 200 340 #REF! #REF! #REF! #REF! 3,680 #REF!
112 Kalsium laktat (Kalk) tablet 500 mg tablet 880 10000 10880 #REF! #REF! #REF! #REF! 69 #REF!
116 Kaptopril 12,5 mg tablet 2991 0 2991 #REF! #REF! #REF! #REF! 69 #REF!
117 Kaptopril 25 mg tablet 1037 2000 3037 #REF! #REF! #REF! #REF! 165 #REF! Des
118 Karbamazepin tablet 200 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 306 #REF!
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 661 900 1561 #REF! #REF! #REF! #REF! 1,725 #REF!
122 Ketokonazol krim 2% tube 19 36 55 #REF! #REF! #REF! #REF! 6,600 #REF! Des
126 Kloramfenikol salep mata 1 % tube 29 48 77 #REF! #REF! #REF! #REF! 1,850 #REF!
130 Klorfeniramin maleat tablet 4 mg tablet 6300 5000 11300 #REF! #REF! #REF! #REF! 45 #REF!
136 Kotrimoksazol tablet 480 mg tablet 3403 1000 4403 #REF! #REF! #REF! #REF! 158 #REF!
146 Masker Kain pcs 1315 0 1315 #REF! #REF! #REF! #REF! 506 #REF!
152 Metformin Hcl 500 mg tablet 1281 500 1781 #REF! #REF! #REF! #REF! 115 #REF!
161 Natrium diklofenak 50 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 161 #REF!
166 Obat anti Tuberklosis kategori FDC I paket 2 0 2 #REF! #REF! #REF! #REF! 413,984 #REF!
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 #REF! #REF! #REF! #REF! 1,317,000 #REF! Des
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 297 0 297 #REF! #REF! #REF! #REF! 1,900 #REF!
175 Omeprazole 20 mg kapsul 600 0 600 #REF! #REF! #REF! #REF! 880 0 Jan
176 Parasetamol drops Botol 20 168 188 #REF! #REF! #REF! #REF! 7,350 #REF! Des
177 Parasetamol sirup 120 mg / 5 ml Botol 7 200 207 #REF! #REF! #REF! #REF! 1,119 #REF! Des
178 Parasetamol tablet 500 mg tablet 6112 20000 26112 #REF! #REF! #REF! #REF! 145 #REF! Des
179 Pehacain injeksi botol 80 100 180 #REF! #REF! #REF! #REF! 4,400 #REF! Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 5960 14000 19960 #REF! #REF! #REF! #REF! 136 #REF!
186 Piroksikam 20 mg tablet 90 0 90 #REF! #REF! #REF! #REF! 220 #REF! Des
187 Plester 2,5 cm x 4 m rol 35 0 35 #REF! #REF! #REF! #REF! 12,076 #REF!
190 Prednison tablet 5 mg tablet 2910 3000 5910 #REF! #REF! #REF! #REF! 193 #REF! Jan
193 Propiltiourasil tablet 100 mg tablet 772 500 1272 #REF! #REF! #REF! #REF! 320 #REF!
195 Ranitidin tablet 150 mg tablet 1400 0 1400 #REF! #REF! #REF! #REF! 132 #REF! Des
202 Ringer Laktat larutan infus steril Botol 40 300 340 #REF! #REF! #REF! #REF! 7,150 #REF!
203 Salbutamol tablet 2 mg tablet 488 500 988 #REF! #REF! #REF! #REF! 99 #REF! Des
206 Salisil bedak 2 % pot 29 100 129 #REF! #REF! #REF! #REF! 1,066 #REF!
208 Sarung Tangan Examination M pcs 0 1000 1000 #REF! #REF! #REF! #REF! 410 #REF!
209 Sarung Tangan Examination L pcs 0 1000 1000 #REF! #REF! #REF! #REF! 410 #REF!
210 Sefadroksil 500 mg kapsul 2000 0 2000 #REF! #REF! #REF! #REF! 557 #REF!
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 1152 5000 6152 #REF! #REF! #REF! #REF! 58 #REF!
216 Simetidine 200 mg tablet 2000 0 2000 #REF! #REF! #REF! #REF! 209 #REF! Jan
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 46 48 94 #REF! #REF! #REF! #REF! 20,825 #REF!
220 Siprofloksasin tablet 500 mg tablet 206 1000 1206 #REF! #REF! #REF! #REF! 298 #REF!
223 Tablet tambah darah kombinasi tablet 13998 0 13998 #REF! #REF! #REF! #REF! 327 #REF! Des
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 3905 15000 18905 #REF! #REF! #REF! #REF! 91 #REF!
237 Vitamin B kompleks tablet tablet 12094 18800 30894 #REF! #REF! #REF! #REF! 132 #REF!
238 Wicold kapsul kapsul 1332 0 1332 #REF! #REF! #REF! #REF! 792 #REF!
242 Zinc Tablet tablet 2862 3000 5862 #REF! #REF! #REF! #REF! 592 #REF!
TOTAL #REF!
jumlah resep
JKN 440 1377 pustu simpo 29 82 11 30 112
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 182 519 11 0 549

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22

40 Asam Askorbat (Vit C) tablet 50 mg tablet 6566 14000 20566 #REF! #REF! #REF! #REF! 120 #REF!
53 Betahistin maleat 24 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 1,210 #REF! Des
107 Infusion set dewasa pcs 140 200 340 #REF! #REF! #REF! #REF! 3,680 #REF!
130 Klorfeniramin maleat tablet 4 mg tablet 6300 5000 11300 #REF! #REF! #REF! #REF! 45 #REF!
161 Natrium diklofenak 50 mg tablet 0 0 0 #REF! #REF! #REF! #REF! 161 #REF!
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 5960 14000 19960 #REF! #REF! #REF! #REF! 136 #REF!
190 Prednison tablet 5 mg tablet 2910 3000 5910 #REF! #REF! #REF! #REF! 193 #REF! Jan
206 Salisil bedak 2 % pot 29 100 129 #REF! #REF! #REF! #REF! 1,066 #REF!
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 46 48 94 #REF! #REF! #REF! #REF! 20,825 #REF!
TOTAL #REF!
jumlah resep
JKN 440 1377 pustu simpo 29 82 11 30 112
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 182 519 11 0 549

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN FEB
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 203 0 203 53 150 150 150 7,500 1,125,000
16 Alupurinol tablet 100 mg tablet 1039 0 1039 0 1039 1039 1,039 95 98,705
18 Ambroxol sirup 15 mg/ml Botol 0 30 30 0 30 30 30 5,500 165,000 Des 5000

19 Ambroxol tablet tablet 0 300 300 0 300 300 300 216 64,800 Des 196
23 Amlodipine 5 mg tablet 12 600 612 0 612 612 612 105 64,260

26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 50 0 50 120 -70 -70 -70 4,147 -290,290
27 Amoksisilin kapsul 250 mg Kapsul 710 2500 3210 0 3210 3210 3,210 207 664,470
28 Amoksisilin kaplet 500 mg kaplet 973 10000 10973 0 10973 10973 10,973 233 2,556,709
31 Antalgin (Metampiron) tablet 500 mg Tablet 1820 0 1820 132 1688 1688 1,688 209 352,792 Des 190
33 Antasida DOEN tablet kombinasi tablet 9981 3000 12981 28 12953 12953 12,953 64 828,992
40 Asam Askorbat (Vit C) tablet 50 mg tablet 10680 7000 17680 0 17680 17680 17,680 120 2,121,600
42 Asam Mefenamat tablet 500 mg tablet 4038 3000 7038 15 7023 7023 7,023 122 856,806 Des 122
45 Asiklovir krim 5% tablet 0 25 25 0 25 25 25 3,960 99,000 Des 3600

47 Attalpulgit tablet 160 0 160 0 160 160 160 173 27,680

53 Betahistin maleat 24 mg tablet 0 150 150 0 150 150 150 1,210 181,500 Des
54 Betametason krim 0.1 % tube 52 96 148 576 -428 -428 -428 1,435 -614,180
64 Diazepam tablet 2 mg tablett 35 0 35 0 35 35 35 134 4,690
69 Doksisilin kapsul 100 mg Kapsul 0 0 0 120 -120 -120 -120 309 -37,080
70 Domperidom suspensi Botol 0 0 0 63 -63 -63 -63 3,180 -200,340
71 Domperidom tablet tablet 300 0 300 3 297 297 297 451 0 Jan 133
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 350 -350 -350 -350 42 -14,700
76 E t a n o l 70 % 100 ml Botol 81 0 81 9 72 72 72 2,625 189,000
78 Eugenol cairan botol 0 2 2 0 2 2 2 18,333 36,666
81 Fervital Kapsul kapsul 0 2000 2000 10 1990 1990 1,990 861 1,713,390

87 Garam Oralit untuk 200 ml Air sak 792 1000 1792 0 1792 1792 1,792 274 491,008
89 Gentian Violet larutan 1 % Botol 11 0 11 0 11 11 11 3,850 42,350 Jan 3500

94 Guaiafenesin Tablet tablet 0 5000 5000 0 5000 5000 5,000 132 660,000 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 543 1000 1543 6 1537 1537 1,537 523 803,083 Des
97 Haloperidol tablet 1,5 mg tablet 2020 0 2020 0 2020 2020 2,020 76 153,520 Des 74
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 30 30 310 -280 -280 -280 8,000 -2,240,000 8000
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 0 0 0 0 8,800 0 Des 8000
104 Ibuprofen tablet 200 mg tablet 1600 2000 3600 11 3589 3589 3,589 111 398,379
112 Kalsium laktat (Kalk) tablet 500 mg tablet 610 3000 3610 0 3610 3610 3,610 69 249,090
113 Kapas pembalut 250 gram buah 10 0 10 60 -50 -50 -50 14,375 -718,750
116 Kaptopril 12,5 mg tablet 5057 0 5057 10 5047 5047 5,047 69 348,243
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 732 0 732 8 724 724 724 1,725 1,248,900
122 Ketokonazol krim 2% tube 0 48 48 600 -552 -552 -552 6,600 -3,643,200 Des
130 Klorfeniramin maleat tablet 4 mg tablet 5000 0 5000 1 4999 4999 4,999 45 224,955
135 Klorpromazin HCI tablet salut 25 mg tablet 1170 500 1670 55 1615 1615 1,615 170 274,550
136 Kotrimoksazol tablet 480 mg tablet 2871 2000 4871 0 4871 4871 4,871 158 769,618
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 0 390 0 390 390 390 138 53,625 Jan 125
140 Lidokain komp. injeksi - 2 ml ampul 103 150 253 882 -629 -629 -629 2,122 -1,334,738
142 Loperamide 2 mg tablet 0 100 100 0 100 100 100 90 9,000
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 0 0 0 1,694 0 Des 3200

145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 1 0 1 0 1 1 1 2,143 2,143 Des 3650
146 Masker Kain pcs 2247 0 2247 764 1483 1483 1,483 506 750,398
147 Mata Pisau No. 15 pcs 95 0 95 0 95 95 95 3,300 313,500
148 Mata Pisau No. 20 pcs 106 0 106 0 106 106 106 3,300 349,800
151 Metilprednisolon tablet 4 mg tablet 10 0 10 12 -2 -2 -2 200 -400
152 Metformin Hcl 500 mg tablet 961 1000 1961 0 1961 1961 1,961 115 225,515
154 Metoklopramida injeksi 5 mg / ml vial 0 50 50 0 50 50 50 6,600 330,000 Jan 6000

158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 0 37,400 0 Des
166 Obat anti Tuberklosis kategori FDC I paket 5 0 5 605 -600 -600 -600 413,984 -248,390,400
167 Obat anti Tuberklosis kategori FDC 2 paket 1 1 2 197 -195 -195 -195 1,317,000 -256,815,000 Des 1319900
168 Obat anti Tuberklosis kategori FDC Anak paket 1 0 1 13 -12 -12 -12 236,500 -2,838,000

173 Oksitetrasiklin HCI salep mata 1 % tube 3 25 28 0 28 28 28 3,300 92,400 Des
175 Omeprazole 20 mg kapsul 600 0 600 0 600 600 600 880 0 Jan 221
176 Parasetamol drops Botol 7 56 63 0 63 63 63 7,350 463,050 Des 7,350
178 Parasetamol tablet 500 mg tablet 594 10000 10594 0 10594 10594 10,594 145 1,536,130 Des 58
179 Pehacain injeksi botol 0 0 0 0 0 0 0 4,400 0 Des
182 Pirantel suspensi 10 ml botol 15 0 15 3 12 12 12 17,600 211,200 Jan
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 7000 7000 0 7000 7000 7,000 136 952,000
186 Piroksikam 20 mg tablet 0 100 100 0 100 100 100 220 22,000 Des
187 Plester 2,5 cm x 4 m rol 55 0 55 0 55 55 55 12,076 664,180
188 Plester 7,5 cm x 4 m rol 9 0 9 0 9 9 9 35,532 319,788
190 Prednison tablet 5 mg tablet 0 3000 3000 0 3000 3000 3,000 193 579,000 Jan 175
193 Propiltiourasil tablet 100 mg tablet 600 500 1100 0 1100 1100 1,100 320 352,000
195 Ranitidin tablet 150 mg tablet 1900 0 1900 0 1900 1900 1,900 132 250,800 Des 132
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0 0 525,000 0 Des 487500
203 Salbutamol tablet 2 mg tablet 888 0 888 0 888 888 888 99 87,912 Des

208 Sarung Tangan Examination M pcs 0 200 200 360 -160 -160 -160 410 -65,600
209 Sarung Tangan Examination L pcs 200 0 200 0 200 200 200 410 82,000
216 Simetidine 200 mg tablet 0 2000 2000 0 2000 2000 2,000 209 418,000 Jan 190
220 Siprofloksasin tablet 500 mg tablet 636 500 1136 0 1136 1136 1,136 298 338,528
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
228 Tiamfenikol 500 mg kapsul 0 100 100 0 100 100 100 1,452 145,200 Jan 1320
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 30 30 0 30 30 30 1,760 52,800 Jan 1600
234 Urine Bag set 16 0 16 10 6 6 6 3,450 20,700

239 Yodium povidon larutan 10 % 60 ml Botol 46 0 46 2330 -2284 -2284 -2,284 7,040 -16,079,360
241 Zinc syrup Botol 0 0 0 0 0 0 0 8,140 0
TOTAL #REF!
jumlah resep
JKN 515 1454 pustu simpo 46 128 1 4 47 132
Lain - lain 2 6 pustu tonrong 25 54 25 54
pustu trong rijang 78 169 78 169
Kunjungan Rawat Inap pkesdes sipodeceng 85 249 85 249
Jamkesda 109 320 pkesdes baranti 58 137 58 137
JKN 9 27 pkesdes passeno 0 0
Lain - lain pkesdes trong 0 0
pkesdes trong rijang 0 0
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 292 737 1 293 741

Mengetahui
dr Hj Uliant Murniaty,S.Farm
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 116 300 416 68 348 348 348 7,500 2,610,000
19 Ambroxol tablet tablet 0 1500 1500 340 1160 1160 1,160 216 250,560 Des


27 Amoksisilin kapsul 250 mg Kapsul 2333 5000 7333 480 6853 6853 6,853 207 1,418,571
41 Asam Folat tablet 200 1500 1700 40 1660 1660 1,660 68 112,880
42 Asam Mefenamat tablet 500 mg tablet 3673 10000 13673 1549 12124 12124 12,124 122 1,479,128 Des


76 E t a n o l 70 % 100 ml Botol 143 100 243 18 225 225 225 2,625 590,625

94 Guaiafenesin Tablet tablet 5000 10000 15000 50 14950 14950 14,950 132 1,973,400 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 1260 1000 2260 96 2164 2164 2,164 523 1,130,690 Des
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 661 900 1561 119 1442 1442 1,442 1,725 2,487,450
146 Masker Kain pcs 1315 0 1315 160 1155 1155 1,155 506 584,430
147 Mata Pisau No. 15 pcs 89 0 89 0 89 89 89 3,300 293,700
148 Mata Pisau No. 20 pcs 103 0 103 3 100 100 100 3,300 330,000
151 Metilprednisolon tablet 4 mg tablet 0 1000 1000 0 1000 1000 1,000 200 200,000
158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0

176 Parasetamol drops Botol 20 168 188 25 163 163 163 7,350 1,198,050 Des
178 Parasetamol tablet 500 mg tablet 6112 20000 26112 7436 18676 18676 18,676 145 2,708,020 Des
182 Pirantel suspensi 10 ml botol 0 0 0 0 0 0 0 17,600 0 EXP
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 5960 14000 19960 2535 17425 17425 17,425 136 2,369,800
187 Plester 2,5 cm x 4 m rol 35 0 35 15 20 20 20 12,076 241,520
188 Plester 7,5 cm x 4 m rol 0 20 20 0 20 20 20 35,532 710,640
190 Prednison tablet 5 mg tablet 2910 3000 5910 1871 4039 4039 4,039 193 779,527 Jan
195 Ranitidin tablet 150 mg tablet 1400 0 1400 670 730 730 730 132 96,360 Des

208 Sarung Tangan Examination M pcs 0 1000 1000 500 500 500 500 410 205,000
209 Sarung Tangan Examination L pcs 0 1000 1000 0 1000 1000 1,000 410 410,000
223 Tablet tambah darah kombinasi tablet 13998 0 13998 1985 12013 12013 12,013 327 3,924,647 Des
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 3905 15000 18905 2550 16355 16355 16,355 91 1,488,305
234 Urine Bag set 14 0 14 2 12 12 12 3,450 41,400
235 Vaksin Jerap Tetanus vial 74 0 74 1 73 73 73 14,498 1,058,354

237 Vitamin B kompleks tablet tablet 12094 18800 30894 2514 28380 28380 28,380 132 3,746,160
241 Zinc syrup Botol 0 0 0 0 0 0 0 8,140 0
196869 47716
TOTAL 108,698,926
jumlah resep
JKN 416 900 pustu simpo 0
Lain - lain 2 4 pustu tonrong 0
pustu trong rijang 0
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 0 0

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN APRIL
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
6 Ansell Steril 7 psg 242 0 242 6 236 236 300 236 7,500 1,770,000
7 Ansell Steri 7 1/2 psg 125 0 125 9 116 116 300 116 7,500 870,000
18 Ambroxol sirup 15 mg/ml Botol 28 0 28 8 20 20 150 20 5,500 110,000 Des
19 Ambroxol tablet tablet 180 0 180 180 0 0 1,500 0 216 0 Des

23 Amlodipine 5 mg tablet 480 0 480 176 304 304 300 304 105 31,920
27 Amoksisilin kapsul 250 mg Kapsul 2652 0 2652 319 2333 2333 5,000 2,333 207 482,931
28 Amoksisilin kaplet 500 mg kaplet 9808 0 9808 3027 6781 6781 20,000 6,781 233 1,579,973
35 Antihemoroid DOEN kombinasi suppos 30 0 30 3 27 27 100 27 3,502 94,554
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0 0 0 5 0 5,800 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 7751 3000 10751 4185 6566 6566 10,000 6,566 120 787,920
42 Asam Mefenamat tablet 500 mg tablet 4847 0 4847 1174 3673 3673 10,000 3,673 122 448,106 Des
43 Asiklovir 200 mg tablet 300 0 300 0 300 300 300 300 272 81,600
44 Asiklovir 400 mg tablet 0 0 0 0 0 0 200 0 381 0
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 0 0 0 500 0 75 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0 0 0 2 0 156,072 0

51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 0 0 2 0 234,238 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0 0 0 2 0 129,210 0
53 Betahistin maleat 24 mg tablet 30 0 30 30 0 0 300 0 1,210 0 Des

56 Bisakodil 10 mg supp suppos 0 0 0 0 0 0 12 0 5,800 0
59 Catgut/benang bedah no .3/0 pcs 153 0 153 20 133 133 96 133 6,421 853,993
61 Deksametason tablet 0,5 mg tablet 13615 0 13615 2052 11563 11563 5,000 11,563 48 555,024
64 Diazepam tablet 2 mg tablett 0 0 0 0 0 0 500 0 134 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 29 0 29 29 0 0 30 0 1,354 0 EXP
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 0 5 0 8,910 0
76 E t a n o l 70 % 100 ml Botol 58 100 158 15 143 143 100 143 2,625 375,375
77 Etil klorida semprot Botol 0 0 0 0 0 0 5 0 115,500 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 212 0 212 212 0 0 250 0 3,754 0 EXP

87 Garam Oralit untuk 200 ml Air sak 1410 0 1410 272 1138 1138 500 1,138 274 311,812
88 Gentamicin inj 40mg/ml Ampul 25 0 25 25 0 0 25 0 3,545 0 EXP
90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 0 0 1 0 434,500 0
91 Glibenklamid tablet 5 mg tablet 2780 0 2780 80 2700 2700 500 2,700 110 297,000 Des
94 Guaiafenesin Tablet tablet 5000 0 5000 0 5000 5000 10,000 5,000 132 660,000 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 1360 0 1360 100 1260 1260 1,000 1,260 523 658,350 Des
97 Haloperidol tablet 1,5 mg tablet 500 0 500 500 0 0 1,000 0 76 0 Des
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 595 0 595 65 530 530 300 530 171 90,630
106 Infusion set anak pcs 93 0 93 7 86 86 50 86 4,025 346,150
107 Infusion set dewasa pcs 153 50 203 63 140 140 200 140 3,680 515,200
110 Kalsium Glukonat inj 10% ampul 0 0 0 0 0 0 25 0 999 0
111 Kalsium Hidroksida pasta buah 0 0 0 0 0 0 1 0 266,200 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 2948 0 2948 2068 880 880 10,000 880 69 60,720
117 Kaptopril 25 mg tablet 1906 0 1906 869 1037 1037 2,000 1,037 165 171,105 Des
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 702 0 702 41 661 661 900 661 1,725 1,140,225
120 Kasa hidrofil 40 x 80 cm roll 4 0 4 4 0 0 15 0 120,750 0
127 Kloramfenikol tetes mata 1 % botol 25 0 25 0 25 25 25 8,250 206,250 Des
130 Klorfeniramin maleat tablet 4 mg tablet 3300 3000 6300 0 6300 6300 5,000 6,300 45 283,500
135 Klorpromazin HCI tablet salut 25 mg tablet 995 0 995 689 306 306 1,000 306 170 52,020
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 1 0 1 0 1 1 5 1 2,143 2,143 Des
146 Masker Kain pcs 1580 0 1580 265 1315 1315 1,315 506 665,390
147 Mata Pisau No. 15 pcs 94 0 94 5 89 89 89 3,300 293,700
148 Mata Pisau No. 20 pcs 103 0 103 0 103 103 103 3,300 339,900
151 Metilprednisolon tablet 4 mg tablet 0 0 0 0 0 0 1,000 0 200 0
152 Metformin Hcl 500 mg tablet 1600 0 1600 319 1281 1281 500 1,281 115 147,315
153 Metoklopramida 10 mg tablet 0 0 0 0 0 0 1,000 0 100 0
156 Metronidazol tablet 500 mg tablet 4004 0 4004 361 3643 3643 1,500 3,643 140 510,020
157 Miconazole Krim tube 40 0 40 3 37 37 48 37 3,737 138,269
158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 100 0 37,400 0 Des
161 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0 750 0 161 0

176 Parasetamol drops Botol 42 0 42 22 20 20 150 20 7,350 147,000 Des
178 Parasetamol tablet 500 mg tablet 14307 0 14307 8195 6112 6112 20,000 6,112 145 886,240 Des
182 Pirantel suspensi 10 ml botol 0 0 0 0 0 17,600 0 EXP
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 4944 3000 7944 1984 5960 5960 15,000 5,960 136 810,560
186 Piroksikam 20 mg tablet 90 0 90 0 90 90 300 90 220 19,800 Des
187 Plester 2,5 cm x 4 m rol 48 0 48 13 35 35 35 12,076 422,660
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 20 0 35,532 0
190 Prednison tablet 5 mg tablet 670 3000 3670 760 2910 2910 3,000 2,910 193 561,630 Jan
203 Salbutamol tablet 2 mg tablet 619 0 619 131 488 488 500 488 99 48,312 Des
205 Salep 2 - 4 kombinasi pot 20 0 20 5 15 15 48 15 2,797 41,955

207 Sarung Tangan Examination S pcs 100 0 100 100 0 0 1,000 0 410 0
208 Sarung Tangan Examination M pcs 500 0 500 500 0 0 1,000 0 410 0
209 Sarung Tangan Examination L pcs 400 0 400 400 0 0 1,000 0 410 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 0 0 1 0 102,850 0
212 Setrizin tablet 10 mg tablet 0 0 0 0 #REF! #REF! #REF! 154 #REF!
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 1412 0 1412 260 1152 1152 5,000 1,152 58 66,816
217 Simvastatin 10 mg tablet 30 600 630 120 510 510 300 510 135 68,850
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 48 12 60 14 46 46 48 46 20,825 957,950
220 Siprofloksasin tablet 500 mg tablet 478 0 478 272 206 206 1,000 206 298 61,388
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
228 Tiamfenikol 500 mg kapsul 90 100 190 100 90 90 200 90 1,452 130,680 Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 1595 3000 4595 690 3905 3905 15,000 3,905 91 355,355
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 0 0 0 1,000 0 97 0
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0 0 0 50 0 8,770 0
234 Urine Bag set 14 0 14 0 14 14 14 3,450 48,300

238 Wicold kapsul kapsul 1682 0 1682 350 1332 1332 3,000 1,332 792 1,054,944
240 Yodium povidon larutan 10 % 300 ml Botol 6 0 6 3 3 3 15 3 21,600 64,800
241 Zinc syrup Botol 0 0 0 0 0 0 60 0 8,140 0
242 Zinc Tablet tablet 3087 0 3087 225 2862 2862 3,000 2,862 592 1,694,304
16862 44811
TOTAL #REF!
jumlah resep
JKN 440 1377 pustu simpo 29 82 11 30 112
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 182 519 11 0 549

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN maret
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
1 IV Catheter Gea No. 18 set #REF! #REF! #REF! #REF! #REF! #REF! #REF! 5,203 #REF!
5 Ansell Steril 6 1/2 psg #REF! #REF! #REF! #REF! #REF! #REF! #REF! 7,500 #REF!
6 Ansell Steril 7 psg #REF! #REF! #REF! #REF! #REF! #REF! #REF! 7,500 #REF!
7 Ansell Steri 7 1/2 psg #REF! #REF! #REF! #REF! #REF! #REF! #REF! 7,500 #REF!
8 Alat Suntik sekali pakai 0,05 ml set #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,650 #REF!
9 Alat Suntik sekali pakai 0,5 ml set #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,240 #REF!
10 Alat suntik sekali pakai 1 ml set #REF! #REF! #REF! #REF! #REF! #REF! #REF! 748 #REF!
13 Alat Suntik sekali pakai 10 ml set #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,064 #REF!
14 Albendasol tablet 400 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 425 #REF!
15 Alkohol Swab kotak #REF! #REF! #REF! #REF! #REF! #REF! #REF! 115 #REF!
16 Alupurinol tablet 100 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 95 #REF!
17 Allpurinol tablet 300 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 244 #REF!
18 Ambroxol sirup 15 mg/ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 5,500 #REF! Des
19 Ambroxol tablet tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 216 #REF! Des
20 Aminofilin tablet 200 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 86 #REF!
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,349 #REF!
22 Amitriptilin HCI tablet salut 25 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 165 #REF!
23 Amlodipine 5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 105 #REF!
24 Amlodipine 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 163 #REF!
25 Amoksisilin sirup kering 125 mg/5 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,200 #REF!
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 4,147 #REF!
27 Amoksisilin kapsul 250 mg Kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 207 #REF!
28 Amoksisilin kaplet 500 mg kaplet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 233 #REF!
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial #REF! #REF! #REF! #REF! #REF! #REF! #REF! 4,600 #REF!
30 Anagens Syrup Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 19,800 #REF!
31 Antalgin (Metampiron) tablet 500 mg Tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 209 #REF! Des
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,500 #REF!
33 Antasida DOEN tablet kombinasi tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 64 #REF!
34 Antasida DOEN suspensi Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,106 #REF!
35 Antihemoroid DOEN kombinasi suppos #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,502 #REF!
36 Antifungi DOEN kombinasi pot #REF! #REF! #REF! #REF! #REF! #REF! #REF! 4,782 #REF!
37 Antibakteri DOEN salep Kombinasi tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,767 #REF!
38 Antimigrain DOEN kombinasi tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 149 #REF!
39 Aqua pro injeksi steril, bebas pirogen vial #REF! #REF! #REF! #REF! #REF! #REF! #REF! 5,800 #REF!
40 Asam Askorbat (Vit C) tablet 50 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 3,000 #REF! 120 #REF!
41 Asam Folat tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 68 #REF!
42 Asam Mefenamat tablet 500 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 122 #REF! Des
43 Asiklovir 200 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 272 #REF!
44 Asiklovir 400 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 381 #REF!
45 Asiklovir krim 5% tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,960 #REF! Des
46 Asetosal tablet 100 mg tabet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 110 #REF!
47 Attalpulgit tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 173 #REF!
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,672 #REF!
49 Atropin Sulfat tablet 0,5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 75 #REF!
50 Benecheck plus Glucose test strip 50's box #REF! #REF! #REF! #REF! #REF! #REF! #REF! 156,072 #REF!
51 Benecheck plus Cholesterol test strip 50's box #REF! #REF! #REF! #REF! #REF! #REF! #REF! 234,238 #REF!
52 Benecheck plus Uric test strip 50's box #REF! #REF! #REF! #REF! #REF! #REF! #REF! 129,210 #REF!
53 Betahistin maleat 24 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 200 #REF! 1,210 #REF! Des
54 Betametason krim 0.1 % tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,435 #REF!
55 Bisakodil 5 mg supp suppos #REF! #REF! #REF! #REF! #REF! #REF! #REF! 5,670 #REF!
56 Bisakodil 10 mg supp suppos #REF! #REF! #REF! #REF! #REF! #REF! #REF! 5,800 #REF!
57 Blood Lancet 26G kotak #REF! #REF! #REF! #REF! #REF! #REF! #REF! 160 #REF!
58 Catgut/benang bedah no .2/0 pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 33,925 #REF!
59 Catgut/benang bedah no .3/0 pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 6,421 #REF!
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,740 #REF!
61 Deksametason tablet 0,5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 48 #REF!
62 Diazepam injeksi 5 mg/ml - 2 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,578 #REF!
63 Diazepam rectal 5mg/2,5 ml buah #REF! #REF! #REF! #REF! #REF! #REF! #REF! 12,749 #REF!
64 Diazepam tablet 2 mg tablett #REF! #REF! #REF! #REF! #REF! #REF! #REF! 134 #REF!
65 Diazepam tablet 5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 65 #REF!
66 Dietilkarbamazin Sitrat tablet 100 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 104 #REF!
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,354 #REF!
68 Digoksin tablet 0,25 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 108 #REF!
69 Doksisilin kapsul 100 mg Kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 309 #REF!
70 Domperidom suspensi Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,180 #REF!
71 Domperidom tablet tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 451 0 Jan
72 Efedrin HCI tablet 25 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 56 #REF!
73 Ekstrak Belladon tablet 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 42 #REF!
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 8,910 #REF!
75 Etakridin (Rivanol) larutan 0,1 % Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,600 #REF!
76 E t a n o l 70 % 100 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! 100 #REF! 2,625 #REF!
77 Etil klorida semprot Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 115,500 #REF!
78 Eugenol cairan botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 18,333 #REF!
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,980 #REF!
80 Fenobarbital tablet 30 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 74 #REF!
81 Fervital Kapsul kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 861 #REF!
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,754 #REF!
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 796 #REF!
84 Foly Catheter No. 18 pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 9,200 #REF!
85 Foly Catheter No. 20 pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 9,200 #REF!
86 Furosemid tablet 40 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 84 #REF!
87 Garam Oralit untuk 200 ml Air sak #REF! #REF! #REF! #REF! #REF! #REF! #REF! 274 #REF!
88 Gentamicin inj 40mg/ml Ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,545 #REF!
89 Gentian Violet larutan 1 % Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,850 #REF! Jan
90 Glass lonomer Cement (GC IX ) buah #REF! #REF! #REF! #REF! #REF! #REF! #REF! 434,500 #REF!
91 Glibenklamid tablet 5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 110 #REF! Des
92 Glimepiride 1 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 220 #REF!
93 Glimepiride 2 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 297 #REF!
94 Guaiafenesin Tablet tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 132 #REF! Des
95 Glukosa larutan infus 5 % steril Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 6,900 #REF!
96 Grisefulvin tablet 125 mg (Micronized) tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 523 #REF! Des
97 Haloperidol tablet 1,5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 76 #REF! Des
98 Haloperidol tablet 2 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 134 #REF!
99 Haloperidol inj 50 mg/ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 91,667 #REF!
100 Hidroklorotiazid (HCT) tablet 25 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 171 #REF!
101 Hidrokortison krim 2,5 % tube #REF! #REF! #REF! #REF! #REF! #REF! 50 #REF! 2,812 #REF!
102 Ibuprofen suspensi 100 mg/5 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 8,000 #REF!
103 Ibuprofen suspensi 200 mg/5 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 8,800 #REF! Des
104 Ibuprofen tablet 200 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 1,000 #REF! 111 #REF!
105 Ibuprofen tablet 400 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 133 #REF!
106 Infusion set anak pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 4,025 #REF!
107 Infusion set dewasa pcs #REF! #REF! #REF! #REF! #REF! #REF! 50 #REF! 3,680 #REF!
108 Isoniazid tablet 100 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 82 #REF!
109 Isosorbid Dinitrat tablet subligual 5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 98 #REF!
110 Kalsium Glukonat inj 10% ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 999 #REF!
111 Kalsium Hidroksida pasta buah #REF! #REF! #REF! #REF! #REF! #REF! #REF! 266,200 #REF!
112 Kalsium laktat (Kalk) tablet 500 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 69 #REF!
113 Kapas pembalut 250 gram buah #REF! #REF! #REF! #REF! #REF! #REF! #REF! 14,375 #REF!
114 Kapas pembalut / Absorben 500 gram bungkus #REF! #REF! #REF! #REF! #REF! #REF! #REF! 31,372 #REF!
115 Kapas pembalut / Absorben 1000 gram bungkus #REF! #REF! #REF! #REF! #REF! #REF! #REF! 62,744 #REF!
116 Kaptopril 12,5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 69 #REF!
117 Kaptopril 25 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 165 #REF! Des
118 Karbamazepin tablet 200 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 306 #REF!
119 Kasa pembalut Hidrofil 4 m x 10 cm roll #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,725 #REF!
120 Kasa hidrofil 40 x 80 cm roll #REF! #REF! #REF! #REF! #REF! #REF! #REF! 120,750 #REF!
121 Kasa pembalut elastis 3 inch roll #REF! #REF! #REF! #REF! #REF! #REF! #REF! 7,700 #REF!
122 Ketokonazol krim 2% tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 6,600 #REF! Des
123 Ketokonazol tablet 200 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 264 #REF! Des
124 Kloramfenikol kapsul 250 mg Kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 616 #REF! Des
125 Kloramfenikol susp 125mg/5 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 4,000 #REF!
126 Kloramfenikol salep mata 1 % tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,850 #REF!
127 Kloramfenikol tetes mata 1 % botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 8,250 #REF! Des
128 Kloramfenikol salep Kulit 2% tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,409 #REF!
129 Kloramfenikol tetes telinga 3 % Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 8,250 #REF! Des
130 Klorfeniramin maleat tablet 4 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 3,000 #REF! 45 #REF!
131 Klorokuin tablet 150 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 112 #REF!
132 Klorfenol Kamfer Menthol Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 60,500 #REF!
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,045 #REF!
134 Klorpromazin HCI tablet salut 100 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 179 #REF!
135 Klorpromazin HCI tablet salut 25 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 170 #REF!
136 Kotrimoksazol tablet 480 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 158 #REF!
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,225 #REF!
138 Kotrimoksazol Pediatrik tablet 120 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 138 #REF! Jan
139 Larutan mengandung elektrolit botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 9,275 #REF!
140 Lidokain komp. injeksi - 2 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,122 #REF!
141 Lisol 1 liter Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 49,200 #REF!
142 Loperamide 2 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 90 #REF!
143 Loratadine 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 149 #REF!
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,694 #REF! Des
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,143 #REF! Des
146 Masker Kain pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 506 #REF!
147 Mata Pisau No. 15 pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,300 #REF!
148 Mata Pisau No. 20 pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,300 #REF!
149 Metilergometrin maleat tablet salut 0,125 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 133 #REF!
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,684 #REF!
151 Metilprednisolon tablet 4 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 200 #REF!
152 Metformin Hcl 500 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 115 #REF!
153 Metoklopramida 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 100 #REF!
154 Metoklopramida injeksi 5 mg / ml vial #REF! #REF! #REF! #REF! #REF! #REF! #REF! 6,600 #REF! Jan
155 Metronidazol tablet 250 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 98 #REF!
156 Metronidazol tablet 500 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 140 #REF!
157 Miconazole Krim tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,737 #REF!
158 Mineral Mix sak #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,450 #REF!
159 Multivitamin (Lycalvit) syrup botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 37,400 #REF! Des
160 Mummifying pasta buah #REF! #REF! #REF! #REF! #REF! #REF! #REF! 193,600 #REF!
161 Natrium diklofenak 50 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 500 #REF! 161 #REF!
162 Natrium klorida larutan infus 0,9 % steril Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 6,410 #REF!
163 Nifedipin 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 123 #REF!
164 Nistatin tablet vagina 100.000 IU / g ovula #REF! #REF! #REF! #REF! #REF! #REF! #REF! 602 #REF!
165 Nistatin vaginal tablet salut 500.000 IU/g tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 704 #REF!
166 Obat anti Tuberklosis kategori FDC I paket #REF! #REF! #REF! #REF! #REF! #REF! #REF! 413,984 #REF!
167 Obat anti Tuberklosis kategori FDC 2 paket #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,317,000 #REF! Des
168 Obat anti Tuberklosis kategori FDC Anak paket #REF! #REF! #REF! #REF! #REF! #REF! #REF! 236,500 #REF!
169 Obat Batuk Hitam (O.B.H) cairan botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 4,400 #REF! Des
170 OBH Itral Syrup Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 16,698 #REF!
171 Ofloksasin tablet 400 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 636 #REF!
172 Oksitetrasiklin HCI salep kulit 3 % tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,869 #REF!
173 Oksitetrasiklin HCI salep mata 1 % tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,300 #REF! Des
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,900 #REF!
175 Omeprazole 20 mg kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 880 0 Jan
176 Parasetamol drops Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 7,350 #REF! Des
177 Parasetamol sirup 120 mg / 5 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,119 #REF! Des
178 Parasetamol tablet 500 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 145 #REF! Des
179 Pehacain injeksi botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 4,400 #REF! Des
180 Permetrin krim 5% tube #REF! #REF! #REF! #REF! #REF! #REF! #REF! 12,155 #REF!
181 Pirantel pamoat tablet 125 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 318 #REF!
182 Pirantel suspensi 10 ml botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 17,600 #REF! Jan
183 Pirantel suspensin 60 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 9,100 #REF! Des
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 3,000 #REF! 136 #REF!
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,030 #REF!
186 Piroksikam 20 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 220 #REF! Des
187 Plester 2,5 cm x 4 m rol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 12,076 #REF!
188 Plester 7,5 cm x 4 m rol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 35,532 #REF!
189 Pot Sputum pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,190 0 Des
190 Prednison tablet 5 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 3,000 #REF! 193 #REF! Jan
191 Primakuin tablet 15 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 120 #REF!
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial #REF! #REF! #REF! #REF! #REF! #REF! #REF! 9,908 #REF!
193 Propiltiourasil tablet 100 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 320 #REF!
194 Propranolol HCI tablet 40 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 69 #REF!
195 Ranitidin tablet 150 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 132 #REF! Des
196 Ranitidin injeksi 25 mg/2 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,600 #REF!
197 Rapid Test VIKIA HIV 1/2 kit #REF! #REF! #REF! #REF! #REF! #REF! #REF! 525,000 #REF! Des
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test #REF! #REF! #REF! #REF! #REF! #REF! #REF! 14,344 #REF!
199 Reagensia ZN botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 270,000 #REF!
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 327 #REF!
201 Retinol (Vitamin A) kapsul 200.000 IU kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 505 #REF!
202 Ringer Laktat larutan infus steril Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 7,150 #REF!
203 Salbutamol tablet 2 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 99 #REF! Des
204 Salbutamol 4 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 88 #REF!
205 Salep 2 - 4 kombinasi pot #REF! #REF! #REF! #REF! #REF! #REF! #REF! 2,797 #REF!
206 Salisil bedak 2 % pot #REF! #REF! #REF! #REF! #REF! #REF! 50 #REF! 1,066 #REF!
207 Sarung Tangan Examination S pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 410 #REF!
208 Sarung Tangan Examination M pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 410 #REF!
209 Sarung Tangan Examination L pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 410 #REF!
210 Sefadroksil 500 mg kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 557 #REF!
211 Semen seng fosfat serbuk dan cairan buah #REF! #REF! #REF! #REF! #REF! #REF! #REF! 102,850 #REF!
212 Setrizin tablet 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 154 #REF!
213 Setrizin syrup Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 7,756 #REF!
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 58 #REF!
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,226 #REF!
216 Simetidine 200 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 209 #REF! Jan
217 Simvastatin 10 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 600 #REF! 135 #REF!
218 Simvastatin 20 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 252 #REF!
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs #REF! #REF! #REF! #REF! #REF! #REF! 12 #REF! 20,825 #REF!
220 Siprofloksasin tablet 500 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 298 #REF!
221 Spironolakton tablet 100 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 878 #REF!
222 Sulfasetamida natrium tetes mata 15 % Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,549 #REF!
223 Tablet tambah darah kombinasi tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 327 #REF! Des
224 Taburia kotak #REF! #REF! #REF! #REF! #REF! #REF! #REF! 18,150 #REF!
225 Temporary stopping (Fletcher) buah #REF! #REF! #REF! #REF! #REF! #REF! #REF! 37,400 #REF!
226 Tetrasiklin HCI kapsul 250 mg kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 162 #REF!
227 Tetrasiklin HCI kapsul 500 mg kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 325 #REF!
228 Tiamfenikol 500 mg kapsul #REF! #REF! #REF! #REF! #REF! #REF! 100 #REF! 1,452 #REF! Jan
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 1,760 #REF! Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! 3,000 #REF! 91 #REF!
231 Triheksifenidil Hidroklorida tablet 2 mg tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 97 #REF!
232 Umbilical Cord kotak #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,163 #REF!
233 U-Pad steril 60 cm x 90 cm pcs #REF! #REF! #REF! #REF! #REF! #REF! #REF! 8,770 #REF!
234 Urine Bag set #REF! #REF! #REF! #REF! #REF! #REF! #REF! 3,450 #REF!
235 Vaksin Jerap Tetanus vial #REF! #REF! #REF! #REF! #REF! #REF! #REF! 14,498 #REF!
236 Vaksin Rabies vero kuur #REF! #REF! #REF! #REF! #REF! #REF! #REF! 700,000 #REF!
237 Vitamin B kompleks tablet tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 132 #REF!
238 Wicold kapsul kapsul #REF! #REF! #REF! #REF! #REF! #REF! #REF! 792 #REF!
239 Yodium povidon larutan 10 % 60 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 7,040 #REF!
240 Yodium povidon larutan 10 % 300 ml Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 21,600 #REF!
241 Zinc syrup Botol #REF! #REF! #REF! #REF! #REF! #REF! #REF! 8,140 #REF!
242 Zinc Tablet tablet #REF! #REF! #REF! #REF! #REF! #REF! #REF! 592 #REF!
TOTAL #REF!
jumlah resep
JKN 515 1454 pustu simpo 46 128 1 4 47 132
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 292 737 1 293 741

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN maret
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22

40 Asam Askorbat (Vit C) tablet 50 mg tablet 12612 0 12612 #REF! #REF! #REF! 3,000 #REF! 120 #REF!
47 Attalpulgit tablet 150 0 150 #REF! #REF! #REF! #REF! 173 #REF!
53 Betahistin maleat 24 mg tablet 150 0 150 #REF! #REF! #REF! 200 #REF! 1,210 #REF! Des
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 29 0 29 #REF! #REF! #REF! #REF! 1,354 #REF!
76 E t a n o l 70 % 100 ml Botol 66 0 66 #REF! #REF! #REF! 100 #REF! 2,625 #REF!
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 228 0 228 #REF! #REF! #REF! #REF! 3,754 #REF!
88 Gentamicin inj 40mg/ml Ampul 25 0 25 #REF! #REF! #REF! #REF! 3,545 #REF!
101 Hidrokortison krim 2,5 % tube 35 0 35 #REF! #REF! #REF! 50 #REF! 2,812 #REF!
104 Ibuprofen tablet 200 mg tablet 3590 0 3590 #REF! #REF! #REF! 1,000 #REF! 111 #REF!
107 Infusion set dewasa pcs 210 0 210 #REF! #REF! #REF! 50 #REF! 3,680 #REF!
130 Klorfeniramin maleat tablet 4 mg tablet 4500 0 4500 #REF! #REF! #REF! 3,000 #REF! 45 #REF!
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 30 0 30 #REF! #REF! #REF! #REF! 1,045 #REF!
161 Natrium diklofenak 50 mg tablet 0 0 0 #REF! #REF! #REF! 500 #REF! 161 #REF!
181 Pirantel pamoat tablet 125 mg tablet 353 0 353 #REF! #REF! #REF! #REF! 318 #REF!
182 Pirantel suspensi 10 ml botol 15 0 15 #REF! #REF! #REF! #REF! 17,600 #REF! Jan
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 7000 0 7000 #REF! #REF! #REF! 3,000 #REF! 136 #REF!
190 Prednison tablet 5 mg tablet 3000 0 3000 #REF! #REF! #REF! 3,000 #REF! 193 #REF! Jan
206 Salisil bedak 2 % pot 57 0 57 #REF! #REF! #REF! 50 #REF! 1,066 #REF!
212 Setrizin tablet 10 mg tablet 100 0 100 #REF! #REF! #REF! #REF! 154 #REF!
217 Simvastatin 10 mg tablet 300 0 300 #REF! #REF! #REF! 600 #REF! 135 #REF!
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 56 0 56 #REF! #REF! #REF! 12 #REF! 20,825 #REF!
228 Tiamfenikol 500 mg kapsul 100 0 100 #REF! #REF! #REF! 100 #REF! 1,452 #REF! Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 4570 0 4570 #REF! #REF! #REF! 3,000 #REF! 91 #REF!
TOTAL #REF!
jumlah resep
JKN 515 1454 pustu simpo 46 128 1 4 47 132
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 292 737 1 293 741

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN FEB
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 203 0 203 12 191 191 191 7,500 1,432,500
19 Ambroxol tablet tablet 0 300 300 0 300 300 300 216 64,800 Des


27 Amoksisilin kapsul 250 mg Kapsul 710 2500 3210 168 3042 3042 3,042 207 629,694
42 Asam Mefenamat tablet 500 mg tablet 4038 3000 7038 1075 5963 5963 5,963 122 727,486 Des

53 Betahistin maleat 24 mg tablet 0 150 150 0 150 150 150 1,210 181,500 Des
76 E t a n o l 70 % 100 ml Botol 81 0 81 15 66 66 66 2,625 173,250
78 Eugenol cairan botol 0 2 2 0 2 2 2 18,333 36,666

94 Guaiafenesin Tablet tablet 0 5000 5000 0 5000 5000 5,000 132 660,000 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 543 1000 1543 45 1498 1498 1,498 523 782,705 Des
97 Haloperidol tablet 1,5 mg tablet 2020 0 2020 920 1100 1100 1,100 76 83,600 Des
135 Klorpromazin HCI tablet salut 25 mg tablet 1170 500 1670 1070 600 600 600 170 102,000
146 Masker Kain pcs 2247 0 2247 363 1884 1884 1,884 506 953,304
147 Mata Pisau No. 15 pcs 95 0 95 0 95 95 95 3,300 313,500
148 Mata Pisau No. 20 pcs 106 0 106 0 106 106 106 3,300 349,800
158 Mineral Mix sak 0 0 0 0 0 0 0 2,450 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 0 37,400 0 Des

178 Parasetamol tablet 500 mg tablet 594 10000 10594 195 10399 10399 10,399 145 1,507,855 Des
179 Pehacain injeksi botol 0 0 0 0 0 0 0 4,400 0 Des
182 Pirantel suspensi 10 ml botol 15 0 15 0 15 15 15 17,600 264,000 Jan
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 7000 7000 0 7000 7000 7,000 136 952,000
187 Plester 2,5 cm x 4 m rol 55 0 55 1 54 54 54 12,076 652,104
188 Plester 7,5 cm x 4 m rol 9 0 9 8 1 1 1 35,532 35,532
190 Prednison tablet 5 mg tablet 0 3000 3000 0 3000 3000 3,000 193 579,000 Jan

208 Sarung Tangan Examination M pcs 0 200 200 0 200 200 200 410 82,000
224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 1500 5000 6500 1930 4570 4570 4,570 91 415,870
234 Urine Bag set 16 0 16 2 14 14 14 3,450 48,300

238 Wicold kapsul kapsul 510 2000 2510 378 2132 2132 2,132 792 1,688,544
241 Zinc syrup Botol 0 0 0 0 0 0 0 8,140 0
TOTAL 92,793,873
jumlah resep
JKN 515 1454 pustu simpo 46 128 1 4 47 132
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 292 737 1 293 741

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
KECAMATAN : BARANTI TGL : BULAN JANUARI
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22
7 Ansell Steri 7 1/2 psg 211 0 211 8 203 203 203 7,500 1,522,500
13 Alat Suntik sekali pakai 10 ml set 200 200 200 200 200 1,064 212,800
15 Alkohol Swab kotak 300 300 300 300 300 115 34,500
18 Ambroxol sirup 15 mg/ml Botol 0 0 0 0 0 0 0 5,500 0 Des
19 Ambroxol tablet tablet 0 0 0 0 0 0 0 216 0 Des


27 Amoksisilin kapsul 250 mg Kapsul 804 0 804 94 710 710 710 207 146,970
42 Asam Mefenamat tablet 500 mg tablet 5470 0 5470 1432 4038 4038 4,038 122 492,636 Des
45 Asiklovir krim 5% tablet 0 0 0 0 0 0 0 3,960 0 Des


64 Diazepam tablet 2 mg tablett 35 0 35 0 35 35 35 134 4,690
76 E t a n o l 70 % 100 ml Botol 100 0 100 19 81 81 81 2,625 212,625

94 Guaiafenesin Tablet tablet 0 0 0 0 0 0 0 132 0 Des
96 Grisefulvin tablet 125 mg (Micronized) tablet 578 0 578 35 543 543 543 523 283,718 Des
97 Haloperidol tablet 1,5 mg tablet 2750 0 2750 730 2020 2020 2,020 76 153,520 Des
115 Kapas pembalut / Absorben 1000 gram bungkus 2 2 2 2 2 62,744 125,488
122 Ketokonazol krim 2% tube 12 0 12 12 0 0 0 6,600 0 Des
135 Klorpromazin HCI tablet salut 25 mg tablet 1800 0 1800 630 1170 1170 1,170 170 198,900
146 Masker Kain pcs 2580 0 2580 333 2247 2247 2,247 506 1,136,982
147 Mata Pisau No. 15 pcs 95 0 95 0 95 95 95 3,300 313,500
148 Mata Pisau No. 20 pcs 106 0 106 0 106 106 106 3,300 349,800
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0 0 0 0 6,600 0 Jan
159 Multivitamin (Lycalvit) syrup botol 0 37,400 0 Des
161 Natrium diklofenak 50 mg tablet 38 0 38 0 38 38 38 161 6,118
167 Obat anti Tuberklosis kategori FDC 2 paket 0 1 1 0 1 1 1 1,317,000 1,317,000 Des

178 Parasetamol tablet 500 mg tablet 704 0 704 110 594 594 594 145 86,130 Des
182 Pirantel suspensi 10 ml botol 0 0 15 15 17,600 264,000 Jan
183 Pirantel suspensin 60 ml Botol 15 15 0 15 15 15 9,100 136,500 Des
186 Piroksikam 20 mg tablet 0 0 0 0 0 0 0 220 0 Des
187 Plester 2,5 cm x 4 m rol 59 0 59 4 55 55 55 12,076 664,180
188 Plester 7,5 cm x 4 m rol 9 0 9 0 9 9 9 35,532 319,788
190 Prednison tablet 5 mg tablet 0 0 0 0 0 0 0 193 0 Jan

208 Sarung Tangan Examination M pcs 100 0 100 100 0 0 0 410 0
216 Simetidine 200 mg tablet 0 0 0 0 0 0 0 209 0 Jan
228 Tiamfenikol 500 mg kapsul 0 0 0 0 0 0 0 1,452 0 Jan
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 0 0 0 1,760 0 Jan
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 4549 0 4549 3049 1500 1500 1,500 91 136,500
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0 0 0 0 8,770 0
234 Urine Bag set 19 0 19 3 16 16 16 3,450 55,200

241 Zinc syrup Botol 0 0 0 0 0 0 0 8,140 0
TOTAL 80,130,060
jumlah resep
JKN 509 1699 pustu simpo 61 175 61 175
Lain - lain pustu tonrong 48 113 48 113
pkesdes duampanua
usila
posbindu
TOTAL 1240 3573 TOTAL 409 1072 0 409 1072

Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

( L P L P O)
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
7 Ansell Steri 7 1/2 psg 211 0 211 8 203 203 203 7,500 1,522,500
20 Amoksisilin kapsul 250 mg Kapsul 804 0 804 94 710 710 2,400 710 207 146,970
21 Amoksisilin kaplet 500 mg kaplet 1286 0 1286 313 973 973 20,000 973 233 226,709
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
23 Antalgin (Metampiron) tablet 500 mg Tablet 1830 0 1830 10 1820 1820 1,820 190 345,800
27 Antihemoroid DOEN kombinasi suppos 0 0 0 0 0 0 50 0 3,502 0
31 Aqua pro injeksi steril, bebas pirogen ampul 0 0 0 0 0 0 0 5,800 0
32 Asam Askorbat (Vit C) tablet 50 mg tablet 15957 0 15957 5277 10680 10680 14,400 10,680 120 1,281,600
34 Asam Mefenamat tablet 500 mg tablet 5470 0 5470 1432 4038 4038 5,000 4,038 113 456,294
35 Asiklovir 200 mg tablet 112 0 112 110 2 2 1,000 2 272 544
37 Asiklovir krim 5% tube 0 0 0 0 0 0 0 3,600 0
38 Asetosal tablet 100 mg tablet 100 0 100 0 100 100 100 110 11,000
41 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 0 0 0 100 0 75 0
43 Catgut/benang bedah no .2/0 sak 0 0 0 0 0 0 0 33,925 0
44 Catgut/benang bedah no .3/0 sak 141 0 141 12 129 129 120 129 6,421 828,309
48 Diazepam tablet 2 mg tablet 35 0 35 0 35 35 1,000 35 134 4,690
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
53 Doksisilin kapsul 100 mg kapsul 0 0 0 0 0 0 0 309 0
54 Domperidom suspensi Botol 5 0 5 5 0 0 100 0 3,180 0
58 Etakridin (Rivanol) larutan 0,1 % botol 9 0 9 1 8 8 8 3,600 28,800
59 E t a n o l 70 % 100 ml botol 100 0 100 19 81 81 81 2,625 212,625
60 Etil klorida semprot botol 0 0 0 0 0 0 0 115,500 0
63 Fenobarbital tablet 30 mg tablet 0 0 0 0 0 0 1,000 0 74 0
64 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 m ampul 258 0 258 15 243 243 243 3,754 912,222
70 Gentamicin inj 40mg/ml ampul 25 0 25 0 25 25 25 3,545 88,625
71 Gentian Violet larutan 1 % botol 11 0 11 0 11 11 11 3,500 38,500
72 Glass lonomer Cement (GC IX ) botol 0 0 0 0 0 0 1 0 434,500 0
73 Glibenklamid tablet 5 mg tablet 2920 0 2920 60 2860 2860 2,860 100 286,000
74 Guafenisin tablet tablet 0 0 0 0 0 0 10,000 0 120 0
75 Glukosa larutan infus 5 % steril botol 99 0 99 29 70 70 40 70 6,900 483,000
76 Grisefulvin tablet 125 mg (Micronized) tablet 578 0 578 35 543 543 1,000 543 475 257,925
77 Haloperidol tablet 1,5 mg tablet 2750 0 2750 730 2020 2020 2,020 74 149,480
81 Ibuprofen suspensi 100 mg/5 ml botol 0 0 0 0 0 0 0 8,000 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
84 Infusion set anak set 124 0 124 11 113 113 113 4,025 454,825
85 Infusion set dewasa set 278 0 278 81 197 197 100 197 3,680 724,960
89 Kalsium Hidroksida pasta tube 0 0 0 0 0 0 0 266,200 0
90 Kalsium laktat (Kalk) tablet 500 mg tablet 764 0 764 154 610 610 5,000 610 69 42,090
93 Kaptopril 25 mg tablet 3338 0 3338 907 2431 2431 5,000 2,431 150 364,650
95 Kasa pembalut Hidrofil 4 m x 10 cm rol 775 0 775 43 732 732 732 1,725 1,262,700
96 Kasa pembalut elastis 3 inch rol 10 0 10 0 10 10 10 7,700 77,000
97 Ketokonazol krim 2% tube 12 0 12 12 0 0 50 0 6,000 0
99 Kloramfenikol kapsul 250 mg kapsul 664 0 664 72 592 592 592 560 331,520
101 Kloramfenikol tetes telinga 3 % botol 0 0 0 0 0 0 0 7,500 0
104 Klorfenol Kamfer Menthol botol 0 0 0 0 0 0 0 60,500 0
107 Klorpromazin HCI tablet salut 25 mg tablet 1800 0 1800 630 1170 1170 500 1,170 170 198,900
109 Kotrimoksazol Suspensi 240 mg/ 5 ml botol 108 0 108 31 77 77 77 2,225 171,325
110 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 0 390 0 390 390 390 125 48,750
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
113 Lisol, mengandung kresol tersabun 50 % botol 5 0 5 0 5 5 5 49,200 246,000
114 Loratadine tablet 450 0 450 0 450 450 450 149 67,050
115 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml vial 0 0 0 0 0 0 0 3,200 0
116 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml vial 1 0 1 0 1 1 5 1 3,650 3,650
117 Masker Kain lembar 2580 0 2580 333 2247 2247 2,247 506 1,136,982
118 Mata Pisau No. 15 pcs 95 0 95 0 95 95 95 3,300 313,500
119 Mata Pisau No. 20 pcs 106 0 106 0 106 106 106 3,300 349,800
122 Metilprednisolon tablet 4 mg tablet 100 0 100 90 10 10 1,000 10 200 2,000
124 Metoklopramida 10 mg tablet 92 0 92 92 0 0 1,000 0 100 0
125 Metoklopramida injeksi 5 mg / ml tablet 0 0 0 0 0 0 50 0 6,000 0
127 Metronidazol tablet 500 mg tablet 2943 0 2943 408 2535 2535 3,000 2,535 140 354,900
128 Mineral Mix sak 0 0 0 0 0 0 80 0 2,450 0
129 Mummifying pasta botol 0 0 0 0 0 0 0 193,600 0
130 Natrium diklofenak 50 mg tablet 38 0 38 0 38 38 2,500 38 161 6,118
131 Natrium klorida larutan infus 0,9 % steril botol 125 0 125 24 101 101 100 101 6,410 647,410
132 Nifedipin 10 mg tablet 134 0 134 3 131 131 100 131 123 16,113
133 Nistatin tablet vagina 100.000 IU / g tablet 90 0 90 0 90 90 90 602 54,180
136 Obat anti Tuberklosis kategori FDC 2 paket 0 1 1 0 1 1 1 1,317,000 1,317,000
141 Oksitetrasiklin HCI salep mata 1 % tube 3 0 3 0 3 3 24 3 3,000 9,000
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
143 Parasetamol drops botol 26 0 26 19 7 7 120 7 5,980 41,860
144 Parasetamol sirup 120 mg / 5 ml botol 85 0 85 67 18 18 240 18 1,535 27,630
145 Parasetamol tablet 500 mg tablet 704 0 704 110 594 594 10,000 594 58 34,452
148 Pirantel suspensi botol 15 0 15 0 15 15 15 16,000 240,000
149 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 0 0 0 0 0 10,000 0 136 0
150 Piroksikam 20 mg kapsul 0 0 0 0 0 0 0 200 0
151 Plester 5 yards x 2 inch rol 59 0 59 4 55 55 55 12,076 664,180
152 Prednison tablet 5 mg tablet 0 0 0 0 0 0 5,000 0 175 0
153 Primakuin tablet 15 mg tablet 0 0 0 0 0 0 100 0 120 0
157 Ranitidin tablet 150 mg tablet 1900 0 1900 0 1900 1900 1,900 115 218,500
158 Ranitidin injeksi 25 mg/2 ml ampul 41 0 41 13 28 28 30 28 1,600 44,800
161 Reagensia ZN paket 0 0 0 0 0 0 0 270,000 0
162 Ringer Laktat larutan infus steril botol 630 0 630 219 411 411 400 411 7,150 2,938,650
165 Salisil bedak 2 % botol 65 0 65 3 62 62 50 62 1,066 66,092
167 Semen seng fosfat serbuk dan cairan botol 0 0 0 0 0 0 0 102,850 0
169 Setrizin syrup botol 94 0 94 1 93 93 93 7,756 721,308
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
174 Silk (benang Bedah Sutera) No. 3 / 0 set 79 0 79 10 69 69 69 20,825 1,436,925
175 Siprofloksasin tablet 500 mg tablet 1036 0 1036 400 636 636 500 636 298 189,528
176 Sulfasetamida natrium tetes mata 15 % botol 0 0 0 0 0 0 0 3,549 0
177 Tablet tambah darah kombinasi tablet 24180 0 24180 3100 21080 21080 21,080 297 6,260,760
178 Taburia kotak 0 0 0 0 0 0 0 18,150 0
179 Temporary stopping (Fletcher) set 0 0 0 0 0 0 0 37,400 0
184 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 4549 0 4549 3049 1500 1500 10,000 1,500 91 136,500
186 Urine Bag pcs 19 0 19 3 16 16 16 3,450 55,200
187 Vaksin Rabies vero set 6 10 16 4 12 12 12 700,000 8,400,000
189 Yodium povidon larutan 10 % 300 ml botol 14 0 14 3 11 11 11 21,600 237,600
190 Yodium povidon larutan 10 % 60 ml botol 47 0 47 1 46 46 46 7,040 323,840
191 Zinc syrup botol 0 0 0 0 0 0 30 0 8,140 0
192 Zinc Tablet tablet 2654 0 2654 220 2434 2434 1,000 2,434 592 1,440,928
193 Pot Sputum pot 0 0 0 0 0 0 0 2,730 0
200 Miconazole Krim Tube 47 0 47 4 43 43 43 3,737 160,691
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
203 Amlodipine 10 mg tablet 0 0 0 0 0 0 600 0 163 0
204 Bisakodil 5 mg supp suppos 0 0 0 0 0 0 20 0 5,670 0
206 Diazepam rectal 5mg/2,5 ml tube 0 0 0 0 0 0 5 0 12,749 0
207 Kloramfenikol susp 125mg/5 ml tablet 105 0 105 0 105 105 105 4,000 420,000
215 Umbilical Cord pcs 193 0 193 7 186 186 186 3,163 588,318
218 Alkohol Swab kotak 0 0 0 0 0 0 0 115 0
222 Sarung Tangan Examination S pcs 200 0 200 0 200 200 1,000 200 410 82,000
223 Sarung Tangan Examination M pcs 100 0 100 100 0 0 3,000 0 410 0
224 Sarung Tangan Examination L pcs 200 0 200 0 200 200 3,000 200 410 82,000
225 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0 0 0 10 0 8,770 0
226 Plester 7,5 cm x 4,5 m rol 9 0 9 0 9 9 30 9 35,532 319,788
227 Anagens Syrup Botol 20 0 20 2 18 18 30 18 19,800 356,400
230 Wicold kapsul 800 0 800 290 510 510 5,000 510 792 403,920
231 Kasa hidrofil 40 x 80 cm roll 1 0 1 1 0 0 15 0 120,750 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
237 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 30 0 7,500 0
238 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 500 0 1,100 0
239 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 50 0 34,000 0
TOTAL 79,595,990
( L P L P O)
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
5 Ansell Steril 6 1/2 psg 436 436 2 434 434 434 7,500 3,255,000
6 Ansell Steril 7 psg 362 362 18 344 344 344 7,500 2,580,000
7 Ansell Steri 7 1/2 psg 249 249 38 211 211 211 7,500 1,582,500
12 Alupurinol tablet 100 mg tablet 1039 1039 0 1039 1039 1,039 95 98,705
13 Ambroxol sirup 15 mg/ml Botol 0 0 0 0 0 0 5,000 0
14 Ambroxol tablet tablet 0 0 0 0 0 0 196 0
16 Aminofilin injeksi 24 mg/ml - 10 ml ampul 7 7 1 6 6 6 3,349 20,094
17 Amitriptilin HCI tablet salut 25 mg tablet 1000 1000 0 1000 1000 1,000 165 165,000
19 Amoksisilin sirup kering forte 250 mg/5 ml Botol 50 50 0 50 50 50 4,147 207,350
20 Amoksisilin kapsul 250 mg Kapsul 1090 1090 286 804 804 804 207 166,428
21 Amoksisilin kaplet 500 mg kaplet 1892 1892 606 1286 1286 1,286 233 299,638
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
23 Antalgin (Metampiron) tablet 500 mg Tablet 1850 1850 20 1830 1830 1,830 190 347,700
25 Antasida DOEN tablet kombinasi tablet 12865 12865 1427 11438 11438 11,438 64 732,032
26 Antasida DOEN suspensi Botol 92 92 15 77 77 77 2,106 162,162
27 Antihemoroid DOEN kombinasi suppos 0 0 0 0 0 0 3,502 0
28 Antifungi DOEN kombinasi pot 24 24 0 24 24 24 4,782 114,768
30 Antimigrain DOEN kombinasi tablet 98 98 0 98 98 98 149 14,602
31 Aqua pro injeksi steril, bebas pirogen ampul 0 0 0 0 0 0 5,800 0
32 Asam Askorbat (Vit C) tablet 50 mg tablet 20307 20307 4350 15957 15957 15,957 120 1,914,840
34 Asam Mefenamat tablet 500 mg tablet 6680 6680 1210 5470 5470 5,470 113 618,110
37 Asiklovir krim 5% tube 0 0 0 0 0 0 3,600 0
38 Asetosal tablet 100 mg tablet 100 100 0 100 100 100 110 11,000
39 Attalpulgit tablet 180 180 0 180 180 180 173 31,140
40 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 10 10 2 8 8 8 1,672 13,376
43 Catgut/benang bedah no .2/0 sak 0 0 0 0 0 0 33,925 0
44 Catgut/benang bedah no .3/0 sak 169 169 28 141 141 141 6,421 905,361
45 Deksametason injeksi 5 mlg/ml - 1 ml ampul 30 30 2 28 28 28 1,740 48,720
46 Deksametason tablet 0,5 mg tablet 18731 18731 1312 17419 17419 17,419 48 836,112
48 Diazepam tablet 2 mg tablet 206 206 171 35 35 35 134 4,690
51 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 29 29 0 29 29 29 1,354 39,266
52 Digoksin tablet 0,25 mg tablet 100 100 0 100 100 100 108 10,800
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
53 Doksisilin kapsul 100 mg kapsul 0 0 0 0 0 0 309 0
54 Domperidom suspensi Botol 16 16 11 5 5 5 3,180 15,900
58 Etakridin (Rivanol) larutan 0,1 % botol 10 10 1 9 9 9 3,600 32,400
59 E t a n o l 70 % 100 ml botol 116 116 16 100 100 100 2,625 262,500
60 Etil klorida semprot botol 0 0 0 0 0 0 115,500 0
62 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 30 30 0 30 30 30 1,980 59,400
64 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 m ampul 275 275 17 258 258 258 3,754 968,532
65 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 585 585 20 565 565 565 796 449,740
68 Furosemid tablet 40 mg tablet 349 349 18 331 331 331 84 27,804
69 Garam Oralit untuk 200 ml Air sak 1254 1254 237 1017 1017 1,017 274 278,658
70 Gentamicin inj 40mg/ml ampul 25 25 0 25 25 25 3,545 88,625
71 Gentian Violet larutan 1 % botol 12 12 1 11 11 11 3,500 38,500
72 Glass lonomer Cement (GC IX ) botol 0 0 0 0 0 0 434,500 0
73 Glibenklamid tablet 5 mg tablet 2940 2940 20 2920 2920 2,920 100 292,000
74 Guafenisin tablet tablet 0 0 0 0 0 0 120 0
75 Glukosa larutan infus 5 % steril botol 108 108 9 99 99 99 6,900 683,100
76 Grisefulvin tablet 125 mg (Micronized) tablet 638 638 60 578 578 578 475 274,550
77 Haloperidol tablet 1,5 mg tablet 3210 3210 460 2750 2750 2,750 74 203,500
79 Hidroklorotiazid (HCT) tablet 25 mg tablet 1094 1094 111 983 983 983 171 168,093
80 Hidrokortison krim 2,5 % tube 127 127 37 90 90 90 2,812 253,080
81 Ibuprofen suspensi 100 mg/5 ml botol 0 0 0 0 0 0 8,000 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
84 Infusion set anak set 134 134 10 124 124 124 4,025 499,100
85 Infusion set dewasa set 320 320 42 278 278 278 3,680 1,023,040
87 Isosorbid Dinitrat tablet subligual 5 mg tablet 251 251 12 239 239 239 98 23,422
89 Kalsium Hidroksida pasta tube 0 0 0 0 0 0 266,200 0
92 Kaptopril 12,5 mg tablet 6282 6282 485 5797 5797 5,797 69 399,993
93 Kaptopril 25 mg tablet 4180 4180 842 3338 3338 3,338 150 500,700
95 Kasa pembalut Hidrofil 4 m x 10 cm rol 876 876 101 775 775 775 1,725 1,336,875
96 Kasa pembalut elastis 3 inch rol 12 12 2 10 10 10 7,700 77,000
97 Ketokonazol krim 2% tube 14 14 2 12 12 12 6,000 72,000
98 Ketokonazol tablet 200 mg tablet 700 700 56 644 644 644 240 154,560
99 Kloramfenikol kapsul 250 mg kapsul 708 708 44 664 664 664 560 371,840
101 Kloramfenikol tetes telinga 3 % botol 0 0 0 0 0 0 7,500 0
102 Klorfeniramin maleat tablet 4 mg tablet 5000 5000 0 5000 5000 5,000 45 225,000
104 Klorfenol Kamfer Menthol botol 0 0 0 0 0 0 60,500 0
105 Klorpromazin HCI injeksi 5 mg/ml - 2 ml ampul 30 30 0 30 30 30 1,045 31,350
107 Klorpromazin HCI tablet salut 25 mg tablet 2310 2310 510 1800 1800 1,800 170 306,000
108 Kotrimoksazol tablet 480 mg tablet 3490 3490 301 3189 3189 3,189 158 503,862
109 Kotrimoksazol Suspensi 240 mg/ 5 ml botol 122 122 14 108 108 108 2,225 240,300
110 Kotrimoksazol Pediatrik tablet 120 mg tablet 390 390 0 390 390 390 125 48,750
111 Larutan mengandung elektrolit botol 100 100 10 90 90 90 9,275 834,750
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
113 Lisol, mengandung kresol tersabun 50 % botol 5 5 0 5 5 5 49,200 246,000
114 Loratadine tablet 450 450 0 450 450 450 149 67,050
115 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml vial 0 0 0 0 0 0 3,200 0
116 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml vial 6 6 5 1 1 1 3,650 3,650
117 Masker Kain lembar 2680 2680 100 2580 2580 2,580 506 1,305,480
118 Mata Pisau No. 15 pcs 99 99 4 95 95 95 3,300 313,500
119 Mata Pisau No. 20 pcs 109 109 3 106 106 106 3,300 349,800
121 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 96 96 2 94 94 94 2,684 252,296
122 Metilprednisolon tablet 4 mg tablet 130 130 30 100 100 100 200 20,000
123 Metformin Hcl 500 mg tablet 1501 1501 301 1200 1200 1,200 115 138,000
124 Metoklopramida 10 mg tablet 254 254 162 92 92 92 100 9,200
125 Metoklopramida injeksi 5 mg / ml tablet 0 0 0 0 0 0 6,000 0
127 Metronidazol tablet 500 mg tablet 3242 3242 299 2943 2943 2,943 140 412,020
128 Mineral Mix sak 0 0 0 0 0 0 2,450 0
129 Mummifying pasta botol 0 0 0 0 0 0 193,600 0
130 Natrium diklofenak 50 mg tablet 38 38 0 38 38 38 161 6,118
131 Natrium klorida larutan infus 0,9 % steril botol 150 150 25 125 125 125 6,410 801,250
132 Nifedipin 10 mg tablet 164 164 30 134 134 134 123 16,482
133 Nistatin tablet vagina 100.000 IU / g tablet 90 90 0 90 90 90 602 54,180
135 Obat anti Tuberklosis kategori FDC I paket 5 5 3 2 2 2 413,984 827,968
136 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 0 1,317,000 0
137 Obat anti Tuberklosis kategori FDC Anak paket 1 1 0 1 1 1 236,500 236,500
138 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0 4,000 0
141 Oksitetrasiklin HCI salep mata 1 % tube 3 3 0 3 3 3 3,000 9,000
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
143 Parasetamol drops botol 51 51 25 26 26 26 5,980 155,480
144 Parasetamol sirup 120 mg / 5 ml botol 206 206 121 85 85 85 1,535 130,475
145 Parasetamol tablet 500 mg tablet 754 754 50 704 704 704 58 40,832
146 Permetrin krim 5% tube 7 7 0 7 7 7 12,155 85,085
148 Pirantel suspensi botol 15 15 0 15 15 15 16,000 240,000
150 Piroksikam 20 mg kapsul 0 0 0 0 0 0 200 0
151 Plester 5 yards x 2 inch rol 66 66 7 59 59 59 12,076 712,484
152 Prednison tablet 5 mg tablet 0 0 0 0 0 0 175 0
154 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 30 30 0 30 30 30 9,908 297,240
155 Propiltiourasil tablet 100 mg tablet 1020 1020 200 820 820 820 320 262,400
156 Propranolol HCI tablet 40 mg tablet 300 300 0 300 300 300 69 20,700
157 Ranitidin tablet 150 mg tablet 2000 2000 100 1900 1900 1,900 115 218,500
158 Ranitidin injeksi 25 mg/2 ml ampul 51 51 10 41 41 41 1,600 65,600
161 Reagensia ZN paket 0 0 0 0 0 0 270,000 0
162 Ringer Laktat larutan infus steril botol 761 761 131 630 630 630 7,150 4,504,500
163 Salbutamol tablet 2 mg tablet 1114 1114 90 1024 1024 1,024 90 92,160
164 Salep 2 - 4 kombinasi pot 26 26 3 23 23 23 2,797 64,331
165 Salisil bedak 2 % botol 96 96 31 65 65 65 1,066 69,290
166 Sefadroksil 500 mg kapsul 0 0 0 0 0 0 557 0
167 Semen seng fosfat serbuk dan cairan botol 0 0 0 0 0 0 102,850 0
168 Setrizin tablet 10 mg tablet 100 100 0 100 100 100 154 15,400
169 Setrizin syrup botol 96 96 2 94 94 94 7,756 729,064
170 Sianokorbalamin (Vit.B 12) 500 mcg tablet 1372 1372 290 1082 1082 1,082 58 62,756
171 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 154 154 3 151 151 151 1,226 185,126
172 Simetidine 200 mg tablet 0 0 0 0 0 0 190 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
173 Simvastatin 10 mg tablet 300 300 0 300 300 300 135 40,500
174 Silk (benang Bedah Sutera) No. 3 / 0 set 87 87 8 79 79 79 20,825 1,645,175
175 Siprofloksasin tablet 500 mg tablet 1348 1348 312 1036 1036 1,036 298 308,728
176 Sulfasetamida natrium tetes mata 15 % botol 0 0 0 0 0 0 3,549 0
177 Tablet tambah darah kombinasi tablet 27090 27090 2910 24180 24180 24,180 297 7,181,460
178 Taburia kotak 0 0 0 0 0 0 18,150 0
179 Temporary stopping (Fletcher) set 0 0 0 0 0 0 37,400 0
182 Tiamfenikol 500 mg kapsul 0 0 0 0 0 0 1,320 0
183 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 0 0 1,600 0
184 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 8300 8300 3751 4549 4549 4,549 91 413,959
186 Urine Bag pcs 20 20 1 19 19 19 3,450 65,550
187 Vaksin Rabies vero set 6 6 0 6 6 6 700,000 4,200,000
188 Vitamin B kompleks tablet tablet 18760 18760 2039 16721 16721 16,721 132 2,207,172
189 Yodium povidon larutan 10 % 300 ml botol 15 15 1 14 14 14 21,600 302,400
190 Yodium povidon larutan 10 % 60 ml botol 47 47 0 47 47 47 7,040 330,880
191 Zinc syrup botol 0 0 0 0 0 0 8,140 0
192 Zinc Tablet tablet 2930 2930 276 2654 2654 2,654 592 1,571,168
193 Pot Sputum pot 0 0 0 0 0 0 2,730 0
194 Salbutamol 4 mg tablet 200 200 0 200 200 200 88 17,600
195 Domperidom tablet tablet 300 300 0 300 300 300 410 123,000
196 Omeprazole 20 mg kapsul 600 600 0 600 600 600 800 480,000
200 Miconazole Krim Tube 48 48 1 47 47 47 3,737 175,639
201 Allpurinol tablet 300 mg tablet 140 140 0 140 140 140 244 34,160
202 Amlodipine 5 mg tablet 300 300 0 300 300 300 105 31,500
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
203 Amlodipine 10 mg tablet 0 0 0 0 0 0 163 0
204 Bisakodil 5 mg supp suppos 3 3 3 0 0 0 5,670 0
206 Diazepam rectal 5mg/2,5 ml tube 0 0 0 0 0 0 12,749 0
207 Kloramfenikol susp 125mg/5 ml tablet 105 105 0 105 105 105 4,000 420,000
208 Simvastatin 20 mg tablet 300 300 0 300 300 300 252 75,600
211 Alat Suntik sekali pakai 0,5 ml set 878 878 17 861 861 861 1,240 1,067,640
212 Spironolakton tablet 100 mg tablet 100 100 0 100 100 100 878 87,800
213 Alat Suntik sekali pakai 10 ml set 200 200 0 200 200 200 1,064 212,800
214 Kloramfenikol salep Kulit 2% tube 24 24 0 24 24 24 3,409 81,816
215 Umbilical Cord pcs 214 214 21 193 193 193 3,163 610,459
216 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 100 100 0 100 100 100 1,030 103,000
217 Vaksin Jerap Tetanus vial 98 98 3 95 95 95 14,498 1,377,310
218 Alkohol Swab kotak 0 0 0 0 0 0 115 0
219 Blood Lancet 26G kotak 500 500 0 500 500 500 160 80,000
223 Sarung Tangan Examination M pcs 300 300 200 100 100 100 410 41,000
224 Sarung Tangan Examination L pcs 200 200 0 200 200 200 410 82,000
226 Plester 7,5 cm x 4,5 m rol 10 10 1 9 9 9 35,532 319,788
227 Anagens Syrup Botol 25 25 5 20 20 20 19,800 396,000
228 Fervital Kapsul kapsul 2990 2990 550 2440 2440 2,440 861 2,100,840
229 OBH Itral Syrup Botol 30 30 5 25 25 25 16,698 417,450
230 Wicold kapsul 990 990 190 800 800 800 792 633,600
231 Kasa hidrofil 40 x 80 cm roll 1 1 0 1 1 1 120,750 120,750
232 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0 487,500 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
237 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 7,500 0
238 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 1,100 0
239 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 34,000 0
TOTAL 83,441,072
( L P L P O)
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
5 Ansell Steril 6 1/2 psg 0 0 0 0 0 0 7,500 0
6 Ansell Steril 7 psg 0 0 0 0 0 0 7,500 0
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0 7,500 0
12 Alupurinol tablet 100 mg tablet 0 0 0 0 0 0 95 0
13 Ambroxol sirup 15 mg/ml Botol 0 0 0 0 0 0 5,000 0
14 Ambroxol tablet tablet 0 0 0 0 0 0 196 0
16 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 0 0 0 3,349 0
17 Amitriptilin HCI tablet salut 25 mg tablet 0 0 0 0 0 0 165 0
19 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 0 0 4,147 0
20 Amoksisilin kapsul 250 mg Kapsul 0 0 0 0 0 0 207 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
23 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 0 0 0 0 190 0
26 Antasida DOEN suspensi Botol 0 0 0 0 0 0 2,106 0
27 Antihemoroid DOEN kombinasi suppos 0 0 0 0 0 0 3,502 0
28 Antifungi DOEN kombinasi pot 0 0 0 0 0 0 4,782 0
30 Antimigrain DOEN kombinasi tablet 0 0 0 0 0 0 149 0
31 Aqua pro injeksi steril, bebas pirogen ampul 0 0 0 0 0 0 5,800 0
34 Asam Mefenamat tablet 500 mg tablet 0 0 0 0 0 0 113 0
35 Asiklovir 200 mg tablet 0 0 0 0 0 0 272 0
36 Asiklovir 400 mg tablet 0 0 0 0 0 0 381 0
37 Asiklovir krim 5% tube 0 0 0 0 0 0 3,600 0
38 Asetosal tablet 100 mg tablet 0 0 0 0 0 0 110 0
39 Attalpulgit tablet 0 0 0 0 0 0 173 0
40 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0 0 1,672 0
42 Betametason krim 0.1 % tube 0 0 0 0 0 0 1,435 0
45 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 0 0 0 1,740 0
51 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0 0 1,354 0
52 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0 108 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
53 Doksisilin kapsul 100 mg kapsul 0 0 0 0 0 0 309 0
54 Domperidom suspensi Botol 0 0 0 0 0 0 3,180 0
58 Etakridin (Rivanol) larutan 0,1 % botol 0 0 0 0 0 0 3,600 0
59 E t a n o l 70 % 100 ml botol 0 0 0 0 0 0 2,625 0
60 Etil klorida semprot botol 0 0 0 0 0 0 115,500 0
62 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0 0 1,980 0
64 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 m ampul 0 0 0 0 0 0 3,754 0
65 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 0 0 0 0 0 0 796 0
66 Foly Catheter No. 18 pcs 0 0 0 0 0 0 9,200 0
67 Foly Catheter No. 20 pcs 0 0 0 0 0 0 9,200 0
68 Furosemid tablet 40 mg tablet 0 0 0 0 0 0 84 0
70 Gentamicin inj 40mg/ml ampul 0 0 0 0 0 0 3,545 0
71 Gentian Violet larutan 1 % botol 0 0 0 0 0 0 3,500 0
72 Glass lonomer Cement (GC IX ) botol 0 0 0 0 0 0 434,500 0
73 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0 100 0
74 Guafenisin tablet tablet 0 0 0 0 0 0 120 0
75 Glukosa larutan infus 5 % steril botol 0 0 0 0 0 0 6,900 0
76 Grisefulvin tablet 125 mg (Micronized) tablet 0 0 0 0 0 0 475 0
77 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 0 74 0
79 Hidroklorotiazid (HCT) tablet 25 mg tablet 0 0 0 0 0 0 171 0
81 Ibuprofen suspensi 100 mg/5 ml botol 0 0 0 0 0 0 8,000 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
84 Infusion set anak set 0 0 0 0 0 0 4,025 0
85 Infusion set dewasa set 0 0 0 0 0 0 3,680 0
87 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 0 0 0 0 98 0
89 Kalsium Hidroksida pasta tube 0 0 0 0 0 0 266,200 0
92 Kaptopril 12,5 mg tablet 0 0 0 0 0 0 69 0
93 Kaptopril 25 mg tablet 0 0 0 0 0 0 150 0
95 Kasa pembalut Hidrofil 4 m x 10 cm rol 0 0 0 0 0 0 1,725 0
96 Kasa pembalut elastis 3 inch rol 0 0 0 0 0 0 7,700 0
97 Ketokonazol krim 2% tube 0 0 0 0 0 0 6,000 0
98 Ketokonazol tablet 200 mg tablet 0 0 0 0 0 0 240 0
99 Kloramfenikol kapsul 250 mg kapsul 0 0 0 0 0 0 560 0
101 Kloramfenikol tetes telinga 3 % botol 0 0 0 0 0 0 7,500 0
104 Klorfenol Kamfer Menthol botol 0 0 0 0 0 0 60,500 0
105 Klorpromazin HCI injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 0 1,045 0
109 Kotrimoksazol Suspensi 240 mg/ 5 ml botol 0 0 0 0 0 0 2,225 0
110 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 0 0 125 0
111 Larutan mengandung elektrolit botol 0 0 0 0 0 0 9,275 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
113 Lisol, mengandung kresol tersabun 50 % botol 0 0 0 0 0 0 49,200 0
114 Loratadine tablet 0 0 0 0 0 0 149 0
117 Masker Kain lembar 0 0 0 0 0 0 506 0
118 Mata Pisau No. 15 pcs 0 0 0 0 0 0 3,300 0
119 Mata Pisau No. 20 pcs 0 0 0 0 0 0 3,300 0
121 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0 0 0 0 2,684 0
122 Metilprednisolon tablet 4 mg tablet 0 0 0 0 0 0 200 0
123 Metformin Hcl 500 mg tablet 0 0 0 0 0 0 115 0
124 Metoklopramida 10 mg tablet 0 0 0 0 0 0 100 0
125 Metoklopramida injeksi 5 mg / ml tablet 0 0 0 0 0 0 6,000 0
128 Mineral Mix sak 0 0 0 0 0 0 2,450 0
129 Mummifying pasta botol 0 0 0 0 0 0 193,600 0
130 Natrium diklofenak 50 mg tablet 0 0 0 0 0 0 161 0
131 Natrium klorida larutan infus 0,9 % steril botol 0 0 0 0 0 0 6,410 0
132 Nifedipin 10 mg tablet 0 0 0 0 0 0 123 0
133 Nistatin tablet vagina 100.000 IU / g tablet 0 0 0 0 0 0 602 0
135 Obat anti Tuberklosis kategori FDC I paket 0 0 0 0 0 0 413,984 0
136 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 0 1,317,000 0
137 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 0 0 0 236,500 0
138 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0 4,000 0
141 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 0 0 3,000 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
143 Parasetamol drops botol 0 0 0 0 0 0 5,980 0
144 Parasetamol sirup 120 mg / 5 ml botol 0 0 0 0 0 0 1,535 0
145 Parasetamol tablet 500 mg tablet 0 0 0 0 0 0 58 0
146 Permetrin krim 5% tube 0 0 0 0 0 0 12,155 0
147 Pirantel pamoat tablet 125 mg tablet 0 0 0 0 0 0 318 0
148 Pirantel suspensi botol 0 0 0 0 0 0 16,000 0
150 Piroksikam 20 mg kapsul 0 0 0 0 0 0 200 0
151 Plester 5 yards x 2 inch rol 0 0 0 0 0 0 12,076 0
152 Prednison tablet 5 mg tablet 0 0 0 0 0 0 175 0
154 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 0 0 0 9,908 0
155 Propiltiourasil tablet 100 mg tablet 0 0 0 0 0 0 320 0
156 Propranolol HCI tablet 40 mg tablet 0 0 0 0 0 0 69 0
157 Ranitidin tablet 150 mg tablet 0 0 0 0 0 0 115 0
158 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 0 0 0 1,600 0
161 Reagensia ZN paket 0 0 0 0 0 0 270,000 0
162 Ringer Laktat larutan infus steril botol 0 0 0 0 0 0 7,150 0
163 Salbutamol tablet 2 mg tablet 0 0 0 0 0 0 90 0
165 Salisil bedak 2 % botol 0 0 0 0 0 0 1,066 0
166 Sefadroksil 500 mg kapsul 0 0 0 0 0 0 557 0
167 Semen seng fosfat serbuk dan cairan botol 0 0 0 0 0 0 102,850 0
168 Setrizin tablet 10 mg tablet 0 0 0 0 0 0 154 0
169 Setrizin syrup botol 0 0 0 0 0 0 7,756 0
171 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 0 0 0 1,226 0
172 Simetidine 200 mg tablet 0 0 0 0 0 0 190 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
174 Silk (benang Bedah Sutera) No. 3 / 0 set 0 0 0 0 0 0 20,825 0
175 Siprofloksasin tablet 500 mg tablet 0 0 0 0 0 0 298 0
176 Sulfasetamida natrium tetes mata 15 % botol 0 0 0 0 0 0 3,549 0
177 Tablet tambah darah kombinasi tablet 0 0 0 0 0 0 297 0
178 Taburia kotak 0 0 0 0 0 0 18,150 0
179 Temporary stopping (Fletcher) set 0 0 0 0 0 0 37,400 0
182 Tiamfenikol 500 mg kapsul 0 0 0 0 0 0 1,320 0
183 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 0 0 1,600 0
186 Urine Bag pcs 0 0 0 0 0 0 3,450 0
187 Vaksin Rabies vero set 0 0 0 0 0 0 700,000 0
189 Yodium povidon larutan 10 % 300 ml botol 0 0 0 0 0 0 21,600 0
190 Yodium povidon larutan 10 % 60 ml botol 0 0 0 0 0 0 7,040 0
191 Zinc syrup botol 0 0 0 0 0 0 8,140 0
192 Zinc Tablet tablet 0 0 0 0 0 0 592 0
193 Pot Sputum pot 0 0 0 0 0 0 2,730 0
194 Salbutamol 4 mg tablet 0 0 0 0 0 0 88 0
195 Domperidom tablet tablet 0 0 0 0 0 0 410 0
196 Omeprazole 20 mg kapsul 0 0 0 0 0 0 800 0
197 Glimepiride 1 mg tablet 0 0 0 0 0 0 220 0
198 Glimepiride 2 mg tablet 0 0 0 0 0 0 297 0
200 Miconazole Krim Tube 0 0 0 0 0 0 3,737 0
201 Allpurinol tablet 300 mg tablet 0 0 0 0 0 0 244 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
206 Diazepam rectal 5mg/2,5 ml tube 0 0 0 0 0 0 12,749 0
207 Kloramfenikol susp 125mg/5 ml tablet 0 0 0 0 0 0 4,000 0
212 Spironolakton tablet 100 mg tablet 0 0 0 0 0 0 878 0
213 Alat Suntik sekali pakai 10 ml set 0 0 0 0 0 0 1,064 0
214 Kloramfenikol salep Kulit 2% tube 0 0 0 0 0 0 3,409 0
215 Umbilical Cord pcs 0 0 0 0 0 0 3,163 0
216 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 0 0 0 1,030 0
218 Alkohol Swab kotak 0 0 0 0 0 0 115 0
219 Blood Lancet 26G kotak 0 0 0 0 0 0 160 0
222 Sarung Tangan Examination S pcs 0 0 0 0 0 0 410 0
224 Sarung Tangan Examination L pcs 0 0 0 0 0 0 410 0
226 Plester 7,5 cm x 4,5 m rol 0 0 0 0 0 0 35,532 0
227 Anagens Syrup Botol 0 0 0 0 0 0 19,800 0
229 OBH Itral Syrup Botol 0 0 0 0 0 0 16,698 0
230 Wicold kapsul 0 0 0 0 0 0 792 0
231 Kasa hidrofil 40 x 80 cm roll 3 3 2 1 1 1 120,750 120,750
232 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0 487,500 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
237 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 7,500 0
238 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 1,100 0
239 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 34,000 0 0
TOTAL 120,750
( L P L P O)
KODE PUSKESMAS :
PUSKESMAS : NO :
KECAMATAN : TGL : BULAN
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
7 Ansell Steri 7 1/2 psg 0 0 0 7,500 0
12 Alupurinol tablet 100 mg tablet 0 0 0 95 0
18 Amoksisilin sirup kering 125 mg/5 ml Botol 0 0 0 2,200 0
21 Amoksisilin kaplet 500 mg kaplet 0 0 0 233 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
25 Antasida DOEN tablet kombinasi tablet 0 0 0 64 0
32 Asam Askorbat (Vit C) tablet 50 mg tablet 0 0 0 120 0
34 Asam Mefenamat tablet 500 mg tablet 0 0 0 113 0
46 Deksametason tablet 0,5 mg tablet 0 0 0 48 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
59 E t a n o l 70 % 100 ml botol 0 0 0 2,625 0
73 Glibenklamid tablet 5 mg tablet 0 0 0 100 0
74 Guafenisin tablet tablet 0 0 0 120 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
90 Kalsium laktat (Kalk) tablet 500 mg tablet 0 0 0 69 0
92 Kaptopril 12,5 mg tablet 0 0 0 69 0
93 Kaptopril 25 mg tablet 0 0 0 150 0
108 Kotrimoksazol tablet 480 mg tablet 0 0 0 158 0
109 Kotrimoksazol Suspensi 240 mg/ 5 ml botol 0 0 0 2,225 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
118 Mata Pisau No. 15 pcs 0 0 0 3,300 0
119 Mata Pisau No. 20 pcs 0 0 0 3,300 0
128 Mineral Mix sak 0 0 0 2,450 0
130 Natrium diklofenak 50 mg tablet 0 0 0 161 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
145 Parasetamol tablet 500 mg tablet 0 0 0 58 0
163 Salbutamol tablet 2 mg tablet 0 0 0 90 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
178 Taburia kotak 0 0 0 18,150 0
182 Tiamfenikol 500 mg kapsul 0 0 0 1,320 0
183 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 1,600 0
184 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 0 0 0 91 0
186 Urine Bag pcs 0 0 0 3,450 0
193 Pot Sputum pot 0 0 0 2,730 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
226 Plester 7,5 cm x 4,5 m rol 0 0 0 35,532 0
232 Rapid Test VIKIA HIV 1/2 kit 0 0 0 487,500 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
233 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 14,344 0
234 Benecheck plus Glucose test strip 50's box 0 0 0 156,072 0
235 Benecheck plus Cholesterol test strip 50's box 0 0 0 234,238 0
236 Benecheck plus Uric test strip 50's box 0 0 0 129,210 0
237 Kloramfenikol tetes mata 1 % botol 0 0 0 7,500 0
238 Betahistin maleat 24 mg tablet 0 0 0 1,100 0
239 Multivitamin (Lycalvit) syrup botol 0 0 0 34,000 0
TOTAL 0
( L P L P O)
KODE PUSKESMAS :
PUSKESMAS : NO :
KECAMATAN : TGL : BULAN
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
7 Ansell Steri 7 1/2 psg 0 0 0 7,500 0
12 Alupurinol tablet 100 mg tablet 0 0 0 95 0
18 Amoksisilin sirup kering 125 mg/5 ml Botol 0 0 0 2,200 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
46 Deksametason tablet 0,5 mg tablet 0 0 0 48 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
59 E t a n o l 70 % 100 ml botol 0 0 0 2,625 0
73 Glibenklamid tablet 5 mg tablet 0 0 0 61 0
74 Gliseril Guayokolat tablet 100 mg tablet 0 0 0 34 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
92 Kaptopril 12,5 mg tablet 0 0 0 69 0
93 Kaptopril 25 mg tablet 0 0 0 100 0
108 Kotrimoksazol tablet 480 mg tablet 0 0 0 158 0
109 Kotrimoksazol Suspensi 240 mg/ 5 ml botol 0 0 0 2,225 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
118 Mata Pisau No. 15 pcs 0 0 0 3,300 0
119 Mata Pisau No. 20 pcs 0 0 0 3,300 0
128 Mineral Mix sak 0 0 0 2,450 0
130 Natrium diklofenak 50 mg tablet 0 0 0 161 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
178 Taburia kotak 0 0 0 18,150 0
182 Tiamfenikol 500 mg kapsul 0 0 0 440 0
183 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 657 0
184 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 0 0 0 91 0
186 Urine Bag pcs 0 0 0 3,450 0
193 Pot Sputum pot 0 0 0 2,930 0
JMLH
SATUAN HARGA
KET
1 2 3 4 5 6=(4+5) 7 8=(6-7) 9 10 12 13 14 15 15 16 17 18 19 20
226 Plester 7,5 cm x 4,5 m rol 0 0 0 35,532 0
TOTAL 0
(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0 0 7333.7 0



76 E t a n o l 70 % 100 ml Botol 0 0 0 0 0 0 0 2,625 0




146 Masker Kain pcs 0 0 0 0 0 0 0 805 0
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

187 Plester 2,5 cm x 4 m rol 1 0 1 0 1 1 1 12,076 12,076
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0


224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0

241 Zinc syrup Botol 0 0 0 0 0 0 0 16,478 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
TOTAL 1,879,989
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0 0 7333.7 0



76 E t a n o l 70 % 100 ml Botol 0 0 0 0 0 0 0 2,625 0




146 Masker Kain pcs 0 0 0 0 0 0 0 805 0
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

187 Plester 2,5 cm x 4 m rol 1 0 1 0 1 1 1 12,076 12,076
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0


224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0

239 Yodium povidon larutan 10 % 60 ml Botol 0 0 0 1 -1 -1 -1 4438.5 -4,439
241 Zinc syrup Botol 0 0 0 0 0 0 0 16,478 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
TOTAL 1,850,926
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

LAPORAN PEMAKAI
PUSTU : SIMPO
KECAMATAN : BARANTI
KABUPATEN : SIDENRENG RAPPANG
SATU STOK PENER

NO. NAMA OBAT
AN AWAL MAAN
1 2 3 4 5
1 IV Catheter Gea No. 18 set 0 0 0
5 Ansell Steril 6 1/2 psg 0 0 0
6 Ansell Steril 7 psg 0 0 0
7 Ansell Steri 7 1/2 psg 2 2 0
8 Alat Suntik sekali pakai 0,05 ml set 0 0 0
10 Alat suntik sekali pakai 1 ml set 0 0 0
13 Alat Suntik sekali pakai 10 ml set 0 0 0
18 Ambroxol sirup 15 mg/ml Botol 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml Botol 4 4 0
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0
28 Amoksisilin kaplet 500 mg kaplet 560 560 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0
30 Anagens Syrup Botol 2 0 0
31 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0
33 Antasida DOEN tablet kombinasi tablet 420 420 0

34 Antasida DOEN suspensi Botol 0 0 0
35 Antihemoroid DOEN kombinasi suppos 0 0 0
36 Antifungi DOEN kombinasi pot 0 0 0
37 Antibakteri DOEN salep Kombinasi tube 0 0 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 80 80 200
42 Asam Mefenamat tablet 500 mg tablet 550 550 0
45 Asiklovir krim 5% tablet 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
50 Benecheck plus Glucose test strip 50's box 0 0 0
51 Benecheck plus Cholesterol test strip 50's 0 0 0
52 Benecheck plus Uric test strip 50's box 0 0 0
53 Betahistin maleat 24 mg tablet 0 0 0
54 Betametason krim 0.1 % tube 0 0 0
55 Bisakodil 5 mg supp suppos 0 0 0
58 Catgut/benang bedah no .2/0 pcs 0 0 0
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0
61 Deksametason tablet 0,5 mg tablet 200 200 0
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0
70 Domperidom suspensi Botol 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 1 1 0
76 E t a n o l 70 % 100 ml Botol 0 0 0
77 Etil klorida semprot Botol 0 0 0
78 Eugenol cairan botol 0 0 0

79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 0 0
84 Foly Catheter No. 18 pcs 0 0 0
87 Garam Oralit untuk 200 ml Air sak 0 0 0
88 Gentamicin inj 40mg/ml Ampul 0 0 0
89 Gentian Violet larutan 1 % Botol 0 0 0
90 Glass lonomer Cement (GC IX ) buah 0 0 0
94 Guaiafenesin Tablet tablet 290 290 0
95 Glukosa larutan infus 5 % steril Botol 0 0 0
99 Haloperidol inj 50 mg/ml ampul 0 0 0
101 Hidrokortison krim 2,5 % tube 7 7 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 6 6 0
106 Infusion set anak pcs 0 0 0
107 Infusion set dewasa pcs 0 0 0
111 Kalsium Hidroksida pasta buah 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 0 0 0
113 Kapas pembalut 250 gram buah 0 0 0
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 0 0 0
120 Kasa hidrofil 40 x 80 cm roll 0 0 0
121 Kasa pembalut elastis 3 inch roll 0 0 0
122 Ketokonazol krim 2% tube 0 0 0

125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0
126 Kloramfenikol salep mata 1 % tube 0 0 0
127 Kloramfenikol tetes mata 1 % botol 0 0 0
128 Kloramfenikol salep Kulit 2% tube 0 0 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0
132 Klorfenol Kamfer Menthol Botol 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0
136 Kotrimoksazol tablet 480 mg tablet 170 170 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 9 9 0
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0
139 Larutan mengandung elektrolit botol 0 0 0
140 Lidokain komp. injeksi - 2 ml ampul 0 0 0
141 Lisol 1 liter Botol 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0
147 Mata Pisau No. 15 pcs 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0
157 Miconazole Krim tube 0 0 0
158 Mineral Mix sak 0 0 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0
160 Mummifying pasta buah 0 0 0
162 Natrium klorida larutan infus 0,9 % steril Botol 0 0 0
166 Obat anti Tuberklosis kategori FDC I paket 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0

169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0
170 OBH Itral Syrup Botol 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 0 0
176 Parasetamol drops Botol 0 0 0
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0
178 Parasetamol tablet 500 mg tablet 250 250 200
179 Pehacain injeksi botol 0 0 0
180 Permetrin krim 5% tube 0 0 0
182 Pirantel suspensi 10 ml botol 0 0 0
183 Pirantel suspensin 60 ml Botol 0 0 0
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0
187 Plester 2,5 cm x 4 m rol 0 0 0
189 Pot Sputum pcs 0 0 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0
199 Reagensia ZN botol 0 0 0
202 Ringer Laktat larutan infus steril Botol 0 0 0
203 Salbutamol tablet 2 mg tablet 0 0 0
205 Salep 2 - 4 kombinasi pot 0 0 0
206 Salisil bedak 2 % pot 4 4 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 0
213 Setrizin syrup Botol 0 0 0

214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 0 0 0
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 0 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0
223 Tablet tambah darah kombinasi tablet 0 0 0
224 Taburia kotak 0 0 0
225 Temporary stopping (Fletcher) buah 0 0 0
228 Tiamfenikol 500 mg kapsul 0 0 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0
232 Umbilical Cord kotak 0 0 0
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0
234 Urine Bag set 0 0 0
235 Vaksin Jerap Tetanus vial 0 0 0
236 Vaksin Rabies vero kuur 0 0 0
237 Vitamin B kompleks tablet tablet 570 570 0
239 Yodium povidon larutan 10 % 60 ml Botol 3 3 0
241 Zinc syrup Botol 0 0 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0
245 Zidovudine 150 mg Btl 0 0 0
246 Lomivudine 150 mg Btl 0 0 0
247 Efavirenz 600 mg Btl 0 0 0
248 Nepirapine 200 mg Btl 0 0 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0
251 TenoFovir 300 mg Btl 0 0 0
252 Tenof EM Btl 0 0 0
253 Samcobion Tablet 0 0 0
255 Lytacur Sirup Btl 0 0 0
256 Susu Produgen Kotak 0 0 0

jumlah resep
generik NON GENERIK
Jamkesda 0 0
JKN 54 153
Lain - lain

Jamkesda
JKN
Lain - lain
TOTAL 54 153
Mengetahui
Kepala Puskesmas Barant
dr Hj Ulianti
NIP.197908072007012013
(LPLPO)
NO :
TGL :30-09-2018
PERSE PEMA SISA STOK PERMIN SUMBER DANA

DIAAN KAIAN STOK OPT TAAN DAK/11 DAK/12 DAK/13 DAK/14
6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2 0 0 2 2
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 2 2 2 2 10
0 0 0 0 0
50 30 30 20 20 500
560 140 140 420 420 500
0 0 0 0 0
2 1 1 1 1
0 0 0 0 0
0 0 0 0 0
420 120 120 300 300 500

0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
#VALUE! 0 0
280 110 110 170 170 1,000
0 0 0 0 0
550 10 10 540 540
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 90 90 110 110 300
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
1 0 0 1 1
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
150 0 0 150 150
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
290 90 90 200 200 300
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
7 0 0 7 7
6 3 3 3 3
0 0 0 0 0
590 90 90 500 500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
220 90 90 130 130 500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
170 20 20 150 150 200
9 1 1 8 8
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
450 250 250 200 200
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 100 100 100 100 500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 10 10 190 190 500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
4 0 0 4 4
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
10 10 10 0 0 1,000
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
570 220 220 350 350 300
0 0 0 0 0
3 0 0 3 3
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
TOTAL
UNIT
PELAYANAN
pustu simpo
pustu tonrong
pustu trong rijang
pkesdes sipodeceng
pkesdes baranti
pkesdes passeno
pkesdes trong
pkesdes duampanua
usila
posbindu
TOTAL
BULAN 9
TAHUN 2018
SUMBER DANA HARGA JUMLAH

JMLH KET
SATUAN HARGA
DAK/15 DAK/16 DAK/17 BANTUAN PROGRAM
15 16 17 18 19 20 21 22 23
0 158 8,050 0
0 219 8,050 0
0 207 8,050 0
0 246 8,515 0
0 300 7333.7 0
0 172 7333.7 0
2 167 7333.7 14,667
0 900 1517.72307 0
0 67 1374,375 0
0 5,368 748 0
0 2,358 748 0
0 1,029 863 0
0 161 1,353 0
0 0 323 0
0 200 114.95 0
0 1,435 95 0
0 0 244 0
0 67 5,500 0
0 0 216 0
0 0 86 0
0 6 3,349 0
0 1,000 165 0
0 1,144 90 0
0 1,395 163 0
2 239 2,200 4,400
0 37 4,147 0
20 3,580 207 4,140
420 29,078 233 97,860
0 0 4,600 0
1 18 19,800 19,800
0 1,470 209 0
0 0 1,500 0
300 12,659 59 17,700

0 68 2,106 0
0 39 3,502 0
0 24 4,782 0
0 0 3,365 0
0 400 149 0
0 5,800 #VALUE!
170 15,956 120 20,400
0 1,045 68 0
540 12,825 102 55,080
0 300 272 0
0 200 381 0
0 3 3,960 0
0 100 153 0
0 0 173 0
0 8 1,672 0
0 0 75 0
0 0 156,072 0
0 0 234,238 0
0 0 129,210 0
0 0 1,210 0
0 245 1,435 0
0 0 5,670 0
0 0 5,800 0
0 300 167.42 0
0 0 7928,333 0
0 174 7929,16666 #VALUE!
0 25 1,740 0
110 8,552 45 4,950
0 0 2,578 0
0 3 12,749 0
0 0 134 0
0 0 65 0
0 0 104 0
0 30 1,354 0
0 100 108 0
0 0 309 0
0 39 3,180 0
0 652 133 0
0 0 56 0
0 0 42 0
0 0 8,910 0
1 15 3,600 3,600
0 99 2,625 0
0 0 115,500 0
0 0 20,815 0
0 0 2,265 0
0 0 74 0
150 2,205 860.64 129,096
0 163 4,167 0
0 30 796 0
0 3 13,970 0
0 6 13,970 0
0 314 91 0
0 912 274 0
0 25 3,545 0
0 5 3,850 0
0 0 434,500 0
0 2,475 110 0
0 0 220 0
0 0 297 0
200 7,808 132 26,400
0 110 6,900 0
0 920 263 0
0 0 74 0
0 0 134 0
0 0 91,667 0
0 1,116 171 0
7 18 2,812 19,684
3 83 2,560 7,680
0 0 8,800 0
500 17,926 111 55,500
0 280 133 0
0 140 2913.3 0
0 413 6622,2 #VALUE!
0 0 82 0
0 0 95 0
0 0 9,955 0
0 0 266,200 0
0 8,920 69 0
0 10 14,366 0
0 3 31,372 0
0 1 62,744 0
0 4,990 69 0
0 5,095 86 0
0 1,990 306 0
0 1,150 1723.7 0
0 4 120,736 0
0 7 7,700 0
0 97 2,790 0
0 290 264 0
0 0 616 0
0 81 4,000 0
0 120 1,850 0
0 0 1,850 0
0 0 3,409 0
0 11 8,250 0
130 11,285 45 5,850
0 0 112 0
0 0 60,500 0
0 29 1,425 0
0 0 179 0
0 0 170 0
150 8,006 158 23,700
8 128 2,225 17,800
0 390 137.5 0
0 24 9,275 0
0 127 2,122 0
0 1 49,192 0
0 0 90 0
0 450 149 0
0 0 1,694 0
0 6 3,650 0
0 439 805 0
0 84 3,300 0
0 100 3,300 0
0 0 133 0
0 90 2,684 0
0 750 200 0
0 1,048 115 0
0 300 100 0
0 18 3,904 0
0 0 98 0
0 3,928 140 0
0 3 3,737 0
0 0 2726.9 0
0 9 37,400 0 EXP
0 0 193,600 0
0 2,478 161 0
0 148 6,410 0
0 300 123 0
0 0 602 0
0 70 704 0
0 0 413,984 0
0 0 1,379,984 0
0 1 236,500 0
0 0 4,400 0
0 14 16,698 0
0 0 636 0
0 0 1,869 0
0 0 3,300 0
0 214 1,900 0
0 150 148 0
0 86 5,980 0
0 14 1,119 0
200 19,592 58 11,600
0 88 4,400 0
0 6 12,155 0
0 232 318 0
0 0 17,600 0
0 0 9,100 0
100 6,605 136 13,600
0 100 1,040 0
0 0 220 0
0 21 12,076 0
0 15 35,532 0
0 40 3137.2 0
190 8,803 85 16,150
0 0 120 0
0 0 9,908 0
0 0 320 0
0 300 69 0
0 3,890 115 0
0 80 1,600 0
0 0 525,000 0
0 0 14,344 0
0 0 276,600 0
0 0 327 0
0 0 583 0
0 245 7,150 0
0 1,325 68 0
0 200 88 0
0 100 2,797 0
4 114 1,066 4,264
0 63 531.3 0
0 400 531.3 0
0 880 531.3 0
0 903 557 0
0 0 102,850 0
0 0 154 0
0 39 7,756 0
0 3,476 58 0
0 140 1,226 0
0 1,800 209 0
0 830 135 0
0 0 252 0
0 43 4124.8366 0
0 1,162 298 0
0 100 878 0
0 0 3,549 0
0 1,240 410 0
0 0 18,150 0
0 0 37,400 0
0 0 162 0
0 400 325 0
0 360 1,452 0
0 30 1,760 0
0 6,955 91 0
0 0 97 0
0 180 1494.9 0
0 68 8768.1 0
0 17 3,432 0
0 31 14,498 0
0 0 174499,6 #VALUE!
350 32,903 132 46,200
0 70 792 0
3 29 4438.5 13,316
0 8 21,593 0
0 30 16,478 0
0 3,259 592 0
0 4 9372.5 0
0 2 25127,5 0
0 1,700 0
0 4,255 0
0 7,331 0
0 3,080 0
0 3,058 0
0 11894.3 0
0 6,475 0
0 12,449 0
0 0 989.659 0
0 314 0
0 14,300 0
0 40,700 0
#VALUE!
JAMKESDA JKN TOTAL
Jml pasien Jml R/ Jml pasien Jml R/ Jml pasien Jml R/
Pengelola obat Pkm Barant
Murniaty,S.Farm
NIP : 198212112009012006
SATU STOK PENER PERSE PEMA
NO. NAMA OBAT
AN AWAL MAAN DIAAN KAIAN
1 2 3 4 5 6 =(4+5) 7
1 IV Catheter Gea No. 18 set

5 Ansell Steril 6 1/2 psg
6 Ansell Steril 7 psg
7 Ansell Steri 7 1/2 psg 4 4 2
8 Alat Suntik sekali pakai 0,05 ml set
10 Alat suntik sekali pakai 1 ml set
13 Alat Suntik sekali pakai 10 ml set
14 Albendasol tablet 400 mg tablet
15 Alkohol Swab kotak p.ton
16 Alupurinol tablet 100 mg tablet
17 Allpurinol tablet 300 mg tablet
18 Ambroxol sirup 15 mg/ml Botol
19 Ambroxol tablet tablet
20 Aminofilin tablet 200 mg tablet
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul
22 Amitriptilin HCI tablet salut 25 mg tablet
23 Amlodipine 5 mg tablet
25 Amoksisilin sirup kering 125 mg/5 ml Botol 2 2 2
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol
28 Amoksisilin kaplet 500 mg kaplet 510 0 510 220
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial
30 Anagens Syrup Botol
31 Antalgin (Metampiron) tablet 500 mg Tablet
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul
33 Antasida DOEN tablet kombinasi tablet 225 225 60
34 Antasida DOEN suspensi Botol
35 Antihemoroid DOEN kombinasi suppos
36 Antifungi DOEN kombinasi pot
37 Antibakteri DOEN salep Kombinasi tube
38 Antimigrain DOEN kombinasi tablet
39 Aqua pro injeksi steril, bebas pirogen vial
40 Asam Askorbat (Vit C) tablet 50 mg tablet 500 0 500 90
41 Asam Folat tablet
42 Asam Mefenamat tablet 500 mg tablet 485 485 65
43 Asiklovir 200 mg tablet
45 Asiklovir krim 5% tablet
46 Asetosal tablet 100 mg tabet
47 Attalpulgit tablet
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul
49 Atropin Sulfat tablet 0,5 mg tablet
50 Benecheck plus Glucose test strip 50's box
51 Benecheck plus Cholesterol test strip 50's box
52 Benecheck plus Uric test strip 50's box
53 Betahistin maleat 24 mg tablet
54 Betametason krim 0.1 % tube
55 Bisakodil 5 mg supp suppos
57 Blood Lancet 26G kotak
58 Catgut/benang bedah no .2/0 pcs
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul
61 Deksametason tablet 0,5 mg tablet 840 840 30
62 Diazepam injeksi 5 mg/ml - 2 ml ampul
63 Diazepam rectal 5mg/2,5 ml buah
64 Diazepam tablet 2 mg tablett
65 Diazepam tablet 5 mg tablet
66 Dietilkarbamazin Sitrat tablet 100 mg tablet
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul
68 Digoksin tablet 0,25 mg tablet
69 Doksisilin kapsul 100 mg Kapsul
70 Domperidom suspensi Botol
71 Domperidom tablet tablet
72 Efedrin HCI tablet 25 mg tablet
73 Ekstrak Belladon tablet 10 mg tablet
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul
76 E t a n o l 70 % 100 ml Botol
77 Etil klorida semprot Botol
78 Eugenol cairan botol
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul
80 Fenobarbital tablet 30 mg tablet
81 Fervital Kapsul kapsul 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet
84 Foly Catheter No. 18 pcs
86 Furosemid tablet 40 mg tablet
87 Garam Oralit untuk 200 ml Air sak 15 0 15 0
88 Gentamicin inj 40mg/ml Ampul
89 Gentian Violet larutan 1 % Botol
90 Glass lonomer Cement (GC IX ) buah
91 Glibenklamid tablet 5 mg tablet
92 Glimepiride 1 mg tablet
94 Guaiafenesin Tablet tablet 95 95 70
95 Glukosa larutan infus 5 % steril Botol
96 Grisefulvin tablet 125 mg (Micronized) tablet 680 0 680 105
97 Haloperidol tablet 1,5 mg tablet
98 Haloperidol tablet 2 mg tablet
99 Haloperidol inj 50 mg/ml ampul
100 Hidroklorotiazid (HCT) tablet 25 mg tablet
101 Hidrokortison krim 2,5 % tube 9 0 9 2
102 Ibuprofen suspensi 100 mg/5 ml Botol
105 Ibuprofen tablet 400 mg tablet
106 Infusion set anak pcs
107 Infusion set dewasa pcs
108 Isoniazid tablet 100 mg tablet
109 Isosorbid Dinitrat tablet subligual 5 mg tablet
110 Kalsium Glukonat inj 10% ampul
111 Kalsium Hidroksida pasta buah
112 Kalsium laktat (Kalk) tablet 500 mg tablet
113 Kapas pembalut 250 gram buah
114 Kapas pembalut / Absorben 500 gram bungkus
116 Kaptopril 12,5 mg tablet
117 Kaptopril 25 mg tablet
118 Karbamazepin tablet 200 mg tablet
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 29 29 2
120 Kasa hidrofil 40 x 80 cm roll
121 Kasa pembalut elastis 3 inch roll
122 Ketokonazol krim 2% tube
123 Ketokonazol tablet 200 mg tablet
124 Kloramfenikol kapsul 250 mg Kapsul
125 Kloramfenikol susp 125mg/5 ml Botol
126 Kloramfenikol salep mata 1 % tube 0 0 0
127 Kloramfenikol tetes mata 1 % botol
128 Kloramfenikol salep Kulit 2% tube
130 Klorfeniramin maleat tablet 4 mg tablet
131 Klorokuin tablet 150 mg tablet
132 Klorfenol Kamfer Menthol Botol
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul
134 Klorpromazin HCI tablet salut 100 mg tablet
136 Kotrimoksazol tablet 480 mg tablet 410 410 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol
138 Kotrimoksazol Pediatrik tablet 120 mg tablet
139 Larutan mengandung elektrolit botol
141 Lisol 1 liter / Litakur srp Botol 0 0 0 0
142 Loperamide 2 mg tablet
143 Loratadine 10 mg tablet
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol
147 Mata Pisau No. 15 pcs
149 Metilergometrin maleat tablet salut 0,125 mg tablet
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul
151 Metilprednisolon tablet 4 mg tablet
152 Metformin Hcl 500 mg tablet
153 Metoklopramida 10 mg tablet
154 Metoklopramida injeksi 5 mg / ml vial
156 Metronidazol tablet 500 mg tablet
157 Miconazole Krim tube
158 Mineral Mix sak
159 Multivitamin (Lycalvit) syrup botol
160 Mummifying pasta buah
161 Natrium diklofenak 50 mg tablet
163 Nifedipin 10 mg tablet
164 Nistatin tablet vagina 100.000 IU / g ovula
165 Nistatin vaginal tablet salut 500.000 IU/g tablet
166 Obat anti Tuberklosis kategori FDC I paket
167 Obat anti Tuberklosis kategori FDC 2 paket
168 Obat anti Tuberklosis kategori FDC Anak paket
169 Obat Batuk Hitam (O.B.H) cairan botol
170 OBH Itral Syrup Botol
171 Ofloksasin tablet 400 mg tablet
172 Oksitetrasiklin HCI salep kulit 3 % tube
173 Oksitetrasiklin HCI salep mata 1 % tube
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul
175 Omeprazole 20 mg kapsul
176 Parasetamol drops Botol 0 0 0
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0
178 Parasetamol tablet 500 mg tablet 830 0 830 145
179 Pehacain injeksi botol
180 Permetrin krim 5% tube
181 Pirantel pamoat tablet 125 mg tablet
182 Pirantel suspensi 10 ml botol
183 Pirantel suspensin 60 ml Botol
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul
186 Piroksikam 20 mg tablet
187 Plester 2,5 cm x 4 m rol 1 1 31-Dec
188 Plester 7,5 cm x 4 m rol
189 Pot Sputum pcs
191 Primakuin tablet 15 mg tablet
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial
193 Propiltiourasil tablet 100 mg tablet
194 Propranolol HCI tablet 40 mg tablet
195 Ranitidin tablet 150 mg tablet
196 Ranitidin injeksi 25 mg/2 ml ampul
197 Rapid Test VIKIA HIV 1/2 kit
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test
199 Reagensia ZN botol
200 Retinol (Vitamin A) kapsul 100.000 IU kapsul
202 Ringer Laktat larutan infus steril Botol
204 Salbutamol 4 mg tablet
205 Salep 2 - 4 kombinasi pot
206 Salisil bedak 2 % pot 0 0 0
207 Sarung Tangan Examination S pcs
208 Sarung Tangan Examination M pcs
209 Sarung Tangan Examination L pcs
210 Sefadroksil 500 mg kapsul
211 Semen seng fosfat serbuk dan cairan buah
212 Setrizin tablet 10 mg tablet
213 Setrizin syrup Botol
214 Sianokorbalamin (Vit.B 12) 500 mcg tablet
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul
216 Simetidine 200 mg tablet
217 Simvastatin 10 mg tablet
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs
220 Siprofloksasin tablet 500 mg tablet
221 Spironolakton tablet 100 mg tablet
222 Sulfasetamida natrium tetes mata 15 % Botol
223 Tablet tambah darah kombinasi tablet
224 Taburia kotak
225 Temporary stopping (Fletcher) buah
226 Tetrasiklin HCI kapsul 250 mg kapsul
228 Tiamfenikol 500 mg kapsul
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet 600 0 600 190
231 Triheksifenidil Hidroklorida tablet 2 mg tablet
232 Umbilical Cord kotak
233 U-Pad steril 60 cm x 90 cm pcs
234 Urine Bag set
235 Vaksin Jerap Tetanus vial
236 Vaksin Rabies vero kuur
237 Vitamin B kompleks tablet tablet 805 0 805 200
239 Yodium povidon larutan 10 % 60 ml Botol
240 Yodium povidon larutan 10 % 300 ml Botol
241 Zinc syrup Botol
Jumlah Pasien : 51
Jumlah Resep : 148
SISA STOK PERMIN SUMBER DANA
STOK OPT TAAN DAK/11 DAK/12 DAK/13 DAK/14 DAK/15 DAK/16 BANTUAN
8 =(6-7) 9 10 11 12 13 14 15 16 17
0
0
0
0
0
0
2 10
0
0
0
16
19
0
0
0
0
0
0
0
0
0
0
0
0
0 10
0
330 500
290 1,000
0
0
0
0
165 300
0
0
0
0
0
0
410 700
0
420 200
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
810
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
15 50
0
0
0
0
0
0
25 1,000
0
575 300
0
0
0
0
7 10
0
0
1120
0
0
0
0
0
0
0
0
0
0
0
0
0
0
27
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
410
0
0
0
10
0
0
0
0
0
26
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1 2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
685 500
0
0
0
0
0
0
0
0
0 1
0
0
120 300
0
0
0
0
0
0
0
0
0
0
0
0
45 200
0
0
0 10
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
410 700
0
0
0
0
0
0
605 700
0 200
0
0
0
0
TOTAL
Tonronge, 29 September 2018.

Kepala Pustu Tonronge
Ns.Abdul Samad Riu, S.Kep.

Nip. 19680617 1991031016.
HARGA JUMLAH
JMLH SATUAN HARGA KET
PROGRAM
18 19 20 21 22
0 5,203 0
0 4,370 0
0 5,203 0
0 5,203 0
0 7,500 0
0 7,500 0
0 7,500 0
0 1,650 0
0 1,240 0
0 748 0
0 748 0
0 863 0 RSK
0 1,064 0
0 425 0
0 115 0
0 95 0
0 244 0
0 5,500 0 Des 5000
0 216 0 Des 196
0 86 0
0 3,349 0
0 165 0
0 105 0
0 163 0
0 2,200 0
0 4,147 0
0 207 0
0 233 0
0 4,600 0
0 19,800 0
0 209 0 Des 190
0 1,500 0
0 64 0
0 2,106 0
0 3,502 0
0 4,782 0
0 2,767 0
0 149 0
0 5,800 0
0 120 0
0 68 0
0 113 0 Des 122
0 272 0
0 381 0
0 3,960 0 Des 3600
0 110 0
0 173 0
0 1,672 0
0 75 0
0 156,072 0
0 234,238 0
0 129,210 0
0 1,210 0 Des
0 1,435 0
0 5,670 0
0 5,800 0
0 160 0
0 33,925 0
0 6,421 0
0 1,740 0
0 48 0
0 2,578 0
0 12,749 0
0 134 0
0 65 0
0 104 0
0 1,354 0
0 108 0
0 309 0
0 3,180 0
0 451 0 Jan 133
0 56 0
0 42 0
0 8,910 0
0 3,600 0
0 2,625 0
0 115,500 0
0 18,333 0
0 1,980 0
0 74 0
0 861 0
0 3,754 0
0 796 0
0 9,200 0
0 9,200 0
0 84 0
0 274 0
0 3,545 0
0 3,850 0 Jan 3500
0 434,500 0
0 110 0 Des
0 220 0
0 297 0
0 132 0 Des
0 6,900 0
0 523 0 Des
0 76 0 Des 74
0 134 0
0 91,667 0
0 171 0
0 2,812 0
0 8,000 0 8000
0 8,800 0 Des 8000
0 111 0
0 133 0
0 4,025 0
0 3,680 0
0 82 0
0 98 0
0 999 0
0 266,200 0
0 69 0
0 14,375 0
0 31,372 0
0 62,744 0
0 69 0
0 165 0 Des
0 306 0
0 1,725 0
0 120,750 0
0 7,700 0
0 6,600 0 Des
0 264 0 Des
0 616 0 Des
0 4,000 0
0 1,850 0
0 8,250 0 Des
0 3,409 0
0 8,250 0 Des
0 45 0
0 112 0
0 60,500 0
0 1,045 0
0 179 0
0 170 0
0 158 0
0 2,225 0
0 138 0 Jan 125
0 9,275 0
0 2,122 0
0 49,200 0
0 90 0
0 149 0
0 1,694 0 Des 3200
0 2,143 0 Des 3650
0 506 0
0 3,300 0
0 3,300 0
0 133 0
0 2,684 0
0 200 0
0 115 0
0 100 0
0 6,600 0 Jan 6000
0 98 0
0 140 0
0 3,737 0
0 2,450 0
0 37,400 0 Des
0 193,600 0
0 161 0
0 6,410 0
0 123 0
0 602 0
0 704 0
0 413,984 0
0 1,317,000 0 Des 1319900
0 236,500 0
0 4,400 0 Des
0 16,698 0
0 636 0
0 1,869 0
0 3,300 0 Des
0 1,900 0
0 880 0 Jan 221
0 5,980 0 Des 7,350
0 1,119 0 Des
0 145 0 Des 58
0 4,400 0 Des
0 12,155 0
0 318 0
0 17,600 0 Jan
0 9,100 0 Des
0 136 0
0 1,030 0
0 220 0 Des
0 12,076 0
0 35,532 0
0 3,190 0 Des
0 193 0 Jan 175
0 120 0
0 9,908 0
0 320 0
0 69 0
0 115 0 Des 132
0 1,600 0
0 525,000 0 Des 487500
0 14,344 0
0 270,000 0
0 327 0
0 505 0
0 7,150 0
0 99 0 Des
0 88 0
0 2,797 0
0 1,066 0
0 410 0
0 410 0
0 410 0
0 557 0
0 102,850 0
0 154 0
0 7,756 0
0 58 0
0 1,226 0
0 209 0 Jan 190
0 135 0
0 252 0
0 20,825 0
0 298 0
0 878 0
0 3,549 0
0 327 0 Des
0 18,150 0
0 37,400 0
0 162 0
0 325 0
0 1,452 0 Jan 1320
0 1,760 0 Jan 1600
0 91 0
0 97 0
0 3,163 0
0 8,770 0
0 3,450 0
0 14,498 0
0 700,000 0
0 132 0
0 792 0
0 7,040 0
0 21,600 0
0 8,140 0
0 592 0
0
6,293,488
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAA
(LPLPO)
KECAMATAN : BARANTI TGL :
SATU STOK PENER PERSE PEMA SISA STOK PERMIN SUMBER DANA
NO. NAMA OBAT
AN AWAL MAAN DIAAN KAIAN STOK OPT TAAN DAK/11 DAK/12 DAK/13
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13
1 IV Catheter Gea No. 18 set 16 16 2 14 14
2 IV Catheter Gea No. 20 set 5 5 0 5 5
5 Ansell Steril 6 1/2 psg 0 0 0
6 Ansell Steril 7 psg 20 20 3 17 17
7 Ansell Steri 7 1/2 psg 5 5 0 5 5
9 Alat Suntik sekali pakai 0,5 ml set 0 0 0 20
13 Alat Suntik sekali pakai 10 ml set 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml Botol 8 8 2 6 6
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0
30 Anagens Syrup Botol 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0

34 Antasida DOEN suspensi Botol 0 0 0
35 Antihemoroid DOEN kombinasi suppos 0 0 0
36 Antifungi DOEN kombinasi pot 0 0 0
37 Antibakteri DOEN salep Kombinasi tube 0 0 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 537 537 178 359 359 500
45 Asiklovir krim 5% tablet 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0
50 Benecheck plus Glucose test strip 50's box 0 0 0
51 Benecheck plus Cholesterol test strip 50's box 0 0 0
52 Benecheck plus Uric test strip 50's box 0 0 0
53 Betahistin maleat 24 mg tablet 0 0 0
54 Betametason krim 0.1 % tube 3 3 2 1 1 5
59 Catgut/benang bedah no .3/0 pcs 5 5 1 4 4 5
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0
70 Domperidom suspensi Botol 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0
76 E t a n o l 70 % 100 ml Botol 3 3 0 3 3
77 Etil klorida semprot Botol 0 0 0
78 Eugenol cairan botol 0 0 0

79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 7 7 1 6 6
87 Garam Oralit untuk 200 ml Air sak 30 30 6 24 24 20
88 Gentamicin inj 40mg/ml Ampul 0 0 0
89 Gentian Violet larutan 1 % Botol 0 0 0
90 Glass lonomer Cement (GC IX ) buah 0 0 0
94 Guaiafenesin Tablet tablet 408 408 77 331 331 300
95 Glukosa larutan infus 5 % steril Botol 2 2 0 2 2
99 Haloperidol inj 50 mg/ml ampul 0 0 0
101 Hidrokortison krim 2,5 % tube 0 0 0
106 Infusion set anak pcs 0 0 0
107 Infusion set dewasa pcs 9 9 1 8 8
111 Kalsium Hidroksida pasta buah 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 10 10 10 0 0 500
113 Kapas pembalut 250 gram buah 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 20 20 0 20 20 50
120 Kasa hidrofil 40 x 80 cm roll 0 0 0
121 Kasa pembalut elastis 3 inch roll 0 0 0
122 Ketokonazol krim 2% tube 0 0 0

125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0
126 Kloramfenikol salep mata 1 % tube 3 3 1 2 2 10
127 Kloramfenikol tetes mata 1 % botol 0 0 0
128 Kloramfenikol salep Kulit 2% tube 0 0 0
132 Klorfenol Kamfer Menthol Botol 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 11 11 1 10 10
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0
139 Larutan mengandung elektrolit botol 0 0 0
141 Lisol 1 liter Botol 1 1 0 1 1
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0
146 Masker Kain pcs 43 43 3 40 40
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0
157 Miconazole Krim tube 0 0 0 5
158 Mineral Mix sak 0 0 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0
160 Mummifying pasta buah 0 0 0
166 Obat anti Tuberklosis kategori FDC I paket 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0

169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0
170 OBH Itral Syrup Botol 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 8 8 1 7 7
176 Parasetamol drops Botol 0 0 0 10
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 20
179 Pehacain injeksi botol 0 0 0
180 Permetrin krim 5% tube 0 0 0
182 Pirantel suspensi 10 ml botol 0 0 0
183 Pirantel suspensin 60 ml Botol 0 0 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 0 0 300
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0
189 Pot Sputum pcs 0 0 0 10
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0
199 Reagensia ZN botol 0 0 0
202 Ringer Laktat larutan infus steril Botol 5 5 1 4 4
205 Salep 2 - 4 kombinasi pot 0 0 0
206 Salisil bedak 2 % pot 6 6 0 6 6
211 Semen seng fosfat serbuk dan cairan buah 0 0 0
213 Setrizin syrup Botol 0 0 0

215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 0 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0
223 Tablet tambah darah kombinasi tablet 550 550 260 290 290 900
224 Taburia kotak 0 0 0
225 Temporary stopping (Fletcher) buah 0 0 0
228 Tiamfenikol 500 mg kapsul 0 0 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0
232 Umbilical Cord kotak 10 10 1 9 9
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 10
234 Urine Bag set 0 0 0
235 Vaksin Jerap Tetanus vial 0 0 0
236 Vaksin Rabies vero kuur 0 0 0
237 Vitamin B kompleks tablet tablet 536 536 133 403 403 300
241 Zinc syrup Botol 0 0 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0
245 Zidovudine 150 mg Btl 0 0 0
246 Lomivudine 150 mg Btl 0 0 0
247 Efavirenz 600 mg Btl 0 0 0
248 Nepirapine 200 mg Btl 0 0 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0
251 TenoFovir 300 mg Btl 0 0 0
252 Tenof EM Btl 0 0 0
253 Samcobion Tablet 0 0 0
255 Lytacur Sirup Btl 10 10 0 10 10
256 Susu Produgen Kotak 0 0 0
TOTAL
jumlah resep
generik NON GENERIK UNIT
Jamkesda PELAYANAN
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
dr Hj Ulianti
NIP.197908072007012013
MBAR PERMINTAAN OBAT
PO)
BULAN 9
TAHUN 2018
SUMBER DANA HARGA

JMLH JUMLAH HARGA KET
SATUAN
DAK/14 DAK/15 DAK/16 DAK/17 BANTUAN PROGRAM
14 15 16 17 18 19 20 21 22 23
14 8,050 112,700
5 8,050 40,250
0 8,050 0
0 8,515 0
0 7333.7 0
17 7333.7 124,673
5 7333.7 36,669
0 1517.72307 0
0 1374,375 0
177 748 132,396
67 748 50,116
5 863 4,315
0 1,353 0
0 323 0
0 114.95 0
0 95 0
0 244 0
0 5,500 0
0 216 0
0 86 0
0 3,349 0
0 165 0
0 90 0
0 163 0
6 2,200 13,200
0 4,147 0
0 207 0
517 233 120,461
0 4,600 0
0 19,800 0
280 209 58,520
0 1,500 0
410 59 24,190
0 2,106 0
0 3,502 0
0 4,782 0
0 3,365 0
0 149 0
0 5,800 0
359 120 43,080
0 68 0
410 102 41,820
0 272 0
0 381 0
0 3,960 0
0 153 0
0 173 0
0 1,672 0
0 75 0
0 156,072 0
0 234,238 0
0 129,210 0
0 1,210 0
1 1,435 1,435
0 5,670 0
0 5,800 0
0 167.42 0
0 7928,333 0
4 7929,16666 #VALUE!
0 1,740 0
201 45 9,045
0 2,578 0
0 12,749 0
0 134 0
0 65 0
0 104 0
0 1,354 0
0 108 0
0 309 0
0 3,180 0
0 133 0
0 56 0
0 42 0
0 8,910 0
0 3,600 0
3 2,625 7,875
0 115,500 0
0 20,815 0
0 2,265 0
0 74 0
0 860.64 0
6 4,167 25,002
0 796 0
0 13,970 0
0 13,970 0
0 91 0
24 274 6,576
0 3,545 0
0 3,850 0
0 434,500 0
0 110 0
0 220 0
0 297 0
331 132 43,692
2 6,900 13,800
0 263 0
0 74 0
0 134 0
0 91,667 0
0 171 0
0 2,812 0
0 2,560 0
0 8,800 0
400 111 44,400
0 133 0
0 2913.3 0
8 6622,2 #VALUE!
0 82 0
0 95 0
0 9,955 0
0 266,200 0
0 69 0
0 14,366 0
0 31,372 0
0 62,744 0
0 69 0
0 86 0
0 306 0
20 1723.7 34,474
0 120,736 0
0 7,700 0
0 2,790 0
0 264 0
0 616 0
0 4,000 0
2 1,850 3,700
0 1,850 0
0 3,409 0
0 8,250 0
544 45 24,480
0 112 0
0 60,500 0
0 1,425 0
0 179 0
0 170 0
0 158 0 EXP
10 2,225 22,250
0 137.5 0
0 9,275 0
0 2,122 0
1 49,192 49,192
0 90 0
0 149 0
0 1,694 0
0 3,650 0
40 805 32,200
0 3,300 0
0 3,300 0
0 133 0
0 2,684 0
0 200 0
0 115 0
0 100 0
0 3,904 0
0 98 0
120 140 16,800
0 3,737 0
0 2726.9 0
0 37,400 0 EXP
0 193,600 0
0 161 0
0 6,410 0
0 123 0
0 602 0
0 704 0
0 413,984 0
0 1,379,984 0
0 236,500 0
0 4,400 0
0 16,698 0
0 636 0
0 1,869 0
0 3,300 0
7 1,900 13,300
0 148 0
0 5,980 0
0 1,119 0
458 58 26,564
0 4,400 0
0 12,155 0
0 318 0
0 17,600 0
0 9,100 0
0 136 0
0 1,040 0
0 220 0
0 12,076 0
0 35,532 0
0 3137.2 0
145 85 12,325
0 120 0
0 9,908 0
0 320 0
0 69 0
0 115 0
0 1,600 0
0 525,000 0
0 14,344 0
0 276,600 0
0 327 0
0 583 0
4 7,150 28,600
0 68 0
0 88 0
0 2,797 0
6 1,066 6,396
0 531.3 0
0 531.3 0
0 531.3 0
0 557 0
0 102,850 0
0 154 0
0 7,756 0
0 58 0
0 1,226 0
0 209 0
0 135 0
0 252 0
0 4124.8366 0
0 298 0
0 878 0
0 3,549 0
290 410 118,900
0 18,150 0
0 37,400 0
0 162 0
0 325 0
0 1,452 0
0 1,760 0
0 91 0
0 97 0
9 1494.9 13,454
0 8768.1 0
0 3,432 0
0 14,498 0
0 174499,6 #VALUE!
403 132 53,196
0 792 0
0 4438.5 0
0 21,593 0
0 16,478 0
0 592 0
0 9372.5 0
0 25127,5 0
0 1,700 0
0 4,255 0
0 7,331 0
0 3,080 0
0 3,058 0
0 11894.3 0
0 6,475 0
0 12,449 0
0 989.659 0
0 314 0
10 14,300 143,000
0 40,700 0
1,637,740
UNIT JAMKESDA JKN TOTAL
PELAYANAN Jml pasien Jml R/ Jml pasien Jml R/ Jml pasien Jml R/
pustu simpo
pustu tonrong
pustu trong rijang
pkesdes sipodeceng 46
pkesdes baranti
pkesdes passeno
pkesdes trong
pkesdes duampanua
usila
posbindu
TOTAL
Murniaty,S.Farm
NIP : 198212112009012006
(LPLPO)
KECAMATAN : BARANTI TGL ###
NO. NAMA OBAT
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13
1 IV Catheter Gea No. 18 set 0 0 0 0 0 0
2 IV Catheter Gea No. 20 set 30 30 60 50 10 10 3
5 Ansell Steril 6 1/2 psg 0 0 0 0 0 0
6 Ansell Steril 7 psg 3 0 3 3 0 0 5
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0
8 Alat Suntik sekali pakai 0,05 ml set 0 0 0 0 0 0
13 Alat Suntik sekali pakai 10 ml set 0 0 0 0 0 0
18 Ambroxol sirup 15 mg/ml Botol 0 0 0 0 0 0 5
19 Ambroxol tablet tablet 0 0 0 0 0 0 500
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml Botol 4 0 4 4 0 0 20
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 0 0
28 Amoksisilin kaplet 500 mg kaplet 170 0 170 170 0 0 10,000
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0 0 0
30 Anagens Syrup Botol 0 0 0 0 0 0
31 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 0 0 0 0 100
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0 0 0
33 Antasida DOEN tablet kombinasi tablet 330 0 330 330 0 0 1,000

34 Antasida DOEN suspensi Botol 6 0 6 6 0 0 10
35 Antihemoroid DOEN kombinasi suppos 0 0 0 0 0 0 20
36 Antifungi DOEN kombinasi pot 0 0 0 0 0 0
37 Antibakteri DOEN salep Kombinasi tube 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0 0 0
41 Asam Folat tablet 0 0 0 0 0 0
42 Asam Mefenamat tablet 500 mg tablet 80 0 80 80 0 0 1,000
45 Asiklovir krim 5% tablet 0 0 0 0 0 0 20
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0 0 0
53 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 100
54 Betametason krim 0.1 % tube 0 0 0 0 0 0 10
55 Bisakodil 5 mg supp suppos 0 0 0 0 0 0
59 Catgut/benang bedah no .3/0 pcs 0 0 0 0 0 0 10
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 0 0 0
61 Deksametason tablet 0,5 mg tablet 0 0 0 0 0 0 1,000
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0 0
70 Domperidom suspensi Botol 3 0 3 3 0 0 10
71 Domperidom tablet tablet 0 0 0 0 0 0 100
73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 0 0 0 300
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 0 0 0 0 0 0 1
76 E t a n o l 70 % 100 ml Botol 0 0 0 0 0 0 1
77 Etil klorida semprot Botol 0 0 0 0 0 0
78 Eugenol cairan botol 0 0 0 0 0 0

79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 0 0 0 0 0
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet 0 0 0 0 0 0 100
84 Foly Catheter No. 18 pcs 0 0 0 0 0 0
87 Garam Oralit untuk 200 ml Air sak 0 0 0 0 0 0
88 Gentamicin inj 40mg/ml Ampul 0 0 0 0 0 0
89 Gentian Violet larutan 1 % Botol 0 0 0 0 0 0 10
90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 0 0
94 Guaiafenesin Tablet tablet 0 0 0 0 0 0 1,500
95 Glukosa larutan infus 5 % steril Botol 0 0 0 0 0 0 5
99 Haloperidol inj 50 mg/ml ampul 0 0 0 0 0 0
101 Hidrokortison krim 2,5 % tube 0 0 0 0 0 0 20
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 0 0 0 0 0
106 Infusion set anak pcs 0 0 0 0 0 0
107 Infusion set dewasa pcs 0 0 0 0 0 0 4
111 Kalsium Hidroksida pasta buah 0 0 0 0 0 0
113 Kapas pembalut 250 gram buah 0 0 0 0 0 0 100
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 0 0 0 0 0 0
120 Kasa hidrofil 40 x 80 cm roll 0 0 0 0 0 0
121 Kasa pembalut elastis 3 inch roll 0 0 0 0 0 0
122 Ketokonazol krim 2% tube 0 0 0 0 0 0 20

124 Kloramfenikol kapsul 250 mg Kapsul 0 0 0 0 0 0 300
125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0 0 0 0
126 Kloramfenikol salep mata 1 % tube 0 0 0 0 0 0 20
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 10
128 Kloramfenikol salep Kulit 2% tube 0 0 0 0 0 0 10
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 0 0 10
132 Klorfenol Kamfer Menthol Botol 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0 0 0
136 Kotrimoksazol tablet 480 mg tablet 0 0 0 0 0 0 1,500
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 0 0 0 0 0 0 20
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 0 0
139 Larutan mengandung elektrolit botol 0 0 0 0 0 0
140 Lidokain komp. injeksi - 2 ml ampul 5 0 5 5 0 0 10
141 Lisol 1 liter Botol 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0 0 0 0
146 Masker Kain pcs 0 0 0 0 0 0
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0 0 0
157 Miconazole Krim tube 0 0 0 0 0 0 20
158 Mineral Mix sak 0 0 0 0 0 0
159 Multivitamin (Lycalvit) syrup botol 0 0 0 0 0 0 10
160 Mummifying pasta buah 0 0 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril Botol 0 0 0 0 0 0 5
166 Obat anti Tuberklosis kategori FDC I paket 0 0 0 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 0 0 0

169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0
170 OBH Itral Syrup Botol 0 0 0 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 0 0 20
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 10 0 10 0 10 10
175 Omeprazole 20 mg kapsul 0 0 0 0 0 0 100
176 Parasetamol drops Botol 0 0 0 0 0 0 20
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 0 0 0 10
178 Parasetamol tablet 500 mg tablet 110 0 110 110 0 0 1,000
179 Pehacain injeksi botol 0 0 0 0 0 0 20
180 Permetrin krim 5% tube 0 0 0 0 0 0
181 Pirantel pamoat tablet 125 mg tablet 0 0 0 0 0 0 100
182 Pirantel suspensi 10 ml botol 0 0 0 0 0 0
183 Pirantel suspensin 60 ml Botol 0 0 0 0 0 0 5
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 0 0 0
186 Piroksikam 20 mg tablet 0 0 0 0 0 0 200
187 Plester 2,5 cm x 4 m rol 2 0 2 2 0 0 3
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0
189 Pot Sputum pcs 0 0 0 0 0 0
190 Prednison tablet 5 mg tablet 80 0 80 80 0 0 100
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 0 0 0
195 Ranitidin tablet 150 mg tablet 0 0 0 0 0 0 200
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 0 0 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 0 0 0
199 Reagensia ZN botol 0 0 0 0 0 0
202 Ringer Laktat larutan infus steril Botol 0 0 0 0 0 0
205 Salep 2 - 4 kombinasi pot 2 2 2 0 0 10
206 Salisil bedak 2 % pot 0 0 0 0 0 0 5
207 Sarung Tangan Examination S pcs 0 0 0 0 0 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 0 0
213 Setrizin syrup Botol 0 0 0 0 0 0

214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 50 50 50 0 0 500
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 0 0 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 0 0 0 0 0 0 5
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0 0 0
223 Tablet tambah darah kombinasi tablet 30 0 30 30 0 0 100
224 Taburia kotak 0 0 0 0 0 0
225 Temporary stopping (Fletcher) buah 0 0 0 0 0 0
228 Tiamfenikol 500 mg kapsul 0 0 0 0 0 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 0 0
232 Umbilical Cord kotak 0 0 0 0 0 0
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0 0 0
234 Urine Bag set 0 0 0 0 0 0
235 Vaksin Jerap Tetanus vial 0 0 0 0 0 0
236 Vaksin Rabies vero kuur 0 0 0 0 0 0
237 Vitamin B kompleks tablet tablet 0 0 0 0 0 0 1,000
238 Wicold kapsul kapsul 0 0 0 0 0 0
239 Yodium povidon larutan 10 % 60 ml Botol 0 0 0 0 0 0
241 Zinc syrup Botol 0 0 0 0 0 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0
245 Zidovudine 150 mg Btl 0 0 0 0 0 0
246 Lomivudine 150 mg Btl 0 0 0 0 0 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0
248 Nepirapine 200 mg Btl 0 0 0 0 0 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0 0 0 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0 0 0 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0
252 Tenof EM Btl 0 0 0 0 0 0
253 Samcobion Tablet 0 0 0 0 0 0
255 Lytacur Sirup Btl 0 0 0 0 0 0
256 Susu Produgen Kotak 0 0 0 0 0 0
TOTAL
jumlah resep
Jamkesda PELAYANAN
JKN 96 pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL 96 TOTAL
Mengetahui Pustu Tonrong Rijang

dr Hj Ulianti Hj Mannasiah S.ST

NIP.197908072007012013 NIP: 1969052619 1989032006
PO)
BULAN SEPTEMBER
TAHUN 2018
SUMBER DANA HARGA

SATUAN
14 15 16 17 18 19 20 21 22 23
0 8,050 0
10 8,050 80,500
0 8,050 0
0 8,515 0
0 7333.7 0
0 7333.7 0
0 7333.7 0
0 1517.72307 0
0 1374,375 0
0 748 0
0 748 0
0 863 0
0 1,353 0
0 323 0
0 114.95 0
0 95 0
0 244 0
0 5,500 0
0 216 0
0 86 0
0 3,349 0
0 165 0
0 90 0
5 163 815
0 2,200 0
0 4,147 0
0 207 0
0 233 0
0 4,600 0
0 19,800 0
0 209 0
0 1,500 0
0 59 0
0 2,106 0
0 3,502 0
0 4,782 0
0 3,365 0
0 149 0
0 5,800 0
0 120 0
0 68 0
0 102 0
0 272 0
0 381 0
0 3,960 0
0 153 0
0 173 0
0 1,672 0
0 75 0
0 156,072 0
0 234,238 0
0 129,210 0
0 1,210 0
0 1,435 0
0 5,670 0
0 5,800 0
0 167.42 0
0 7928,333 0
0 7929,16666 #VALUE!
0 1,740 0
0 45 0
0 2,578 0
0 12,749 0
0 134 0
0 65 0
0 104 0
0 1,354 0
0 108 0
0 309 0
0 3,180 0
0 133 0
0 56 0
0 42 0
0 8,910 0
0 3,600 0
0 2,625 0
0 115,500 0
0 20,815 0
0 2,265 0
0 74 0
0 860.64 0
0 4,167 0
0 796 0
0 13,970 0
0 13,970 0
0 91 0
0 274 0
0 3,545 0
0 3,850 0
0 434,500 0
0 110 0
0 220 0
0 297 0
0 132 0
0 6,900 0
0 263 0
0 74 0
0 134 0
0 91,667 0
0 171 0
0 2,812 0
0 2,560 0
0 8,800 0
150 111 16,650
0 133 0
0 2913.3 0
0 6622,2 #VALUE!
0 82 0
0 95 0
0 9,955 0
0 266,200 0
50 69 3,450
0 14,366 0
0 31,372 0
0 62,744 0
0 69 0
0 86 0
0 306 0
0 1723.7 0
0 120,736 0
0 7,700 0
0 2,790 0
0 264 0
0 616 0
0 4,000 0
0 1,850 0
0 1,850 0
0 3,409 0
0 8,250 0
0 45 0
0 112 0
0 60,500 0
0 1,425 0
0 179 0
0 170 0
0 158 0
0 2,225 0
0 137.5 0
0 9,275 0
0 2,122 0
0 49,192 0
0 90 0
0 149 0
0 1,694 0
0 3,650 0
0 805 0
0 3,300 0
0 3,300 0
0 133 0
0 2,684 0
0 200 0
0 115 0
0 100 0
0 3,904 0
0 98 0
30 140 4,200
0 3,737 0
0 2726.9 0
0 37,400 0 EXP
0 193,600 0
0 161 0
0 6,410 0
0 123 0
0 602 0
0 704 0
0 413,984 0
0 1,379,984 0
0 236,500 0
0 4,400 0
0 16,698 0
0 636 0
0 1,869 0
0 3,300 0
10 1,900 19,000
0 148 0
0 5,980 0
0 1,119 0
0 58 0
0 4,400 0
0 12,155 0
0 318 0
0 17,600 0
0 9,100 0
0 136 0
0 1,040 0
0 220 0
0 12,076 0
0 35,532 0
0 3137.2 0
0 85 0
0 120 0
0 9,908 0
0 320 0
0 69 0
0 115 0
0 1,600 0
0 525,000 0
0 14,344 0
0 276,600 0
0 327 0
0 583 0
0 7,150 0
0 68 0
0 88 0
0 2,797 0
0 1,066 0
0 531.3 0
0 531.3 0
0 531.3 0
0 557 0
0 102,850 0
0 154 0
0 7,756 0
0 58 0
0 1,226 0
0 209 0
0 135 0
0 252 0
0 4124.8366 0
0 298 0
0 878 0
0 3,549 0
0 410 0
0 18,150 0
0 37,400 0
0 162 0
0 325 0
0 1,452 0
0 1,760 0
0 91 0
0 97 0
0 1494.9 0
0 8768.1 0
0 3,432 0
0 14,498 0
0 174499,6 #VALUE!
0 132 0
0 792 0
0 4438.5 0
0 21,593 0
0 16,478 0
0 592 0
0 9372.5 0
0 25127,5 0
0 1,700 0
0 4,255 0
0 7,331 0
0 3,080 0
0 3,058 0
0 11894.3 0
0 6,475 0
0 12,449 0
0 989.659 0
0 314 0
0 14,300 0
0 40,700 0
124,615
pustu simpo
pustu tonrong
pustu trong rijang
pkesdes sipodeceng
pkesdes baranti
pkesdes passeno
pkesdes trong
pkesdes duampanua
usila
posbindu
TOTAL
Murniaty,S.Farm
NIP : 198212112009012006
SATU STOK PENER PERSE PEMA
NO. NAMA OBAT
AN AWAL MAAN DIAAN KAIAN
1 2 3 4 5 6 =(4+5) 7
1 IV Catheter Gea No. 18 set 9 0 9 0
5 Ansell Steril 6 1/2 psg 0 0 0 0
6 Ansell Steril 7 psg 6 0 6 3
7 Ansell Steri 7 1/2 psg 0 0 0 0
13 Alat Suntik sekali pakai 10 ml set 0 0 0 0
19 Ambroxol tablet tablet 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 0
25 Amoksisilin sirup kering 125 mg/5 ml Botol 7 0 7 1
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0
30 Anagens Syrup Botol 0 0 0 0
31 Antalgin (Metampiron) tablet 500 mg Tablet 0 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0
33 Antasida DOEN tablet kombinasi tablet 70 0 70 30
34 Antasida DOEN suspensi Botol 0 0 0 0
35 Antihemoroid DOEN kombinasi suppos 0 0 0 0
36 Antifungi DOEN kombinasi pot 0 0 0 0
37 Antibakteri DOEN salep Kombinasi tube 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 140 0 140 40
42 Asam Mefenamat tablet 500 mg tablet 130 0 130 130

45 Asiklovir krim 5% tablet 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0
53 Betahistin maleat 24 mg tablet 0 0 0 0
54 Betametason krim 0.1 % tube 0 0 0 0
55 Bisakodil 5 mg supp suppos 0 0 0 0
56 Bisakodil 10 mg supp suppos 0 0 0 0
58 Catgut/benang bedah no .2/0 pcs 0 0 0 0
59 Catgut/benang bedah no .3/0 pcs 3 0 3 0
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 0
61 Deksametason tablet 0,5 mg tablet 250 0 250 50
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 0
70 Domperidom suspensi Botol 0 0 0 0
71 Domperidom tablet tablet 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 0 0 0 0
76 E t a n o l 70 % 100 ml Botol 1 0 1 0
77 Etil klorida semprot Botol 0 0 0 0
78 Eugenol cairan botol 0 0 0 0
79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 9 0 9 0
84 Foly Catheter No. 18 pcs 0 0 0 0
85 Foly Catheter No. 20 pcs 0 0 0 0

88 Gentamicin inj 40mg/ml Ampul 0 0 0 0
89 Gentian Violet larutan 1 % Botol 0 0 0 0
90 Glass lonomer Cement (GC IX ) buah 0 0 0 0
91 Glibenklamid tablet 5 mg tablet 0 0 0 0
94 Guaiafenesin Tablet tablet 0 0 0 0
95 Glukosa larutan infus 5 % steril Botol 5 0 5 0
96 Grisefulvin tablet 125 mg (Micronized) tablet 0 0 0 0
97 Haloperidol tablet 1,5 mg tablet 0 0 0 0
99 Haloperidol inj 50 mg/ml ampul 0 0 0 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 3 0 3 1
103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 0
106 Infusion set anak pcs 0 0 0 0
107 Infusion set dewasa pcs 5 0 5 0
111 Kalsium Hidroksida pasta buah 0 0 0 0
113 Kapas pembalut 250 gram buah 0 0 0 0
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 0 0
115 Kapas pembalut / Absorben 1000 gram bungkus 0 0 0 0
117 Kaptopril 25 mg tablet 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 0 0 0 0
120 Kasa hidrofil 40 x 80 cm roll 0 0 0 0
121 Kasa pembalut elastis 3 inch roll 0 0 0 0
122 Ketokonazol krim 2% tube 0 0 0 0
123 Ketokonazol tablet 200 mg tablet 0 0 0 0
124 Kloramfenikol kapsul 250 mg Kapsul 0 0 0 0
125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0 0
126 Kloramfenikol salep mata 1 % tube 0 0 0 0
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0
128 Kloramfenikol salep Kulit 2% tube 0 0 0 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0
132 Klorfenol Kamfer Menthol Botol 0 0 0 0

133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0
136 Kotrimoksazol tablet 480 mg tablet 190 0 190 10
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 0 0 0 0
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0
139 Larutan mengandung elektrolit botol 0 0 0 0
140 Lidokain komp. injeksi - 2 ml ampul 11 0 11 1
141 Lisol 1 liter Botol 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0 0
146 Masker Kain pcs 9 0 12 2
147 Mata Pisau No. 15 pcs 0 0 0 0
148 Mata Pisau No. 20 pcs 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0
157 Miconazole Krim tube 0 0 0 0
158 Mineral Mix sak 0 0 0 0
159 Multivitamin (Lycalfit) syrup botol 0 0 0 0
160 Mummifying pasta buah 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril Botol 8 0 8 0
166 Obat anti Tuberklosis kategori FDC I paket 0 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 0
169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0
170 OBH Itral Syrup Botol 0 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 8 0 8 0
175 Omeprazole 20 mg kapsul 0 0 0 0
176 Parasetamol drops Botol 0 0 0 0
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 0

178 Parasetamol tablet 500 mg tablet 410 0 410 130
179 Pehacain injeksi botol 0 0 0 0
180 Permetrin krim 5% tube 0 0 0 0
182 Pirantel suspensi 10 ml botol 0 0 0 0
183 Pirantel suspensin 60 ml Botol 0 0 0 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 240 0 240 40
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 0
186 Piroksikam 20 mg tablet 0 0 0 0
187 Plester 2,5 cm x 4 m rol 1 0 1 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0
189 Pot Sputum pcs 0 0 0 0
190 Prednison tablet 5 mg tablet 0 0 0 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 0
195 Ranitidin tablet 150 mg tablet 0 0 0 0
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 0
199 Reagensia ZN botol 0 0 0 0
202 Ringer Laktat larutan infus steril Botol 9 0 9 0
203 Salbutamol tablet 2 mg tablet 30 0 30 0
205 Salep 2 - 4 kombinasi pot 5 0 5 0
206 Salisil bedak 2 % pot 1 0 1 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0
213 Setrizin syrup Botol 0 0 0 0
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 0
216 Simetidine 200 mg tablet 0 0 0 0
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 4 0 4 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0

223 Tablet tambah darah kombinasi tablet 420 0 420 180
224 Taburia kotak 0 0 0 0
225 Temporary stopping (Fletcher) buah 0 0 0 0
228 Tiamfenikol 500 mg kapsul 0 0 0 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0
232 Umbilical Cord kotak 5 0 5 0
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0
234 Urine Bag set 0 0 0 0
235 Vaksin Jerap Tetanus vial 0 0 0 0
236 Vaksin Rabies vero kuur 0 0 0 0
239 Yodium povidon larutan 10 % 60 ml Botol 0 0 0 0
241 Zinc syrup Botol 0 0 0 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0
245 Zidovudine 150 mg Btl 0 0 0 0
246 Lomivudine 150 mg Btl 0 0 0 0
247 Efavirenz 600 mg Btl 0 0 0 0
248 Nepirapine 200 mg Btl 0 0 0 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0 0
251 TenoFovir 300 mg Btl 0 0 0 0
252 Tenof EM Btl 0 0 0 0
253 Samcobion Tablet 0 0 0 0
254 Spironolakton tablet 25 mg Tablet 0 0 0 0
255 Lytacur Sirup Btl 2 0 2 0
256 Susu Produgen Kotak 0 0 0 0

SISA STOK PERMIN
STOK OPT TAAN DAK/11 DAK/12 DAK/13 DAK/14 DAK/15 DAK/16 DAK/17
8 =(6-7) 9 10 11 12 13 14 15 16 17
9 9
5 5
0 0
0 0
0 0
3 3
0 0 20
0 0
0 0 10
74 74
14 14 10
6 6
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
6 6 10
0 0
40 40 200
0 0 500
0 0
0 0
0 0
0 0
40 40 300
0 0
0 0
0 0
0 0
0 0
0 0
100 100 300
0 0 300
0 0 300
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3 3 5
0 0
200 200 200
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 300
0 0
0 0
1 1 5
0 0
0 0
0 0
0 0
0 0
9 9
0 0
0 0
0 0
0 0
5 5 50
0 0
0 0
0 0
0 0
0 0
0 0
0 0 500
5 5
0 0
0 0
0 0
0 0
0 0
6 6
2 2 5
0 0
60 60 300
0 0
0 0
5 5
0 0
0 0
0 0
0 0
0 0 500
0 0
0 0
0 0
0 0
0 0
0 0
0 0 50
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
100 100 500
0 0
0 0
0 0
0 0
0 0
180 180 200
0 0 5
0 0
0 0
10 10
0 0
0 0
0 0
0 0
0 0
10 10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
100 100
0 0
0 0
0 0
0 0
0 0
8 8
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
8 8
0 0
0 0 5
0 0 10
280 280 500
0 0
0 0
0 0
0 0
0 0
200 200 200
0 0
0 0
1 1
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
9 9
30 30 100
0 0
5 5
1 1
0 0
0 0 50
0 0
0 0
0 0
0 0
0 0
20 20 200
0 0
0 0
0 0
0 0
4 4 5
0 0
0 0
0 0
240 240 500
0 0
0 0
0 0
0 0
0 0
0 0
340 340
0 0
5 5 20
0 0 10
0 0
0 0
0 0
135 135 300
0 0
0 0
0 0
0 0
0 0 300
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 2
0 0
HARGA JUMLAH
JMLH KET
SATUAN HARGA
BANTUAN PROGRAM
18 19 20 21 22 23
9 8,050 72,450
5 8,050 40,250
0 8,050 0
0 8,515 0
0 7333.7 0
3 7333.7 22,001
0 7333.7 0
0 1517.72307 0
0 1374,375 0
74 748 55,352
14 748 10,472
6 863 5,178
0 1,353 0
0 323 0
0 114.95 0
0 95 0
0 244 0
0 5,500 0
0 216 0
0 86 0
0 3,349 0
0 165 0
0 90 0
0 163 0
6 2,200 13,200
0 4,147 0
40 207 8,280
0 233 0
0 4,600 0
0 19,800 0
0 209 0
0 1,500 0
40 59 2,360
0 2,106 0
0 3,502 0
0 4,782 0
0 3,365 0
0 149 0
0 5,800 0
100 120 12,000
0 68 0
0 102 0
0 272 0
0 381 0
0 3,960 0
0 153 0
0 173 0
0 1,672 0
0 75 0
0 156,072 0
0 234,238 0
0 129,210 0
0 1,210 0
0 1,435 0
0 5,670 0
0 5,800 0
0 167.42 0
0 7928,333 0
3 7929,16666 #VALUE!
0 1,740 0
200 45 9,000
0 2,578 0
0 12,749 0
0 134 0
0 65 0
0 104 0
0 1,354 0
0 108 0
0 309 0
0 3,180 0
0 133 0
0 56 0
0 42 0
0 8,910 0
0 3,600 0
1 2,625 2,625
0 115,500 0
0 20,815 0
0 2,265 0
0 74 0
0 860.64 0
9 4,167 37,503
0 796 0
0 13,970 0
0 13,970 0
0 91 0
5 274 1,370
0 3,545 0
0 3,850 0
0 434,500 0
0 110 0
0 220 0
0 297 0
0 132 0
5 6,900 34,500
0 263 0
0 74 0
0 134 0
0 91,667 0
0 171 0
6 2,812 16,872
2 2,560 5,120
0 8,800 0
60 111 6,660
0 133 0
0 2913.3 0
5 6622,2 #VALUE!
0 82 0
0 95 0
0 9,955 0
0 266,200 0
0 69 0
0 14,366 0
0 31,372 0
0 62,744 0
0 69 0
0 86 0
0 306 0
0 1723.7 0
0 120,736 0
0 7,700 0
0 2,790 0
0 264 0
0 616 0
0 4,000 0
0 1,850 0
0 1,850 0
0 3,409 0
0 8,250 0
100 45 4,500
0 112 0
0 60,500 0
0 1,425 0
0 179 0
0 170 0
180 158 28,440
0 2,225 0
0 137.5 0
0 9,275 0
10 2,122 21,220
0 49,192 0
0 90 0
0 149 0
0 1,694 0
0 3,650 0
10 805 8,050
0 3,300 0
0 3,300 0
0 133 0
0 2,684 0
0 200 0
0 115 0
0 100 0
0 3,904 0
0 98 0
100 140 14,000
0 3,737 0
0 2726.9 0
0 37,400 0 EXP
0 193,600 0
0 161 0
8 6,410 51,280
0 123 0
0 602 0
0 704 0
0 413,984 0
0 1,379,984 0
0 236,500 0
0 4,400 0
0 16,698 0
0 636 0
0 1,869 0
0 3,300 0
8 1,900 15,200
0 148 0
0 5,980 0
0 1,119 0
280 58 16,240
0 4,400 0
0 12,155 0
0 318 0
0 17,600 0
0 9,100 0
200 136 27,200
0 1,040 0
0 220 0
1 12,076 12,076
0 35,532 0
0 3137.2 0
0 85 0
0 120 0
0 9,908 0
0 320 0
0 69 0
0 115 0
0 1,600 0
0 525,000 0
0 14,344 0
0 276,600 0
0 327 0
0 583 0
9 7,150 64,350
30 68 2,040
0 88 0
5 2,797 13,985
1 1,066 1,066
0 531.3 0
0 531.3 0
0 531.3 0
0 557 0
0 102,850 0
0 154 0
0 7,756 0
20 58 1,160
0 1,226 0
0 209 0
0 135 0
0 252 0
4 4124.8366 16,499
0 298 0
0 878 0
0 3,549 0
240 410 98,400
0 18,150 0
0 37,400 0
0 162 0
0 325 0
0 1,452 0
0 1,760 0
340 91 30,940
0 97 0
5 1494.9 7,475
0 8768.1 0
0 3,432 0
0 14,498 0
0 174499,6 #VALUE!
135 132 17,820
0 792 0
0 4438.5 0
0 21,593 0
0 16,478 0
0 592 0 EXP
0 9372.5 0
0 25127,5 0
0 1,700 0
0 4,255 0
0 7,331 0
0 3,080 0
0 3,058 0
0 11894.3 0
0 6,475 0
0 12,449 0
0 989.659 0
0 314 0
2 14,300 28,600
0 40,700 0
LAPORAN PEMAKAIAN DAN LEMBAR PERMIN
( L P L P O ) JKD
PUSKESMAS : BARANTI/TONRONGE NO
KECAMATAN : BARANTI TGL
SATU STOK PENER PERSE PEMA SISA STOK PERMIN SUMBE

NO. NAMA OBAT
AN AWAL MAAN DIAAN KAIAN STOK OPT TAAN DAK/11 DAK/12
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12
5 Ansell Steril 6 1/2 psg
6 Ansell Steril 7 psg
7 Ansell Steri 7 1/2 psg 5 10 15 7 8 10
9 Alat Suntik sekali pakai 0,5 ml set 11 11 5 6 20
13 Alat Suntik sekali pakai 10 ml set
14 Albendasol tablet 400 mg tablet
15 Alkohol Swab kotak
16 Alupurinol tablet 100 mg tablet
17 Allpurinol tablet 300 mg tablet
18 Ambroxol sirup 15 mg/ml Botol
19 Ambroxol tablet tablet
20 Aminofilin tablet 200 mg tablet
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul
22 Amitriptilin HCI tablet salut 25 mg tablet
25 Amoksisilin sirup kering 125 mg/5 ml Botol 0 0 0 0 10
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol
27 Amoksisilin kapsul 250 mg Kapsul
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial
30 Anagens Syrup Botol
31 Antalgin (Metampiron) tablet 500 mg Tablet
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul
33 Antasida DOEN tablet kombinasi tablet 480 480 20 460

34 Antasida DOEN suspensi Botol
35 Antihemoroid DOEN kombinasi suppos
36 Antifungi DOEN kombinasi pot
37 Antibakteri DOEN salep Kombinasi tube
38 Antimigrain DOEN kombinasi tablet
39 Aqua pro injeksi steril, bebas pirogen vial
41 Asam Folat tablet 500
42 Asam Mefenamat tablet 500 mg tablet 480 480 30 450
45 Asiklovir krim 5% tablet
46 Asetosal tablet 100 mg tabet
47 Attalpulgit tablet
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul
49 Atropin Sulfat tablet 0,5 mg tablet
50 Benecheck plus Glucose test strip 50's box
51 Benecheck plus Cholesterol test strip 50's box
52 Benecheck plus Uric test strip 50's box
53 Betahistin maleat 24 mg tablet
54 Betametason krim 0.1 % tube
57 Blood Lancet 26G kotak
59 Catgut/benang bedah no .3/0 pcs 1 6 7 2 5
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul
61 Deksametason tablet 0,5 mg tablet 170 170 0 170
62 Diazepam injeksi 5 mg/ml - 2 ml ampul
63 Diazepam rectal 5mg/2,5 ml buah
64 Diazepam tablet 2 mg tablett
65 Diazepam tablet 5 mg tablet
66 Dietilkarbamazin Sitrat tablet 100 mg tablet
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul
68 Digoksin tablet 0,25 mg tablet
69 Doksisilin kapsul 100 mg Kapsul
70 Domperidom suspensi Botol
71 Domperidom tablet tablet
72 Efedrin HCI tablet 25 mg tablet
73 Ekstrak Belladon tablet 10 mg tablet
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul
75 Etakridin (Rivanol) larutan 0,1 % Botol 1 1 0 1
76 E t a n o l 70 % 100 ml Botol 2 2 1 1 5
77 Etil klorida semprot Botol
78 Eugenol cairan botol

79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul
80 Fenobarbital tablet 30 mg tablet
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 10 10 1 9
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 mg tablet
86 Furosemid tablet 40 mg tablet
88 Gentamicin inj 40mg/ml Ampul
89 Gentian Violet larutan 1 % Botol
90 Glass lonomer Cement (GC IX ) buah
91 Glibenklamid tablet 5 mg tablet
94 Guaiafenesin Tablet tablet 40 40 20 20 300
95 Glukosa larutan infus 5 % steril Botol 8 8 0 8
96 Grisefulvin tablet 125 mg (Micronized) tablet
97 Haloperidol tablet 1,5 mg tablet
98 Haloperidol tablet 2 mg tablet
99 Haloperidol inj 50 mg/ml ampul
100 Hidroklorotiazid (HCT) tablet 25 mg tablet
102 Ibuprofen suspensi 100 mg/5 ml Botol 3 3 1 2 5
106 Infusion set anak pcs
107 Infusion set dewasa pcs 9 9 0 9
108 Isoniazid tablet 100 mg tablet
109 Isosorbid Dinitrat tablet subligual 5 mg tablet
110 Kalsium Glukonat inj 10% ampul
111 Kalsium Hidroksida pasta buah
113 Kapas pembalut 250 gram buah
116 Kaptopril 12,5 mg tablet
117 Kaptopril 25 mg tablet
118 Karbamazepin tablet 200 mg tablet
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 40 40 0 40
120 Kasa hidrofil 40 x 80 cm roll
121 Kasa pembalut elastis 3 inch roll
122 Ketokonazol krim 2% tube
123 Ketokonazol tablet 200 mg tablet

124 Kloramfenikol kapsul 250 mg Kapsul
125 Kloramfenikol susp 125mg/5 ml Botol
126 Kloramfenikol salep mata 1 % tube 3 3 1 2 10
127 Kloramfenikol tetes mata 1 % botol
128 Kloramfenikol salep Kulit 2% tube
129 Kloramfenikol tetes telinga 3 % Botol
131 Klorokuin tablet 150 mg tablet
132 Klorfenol Kamfer Menthol Botol
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul
136 Kotrimoksazol tablet 480 mg tablet 310 310 10 300
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 1 1 0 1 5
138 Kotrimoksazol Pediatrik tablet 120 mg tablet
139 Larutan mengandung elektrolit botol
140 Lidokain komp. injeksi - 2 ml ampul 4 4 0 4 10
141 Lisol 1 liter Botol
142 Loperamide 2 mg tablet
143 Loratadine 10 mg tablet
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol
146 Masker Kain pcs
149 Metilergometrin maleat tablet salut 0,125 mg tablet
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul
151 Metilprednisolon tablet 4 mg tablet
152 Metformin Hcl 500 mg tablet
153 Metoklopramida 10 mg tablet
154 Metoklopramida injeksi 5 mg / ml vial
155 Metronidazol tablet 250 mg tablet
157 Miconazole Krim tube
158 Mineral Mix sak
159 Multivitamin (Lycalvit) syrup botol 0 0 0 0
160 Mummifying pasta buah
161 Natrium diklofenak 50 mg tablet
162 Natrium klorida larutan infus 0,9 % steril Botol 8 8 0 8
163 Nifedipin 10 mg tablet
164 Nistatin tablet vagina 100.000 IU / g ovula
165 Nistatin vaginal tablet salut 500.000 IU/g tablet
166 Obat anti Tuberklosis kategori FDC I paket
167 Obat anti Tuberklosis kategori FDC 2 paket
168 Obat anti Tuberklosis kategori FDC Anak paket

169 Obat Batuk Hitam (O.B.H) cairan botol
170 OBH Itral Syrup Botol
171 Ofloksasin tablet 400 mg tablet
172 Oksitetrasiklin HCI salep kulit 3 % tube
173 Oksitetrasiklin HCI salep mata 1 % tube
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 3 3 2 1 10
175 Omeprazole 20 mg kapsul
176 Parasetamol drops Botol 5
177 Parasetamol sirup 120 mg / 5 ml Botol 0 0 0 0 10
179 Pehacain injeksi botol
180 Permetrin krim 5% tube
182 Pirantel suspensi 10 ml botol
183 Pirantel suspensin 60 ml Botol
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul
186 Piroksikam 20 mg tablet
187 Plester 2,5 cm x 4 m rol 1 1 0 1
188 Plester 7,5 cm x 4 m rol
189 Pot Sputum pcs
190 Prednison tablet 5 mg tablet
191 Primakuin tablet 15 mg tablet
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial
193 Propiltiourasil tablet 100 mg tablet
194 Propranolol HCI tablet 40 mg tablet
195 Ranitidin tablet 150 mg tablet
196 Ranitidin injeksi 25 mg/2 ml ampul
197 Rapid Test VIKIA HIV 1/2 kit
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test
199 Reagensia ZN botol
202 Ringer Laktat larutan infus steril Botol 5 5 0 5
204 Salbutamol 4 mg tablet
205 Salep 2 - 4 kombinasi pot 3 3 0 3
206 Salisil bedak 2 % pot 3 3 0 3
207 Sarung Tangan Examination S pcs
208 Sarung Tangan Examination M pcs
210 Sefadroksil 500 mg kapsul
211 Semen seng fosfat serbuk dan cairan buah
212 Setrizin tablet 10 mg tablet
213 Setrizin syrup Botol

215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul
216 Simetidine 200 mg tablet
219 Silk (benang Bedah Sutera) No. 3 / 0 pcs 5 5 0 5
220 Siprofloksasin tablet 500 mg tablet
221 Spironolakton tablet 100 mg tablet
222 Sulfasetamida natrium tetes mata 15 % Botol
224 Taburia kotak
225 Temporary stopping (Fletcher) buah
228 Tiamfenikol 500 mg kapsul
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 mg tablet
231 Triheksifenidil Hidroklorida tablet 2 mg tablet
232 Umbilical Cord kotak 1 1 2 0 10
233 U-Pad steril 60 cm x 90 cm pcs 5
234 Urine Bag set
235 Vaksin Jerap Tetanus vial 0 0 0 0
236 Vaksin Rabies vero kuur
238 Wicold kapsul kapsul
239 Yodium povidon larutan 10 % 60 ml Botol 1 1 2 0 2
241 Zinc syrup Botol
243 Paper Tape 2,5 x 9,14 Rol
244 Paper Tape 7,5 x 9,14 Rol
245 Zidovudine 150 mg Btl
246 Lomivudine 150 mg Btl
247 Efavirenz 600 mg Btl
248 Nepirapine 200 mg Btl
249 ZDV + 3 TC + NVP Ped Triple FDC Btl
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl
251 TenoFovir 300 mg Btl
252 Tenof EM Btl
253 Samcobion Tablet 0 0 0 0 100
254 Spironolakton tablet 25 mg Tablet
255 Lytacur Sirup Btl 5 5 0 5
256 Susu Produgen Kotak
TOTAL
jumlah resep
generik NON GENERIK
Jamkesda
JKN
Lain - lain

Jamkesda
JKN
Lain - lain
TOTAL
Mengetahui
dr Hj Ulianti
NIP.197908072007012013
N LEMBAR PERMINTAAN OBAT
L P O ) JKD
:
: BULAN 9
TAHUN 2018
SUMBER DANA HARGA

SATUAN
DAK/13 DAK/14 DAK/15 DAK/16 DAK/17 BANTUAN PROGRAM
13 14 15 16 17 18 19 20 21 22 23
0 8,050 0
0 8,050 0
0 8,050 0
0 8,515 0
0 7333.7 0
0 7333.7 0
0 7333.7 0
0 1517.72307 0
0 1374,375 0
0 748 0
0 748 0
0 863 0
0 1,353 0
0 323 0
0 114.95 0
0 95 0
0 244 0
0 5,500 0
0 216 0
0 86 0
0 3,349 0
0 165 0
0 90 0
0 163 0
0 2,200 0
0 4,147 0
0 207 0
0 233 0
0 4,600 0
0 19,800 0
0 209 0
0 1,500 0
0 59 0
0 2,106 0
0 3,502 0
0 4,782 0
0 3,365 0
0 149 0
0 5,800 0
0 120 0 EXF 100
0 68 0
0 102 0
0 272 0
0 381 0
0 3,960 0
0 153 0
0 173 0
0 1,672 0
0 75 0
0 156,072 0
0 234,238 0
0 129,210 0
0 1,210 0
0 1,435 0
0 5,670 0
0 5,800 0
0 167.42 0
0 7928,333 0
0 7929,16666 #VALUE!
0 1,740 0
0 45 0
0 2,578 0
0 12,749 0
0 134 0
0 65 0
0 104 0
0 1,354 0
0 108 0
0 309 0
0 3,180 0
0 133 0
0 56 0
0 42 0
0 8,910 0
0 3,600 0
0 2,625 0
0 115,500 0
0 20,815 0
0 2,265 0
0 74 0
0 860.64 0
0 4,167 EXF: 6
0 796 0
0 13,970 0
0 13,970 0
0 91 0
0 274 0
0 3,545 0
0 3,850 0
0 434,500 0
0 110 0
0 220 0
0 297 0
0 132 0
0 6,900 0
0 263 0
0 74 0
0 134 0
0 91,667 0
0 171 0
0 2,812 0
0 2,560 0
0 8,800 0
0 111 0
0 133 0
0 2913.3 0
0 6622,2 #VALUE!
0 82 0
0 95 0
0 9,955 0
0 266,200 0
0 69 0
0 14,366 0
0 31,372 0
0 62,744 0
0 69 0
0 86 0
0 306 0
0 1723.7 0
0 120,736 0
0 7,700 0
0 2,790 0
0 264 0
0 616 0
0 4,000 0
0 1,850 0
0 1,850 0
0 3,409 0
0 8,250 0
0 45 0
0 112 0
0 60,500 0
0 1,425 0
0 179 0
0 170 0
0 158 0
0 2,225 0
0 137.5 0
0 9,275 0
0 2,122 0
0 49,192 0
0 90 0
0 149 0
0 1,694 0
0 3,650 0
0 805 0
0 3,300 0
0 3,300 0
0 133 0
0 2,684 0
0 200 0
0 115 0
0 100 0
0 3,904 0
0 98 0
0 140 0
0 3,737 0
0 2726.9 0
0 37,400 0 EXP
0 193,600 0
0 161 0
0 6,410 0
0 123 0
0 602 0
0 704 0
0 413,984 0
0 1,379,984 0
0 236,500 0
0 4,400 0
0 16,698 0
0 636 0
0 1,869 0
0 3,300 0
0 1,900 0
0 148 0
0 5,980 0
0 1,119 0
0 58 0
0 4,400 0
0 12,155 0
0 318 0 EXP
0 17,600 0
0 9,100 0
0 136 0
0 1,040 0
0 220 0
0 12,076 0
0 35,532 0
0 3137.2 0
0 85 0
0 120 0
0 9,908 0
0 320 0
0 69 0
0 115 0
0 1,600 0
0 525,000 0
0 14,344 0
0 276,600 0
0 327 0
0 583 0
0 7,150 0
0 68 0
0 88 0
0 2,797 0
0 1,066 0
0 531.3 0
0 531.3 0
0 531.3 0
0 557 0
0 102,850 0
0 154 0
0 7,756 0
0 58 0
0 1,226 0
0 209 0
0 135 0
0 252 0
0 4124.8366 0
0 298 0
0 878 0
0 3,549 0
0 410 0
0 18,150 0
0 37,400 0
0 162 0
0 325 0
0 1,452 0
0 1,760 0
0 91 0
0 97 0
0 1494.9 0
0 8768.1 0
0 3,432 0
0 14,498 0
0 174499,6 #VALUE!
0 132 0
0 792 0
0 4438.5 0
0 21,593 0
0 16,478 0
0 592 0 100 EXF
0 9372.5 0
0 25127,5 0
0 1,700 0
0 4,255 0
0 7,331 0
0 3,080 0
0 3,058 0
0 11894.3 0
0 6,475 0
0 12,449 0
0 989.659 0
0 314 0
0 14,300 0
0 40,700 0
0
pustu simpo
pustu tonrong
pustu trong rijang
pkesdes sipodeceng
pkesdes baranti
pkesdes passeno
pkesdes trong
pkesdes duampanua
usila
posbindu
TOTAL
Murniaty,S.Farm
NIP : 198212112009012006
(LPLPO)
KECAMATAN : BARANTI TGL :
NO. NAMA OBAT
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13
5 Ansell Steril 6 1/2 psg 0 0 0 0 0 0 10
6 Ansell Steril 7 psg 0 0 0 0 0 0
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0
13 Alat Suntik sekali pakai 10 ml set 0 0 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 0 0 0
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 0 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0 0 0
30 Anagens Syrup Botol 0 0 0 0 0 0
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0 0 0
35 Antihemoroid DOEN kombinasi suppos 0 0 0 0 0 0
36 Antifungi DOEN kombinasi pot 0 0 0 0 0 0
37 Antibakteri DOEN salep Kombinasi tube 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0 0 0
45 Asiklovir krim 5% tablet 0 0 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0 0 0
53 Betahistin maleat 24 mg tablet 0 0 0 0 0 0
54 Betametason krim 0.1 % tube 0 0 0 0 0 0
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 0 0 0
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0 0
70 Domperidom suspensi Botol 0 0 0 0 0 0
71 Domperidom tablet tablet 0 0 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 0 0 0 0 0 0
76 E t a n o l 70 % 100 ml Botol 0 0 0 0 0 0
77 Etil klorida semprot Botol 0 0 0 0 0 0
78 Eugenol cairan botol 0 0 0 0 0 0

79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 0 0 0 0 0 0 15
85 Foly Catheter No. 20 pcs 0 0 0 0 0 0 1
88 Gentamicin inj 40mg/ml Ampul 0 0 0 0 0 0
89 Gentian Violet larutan 1 % Botol 0 0 0 0 0 0
90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 0 0
91 Glibenklamid tablet 5 mg tablet 0 0 0 0 0 0
94 Guaiafenesin Tablet tablet 0 0 0 0 0 0
99 Haloperidol inj 50 mg/ml ampul 0 0 0 0 0 0
101 Hidrokortison krim 2,5 % tube 0 0 0 0 0 0
106 Infusion set anak pcs 10 0 10 0 10 10
107 Infusion set dewasa pcs 0 0 0 0 0 0
111 Kalsium Hidroksida pasta buah 0 0 0 0 0 0
112 Kalsium laktat (Kalk) tablet 500 mg tablet 80 0 80 80 0 0 1,000
113 Kapas pembalut 250 gram buah 0 0 0 0 0 0
114 Kapas pembalut / Absorben 500 gram bungkus 0 0 0 0 0 0 1
117 Kaptopril 25 mg tablet 0 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 0 0 0 0 0 0 100
120 Kasa hidrofil 40 x 80 cm roll 0 0 0 0 0 0
121 Kasa pembalut elastis 3 inch roll 0 0 0 0 0 0
122 Ketokonazol krim 2% tube 0 0 0 0 0 0

125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0 0 0 0
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0
128 Kloramfenikol salep Kulit 2% tube 0 0 0 0 0 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 0 0
132 Klorfenol Kamfer Menthol Botol 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0 0 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 0 0 0 0 0 0
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 0 0
139 Larutan mengandung elektrolit botol 0 0 0 0 0 0
141 Lisol 1 liter Botol 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0 0 0 0
146 Masker Kain pcs 20 0 20 20 0 0 100
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ml ampul 0 0 0 0 0 0
152 Metformin Hcl 500 mg tablet 0 0 0 0 0 0 100
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0 0 0
157 Miconazole Krim tube 0 0 0 0 0 0
158 Mineral Mix sak 0 0 0 0 0 0
160 Mummifying pasta buah 0 0 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril Botol 5 0 5 5 0 0
166 Obat anti Tuberklosis kategori FDC I paket 0 0 0 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 0 0 0

169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0 5
170 OBH Itral Syrup Botol 0 0 0 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 0 0
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 1 0 1 1 0 0 15
175 Omeprazole 20 mg kapsul 0 0 0 0 0 0
178 Parasetamol tablet 500 mg tablet 450 0 450 210 240 240 1,000
179 Pehacain injeksi botol 0 0 0 0 0 0
180 Permetrin krim 5% tube 0 0 0 0 0 0
182 Pirantel suspensi 10 ml botol 0 0 0 0 0 0
183 Pirantel suspensin 60 ml Botol 0 0 0 0 0 0
184 Piridoksin HCI (Vit. B6 ) tablet 10 mg tablet 0 0 0 0 0 0 1,000
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 0 0 0
186 Piroksikam 20 mg tablet 0 0 0 0 0 0
187 Plester 2,5 cm x 4 m rol 0 0 0 0 0 0 2
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0
189 Pot Sputum pcs 0 0 0 0 0 0
190 Prednison tablet 5 mg tablet 0 0 0 0 0 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 0 0 0
195 Ranitidin tablet 150 mg tablet 0 0 0 0 0 0
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 0 0 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 0 0 0
199 Reagensia ZN botol 0 0 0 0 0 0
202 Ringer Laktat larutan infus steril Botol 5 0 5 5 0 0 10
205 Salep 2 - 4 kombinasi pot 0 0 0 0 0 0
207 Sarung Tangan Examination S pcs 0 0 0 0 0 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 0 0
213 Setrizin syrup Botol 0 0 0 0 0 0

214 Sianokorbalamin (Vit.B 12) 500 mcg tablet 320 0 320 130 190 190
215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 0 0 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0 0 0
223 Tablet tambah darah kombinasi tablet 0 0 0 0 0 0 1,000
224 Taburia kotak 0 0 0 0 0 0
225 Temporary stopping (Fletcher) buah 0 0 0 0 0 0
228 Tiamfenikol 500 mg kapsul 0 0 0 0 0 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 0 0
232 Umbilical Cord kotak 0 0 0 0 0 0 20
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0 0 0 30
234 Urine Bag set 0 0 0 0 0 0
235 Vaksin Jerap Tetanus vial 0 0 0 0 0 0
236 Vaksin Rabies vero kuur 0 0 0 0 0 0
237 Vitamin B kompleks tablet tablet 110 0 110 110 0 0 1,000
241 Zinc syrup Botol 5 0 5 0 5 5
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0
245 Zidovudine 150 mg Btl 0 0 0 0 0 0
246 Lomivudine 150 mg Btl 0 0 0 0 0 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0
248 Nepirapine 200 mg Btl 0 0 0 0 0 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0 0 0 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0 0 0 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0
252 Tenof EM Btl 0 0 0 0 0 0
253 Samcobion Tablet 0 0 0 0 0 0
255 Lytacur Sirup Btl 0 0 0 0 0 0 15
256 Susu Produgen Kotak 0 0 0 0 0 0
TOTAL
jumlah resep
Jamkesda PELAYANAN
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
dr Hj Ulianti
NIP.197908072007012013
PO)
9/30/2018 BULAN 9
TAHUN 2018
SUMBER DANA HARGA

SATUAN
14 15 16 17 18 19 20 21 22 23
0 8,050 0
3 8,050 24,150
0 8,050 0
24 8,515 204,360
0 7333.7 0
0 7333.7 0
0 7333.7 0
0 1517.72307 0
0 1374,375 0
0 748 0
0 748 0
0 863 0
0 1,353 0
0 323 0
0 114.95 0
0 95 0
0 244 0
0 5,500 0
0 216 0
0 86 0
0 3,349 0
0 165 0
0 90 0
0 163 0
0 2,200 0
0 4,147 0
40 207 8,280
500 233 116,500
0 4,600 0
0 19,800 0
0 209 0
0 1,500 0
170 59 10,030
0 2,106 0
0 3,502 0
0 4,782 0
0 3,365 0
0 149 0
0 5,800 0
0 120 0
0 68 0
230 102 23,460
0 272 0
0 381 0
0 3,960 0
0 153 0
0 173 0
0 1,672 0
0 75 0
0 156,072 0
0 234,238 0
0 129,210 0
0 1,210 0
0 1,435 0
0 5,670 0
0 5,800 0
0 167.42 0
0 7928,333 0
0 7929,16666 #VALUE!
0 1,740 0
140 45 6,300
0 2,578 0
0 12,749 0
0 134 0
0 65 0
0 104 0
0 1,354 0
0 108 0
0 309 0
0 3,180 0
0 133 0
0 56 0
0 42 0
0 8,910 0
0 3,600 0
0 2,625 0
0 115,500 0
0 20,815 0
0 2,265 0
0 74 0
0 860.64 0
0 4,167 0
0 796 0
0 13,970 0
0 13,970 0
0 91 0
20 274 5,480
0 3,545 0
0 3,850 0
0 434,500 0
0 110 0
0 220 0
0 297 0
0 132 0
0 6,900 0
0 263 0
0 74 0
0 134 0
0 91,667 0
0 171 0
0 2,812 0
0 2,560 0
0 8,800 0
110 111 12,210
0 133 0
10 2913.3 29,133
0 6622,2 #VALUE!
0 82 0
0 95 0
0 9,955 0
0 266,200 0
0 69 0
0 14,366 0
0 31,372 0
0 62,744 0
0 69 0
0 86 0
0 306 0
0 1723.7 0
0 120,736 0
0 7,700 0
0 2,790 0
0 264 0
0 616 0
0 4,000 0
2 1,850 3,700
0 1,850 0
0 3,409 0
0 8,250 0
0 45 0
0 112 0
0 60,500 0
0 1,425 0
0 179 0
0 170 0
0 158 0
0 2,225 0
0 137.5 0
0 9,275 0
5 2,122 10,610
0 49,192 0
0 90 0
0 149 0
0 1,694 0
0 3,650 0
0 805 0
0 3,300 0
0 3,300 0
0 133 0
0 2,684 0
0 200 0
0 115 0
0 100 0
0 3,904 0
120 98 11,760
0 140 0
0 3,737 0
0 2726.9 0
0 37,400 0 EXP
0 193,600 0
0 161 0
0 6,410 0
0 123 0
0 602 0
0 704 0
0 413,984 0
0 1,379,984 0
0 236,500 0
0 4,400 0
0 16,698 0
0 636 0
0 1,869 0
0 3,300 0
0 1,900 0
0 148 0
0 5,980 0
0 1,119 0
240 58 13,920
0 4,400 0
0 12,155 0
0 318 0
0 17,600 0
0 9,100 0
0 136 0
0 1,040 0
0 220 0
0 12,076 0
0 35,532 0
0 3137.2 0
0 85 0
0 120 0
0 9,908 0
0 320 0
0 69 0
0 115 0
0 1,600 0
0 525,000 0
0 14,344 0
0 276,600 0
0 327 0
0 583 0
0 7,150 0
0 68 0
0 88 0
0 2,797 0
0 1,066 0
0 531.3 0
0 531.3 0
0 531.3 0
0 557 0
0 102,850 0
0 154 0
0 7,756 0
190 58 11,020
0 1,226 0
0 209 0
0 135 0
0 252 0
0 4124.8366 0
0 298 0
0 878 0
0 3,549 0
0 410 0
0 18,150 0
0 37,400 0
0 162 0
0 325 0
0 1,452 0
0 1,760 0
250 91 22,750
0 97 0
0 1494.9 0
0 8768.1 0
0 3,432 0
0 14,498 0
0 174499,6 #VALUE!
0 132 0
0 792 0
0 4438.5 0
0 21,593 0
5 16,478 82,390
0 592 0
0 9372.5 0
0 25127,5 0
0 1,700 0
0 4,255 0
0 7,331 0
0 3,080 0
0 3,058 0
0 11894.3 0
0 6,475 0
0 12,449 0
0 989.659 0
0 314 0
0 14,300 0
0 40,700 0
596,053
pustu simpo
pustu tonrong
pustu trong rijang
pkesdes sipodeceng
pkesdes baranti
pkesdes passeno
pkesdes trong
pkesdes duampanua
usila
posbindu
TOTAL
Murniaty,S.Farm
NIP : 198212112009012006
(LPLPO)
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
7 Ansell Steri 7 1/2 psg 0 0 0 0 0 0 0 7333.7 0



76 E t a n o l 70 % 100 ml Botol 0 0 0 0 0 0 0 2,625 0




146 Masker Kain pcs 0 0 0 0 0 0 0 805 0
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0 3,300 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0 3,300 0
158 Mineral Mix sak 0 0 0 0 0 0 0 2726.9 0

187 Plester 2,5 cm x 4 m rol 1 0 1 1 0 0 0 12,076 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0 35,532 0
189 Pot Sputum pcs 0 0 0 0 0 0 0 3137.2 0


224 Taburia kotak 0 0 0 0 0 0 0 18,150 0
234 Urine Bag set 0 0 0 0 0 0 0 3,432 0

241 Zinc syrup Botol 0 0 0 0 0 0 0 16,478 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0 9372.5 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0 25127,5 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0 7,331 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0 6,475 0
252 Tenof EM Btl 0 0 0 0 0 0 0 12,449 0
TOTAL 1,344,938
jumlah resep
JKN pustu simpo
pustu trong rijang
JKN pkesdes passeno
pkesdes duampanua
usila
posbindu
TOTAL TOTAL
Mengetahui
NIP.197908072007012013 NIP : 198212112009012006

LAPORAN PEMAKAIAN DAN LEMBAR PERMINTA
(LPLPO)
PUSKESMAS : BARANTI NO
KECAMATAN : BARANTI TGL
SATU STOK PENER PERSE PEMA SISA STOK PERMIN SUMBER DAN
NO. NAMA OBAT
AN AWAL MAAN DIAAN KAIAN STOK OPT TAAN DAK/11 DAK/12
1 2 3 4 5 6 =(4+5) 7 8 =(6-7) 9 10 11 12
5 Ansell Steril 6 1/2 psg 0 0 0 0 0 0 0
6 Ansell Steril 7 psg 0 0 0 0 0 0 50
7 Ansell Steri 7 1/2 psg 5 0 5 5 0 0 0
8 Alat Suntik sekali pakai 0,05 ml set 0 0 0 0 0 0 0
9 Alat Suntik sekali pakai 0,5 ml set 20 0 20 10 10 10 20
13 Alat Suntik sekali pakai 10 ml set 0 0 0 0 0 0 0
14 Albendasol tablet 400 mg tablet 0 0 0 0 0 0 0
17 Allpurinol tablet 300 mg tablet 0 0 0 0 0 0 0
20 Aminofilin tablet 200 mg tablet 0 0 0 0 0 0 0
21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 0 0 0 0 0 0 0
22 Amitriptilin HCI tablet salut 25 mg tablet 0 0 0 0 0 0 0
26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 0 0 0 0 0 0 0
29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0 0 0 0
30 Anagens Syrup Botol 4 0 4 0 4 4 0
32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0 0 0 0

35 Antihemoroid DOEN kombinasi suppos 0 0 0 0 0 0 0
36 Antifungi DOEN kombinasi pot 0 0 0 0 0 0 0
37 Antibakteri DOEN salep Kombinasi tube 0 0 0 0 0 0 0
38 Antimigrain DOEN kombinasi tablet 0 0 0 0 0 0 0
39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0 0 0 0
40 Asam Askorbat (Vit C) tablet 50 mg tablet 314 0 314 314 0 EXPIRATE 300 EXPIRATE
45 Asiklovir krim 5% tablet 0 0 0 0 0 0 0
46 Asetosal tablet 100 mg tabet 0 0 0 0 0 0 0
47 Attalpulgit tablet 0 0 0 0 0 0 0
48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 0 0 0 0 0 0 0
49 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 0 0 0 0
50 Benecheck plus Glucose test strip 50's box 0 0 0 0 0 0 0
51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 0 0 0
52 Benecheck plus Uric test strip 50's box 0 0 0 0 0 0 0
53 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 0
54 Betametason krim 0.1 % tube 0 0 0 0 0 0 0
55 Bisakodil 5 mg supp suppos 0 0 0 0 0 0 0
56 Bisakodil 10 mg supp suppos 0 0 0 0 0 0 0
57 Blood Lancet 26G kotak 0 0 0 0 0 0 0
60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 0 0 0 0 0 0 0
62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 0 0
63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0 0 0 0
64 Diazepam tablet 2 mg tablett 0 0 0 0 0 0 0
65 Diazepam tablet 5 mg tablet 0 0 0 0 0 0 0
66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 0 0 0 0 0
67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 0 0 0 0 0 0 0
68 Digoksin tablet 0,25 mg tablet 0 0 0 0 0 0 0
69 Doksisilin kapsul 100 mg Kapsul 0 0 0 0 0 0 0
70 Domperidom suspensi Botol 0 0 0 0 0 0 0
71 Domperidom tablet tablet 0 0 0 0 0 0 300
72 Efedrin HCI tablet 25 mg tablet 0 0 0 0 0 0 0
74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 0 0
75 Etakridin (Rivanol) larutan 0,1 % Botol 0 0 0 0 0 0 0
76 E t a n o l 70 % 100 ml Botol 1 0 1 1 0 0 0
77 Etil klorida semprot Botol 0 0 0 0 0 0 0
78 Eugenol cairan botol 0 0 0 0 0 0 0

79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 0 0 0 0 0 0 0
80 Fenobarbital tablet 30 mg tablet 0 0 0 0 0 0 0
82 Fitomenadion ( Vit. K1 ) inj. 10 mg/ml - 1 ml ampul 12 0 12 3 9 9 20
83 Fitomenadion ( Vit. K1 ) tablet salut gula 10 tablet 0 0 0 0 0 0 0
88 Gentamicin inj 40mg/ml Ampul 0 0 0 0 0 0 0
89 Gentian Violet larutan 1 % Botol 0 0 0 0 0 0 0
90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 0 0 0
94 Guaiafenesin Tablet tablet 280 0 280 0 280 280 0
96 Grisefulvin tablet 125 mg (Micronized) tablet 10 0 10 10 0 0 0
97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 0 0
98 Haloperidol tablet 2 mg tablet 0 0 0 0 0 0 0
99 Haloperidol inj 50 mg/ml ampul 0 0 0 0 0 0 0
100 Hidroklorotiazid (HCT) tablet 25 mg tablet 0 0 0 0 0 0 0
101 Hidrokortison krim 2,5 % tube 0 0 0 0 0 0 0
102 Ibuprofen suspensi 100 mg/5 ml Botol 0 0 0 0 0 0 0
103 Ibuprofen suspensi 200 mg/5 ml Botol 1 0 1 1 0 0 0
106 Infusion set anak pcs 0 0 0 0 0 0 0
107 Infusion set dewasa pcs 4 0 4 0 4 4 10
108 Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 0
110 Kalsium Glukonat inj 10% ampul 0 0 0 0 0 0 0
111 Kalsium Hidroksida pasta buah 0 0 0 0 0 0 0
113 Kapas pembalut 250 gram buah 0 0 0 0 0 0 0
118 Karbamazepin tablet 200 mg tablet 0 0 0 0 0 0 0
119 Kasa pembalut Hidrofil 4 m x 10 cm roll 0 0 0 0 0 0 30
120 Kasa hidrofil 40 x 80 cm roll 0 0 0 0 0 0 0
121 Kasa pembalut elastis 3 inch roll 0 0 0 0 0 0 0
122 Ketokonazol krim 2% tube 0 0 0 0 0 0 0
123 Ketokonazol tablet 200 mg tablet 0 0 0 0 0 0 0

125 Kloramfenikol susp 125mg/5 ml Botol 0 0 0 0 0 0 0
127 Kloramfenikol tetes mata 1 % botol 0 0 0 0 0 0 0
128 Kloramfenikol salep Kulit 2% tube 0 0 0 0 0 0 0
129 Kloramfenikol tetes telinga 3 % Botol 0 0 0 0 0 0 0
130 Klorfeniramin maleat tablet 4 mg tablet 0 0 0 0 0 0 200
131 Klorokuin tablet 150 mg tablet 0 0 0 0 0 0 0
132 Klorfenol Kamfer Menthol Botol 0 0 0 0 0 0 0
133 Klorpromazin HCI injeksi 25 mg/ml - 2 ml ampul 0 0 0 0 0 0 0
137 Kotrimoksazol Suspensi 240 mg/ 5 ml Botol 6 0 6 0 6 6 0
138 Kotrimoksazol Pediatrik tablet 120 mg tablet 0 0 0 0 0 0 0
139 Larutan mengandung elektrolit botol 0 0 0 0 0 0 0
141 Lisol 1 liter Botol 0 0 0 0 0 0 0
142 Loperamide 2 mg tablet 0 0 0 0 0 0 0
143 Loratadine 10 mg tablet 0 0 0 0 0 0 0
144 Magnesium sulfat injeksi ( IV ) 20 % - 25 ml Botol 0 0 0 0 0 0 0
145 Magnesium sulfat injeksi ( IV ) 40 % - 25 ml botol 0 0 0 0 0 0 0
146 Masker Kain pcs 20 0 20 10 10 10 50
147 Mata Pisau No. 15 pcs 0 0 0 0 0 0 0
148 Mata Pisau No. 20 pcs 0 0 0 0 0 0 0
149 Metilergometrin maleat tablet salut 0,125 m tablet 0 0 0 0 0 0 0
150 Metilergometrin maleat injeksi 0.200 mg - 1 ampul 0 0 0 0 0 0 0
151 Metilprednisolon tablet 4 mg tablet 0 0 0 0 0 0 0
152 Metformin Hcl 500 mg tablet 0 0 0 0 0 0 0
153 Metoklopramida 10 mg tablet 0 0 0 0 0 0 0
154 Metoklopramida injeksi 5 mg / ml vial 0 0 0 0 0 0 0
157 Miconazole Krim tube 0 0 0 0 0 0 5
158 Mineral Mix sak 0 0 0 0 0 0 0
160 Mummifying pasta buah 0 0 0 0 0 0 0
162 Natrium klorida larutan infus 0,9 % steril Botol 3 0 3 0 3 3 0
166 Obat anti Tuberklosis kategori FDC I paket 0 0 0 0 0 0 0
167 Obat anti Tuberklosis kategori FDC 2 paket 0 0 0 0 0 0 0
168 Obat anti Tuberklosis kategori FDC Anak paket 0 0 0 0 0 0 0

169 Obat Batuk Hitam (O.B.H) cairan botol 0 0 0 0 0 0 0
170 OBH Itral Syrup Botol 0 0 0 0 0 0 0
171 Ofloksasin tablet 400 mg tablet 0 0 0 0 0 0 0
172 Oksitetrasiklin HCI salep kulit 3 % tube 0 0 0 0 0 0 0
173 Oksitetrasiklin HCI salep mata 1 % tube 0 0 0 0 0 0 10
174 Oksitosin injeksi 10 IU / ml - 1 ml ampul 0 0 0 0 0 0 20
175 Omeprazole 20 mg kapsul 0 0 0 0 0 0 0
178 Parasetamol tablet 500 mg tablet 118 0 118 70 48 48 500
179 Pehacain injeksi botol 0 0 0 0 0 0 0
180 Permetrin krim 5% tube 0 0 0 0 0 0 0
182 Pirantel suspensi 10 ml botol 0 0 0 0 0 0 0
183 Pirantel suspensin 60 ml Botol 0 0 0 0 0 0 0
185 Piridoksin HCI (Vit. B6 ) injeksi 100 mg/ml ampul 0 0 0 0 0 0 0
186 Piroksikam 20 mg tablet 0 0 0 0 0 0 0
187 Plester 2,5 cm x 4 m rol 1 0 1 1 0 0 0
188 Plester 7,5 cm x 4 m rol 0 0 0 0 0 0 0
189 Pot Sputum pcs 0 0 0 0 0 0 0
190 Prednison tablet 5 mg tablet 0 0 0 0 0 0 0
191 Primakuin tablet 15 mg tablet 0 0 0 0 0 0 0
192 Prokain benzil penisilin injeksi 3 Juta IU / vial vial 0 0 0 0 0 0 0
193 Propiltiourasil tablet 100 mg tablet 0 0 0 0 0 0 0
194 Propranolol HCI tablet 40 mg tablet 0 0 0 0 0 0 0
195 Ranitidin tablet 150 mg tablet 40 0 40 0 40 40 0
196 Ranitidin injeksi 25 mg/2 ml ampul 0 0 0 0 0 0 0
197 Rapid Test VIKIA HIV 1/2 kit 0 0 0 0 0 0 0
198 Rapid Test SD Bioline HIV 1/2 3.0 strip test 0 0 0 0 0 0 0
199 Reagensia ZN botol 0 0 0 0 0 0 0
202 Ringer Laktat larutan infus steril Botol 1 0 1 0 1 1 0
203 Salbutamol tablet 2 mg tablet 90 0 90 10 80 80 0
205 Salep 2 - 4 kombinasi pot 1 0 1 1 0 0 0
207 Sarung Tangan Examination S pcs 0 0 0 0 0 0 0
209 Sarung Tangan Examination L pcs 0 0 0 0 0 0 0
210 Sefadroksil 500 mg kapsul 0 0 0 0 0 0 0
211 Semen seng fosfat serbuk dan cairan buah 0 0 0 0 0 0 0
212 Setrizin tablet 10 mg tablet 0 0 0 0 0 0 0
213 Setrizin syrup Botol 0 0 0 0 0 0 0

215 Sianokorbalamin (Vit.B 12) inj. 500 mg / ml ampul 0 0 0 0 0 0 0
216 Simetidine 200 mg tablet 0 0 0 0 0 0 0
221 Spironolakton tablet 100 mg tablet 0 0 0 0 0 0 0
222 Sulfasetamida natrium tetes mata 15 % Botol 0 0 0 0 0 0 0
223 Tablet tambah darah kombinasi tablet 20 0 20 20 0 0 1,000
224 Taburia kotak 0 0 0 0 0 0 0
225 Temporary stopping (Fletcher) buah 0 0 0 0 0 0 0
228 Tiamfenikol 500 mg kapsul 0 0 0 0 0 0 0
229 Tiamin HCI (Vit. B1) injeksi 100 mg / ml - 1 ml ampul 0 0 0 0 0 0 0
230 Tiamin HCI / Mononitrat ( Vit. B1 ) tablet 50 tablet 120 0 120 80 40 40 300
231 Triheksifenidil Hidroklorida tablet 2 mg tablet 0 0 0 0 0 0 0
232 Umbilical Cord kotak 0 0 0 0 0 0 0
233 U-Pad steril 60 cm x 90 cm pcs 0 0 0 0 0 0 0
234 Urine Bag set 0 0 0 0 0 0 0
235 Vaksin Jerap Tetanus vial 0 0 0 0 0 0 0
236 Vaksin Rabies vero kuur 0 0 0 0 0 0 0
239 Yodium povidon larutan 10 % 60 ml Botol 3 0 3 0 3 3 0
240 Yodium povidon larutan 10 % 300 ml Botol 0 0 0 0 0 0 0
241 Zinc syrup Botol 0 0 0 0 0 0 0
243 Paper Tape 2,5 x 9,14 Rol 0 0 0 0 0 0 0
244 Paper Tape 7,5 x 9,14 Rol 0 0 0 0 0 0 0
245 Zidovudine 150 mg Btl 0 0 0 0 0 0 0
246 Lomivudine 150 mg Btl 0 0 0 0 0 0 0
247 Efavirenz 600 mg Btl 0 0 0 0 0 0 0
248 Nepirapine 200 mg Btl 0 0 0 0 0 0 0
249 ZDV + 3 TC + NVP Ped Triple FDC Btl 0 0 0 0 0 0 0
250 TDF + 3TC EFV(300/300/600) Triple FDC Btl 0 0 0 0 0 0 0
251 TenoFovir 300 mg Btl 0 0 0 0 0 0 0
252 Tenof EM Btl 0 0 0 0 0 0 0
253 Samcobion Tablet 0 0 0 0 0 0 0
254 Spironolakton tablet 25 mg Tablet 0 0 0 0 0 0 0
255 Lytacur Sirup Btl 0 0 0 0 0 0 0
256 Susu Produgen Kotak 0 0 0 0 0 0 0
TOTAL
jumlah resep
generik NON GENERIK
Jamkesda
JKN
Lain - lain

Jamkesda
JKN
Lain - lain
TOTAL
Mengetahui
dr Hj Ulianti
NIP.197908072007012013
LEMBAR PERMINTAAN OBAT
)
:
: BULAN 5
TAHUN 2018
SUMBER DANA HARGA JUMLAH

JMLH KET
SATUAN HARGA
DAK/13 DAK/14 DAK/15 DAK/16 DAK/17 BANTUANPROGRAM
13 14 15 16 17 18 19 20 21 22 23
5 8,050 40,250
2 8,050 16,100
7 8,050 56,350
0 8,515 0
0 7333.7 0
0 7333.7 0
0 7333.7 0
0 ### 0
10 1374,375 ###
0 748 0
18 748 13,464
8 863 6,904
0 1,353 0
0 323 0
0 114.95 0
0 95 0
0 244 0
0 5,500 0
0 216 0
0 86 0
0 3,349 0
0 165 0
0 90 0
0 163 0
9 2,200 19,800
0 4,147 0
0 207 0
810 233 188,730
0 4,600 0
4 19,800 79,200
60 209 12,540
0 1,500 0
190 59 11,210
0 2,106 0
0 3,502 0
0 4,782 0
0 3,365 0
0 149 0
0 5,800 0
EXPIRATE 120 #VALUE!
0 68 0
210 102 21,420
0 272 0
0 381 0
0 3,960 0
0 153 0
0 173 0
0 1,672 0
0 75 0
0 156,072 0
0 234,238 0
0 129,210 0
0 1,210 0
0 1,435 0
0 5,670 0
0 5,800 0
0 167.42 0
0 7928,333 0
0 929,16666 #VALUE!
0 1,740 0
56 45 2,520
0 2,578 0
0 12,749 0
0 134 0
0 65 0
0 104 0
0 1,354 0
0 108 0
0 309 0
0 3,180 0
0 133 0
0 56 0
0 42 0
0 8,910 0
0 3,600 0
0 2,625 0
0 115,500 0
0 20,815 0
0 2,265 0
0 74 0
0 860.64 0
9 4,167 37,503
0 796 0
0 13,970 0
0 13,970 0
0 91 0
12 274 3,288
0 3,545 0
0 3,850 0
0 434,500 0
0 110 0
0 220 0
0 297 0
280 132 36,960
0 6,900 0
0 263 0
0 74 0
0 134 0
0 91,667 0
0 171 0
0 2,812 0
0 2,560 0
0 8,800 0
590 111 65,490
0 133 0
0 2913.3 0
4 6622,2 #VALUE!
0 82 0
0 95 0
0 9,955 0
0 266,200 0
30 69 2,070
0 14,366 0
0 31,372 0
0 62,744 0
0 69 0
0 86 0
0 306 0
0 1723.7 0
0 120,736 0
0 7,700 0
0 2,790 0
0 264 0
0 616 0
0 4,000 0
0 1,850 0
0 1,850 0
0 3,409 0
0 8,250 0
0 45 0
0 112 0
0 60,500 0
0 1,425 0
0 179 0
0 170 0
430 158 67,940
6 2,225 13,350
0 137.5 0
0 9,275 0
0 2,122 0
0 49,192 0
0 90 0
0 149 0
0 1,694 0
0 3,650 0
10 805 8,050
0 3,300 0
0 3,300 0
0 133 0
0 2,684 0
0 200 0
0 115 0
0 100 0
0 3,904 0
0 98 0
140 140 19,600
0 3,737 0
0 2726.9 0
0 37,400 0 EXP
0 193,600 0
0 161 0
3 6,410 19,230
0 123 0
0 602 0
0 704 0
0 413,984 0
0 1,379,984 0
0 236,500 0
0 4,400 0
0 16,698 0
0 636 0
0 1,869 0
0 3,300 0
0 1,900 0
0 148 0
0 5,980 0
0 1,119 0
48 58 2,784
0 4,400 0
0 12,155 0
6 318 1,908
0 17,600 0
0 9,100 0
0 136 0
0 1,040 0
0 220 0
0 12,076 0
0 35,532 0
0 3137.2 0
0 85 0
0 120 0
0 9,908 0
0 320 0
0 69 0
40 115 4,600
0 1,600 0
0 525,000 0
0 14,344 0
0 276,600 0
0 327 0
0 583 0
1 7,150 7,150
80 68 5,440
0 88 0
0 2,797 0
3 1,066 3,198
0 531.3 0
0 531.3 0
0 531.3 0
0 557 0
0 102,850 0
0 154 0
0 7,756 0
160 58 9,280
0 1,226 0
0 209 0
0 135 0
0 252 0
0 ### 0
0 298 0
0 878 0
0 3,549 0
0 410 0
0 18,150 0
0 37,400 0
0 162 0
0 325 0
0 1,452 0
0 1,760 0
40 91 3,640
0 97 0
0 1494.9 0
0 8768.1 0
0 3,432 0
0 14,498 0
0 174499,6 #VALUE!
0 132 0
0 792 0
3 4438.5 13,316
0 21,593 0
0 16,478 0
120 592 71,040
0 9372.5 0
0 25127,5 0
0 1,700 0
0 4,255 0
0 7,331 0
0 3,080 0
0 3,058 0
0 11894.3 0
0 6,475 0
0 12,449 0
0 989.659 0
0 314 0
0 14,300 0
0 40,700 0
###
PELAYANAN Jml pasienJml R/ Jml pasienJml R/Jml pasienJml R/
pustu simpo
pustu tonrong
pustu trong rijang
pkesdes sipodeceng
pkesdes baranti
pkesdes passeno
pkesdes trong
pkesdes duampanua
usila
posbindu
TOTAL
Murniaty,S.Farm
NIP : 198212112009012006

JKD September

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JKD September

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LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT

14 Albendasol tablet 400 mg tablet 0 0 0 0 0 0 0 425 0

17 Allpurinol tablet 300 mg tablet 40 0 40 0 40 40 40 244 9,760

20 Aminofilin tablet 200 mg tablet 0 0 0 0 0 0 0 86 0

21 Aminofilin injeksi 24 mg/ml - 10 ml ampul 6 0 6 0 6 6 6 3,349 20,094

23 Amlodipine 5 mg tablet 0 0 0 0 0 0 0 105 0

24 Amlodipine 10 mg tablet 0 0 0 0 0 0 0 163 0

26 Amoksisilin sirup kering forte 250 mg/5 ml Botol 37 0 37 0 37 37 37 4,147 153,439

29 Ampisilin serbuk injeksi i.m/i.v 1000 mg vial 0 0 0 0 0 0 0 4,600 0

30 Anagens Syrup Botol 23 0 23 0 23 23 23 19,800 455,400

32 Antalgin injeksi 250 mg/ml - 2 ml Ampul 0 0 0 0 0 0 0 1,500 0

34 Antasida DOEN suspensi Botol 79 0 79 36 43 43 100 43 2,106 90,558

35 Antihemoroid DOEN kombinasi suppos 61 0 61 48 13 13 50 13 3,502 45,526

36 Antifungi DOEN kombinasi pot 24 0 24 0 24 24 24 4,782 114,768

37 Antibakteri DOEN salep Kombinasi tube 0 0 0 0 0 0 0 2,767 0

38 Antimigrain DOEN kombinasi tablet 215 0 215 194 21 21 21 149 3,129

39 Aqua pro injeksi steril, bebas pirogen vial 0 0 0 0 0 0 0 5,800 0

45 Asiklovir krim 5% tablet 25 0 25 0 25 25 25 25 3,960 99,000 Des

47 Attalpulgit tablet 0 0 0 0 0 0 0 173 0 EXP

48 Atropin Sulfat injeksi 0,25 mg/ml - 1 ml ampul 8 0 8 0 8 8 8 1,672 13,376

49 Atropin Sulfat tablet 0,5 mg tablet 0 0 0 0 0 0 0 75 0

50 Benecheck plus Glucose test strip 50's box 0 0 0 0 0 0 0 156,072 0

51 Benecheck plus Cholesterol test strip 50's box 0 0 0 0 0 0 0 234,238 0

52 Benecheck plus Uric test strip 50's box 0 0 0 0 0 0 0 129,210 0

53 Betahistin maleat 24 mg tablet 0 0 0 0 0 0 1,000 0 1,210 0 Des

55 Bisakodil 5 mg supp suppos 10 0 10 0 10 10 12 10 5,670 56,700

56 Bisakodil 10 mg supp suppos 8 0 8 11 -3 -3 12 -3 5,800 -17,400

58 Catgut/benang bedah no .2/0 pcs 0 0 0 0 0 0 0 33,925 0

60 Deksametason injeksi 5 mlg/ml - 1 ml ampul 28 0 28 0 28 28 28 1,740 48,720

62 Diazepam injeksi 5 mg/ml - 2 ml ampul 0 0 0 0 0 0 10 0 2,578 0

63 Diazepam rectal 5mg/2,5 ml buah 0 0 0 0 0 0 5 0 12,749 0

64 Diazepam tablet 2 mg tablett 0 0 0 0 0 0 1,000 0 134 0

65 Diazepam tablet 5 mg tablet 0 0 0 0 0 0 0 65 0

66 Dietilkarbamazin Sitrat tablet 100 mg tablet 0 0 0 0 0 0 0 104 0

67 Difenhidramin HCI injeksi 10 mg/ml - 1 ml ampul 30 0 30 0 30 30 30 1,354 40,620 EXP

69 Doksisilin kapsul 100 mg Kapsul 0 0 0 0 0 0 0 309 0

70 Domperidom suspensi Botol 24 30 54 8 46 46 100 46 3,180 146,280

72 Efedrin HCI tablet 25 mg tablet 0 0 0 0 0 0 0 56 0

73 Ekstrak Belladon tablet 10 mg tablet 0 0 0 0 0 0 5,000 0 42 0

74 Efinefrina HCI / Bitartrat injeksi 0,1 % - 1 ml ampul 0 0 0 0 0 0 10 0 8,910 0

75 Etakridin (Rivanol) larutan 0,1 % Botol 9 0 9 3 6 6 10 6 3,600 21,600

76 E t a n o l 70 % 100 ml Botol 203 0 203 8 195 195 195 2,625 511,875

77 Etil klorida semprot Botol 0 0 0 0 0 0 0 115,500 0

78 Eugenol cairan botol 0 0 0 0 0 0 0 18,333 0

79 Fenobarbital injeksi 50 mg/ml - 2 ml ampul 29 0 29 0 29 29 29 1,980 57,420

80 Fenobarbital tablet 30 mg tablet 0 0 0 0 0 0 0 74 0

84 Foly Catheter No. 18 pcs 9 0 9 1 8 8 8 9,200 73,600

85 Foly Catheter No. 20 pcs 7 0 7 0 7 7 7 9,200 64,400

88 Gentamicin inj 40mg/ml Ampul 25 0 25 0 25 25 25 3,545 88,625 EXP

89 Gentian Violet larutan 1 % Botol 7 0 7 0 7 7 7 3,850 26,950 Jan

90 Glass lonomer Cement (GC IX ) buah 0 0 0 0 0 0 0 434,500 0

92 Glimepiride 1 mg tablet 200 0 200 10 190 190 190 220 41,800

93 Glimepiride 2 mg tablet 50 0 50 0 50 50 50 297 14,850

95 Glukosa larutan infus 5 % steril Botol 105 0 105 26 79 79 79 6,900 545,100

97 Haloperidol tablet 1,5 mg tablet 0 0 0 0 0 0 1,000 0 76 0 Des

98 Haloperidol tablet 2 mg tablet 0 0 0 0 0 0 0 134 0

99 Haloperidol inj 50 mg/ml ampul 0 0 0 0 0 0 0 91,667 0

102 Ibuprofen suspensi 100 mg/5 ml Botol 13 0 13 0 13 13 13 8,000 104,000

103 Ibuprofen suspensi 200 mg/5 ml Botol 0 0 0 0 0 0 0 8,800 0 Des

106 Infusion set anak pcs 96 0 96 12 84 84 50 84 4,025 338,100

108 Isoniazid tablet 100 mg tablet 0 0 0 0 0 0 0 82 0

109 Isosorbid Dinitrat tablet subligual 5 mg tablet 0 0 0 0 0 0 0 98 0

110 Kalsium Glukonat inj 10% ampul 0 0 0 0 0 0 0 999 0