MASTER

MASTER
LAPORAN LAPORAN
LAPORAN PERSEDIAAN,
OBAT
OBAT LPLPO STOK OPNAME
PUSKESM
PUSKESM DAN MUTASI
AS
AS OBAT
2017 MARET
JANUARI JULI

FEBRUA AGUSTU
STOK AWAL RI S

PENERIMA
JUNI SEPTEM
MARET
AN BER

PENGELUA OKTOBE
SEPTEMBE APRIL
R
RAN
R
STOK NOVEM
MEI
AKHIR BER

PERMINTAA DESEMBER DESEMB

JUNI
N ER

OBAT
TAMBAHAN ISIAN DATA PKM TANGGAL
UNTUK LAPORAN KADALUWARSA D
 LAPORAN ASSET
PERSEDIAAN, STOK
OPNAME DAN
MUTASI OBAT

JANUARI JULI

FEBRUA AGUSTU
RI S
SEPTEM
MARET
BER
OKTOBE
APRIL
R
NOVEM
MEI
BER
DESEMB
JUNI
ER

Data Komputer

E Docume Google
nt Chrome
 MASTER LAPORAN OBAT PUSKESMAS 2017

No. Nama Obat Satuan Harga

1 Air Untuk Injeksi 20 ml vial 6,000

2 Albendazole tab 400 mg tablet 363
3 Albendazole susp 200 mg/5 ml botol 4,234
4 Allopurinol tab 100 mg tablet 143
5 Allopurinol tab 300 mg tablet 233
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275
7 Ambroksol tab 30 mg tablet 200
8 Aminophyllin tab 200 mg tablet 86
9 Aminophyllin inj 24 mg ampul 4,204
10 Amitriptiline HCl tab 25 mg tablet 123
11 Amlodipin tab 5 mg tablet 197
12 Amlodipin tab 10 mg tablet 935
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730
14 Amoxicillin SK 125 mg/5 ml botol 2,560
15 Amoxicillin tab 250 mg tablet 220
16 Amoxicillin tab 500 mg tablet 370
17 Ampicillin serb inj 1000 mg vial 5,610
18 Antasida DOEN susp 60 ml botol 2,213
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidroks tablet 78
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767
21 Antifungi DOEN kombinasi 30 g pot 1,890
22 Antihemoroid DOEN suppo supp 3,200
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin 200tablet -
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mg tablet 3,220
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mg tablet 149
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mg Kapsul 1,650
28 Artemether inj 80 mg/mL ampul 24,384
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127
34 Asam Folat tab 0,4 mg tablet 104
35 Asam Folat tab 1 mg tablet 52
36 Asam Mefenamat tab 250 mg tablet 175
37 Asam Mefenamat tab 500 mg tablet 176
38 Asam Traneksamat inj 50 mg/mL ampul 2,950
39 Asiklovir tab 200 mg tablet 251
40 Asiklovir tab 400 mg tablet 357
41 Atenolol tab 50 mg tablet 387
42 Atapulgit tab 600 mg tablet 220
43 Atropin tab 0,5 mg tablet 81
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400
45 Azitromisin tablet 500 mg kaplet 4,725
46 Bedak Salisil serb 2% Kotak 1,350
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740
49 Betametason krim 0,5 mg/g tube 1,596
50 Betametason tts mata 1 mg/ml botol 25,106
51 Bisakodil sup 5 mg supp 4,990
52 Bisakodil sup 10 mg supp 6,045
53 Bromheksin tab 8 mg tablet 82
54 Cefadroksil kaps 250 mg kapsul 564
55 Cefadroksil kaps/tab 500 mg kapsul 548
56 Cefadroksil SK 125 mg/5 mL botol 5,286
57 Cefadroksil SK 250 mg/5 mL botol 6,285
58 Cefiksime tab 100 mg kapsul 1,000
59 Cefiksime sir 100 mg/5 mL botol 9,400
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900
61 Cetrizine tab 10 mg tablet 190
62 Cetrizine sir 5 mg/5 ml botol 8,799
63 Cimetidine tab 200 mg tablet 205
64 Copper T set/buah 125,483
65 Deksametason tab 0,5 mg tablet 68
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738
67 Diazepam tab 2 mg tablet 47
68 Diazepam tab 5 mg tablet 179
69 Diazepam inj 5 mg/ml ampul 4,598
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751
72 Dietil Karbamazin tab 100 mg tablet 150
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160
74 Digoksin tab 0,25 mg tablet 103
75 Diltiazem kaps SR 100 mg kapsul 4,033
76 Diltiazem kaps SR 200 mg kapsul 4,417
77 Diltiazem tab 30 mg tablet 141
78 Dimenhidrinat tab 50 mg tablet 109
79 Doksisiklin kaps 100 mg kapsul 298
80 Domperidon susp 5 mg/5 ml botol 3,490
81 Domperidon tab 10 mg tablet 286
82 Efedrin inj 50 mg/mL tablet 14,650
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000
86 Eritromisin kaps 250 mg kapsul 522
87 Eritromisin kaps 500 mg kapsul 1,023
88 Erytromisin SK 200 mg/5 ml botol 8,090
89 Etakridin (Rivanol) lar 0,1% botol 5,456
90 Etambutol tab 250 mg tablet 330
91 Etambutol tab 500 mg tablet 478
92 Etanol 70 % lar 100 ml botol 2,625
93 Etil Klorida semprot 100 mL botol 175,500
94 Etonogestrel implan 68 mg subd implant 128,779
95 Fenobarbital tab 30 mg tablet 149
96 Fenobarbital tab 100 mg tablet 242
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980
98 Fenol Gliserol tts telinga 10% botol 1,920
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754
101 Flukonazol kaps 150 mg kapsul 24,200
102 Fluor tab 0,5 mg tablet 975
103 Furosemid tab 40 mg tablet 84
104 Furosemide inj 10 mg/ml ampul 2,012
105 Gameksan lotion 1% - 30 ml botol 2,420
106 Garam Oralit kombinasi sacchet 317
107 Gemfibrozil kaps 300 mg kapsul 318
108 Gentamicin krim 10% tube -
109 Gentamicin salep kulit 10% tube -
110 Gentamicin salep mata 0,3% tube 2,786
111 Gentamicin tts mata 0,3% botol 3,513
112 Gentamisin inj 40 mg/ml ampul 3,739
113 Gentamisin inj 80 mg/ml vial 4,160
114 Glibenklamid tab 5 mg tablet 61
115 Glimepirid tab 1 mg tablet 278
116 Glimepirid tab 2 mg tablet 458
117 Glipizid tab 5 mg tablet 3,000
118 Gliseril Guaikolat tab 100 mg tablet 27
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650
120 Gliserin lar 50% botol 5,867
121 Glukosa lar infus steril 5% - 500 ml botol 5,720
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270
123 Griseofulvin tab 125 mg tablet 230
124 Haloperidol tab 0,5 mg tablet 62
125 Haloperidol tab 1,5 mg tablet 76
126 Haloperidol tab 2 mg tablet 134
127 Haloperidol tab 5 mg tablet 105
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223
129 Hiosina Butilbromida tab 10 mg tablet 648
130 Hydroklortiazid (HCT) tab 25 mg tablet 163
131 Hydrokortison krim 2,5 % - 5 g tube 2,938
132 Ibuprofen tab 200 mg tablet 121
133 Ibuprofen tab 400 mg tablet 157
134 Ibuprofen sir 100 mg/5 ml botol 3,849
135 Ibuprofen sir 200 mg/5 ml botol 4,949
136 Isoniazid tab 100 mg tablet 72
137 Isoniazid tab 300 mg tablet 174
138 Isosorbid Dinitrat tab 5 mg tablet 98
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800
140 Kalsium Karbonat tab 500 mg tablet 448
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76
142 Kanamisin inj 1.000 mg/vial vial 5,100
143 Kaptopril tab 12,5 mg tablet 90
144 Kaptopril tab 25 mg tablet 138
145 Kaptopril tab 50 mg tablet 141
146 Karbamazepin tab 200 mg tablet 269
147 Karbamazepin sir 100 mg/5 mL botol 44,770
148 Karbogliserin tts telinga 10% botol 2,246
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000
151 Ketokonazole krim 2% - 15 g tube 5,150
152 Ketokonazole tab 200 mg tablet 320
153 Klaritromisin tab 500 mg tablet 3,600
154 Klindamisin kaps 150 mg kapsul 405
155 Klindamisin kaps 300 mg kapsul 619
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500
157 Kloramfenikol kaps 250 mg kapsul 275
158 Kloramfenikol kaps 500 mg kapsul 935
159 Kloramfenikol salap mata 1% tube 1,680
160 Kloramfenikol salep kulit 2% tube 4,138
161 Kloramfenikol susp 125 mg/5 ml botol 5,500
162 Kloramfenikol tts mata 0,5% botol 20,360
163 Kloramfenikol tts telinga 3% botol 11,440
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54
165 Klorpromazin HCl tab 25 mg tablet 75
166 Klorpromazin HCl tab 100 mg tablet 162
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155
168 Kodein HCL tab 10 mg tablet 550
169 Kontrasepsi Progesteron Depot (3 Bulan) vial -
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol 30 tablet 2,298
171 Kotrimoxazol tab 480 mg (adult) tablet 152
172 Kotrimoxazol susp 60 ml botol 2,298
173 Kuinin tab 200 mg tablet 737
174 Kuinin tab 222 mg tablet 594
175 Kuinin inj 25% (i.v) ampul 6,820
176 Levofloxacin tab 500 mg tablet 581
177 Levofloxacin inf 5 mg/mL botol 43,809
178 Levonorgestrel implan 2 rods - 75 mg subdermal implant -
179 Lidokain inj 1% (infltr) ampul 929
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499
181 Lidokain gel 2% botol 40,000
182 Lidokain semprot 10% botol 156,200
183 Lisol lar 1.000 ml botol 49,862
184 Loratadin tab 10 mg tablet 333
185 Magnesium Sulfat serb 30 g sacchet 3,803
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500
188 Mebendazol tab 100 mg tablet 7,150
189 Mebendazol tab 500 mg tablet 7,854
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560
192 Metampiron (Antalgin) tab 500 mg tablet 350
193 Metformin tab 500 mg tablet 182
194 Metformin tab 850 mg tablet 280
195 Metilergometrin Maleat tab 0.125 mg tablet 169
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750
197 Metilprednisolon tab 4 mg tablet 230
198 Metilprednisolon tab 8 mg tablet 390
199 Metilprednisolon tab 16 mg tablet 875
200 Metoklopramid tab 5 mg tablet 113
201 Metoklopramid tab 10 mg tablet 100
202 Metronidazol tab 250 mg tablet 116
203 Metronidazol tab 500 mg tablet 169
204 Metronidazol sir 125 mg/5 ml botol 4,350
205 Metronidazol lar inf 5 mg/mL botol 12,980
206 Miconazole krim 2% tube 3,150
207 Natrium Diklofenak tab 25 mg tablet 146
208 Natrium Diklofenak tab 50 mg tablet 193
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170
210 Nifedipine tab 10 mg tablet 127
211 Nistatin tab vaginal 100.000 IU ovula 528
212 Nistatin tab vaginal 500.000 IU tablet 704
213 Obat Anti TB Kategori Anak Paket 189,195
214 Obat Anti TB Kategori Anak FDC Paket 236,490
215 Obat Anti TB Kategori I Paket 317,015
216 Obat Anti TB Kategori I FDC Paket 396,000
217 Obat Anti TB Kategori I Kombipak Paket 316,920
218 Obat Anti TB Kategori II Paket 1,320,000
219 Obat Anti TB Kategori II FDC Paket 1,319,990
220 Obat Anti TB Kategori III Paket 154,000
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500
223 Ofloxacin tab 200 mg tablet 440
224 Ofloxacin tab 400 mg tablet 700
225 Oksimetazolin tts hidung 0,025 % botol 30,305
226 Oksimetazolin tts hidung 0,050 % botol 32,000
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500
230 Olopatadin tts mata 0,1% botol 68,000
231 Omeprazol kaps 20 mg kapsul 409
232 Omeprazol inj 40 mg/10 mL vial 42,000
233 Paracetamol tab 500 mg tablet 88
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535
235 Paracetamol tts 60 mg/0,6 mL botol 7,350
236 Perak Sulfadiazin krim 1% tube 25,350
237 Permetrin krim 5% tube 11,475
238 Pirantel Pamoat tab 125 mg tablet 318
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100
240 Pirazinamid tab 500 mg tablet 225
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121
243 Piroxicam tab 10 mg tablet 149
244 Povidon Iodida lar 10% - 1000 ml botol 40,202
245 Povidon Iodida lar 10% - 300 ml botol 15,386
246 Povidon Iodida lar 10% - 60 ml botol 6,500
247 Povidon Iodida lar 10% - 30 ml botol 2,344
248 Prednison tab 5 mg tablet 192
249 Primakuin tab 15 mg tablet 205
250 Probenesid tab 500 mg tablet 1,815
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768
252 Propranolol tab 10 mg tablet 80
253 Propiltiourasil ( PTU) tab 100 mg tablet 351
254 Ranitidin tab 150 mg tablet 220
255 Ranitidin inj 25 mg/mL ampul 1,340
256 Retinol (Vit A) softcap 100.000 IU softcap 286
257 Retinol (Vit A) softcap 200.000 IU softcap 505
258 Rifampicin kaps 300 mg kapsul 670
259 Rifampicin tab 450 mg tablet 868
260 Rifampicin tab 600 mg tablet 1,209
261 Ringer Laktat lar inf steril 500 ml botol 4,727
262 Salbutamol tab 2 mg tablet 65
263 Salbutamol tab 4 mg tablet 93
264 Salbutamol cairan ih 0,1% botol 7,260
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903
268 Serum Antidifteri inj 10,000 IU vial -
269 Serum Antidifteri inj 20,000 IU vial 1,209,035
270 Serum Antitetanus inj 1.500 IU vial 161,000
271 Serum Antitetanus inj 10.000 IU vial -
272 Serum Antitetanus inj 20.000 IU vial 324,550
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150
275 Simvastatin tab 10 mg tablet 294
276 Simvastatin tab 20 mg tablet 480
277 Siprofloksasin tab 500 mg tablet 290
278 Spironolakton tab 25 mg tablet 350
279 Streptomisin serb inj 1,000 mg/vial vial 4,015
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat 0, tablet 112
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500
282 Tetrasiklin kaps 250 mg kapsul 162
283 Tetrasiklin kaps 500 mg kapsul 325
284 Thiamfenikol kaps 500 mg kapsul 985
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500
287 Tramadol inj 50 mg/mL ampul 2,680
288 Triheksipenidil tab 2 mg tablet 70
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339
290 Valproat tab sal 250 mg tablet salut 1,680
291 Valproat tab sal 500 mg tablet salut 5,450
292 Valproat sir 250 mg/5 mL botol 41,800
293 Vankomisin serb inj 500 mg/vial vial 142,000
294 Vitamin B Kompleks tablet 112
295 Zinc sir 10 mg/ml botol 16,478
296 Zinc sir 20 mg/5 ml botol 8,140
297 Zinc dispersible 20 mg tablet 521
298 Alprazolam tab 1 mg tablet 245
299 Betahistin tab 6 mg tablet -
300 Idometasin kapl 25 mg kaplet 380
301 Karbon Aktif tab 125 mg tablet 127
302 Klobazam tab 10 mg tablet 950
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499
304 Loperamid tab 2 mg tablet 97
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950
306 Papaverin 40 mg tablet -
307 Piracetam tab 400 mg tablet -
308 Thiamfenikol tab 250 mg tablet -
309 Piracetam tab 800 mg tablet -
310 Piroxicam tab 20 mg tablet -
311 Asam Askorbat (Vit.C) tab 25 mg tablet -
312 Etanol 70% lar 1000 ml botol -
313 Etanol 70% lar 300 ml botol -
314 Neurosanbe injeksi ampul -
315 H2O2 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 1,262
2 Alat Suntik 2.5 ml pcs 1,102
3 Alat Suntik 3 ml pcs 1,010
4 Alat Suntik 5 ml pcs 1,248
5 Alat Suntik 10 ml pcs 1,694
6 Alat Suntik 20 ml pcs 2,228
7 Alat Suntik 50 ml pcs 10,350
8 Alat Suntik ADS 0,5 ml pcs 1,925
9 Alat Suntik ADS 3 ml (BD) pcs 1,797
10 Alat Suntik ADS 5 ml (BD) pcs 1,797
11 Alat Suntik ADS 5 ml BCG pcs 2,585
12 Alat Suntik ADS 10 ml (BD) pcs 2,900
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000
17 Catgut no.2/0 pcs 213,525
18 Catgut no.3/0 pcs 213,525
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000
20 Catheter (folley cathteter) no.10 pcs 13,750
21 Catheter (folley cathteter) no.12 pcs 13,750
22 Catheter (folley cathteter) no.14 pcs 13,750
23 Catheter (folley cathteter) no.16 pcs 13,750
24 Catheter (folley cathteter) no.18 pcs 13,750
25 Cholesterol test btl/10 strip botol 320,000
26 Copper T set 125,000
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370
30 Glukosa test btl/25 strip botol 180,000
31 Hand Schoen no 7 set 14,850
32 Hand Schoen no 7.5 set 14,850
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000
34 Hand Schoen no 8 set 14,850
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500
44 Hand Schoen (Examination Gloves Size S) set 57,750
45 Hand Schoen (Examination Gloves Size M) set 57,750
46 Hand Schoen (Examination Gloves Size L) set 57,750
47 Infusion Set Anak set 6,375
48 Infusion Set Dewasa set 12,100
49 Infusion Set Macro 2 Cabang set 35,000
50 IV Catheter no. 16 pcs 8,948
51 IV Catheter no. 18 pcs 8,948
52 IV Catheter no. 20 pcs 8,948
53 IV Catheter no. 22 pcs 8,948
54 IV Catheter no. 24 pcs 8,948
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018
61 Jarum Jahit Otot all size lusin 18,500
62 Jarum Jahit 1/2 Surgical lusin 135,000
63 Jarum Jahit 3/8 Surgical lusin 120,000
64 Kaca Slide pcs 50,000
65 Kapas Pembalut 250 g roll 22,000
66 Kapas Pembalut 500 g roll 35,000
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723
70 Kasa Pembalut 2 m x 80 cm roll 13,366
71 Kasa Pembalut 4 m x 5 cm roll -
72 Kasa Pembalut 4 m x 10 cm roll 2,601
73 Kasa Pembalut 4 m x 15 cm roll -
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638
77 Kasa Steril 16 cm x 16 cm box 6,743
78 Kasa Steril 18 cm x 22 cm box 16,500
79 Masker Ear Loop Pcs 495
80 Mata Pisau Bedah No. 10 pcs 9,750
81 Mata Pisau Bedah No. 11 Pcs 9,750
82 Mata Pisau Bedah No. 15 Pcs 9,750
83 Mata Pisau Bedah No. 21 Pcs 9,750
84 Nasal Oxygen (Aximed) size M Pcs 6,600
85 Nasal Oxygen (Aximed) size L Pcs 6,600
86 Nasal Oxygen (Aximed) size XS Pcs 6,600
87 Plester 5 yard x 2 inchi roll 7,186
88 Plester 5 cm x 4,5 cm roll -
89 Plester 7,5 cm x 4,5 cm roll 34,650
90 Pot Sputum pot 2,000
91 RDT pcs -
92 Regulator Oxygen pcs 450,000
93 Safety Box kotak -
94 Selang Oxygen pcs 8,250
95 Silk (benang bedah sutra) no.2/0 pcs 251,400
96 Silk (benang bedah sutra) no.3/0 pcs 206,779
97 Sound Timer unit 1,219,143
98 Stempel ISPA pcs -
99 Uric Acid test btl/25 strip botol 240,000
100 Urine bag pcs 6,875

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 15,000
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500
3 Larutan Asam Klorida (HCl) 0,1 N botol -
4 Larutan Asam Sulfa Salisilat 20% botol 24,755
5 Larutan Benedik botol 40,040
6 Larutan Eosin 2% botol 36,595
7 Larutan Etanol Asam botol 34,126
8 Larutan Giemsa Stein botol 63,348
9 Larutan Karbol Fuksin botol 23,231
10 Larutan Metanol botol 118,300
11 Larutan Metilen Biru botol 17,086
12 Larutan Turk botol 54,600
13 Reagen TBC kit -
14 Test Asam Urat test 250,000
15 Test Comburt Reagens set 251,200
16 Test Golongan Darah set 286,365
17 Test Golongan Darah Reagens set 251,200
18 Test Gula Darah test 200,000
19 Test Kehamilan strip 2,400
20 Test Kolesterol test 350,000
21 Test Urine Rutin strip 3,000

GIGI
1 Air raksa Dental Use - 108,195
2 Devitalisasi pasta (arsen) kotak 390,000
3 Eugenol cairan 10 ml botol 18,333
4 Fluoride 0.5 mg tablet 30,000
5 Fluoride 1 mg tablet 4,456
6 Hemospon (Spongostan Dental) pcs 536,250
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500
9 Kalsium Hidroksida Pasta tube 341,250
10 Klorheksidin lar 0,2% botol -
11 Klorheksidin lar 15% botol -
12 Mata Bor Gigi pcs 48,750
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500
15 Trikresol Formalin (TKF) cairan botol 7,239

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083
3 Becefort sir 60 ml botol 26,230
4 Bronex (Bromheksin) tab 8 mg tablet 82
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070
6 Fluoride 1 mg tablet 976
7 Kandistatin susp 12 ml botol 36,300
8 KY Jelly tube 85,000
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800
10 Norit (Karbon Aktif) tab 125 mg tablet -
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688
12 Pehavral tablet salut 70,785
13 Reco (Kloramfenikol) salep mata 1% tube 2,501
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688
17 Vaksin Antirabies Vero (VAR) vial 48,400
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140
19 Cendo Xytrol TM 5 ml botol 35,850
20 Formalin 40 % botol 42,000
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265
23 Pritamox (Amoxicillin) tab 500 mg tablet 297
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469
25 Vical susp 100 ml botol 4,890
26 Vitamin D3 00 IU/D-Vit tablet tablet 680
27 Vinafluor (Fluoride) kapl 1 mg kaplet -
28 Sanmol (Parasetamol) 500 mg tablet 325
29 Cardisan ( Amlodipine) 5 mg tablet 11,918
30 Purecemia (Allopurinol) 300 mg tablet 3,269
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575
35 Cholvastin (Lovastatin) 20 mg tablet 12,043
36 Histigo (Betahistin) tab 6 mg tablet -
37 Novadium (Loperamid) tab 2 mg tablet -
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol -
39 Metolon (Metoklorperamid) tab 10 mg tablet -
40 Novabion tablet -
41 Novagesic (Parasetamol) tab 500 mg tablet -
42 Defamol (Parasetamol) tab 500 mg tablet -
43 Sultrimix syrup botol -
44 Biovitan syrup botol -
45 Caviplex syrup botol -
46 Farsifen (Ibuprofen) syrup botol -
47 Novaxifen (Ibuprofen) tab 200 mg tablet -
48 Lexigo (Betahistin) tab 6 mg tablet -
49 Loric (Allopurinol) tab 100 mg tablet -
50 Eryra Forte (Erytromicin) kaps 500 mg tablet -
51 Arkavit tablet -
52 Novadex (Dexametason) 0,5 mg tablet -
53 Carbidu (Dexametason) 0,5 mg tablet -
54 Gralixa (Furosemid) 40 mg tablet -
55 Grafazol (Metronidazol) tab 500 mg tablet -
56 Glikos (Metformin) tab 500 mg tablet -
57 Vesverum (Domperidon Maleat) tab 10 mg tablet -
58 Metaneuron (Metamizolesodium + Diazepam) tablet -
59 Trifadium ( Loperamide HCL 2 mg) tablet -
0 0 0 -
0 0 0 -
0 0 0 -
0 0 0 -
 Peringatan

Menu
!
 STOK AWAL
JANUARI 2017 FEBRUARI 2017
No. Nama Obat Satuan Harga BUFFER STOK BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT
PROVINSI AWAL PROVINSI
1 Air Untuk Injeksi 20 ml vial 6,000 18 0 18 17
2 Albendazole tab 400 mg tablet 363 2150 0 2150 2150
3 Albendazole susp 200 mg/5 ml botol 4,234 0 0 0 0
4 Allopurinol tab 100 mg tablet 143 0 0 200 200 0
5 Allopurinol tab 300 mg tablet 233 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 0 0 0 0
7 Ambroksol tab 30 mg tablet 200 0 0 0 0
8 Aminophyllin tab 200 mg tablet 86 0 0 0 0
9 Aminophyllin inj 24 mg ampul 4,204 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 123 0 0 0 0
11 Amlodipin tab 5 mg tablet 197 0 0 0 0
12 Amlodipin tab 10 mg tablet 935 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 2,560 10 0 10 0
15 Amoxicillin tab 250 mg tablet 220 0 0 0 0
16 Amoxicillin tab 500 mg tablet 370 0 0 1000 1000 0
17 Ampicillin serb inj 1000 mg vial 5,610 0 0 0 0
18 Antasida DOEN susp 60 ml botol 2,213 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrtablet 78 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 1,890 0 0 0 0
22 Antihemoroid DOEN suppo supp 3,200 10 0 10 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mtablet 3,220 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 tablet 149 0 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mKapsul 1,650 0 0 0
28 Artemether inj 80 mg/mL ampul 24,384 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 0 0 0
34 Asam Folat tab 0,4 mg tablet 104 0 0 0
35 Asam Folat tab 1 mg tablet 52 0 0 0
36 Asam Mefenamat tab 250 mg tablet 175 0 0 0
37 Asam Mefenamat tab 500 mg tablet 176 400 400 0
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 0 0 0
39 Asiklovir tab 200 mg tablet 251 0 0 0
40 Asiklovir tab 400 mg tablet 357 0 0 0
41 Atenolol tab 50 mg tablet 387 0 0 0
42 Atapulgit tab 600 mg tablet 220 0 0 0
43 Atropin tab 0,5 mg tablet 81 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 0 0 0
45 Azitromisin tablet 500 mg kaplet 4,725 0 0 0
46 Bedak Salisil serb 2% Kotak 1,350 17 17 8
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 0 0 0
49 Betametason krim 0,5 mg/g tube 1,596 0 0 0
50 Betametason tts mata 1 mg/ml botol 25,106 0 0 0
51 Bisakodil sup 5 mg supp 4,990 0 0 0
52 Bisakodil sup 10 mg supp 6,045 0 0 0
53 Bromheksin tab 8 mg tablet 82 0 0 0
54 Cefadroksil kaps 250 mg kapsul 564 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 548 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 5,286 27 27 19
57 Cefadroksil SK 250 mg/5 mL botol 6,285 0 0 0
58 Cefiksime tab 100 mg kapsul 1,000 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 9,400 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 0 0 0
61 Cetrizine tab 10 mg tablet 190 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 8,799 0 0 0
63 Cimetidine tab 200 mg tablet 205 0 0 0
64 Copper T set/buah 125,483 0 0 0
65 Deksametason tab 0,5 mg tablet 68 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 0 0 0
67 Diazepam tab 2 mg tablet 47 0 0 0
68 Diazepam tab 5 mg tablet 179 0 0 0
69 Diazepam inj 5 mg/ml ampul 4,598 3 3 3
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 150 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 0 0 0
74 Digoksin tab 0,25 mg tablet 103 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 4,033 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 4,417 0 0 0
77 Diltiazem tab 30 mg tablet 141 0 0 0
78 Dimenhidrinat tab 50 mg tablet 109 0 0 0
79 Doksisiklin kaps 100 mg kapsul 298 0 0 0
80 Domperidon susp 5 mg/5 ml botol 3,490 0 0 0
81 Domperidon tab 10 mg tablet 286 0 100 100 0
82 Efedrin inj 50 mg/mL tablet 14,650 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 0 0 0
86 Eritromisin kaps 250 mg kapsul 522 0 0 0
87 Eritromisin kaps 500 mg kapsul 1,023 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 8,090 55 55 50
89 Etakridin (Rivanol) lar 0,1% botol 5,456 11 5 16 11
90 Etambutol tab 250 mg tablet 330 0 0 0
91 Etambutol tab 500 mg tablet 478 0 0 0
92 Etanol 70 % lar 100 ml botol 2,625 0 0 0
93 Etil Klorida semprot 100 mL botol 175,500 1 1 0
94 Etonogestrel implan 68 mg subd implant 128,779 0 0 0
95 Fenobarbital tab 30 mg tablet 149 0 0 0
96 Fenobarbital tab 100 mg tablet 242 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 0 0 0
98 Fenol Gliserol tts telinga 10% botol 1,920 0 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 0 0 0
101 Flukonazol kaps 150 mg kapsul 24,200 0 0 0
102 Fluor tab 0,5 mg tablet 975 0 0 0
103 Furosemid tab 40 mg tablet 84 0 0 0
104 Furosemide inj 10 mg/ml ampul 2,012 0 0 0
105 Gameksan lotion 1% - 30 ml botol 2,420 0 0 0
106 Garam Oralit kombinasi sacchet 317 350 350 200
107 Gemfibrozil kaps 300 mg kapsul 318 0 0 0
108 Gentamicin krim 10% tube - 0 0 0
109 Gentamicin salep kulit 10% tube - 0 0 0
110 Gentamicin salep mata 0,3% tube 2,786 0 0 0
111 Gentamicin tts mata 0,3% botol 3,513 0 0 0
112 Gentamisin inj 40 mg/ml ampul 3,739 0 0 0
113 Gentamisin inj 80 mg/ml vial 4,160 0 0 0
114 Glibenklamid tab 5 mg tablet 61 0 900 900 0
115 Glimepirid tab 1 mg tablet 278 100 100 100
116 Glimepirid tab 2 mg tablet 458 0 0 0
117 Glipizid tab 5 mg tablet 3,000 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 27 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 0 0 0
120 Gliserin lar 50% botol 5,867 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 75 75 75
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 0 0 0
123 Griseofulvin tab 125 mg tablet 230 450 450 450
124 Haloperidol tab 0,5 mg tablet 62 0 0 0
125 Haloperidol tab 1,5 mg tablet 76 0 0 0
126 Haloperidol tab 2 mg tablet 134 0 0 0
127 Haloperidol tab 5 mg tablet 105 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 648 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 1000 1000 1000
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 0 0 0
132 Ibuprofen tab 200 mg tablet 121 0 0 0
133 Ibuprofen tab 400 mg tablet 157 0 200 200 0
134 Ibuprofen sir 100 mg/5 ml botol 3,849 0 0 0
135 Ibuprofen sir 200 mg/5 ml botol 4,949 0 0 0
136 Isoniazid tab 100 mg tablet 72 0 0 0
137 Isoniazid tab 300 mg tablet 174 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 98 0 200 200 0
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 448 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 5,100 0 0 0
143 Kaptopril tab 12,5 mg tablet 90 0 0 0
144 Kaptopril tab 25 mg tablet 138 100 300 400 0
145 Kaptopril tab 50 mg tablet 141 0 0 0
146 Karbamazepin tab 200 mg tablet 269 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 44,770 0 0 0
148 Karbogliserin tts telinga 10% botol 2,246 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 0 0 0
151 Ketokonazole krim 2% - 15 g tube 5,150 0 0 0
152 Ketokonazole tab 200 mg tablet 320 0 0 0
153 Klaritromisin tab 500 mg tablet 3,600 0 0 0
154 Klindamisin kaps 150 mg kapsul 405 0 0 0
155 Klindamisin kaps 300 mg kapsul 619 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 275 1300 1300 1200
158 Kloramfenikol kaps 500 mg kapsul 935 0 0 0
159 Kloramfenikol salap mata 1% tube 1,680 1 1 0
160 Kloramfenikol salep kulit 2% tube 4,138 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 0 0 0
162 Kloramfenikol tts mata 0,5% botol 20,360 0 0 0
163 Kloramfenikol tts telinga 3% botol 11,440 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 600 600 0
165 Klorpromazin HCl tab 25 mg tablet 75 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 162 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 0 0 0
168 Kodein HCL tab 10 mg tablet 550 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiotablet 2,298 0 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 152 0 100 100 0
172 Kotrimoxazol susp 60 ml botol 2,298 0 6 6 0
173 Kuinin tab 200 mg tablet 737 0 0 0
174 Kuinin tab 222 mg tablet 594 0 0 0
175 Kuinin inj 25% (i.v) ampul 6,820 0 0 0
176 Levofloxacin tab 500 mg tablet 581 0 0 0
177 Levofloxacin inf 5 mg/mL botol 43,809 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - 0 0 0
179 Lidokain inj 1% (infltr) ampul 929 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 0 13 13 0
181 Lidokain gel 2% botol 40,000 0 0 0
182 Lidokain semprot 10% botol 156,200 0 0 0
183 Lisol lar 1.000 ml botol 49,862 0 0 0
184 Loratadin tab 10 mg tablet 333 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 3,803 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 25 25 25
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 5 5 5
188 Mebendazol tab 100 mg tablet 7,150 0 0 0
189 Mebendazol tab 500 mg tablet 7,854 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 15 15 15
192 Metampiron (Antalgin) tab 500 mg tablet 350 600 600 500
193 Metformin tab 500 mg tablet 182 0 850 850 0
194 Metformin tab 850 mg tablet 280 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 169 0 750 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 0 0 0
197 Metilprednisolon tab 4 mg tablet 230 0 0 0
198 Metilprednisolon tab 8 mg tablet 390 0 0 0
199 Metilprednisolon tab 16 mg tablet 875 0 0 0
200 Metoklopramid tab 5 mg tablet 113 0 0 0
201 Metoklopramid tab 10 mg tablet 100 100 100 200 70
202 Metronidazol tab 250 mg tablet 116 800 800 800
203 Metronidazol tab 500 mg tablet 169 1000 250 1250 900
204 Metronidazol sir 125 mg/5 ml botol 4,350 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 12,980 0 0 0
206 Miconazole krim 2% tube 3,150 35 35 20
207 Natrium Diklofenak tab 25 mg tablet 146 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 193 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 111 111 100
210 Nifedipine tab 10 mg tablet 127 300 300 200
211 Nistatin tab vaginal 100.000 IU ovula 528 300 300 290
212 Nistatin tab vaginal 500.000 IU tablet 704 300 300 300
213 Obat Anti TB Kategori Anak Paket 189,195 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 236,490 0 0 0
215 Obat Anti TB Kategori I Paket 317,015 0 0 0
216 Obat Anti TB Kategori I FDC Paket 396,000 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 316,920 0 0 0
218 Obat Anti TB Kategori II Paket 1,320,000 0 0 0
219 Obat Anti TB Kategori II FDC Paket 1,319,990 0 0 0
220 Obat Anti TB Kategori III Paket 154,000 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 0 0 0
223 Ofloxacin tab 200 mg tablet 440 0 0 0
224 Ofloxacin tab 400 mg tablet 700 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 30,305 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 32,000 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 0 30 30 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 0 0 0
230 Olopatadin tts mata 0,1% botol 68,000 0 0 0
231 Omeprazol kaps 20 mg kapsul 409 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 42,000 0 0 0
233 Paracetamol tab 500 mg tablet 88 0 900 900 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 0 0 0
236 Perak Sulfadiazin krim 1% tube 25,350 0 0 0
237 Permetrin krim 5% tube 11,475 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 318 500 500 500
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 11 11 11
240 Pirazinamid tab 500 mg tablet 225 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 900 900 700
243 Piroxicam tab 10 mg tablet 149 0 200 200 0
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 15,386 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 6,500 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 2,344 0 0 0
248 Prednison tab 5 mg tablet 192 0 0 0
249 Primakuin tab 15 mg tablet 205 0 0 0
250 Probenesid tab 500 mg tablet 1,815 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 0 0 0
252 Propranolol tab 10 mg tablet 80 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 0 0 0
254 Ranitidin tab 150 mg tablet 220 0 200 200 0
255 Ranitidin inj 25 mg/mL ampul 1,340 0 2 2 0
256 Retinol (Vit A) softcap 100.000 IU softcap 286 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 505 0 0 0
258 Rifampicin kaps 300 mg kapsul 670 0 0 0
259 Rifampicin tab 450 mg tablet 868 0 0 0
260 Rifampicin tab 600 mg tablet 1,209 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 4,727 39 39 21
262 Salbutamol tab 2 mg tablet 65 0 0 0
263 Salbutamol tab 4 mg tablet 93 0 0 0
264 Salbutamol cairan ih 0,1% botol 7,260 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 0 0 0
268 Serum Antidifteri inj 10,000 IU vial - 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 161,000 0 0 0
271 Serum Antitetanus inj 10.000 IU vial - 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 324,550 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 0 1000 1000 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 0 0 0
275 Simvastatin tab 10 mg tablet 294 0 100 100 0
276 Simvastatin tab 20 mg tablet 480 0 0 0
277 Siprofloksasin tab 500 mg tablet 290 0 400 400 0
278 Spironolakton tab 25 mg tablet 350 0 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folattablet 112 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 162 100 100 30
283 Tetrasiklin kaps 500 mg kapsul 325 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 985 200 200 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 2400 2400 1250
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 0 0 0
287 Tramadol inj 50 mg/mL ampul 2,680 0 0 0
288 Triheksipenidil tab 2 mg tablet 70 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 0 0 0
290 Valproat tab sal 250 mg tablet salut 1,680 0 0 0
291 Valproat tab sal 500 mg tablet salut 5,450 0 0 0
292 Valproat sir 250 mg/5 mL botol 41,800 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 142,000 0 0 0
294 Vitamin B Kompleks tablet 112 0 0 0
295 Zinc sir 10 mg/ml botol 16,478 0 0 0
296 Zinc sir 20 mg/5 ml botol 8,140 0 0 0
297 Zinc dispersible 20 mg tablet 521 0 0 0
298 Alprazolam tab 1 mg tablet 245 0 0 0
299 Betahistin tab 6 mg tablet - 30 30 0
300 Idometasin kapl 25 mg kaplet 380 0 0 0
301 Karbon Aktif tab 125 mg tablet 127 0 0 0
302 Klobazam tab 10 mg tablet 950 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 0 0 0
304 Loperamid tab 2 mg tablet 97 0 200 200 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 0 0 0
306 Papaverin 40 mg tablet - 0 0 0
307 Piracetam tab 400 mg tablet - 100 100 100
308 Thiamfenikol tab 250 mg tablet - 0 0 0
309 Piracetam tab 800 mg tablet - 0 0 0
310 Piroxicam tab 20 mg tablet - 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet - 0 0 0
312 Etanol 70% lar 1000 ml botol - 0 0 0
313 Etanol 70% lar 300 ml botol - 0 0 0
314 Neurosanbe injeksi ampul - 0 0 0
315 H2O2 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0 0
0 0 0 - 0 0
0 0
0 0
0 0
BAHAN MEDIS HABIS PAKAI 0 0
1 Alat Suntik 1 ml pcs 1,262 8 8 0
2 Alat Suntik 2.5 ml pcs 1,102 0 0 0
3 Alat Suntik 3 ml pcs 1,010 0 0 0
4 Alat Suntik 5 ml pcs 1,248 0 0 0
5 Alat Suntik 10 ml pcs 1,694 0 0 0
6 Alat Suntik 20 ml pcs 2,228 0 0 0
7 Alat Suntik 50 ml pcs 10,350 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 1,925 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 2,585 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 0 0 0
17 Catgut no.2/0 pcs 213,525 0 0 0
18 Catgut no.3/0 pcs 213,525 80 3 83 72
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 0 0 0
20 Catheter (folley cathteter) no.10 pcs 13,750 0 0 0
21 Catheter (folley cathteter) no.12 pcs 13,750 0 0 0
22 Catheter (folley cathteter) no.14 pcs 13,750 0 0 0
23 Catheter (folley cathteter) no.16 pcs 13,750 0 0 0
24 Catheter (folley cathteter) no.18 pcs 13,750 0 0 0
25 Cholesterol test btl/10 strip botol 320,000 0 0 0
26 Copper T set 125,000 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 0 0 0
30 Glukosa test btl/25 strip botol 180,000 0 0 0
31 Hand Schoen no 7 set 14,850 0 0 0
32 Hand Schoen no 7.5 set 14,850 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 0 0 0
34 Hand Schoen no 8 set 14,850 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 0 50 50 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 57,750 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 57,750 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 57,750 0 0 0
47 Infusion Set Anak set 6,375 36 36 36
48 Infusion Set Dewasa set 12,100 0 10 10 0
49 Infusion Set Macro 2 Cabang set 35,000 0 0 0
50 IV Catheter no. 16 pcs 8,948 0 0 0
51 IV Catheter no. 18 pcs 8,948 47 47 44
52 IV Catheter no. 20 pcs 8,948 0 15 15 0
53 IV Catheter no. 22 pcs 8,948 0 0 0
54 IV Catheter no. 24 pcs 8,948 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 0 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 0 0 0
61 Jarum Jahit Otot all size lusin 18,500 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 135,000 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 120,000 0 0 0
64 Kaca Slide pcs 50,000 0 0 0
65 Kapas Pembalut 250 g roll 22,000 1 1 0
66 Kapas Pembalut 500 g roll 35,000 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 13,366 2 2 0
71 Kasa Pembalut 4 m x 5 cm roll - 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 2,601 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll - 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 0 0 0
77 Kasa Steril 16 cm x 16 cm box 6,743 0 0 0
78 Kasa Steril 18 cm x 22 cm box 16,500 0 0 0
79 Masker Ear Loop Pcs 495 0 20 20 0
80 Mata Pisau Bedah No. 10 pcs 9,750 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 9,750 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 9,750 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 9,750 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 6,600 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 6,600 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 0 0 0
87 Plester 5 yard x 2 inchi roll 7,186 0 0 0
88 Plester 5 cm x 4,5 cm roll - 0 1 1 0
89 Plester 7,5 cm x 4,5 cm roll 34,650 0 0 0
90 Pot Sputum pot 2,000 0 0 0
91 RDT pcs - 0 0 0
92 Regulator Oxygen pcs 450,000 0 0 0
93 Safety Box kotak - 0 0 0
94 Selang Oxygen pcs 8,250 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 96 96 84
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 9 9 6
97 Sound Timer unit 1,219,143 4 4 3
98 Stempel ISPA pcs - 0 0 0
99 Uric Acid test btl/25 strip botol 240,000 0 0 0
100 Urine bag pcs 6,875 5 5 4
101 0 0
0 0
0 0
BHP/REAGENT LAB 0 0
1 Cairan Spritus 1000 ml botol 15,000 1 1 1
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol - 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 0 0
5 Larutan Benedik botol 40,040 0 0
6 Larutan Eosin 2% botol 36,595 0 0
7 Larutan Etanol Asam botol 34,126 0 0
8 Larutan Giemsa Stein botol 63,348 0 0
9 Larutan Karbol Fuksin botol 23,231 0 0
10 Larutan Metanol botol 118,300 0 0
11 Larutan Metilen Biru botol 17,086 0 0
12 Larutan Turk botol 54,600 0 0
13 Reagen TBC kit - 0 0
14 Test Asam Urat test 250,000 0 0
15 Test Comburt Reagens set 251,200 0 0
16 Test Golongan Darah set 286,365 0 0
17 Test Golongan Darah Reagens set 251,200 0 0
18 Test Gula Darah test 200,000 0 0
19 Test Kehamilan strip 2,400 0 0
20 Test Kolesterol test 350,000 0 0
21 Test Urine Rutin strip 3,000 0 0
0 0
0 0
0 0
GIGI 0 0
1 Air raksa Dental Use - 108,195 0 0
2 Devitalisasi pasta (arsen) kotak 390,000 0 0
3 Eugenol cairan 10 ml botol 18,333 0 0
4 Fluoride 0.5 mg tablet 30,000 0 0
5 Fluoride 1 mg tablet 4,456 0 0
6 Hemospon (Spongostan Dental) pcs 536,250 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 0 0
9 Kalsium Hidroksida Pasta tube 341,250 0 0
10 Klorheksidin lar 0,2% botol - 0 0
11 Klorheksidin lar 15% botol - 0 0
12 Mata Bor Gigi pcs 48,750 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 0 0
15 Trikresol Formalin (TKF) cairan botol 7,239 0 0
0 0
0 0
0 0
OBAT KHUSUS 0 0
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 0 0
3 Becefort sir 60 ml botol 26,230 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 82 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 0 0
6 Fluoride 1 mg tablet 976 0 0
7 Kandistatin susp 12 ml botol 36,300 0 0
8 KY Jelly tube 85,000 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet - 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 0 0
12 Pehavral tablet salut 70,785 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 0 0
17 Vaksin Antirabies Vero (VAR) vial 48,400 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 2 2 2
19 Cendo Xytrol TM 5 ml botol 35,850 0 0
20 Formalin 40 % botol 42,000 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 72 72 52
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 570 570 500
25 Vical susp 100 ml botol 4,890 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 480 480 480
27 Vinafluor (Fluoride) kapl 1 mg kaplet - 0 0
28 Sanmol (Parasetamol) 500 mg tablet 325 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 0 0
30 Purecemia (Allopurinol) 300 mg tablet 3,269 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 0 0
36 Histigo (Betahistin) tab 6 mg tablet - 0 0
37 Novadium (Loperamid) tab 2 mg tablet - 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet - 0 0
40 Novabion tablet - 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet - 0 0
42 Defamol (Parasetamol) tab 500 mg tablet - 0 0
43 Sultrimix syrup botol - 0 0
44 Biovitan syrup botol - 0 0
45 Caviplex syrup botol - 0 0
46 Farsifen (Ibuprofen) syrup botol - 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet - 0 0
48 Lexigo (Betahistin) tab 6 mg tablet - 0 0
49 Loric (Allopurinol) tab 100 mg tablet - 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - 0 0
51 Arkavit tablet - 0 0
52 Novadex (Dexametason) 0,5 mg tablet - 0 0
53 Carbidu (Dexametason) 0,5 mg tablet - 0 0
54 Gralixa (Furosemid) 40 mg tablet - 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet - 0 0
56 Glikos (Metformin) tab 500 mg tablet - 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet - 90 90 90
59 Trifadium ( Loperamide HCL 2 mg) tablet - 0 0
0 0 0 - 0 0
0 0 0 - 0 0
0 0 0 - 0 0
0 0 0 - 0 0
UARI 2017 MARET 2017
STOK BUFFER STOK
PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
AWAL PROVINSI AWAL
0 17 15 0 15
0 2150 2150 0 2150
0 0 0 0 0
0 0 400 0 400
0 0 0 0 0
0 0 0 0 0
0 0 300 300 600
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
120 120 0 0 0
0 0 0 0 0
6 6 6 0 6
0 0 0 0 0
0 0 300 500 800
0 0 0 0 0
0 0 0 0 0
1000 1000 600 0 600
0 0 0 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
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 200 400 500 900
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 8 27 0 27
0 0 0 0 0
0 0 0 0 0
0 0 10 25 35
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 300 100 400
0 19 61 0 61
0 0 0 0 0
0 0 100 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
300 300 0 0 0
24 24 0 23 23
0 0 0 0 0
0 0 0 0 0
0 3 3 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
100 100 400 80 480
0 0 0 0 0
0 0 30 0 30
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 50 51 0 51
5 16 15 5 20
0 0 0 0 0
0 0 0 0 0
0 0 3 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 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
0 200 620 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
700 700 0 500 500
0 100 250 0 250
0 0 0 0 0
0 0 0 0 0
0 0 600 1000 1600
0 0 0 0 0
0 0 0 0 0
0 75 75 0 75
0 0 0 0 0
0 450 800 0 800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1000 900 0 900
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 0 0 0
100 100 0 100 100
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 0 0 0 0 0
0 0 400 0 400
0 0 250 0 250
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 1200 900 0 900
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 700 1000 1700
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 200 0 300 300
0 0 0 9 9
0 0 0 0 0
0 0 0 0 0
0 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 14 0 11 11
 0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 25 45 0 45
0 5 5 0 5
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 15 19 0 19
0 500 900 0 900
850 850 300 750 1050
0 0 0 0 0
750 750 0 750 750
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
100 170 600 100 700
0 800 1100 0 1100
250 1150 1200 250 1450
0 0 0 0 0
0 0 0 0 0
0 20 33 0 33
0 0 50 0 50
0 0 0 0 0
0 100 90 0 90
0 200 400 0 400
0 290 490 0 490
0 300 500 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 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
26 26 0 9 9
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
200 200 0 500 500
0 0 0 7 7
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 500 500 0 500
0 11 26 0 26
0 0 0 0 0
0 0 0 0 0
0 700 950 0 950
0 0 0 300 300
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 0 300 300
25 25 0 22 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
0 21 60 0 60
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 350 0 350
0 0 0 0 0
100 100 500 300 800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 30 200 0 200
0 0 0 0 0
0 0 0 0 0
0 1250 1800 0 1800
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 850 0 850
0 0 0 0 0
0 0 0 0 0
0 0 0 200 200
0 0 0 0 0
0 0 240 0 240
0 0 0 0 0
0 0 0 0 0
0 0 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 80 0 80
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
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 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
13 13 70 8 78
0 0 0 0 0
0 0 79 3 82
0 0 100 0 100
0 0 40 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 15 0 15
3 75 93 3 96
0 0 0 0 0
0 0 10 0 10
0 0 10 0 10
0 0 10 0 10
0 0 10 0 10
0 0 10 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 0 0
0 0 0 0 0
0 0 0 0 0
0 0 5 0 5
0 0 0 0 0
0 0 12 0 12
0 0 0 0 0
0 0 0 0 0
20 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 36 54 0 54
0 0 6 0 6
0 0 0 0 0
0 0 0 0 0
0 44 64 0 64
10 10 17 12 29
0 0 17 0 17
11 11 17 11 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 1 0 1
0 0 1 0 1
0 0 0 0 0
0 0 8 2 10
0 0 5 0 5
0 0 0 0 0
0 0 3 0 3
0 0 6 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 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 1 0 1
20 20 0 0 0
0 0 3 0 3
0 0 4 0 4
0 0 10 0 10
0 0 8 0 8
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
2 2 4 0 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
2 2 0 1 1
0 84 76 0 76
0 6 3 0 3
0 3 2 0 2
0 0 0 0 0
0 0 0 0 0
0 4 14 0 14
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 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 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 3 0 3
0 0 0 0 0
0 0 0 0 0
0 0 400 0 400
0 52 0 0 0
0 0 0 0 0
0 500 500 0 500
0 0 35 0 35
0 480 480 0 480
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 200 200
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
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 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 80 0 80
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 APRIL 2017 MEI 2017 JUNI 2017
BUFFER STOK BUFFER STOK BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI AWAL PROVINSI AWAL PROVINSI
12 0 12 8 0 8 16 0
2150 0 2150 2150 0 2150 2150 0
0 0 0 0 0 0 0 0
200 0 200 0 0 0 400 0
0 0 0 0 0 0 0 0
0 0 0 0 6 6 15 0
0 200 200 0 0 0 350 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 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 1000 1000 300 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
200 0 200 0 200 200 800 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
20 0 20 20 0 20 30 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 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 0 0 0 0 0 0
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 0 100 0 400 400 300 200
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 300 300 0 200
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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
10 0 10 5 0 5 10 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 20 20 0 5 5 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
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0
0 23 23 0 20 20 0 20
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3 0 3 3 0 3 3 0
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
300 80 380 200 0 200 400 0
0 0 0 0 0 0 0 0
29 0 29 29 0 29 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
51 0 51 48 0 48 33 0
9 4 13 9 3 12 7 2
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
3 0 3 1 0 1 12 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 20 3 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
470 0 470 400 0 400 310 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 400 400 0 400 400 0 400
150 0 150 150 0 150 150 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
600 0 600 0 0 0 350 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
75 0 75 75 0 75 75 0
0 0 0 0 0 0 0 0
700 0 700 600 0 600 600 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
900 0 900 0 0 0 0 0
0 0 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 100 100 0 100 100 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
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0 0 0 0 0 0 400 0
0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
900 0 900 900 0 900 700 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 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
500 1000 1500 450 0 450 1000 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 200 200 0 200 200 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 0 0
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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 0 0 0 0
0 0 0 0 0 0 250 0
0 0 0 0 0 0 0 0
45 0 45 45 0 45 45 0
5 0 5 5 0 5 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
18 0 18 18 0 18 18 0
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300 550 850 300 550 850 800 550
0 0 0 0 0 0 0 0
0 750 750 0 750 750 0 750
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
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1100 250 1350 1000 200 1200 900 200
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0 0 0 0 0 0 0 0
27 0 27 24 0 24 37 0
0 0 0 0 0 0 750 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 14 14 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
412 0 412 412 0 412 412 0
26 0 26 26 0 26 26 0
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
47 0 47 17 0 17 107 0
0 0 0 0 350 350 0 0
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0 0 0 0 0 0 0 0
300 200 500 100 0 100 100 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
200 0 200 100 0 100 400 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1000 0 1000 0 0 0 750 0
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0 0 0 0 0 0 0 0
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0 100 100 0 0 0 0 0
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210 0 210 180 0 180 360 0
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80 0 80 0 0 0 0 0
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0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
39 8 47 20 0 20 57 0
0 0 0 0 0 0 0 0
38 0 38 33 0 33 50 0
100 0 100 100 0 100 100 0
37 0 37 31 0 31 31 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
5 0 5 0 0 0 36 0
93 1 94 72 0 72 48 0
0 0 0 0 0 0 0 0
9 0 9 9 0 9 19 0
10 0 10 10 0 10 20 0
6 0 6 3 0 3 13 0
8 0 8 8 0 8 17 0
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0 0 0 0 10 10 37 3
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0 0 0 0 0 0 0 0
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8 0 8 0 10 10 0 35
17 0 17 15 0 15 22 0
16 5 21 14 4 18 34 4
0 0 0 0 0 0 0 0
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6 2 8 6 2 8 10 2
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0 0 0 0 0 0 0 0
2 0 2 1 2 3 5 0
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2 0 2 1 0 1 10 0
2 0 2 0 0 0 10 0
9 0 9 9 0 9 16 0
7 0 7 6 0 6 5 0
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0 0 0 0 0 0 0 0
72 0 72 60 0 60 81 0
1 0 1 0 0 0 0 0
2 0 2 2 0 2 0 0
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14 0 14 8 0 8 6 0
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 41 41 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 1550 0
0 0 0 0 0 0 100 0
0 0 0 0 0 0 0 0
400 0 400 300 0 300 400 0
17 0 17 11 0 11 18 0
480 0 480 480 0 480 480 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 100 100 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
80 0 80 80 0 80 80 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
STOK
AWAL
16
2150
0
400
0
15
350
0
0
0
0
90
24
0
0
300
0
0
800
0
0
30
0
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0
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0
0
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10
0
0
20
0
0
0
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56
0
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0
0
0
0
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0
20
0
0
3
0
0
0
0
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0
0
0
0
0
0
400
0
29
0
0
0
0
33
9
0
0
12
0
0
0
0
0
0
0
3
0
0
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0
0
310
0
0
0
0
0
0
0
400
150
0
0
350
0
0
75
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
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0
400
0
0
0
0
0
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0
0
0
0
0
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0
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0
0
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0
0
0
0
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0
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0
0
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0
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0
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0
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0
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0
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0
0
0
0
0
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0
0
37
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0
75
400
400
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0
0
0
0
0
0
0
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0
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0
0
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0
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0
5
0
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0
0
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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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0
0
0
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57
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36
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19
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17
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0
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11
0
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0
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0
0
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0
0
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0
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40
0
0
65
35
22
38
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0
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12
10
0
5
20
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0
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5
0
10
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0
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81
0
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0
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0
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0
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0
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0
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18
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0
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0
0
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0
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0
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 X

JULI 2017 AGUSTUS 2017 SEPTEMBER 2017

BUFFER STOK BUFFER STOK BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI AWAL PROVINSI AWAL PROVINSI
16 0 16 34 0 34 24 0
2150 0 2150 2150 0 2150 2150 0
0 0 0 0 0 0 0 0
250 0 250 1100 0 1100 850 0
0 0 0 0 0 0 0 0
7 0 7 26 0 26 5 0
0 0 0 400 0 400 0 0
0 0 0 0 0 0 0 0
0 0 0 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 0 180 0 0
12 0 12 44 0 44 26 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 1600 0 1600 400 200
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
100 0 100 1950 0 1950 1200 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
10 0 10 10 0 10 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
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 700
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 1700 0 1700 650 200
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 200 200 0 200 200 0 200
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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
7 0 7 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
15 0 15 2 0 2 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
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 800 0 800 0 0
53 0 53 85 0 85 69 0
0 0 0 0 0 0 0 0
200 0 200 1700 0 1700 1530 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 3 0 3 3 0
0 0 0 0 0 0 0 400
0 19 19 0 17 17 0 9
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
3 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
250 0 250 700 0 700 560 0
0 0 0 0 0 0 0 0
26 0 26 26 0 26 26 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
27 0 27 22 0 22 9 0
7 0 7 5 0 5 3 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
9 0 9 14 0 14 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
300 0 300 200 0 200 180 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 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 10 10 0
0 0 0 0 0 0 0 0
0 400 400 0 400 400 0 330
100 0 100 100 0 100 100 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 800 0 800 400 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
75 0 75 70 0 70 70 0
0 0 0 0 0 0 0 0
550 0 550 1000 0 1000 930 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 200 200 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 0
0 0 0 0 0 0 0 0
0 100 100 0 100 100 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 0 0
0 0 0 2000 0 2000 1700 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
600 0 600 500 0 500 100 0
0 0 0 0 0 0 0 0
4 0 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
200 0 200 2900 0 2900 2000 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 100 100 0 100 100 0 200
0 0 0 0 7 7 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 15 15 0 17 17 0 5
 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 2 0 2 1 0
250 0 250 450 0 450 380 0
0 0 0 0 0 0 0 0
45 0 45 45 0 45 45 0
5 0 5 5 0 5 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
18 0 18 18 0 18 18 0
500 0 500 300 0 300 0 0
800 550 1350 2300 450 2750 2280 450
0 0 0 0 0 0 0 0
0 750 750 0 750 750 0 650
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
700 0 700 500 0 500 500 0
1000 0 1000 900 0 900 900 0
800 200 1000 500 200 700 500 200
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
33 0 33 72 0 72 54 0
500 0 500 1150 0 1150 510 0
0 0 0 0 0 0 0 0
69 0 69 106 0 106 94 0
400 0 400 400 0 400 400 0
400 0 400 500 0 500 500 0
500 0 500 500 0 500 500 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
4 0 4 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 0
0 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 5 0 0 0 0 0
0 0 0 0 0 0 0 0
240 0 240 570 0 570 260 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 5 5 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
412 0 412 300 0 300 300 0
26 0 26 26 0 26 26 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1950 0 1950 1500 0 1500 1500 0
0 0 0 0 0 0 0 200
0 0 0 0 1 1 0 0.5
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 1000 1000 0 380
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 0 400 2100 0 2100 1580 0
0 0 0 0 8 8 0 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
64 0 64 170 0 170 144 0
0 0 0 0 0 0 0 0
0 0 0 0 100 100 0 190
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
350 0 350 1150 0 1150 1050 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
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 0 250 220 0 220 90 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
600 0 600 1500 0 1500 1160 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
800 0 800 3600 0 3600 1400 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0
360 0 360 510 0 510 450 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 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 9 70 0 70 18 0
0 0 0 0 0 0 0 0
25 0 25 11 0 11 6 0
100 0 100 100 0 100 80 0
20 0 20 14 0 14 12 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 9 67 0 67 57 0
48 0 48 96 0 96 96 0
0 0 0 0 0 0 0 0
18 0 18 18 0 18 18 0
20 0 20 20 0 20 20 0
12 0 12 12 0 12 12 0
17 0 17 17 0 17 17 0
11 0 11 110 0 110 110 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 2 24 0 24 18 0
0 0 0 21 0 21 10 0
0 0 0 0 0 0 0 0
0 0 0 25 0 25 19 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 24 0 24 24 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 0 0 0 0 0
20 5 25 17 0 17 9 0
3 2 5 46 5 51 27 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
46 3 49 56 3 59 50 0
0 0 0 0 0 0 0 6
5 0 5 23 0 23 6 0
7 4 11 54 4 58 50 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
1 0 1 1 0 1 1 0
1 0 1 1 0 1 1 0
0 0 0 144 0 144 0 0
8 0 8 8 0 8 8 0
10 0 10 10 0 10 10 0
0 0 0 0 0 0 0 0
3 0 3 10 0 10 8 0
20 0 20 30 0 30 22 0
0 0 0 10 0 10 9 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 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 2 0 0
4 0 4 6 0 6 3 0
0 0 0 25 0 25 0 0
10 0 10 19 0 19 17 0
10 0 10 20 0 20 17 0
15 0 15 21 0 21 11 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 0 0 0
0 0 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 65 0 65 0 0
0 0 0 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 2 1 5
67 0 67 66 0 66 57 0
0 0 0 0 0 0 0 0
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 5 10 0 10 7 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 41 0 41 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
13 0 13 63 0 63 45 0
40 0 40 39 0 39 35 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 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0
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 5 8 0 8 8 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1400 0 1400 1200 0 1200 635 0
100 0 100 100 0 100 100 0
0 0 0 0 0 0 0 0
400 0 400 400 0 400 180 0
11 0 11 39 0 39 23 0
480 0 480 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 120 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 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 0 80 80 0 80 80 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
STOK
AWAL
24
2150
0
850
0
5
0
0
0
0
0
0
26
0
0
600
0
0
1200
0
0
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0
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6
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9
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0
0
180
0
0
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330
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0
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0
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500
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0
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0
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0
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0
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26
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0
0
0
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0
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0
0
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0
0
0
0
0
0
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18
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18
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0
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0
0

0
0
0
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0
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0
0
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100
0
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23
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0
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0
0
0
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0
0
0
0
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0
0
0
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0
0
0
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0
0
0
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80
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 OKTOBER 2017 NOVEMBER 2017 DESEMBER 2017
BUFFER STOK BUFFER STOK BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI AWAL PROVINSI AWAL PROVINSI
22 0 22 0 0 0 0 0
2000 0 2000 0 0 0 0 0
0 0 0 0 0 0 0 0
550 0 550 0 0 0 0 0
0 0 0 0 0 0 0 0
0 7 7 0 0 0 0 0
0 780 780 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 235 235 0 0 0 0 0
0 0 0 0 0 0 0 0
11 0 11 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 1130 1130 0 0 0 0 0
0 0 0 0 0 0 0 0
0 9 9 0 0 0 0 0
0 750 750 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
10 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 200 200 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 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
200 840 1040 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 170 170 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
55 0 55 0 0 0 0 0
0 0 0 0 0 0 0 0
1400 0 1400 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 240 240 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
 3 0 3 0 0 0 0 0
0 1000 1000 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 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 0 145 0 0 0 0 0
0 0 0 0 0 0 0 0
26 0 26 0 0 0 0 0
0 0 0 0 0 0 0 0
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 4 0 0 0 0 0
2 0 2 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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
177 0 177 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 10 0 0 0 0 0
0 0 0 0 0 0 0 0
0 280 280 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
0 700 700 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
50 0 50 0 0 0 0 0
0 0 0 0 0 0 0 0
610 0 610 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 520 520 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 100 100 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 670 670 0 0 0 0 0
 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
980 0 980 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
970 0 970 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 790 790 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 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 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 15 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 0 0 0 0
250 0 250 0 0 0 0 0
0 0 0 0 0 0 0 0
45 0 45 0 0 0 0 0
5 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 0 0 0 0 0
18 0 18 0 0 0 0 0
0 0 0 0 0 0 0 0
2130 450 2580 0 0 0 0 0
0 0 0 0 0 0 0 0
0 650 650 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
860 0 860 0 0 0 0 0
500 100 600 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
54 0 54 0 0 0 0 0
130 0 130 0 0 0 0 0
0 0 0 0 0 0 0 0
89 0 89 0 0 0 0 0
400 0 400 0 0 0 0 0
500 0 500 0 0 0 0 0
500 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
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 50 0 0 0 0 0
0 0 0 0 0 0 0 0
0 1620 1620 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 0
0 0 0 0 0 0 0 0
300 0 300 0 0 0 0 0
25 0 25 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1320 0 1320 0 0 0 0 0
0 400 400 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 0 0
0 0 0 0 0 0 0 0
0 800 800 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
1010 0 1010 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 0
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0 0 0 0 0 0
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0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0

0 0 0 0 41 41
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 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 40
0 0 0 0 0 0
0 0 0 0 0 0
5495 0 0 0 0 5495
624 0 0 0 0 624
0 0 0 0 0 0
3750 0 0 0 0 3750
165 0 0 0 0 165
3360 0 0 0 0 3360
0 0 0 0 0 0
320 0 0 0 0 320
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 300 300
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 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
820 0 0 0 0 820
0 0 0 0 500 500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 Penerimaan
Peringatan
Menu Pengeluaran
!
Stok Akhir
 PENERIMAAN
JANUARI 2017 FEBRUARI 2017
No. Nama Obat Satuan Harga BUFFER TOTAL BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT
PROVINSI TERIMA PROVINSI
1 Air Untuk Injeksi 20 ml vial 6,000 0
2 Albendazole tab 400 mg tablet 363 0
3 Albendazole susp 200 mg/5 ml botol 4,234 0
4 Allopurinol tab 100 mg tablet 143 0 500
5 Allopurinol tab 300 mg tablet 233 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 0 25
7 Ambroksol tab 30 mg tablet 200 0 700
8 Aminophyllin tab 200 mg tablet 86 0
9 Aminophyllin inj 24 mg ampul 4,204 0
10 Amitriptiline HCl tab 25 mg tablet 123 0
11 Amlodipin tab 5 mg tablet 197 0
12 Amlodipin tab 10 mg tablet 935 150 150 180
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 0
14 Amoxicillin SK 125 mg/5 ml botol 2,560 14 14 20
15 Amoxicillin tab 250 mg tablet 220 0
16 Amoxicillin tab 500 mg tablet 370 700 700 1000
17 Ampicillin serb inj 1000 mg vial 5,610 0
18 Antasida DOEN susp 60 ml botol 2,213 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidr tablet 78 1000 1000 1500
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 0
21 Antifungi DOEN kombinasi 30 g pot 1,890 0
22 Antihemoroid DOEN suppo supp 3,200 0 20
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 m tablet 3,220 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 tablet 149 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mKapsul 1,650 0
28 Artemether inj 80 mg/mL ampul 24,384 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 0
34 Asam Folat tab 0,4 mg tablet 104 0
35 Asam Folat tab 1 mg tablet 52 0
36 Asam Mefenamat tab 250 mg tablet 175 0
37 Asam Mefenamat tab 500 mg tablet 176 300 300 1000
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 0
39 Asiklovir tab 200 mg tablet 251 0
40 Asiklovir tab 400 mg tablet 357 0
41 Atenolol tab 50 mg tablet 387 0
42 Atapulgit tab 600 mg tablet 220 0
43 Atropin tab 0,5 mg tablet 81 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 0
45 Azitromisin tablet 500 mg kaplet 4,725 0
46 Bedak Salisil serb 2% Kotak 1,350 0 36
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 0
49 Betametason krim 0,5 mg/g tube 1,596 0 25
50 Betametason tts mata 1 mg/ml botol 25,106 0
51 Bisakodil sup 5 mg supp 4,990 0
52 Bisakodil sup 10 mg supp 6,045 0
53 Bromheksin tab 8 mg tablet 82 0
54 Cefadroksil kaps 250 mg kapsul 564 0
55 Cefadroksil kaps/tab 500 mg kapsul 548 0 700
56 Cefadroksil SK 125 mg/5 mL botol 5,286 0 50
57 Cefadroksil SK 250 mg/5 mL botol 6,285 0
58 Cefiksime tab 100 mg kapsul 1,000 0 500
59 Cefiksime sir 100 mg/5 mL botol 9,400 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 0
61 Cetrizine tab 10 mg tablet 190 0
62 Cetrizine sir 5 mg/5 ml botol 8,799 0
63 Cimetidine tab 200 mg tablet 205 0
64 Copper T set/buah 125,483 0
65 Deksametason tab 0,5 mg tablet 68 1000 1000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 30 30
67 Diazepam tab 2 mg tablet 47 0
68 Diazepam tab 5 mg tablet 179 0
69 Diazepam inj 5 mg/ml ampul 4,598 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 0
72 Dietil Karbamazin tab 100 mg tablet 150 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 0
74 Digoksin tab 0,25 mg tablet 103 0
75 Diltiazem kaps SR 100 mg kapsul 4,033 0
76 Diltiazem kaps SR 200 mg kapsul 4,417 0
77 Diltiazem tab 30 mg tablet 141 0
78 Dimenhidrinat tab 50 mg tablet 109 0
79 Doksisiklin kaps 100 mg kapsul 298 0
80 Domperidon susp 5 mg/5 ml botol 3,490 0
81 Domperidon tab 10 mg tablet 286 0 500
82 Efedrin inj 50 mg/mL tablet 14,650 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 0 30
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 0
86 Eritromisin kaps 250 mg kapsul 522 0
87 Eritromisin kaps 500 mg kapsul 1,023 0
88 Erytromisin SK 200 mg/5 ml botol 8,090 0 30
89 Etakridin (Rivanol) lar 0,1% botol 5,456 0 5
90 Etambutol tab 250 mg tablet 330 0
91 Etambutol tab 500 mg tablet 478 0
92 Etanol 70 % lar 100 ml botol 2,625 0 10
93 Etil Klorida semprot 100 mL botol 175,500 0
94 Etonogestrel implan 68 mg subd implant 128,779 0
95 Fenobarbital tab 30 mg tablet 149 0
96 Fenobarbital tab 100 mg tablet 242 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 0
98 Fenol Gliserol tts telinga 10% botol 1,920 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 0 20
101 Flukonazol kaps 150 mg kapsul 24,200 0
102 Fluor tab 0,5 mg tablet 975 0
103 Furosemid tab 40 mg tablet 84 0
104 Furosemide inj 10 mg/ml ampul 2,012 0
105 Gameksan lotion 1% - 30 ml botol 2,420 0
106 Garam Oralit kombinasi sacchet 317 0 500
107 Gemfibrozil kaps 300 mg kapsul 318 0
108 Gentamicin krim 10% tube - 0
109 Gentamicin salep kulit 10% tube - 0
110 Gentamicin salep mata 0,3% tube 2,786 0
111 Gentamicin tts mata 0,3% botol 3,513 0
112 Gentamisin inj 40 mg/ml ampul 3,739 0
113 Gentamisin inj 80 mg/ml vial 4,160 0
114 Glibenklamid tab 5 mg tablet 61 0
115 Glimepirid tab 1 mg tablet 278 0 200
116 Glimepirid tab 2 mg tablet 458 0
117 Glipizid tab 5 mg tablet 3,000 0
118 Gliseril Guaikolat tab 100 mg tablet 27 1000 1000 1000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 0
120 Gliserin lar 50% botol 5,867 0
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 0
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 0
123 Griseofulvin tab 125 mg tablet 230 0 500
124 Haloperidol tab 0,5 mg tablet 62 0
125 Haloperidol tab 1,5 mg tablet 76 0
126 Haloperidol tab 2 mg tablet 134 0
127 Haloperidol tab 5 mg tablet 105 0
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 0
129 Hiosina Butilbromida tab 10 mg tablet 648 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 0
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 0
132 Ibuprofen tab 200 mg tablet 121 0
133 Ibuprofen tab 400 mg tablet 157 400 400
134 Ibuprofen sir 100 mg/5 ml botol 3,849 0
135 Ibuprofen sir 200 mg/5 ml botol 4,949 0
136 Isoniazid tab 100 mg tablet 72 0
137 Isoniazid tab 300 mg tablet 174 0
138 Isosorbid Dinitrat tab 5 mg tablet 98 0
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 0
140 Kalsium Karbonat tab 500 mg tablet 448 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 0
142 Kanamisin inj 1.000 mg/vial vial 5,100 0
143 Kaptopril tab 12,5 mg tablet 90 0 700
144 Kaptopril tab 25 mg tablet 138 100 100 800
145 Kaptopril tab 50 mg tablet 141 0
146 Karbamazepin tab 200 mg tablet 269 0
147 Karbamazepin sir 100 mg/5 mL botol 44,770 0
148 Karbogliserin tts telinga 10% botol 2,246 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 0
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 0
151 Ketokonazole krim 2% - 15 g tube 5,150 0
152 Ketokonazole tab 200 mg tablet 320 0
153 Klaritromisin tab 500 mg tablet 3,600 0
154 Klindamisin kaps 150 mg kapsul 405 0
155 Klindamisin kaps 300 mg kapsul 619 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 0
157 Kloramfenikol kaps 250 mg kapsul 275 0
158 Kloramfenikol kaps 500 mg kapsul 935 0
159 Kloramfenikol salap mata 1% tube 1,680 0
160 Kloramfenikol salep kulit 2% tube 4,138 0
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 0
162 Kloramfenikol tts mata 0,5% botol 20,360 0
163 Kloramfenikol tts telinga 3% botol 11,440 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 1000 1000 2000
165 Klorpromazin HCl tab 25 mg tablet 75 0
166 Klorpromazin HCl tab 100 mg tablet 162 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 0
168 Kodein HCL tab 10 mg tablet 550 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradio tablet 2,298 0
171 Kotrimoxazol tab 480 mg (adult) tablet 152 400 400
172 Kotrimoxazol susp 60 ml botol 2,298 0
173 Kuinin tab 200 mg tablet 737 0
174 Kuinin tab 222 mg tablet 594 0
175 Kuinin inj 25% (i.v) ampul 6,820 0
176 Levofloxacin tab 500 mg tablet 581 0
177 Levofloxacin inf 5 mg/mL botol 43,809 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - 0
179 Lidokain inj 1% (infltr) ampul 929 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 30 30
181 Lidokain gel 2% botol 40,000 0
182 Lidokain semprot 10% botol 156,200 0
183 Lisol lar 1.000 ml botol 49,862 0 1
184 Loratadin tab 10 mg tablet 333 0
185 Magnesium Sulfat serb 30 g sacchet 3,803 0
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 0 20
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 0
188 Mebendazol tab 100 mg tablet 7,150 0
189 Mebendazol tab 500 mg tablet 7,854 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 0 5
192 Metampiron (Antalgin) tab 500 mg tablet 350 0 500
193 Metformin tab 500 mg tablet 182 0 300
194 Metformin tab 850 mg tablet 280 0
195 Metilergometrin Maleat tab 0.125 mg tablet 169 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 0
197 Metilprednisolon tab 4 mg tablet 230 0
198 Metilprednisolon tab 8 mg tablet 390 0
199 Metilprednisolon tab 16 mg tablet 875 0
200 Metoklopramid tab 5 mg tablet 113 0
201 Metoklopramid tab 10 mg tablet 100 0 700
202 Metronidazol tab 250 mg tablet 116 0 400
203 Metronidazol tab 500 mg tablet 169 0 500
204 Metronidazol sir 125 mg/5 ml botol 4,350 0
205 Metronidazol lar inf 5 mg/mL botol 12,980 0
206 Miconazole krim 2% tube 3,150 0 24
207 Natrium Diklofenak tab 25 mg tablet 146 0 500
208 Natrium Diklofenak tab 50 mg tablet 193 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 0
210 Nifedipine tab 10 mg tablet 127 0 200
211 Nistatin tab vaginal 100.000 IU ovula 528 0 200
212 Nistatin tab vaginal 500.000 IU tablet 704 0 200
213 Obat Anti TB Kategori Anak Paket 189,195 0
214 Obat Anti TB Kategori Anak FDC Paket 236,490 0
215 Obat Anti TB Kategori I Paket 317,015 0
216 Obat Anti TB Kategori I FDC Paket 396,000 0
217 Obat Anti TB Kategori I Kombipak Paket 316,920 0
218 Obat Anti TB Kategori II Paket 1,320,000 0
219 Obat Anti TB Kategori II FDC Paket 1,319,990 0
220 Obat Anti TB Kategori III Paket 154,000 0
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 0 25
223 Ofloxacin tab 200 mg tablet 440 0
224 Ofloxacin tab 400 mg tablet 700 0
225 Oksimetazolin tts hidung 0,025 % botol 30,305 0
226 Oksimetazolin tts hidung 0,050 % botol 32,000 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 0
230 Olopatadin tts mata 0,1% botol 68,000 0
231 Omeprazol kaps 20 mg kapsul 409 90 90 180
232 Omeprazol inj 40 mg/10 mL vial 42,000 0
233 Paracetamol tab 500 mg tablet 88 700 700
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 6 6
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 0
236 Perak Sulfadiazin krim 1% tube 25,350 0
237 Permetrin krim 5% tube 11,475 0
238 Pirantel Pamoat tab 125 mg tablet 318 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 0 15
240 Pirazinamid tab 500 mg tablet 225 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 0 1000
243 Piroxicam tab 10 mg tablet 149 0
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 0
245 Povidon Iodida lar 10% - 300 ml botol 15,386 0
246 Povidon Iodida lar 10% - 60 ml botol 6,500 0
247 Povidon Iodida lar 10% - 30 ml botol 2,344 0
248 Prednison tab 5 mg tablet 192 1000 1000
249 Primakuin tab 15 mg tablet 205 0
250 Probenesid tab 500 mg tablet 1,815 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 0
252 Propranolol tab 10 mg tablet 80 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 0
254 Ranitidin tab 150 mg tablet 220 300 300 500
255 Ranitidin inj 25 mg/mL ampul 1,340 25 25
256 Retinol (Vit A) softcap 100.000 IU softcap 286 0
257 Retinol (Vit A) softcap 200.000 IU softcap 505 0
258 Rifampicin kaps 300 mg kapsul 670 0
259 Rifampicin tab 450 mg tablet 868 0
260 Rifampicin tab 600 mg tablet 1,209 0
261 Ringer Laktat lar inf steril 500 ml botol 4,727 0 60
262 Salbutamol tab 2 mg tablet 65 0
263 Salbutamol tab 4 mg tablet 93 0
264 Salbutamol cairan ih 0,1% botol 7,260 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 0
268 Serum Antidifteri inj 10,000 IU vial - 0
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 0
270 Serum Antitetanus inj 1.500 IU vial 161,000 0
271 Serum Antitetanus inj 10.000 IU vial - 0
272 Serum Antitetanus inj 20.000 IU vial 324,550 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 0
275 Simvastatin tab 10 mg tablet 294 0 500
276 Simvastatin tab 20 mg tablet 480 0
277 Siprofloksasin tab 500 mg tablet 290 0 500
278 Spironolakton tab 25 mg tablet 350 0
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folattablet 112 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 0
282 Tetrasiklin kaps 250 mg kapsul 162 0 500
283 Tetrasiklin kaps 500 mg kapsul 325 0
284 Thiamfenikol kaps 500 mg kapsul 985 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 0 2000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 0
287 Tramadol inj 50 mg/mL ampul 2,680 0
288 Triheksipenidil tab 2 mg tablet 70 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 0
290 Valproat tab sal 250 mg tablet salut 1,680 0
291 Valproat tab sal 500 mg tablet salut 5,450 0
292 Valproat sir 250 mg/5 mL botol 41,800 0
293 Vankomisin serb inj 500 mg/vial vial 142,000 0
294 Vitamin B Kompleks tablet 112 0 2000
295 Zinc sir 10 mg/ml botol 16,478 0
296 Zinc sir 20 mg/5 ml botol 8,140 0 3
297 Zinc dispersible 20 mg tablet 521 100 100
298 Alprazolam tab 1 mg tablet 245 0
299 Betahistin tab 6 mg tablet - 0 300
300 Idometasin kapl 25 mg kaplet 380 0
301 Karbon Aktif tab 125 mg tablet 127 0
302 Klobazam tab 10 mg tablet 950 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 0
304 Loperamid tab 2 mg tablet 97 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 0
306 Papaverin 40 mg tablet - 0
307 Piracetam tab 400 mg tablet - 0
308 Thiamfenikol tab 250 mg tablet - 0
309 Piracetam tab 800 mg tablet - 0
310 Piroxicam tab 20 mg tablet - 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet - 1000 1000
312 Etanol 70% lar 1000 ml botol - 0
313 Etanol 70% lar 300 ml botol - 0
314 Neurosanbe injeksi ampul - 0
315 H2O2 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

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 1,262 30 30 100
2 Alat Suntik 2.5 ml pcs 1,102 0
3 Alat Suntik 3 ml pcs 1,010 0 100
4 Alat Suntik 5 ml pcs 1,248 0 100
5 Alat Suntik 10 ml pcs 1,694 0 50
6 Alat Suntik 20 ml pcs 2,228 0
7 Alat Suntik 50 ml pcs 10,350 0
8 Alat Suntik ADS 0,5 ml pcs 1,925 0
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 0
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 0
11 Alat Suntik ADS 5 ml BCG pcs 2,585 0
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 0
17 Catgut no.2/0 pcs 213,525 0 24
18 Catgut no.3/0 pcs 213,525 0 24
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 0
20 Catheter (folley cathteter) no.10 pcs 13,750 0 10
21 Catheter (folley cathteter) no.12 pcs 13,750 0 10
22 Catheter (folley cathteter) no.14 pcs 13,750 0 10
23 Catheter (folley cathteter) no.16 pcs 13,750 0 10
24 Catheter (folley cathteter) no.18 pcs 13,750 0 10
25 Cholesterol test btl/10 strip botol 320,000 0
26 Copper T set 125,000 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 0
30 Glukosa test btl/25 strip botol 180,000 0
31 Hand Schoen no 7 set 14,850 0 20
32 Hand Schoen no 7.5 set 14,850 0 20
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 0
34 Hand Schoen no 8 set 14,850 0 20
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 150 150
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 0
44 Hand Schoen (Examination Gloves Size S) set 57,750 0
45 Hand Schoen (Examination Gloves Size M) set 57,750 0
46 Hand Schoen (Examination Gloves Size L) set 57,750 0
47 Infusion Set Anak set 6,375 0 20
48 Infusion Set Dewasa set 12,100 15 15 20
49 Infusion Set Macro 2 Cabang set 35,000 0
50 IV Catheter no. 16 pcs 8,948 0
51 IV Catheter no. 18 pcs 8,948 0 20
52 IV Catheter no. 20 pcs 8,948 19 19 20
53 IV Catheter no. 22 pcs 8,948 0 20
54 IV Catheter no. 24 pcs 8,948 20 20 20
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 0
61 Jarum Jahit Otot all size lusin 18,500 0
62 Jarum Jahit 1/2 Surgical lusin 135,000 0 1
63 Jarum Jahit 3/8 Surgical lusin 120,000 0 1
64 Kaca Slide pcs 50,000 0
65 Kapas Pembalut 250 g roll 22,000 0 10
66 Kapas Pembalut 500 g roll 35,000 0 10
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 0
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 0 5
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 0 10
70 Kasa Pembalut 2 m x 80 cm roll 13,366 0
71 Kasa Pembalut 4 m x 5 cm roll - 0
72 Kasa Pembalut 4 m x 10 cm roll 2,601 0
73 Kasa Pembalut 4 m x 15 cm roll - 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 0 10
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 0 10
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 0 10
77 Kasa Steril 16 cm x 16 cm box 6,743 0 1
78 Kasa Steril 18 cm x 22 cm box 16,500 0 24
79 Masker Ear Loop Pcs 495 150 150 100
80 Mata Pisau Bedah No. 10 pcs 9,750 0 5
81 Mata Pisau Bedah No. 11 Pcs 9,750 0 5
82 Mata Pisau Bedah No. 15 Pcs 9,750 0 10
83 Mata Pisau Bedah No. 21 Pcs 9,750 0 10
84 Nasal Oxygen (Aximed) size M Pcs 6,600 0
85 Nasal Oxygen (Aximed) size L Pcs 6,600 0
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 0
87 Plester 5 yard x 2 inchi roll 7,186 0
88 Plester 5 cm x 4,5 cm roll - 3 3 5
89 Plester 7,5 cm x 4,5 cm roll 34,650 0
90 Pot Sputum pot 2,000 0
91 RDT pcs - 0
92 Regulator Oxygen pcs 450,000 0
93 Safety Box kotak - 0
94 Selang Oxygen pcs 8,250 4 4
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 0
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 0
97 Sound Timer unit 1,219,143 0
98 Stempel ISPA pcs - 0
99 Uric Acid test btl/25 strip botol 240,000 0
100 Urine bag pcs 6,875 0 10

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 15,000 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 0
3 Larutan Asam Klorida (HCl) 0,1 N botol - 0
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 0
5 Larutan Benedik botol 40,040 0
6 Larutan Eosin 2% botol 36,595 0
7 Larutan Etanol Asam botol 34,126 0
8 Larutan Giemsa Stein botol 63,348 0
9 Larutan Karbol Fuksin botol 23,231 0
10 Larutan Metanol botol 118,300 0
11 Larutan Metilen Biru botol 17,086 0
12 Larutan Turk botol 54,600 0
13 Reagen TBC kit - 0
14 Test Asam Urat test 250,000 0 1
15 Test Comburt Reagens set 251,200 0
16 Test Golongan Darah set 286,365 0
17 Test Golongan Darah Reagens set 251,200 0
18 Test Gula Darah test 200,000 0 1
19 Test Kehamilan strip 2,400 0
20 Test Kolesterol test 350,000 0 1
21 Test Urine Rutin strip 3,000 0

GIGI
1 Air raksa Dental Use - 108,195 0
2 Devitalisasi pasta (arsen) kotak 390,000 0
3 Eugenol cairan 10 ml botol 18,333 0
4 Fluoride 0.5 mg tablet 30,000 0
5 Fluoride 1 mg tablet 4,456 0
6 Hemospon (Spongostan Dental) pcs 536,250 0
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 0
9 Kalsium Hidroksida Pasta tube 341,250 0
10 Klorheksidin lar 0,2% botol - 0
11 Klorheksidin lar 15% botol - 0
12 Mata Bor Gigi pcs 48,750 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 0
15 Trikresol Formalin (TKF) cairan botol 7,239 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 0
3 Becefort sir 60 ml botol 26,230 0
4 Bronex (Bromheksin) tab 8 mg tablet 82 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 0
6 Fluoride 1 mg tablet 976 0
7 Kandistatin susp 12 ml botol 36,300 0
8 KY Jelly tube 85,000 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 0
10 Norit (Karbon Aktif) tab 125 mg tablet - 0
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 0
12 Pehavral tablet salut 70,785 0
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 0
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 0
17 Vaksin Antirabies Vero (VAR) vial 48,400 0

18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 0 1

19 Cendo Xytrol TM 5 ml botol 35,850 0

20 Formalin 40 % botol 42,000 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 0 1000
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 0
25 Vical susp 100 ml botol 4,890 0 60
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet - 0
28 Sanmol (Parasetamol) 500 mg tablet 325 0 500
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 0
30 Purecemia (Allopurinol) 300 mg tablet 3,269 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 0
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 0
36 Histigo (Betahistin) tab 6 mg tablet - 0
37 Novadium (Loperamid) tab 2 mg tablet - 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - 0
39 Metolon (Metoklorperamid) tab 10 mg tablet - 0
40 Novabion tablet - 0
41 Novagesic (Parasetamol) tab 500 mg tablet - 0
42 Defamol (Parasetamol) tab 500 mg tablet - 0
43 Sultrimix syrup botol - 0
44 Biovitan syrup botol - 0
45 Caviplex syrup botol - 0
46 Farsifen (Ibuprofen) syrup botol - 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet - 0
48 Lexigo (Betahistin) tab 6 mg tablet - 0
49 Loric (Allopurinol) tab 100 mg tablet - 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - 0
51 Arkavit tablet - 0
52 Novadex (Dexametason) 0,5 mg tablet - 0
53 Carbidu (Dexametason) 0,5 mg tablet - 0
54 Gralixa (Furosemid) 40 mg tablet - 0
55 Grafazol (Metronidazol) tab 500 mg tablet - 0
56 Glikos (Metformin) tab 500 mg tablet - 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet - 0
59 Trifadium ( Loperamide HCL 2 mg) tablet - 0
0 0 0 - 0
0 0 0 - 0
0 0 0 - 0
0 0 0 - 0
UARI 2017 MARET 2017
TOTAL BUFFER TOTAL
PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
TERIMA PROVINSI TERIMA
0 0
0 0
0 0
500 0
0 0
25 0
500 1200 0
0 0
0 0
0 0
0 0
180 0
0 0
20 0
0 0
1000 2000 0
0 0
0 0
1500 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
1000 2000 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
36 0
0 0
0 0
50 75 0
0 0
0 0
0 0
0 0
0 0
500 1200 0
50 0
0 0
500 0
0 0
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 0
0 0
0 0
0 0
0 0
0 0
500 0
0 0
30 0
0 0
0 0
0 0
0 0
30 0
5 0
0 0
0 0
10 5 5
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
500 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
200 0
0 0
0 0
1000 2000 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
700 0
800 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2000 4000 0
0 0
0 0
0 0
0 0
0 0
0 0
600 600 0
15 15 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
28 28 0
 0 0
0 0
1 0
0 0
0 0
20 0
0 0
0 0
0 0
0 0
5 0
500 0
300 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
700 0
400 0
500 0
0 0
0 0
24 0
500 0
0 0
0 0
200 0
200 0
200 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
25 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
180 0
0 0
1000 1000 0
11 11 0
0 0
0 0
0 0
0 0
15 0
0 0
0 0
1000 0
400 400 0
0 0
0 0
0 0
0 5 5
1000 1000 0
0 0
0 0
0 0
0 0
0 0
800 1300 0
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
0 0
0 0
0 0
0 0
500 0
0 0
500 1000 0
0 0
0 0
0 0
0 0
500 0
0 0
0 0
2000 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2000 0
0 0
3 0
300 300 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 0
1 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

100 0
0 0
100 0
100 0
50 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
24 0
24 0
0 0
10 0
10 0
10 0
10 0
10 0
0 0
0 0
0 0
0 0
0 0
0 0
20 0
20 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
20 0
2 22 0
0 0
0 0
20 0
25 45 0
20 0
20 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 0
1 0
0 0
4 14 0
10 0
0 0
5 0
10 0
0 0
0 0
0 0
0 0
10 0
10 0
10 0
1 0
24 0
200 300 0
5 0
5 0
10 0
10 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
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
1 0
0 0
0 0
0 0
1 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

1 0

0 0
0 0
1000 0
0 0
0 0
0 0
60 0
0 0
0 0
500 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
 APRIL 2017 MEI 2017 JUNI 2017
BUFFER TOTAL BUFFER TOTAL BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI TERIMA PROVINSI TERIMA PROVINSI
0 10 10
0 0
0 0
0 500 500
0 0
12 12 20 20
0 500 500
0 0
0 0
0 0
0 0
150 150 300 300
0 50 50
0 0
0 0
1800 1800 1000 1000
0 0
0 0
600 600 1500 1500
0 0
0 0
0 10 10
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
2000 2000 0
0 0
0 0
0 0
0 0
0 0
0 0
1000 1000 1000 1000
0 0
0 0
300 300 0
0 0
0 0
0 0
0 0
0 0
0 6 6
0 0
0 0
0 25 25
0 0
0 0
0 0
0 0
0 0
0 1000 1000
0 50 50
0 0
0 300 300
0 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 0
0 0
0 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 0
0 15 15
0 0
0 0
0 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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 1000 1000
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
1000 1000 0
0 0
0 0
0 0
0 0
0 0
0 0
0 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
0 0
0 0
0 0
0 0
0 10 10
0 0
0 0
0 0
0 0
0 1500 1500
0 0
0 0
0 0
0 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 52 20
0 0
0 0
0 1 1
0 300 300
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 500 500
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 500 500
0 0
0 0
0 0
0 0
0 24 24
0 1000 1000
0 0
0 0
0 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 30
0 0
0 0
0 0
0 0
0 40 40
0 0
0 0
0 0
0 450 450
0 0
0 0
26 26 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 4
4 4 5 5
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 1000 1000
0 0
0 0
0 0
0 0
 0 0
0 0
0 140 140
600 600 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 500 500
0 0
0 0
0 0
0 0
0 0
0 0
0 500 500
0 0
0 0
0 1000 1000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 3000 3000
0 0
0 0
0 0
 0 0
0 180 180
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 0
0 0
0 0
0 0
0 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 50
0 0
0 50 50
0 0
0 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 48
0 0
0 0
0 10 10
0 10 10
0 10 10
0 10 10
0 10 10
0 0
0 4 4
0 0
0 0
0 0
0 0
0 50 50
0 26 26
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 6 6 4
0 0
0 0 15
26 26 50 50 17
0 0
0 0
0 10 3 13
26 26 10 30 40 20
0 10 10
0 20 20
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 1 1
0 1 1
0 0
0 5 5
0 5 5
0 0
3 3 5 5
0 20 20
0 0
0 10 10
0 10 10
0 10 10
0 0
0 0
0 0
0 0
0 5 5
200 200 50 50 200
0 10 10
0 10 10
0 10 10
0 0
0 0
0 0
0 0
0 0
0 4 4
0 0
0 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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 25 25
0 0
0 0
0 0
0 25 25
 0 50 50
0 20 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

52 52 0
0 0
0 0
0 0
0 0
0 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 5

0 0
0 0
0 2000 2000
0 100 100
0 0
0 100 100
0 15 15
0 0
0 0
0 500 500
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
 TOTAL
TERIMA
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
0
0
0
0
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
15
17
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
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 JULI 2017 AGUSTUS 2017 SEPTEMBER 2017
BUFFER TOTAL BUFFER TOTAL BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI TERIMA PROVINSI TERIMA PROVINSI
20 20 0
0 0
0 0
1000 1000 0
0 0
30 30 0 10
500 500 300 300 1000
0 0
0 0
0 0
0 0 330
300 300 0
50 50 0
0 0
0 0
2000 600 2600 900 900 1700
0 0
0 0 10
2000 2000 0 1000
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 1000 1000
0 0
0 0
0 0
0 0
0 0
2000 700 2700 500 500 900
0 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
0 0
0 0
0 0
1000 1000 0 200
45 45 0
0 0
1500 1500 0
0 0
0 0
0 0 250
0 0
0 0
 2 2 0
500 500 700 700 1000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
500 500 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
6 6 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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
10 10 0
0 0
0 0
0 0
0 0
0 0
1000 1000 0 800
0 0
0 0
0 0
0 0
500 500 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5 5 0
0 0
500 500 300 300 800
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0 750
 0 0
0 0
2000 2000 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3000 3000 0
0 0
0 0
0 0
0 0
0 0
0 0
200 200 400 400 800
15 15 10 10 10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
15 15 24 24 21
 0 0
0 0
4 4 0
250 250 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1500 1500 0
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 48 0
800 800 0
0 0
40 40 0
0 0
100 100 0
100 100 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
20 20 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
450 450 0
0 0
800 800 1200 1200 2000
16 16 12 12 10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1000 1000 0
0 400 400 600
2 2 0 2
0 0
0 0
0 0
2000 2000 600 600 1000
0 0
0 0
0 0
0 0
0 0
2000 2000 0
15 15 0 6
0 0
0 0
0 0
 0 0
0 0
180 180 0
0 0
600 600 300 300 500
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1000 1000 0
0 0
500 500 0 200
0 0
0 0
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
3000 3000 0
0 0
0 0
0 0
 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
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

72 72 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
72 72 0
48 48 0
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
29 29 0
26 26 0
0 0
30 30 0
0 0
0 0
0 0
0 0
0 0
30 30 0
0 0
0 0
0 0
0 0
 3 3 3 3 1
0 0
0 0
50 5 55 0
0 0
0 0
10 10 0
14 14 18 18 17
20 20 0
50 50 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
144 144 0
0 0
0 0
48 48 0
8 8 0
10 10 0
10 10 0
0 0
0 0
0 0
0 0
0 0
0 0
2 2 0
4 4 0
50 50 100 100 50
9 9 0
10 10 0
10 10 0
0 0
 0 0
0 0
0 0
0 0
1 1 3 3 1
0 0
65 65 0
0 0
0 0
0 0
5 5 9 9
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 0
0 0
0 0
0 0
50 50 0
0 0
0 0
0 0
50 50 0
 0 0
20 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

3 3 0

0 0
0 0
0 0
0 0
0 0
0 0
30 30 0
0 0
0 0
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 0 500
0 0
0 0
0 0
0 0
 TOTAL
TERIMA
0
0
0
0
0
10
1000
0
0
0
330
0
0
0
0
1700
0
10
1000
0
0
0
0
0
 0
0
0
0
0
0
0
0
0
0
0
0
900
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
200
0
0
0
0
0
250
0
0
 0
1000
0
0
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
0
0
0
0
0
0
0
0
0
0
 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
800
0
0
0
0
0
0
0
0
0
0
0
0
0
0
800
0
0
0
0
0
0
0
750
 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
800
10
0
0
0
0
0
0
0
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 0
0
0
0
0
0
0
0
0
0
0
0
0
2000
10
0
0
0
0
0
0
0
0
600
2
0
0
0
1000
0
0
0
0
0
0
6
0
0
0
 0
0
0
0
500
0
0
0
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
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
50
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
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 0
0
0
0
0
0
0
500
0
0
0
0
 OKTOBER 2017 NOVEMBER 2017 DESEMBER 2017
BUFFER TOTAL BUFFER TOTAL BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI TERIMA PROVINSI TERIMA PROVINSI
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
TERIMA
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 JUMLAH
BUFFER TOTAL
DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI TERIMA
30 0 0 0 0 30
0 0 0 0 0 0
0 0 0 0 0 0
2000 0 0 0 0 2000
0 0 0 0 0 0
75 0 0 0 22 97
1700 0 0 0 1800 3500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 330 330
780 0 0 0 300 1080
100 0 0 0 0 100
20 0 0 0 14 34
0 0 0 0 0 0
4000 0 0 0 6700 10700
0 0 0 0 0 0
0 0 0 0 10 10
5000 0 0 0 2600 7600
0 0 0 0 0 0
0 0 0 0 0 0
30 0 0 0 0 30
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 2000 2000
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 0 0 0 0
0 0 0 0 0 0
4000 0 0 0 4400 8400
0 0 0 0 0 0
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 0 0 0 0 0
0 0 0 0 0 0
42 0 0 0 0 42
0 0 0 0 0 0
0 0 0 0 0 0
50 0 0 0 58 108
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
2700 0 0 0 700 3400
145 0 0 0 0 145
0 0 0 0 0 0
2300 0 0 0 0 2300
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 250 250
0 0 0 0 0 0
0 0 0 0 0 0
 4 0 0 0 0 4
0 0 0 0 4200 4200
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 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1300 0 0 0 0 1300
0 0 0 0 0 0
30 0 0 0 0 30
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
5 0 0 0 0 5
0 0 0 0 0 0
0 0 0 0 0 0
36 0 0 0 6 42
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 0 0 0 50
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
500 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
10 0 0 0 0 10
0 0 0 0 0 0
0 0 0 0 0 0
200 0 0 0 0 200
0 0 0 0 0 0
0 0 0 0 0 0
3000 0 0 0 2800 5800
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1300 0 0 0 0 1300
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 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 5
0 0 0 0 1000 1000
0 0 0 0 2000 2000
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 750 750
 0 0 0 0 0 0
700 0 0 0 0 700
3800 0 0 0 100 3900
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 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 0
6500 0 0 0 3000 9500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 2400 2400
0 0 0 0 50 50
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 190 190
 0 0 0 0 0 0
0 0 0 0 0 0
6 0 0 0 0 6
550 0 0 0 0 550
0 0 0 0 0 0
20 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
5 0 0 0 0 5
500 0 0 0 0 500
2300 0 0 0 0 2300
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1200 0 0 0 0 1200
400 0 0 0 0 400
500 0 0 0 0 500
0 0 0 0 0 0
0 0 0 0 0 0
96 0 0 0 0 96
2300 0 0 0 0 2300
0 0 0 0 0 0
40 0 0 0 0 40
200 0 0 0 0 200
300 0 0 0 0 300
300 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
0 0 0 0 0 0
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 0 0 0 0 75
0 0 0 0 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 40
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1080 0 0 0 90 1170
0 0 0 0 0 0
0 0 0 0 5700 5700
0 0 0 0 81 81
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 0 0 0 0 15
0 0 0 0 0 0
0 0 0 0 0 0
2000 0 0 0 0 2000
0 0 0 0 1400 1400
0 0 0 0 8 8
0 0 0 0 9 9
0 0 0 0 0 0
5 0 0 0 0 5
0 0 0 0 5600 5600
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
3500 0 0 0 1100 4600
0 0 0 0 46 46
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
380 0 0 0 0 380
0 0 0 0 600 600
0 0 0 0 1400 1400
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
2000 0 0 0 0 2000
0 0 0 0 0 0
500 0 0 0 1200 1700
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1000 0 0 0 0 1000
0 0 0 0 0 0
0 0 0 0 0 0
4000 0 0 0 0 4000
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
8000 0 0 0 0 8000
0 0 0 0 0 0
3 0 0 0 0 3
0 0 0 0 400 400
 0 0 0 0 0 0
630 0 0 0 0 630
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 1000 1000
0 0 0 0 4 4
0 0 0 0 4 4
0 0 0 0 0 0
1 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 0 0 0 0 0

222 0 0 0 30 252
0 0 0 0 0 0
150 0 0 0 0 150
100 0 0 0 0 100
50 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 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
144 0 0 0 0 144
72 0 0 0 0 72
0 0 0 0 0 0
20 0 0 0 0 20
20 0 0 0 0 20
20 0 0 0 0 20
20 0 0 0 0 20
120 0 0 0 0 120
0 0 0 0 0 0
4 0 0 0 0 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
99 0 0 0 0 99
72 0 0 0 0 72
0 0 0 0 0 0
50 0 0 0 0 50
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 150 150
0 0 0 0 0 0
0 0 0 0 0 0
30 0 0 0 0 30
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 0 0 17 17
0 0 0 0 0 0
20 0 0 0 15 35
120 0 0 0 65 185
0 0 0 0 0 0
0 0 0 0 0 0
40 0 0 0 3 43
30 0 0 0 169 199
50 0 0 0 0 50
90 0 0 0 20 110
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 0 0 2
2 0 0 0 0 2
144 0 0 0 0 144
15 0 0 0 4 19
15 0 0 0 0 15
48 0 0 0 0 48
18 0 0 0 3 21
40 0 0 0 0 40
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
3 0 0 0 0 3
33 0 0 0 0 33
200 0 0 0 900 1100
24 0 0 0 0 24
25 0 0 0 0 25
30 0 0 0 0 30
10 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 0 0 0
10 0 0 0 7 17
0 0 0 0 0 0
65 0 0 0 0 65
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
5 0 0 0 13 18
24 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 0 0 0
15 0 0 0 0 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 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
76 0 0 0 0 76
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
76 0 0 0 0 76
50 0 0 0 0 50
41 0 0 0 0 41
0 0 0 0 0 0

0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 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 52
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 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 9

0 0 0 0 0 0
0 0 0 0 0 0
3000 0 0 0 0 3000
100 0 0 0 0 100
0 0 0 0 0 0
100 0 0 0 0 100
105 0 0 0 0 105
0 0 0 0 0 0
0 0 0 0 0 0
1500 0 0 0 0 1500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 500 500
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 0
0 0 0 0 500 500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 Peringatan
Pengeluaran
Menu
!
Stok Akhir
 PENGELUARAN
JANUARI 2017 FEBRUARI 2017
No. Nama Obat Satuan Harga BUFFER TOTAL BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT
PROVINSI KELUAR PROVINSI
1 Air Untuk Injeksi 20 ml vial 6,000 1 0 0 0 0 1 2 0 0
2 Albendazole tab 400 mg tablet 363 0 0 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 4,234 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 143 0 0 0 0 200 200 100 0 0
5 Allopurinol tab 300 mg tablet 233 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 0 0 0 0 0 0 25 0 0
7 Ambroksol tab 30 mg tablet 200 0 0 0 0 0 0 400 0 0
8 Aminophyllin tab 200 mg tablet 86 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 4,204 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 123 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 197 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 935 0 0 0 0 30 30 180 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 0 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 2,560 10 0 0 0 8 18 14 0 0
15 Amoxicillin tab 250 mg tablet 220 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 370 0 0 0 0 1700 1700 700 0 0
17 Ampicillin serb inj 1000 mg vial 5,610 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 2,213 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidr tablet 78 0 0 0 0 0 0 900 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 1,890 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 3,200 10 0 0 0 0 10 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 m tablet 3,220 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 tablet 149 0 0 0 0 0 0 0 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mKapsul 1,650 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 24,384 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 104 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 52 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 175 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 176 400 0 0 0 100 500 600 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 251 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 357 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 387 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 220 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 81 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 4,725 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 1,350 9 0 0 0 0 9 17 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 1,596 0 0 0 0 0 0 15 0 0
50 Betametason tts mata 1 mg/ml botol 25,106 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 4,990 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 6,045 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 82 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 564 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 548 0 0 0 0 0 0 400 0 0
56 Cefadroksil SK 125 mg/5 mL botol 5,286 8 0 0 0 0 8 8 0 0
57 Cefadroksil SK 250 mg/5 mL botol 6,285 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 1,000 0 0 0 0 0 0 400 0 0
59 Cefiksime sir 100 mg/5 mL botol 9,400 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 190 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 8,799 0 0 0 0 0 0 0 0 0
63 Cimetidine tab 200 mg tablet 205 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 125,483 0 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 68 0 0 0 0 700 700 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 0 0 0 0 6 6 0 0 0
67 Diazepam tab 2 mg tablet 47 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 179 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 4,598 0 0 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 150 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 103 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 4,033 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 4,417 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 141 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 109 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 298 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 3,490 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 286 0 0 0 0 0 0 100 0 0
82 Efedrin inj 50 mg/mL tablet 14,650 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 0 0 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 522 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 1,023 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 8,090 5 0 0 0 0 5 29 0 0
89 Etakridin (Rivanol) lar 0,1% botol 5,456 0 0 0 0 0 0 1 0 0
90 Etambutol tab 250 mg tablet 330 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 478 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 2,625 0 0 0 0 0 0 7 0 0
93 Etil Klorida semprot 100 mL botol 175,500 1 0 0 0 0 1 0 0 0
94 Etonogestrel implan 68 mg subd implant 128,779 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 149 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 242 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 1,920 0 0 0 0 0 0 0 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 0 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 24,200 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 975 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 84 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 2,012 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 2,420 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 317 150 0 0 0 0 150 80 0 0
107 Gemfibrozil kaps 300 mg kapsul 318 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube - 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube - 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 2,786 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 3,513 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 3,739 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 4,160 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 61 0 0 0 0 200 200 0 0 0
115 Glimepirid tab 1 mg tablet 278 0 0 0 0 0 0 50 0 0
116 Glimepirid tab 2 mg tablet 458 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 3,000 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 27 0 0 0 0 1000 1000 400 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 5,867 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 0 0 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 230 0 0 0 0 0 0 150 0 0
124 Haloperidol tab 0,5 mg tablet 62 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 76 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 134 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 105 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 648 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 0 0 0 0 0 0 100 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 121 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 157 0 0 0 0 400 400 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 3,849 0 0 0 0 0 0 0 0 0
135 Ibuprofen sir 200 mg/5 ml botol 4,949 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 72 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 174 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 98 0 0 0 0 100 100 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 448 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 5,100 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 90 0 0 0 0 0 0 300 0 0
144 Kaptopril tab 25 mg tablet 138 100 0 0 0 400 500 550 0 0
145 Kaptopril tab 50 mg tablet 141 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 269 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 44,770 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 2,246 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 5,150 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 320 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 3,600 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 405 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 619 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 275 100 0 0 0 0 100 300 0 0
158 Kloramfenikol kaps 500 mg kapsul 935 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 1,680 1 0 0 0 0 1 0 0 0
160 Kloramfenikol salep kulit 2% tube 4,138 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 20,360 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 11,440 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 600 0 0 0 1000 1600 1300 0 0
165 Klorpromazin HCl tab 25 mg tablet 75 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 162 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 550 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradio tablet 2,298 0 0 0 0 0 0 0 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 152 0 0 0 0 300 300 0 0 0
172 Kotrimoxazol susp 60 ml botol 2,298 0 0 0 0 6 6 0 0 0
173 Kuinin tab 200 mg tablet 737 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 594 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 6,820 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 581 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 43,809 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 929 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 0 0 0 0 29 29 0 0 0
181 Lidokain gel 2% botol 40,000 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 156,200 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 49,862 0 0 0 0 0 0 1 0 0
184 Loratadin tab 10 mg tablet 333 0 0 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 3,803 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 0 0 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 0 0 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 7,150 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 7,854 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 0 0 0 0 0 0 1 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 350 100 0 0 0 0 100 100 0 0
193 Metformin tab 500 mg tablet 182 0 0 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 280 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 169 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 230 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 390 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 875 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 113 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 100 30 0 0 0 0 30 170 0 0
202 Metronidazol tab 250 mg tablet 116 0 0 0 0 0 0 100 0 0
203 Metronidazol tab 500 mg tablet 169 100 0 0 0 0 100 200 0 0
204 Metronidazol sir 125 mg/5 ml botol 4,350 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 12,980 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 3,150 15 0 0 0 0 15 11 0 0
207 Natrium Diklofenak tab 25 mg tablet 146 0 0 0 0 0 0 450 0 0
208 Natrium Diklofenak tab 50 mg tablet 193 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 11 0 0 0 0 11 10 0 0
210 Nifedipine tab 10 mg tablet 127 100 0 0 0 0 100 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 528 10 0 0 0 0 10 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 704 0 0 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 189,195 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 236,490 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 317,015 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 396,000 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 316,920 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 1,320,000 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 1,319,990 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 154,000 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 0 0 0 0 0 0 5 0 0
223 Ofloxacin tab 200 mg tablet 440 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 700 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 30,305 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 32,000 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 0 0 0 0 4 4 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 68,000 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 409 0 0 0 0 90 90 180 0 0
232 Omeprazol inj 40 mg/10 mL vial 42,000 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 88 0 0 0 0 1400 1400 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 0 0 0 0 6 6 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 25,350 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 11,475 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 318 0 0 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 0 0 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 225 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 200 0 0 0 0 200 750 0 0
243 Piroxicam tab 10 mg tablet 149 0 0 0 0 200 200 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 15,386 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 6,500 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 2,344 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 192 0 0 0 0 1000 1000 0 0 0
249 Primakuin tab 15 mg tablet 205 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 1,815 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 80 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 220 0 0 0 0 500 500 500 0 0
255 Ranitidin inj 25 mg/mL ampul 1,340 0 0 0 0 2 2 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 286 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 505 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 670 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 868 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 1,209 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 4,727 18 0 0 0 0 18 21 0 0
262 Salbutamol tab 2 mg tablet 65 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 93 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 7,260 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial - 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 161,000 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial - 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 324,550 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 0 0 0 0 1000 1000 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 294 0 0 0 0 100 100 150 0 0
276 Simvastatin tab 20 mg tablet 480 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 290 0 0 0 0 300 300 0 0 0
278 Spironolakton tab 25 mg tablet 350 0 0 0 0 0 0 0 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folattablet 112 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 162 70 0 0 0 0 70 330 0 0
283 Tetrasiklin kaps 500 mg kapsul 325 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 985 200 0 0 0 0 200 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 1150 0 0 0 0 1150 1450 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 2,680 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 70 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 1,680 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 5,450 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 41,800 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 142,000 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 112 0 0 0 0 0 0 1150 0 0
295 Zinc sir 10 mg/ml botol 16,478 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 8,140 0 0 0 0 0 0 3 0 0
297 Zinc dispersible 20 mg tablet 521 0 0 0 0 100 100 0 0 0
298 Alprazolam tab 1 mg tablet 245 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet - 30 0 0 0 0 30 60 0 0
300 Idometasin kapl 25 mg kaplet 380 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 127 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 950 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 97 0 0 0 0 200 200 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet - 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet - 0 0 0 0 0 0 20 0 0
308 Thiamfenikol tab 250 mg tablet - 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet - 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet - 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet - 0 0 0 0 1000 1000 0 0 0
312 Etanol 70% lar 1000 ml botol - 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol - 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul - 0 0 0 0 0 0 0 0 0
315 H2O2 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
BAHAN MEDIS HABIS PAKAI 0 0 0 0 0 0 0 0
1 Alat Suntik 1 ml pcs 1,262 8 0 0 0 17 25 30 0 0
2 Alat Suntik 2.5 ml pcs 1,102 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 1,010 0 0 0 0 0 0 21 0 0
4 Alat Suntik 5 ml pcs 1,248 0 0 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 1,694 0 0 0 0 0 0 10 0 0
6 Alat Suntik 20 ml pcs 2,228 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 10,350 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 1,925 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 2,585 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 213,525 0 0 0 0 0 0 9 0 0
18 Catgut no.3/0 pcs 213,525 8 0 0 0 0 8 3 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 0 0 0 0 0 0 0 0 0
20 Catheter (folley cathteter) no.10 pcs 13,750 0 0 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 13,750 0 0 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 13,750 0 0 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 13,750 0 0 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 13,750 0 0 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 320,000 0 0 0 0 0 0 0 0 0
26 Copper T set 125,000 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 180,000 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 14,850 0 0 0 0 0 0 20 0 0
32 Hand Schoen no 7.5 set 14,850 0 0 0 0 0 0 15 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 14,850 0 0 0 0 0 0 8 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 0 0 0 0 180 180 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 57,750 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 57,750 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 57,750 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 6,375 0 0 0 0 0 0 2 0 0
48 Infusion Set Dewasa set 12,100 0 0 0 0 25 25 14 0 0
49 Infusion Set Macro 2 Cabang set 35,000 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 8,948 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 8,948 3 0 0 0 0 3 0 0 0
52 IV Catheter no. 20 pcs 8,948 0 0 0 0 24 24 3 0 0
53 IV Catheter no. 22 pcs 8,948 0 0 0 0 0 0 3 0 0
54 IV Catheter no. 24 pcs 8,948 0 0 0 0 9 9 3 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 0 0 0 0 0 0 0 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 18,500 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 135,000 0 0 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 120,000 0 0 0 0 0 0 0 0 0
64 Kaca Slide pcs 50,000 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 22,000 1 0 0 0 0 1 2 0 0
66 Kapas Pembalut 500 g roll 35,000 0 0 0 0 0 0 5 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 0 0 0 0 0 0 2 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 0 0 0 0 0 0 4 0 0
70 Kasa Pembalut 2 m x 80 cm roll 13,366 2 0 0 0 0 2 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll - 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 2,601 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll - 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 0 0 0 0 0 0 10 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 0 0 0 0 0 0 10 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 0 0 0 0 0 0 10 0 0
77 Kasa Steril 16 cm x 16 cm box 6,743 0 0 0 0 0 0 1 0 0
78 Kasa Steril 18 cm x 22 cm box 16,500 0 0 0 0 0 0 23 0 0
79 Masker Ear Loop Pcs 495 0 0 0 0 150 150 100 0 0
80 Mata Pisau Bedah No. 10 pcs 9,750 0 0 0 0 0 0 2 0 0
81 Mata Pisau Bedah No. 11 Pcs 9,750 0 0 0 0 0 0 1 0 0
82 Mata Pisau Bedah No. 15 Pcs 9,750 0 0 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 9,750 0 0 0 0 0 0 2 0 0
84 Nasal Oxygen (Aximed) size M Pcs 6,600 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 6,600 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 7,186 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll - 0 0 0 0 2 2 1 0 0
89 Plester 7,5 cm x 4,5 cm roll 34,650 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 2,000 0 0 0 0 0 0 0 0 0
91 RDT pcs - 0 0 0 0 0 0 0 0 0
92 Regulator Oxygen pcs 450,000 0 0 0 0 0 0 0 0 0
93 Safety Box kotak - 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 8,250 0 0 0 0 2 2 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 12 0 0 0 0 12 8 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 3 0 0 0 0 3 3 0 0
97 Sound Timer unit 1,219,143 1 0 0 0 0 1 1 0 0
98 Stempel ISPA pcs - 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 240,000 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 6,875 1 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
BHP/REAGENT LAB 0 0 0 0 0 0 0 0
1 Cairan Spritus 1000 ml botol 15,000 0 0 0 0 0 0 1 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol - 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 40,040 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 36,595 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 34,126 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 63,348 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 23,231 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 118,300 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 17,086 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 54,600 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit - 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 250,000 0 0 0 0 0 0 1 0 0
15 Test Comburt Reagens set 251,200 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 286,365 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 251,200 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 200,000 0 0 0 0 0 0 1 0 0
19 Test Kehamilan strip 2,400 0 0 0 0 0 0 0 0 0
20 Test Kolesterol test 350,000 0 0 0 0 0 0 1 0 0
21 Test Urine Rutin strip 3,000 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 0 0 0
GIGI 0 0 0 0 0 0 0 0
1 Air raksa Dental Use - 108,195 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 390,000 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 18,333 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 30,000 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 4,456 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 536,250 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 341,250 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol - 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol - 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 48,750 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 7,239 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0
OBAT KHUSUS 0 0 0 0 0 0 0 0
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 26,230 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 82 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 976 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 36,300 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 85,000 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet - 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 70,785 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 0 0 0 0 0 0 0 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 48,400 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 0 0 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 35,850 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 42,000 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 0 0 0 0 0 0 600 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 20 0 0 0 0 20 52 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 70 0 0 0 0 70 0 0 0
25 Vical susp 100 ml botol 4,890 0 0 0 0 0 0 25 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 0 0 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet - 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 325 0 0 0 0 0 0 500 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 3,269 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet - 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet - 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet - 0 0 0 0 0 0 0 0 0
40 Novabion tablet - 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet - 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet - 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol - 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol - 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol - 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol - 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet - 0 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet - 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet - 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - 0 0 0 0 0 0 0 0 0
51 Arkavit tablet - 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet - 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet - 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet - 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet - 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet - 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet - 0 0 0 0 0 0 10 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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
0 0 0 - 0 0 0 0 0 0 0 0 0
0 0 0 - 0 0 0 0 0 0 0 0 0
UARI 2017 MARET 2017
TOTAL BUFFER TOTAL
PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
KELUAR PROVINSI KELUAR
0 0 2 3 0 0 0 0 3
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 100 200 0 0 0 0 200
0 0 0 0 0 0 0 0 0
0 0 25 0 0 0 0 0 0
0 200 600 300 0 0 0 100 400
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 120 300 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 6 20 6 0 0 0 0 6
0 0 0 0 0 0 0 0 0
0 500 1200 300 0 0 0 500 800
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 1000 1900 400 0 0 0 0 400
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 700 1300 300 0 0 0 500 800
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 17 0 0 0 0 17
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 25 40 10 0 0 0 5 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 0 0 0 0
0 0 0 0 0 0 0 0 0
0 400 800 300 0 0 0 100 400
0 0 8 18 0 0 0 0 18
0 0 0 0 0 0 0 0 0
0 0 400 100 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 1300 1300 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 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 20 120 100 0 0 0 0 100
0 0 0 0 0 0 0 0 0
0 0 0 1 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 29 0 0 0 0 0 0
0 0 1 6 0 0 0 1 7
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 7 5 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 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 80 150 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 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 200 200 0 0 0 0 100 100
0 0 50 100 0 0 0 0 100
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 400 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 150 100 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 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 0 0 0 0 0
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 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 300 200 0 0 0 0 200
0 0 550 250 0 0 0 0 250
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 1000 2300 200 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 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 500 500 0 0 0 0 100 100
0 6 6 0 0 0 0 9 9
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 31 31 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 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 0 0
0 0 1 1 0 0 0 0 1
0 0 100 200 0 0 0 0 200
0 100 100 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 170 200 0 0 0 0 200
0 0 100 0 0 0 0 0 0
0 0 200 100 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 11 6 0 0 0 0 6
0 0 450 50 0 0 0 0 50
0 0 0 0 0 0 0 0 0
0 0 10 10 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 13 0 0 0 0 13
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 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 17 0 0 0 0 9 9
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 180 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 700 700 0 0 0 0 500 500
0 4 4 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 0 0 0 0 0 0 0
0 0 0 88 0 0 0 0 88
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 750 0 0 0 0 0 0
0 100 100 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 0 0 0 0 0 0 0 0
0 0 0 5 0 0 0 0 5
0 1000 1000 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 500 1000 0 0 0 0 300 300
0 3 3 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 0 0 0 0 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 13 0 0 0 0 13
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 150 150 0 0 0 0 150
0 0 0 0 0 0 0 0 0
0 300 300 200 0 0 0 100 300
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 0 330 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 1450 800 0 0 0 0 800
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 1150 850 0 0 0 0 850
0 0 0 0 0 0 0 0 0
0 0 3 0 0 0 0 0 0
0 100 100 0 0 0 0 100 100
0 0 0 0 0 0 0 0 0
0 0 60 30 0 0 0 0 30
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 35 31 0 0 0 0 31
0 0 0 0 0 0 0 0 0
0 -3 18 41 0 0 0 3 44
0 0 0 0 0 0 0 0 0
0 0 10 3 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 0
0 0 9 10 0 0 0 0 10
0 0 3 0 0 0 0 2 2
0 0 0 0 0 0 0 0 0
0 0 0 1 0 0 0 0 1
0 0 0 0 0 0 0 0 0
0 0 0 4 0 0 0 0 4
0 0 0 2 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 20 0 0 0 0 0 0
0 0 15 5 0 0 0 0 5
0 0 0 0 0 0 0 0 0
0 0 8 12 0 0 0 0 12
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 20 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 0 2 4 0 0 0 0 4
0 2 16 6 0 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 0 0 0
0 23 26 9 0 0 0 12 21
0 0 3 0 0 0 0 0 0
0 0 3 1 0 0 0 6 7
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 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 4 2 0 0 0 0 2
0 0 5 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 2 1 0 0 0 0 1
0 0 4 1 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 10 0 0 0 0 0 0
0 0 10 0 0 0 0 0 0
0 0 10 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0
0 0 23 1 0 0 0 0 1
0 220 320 0 0 0 0 0 0
0 0 2 1 0 0 0 0 1
0 0 1 2 0 0 0 0 2
0 0 0 1 0 0 0 0 1
0 0 2 1 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 2 3 1 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 1 1 0 0 0 0 1 1
0 0 8 4 0 0 0 0 4
0 0 3 2 0 0 0 0 2
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 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 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 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 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 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 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 3
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 600 400 0 0 0 0 400
0 0 52 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 100 0 0 0 0 100
0 0 25 18 0 0 0 0 18
0 0 0 0 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 300 300 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0
 APRIL 2017 MEI 2017 JUNI 2017
BUFFER TOTAL BUFFER TOTAL BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI KELUAR PROVINSI KELUAR PROVINSI
4 0 0 0 0 4 2 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
200 0 0 0 0 200 100 0 0 0 0 100 150 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 6 6 5 0 0 0 6 11 8 0 0 0 0
0 0 0 0 200 200 150 0 0 0 0 150 350 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 150 150 210 0 0 0 0 210 90 0 0 0 0
0 0 0 0 0 0 26 0 0 0 0 26 12 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 800 800 700 0 0 0 1000 1700 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
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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 25 0 0 0 0 25 -13 0 0 0 0
0 0 0 0 0 0 3 0 0 0 0 3 7 0 0 0 0
0 0 0 0 0 0 20 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 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 11 11 0 0 0 0 41 41 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 450 150 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
100 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0
6 0 0 0 0 6 8 0 0 0 0 8 7 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 300 200 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 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 100 100 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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
KELUAR
0
0
0
150
0
8
350
0
0
0
0
90
12
0
0
300
0
0
700
0
0
20
0
0
 0
0
0
0
0
0
0
0
0
0
0
0
500
0
0
0
0
0
0
0
0
3
0
0
5
0
0
0
0
0
500
3
0
0
0
0
0
0
0
 1
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
150
0
3
0
0
0
0
6
2
0
0
3
0
0
0
0
0
0
0
3
0
0
 0
0
0
10
0
0
0
0
0
0
0
0
50
0
0
350
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
400
0
0
0
0
0
0
0
0
0
0
0
0
100
0
6
0
0
0
0
800
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
55
 0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
100
0
100
0
0
4
250
0
6
0
0
0
0
0
0
0
0
0
0
 0
0
10
0
0
0
0
40
0
0
0
80
0
0
6
0
0
0
0
0
0
0
-1000
0
4
3
0
0
0
0
0
0
0
0
300
0
0
0
0
 0
0
43
0
0
0
0
0
0
0
0
0
0
0
0
0
150
0
100
0
0
0
0
150
0
0
150
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
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

48
0
25
0
11
0
0
0
0
0
0
0
0
0
0
0
27
0
0
1
0
1
0
2
0
0
0
0
0
0
31
11
0
0
0
0
0
0
0
0
0
0
0
0
 9
0
20
52
0
0
16
55
17
27
0
0
0
0
0
0
0
0
0
0
4
0
0
2
0
0
0
0
0
0
0
0
0
1
200
0
0
1
4
 0
0
0
0
3
0
0
0
0
0
0
14
0
0
0
0
1

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-13
7
0
0

0
0
0
0
0
0
0
0
0
0
0
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
0
7
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
0
0
0
0
0
0
0
0
0
0
0
0
0
 JULI 2017 AGUSTUS 2017 SEPTEMBER 2017
BUFFER TOTAL BUFFER TOTAL BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI KELUAR PROVINSI KELUAR PROVINSI
2 0 0 0 0 2 10 0 0 0 0 10 2 0 0 0 0
0 0 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
150 0 0 0 0 150 250 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 0
11 0 0 0 0 11 21 0 0 0 0 21 5 0 0 0 3
100 0 0 0 0 100 400 0 0 0 300 700 0 0 0 0 220
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 95
120 0 0 0 0 120 180 0 0 0 0 180 0 0 0 0 0
18 0 0 0 0 18 18 0 0 0 0 18 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 0 0 0 0 0 0
400 0 0 0 600 1000 1200 0 0 0 700 1900 400 0 0 0 770
0 0 0 0 0 0 0 0 0 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
150 0 0 0 0 150 750 0 0 0 0 750 1200 0 0 0 250
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 300 300 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 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 0 700 1000 1050 0 0 0 300 1350 450 0 0 0 260
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 7 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
13 0 0 0 0 13 2 0 0 0 2 4 0 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 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 200 800 0 0 0 0 800 0 0 0 0 200
13 0 0 0 0 13 16 0 0 0 0 16 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 0 170 0 0 0 0 170 130 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 500 500 0 0 0 0 300 300 0 0 0 0 400
0 0 0 0 2 2 0 0 0 0 8 8 0 0 0 0 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
3 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 50 140 0 0 0 0 140 415 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 5 13 0 0 0 0 13 5 0 0 0 0
2 0 0 0 0 2 2 0 0 0 0 2 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
1 0 0 0 0 1 10 0 0 0 0 10 4 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 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 100 20 0 0 0 0 20 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 0 0 0 0 0 0 0 0
0 0 0 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 70 0 0 0 0 50
0 0 0 0 0 0 0 0 0 0 0 0 80 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 200 400 0 0 0 0 400 400 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
5 0 0 0 0 5 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
50 0 0 0 0 50 70 0 0 0 0 70 320 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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 0 300 300 0 0 0 0 500 500 0 0 0 0 280
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 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
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 300 720 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 100 400 0 0 0 0 400 100 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
4 0 0 0 0 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
300 0 0 0 0 300 900 0 0 0 0 900 1030 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 200 200 0 0 0 0 300 300 0 0 0 0 210
0 0 0 0 8 8 0 0 0 0 15 15 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 13 13 0 0 0 0 36 36 0 0 0 0 11
 0 0 0 0 0 0 0 0 0 0 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 0 0 2 1 0 0 0 0 1 0 0 0 0 0
50 0 0 0 0 50 70 0 0 0 0 70 130 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 200 300 0 0 0 0 300 0 0 0 0 0
0 0 0 0 100 100 20 0 0 0 0 20 150 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 200 0 0 0 0 0 0 500 0 0 0 0
100 0 0 0 0 100 0 0 0 0 0 0 40 0 0 0 0
300 0 0 0 0 300 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
9 0 0 0 0 9 18 0 0 0 0 18 0 0 0 0 0
150 0 0 0 0 150 640 0 0 0 0 640 380 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 3 12 0 0 0 0 12 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 0 0 0 0 0
100 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 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 0 0 4 20 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 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0
120 0 0 0 0 120 310 0 0 0 0 310 210 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 800 800 0 0 0 0 1200 1200 0 0 0 0 380
0 0 0 0 11 11 0 0 0 0 15 15 0 0 0 0 11
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 112 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
1450 0 0 0 0 1450 0 0 0 0 0 0 180 0 0 0 0
0 0 0 0 0 0 0 0 0 0 200 200 0 0 0 0 400
0 0 0 0 1 1 0 0 0 0 0.5 0.5 0 0 0 0 0.5
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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1000 1000 0 0 0 0 1220 1220 0 0 0 0 580
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 300 520 0 0 0 0 520 570 0 0 0 0
0 0 0 0 7 7 0 0 0 0 4 4 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 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 74 26 0 0 0 0 26 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 0 500 500 0 0 0 0 210 210 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 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 200 100 0 0 0 0 100 210 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 400 400 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 30 130 0 0 0 0 130 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
100 0 0 0 0 100 340 0 0 0 0 340 160 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 200 2200 0 0 0 0 2200 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 0 0
0 0 0 0 0 0 60 0 0 0 0 60 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 0 0 0 0 11 52 0 0 0 0 52 8 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
14 0 0 0 0 14 5 0 0 0 0 5 0 0 0 0 0
0 0 0 0 0 0 20 0 0 0 0 20 0 0 0 0 0
6 0 0 0 0 6 2 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
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 14 10 0 0 0 0 10 9 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 7 6 0 0 0 0 6 9 0 0 0 0
5 0 0 0 0 5 11 0 0 0 0 11 2 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 5 6 0 0 0 0 6 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
6 0 0 0 0 6 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 3 3 0 0 0 0 1 1 0 0 0 0 3
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
3 0 0 0 5 8 8 0 0 0 0 8 2 0 0 0 0
7 0 0 0 2 9 19 0 0 0 5 24 18 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 3 9 2 0 0 0 0
0 0 0 0 14 14 0 0 0 0 12 12 0 0 0 0 3
2 0 0 0 0 2 17 0 0 0 0 17 5 0 0 0 0
3 0 0 0 0 3 4 0 0 0 2 6 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 0 144 0 0 0 0 144 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 48 0 0 0 0 0 0 0 0 0 0 0
1 0 0 0 0 1 2 0 0 0 0 2 1 0 0 0 0
0 0 0 0 0 0 8 0 0 0 0 8 12 0 0 0 0
0 0 0 0 0 0 1 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 2 0 0 0 0 0
2 0 0 0 0 2 3 0 0 0 0 3 1 0 0 0 0
25 0 0 0 0 25 25 0 0 0 100 125 0 0 0 0 50
0 0 0 0 0 0 2 0 0 0 0 2 1 0 0 0 0
0 0 0 0 0 0 3 0 0 0 0 3 0 0 0 0 0
4 0 0 0 0 4 10 0 0 0 0 10 6 0 0 0 0
1 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 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 3 3 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 65 0 0 0 0 65 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 3 1 0 0 0 4 5 0 0 0 0 2
1 0 0 0 0 1 9 0 0 0 0 9 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 3 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 9 16 0 0 0 0 16 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 18 0 0 0 0 0
1 0 0 0 0 1 4 0 0 0 0 4 14 0 0 0 0
0 0 0 0 0 0 20 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 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
200 0 0 0 0 200 565 0 0 0 0 565 325 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 220 80 0 0 0 0
2 0 0 0 0 2 16 0 0 0 0 16 12 0 0 0 0
480 0 0 0 0 480 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
380 0 0 0 0 380 120 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
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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
KELUAR
2
150
0
300
0
8
220
0
0
0
95
0
15
0
0
1170
0
1
1450
0
0
0
0
0
 0
0
0
0
0
0
500
0
0
0
0
0
710
0
0
30
0
0
0
0
0
0
0
0
6
0
0
0
0
0
200
14
0
130
0
0
10
0
0
 0
400
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
415
0
0
0
0
0
0
5
1
0
0
6
0
0
0
0
0
0
0
0
0
0
 0
0
0
3
0
0
0
0
0
0
0
50
80
0
0
500
0
0
20
0
320
0
0
0
0
0
0
0
0
0
280
0
0
0
0
0
0
0
80
 0
0
720
0
0
0
0
0
0
0
0
0
0
0
0
100
0
0
0
0
0
0
1030
0
0
0
0
0
0
210
2
0
0
0
0
0
0
0
11
 0
0
0
130
0
0
0
0
0
0
0
0
150
0
0
0
0
0
0
0
500
40
100
0
0
0
380
0
5
0
0
0
0
0
0
0
0
0
0
 0
0
0
0
0
0
0
0
0
0
0
210
0
380
11
0
0
0
0
1
0
0
180
400
0.5
0
0
0
580
0
0
0
0
0
570
5
0
0
0
 0
0
4
0
200
0
0
0
0
0
0
0
0
0
0
0
210
0
0
0
0
0
0
90
0
0
160
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

8
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
0
0
0
9
2
0
2
0
0
0
0
0
2
0
0
0
0
3
0
2
18
0
0
2
3
5
2
0
0
0
0
0
0
0
0
0
0
0
0
0
1
12
4
0
0
0
0
0
0
0
1
50
1
0
6
0
0
0
0
0
1
0
0
0
0
0
2
4
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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
 0
0
0
0
1
0
0
325
0
0
80
12
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 OKTOBER 2017 NOVEMBER 2017 DESEMBER 2017
BUFFER TOTAL BUFFER TOTAL BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI KELUAR PROVINSI KELUAR PROVINSI
22 0 0 0 0 22 0 0 0 0 0 0 0 0 0 0 0
2000 0 0 0 0 2000 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
550 0 0 0 0 550 0 0 0 0 0 0 0 0 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 7 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 780 780 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 235 235 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
11 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 1130 1130 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 750 750 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 200 200 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 840 1040 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 170 170 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
7 0 0 0 0 7 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
310 0 0 0 0 310 0 0 0 0 0 0 0 0 0 0 0
100 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
100 0 0 0 0 100 0 0 0 0 0 0 0 0 0 0 0
11 0 0 0 0 11 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 80 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 500 500 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
 TOTAL
KELUAR
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 JUMLAH
BUFFER TOTAL
DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI KELUAR
48 0 0 0 0 48
2150 0 0 0 0 2150
0 0 0 0 0 0
2000 0 0 0 200 2200
0 0 0 0 0 0
75 0 0 0 22 97
1700 0 0 0 1800 3500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 330 330
780 0 0 0 300 1080
100 0 0 0 0 100
30 0 0 0 14 44
0 0 0 0 0 0
4000 0 0 0 7700 11700
0 0 0 0 0 0
0 0 0 0 10 10
5000 0 0 0 2600 7600
0 0 0 0 0 0
0 0 0 0 0 0
40 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 2000 2000
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 0 0 0 0
0 0 0 0 0 0
4400 0 0 0 4400 8800
0 0 0 0 0 0
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 0 0 0 0 0
0 0 0 0 0 0
59 0 0 0 0 59
0 0 0 0 0 0
0 0 0 0 0 0
50 0 0 0 58 108
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
2700 0 0 0 700 3400
172 0 0 0 0 172
0 0 0 0 0 0
2300 0 0 0 0 2300
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 250 250
0 0 0 0 0 0
0 0 0 0 0 0
 4 0 0 0 0 4
0 0 0 0 4200 4200
0 0 0 0 30 30
0 0 0 0 0 0
0 0 0 0 0 0
3 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
1300 0 0 0 100 1400
0 0 0 0 0 0
30 0 0 0 0 30
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
85 0 0 0 0 85
16 0 0 0 5 21
0 0 0 0 0 0
0 0 0 0 0 0
36 0 0 0 6 42
1 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
50 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 0 0 0 0
0 0 0 0 0 0
850 0 0 0 0 850
0 0 0 0 0 0
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 0 0 10
0 0 0 0 0 0
0 0 0 0 900 900
300 0 0 0 0 300
0 0 0 0 0 0
0 0 0 0 0 0
3000 0 0 0 2800 5800
0 0 0 0 0 0
0 0 0 0 0 0
75 0 0 0 0 75
0 0 0 0 0 0
1750 0 0 0 0 1750
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1000 0 0 0 0 1000
0 0 0 0 5 5
0 0 0 0 1000 1000
0 0 0 0 2200 2200
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 200 200
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 750 750
 0 0 0 0 0 0
700 0 0 0 0 700
3900 0 0 0 400 4300
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1300 0 0 0 0 1300
0 0 0 0 0 0
11 0 0 0 0 11
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
7100 0 0 0 3000 10100
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 2500 2500
0 0 0 0 56 56
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 203 203
 0 0 0 0 0 0
0 0 0 0 0 0
6 0 0 0 0 6
550 0 0 0 0 550
0 0 0 0 0 0
45 0 0 0 0 45
5 0 0 0 0 5
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
20 0 0 0 0 20
1100 0 0 0 0 1100
2300 0 0 0 850 3150
0 0 0 0 0 0
0 0 0 0 750 750
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1300 0 0 0 100 1400
1200 0 0 0 0 1200
1500 0 0 0 250 1750
0 0 0 0 0 0
0 0 0 0 0 0
131 0 0 0 0 131
2300 0 0 0 0 2300
0 0 0 0 0 0
151 0 0 0 0 151
500 0 0 0 0 500
600 0 0 0 0 600
600 0 0 0 0 600
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 0 0 0 0 75
0 0 0 0 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 40
0 0 0 0 30 30
0 0 0 0 0 0
0 0 0 0 0 0
1080 0 0 0 90 1170
0 0 0 0 0 0
0 0 0 0 6600 6600
0 0 0 0 81 81
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
500 0 0 0 0 500
26 0 0 0 0 26
0 0 0 0 0 0
0 0 0 0 0 0
2900 0 0 0 0 2900
0 0 0 0 1600 1600
0 0 0 0 8 8
0 0 0 0 9 9
0 0 0 0 0 0
5 0 0 0 0 5
0 0 0 0 5600 5600
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
3500 0 0 0 1300 4800
0 0 0 0 48 48
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
419 0 0 0 0 419
0 0 0 0 600 600
0 0 0 0 1400 1400
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 1000 1000
0 0 0 0 0 0
2000 0 0 0 100 2100
0 0 0 0 0 0
500 0 0 0 1600 2100
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1100 0 0 0 0 1100
0 0 0 0 0 0
200 0 0 0 0 200
6400 0 0 0 0 6400
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
8000 0 0 0 0 8000
0 0 0 0 0 0
3 0 0 0 0 3
0 0 0 0 400 400
 0 0 0 0 0 0
660 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 0
0 0 0 0 200 200
0 0 0 0 0 0
0 0 0 0 0 0
100 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 1000 1000
0 0 0 0 4 4
0 0 0 0 4 4
0 0 0 0 0 0
1 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 0 0 0 0 0

230 0 0 0 30 260
0 0 0 0 0 0
150 0 0 0 0 150
100 0 0 0 0 100
50 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 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
144 0 0 0 0 144
152 0 0 0 3 155
0 0 0 0 0 0
20 0 0 0 0 20
20 0 0 0 0 20
20 0 0 0 0 20
20 0 0 0 0 20
120 0 0 0 0 120
0 0 0 0 0 0
4 0 0 0 0 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
99 0 0 0 0 99
72 0 0 0 0 72
0 0 0 0 0 0
50 0 0 0 0 50
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 200 200
0 0 0 0 0 0
0 0 0 0 0 0
30 0 0 0 0 30
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 0 0 17 17
0 0 0 0 0 0
56 0 0 0 15 71
120 0 0 0 75 195
0 0 0 0 0 0
0 0 0 0 0 0
87 0 0 0 3 90
30 0 0 0 184 214
50 0 0 0 0 50
90 0 0 0 20 110
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 0 0 2
2 0 0 0 0 2
144 0 0 0 0 144
16 0 0 0 4 20
15 0 0 0 0 15
48 0 0 0 0 48
18 0 0 0 3 21
40 0 0 0 0 40
12 0 0 0 0 12
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
10 0 0 0 0 10
3 0 0 0 0 3
33 0 0 0 0 33
200 0 0 0 920 1120
24 0 0 0 0 24
25 0 0 0 0 25
30 0 0 0 0 30
10 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 0 0 0
10 0 0 0 8 18
0 0 0 0 0 0
65 0 0 0 0 65
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
5 0 0 0 13 18
120 0 0 0 0 120
9 0 0 0 0 9
4 0 0 0 0 4
0 0 0 0 0 0
0 0 0 0 0 0
20 0 0 0 0 20

1 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 0 0 0 0 0
76 0 0 0 0 76
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
76 0 0 0 0 76
50 0 0 0 0 50
41 0 0 0 0 41
0 0 0 0 0 0

0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 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 52
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
11 0 0 0 0 11
0 0 0 0 0 0
0 0 0 0 0 0
3000 0 0 0 0 3000
172 0 0 0 0 172
0 0 0 0 0 0
670 0 0 0 0 670
105 0 0 0 0 105
480 0 0 0 0 480
0 0 0 0 0 0
1500 0 0 0 0 1500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 500 500
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
90 0 0 0 0 90
0 0 0 0 500 500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 Peringatan

Stok Akhir
Menu !
 STOK AKHIR
JANUARI 2017 FEBRUARI 2017
No. Nama Obat Satuan Harga BUFFER STOK BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT
PROVINSI AKHIR PROVINSI
1 Air Untuk Injeksi 20 ml vial 6,000 17 17 15
2 Albendazole tab 400 mg tablet 363 2150 2150 2150
3 Albendazole susp 200 mg/5 ml botol 4,234 0
4 Allopurinol tab 100 mg tablet 143 0 400
5 Allopurinol tab 300 mg tablet 233 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 0
7 Ambroksol tab 30 mg tablet 200 0 300
8 Aminophyllin tab 200 mg tablet 86 0
9 Aminophyllin inj 24 mg ampul 4,204 0
10 Amitriptiline HCl tab 25 mg tablet 123 0
11 Amlodipin tab 5 mg tablet 197 0
12 Amlodipin tab 10 mg tablet 935 120 120
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 0
14 Amoxicillin SK 125 mg/5 ml botol 2,560 6 6 6
15 Amoxicillin tab 250 mg tablet 220 0
16 Amoxicillin tab 500 mg tablet 370 0 300
17 Ampicillin serb inj 1000 mg vial 5,610 0
18 Antasida DOEN susp 60 ml botol 2,213 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrtablet 78 1000 1000 600
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 0
21 Antifungi DOEN kombinasi 30 g pot 1,890 0
22 Antihemoroid DOEN suppo supp 3,200 0 20
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mtablet 3,220 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 tablet 149 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mKapsul 1,650 0
28 Artemether inj 80 mg/mL ampul 24,384 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 0
34 Asam Folat tab 0,4 mg tablet 104 0
35 Asam Folat tab 1 mg tablet 52 0
36 Asam Mefenamat tab 250 mg tablet 175 0
37 Asam Mefenamat tab 500 mg tablet 176 200 200 400
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 0
39 Asiklovir tab 200 mg tablet 251 0
40 Asiklovir tab 400 mg tablet 357 0
41 Atenolol tab 50 mg tablet 387 0
42 Atapulgit tab 600 mg tablet 220 0
43 Atropin tab 0,5 mg tablet 81 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 0
45 Azitromisin tablet 500 mg kaplet 4,725 0
46 Bedak Salisil serb 2% Kotak 1,350 8 8 27
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 0
49 Betametason krim 0,5 mg/g tube 1,596 0 10
50 Betametason tts mata 1 mg/ml botol 25,106 0
51 Bisakodil sup 5 mg supp 4,990 0
52 Bisakodil sup 10 mg supp 6,045 0
53 Bromheksin tab 8 mg tablet 82 0
54 Cefadroksil kaps 250 mg kapsul 564 0
55 Cefadroksil kaps/tab 500 mg kapsul 548 0 300
56 Cefadroksil SK 125 mg/5 mL botol 5,286 19 19 61
57 Cefadroksil SK 250 mg/5 mL botol 6,285 0
58 Cefiksime tab 100 mg kapsul 1,000 0 100
59 Cefiksime sir 100 mg/5 mL botol 9,400 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 0
61 Cetrizine tab 10 mg tablet 190 0
62 Cetrizine sir 5 mg/5 ml botol 8,799 0
63 Cimetidine tab 200 mg tablet 205 0
64 Copper T set/buah 125,483 0
65 Deksametason tab 0,5 mg tablet 68 300 300
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 24 24
67 Diazepam tab 2 mg tablet 47 0
68 Diazepam tab 5 mg tablet 179 0
69 Diazepam inj 5 mg/ml ampul 4,598 3 3 3
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 0
72 Dietil Karbamazin tab 100 mg tablet 150 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 0
74 Digoksin tab 0,25 mg tablet 103 0
75 Diltiazem kaps SR 100 mg kapsul 4,033 0
76 Diltiazem kaps SR 200 mg kapsul 4,417 0
77 Diltiazem tab 30 mg tablet 141 0
78 Dimenhidrinat tab 50 mg tablet 109 0
79 Doksisiklin kaps 100 mg kapsul 298 0
80 Domperidon susp 5 mg/5 ml botol 3,490 0
81 Domperidon tab 10 mg tablet 286 100 100 400
82 Efedrin inj 50 mg/mL tablet 14,650 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 0 30
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 0
86 Eritromisin kaps 250 mg kapsul 522 0
87 Eritromisin kaps 500 mg kapsul 1,023 0
88 Erytromisin SK 200 mg/5 ml botol 8,090 50 50 51
89 Etakridin (Rivanol) lar 0,1% botol 5,456 11 5 16 15
90 Etambutol tab 250 mg tablet 330 0
91 Etambutol tab 500 mg tablet 478 0
92 Etanol 70 % lar 100 ml botol 2,625 0 3
93 Etil Klorida semprot 100 mL botol 175,500 0
94 Etonogestrel implan 68 mg subd implant 128,779 0
95 Fenobarbital tab 30 mg tablet 149 0
96 Fenobarbital tab 100 mg tablet 242 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 0
98 Fenol Gliserol tts telinga 10% botol 1,920 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 0 20
101 Flukonazol kaps 150 mg kapsul 24,200 0
102 Fluor tab 0,5 mg tablet 975 0
103 Furosemid tab 40 mg tablet 84 0
104 Furosemide inj 10 mg/ml ampul 2,012 0
105 Gameksan lotion 1% - 30 ml botol 2,420 0
106 Garam Oralit kombinasi sacchet 317 200 200 620
107 Gemfibrozil kaps 300 mg kapsul 318 0
108 Gentamicin krim 10% tube - 0
109 Gentamicin salep kulit 10% tube - 0
110 Gentamicin salep mata 0,3% tube 2,786 0
111 Gentamicin tts mata 0,3% botol 3,513 0
112 Gentamisin inj 40 mg/ml ampul 3,739 0
113 Gentamisin inj 80 mg/ml vial 4,160 0
114 Glibenklamid tab 5 mg tablet 61 700 700
115 Glimepirid tab 1 mg tablet 278 100 100 250
116 Glimepirid tab 2 mg tablet 458 0
117 Glipizid tab 5 mg tablet 3,000 0
118 Gliseril Guaikolat tab 100 mg tablet 27 0 600
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 0
120 Gliserin lar 50% botol 5,867 0
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 75 75 75
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 0
123 Griseofulvin tab 125 mg tablet 230 450 450 800
124 Haloperidol tab 0,5 mg tablet 62 0
125 Haloperidol tab 1,5 mg tablet 76 0
126 Haloperidol tab 2 mg tablet 134 0
127 Haloperidol tab 5 mg tablet 105 0
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 0
129 Hiosina Butilbromida tab 10 mg tablet 648 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 1000 1000 900
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 0
132 Ibuprofen tab 200 mg tablet 121 0
133 Ibuprofen tab 400 mg tablet 157 200 200
134 Ibuprofen sir 100 mg/5 ml botol 3,849 0
135 Ibuprofen sir 200 mg/5 ml botol 4,949 0
136 Isoniazid tab 100 mg tablet 72 0
137 Isoniazid tab 300 mg tablet 174 0
138 Isosorbid Dinitrat tab 5 mg tablet 98 100 100
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 0
140 Kalsium Karbonat tab 500 mg tablet 448 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 0
142 Kanamisin inj 1.000 mg/vial vial 5,100 0
143 Kaptopril tab 12,5 mg tablet 90 0 400
144 Kaptopril tab 25 mg tablet 138 0 250
145 Kaptopril tab 50 mg tablet 141 0
146 Karbamazepin tab 200 mg tablet 269 0
147 Karbamazepin sir 100 mg/5 mL botol 44,770 0
148 Karbogliserin tts telinga 10% botol 2,246 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 0
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 0
151 Ketokonazole krim 2% - 15 g tube 5,150 0
152 Ketokonazole tab 200 mg tablet 320 0
153 Klaritromisin tab 500 mg tablet 3,600 0
154 Klindamisin kaps 150 mg kapsul 405 0
155 Klindamisin kaps 300 mg kapsul 619 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 0
157 Kloramfenikol kaps 250 mg kapsul 275 1200 1200 900
158 Kloramfenikol kaps 500 mg kapsul 935 0
159 Kloramfenikol salap mata 1% tube 1,680 0
160 Kloramfenikol salep kulit 2% tube 4,138 0
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 0
162 Kloramfenikol tts mata 0,5% botol 20,360 0
163 Kloramfenikol tts telinga 3% botol 11,440 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 0 700
165 Klorpromazin HCl tab 25 mg tablet 75 0
166 Klorpromazin HCl tab 100 mg tablet 162 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 0
168 Kodein HCL tab 10 mg tablet 550 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiotablet 2,298 0
171 Kotrimoxazol tab 480 mg (adult) tablet 152 200 200
172 Kotrimoxazol susp 60 ml botol 2,298 0
173 Kuinin tab 200 mg tablet 737 0
174 Kuinin tab 222 mg tablet 594 0
175 Kuinin inj 25% (i.v) ampul 6,820 0
176 Levofloxacin tab 500 mg tablet 581 0
177 Levofloxacin inf 5 mg/mL botol 43,809 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - 0
179 Lidokain inj 1% (infltr) ampul 929 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 14 14
181 Lidokain gel 2% botol 40,000 0
182 Lidokain semprot 10% botol 156,200 0
183 Lisol lar 1.000 ml botol 49,862 0
184 Loratadin tab 10 mg tablet 333 0
185 Magnesium Sulfat serb 30 g sacchet 3,803 0
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 25 25 45
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 5 5 5
188 Mebendazol tab 100 mg tablet 7,150 0
189 Mebendazol tab 500 mg tablet 7,854 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 15 15 19
192 Metampiron (Antalgin) tab 500 mg tablet 350 500 500 900
193 Metformin tab 500 mg tablet 182 850 850 300
194 Metformin tab 850 mg tablet 280 0
195 Metilergometrin Maleat tab 0.125 mg tablet 169 750 750
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 0
197 Metilprednisolon tab 4 mg tablet 230 0
198 Metilprednisolon tab 8 mg tablet 390 0
199 Metilprednisolon tab 16 mg tablet 875 0
200 Metoklopramid tab 5 mg tablet 113 0
201 Metoklopramid tab 10 mg tablet 100 70 100 170 600
202 Metronidazol tab 250 mg tablet 116 800 800 1100
203 Metronidazol tab 500 mg tablet 169 900 250 1150 1200
204 Metronidazol sir 125 mg/5 ml botol 4,350 0
205 Metronidazol lar inf 5 mg/mL botol 12,980 0
206 Miconazole krim 2% tube 3,150 20 20 33
207 Natrium Diklofenak tab 25 mg tablet 146 0 50
208 Natrium Diklofenak tab 50 mg tablet 193 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 100 100 90
210 Nifedipine tab 10 mg tablet 127 200 200 400
211 Nistatin tab vaginal 100.000 IU ovula 528 290 290 490
212 Nistatin tab vaginal 500.000 IU tablet 704 300 300 500
213 Obat Anti TB Kategori Anak Paket 189,195 0
214 Obat Anti TB Kategori Anak FDC Paket 236,490 0
215 Obat Anti TB Kategori I Paket 317,015 0
216 Obat Anti TB Kategori I FDC Paket 396,000 0
217 Obat Anti TB Kategori I Kombipak Paket 316,920 0
218 Obat Anti TB Kategori II Paket 1,320,000 0
219 Obat Anti TB Kategori II FDC Paket 1,319,990 0
220 Obat Anti TB Kategori III Paket 154,000 0
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 0 20
223 Ofloxacin tab 200 mg tablet 440 0
224 Ofloxacin tab 400 mg tablet 700 0
225 Oksimetazolin tts hidung 0,025 % botol 30,305 0
226 Oksimetazolin tts hidung 0,050 % botol 32,000 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 26 26
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 0
230 Olopatadin tts mata 0,1% botol 68,000 0
231 Omeprazol kaps 20 mg kapsul 409 0
232 Omeprazol inj 40 mg/10 mL vial 42,000 0
233 Paracetamol tab 500 mg tablet 88 200 200
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 0
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 0
236 Perak Sulfadiazin krim 1% tube 25,350 0
237 Permetrin krim 5% tube 11,475 0
238 Pirantel Pamoat tab 125 mg tablet 318 500 500 500
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 11 11 26
240 Pirazinamid tab 500 mg tablet 225 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 700 700 950
243 Piroxicam tab 10 mg tablet 149 0
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 0
245 Povidon Iodida lar 10% - 300 ml botol 15,386 0
246 Povidon Iodida lar 10% - 60 ml botol 6,500 0
247 Povidon Iodida lar 10% - 30 ml botol 2,344 0
248 Prednison tab 5 mg tablet 192 0
249 Primakuin tab 15 mg tablet 205 0
250 Probenesid tab 500 mg tablet 1,815 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 0
252 Propranolol tab 10 mg tablet 80 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 0
254 Ranitidin tab 150 mg tablet 220 0
255 Ranitidin inj 25 mg/mL ampul 1,340 25 25
256 Retinol (Vit A) softcap 100.000 IU softcap 286 0
257 Retinol (Vit A) softcap 200.000 IU softcap 505 0
258 Rifampicin kaps 300 mg kapsul 670 0
259 Rifampicin tab 450 mg tablet 868 0
260 Rifampicin tab 600 mg tablet 1,209 0
261 Ringer Laktat lar inf steril 500 ml botol 4,727 21 21 60
262 Salbutamol tab 2 mg tablet 65 0
263 Salbutamol tab 4 mg tablet 93 0
264 Salbutamol cairan ih 0,1% botol 7,260 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 0
268 Serum Antidifteri inj 10,000 IU vial - 0
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 0
270 Serum Antitetanus inj 1.500 IU vial 161,000 0
271 Serum Antitetanus inj 10.000 IU vial - 0
272 Serum Antitetanus inj 20.000 IU vial 324,550 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 0
275 Simvastatin tab 10 mg tablet 294 0 350
276 Simvastatin tab 20 mg tablet 480 0
277 Siprofloksasin tab 500 mg tablet 290 100 100 500
278 Spironolakton tab 25 mg tablet 350 0
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folattablet 112 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 0
282 Tetrasiklin kaps 250 mg kapsul 162 30 30 200
283 Tetrasiklin kaps 500 mg kapsul 325 0
284 Thiamfenikol kaps 500 mg kapsul 985 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 1250 1250 1800
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 0
287 Tramadol inj 50 mg/mL ampul 2,680 0
288 Triheksipenidil tab 2 mg tablet 70 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 0
290 Valproat tab sal 250 mg tablet salut 1,680 0
291 Valproat tab sal 500 mg tablet salut 5,450 0
292 Valproat sir 250 mg/5 mL botol 41,800 0
293 Vankomisin serb inj 500 mg/vial vial 142,000 0
294 Vitamin B Kompleks tablet 112 0 850
295 Zinc sir 10 mg/ml botol 16,478 0
296 Zinc sir 20 mg/5 ml botol 8,140 0
297 Zinc dispersible 20 mg tablet 521 0
298 Alprazolam tab 1 mg tablet 245 0
299 Betahistin tab 6 mg tablet - 0 240
300 Idometasin kapl 25 mg kaplet 380 0
301 Karbon Aktif tab 125 mg tablet 127 0
302 Klobazam tab 10 mg tablet 950 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 0
304 Loperamid tab 2 mg tablet 97 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 0
306 Papaverin 40 mg tablet - 0
307 Piracetam tab 400 mg tablet - 100 100 80
308 Thiamfenikol tab 250 mg tablet - 0
309 Piracetam tab 800 mg tablet - 0
310 Piroxicam tab 20 mg tablet - 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet - 0
312 Etanol 70% lar 1000 ml botol - 0
313 Etanol 70% lar 300 ml botol - 0
314 Neurosanbe injeksi ampul - 0
315 H2O2 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
BAHAN MEDIS HABIS PAKAI 0
1 Alat Suntik 1 ml pcs 1,262 13 13 70
2 Alat Suntik 2.5 ml pcs 1,102 0
3 Alat Suntik 3 ml pcs 1,010 0 79
4 Alat Suntik 5 ml pcs 1,248 0 100
5 Alat Suntik 10 ml pcs 1,694 0 40
6 Alat Suntik 20 ml pcs 2,228 0
7 Alat Suntik 50 ml pcs 10,350 0
8 Alat Suntik ADS 0,5 ml pcs 1,925 0
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 0
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 0
11 Alat Suntik ADS 5 ml BCG pcs 2,585 0
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 0
17 Catgut no.2/0 pcs 213,525 0 15
18 Catgut no.3/0 pcs 213,525 72 3 75 93
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 0
20 Catheter (folley cathteter) no.10 pcs 13,750 0 10
21 Catheter (folley cathteter) no.12 pcs 13,750 0 10
22 Catheter (folley cathteter) no.14 pcs 13,750 0 10
23 Catheter (folley cathteter) no.16 pcs 13,750 0 10
24 Catheter (folley cathteter) no.18 pcs 13,750 0 10
25 Cholesterol test btl/10 strip botol 320,000 0
26 Copper T set 125,000 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 0
30 Glukosa test btl/25 strip botol 180,000 0
31 Hand Schoen no 7 set 14,850 0
32 Hand Schoen no 7.5 set 14,850 0 5
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 0
34 Hand Schoen no 8 set 14,850 0 12
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 20 20
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 0
44 Hand Schoen (Examination Gloves Size S) set 57,750 0
45 Hand Schoen (Examination Gloves Size M) set 57,750 0
46 Hand Schoen (Examination Gloves Size L) set 57,750 0
47 Infusion Set Anak set 6,375 36 36 54
48 Infusion Set Dewasa set 12,100 0 6
49 Infusion Set Macro 2 Cabang set 35,000 0
50 IV Catheter no. 16 pcs 8,948 0
51 IV Catheter no. 18 pcs 8,948 44 44 64
52 IV Catheter no. 20 pcs 8,948 10 10 17
53 IV Catheter no. 22 pcs 8,948 0 17
54 IV Catheter no. 24 pcs 8,948 11 11 17
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 0
61 Jarum Jahit Otot all size lusin 18,500 0
62 Jarum Jahit 1/2 Surgical lusin 135,000 0 1
63 Jarum Jahit 3/8 Surgical lusin 120,000 0 1
64 Kaca Slide pcs 50,000 0
65 Kapas Pembalut 250 g roll 22,000 0 8
66 Kapas Pembalut 500 g roll 35,000 0 5
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 0
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 0 3
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 0 6
70 Kasa Pembalut 2 m x 80 cm roll 13,366 0
71 Kasa Pembalut 4 m x 5 cm roll - 0
72 Kasa Pembalut 4 m x 10 cm roll 2,601 0
73 Kasa Pembalut 4 m x 15 cm roll - 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 0
77 Kasa Steril 16 cm x 16 cm box 6,743 0
78 Kasa Steril 18 cm x 22 cm box 16,500 0 1
79 Masker Ear Loop Pcs 495 20 20
80 Mata Pisau Bedah No. 10 pcs 9,750 0 3
81 Mata Pisau Bedah No. 11 Pcs 9,750 0 4
82 Mata Pisau Bedah No. 15 Pcs 9,750 0 10
83 Mata Pisau Bedah No. 21 Pcs 9,750 0 8
84 Nasal Oxygen (Aximed) size M Pcs 6,600 0
85 Nasal Oxygen (Aximed) size L Pcs 6,600 0
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 0
87 Plester 5 yard x 2 inchi roll 7,186 0
88 Plester 5 cm x 4,5 cm roll - 2 2 4
89 Plester 7,5 cm x 4,5 cm roll 34,650 0
90 Pot Sputum pot 2,000 0
91 RDT pcs - 0
92 Regulator Oxygen pcs 450,000 0
93 Safety Box kotak - 0
94 Selang Oxygen pcs 8,250 2 2
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 84 84 76
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 6 6 3
97 Sound Timer unit 1,219,143 3 3 2
98 Stempel ISPA pcs - 0
99 Uric Acid test btl/25 strip botol 240,000 0
100 Urine bag pcs 6,875 4 4 14
0
0
0
BHP/REAGENT LAB 0
1 Cairan Spritus 1000 ml botol 15,000 1 1
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 0
3 Larutan Asam Klorida (HCl) 0,1 N botol - 0
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 0
5 Larutan Benedik botol 40,040 0
6 Larutan Eosin 2% botol 36,595 0
7 Larutan Etanol Asam botol 34,126 0
8 Larutan Giemsa Stein botol 63,348 0
9 Larutan Karbol Fuksin botol 23,231 0
10 Larutan Metanol botol 118,300 0
11 Larutan Metilen Biru botol 17,086 0
12 Larutan Turk botol 54,600 0
13 Reagen TBC kit - 0
14 Test Asam Urat test 250,000 0
15 Test Comburt Reagens set 251,200 0
16 Test Golongan Darah set 286,365 0
17 Test Golongan Darah Reagens set 251,200 0
18 Test Gula Darah test 200,000 0
19 Test Kehamilan strip 2,400 0
20 Test Kolesterol test 350,000 0
21 Test Urine Rutin strip 3,000 0
0
0
0
GIGI 0
1 Air raksa Dental Use - 108,195 0
2 Devitalisasi pasta (arsen) kotak 390,000 0
3 Eugenol cairan 10 ml botol 18,333 0
4 Fluoride 0.5 mg tablet 30,000 0
5 Fluoride 1 mg tablet 4,456 0
6 Hemospon (Spongostan Dental) pcs 536,250 0
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 0
9 Kalsium Hidroksida Pasta tube 341,250 0
10 Klorheksidin lar 0,2% botol - 0
11 Klorheksidin lar 15% botol - 0
12 Mata Bor Gigi pcs 48,750 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 0
15 Trikresol Formalin (TKF) cairan botol 7,239 0
0
0
0
OBAT KHUSUS 0
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 0
3 Becefort sir 60 ml botol 26,230 0
4 Bronex (Bromheksin) tab 8 mg tablet 82 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 0
6 Fluoride 1 mg tablet 976 0
7 Kandistatin susp 12 ml botol 36,300 0
8 KY Jelly tube 85,000 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 0
10 Norit (Karbon Aktif) tab 125 mg tablet - 0
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 0
12 Pehavral tablet salut 70,785 0
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 0
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 0
17 Vaksin Antirabies Vero (VAR) vial 48,400 0

18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 2 2 3

19 Cendo Xytrol TM 5 ml botol 35,850 0

20 Formalin 40 % botol 42,000 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 0 400
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 52 52
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 500 500 500
25 Vical susp 100 ml botol 4,890 0 35
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 480 480 480
27 Vinafluor (Fluoride) kapl 1 mg kaplet - 0
28 Sanmol (Parasetamol) 500 mg tablet 325 0
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 0
30 Purecemia (Allopurinol) 300 mg tablet 3,269 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 0
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 0
36 Histigo (Betahistin) tab 6 mg tablet - 0
37 Novadium (Loperamid) tab 2 mg tablet - 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - 0
39 Metolon (Metoklorperamid) tab 10 mg tablet - 0
40 Novabion tablet - 0
41 Novagesic (Parasetamol) tab 500 mg tablet - 0
42 Defamol (Parasetamol) tab 500 mg tablet - 0
43 Sultrimix syrup botol - 0
44 Biovitan syrup botol - 0
45 Caviplex syrup botol - 0
46 Farsifen (Ibuprofen) syrup botol - 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet - 0
48 Lexigo (Betahistin) tab 6 mg tablet - 0
49 Loric (Allopurinol) tab 100 mg tablet - 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - 0
51 Arkavit tablet - 0
52 Novadex (Dexametason) 0,5 mg tablet - 0
53 Carbidu (Dexametason) 0,5 mg tablet - 0
54 Gralixa (Furosemid) 40 mg tablet - 0
55 Grafazol (Metronidazol) tab 500 mg tablet - 0
56 Glikos (Metformin) tab 500 mg tablet - 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet - 90 90 80
59 Trifadium ( Loperamide HCL 2 mg) tablet - 0
0 0 0 - 0
0 0 0 - 0
0 0 0 - 0
0 0 0 - 0
UARI 2017 MARET 2017
STOK BUFFER STOK
PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
AKHIR PROVINSI AKHIR
15 12 12
2150 2150 2150
0 0
400 200 200
0 0
0 0
300 600 200 200
0 0
0 0
0 0
0 0
0 0
0 0
6 0
0 0
500 800 0
0 0
0 0
600 200 200
0 0
0 0
20 20 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
500 900 100 100
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
27 10 10
0 0
0 0
25 35 20 20
0 0
0 0
0 0
0 0
0 0
100 400 0
61 43 43
0 0
100 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
23 23 23 23
0 0
0 0
3 3 3
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
80 480 300 80 380
0 0
30 29 29
0 0
0 0
0 0
0 0
51 51 51
5 20 9 4 13
0 0
0 0
3 3 3
0 0
0 0
0 0
0 0
0 0
0 0
0 0
20 20 20
0 0
0 0
 0 0
0 0
0 0
620 470 470
0 0
0 0
0 0
0 0
0 0
0 0
0 0
500 500 400 400
250 150 150
0 0
0 0
1000 1600 600 600
0 0
0 0
75 75 75
0 0
800 700 700
0 0
0 0
0 0
0 0
0 0
0 0
900 900 900
0 0
0 0
0 0
0 0
0 0
0 0
0 0
100 100 100 100
0 0
0 0
0 0
 0 0
400 200 200
250 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
900 900 900
0 0
0 0
0 0
0 0
0 0
0 0
1000 1700 500 1000 1500
0 0
0 0
0 0
0 0
0 0
0 0
300 300 200 200
9 9 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
11 11 0
 0 0
0 0
0 0
0 0
0 0
45 45 45
5 5 5
0 0
0 0
0 0
19 18 18
900 700 700
750 1050 300 550 850
0 0
750 750 750 750
0 0
0 0
0 0
0 0
0 0
100 700 400 100 500
1100 1100 1100
250 1450 1100 250 1350
0 0
0 0
33 27 27
50 0
0 0
90 80 80
400 400 400
490 490 490
500 500 500
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
20 7 7
0 0
0 0
0 0
0 0
0 0
9 9 0
0 0
0 0
0 0
0 0
500 500 0
7 7 0
0 0
0 0
0 0
500 412 412
26 26 26
0 0
0 0
950 950 950
300 300 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
300 300 0
22 22 20 20
0 0
0 0
0 0
 0 0
0 0
60 47 47
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
350 200 200
0 0
300 800 300 200 500
0 0
0 0
0 0
0 0
200 200 200
0 0
0 0
1800 1000 1000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
850 0
0 0
0 0
200 200 100 100
 0 0
240 210 210
0 0
0 0
0 0
0 0
0 0
0 0
0 0
80 80 80
0 0
0 0
0 0
0 0
1 1 1 1
0 0
0 0
1 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
0 0
0 0
8 78 39 8 47
0 0
3 82 38 38
100 100 100
40 37 37
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
15 5 5
3 96 93 1 94
0 0
10 9 9
10 10 10
10 6 6
10 8 8
10 10 10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
5 0
0 0
12 0
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 50 50
6 0
0 0
0 0
64 64 64
12 29 8 8
17 17 17
11 28 16 5 21
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 1 1
1 1 1
0 0
2 10 6 2 8
5 5 5
0 0
3 2 2
6 5 5
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 0
0 0
3 2 2
4 2 2
10 9 9
8 7 7
 0 0
0 0
0 0
0 0
4 3 3
0 0
0 0
0 0
0 0
0 0
1 1 0
76 72 72
3 1 1
2 2 2
0 0
0 0
14 14 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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
400 0
0 0
0 0
500 400 400
35 17 17
480 480 480
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
200 200 100 100
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
0 0
80 80 80
0 0
0 0
0 0
0 0
0 0
 APRIL 2017 MEI 2017 JUNI 2017
BUFFER STOK BUFFER STOK BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI AKHIR PROVINSI AKHIR PROVINSI
8 8 16 16 16
2150 2150 2150 2150 2150
0 0
0 400 400 250
0 0
6 6 15 15 7
0 350 350
0 0
0 0
0 0
0 0
0 90 90
0 24 24 12
0 0
0 0
1000 1000 300 300
0 0
0 0
200 200 800 800 100
0 0
0 0
20 20 30 30 10
0 0
0 0
 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
400 400 300 200 500
0 0
0 0
300 300 200 200 200
0 0
0 0
0 0
0 0
0 0
5 5 10 10 7
0 0
0 0
5 5 20 20 15
0 0
0 0
0 0
0 0
0 0
0 500 500
19 19 56 56 53
0 0
0 200 200 200
0 0
0 0
0 0
0 0
0 0
 0 2 2 1
0 0
20 20 20 20 19
0 0
0 0
3 3 3 3 3
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
200 200 400 400 250
0 0
29 29 29 29 26
0 0
0 0
0 0
0 0
48 48 33 33 27
9 3 12 7 2 9 7
0 0
0 0
1 1 12 12 9
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3 3 3 3
0 0
0 0
 0 0
0 0
0 0
400 400 310 310 300
0 0
0 0
0 0
0 0
0 0
0 0
0 0
400 400 400 400 400
150 150 150 150 100
0 0
0 0
0 350 350
0 0
0 0
75 75 75 75 75
0 0
600 600 600 600 550
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
200 200 0
0 0
0 0
0 0
0 0
0 0
100 100 100 100 100
0 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 0
0 0
0 0
900 900 700 700 600
0 0
0 10 10 4
0 0
0 0
0 0
0 0
450 450 1000 1000 200
0 0
0 0
0 0
0 0
0 0
0 0
200 200 100 100 100
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 50 50 15
 0 0
0 0
0 0
0 250 250 250
0 0
45 45 45 45 45
5 5 5 5 5
0 0
0 0
0 0
18 18 18 18 18
700 700 600 600 500
300 550 850 800 550 1350 800 550
0 0
750 750 750 750 750
0 0
0 0
0 0
0 0
0 0
400 400 800 800 700
1000 1000 1000 1000 1000
1000 200 1200 900 200 1100 800 200
0 0
0 0
24 24 37 37 33
0 750 750 500
0 0
75 75 75 75 69
400 400 400 400 400
490 490 400 400 400
500 500 500 500 500
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
0 14 14 4
0 0
0 0
0 0
0 0
0 40 40
0 0
5 5 5 5 5
0 0
0 320 320 240
0 0
0 0
14 14 6 6
0 0
0 0
0 0
412 412 412 412 412
26 26 26 26 26
0 0
0 0
950 950 950 950 1950
0 0
0 0
3 3 5 5 2
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 700 700 400
16 16 0
0 0
0 0
0 0
 0 0
0 0
17 17 107 107 64
350 350 0
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 50 500 500 350
0 0
100 100 100 100
0 0
0 0
0 0
0 0
100 100 400 400 250
0 0
0 0
0 750 750 600
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 1300 1300 800
0 0
0 0
0 0
 0 0
180 180 360 360 360
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 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
20 20 57 57 9
0 0
33 33 50 50 25
100 100 100 100 100
31 31 31 31 20
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 36 36 9
72 72 48 48 48
0 0
9 9 19 19 18
10 10 20 20 20
3 3 13 13 12
8 8 17 17 17
7 7 13 13 11
0 0
0 0
0 0
0 0
0 0
0 0
0 33 33 2
0 11 11
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 1 0
 0 5 5
0 0
43 43 30 30 20 5
10 10 37 3 40 3 2
0 0
0 0
62 62 62 3 65 46 3
10 10 35 35
15 15 22 22 5
14 4 18 34 4 38 7 4
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 1 1 1 1
1 1 1 1 1
0 0
6 2 8 10 2 12 8
5 5 10 10 10
0 0
1 2 3 5 5 3
4 4 20 20 20
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 5 5 4
100 100 0
1 1 10 10 10
0 10 10 10
9 9 16 16 15
6 6 5 5 1
 0 0
0 0
0 0
0 0
0 3 3
0 0
0 0
0 0
0 0
0 0
0 0
60 60 81 81 67
0 0
2 2 0
0 0
0 0
8 8 6 6 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 0
0 0
0 0
0 0
0 0
0 0 13
 0 47 47 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
41 41 0
0 0
0 0
0 0
0 0
0 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 5 5

0 0
0 0
0 1550 1550 1400
0 100 100 100
0 0
300 300 400 400 400
11 11 18 18 11
480 480 480 480 480
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
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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 80 80 80 80
0 0
0 0
0 0
0 0
0 0
STOK
AKHIR
16
2150
0
250
0
7
0
0
0
0
0
0
12
0
0
0
0
0
100
0
0
10
0
0
 0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
200
0
0
0
0
0
7
0
0
15
0
0
0
0
0
0
53
0
200
0
0
0
0
0
 1
0
19
0
0
3
0
0
0
0
0
0
0
0
0
0
0
250
0
26
0
0
0
0
27
7
0
0
9
0
0
0
0
0
0
0
0
0
0
 0
0
0
300
0
0
0
0
0
0
0
400
100
0
0
0
0
0
75
0
550
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
0
0
0
0
0
0
0
0
600
0
4
0
0
0
0
200
0
0
0
0
0
0
100
0
0
0
0
0
0
0
0
15
 0
0
0
250
0
45
5
0
0
0
18
500
1350
0
750
0
0
0
0
0
700
1000
1000
0
0
33
500
0
69
400
400
500
0
0
0
0
0
0
0
 0
0
4
0
0
0
0
0
0
5
0
240
0
0
0
0
0
0
412
26
0
0
1950
0
0
2
0
0
0
0
0
0
0
0
400
0
0
0
0
 0
0
64
0
0
0
0
0
0
0
0
0
0
0
0
0
350
0
0
0
0
0
0
250
0
0
600
0
0
0
0
0
0
0
0
800
0
0
0
 0
360
0
0
0
0
0
0
0
0
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
25
100
20
0
0
0
0
0
0
0
0
0
0
0
9
48
0
18
20
12
17
11
0
0
0
0
0
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
25
5
0
0
49
0
5
11
0
0
0
0
0
0
0
1
1
0
8
10
0
3
20
0
0
0
0
0
0
0
0
4
0
10
10
15
1
0
0
0
0
0
0
0
0
0
0
0
67
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
13
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
1400
100
0
400
11
480
0
0
0
0
0
0
0
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
0
0
0
0
0
 JULI 2017 AGUSTUS 2017 SEPTEMBER 2017
BUFFER STOK BUFFER STOK BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI AKHIR PROVINSI AKHIR PROVINSI
34 34 24 24 22
2150 2150 2150 2150 2000
0 0
1100 1100 850 850 550
0 0
26 26 5 5 7
400 400 0 780
0 0
0 0
0 0
0 0 235
180 180 0
44 44 26 26 11
0 0
0 0
1600 1600 400 200 600 1130
0 0
0 0 9
1950 1950 1200 1200 750
0 0
0 0
10 10 10 10 10
0 0
0 0
 0 0
0 0
0 0
0 0
0 0
0 0
0 700 700 200
0 0
0 0
0 0
0 0
0 0
1700 1700 650 200 850 200 840
0 0
0 0
200 200 200 200 170
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
2 2 6 6
0 0
0 0
0 0
0 0
0 0
800 800 0
85 85 69 69 55
0 0
1700 1700 1530 1530 1400
0 0
0 0
0 0 240
0 0
0 0
 3 3 3 3 3
0 400 400 1000
17 17 9 9 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
700 700 560 560 145
0 0
26 26 26 26 26
0 0
0 0
0 0
0 0
22 22 9 9 4
5 5 3 3 2
0 0
0 0
14 14 4 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
200 200 180 180 177
0 0
0 0
0 0
0 0
0 0
10 10 10 10 10
0 0
400 400 330 330 280
100 100 100 100 20
0 0
0 0
800 800 400 400 700
0 0
0 0
70 70 70 70 50
0 0
1000 1000 930 930 610
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
200 200 0 520
0 0
0 0
0 0
0 0
100 100 100 100 100
0 0
0 0
0 0 670
 0 0
0 0
2000 2000 1700 1700 980
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
500 500 100 100
0 0
0 0
0 0
0 0
0 0
0 0
2900 2900 2000 2000 970
0 0
0 0
0 0
0 0
0 0
0 0
100 100 200 200 790
7 7 2 2 10
0 0
0 0
0 0
0 0
0 0
0 0
0 0
17 17 5 5 15
 0 0
0 0
2 2 1 1 1
450 450 380 380 250
0 0
45 45 45 45 45
5 5 5 5 5
0 0
0 0
0 0
18 18 18 18 18
300 300 0
2300 450 2750 2280 450 2730 2130 450
0 0
750 750 650 650 650
0 0
0 0
0 0
0 0
0 0
500 500 500 500
900 900 900 900 860
500 200 700 500 200 700 500 100
0 0
0 0
72 72 54 54 54
1150 1150 510 510 130
0 0
106 106 94 94 89
400 400 400 400 400
500 500 500 500 500
500 500 500 500 500
0 0
0 0
0 0
0 0
0 0
0 0
0 0
 0 0
0 0
20 20 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
570 570 260 260 50
0 0
0 0 1620
5 5 2 2 1
0 0
0 0
0 0
300 300 300 300 300
26 26 26 26 25
0 0
0 0
1500 1500 1500 1500 1320
0 200 200 400
1 1 0.5 0.5 2
0 0
0 0
0 0
1000 1000 380 380 800
0 0
0 0
0 0
0 0
0 0
2100 2100 1580 1580 1010
8 8 4 4 5
0 0
0 0
0 0
 0 0
0 0
170 170 144 144 140
0 0
100 100 190 190 490
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1150 1150 1050 1050 840
0 0
100 100 0 200
0 0
0 0
0 0
0 0
220 220 90 90
0 0
0 0
1500 1500 1160 1160 1000
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
3600 3600 1400 1400 1310
0 0
0 0
0 0
 0 0
510 510 450 450 450
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 0
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 70 18 18 10
0 0
11 11 6 6 6
100 100 80 80 80
14 14 12 12 12
 0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
67 67 57 57 48
96 96 96 96 96
0 0
18 18 18 18 18
20 20 20 20 20
12 12 12 12 12
17 17 17 17 17
110 110 110 110 110
0 0
0 0
0 0
0 0
0 0
0 0
24 24 18 18 9
21 21 10 10 8
0 0
25 25 19 19 17
0 0
0 0
0 0
0 0
0 0
24 24 24 24 22
0 0
0 0
0 0
0 0
 0 2 2
0 0
17 17 9 9 7
46 5 51 27 27 9
0 0
0 0
56 3 59 50 50 48
0 6 6 20
23 23 6 6 1
54 4 58 50 2 52 50
0 0
0 0
0 0
0 0
0 0
0 0
0 0
1 1 1 1 1
1 1 1 1 1
144 144 0
8 8 8 8 8
10 10 10 10 10
0 0
10 10 8 8 7
30 30 22 22 10
10 10 9 9 5
0 0
0 0
0 0
0 0
0 0
0 0
2 2 0
6 6 3 3 2
25 25 0
19 19 17 17 16
20 20 17 17 17
21 21 11 11 5
0 0
 0 0
0 0
0 0
0 0
1 1 1 1 1
0 0
65 65 0
0 0
0 0
0 0
2 2 1 5 6 1 3
66 66 57 57 53
0 0
0 0
0 0
0 0
10 10 7 7 7
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
41 41 25 25 25
0 0
0 0
0 0
63 63 45 45 45
39 39 35 35 21
20 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

8 8 8 8 7

0 0
0 0
1200 1200 635 635 310
100 100 100 100 100
0 0
400 400 180 180 100
39 39 23 23 11
0 0
0 0
120 120 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 0
0 0
80 80 80 80 80
0 0 500
0 0
0 0
0 0
0 0
STOK
AKHIR
22
2000
0
550
0
7
780
0
0
0
235
0
11
0
0
1130
0
9
750
0
0
10
0
0
 0
0
0
0
0
0
200
0
0
0
0
0
1040
0
0
170
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
55
0
1400
0
0
240
0
0
 3
1000
5
0
0
0
0
0
0
0
0
0
0
0
0
0
0
145
0
26
0
0
0
0
4
2
0
0
4
0
0
0
0
0
0
0
0
0
0
 0
0
0
177
0
0
0
0
0
10
0
280
20
0
0
700
0
0
50
0
610
0
0
0
0
0
0
0
0
0
520
0
0
0
0
100
0
0
670
 0
0
980
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
970
0
0
0
0
0
0
790
10
0
0
0
0
0
0
0
15
 0
0
1
250
0
45
5
0
0
0
18
0
2580
0
650
0
0
0
0
0
0
860
600
0
0
54
130
0
89
400
500
500
0
0
0
0
0
0
0
 0
0
0
0
0
0
0
0
0
0
0
50
0
1620
1
0
0
0
300
25
0
0
1320
400
2
0
0
0
800
0
0
0
0
0
1010
5
0
0
0
 0
0
140
0
490
0
0
0
0
0
0
0
0
0
0
0
840
0
200
0
0
0
0
0
0
0
1000
0
0
0
0
0
0
0
0
1310
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
10
0
6
80
12
 0
0
0
0
0
0
0
0
0
0
0
48
96
0
18
20
12
17
110
0
0
0
0
0
0
9
8
0
17
0
0
0
0
0
22
0
0
0
0
0
0
7
9
0
0
48
20
1
50
0
0
0
0
0
0
0
1
1
0
8
10
0
7
10
5
0
0
0
0
0
0
0
2
0
16
17
5
0
0
0
0
0
1
0
0
0
0
0
4
53
0
0
0
0
7
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
25
0
0
0
45
21
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 0
0
0
0

0
0
310
100
0
100
11
0
0
0
0
0
0
0
0
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
500
0
0
0
0
 OKTOBER 2017 NOVEMBER 2017 DESEMBER 2017
BUFFER STOK BUFFER STOK BUFFER
DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI AKHIR PROVINSI AKHIR PROVINSI
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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
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0 0
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0 0
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0 0
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0 0
0 0
0 0
0 0
0 0
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0 0
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0 0
0 0
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0 0
0 0
0 0
0 0
0 0
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0 0
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0 0
0 0
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0 0
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0 0
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0 0
0 0
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0 0
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0 0
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0 0
0 0
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0 0
0 0
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0 0
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0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0

0 0

0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
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0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
0 0
STOK
AKHIR
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
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0
0
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0
0
0
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0
0
0
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0
0
0
0
0
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0
0
0
0
0
0
0
0
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0
0
0
0
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0
0
0
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0
0
0
0
0
0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
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0
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0
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0
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0
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0
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0
0
0
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0
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0
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0
0
0
0
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0
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0
0
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0
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0
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0
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0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
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0
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0
0
0
0
0
0
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0
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0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
 JUMLAH
BUFFER STOK
DAU/PKD PUSAT PROGRAM BPJS-JKN
PROVINSI AKHIR
164 0 0 0 0 164
19200 0 0 0 0 19200
0 0 0 0 0 0
3750 0 0 0 0 3750
0 0 0 0 0 0
53 0 0 0 13 66
1050 0 0 0 1280 2330
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 235 235
270 0 0 0 120 390
117 0 0 0 0 117
6 0 0 0 6 12
0 0 0 0 0 0
2600 0 0 0 2830 5430
0 0 0 0 0 0
0 0 0 0 9 9
4850 0 0 0 1950 6800
0 0 0 0 0 0
0 0 0 0 0 0
130 0 0 0 0 130
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 1000 1000
0 0 0 0 900 900
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
3350 0 0 0 2340 5690
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 1270 1270
0 0 0 0 0 0
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 0 0 0 0 67
0 0 0 0 0 0
0 0 0 0 0 0
47 0 0 0 56 103
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
1600 0 0 0 100 1700
460 0 0 0 0 460
0 0 0 0 0 0
5130 0 0 0 0 5130
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 240 240
0 0 0 0 0 0
0 0 0 0 0 0
 12 0 0 0 0 12
0 0 0 0 1700 1700
0 0 0 0 160 160
0 0 0 0 0 0
0 0 0 0 0 0
18 0 0 0 0 18
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
2955 0 0 0 260 3215
0 0 0 0 0 0
221 0 0 0 0 221
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
295 0 0 0 0 295
68 0 0 0 19 87
0 0 0 0 0 0
0 0 0 0 0 0
46 0 0 0 4 50
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 0 0 0 0 46
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
2857 0 0 0 0 2857
0 0 0 0 0 0
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
0 0 0 0 0 0
0 0 0 0 3810 3810
1120 0 0 0 0 1120
0 0 0 0 0 0
0 0 0 0 0 0
2750 0 0 0 1700 4450
0 0 0 0 0 0
0 0 0 0 0 0
640 0 0 0 0 640
0 0 0 0 0 0
6240 0 0 0 0 6240
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
2800 0 0 0 0 2800
0 0 0 0 0 0
0 0 0 0 200 200
0 0 0 0 920 920
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 900 900
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 670 670
 0 0 0 0 0 0
600 0 0 0 0 600
5330 0 0 0 0 5330
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
5800 0 0 0 0 5800
0 0 0 0 0 0
14 0 0 0 0 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
8720 0 0 0 2000 10720
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 2190 2190
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 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 127 127
 0 0 0 0 0 0
0 0 0 0 0 0
4 0 0 0 0 4
1580 0 0 0 0 1580
0 0 0 0 0 0
385 0 0 0 0 385
45 0 0 0 0 45
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
160 0 0 0 0 160
4200 0 0 0 0 4200
9210 0 0 0 5150 14360
0 0 0 0 0 0
0 0 0 0 6550 6550
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
3970 0 0 0 300 4270
8660 0 0 0 0 8660
7400 0 0 0 1850 9250
0 0 0 0 0 0
0 0 0 0 0 0
354 0 0 0 0 354
3090 0 0 0 0 3090
0 0 0 0 0 0
778 0 0 0 0 778
3400 0 0 0 0 3400
4060 0 0 0 0 4060
4300 0 0 0 0 4300
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
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 0 0 0 0 65
0 0 0 0 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 40
0 0 0 0 35 35
0 0 0 0 15 15
0 0 0 0 0 0
1440 0 0 0 0 1440
0 0 0 0 0 0
0 0 0 0 2320 2320
0 0 0 0 35 35
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
3548 0 0 0 0 3548
218 0 0 0 0 218
0 0 0 0 0 0
0 0 0 0 0 0
10770 0 0 0 0 10770
0 0 0 0 900 900
0 0 0 0 3.5 3.5
0 0 0 0 10 10
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 2180 2180
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
5790 0 0 0 300 6090
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 0 0 0 0
0 0 0 0 0 0
770 0 0 0 0 770
0 0 0 0 350 350
0 0 0 0 780 780
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
4490 0 0 0 0 4490
0 0 0 0 0 0
1000 0 0 0 900 1900
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
1490 0 0 0 0 1490
0 0 0 0 0 0
0 0 0 0 0 0
9060 0 0 0 0 9060
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
9260 0 0 0 0 9260
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 300 300
 0 0 0 0 0 0
2760 0 0 0 0 2760
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
260 0 0 0 0 260
0 0 0 0 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 5
0 0 0 0 0 0
0 0 0 0 0 0
2 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

293 0 0 0 29 322
0 0 0 0 0 0
248 0 0 0 3 251
760 0 0 0 0 760
197 0 0 0 0 197
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
237 0 0 0 0 237
714 0 0 0 7 721
0 0 0 0 0 0
119 0 0 0 0 119
130 0 0 0 0 130
80 0 0 0 0 80
111 0 0 0 0 111
381 0 0 0 0 381
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
86 0 0 0 0 86
55 0 0 0 0 55
0 0 0 0 0 0
73 0 0 0 0 73
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 20 20
0 0 0 0 0 0
0 0 0 0 0 0
70 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 1 1
 0 0 0 0 7 7
0 0 0 0 0 0
266 0 0 0 5 271
128 0 0 0 20 148
0 0 0 0 0 0
0 0 0 0 0 0
496 0 0 0 9 505
25 0 0 0 93 118
106 0 0 0 0 106
242 0 0 0 45 287
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
8 0 0 0 0 8
8 0 0 0 0 8
144 0 0 0 0 144
62 0 0 0 8 70
65 0 0 0 0 65
0 0 0 0 0 0
39 0 0 0 2 41
117 0 0 0 0 117
24 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 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
2 0 0 0 0 2
21 0 0 0 0 21
25 0 0 0 120 145
78 0 0 0 0 78
80 0 0 0 0 80
96 0 0 0 0 96
27 0 0 0 0 27
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
12 0 0 0 3 15
0 0 0 0 0 0
65 0 0 0 0 65
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
4 0 0 0 11 15
616 0 0 0 0 616
10 0 0 0 0 10
9 0 0 0 0 9
0 0 0 0 0 0
0 0 0 0 0 0
75 0 0 0 0 75

1 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 0 0 0 0 0
91 0 0 0 0 91
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
166 0 0 0 0 166
182 0 0 0 0 182
20 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 0 0
0 0 0 0 0 0

0 0 0 0 41 41
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 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 0 0 0 0 38

0 0 0 0 0 0
0 0 0 0 0 0
5495 0 0 0 0 5495
552 0 0 0 0 552
0 0 0 0 0 0
3180 0 0 0 0 3180
165 0 0 0 0 165
2880 0 0 0 0 2880
0 0 0 0 0 0
320 0 0 0 0 320
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 300 300
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 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
730 0 0 0 0 730
0 0 0 0 500 500
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
 Peringatan
Menu
!
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 17 1

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0 20
4 Allopurinol tab 100 mg tablet 0 200 1000
5 Allopurinol tab 300 mg tablet 0 0 1000
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0 50
7 Ambroksol tab 30 mg tablet 0 0 1000
8 Aminophyllin tab 200 mg tablet 0 0 500
9 Aminophyllin inj 24 mg ampul 0 0 10
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0 1500
12 Amlodipin tab 10 mg tablet 120 30 1500
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0 20
14 Amoxicillin SK 125 mg/5 ml botol 6 18 100
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 1700 2000
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0 100
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 1000 0 2000
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 0 10 10
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 3000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 1000
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0 100
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 200 500 3000
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 10
39 Asiklovir tab 200 mg tablet 0 0 500
40 Asiklovir tab 400 mg tablet 0 0 500
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 8 9 24
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 0 0 50
50 Betametason tts mata 1 mg/ml botol 0 0 10
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0 500

52 Bisakodil sup 10 mg supp 0 0 500
53 Bromheksin tab 8 mg tablet 0 0 500
54 Cefadroksil kaps 250 mg kapsul 0 0 500
55 Cefadroksil kaps/tab 500 mg kapsul 0 0 1000
56 Cefadroksil SK 125 mg/5 mL botol 19 8 50
57 Cefadroksil SK 250 mg/5 mL botol 0 0 50
58 Cefiksime tab 100 mg kapsul 0 0 500
59 Cefiksime sir 100 mg/5 mL botol 0 0 50
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0 1500
62 Cetrizine sir 5 mg/5 ml botol 0 0 50
63 Cimetidine tab 200 mg tablet 0 0 1500
64 Copper T set/buah 0 0
65 Deksametason tab 0,5 mg tablet 300 700 4000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 24 6 100
67 Diazepam tab 2 mg tablet 0 0 200
68 Diazepam tab 5 mg tablet 0 0 200
69 Diazepam inj 5 mg/ml ampul 3 0 10
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 50
81 Domperidon tab 10 mg tablet 100 0 1500
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 500
87 Eritromisin kaps 500 mg kapsul 0 0 500
88 Erytromisin SK 200 mg/5 ml botol 50 5 50
89 Etakridin (Rivanol) lar 0,1% botol 16 0 100
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 0 0 100
93 Etil Klorida semprot 100 mL botol 0 1 5
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 500
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 20
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 200 150 500
107 Gemfibrozil kaps 300 mg kapsul 0 0 500
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 700 200 1300
115 Glimepirid tab 1 mg tablet 100 0
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 1000 3000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 450 0 100
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 1000 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 100
132 Ibuprofen tab 200 mg tablet 0 0 1000
133 Ibuprofen tab 400 mg tablet 200 400 2000
134 Ibuprofen sir 100 mg/5 ml botol 0 0 25
135 Ibuprofen sir 200 mg/5 ml botol 0 0 25
136 Isoniazid tab 100 mg tablet 0 0 200
137 Isoniazid tab 300 mg tablet 0 0 200
138 Isosorbid Dinitrat tab 5 mg tablet 100 100 500
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 5000
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 0 500 500
145 Kaptopril tab 50 mg tablet 0 0 1000
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 50
152 Ketokonazole tab 200 mg tablet 0 0 200
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 500
155 Klindamisin kaps 300 mg kapsul 0 0 500
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 50
157 Kloramfenikol kaps 250 mg kapsul 1200 100 1000
158 Kloramfenikol kaps 500 mg kapsul 0 0 500
159 Kloramfenikol salap mata 1% tube 0 1 5
160 Kloramfenikol salep kulit 2% tube 0 0 5
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 20
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 5
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 0 1600 5000
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 50

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 100
171 Kotrimoxazol tab 480 mg (adult) tablet 200 300 1000
172 Kotrimoxazol susp 60 ml botol 0 6 100
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0 1000
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 14 29 200
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 0 5
184 Loratadin tab 10 mg tablet 0 0 500
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 25 0 10
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 10
188 Mebendazol tab 100 mg tablet 0 0 500
189 Mebendazol tab 500 mg tablet 0 0 500
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 30
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 15 0
192 Metampiron (Antalgin) tab 500 mg tablet 500 100
193 Metformin tab 500 mg tablet 850 0 1000
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0 500
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 1000
198 Metilprednisolon tab 8 mg tablet 0 0 200
199 Metilprednisolon tab 16 mg tablet 0 0 100
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 170 30 1500
202 Metronidazol tab 250 mg tablet 800 0
203 Metronidazol tab 500 mg tablet 1150 100 1500
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 20 15 50
207 Natrium Diklofenak tab 25 mg tablet 0 0 1000
208 Natrium Diklofenak tab 50 mg tablet 0 0 1000
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 100 11 60
210 Nifedipine tab 10 mg tablet 200 100 500
211 Nistatin tab vaginal 100.000 IU ovula 290 10
212 Nistatin tab vaginal 500.000 IU tablet 300 0 500
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0 50
223 Ofloxacin tab 200 mg tablet 0 0 500
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 5
226 Oksimetazolin tts hidung 0,050 % botol 0 0 5
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 50
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 26 4

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 200
230 Olopatadin tts mata 0,1% botol 0 0 5
231 Omeprazol kaps 20 mg kapsul 0 90 1000
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 200 1400 2000
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 6 100
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 50
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 500 0 500
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 11 0 50
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 700 200 3000
243 Piroxicam tab 10 mg tablet 0 200 1000
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 5
245 Povidon Iodida lar 10% - 300 ml botol 0 0 5
246 Povidon Iodida lar 10% - 60 ml botol 0 0 5
247 Povidon Iodida lar 10% - 30 ml botol 0 0 20
248 Prednison tab 5 mg tablet 0 1000 3000
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 0 500 2000
255 Ranitidin inj 25 mg/mL ampul 25 2 100
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 100
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 100
258 Rifampicin kaps 300 mg kapsul 0 0 500
259 Rifampicin tab 450 mg tablet 0 0 300
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 21 18 60
262 Salbutamol tab 2 mg tablet 0 0 1000
263 Salbutamol tab 4 mg tablet 0 0
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 20
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 5
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 5
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 1000 3000
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 10
275 Simvastatin tab 10 mg tablet 0 100
276 Simvastatin tab 20 mg tablet 0 0 1000
277 Siprofloksasin tab 500 mg tablet 100 300 1000
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 2000
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 30 70
283 Tetrasiklin kaps 500 mg kapsul 0 0 1000
284 Thiamfenikol kaps 500 mg kapsul 0 200 1000
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1250 1150 3000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 20
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 0 0 3000
295 Zinc sir 10 mg/ml botol 0 0 20
296 Zinc sir 20 mg/5 ml botol 0 0 10
297 Zinc dispersible 20 mg tablet 0 100 1000
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 0 30 500
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 100
304 Loperamid tab 2 mg tablet 0 200 2000
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0 2000
307 Piracetam tab 400 mg tablet 100 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0 2000
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 1000 3000
312 Etanol 70% lar 1000 ml botol 0 0 4
313 Etanol 70% lar 300 ml botol 0 0 10
314 Neurosanbe injeksi ampul 0 0 5
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 13 25 500
2 Alat Suntik 2.5 ml pcs 0 0 500
3 Alat Suntik 3 ml pcs 0 0 100
4 Alat Suntik 5 ml pcs 0 0 100
5 Alat Suntik 10 ml pcs 0 0 100
6 Alat Suntik 20 ml pcs 0 0 50
7 Alat Suntik 50 ml pcs 0 0 50
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 3
17 Catgut no.2/0 pcs 0 0 36
18 Catgut no.3/0 pcs 75 8
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 2
20 Catheter (folley cathteter) no.10 pcs 0 0 5
21 Catheter (folley cathteter) no.12 pcs 0 0 5
22 Catheter (folley cathteter) no.14 pcs 0 0 5
23 Catheter (folley cathteter) no.16 pcs 0 0 5
24 Catheter (folley cathteter) no.18 pcs 0 0 5
25 Cholesterol test btl/10 strip botol 0 0 3
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0 3
31 Hand Schoen no 7 set 0 0 50
32 Hand Schoen no 7.5 set 0 0 50
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 50
34 Hand Schoen no 8 set 0 0 50
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 50
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 50
37 Hand Schoen (Aximed Exam Gloves size M) pcs 20 180 50
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 50
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 50
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 50
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 50
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 50
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 50
44 Hand Schoen (Examination Gloves Size S) set 0 0 50
45 Hand Schoen (Examination Gloves Size M) set 0 0 50
46 Hand Schoen (Examination Gloves Size L) set 0 0 50
47 Infusion Set Anak set 36 0
48 Infusion Set Dewasa set 0 25 100
49 Infusion Set Macro 2 Cabang set 0 0 10
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 44 3 20
52 IV Catheter no. 20 pcs 10 24 100
53 IV Catheter no. 22 pcs 0 0 50
54 IV Catheter no. 24 pcs 11 9 50
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 20
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 20
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 20
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 20
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 20
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 20
61 Jarum Jahit Otot all size lusin 0 0 5
62 Jarum Jahit 1/2 Surgical lusin 0 0 5
63 Jarum Jahit 3/8 Surgical lusin 0 0 5
64 Kaca Slide pcs 0 0 50
65 Kapas Pembalut 250 g roll 0 1 20
66 Kapas Pembalut 500 g roll 0 0 10
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 10
68 Kasa Hydrofil 40 yard x 80 cm roll 0 0 5
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 0 20
70 Kasa Pembalut 2 m x 80 cm roll 0 2 10
71 Kasa Pembalut 4 m x 5 cm roll 0 0 10
72 Kasa Pembalut 4 m x 10 cm roll 0 0 10
73 Kasa Pembalut 4 m x 15 cm roll 0 0 10
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 10

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 10
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 10
77 Kasa Steril 16 cm x 16 cm box 0 0 10
78 Kasa Steril 18 cm x 22 cm box 0 0 10
79 Masker Ear Loop Pcs 20 150 300
80 Mata Pisau Bedah No. 10 pcs 0 0 10
81 Mata Pisau Bedah No. 11 Pcs 0 0 10
82 Mata Pisau Bedah No. 15 Pcs 0 0 10
83 Mata Pisau Bedah No. 21 Pcs 0 0 10
84 Nasal Oxygen (Aximed) size M Pcs 0 0 10
85 Nasal Oxygen (Aximed) size L Pcs 0 0 10
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 10
87 Plester 5 yard x 2 inchi roll 0 0 5
88 Plester 5 cm x 4,5 cm roll 2 2 5
89 Plester 7,5 cm x 4,5 cm roll 0 0 5
90 Pot Sputum pot 0 0 2
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0 5
93 Safety Box kotak 0 0 2
94 Selang Oxygen pcs 2 2 10
95 Silk (benang bedah sutra) no.2/0 pcs 84 12
96 Silk (benang bedah sutra) no.3/0 pcs 6 3 12
97 Sound Timer unit 3 1
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 4 1 5

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 1 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 5
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 0 5
15 Test Comburt Reagens set 0 0 5
16 Test Golongan Darah set 0 0 5
17 Test Golongan Darah Reagens set 0 0 5
18 Test Gula Darah test 0 0 5
19 Test Kehamilan strip 0 0 50
20 Test Kolesterol test 0 0 5
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 100
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 10
3 Becefort sir 60 ml botol 0 0 10
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 10
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 10
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0 10
8 KY Jelly tube 0 0 5
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 20
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0 500
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 25
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 25
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 25
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 100
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 2 0 50
19 Cendo Xytrol TM 5 ml botol 0 0 10
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 0 1000
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 52 20 100
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 1000
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 500 70
25 Vical susp 100 ml botol 0 0 20
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 50
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 1000
30 Purecemia (Allopurinol) 300 mg tablet 0 0 500
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 1000
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 1000
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 400
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 500
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 200
36 Histigo (Betahistin) tab 6 mg tablet 0 0 500
37 Novadium (Loperamid) tab 2 mg tablet 0 0 1000
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 20
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 500
40 Novabion tablet 0 0 1000
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 5000
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 2000
43 Sultrimix syrup botol 0 0 10
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0 10

45 Caviplex syrup botol 0 0 20
46 Farsifen (Ibuprofen) syrup botol 0 0 50
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 1000
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 500
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 3000
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 2000
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 1000
58 Metaneuron (Metamizolesodium + Diazepam) tablet 90 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Am. Keb

Nip. 19670824 198903 2 008
asi

BULAN : JANUARI
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 31 Januari 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 15 2

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 400 100
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 25
7 Ambroksol tab 30 mg tablet 600 600
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 300
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0
14 Amoxicillin SK 125 mg/5 ml botol 6 20
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 800 1200
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 600 1900
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 20 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 900 1300
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 0 0
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 27 17
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 35 40
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 400 800
56 Cefadroksil SK 125 mg/5 mL botol 61 8
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 100 400
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 0 0
65 Deksametason tab 0,5 mg tablet 0 1300
66 Deksamethason inj 5 mg/ml - 1 ml ampul 23 1
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 3 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 480 120
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 30 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 51 29
89 Etakridin (Rivanol) lar 0,1% botol 20 1
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 3 7
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 20 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 620 80
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 500 200
115 Glimepirid tab 1 mg tablet 250 50
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 1600 400
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 800 150
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 900 100
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 200
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 400 300
144 Kaptopril tab 25 mg tablet 250 550
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 900 300
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 1700 2300
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 300 500
172 Kotrimoxazol susp 60 ml botol 9 6
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 11 31
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 1
184 Loratadin tab 10 mg tablet 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 19 1
192 Metampiron (Antalgin) tab 500 mg tablet 900 100
193 Metformin tab 500 mg tablet 1050 100
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 700 170
202 Metronidazol tab 250 mg tablet 1100 100
203 Metronidazol tab 500 mg tablet 1450 200
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 33 11
207 Natrium Diklofenak tab 25 mg tablet 50 450
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 90 10
210 Nifedipine tab 10 mg tablet 400 0
211 Nistatin tab vaginal 100.000 IU ovula 490 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 20 5
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 9 17

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 0 180
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 500 700
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 7 4
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 500 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 750
243 Piroxicam tab 10 mg tablet 300 100
244 Povidon Iodida lar 10% - 1000 ml botol 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 1000
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 300 1000
255 Ranitidin inj 25 mg/mL ampul 22 3
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 60 21
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 0 0
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 350 150
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 800 300
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 200 330
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1800 1450
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 850 1150
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 3
297 Zinc dispersible 20 mg tablet 200 100
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 240 60
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 80 20
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 1 0
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 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

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 78 35
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 82 18
4 Alat Suntik 5 ml pcs 100 0
5 Alat Suntik 10 ml pcs 40 10
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 15 9
18 Catgut no.3/0 pcs 96 3
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 10 0
21 Catheter (folley cathteter) no.12 pcs 10 0
22 Catheter (folley cathteter) no.14 pcs 10 0
23 Catheter (folley cathteter) no.16 pcs 10 0
24 Catheter (folley cathteter) no.18 pcs 10 0
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 0 20
32 Hand Schoen no 7.5 set 5 15
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 12 8
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 20
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 54 2
48 Infusion Set Dewasa set 6 16
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 64 0
52 IV Catheter no. 20 pcs 29 26
53 IV Catheter no. 22 pcs 17 3
54 IV Catheter no. 24 pcs 28 3
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 10 4
66 Kapas Pembalut 500 g roll 5 5
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 3 2
69 Kasa Kompres Steril 40 x 40 cm bungkus 6 4
70 Kasa Pembalut 2 m x 80 cm roll 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 10

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 10
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 10
77 Kasa Steril 16 cm x 16 cm box 0 1
78 Kasa Steril 18 cm x 22 cm box 1 23
79 Masker Ear Loop Pcs 0 320
80 Mata Pisau Bedah No. 10 pcs 3 2
81 Mata Pisau Bedah No. 11 Pcs 4 1
82 Mata Pisau Bedah No. 15 Pcs 10 0
83 Mata Pisau Bedah No. 21 Pcs 8 2
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 4 3
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 1 1
95 Silk (benang bedah sutra) no.2/0 pcs 76 8
96 Silk (benang bedah sutra) no.3/0 pcs 3 3
97 Sound Timer unit 2 1
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 14 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 1
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 1
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 0 1
19 Test Kehamilan strip 0 0
20 Test Kolesterol test 0 1
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 3 0
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 400 600
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 52
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 500 0
25 Vical susp 100 ml botol 35 25
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 200 300
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 10
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Am. Keb

Nip. 19670824 198903 2 008
asi

BULAN : FEBRUARI
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 28 Februari 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 12 3

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 200 200
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0
7 Ambroksol tab 30 mg tablet 200 400 1000
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 6
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 800
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 200 400
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 20 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 100 800
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 0 0
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 10 17
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 20 15
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 400
56 Cefadroksil SK 125 mg/5 mL botol 43 18
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 0 100
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 0 0
65 Deksametason tab 0,5 mg tablet 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 23 0
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 3 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 380 100
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 29 1
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 51 0
89 Etakridin (Rivanol) lar 0,1% botol 13 7
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 3 5
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 20 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 470 150
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 400 100
115 Glimepirid tab 1 mg tablet 150 100
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 600 1000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 700 100
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 900 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 200 200
144 Kaptopril tab 25 mg tablet 0 250
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 900 0
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 1500 200
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 200 100
172 Kotrimoxazol susp 60 ml botol 0 9
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 11
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 0
184 Loratadin tab 10 mg tablet 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 1
192 Metampiron (Antalgin) tab 500 mg tablet 700 200
193 Metformin tab 500 mg tablet 850 200
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 500 200
202 Metronidazol tab 250 mg tablet 1100 0
203 Metronidazol tab 500 mg tablet 1350 100
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 27 6
207 Natrium Diklofenak tab 25 mg tablet 0 50
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 80 10
210 Nifedipine tab 10 mg tablet 400 0
211 Nistatin tab vaginal 100.000 IU ovula 490 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 7 13
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 9

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 500
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 7
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 88
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 0
243 Piroxicam tab 10 mg tablet 0 300
244 Povidon Iodida lar 10% - 1000 ml botol 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 5
248 Prednison tab 5 mg tablet 0 0
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 0 300
255 Ranitidin inj 25 mg/mL ampul 20 2
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 47 13
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 0 0
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 200 150
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 500 300
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 200 0
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1000 800
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 0 850
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 100 100
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 210 30
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 80 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 1 0
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 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

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 47 31
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 38 44
4 Alat Suntik 5 ml pcs 100 0
5 Alat Suntik 10 ml pcs 37 3
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 5 10
18 Catgut no.3/0 pcs 94 2
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 9 1
21 Catheter (folley cathteter) no.12 pcs 10 0
22 Catheter (folley cathteter) no.14 pcs 6 4
23 Catheter (folley cathteter) no.16 pcs 8 2
24 Catheter (folley cathteter) no.18 pcs 10 0
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 0 0
32 Hand Schoen no 7.5 set 0 5
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 0 12
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 50 4
48 Infusion Set Dewasa set 0 6
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 64 0
52 IV Catheter no. 20 pcs 8 21
53 IV Catheter no. 22 pcs 17 0
54 IV Catheter no. 24 pcs 21 7
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 8 2
66 Kapas Pembalut 500 g roll 5 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 2 1
69 Kasa Kompres Steril 40 x 40 cm bungkus 5 1
70 Kasa Pembalut 2 m x 80 cm roll 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 0 1
79 Masker Ear Loop Pcs 0 0
80 Mata Pisau Bedah No. 10 pcs 2 1
81 Mata Pisau Bedah No. 11 Pcs 2 2
82 Mata Pisau Bedah No. 15 Pcs 9 1
83 Mata Pisau Bedah No. 21 Pcs 7 1
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 3 1
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 1
95 Silk (benang bedah sutra) no.2/0 pcs 72 4
96 Silk (benang bedah sutra) no.3/0 pcs 1 2
97 Sound Timer unit 2 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 14 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 0
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 0 0
19 Test Kehamilan strip 0 0
20 Test Kolesterol test 0 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 3
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 400
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 100
25 Vical susp 100 ml botol 17 18
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 100 100
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : MARET
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 31 Maret 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 8 4

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 0 200
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 6 6
7 Ambroksol tab 30 mg tablet 0 200
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 150
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 1000 800
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 200 600
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 20 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 1000 1000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 400 700
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 300 0
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 5 5
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 5 15
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0
56 Cefadroksil SK 125 mg/5 mL botol 19 24
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 0 0
65 Deksametason tab 0,5 mg tablet 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 20 3
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 3 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 200 180
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 29 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 48 3
89 Etakridin (Rivanol) lar 0,1% botol 12 1
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 1 2
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3 17
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 400 70
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 400 0
115 Glimepirid tab 1 mg tablet 150 0
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 600
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 600 100
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 900
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 200 800
133 Ibuprofen tab 400 mg tablet 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 200
144 Kaptopril tab 25 mg tablet 0 0
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 900 0
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 450 1050
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 200 0
172 Kotrimoxazol susp 60 ml botol 0 0
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 0
184 Loratadin tab 10 mg tablet 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0
192 Metampiron (Antalgin) tab 500 mg tablet 700 0
193 Metformin tab 500 mg tablet 850 0
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 400 100
202 Metronidazol tab 250 mg tablet 1000 100
203 Metronidazol tab 500 mg tablet 1200 150
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 24 3
207 Natrium Diklofenak tab 25 mg tablet 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 75 5
210 Nifedipine tab 10 mg tablet 400 0
211 Nistatin tab vaginal 100.000 IU ovula 490 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 7
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 5 -5
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 14 12
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 0
243 Piroxicam tab 10 mg tablet 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0
245 Povidon Iodida lar 10% - 300 ml botol 3 1
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 0
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 0 0
255 Ranitidin inj 25 mg/mL ampul 16 4
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 17 30
262 Salbutamol tab 2 mg tablet 350 250
263 Salbutamol tab 4 mg tablet 0 0
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 50 150
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 100 400
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 100 100
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 0 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 0 0
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 100
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 180 30
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 80
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 2 2
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 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

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 20 27
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 33 5
4 Alat Suntik 5 ml pcs 100 0
5 Alat Suntik 10 ml pcs 31 6
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 0 5
18 Catgut no.3/0 pcs 72 22
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 9 0
21 Catheter (folley cathteter) no.12 pcs 10 0
22 Catheter (folley cathteter) no.14 pcs 3 3
23 Catheter (folley cathteter) no.16 pcs 8 0
24 Catheter (folley cathteter) no.18 pcs 7 3
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 0 0
32 Hand Schoen no 7.5 set 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 1 1
45 Hand Schoen (Examination Gloves Size M) set 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 43 7
48 Infusion Set Dewasa set 10 16
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 62 2
52 IV Catheter no. 20 pcs 10 24
53 IV Catheter no. 22 pcs 15 2
54 IV Catheter no. 24 pcs 18 3
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 8 0
66 Kapas Pembalut 500 g roll 5 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 3 2
69 Kasa Kompres Steril 40 x 40 cm bungkus 4 1
70 Kasa Pembalut 2 m x 80 cm roll 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 0 0
79 Masker Ear Loop Pcs 100 100
80 Mata Pisau Bedah No. 10 pcs 1 1
81 Mata Pisau Bedah No. 11 Pcs 0 2
82 Mata Pisau Bedah No. 15 Pcs 9 0
83 Mata Pisau Bedah No. 21 Pcs 6 1
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 0 3
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 60 12
96 Silk (benang bedah sutra) no.3/0 pcs 0 1
97 Sound Timer unit 2 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 8 6

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 0
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 0 0
19 Test Kehamilan strip 0 0
20 Test Kolesterol test 0 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 41 11
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 0
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 300 100
25 Vical susp 100 ml botol 11 6
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 100
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : APRIL
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 28 April 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 16 2

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 400 100
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 15 11
7 Ambroksol tab 30 mg tablet 350 150
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 90 210
13 Amoxicillin sir forte 250 mg/5 ml botol 24 26
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 300 1700
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 800 900
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 30 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 1000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 500 900
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 200 100
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 10 1
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 20 10
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 500 500
56 Cefadroksil SK 125 mg/5 mL botol 56 13
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 200 100
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 2 0
65 Deksametason tab 0,5 mg tablet 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 20 0
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 3 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 400 100
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 29 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 33 15
89 Etakridin (Rivanol) lar 0,1% botol 9 3
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 12 4
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3 30
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 310 90
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 400 0
115 Glimepirid tab 1 mg tablet 150 0
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 350 650
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 600 300
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 200
133 Ibuprofen tab 400 mg tablet 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 400 600
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 700 200
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 10 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 1000 950
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 100 100
172 Kotrimoxazol susp 60 ml botol 0 0
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 50 2
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 1
184 Loratadin tab 10 mg tablet 250 50
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0
192 Metampiron (Antalgin) tab 500 mg tablet 600 100
193 Metformin tab 500 mg tablet 1350 0
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 800 100
202 Metronidazol tab 250 mg tablet 1000 0
203 Metronidazol tab 500 mg tablet 1100 100
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 37 11
207 Natrium Diklofenak tab 25 mg tablet 750 250
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 75 0
210 Nifedipine tab 10 mg tablet 400 0
211 Nistatin tab vaginal 100.000 IU ovula 400 90
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 14 16
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 40 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 5 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 320 130
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 6 8
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 0
243 Piroxicam tab 10 mg tablet 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0
245 Povidon Iodida lar 10% - 300 ml botol 5 3
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 0
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 700 300
255 Ranitidin inj 25 mg/mL ampul 0 16
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 107 50
262 Salbutamol tab 2 mg tablet 0 350
263 Salbutamol tab 4 mg tablet 0 0
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 500 50
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 100 0
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 400 200
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 750 250
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 1300 1700
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 360 0
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 1 1
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 57 13
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 50 33
4 Alat Suntik 5 ml pcs 100 0
5 Alat Suntik 10 ml pcs 31 0
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 36 12
18 Catgut no.3/0 pcs 48 24
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 19 0
21 Catheter (folley cathteter) no.12 pcs 20 0
22 Catheter (folley cathteter) no.14 pcs 13 0
23 Catheter (folley cathteter) no.16 pcs 17 1
24 Catheter (folley cathteter) no.18 pcs 13 4
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 4
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 33 17
32 Hand Schoen no 7.5 set 11 15
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 1
45 Hand Schoen (Examination Gloves Size M) set 5 1
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 30 13
48 Infusion Set Dewasa set 40 20
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 65 10
52 IV Catheter no. 20 pcs 35 15
53 IV Catheter no. 22 pcs 22 3
54 IV Catheter no. 24 pcs 38 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 1
63 Jarum Jahit 3/8 Surgical lusin 1 1
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 12 1
66 Kapas Pembalut 500 g roll 10 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 5 3
69 Kasa Kompres Steril 40 x 40 cm bungkus 20 4
70 Kasa Pembalut 2 m x 80 cm roll 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 10
72 Kasa Pembalut 4 m x 10 cm roll 0 10
73 Kasa Pembalut 4 m x 15 cm roll 0 10
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 5 0
79 Masker Ear Loop Pcs 0 150
80 Mata Pisau Bedah No. 10 pcs 10 1
81 Mata Pisau Bedah No. 11 Pcs 10 0
82 Mata Pisau Bedah No. 15 Pcs 16 3
83 Mata Pisau Bedah No. 21 Pcs 5 1
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 3 1
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 81 3
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 2
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 6 2

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 25
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 0 25
19 Test Kehamilan strip 47 3
20 Test Kolesterol test 0 20
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 41
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 5 0
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 1550 450
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 0
25 Vical susp 100 ml botol 18 8
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 200 300
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : MEI
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 31 Mei 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 16 0

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 250 150
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 7 8
7 Ambroksol tab 30 mg tablet 0 350
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 90
13 Amoxicillin sir forte 250 mg/5 ml botol 12 12
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 300
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 100 700
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 10 20
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 0 500
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 200 0
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 7 3
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 15 5
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 500
56 Cefadroksil SK 125 mg/5 mL botol 53 3
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 200 0
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 1 1
65 Deksametason tab 0,5 mg tablet 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 19 1
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 3 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 250 150
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 3
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 27 6
89 Etakridin (Rivanol) lar 0,1% botol 7 2
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 9 3
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 3
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 300 10
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 400 0
115 Glimepirid tab 1 mg tablet 100 50
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 350
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 550 50
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 0 400
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 600 100
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 4 6
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 200 800
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 100 0
172 Kotrimoxazol susp 60 ml botol 0 0
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 15 55
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 0
184 Loratadin tab 10 mg tablet 250 0
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0
192 Metampiron (Antalgin) tab 500 mg tablet 500 100
193 Metformin tab 500 mg tablet 1350 0
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 700 100
202 Metronidazol tab 250 mg tablet 1000 0
203 Metronidazol tab 500 mg tablet 1000 100
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 33 4
207 Natrium Diklofenak tab 25 mg tablet 500 250
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 69 6
210 Nifedipine tab 10 mg tablet 400 0
211 Nistatin tab vaginal 100.000 IU ovula 400 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 4 10
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 40
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 5 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 240 80
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 6
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1950 -1000
243 Piroxicam tab 10 mg tablet 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 4
245 Povidon Iodida lar 10% - 300 ml botol 2 3
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 0
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 400 300
255 Ranitidin inj 25 mg/mL ampul 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 64 43
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 0 0
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 350 150
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 0 100
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 250 150
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 600 150
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 800 500
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 360 0
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 0 1
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 9 48
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 25 25
4 Alat Suntik 5 ml pcs 100 0
5 Alat Suntik 10 ml pcs 20 11
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 9 27
18 Catgut no.3/0 pcs 48 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 18 1
21 Catheter (folley cathteter) no.12 pcs 20 0
22 Catheter (folley cathteter) no.14 pcs 12 1
23 Catheter (folley cathteter) no.16 pcs 17 0
24 Catheter (folley cathteter) no.18 pcs 11 2
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 2 31
32 Hand Schoen no 7.5 set 0 11
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 9
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 25 20
48 Infusion Set Dewasa set 5 52
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 49 16
52 IV Catheter no. 20 pcs 0 55
53 IV Catheter no. 22 pcs 5 17
54 IV Catheter no. 24 pcs 11 27
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 8 4
66 Kapas Pembalut 500 g roll 10 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 3 2
69 Kasa Kompres Steril 40 x 40 cm bungkus 20 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 4 1
79 Masker Ear Loop Pcs 0 200
80 Mata Pisau Bedah No. 10 pcs 10 0
81 Mata Pisau Bedah No. 11 Pcs 10 0
82 Mata Pisau Bedah No. 15 Pcs 15 1
83 Mata Pisau Bedah No. 21 Pcs 1 4
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 0 3
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 67 14
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 5 1

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 0
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 13 -13
19 Test Kehamilan strip 40 7
20 Test Kolesterol test 0 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 5 0
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 1400 150
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 0
25 Vical susp 100 ml botol 11 7
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 200
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : JUNI
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 30 Juni 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 34 2

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 1100 150
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 26 11
7 Ambroksol tab 30 mg tablet 400 100
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 180 120
13 Amoxicillin sir forte 250 mg/5 ml botol 44 18
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 1600 1000
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 1950 150
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 10 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 1700 1000
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 200 0
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 0 7
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 2 13
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 800 200
56 Cefadroksil SK 125 mg/5 mL botol 85 13
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 1700 0
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 3 0
65 Deksametason tab 0,5 mg tablet 0 500
66 Deksamethason inj 5 mg/ml - 1 ml ampul 17 2
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 0 3
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 700 50
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 22 5
89 Etakridin (Rivanol) lar 0,1% botol 5 2
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 14 1
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 200 100
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 10 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 400 0
115 Glimepirid tab 1 mg tablet 100 0
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 800 200
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 70 5
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 1000 50
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 5
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 200 300
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 2000 0
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 500 100
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 4
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 2900 300
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 100 200
172 Kotrimoxazol susp 60 ml botol 7 8
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 17 13
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 2 2
184 Loratadin tab 10 mg tablet 450 50
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0
192 Metampiron (Antalgin) tab 500 mg tablet 300 200
193 Metformin tab 500 mg tablet 2750 100
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 500 200
202 Metronidazol tab 250 mg tablet 900 100
203 Metronidazol tab 500 mg tablet 700 300
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 72 9
207 Natrium Diklofenak tab 25 mg tablet 1150 150
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 106 3
210 Nifedipine tab 10 mg tablet 400 0
211 Nistatin tab vaginal 100.000 IU ovula 500 0
212 Nistatin tab vaginal 500.000 IU tablet 500 100
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 20 4
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 5
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 570 120
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 800
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 5 11
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 300 112
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1500 1450
243 Piroxicam tab 10 mg tablet 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 1 1
245 Povidon Iodida lar 10% - 300 ml botol 0 2
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 1000 1000
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 2100 300
255 Ranitidin inj 25 mg/mL ampul 8 7
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 170 74
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 100 500
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 1150 200
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 100 400
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 220 30
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1500 100
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 3600 200
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 510 0
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 0 0
313 Etanol 70% lar 300 ml botol 0 4
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 70 11
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 11 14
4 Alat Suntik 5 ml pcs 100 0
5 Alat Suntik 10 ml pcs 14 6
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 67 14
18 Catgut no.3/0 pcs 96 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 18 0
21 Catheter (folley cathteter) no.12 pcs 20 0
22 Catheter (folley cathteter) no.14 pcs 12 0
23 Catheter (folley cathteter) no.16 pcs 17 0
24 Catheter (folley cathteter) no.18 pcs 110 1
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 24 7
32 Hand Schoen no 7.5 set 21 5
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 25 5
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 24 6
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 3
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 17 8
48 Infusion Set Dewasa set 51 9
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 59 0
52 IV Catheter no. 20 pcs 0 14
53 IV Catheter no. 22 pcs 23 2
54 IV Catheter no. 24 pcs 58 3
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 144 0
65 Kapas Pembalut 250 g roll 8 0
66 Kapas Pembalut 500 g roll 10 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 48
68 Kasa Hydrofil 40 yard x 80 cm roll 10 1
69 Kasa Kompres Steril 40 x 40 cm bungkus 30 0
70 Kasa Pembalut 2 m x 80 cm roll 10 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 2 0
78 Kasa Steril 18 cm x 22 cm box 6 2
79 Masker Ear Loop Pcs 25 25
80 Mata Pisau Bedah No. 10 pcs 19 0
81 Mata Pisau Bedah No. 11 Pcs 20 0
82 Mata Pisau Bedah No. 15 Pcs 21 4
83 Mata Pisau Bedah No. 21 Pcs 0 1
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 1 0
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 65 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 2 3
95 Silk (benang bedah sutra) no.2/0 pcs 66 1
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 10 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 41 9
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 63 0
19 Test Kehamilan strip 39 1
20 Test Kolesterol test 20 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8 0
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 1200 200
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 0
25 Vical susp 100 ml botol 39 2
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 480
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 120 380
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : JULI
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 31 Juli 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 24 10

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 850 250
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 5 21
7 Ambroksol tab 30 mg tablet 0 700
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 180
13 Amoxicillin sir forte 250 mg/5 ml botol 26 18
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 600 1900
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 1200 750
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 10 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 700 300
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 850 1350
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 200 0
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 6 4
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 800
56 Cefadroksil SK 125 mg/5 mL botol 69 16
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 1530 170
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 3 0
65 Deksametason tab 0,5 mg tablet 400 300
66 Deksamethason inj 5 mg/ml - 1 ml ampul 9 8
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 560 140
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 9 13
89 Etakridin (Rivanol) lar 0,1% botol 3 2
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 4 10
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 180 20
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 10 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 330 70
115 Glimepirid tab 1 mg tablet 100 0
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 400 400
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 70 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 930 70
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 500
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 1700 300
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 100 400
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 2000 900
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 200 300
172 Kotrimoxazol susp 60 ml botol 2 15
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 5 36
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 1 1
184 Loratadin tab 10 mg tablet 380 70
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 300
193 Metformin tab 500 mg tablet 2730 20
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 650 100
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 500 0
202 Metronidazol tab 250 mg tablet 900 0
203 Metronidazol tab 500 mg tablet 700 0
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 54 18
207 Natrium Diklofenak tab 25 mg tablet 510 640
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 94 12
210 Nifedipine tab 10 mg tablet 400 0
211 Nistatin tab vaginal 100.000 IU ovula 500 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 20
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 260 310
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 1200
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 2 15
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 300 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1500 0
243 Piroxicam tab 10 mg tablet 200 200
244 Povidon Iodida lar 10% - 1000 ml botol 0.5 0.5
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 380 1220
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 1580 520
255 Ranitidin inj 25 mg/mL ampul 4 4
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 144 26
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 190 210
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 1050 100
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 0 100
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 90 130
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1160 340
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 1400 2200
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 450 60
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 0 0
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 18 52
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 6 5
4 Alat Suntik 5 ml pcs 80 20
5 Alat Suntik 10 ml pcs 12 2
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 57 10
18 Catgut no.3/0 pcs 96 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 18 0
21 Catheter (folley cathteter) no.12 pcs 20 0
22 Catheter (folley cathteter) no.14 pcs 12 0
23 Catheter (folley cathteter) no.16 pcs 17 0
24 Catheter (folley cathteter) no.18 pcs 110 0
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 18 6
32 Hand Schoen no 7.5 set 10 11
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 19 6
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 24 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 2 1
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 9 8
48 Infusion Set Dewasa set 27 24
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 50 9
52 IV Catheter no. 20 pcs 6 12
53 IV Catheter no. 22 pcs 6 17
54 IV Catheter no. 24 pcs 52 6
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 0 144
65 Kapas Pembalut 250 g roll 8 0
66 Kapas Pembalut 500 g roll 10 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 8 2
69 Kasa Kompres Steril 40 x 40 cm bungkus 22 8
70 Kasa Pembalut 2 m x 80 cm roll 9 1
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 2
78 Kasa Steril 18 cm x 22 cm box 3 3
79 Masker Ear Loop Pcs 0 125
80 Mata Pisau Bedah No. 10 pcs 17 2
81 Mata Pisau Bedah No. 11 Pcs 17 3
82 Mata Pisau Bedah No. 15 Pcs 11 10
83 Mata Pisau Bedah No. 21 Pcs 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 1 3
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 65
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 6 5
95 Silk (benang bedah sutra) no.2/0 pcs 57 9
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 7 3

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 25 16
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 45 18
19 Test Kehamilan strip 35 4
20 Test Kolesterol test 0 20
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8 0
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 635 565
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 180 220
25 Vical susp 100 ml botol 23 16
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 120
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : AGUSTUS
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 31 Agustus 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 22 2

2 Albendazole tab 400 mg tablet 2000 150
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 550 300
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 7 8
7 Ambroksol tab 30 mg tablet 780 220
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 235 95
12 Amlodipin tab 10 mg tablet 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 11 15
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 1130 1170
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 9 1
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 750 1450
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 10 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 200 500
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 1040 710
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 170 30
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 0 6
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 200
56 Cefadroksil SK 125 mg/5 mL botol 55 14
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 1400 130
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 240 10
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 3 0
65 Deksametason tab 0,5 mg tablet 1000 400
66 Deksamethason inj 5 mg/ml - 1 ml ampul 5 4
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 145 415
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 4 5
89 Etakridin (Rivanol) lar 0,1% botol 2 1
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 4 6
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 177 3
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 10 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 280 50
115 Glimepirid tab 1 mg tablet 20 80
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 700 500
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 50 20
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 610 320
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 520 280
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 670 80
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 980 720
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 100
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 970 1030
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 790 210
172 Kotrimoxazol susp 60 ml botol 10 2
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 15 11
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 1 0
184 Loratadin tab 10 mg tablet 250 130
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 0
193 Metformin tab 500 mg tablet 2580 150
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 650 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 0 500
202 Metronidazol tab 250 mg tablet 860 40
203 Metronidazol tab 500 mg tablet 600 100
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 54 0
207 Natrium Diklofenak tab 25 mg tablet 130 380
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 89 5
210 Nifedipine tab 10 mg tablet 400 0
211 Nistatin tab vaginal 100.000 IU ovula 500 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 50 210
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 1620 380
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1 11
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 300 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 25 1
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1320 180
243 Piroxicam tab 10 mg tablet 400 400
244 Povidon Iodida lar 10% - 1000 ml botol 2 0.5
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 800 580
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 1010 570
255 Ranitidin inj 25 mg/mL ampul 5 5
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 140 4
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 490 200
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 840 210
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 200 0
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 90
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1000 160
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 1310 90
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 450 0
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 0 0
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 10 8
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 6 0
4 Alat Suntik 5 ml pcs 80 0
5 Alat Suntik 10 ml pcs 12 0
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 48 9
18 Catgut no.3/0 pcs 96 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 18 0
21 Catheter (folley cathteter) no.12 pcs 20 0
22 Catheter (folley cathteter) no.14 pcs 12 0
23 Catheter (folley cathteter) no.16 pcs 17 0
24 Catheter (folley cathteter) no.18 pcs 110 0
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 9 9
32 Hand Schoen no 7.5 set 8 2
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 17 2
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 22 2
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 3
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 7 2
48 Infusion Set Dewasa set 9 18
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 48 2
52 IV Catheter no. 20 pcs 20 3
53 IV Catheter no. 22 pcs 1 5
54 IV Catheter no. 24 pcs 50 2
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 8 0
66 Kapas Pembalut 500 g roll 10 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 7 1
69 Kasa Kompres Steril 40 x 40 cm bungkus 10 12
70 Kasa Pembalut 2 m x 80 cm roll 5 4
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 2 1
79 Masker Ear Loop Pcs 0 50
80 Mata Pisau Bedah No. 10 pcs 16 1
81 Mata Pisau Bedah No. 11 Pcs 17 0
82 Mata Pisau Bedah No. 15 Pcs 5 6
83 Mata Pisau Bedah No. 21 Pcs 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 1 1
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 4 2
95 Silk (benang bedah sutra) no.2/0 pcs 53 4
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 7 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 25 0
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 45 0
19 Test Kehamilan strip 21 14
20 Test Kolesterol test 0 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 7 1
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 310 325
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 100 80
25 Vical susp 100 ml botol 11 12
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 500 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : SEPTEMBER
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 29 September 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 0 22

2 Albendazole tab 400 mg tablet 0 2000
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 0 550
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 7
7 Ambroksol tab 30 mg tablet 0 780
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 235
12 Amlodipin tab 10 mg tablet 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 11
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 1130
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 9
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 750
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 0 10
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 200
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 0 1040
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 0 170
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 0 0
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0
56 Cefadroksil SK 125 mg/5 mL botol 0 55
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 0 1400
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 240
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 0 3
65 Deksametason tab 0,5 mg tablet 0 1000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 5
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 0 145
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 26
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 0 4
89 Etakridin (Rivanol) lar 0,1% botol 0 2
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 0 4
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 0 177
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 10
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 0 280
115 Glimepirid tab 1 mg tablet 0 20
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 700
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 0 50
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 0 610
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 520
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 100
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 670
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 0 980
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 0 970
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 790
172 Kotrimoxazol susp 60 ml botol 0 10
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 15
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 1
184 Loratadin tab 10 mg tablet 0 250
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 0 45
187 Magnesium Sulfat inj 40% - 25 ml vial 0 5
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 0 18
192 Metampiron (Antalgin) tab 500 mg tablet 0 0
193 Metformin tab 500 mg tablet 0 2580
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 650
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 0 0
202 Metronidazol tab 250 mg tablet 0 860
203 Metronidazol tab 500 mg tablet 0 600
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 0 54
207 Natrium Diklofenak tab 25 mg tablet 0 130
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 0 89
210 Nifedipine tab 10 mg tablet 0 400
211 Nistatin tab vaginal 100.000 IU ovula 0 500
212 Nistatin tab vaginal 500.000 IU tablet 0 500
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 0 50
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 1620
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 1
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 0 300
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 0 25
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 0 1320
243 Piroxicam tab 10 mg tablet 0 400
244 Povidon Iodida lar 10% - 1000 ml botol 0 2
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 800
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 0 1010
255 Ranitidin inj 25 mg/mL ampul 0 5
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 0 140
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 0 490
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 0 840
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 0 200
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 0 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 0 1310
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 0 450
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 0 0
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 0 10
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 0 6
4 Alat Suntik 5 ml pcs 0 80
5 Alat Suntik 10 ml pcs 0 12
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 0 48
18 Catgut no.3/0 pcs 0 96
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 0 18
21 Catheter (folley cathteter) no.12 pcs 0 20
22 Catheter (folley cathteter) no.14 pcs 0 12
23 Catheter (folley cathteter) no.16 pcs 0 17
24 Catheter (folley cathteter) no.18 pcs 0 110
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 0 9
32 Hand Schoen no 7.5 set 0 8
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 0 17
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 22
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 0 7
48 Infusion Set Dewasa set 0 9
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 0 48
52 IV Catheter no. 20 pcs 0 20
53 IV Catheter no. 22 pcs 0 1
54 IV Catheter no. 24 pcs 0 50
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 1
63 Jarum Jahit 3/8 Surgical lusin 0 1
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 0 8
66 Kapas Pembalut 500 g roll 0 10
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 0 7
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 10
70 Kasa Pembalut 2 m x 80 cm roll 0 5
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 0 2
79 Masker Ear Loop Pcs 0 0
80 Mata Pisau Bedah No. 10 pcs 0 16
81 Mata Pisau Bedah No. 11 Pcs 0 17
82 Mata Pisau Bedah No. 15 Pcs 0 5
83 Mata Pisau Bedah No. 21 Pcs 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 0 1
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 4
95 Silk (benang bedah sutra) no.2/0 pcs 0 53
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 0 7

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 25
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 0 45
19 Test Kehamilan strip 0 21
20 Test Kolesterol test 0 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 7
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 310
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 100
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 0 100
25 Vical susp 100 ml botol 0 11
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 0 80
59 Trifadium ( Loperamide HCL 2 mg) tablet 0 500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : OKTOBER
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 31 Oktober 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 0 0

2 Albendazole tab 400 mg tablet 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 0 0
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0
7 Ambroksol tab 30 mg tablet 0 0
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 0
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 0 0
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 0 0
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0
56 Cefadroksil SK 125 mg/5 mL botol 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 0 0
65 Deksametason tab 0,5 mg tablet 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 0 0
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 0 0
89 Etakridin (Rivanol) lar 0,1% botol 0 0
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 0 0
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 0 0
115 Glimepirid tab 1 mg tablet 0 0
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 0 0
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 0 0
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0
172 Kotrimoxazol susp 60 ml botol 0 0
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 0
184 Loratadin tab 10 mg tablet 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 0 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 0
193 Metformin tab 500 mg tablet 0 0
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 0 0
202 Metronidazol tab 250 mg tablet 0 0
203 Metronidazol tab 500 mg tablet 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 0 0
207 Natrium Diklofenak tab 25 mg tablet 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 0 0
210 Nifedipine tab 10 mg tablet 0 0
211 Nistatin tab vaginal 100.000 IU ovula 0 0
212 Nistatin tab vaginal 500.000 IU tablet 0 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 0 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 0 0
243 Piroxicam tab 10 mg tablet 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 0
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 0 0
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 0 0
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 0 0
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 0 0
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 0 0
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 0 0
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 0 0
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 0 0
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 0 0
4 Alat Suntik 5 ml pcs 0 0
5 Alat Suntik 10 ml pcs 0 0
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 0 0
18 Catgut no.3/0 pcs 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 0 0
21 Catheter (folley cathteter) no.12 pcs 0 0
22 Catheter (folley cathteter) no.14 pcs 0 0
23 Catheter (folley cathteter) no.16 pcs 0 0
24 Catheter (folley cathteter) no.18 pcs 0 0
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 0 0
32 Hand Schoen no 7.5 set 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 0 0
48 Infusion Set Dewasa set 0 0
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 0 0
52 IV Catheter no. 20 pcs 0 0
53 IV Catheter no. 22 pcs 0 0
54 IV Catheter no. 24 pcs 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 0
63 Jarum Jahit 3/8 Surgical lusin 0 0
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 0 0
66 Kapas Pembalut 500 g roll 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 0 0
79 Masker Ear Loop Pcs 0 0
80 Mata Pisau Bedah No. 10 pcs 0 0
81 Mata Pisau Bedah No. 11 Pcs 0 0
82 Mata Pisau Bedah No. 15 Pcs 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 0
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 0 0
19 Test Kehamilan strip 0 0
20 Test Kolesterol test 0 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 0
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 0 0
25 Vical susp 100 ml botol 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 0 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : NOVEMBER
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 30 November 2017

Penanggung Jawab Farmasi

DEWI SARTIKA, AMF

Nip. 19890705 201504 2 001
 Surat Permintaan (SP) Obat dan Perbekalan Farmasi
diluar jadwal permintaan reguler

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

1 Air Untuk Injeksi 20 ml vial 0 0

2 Albendazole tab 400 mg tablet 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 0 0
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0
7 Ambroksol tab 30 mg tablet 0 0
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 0
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 0 0
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 0 0
50 Betametason tts mata 1 mg/ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0
56 Cefadroksil SK 125 mg/5 mL botol 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 0 0
65 Deksametason tab 0,5 mg tablet 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 0 0
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 0 0
89 Etakridin (Rivanol) lar 0,1% botol 0 0
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 0 0
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 0 0
115 Glimepirid tab 1 mg tablet 0 0
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 0 0
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 0 0
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0
172 Kotrimoxazol susp 60 ml botol 0 0
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 0
184 Loratadin tab 10 mg tablet 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 0 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 0
193 Metformin tab 500 mg tablet 0 0
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 0 0
202 Metronidazol tab 250 mg tablet 0 0
203 Metronidazol tab 500 mg tablet 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 0 0
207 Natrium Diklofenak tab 25 mg tablet 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 0 0
210 Nifedipine tab 10 mg tablet 0 0
211 Nistatin tab vaginal 100.000 IU ovula 0 0
212 Nistatin tab vaginal 500.000 IU tablet 0 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 0 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 0 0
243 Piroxicam tab 10 mg tablet 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 0
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 0 0
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 0 0
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 0 0
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 0 0
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 0 0
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 0 0
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 0 0
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 0 0
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 0 0
4 Alat Suntik 5 ml pcs 0 0
5 Alat Suntik 10 ml pcs 0 0
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 0 0
18 Catgut no.3/0 pcs 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 0 0
21 Catheter (folley cathteter) no.12 pcs 0 0
22 Catheter (folley cathteter) no.14 pcs 0 0
23 Catheter (folley cathteter) no.16 pcs 0 0
24 Catheter (folley cathteter) no.18 pcs 0 0
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 0 0
32 Hand Schoen no 7.5 set 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 0 0
48 Infusion Set Dewasa set 0 0
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 0 0
52 IV Catheter no. 20 pcs 0 0
53 IV Catheter no. 22 pcs 0 0
54 IV Catheter no. 24 pcs 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 0
63 Jarum Jahit 3/8 Surgical lusin 0 0
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 0 0
66 Kapas Pembalut 500 g roll 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 0 0
79 Masker Ear Loop Pcs 0 0
80 Mata Pisau Bedah No. 10 pcs 0 0
81 Mata Pisau Bedah No. 11 Pcs 0 0
82 Mata Pisau Bedah No. 15 Pcs 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 0
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 0 0
19 Test Kehamilan strip 0 0
20 Test Kolesterol test 0 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 0
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 0 0
25 Vical susp 100 ml botol 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
No. Nama Obat Satuan Sisa Stock Pemakaian Permintaan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 0 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
asi

BULAN : DESEMBER
TAHUN : 2017

Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi
 Pemberian
DAK
DAU/PKD
Pusat Provinsi

Inebenggi, 29 Desember 2017

Penanggung Jawab Farmasi

DEWI SARTIKA, AMF

Nip. 19890705 201504 2 001
 Isian Permintaan Obat dan Perbekalan Farmasi untuk LPLPO

PUSKESMAS : MOWEWE BULAN : MARET

KECAMATAN : MOWEWE TAHUN : 2017
KAB/KOTA : KOLAKA TIMUR

Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

1 Air Untuk Injeksi 20 ml vial 12 6 20

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 200 500 1000
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 25 50
7 Ambroksol tab 30 mg tablet 200 1000 1000
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 330 1000
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 44 100
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 3700 3000
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0 50
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 200 2300 2000
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 20 10 10
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 2000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 2000
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 100 2600 3000
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0 500
40 Asiklovir tab 400 mg tablet 0 0 500
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 10 43 50
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 20 55 50
50 Betametason tts mata 1 mg/ml botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

51 Bisakodil sup 5 mg supp 0 0 20

52 Bisakodil sup 10 mg supp 0 0 20
53 Bromheksin tab 8 mg tablet 0 0 1000
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 1200 2000
56 Cefadroksil SK 125 mg/5 mL botol 43 34 50
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 0 500 2000
59 Cefiksime sir 100 mg/5 mL botol 0 0 20
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0 1000
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 0 0
65 Deksametason tab 0,5 mg tablet 0 2000 3000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 23 7 20
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 3 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 380 220 1000
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 29 1
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 51 34
89 Etakridin (Rivanol) lar 0,1% botol 13 8
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 3 12 50
93 Etil Klorida semprot 100 mL botol 0 1 2
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 20 0 20
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 470 380
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0 20
109 Gentamicin salep kulit 10% tube 0 0 20
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 400 500 1000
115 Glimepirid tab 1 mg tablet 150 150
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 600 2400 3000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 700 250 500
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 900 100
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 600 2000
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0 500
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 100 500
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 3000
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 200 500 1000
144 Kaptopril tab 25 mg tablet 0 1300 2000
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 25
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 900 400
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 1 10
160 Kloramfenikol salep kulit 2% tube 0 0 25
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 5
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 1500 4100 3000
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 10

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 10
171 Kotrimoxazol tab 480 mg (adult) tablet 200 900 2000
172 Kotrimoxazol susp 60 ml botol 0 21 50
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 100
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 71 100
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0 3
183 Lisol lar 1.000 ml botol 0 1
184 Loratadin tab 10 mg tablet 0 0 500
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 2
192 Metampiron (Antalgin) tab 500 mg tablet 700 400
193 Metformin tab 500 mg tablet 850 300 1000
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 1000
198 Metilprednisolon tab 8 mg tablet 0 0 1000
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0 1000
201 Metoklopramid tab 10 mg tablet 500 400 1000
202 Metronidazol tab 250 mg tablet 1100 100
203 Metronidazol tab 500 mg tablet 1350 400
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 27 32 50
207 Natrium Diklofenak tab 25 mg tablet 0 500 1000
208 Natrium Diklofenak tab 50 mg tablet 0 0 2000
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 80 31
210 Nifedipine tab 10 mg tablet 400 100 500
211 Nistatin tab vaginal 100.000 IU ovula 490 10
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 7 18 50
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 50
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 30 25

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 100
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 0 270 1000
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 2600 5000
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 17 100
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 88
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 950
243 Piroxicam tab 10 mg tablet 0 600
244 Povidon Iodida lar 10% - 1000 ml botol 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 5
248 Prednison tab 5 mg tablet 0 2000 2000
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 0 1800 2000
255 Ranitidin inj 25 mg/mL ampul 20 7 25
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 47 52 80
262 Salbutamol tab 2 mg tablet 0 0 1000
263 Salbutamol tab 4 mg tablet 0 0 1000
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 20
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 1000 2000
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 25
275 Simvastatin tab 10 mg tablet 200 400 1000
276 Simvastatin tab 20 mg tablet 0 0 1000
277 Siprofloksasin tab 500 mg tablet 500 900 2000
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 2000
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 200 400
283 Tetrasiklin kaps 500 mg kapsul 0 0 500
284 Thiamfenikol kaps 500 mg kapsul 0 200
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1000 3400 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 0 2000 3000
295 Zinc sir 10 mg/ml botol 0 0 10
296 Zinc sir 20 mg/5 ml botol 0 3 10
297 Zinc dispersible 20 mg tablet 100 300 1500
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 210 120 200
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 100
304 Loperamid tab 2 mg tablet 0 200 1000
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0 2000
307 Piracetam tab 400 mg tablet 80 20
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0 2000
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 1000 2000
312 Etanol 70% lar 1000 ml botol 1 0 3
313 Etanol 70% lar 300 ml botol 0 0 5
314 Neurosanbe injeksi ampul 0 0 5
315 H2O2 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

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 47 91 200
2 Alat Suntik 2.5 ml pcs 0 0 200
3 Alat Suntik 3 ml pcs 38 62 200
4 Alat Suntik 5 ml pcs 100 0
5 Alat Suntik 10 ml pcs 37 13
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 5 19 60
18 Catgut no.3/0 pcs 94 13
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 9 1 10
21 Catheter (folley cathteter) no.12 pcs 10 0 10
22 Catheter (folley cathteter) no.14 pcs 6 4 50
23 Catheter (folley cathteter) no.16 pcs 8 2 10
24 Catheter (folley cathteter) no.18 pcs 10 0 10
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 0 20 100
32 Hand Schoen no 7.5 set 0 20 100
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 50
34 Hand Schoen no 8 set 0 20 100
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 50
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 20
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 200 20
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 20
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 20
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 30
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 30
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 30
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 30
44 Hand Schoen (Examination Gloves Size S) set 0 0 30
45 Hand Schoen (Examination Gloves Size M) set 0 0 30
46 Hand Schoen (Examination Gloves Size L) set 0 0 30
47 Infusion Set Anak set 50 6
48 Infusion Set Dewasa set 0 47 100
49 Infusion Set Macro 2 Cabang set 0 0 10
50 IV Catheter no. 16 pcs 0 0 30
51 IV Catheter no. 18 pcs 64 3 30
52 IV Catheter no. 20 pcs 8 71 50
53 IV Catheter no. 22 pcs 17 3 20
54 IV Catheter no. 24 pcs 21 19 50
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 0 0 100
65 Kapas Pembalut 250 g roll 8 7 5
66 Kapas Pembalut 500 g roll 5 5 5
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 50
68 Kasa Hydrofil 40 yard x 80 cm roll 2 3 20
69 Kasa Kompres Steril 40 x 40 cm bungkus 5 5 20
70 Kasa Pembalut 2 m x 80 cm roll 0 2 20
71 Kasa Pembalut 4 m x 5 cm roll 0 0 30
72 Kasa Pembalut 4 m x 10 cm roll 0 0 30
73 Kasa Pembalut 4 m x 15 cm roll 0 0 30
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 10 30

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 10 30
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 10 320
77 Kasa Steril 16 cm x 16 cm box 0 1 20
78 Kasa Steril 18 cm x 22 cm box 0 24 20
79 Masker Ear Loop Pcs 0 470 300
80 Mata Pisau Bedah No. 10 pcs 2 3 10
81 Mata Pisau Bedah No. 11 Pcs 2 3 10
82 Mata Pisau Bedah No. 15 Pcs 9 1 10
83 Mata Pisau Bedah No. 21 Pcs 7 3 10
84 Nasal Oxygen (Aximed) size M Pcs 0 0 10
85 Nasal Oxygen (Aximed) size L Pcs 0 0 10
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 10
87 Plester 5 yard x 2 inchi roll 0 0 5
88 Plester 5 cm x 4,5 cm roll 3 6 5
89 Plester 7,5 cm x 4,5 cm roll 0 0 5
90 Pot Sputum pot 0 0 3
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0 5
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 4 10
95 Silk (benang bedah sutra) no.2/0 pcs 72 24
96 Silk (benang bedah sutra) no.3/0 pcs 1 8 50
97 Sound Timer unit 2 2
98 Stempel ISPA pcs 0 0 1
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 14 1

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 1
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 1
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 1
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0 1
17 Test Golongan Darah Reagens set 0 0 1
18 Test Gula Darah test 0 1 1
19 Test Kehamilan strip 0 0 50
20 Test Kolesterol test 0 1 3
21 Test Urine Rutin strip 0 0 1

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 100
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 10
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0 5
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 5
12 Pehavral tablet salut 0 0 1000
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 5
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 10
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 3 20
19 Cendo Xytrol TM 5 ml botol 0 0 5
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 1000 2000
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 72 200
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 3000
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 170
25 Vical susp 100 ml botol 17 43 50
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 5000
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 1000
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 1000
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 2000
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 100 400 1000
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0 2000
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 1000
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0 2000
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 1000
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 1000
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 10 100
59 Trifadium ( Loperamide HCL 2 mg) tablet 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 Isian Permintaan Obat dan Perbekalan Farmasi untuk LPLPO

PUSKESMAS : MOWEWE BULAN : JUNI

KECAMATAN : MOWEWE TAHUN : 2017
KAB/KOTA : KOLAKA TIMUR

Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

1 Air Untuk Injeksi 20 ml vial 16 6 40

2 Albendazole tab 400 mg tablet 2150 0
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 250 450 1000
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 7 25 50
7 Ambroksol tab 30 mg tablet 0 700 1000
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 0
12 Amlodipin tab 10 mg tablet 0 450 1000
13 Amoxicillin sir forte 250 mg/5 ml botol 12 38
14 Amoxicillin SK 125 mg/5 ml botol 0 0 100
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 2800 3000
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 0 50
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 100 2200 2000
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 5
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 10 20
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 2000 2000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 2000
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 0 2100 3000
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0 500
40 Asiklovir tab 400 mg tablet 200 100 500
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 7 9 50
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 15 30 50
50 Betametason tts mata 1 mg/ml botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

51 Bisakodil sup 5 mg supp 0 0 20

52 Bisakodil sup 10 mg supp 0 0 20
53 Bromheksin tab 8 mg tablet 0 0 1000
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 1000 2000
56 Cefadroksil SK 125 mg/5 mL botol 53 40 50
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 200 100 2000
59 Cefiksime sir 100 mg/5 mL botol 0 0 20
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 0 1000
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0 1000
64 Copper T set/buah 1 1
65 Deksametason tab 0,5 mg tablet 0 0 3000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 19 4 20
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 3 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 250 430 1000
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 3
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 27 24
89 Etakridin (Rivanol) lar 0,1% botol 7 6
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 9 9 20
93 Etil Klorida semprot 100 mL botol 0 0 2
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 50 20
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 300 170
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0 20
109 Gentamicin salep kulit 10% tube 0 0 20
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

110 Gentamicin salep mata 0,3% tube 0 0 5

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 400 0 1000
115 Glimepirid tab 1 mg tablet 100 50
116 Glimepirid tab 2 mg tablet 0 0 300
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 1600 3000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 550 450 500
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 900 1000
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 50
132 Ibuprofen tab 200 mg tablet 0 1000 1000
133 Ibuprofen tab 400 mg tablet 0 0 2000
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0 500
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0 500
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 3000
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 200 1000
144 Kaptopril tab 25 mg tablet 0 1000 2000
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 25
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 600 300
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 4 6 5
160 Kloramfenikol salep kulit 2% tube 0 0 25
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 5
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 200 2800 3000
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 10

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 10
171 Kotrimoxazol tab 480 mg (adult) tablet 100 100 2000
172 Kotrimoxazol susp 60 ml botol 0 0 50
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0 100
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 100
180 Lidokain inj 2% (infiltr/p.v.) ampul 15 57 100
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0 3
183 Lisol lar 1.000 ml botol 0 1
184 Loratadin tab 10 mg tablet 250 50 500
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0
192 Metampiron (Antalgin) tab 500 mg tablet 500 200
193 Metformin tab 500 mg tablet 1350 0 700
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 1000
198 Metilprednisolon tab 8 mg tablet 0 0 1000
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0 1000
201 Metoklopramid tab 10 mg tablet 700 300 1000
202 Metronidazol tab 250 mg tablet 1000 100
203 Metronidazol tab 500 mg tablet 1000 350
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 33 18 50
207 Natrium Diklofenak tab 25 mg tablet 500 500 1000
208 Natrium Diklofenak tab 50 mg tablet 0 0 2000
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 69 11
210 Nifedipine tab 10 mg tablet 400 0 500
211 Nistatin tab vaginal 100.000 IU ovula 400 90
212 Nistatin tab vaginal 500.000 IU tablet 500 0
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 4 33 50
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 40 50
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 25

229 Oksitosin inj 10 IU/ml - 1 ml ampul 5 -5 100
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 240 210 1000
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 0 5000
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 26 100
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1950 -1000
243 Piroxicam tab 10 mg tablet 0 0 1500
244 Povidon Iodida lar 10% - 1000 ml botol 0 4 3
245 Povidon Iodida lar 10% - 300 ml botol 2 7 5
246 Povidon Iodida lar 10% - 60 ml botol 0 0 10
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 0 2000
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 400 600 2000
255 Ranitidin inj 25 mg/mL ampul 0 20 25
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 64 123 100
262 Salbutamol tab 2 mg tablet 0 600 1000
263 Salbutamol tab 4 mg tablet 0 0 1000
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 20
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 2000
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 25
275 Simvastatin tab 10 mg tablet 350 350 1000
276 Simvastatin tab 20 mg tablet 0 0 1000
277 Siprofloksasin tab 500 mg tablet 0 500 2000
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 2000
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 250 450
283 Tetrasiklin kaps 500 mg kapsul 0 0 500
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 600 1400 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 800 2200 3000
295 Zinc sir 10 mg/ml botol 0 0 10
296 Zinc sir 20 mg/5 ml botol 0 0 10
297 Zinc dispersible 20 mg tablet 0 100 1500
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 360 30 200
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 100
304 Loperamid tab 2 mg tablet 0 0 1000
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0 2000
307 Piracetam tab 400 mg tablet 0 80
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0 2000
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 2000
312 Etanol 70% lar 1000 ml botol 0 4 3
313 Etanol 70% lar 300 ml botol 0 0 5
314 Neurosanbe injeksi ampul 0 0 5
315 H2O2 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

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 9 88 200
2 Alat Suntik 2.5 ml pcs 0 0 50
3 Alat Suntik 3 ml pcs 25 63 200
4 Alat Suntik 5 ml pcs 100 0
5 Alat Suntik 10 ml pcs 20 17
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 2
17 Catgut no.2/0 pcs 9 44 60
18 Catgut no.3/0 pcs 48 46
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 18 1
21 Catheter (folley cathteter) no.12 pcs 20 0
22 Catheter (folley cathteter) no.14 pcs 12 4 10
23 Catheter (folley cathteter) no.16 pcs 17 1
24 Catheter (folley cathteter) no.18 pcs 11 9 10
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 4
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0 1
31 Hand Schoen no 7 set 2 48 50
32 Hand Schoen no 7.5 set 0 26 50
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 50
34 Hand Schoen no 8 set 0 0 100
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 50
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 20
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 20
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 20
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 20
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 30
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 30
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 30
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 30
44 Hand Schoen (Examination Gloves Size S) set 0 2 30
45 Hand Schoen (Examination Gloves Size M) set 0 10 30
46 Hand Schoen (Examination Gloves Size L) set 0 0 30
47 Infusion Set Anak set 25 40
48 Infusion Set Dewasa set 5 88 100
49 Infusion Set Macro 2 Cabang set 0 0 10
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 49 28 10
52 IV Catheter no. 20 pcs 0 94 50
53 IV Catheter no. 22 pcs 5 22 20
54 IV Catheter no. 24 pcs 11 30 50
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 1
63 Jarum Jahit 3/8 Surgical lusin 1 1
64 Kaca Slide pcs 0 0 100
65 Kapas Pembalut 250 g roll 8 5
66 Kapas Pembalut 500 g roll 10 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 50
68 Kasa Hydrofil 40 yard x 80 cm roll 3 7 20
69 Kasa Kompres Steril 40 x 40 cm bungkus 20 5 20
70 Kasa Pembalut 2 m x 80 cm roll 0 0 20
71 Kasa Pembalut 4 m x 5 cm roll 0 10 30
72 Kasa Pembalut 4 m x 10 cm roll 0 10 30
73 Kasa Pembalut 4 m x 15 cm roll 0 10 30
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 30

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 30
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 320
77 Kasa Steril 16 cm x 16 cm box 0 0 20
78 Kasa Steril 18 cm x 22 cm box 4 1 20
79 Masker Ear Loop Pcs 0 450 300
80 Mata Pisau Bedah No. 10 pcs 10 2 10
81 Mata Pisau Bedah No. 11 Pcs 10 2 10
82 Mata Pisau Bedah No. 15 Pcs 15 4 10
83 Mata Pisau Bedah No. 21 Pcs 1 6 10
84 Nasal Oxygen (Aximed) size M Pcs 0 0 10
85 Nasal Oxygen (Aximed) size L Pcs 0 0 10
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 10
87 Plester 5 yard x 2 inchi roll 0 0 5
88 Plester 5 cm x 4,5 cm roll 0 7 5
89 Plester 7,5 cm x 4,5 cm roll 0 0 5
90 Pot Sputum pot 0 0 3
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0 5
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 0 10
95 Silk (benang bedah sutra) no.2/0 pcs 67 29
96 Silk (benang bedah sutra) no.3/0 pcs 0 1 50
97 Sound Timer unit 0 2
98 Stempel ISPA pcs 0 0 1
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 5 9 5

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 3
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 25 1
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0 1
17 Test Golongan Darah Reagens set 0 0 1
18 Test Gula Darah test 13 12 1
19 Test Kehamilan strip 40 10
20 Test Kolesterol test 0 20 3
21 Test Urine Rutin strip 0 0 1

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 52 100
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 10
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 100
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0 5
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 5
12 Pehavral tablet salut 0 0 1000
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 5
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 10
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 5 0 20
19 Cendo Xytrol TM 5 ml botol 0 0 5
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 1400 600 2000
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 200
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 3000
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 100
25 Vical susp 100 ml botol 11 21 50
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 5000
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 1000
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 1000
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 2000
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 100 1000
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0 2000
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 1000
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

44 Biovitan syrup botol 0 0 10

45 Caviplex syrup botol 0 0 2000
46 Farsifen (Ibuprofen) syrup botol 0 0 5
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 1000
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 1000
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 100
59 Trifadium ( Loperamide HCL 2 mg) tablet 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 Isian Permintaan Obat dan Perbekalan Farmasi untuk LPLPO

PUSKESMAS : MOWEWE BULAN : SEPTEMBER

KECAMATAN : MOWEWE TAHUN : 2017
KAB/KOTA : KOLAKA TIMUR

Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

1 Air Untuk Injeksi 20 ml vial 22 14 40

2 Albendazole tab 400 mg tablet 2000 150
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 550 700 1000
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 7 40 50
7 Ambroksol tab 30 mg tablet 780 1020 1000
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 235 95 1000
12 Amlodipin tab 10 mg tablet 0 300 1000
13 Amoxicillin sir forte 250 mg/5 ml botol 11 51 100
14 Amoxicillin SK 125 mg/5 ml botol 0 0 100
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 1130 4070 5000
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 9 1 50
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 750 2350 2000
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 5
21 Antifungi DOEN kombinasi 30 g pot 0 0 5
22 Antihemoroid DOEN suppo supp 10 0 10
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 3000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 200 800 3000
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 1040 3060 5000
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0 500
40 Asiklovir tab 400 mg tablet 170 30 500
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 0 7 50
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 0 23 50
50 Betametason tts mata 1 mg/ml botol 0 0 5
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

51 Bisakodil sup 5 mg supp 0 0 20

52 Bisakodil sup 10 mg supp 0 0 20
53 Bromheksin tab 8 mg tablet 0 0 1000
54 Cefadroksil kaps 250 mg kapsul 0 0 1000
55 Cefadroksil kaps/tab 500 mg kapsul 0 1200 2000
56 Cefadroksil SK 125 mg/5 mL botol 55 43 50
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 1400 300 500
59 Cefiksime sir 100 mg/5 mL botol 0 0 10
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 240 10 1000
62 Cetrizine sir 5 mg/5 ml botol 0 0 5
63 Cimetidine tab 200 mg tablet 0 0 1000
64 Copper T set/buah 3 0
65 Deksametason tab 0,5 mg tablet 1000 1200 3000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 5 14 20
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 0 3
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 145 605 1000
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 1000
88 Erytromisin SK 200 mg/5 ml botol 4 23 50
89 Etakridin (Rivanol) lar 0,1% botol 2 5 10
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 4 17 50
93 Etil Klorida semprot 100 mL botol 0 0 3
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 20
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 5
106 Garam Oralit kombinasi sacchet 177 123
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0 20
109 Gentamicin salep kulit 10% tube 0 0 20
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

110 Gentamicin salep mata 0,3% tube 0 0 5

111 Gentamicin tts mata 0,3% botol 0 0 5
112 Gentamisin inj 40 mg/ml ampul 10 0
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 280 120 1000
115 Glimepirid tab 1 mg tablet 20 80
116 Glimepirid tab 2 mg tablet 0 0 500
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 700 1100 5000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 50 25
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 610 440 300
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 2000
131 Hydrokortison krim 2,5 % - 5 g tube 0 5 50
132 Ibuprofen tab 200 mg tablet 0 0 1000
133 Ibuprofen tab 400 mg tablet 520 1080 2000
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0 500
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0 500
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 670 80 3000
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 1000
144 Kaptopril tab 25 mg tablet 980 1020 2000
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 25
152 Ketokonazole tab 200 mg tablet 0 0 500
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 300
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 600
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 4 5
160 Kloramfenikol salep kulit 2% tube 0 0 25
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 5
163 Kloramfenikol tts telinga 3% botol 0 0 5
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 970 2230 3000
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 10

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 10
171 Kotrimoxazol tab 480 mg (adult) tablet 790 710 3000
172 Kotrimoxazol susp 60 ml botol 10 25 50
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0 100
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal impl 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 100
180 Lidokain inj 2% (infiltr/p.v.) ampul 15 60 100
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0 3
183 Lisol lar 1.000 ml botol 1 3 3
184 Loratadin tab 10 mg tablet 250 250 500
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 500 500
193 Metformin tab 500 mg tablet 2580 270 700
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 650 100
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 1000
198 Metilprednisolon tab 8 mg tablet 0 0 1000
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0 1000
201 Metoklopramid tab 10 mg tablet 0 700 1000
202 Metronidazol tab 250 mg tablet 860 140
203 Metronidazol tab 500 mg tablet 600 400
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 54 27 50
207 Natrium Diklofenak tab 25 mg tablet 130 1170 1000
208 Natrium Diklofenak tab 50 mg tablet 0 0 2000
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 89 20
210 Nifedipine tab 10 mg tablet 400 0 500
211 Nistatin tab vaginal 100.000 IU ovula 500 0
212 Nistatin tab vaginal 500.000 IU tablet 500 100
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 24 50
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 5
226 Oksimetazolin tts hidung 0,050 % botol 0 0 5
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 50
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 25

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 5 100
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 50 640 1000
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 1620 2380 5000
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1 37 100
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 50
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 300 112
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 25 1
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1320 1630
243 Piroxicam tab 10 mg tablet 400 600 2000
244 Povidon Iodida lar 10% - 1000 ml botol 2 2 3
245 Povidon Iodida lar 10% - 300 ml botol 0 2 5
246 Povidon Iodida lar 10% - 60 ml botol 0 0 10
247 Povidon Iodida lar 10% - 30 ml botol 0 0 20
248 Prednison tab 5 mg tablet 800 2800 3000
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 1010 1390 2000
255 Ranitidin inj 25 mg/mL ampul 5 16 25
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 100
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 100
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 140 104 100
262 Salbutamol tab 2 mg tablet 0 0 1000
263 Salbutamol tab 4 mg tablet 490 910 1000
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 20
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 2000
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 25
275 Simvastatin tab 10 mg tablet 840 510 1000
276 Simvastatin tab 20 mg tablet 0 0 1000
277 Siprofloksasin tab 500 mg tablet 200 500 2000
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 3000
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 5
282 Tetrasiklin kaps 250 mg kapsul 0 250
283 Tetrasiklin kaps 500 mg kapsul 0 0 500
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1000 600 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 1310 2490 3000
295 Zinc sir 10 mg/ml botol 0 0 10
296 Zinc sir 20 mg/5 ml botol 0 0 10
297 Zinc dispersible 20 mg tablet 0 0 1500
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 450 60
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 100
304 Loperamid tab 2 mg tablet 0 0 1000
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0 2000
307 Piracetam tab 400 mg tablet 0 0 100
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0 2000
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 3000
312 Etanol 70% lar 1000 ml botol 0 0 3
313 Etanol 70% lar 300 ml botol 0 4 5
314 Neurosanbe injeksi ampul 0 0 5
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 10 71 200
2 Alat Suntik 2.5 ml pcs 0 0 50
3 Alat Suntik 3 ml pcs 6 19 200
4 Alat Suntik 5 ml pcs 80 20
5 Alat Suntik 10 ml pcs 12 8
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 2
17 Catgut no.2/0 pcs 48 33 60
18 Catgut no.3/0 pcs 96 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 18 0
21 Catheter (folley cathteter) no.12 pcs 20 0
22 Catheter (folley cathteter) no.14 pcs 12 0
23 Catheter (folley cathteter) no.16 pcs 17 0
24 Catheter (folley cathteter) no.18 pcs 110 1
25 Cholesterol test btl/10 strip botol 0 0 1
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0 1
31 Hand Schoen no 7 set 9 22 50
32 Hand Schoen no 7.5 set 8 18 50
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 50
34 Hand Schoen no 8 set 17 13 100
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 50
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 20
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 20
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 20
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 20
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 22 8 30
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 30
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 30
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 30
44 Hand Schoen (Examination Gloves Size S) set 0 0 30
45 Hand Schoen (Examination Gloves Size M) set 0 7 30
46 Hand Schoen (Examination Gloves Size L) set 0 0 30
47 Infusion Set Anak set 7 18 100
48 Infusion Set Dewasa set 9 51 100
49 Infusion Set Macro 2 Cabang set 0 0 10
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 48 11 10
52 IV Catheter no. 20 pcs 20 29 100
53 IV Catheter no. 22 pcs 1 24 30
54 IV Catheter no. 24 pcs 50 11 100
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0
63 Jarum Jahit 3/8 Surgical lusin 1 0
64 Kaca Slide pcs 0 144 100
65 Kapas Pembalut 250 g roll 8 0
66 Kapas Pembalut 500 g roll 10 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 48 50
68 Kasa Hydrofil 40 yard x 80 cm roll 7 4 20
69 Kasa Kompres Steril 40 x 40 cm bungkus 10 20 20
70 Kasa Pembalut 2 m x 80 cm roll 5 5 20
71 Kasa Pembalut 4 m x 5 cm roll 0 0 30
72 Kasa Pembalut 4 m x 10 cm roll 0 0 30
73 Kasa Pembalut 4 m x 15 cm roll 0 0 30
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 30

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 30
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 320
77 Kasa Steril 16 cm x 16 cm box 0 2 20
78 Kasa Steril 18 cm x 22 cm box 2 6 20
79 Masker Ear Loop Pcs 0 200 300
80 Mata Pisau Bedah No. 10 pcs 16 3 10
81 Mata Pisau Bedah No. 11 Pcs 17 3 10
82 Mata Pisau Bedah No. 15 Pcs 5 20 10
83 Mata Pisau Bedah No. 21 Pcs 0 1 10
84 Nasal Oxygen (Aximed) size M Pcs 0 0 10
85 Nasal Oxygen (Aximed) size L Pcs 0 0 10
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 10
87 Plester 5 yard x 2 inchi roll 0 0 5
88 Plester 5 cm x 4,5 cm roll 1 4 5
89 Plester 7,5 cm x 4,5 cm roll 0 0 5
90 Pot Sputum pot 0 65 3
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0 5
93 Safety Box kotak 0 0 2
94 Selang Oxygen pcs 4 10 10
95 Silk (benang bedah sutra) no.2/0 pcs 53 14
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 50
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0 1
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 7 3 5

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 3
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 25 25 1
15 Test Comburt Reagens set 0 0 1
16 Test Golongan Darah set 0 0 1
17 Test Golongan Darah Reagens set 0 0 1
18 Test Gula Darah test 45 18 1
19 Test Kehamilan strip 21 19 50
20 Test Kolesterol test 0 20 3
21 Test Urine Rutin strip 0 0 1

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 1
3 Eugenol cairan 10 ml botol 0 0 1
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 1
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0 1
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0 1
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 100
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 10
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 100
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0 5
8 KY Jelly tube 0 0 2
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 5
12 Pehavral tablet salut 0 0 1000
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 5
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 10
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 7 1 20
19 Cendo Xytrol TM 5 ml botol 0 0 10
20 Formalin 40 % botol 0 0 1
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 310 1090 3000
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 100
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 100
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 100 300 100
25 Vical susp 100 ml botol 11 30 50
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 480
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 5000
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 1000
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 1000
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 2000
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 1000
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0 2000
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 1000
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

44 Biovitan syrup botol 0 0 10

45 Caviplex syrup botol 0 0 20
46 Farsifen (Ibuprofen) syrup botol 0 0 5
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0 500
52 Novadex (Dexametason) 0,5 mg tablet 0 0 1000
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 1000
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 100
59 Trifadium ( Loperamide HCL 2 mg) tablet 500 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 Isian Permintaan Obat dan Perbekalan Farmasi untuk LPLPO

PUSKESMAS : MOWEWE BULAN : DESEMBER

KECAMATAN : MOWEWE TAHUN : 2017
KAB/KOTA : KOLAKA TIMUR

Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

1 Air Untuk Injeksi 20 ml vial 0 22

2 Albendazole tab 400 mg tablet 0 2000
3 Albendazole susp 200 mg/5 ml botol 0 0
4 Allopurinol tab 100 mg tablet 0 550
5 Allopurinol tab 300 mg tablet 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 7
7 Ambroksol tab 30 mg tablet 0 780
8 Aminophyllin tab 200 mg tablet 0 0
9 Aminophyllin inj 24 mg ampul 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0
11 Amlodipin tab 5 mg tablet 0 235
12 Amlodipin tab 10 mg tablet 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 11
14 Amoxicillin SK 125 mg/5 ml botol 0 0
15 Amoxicillin tab 250 mg tablet 0 0
16 Amoxicillin tab 500 mg tablet 0 1130
17 Ampicillin serb inj 1000 mg vial 0 0
18 Antasida DOEN susp 60 ml botol 0 9
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 750
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0
22 Antihemoroid DOEN suppo supp 0 10
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0
28 Artemether inj 80 mg/mL ampul 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 200
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0
34 Asam Folat tab 0,4 mg tablet 0 0
35 Asam Folat tab 1 mg tablet 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0
37 Asam Mefenamat tab 500 mg tablet 0 1040
38 Asam Traneksamat inj 50 mg/mL ampul 0 0
39 Asiklovir tab 200 mg tablet 0 0
40 Asiklovir tab 400 mg tablet 0 170
41 Atenolol tab 50 mg tablet 0 0
42 Atapulgit tab 600 mg tablet 0 0
43 Atropin tab 0,5 mg tablet 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0
45 Azitromisin tablet 500 mg kaplet 0 0
46 Bedak Salisil serb 2% Kotak 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0
49 Betametason krim 0,5 mg/g tube 0 0
50 Betametason tts mata 1 mg/ml botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

51 Bisakodil sup 5 mg supp 0 0

52 Bisakodil sup 10 mg supp 0 0
53 Bromheksin tab 8 mg tablet 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0
56 Cefadroksil SK 125 mg/5 mL botol 0 55
57 Cefadroksil SK 250 mg/5 mL botol 0 0
58 Cefiksime tab 100 mg kapsul 0 1400
59 Cefiksime sir 100 mg/5 mL botol 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0
61 Cetrizine tab 10 mg tablet 0 240
62 Cetrizine sir 5 mg/5 ml botol 0 0
63 Cimetidine tab 200 mg tablet 0 0
64 Copper T set/buah 0 3
65 Deksametason tab 0,5 mg tablet 0 1000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 5
67 Diazepam tab 2 mg tablet 0 0
68 Diazepam tab 5 mg tablet 0 0
69 Diazepam inj 5 mg/ml ampul 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0
74 Digoksin tab 0,25 mg tablet 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0
77 Diltiazem tab 30 mg tablet 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0
81 Domperidon tab 10 mg tablet 0 145
82 Efedrin inj 50 mg/mL tablet 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 26
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0
86 Eritromisin kaps 250 mg kapsul 0 0
87 Eritromisin kaps 500 mg kapsul 0 0
88 Erytromisin SK 200 mg/5 ml botol 0 4
89 Etakridin (Rivanol) lar 0,1% botol 0 2
90 Etambutol tab 250 mg tablet 0 0
91 Etambutol tab 500 mg tablet 0 0
92 Etanol 70 % lar 100 ml botol 0 4
93 Etil Klorida semprot 100 mL botol 0 0
94 Etonogestrel implan 68 mg subd implant 0 0
95 Fenobarbital tab 30 mg tablet 0 0
96 Fenobarbital tab 100 mg tablet 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0
101 Flukonazol kaps 150 mg kapsul 0 0
102 Fluor tab 0,5 mg tablet 0 0
103 Furosemid tab 40 mg tablet 0 0
104 Furosemide inj 10 mg/ml ampul 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0
106 Garam Oralit kombinasi sacchet 0 177
107 Gemfibrozil kaps 300 mg kapsul 0 0
108 Gentamicin krim 10% tube 0 0
109 Gentamicin salep kulit 10% tube 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

110 Gentamicin salep mata 0,3% tube 0 0

111 Gentamicin tts mata 0,3% botol 0 0
112 Gentamisin inj 40 mg/ml ampul 0 10
113 Gentamisin inj 80 mg/ml vial 0 0
114 Glibenklamid tab 5 mg tablet 0 280
115 Glimepirid tab 1 mg tablet 0 20
116 Glimepirid tab 2 mg tablet 0 0
117 Glipizid tab 5 mg tablet 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 700
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0
120 Gliserin lar 50% botol 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 0 50
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0
123 Griseofulvin tab 125 mg tablet 0 610
124 Haloperidol tab 0,5 mg tablet 0 0
125 Haloperidol tab 1,5 mg tablet 0 0
126 Haloperidol tab 2 mg tablet 0 0
127 Haloperidol tab 5 mg tablet 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0
132 Ibuprofen tab 200 mg tablet 0 0
133 Ibuprofen tab 400 mg tablet 0 520
134 Ibuprofen sir 100 mg/5 ml botol 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0
136 Isoniazid tab 100 mg tablet 0 0
137 Isoniazid tab 300 mg tablet 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 100
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 670
142 Kanamisin inj 1.000 mg/vial vial 0 0
143 Kaptopril tab 12,5 mg tablet 0 0
144 Kaptopril tab 25 mg tablet 0 980
145 Kaptopril tab 50 mg tablet 0 0
146 Karbamazepin tab 200 mg tablet 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0
148 Karbogliserin tts telinga 10% botol 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0
152 Ketokonazole tab 200 mg tablet 0 0
153 Klaritromisin tab 500 mg tablet 0 0
154 Klindamisin kaps 150 mg kapsul 0 0
155 Klindamisin kaps 300 mg kapsul 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0
159 Kloramfenikol salap mata 1% tube 0 0
160 Kloramfenikol salep kulit 2% tube 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0
163 Kloramfenikol tts telinga 3% botol 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 0 970
165 Klorpromazin HCl tab 25 mg tablet 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0
168 Kodein HCL tab 10 mg tablet 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0

170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 790
172 Kotrimoxazol susp 60 ml botol 0 10
173 Kuinin tab 200 mg tablet 0 0
174 Kuinin tab 222 mg tablet 0 0
175 Kuinin inj 25% (i.v) ampul 0 0
176 Levofloxacin tab 500 mg tablet 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal implant 0 0
179 Lidokain inj 1% (infltr) ampul 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 15
181 Lidokain gel 2% botol 0 0
182 Lidokain semprot 10% botol 0 0
183 Lisol lar 1.000 ml botol 0 1
184 Loratadin tab 10 mg tablet 0 250
185 Magnesium Sulfat serb 30 g sacchet 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 0 45
187 Magnesium Sulfat inj 40% - 25 ml vial 0 5
188 Mebendazol tab 100 mg tablet 0 0
189 Mebendazol tab 500 mg tablet 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 0 18
192 Metampiron (Antalgin) tab 500 mg tablet 0 0
193 Metformin tab 500 mg tablet 0 2580
194 Metformin tab 850 mg tablet 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 650
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0
197 Metilprednisolon tab 4 mg tablet 0 0
198 Metilprednisolon tab 8 mg tablet 0 0
199 Metilprednisolon tab 16 mg tablet 0 0
200 Metoklopramid tab 5 mg tablet 0 0
201 Metoklopramid tab 10 mg tablet 0 0
202 Metronidazol tab 250 mg tablet 0 860
203 Metronidazol tab 500 mg tablet 0 600
204 Metronidazol sir 125 mg/5 ml botol 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0
206 Miconazole krim 2% tube 0 54
207 Natrium Diklofenak tab 25 mg tablet 0 130
208 Natrium Diklofenak tab 50 mg tablet 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 0 89
210 Nifedipine tab 10 mg tablet 0 400
211 Nistatin tab vaginal 100.000 IU ovula 0 500
212 Nistatin tab vaginal 500.000 IU tablet 0 500
213 Obat Anti TB Kategori Anak Paket 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0
215 Obat Anti TB Kategori I Paket 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0
218 Obat Anti TB Kategori II Paket 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0
220 Obat Anti TB Kategori III Paket 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0
223 Ofloxacin tab 200 mg tablet 0 0
224 Ofloxacin tab 400 mg tablet 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0

229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0
230 Olopatadin tts mata 0,1% botol 0 0
231 Omeprazol kaps 20 mg kapsul 0 50
232 Omeprazol inj 40 mg/10 mL vial 0 0
233 Paracetamol tab 500 mg tablet 0 1620
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 1
235 Paracetamol tts 60 mg/0,6 mL botol 0 0
236 Perak Sulfadiazin krim 1% tube 0 0
237 Permetrin krim 5% tube 0 0
238 Pirantel Pamoat tab 125 mg tablet 0 300
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 0 25
240 Pirazinamid tab 500 mg tablet 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 0 1320
243 Piroxicam tab 10 mg tablet 0 400
244 Povidon Iodida lar 10% - 1000 ml botol 0 2
245 Povidon Iodida lar 10% - 300 ml botol 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0
248 Prednison tab 5 mg tablet 0 800
249 Primakuin tab 15 mg tablet 0 0
250 Probenesid tab 500 mg tablet 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0
252 Propranolol tab 10 mg tablet 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0
254 Ranitidin tab 150 mg tablet 0 1010
255 Ranitidin inj 25 mg/mL ampul 0 5
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0
258 Rifampicin kaps 300 mg kapsul 0 0
259 Rifampicin tab 450 mg tablet 0 0
260 Rifampicin tab 600 mg tablet 0 0
261 Ringer Laktat lar inf steril 500 ml botol 0 140
262 Salbutamol tab 2 mg tablet 0 0
263 Salbutamol tab 4 mg tablet 0 490
264 Salbutamol cairan ih 0,1% botol 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0
275 Simvastatin tab 10 mg tablet 0 840
276 Simvastatin tab 20 mg tablet 0 0
277 Siprofloksasin tab 500 mg tablet 0 200
278 Spironolakton tab 25 mg tablet 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 0 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

287 Tramadol inj 50 mg/mL ampul 0 0

288 Triheksipenidil tab 2 mg tablet 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0
290 Valproat tab sal 250 mg tablet salut 0 0
291 Valproat tab sal 500 mg tablet salut 0 0
292 Valproat sir 250 mg/5 mL botol 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0
294 Vitamin B Kompleks tablet 0 1310
295 Zinc sir 10 mg/ml botol 0 0
296 Zinc sir 20 mg/5 ml botol 0 0
297 Zinc dispersible 20 mg tablet 0 0
298 Alprazolam tab 1 mg tablet 0 0
299 Betahistin tab 6 mg tablet 0 450
300 Idometasin kapl 25 mg kaplet 0 0
301 Karbon Aktif tab 125 mg tablet 0 0
302 Klobazam tab 10 mg tablet 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0
304 Loperamid tab 2 mg tablet 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0
306 Papaverin 40 mg tablet 0 0
307 Piracetam tab 400 mg tablet 0 0
308 Thiamfenikol tab 250 mg tablet 0 0
309 Piracetam tab 800 mg tablet 0 0
310 Piroxicam tab 20 mg tablet 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0
312 Etanol 70% lar 1000 ml botol 0 0
313 Etanol 70% lar 300 ml botol 0 0
314 Neurosanbe injeksi ampul 0 0
315 H2O2 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 0 10
2 Alat Suntik 2.5 ml pcs 0 0
3 Alat Suntik 3 ml pcs 0 6
4 Alat Suntik 5 ml pcs 0 80
5 Alat Suntik 10 ml pcs 0 12
6 Alat Suntik 20 ml pcs 0 0
7 Alat Suntik 50 ml pcs 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0

16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0
17 Catgut no.2/0 pcs 0 48
18 Catgut no.3/0 pcs 0 96
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0
20 Catheter (folley cathteter) no.10 pcs 0 18
21 Catheter (folley cathteter) no.12 pcs 0 20
22 Catheter (folley cathteter) no.14 pcs 0 12
23 Catheter (folley cathteter) no.16 pcs 0 17
24 Catheter (folley cathteter) no.18 pcs 0 110
25 Cholesterol test btl/10 strip botol 0 0
26 Copper T set 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0
30 Glukosa test btl/25 strip botol 0 0
31 Hand Schoen no 7 set 0 9
32 Hand Schoen no 7.5 set 0 8
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0
34 Hand Schoen no 8 set 0 17
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 22
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0
47 Infusion Set Anak set 0 7
48 Infusion Set Dewasa set 0 9
49 Infusion Set Macro 2 Cabang set 0 0
50 IV Catheter no. 16 pcs 0 0
51 IV Catheter no. 18 pcs 0 48
52 IV Catheter no. 20 pcs 0 20
53 IV Catheter no. 22 pcs 0 1
54 IV Catheter no. 24 pcs 0 50
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0
61 Jarum Jahit Otot all size lusin 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 1
63 Jarum Jahit 3/8 Surgical lusin 0 1
64 Kaca Slide pcs 0 0
65 Kapas Pembalut 250 g roll 0 8
66 Kapas Pembalut 500 g roll 0 10
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 0 7
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 10
70 Kasa Pembalut 2 m x 80 cm roll 0 5
71 Kasa Pembalut 4 m x 5 cm roll 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0

75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0
78 Kasa Steril 18 cm x 22 cm box 0 2
79 Masker Ear Loop Pcs 0 0
80 Mata Pisau Bedah No. 10 pcs 0 16
81 Mata Pisau Bedah No. 11 Pcs 0 17
82 Mata Pisau Bedah No. 15 Pcs 0 5
83 Mata Pisau Bedah No. 21 Pcs 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0
87 Plester 5 yard x 2 inchi roll 0 0
88 Plester 5 cm x 4,5 cm roll 0 1
89 Plester 7,5 cm x 4,5 cm roll 0 0
90 Pot Sputum pot 0 0
91 RDT pcs 0 0
92 Regulator Oxygen pcs 0 0
93 Safety Box kotak 0 0
94 Selang Oxygen pcs 0 4
95 Silk (benang bedah sutra) no.2/0 pcs 0 53
96 Silk (benang bedah sutra) no.3/0 pcs 0 0
97 Sound Timer unit 0 0
98 Stempel ISPA pcs 0 0
99 Uric Acid test btl/25 strip botol 0 0
100 Urine bag pcs 0 7

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0
5 Larutan Benedik botol 0 0
6 Larutan Eosin 2% botol 0 0
7 Larutan Etanol Asam botol 0 0
8 Larutan Giemsa Stein botol 0 0
9 Larutan Karbol Fuksin botol 0 0
10 Larutan Metanol botol 0 0
11 Larutan Metilen Biru botol 0 0
12 Larutan Turk botol 0 0
13 Reagen TBC kit 0 0
14 Test Asam Urat test 0 25
15 Test Comburt Reagens set 0 0
16 Test Golongan Darah set 0 0
17 Test Golongan Darah Reagens set 0 0
18 Test Gula Darah test 0 45
19 Test Kehamilan strip 0 21
20 Test Kolesterol test 0 0
21 Test Urine Rutin strip 0 0

GIGI
1 Air raksa Dental Use - 0 0
2 Devitalisasi pasta (arsen) kotak 0 0
3 Eugenol cairan 10 ml botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

4 Fluoride 0.5 mg tablet 0 0

5 Fluoride 1 mg tablet 0 0
6 Hemospon (Spongostan Dental) pcs 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0
9 Kalsium Hidroksida Pasta tube 0 0
10 Klorheksidin lar 0,2% botol 0 0
11 Klorheksidin lar 15% botol 0 0
12 Mata Bor Gigi pcs 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0
3 Becefort sir 60 ml botol 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0
6 Fluoride 1 mg tablet 0 0
7 Kandistatin susp 12 ml botol 0 0
8 KY Jelly tube 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0
12 Pehavral tablet salut 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 7
19 Cendo Xytrol TM 5 ml botol 0 0
20 Formalin 40 % botol 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 310
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 100
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 0 100
25 Vical susp 100 ml botol 0 11
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0
40 Novabion tablet 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0
43 Sultrimix syrup botol 0 0
 Pemakaian
No. Nama Obat Satuan Sisa Stock Permintaan
selama 3 bulan

44 Biovitan syrup botol 0 0

45 Caviplex syrup botol 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0
51 Arkavit tablet 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 0 80
59 Trifadium ( Loperamide HCL 2 mg) tablet 0 500
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
0 0 0 0 0
 Menu

Peringatan

!
 TANGGAL KADALUWARSA
Tgl Kadaluwarsa
No. Nama Obat Satuan Nomor Batch
(Bln/Tgl/Thn)

1 Air Untuk Injeksi 20 ml vial

2 Albendazole tab 400 mg tablet
3 Albendazole susp 200 mg/5 ml botol
4 Allopurinol tab 100 mg tablet
5 Allopurinol tab 300 mg tablet
6 Ambroksol sir 15 mg/ml - 60 ml botol
7 Ambroksol tab 30 mg tablet
8 Aminophyllin tab 200 mg tablet
9 Aminophyllin inj 24 mg ampul
10 Amitriptiline HCl tab 25 mg tablet
11 Amlodipin tab 5 mg tablet
12 Amlodipin tab 10 mg tablet
13 Amoxicillin sir forte 250 mg/5 ml botol
14 Amoxicillin SK 125 mg/5 ml botol
15 Amoxicillin tab 250 mg tablet
16 Amoxicillin tab 500 mg tablet
17 Ampicillin serb inj 1000 mg vial
18 Antasida DOEN susp 60 ml botol
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrtablet
20 Anti Bakteri DOEN salep kombinasi 5 g pot
21 Antifungi DOEN kombinasi 30 g pot
22 Antihemoroid DOEN suppo supp
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mtablet
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 tablet
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mKapsul
28 Artemether inj 80 mg/mL ampul
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet
34 Asam Folat tab 0,4 mg tablet
35 Asam Folat tab 1 mg tablet
36 Asam Mefenamat tab 250 mg tablet
37 Asam Mefenamat tab 500 mg tablet
38 Asam Traneksamat inj 50 mg/mL ampul
39 Asiklovir tab 200 mg tablet
40 Asiklovir tab 400 mg tablet
41 Atenolol tab 50 mg tablet
42 Atapulgit tab 600 mg tablet
43 Atropin tab 0,5 mg tablet
44 Atropin Sulfat inj 0,25 mg/ml ampul
45 Azitromisin tablet 500 mg kaplet
46 Bedak Salisil serb 2% Kotak
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial
49 Betametason krim 0,5 mg/g tube
50 Betametason tts mata 1 mg/ml botol
51 Bisakodil sup 5 mg supp
52 Bisakodil sup 10 mg supp
53 Bromheksin tab 8 mg tablet
54 Cefadroksil kaps 250 mg kapsul
55 Cefadroksil kaps/tab 500 mg kapsul
56 Cefadroksil SK 125 mg/5 mL botol
57 Cefadroksil SK 250 mg/5 mL botol
58 Cefiksime tab 100 mg kapsul
59 Cefiksime sir 100 mg/5 mL botol
60 Ceftriaxone serb inj 1.000 mg/vial vial
61 Cetrizine tab 10 mg tablet
62 Cetrizine sir 5 mg/5 ml botol
63 Cimetidine tab 200 mg tablet
64 Copper T set/buah
65 Deksametason tab 0,5 mg tablet
66 Deksamethason inj 5 mg/ml - 1 ml ampul
67 Diazepam tab 2 mg tablet
68 Diazepam tab 5 mg tablet
69 Diazepam inj 5 mg/ml ampul
70 Diazepam lar rektal 10 mg/2,5 ml botol
71 Diazepam lar rektal 5 mg/2,5 ml botol
72 Dietil Karbamazin tab 100 mg tablet
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul
74 Digoksin tab 0,25 mg tablet
75 Diltiazem kaps SR 100 mg kapsul
76 Diltiazem kaps SR 200 mg kapsul
77 Diltiazem tab 30 mg tablet
78 Dimenhidrinat tab 50 mg tablet
79 Doksisiklin kaps 100 mg kapsul
80 Domperidon susp 5 mg/5 ml botol
81 Domperidon tab 10 mg tablet
82 Efedrin inj 50 mg/mL tablet
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol
86 Eritromisin kaps 250 mg kapsul
87 Eritromisin kaps 500 mg kapsul
88 Erytromisin SK 200 mg/5 ml botol
89 Etakridin (Rivanol) lar 0,1% botol
90 Etambutol tab 250 mg tablet
91 Etambutol tab 500 mg tablet
92 Etanol 70 % lar 100 ml botol
93 Etil Klorida semprot 100 mL botol
94 Etonogestrel implan 68 mg subd implant
95 Fenobarbital tab 30 mg tablet
96 Fenobarbital tab 100 mg tablet
97 Fenobarbital inj 50 mg/ml-1 ml ampul
98 Fenol Gliserol tts telinga 10% botol
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul
101 Flukonazol kaps 150 mg kapsul
102 Fluor tab 0,5 mg tablet
103 Furosemid tab 40 mg tablet
104 Furosemide inj 10 mg/ml ampul
105 Gameksan lotion 1% - 30 ml botol
106 Garam Oralit kombinasi sacchet
107 Gemfibrozil kaps 300 mg kapsul
108 Gentamicin krim 10% tube
109 Gentamicin salep kulit 10% tube
110 Gentamicin salep mata 0,3% tube
111 Gentamicin tts mata 0,3% botol
112 Gentamisin inj 40 mg/ml ampul
113 Gentamisin inj 80 mg/ml vial
114 Glibenklamid tab 5 mg tablet
115 Glimepirid tab 1 mg tablet
116 Glimepirid tab 2 mg tablet
117 Glipizid tab 5 mg tablet
118 Gliseril Guaikolat tab 100 mg tablet
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub
120 Gliserin lar 50% botol
121 Glukosa lar infus steril 5% - 500 ml botol
122 Glukosa lar Infus steril 10% - 500 ml botol
123 Griseofulvin tab 125 mg tablet
124 Haloperidol tab 0,5 mg tablet
125 Haloperidol tab 1,5 mg tablet
126 Haloperidol tab 2 mg tablet
127 Haloperidol tab 5 mg tablet
128 Hidrogen Peroksida lar konsentrat 3% botol
129 Hiosina Butilbromida tab 10 mg tablet
130 Hydroklortiazid (HCT) tab 25 mg tablet
131 Hydrokortison krim 2,5 % - 5 g tube
132 Ibuprofen tab 200 mg tablet
133 Ibuprofen tab 400 mg tablet
134 Ibuprofen sir 100 mg/5 ml botol
135 Ibuprofen sir 200 mg/5 ml botol
136 Isoniazid tab 100 mg tablet
137 Isoniazid tab 300 mg tablet
138 Isosorbid Dinitrat tab 5 mg tablet
139 Kalsium Glukonat inj 100 mg/mL ampul
140 Kalsium Karbonat tab 500 mg tablet
141 Kalsium Laktat (Kalk) tab 500 mg tablet
142 Kanamisin inj 1.000 mg/vial vial
143 Kaptopril tab 12,5 mg tablet
144 Kaptopril tab 25 mg tablet
145 Kaptopril tab 50 mg tablet
146 Karbamazepin tab 200 mg tablet
147 Karbamazepin sir 100 mg/5 mL botol
148 Karbogliserin tts telinga 10% botol
149 Ketamin inj 50 mg/ml - 20 ml ampul
150 Ketamin inj 100 mg/ml - 20ml ampul
151 Ketokonazole krim 2% - 15 g tube
152 Ketokonazole tab 200 mg tablet
153 Klaritromisin tab 500 mg tablet
154 Klindamisin kaps 150 mg kapsul
155 Klindamisin kaps 300 mg kapsul
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol
157 Kloramfenikol kaps 250 mg kapsul
158 Kloramfenikol kaps 500 mg kapsul
159 Kloramfenikol salap mata 1% tube
160 Kloramfenikol salep kulit 2% tube
161 Kloramfenikol susp 125 mg/5 ml botol
162 Kloramfenikol tts mata 0,5% botol
163 Kloramfenikol tts telinga 3% botol
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet
165 Klorpromazin HCl tab 25 mg tablet
166 Klorpromazin HCl tab 100 mg tablet
167 Klorpromazin inj 5 mg/mL (i.m.) ampul
168 Kodein HCL tab 10 mg tablet
169 Kontrasepsi Progesteron Depot (3 Bulan) vial
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiotablet
171 Kotrimoxazol tab 480 mg (adult) tablet
172 Kotrimoxazol susp 60 ml botol
173 Kuinin tab 200 mg tablet
174 Kuinin tab 222 mg tablet
175 Kuinin inj 25% (i.v) ampul
176 Levofloxacin tab 500 mg tablet
177 Levofloxacin inf 5 mg/mL botol
178 Levonorgestrel implan 2 rods - 75 mg subdermal implant
179 Lidokain inj 1% (infltr) ampul
180 Lidokain inj 2% (infiltr/p.v.) ampul
181 Lidokain gel 2% botol
182 Lidokain semprot 10% botol
183 Lisol lar 1.000 ml botol
184 Loratadin tab 10 mg tablet
185 Magnesium Sulfat serb 30 g sacchet
186 Magnesium Sulfat inj 20% - 25 ml vial
187 Magnesium Sulfat inj 40% - 25 ml vial
188 Mebendazol tab 100 mg tablet
189 Mebendazol tab 500 mg tablet
190 Mebendazol sir 100 mg/5 ml - 30 ml botol
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul
192 Metampiron (Antalgin) tab 500 mg tablet
193 Metformin tab 500 mg tablet
194 Metformin tab 850 mg tablet
195 Metilergometrin Maleat tab 0.125 mg tablet
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul
197 Metilprednisolon tab 4 mg tablet
198 Metilprednisolon tab 8 mg tablet
199 Metilprednisolon tab 16 mg tablet
200 Metoklopramid tab 5 mg tablet
201 Metoklopramid tab 10 mg tablet
202 Metronidazol tab 250 mg tablet
203 Metronidazol tab 500 mg tablet
204 Metronidazol sir 125 mg/5 ml botol
205 Metronidazol lar inf 5 mg/mL botol
206 Miconazole krim 2% tube
207 Natrium Diklofenak tab 25 mg tablet
208 Natrium Diklofenak tab 50 mg tablet
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol
210 Nifedipine tab 10 mg tablet
211 Nistatin tab vaginal 100.000 IU ovula
212 Nistatin tab vaginal 500.000 IU tablet
213 Obat Anti TB Kategori Anak Paket
214 Obat Anti TB Kategori Anak FDC Paket
215 Obat Anti TB Kategori I Paket
216 Obat Anti TB Kategori I FDC Paket
217 Obat Anti TB Kategori I Kombipak Paket
218 Obat Anti TB Kategori II Paket
219 Obat Anti TB Kategori II FDC Paket
220 Obat Anti TB Kategori III Paket
221 Obat Anti TB Kategori Sisipan FDC Paket
222 Obat Batuk Hitam (OBH) sir 100 ml botol
223 Ofloxacin tab 200 mg tablet
224 Ofloxacin tab 400 mg tablet
225 Oksimetazolin tts hidung 0,025 % botol
226 Oksimetazolin tts hidung 0,050 % botol
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube
229 Oksitosin inj 10 IU/ml - 1 ml ampul
230 Olopatadin tts mata 0,1% botol
231 Omeprazol kaps 20 mg kapsul
232 Omeprazol inj 40 mg/10 mL vial
233 Paracetamol tab 500 mg tablet
234 Paracetamol sir 120 mg/5 ml - 60 ml botol
235 Paracetamol tts 60 mg/0,6 mL botol
236 Perak Sulfadiazin krim 1% tube
237 Permetrin krim 5% tube
238 Pirantel Pamoat tab 125 mg tablet
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol
240 Pirazinamid tab 500 mg tablet
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul
242 Piridoksin (Vitamin B6) tab 10 mg tablet
243 Piroxicam tab 10 mg tablet
244 Povidon Iodida lar 10% - 1000 ml botol
245 Povidon Iodida lar 10% - 300 ml botol
246 Povidon Iodida lar 10% - 60 ml botol
247 Povidon Iodida lar 10% - 30 ml botol
248 Prednison tab 5 mg tablet
249 Primakuin tab 15 mg tablet
250 Probenesid tab 500 mg tablet
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial
252 Propranolol tab 10 mg tablet
253 Propiltiourasil ( PTU) tab 100 mg tablet
254 Ranitidin tab 150 mg tablet
255 Ranitidin inj 25 mg/mL ampul
256 Retinol (Vit A) softcap 100.000 IU softcap
257 Retinol (Vit A) softcap 200.000 IU softcap
258 Rifampicin kaps 300 mg kapsul
259 Rifampicin tab 450 mg tablet
260 Rifampicin tab 600 mg tablet
261 Ringer Laktat lar inf steril 500 ml botol
262 Salbutamol tab 2 mg tablet
263 Salbutamol tab 4 mg tablet
264 Salbutamol cairan ih 0,1% botol
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial
267 Serum Antibisa Ular inj 5 ml (ABU I) vial
268 Serum Antidifteri inj 10,000 IU vial
269 Serum Antidifteri inj 20,000 IU vial
270 Serum Antitetanus inj 1.500 IU vial
271 Serum Antitetanus inj 10.000 IU vial
272 Serum Antitetanus inj 20.000 IU vial
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul
275 Simvastatin tab 10 mg tablet
276 Simvastatin tab 20 mg tablet
277 Siprofloksasin tab 500 mg tablet
278 Spironolakton tab 25 mg tablet
279 Streptomisin serb inj 1,000 mg/vial vial
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folattablet
281 Tetracain HCl tts mata 0,5% - 5 ml botol
282 Tetrasiklin kaps 250 mg kapsul
283 Tetrasiklin kaps 500 mg kapsul
284 Thiamfenikol kaps 500 mg kapsul
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul
287 Tramadol inj 50 mg/mL ampul
288 Triheksipenidil tab 2 mg tablet
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul
290 Valproat tab sal 250 mg tablet salut
291 Valproat tab sal 500 mg tablet salut
292 Valproat sir 250 mg/5 mL botol
293 Vankomisin serb inj 500 mg/vial vial
294 Vitamin B Kompleks tablet
295 Zinc sir 10 mg/ml botol
296 Zinc sir 20 mg/5 ml botol
297 Zinc dispersible 20 mg tablet
298 Alprazolam tab 1 mg tablet
299 Betahistin tab 6 mg tablet
300 Idometasin kapl 25 mg kaplet
301 Karbon Aktif tab 125 mg tablet
302 Klobazam tab 10 mg tablet
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul
304 Loperamid tab 2 mg tablet
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul
306 Papaverin 40 mg tablet
307 Piracetam tab 400 mg tablet
308 Thiamfenikol tab 250 mg tablet
309 Piracetam tab 800 mg tablet
310 Piroxicam tab 20 mg tablet
311 Asam Askorbat (Vit.C) tab 25 mg tablet
312 Etanol 70% lar 1000 ml botol
313 Etanol 70% lar 300 ml botol
314 Neurosanbe injeksi ampul
315 H2O2 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs
2 Alat Suntik 2.5 ml pcs
3 Alat Suntik 3 ml pcs
4 Alat Suntik 5 ml pcs
5 Alat Suntik 10 ml pcs
6 Alat Suntik 20 ml pcs
7 Alat Suntik 50 ml pcs
8 Alat Suntik ADS 0,5 ml pcs
9 Alat Suntik ADS 3 ml (BD) pcs
10 Alat Suntik ADS 5 ml (BD) pcs
11 Alat Suntik ADS 5 ml BCG pcs
12 Alat Suntik ADS 10 ml (BD) pcs
13 Alat Suntik (Nipro Syringe) 3 ml pcs
14 Alat Suntik (Nipro Syringe) 5 ml pcs
15 Alat Suntik (Nipro Syringe) 10 ml pcs
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit
17 Catgut no.2/0 pcs
18 Catgut no.3/0 pcs
19 Catheter (Aximed Foleycath 2-Way no.14) pcs
20 Catheter (folley cathteter) no.10 pcs
21 Catheter (folley cathteter) no.12 pcs
22 Catheter (folley cathteter) no.14 pcs
23 Catheter (folley cathteter) no.16 pcs
24 Catheter (folley cathteter) no.18 pcs
25 Cholesterol test btl/10 strip botol
26 Copper T set
27 Feeding Tube (Aximed) 40 cm no. 6 pcs
28 Feeding Tube (Aximed) 40 cm no. 8 pcs
29 Feeding Tube (Aximed) 40 cm no. 10 pcs
30 Glukosa test btl/25 strip botol
31 Hand Schoen no 7 set
32 Hand Schoen no 7.5 set
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set
34 Hand Schoen no 8 set
35 Hand Schoen no 8 U/ manual Placenta ( Long) set
36 Hand Schoen (Aximed Exam Gloves size S) pcs
37 Hand Schoen (Aximed Exam Gloves size M) pcs
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs
40 Hand Schoen (Chirurgic Gloves no. 6,5) set
41 Hand Schoen (Chirurgic Gloves no. 7,0) set
42 Hand Schoen (Chirurgic Gloves no. 7,5) set
43 Hand Schoen (Chirurgic Gloves no. 8,0) set
44 Hand Schoen (Examination Gloves Size S) set
45 Hand Schoen (Examination Gloves Size M) set
46 Hand Schoen (Examination Gloves Size L) set
47 Infusion Set Anak set
48 Infusion Set Dewasa set
49 Infusion Set Macro 2 Cabang set
50 IV Catheter no. 16 pcs
51 IV Catheter no. 18 pcs
52 IV Catheter no. 20 pcs
53 IV Catheter no. 22 pcs
54 IV Catheter no. 24 pcs
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs
61 Jarum Jahit Otot all size lusin
62 Jarum Jahit 1/2 Surgical lusin
63 Jarum Jahit 3/8 Surgical lusin
64 Kaca Slide pcs
65 Kapas Pembalut 250 g roll
66 Kapas Pembalut 500 g roll
67 Kasa Hydrofil 18 yard x 22 cm roll
68 Kasa Hydrofil 40 yard x 80 cm roll
69 Kasa Kompres Steril 40 x 40 cm bungkus
70 Kasa Pembalut 2 m x 80 cm roll
71 Kasa Pembalut 4 m x 5 cm roll
72 Kasa Pembalut 4 m x 10 cm roll
73 Kasa Pembalut 4 m x 15 cm roll
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll
77 Kasa Steril 16 cm x 16 cm box
78 Kasa Steril 18 cm x 22 cm box
79 Masker Ear Loop Pcs
80 Mata Pisau Bedah No. 10 pcs
81 Mata Pisau Bedah No. 11 Pcs
82 Mata Pisau Bedah No. 15 Pcs
83 Mata Pisau Bedah No. 21 Pcs
84 Nasal Oxygen (Aximed) size M Pcs
85 Nasal Oxygen (Aximed) size L Pcs
86 Nasal Oxygen (Aximed) size XS Pcs
87 Plester 5 yard x 2 inchi roll
88 Plester 5 cm x 4,5 cm roll
89 Plester 7,5 cm x 4,5 cm roll
90 Pot Sputum pot
91 RDT pcs
92 Regulator Oxygen pcs
93 Safety Box kotak
94 Selang Oxygen pcs
95 Silk (benang bedah sutra) no.2/0 pcs
96 Silk (benang bedah sutra) no.3/0 pcs
97 Sound Timer unit
98 Stempel ISPA pcs
99 Uric Acid test btl/25 strip botol
100 Urine bag pcs

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol
3 Larutan Asam Klorida (HCl) 0,1 N botol
4 Larutan Asam Sulfa Salisilat 20% botol
5 Larutan Benedik botol
6 Larutan Eosin 2% botol
7 Larutan Etanol Asam botol
8 Larutan Giemsa Stein botol
9 Larutan Karbol Fuksin botol
10 Larutan Metanol botol
11 Larutan Metilen Biru botol
12 Larutan Turk botol
13 Reagen TBC kit
14 Test Asam Urat test
15 Test Comburt Reagens set
16 Test Golongan Darah set
17 Test Golongan Darah Reagens set
18 Test Gula Darah test
19 Test Kehamilan strip
20 Test Kolesterol test
21 Test Urine Rutin strip

GIGI
1 Air raksa Dental Use -
2 Devitalisasi pasta (arsen) kotak
3 Eugenol cairan 10 ml botol
4 Fluoride 0.5 mg tablet
5 Fluoride 1 mg tablet
6 Hemospon (Spongostan Dental) pcs
7 Iodoform Pasta (Mumyfyng Pasta) set
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin
9 Kalsium Hidroksida Pasta tube
10 Klorheksidin lar 0,2% botol
11 Klorheksidin lar 15% botol
12 Mata Bor Gigi pcs
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol
14 Semen Seng Fosfat serbuk/cair 30 gram botol
15 Trikresol Formalin (TKF) cairan botol

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol
3 Becefort sir 60 ml botol
4 Bronex (Bromheksin) tab 8 mg tablet
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol
6 Fluoride 1 mg tablet
7 Kandistatin susp 12 ml botol
8 KY Jelly tube
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol
10 Norit (Karbon Aktif) tab 125 mg tablet
11 Pantocain (Tetrakain HCl) tetes mata botol
12 Pehavral tablet salut
13 Reco (Kloramfenikol) salep mata 1% tube
14 Reco (Kloramfenikol) tts telinga 3% botol
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul
17 Vaksin Antirabies Vero (VAR) vial
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol
19 Cendo Xytrol TM 5 ml botol
20 Formalin 40 % botol
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet
23 Pritamox (Amoxicillin) tab 500 mg tablet
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul
25 Vical susp 100 ml botol
26 Vitamin D3 00 IU/D-Vit tablet tablet
27 Vinafluor (Fluoride) kapl 1 mg kaplet
28 Sanmol (Parasetamol) 500 mg tablet
29 Cardisan ( Amlodipine) 5 mg tablet
30 Purecemia (Allopurinol) 300 mg tablet
31 Mefinal (Asam Mefenamat) 500 mg kaplet
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet
34 Mucohexin (Bromhexine HCl) 8 mg tablet
35 Cholvastin (Lovastatin) 20 mg tablet
36 Histigo (Betahistin) tab 6 mg tablet
37 Novadium (Loperamid) tab 2 mg tablet
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol
39 Metolon (Metoklorperamid) tab 10 mg tablet
40 Novabion tablet
41 Novagesic (Parasetamol) tab 500 mg tablet
42 Defamol (Parasetamol) tab 500 mg tablet
43 Sultrimix syrup botol
44 Biovitan syrup botol
45 Caviplex syrup botol
46 Farsifen (Ibuprofen) syrup botol
47 Novaxifen (Ibuprofen) tab 200 mg tablet
48 Lexigo (Betahistin) tab 6 mg tablet
49 Loric (Allopurinol) tab 100 mg tablet
50 Eryra Forte (Erytromicin) kaps 500 mg tablet
51 Arkavit tablet
52 Novadex (Dexametason) 0,5 mg tablet
53 Carbidu (Dexametason) 0,5 mg tablet
54 Gralixa (Furosemid) 40 mg tablet
55 Grafazol (Metronidazol) tab 500 mg tablet
56 Glikos (Metformin) tab 500 mg tablet
57 Vesverum (Domperidon Maleat) tab 10 mg tablet
58 Metaneuron (Metamizolesodium + Diazepam) tablet
59 Trifadium ( Loperamide HCL 2 mg) tablet
0 0 0
0 0 0
0 0 0
0 0 0
 Peringatan
Menu
!

Tulislah nomor batch dan tanggal kadaluwarsa

obat pada kolom yang telah disediakan, dengan
cara penulisan seperti contoh di bawah ini: Contoh
1). Kadaluwarsa tgl: 18 ; bln: 3; thn:2016, ditulis
3/18/2016. Contoh 2).
Kadaluwarsa tgl: tdk tertulis; bln:4; thn: 2016,
ditulis 4/1/2016.

Setelah beberapa waktu, jika nama obat dengan

kolom tanggal kadaluwarsa berubah menjadi
warna merah, berarti obat tersebut telah masuk
dalam bulan kadaluwarsanya (obat dalam kondisi
kadaluwarsa).
 ISIAN DATA PUSKESMAS UNTUK PENULISAN LAP
LAPORAN BULAN JANUARI

TAHUN : 2017
BULAN : JANUARI
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN FEBRUARI

TAHUN : 2017
BULAN : FEBRUARI
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN MARET

TAHUN : 2017
BULAN : MARET
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN APRIL

TAHUN : 2017
BULAN : APRIL
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN MEI

TAHUN : 2017
BULAN : MEI
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN JUNI

TAHUN : 2017
BULAN : JUNI
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA
 LAPORAN BULAN JULI

TAHUN : 2017
BULAN : JULI
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN AGUSTUS

TAHUN : 2017
BULAN : AGUSTUS
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN SEPTEMBER

TAHUN : 2017
BULAN : SEPTEMBER
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN OKTOBER

TAHUN : 2017
BULAN : OKTOBER
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN NOVEMBER

TAHUN : 2017
BULAN : NOVEMBER
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

LAPORAN BULAN DESEMBER

TAHUN : 2017
BULAN : DESEMBER
NAMA PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KOTA/KABUPATEN : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA
ESMAS UNTUK PENULISAN LAPORAN
PORAN BULAN JANUARI

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
: SELVINA LAKASA, Am. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi

DESA ATAU KEL./TANGGAL - BULAN - TAHUN

: Inebenggi, 31 Januari 2017
PENULISAN LAPORAN

PORAN BULAN FEBRUARI

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
DESA ATAU KEL./TANGGAL - BULAN - TAHUN
PENULISAN LAPORAN
: SELVINA LAKASA, Am. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi
: Inebenggi, 28 Februari 2017

APORAN BULAN MARET

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
DESA ATAU KEL./TANGGAL - BULAN - TAHUN
PENULISAN LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi
: Inebenggi, 31 Maret 2017

LAPORAN BULAN APRIL

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
DESA ATAU KEL./TANGGAL - BULAN - TAHUN
PENULISAN LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi
: Inebenggi, 28 April 2017

LAPORAN BULAN MEI

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
DESA ATAU KEL./TANGGAL - BULAN - TAHUN
PENULISAN LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi
: Inebenggi, 31 Mei 2017

LAPORAN BULAN JUNI

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS : SELVINA LAKASA, Amd. Keb
NIP KEPALA PUSKESMAS : Nip. 19670824 198903 2 008
NAMA PEMEGANG LAPORAN : DINA MARDIANA, A.Md.Far
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
DESA ATAU KEL./TANGGAL - BULAN - TAHUN
PENULISAN LAPORAN
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi
: Inebenggi, 30 Juni 2017
LAPORAN BULAN JULI

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi

DESA ATAU KEL./TANGGAL - BULAN - TAHUN

: Inebenggi, 31 Juli 2017
PENULISAN LAPORAN

PORAN BULAN AGUSTUS

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi

DESA ATAU KEL./TANGGAL - BULAN - TAHUN

: Inebenggi, 31 Agustus 2017
PENULISAN LAPORAN

ORAN BULAN SEPTEMBER

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi

DESA ATAU KEL./TANGGAL - BULAN - TAHUN

: Inebenggi, 29 September 2017
PENULISAN LAPORAN

PORAN BULAN OKTOBER

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DINA MARDIANA, A.Md.Far
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi

DESA ATAU KEL./TANGGAL - BULAN - TAHUN

: Inebenggi, 31 Oktober 2017
PENULISAN LAPORAN

PORAN BULAN NOVEMBER

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DEWI SARTIKA, AMF
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi

DESA ATAU KEL./TANGGAL - BULAN - TAHUN

: Inebenggi, 30 November 2017
PENULISAN LAPORAN

PORAN BULAN DESEMBER

MENGETAHUI : KEPALA PUSKESMAS MOWEWE

NAMA KEPALA PUSKESMAS
NIP KEPALA PUSKESMAS
NAMA PEMEGANG LAPORAN
NIP PEMEGANG LAPORAN
TUGAS PEMEGANG LAPORAN
: SELVINA LAKASA, Amd. Keb
: Nip. 19670824 198903 2 008
: DEWI SARTIKA, AMF
: Nip. 19890705 201504 2 001
: Penanggung Jawab Farmasi
DESA ATAU KEL./TANGGAL - BULAN - TAHUN
: Inebenggi, 29 Desember 2017
PENULISAN LAPORAN
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 18 0 1 17 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 0 2150 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 10 0 10 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 0 0 0 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 10 0 10 0 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 400 0 400 0 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 17 0 9 8 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 0 0 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 27 0 8 19 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
64 Copper T set/buah 0 0 0 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 0 3 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 55 0 5 50 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 11 0 0 11 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 1 0 1 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 350 0 150 200 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 100 0 0 100 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 0 75 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 450 0 0 450 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 1000 0 0 1000 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 100 0 100 0 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 1300 0 100 1200 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 1 0 1 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 600 0 600 0 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 0 0 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 25 0 0 25 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 15 0 0 15 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 600 0 100 500 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 100 0 30 70 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 800 0 0 800 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 1000 0 100 900 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 35 0 15 20 0 0 0 0 0 0 0
207 Natrium Diklofenak tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 111 0 11 100 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 300 0 100 200 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 300 0 10 290 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 300 0 0 300 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 500 0 0 500 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 11 0 0 11 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 900 0 200 700 0 0 0 0 0 0 0
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 0 0 0 0 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 39 0 18 21 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 100 0 70 30 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 200 0 200 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 2400 0 1150 1250 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 0 0 0 0 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 30 0 30 0 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 100 0 0 100 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 8 0 8 0 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 0 0 0 0 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 80 0 8 72 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
20 Catheter (folley cathteter) no.10 pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
21 Catheter (folley cathteter) no.12 pcs 0 0 0 0 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 0 0 0 0 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 0 0 0 0 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 0 0 0 0 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 0 0 0 0 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 0 0 0 0 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 0 0 0 0 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 36 0 0 36 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 0 0 0 0 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 47 0 3 44 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 0 0 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 0 0 0 0 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 0 0 0 0 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 0 0 0 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 0 0 0 0 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 1 0 1 0 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 0 0 0 0 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 0 0 0 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 2 0 2 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 0 0 0 0 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 0 0 0 0 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 0 0 0 0 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 0 0 0 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
94 Selang Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 96 0 12 84 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 9 0 3 6 0 0 0 0 0 0 0
97 Sound Timer unit 4 0 1 3 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 5 0 1 4 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 1 0 0 1 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 0 0 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 0 0 0 0 0 0 0 0 0 0 0
19 Test Kehamilan strip 0 0 0 0 0 0 0 0 0 0 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0

GIGI
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 2 0 0 2 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 0 0 0 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 72 0 20 52 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 570 0 70 500 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 0 480 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 90 0 0 90 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Am. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : JANUARI
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 18 0 1 17
0 0 0 0 0 0 0 0 0 2150 0 0 2150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 200 0 200 0 200 0 200 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 30 120 0 150 30 120
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 14 8 6 10 14 18 6
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1000 700 1700 0 1000 700 1700 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 0 1000 0 1000 0 1000
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 300 100 200 400 300 500 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 9 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 27 0 8 19
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 700 300 0 1000 700 300
0 0 0 0 0 0 30 6 24 0 30 6 24
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 55 0 5 50
0 0 0 0 0 5 0 0 5 16 0 0 16
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 350 0 150 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 900 0 200 700 900 0 200 700
0 0 0 0 0 0 0 0 0 100 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 1000 1000 0 0 1000 1000 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 75
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 450 0 0 450
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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1000 0 0 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 200 400 400 200 200 400 400 200
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 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 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 0 100 100 200 0 100 100
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 300 100 400 0 400 100 500 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1300 0 100 1200
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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 1000 0 600 1000 1600 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 400 300 200 100 400 300 200
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 6 0 6 0 6 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 13 30 29 14 13 30 29 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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 25 0 0 25
0 0 0 0 0 0 0 0 0 5 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 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 0 0 15
0 0 0 0 0 0 0 0 0 600 0 100 500
0 0 0 0 0 850 0 0 850 850 0 0 850
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 750 0 0 750 750 0 0 750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 200 0 30 170
0 0 0 0 0 0 0 0 0 800 0 0 800
0 0 0 0 0 250 0 0 250 1250 0 100 1150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 35 0 15 20
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 111 0 11 100
0 0 0 0 0 0 0 0 0 300 0 100 200
0 0 0 0 0 0 0 0 0 300 0 10 290
0 0 0 0 0 0 0 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 4 26 30 0 4 26
0 0 0 0 0 0 0 0 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 90 0 0 90 90 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 900 700 1400 200 900 700 1400 200
0 0 0 0 0 0 6 6 0 0 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 0 500
0 0 0 0 0 0 0 0 0 11 0 0 11
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 900 0 200 700
0 0 0 0 0 200 0 200 0 200 0 200 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 1000 0 0 1000 1000 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 200 300 500 0 200 300 500 0
0 0 0 0 0 2 25 2 25 2 25 2 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 0 0 0 0 0 0 39 0 18 21
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1000 0 1000 0 1000 0 1000 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 0 100 0 100 0 100 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 400 0 300 100 400 0 300 100
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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 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 70 30
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 200 0 200 0
0 0 0 0 0 0 0 0 0 2400 0 1150 1250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 100 100 0 0 100 100 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 30 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 200 0 200 0 200 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 0 0
0 0 0 0 0 0 0 0 0 100 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 0
0 0 0 0 0 0 1000 1000 0 0 1000 1000 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 17 13 8 30 25 13
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 3 83 0 8 75
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 50 150 180 20 50 150 180 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 36 0 0 36
0 0 0 0 0 10 15 25 0 10 15 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 47 0 3 44
0 0 0 0 0 15 19 24 10 15 19 24 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 20 9 11 0 20 9 11
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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 20 150 150 20 20 150 150 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 3 2 2 1 3 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 4 2 2 0 4 2 2
0 0 0 0 0 0 0 0 0 96 0 12 84
0 0 0 0 0 0 0 0 0 9 0 3 6
0 0 0 0 0 0 0 0 0 4 0 1 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 5 0 1 4

0 0 0 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 72 0 20 52
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 570 0 70 500
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 480 0 0 480
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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

Inebenggi, 31 Januari 2017

TERLAMBAT
2/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
2/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
2/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 17 0 2 15 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 0 2150 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 0 500 100 400 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 25 25 0 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 700 400 300 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 180 180 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 20 14 6 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 1000 700 300 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 1500 900 600 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 0 20 0 20 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 0 1000 600 400 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 8 36 17 27 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 25 15 10 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 700 400 300 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 19 50 8 61 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 0 500 400 100 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
64 Copper T set/buah 0 0 0 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 0 3 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 0 500 100 400 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 30 0 30 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 50 30 29 51 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 11 5 1 15 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 0 10 7 3 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 20 0 20 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 200 500 80 620 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 100 200 50 250 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 1000 400 600 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 0 75 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 450 500 150 800 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 1000 0 100 900 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 700 300 400 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 0 800 550 250 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 1200 0 300 900 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 0 2000 1300 700 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 1 1 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 25 20 0 45 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 15 5 1 19 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 500 500 100 900 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 0 300 0 300 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 70 700 170 600 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 800 400 100 1100 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 900 500 200 1200 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 20 24 11 33 0 0 0 0 0 0 0
207 Natrium Diklofenak tab 25 mg tablet 0 500 450 50 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 100 0 10 90 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 200 200 0 400 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 290 200 0 490 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 300 200 0 500 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 25 5 20 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 180 180 0 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 500 0 0 500 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 11 15 0 26 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 700 1000 750 950 0 0 0 0 0 0 0
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 0 500 500 0 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 21 60 21 60 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 0 500 150 350 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 0 500 0 500 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 30 500 330 200 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1250 2000 1450 1800 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 0 2000 1150 850 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 3 3 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 0 300 60 240 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 100 0 20 80 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
315 H2O2 0 0 1 0 1 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 0 100 30 70 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 0 100 21 79 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 0 100 0 100 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 0 50 10 40 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 0 24 9 15 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 72 24 3 93 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
20 Catheter (folley cathteter) no.10 pcs 0 10 0 10 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
21 Catheter (folley cathteter) no.12 pcs 0 10 0 10 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 0 10 0 10 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 0 10 0 10 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 0 10 0 10 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 0 20 20 0 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 0 20 15 5 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 0 20 8 12 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 36 20 2 54 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 0 20 14 6 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 44 20 0 64 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 20 3 17 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 0 20 3 17 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 0 20 3 17 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 1 0 1 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 0 1 0 1 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 0 10 2 8 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 0 10 5 5 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 0 5 2 3 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 10 4 6 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 10 10 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 10 10 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 10 10 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 1 1 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 0 24 23 1 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 100 100 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 0 5 2 3 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 0 5 1 4 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 0 10 0 10 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 10 2 8 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 0 5 1 4 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 84 0 8 76 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 6 0 3 3 0 0 0 0 0 0 0
97 Sound Timer unit 3 0 1 2 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 4 10 0 14 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 1 0 1 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 1 1 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 0 1 1 0 0 0 0 0 0 0 0
19 Test Kehamilan strip 0 0 0 0 0 0 0 0 0 0 0
20 Test Kolesterol test 0 1 1 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 2 1 0 3 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 1000 600 400 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 52 0 52 0 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 500 0 0 500 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 0 60 25 35 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 0 480 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 500 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 90 0 10 80 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Am. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : FEBRUARI
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 17 0 2 15
0 0 0 0 0 0 0 0 0 2150 0 0 2150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 500 100 400
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 25 25 0
0 0 0 0 0 0 500 200 300 0 1200 600 600
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 120 0 120 180 300 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 6 0 6 0 6 20 20 6
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 500 500 0 2000 1200 800
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1000 0 1000 0 1000 1500 1900 600
0 0 0 0 0 0 0 0 0 0 0 0 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 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 1000 700 500 200 2000 1300 900
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 8 36 17 27
0 0 0 0 0 0 0 0 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 25 25 0 75 40 35
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 500 400 100 0 1200 800 400
0 0 0 0 0 0 0 0 0 19 50 8 61
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 500 400 100
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 300 1000 1300 0 300 1000 1300 0
0 0 0 0 0 24 0 1 23 24 0 1 23
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 20 80 100 500 120 480
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 30
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 30 29 51
0 0 0 0 0 5 0 0 5 16 5 1 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 10 7 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 200 500 80 620
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 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 700 0 200 500 700 0 200 500
0 0 0 0 0 0 0 0 0 100 200 50 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 0 1000 0 2000 400 1600
0 0 0 0 0 0 0 0 0 0 0 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 0 0 75
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 450 500 150 800
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1000 0 100 900
0 0 0 0 0 0 0 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 0 200 0 200 0 200 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 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 700 300 400
0 0 0 0 0 0 0 0 0 0 800 550 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1200 0 300 900
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 1000 1000 0 4000 2300 1700
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 200 600 500 300 200 600 500 300
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 15 6 9 0 15 6 9
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 28 31 11 14 28 31 11
0 0 0 0 0 0 0 0 0 0 0 0 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 25 20 0 45
0 0 0 0 0 0 0 0 0 5 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 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 5 1 19
0 0 0 0 0 0 0 0 0 500 500 100 900
0 0 0 0 0 850 0 100 750 850 300 100 1050
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 750 0 0 750 750 0 0 750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 170 700 170 700
0 0 0 0 0 0 0 0 0 800 400 100 1100
0 0 0 0 0 250 0 0 250 1150 500 200 1450
0 0 0 0 0 0 0 0 0 0 0 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 24 11 33
0 0 0 0 0 0 0 0 0 0 500 450 50
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 100 0 10 90
0 0 0 0 0 0 0 0 0 200 200 0 400
0 0 0 0 0 0 0 0 0 290 200 0 490
0 0 0 0 0 0 0 0 0 300 200 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 25 5 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 26 0 17 9 26 0 17 9
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 180 180 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 200 1000 700 500 200 1000 700 500
0 0 0 0 0 0 11 4 7 0 11 4 7
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 0 500
0 0 0 0 0 0 0 0 0 11 15 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 700 1000 750 950
0 0 0 0 0 0 400 100 300 0 400 100 300
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 1000 0 0 1000 1000 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 800 500 300 0 1300 1000 300
0 0 0 0 0 25 0 3 22 25 0 3 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 60 21 60
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 500 150 350
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 500 300 300 100 1000 300 800
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 30 500 330 200
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 0
0 0 0 0 0 0 0 0 0 1250 2000 1450 1800
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 2000 1150 850
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 0
0 0 0 0 0 0 300 100 200 0 300 100 200
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 300 60 240
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 20 80
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 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
0 0 0 0 0 0 0 0 0 0 1 0 1
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 13 0 5 8 13 100 35 78
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 -3 3 0 100 18 82
0 0 0 0 0 0 0 0 0 0 100 0 100
0 0 0 0 0 0 0 0 0 0 50 10 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 24 9 15
0 0 0 0 0 3 0 0 3 75 24 3 96
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 10
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 10 0 10
0 0 0 0 0 0 0 0 0 0 10 0 10
0 0 0 0 0 0 0 0 0 0 10 0 10
0 0 0 0 0 0 0 0 0 0 10 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 20 0
0 0 0 0 0 0 0 0 0 0 20 15 5
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 20 8 12
0 0 0 0 0 0 0 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 20 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 36 20 2 54
0 0 0 0 0 0 2 2 0 0 22 16 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 0 0
0 0 0 0 0 0 0 0 0 44 20 0 64
0 0 0 0 0 10 25 23 12 10 45 26 29
0 0 0 0 0 0 0 0 0 0 20 3 17
0 0 0 0 0 11 0 0 11 11 20 3 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 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 4 2 2 0 14 4 10
0 0 0 0 0 0 0 0 0 0 10 5 5
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 5 2 3
0 0 0 0 0 0 0 0 0 0 10 4 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 0
0 0 0 0 0 0 0 0 0 0 10 10 0
0 0 0 0 0 0 0 0 0 0 10 10 0
0 0 0 0 0 0 0 0 0 0 1 1 0
0 0 0 0 0 0 0 0 0 0 24 23 1
0 0 0 0 0 20 200 220 0 20 300 320 0
0 0 0 0 0 0 0 0 0 0 5 2 3
0 0 0 0 0 0 0 0 0 0 5 1 4
0 0 0 0 0 0 0 0 0 0 10 0 10
0 0 0 0 0 0 0 0 0 0 10 2 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 2 0 2 0 2 5 3 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 1 1 2 0 1 1
0 0 0 0 0 0 0 0 0 84 0 8 76
0 0 0 0 0 0 0 0 0 6 0 3 3
0 0 0 0 0 0 0 0 0 3 0 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 0 0 0 4 10 0 14

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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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 1000 600 400
0 0 0 0 0 0 0 0 0 52 0 52 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 0 500
0 0 0 0 0 0 0 0 0 0 60 25 35
0 0 0 0 0 0 0 0 0 480 0 0 480
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 500 500 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 0 500 300 200 0 500 300 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 10 80
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Inebenggi, 28 Februari 2017

TERLAMBAT
3/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
3/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
3/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 15 0 3 12 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 0 2150 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 400 0 200 200 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 300 0 300 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 6 0 6 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 300 0 300 0 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 600 0 400 200 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 20 0 0 20 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 400 0 300 100 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 27 0 17 10 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 10 0 10 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 300 0 300 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 61 0 18 43 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 100 0 100 0 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
64 Copper T set/buah 0 0 0 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 0 3 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 400 0 100 300 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 30 0 1 29 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 51 0 0 51 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 15 0 6 9 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 3 5 5 3 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 20 0 0 20 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 620 0 150 470 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 250 0 100 150 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 600 0 0 600 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 0 75 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 800 0 100 700 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 900 0 0 900 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 400 0 200 200 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 250 0 250 0 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 900 0 0 900 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 700 0 200 500 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 0 0 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 0 45 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 19 0 1 18 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 900 0 200 700 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 300 0 0 300 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 600 0 200 400 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 1100 0 0 1100 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 1200 0 100 1100 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 33 0 6 27 0 0 0 0 0 0 0
207 Natrium Diklofenak tab 25 mg tablet 50 0 50 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 90 0 10 80 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 400 0 0 400 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 490 0 0 490 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 0 500 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 20 0 13 7 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 500 0 88 412 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 0 26 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 0 0 950 0 0 0 0 0 0 0
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 5 5 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 0 0 0 0 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 60 0 13 47 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 350 0 150 200 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 500 0 200 300 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 200 0 0 200 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1800 0 800 1000 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 850 0 850 0 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 240 0 30 210 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 80 0 0 80 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
315 H2O2 0 1 0 0 1 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 70 0 31 39 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 79 0 41 38 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 100 0 0 100 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 40 0 3 37 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 15 0 10 5 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 93 0 0 93 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
20 Catheter (folley cathteter) no.10 pcs 10 0 1 9 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
21 Catheter (folley cathteter) no.12 pcs 10 0 0 10 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 10 0 4 6 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 10 0 2 8 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 10 0 0 10 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 0 0 0 0 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 5 0 5 0 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 12 0 12 0 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 54 0 4 50 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 6 0 6 0 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 64 0 0 64 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 17 0 9 8 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 17 0 0 17 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 17 0 1 16 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 8 0 2 6 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 5 0 0 5 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 3 0 1 2 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 6 0 1 5 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 1 0 1 0 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 3 0 1 2 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 4 0 2 2 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 10 0 1 9 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 8 0 1 7 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 4 0 1 3 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 76 0 4 72 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 3 0 2 1 0 0 0 0 0 0 0
97 Sound Timer unit 2 0 0 2 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 14 0 0 14 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 0 0 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 0 0 0 0 0 0 0 0 0 0 0
19 Test Kehamilan strip 0 0 0 0 0 0 0 0 0 0 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 3 0 3 0 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 400 0 400 0 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 0 0 0 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 500 0 100 400 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 35 0 18 17 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 0 480 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 0 80 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : MARET
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 15 0 3 12
0 0 0 0 0 0 0 0 0 2150 0 0 2150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 400 0 200 200
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 0
0 0 0 0 0 300 0 100 200 600 0 400 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 6 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 500 0 500 0 800 0 800 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 600 0 400 200
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 0
0 0 0 0 0 0 0 0 0 20 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 500 0 500 0 900 0 800 100
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 27 0 17 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 25 0 5 20 35 0 15 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 0 100 0 100 0 400 0 400 0
0 0 0 0 0 0 0 0 0 61 0 18 43
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 100 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 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 23 23 0 0 23
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 0 80 480 0 100 380
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 30 0 1 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 51 0 0 51
0 0 0 0 0 5 0 1 4 20 0 7 13
0 0 0 0 0 0 0 0 0 0 0 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 5 5 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 20 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 0 620 0 150 470
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 500 0 100 400 500 0 100 400
0 0 0 0 0 0 0 0 0 250 0 100 150
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 1000 0 1000 0 1600 0 1000 600
0 0 0 0 0 0 0 0 0 0 0 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 0 0 75
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 800 0 100 700
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 900 0 0 900
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 400 0 200 200
0 0 0 0 0 0 0 0 0 250 0 250 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 900 0 0 900
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1000 0 0 1000 1700 0 200 1500
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 200 300 0 100 200
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 9 0 9 0 9 0 9 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 11 0 11 0 11 0 11 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 45
0 0 0 0 0 0 0 0 0 5 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 19 0 1 18
0 0 0 0 0 0 0 0 0 900 0 200 700
0 0 0 0 0 750 0 200 550 1050 0 200 850
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 750 0 0 750 750 0 0 750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 700 0 200 500
0 0 0 0 0 0 0 0 0 1100 0 0 1100
0 0 0 0 0 250 0 0 250 1450 0 100 1350
0 0 0 0 0 0 0 0 0 0 0 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 0 6 27
0 0 0 0 0 0 0 0 0 50 0 50 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 90 0 10 80
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 490 0 0 490
0 0 0 0 0 0 0 0 0 500 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 13 7
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 9 0 9 0 9 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 500 0 500 0 500 0 500 0
0 0 0 0 0 7 0 7 0 7 0 7 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 88 412
0 0 0 0 0 0 0 0 0 26 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 950 0 0 950
0 0 0 0 0 300 0 300 0 300 0 300 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 300 0 300 0 300 0
0 0 0 0 0 22 0 2 20 22 0 2 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 60 0 13 47
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 350 0 150 200
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 300 0 100 200 800 0 300 500
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 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0
0 0 0 0 0 0 0 0 0 1800 0 800 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 850 0 850 0
0 0 0 0 0 0 0 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 0 100 100 200 0 100 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 240 0 30 210
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 80
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 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 1 0 0 1
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 8 0 0 8 78 0 31 47
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 3 0 3 0 82 0 44 38
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 40 0 3 37
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 10 5
0 0 0 0 0 3 0 2 1 96 0 2 94
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 10 0 1 9
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 10 0 0 10
0 0 0 0 0 0 0 0 0 10 0 4 6
0 0 0 0 0 0 0 0 0 10 0 2 8
0 0 0 0 0 0 0 0 0 10 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 5 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 12 0 12 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 4 50
0 0 0 0 0 0 0 0 0 6 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 0 0 0
0 0 0 0 0 0 0 0 0 64 0 0 64
0 0 0 0 0 12 0 12 0 29 0 21 8
0 0 0 0 0 0 0 0 0 17 0 0 17
0 0 0 0 0 11 0 6 5 28 0 7 21
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 0 2 10 0 2 8
0 0 0 0 0 0 0 0 0 5 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 3 0 1 2
0 0 0 0 0 0 0 0 0 6 0 1 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 3 0 1 2
0 0 0 0 0 0 0 0 0 4 0 2 2
0 0 0 0 0 0 0 0 0 10 0 1 9
0 0 0 0 0 0 0 0 0 8 0 1 7
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 1 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1 0 1 0 1 0 1 0
0 0 0 0 0 0 0 0 0 76 0 4 72
0 0 0 0 0 0 0 0 0 3 0 2 1
0 0 0 0 0 0 0 0 0 2 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 14 0 0 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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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 0 400 0 400 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 100 400
0 0 0 0 0 0 0 0 0 35 0 18 17
0 0 0 0 0 0 0 0 0 480 0 0 480
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 100 200 0 100 100
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 80
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Inebenggi, 31 Maret 2017

TERLAMBAT
4/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
4/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
4/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(L P L P O)
T
PUSKESMAS : MOWEWE BULAN : MARET
KECAMATAN : MOWEWE TAHUN : 2017
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA
LB 2

Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
1 Air Untuk Injeksi 20 ml vial 18 0 18 6 12 13.5 17.55 20
2 Albendazole tab 400 mg tablet 2150 0 2150 0 2150 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 200 500 700 500 200 1125 1462.5 1000
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 25 25 25 0 56.25 73.125 50
7 Ambroksol tab 30 mg tablet 0 1200 1200 1000 200 2250 2925 1000
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 330 330 330 0 742.5 965.25 1000
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 10 34 44 44 0 99 128.7 100
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 1000 2700 3700 3700 0 8325 10822.5 3000
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 50
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 2500 2500 2300 200 5175 6727.5 2000
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 10 20 30 10 20 22.5 29.25 10
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 2000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 2000
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 400 2300 2700 2600 100 5850 7605 3000
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 500
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 500
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 17 36 53 43 10 96.75 125.775 50
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 75 75 55 20 123.75 160.875 50
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 20
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 20
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 1000
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 1200 1200 1200 0 2700 3510 2000
56 Cefadroksil SK 125 mg/5 mL botol 27 50 77 34 43 76.5 99.45 50
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 0 500 500 500 0 1125 1462.5 2000
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 20
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 1000
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0
64 Copper T set/buah 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 2000 2000 2000 0 4500 5850 3000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 30 30 7 23 15.75 20.475 20
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 3 0 3 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 100 500 600 220 380 495 643.5 1000
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 30 30 1 29 2.25 2.925 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 55 30 85 34 51 76.5 99.45 0
89 Etakridin (Rivanol) lar 0,1% botol 16 5 21 8 13 18 23.4 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 0 15 15 12 3 27 35.1 50
93 Etil Klorida semprot 100 mL botol 1 0 1 1 0 2.25 2.925 2
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 20 20 0 20 0 0 20
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 350 500 850 380 470 855 1111.5 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 20
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 20
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 900 0 900 500 400 1125 1462.5 1000
115 Glimepirid tab 1 mg tablet 100 200 300 150 150 337.5 438.75 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 3000 3000 2400 600 5400 7020 3000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 75 0 75 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 450 500 950 250 700 562.5 731.25 500
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 1000 0 1000 100 900 225 292.5 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 200 400 600 600 0 1350 1755 2000
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 500
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 200 0 200 100 100 225 292.5 500
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 3000
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 700 700 500 200 1125 1462.5 1000
144 Kaptopril tab 25 mg tablet 400 900 1300 1300 0 2925 3802.5 2000
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 25
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 1300 0 1300 400 900 900 1170 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 1 0 1 1 0 2.25 2.925 10
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 25
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 5
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 600 5000 5600 4100 1500 9225 11992.5 3000
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 10
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 10
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
171 Kotrimoxazol tab 480 mg (adult) tablet 100 1000 1100 900 200 2025 2632.5 2000
172 Kotrimoxazol susp 60 ml botol 6 15 21 21 0 47.25 61.425 50
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 100
180 Lidokain inj 2% (infiltr/p.v.) ampul 13 58 71 71 0 159.75 207.675 100
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 3
183 Lisol lar 1.000 ml botol 0 1 1 1 0 2.25 2.925 0
184 Loratadin tab 10 mg tablet 0 0 0 0 0 0 0 500
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 25 20 45 0 45 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 5 0 5 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 15 5 20 2 18 4.5 5.85 0
192 Metampiron (Antalgin) tab 500 mg tablet 600 500 1100 400 700 900 1170 0
193 Metformin tab 500 mg tablet 850 300 1150 300 850 675 877.5 1000
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0 750 0 750 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 1000
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 1000
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 1000
201 Metoklopramid tab 10 mg tablet 200 700 900 400 500 900 1170 1000
202 Metronidazol tab 250 mg tablet 800 400 1200 100 1100 225 292.5 0
203 Metronidazol tab 500 mg tablet 1250 500 1750 400 1350 900 1170 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 35 24 59 32 27 72 93.6 50
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
207 Natrium Diklofenak tab 25 mg tablet 0 500 500 500 0 1125 1462.5 1000
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 2000
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 111 0 111 31 80 69.75 90.675 0
210 Nifedipine tab 10 mg tablet 300 200 500 100 400 225 292.5 500
211 Nistatin tab vaginal 100.000 IU ovula 300 200 500 10 490 22.5 29.25 0
212 Nistatin tab vaginal 500.000 IU tablet 300 200 500 0 500 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 25 25 18 7 40.5 52.65 50
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 50
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 30 0 30 30 0 67.5 87.75 25
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 100
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 270 270 270 0 607.5 789.75 1000
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 900 1700 2600 2600 0 5850 7605 5000
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 17 17 17 0 38.25 49.725 100
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 500 0 500 88 412 198 257.4 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 11 15 26 0 26 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 900 1000 1900 950 950 2137.5 2778.75 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
243 Piroxicam tab 10 mg tablet 200 400 600 600 0 1350 1755 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
247 Povidon Iodida lar 10% - 30 ml botol 0 5 5 5 0 11.25 14.625 0
248 Prednison tab 5 mg tablet 0 2000 2000 2000 0 4500 5850 2000
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 200 1600 1800 1800 0 4050 5265 2000
255 Ranitidin inj 25 mg/mL ampul 2 25 27 7 20 15.75 20.475 25
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 39 60 99 52 47 117 152.1 80
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 1000
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 1000
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 20
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 1000 0 1000 1000 0 2250 2925 2000
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 25
275 Simvastatin tab 10 mg tablet 100 500 600 400 200 900 1170 1000
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 1000
277 Siprofloksasin tab 500 mg tablet 400 1000 1400 900 500 2025 2632.5 2000
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 2000
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 100 500 600 400 200 900 1170 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 500
284 Thiamfenikol kaps 500 mg kapsul 200 0 200 200 0 450 585 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 2400 2000 4400 3400 1000 7650 9945 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 0 2000 2000 2000 0 4500 5850 3000
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 10
296 Zinc sir 20 mg/5 ml botol 0 3 3 3 0 6.75 8.775 10
297 Zinc dispersible 20 mg tablet 0 400 400 300 100 675 877.5 1500
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 30 300 330 120 210 270 351 200
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 100
304 Loperamid tab 2 mg tablet 200 0 200 200 0 450 585 1000
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 2000
307 Piracetam tab 400 mg tablet 100 0 100 20 80 45 58.5 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 2000
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 1000 1000 1000 0 2250 2925 2000
312 Etanol 70% lar 1000 ml botol 0 1 1 0 1 0 0 3
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 5
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 5
315 H2O2 0 0 1 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 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 8 130 138 91 47 204.75 266.175 200
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 200
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
3 Alat Suntik 3 ml pcs 0 100 100 62 38 139.5 181.35 200
4 Alat Suntik 5 ml pcs 0 100 100 0 100 0 0 0
5 Alat Suntik 10 ml pcs 0 50 50 13 37 29.25 38.025 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 0 24 24 19 5 42.75 55.575 60
18 Catgut no.3/0 pcs 83 24 107 13 94 29.25 38.025 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0
20 Catheter (folley cathteter) no.10 pcs 0 10 10 1 9 2.25 2.925 10
21 Catheter (folley cathteter) no.12 pcs 0 10 10 0 10 0 0 10
22 Catheter (folley cathteter) no.14 pcs 0 10 10 4 6 9 11.7 50
23 Catheter (folley cathteter) no.16 pcs 0 10 10 2 8 4.5 5.85 10
24 Catheter (folley cathteter) no.18 pcs 0 10 10 0 10 0 0 10
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 0 20 20 20 0 45 58.5 100
32 Hand Schoen no 7.5 set 0 20 20 20 0 45 58.5 100
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 50
34 Hand Schoen no 8 set 0 20 20 20 0 45 58.5 100
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 50
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 20
37 Hand Schoen (Aximed Exam Gloves size M) pcs 50 150 200 200 0 450 585 20
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 20
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 20
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 30
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 30
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 30
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 30
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 30
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 30
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 30
47 Infusion Set Anak set 36 20 56 6 50 13.5 17.55 0
48 Infusion Set Dewasa set 10 37 47 47 0 105.75 137.475 100
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 10
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 30
51 IV Catheter no. 18 pcs 47 20 67 3 64 6.75 8.775 30
52 IV Catheter no. 20 pcs 15 64 79 71 8 159.75 207.675 50
53 IV Catheter no. 22 pcs 0 20 20 3 17 6.75 8.775 20
54 IV Catheter no. 24 pcs 0 40 40 19 21 42.75 55.575 50
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 1 1 0 1 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 0 1 1 0 1 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 100
65 Kapas Pembalut 250 g roll 1 14 15 7 8 15.75 20.475 5
66 Kapas Pembalut 500 g roll 0 10 10 5 5 11.25 14.625 5
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 50
68 Kasa Hydrofil 40 yard x 80 cm roll 0 5 5 3 2 6.75 8.775 20
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 10 10 5 5 11.25 14.625 20
70 Kasa Pembalut 2 m x 80 cm roll 2 0 2 2 0 4.5 5.85 20
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 30
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 30
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 30
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 10 10 10 0 22.5 29.25 30
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 10 10 10 0 22.5 29.25 30
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 10 10 10 0 22.5 29.25 320
77 Kasa Steril 16 cm x 16 cm box 0 1 1 1 0 2.25 2.925 20
78 Kasa Steril 18 cm x 22 cm box 0 24 24 24 0 54 70.2 20
79 Masker Ear Loop Pcs 20 450 470 470 0 1057.5 1374.75 300
80 Mata Pisau Bedah No. 10 pcs 0 5 5 3 2 6.75 8.775 10
81 Mata Pisau Bedah No. 11 Pcs 0 5 5 3 2 6.75 8.775 10
82 Mata Pisau Bedah No. 15 Pcs 0 10 10 1 9 2.25 2.925 10
83 Mata Pisau Bedah No. 21 Pcs 0 10 10 3 7 6.75 8.775 10
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 10
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 10
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 10
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 5
88 Plester 5 cm x 4,5 cm roll 1 8 9 6 3 13.5 17.55 5
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 5
90 Pot Sputum pot 0 0 0 0 0 0 0 3
91 RDT pcs 0 0 0 0 0 0 0 0
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 5
93 Safety Box kotak 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 4 4 4 0 9 11.7 10
95 Silk (benang bedah sutra) no.2/0 pcs 96 0 96 24 72 54 70.2 0
96 Silk (benang bedah sutra) no.3/0 pcs 9 0 9 8 1 18 23.4 50
97 Sound Timer unit 4 0 4 2 2 4.5 5.85 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 1
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0
100 Urine bag pcs 5 10 15 1 14 2.25 2.925 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 1 0 1 1 0 2.25 2.925 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 1
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 1 1 1 0 2.25 2.925 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 1
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 1
18 Test Gula Darah test 0 1 1 1 0 2.25 2.925 1
19 Test Kehamilan strip 0 0 0 0 0 0 0 50
20 Test Kolesterol test 0 1 1 1 0 2.25 2.925 3
21 Test Urine Rutin strip 0 0 0 0 0 0 0 1

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 100
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 10
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 5
8 KY Jelly tube 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 5
12 Pehavral tablet salut 0 0 0 0 0 0 0 1000
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 5
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 10
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 2 1 3 3 0 6.75 8.775 20
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 5
20 Formalin 40 % botol 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 1000 1000 1000 0 2250 2925 2000
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 72 0 72 72 0 162 210.6 200
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 3000
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 570 0 570 170 400 382.5 497.25 0
25 Vical susp 100 ml botol 0 60 60 43 17 96.75 125.775 50
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 480 0 480 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 500 500 0 1125 1462.5 5000
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 1000
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 1000
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 2000
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 500 500 400 100 900 1170 1000
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 2000
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 1000
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 2000
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 1000
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 1000
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 90 0 90 10 80 22.5 29.25 100
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

Inebe
MENGETAHUI
TERLAMBAT
4/25/2017
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
KEPALA PUSKESMAS MOWEWE Penan

TERLAMBAT
4/18/2017

SELVINA LAKASA, Amd. Keb DINA M

Nip. 19670824 198903 2 008
TERLAMBAT
4/11/2017
Nip. 19
TERLAMBAT

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Inebenggi, 31 Maret 2017

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DAK
PUSAT PROVINSI PROGRAM
Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
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Peringatan

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 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 12 0 4 8 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 0 2150 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 200 0 200 0 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 200 0 200 0 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 20 0 0 20 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 100 0 100 0 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 10 0 5 5 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 0 0 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 43 0 24 19 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
64 Copper T set/buah 0 0 0 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 0 3 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 300 0 100 200 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 29 0 0 29 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 51 0 3 48 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 9 0 0 9 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 3 0 2 1 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 20 0 17 3 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 470 0 70 400 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 150 0 0 150 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 600 0 600 0 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 0 75 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 700 0 100 600 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 900 0 900 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 200 0 200 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 900 0 0 900 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 500 0 50 450 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 0 0 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 0 45 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 0 18 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 700 0 0 700 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 300 0 0 300 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 400 0 0 400 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 1100 0 100 1000 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 1100 0 100 1000 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 27 0 3 24 0 0 0 0 0 0 0
207 Natrium Diklofenak tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 80 0 5 75 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 400 0 0 400 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 490 0 0 490 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 0 500 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 7 0 7 0 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0 0 412 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 0 26 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 0 0 950 0 0 0 0 0 0 0
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 0 0 0 0 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 47 0 30 17 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 200 0 150 50 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 300 0 200 100 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 200 0 100 100 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1000 0 1000 0 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 0 0 0 0 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 210 0 30 180 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 80 0 80 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
315 H2O2 0 1 0 1 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 39 0 19 20 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 38 0 5 33 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 100 0 0 100 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 37 0 6 31 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 5 0 5 0 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 93 0 21 72 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
20 Catheter (folley cathteter) no.10 pcs 9 0 0 9 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
21 Catheter (folley cathteter) no.12 pcs 10 0 0 10 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 6 0 3 3 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 8 0 0 8 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 10 0 3 7 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 0 0 0 0 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 0 0 0 0 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 0 0 0 0 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 50 0 7 43 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 0 0 0 0 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 64 0 2 62 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 8 0 8 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 17 0 2 15 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 16 0 2 14 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 6 0 0 6 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 5 0 0 5 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 2 0 1 1 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 5 0 1 4 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 0 0 0 0 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 2 0 1 1 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 2 0 2 0 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 9 0 0 9 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 7 0 1 6 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 3 0 3 0 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 72 0 12 60 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 1 0 1 0 0 0 0 0 0 0 0
97 Sound Timer unit 2 0 0 2 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 14 0 6 8 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 0 0 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 0 0 0 0 0 0 0 0 0 0 0
19 Test Kehamilan strip 0 0 0 0 0 0 0 0 0 0 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 0 0 0 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 0 0 0 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 0 100 300 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 17 0 6 11 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 0 480 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 0 80 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : APRIL
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 12 0 4 8
0 0 0 0 0 0 0 0 0 2150 0 0 2150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 200 0 200 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 12 6 6 0 12 6 6
0 0 0 0 0 200 0 200 0 200 0 200 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 150 150 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 1800 800 1000 0 1800 800 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 600 400 200 200 600 600 200
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 0
0 0 0 0 0 0 0 0 0 20 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 1000 1000 0 2000 1000 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 600 400 100 1000 700 400
0 0 0 0 0 0 0 0 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 0 300 0 300 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 5 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 20 0 15 5 20 0 15 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 43 0 24 19
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 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 3 20 23 0 3 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 3 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 80 0 380 0 180 200
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 29
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 3 0 2 1
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 20 0 17 3
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 400 0 0 400 400 0 0 400
0 0 0 0 0 0 0 0 0 150 0 0 150
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 600 0 600 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 75 0 0 75
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 700 0 100 600
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 900 0 900 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 800 200 0 1000 800 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 900 0 0 900
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1000 0 1000 0 1500 0 1050 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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 0 200 200 0 0 200
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 18 0 0 18
0 0 0 0 0 0 0 0 0 700 0 0 700
0 0 0 0 0 550 0 0 550 850 0 0 850
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 750 0 0 750 750 0 0 750
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 0 100 0 500 0 100 400
0 0 0 0 0 0 0 0 0 1100 0 100 1000
0 0 0 0 0 250 0 50 200 1350 0 150 1200
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 27 0 3 24
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 80 0 5 75
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 490 0 0 490
0 0 0 0 0 0 0 0 0 500 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
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 -5 5 0 0 -5 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 26 12 14 0 26 12 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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 412 0 0 412
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 950 0 0 950
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 47 0 30 17
0 0 0 0 0 0 600 250 350 0 600 250 350
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 200 0 150 50
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 200 0 200 0 500 0 400 100
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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 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 0 100 100
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 1000 0 1000 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 0 100 0 100 0 100 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 210 0 30 180
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 80 0 80 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 3 2 2 1 3 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 1 0 1 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 8 0 8 0 47 0 27 20
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 38 0 5 33
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 37 0 6 31
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0 0 0 0 0 0 0 0 0 5 0 5 0
0 0 0 0 0 1 0 1 0 94 0 22 72
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 9
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 10 0 0 10
0 0 0 0 0 0 0 0 0 6 0 3 3
0 0 0 0 0 0 0 0 0 8 0 0 8
0 0 0 0 0 0 0 0 0 10 0 3 7
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 1 1 0 2 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 0 0 0 0 0 0 0 50 0 7 43
0 0 0 0 0 0 26 16 10 0 26 16 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 0 0 64 0 2 62
0 0 0 0 0 0 26 16 10 8 26 24 10
0 0 0 0 0 0 0 0 0 17 0 2 15
0 0 0 0 0 5 0 1 4 21 0 3 18
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 0 2 8 0 0 8
0 0 0 0 0 0 0 0 0 5 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 3 1 2 2 3 2 3
0 0 0 0 0 0 0 0 0 5 0 1 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
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 200 100 100 0 200 100 100
0 0 0 0 0 0 0 0 0 2 0 1 1
0 0 0 0 0 0 0 0 0 2 0 2 0
0 0 0 0 0 0 0 0 0 9 0 0 9
0 0 0 0 0 0 0 0 0 7 0 1 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 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 72 0 12 60
0 0 0 0 0 0 0 0 0 1 0 1 0
0 0 0 0 0 0 0 0 0 2 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 14 0 6 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
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 11 41 0 52 11 41
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 100 300
0 0 0 0 0 0 0 0 0 17 0 6 11
0 0 0 0 0 0 0 0 0 480 0 0 480
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 0 100 0 100 0 100 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 80 0 0 80
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Inebenggi, 28 April 2017

TERLAMBAT
5/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
5/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
5/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 8 10 2 16 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 0 2150 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 0 500 100 400 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 20 5 15 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 500 150 350 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 300 210 90 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 50 26 24 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 1000 700 300 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 1500 700 800 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 20 10 0 30 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 0 1000 700 300 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 5 6 1 10 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 25 5 20 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 1000 500 500 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 19 50 13 56 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 0 300 100 200 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 0 2 0 2 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 0 3 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 200 300 100 400 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 29 0 0 29 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 48 0 15 33 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 9 0 2 7 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 1 15 4 12 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3 30 30 3 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 400 0 90 310 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 150 0 0 150 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 1000 650 350 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 0 75 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 600 300 300 600 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 0 1000 600 400 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 900 0 200 700 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 10 0 10 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 450 1500 950 1000 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 1 1 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 0 300 50 250 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 0 45 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 0 18 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 700 0 100 600 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 300 500 0 800 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 400 500 100 800 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 1000 0 0 1000 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 1000 0 100 900 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 24 24 11 37 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
207 Natrium Diklofenak tab 25 mg tablet 0 1000 250 750 0 0 0 0 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 75 0 0 75 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 400 0 0 400 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 490 0 90 400 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 0 500 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 30 16 14 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 450 130 320 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0 0 412 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 0 26 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 0 0 950 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 0 1000 300 700 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 17 140 50 107 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 50 500 50 500 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 100 0 0 100 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 100 500 200 400 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 0 1000 250 750 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 0 3000 1700 1300 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 180 180 0 360 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 20 50 13 57 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 33 50 33 50 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 100 0 0 100 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 31 0 0 31 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 0 48 12 36 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 72 0 24 48 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
20 Catheter (folley cathteter) no.10 pcs 9 10 0 19 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 10 10 0 20 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 3 10 0 13 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 8 10 1 17 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 7 10 4 13 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 4 4 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 0 50 17 33 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 0 26 15 11 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 0 0 0 0 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 43 0 13 30 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 0 50 13 37 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 62 10 10 62 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 10 10 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 15 10 3 22 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 14 20 0 34 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 1 1 1 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 1 1 1 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 6 5 1 10 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 5 5 0 10 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 1 5 1 5 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 4 20 4 20 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 10 10 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 10 10 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 10 10 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 0 5 0 5 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 50 50 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 1 10 1 10 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 0 10 0 10 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 9 10 3 16 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 6 0 1 5 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 0 4 1 3 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 60 24 3 81 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
97 Sound Timer unit 2 0 2 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 8 0 2 6 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 25 25 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 0 25 25 0 0 0 0 0 0 0 0
19 Test Kehamilan strip 0 50 3 47 0 0 0 0 0 0 0
20 Test Kolesterol test 0 20 20 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 5 0 5 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 2000 450 1550 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 100 0 100 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 300 100 0 400 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 11 15 8 18 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 0 480 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 300 200 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 0 80 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : MEI
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 8 10 2 16
0 0 0 0 0 0 0 0 0 2150 0 0 2150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 500 100 400
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 6 0 6 0 6 20 11 15
0 0 0 0 0 0 0 0 0 0 500 150 350
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 300 210 90
0 0 0 0 0 0 0 0 0 0 50 26 24
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1000 0 1000 0 1000 1000 1700 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 0 200 0 200 0 200 1500 900 800
0 0 0 0 0 0 0 0 0 0 0 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 0 30
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1000 0 1000 0 1000 0 1000 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 200 200 400 1000 900 500
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 0 300 0 100 200 300 0 100 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 6 1 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 5 0 5 0 5 25 10 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 1000 500 500
0 0 0 0 0 0 0 0 0 19 50 13 56
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 300 100 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 2
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 20 0 0 20 20 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 3 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 200 300 100 400
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 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 48 0 15 33
0 0 0 0 0 3 0 1 2 12 0 3 9
0 0 0 0 0 0 0 0 0 0 0 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 15 4 12
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 3 30 30 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 0 400 0 90 310
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 400 400 0 0 400
0 0 0 0 0 0 0 0 0 150 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
0 0 0 0 0 0 0 0 0 0 1000 650 350
0 0 0 0 0 0 0 0 0 0 0 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 0 0 75
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 600 300 300 600
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 200 0 200 0 200 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 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1000 600 400
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 900 0 200 700
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 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 0 0 0 0 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 1500 950 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 200 0 100 100 200 0 100 100
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 2 50 0 52 2 50
0 0 0 0 0 0 0 0 0 0 0 0 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 0
0 0 0 0 0 0 0 0 0 0 300 50 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 45 0 0 45
0 0 0 0 0 0 0 0 0 5 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 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 0 0 18
0 0 0 0 0 0 0 0 0 700 0 100 600
0 0 0 0 0 550 0 0 550 850 500 0 1350
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 750 0 0 750 750 0 0 750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 400 500 100 800
0 0 0 0 0 0 0 0 0 1000 0 0 1000
0 0 0 0 0 200 0 0 200 1200 0 100 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 24 24 11 37
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 1000 250 750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 75 0 0 75
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 490 0 90 400
0 0 0 0 0 0 0 0 0 500 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 16 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 0 0 0 0 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 40 0 40 0 40
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 5 0 0 5 5 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 0 450 130 320
0 0 0 0 0 0 0 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 0 8 6 14 0 8 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 412 0 0 412
0 0 0 0 0 0 0 0 0 26 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 950 0 0 950
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 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 5 3 5 3 5 3 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1000 300 700
0 0 0 0 0 16 0 16 0 16 0 16 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 17 140 50 107
0 0 0 0 0 350 0 350 0 350 0 350 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 50 500 50 500
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 100 500 200 400
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 1000 250 750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 3000 1700 1300
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 180 180 0 360
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 1 1 2 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 50 13 57
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 33 50 33 50
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 31 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 12 36
0 0 0 0 0 0 0 0 0 72 0 24 48
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 9 10 0 19
0 0 0 0 0 0 0 0 0 10 10 0 20
0 0 0 0 0 0 0 0 0 3 10 0 13
0 0 0 0 0 0 0 0 0 8 10 1 17
0 0 0 0 0 0 0 0 0 7 10 4 13
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 50 17 33
0 0 0 0 0 0 0 0 0 0 26 15 11
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 1 0 1 0
0 0 0 0 0 0 6 1 5 0 6 1 5
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 43 0 13 30
0 0 0 0 0 10 0 7 3 10 50 20 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 3 0 3 62 13 10 65
0 0 0 0 0 10 30 5 35 10 40 15 35
0 0 0 0 0 0 0 0 0 15 10 3 22
0 0 0 0 0 4 0 0 4 18 20 0 38
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 1 1
0 0 0 0 0 0 0 0 0 1 1 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 0 2 8 5 1 12
0 0 0 0 0 0 0 0 0 5 5 0 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 2 0 3 5 3 5
0 0 0 0 0 0 0 0 0 4 20 4 20
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 0
0 0 0 0 0 0 0 0 0 0 10 10 0
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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 5
0 0 0 0 0 100 0 100 0 100 50 150 0
0 0 0 0 0 0 0 0 0 1 10 1 10
0 0 0 0 0 0 0 0 0 0 10 0 10
0 0 0 0 0 0 0 0 0 9 10 3 16
0 0 0 0 0 0 0 0 0 6 0 1 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 0 0 0 0 0 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 1 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 24 3 81
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2 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 8 0 2 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 25 25 0
0 0 0 0 0 0 0 0 0 0 50 3 47
0 0 0 0 0 0 0 0 0 0 20 20 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 41 0 41 0 41 0 41 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 2000 450 1550
0 0 0 0 0 0 0 0 0 0 100 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 300 100 0 400
0 0 0 0 0 0 0 0 0 11 15 8 18
0 0 0 0 0 0 0 0 0 480 0 0 480
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 500 300 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 80
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0
TERLAMBAT
6/25/2017

0
TERLAMBAT
6/18/2017

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TERLAMBAT
6/11/2017
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 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 16 0 0 16 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 0 2150 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 400 0 150 250 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 15 0 8 7 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 350 0 350 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 90 0 90 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 24 0 12 12 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 300 0 300 0 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 800 0 700 100 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 30 0 20 10 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 300 0 300 0 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 10 0 3 7 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 20 0 5 15 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 500 0 500 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 56 0 3 53 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 200 0 0 200 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 2 0 1 1 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 0 3 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 400 0 150 250 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 29 0 3 26 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 33 0 6 27 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 7 0 0 7 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 12 0 3 9 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3 0 3 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 310 0 10 300 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 150 0 50 100 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 350 0 350 0 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 0 75 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 600 0 50 550 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 400 0 400 0 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 700 0 100 600 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 10 0 6 4 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 1000 0 800 200 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 0 0 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 250 0 0 250 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 0 45 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 0 18 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 600 0 100 500 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 800 0 0 800 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 800 0 100 700 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
202 Metronidazol tab 250 mg tablet 1000 0 0 1000 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 900 0 100 800 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 37 0 4 33 0 0 0 0 0 0 0
207 Natrium Diklofenak tab 25 mg tablet 750 0 250 500 0 0 0 0 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 75 0 6 69 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 400 0 0 400 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 400 0 0 400 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 0 500 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 14 0 10 4 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 320 0 80 240 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0 0 412 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 0 26 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 0 -1000 1950 0 0 0 0 0 0 0
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 700 0 300 400 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 107 0 43 64 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 500 0 150 350 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 100 0 100 0 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 400 0 150 250 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 750 0 150 600 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 1300 0 500 800 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 360 0 0 360 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 57 0 48 9 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 50 0 25 25 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 100 0 0 100 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 31 0 11 20 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 36 0 27 9 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 48 0 0 48 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
20 Catheter (folley cathteter) no.10 pcs 19 0 1 18 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 20 0 0 20 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 13 0 1 12 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 17 0 0 17 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 13 0 2 11 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 33 0 31 2 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 11 0 11 0 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 0 0 0 0 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 30 0 10 20 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 37 0 34 3 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 62 0 16 46 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 0 0 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 22 0 17 5 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 34 0 27 7 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 10 0 2 8 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 10 0 0 10 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 5 0 2 3 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 20 0 0 20 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 5 0 1 4 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 10 0 0 10 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
81 Mata Pisau Bedah No. 11 Pcs 10 0 0 10 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 16 0 1 15 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 5 0 4 1 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 3 0 3 0 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 81 0 14 67 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
97 Sound Timer unit 0 0 0 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 6 0 1 5 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 0 0 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 0 0 -13 13 0 0 0 0 0 0 0
19 Test Kehamilan strip 47 0 7 40 0 0 0 0 0 0 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 5 0 0 5 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 1550 0 150 1400 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 0 100 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 0 0 400 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 18 0 7 11 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 0 480 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 200 0 200 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 0 80 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : JUNI
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 16 0 0 16
0 0 0 0 0 0 0 0 0 2150 0 0 2150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 400 0 150 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 15 0 8 7
0 0 0 0 0 0 0 0 0 350 0 350 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 90 0
0 0 0 0 0 0 0 0 0 24 0 12 12
0 0 0 0 0 0 0 0 0 0 0 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 0 300 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 0 800 0 700 100
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 30 0 20 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 200 0 500 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 0 200 0 0 200 200 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 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 3 7
0 0 0 0 0 0 0 0 0 0 0 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 5 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 500 0
0 0 0 0 0 0 0 0 0 56 0 3 53
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 200 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 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 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 1 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 20 0 1 19 20 0 1 19
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 150 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 29 0 3 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 6 27
0 0 0 0 0 2 0 2 0 9 0 2 7
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 12 0 3 9
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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 0 310 0 10 300
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
0 0 0 0 0 0 0 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 0 400 400 0 0 400
0 0 0 0 0 0 0 0 0 150 0 50 100
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 0 350 0 350 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 75
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 600 0 50 550
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 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 0 400 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 700 0 100 600
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 10 0 6 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 1000 0 800 200
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 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 20 55 15 50 20 55 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 250 0 0 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 45 0 0 45
0 0 0 0 0 0 0 0 0 5 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 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 0 0 18
0 0 0 0 0 0 0 0 0 600 0 100 500
0 0 0 0 0 550 0 0 550 1350 0 0 1350
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 750 0 0 750 750 0 0 750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 800 0 100 700
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 1000 0 0 1000
0 0 0 0 0 200 0 0 200 1100 0 100 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 37 0 4 33
0 0 0 0 0 0 0 0 0 750 0 250 500
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 75 0 6 69
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 500 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 10 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 40 0 40 0 40 0 40 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 5 0 0 5 5 0 0 5
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 320 0 80 240
0 0 0 0 0 0 0 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 0 6 0 6 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 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 412 0 0 412
0 0 0 0 0 0 0 0 0 26 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 950 0 -1000 1950
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 4 4 0 0 4 4 0
0 0 0 0 0 5 0 3 2 5 0 3 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 0 700 0 300 400
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 107 0 43 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 150 350
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 100 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 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 0 150 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 750 0 150 600
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1300 0 500 800
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 360 0 0 360
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 48 9
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 50 0 25 25
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 31 0 11 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
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 36 0 27 9
0 0 0 0 0 0 0 0 0 48 0 0 48
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 19 0 1 18
0 0 0 0 0 0 0 0 0 20 0 0 20
0 0 0 0 0 0 0 0 0 13 0 1 12
0 0 0 0 0 0 0 0 0 17 0 0 17
0 0 0 0 0 0 0 0 0 13 0 2 11
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 31 2
0 0 0 0 0 0 0 0 0 11 0 11 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 4 9 0 5 4 9 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 15 10 5 30 15 20 25
0 0 0 0 0 3 17 18 2 40 17 52 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 3 0 0 3 65 0 16 49
0 0 0 0 0 35 20 55 0 35 20 55 0
0 0 0 0 0 0 0 0 0 22 0 17 5
0 0 0 0 0 4 0 0 4 38 0 27 11
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 2 0 2 0 12 0 4 8
0 0 0 0 0 0 0 0 0 10 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 5 0 2 3
0 0 0 0 0 0 0 0 0 20 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 0 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 1 4
0 0 0 0 0 0 200 200 0 0 200 200 0
0 0 0 0 0 0 0 0 0 10 0 0 10
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 10 0 0 10
0 0 0 0 0 0 0 0 0 16 0 1 15
0 0 0 0 0 0 0 0 0 5 0 4 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 3 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 81 0 14 67
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 1 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 -13 13
0 0 0 0 0 0 0 0 0 47 0 7 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 1550 0 150 1400
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 18 0 7 11
0 0 0 0 0 0 0 0 0 480 0 0 480
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 200 0 200 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 80
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Inebenggi, 30 Juni 2017

TERLAMBAT
7/25/2017
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
TERLAMBAT
7/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
7/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
7/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(L P L P O)

PUSKESMAS : MOWEWE BULAN : JUNI

KECAMATAN : MOWEWE TAHUN : 2017
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA
LB 2
Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
1 Air Untuk Injeksi 20 ml vial 12 10 22 6 16 9 11.7 40
2 Albendazole tab 400 mg tablet 2150 0 2150 0 2150 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 200 500 700 450 250 675 877.5 1000
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 32 32 25 7 37.5 48.75 50
7 Ambroksol tab 30 mg tablet 200 500 700 700 0 1050 1365 1000
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 450 450 450 0 675 877.5 1000
13 Amoxicillin sir forte 250 mg/5 ml botol 0 50 50 38 12 57 74.1 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 100
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 2800 2800 2800 0 4200 5460 3000
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 50
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 200 2100 2300 2200 100 3300 4290 2000
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 5
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 20 10 30 20 10 30 39 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 2000 2000 2000 0 3000 3900 2000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 2000
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 100 2000 2100 2100 0 3150 4095 3000
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 500
40 Asiklovir tab 400 mg tablet 0 300 300 100 200 150 195 500
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 10 6 16 9 7 13.5 17.55 50
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 20 25 45 30 15 45 58.5 50
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 20
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 20
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 1000
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 1000 1000 1000 0 1500 1950 2000
56 Cefadroksil SK 125 mg/5 mL botol 43 50 93 40 53 60 78 50
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 0 300 300 100 200 150 195 2000
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 20
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 1000
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 1000
64 Copper T set/buah 0 2 2 1 1 1.5 1.95 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 3000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 23 0 23 4 19 6 7.8 20
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 3 0 3 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 380 300 680 430 250 645 838.5 1000
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 29 0 29 3 26 4.5 5.85 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 51 0 51 24 27 36 46.8 0
89 Etakridin (Rivanol) lar 0,1% botol 13 0 13 6 7 9 11.7 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 3 15 18 9 9 13.5 17.55 20
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 2
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 20 30 50 50 0 75 97.5 20
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 470 0 470 170 300 255 331.5 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 20
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 20
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 5
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 400 0 400 0 400 0 0 1000
115 Glimepirid tab 1 mg tablet 150 0 150 50 100 75 97.5 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 300
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 600 1000 1600 1600 0 2400 3120 3000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 75 0 75 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 700 300 1000 450 550 675 877.5 500
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 900 0 900 900 0 1350 1755 1000
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 50
132 Ibuprofen tab 200 mg tablet 0 1000 1000 1000 0 1500 1950 1000
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 2000
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 500
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0 100 0 100 0 0 500
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 3000
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 200 0 200 200 0 300 390 1000
144 Kaptopril tab 25 mg tablet 0 1000 1000 1000 0 1500 1950 2000
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 25
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 900 0 900 300 600 450 585 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 10 10 6 4 9 11.7 5
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 25
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 5
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 1500 1500 3000 2800 200 4200 5460 3000
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 10
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 10
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
171 Kotrimoxazol tab 480 mg (adult) tablet 200 0 200 100 100 150 195 2000
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 50
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 100
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 100
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 72 72 57 15 85.5 111.15 100
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 3
183 Lisol lar 1.000 ml botol 0 1 1 1 0 1.5 1.95 0
184 Loratadin tab 10 mg tablet 0 300 300 50 250 75 97.5 500
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 45 0 45 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 5 0 5 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 18 0 18 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 700 0 700 200 500 300 390 0
193 Metformin tab 500 mg tablet 850 500 1350 0 1350 0 0 700
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0 750 0 750 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 1000
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 1000
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 1000
201 Metoklopramid tab 10 mg tablet 500 500 1000 300 700 450 585 1000
202 Metronidazol tab 250 mg tablet 1100 0 1100 100 1000 150 195 0
203 Metronidazol tab 500 mg tablet 1350 0 1350 350 1000 525 682.5 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 27 24 51 18 33 27 35.1 50
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
207 Natrium Diklofenak tab 25 mg tablet 0 1000 1000 500 500 750 975 1000
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 2000
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 80 0 80 11 69 16.5 21.45 0
210 Nifedipine tab 10 mg tablet 400 0 400 0 400 0 0 500
211 Nistatin tab vaginal 100.000 IU ovula 490 0 490 90 400 135 175.5 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 500 0 500 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 7 30 37 33 4 49.5 64.35 50
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 40 40 40 0 60 78 50
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 25
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 -5 5 -7.5 -9.75 100
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 450 450 210 240 315 409.5 1000
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 5000
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 26 26 26 0 39 50.7 100
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0 412 0 412 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 26 0 26 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 950 0 950 -1000 1950 -1500 -1950 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 1500
244 Povidon Iodida lar 10% - 1000 ml botol 0 4 4 4 0 6 7.8 3
245 Povidon Iodida lar 10% - 300 ml botol 0 9 9 7 2 10.5 13.65 5
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 10
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 2000
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 0 1000 1000 600 400 900 1170 2000
255 Ranitidin inj 25 mg/mL ampul 20 0 20 20 0 30 39 25
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 47 140 187 123 64 184.5 239.85 100
262 Salbutamol tab 2 mg tablet 0 600 600 600 0 900 1170 1000
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 1000
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 20
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 2000
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 25
275 Simvastatin tab 10 mg tablet 200 500 700 350 350 525 682.5 1000
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 1000
277 Siprofloksasin tab 500 mg tablet 500 0 500 500 0 750 975 2000
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 2000
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 200 500 700 450 250 675 877.5 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 500
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1000 1000 2000 1400 600 2100 2730 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 0 3000 3000 2200 800 3300 4290 3000
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 10
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 10
297 Zinc dispersible 20 mg tablet 100 0 100 100 0 150 195 1500
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 210 180 390 30 360 45 58.5 200
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 100
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 1000
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 2000
307 Piracetam tab 400 mg tablet 80 0 80 80 0 120 156 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 2000
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 2000
312 Etanol 70% lar 1000 ml botol 1 3 4 4 0 6 7.8 3
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 5
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 5
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
315 H2O2 0 1 0 1 1 0 1.5 1.95 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 47 50 97 88 9 132 171.6 200
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 50
3 Alat Suntik 3 ml pcs 38 50 88 63 25 94.5 122.85 200
4 Alat Suntik 5 ml pcs 100 0 100 0 100 0 0 0
5 Alat Suntik 10 ml pcs 37 0 37 17 20 25.5 33.15 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 2
17 Catgut no.2/0 pcs 5 48 53 44 9 66 85.8 60
18 Catgut no.3/0 pcs 94 0 94 46 48 69 89.7 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
20 Catheter (folley cathteter) no.10 pcs 9 10 19 1 18 1.5 1.95 0
21 Catheter (folley cathteter) no.12 pcs 10 10 20 0 20 0 0 0
22 Catheter (folley cathteter) no.14 pcs 6 10 16 4 12 6 7.8 10
23 Catheter (folley cathteter) no.16 pcs 8 10 18 1 17 1.5 1.95 0
24 Catheter (folley cathteter) no.18 pcs 10 10 20 9 11 13.5 17.55 10
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0
26 Copper T set 0 4 4 4 0 6 7.8 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 1
31 Hand Schoen no 7 set 0 50 50 48 2 72 93.6 50
32 Hand Schoen no 7.5 set 0 26 26 26 0 39 50.7 50
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 50
34 Hand Schoen no 8 set 0 0 0 0 0 0 0 100
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 50
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 20
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 20
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 20
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 20
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 30
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 30
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 30
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 30
44 Hand Schoen (Examination Gloves Size S) set 0 2 2 2 0 3 3.9 30
45 Hand Schoen (Examination Gloves Size M) set 0 10 10 10 0 15 19.5 30
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 30
47 Infusion Set Anak set 50 15 65 40 25 60 78 0
48 Infusion Set Dewasa set 0 93 93 88 5 132 171.6 100
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 10
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 64 13 77 28 49 42 54.6 10
52 IV Catheter no. 20 pcs 8 86 94 94 0 141 183.3 50
53 IV Catheter no. 22 pcs 17 10 27 22 5 33 42.9 20
54 IV Catheter no. 24 pcs 21 20 41 30 11 45 58.5 50
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 1 2 1 1 1.5 1.95 0
63 Jarum Jahit 3/8 Surgical lusin 1 1 2 1 1 1.5 1.95 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 100
65 Kapas Pembalut 250 g roll 8 5 13 5 8 7.5 9.75 0
66 Kapas Pembalut 500 g roll 5 5 10 0 10 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 50
68 Kasa Hydrofil 40 yard x 80 cm roll 2 8 10 7 3 10.5 13.65 20
69 Kasa Kompres Steril 40 x 40 cm bungkus 5 20 25 5 20 7.5 9.75 20
70 Kasa Pembalut 2 m x 80 cm roll 0 0 0 0 0 0 0 20
71 Kasa Pembalut 4 m x 5 cm roll 0 10 10 10 0 15 19.5 30
72 Kasa Pembalut 4 m x 10 cm roll 0 10 10 10 0 15 19.5 30
73 Kasa Pembalut 4 m x 15 cm roll 0 10 10 10 0 15 19.5 30
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 30
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 30
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 320
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 20
78 Kasa Steril 18 cm x 22 cm box 0 5 5 1 4 1.5 1.95 20
79 Masker Ear Loop Pcs 0 450 450 450 0 675 877.5 300
80 Mata Pisau Bedah No. 10 pcs 2 10 12 2 10 3 3.9 10
81 Mata Pisau Bedah No. 11 Pcs 2 10 12 2 10 3 3.9 10
82 Mata Pisau Bedah No. 15 Pcs 9 10 19 4 15 6 7.8 10
83 Mata Pisau Bedah No. 21 Pcs 7 0 7 6 1 9 11.7 10
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 10
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 10
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 10
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 5
88 Plester 5 cm x 4,5 cm roll 3 4 7 7 0 10.5 13.65 5
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 5
90 Pot Sputum pot 0 0 0 0 0 0 0 3
91 RDT pcs 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 5
93 Safety Box kotak 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 0 0 0 0 0 0 10
95 Silk (benang bedah sutra) no.2/0 pcs 72 24 96 29 67 43.5 56.55 0
96 Silk (benang bedah sutra) no.3/0 pcs 1 0 1 1 0 1.5 1.95 50
97 Sound Timer unit 2 0 2 2 0 3 3.9 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 1
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0
100 Urine bag pcs 14 0 14 9 5 13.5 17.55 5

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 3
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 25 25 25 0 37.5 48.75 1
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 1
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 1
18 Test Gula Darah test 0 25 25 12 13 18 23.4 1
19 Test Kehamilan strip 0 50 50 10 40 15 19.5 0
20 Test Kolesterol test 0 20 20 20 0 30 39 3
21 Test Urine Rutin strip 0 0 0 0 0 0 0 1
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 52 52 52 0 78 101.4 100
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 10
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 100
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 5
8 KY Jelly tube 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 5
12 Pehavral tablet salut 0 0 0 0 0 0 0 1000
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 5
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 10
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 5 5 0 5 0 0 20
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 5
20 Formalin 40 % botol 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 2000 2000 600 1400 900 1170 2000
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 100 100 0 100 0 0 200
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 3000
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 100 500 100 400 150 195 0
25 Vical susp 100 ml botol 17 15 32 21 11 31.5 40.95 50
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 480 0 480 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 500 500 0 750 975 5000
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 1000
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 1000
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 2000
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 100 0 100 100 0 150 195 1000
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 2000
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 1000
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 10
45 Caviplex syrup botol 0 0 0 0 0 0 0 2000
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 5
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 1000
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 1000
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 80 0 80 0 0 100
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

Inebe
MENGETAHUI
TERLAMBAT
7/25/2017

KEPALA PUSKESMAS MOWEWE Penang

TERLAMBAT
7/18/2017

SELVINA LAKASA, Amd. Keb DINA M

TERLAMBAT
7/11/2017
Nip. 19670824 198903 2 008 Nip. 19
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PUSAT PROVINSI PROGRAM
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Inebenggi, 30 Juni 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 16 20 2 34 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 0 2150 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 250 1000 150 1100 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 7 30 11 26 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 500 100 400 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 300 120 180 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 12 50 18 44 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 2000 400 1600 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 100 2000 150 1950 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 10 0 0 10 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 0 2000 300 1700 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 7 0 7 0 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 15 0 13 2 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 1000 200 800 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 53 45 13 85 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 200 1500 0 1700 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 1 2 0 3 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 3 0 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 250 500 50 700 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0 0 26 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 27 0 5 22 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 7 0 2 5 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 9 6 1 14 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 300 0 100 200 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 10 0 10 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 100 0 0 100 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 1000 200 800 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 5 70 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 550 500 50 1000 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 0 2000 0 2000 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 600 0 100 500 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 4 0 4 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 200 3000 300 2900 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 4 2 2 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 250 250 50 450 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 0 45 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 0 18 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 500 0 200 300 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 800 1500 0 2300 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 700 0 200 500 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 1000 0 100 900 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 800 0 300 500 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 33 48 9 72 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
207 Natrium Diklofenak tab 25 mg tablet 500 800 150 1150 0 0 0 0 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 69 40 3 106 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 400 0 0 400 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 400 100 0 500 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 100 100 500 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 4 20 4 20 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 240 450 120 570 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0 112 300 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 0 26 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1950 1000 1450 1500 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 400 2000 300 2100 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 64 180 74 170 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 350 1000 200 1150 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 250 0 30 220 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 600 1000 100 1500 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 800 3000 200 3600 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 360 150 0 510 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 9 72 11 70 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 25 0 14 11 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 100 0 0 100 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 20 0 6 14 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 9 72 14 67 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 48 48 0 96 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
20 Catheter (folley cathteter) no.10 pcs 18 0 0 18 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 20 0 0 20 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 12 0 0 12 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 17 0 0 17 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 11 100 1 110 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 2 29 7 24 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 0 26 5 21 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 0 30 5 25 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 30 6 24 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 20 0 3 17 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 3 50 7 46 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 46 10 0 56 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 0 0 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 5 20 2 23 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 7 50 3 54 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 144 0 144 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 8 0 0 8 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 10 0 0 10 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 48 48 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 3 8 1 10 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 20 10 0 30 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 10 0 10 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 2 0 2 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 4 4 2 6 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 50 25 25 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 10 9 0 19 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 10 10 0 20 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 15 10 4 21 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 1 0 1 0 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 0 1 0 1 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 65 0 65 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 5 3 2 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 67 0 1 66 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
97 Sound Timer unit 0 0 0 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 5 5 0 10 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 50 9 41 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 13 50 0 63 0 0 0 0 0 0 0
19 Test Kehamilan strip 40 0 1 39 0 0 0 0 0 0 0
20 Test Kolesterol test 0 20 0 20 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 5 3 0 8 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 1400 0 200 1200 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 0 100 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 0 0 400 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 11 30 2 39 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 480 0 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 380 120 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 0 80 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

MEMGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : JULI
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 16 20 2 34
0 0 0 0 0 0 0 0 0 2150 0 0 2150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 250 1000 150 1100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 7 30 11 26
0 0 0 0 0 0 0 0 0 0 500 100 400
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 300 120 180
0 0 0 0 0 0 0 0 0 12 50 18 44
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 600 600 0 0 2600 1000 1600
0 0 0 0 0 0 0 0 0 0 0 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 2000 150 1950
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 700 700 0 0 2700 1000 1700
0 0 0 0 0 0 0 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 0 0 200 200 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 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 7 0
0 0 0 0 0 0 0 0 0 0 0 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 0 13 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 1000 200 800
0 0 0 0 0 0 0 0 0 53 45 13 85
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 200 1500 0 1700
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1 2 0 3
0 0 0 0 0 0 500 500 0 0 500 500 0
0 0 0 0 0 19 0 2 17 19 0 2 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 0 0 0 3 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 250 500 50 700
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 26 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 27 0 5 22
0 0 0 0 0 0 0 0 0 7 0 2 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 0 0 9 6 1 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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 100 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 400 0 0 400 400 0 0 400
0 0 0 0 0 0 0 0 0 100 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 1000 200 800
0 0 0 0 0 0 0 0 0 0 0 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 0 5 70
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 550 500 50 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 5 0 0 5 5 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 500 300 200 0 500 300 200
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 2000 0 2000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 600 0 100 500
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 4 0 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 0 200 3000 300 2900
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 100 200 200 100 100 200 200 100
0 0 0 0 0 0 15 8 7 0 15 8 7
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 15 13 17 15 15 13 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 0 0 0 0 4 2 2
0 0 0 0 0 0 0 0 0 250 250 50 450
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 45 0 0 45
0 0 0 0 0 0 0 0 0 5 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 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 0 0 18
0 0 0 0 0 0 0 0 0 500 0 200 300
0 0 0 0 0 550 0 100 450 1350 1500 100 2750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 750 0 0 750 750 0 0 750
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 700 0 200 500
0 0 0 0 0 0 0 0 0 1000 0 100 900
0 0 0 0 0 200 0 0 200 1000 0 300 700
0 0 0 0 0 0 0 0 0 0 0 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 48 9 72
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 500 800 150 1150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 69 40 3 106
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 400 100 0 500
0 0 0 0 0 0 0 0 0 500 100 100 500
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 20 4 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 5 0 5 0 5 0 5 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 240 450 120 570
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 800 800 0 0 800 800 0
0 0 0 0 0 0 16 11 5 0 16 11 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 412 0 112 300
0 0 0 0 0 0 0 0 0 26 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1950 1000 1450 1500
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 1 1 0 2 1 1
0 0 0 0 0 2 0 2 0 2 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 2000 1000 1000 0 2000 1000 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 2000 300 2100
0 0 0 0 0 0 15 7 8 0 15 7 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 64 180 74 170
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 600 500 100 0 600 500 100
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 350 1000 200 1150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 500 400 100 0 500 400 100
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 30 220
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 600 1000 100 1500
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 800 3000 200 3600
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 360 150 0 510
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 4 0 0 4 4 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 72 11 70
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 25 0 14 11
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 20 0 6 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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 72 14 67
0 0 0 0 0 0 0 0 0 48 48 0 96
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 18 0 0 18
0 0 0 0 0 0 0 0 0 20 0 0 20
0 0 0 0 0 0 0 0 0 12 0 0 12
0 0 0 0 0 0 0 0 0 17 0 0 17
0 0 0 0 0 0 0 0 0 11 100 1 110
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 29 7 24
0 0 0 0 0 0 0 0 0 0 26 5 21
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 30 5 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 0 0 0 0 0 0 0 30 6 24
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 0 0 3 3 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 5 0 5 0 25 0 8 17
0 0 0 0 0 2 5 2 5 5 55 9 51
0 0 0 0 0 0 0 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 3 49 10 0 59
0 0 0 0 0 0 14 14 0 0 14 14 0
0 0 0 0 0 0 0 0 0 5 20 2 23
0 0 0 0 0 4 0 0 4 11 50 3 58
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 0 144 0 144
0 0 0 0 0 0 0 0 0 8 0 0 8
0 0 0 0 0 0 0 0 0 10 0 0 10
0 0 0 0 0 0 0 0 0 0 48 48 0
0 0 0 0 0 0 0 0 0 3 8 1 10
0 0 0 0 0 0 0 0 0 20 10 0 30
0 0 0 0 0 0 0 0 0 0 10 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 2
0 0 0 0 0 0 0 0 0 4 4 2 6
0 0 0 0 0 0 0 0 0 0 50 25 25
0 0 0 0 0 0 0 0 0 10 9 0 19
0 0 0 0 0 0 0 0 0 10 10 0 20
0 0 0 0 0 0 0 0 0 15 10 4 21
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 0
0 0 0 0 0 0 0 0 0 0 0 0 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 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 65 0 65
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 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 3 2
0 0 0 0 0 0 0 0 0 67 0 1 66
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 5 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 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 9 41
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 13 50 0 63
0 0 0 0 0 0 0 0 0 40 0 1 39
0 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 3 0 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 1400 0 200 1200
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 11 30 2 39
0 0 0 0 0 0 0 0 0 480 0 480 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 500 380 120
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 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 80
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Inebenggi, 31 Juli 2017

TERLAMBAT
8/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
8/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
8/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 34 0 10 24 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 0 2150 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 1100 0 250 850 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 26 0 21 5 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 400 0 400 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 180 0 180 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 44 0 18 26 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 1600 0 1200 400 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 1950 0 750 1200 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 10 0 0 10 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 1700 0 1050 650 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 0 0 0 0 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 2 0 2 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 800 0 800 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 85 0 16 69 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 1700 0 170 1530 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 3 0 0 3 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 700 0 140 560 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0 0 26 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 22 0 13 9 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 5 0 2 3 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 14 0 10 4 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 200 0 20 180 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 10 0 0 10 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 100 0 0 100 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 800 0 400 400 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 70 0 0 70 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 1000 0 70 930 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 2000 0 300 1700 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 500 0 400 100 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 2900 0 900 2000 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 2 0 1 1 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 450 0 70 380 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 0 45 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 0 18 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 300 0 300 0 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 2300 0 20 2280 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 500 0 0 500 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 900 0 0 900 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 500 0 0 500 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 72 0 18 54 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
207 Natrium Diklofenak tab 25 mg tablet 1150 0 640 510 0 0 0 0 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 106 0 12 94 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 400 0 0 400 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 500 0 0 500 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 0 500 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 20 0 20 0 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 570 0 310 260 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 300 0 0 300 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 0 26 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1500 0 0 1500 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 2100 0 520 1580 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 170 0 26 144 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 1150 0 100 1050 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 220 0 130 90 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1500 0 340 1160 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 3600 0 2200 1400 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 510 0 60 450 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 70 0 52 18 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 11 0 5 6 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 100 0 20 80 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 14 0 2 12 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 67 0 10 57 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 96 0 0 96 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
20 Catheter (folley cathteter) no.10 pcs 18 0 0 18 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 20 0 0 20 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 12 0 0 12 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 17 0 0 17 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 110 0 0 110 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 24 0 6 18 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 21 0 11 10 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 25 0 6 19 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 24 0 0 24 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 17 0 8 9 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 46 0 19 27 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 56 0 6 50 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 0 0 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 23 0 17 6 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 54 0 4 50 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
64 Kaca Slide pcs 144 0 144 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 8 0 0 8 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 10 0 0 10 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 10 0 2 8 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 30 0 8 22 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 10 0 1 9 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 2 0 2 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 6 0 3 3 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 25 0 25 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 19 0 2 17 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 20 0 3 17 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 21 0 10 11 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 0 0 0 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 1 0 0 1 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 65 0 65 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 2 0 1 1 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 66 0 9 57 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
97 Sound Timer unit 0 0 0 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 10 0 3 7 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 41 0 16 25 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 63 0 18 45 0 0 0 0 0 0 0
19 Test Kehamilan strip 39 0 4 35 0 0 0 0 0 0 0
20 Test Kolesterol test 20 0 20 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8 0 0 8 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 1200 0 565 635 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 0 100 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 0 220 180 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 39 0 16 23 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0 0 0 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 120 0 120 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 0 80 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : AGUSTUS
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 34 0 10 24
0 0 0 0 0 0 0 0 0 2150 0 0 2150
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1100 0 250 850
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 26 0 21 5
0 0 0 0 0 0 300 300 0 400 300 700 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 180 0
0 0 0 0 0 0 0 0 0 44 0 18 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 900 700 200 1600 900 1900 600
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1950 0 750 1200
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1000 300 700 0 1000 300 700
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 500 300 200 1700 500 1350 850
0 0 0 0 0 0 0 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 0 0 200 200 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 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 8 2 6 2 8 4 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 800 0 800 0
0 0 0 0 0 0 0 0 0 85 0 16 69
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1700 0 170 1530
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 3
0 0 0 0 0 0 700 300 400 0 700 300 400
0 0 0 0 0 17 0 8 9 17 0 8 9
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 700 0 140 560
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 26 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 13 9
0 0 0 0 0 0 0 0 0 5 0 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 0 0 14 0 10 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 20 180
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 400 0 70 330 400 0 70 330
0 0 0 0 0 0 0 0 0 100 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 0 800 0 400 400
0 0 0 0 0 0 0 0 0 0 0 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 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 1000 0 70 930
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 200 300 500 0 200 300 500 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 100 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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2000 0 300 1700
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 400 100
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2900 0 900 2000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 100 400 300 200 100 400 300 200
0 0 0 0 0 7 10 15 2 7 10 15 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 17 24 36 5 17 24 36 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 0 0 2 0 1 1
0 0 0 0 0 0 0 0 0 450 0 70 380
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 45 0 0 45
0 0 0 0 0 0 0 0 0 5 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 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 0 0 18
0 0 0 0 0 0 0 0 0 300 0 300 0
0 0 0 0 0 450 0 0 450 2750 0 20 2730
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 750 0 100 650 750 0 100 650
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 0 500
0 0 0 0 0 0 0 0 0 900 0 0 900
0 0 0 0 0 200 0 0 200 700 0 0 700
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 72 0 18 54
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 1150 0 640 510
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 106 0 12 94
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 500 0 0 500
0 0 0 0 0 0 0 0 0 500 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 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 0 310 260
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 1200 1200 0 0 1200 1200 0
0 0 0 0 0 5 12 15 2 5 12 15 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 0 300 0 0 300
0 0 0 0 0 0 0 0 0 26 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1500 0 0 1500
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 400 200 200 0 400 200 200
0 0 0 0 0 1 0 0.5 0.5 1 0 0.5 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1000 600 1220 380 1000 600 1220 380
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2100 0 520 1580
0 0 0 0 0 8 0 4 4 8 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 0 170 0 26 144
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 300 210 190 100 300 210 190
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1150 0 100 1050
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 100 0 100 0 100 0 100 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 130 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 1500 0 340 1160
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 3600 0 2200 1400
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 510 0 60 450
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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 52 18
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 11 0 5 6
0 0 0 0 0 0 0 0 0 100 0 20 80
0 0 0 0 0 0 0 0 0 14 0 2 12
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 10 57
0 0 0 0 0 0 0 0 0 96 0 0 96
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 18 0 0 18
0 0 0 0 0 0 0 0 0 20 0 0 20
0 0 0 0 0 0 0 0 0 12 0 0 12
0 0 0 0 0 0 0 0 0 17 0 0 17
0 0 0 0 0 0 0 0 0 110 0 0 110
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 24 0 6 18
0 0 0 0 0 0 0 0 0 21 0 11 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 25 0 6 19
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 24 0 0 24
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 1 2 0 3 1 2
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 17 0 8 9
0 0 0 0 0 5 0 5 0 51 0 24 27
0 0 0 0 0 0 0 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 3 0 59 0 9 50
0 0 0 0 0 0 18 12 6 0 18 12 6
0 0 0 0 0 0 0 0 0 23 0 17 6
0 0 0 0 0 4 0 2 2 58 0 6 52
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 144 0 144 0
0 0 0 0 0 0 0 0 0 8 0 0 8
0 0 0 0 0 0 0 0 0 10 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 10 0 2 8
0 0 0 0 0 0 0 0 0 30 0 8 22
0 0 0 0 0 0 0 0 0 10 0 1 9
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 2 0
0 0 0 0 0 0 0 0 0 6 0 3 3
0 0 0 0 0 0 100 100 0 25 100 125 0
0 0 0 0 0 0 0 0 0 19 0 2 17
0 0 0 0 0 0 0 0 0 20 0 3 17
0 0 0 0 0 0 0 0 0 21 0 10 11
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 0 1 3 3 1
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 65 0 65 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 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 4 5 2 9 5 6
0 0 0 0 0 0 0 0 0 66 0 9 57
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 3 7

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 41 0 16 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 63 0 18 45
0 0 0 0 0 0 0 0 0 39 0 4 35
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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 8 0 0 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 1200 0 565 635
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 400 0 220 180
0 0 0 0 0 0 0 0 0 39 0 16 23
0 0 0 0 0 0 0 0 0 0 0 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 0 120 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 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 80
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

Inebenggi, 31 Agustus 2017

TERLAMBAT
9/25/2016

Penanggung Jawab Farmasi

TERLAMBAT
9/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
9/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 24 0 2 22 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2150 0 150 2000 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 850 0 300 550 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 5 0 5 0 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 26 0 15 11 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 400 0 400 0 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 1200 0 1200 0 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 10 0 0 10 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 650 0 450 200 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 0 0 0 0 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 0 0 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 69 0 14 55 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 1530 0 130 1400 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 3 0 0 3 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 560 0 415 145 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0 0 26 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 9 0 5 4 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 3 0 1 2 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 4 0 4 0 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 180 0 3 177 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 10 0 0 10 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 100 0 80 20 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 400 0 400 0 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 70 0 20 50 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 930 0 320 610 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 1700 0 720 980 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 100 0 100 0 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 2000 0 1030 970 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 1 0 0 1 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 380 0 130 250 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 0 45 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 0 5 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 0 18 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 2280 0 150 2130 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 500 0 500 0 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 900 0 40 860 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 500 0 0 500 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 54 0 0 54 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
207 Natrium Diklofenak tab 25 mg tablet 510 0 380 130 0 0 0 0 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 94 0 5 89 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 400 0 0 400 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 500 0 0 500 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 0 500 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 260 0 210 50 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 300 0 0 300 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 1 25 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1500 0 180 1320 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 1580 0 570 1010 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 144 0 4 140 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 1050 0 210 840 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 90 0 90 0 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1160 0 160 1000 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 1400 0 90 1310 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 450 0 0 450 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 18 0 8 10 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 6 0 0 6 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 80 0 0 80 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 12 0 0 12 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 57 0 9 48 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 96 0 0 96 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
20 Catheter (folley cathteter) no.10 pcs 18 0 0 18 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 20 0 0 20 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 12 0 0 12 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 17 0 0 17 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 110 0 0 110 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 18 0 9 9 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 10 0 2 8 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 19 0 2 17 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 24 0 2 22 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 9 0 2 7 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 27 0 18 9 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 50 0 2 48 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 0 0 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 6 0 5 1 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 50 0 0 50 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 0 1 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 8 0 0 8 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 10 0 0 10 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 8 0 1 7 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 22 0 12 10 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 9 0 4 5 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 3 0 1 2 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 17 0 1 16 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 17 0 0 17 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 11 0 6 5 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 0 0 0 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 1 0 1 0 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 1 0 0 1 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 57 0 4 53 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
97 Sound Timer unit 0 0 0 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 7 0 0 7 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 25 0 0 25 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 45 0 0 45 0 0 0 0 0 0 0
19 Test Kehamilan strip 35 0 14 21 0 0 0 0 0 0 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 GIGI 0 0 0 0 0 0 0 0 0 0 0 0
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8 0 1 7 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 635 0 325 310 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 0 100 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 180 0 80 100 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 23 0 12 11 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0 0 0 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 0 80 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : SEPTEMBER
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 24 0 2 22
0 0 0 0 0 0 0 0 0 2150 0 150 2000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 850 0 300 550
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 10 3 7 5 10 8 7
0 0 0 0 0 0 1000 220 780 0 1000 220 780
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 330 95 235 0 330 95 235
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 26 0 15 11
0 0 0 0 0 0 0 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 1700 770 1130 600 1700 1170 1130
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 10 1 9 0 10 1 9
0 0 0 0 0 0 1000 250 750 1200 1000 1450 750
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 700 0 500 200 700 0 500 200
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 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 200 900 260 840 850 900 710 1040
0 0 0 0 0 0 0 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 0 30 170 200 0 30 170
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 6 0 6 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 200 200 0 0 200 200 0
0 0 0 0 0 0 0 0 0 69 0 14 55
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1530 0 130 1400
0 0 0 0 0 0 0 0 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 10 240 0 250 10 240
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 3
0 0 0 0 0 400 1000 400 1000 400 1000 400 1000
0 0 0 0 0 9 0 4 5 9 0 4 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 560 0 415 145
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 26 0 0 26
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 5 4
0 0 0 0 0 0 0 0 0 3 0 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 6 2 4 4 6 6 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
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 3 177
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 330 0 50 280 330 0 50 280
0 0 0 0 0 0 0 0 0 100 0 80 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 0 800 100 700 400 800 500 700
0 0 0 0 0 0 0 0 0 0 0 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 0 20 50
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 930 0 320 610
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 800 280 520 0 800 280 520
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 100 100 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 0 750 80 670 0 750 80 670
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1700 0 720 980
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 100 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 2000 0 1030 970
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 200 800 210 790 200 800 210 790
0 0 0 0 0 2 10 2 10 2 10 2 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 21 11 15 5 21 11 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 0 0 0 1 0 0 1
0 0 0 0 0 0 0 0 0 380 0 130 250
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 45 0 0 45
0 0 0 0 0 0 0 0 0 5 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 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 0 0 18
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 450 0 0 450 2730 0 150 2580
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 650 0 0 650 650 0 0 650
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 500 0 500 0
0 0 0 0 0 0 0 0 0 900 0 40 860
0 0 0 0 0 200 0 100 100 700 0 100 600
0 0 0 0 0 0 0 0 0 0 0 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 0 0 54
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 510 0 380 130
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 94 0 5 89
0 0 0 0 0 0 0 0 0 400 0 0 400
0 0 0 0 0 0 0 0 0 500 0 0 500
0 0 0 0 0 0 0 0 0 500 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 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 260 0 210 50
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2000 380 1620 0 2000 380 1620
0 0 0 0 0 2 10 11 1 2 10 11 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 0 300 0 0 300
0 0 0 0 0 0 0 0 0 26 0 1 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 1500 0 180 1320
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 200 600 400 400 200 600 400 400
0 0 0 0 0 0.5 2 0.5 2 0.5 2 0.5 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 0 380 1000 580 800 380 1000 580 800
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1580 0 570 1010
0 0 0 0 0 4 6 5 5 4 6 5 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 144 0 4 140
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 190 500 200 490 190 500 200 490
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1050 0 210 840
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 200 0 200 0 200 0 200
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 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 1160 0 160 1000
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1400 0 90 1310
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 450
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
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 8 10
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 6 0 0 6
0 0 0 0 0 0 0 0 0 80 0 0 80
0 0 0 0 0 0 0 0 0 12 0 0 12
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 9 48
0 0 0 0 0 0 0 0 0 96 0 0 96
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 18 0 0 18
0 0 0 0 0 0 0 0 0 20 0 0 20
0 0 0 0 0 0 0 0 0 12 0 0 12
0 0 0 0 0 0 0 0 0 17 0 0 17
0 0 0 0 0 0 0 0 0 110 0 0 110
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 9 9
0 0 0 0 0 0 0 0 0 10 0 2 8
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 19 0 2 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 24 0 2 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 0
0 0 0 0 0 0 0 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 3 0 2 1 3 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 2 7
0 0 0 0 0 0 0 0 0 27 0 18 9
0 0 0 0 0 0 0 0 0 0 0 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 2 48
0 0 0 0 0 6 17 3 20 6 17 3 20
0 0 0 0 0 0 0 0 0 6 0 5 1
0 0 0 0 0 2 0 2 0 52 0 2 50
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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
0 0 0 0 0 0 0 0 0 1 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 8 0 0 8
0 0 0 0 0 0 0 0 0 10 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 8 0 1 7
0 0 0 0 0 0 0 0 0 22 0 12 10
0 0 0 0 0 0 0 0 0 9 0 4 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 1 2
0 0 0 0 0 0 50 50 0 0 50 50 0
0 0 0 0 0 0 0 0 0 17 0 1 16
0 0 0 0 0 0 0 0 0 17 0 0 17
0 0 0 0 0 0 0 0 0 11 0 6 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 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 1 1 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 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 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 2 3 6 0 2 4
0 0 0 0 0 0 0 0 0 57 0 4 53
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 25 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 45 0 0 45
0 0 0 0 0 0 0 0 0 35 0 14 21
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 8 0 1 7
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 635 0 325 310
0 0 0 0 0 0 0 0 0 100 0 0 100
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 180 0 80 100
0 0 0 0 0 0 0 0 0 23 0 12 11
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 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 0 0 80
0 0 0 0 0 0 500 0 500 0 500 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

Inebenggi, 29 September 2017

TERLAMBAT
10/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
10/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
10/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(L P L P O)

PUSKESMAS : MOWEWE BULAN : SEPTEMBER

KECAMATAN : MOWEWE TAHUN : 2017
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA
LB 2
Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
1 Air Untuk Injeksi 20 ml vial 16 20 36 14 22 21 27.3 40
2 Albendazole tab 400 mg tablet 2150 0 2150 150 2000 225 292.5 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 250 1000 1250 700 550 1050 1365 1000
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 7 40 47 40 7 60 78 50
7 Ambroksol tab 30 mg tablet 0 1800 1800 1020 780 1530 1989 1000
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 330 330 95 235 142.5 185.25 1000
12 Amlodipin tab 10 mg tablet 0 300 300 300 0 450 585 1000
13 Amoxicillin sir forte 250 mg/5 ml botol 12 50 62 51 11 76.5 99.45 100
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 100
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 5200 5200 4070 1130 6105 7936.5 5000
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 10 10 1 9 1.5 1.95 50
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 100 3000 3100 2350 750 3525 4582.5 2000
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 5
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 5
22 Antihemoroid DOEN suppo supp 10 0 10 0 10 0 0 10
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 3000
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 1000 1000 800 200 1200 1560 3000
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 0 4100 4100 3060 1040 4590 5967 5000
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 500
40 Asiklovir tab 400 mg tablet 200 0 200 30 170 45 58.5 500
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 7 0 7 7 0 10.5 13.65 50
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 15 8 23 23 0 34.5 44.85 50
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 5
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 20
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 20
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 1000
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 1000
55 Cefadroksil kaps/tab 500 mg kapsul 0 1200 1200 1200 0 1800 2340 2000
56 Cefadroksil SK 125 mg/5 mL botol 53 45 98 43 55 64.5 83.85 50
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 200 1500 1700 300 1400 450 585 500
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 10
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 250 250 10 240 15 19.5 1000
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 5
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 1000
64 Copper T set/buah 1 2 3 0 3 0 0 0
65 Deksametason tab 0,5 mg tablet 0 2200 2200 1200 1000 1800 2340 3000
66 Deksamethason inj 5 mg/ml - 1 ml ampul 19 0 19 14 5 21 27.3 20
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 3 0 3 3 0 4.5 5.85 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 250 500 750 605 145 907.5 1179.75 1000
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0 26 0 26 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 1000
88 Erytromisin SK 200 mg/5 ml botol 27 0 27 23 4 34.5 44.85 50
89 Etakridin (Rivanol) lar 0,1% botol 7 0 7 5 2 7.5 9.75 10
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 9 12 21 17 4 25.5 33.15 50
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 3
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 20
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 5
106 Garam Oralit kombinasi sacchet 300 0 300 123 177 184.5 239.85 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 20
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 20
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 5
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 5
112 Gentamisin inj 40 mg/ml ampul 0 10 10 0 10 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 400 0 400 120 280 180 234 1000
115 Glimepirid tab 1 mg tablet 100 0 100 80 20 120 156 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 500
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 1800 1800 1100 700 1650 2145 5000
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 75 0 75 25 50 37.5 48.75 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 550 500 1050 440 610 660 858 300
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 2000
131 Hydrokortison krim 2,5 % - 5 g tube 0 5 5 5 0 7.5 9.75 50
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 1000
133 Ibuprofen tab 400 mg tablet 0 1600 1600 1080 520 1620 2106 2000
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 500
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0 100 0 100 0 0 500
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 750 750 80 670 120 156 3000
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 1000
144 Kaptopril tab 25 mg tablet 0 2000 2000 1020 980 1530 1989 2000
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 25
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 500
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 300
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 600 0 600 600 0 900 1170 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 4 0 4 4 0 6 7.8 5
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 25
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 5
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 5
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 200 3000 3200 2230 970 3345 4348.5 3000
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 10
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 10
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
171 Kotrimoxazol tab 480 mg (adult) tablet 100 1400 1500 710 790 1065 1384.5 3000
172 Kotrimoxazol susp 60 ml botol 0 35 35 25 10 37.5 48.75 50
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 100
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 100
180 Lidokain inj 2% (infiltr/p.v.) ampul 15 60 75 60 15 90 117 100
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 3
183 Lisol lar 1.000 ml botol 0 4 4 3 1 4.5 5.85 3
184 Loratadin tab 10 mg tablet 250 250 500 250 250 375 487.5 500
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 45 0 45 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 5 0 5 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 18 0 18 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 500 0 500 500 0 750 975 500
193 Metformin tab 500 mg tablet 1350 1500 2850 270 2580 405 526.5 700
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 750 0 750 100 650 150 195 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 1000
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 1000
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 1000
201 Metoklopramid tab 10 mg tablet 700 0 700 700 0 1050 1365 1000
202 Metronidazol tab 250 mg tablet 1000 0 1000 140 860 210 273 0
203 Metronidazol tab 500 mg tablet 1000 0 1000 400 600 600 780 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 33 48 81 27 54 40.5 52.65 50
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
207 Natrium Diklofenak tab 25 mg tablet 500 800 1300 1170 130 1755 2281.5 1000
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 2000
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 69 40 109 20 89 30 39 0
210 Nifedipine tab 10 mg tablet 400 0 400 0 400 0 0 500
211 Nistatin tab vaginal 100.000 IU ovula 400 100 500 0 500 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 100 600 100 500 150 195 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 4 20 24 24 0 36 46.8 50
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 5
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 5
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 50
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 25
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5 0 5 5 0 7.5 9.75 100
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 240 450 690 640 50 960 1248 1000
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 4000 4000 2380 1620 3570 4641 5000
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 38 38 37 1 55.5 72.15 100
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 50
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 412 0 412 112 300 168 218.4 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 26 0 26 1 25 1.5 1.95 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1950 1000 2950 1630 1320 2445 3178.5 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
243 Piroxicam tab 10 mg tablet 0 1000 1000 600 400 900 1170 2000
244 Povidon Iodida lar 10% - 1000 ml botol 0 4 4 2 2 3 3.9 3
245 Povidon Iodida lar 10% - 300 ml botol 2 0 2 2 0 3 3.9 5
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 10
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 20
248 Prednison tab 5 mg tablet 0 3600 3600 2800 800 4200 5460 3000
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 400 2000 2400 1390 1010 2085 2710.5 2000
255 Ranitidin inj 25 mg/mL ampul 0 21 21 16 5 24 31.2 25
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 100
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 100
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 64 180 244 104 140 156 202.8 100
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 1000
263 Salbutamol tab 4 mg tablet 0 1400 1400 910 490 1365 1774.5 1000
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 20
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 2000
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 25
275 Simvastatin tab 10 mg tablet 350 1000 1350 510 840 765 994.5 1000
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 1000
277 Siprofloksasin tab 500 mg tablet 0 700 700 500 200 750 975 2000
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 3000
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 5
282 Tetrasiklin kaps 250 mg kapsul 250 0 250 250 0 375 487.5 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 500
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 600 1000 1600 600 1000 900 1170 1000
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 800 3000 3800 2490 1310 3735 4855.5 3000
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 10
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 10
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 1500
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 360 150 510 60 450 90 117 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 100
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 1000
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 2000
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 100
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 2000
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 3000
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 3
313 Etanol 70% lar 300 ml botol 0 4 4 4 0 6 7.8 5
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 5
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
315 H2O2 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 9 72 81 71 10 106.5 138.45 200
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 50
3 Alat Suntik 3 ml pcs 25 0 25 19 6 28.5 37.05 200
4 Alat Suntik 5 ml pcs 100 0 100 20 80 30 39 0
5 Alat Suntik 10 ml pcs 20 0 20 8 12 12 15.6 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 2
17 Catgut no.2/0 pcs 9 72 81 33 48 49.5 64.35 60
18 Catgut no.3/0 pcs 48 48 96 0 96 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
20 Catheter (folley cathteter) no.10 pcs 18 0 18 0 18 0 0 0
21 Catheter (folley cathteter) no.12 pcs 20 0 20 0 20 0 0 0
22 Catheter (folley cathteter) no.14 pcs 12 0 12 0 12 0 0 0
23 Catheter (folley cathteter) no.16 pcs 17 0 17 0 17 0 0 0
24 Catheter (folley cathteter) no.18 pcs 11 100 111 1 110 1.5 1.95 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 1
26 Copper T set 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 1
31 Hand Schoen no 7 set 2 29 31 22 9 33 42.9 50
32 Hand Schoen no 7.5 set 0 26 26 18 8 27 35.1 50
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 50
34 Hand Schoen no 8 set 0 30 30 13 17 19.5 25.35 100
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 50
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 20
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 20
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 20
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 20
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 30 30 8 22 12 15.6 30
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 30
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 30
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 30
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 30
45 Hand Schoen (Examination Gloves Size M) set 0 7 7 7 0 10.5 13.65 30
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 30
47 Infusion Set Anak set 25 0 25 18 7 27 35.1 100
48 Infusion Set Dewasa set 5 55 60 51 9 76.5 99.45 100
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 10
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 49 10 59 11 48 16.5 21.45 10
52 IV Catheter no. 20 pcs 0 49 49 29 20 43.5 56.55 100
53 IV Catheter no. 22 pcs 5 20 25 24 1 36 46.8 30
54 IV Catheter no. 24 pcs 11 50 61 11 50 16.5 21.45 100
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 1 0 1 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 1 0 1 0 0 0
64 Kaca Slide pcs 0 144 144 144 0 216 280.8 100
65 Kapas Pembalut 250 g roll 8 0 8 0 8 0 0 0
66 Kapas Pembalut 500 g roll 10 0 10 0 10 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 48 48 48 0 72 93.6 50
68 Kasa Hydrofil 40 yard x 80 cm roll 3 8 11 4 7 6 7.8 20
69 Kasa Kompres Steril 40 x 40 cm bungkus 20 10 30 20 10 30 39 20
70 Kasa Pembalut 2 m x 80 cm roll 0 10 10 5 5 7.5 9.75 20
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 30
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 30
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 30
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 30
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 30
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 320
77 Kasa Steril 16 cm x 16 cm box 0 2 2 2 0 3 3.9 20
78 Kasa Steril 18 cm x 22 cm box 4 4 8 6 2 9 11.7 20
79 Masker Ear Loop Pcs 0 200 200 200 0 300 390 300
80 Mata Pisau Bedah No. 10 pcs 10 9 19 3 16 4.5 5.85 10
81 Mata Pisau Bedah No. 11 Pcs 10 10 20 3 17 4.5 5.85 10
82 Mata Pisau Bedah No. 15 Pcs 15 10 25 20 5 30 39 10
83 Mata Pisau Bedah No. 21 Pcs 1 0 1 1 0 1.5 1.95 10
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 10
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 10
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 10
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 5
88 Plester 5 cm x 4,5 cm roll 0 5 5 4 1 6 7.8 5
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 5
90 Pot Sputum pot 0 65 65 65 0 97.5 126.75 3
91 RDT pcs 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 5
93 Safety Box kotak 0 0 0 0 0 0 0 2
94 Selang Oxygen pcs 0 14 14 10 4 15 19.5 10
95 Silk (benang bedah sutra) no.2/0 pcs 67 0 67 14 53 21 27.3 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 50
97 Sound Timer unit 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 1
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0
100 Urine bag pcs 5 5 10 3 7 4.5 5.85 5

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 3
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 50 50 25 25 37.5 48.75 1
15 Test Comburt Reagens set 0 0 0 0 0 0 0 1
16 Test Golongan Darah set 0 0 0 0 0 0 0 1
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 1
18 Test Gula Darah test 13 50 63 18 45 27 35.1 1
19 Test Kehamilan strip 40 0 40 19 21 28.5 37.05 50
20 Test Kolesterol test 0 20 20 20 0 30 39 3
21 Test Urine Rutin strip 0 0 0 0 0 0 0 1
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 1
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 1
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 1
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 1
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 1
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 100
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 10
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 100
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 5
8 KY Jelly tube 0 0 0 0 0 0 0 2
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 5
12 Pehavral tablet salut 0 0 0 0 0 0 0 1000
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 5
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 10
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 5 3 8 1 7 1.5 1.95 20
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 10
20 Formalin 40 % botol 0 0 0 0 0 0 0 1
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 1400 0 1400 1090 310 1635 2125.5 3000
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 100 0 100 0 0 100
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 100
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 400 0 400 300 100 450 585 100
25 Vical susp 100 ml botol 11 30 41 30 11 45 58.5 50
26 Vitamin D3 00 IU/D-Vit tablet tablet 480 0 480 480 0 720 936 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 500 500 500 0 750 975 5000
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 1000
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 1000
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 2000
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 1000
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 2000
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 1000
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 10
45 Caviplex syrup botol 0 0 0 0 0 0 0 20
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 5
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 500
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 1000
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 1000
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 80 0 80 0 0 100
59 Trifadium ( Loperamide HCL 2 mg) tablet 0 500 500 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

Inebeng
MENGETAHUI
TERLAMBAT
10/25/2017

KEPALA PUSKESMAS MOWEWE Penan

TERLAMBAT
10/18/2017

SELVINA LAKASA, Amd. Keb DINA M

Nip. 19670824 198903 2 008
TERLAMBAT
10/11/2017
Nip. 19
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Pemberian
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PUSAT PROVINSI PROGRAM
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PUSAT PROVINSI PROGRAM

Inebenggi, 29 September 2017

Penanggung Jawab Farmasi

DINA MARDIANA, A.Md.Far

Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 22 0 22 0 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 2000 0 2000 0 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 550 0 550 0 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 11 0 11 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 0 0 0 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 10 0 10 0 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 200 0 200 0 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 0 0 0 0 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 0 0 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 55 0 55 0 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 1400 0 1400 0 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 3 0 3 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 145 0 145 0 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0 26 0 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 4 0 4 0 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 2 0 2 0 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 177 0 177 0 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 10 0 10 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 20 0 20 0 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 50 0 50 0 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 610 0 610 0 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 980 0 980 0 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 970 0 970 0 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 1 0 1 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 250 0 250 0 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 45 0 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 5 0 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 18 0 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 2130 0 2130 0 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 860 0 860 0 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 500 0 500 0 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 54 0 54 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
207 Natrium Diklofenak tab 25 mg tablet 130 0 130 0 0 0 0 0 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 89 0 89 0 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 400 0 400 0 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 500 0 500 0 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 500 0 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 50 0 50 0 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 300 0 300 0 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 25 0 25 0 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1320 0 1320 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 1010 0 1010 0 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 140 0 140 0 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 840 0 840 0 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1000 0 1000 0 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 1310 0 1310 0 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 450 0 450 0 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 10 0 10 0 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 6 0 6 0 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 80 0 80 0 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 12 0 12 0 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 48 0 48 0 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 96 0 96 0 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
20 Catheter (folley cathteter) no.10 pcs 18 0 18 0 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 20 0 20 0 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 12 0 12 0 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 17 0 17 0 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 110 0 110 0 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 9 0 9 0 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 8 0 8 0 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 17 0 17 0 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 22 0 22 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 7 0 7 0 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 9 0 9 0 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 48 0 48 0 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 0 0 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 1 0 1 0 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 50 0 50 0 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 1 0 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 1 0 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 8 0 8 0 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 10 0 10 0 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 7 0 7 0 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 10 0 10 0 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 5 0 5 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 2 0 2 0 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 16 0 16 0 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 17 0 17 0 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 5 0 5 0 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 0 0 0 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 1 0 1 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 53 0 53 0 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
97 Sound Timer unit 0 0 0 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 7 0 7 0 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 25 0 25 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 45 0 45 0 0 0 0 0 0 0 0
19 Test Kehamilan strip 21 0 21 0 0 0 0 0 0 0 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 7 0 7 0 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 310 0 310 0 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 100 0 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 100 0 100 0 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 11 0 11 0 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0 0 0 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 80 0 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : OKTOBER
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 22 0 22 0
0 0 0 0 0 0 0 0 0 2000 0 2000 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 550 0 550 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 7 0 7 0 7 0 7 0
0 0 0 0 0 780 0 780 0 780 0 780 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 235 0 235 0 235 0 235 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 11 0 11 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 1130 0 1130 0 1130 0 1130 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 9 0 9 0 9 0 9 0
0 0 0 0 0 750 0 750 0 750 0 750 0
0 0 0 0 0 0 0 0 0 0 0 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 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 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 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 0 200 0 200 0 200 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 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 840 0 840 0 1040 0 1040 0
0 0 0 0 0 0 0 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 0 170 0 170 0 170 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 55 0 55 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 1400 0 1400 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 240 0 240 0 240 0 240 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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Inebenggi, 31 Oktober 2017

TERLAMBAT
11/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
11/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
11/11/2017
Nip. 19890705 201504 2 001
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!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OB

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 0 0 0 0 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 0 0 0 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 0 0 0 0 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 0 0 0 0 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 0 0 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 0 0 0 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 0 0 0 0 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 0 0 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 0 0 0 0 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 0 0 0 0 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
207 Natrium Diklofenak tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 0 0 0 0 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 0 0 0 0 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 0 0 0 0 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 0 0 0 0 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 0 0 0 0 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 0 0 0 0 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 0 0 0 0 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
20 Catheter (folley cathteter) no.10 pcs 0 0 0 0 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 0 0 0 0 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 0 0 0 0 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 0 0 0 0 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 0 0 0 0 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 0 0 0 0 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 0 0 0 0 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 0 0 0 0 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 0 0 0 0 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 0 0 0 0 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 0 0 0 0 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 0 0 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 0 0 0 0 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 0 0 0 0 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 0 0 0 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 0 0 0 0 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 0 0 0 0 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 0 0 0 0 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 0 0 0 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 0 0 0 0 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 0 0 0 0 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 0 0 0 0 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 0 0 0 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 0 0 0 0 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
97 Sound Timer unit 0 0 0 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 0 0 0 0 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 0 0 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 0 0 0 0 0 0 0 0 0 0 0
19 Test Kehamilan strip 0 0 0 0 0 0 0 0 0 0 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 0 0 0 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 0 0 0 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0 0 0 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 0 0 0 0 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar

MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : NOVEMBER
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 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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I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
I PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

Inebenggi, 30 November 2017

TERLAMBAT
12/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
12/18/2017

DEWI SARTIKA, AMF

TERLAMBAT
12/11/2017
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PERSEDIAAN, STOK OPNAME DAN MUTASI OBA

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA

DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
1 Air Untuk Injeksi 20 ml vial 0 0 0 0 0 0 0 0 0 0 0
2 Albendazole tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
7 Ambroksol tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
12 Amlodipin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 0 0 0 0 0 0 0 0 0 0 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 0 0 0 0 0 0 0 0 0 0 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 0 0 0 0 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 0 0 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
64 Copper T set/buah 0 0 0 0 0 0 0 0 0 0 0
65 Deksametason tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
89 Etakridin (Rivanol) lar 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 0 0 0 0 0 0 0 0 0 0 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
115 Glimepirid tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
171 Kotrimoxazol tab 480 mg (adult) tablet 0 0 0 0 0 0 0 0 0 0 0
172 Kotrimoxazol susp 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 0 0 0 0 0 0 0 0 0 0 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 0 0 0 0 0 0 0 0 0 0 0
184 Loratadin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 0 0 0 0 0 0 0 0 0 0 0
187 Magnesium Sulfat inj 40% - 25 ml vial 0 0 0 0 0 0 0 0 0 0 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
203 Metronidazol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
207 Natrium Diklofenak tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
210 Nifedipine tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
211 Nistatin tab vaginal 100.000 IU ovula 0 0 0 0 0 0 0 0 0 0 0
212 Nistatin tab vaginal 500.000 IU tablet 0 0 0 0 0 0 0 0 0 0 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 0 0 0 0 0 0 0 0 0 0 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
243 Piroxicam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
244 Povidon Iodida lar 10% - 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 0 0 0 0 0 0 0 0 0 0 0
255 Ranitidin inj 25 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 0 0 0 0 0 0 0 0 0 0 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 0 0 0 0 0 0 0 0 0 0 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 0 0 0 0 0 0 0 0 0 0 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 0 0 0 0 0 0 0 0 0 0 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
315 H2O2 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 0 0 0 0 0 0 0 0 0 0 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
4 Alat Suntik 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
5 Alat Suntik 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 0 0 0 0 0 0 0 0 0 0 0
18 Catgut no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
20 Catheter (folley cathteter) no.10 pcs 0 0 0 0 0 0 0 0 0 0 0
21 Catheter (folley cathteter) no.12 pcs 0 0 0 0 0 0 0 0 0 0 0
22 Catheter (folley cathteter) no.14 pcs 0 0 0 0 0 0 0 0 0 0 0
23 Catheter (folley cathteter) no.16 pcs 0 0 0 0 0 0 0 0 0 0 0
24 Catheter (folley cathteter) no.18 pcs 0 0 0 0 0 0 0 0 0 0 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 0 0 0 0 0 0 0 0 0 0 0
32 Hand Schoen no 7.5 set 0 0 0 0 0 0 0 0 0 0 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 0 0 0 0 0 0 0 0 0 0 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 0 0 0 0 0 0 0 0 0 0 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 0 0 0 0 0 0 0 0 0 0 0
48 Infusion Set Dewasa set 0 0 0 0 0 0 0 0 0 0 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 0 0 0 0 0 0 0 0 0 0 0
52 IV Catheter no. 20 pcs 0 0 0 0 0 0 0 0 0 0 0
53 IV Catheter no. 22 pcs 0 0 0 0 0 0 0 0 0 0 0
54 IV Catheter no. 24 pcs 0 0 0 0 0 0 0 0 0 0 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 0 0 0 0 0 0 0 0 0 0 0
63 Jarum Jahit 3/8 Surgical lusin 0 0 0 0 0 0 0 0 0 0 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 0 0 0 0 0 0 0 0 0 0 0
66 Kapas Pembalut 500 g roll 0 0 0 0 0 0 0 0 0 0 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 0 0 0 0 0 0 0 0 0 0 0
70 Kasa Pembalut 2 m x 80 cm roll 0 0 0 0 0 0 0 0 0 0 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 0 0 0 0 0 0 0 0 0 0 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 0 0 0 0 0 0 0 0 0 0 0
81 Mata Pisau Bedah No. 11 Pcs 0 0 0 0 0 0 0 0 0 0 0
82 Mata Pisau Bedah No. 15 Pcs 0 0 0 0 0 0 0 0 0 0 0
83 Mata Pisau Bedah No. 21 Pcs 0 0 0 0 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
93 Safety Box kotak 0 0 0 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 0 0 0 0 0 0 0 0 0 0 0
95 Silk (benang bedah sutra) no.2/0 pcs 0 0 0 0 0 0 0 0 0 0 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0 0 0 0
97 Sound Timer unit 0 0 0 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0 0 0 0
100 Urine bag pcs 0 0 0 0 0 0 0 0 0 0 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0 0 0 0
14 Test Asam Urat test 0 0 0 0 0 0 0 0 0 0 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0 0 0 0
18 Test Gula Darah test 0 0 0 0 0 0 0 0 0 0 0
19 Test Kehamilan strip 0 0 0 0 0 0 0 0 0 0 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0 0 0 0
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 0 0 0 0 0 0 0 0 0 0 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 0 0 0 0 0 0 0 0 0 0 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 0 0 0 0 0 0 0 0 0 0 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 0 0 0 0 0 0 0 0 0 0 0
25 Vical susp 100 ml botol 0 0 0 0 0 0 0 0 0 0 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0 0 0 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0 0 0 0
 DAU/PKD DAK
No. Nama Obat Satuan Penerimaa Pengeluara PUSAT BUFFER PROVINSI
Stok Awal Stok Akhir
n n Awal Terima Keluar Akhir Awal Terima Keluar
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0 0 0 0
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 0 0 0 0 0 0 0 0 0 0 0
59 Trifadium ( Loperamide HCL 2 mg) 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 0 0 0 0 0 0
0 0 0 0 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 MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
MUTASI OBAT

BULAN : DESEMBER
TAHUN : 2017

LB 2
BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0 0 0
 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n

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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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 BPJS - JKN JUMLAH KESELURUHAN
SI PROGRAM Penerimaa Pengeluara Penerimaa Pengeluara
Stok Awal Stok Akhir Stok Awal Stok Akhir
Akhir Awal Terima Keluar Akhir n n n n
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0 0 0 0 0 0 0 0 0 0 0 0 0

Inebenggi, 29 Desember 2017

TERLAMBAT
1/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
1/18/2017

DEWI SARTIKA, AMF

TERLAMBAT
1/11/2018
Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT
(L P L P O)

PUSKESMAS : MOWEWE BULAN : DESEMBER

KECAMATAN : MOWEWE TAHUN : 2017
KAB/KOTA : KOLAKA TIMUR
PROVINSI : SULAWESI TENGGARA
LB 2
Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
1 Air Untuk Injeksi 20 ml vial 22 0 22 22 0 33 42.9 0
2 Albendazole tab 400 mg tablet 2000 0 2000 2000 0 3000 3900 0
3 Albendazole susp 200 mg/5 ml botol 0 0 0 0 0 0 0 0
4 Allopurinol tab 100 mg tablet 550 0 550 550 0 825 1072.5 0
5 Allopurinol tab 300 mg tablet 0 0 0 0 0 0 0 0
6 Ambroksol sir 15 mg/ml - 60 ml botol 7 0 7 7 0 10.5 13.65 0
7 Ambroksol tab 30 mg tablet 780 0 780 780 0 1170 1521 0
8 Aminophyllin tab 200 mg tablet 0 0 0 0 0 0 0 0
9 Aminophyllin inj 24 mg ampul 0 0 0 0 0 0 0 0
10 Amitriptiline HCl tab 25 mg tablet 0 0 0 0 0 0 0 0
11 Amlodipin tab 5 mg tablet 235 0 235 235 0 352.5 458.25 0
12 Amlodipin tab 10 mg tablet 0 0 0 0 0 0 0 0
13 Amoxicillin sir forte 250 mg/5 ml botol 11 0 11 11 0 16.5 21.45 0
14 Amoxicillin SK 125 mg/5 ml botol 0 0 0 0 0 0 0 0
15 Amoxicillin tab 250 mg tablet 0 0 0 0 0 0 0 0
16 Amoxicillin tab 500 mg tablet 1130 0 1130 1130 0 1695 2203.5 0
17 Ampicillin serb inj 1000 mg vial 0 0 0 0 0 0 0 0
18 Antasida DOEN susp 60 ml botol 9 0 9 9 0 13.5 17.55 0
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 750 0 750 750 0 1125 1462.5 0
20 Anti Bakteri DOEN salep kombinasi 5 g pot 0 0 0 0 0 0 0 0
21 Antifungi DOEN kombinasi 30 g pot 0 0 0 0 0 0 0 0
22 Antihemoroid DOEN suppo supp 10 0 10 10 0 15 19.5 0
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet 0 0 0 0 0 0 0 0
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 0 0 0 0 0 0 0 0
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 0 0 0 0 0 0 0 0
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 0 0 0 0 0 0 0 0
28 Artemether inj 80 mg/mL ampul 0 0 0 0 0 0 0 0
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 0 0 0 0 0 0 0 0
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 0 0 0 0 0 0 0 0
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 200 0 200 200 0 300 390 0
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 0 0 0 0 0 0 0 0
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 0 0 0 0 0 0 0 0
34 Asam Folat tab 0,4 mg tablet 0 0 0 0 0 0 0 0
35 Asam Folat tab 1 mg tablet 0 0 0 0 0 0 0 0
36 Asam Mefenamat tab 250 mg tablet 0 0 0 0 0 0 0 0
37 Asam Mefenamat tab 500 mg tablet 1040 0 1040 1040 0 1560 2028 0
38 Asam Traneksamat inj 50 mg/mL ampul 0 0 0 0 0 0 0 0
39 Asiklovir tab 200 mg tablet 0 0 0 0 0 0 0 0
40 Asiklovir tab 400 mg tablet 170 0 170 170 0 255 331.5 0
41 Atenolol tab 50 mg tablet 0 0 0 0 0 0 0 0
42 Atapulgit tab 600 mg tablet 0 0 0 0 0 0 0 0
43 Atropin tab 0,5 mg tablet 0 0 0 0 0 0 0 0
44 Atropin Sulfat inj 0,25 mg/ml ampul 0 0 0 0 0 0 0 0
45 Azitromisin tablet 500 mg kaplet 0 0 0 0 0 0 0 0
46 Bedak Salisil serb 2% Kotak 0 0 0 0 0 0 0 0
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 0 0 0 0 0 0 0 0
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 0 0 0 0 0 0 0 0
49 Betametason krim 0,5 mg/g tube 0 0 0 0 0 0 0 0
50 Betametason tts mata 1 mg/ml botol 0 0 0 0 0 0 0 0
51 Bisakodil sup 5 mg supp 0 0 0 0 0 0 0 0
52 Bisakodil sup 10 mg supp 0 0 0 0 0 0 0 0
53 Bromheksin tab 8 mg tablet 0 0 0 0 0 0 0 0
54 Cefadroksil kaps 250 mg kapsul 0 0 0 0 0 0 0 0
55 Cefadroksil kaps/tab 500 mg kapsul 0 0 0 0 0 0 0 0
56 Cefadroksil SK 125 mg/5 mL botol 55 0 55 55 0 82.5 107.25 0
57 Cefadroksil SK 250 mg/5 mL botol 0 0 0 0 0 0 0 0
58 Cefiksime tab 100 mg kapsul 1400 0 1400 1400 0 2100 2730 0
59 Cefiksime sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0
60 Ceftriaxone serb inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0
61 Cetrizine tab 10 mg tablet 240 0 240 240 0 360 468 0
62 Cetrizine sir 5 mg/5 ml botol 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
63 Cimetidine tab 200 mg tablet 0 0 0 0 0 0 0 0
64 Copper T set/buah 3 0 3 3 0 4.5 5.85 0
65 Deksametason tab 0,5 mg tablet 1000 0 1000 1000 0 1500 1950 0
66 Deksamethason inj 5 mg/ml - 1 ml ampul 5 0 5 5 0 7.5 9.75 0
67 Diazepam tab 2 mg tablet 0 0 0 0 0 0 0 0
68 Diazepam tab 5 mg tablet 0 0 0 0 0 0 0 0
69 Diazepam inj 5 mg/ml ampul 0 0 0 0 0 0 0 0
70 Diazepam lar rektal 10 mg/2,5 ml botol 0 0 0 0 0 0 0 0
71 Diazepam lar rektal 5 mg/2,5 ml botol 0 0 0 0 0 0 0 0
72 Dietil Karbamazin tab 100 mg tablet 0 0 0 0 0 0 0 0
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 0 0 0 0 0 0 0 0
74 Digoksin tab 0,25 mg tablet 0 0 0 0 0 0 0 0
75 Diltiazem kaps SR 100 mg kapsul 0 0 0 0 0 0 0 0
76 Diltiazem kaps SR 200 mg kapsul 0 0 0 0 0 0 0 0
77 Diltiazem tab 30 mg tablet 0 0 0 0 0 0 0 0
78 Dimenhidrinat tab 50 mg tablet 0 0 0 0 0 0 0 0
79 Doksisiklin kaps 100 mg kapsul 0 0 0 0 0 0 0 0
80 Domperidon susp 5 mg/5 ml botol 0 0 0 0 0 0 0 0
81 Domperidon tab 10 mg tablet 145 0 145 145 0 217.5 282.75 0
82 Efedrin inj 50 mg/mL tablet 0 0 0 0 0 0 0 0
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 26 0 26 26 0 39 50.7 0
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 0 0 0 0 0 0 0 0
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 0 0 0 0 0 0 0 0
86 Eritromisin kaps 250 mg kapsul 0 0 0 0 0 0 0 0
87 Eritromisin kaps 500 mg kapsul 0 0 0 0 0 0 0 0
88 Erytromisin SK 200 mg/5 ml botol 4 0 4 4 0 6 7.8 0
89 Etakridin (Rivanol) lar 0,1% botol 2 0 2 2 0 3 3.9 0
90 Etambutol tab 250 mg tablet 0 0 0 0 0 0 0 0
91 Etambutol tab 500 mg tablet 0 0 0 0 0 0 0 0
92 Etanol 70 % lar 100 ml botol 4 0 4 4 0 6 7.8 0
93 Etil Klorida semprot 100 mL botol 0 0 0 0 0 0 0 0
94 Etonogestrel implan 68 mg subd implant 0 0 0 0 0 0 0 0
95 Fenobarbital tab 30 mg tablet 0 0 0 0 0 0 0 0
96 Fenobarbital tab 100 mg tablet 0 0 0 0 0 0 0 0
97 Fenobarbital inj 50 mg/ml-1 ml ampul 0 0 0 0 0 0 0 0
98 Fenol Gliserol tts telinga 10% botol 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 0 0 0 0 0 0 0 0
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 0 0 0 0 0 0 0 0
101 Flukonazol kaps 150 mg kapsul 0 0 0 0 0 0 0 0
102 Fluor tab 0,5 mg tablet 0 0 0 0 0 0 0 0
103 Furosemid tab 40 mg tablet 0 0 0 0 0 0 0 0
104 Furosemide inj 10 mg/ml ampul 0 0 0 0 0 0 0 0
105 Gameksan lotion 1% - 30 ml botol 0 0 0 0 0 0 0 0
106 Garam Oralit kombinasi sacchet 177 0 177 177 0 265.5 345.15 0
107 Gemfibrozil kaps 300 mg kapsul 0 0 0 0 0 0 0 0
108 Gentamicin krim 10% tube 0 0 0 0 0 0 0 0
109 Gentamicin salep kulit 10% tube 0 0 0 0 0 0 0 0
110 Gentamicin salep mata 0,3% tube 0 0 0 0 0 0 0 0
111 Gentamicin tts mata 0,3% botol 0 0 0 0 0 0 0 0
112 Gentamisin inj 40 mg/ml ampul 10 0 10 10 0 15 19.5 0
113 Gentamisin inj 80 mg/ml vial 0 0 0 0 0 0 0 0
114 Glibenklamid tab 5 mg tablet 280 0 280 280 0 420 546 0
115 Glimepirid tab 1 mg tablet 20 0 20 20 0 30 39 0
116 Glimepirid tab 2 mg tablet 0 0 0 0 0 0 0 0
117 Glipizid tab 5 mg tablet 0 0 0 0 0 0 0 0
118 Gliseril Guaikolat tab 100 mg tablet 700 0 700 700 0 1050 1365 0
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 0 0 0 0 0 0 0 0
120 Gliserin lar 50% botol 0 0 0 0 0 0 0 0
121 Glukosa lar infus steril 5% - 500 ml botol 50 0 50 50 0 75 97.5 0
122 Glukosa lar Infus steril 10% - 500 ml botol 0 0 0 0 0 0 0 0
123 Griseofulvin tab 125 mg tablet 610 0 610 610 0 915 1189.5 0
124 Haloperidol tab 0,5 mg tablet 0 0 0 0 0 0 0 0
125 Haloperidol tab 1,5 mg tablet 0 0 0 0 0 0 0 0
126 Haloperidol tab 2 mg tablet 0 0 0 0 0 0 0 0
127 Haloperidol tab 5 mg tablet 0 0 0 0 0 0 0 0
128 Hidrogen Peroksida lar konsentrat 3% botol 0 0 0 0 0 0 0 0
129 Hiosina Butilbromida tab 10 mg tablet 0 0 0 0 0 0 0 0
130 Hydroklortiazid (HCT) tab 25 mg tablet 0 0 0 0 0 0 0 0
131 Hydrokortison krim 2,5 % - 5 g tube 0 0 0 0 0 0 0 0
132 Ibuprofen tab 200 mg tablet 0 0 0 0 0 0 0 0
133 Ibuprofen tab 400 mg tablet 520 0 520 520 0 780 1014 0
134 Ibuprofen sir 100 mg/5 ml botol 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
135 Ibuprofen sir 200 mg/5 ml botol 0 0 0 0 0 0 0 0
136 Isoniazid tab 100 mg tablet 0 0 0 0 0 0 0 0
137 Isoniazid tab 300 mg tablet 0 0 0 0 0 0 0 0
138 Isosorbid Dinitrat tab 5 mg tablet 100 0 100 100 0 150 195 0
139 Kalsium Glukonat inj 100 mg/mL ampul 0 0 0 0 0 0 0 0
140 Kalsium Karbonat tab 500 mg tablet 0 0 0 0 0 0 0 0
141 Kalsium Laktat (Kalk) tab 500 mg tablet 670 0 670 670 0 1005 1306.5 0
142 Kanamisin inj 1.000 mg/vial vial 0 0 0 0 0 0 0 0
143 Kaptopril tab 12,5 mg tablet 0 0 0 0 0 0 0 0
144 Kaptopril tab 25 mg tablet 980 0 980 980 0 1470 1911 0
145 Kaptopril tab 50 mg tablet 0 0 0 0 0 0 0 0
146 Karbamazepin tab 200 mg tablet 0 0 0 0 0 0 0 0
147 Karbamazepin sir 100 mg/5 mL botol 0 0 0 0 0 0 0 0
148 Karbogliserin tts telinga 10% botol 0 0 0 0 0 0 0 0
149 Ketamin inj 50 mg/ml - 20 ml ampul 0 0 0 0 0 0 0 0
150 Ketamin inj 100 mg/ml - 20ml ampul 0 0 0 0 0 0 0 0
151 Ketokonazole krim 2% - 15 g tube 0 0 0 0 0 0 0 0
152 Ketokonazole tab 200 mg tablet 0 0 0 0 0 0 0 0
153 Klaritromisin tab 500 mg tablet 0 0 0 0 0 0 0 0
154 Klindamisin kaps 150 mg kapsul 0 0 0 0 0 0 0 0
155 Klindamisin kaps 300 mg kapsul 0 0 0 0 0 0 0 0
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 0 0 0 0 0 0 0 0
157 Kloramfenikol kaps 250 mg kapsul 0 0 0 0 0 0 0 0
158 Kloramfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0
159 Kloramfenikol salap mata 1% tube 0 0 0 0 0 0 0 0
160 Kloramfenikol salep kulit 2% tube 0 0 0 0 0 0 0 0
161 Kloramfenikol susp 125 mg/5 ml botol 0 0 0 0 0 0 0 0
162 Kloramfenikol tts mata 0,5% botol 0 0 0 0 0 0 0 0
163 Kloramfenikol tts telinga 3% botol 0 0 0 0 0 0 0 0
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 970 0 970 970 0 1455 1891.5 0
165 Klorpromazin HCl tab 25 mg tablet 0 0 0 0 0 0 0 0
166 Klorpromazin HCl tab 100 mg tablet 0 0 0 0 0 0 0 0
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 0 0 0 0 0 0 0 0
168 Kodein HCL tab 10 mg tablet 0 0 0 0 0 0 0 0
169 Kontrasepsi Progesteron Depot (3 Bulan) vial 0 0 0 0 0 0 0 0
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
171 Kotrimoxazol tab 480 mg (adult) tablet 790 0 790 790 0 1185 1540.5 0
172 Kotrimoxazol susp 60 ml botol 10 0 10 10 0 15 19.5 0
173 Kuinin tab 200 mg tablet 0 0 0 0 0 0 0 0
174 Kuinin tab 222 mg tablet 0 0 0 0 0 0 0 0
175 Kuinin inj 25% (i.v) ampul 0 0 0 0 0 0 0 0
176 Levofloxacin tab 500 mg tablet 0 0 0 0 0 0 0 0
177 Levofloxacin inf 5 mg/mL botol 0 0 0 0 0 0 0 0
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp 0 0 0 0 0 0 0 0
179 Lidokain inj 1% (infltr) ampul 0 0 0 0 0 0 0 0
180 Lidokain inj 2% (infiltr/p.v.) ampul 15 0 15 15 0 22.5 29.25 0
181 Lidokain gel 2% botol 0 0 0 0 0 0 0 0
182 Lidokain semprot 10% botol 0 0 0 0 0 0 0 0
183 Lisol lar 1.000 ml botol 1 0 1 1 0 1.5 1.95 0
184 Loratadin tab 10 mg tablet 250 0 250 250 0 375 487.5 0
185 Magnesium Sulfat serb 30 g sacchet 0 0 0 0 0 0 0 0
186 Magnesium Sulfat inj 20% - 25 ml vial 45 0 45 45 0 67.5 87.75 0
187 Magnesium Sulfat inj 40% - 25 ml vial 5 0 5 5 0 7.5 9.75 0
188 Mebendazol tab 100 mg tablet 0 0 0 0 0 0 0 0
189 Mebendazol tab 500 mg tablet 0 0 0 0 0 0 0 0
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 0 0 0 0 0 0 0 0
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 18 0 18 18 0 27 35.1 0
192 Metampiron (Antalgin) tab 500 mg tablet 0 0 0 0 0 0 0 0
193 Metformin tab 500 mg tablet 2580 0 2580 2580 0 3870 5031 0
194 Metformin tab 850 mg tablet 0 0 0 0 0 0 0 0
195 Metilergometrin Maleat tab 0.125 mg tablet 650 0 650 650 0 975 1267.5 0
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 0 0 0 0 0 0 0 0
197 Metilprednisolon tab 4 mg tablet 0 0 0 0 0 0 0 0
198 Metilprednisolon tab 8 mg tablet 0 0 0 0 0 0 0 0
199 Metilprednisolon tab 16 mg tablet 0 0 0 0 0 0 0 0
200 Metoklopramid tab 5 mg tablet 0 0 0 0 0 0 0 0
201 Metoklopramid tab 10 mg tablet 0 0 0 0 0 0 0 0
202 Metronidazol tab 250 mg tablet 860 0 860 860 0 1290 1677 0
203 Metronidazol tab 500 mg tablet 600 0 600 600 0 900 1170 0
204 Metronidazol sir 125 mg/5 ml botol 0 0 0 0 0 0 0 0
205 Metronidazol lar inf 5 mg/mL botol 0 0 0 0 0 0 0 0
206 Miconazole krim 2% tube 54 0 54 54 0 81 105.3 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
207 Natrium Diklofenak tab 25 mg tablet 130 0 130 130 0 195 253.5 0
208 Natrium Diklofenak tab 50 mg tablet 0 0 0 0 0 0 0 0
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 89 0 89 89 0 133.5 173.55 0
210 Nifedipine tab 10 mg tablet 400 0 400 400 0 600 780 0
211 Nistatin tab vaginal 100.000 IU ovula 500 0 500 500 0 750 975 0
212 Nistatin tab vaginal 500.000 IU tablet 500 0 500 500 0 750 975 0
213 Obat Anti TB Kategori Anak Paket 0 0 0 0 0 0 0 0
214 Obat Anti TB Kategori Anak FDC Paket 0 0 0 0 0 0 0 0
215 Obat Anti TB Kategori I Paket 0 0 0 0 0 0 0 0
216 Obat Anti TB Kategori I FDC Paket 0 0 0 0 0 0 0 0
217 Obat Anti TB Kategori I Kombipak Paket 0 0 0 0 0 0 0 0
218 Obat Anti TB Kategori II Paket 0 0 0 0 0 0 0 0
219 Obat Anti TB Kategori II FDC Paket 0 0 0 0 0 0 0 0
220 Obat Anti TB Kategori III Paket 0 0 0 0 0 0 0 0
221 Obat Anti TB Kategori Sisipan FDC Paket 0 0 0 0 0 0 0 0
222 Obat Batuk Hitam (OBH) sir 100 ml botol 0 0 0 0 0 0 0 0
223 Ofloxacin tab 200 mg tablet 0 0 0 0 0 0 0 0
224 Ofloxacin tab 400 mg tablet 0 0 0 0 0 0 0 0
225 Oksimetazolin tts hidung 0,025 % botol 0 0 0 0 0 0 0 0
226 Oksimetazolin tts hidung 0,050 % botol 0 0 0 0 0 0 0 0
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 0 0 0 0 0 0 0 0
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 0 0 0 0 0 0 0 0
229 Oksitosin inj 10 IU/ml - 1 ml ampul 0 0 0 0 0 0 0 0
230 Olopatadin tts mata 0,1% botol 0 0 0 0 0 0 0 0
231 Omeprazol kaps 20 mg kapsul 50 0 50 50 0 75 97.5 0
232 Omeprazol inj 40 mg/10 mL vial 0 0 0 0 0 0 0 0
233 Paracetamol tab 500 mg tablet 1620 0 1620 1620 0 2430 3159 0
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1 0 1 1 0 1.5 1.95 0
235 Paracetamol tts 60 mg/0,6 mL botol 0 0 0 0 0 0 0 0
236 Perak Sulfadiazin krim 1% tube 0 0 0 0 0 0 0 0
237 Permetrin krim 5% tube 0 0 0 0 0 0 0 0
238 Pirantel Pamoat tab 125 mg tablet 300 0 300 300 0 450 585 0
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 25 0 25 25 0 37.5 48.75 0
240 Pirazinamid tab 500 mg tablet 0 0 0 0 0 0 0 0
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 0 0 0 0 0 0 0 0
242 Piridoksin (Vitamin B6) tab 10 mg tablet 1320 0 1320 1320 0 1980 2574 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
243 Piroxicam tab 10 mg tablet 400 0 400 400 0 600 780 0
244 Povidon Iodida lar 10% - 1000 ml botol 2 0 2 2 0 3 3.9 0
245 Povidon Iodida lar 10% - 300 ml botol 0 0 0 0 0 0 0 0
246 Povidon Iodida lar 10% - 60 ml botol 0 0 0 0 0 0 0 0
247 Povidon Iodida lar 10% - 30 ml botol 0 0 0 0 0 0 0 0
248 Prednison tab 5 mg tablet 800 0 800 800 0 1200 1560 0
249 Primakuin tab 15 mg tablet 0 0 0 0 0 0 0 0
250 Probenesid tab 500 mg tablet 0 0 0 0 0 0 0 0
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 0 0 0 0 0 0 0 0
252 Propranolol tab 10 mg tablet 0 0 0 0 0 0 0 0
253 Propiltiourasil ( PTU) tab 100 mg tablet 0 0 0 0 0 0 0 0
254 Ranitidin tab 150 mg tablet 1010 0 1010 1010 0 1515 1969.5 0
255 Ranitidin inj 25 mg/mL ampul 5 0 5 5 0 7.5 9.75 0
256 Retinol (Vit A) softcap 100.000 IU softcap 0 0 0 0 0 0 0 0
257 Retinol (Vit A) softcap 200.000 IU softcap 0 0 0 0 0 0 0 0
258 Rifampicin kaps 300 mg kapsul 0 0 0 0 0 0 0 0
259 Rifampicin tab 450 mg tablet 0 0 0 0 0 0 0 0
260 Rifampicin tab 600 mg tablet 0 0 0 0 0 0 0 0
261 Ringer Laktat lar inf steril 500 ml botol 140 0 140 140 0 210 273 0
262 Salbutamol tab 2 mg tablet 0 0 0 0 0 0 0 0
263 Salbutamol tab 4 mg tablet 490 0 490 490 0 735 955.5 0
264 Salbutamol cairan ih 0,1% botol 0 0 0 0 0 0 0 0
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 0 0 0 0 0 0 0 0
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 0 0 0 0 0 0 0 0
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 0 0 0 0 0 0 0 0
268 Serum Antidifteri inj 10,000 IU vial 0 0 0 0 0 0 0 0
269 Serum Antidifteri inj 20,000 IU vial 0 0 0 0 0 0 0 0
270 Serum Antitetanus inj 1.500 IU vial 0 0 0 0 0 0 0 0
271 Serum Antitetanus inj 10.000 IU vial 0 0 0 0 0 0 0 0
272 Serum Antitetanus inj 20.000 IU vial 0 0 0 0 0 0 0 0
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 0 0 0 0 0 0 0 0
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 0 0 0 0 0 0 0 0
275 Simvastatin tab 10 mg tablet 840 0 840 840 0 1260 1638 0
276 Simvastatin tab 20 mg tablet 0 0 0 0 0 0 0 0
277 Siprofloksasin tab 500 mg tablet 200 0 200 200 0 300 390 0
278 Spironolakton tab 25 mg tablet 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
279 Streptomisin serb inj 1,000 mg/vial vial 0 0 0 0 0 0 0 0
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 0 0 0 0 0 0 0 0
281 Tetracain HCl tts mata 0,5% - 5 ml botol 0 0 0 0 0 0 0 0
282 Tetrasiklin kaps 250 mg kapsul 0 0 0 0 0 0 0 0
283 Tetrasiklin kaps 500 mg kapsul 0 0 0 0 0 0 0 0
284 Thiamfenikol kaps 500 mg kapsul 0 0 0 0 0 0 0 0
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 1000 0 1000 1000 0 1500 1950 0
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 0 0 0 0 0 0 0 0
287 Tramadol inj 50 mg/mL ampul 0 0 0 0 0 0 0 0
288 Triheksipenidil tab 2 mg tablet 0 0 0 0 0 0 0 0
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 0 0 0 0 0 0 0 0
290 Valproat tab sal 250 mg tablet salut 0 0 0 0 0 0 0 0
291 Valproat tab sal 500 mg tablet salut 0 0 0 0 0 0 0 0
292 Valproat sir 250 mg/5 mL botol 0 0 0 0 0 0 0 0
293 Vankomisin serb inj 500 mg/vial vial 0 0 0 0 0 0 0 0
294 Vitamin B Kompleks tablet 1310 0 1310 1310 0 1965 2554.5 0
295 Zinc sir 10 mg/ml botol 0 0 0 0 0 0 0 0
296 Zinc sir 20 mg/5 ml botol 0 0 0 0 0 0 0 0
297 Zinc dispersible 20 mg tablet 0 0 0 0 0 0 0 0
298 Alprazolam tab 1 mg tablet 0 0 0 0 0 0 0 0
299 Betahistin tab 6 mg tablet 450 0 450 450 0 675 877.5 0
300 Idometasin kapl 25 mg kaplet 0 0 0 0 0 0 0 0
301 Karbon Aktif tab 125 mg tablet 0 0 0 0 0 0 0 0
302 Klobazam tab 10 mg tablet 0 0 0 0 0 0 0 0
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 0 0 0 0 0 0 0 0
304 Loperamid tab 2 mg tablet 0 0 0 0 0 0 0 0
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 0 0 0 0 0 0 0 0
306 Papaverin 40 mg tablet 0 0 0 0 0 0 0 0
307 Piracetam tab 400 mg tablet 0 0 0 0 0 0 0 0
308 Thiamfenikol tab 250 mg tablet 0 0 0 0 0 0 0 0
309 Piracetam tab 800 mg tablet 0 0 0 0 0 0 0 0
310 Piroxicam tab 20 mg tablet 0 0 0 0 0 0 0 0
311 Asam Askorbat (Vit.C) tab 25 mg tablet 0 0 0 0 0 0 0 0
312 Etanol 70% lar 1000 ml botol 0 0 0 0 0 0 0 0
313 Etanol 70% lar 300 ml botol 0 0 0 0 0 0 0 0
314 Neurosanbe injeksi ampul 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
315 H2O2 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 10 0 10 10 0 15 19.5 0
2 Alat Suntik 2.5 ml pcs 0 0 0 0 0 0 0 0
3 Alat Suntik 3 ml pcs 6 0 6 6 0 9 11.7 0
4 Alat Suntik 5 ml pcs 80 0 80 80 0 120 156 0
5 Alat Suntik 10 ml pcs 12 0 12 12 0 18 23.4 0
6 Alat Suntik 20 ml pcs 0 0 0 0 0 0 0 0
7 Alat Suntik 50 ml pcs 0 0 0 0 0 0 0 0
8 Alat Suntik ADS 0,5 ml pcs 0 0 0 0 0 0 0 0
9 Alat Suntik ADS 3 ml (BD) pcs 0 0 0 0 0 0 0 0
10 Alat Suntik ADS 5 ml (BD) pcs 0 0 0 0 0 0 0 0
11 Alat Suntik ADS 5 ml BCG pcs 0 0 0 0 0 0 0 0
12 Alat Suntik ADS 10 ml (BD) pcs 0 0 0 0 0 0 0 0
13 Alat Suntik (Nipro Syringe) 3 ml pcs 0 0 0 0 0 0 0 0
14 Alat Suntik (Nipro Syringe) 5 ml pcs 0 0 0 0 0 0 0 0
15 Alat Suntik (Nipro Syringe) 10 ml pcs 0 0 0 0 0 0 0 0
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 0 0 0 0 0 0 0 0
17 Catgut no.2/0 pcs 48 0 48 48 0 72 93.6 0
18 Catgut no.3/0 pcs 96 0 96 96 0 144 187.2 0
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 0 0 0 0 0 0 0 0
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No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
20 Catheter (folley cathteter) no.10 pcs 18 0 18 18 0 27 35.1 0
21 Catheter (folley cathteter) no.12 pcs 20 0 20 20 0 30 39 0
22 Catheter (folley cathteter) no.14 pcs 12 0 12 12 0 18 23.4 0
23 Catheter (folley cathteter) no.16 pcs 17 0 17 17 0 25.5 33.15 0
24 Catheter (folley cathteter) no.18 pcs 110 0 110 110 0 165 214.5 0
25 Cholesterol test btl/10 strip botol 0 0 0 0 0 0 0 0
26 Copper T set 0 0 0 0 0 0 0 0
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 0 0 0 0 0 0 0 0
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 0 0 0 0 0 0 0 0
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 0 0 0 0 0 0 0 0
30 Glukosa test btl/25 strip botol 0 0 0 0 0 0 0 0
31 Hand Schoen no 7 set 9 0 9 9 0 13.5 17.55 0
32 Hand Schoen no 7.5 set 8 0 8 8 0 12 15.6 0
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0
34 Hand Schoen no 8 set 17 0 17 17 0 25.5 33.15 0
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 0 0 0 0 0 0 0 0
36 Hand Schoen (Aximed Exam Gloves size S) pcs 0 0 0 0 0 0 0 0
37 Hand Schoen (Aximed Exam Gloves size M) pcs 0 0 0 0 0 0 0 0
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 0 0 0 0 0 0 0 0
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 0 0 0 0 0 0 0 0
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 22 0 22 22 0 33 42.9 0
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 0 0 0 0 0 0 0 0
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 0 0 0 0 0 0 0 0
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 0 0 0 0 0 0 0 0
44 Hand Schoen (Examination Gloves Size S) set 0 0 0 0 0 0 0 0
45 Hand Schoen (Examination Gloves Size M) set 0 0 0 0 0 0 0 0
46 Hand Schoen (Examination Gloves Size L) set 0 0 0 0 0 0 0 0
47 Infusion Set Anak set 7 0 7 7 0 10.5 13.65 0
48 Infusion Set Dewasa set 9 0 9 9 0 13.5 17.55 0
49 Infusion Set Macro 2 Cabang set 0 0 0 0 0 0 0 0
50 IV Catheter no. 16 pcs 0 0 0 0 0 0 0 0
51 IV Catheter no. 18 pcs 48 0 48 48 0 72 93.6 0
52 IV Catheter no. 20 pcs 20 0 20 20 0 30 39 0
53 IV Catheter no. 22 pcs 1 0 1 1 0 1.5 1.95 0
54 IV Catheter no. 24 pcs 50 0 50 50 0 75 97.5 0
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 0 0 0 0 0 0 0 0
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 0 0 0 0 0 0 0 0
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 0 0 0 0 0 0 0 0
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 0 0 0 0 0 0 0 0
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 0 0 0 0 0 0 0 0
61 Jarum Jahit Otot all size lusin 0 0 0 0 0 0 0 0
62 Jarum Jahit 1/2 Surgical lusin 1 0 1 1 0 1.5 1.95 0
63 Jarum Jahit 3/8 Surgical lusin 1 0 1 1 0 1.5 1.95 0
64 Kaca Slide pcs 0 0 0 0 0 0 0 0
65 Kapas Pembalut 250 g roll 8 0 8 8 0 12 15.6 0
66 Kapas Pembalut 500 g roll 10 0 10 10 0 15 19.5 0
67 Kasa Hydrofil 18 yard x 22 cm roll 0 0 0 0 0 0 0 0
68 Kasa Hydrofil 40 yard x 80 cm roll 7 0 7 7 0 10.5 13.65 0
69 Kasa Kompres Steril 40 x 40 cm bungkus 10 0 10 10 0 15 19.5 0
70 Kasa Pembalut 2 m x 80 cm roll 5 0 5 5 0 7.5 9.75 0
71 Kasa Pembalut 4 m x 5 cm roll 0 0 0 0 0 0 0 0
72 Kasa Pembalut 4 m x 10 cm roll 0 0 0 0 0 0 0 0
73 Kasa Pembalut 4 m x 15 cm roll 0 0 0 0 0 0 0 0
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 0 0 0 0 0 0 0 0
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 0 0 0 0 0 0 0 0
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 0 0 0 0 0 0 0 0
77 Kasa Steril 16 cm x 16 cm box 0 0 0 0 0 0 0 0
78 Kasa Steril 18 cm x 22 cm box 2 0 2 2 0 3 3.9 0
79 Masker Ear Loop Pcs 0 0 0 0 0 0 0 0
80 Mata Pisau Bedah No. 10 pcs 16 0 16 16 0 24 31.2 0
81 Mata Pisau Bedah No. 11 Pcs 17 0 17 17 0 25.5 33.15 0
82 Mata Pisau Bedah No. 15 Pcs 5 0 5 5 0 7.5 9.75 0
83 Mata Pisau Bedah No. 21 Pcs 0 0 0 0 0 0 0 0
84 Nasal Oxygen (Aximed) size M Pcs 0 0 0 0 0 0 0 0
85 Nasal Oxygen (Aximed) size L Pcs 0 0 0 0 0 0 0 0
86 Nasal Oxygen (Aximed) size XS Pcs 0 0 0 0 0 0 0 0
87 Plester 5 yard x 2 inchi roll 0 0 0 0 0 0 0 0
88 Plester 5 cm x 4,5 cm roll 1 0 1 1 0 1.5 1.95 0
89 Plester 7,5 cm x 4,5 cm roll 0 0 0 0 0 0 0 0
90 Pot Sputum pot 0 0 0 0 0 0 0 0
91 RDT pcs 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
92 Regulator Oxygen pcs 0 0 0 0 0 0 0 0
93 Safety Box kotak 0 0 0 0 0 0 0 0
94 Selang Oxygen pcs 4 0 4 4 0 6 7.8 0
95 Silk (benang bedah sutra) no.2/0 pcs 53 0 53 53 0 79.5 103.35 0
96 Silk (benang bedah sutra) no.3/0 pcs 0 0 0 0 0 0 0 0
97 Sound Timer unit 0 0 0 0 0 0 0 0
98 Stempel ISPA pcs 0 0 0 0 0 0 0 0
99 Uric Acid test btl/25 strip botol 0 0 0 0 0 0 0 0
100 Urine bag pcs 7 0 7 7 0 10.5 13.65 0

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 0 0 0 0 0 0 0 0
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 0 0 0 0 0 0 0 0
3 Larutan Asam Klorida (HCl) 0,1 N botol 0 0 0 0 0 0 0 0
4 Larutan Asam Sulfa Salisilat 20% botol 0 0 0 0 0 0 0 0
5 Larutan Benedik botol 0 0 0 0 0 0 0 0
6 Larutan Eosin 2% botol 0 0 0 0 0 0 0 0
7 Larutan Etanol Asam botol 0 0 0 0 0 0 0 0
8 Larutan Giemsa Stein botol 0 0 0 0 0 0 0 0
9 Larutan Karbol Fuksin botol 0 0 0 0 0 0 0 0
10 Larutan Metanol botol 0 0 0 0 0 0 0 0
11 Larutan Metilen Biru botol 0 0 0 0 0 0 0 0
12 Larutan Turk botol 0 0 0 0 0 0 0 0
13 Reagen TBC kit 0 0 0 0 0 0 0 0
14 Test Asam Urat test 25 0 25 25 0 37.5 48.75 0
15 Test Comburt Reagens set 0 0 0 0 0 0 0 0
16 Test Golongan Darah set 0 0 0 0 0 0 0 0
17 Test Golongan Darah Reagens set 0 0 0 0 0 0 0 0
18 Test Gula Darah test 45 0 45 45 0 67.5 87.75 0
19 Test Kehamilan strip 21 0 21 21 0 31.5 40.95 0
20 Test Kolesterol test 0 0 0 0 0 0 0 0
21 Test Urine Rutin strip 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD

GIGI
1 Air raksa Dental Use - 0 0 0 0 0 0 0 0
2 Devitalisasi pasta (arsen) kotak 0 0 0 0 0 0 0 0
3 Eugenol cairan 10 ml botol 0 0 0 0 0 0 0 0
4 Fluoride 0.5 mg tablet 0 0 0 0 0 0 0 0
5 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0
6 Hemospon (Spongostan Dental) pcs 0 0 0 0 0 0 0 0
7 Iodoform Pasta (Mumyfyng Pasta) set 0 0 0 0 0 0 0 0
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 0 0 0 0 0 0 0 0
9 Kalsium Hidroksida Pasta tube 0 0 0 0 0 0 0 0
10 Klorheksidin lar 0,2% botol 0 0 0 0 0 0 0 0
11 Klorheksidin lar 15% botol 0 0 0 0 0 0 0 0
12 Mata Bor Gigi pcs 0 0 0 0 0 0 0 0
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 0 0 0 0 0 0 0 0
14 Semen Seng Fosfat serbuk/cair 30 gram botol 0 0 0 0 0 0 0 0
15 Trikresol Formalin (TKF) cairan botol 0 0 0 0 0 0 0 0

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 0 0 0 0 0 0 0 0
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 0 0 0 0 0 0 0 0
3 Becefort sir 60 ml botol 0 0 0 0 0 0 0 0
4 Bronex (Bromheksin) tab 8 mg tablet 0 0 0 0 0 0 0 0
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 0 0 0 0 0 0 0 0
6 Fluoride 1 mg tablet 0 0 0 0 0 0 0 0
7 Kandistatin susp 12 ml botol 0 0 0 0 0 0 0 0
8 KY Jelly tube 0 0 0 0 0 0 0 0
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 0 0 0 0 0 0 0 0
10 Norit (Karbon Aktif) tab 125 mg tablet 0 0 0 0 0 0 0 0
11 Pantocain (Tetrakain HCl) tetes mata botol 0 0 0 0 0 0 0 0
12 Pehavral tablet salut 0 0 0 0 0 0 0 0
13 Reco (Kloramfenikol) salep mata 1% tube 0 0 0 0 0 0 0 0
14 Reco (Kloramfenikol) tts telinga 3% botol 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 0 0 0 0 0 0 0 0
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 0 0 0 0 0 0 0 0
17 Vaksin Antirabies Vero (VAR) vial 0 0 0 0 0 0 0 0
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 7 0 7 7 0 10.5 13.65 0
19 Cendo Xytrol TM 5 ml botol 0 0 0 0 0 0 0 0
20 Formalin 40 % botol 0 0 0 0 0 0 0 0
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 310 0 310 310 0 465 604.5 0
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 100 0 100 100 0 150 195 0
23 Pritamox (Amoxicillin) tab 500 mg tablet 0 0 0 0 0 0 0 0
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 100 0 100 100 0 150 195 0
25 Vical susp 100 ml botol 11 0 11 11 0 16.5 21.45 0
26 Vitamin D3 00 IU/D-Vit tablet tablet 0 0 0 0 0 0 0 0
27 Vinafluor (Fluoride) kapl 1 mg kaplet 0 0 0 0 0 0 0 0
28 Sanmol (Parasetamol) 500 mg tablet 0 0 0 0 0 0 0 0
29 Cardisan ( Amlodipine) 5 mg tablet 0 0 0 0 0 0 0 0
30 Purecemia (Allopurinol) 300 mg tablet 0 0 0 0 0 0 0 0
31 Mefinal (Asam Mefenamat) 500 mg kaplet 0 0 0 0 0 0 0 0
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 0 0 0 0 0 0 0 0
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 0 0 0 0 0 0 0 0
34 Mucohexin (Bromhexine HCl) 8 mg tablet 0 0 0 0 0 0 0 0
35 Cholvastin (Lovastatin) 20 mg tablet 0 0 0 0 0 0 0 0
36 Histigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0
37 Novadium (Loperamid) tab 2 mg tablet 0 0 0 0 0 0 0 0
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol 0 0 0 0 0 0 0 0
39 Metolon (Metoklorperamid) tab 10 mg tablet 0 0 0 0 0 0 0 0
40 Novabion tablet 0 0 0 0 0 0 0 0
41 Novagesic (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0
42 Defamol (Parasetamol) tab 500 mg tablet 0 0 0 0 0 0 0 0
43 Sultrimix syrup botol 0 0 0 0 0 0 0 0
44 Biovitan syrup botol 0 0 0 0 0 0 0 0
45 Caviplex syrup botol 0 0 0 0 0 0 0 0
46 Farsifen (Ibuprofen) syrup botol 0 0 0 0 0 0 0 0
47 Novaxifen (Ibuprofen) tab 200 mg tablet 0 0 0 0 0 0 0 0
48 Lexigo (Betahistin) tab 6 mg tablet 0 0 0 0 0 0 0 0
 Stok
No. Nama Obat Satuan Stok Awal Penerimaan Persediaan Pengeluaran Stok Akhir Optimum Permintaan DAU
Optimum
PKD
49 Loric (Allopurinol) tab 100 mg tablet 0 0 0 0 0 0 0 0
50 Eryra Forte (Erytromicin) kaps 500 mg tablet 0 0 0 0 0 0 0 0
51 Arkavit tablet 0 0 0 0 0 0 0 0
52 Novadex (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0
53 Carbidu (Dexametason) 0,5 mg tablet 0 0 0 0 0 0 0 0
54 Gralixa (Furosemid) 40 mg tablet 0 0 0 0 0 0 0 0
55 Grafazol (Metronidazol) tab 500 mg tablet 0 0 0 0 0 0 0 0
56 Glikos (Metformin) tab 500 mg tablet 0 0 0 0 0 0 0 0
57 Vesverum (Domperidon Maleat) tab 10 mg tablet 0 0 0 0 0 0 0 0
58 Metaneuron (Metamizolesodium + Diazepam) tablet 80 0 80 80 0 120 156 0
59 Trifadium ( Loperamide HCL 2 mg) tablet 500 0 500 500 0 750 975 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0 0

Inebeng
MENGETAHUI
TERLAMBAT
1/25/2018

KEPALA PUSKESMAS MOWEWE Penan

TERLAMBAT
1/18/2018

SELVINA LAKASA, Amd. Keb DEW

Nip. 19670824 198903 2 008
TERLAMBAT
1/11/2018
Nip. 19
R

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Inebenggi, 29 Desember 2017

Penanggung Jawab Farmasi

DEWI SARTIKA, AMF

Nip. 19890705 201504 2 001
 Menu

Peringatan

!
 LAPORAN ASSET PERSEDIAAN, ST

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

DAU/PKD
No. Nama Obat Satuan Harga PUSAT
Stok Awal Penerimaan Pengeluaran Stok Akhir
Awal Terima Keluar Akhir
1 Air Untuk Injeksi 20 ml vial 6,000 108,000 - 6,000 102,000 - - - -
2 Albendazole tab 400 mg tablet 363 780,450 - - 780,450 - - - -
3 Albendazole susp 200 mg/5 ml botol 4,234 - - - - - - - -
4 Allopurinol tab 100 mg tablet 143 - - - - - - - -
5 Allopurinol tab 300 mg tablet 233 - - - - - - - -
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 - - - - - - - -
7 Ambroksol tab 30 mg tablet 200 - - - - - - - -
8 Aminophyllin tab 200 mg tablet 86 - - - - - - - -
9 Aminophyllin inj 24 mg ampul 4,204 - - - - - - - -
10 Amitriptiline HCl tab 25 mg tablet 123 - - - - - - - -
11 Amlodipin tab 5 mg tablet 197 - - - - - - - -
12 Amlodipin tab 10 mg tablet 935 - - - - - - - -
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 - - - - - - - -
14 Amoxicillin SK 125 mg/5 ml botol 2,560 25,600 - 25,600 - - - - -
15 Amoxicillin tab 250 mg tablet 220 - - - - - - - -
16 Amoxicillin tab 500 mg tablet 370 - - - - - - - -
17 Ampicillin serb inj 1000 mg vial 5,610 - - - - - - - -
18 Antasida DOEN susp 60 ml botol 2,213 - - - - - - - -
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidr tablet 78 - - - - - - - -
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 - - - - - - - -
21 Antifungi DOEN kombinasi 30 g pot 1,890 - - - - - - - -
22 Antihemoroid DOEN suppo supp 3,200 32,000 - 32,000 - - - - -
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - - - - - - - - -
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 m tablet 3,220 - - - - - - - -
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 - - - - - - - -
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 tablet 149 - - - - - - - -
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 m Kapsul 1,650 - - - - - - - -
28 Artemether inj 80 mg/mL ampul 24,384 - - - - - - - -
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 - - - - - - - -
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 - - - - - - - -
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 - - - - - - - -
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 - - - - - - - -
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 - - - - - - - -
34 Asam Folat tab 0,4 mg tablet 104 - - - - - - - -
35 Asam Folat tab 1 mg tablet 52 - - - - - - - -
36 Asam Mefenamat tab 250 mg tablet 175 - - - - - - - -
37 Asam Mefenamat tab 500 mg tablet 176 70,400 - 70,400 - - - - -
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 - - - - - - - -
39 Asiklovir tab 200 mg tablet 251 - - - - - - - -
40 Asiklovir tab 400 mg tablet 357 - - - - - - - -
41 Atenolol tab 50 mg tablet 387 - - - - - - - -
42 Atapulgit tab 600 mg tablet 220 - - - - - - - -
43 Atropin tab 0,5 mg tablet 81 - - - - - - - -
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 - - - - - - - -
45 Azitromisin tablet 500 mg kaplet 4,725 - - - - - - - -
46 Bedak Salisil serb 2% Kotak 1,350 22,950 - 12,150 10,800 - - - -
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 - - - - - - - -
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 - - - - - - - -
49 Betametason krim 0,5 mg/g tube 1,596 - - - - - - - -
50 Betametason tts mata 1 mg/ml botol 25,106 - - - - - - - -
51 Bisakodil sup 5 mg supp 4,990 - - - - - - - -
52 Bisakodil sup 10 mg supp 6,045 - - - - - - - -
53 Bromheksin tab 8 mg tablet 82 - - - - - - - -
54 Cefadroksil kaps 250 mg kapsul 564 - - - - - - - -
55 Cefadroksil kaps/tab 500 mg kapsul 548 - - - - - - - -
56 Cefadroksil SK 125 mg/5 mL botol 5,286 142,722 - 42,288 100,434 - - - -
57 Cefadroksil SK 250 mg/5 mL botol 6,285 - - - - - - - -
58 Cefiksime tab 100 mg kapsul 1,000 - - - - - - - -
59 Cefiksime sir 100 mg/5 mL botol 9,400 - - - - - - - -
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 - - - - - - - -
61 Cetrizine tab 10 mg tablet 190 - - - - - - - -
62 Cetrizine sir 5 mg/5 ml botol 8,799 - - - - - - - -
63 Cimetidine tab 200 mg tablet 205 - - - - - - - -
64 Copper T set/buah 125,483 - - - - - - - -
65 Deksametason tab 0,5 mg tablet 68 - - - - - - - -
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 - - - - - - - -
67 Diazepam tab 2 mg tablet 47 - - - - - - - -
68 Diazepam tab 5 mg tablet 179 - - - - - - - -
69 Diazepam inj 5 mg/ml ampul 4,598 13,794 - - 13,794 - - - -
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 - - - - - - - -
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 - - - - - - - -
72 Dietil Karbamazin tab 100 mg tablet 150 - - - - - - - -
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 - - - - - - - -
74 Digoksin tab 0,25 mg tablet 103 - - - - - - - -
75 Diltiazem kaps SR 100 mg kapsul 4,033 - - - - - - - -
76 Diltiazem kaps SR 200 mg kapsul 4,417 - - - - - - - -
77 Diltiazem tab 30 mg tablet 141 - - - - - - - -
78 Dimenhidrinat tab 50 mg tablet 109 - - - - - - - -
79 Doksisiklin kaps 100 mg kapsul 298 - - - - - - - -
80 Domperidon susp 5 mg/5 ml botol 3,490 - - - - - - - -
81 Domperidon tab 10 mg tablet 286 - - - - - - - -
82 Efedrin inj 50 mg/mL tablet 14,650 - - - - - - - -
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 - - - - - - - -
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 - - - - - - - -
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 - - - - - - - -
86 Eritromisin kaps 250 mg kapsul 522 - - - - - - - -
87 Eritromisin kaps 500 mg kapsul 1,023 - - - - - - - -
88 Erytromisin SK 200 mg/5 ml botol 8,090 444,950 - 40,450 404,500 - - - -
89 Etakridin (Rivanol) lar 0,1% botol 5,456 60,016 - - 60,016 - - - -
90 Etambutol tab 250 mg tablet 330 - - - - - - - -
91 Etambutol tab 500 mg tablet 478 - - - - - - - -
92 Etanol 70 % lar 100 ml botol 2,625 - - - - - - - -
93 Etil Klorida semprot 100 mL botol 175,500 175,500 - 175,500 - - - - -
94 Etonogestrel implan 68 mg subd implant 128,779 - - - - - - - -
95 Fenobarbital tab 30 mg tablet 149 - - - - - - - -
96 Fenobarbital tab 100 mg tablet 242 - - - - - - - -
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 - - - - - - - -
98 Fenol Gliserol tts telinga 10% botol 1,920 - - - - - - - -
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 - - - - - - - -
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 - - - - - - - -
101 Flukonazol kaps 150 mg kapsul 24,200 - - - - - - - -
102 Fluor tab 0,5 mg tablet 975 - - - - - - - -
103 Furosemid tab 40 mg tablet 84 - - - - - - - -
104 Furosemide inj 10 mg/ml ampul 2,012 - - - - - - - -
105 Gameksan lotion 1% - 30 ml botol 2,420 - - - - - - - -
106 Garam Oralit kombinasi sacchet 317 110,950 - 47,550 63,400 - - - -
107 Gemfibrozil kaps 300 mg kapsul 318 - - - - - - - -
108 Gentamicin krim 10% tube - - - - - - - - -
109 Gentamicin salep kulit 10% tube - - - - - - - - -
110 Gentamicin salep mata 0,3% tube 2,786 - - - - - - - -
111 Gentamicin tts mata 0,3% botol 3,513 - - - - - - - -
112 Gentamisin inj 40 mg/ml ampul 3,739 - - - - - - - -
113 Gentamisin inj 80 mg/ml vial 4,160 - - - - - - - -
114 Glibenklamid tab 5 mg tablet 61 - - - - - - - -
115 Glimepirid tab 1 mg tablet 278 27,800 - - 27,800 - - - -
116 Glimepirid tab 2 mg tablet 458 - - - - - - - -
117 Glipizid tab 5 mg tablet 3,000 - - - - - - - -
118 Gliseril Guaikolat tab 100 mg tablet 27 - - - - - - - -
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 - - - - - - - -
120 Gliserin lar 50% botol 5,867 - - - - - - - -
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 429,000 - - 429,000 - - - -
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 - - - - - - - -
123 Griseofulvin tab 125 mg tablet 230 103,500 - - 103,500 - - - -
124 Haloperidol tab 0,5 mg tablet 62 - - - - - - - -
125 Haloperidol tab 1,5 mg tablet 76 - - - - - - - -
126 Haloperidol tab 2 mg tablet 134 - - - - - - - -
127 Haloperidol tab 5 mg tablet 105 - - - - - - - -
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 - - - - - - - -
129 Hiosina Butilbromida tab 10 mg tablet 648 - - - - - - - -
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 163,000 - - 163,000 - - - -
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 - - - - - - - -
132 Ibuprofen tab 200 mg tablet 121 - - - - - - - -
133 Ibuprofen tab 400 mg tablet 157 - - - - - - - -
134 Ibuprofen sir 100 mg/5 ml botol 3,849 - - - - - - - -
135 Ibuprofen sir 200 mg/5 ml botol 4,949 - - - - - - - -
136 Isoniazid tab 100 mg tablet 72 - - - - - - - -
137 Isoniazid tab 300 mg tablet 174 - - - - - - - -
138 Isosorbid Dinitrat tab 5 mg tablet 98 - - - - - - - -
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 - - - - - - - -
140 Kalsium Karbonat tab 500 mg tablet 448 - - - - - - - -
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 - - - - - - - -
142 Kanamisin inj 1.000 mg/vial vial 5,100 - - - - - - - -
143 Kaptopril tab 12,5 mg tablet 90 - - - - - - - -
144 Kaptopril tab 25 mg tablet 138 13,800 - 13,800 - - - - -
145 Kaptopril tab 50 mg tablet 141 - - - - - - - -
146 Karbamazepin tab 200 mg tablet 269 - - - - - - - -
147 Karbamazepin sir 100 mg/5 mL botol 44,770 - - - - - - - -
148 Karbogliserin tts telinga 10% botol 2,246 - - - - - - - -
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 - - - - - - - -
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 - - - - - - - -
151 Ketokonazole krim 2% - 15 g tube 5,150 - - - - - - - -
152 Ketokonazole tab 200 mg tablet 320 - - - - - - - -
153 Klaritromisin tab 500 mg tablet 3,600 - - - - - - - -
154 Klindamisin kaps 150 mg kapsul 405 - - - - - - - -
155 Klindamisin kaps 300 mg kapsul 619 - - - - - - - -
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 - - - - - - - -
157 Kloramfenikol kaps 250 mg kapsul 275 357,500 - 27,500 330,000 - - - -
158 Kloramfenikol kaps 500 mg kapsul 935 - - - - - - - -
159 Kloramfenikol salap mata 1% tube 1,680 1,680 - 1,680 - - - - -
160 Kloramfenikol salep kulit 2% tube 4,138 - - - - - - - -
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 - - - - - - - -
162 Kloramfenikol tts mata 0,5% botol 20,360 - - - - - - - -
163 Kloramfenikol tts telinga 3% botol 11,440 - - - - - - - -
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 32,400 - 32,400 - - - - -
165 Klorpromazin HCl tab 25 mg tablet 75 - - - - - - - -
166 Klorpromazin HCl tab 100 mg tablet 162 - - - - - - - -
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 - - - - - - - -
168 Kodein HCL tab 10 mg tablet 550 - - - - - - - -
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - - - - - - - - -
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradio tablet 2,298 - - - - - - - -
171 Kotrimoxazol tab 480 mg (adult) tablet 152 - - - - - - - -
172 Kotrimoxazol susp 60 ml botol 2,298 - - - - - - - -
173 Kuinin tab 200 mg tablet 737 - - - - - - - -
174 Kuinin tab 222 mg tablet 594 - - - - - - - -
175 Kuinin inj 25% (i.v) ampul 6,820 - - - - - - - -
176 Levofloxacin tab 500 mg tablet 581 - - - - - - - -
177 Levofloxacin inf 5 mg/mL botol 43,809 - - - - - - - -
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - - - - - - - - -
179 Lidokain inj 1% (infltr) ampul 929 - - - - - - - -
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 - - - - - - - -
181 Lidokain gel 2% botol 40,000 - - - - - - - -
182 Lidokain semprot 10% botol 156,200 - - - - - - - -
183 Lisol lar 1.000 ml botol 49,862 - - - - - - - -
184 Loratadin tab 10 mg tablet 333 - - - - - - - -
185 Magnesium Sulfat serb 30 g sacchet 3,803 - - - - - - - -
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 137,500 - - 137,500 - - - -
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 17,500 - - 17,500 - - - -
188 Mebendazol tab 100 mg tablet 7,150 - - - - - - - -
189 Mebendazol tab 500 mg tablet 7,854 - - - - - - - -
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 - - - - - - - -
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 38,400 - - 38,400 - - - -
192 Metampiron (Antalgin) tab 500 mg tablet 350 210,000 - 35,000 175,000 - - - -
193 Metformin tab 500 mg tablet 182 - - - - - - - -
194 Metformin tab 850 mg tablet 280 - - - - - - - -
195 Metilergometrin Maleat tab 0.125 mg tablet 169 - - - - - - - -
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 - - - - - - - -
197 Metilprednisolon tab 4 mg tablet 230 - - - - - - - -
198 Metilprednisolon tab 8 mg tablet 390 - - - - - - - -
199 Metilprednisolon tab 16 mg tablet 875 - - - - - - - -
200 Metoklopramid tab 5 mg tablet 113 - - - - - - - -
201 Metoklopramid tab 10 mg tablet 100 10,000 - 3,000 7,000 - - - -
202 Metronidazol tab 250 mg tablet 116 92,800 - - 92,800 - - - -
203 Metronidazol tab 500 mg tablet 169 169,000 - 16,900 152,100 - - - -
204 Metronidazol sir 125 mg/5 ml botol 4,350 - - - - - - - -
205 Metronidazol lar inf 5 mg/mL botol 12,980 - - - - - - - -
206 Miconazole krim 2% tube 3,150 110,250 - 47,250 63,000 - - - -
207 Natrium Diklofenak tab 25 mg tablet 146 - - - - - - - -
208 Natrium Diklofenak tab 50 mg tablet 193 - - - - - - - -
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 573,870 - 56,870 517,000 - - - -
210 Nifedipine tab 10 mg tablet 127 38,100 - 12,700 25,400 - - - -
211 Nistatin tab vaginal 100.000 IU ovula 528 158,400 - 5,280 153,120 - - - -
212 Nistatin tab vaginal 500.000 IU tablet 704 211,200 - - 211,200 - - - -
213 Obat Anti TB Kategori Anak Paket 189,195 - - - - - - - -
214 Obat Anti TB Kategori Anak FDC Paket 236,490 - - - - - - - -
215 Obat Anti TB Kategori I Paket 317,015 - - - - - - - -
216 Obat Anti TB Kategori I FDC Paket 396,000 - - - - - - - -
217 Obat Anti TB Kategori I Kombipak Paket 316,920 - - - - - - - -
218 Obat Anti TB Kategori II Paket 1,320,000 - - - - - - - -
219 Obat Anti TB Kategori II FDC Paket 1,319,990 - - - - - - - -
220 Obat Anti TB Kategori III Paket 154,000 - - - - - - - -
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 - - - - - - - -
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 - - - - - - - -
223 Ofloxacin tab 200 mg tablet 440 - - - - - - - -
224 Ofloxacin tab 400 mg tablet 700 - - - - - - - -
225 Oksimetazolin tts hidung 0,025 % botol 30,305 - - - - - - - -
226 Oksimetazolin tts hidung 0,050 % botol 32,000 - - - - - - - -
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 - - - - - - - -
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 - - - - - - - -
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 - - - - - - - -
230 Olopatadin tts mata 0,1% botol 68,000 - - - - - - - -
231 Omeprazol kaps 20 mg kapsul 409 - - - - - - - -
232 Omeprazol inj 40 mg/10 mL vial 42,000 - - - - - - - -
233 Paracetamol tab 500 mg tablet 88 - - - - - - - -
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 - - - - - - - -
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 - - - - - - - -
236 Perak Sulfadiazin krim 1% tube 25,350 - - - - - - - -
237 Permetrin krim 5% tube 11,475 - - - - - - - -
238 Pirantel Pamoat tab 125 mg tablet 318 159,000 - - 159,000 - - - -
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 100,100 - - 100,100 - - - -
240 Pirazinamid tab 500 mg tablet 225 - - - - - - - -
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 - - - - - - - -
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 108,900 - 24,200 84,700 - - - -
243 Piroxicam tab 10 mg tablet 149 - - - - - - - -
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 - - - - - - - -
245 Povidon Iodida lar 10% - 300 ml botol 15,386 - - - - - - - -
246 Povidon Iodida lar 10% - 60 ml botol 6,500 - - - - - - - -
247 Povidon Iodida lar 10% - 30 ml botol 2,344 - - - - - - - -
248 Prednison tab 5 mg tablet 192 - - - - - - - -
249 Primakuin tab 15 mg tablet 205 - - - - - - - -
250 Probenesid tab 500 mg tablet 1,815 - - - - - - - -
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 - - - - - - - -
252 Propranolol tab 10 mg tablet 80 - - - - - - - -
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 - - - - - - - -
254 Ranitidin tab 150 mg tablet 220 - - - - - - - -
255 Ranitidin inj 25 mg/mL ampul 1,340 - - - - - - - -
256 Retinol (Vit A) softcap 100.000 IU softcap 286 - - - - - - - -
257 Retinol (Vit A) softcap 200.000 IU softcap 505 - - - - - - - -
258 Rifampicin kaps 300 mg kapsul 670 - - - - - - - -
259 Rifampicin tab 450 mg tablet 868 - - - - - - - -
260 Rifampicin tab 600 mg tablet 1,209 - - - - - - - -
261 Ringer Laktat lar inf steril 500 ml botol 4,727 184,353 - 85,086 99,267 - - - -
262 Salbutamol tab 2 mg tablet 65 - - - - - - - -
263 Salbutamol tab 4 mg tablet 93 - - - - - - - -
264 Salbutamol cairan ih 0,1% botol 7,260 - - - - - - - -
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 - - - - - - - -
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 - - - - - - - -
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 - - - - - - - -
268 Serum Antidifteri inj 10,000 IU vial - - - - - - - - -
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 - - - - - - - -
270 Serum Antitetanus inj 1.500 IU vial 161,000 - - - - - - - -
271 Serum Antitetanus inj 10.000 IU vial - - - - - - - - -
272 Serum Antitetanus inj 20.000 IU vial 324,550 - - - - - - - -
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 - - - - - - - -
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 - - - - - - - -
275 Simvastatin tab 10 mg tablet 294 - - - - - - - -
276 Simvastatin tab 20 mg tablet 480 - - - - - - - -
277 Siprofloksasin tab 500 mg tablet 290 - - - - - - - -
278 Spironolakton tab 25 mg tablet 350 - - - - - - - -
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 - - - - - - - -
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 112 - - - - - - - -
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 - - - - - - - -
282 Tetrasiklin kaps 250 mg kapsul 162 16,200 - 11,340 4,860 - - - -
283 Tetrasiklin kaps 500 mg kapsul 325 - - - - - - - -
284 Thiamfenikol kaps 500 mg kapsul 985 197,000 - 197,000 - - - - -
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 144,000 - 69,000 75,000 - - - -
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 - - - - - - - -
287 Tramadol inj 50 mg/mL ampul 2,680 - - - - - - - -
288 Triheksipenidil tab 2 mg tablet 70 - - - - - - - -
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 - - - - - - - -
290 Valproat tab sal 250 mg tablet salut 1,680 - - - - - - - -
291 Valproat tab sal 500 mg tablet salut 5,450 - - - - - - - -
292 Valproat sir 250 mg/5 mL botol 41,800 - - - - - - - -
293 Vankomisin serb inj 500 mg/vial vial 142,000 - - - - - - - -
294 Vitamin B Kompleks tablet 112 - - - - - - - -
295 Zinc sir 10 mg/ml botol 16,478 - - - - - - - -
296 Zinc sir 20 mg/5 ml botol 8,140 - - - - - - - -
297 Zinc dispersible 20 mg tablet 521 - - - - - - - -
298 Alprazolam tab 1 mg tablet 245 - - - - - - - -
299 Betahistin tab 6 mg tablet - - - - - - - - -
300 Idometasin kapl 25 mg kaplet 380 - - - - - - - -
301 Karbon Aktif tab 125 mg tablet 127 - - - - - - - -
302 Klobazam tab 10 mg tablet 950 - - - - - - - -
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 - - - - - - - -
304 Loperamid tab 2 mg tablet 97 - - - - - - - -
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 - - - - - - - -
306 Papaverin 40 mg tablet - - - - - - - - -
307 Piracetam tab 400 mg tablet - - - - - - - - -
308 Thiamfenikol tab 250 mg tablet - - - - - - - - -
309 Piracetam tab 800 mg tablet - - - - - - - - -
310 Piroxicam tab 20 mg tablet - - - - - - - - -
311 Asam Askorbat (Vit.C) tab 25 mg tablet - - - - - - - - -
312 Etanol 70% lar 1000 ml botol - - - - - - - - -
313 Etanol 70% lar 300 ml botol - - - - - - - - -
314 Neurosanbe injeksi ampul - - - - - - - - -
315 H2O2 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 1,262 10,096 - 10,096 - - - - -
2 Alat Suntik 2.5 ml pcs 1,102 - - - - - - - -
3 Alat Suntik 3 ml pcs 1,010 - - - - - - - -
4 Alat Suntik 5 ml pcs 1,248 - - - - - - - -
5 Alat Suntik 10 ml pcs 1,694 - - - - - - - -
6 Alat Suntik 20 ml pcs 2,228 - - - - - - - -
7 Alat Suntik 50 ml pcs 10,350 - - - - - - - -
8 Alat Suntik ADS 0,5 ml pcs 1,925 - - - - - - - -
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 - - - - - - - -
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 - - - - - - - -
11 Alat Suntik ADS 5 ml BCG pcs 2,585 - - - - - - - -
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 - - - - - - - -
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 - - - - - - - -
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 - - - - - - - -
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 - - - - - - - -
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 - - - - - - - -
17 Catgut no.2/0 pcs 213,525 - - - - - - - -
18 Catgut no.3/0 pcs 213,525 17,082,000 - 1,708,200 15,373,800 - - - -
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 - - - - - - - -
20 Catheter (folley cathteter) no.10 pcs 13,750 - - - - - - - -
21 Catheter (folley cathteter) no.12 pcs 13,750 - - - - - - - -
22 Catheter (folley cathteter) no.14 pcs 13,750 - - - - - - - -
23 Catheter (folley cathteter) no.16 pcs 13,750 - - - - - - - -
24 Catheter (folley cathteter) no.18 pcs 13,750 - - - - - - - -
25 Cholesterol test btl/10 strip botol 320,000 - - - - - - - -
26 Copper T set 125,000 - - - - - - - -
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 - - - - - - - -
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 - - - - - - - -
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 - - - - - - - -
30 Glukosa test btl/25 strip botol 180,000 - - - - - - - -
31 Hand Schoen no 7 set 14,850 - - - - - - - -
32 Hand Schoen no 7.5 set 14,850 - - - - - - - -
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
34 Hand Schoen no 8 set 14,850 - - - - - - - -
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 - - - - - - - -
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 - - - - - - - -
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 - - - - - - - -
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 - - - - - - - -
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 - - - - - - - -
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 - - - - - - - -
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 - - - - - - - -
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 - - - - - - - -
44 Hand Schoen (Examination Gloves Size S) set 57,750 - - - - - - - -
45 Hand Schoen (Examination Gloves Size M) set 57,750 - - - - - - - -
46 Hand Schoen (Examination Gloves Size L) set 57,750 - - - - - - - -
47 Infusion Set Anak set 6,375 229,500 - - 229,500 - - - -
48 Infusion Set Dewasa set 12,100 - - - - - - - -
49 Infusion Set Macro 2 Cabang set 35,000 - - - - - - - -
50 IV Catheter no. 16 pcs 8,948 - - - - - - - -
51 IV Catheter no. 18 pcs 8,948 420,556 - 26,844 393,712 - - - -
52 IV Catheter no. 20 pcs 8,948 - - - - - - - -
53 IV Catheter no. 22 pcs 8,948 - - - - - - - -
54 IV Catheter no. 24 pcs 8,948 - - - - - - - -
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 - - - - - - - -
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 - - - - - - - -
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 - - - - - - - -
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 - - - - - - - -
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 - - - - - - - -
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 - - - - - - - -
61 Jarum Jahit Otot all size lusin 18,500 - - - - - - - -
62 Jarum Jahit 1/2 Surgical lusin 135,000 - - - - - - - -
63 Jarum Jahit 3/8 Surgical lusin 120,000 - - - - - - - -
64 Kaca Slide pcs 50,000 - - - - - - - -
65 Kapas Pembalut 250 g roll 22,000 22,000 - 22,000 - - - - -
66 Kapas Pembalut 500 g roll 35,000 - - - - - - - -
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 - - - - - - - -
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 - - - - - - - -
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 - - - - - - - -
70 Kasa Pembalut 2 m x 80 cm roll 13,366 26,732 - 26,732 - - - - -
71 Kasa Pembalut 4 m x 5 cm roll - - - - - - - - -
72 Kasa Pembalut 4 m x 10 cm roll 2,601 - - - - - - - -
73 Kasa Pembalut 4 m x 15 cm roll - - - - - - - - -
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 - - - - - - - -
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 - - - - - - - -
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 - - - - - - - -
77 Kasa Steril 16 cm x 16 cm box 6,743 - - - - - - - -
78 Kasa Steril 18 cm x 22 cm box 16,500 - - - - - - - -
79 Masker Ear Loop Pcs 495 - - - - - - - -
80 Mata Pisau Bedah No. 10 pcs 9,750 - - - - - - - -
81 Mata Pisau Bedah No. 11 Pcs 9,750 - - - - - - - -
82 Mata Pisau Bedah No. 15 Pcs 9,750 - - - - - - - -
83 Mata Pisau Bedah No. 21 Pcs 9,750 - - - - - - - -
84 Nasal Oxygen (Aximed) size M Pcs 6,600 - - - - - - - -
85 Nasal Oxygen (Aximed) size L Pcs 6,600 - - - - - - - -
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 - - - - - - - -
87 Plester 5 yard x 2 inchi roll 7,186 - - - - - - - -
88 Plester 5 cm x 4,5 cm roll - - - - - - - - -
89 Plester 7,5 cm x 4,5 cm roll 34,650 - - - - - - - -
90 Pot Sputum pot 2,000 - - - - - - - -
91 RDT pcs - - - - - - - - -
92 Regulator Oxygen pcs 450,000 - - - - - - - -
93 Safety Box kotak - - - - - - - - -
94 Selang Oxygen pcs 8,250 - - - - - - - -
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 24,134,400 - 3,016,800 21,117,600 - - - -
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 1,861,011 - 620,337 1,240,674 - - - -
97 Sound Timer unit 1,219,143 4,876,572 - 1,219,143 3,657,429 - - - -
98 Stempel ISPA pcs - - - - - - - - -
99 Uric Acid test btl/25 strip botol 240,000 - - - - - - - -
100 Urine bag pcs 6,875 34,375 - 6,875 27,500 - - - -

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 15,000 15,000 - - 15,000 - - - -
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 - - - - - - - -
3 Larutan Asam Klorida (HCl) 0,1 N botol - - - - - - - - -
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 - - - - - - - -
5 Larutan Benedik botol 40,040 - - - - - - - -
6 Larutan Eosin 2% botol 36,595 - - - - - - - -
7 Larutan Etanol Asam botol 34,126 - - - - - - - -
8 Larutan Giemsa Stein botol 63,348 - - - - - - - -
9 Larutan Karbol Fuksin botol 23,231 - - - - - - - -
10 Larutan Metanol botol 118,300 - - - - - - - -
11 Larutan Metilen Biru botol 17,086 - - - - - - - -
12 Larutan Turk botol 54,600 - - - - - - - -
13 Reagen TBC kit - - - - - - - - -
14 Test Asam Urat test 250,000 - - - - - - - -
15 Test Comburt Reagens set 251,200 - - - - - - - -
16 Test Golongan Darah set 286,365 - - - - - - - -
17 Test Golongan Darah Reagens set 251,200 - - - - - - - -
18 Test Gula Darah test 200,000 - - - - - - - -
19 Test Kehamilan strip 2,400 - - - - - - - -
20 Test Kolesterol test 350,000 - - - - - - - -
21 Test Urine Rutin strip 3,000 - - - - - - - -

GIGI
1 Air raksa Dental Use - 108,195 - - - - - - - -
2 Devitalisasi pasta (arsen) kotak 390,000 - - - - - - - -
3 Eugenol cairan 10 ml botol 18,333 - - - - - - - -
4 Fluoride 0.5 mg tablet 30,000 - - - - - - - -
5 Fluoride 1 mg tablet 4,456 - - - - - - - -
6 Hemospon (Spongostan Dental) pcs 536,250 - - - - - - - -
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 - - - - - - - -
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 - - - - - - - -
9 Kalsium Hidroksida Pasta tube 341,250 - - - - - - - -
10 Klorheksidin lar 0,2% botol - - - - - - - - -
11 Klorheksidin lar 15% botol - - - - - - - - -
12 Mata Bor Gigi pcs 48,750 - - - - - - - -
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 - - - - - - - -
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 - - - - - - - -
15 Trikresol Formalin (TKF) cairan botol 7,239 - - - - - - - -

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 - - - - - - - -
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 - - - - - - - -
3 Becefort sir 60 ml botol 26,230 - - - - - - - -
4 Bronex (Bromheksin) tab 8 mg tablet 82 - - - - - - - -
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 - - - - - - - -
6 Fluoride 1 mg tablet 976 - - - - - - - -
7 Kandistatin susp 12 ml botol 36,300 - - - - - - - -
8 KY Jelly tube 85,000 - - - - - - - -
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 - - - - - - - -
10 Norit (Karbon Aktif) tab 125 mg tablet - - - - - - - - -
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 - - - - - - - -
12 Pehavral tablet salut 70,785 - - - - - - - -
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 - - - - - - - -
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 - - - - - - - -
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 - - - - - - - -
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 - - - - - - - -
17 Vaksin Antirabies Vero (VAR) vial 48,400 - - - - - - - -
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 16,280 - - 16,280 - - - -
19 Cendo Xytrol TM 5 ml botol 35,850 - - - - - - - -
20 Formalin 40 % botol 42,000 - - - - - - - -
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 - - - - - - - -
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 91,080 - 25,300 65,780 - - - -
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 - - - - - - - -
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 8,247,330 - 1,012,830 7,234,500 - - - -
25 Vical susp 100 ml botol 4,890 - - - - - - - -
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 326,400 - - 326,400 - - - -
27 Vinafluor (Fluoride) kapl 1 mg kaplet - - - - - - - - -
28 Sanmol (Parasetamol) 500 mg tablet 325 - - - - - - - -
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 - - - - - - - -
30 Purecemia (Allopurinol) 300 mg tablet 3,269 - - - - - - - -
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 - - - - - - - -
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 - - - - - - - -
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 - - - - - - - -
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 - - - - - - - -
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 - - - - - - - -
36 Histigo (Betahistin) tab 6 mg tablet - - - - - - - - -
37 Novadium (Loperamid) tab 2 mg tablet - - - - - - - - -
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - - - - - - - - -
39 Metolon (Metoklorperamid) tab 10 mg tablet - - - - - - - - -
40 Novabion tablet - - - - - - - - -
41 Novagesic (Parasetamol) tab 500 mg tablet - - - - - - - - -
42 Defamol (Parasetamol) tab 500 mg tablet - - - - - - - - -
43 Sultrimix syrup botol - - - - - - - - -
44 Biovitan syrup botol - - - - - - - - -
45 Caviplex syrup botol - - - - - - - - -
46 Farsifen (Ibuprofen) syrup botol - - - - - - - - -
47 Novaxifen (Ibuprofen) tab 200 mg tablet - - - - - - - - -
48 Lexigo (Betahistin) tab 6 mg tablet - - - - - - - - -
49 Loric (Allopurinol) tab 100 mg tablet - - - - - - - - -
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - - - - - - - - -
51 Arkavit tablet - - - - - - - - -
52 Novadex (Dexametason) 0,5 mg tablet - - - - - - - - -
53 Carbidu (Dexametason) 0,5 mg tablet - - - - - - - - -
54 Gralixa (Furosemid) 40 mg tablet - - - - - - - - -
55 Grafazol (Metronidazol) tab 500 mg tablet - - - - - - - - -
56 Glikos (Metformin) tab 500 mg tablet - - - - - - - - -
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - - - - - - - - -
58 Metaneuron (Metamizolesodium + Diazepam) tablet - - - - - - - - -
59 Trifadium ( Loperamide HCL 2 mg) tablet - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
 TOTAL 63,185,917 - 8,786,101 54,399,816 - - - -

MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Am. Keb

Nip. 19670824 198903 2 008
DIAAN, STOK OPNAME DAN MUTASI OBAT

BULAN : JANUARI
TAHUN : 2017

DAK BPJS - JKN JUMLAH KESELURUHAN

BUFFER PROVINSI PROGRAM
Stok Awal Penerimaan Pengeluaran Stok Akhir Stok Awal Penerimaan Pengeluaran
Awal Terima Keluar Akhir Awal Terima Keluar Akhir
- - - - - - - - - - - - 108,000 - 6,000
- - - - - - - - - - - - 780,450 - -
- - - - - - - - - - - - - - -
- - - - - - - - 28,600 - 28,600 - 28,600 - 28,600
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 140,250 28,050 112,200 - 140,250 28,050
- - - - - - - - - - - - - - -
- - - - - - - - - 35,840 20,480 15,360 25,600 35,840 46,080
- - - - - - - - - - - - - - -
- - - - - - - - 370,000 259,000 629,000 - 370,000 259,000 629,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 78,000 - 78,000 - 78,000 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 32,000 - 32,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 52,800 17,600 35,200 70,400 52,800 88,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 22,950 - 12,150
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 142,722 - 42,288
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 68,000 47,600 20,400 - 68,000 47,600
- - - - - - - - - 52,140 10,428 41,712 - 52,140 10,428
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 13,794 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 28,600 - - 28,600 28,600 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 444,950 - 40,450
- - - - - - - - 27,280 - - 27,280 87,296 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 175,500 - 175,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 110,950 - 47,550
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 54,900 - 12,200 42,700 54,900 - 12,200
- - - - - - - - - - - - 27,800 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 26,618 26,618 - - 26,618 26,618
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 429,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 103,500 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 163,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 31,400 62,800 62,800 31,400 31,400 62,800 62,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 19,600 - 9,800 9,800 19,600 - 9,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 41,400 13,800 55,200 - 55,200 13,800 69,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 357,500 - 27,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 1,680 - 1,680
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 54,000 54,000 - 32,400 54,000 86,400
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 15,200 60,800 45,600 30,400 15,200 60,800 45,600
- - - - - - - - 13,788 - 13,788 - 13,788 - 13,788
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 19,487 44,970 43,471 20,986 19,487 44,970 43,471
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 137,500 - -
- - - - - - - - - - - - 17,500 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 38,400 - -
- - - - - - - - - - - - 210,000 - 35,000
- - - - - - - - 154,700 - - 154,700 154,700 - -
- - - - - - - - - - - - - - -
- - - - - - - - 126,750 - - 126,750 126,750 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 10,000 - - 10,000 20,000 - 3,000
- - - - - - - - - - - - 92,800 - -
- - - - - - - - 42,250 - - 42,250 211,250 - 16,900
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 110,250 - 47,250
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 573,870 - 56,870
- - - - - - - - - - - - 38,100 - 12,700
- - - - - - - - - - - - 158,400 - 5,280
- - - - - - - - - - - - 211,200 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 69,300 - 9,240 60,060 69,300 - 9,240
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 36,810 36,810 - - 36,810 36,810
- - - - - - - - - - - - - - -
- - - - - - - - 79,200 61,600 123,200 17,600 79,200 61,600 123,200
- - - - - - - - - 9,210 9,210 - - 9,210 9,210
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 159,000 - -
- - - - - - - - - - - - 100,100 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 108,900 - 24,200
- - - - - - - - 29,800 - 29,800 - 29,800 - 29,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 192,000 192,000 - - 192,000 192,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 44,000 66,000 110,000 - 44,000 66,000 110,000
- - - - - - - - 2,680 33,500 2,680 33,500 2,680 33,500 2,680
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 184,353 - 85,086
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 63,000 - 63,000 - 63,000 - 63,000
- - - - - - - - - - - - - - -
- - - - - - - - 29,400 - 29,400 - 29,400 - 29,400
- - - - - - - - - - - - - - -
- - - - - - - - 116,000 - 87,000 29,000 116,000 - 87,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 16,200 - 11,340
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 197,000 - 197,000
- - - - - - - - - - - - 144,000 - 69,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 52,100 52,100 - - 52,100 52,100
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 19,400 - 19,400 - 19,400 - 19,400
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - 37,860 21,454 16,406 10,096 37,860 31,550

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 640,575 - - 640,575 17,722,575 - 1,708,200
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 2,310,000 6,930,000 8,316,000 924,000 2,310,000 6,930,000 8,316,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 229,500 - -
- - - - - - - - 121,000 181,500 302,500 - 121,000 181,500 302,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 420,556 - 26,844
- - - - - - - - 134,220 170,012 214,752 89,480 134,220 170,012 214,752
- - - - - - - - - - - - - - -
- - - - - - - - - 178,960 80,532 98,428 - 178,960 80,532
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 22,000 - 22,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 26,732 - 26,732
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 9,900 74,250 74,250 9,900 9,900 74,250 74,250
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 33,000 16,500 16,500 - 33,000 16,500
- - - - - - - - - - - - 24,134,400 - 3,016,800
- - - - - - - - - - - - 1,861,011 - 620,337
- - - - - - - - - - - - 4,876,572 - 1,219,143
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 34,375 - 6,875

- - - - - - - - - - - - 15,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 16,280 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 91,080 - 25,300
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 8,247,330 - 1,012,830
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 326,400 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 4,652,430 9,005,820 10,895,063 2,763,187 67,838,347 9,005,820 19,681,164

Inebenggi, 31 Januari 2017

TERLAMBAT
2/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
2/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
2/11/2017
Nip. 19890705 201504 2 001
N

Stok Akhir

102,000
780,450
-
-
-
-
-
-
-
-
-
112,200
-
15,360
-
-
-
-
78,000
-
-
-
-
-
-
-
 -
-
-
-
-
-
-
-
-
-
35,200
-
-
-
-
-
-
-
-
10,800
-
-
-
-
-
-
-
-
-
100,434
-
-
-
-
-
-
-
-
20,400
 41,712
-
-
13,794
-
-
-
-
-
-
-
-
-
-
-
28,600
-
-
-
-
-
-
404,500
87,296
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 -
63,400
-
-
-
-
-
-
-
42,700
27,800
-
-
-
-
-
429,000
-
103,500
-
-
-
-
-
-
163,000
-
-
31,400
-
-
-
-
9,800
-
-
-
-
-
 -
-
-
-
-
-
-
-
-
-
-
-
-
330,000
-
-
-
-
-
-
-
-
-
-
-
-
-
30,400
-
-
-
-
-
-
-
-
20,986
-
-
 -
-
-
137,500
17,500
-
-
-
38,400
175,000
154,700
-
126,750
-
-
-
-
-
17,000
92,800
194,350
-
-
63,000
-
-
517,000
25,400
153,120
211,200
-
-
-
-
-
-
-
-
-
 -
-
-
-
-
-
60,060
-
-
-
-
17,600
-
-
-
-
159,000
100,100
-
-
84,700
-
-
-
-
-
-
-
-
-
-
-
-
33,500
-
-
-
-
-
99,267
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
29,000
-
-
-
-
4,860
-
-
75,000
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

16,406
-
-
-
-
-
-
 -
-
-
-
-
-
-
-
-
-
16,014,375
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
924,000
-
-
-
-
-
-
-
-
-
229,500
-
-
-
393,712
89,480
-
98,428
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
9,900
-
-
-
-
-
-
 -
-
-
-
-
-
-
-
16,500
21,117,600
1,240,674
3,657,429
-
-
27,500

15,000
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 -
-
16,280
-
-
-
65,780
-
7,234,500
-
326,400
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
57,163,003
 Menu

Peringatan

!
 LAPORAN ASSET PERSEDIAAN, STO

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

DAU/PKD
No. Nama Obat Satuan Harga PUSAT
Stok Awal Penerimaan Pengeluaran Stok Akhir
Awal Terima Keluar Akhir
1 Air Untuk Injeksi 20 ml vial 6,000 102,000 - 12,000 90,000 - - - -
2 Albendazole tab 400 mg tablet 363 780,450 - - 780,450 - - - -
3 Albendazole susp 200 mg/5 ml botol 4,234 - - - - - - - -
4 Allopurinol tab 100 mg tablet 143 - 71,500 14,300 57,200 - - - -
5 Allopurinol tab 300 mg tablet 233 - - - - - - - -
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 - 131,875 131,875 - - - - -
7 Ambroksol tab 30 mg tablet 200 - 140,000 80,000 60,000 - - - -
8 Aminophyllin tab 200 mg tablet 86 - - - - - - - -
9 Aminophyllin inj 24 mg ampul 4,204 - - - - - - - -
10 Amitriptiline HCl tab 25 mg tablet 123 - - - - - - - -
11 Amlodipin tab 5 mg tablet 197 - - - - - - - -
12 Amlodipin tab 10 mg tablet 935 - 168,300 168,300 - - - - -
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 - - - - - - - -
14 Amoxicillin SK 125 mg/5 ml botol 2,560 - 51,200 35,840 15,360 - - - -
15 Amoxicillin tab 250 mg tablet 220 - - - - - - - -
16 Amoxicillin tab 500 mg tablet 370 - 370,000 259,000 111,000 - - - -
17 Ampicillin serb inj 1000 mg vial 5,610 - - - - - - - -
18 Antasida DOEN susp 60 ml botol 2,213 - - - - - - - -
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 78 - 117,000 70,200 46,800 - - - -
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 - - - - - - - -
21 Antifungi DOEN kombinasi 30 g pot 1,890 - - - - - - - -
22 Antihemoroid DOEN suppo supp 3,200 - 64,000 - 64,000 - - - -
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - - - - - - - - -
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 3,220 - - - - - - - -
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 - - - - - - - -
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 149 - - - - - - - -
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 1,650 - - - - - - - -
28 Artemether inj 80 mg/mL ampul 24,384 - - - - - - - -
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 - - - - - - - -
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 - - - - - - - -
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 - - - - - - - -
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 - - - - - - - -
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 - - - - - - - -
34 Asam Folat tab 0,4 mg tablet 104 - - - - - - - -
35 Asam Folat tab 1 mg tablet 52 - - - - - - - -
36 Asam Mefenamat tab 250 mg tablet 175 - - - - - - - -
37 Asam Mefenamat tab 500 mg tablet 176 - 176,000 105,600 70,400 - - - -
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 - - - - - - - -
39 Asiklovir tab 200 mg tablet 251 - - - - - - - -
40 Asiklovir tab 400 mg tablet 357 - - - - - - - -
41 Atenolol tab 50 mg tablet 387 - - - - - - - -
42 Atapulgit tab 600 mg tablet 220 - - - - - - - -
43 Atropin tab 0,5 mg tablet 81 - - - - - - - -
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 - - - - - - - -
45 Azitromisin tablet 500 mg kaplet 4,725 - - - - - - - -
46 Bedak Salisil serb 2% Kotak 1,350 10,800 48,600 22,950 36,450 - - - -
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 - - - - - - - -
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 - - - - - - - -
49 Betametason krim 0,5 mg/g tube 1,596 - 39,900 23,940 15,960 - - - -
50 Betametason tts mata 1 mg/ml botol 25,106 - - - - - - - -
51 Bisakodil sup 5 mg supp 4,990 - - - - - - - -
52 Bisakodil sup 10 mg supp 6,045 - - - - - - - -
53 Bromheksin tab 8 mg tablet 82 - - - - - - - -
54 Cefadroksil kaps 250 mg kapsul 564 - - - - - - - -
55 Cefadroksil kaps/tab 500 mg kapsul 548 - 383,600 219,200 164,400 - - - -
56 Cefadroksil SK 125 mg/5 mL botol 5,286 100,434 264,300 42,288 322,446 - - - -
57 Cefadroksil SK 250 mg/5 mL botol 6,285 - - - - - - - -
58 Cefiksime tab 100 mg kapsul 1,000 - 500,000 400,000 100,000 - - - -
59 Cefiksime sir 100 mg/5 mL botol 9,400 - - - - - - - -
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 - - - - - - - -
61 Cetrizine tab 10 mg tablet 190 - - - - - - - -
62 Cetrizine sir 5 mg/5 ml botol 8,799 - - - - - - - -
63 Cimetidine tab 200 mg tablet 205 - - - - - - - -
64 Copper T set/buah 125,483 - - - - - - - -
65 Deksametason tab 0,5 mg tablet 68 - - - - - - - -
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 - - - - - - - -
67 Diazepam tab 2 mg tablet 47 - - - - - - - -
68 Diazepam tab 5 mg tablet 179 - - - - - - - -
69 Diazepam inj 5 mg/ml ampul 4,598 13,794 - - 13,794 - - - -
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 - - - - - - - -
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 - - - - - - - -
72 Dietil Karbamazin tab 100 mg tablet 150 - - - - - - - -
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 - - - - - - - -
74 Digoksin tab 0,25 mg tablet 103 - - - - - - - -
75 Diltiazem kaps SR 100 mg kapsul 4,033 - - - - - - - -
76 Diltiazem kaps SR 200 mg kapsul 4,417 - - - - - - - -
77 Diltiazem tab 30 mg tablet 141 - - - - - - - -
78 Dimenhidrinat tab 50 mg tablet 109 - - - - - - - -
79 Doksisiklin kaps 100 mg kapsul 298 - - - - - - - -
80 Domperidon susp 5 mg/5 ml botol 3,490 - - - - - - - -
81 Domperidon tab 10 mg tablet 286 - 143,000 28,600 114,400 - - - -
82 Efedrin inj 50 mg/mL tablet 14,650 - - - - - - - -
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 - 267,300 - 267,300 - - - -
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 - - - - - - - -
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 - - - - - - - -
86 Eritromisin kaps 250 mg kapsul 522 - - - - - - - -
87 Eritromisin kaps 500 mg kapsul 1,023 - - - - - - - -
88 Erytromisin SK 200 mg/5 ml botol 8,090 404,500 242,700 234,610 412,590 - - - -
89 Etakridin (Rivanol) lar 0,1% botol 5,456 60,016 27,280 5,456 81,840 - - - -
90 Etambutol tab 250 mg tablet 330 - - - - - - - -
91 Etambutol tab 500 mg tablet 478 - - - - - - - -
92 Etanol 70 % lar 100 ml botol 2,625 - 26,250 18,375 7,875 - - - -
93 Etil Klorida semprot 100 mL botol 175,500 - - - - - - - -
94 Etonogestrel implan 68 mg subd implant 128,779 - - - - - - - -
95 Fenobarbital tab 30 mg tablet 149 - - - - - - - -
96 Fenobarbital tab 100 mg tablet 242 - - - - - - - -
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 - - - - - - - -
98 Fenol Gliserol tts telinga 10% botol 1,920 - - - - - - - -
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 - - - - - - - -
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 - 75,080 - 75,080 - - - -
101 Flukonazol kaps 150 mg kapsul 24,200 - - - - - - - -
102 Fluor tab 0,5 mg tablet 975 - - - - - - - -
103 Furosemid tab 40 mg tablet 84 - - - - - - - -
104 Furosemide inj 10 mg/ml ampul 2,012 - - - - - - - -
105 Gameksan lotion 1% - 30 ml botol 2,420 - - - - - - - -
106 Garam Oralit kombinasi sacchet 317 63,400 158,500 25,360 196,540 - - - -
107 Gemfibrozil kaps 300 mg kapsul 318 - - - - - - - -
108 Gentamicin krim 10% tube - - - - - - - - -
109 Gentamicin salep kulit 10% tube - - - - - - - - -
110 Gentamicin salep mata 0,3% tube 2,786 - - - - - - - -
111 Gentamicin tts mata 0,3% botol 3,513 - - - - - - - -
112 Gentamisin inj 40 mg/ml ampul 3,739 - - - - - - - -
113 Gentamisin inj 80 mg/ml vial 4,160 - - - - - - - -
114 Glibenklamid tab 5 mg tablet 61 - - - - - - - -
115 Glimepirid tab 1 mg tablet 278 27,800 55,600 13,900 69,500 - - - -
116 Glimepirid tab 2 mg tablet 458 - - - - - - - -
117 Glipizid tab 5 mg tablet 3,000 - - - - - - - -
118 Gliseril Guaikolat tab 100 mg tablet 27 - 26,618 10,647 15,971 - - - -
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 - - - - - - - -
120 Gliserin lar 50% botol 5,867 - - - - - - - -
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 429,000 - - 429,000 - - - -
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 - - - - - - - -
123 Griseofulvin tab 125 mg tablet 230 103,500 115,000 34,500 184,000 - - - -
124 Haloperidol tab 0,5 mg tablet 62 - - - - - - - -
125 Haloperidol tab 1,5 mg tablet 76 - - - - - - - -
126 Haloperidol tab 2 mg tablet 134 - - - - - - - -
127 Haloperidol tab 5 mg tablet 105 - - - - - - - -
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 - - - - - - - -
129 Hiosina Butilbromida tab 10 mg tablet 648 - - - - - - - -
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 163,000 - 16,300 146,700 - - - -
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 - - - - - - - -
132 Ibuprofen tab 200 mg tablet 121 - - - - - - - -
133 Ibuprofen tab 400 mg tablet 157 - - - - - - - -
134 Ibuprofen sir 100 mg/5 ml botol 3,849 - - - - - - - -
135 Ibuprofen sir 200 mg/5 ml botol 4,949 - - - - - - - -
136 Isoniazid tab 100 mg tablet 72 - - - - - - - -
137 Isoniazid tab 300 mg tablet 174 - - - - - - - -
138 Isosorbid Dinitrat tab 5 mg tablet 98 - - - - - - - -
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 - - - - - - - -
140 Kalsium Karbonat tab 500 mg tablet 448 - - - - - - - -
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 - - - - - - - -
142 Kanamisin inj 1.000 mg/vial vial 5,100 - - - - - - - -
143 Kaptopril tab 12,5 mg tablet 90 - 63,000 27,000 36,000 - - - -
144 Kaptopril tab 25 mg tablet 138 - 110,400 75,900 34,500 - - - -
145 Kaptopril tab 50 mg tablet 141 - - - - - - - -
146 Karbamazepin tab 200 mg tablet 269 - - - - - - - -
147 Karbamazepin sir 100 mg/5 mL botol 44,770 - - - - - - - -
148 Karbogliserin tts telinga 10% botol 2,246 - - - - - - - -
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 - - - - - - - -
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 - - - - - - - -
151 Ketokonazole krim 2% - 15 g tube 5,150 - - - - - - - -
152 Ketokonazole tab 200 mg tablet 320 - - - - - - - -
153 Klaritromisin tab 500 mg tablet 3,600 - - - - - - - -
154 Klindamisin kaps 150 mg kapsul 405 - - - - - - - -
155 Klindamisin kaps 300 mg kapsul 619 - - - - - - - -
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 - - - - - - - -
157 Kloramfenikol kaps 250 mg kapsul 275 330,000 - 82,500 247,500 - - - -
158 Kloramfenikol kaps 500 mg kapsul 935 - - - - - - - -
159 Kloramfenikol salap mata 1% tube 1,680 - - - - - - - -
160 Kloramfenikol salep kulit 2% tube 4,138 - - - - - - - -
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 - - - - - - - -
162 Kloramfenikol tts mata 0,5% botol 20,360 - - - - - - - -
163 Kloramfenikol tts telinga 3% botol 11,440 - - - - - - - -
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 - 108,000 70,200 37,800 - - - -
165 Klorpromazin HCl tab 25 mg tablet 75 - - - - - - - -
166 Klorpromazin HCl tab 100 mg tablet 162 - - - - - - - -
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 - - - - - - - -
168 Kodein HCL tab 10 mg tablet 550 - - - - - - - -
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - - - - - - - - -
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 2,298 - - - - - - - -
171 Kotrimoxazol tab 480 mg (adult) tablet 152 - - - - - - - -
172 Kotrimoxazol susp 60 ml botol 2,298 - - - - - - - -
173 Kuinin tab 200 mg tablet 737 - - - - - - - -
174 Kuinin tab 222 mg tablet 594 - - - - - - - -
175 Kuinin inj 25% (i.v) ampul 6,820 - - - - - - - -
176 Levofloxacin tab 500 mg tablet 581 - - - - - - - -
177 Levofloxacin inf 5 mg/mL botol 43,809 - - - - - - - -
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - - - - - - - - -
179 Lidokain inj 1% (infltr) ampul 929 - - - - - - - -
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 - - - - - - - -
181 Lidokain gel 2% botol 40,000 - - - - - - - -
182 Lidokain semprot 10% botol 156,200 - - - - - - - -
183 Lisol lar 1.000 ml botol 49,862 - 49,862 49,862 - - - - -
184 Loratadin tab 10 mg tablet 333 - - - - - - - -
185 Magnesium Sulfat serb 30 g sacchet 3,803 - - - - - - - -
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 137,500 110,000 - 247,500 - - - -
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 17,500 - - 17,500 - - - -
188 Mebendazol tab 100 mg tablet 7,150 - - - - - - - -
189 Mebendazol tab 500 mg tablet 7,854 - - - - - - - -
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 - - - - - - - -
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 38,400 12,800 2,560 48,640 - - - -
192 Metampiron (Antalgin) tab 500 mg tablet 350 175,000 175,000 35,000 315,000 - - - -
193 Metformin tab 500 mg tablet 182 - 54,600 - 54,600 - - - -
194 Metformin tab 850 mg tablet 280 - - - - - - - -
195 Metilergometrin Maleat tab 0.125 mg tablet 169 - - - - - - - -
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 - - - - - - - -
197 Metilprednisolon tab 4 mg tablet 230 - - - - - - - -
198 Metilprednisolon tab 8 mg tablet 390 - - - - - - - -
199 Metilprednisolon tab 16 mg tablet 875 - - - - - - - -
200 Metoklopramid tab 5 mg tablet 113 - - - - - - - -
201 Metoklopramid tab 10 mg tablet 100 7,000 70,000 17,000 60,000 - - - -
202 Metronidazol tab 250 mg tablet 116 92,800 46,400 11,600 127,600 - - - -
203 Metronidazol tab 500 mg tablet 169 152,100 84,500 33,800 202,800 - - - -
204 Metronidazol sir 125 mg/5 ml botol 4,350 - - - - - - - -
205 Metronidazol lar inf 5 mg/mL botol 12,980 - - - - - - - -
206 Miconazole krim 2% tube 3,150 63,000 75,600 34,650 103,950 - - - -
207 Natrium Diklofenak tab 25 mg tablet 146 - 73,000 65,700 7,300 - - - -
208 Natrium Diklofenak tab 50 mg tablet 193 - - - - - - - -
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 517,000 - 51,700 465,300 - - - -
210 Nifedipine tab 10 mg tablet 127 25,400 25,400 - 50,800 - - - -
211 Nistatin tab vaginal 100.000 IU ovula 528 153,120 105,600 - 258,720 - - - -
212 Nistatin tab vaginal 500.000 IU tablet 704 211,200 140,800 - 352,000 - - - -
213 Obat Anti TB Kategori Anak Paket 189,195 - - - - - - - -
214 Obat Anti TB Kategori Anak FDC Paket 236,490 - - - - - - - -
215 Obat Anti TB Kategori I Paket 317,015 - - - - - - - -
216 Obat Anti TB Kategori I FDC Paket 396,000 - - - - - - - -
217 Obat Anti TB Kategori I Kombipak Paket 316,920 - - - - - - - -
218 Obat Anti TB Kategori II Paket 1,320,000 - - - - - - - -
219 Obat Anti TB Kategori II FDC Paket 1,319,990 - - - - - - - -
220 Obat Anti TB Kategori III Paket 154,000 - - - - - - - -
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 - - - - - - - -
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 - 87,500 17,500 70,000 - - - -
223 Ofloxacin tab 200 mg tablet 440 - - - - - - - -
224 Ofloxacin tab 400 mg tablet 700 - - - - - - - -
225 Oksimetazolin tts hidung 0,025 % botol 30,305 - - - - - - - -
226 Oksimetazolin tts hidung 0,050 % botol 32,000 - - - - - - - -
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 - - - - - - - -
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 - - - - - - - -
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 - - - - - - - -
230 Olopatadin tts mata 0,1% botol 68,000 - - - - - - - -
231 Omeprazol kaps 20 mg kapsul 409 - 73,620 73,620 - - - - -
232 Omeprazol inj 40 mg/10 mL vial 42,000 - - - - - - - -
233 Paracetamol tab 500 mg tablet 88 - - - - - - - -
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 - - - - - - - -
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 - - - - - - - -
236 Perak Sulfadiazin krim 1% tube 25,350 - - - - - - - -
237 Permetrin krim 5% tube 11,475 - - - - - - - -
238 Pirantel Pamoat tab 125 mg tablet 318 159,000 - - 159,000 - - - -
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 100,100 136,500 - 236,600 - - - -
240 Pirazinamid tab 500 mg tablet 225 - - - - - - - -
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 - - - - - - - -
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 84,700 121,000 90,750 114,950 - - - -
243 Piroxicam tab 10 mg tablet 149 - - - - - - - -
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 - - - - - - - -
245 Povidon Iodida lar 10% - 300 ml botol 15,386 - - - - - - - -
246 Povidon Iodida lar 10% - 60 ml botol 6,500 - - - - - - - -
247 Povidon Iodida lar 10% - 30 ml botol 2,344 - - - - - - - -
248 Prednison tab 5 mg tablet 192 - - - - - - - -
249 Primakuin tab 15 mg tablet 205 - - - - - - - -
250 Probenesid tab 500 mg tablet 1,815 - - - - - - - -
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 - - - - - - - -
252 Propranolol tab 10 mg tablet 80 - - - - - - - -
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 - - - - - - - -
254 Ranitidin tab 150 mg tablet 220 - 110,000 110,000 - - - - -
255 Ranitidin inj 25 mg/mL ampul 1,340 - - - - - - - -
256 Retinol (Vit A) softcap 100.000 IU softcap 286 - - - - - - - -
257 Retinol (Vit A) softcap 200.000 IU softcap 505 - - - - - - - -
258 Rifampicin kaps 300 mg kapsul 670 - - - - - - - -
259 Rifampicin tab 450 mg tablet 868 - - - - - - - -
260 Rifampicin tab 600 mg tablet 1,209 - - - - - - - -
261 Ringer Laktat lar inf steril 500 ml botol 4,727 99,267 283,620 99,267 283,620 - - - -
262 Salbutamol tab 2 mg tablet 65 - - - - - - - -
263 Salbutamol tab 4 mg tablet 93 - - - - - - - -
264 Salbutamol cairan ih 0,1% botol 7,260 - - - - - - - -
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 - - - - - - - -
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 - - - - - - - -
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 - - - - - - - -
268 Serum Antidifteri inj 10,000 IU vial - - - - - - - - -
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 - - - - - - - -
270 Serum Antitetanus inj 1.500 IU vial 161,000 - - - - - - - -
271 Serum Antitetanus inj 10.000 IU vial - - - - - - - - -
272 Serum Antitetanus inj 20.000 IU vial 324,550 - - - - - - - -
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 - - - - - - - -
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 - - - - - - - -
275 Simvastatin tab 10 mg tablet 294 - 147,000 44,100 102,900 - - - -
276 Simvastatin tab 20 mg tablet 480 - - - - - - - -
277 Siprofloksasin tab 500 mg tablet 290 - 145,000 - 145,000 - - - -
278 Spironolakton tab 25 mg tablet 350 - - - - - - - -
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 - - - - - - - -
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 112 - - - - - - - -
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 - - - - - - - -
282 Tetrasiklin kaps 250 mg kapsul 162 4,860 81,000 53,460 32,400 - - - -
283 Tetrasiklin kaps 500 mg kapsul 325 - - - - - - - -
284 Thiamfenikol kaps 500 mg kapsul 985 - - - - - - - -
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 75,000 120,000 87,000 108,000 - - - -
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 - - - - - - - -
287 Tramadol inj 50 mg/mL ampul 2,680 - - - - - - - -
288 Triheksipenidil tab 2 mg tablet 70 - - - - - - - -
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 - - - - - - - -
290 Valproat tab sal 250 mg tablet salut 1,680 - - - - - - - -
291 Valproat tab sal 500 mg tablet salut 5,450 - - - - - - - -
292 Valproat sir 250 mg/5 mL botol 41,800 - - - - - - - -
293 Vankomisin serb inj 500 mg/vial vial 142,000 - - - - - - - -
294 Vitamin B Kompleks tablet 112 - 224,000 128,800 95,200 - - - -
295 Zinc sir 10 mg/ml botol 16,478 - - - - - - - -
296 Zinc sir 20 mg/5 ml botol 8,140 - 24,420 24,420 - - - - -
297 Zinc dispersible 20 mg tablet 521 - - - - - - - -
298 Alprazolam tab 1 mg tablet 245 - - - - - - - -
299 Betahistin tab 6 mg tablet - - - - - - - - -
300 Idometasin kapl 25 mg kaplet 380 - - - - - - - -
301 Karbon Aktif tab 125 mg tablet 127 - - - - - - - -
302 Klobazam tab 10 mg tablet 950 - - - - - - - -
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 - - - - - - - -
304 Loperamid tab 2 mg tablet 97 - - - - - - - -
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 - - - - - - - -
306 Papaverin 40 mg tablet - - - - - - - - -
307 Piracetam tab 400 mg tablet - - - - - - - - -
308 Thiamfenikol tab 250 mg tablet - - - - - - - - -
309 Piracetam tab 800 mg tablet - - - - - - - - -
310 Piroxicam tab 20 mg tablet - - - - - - - - -
311 Asam Askorbat (Vit.C) tab 25 mg tablet - - - - - - - - -
312 Etanol 70% lar 1000 ml botol - - - - - - - - -
313 Etanol 70% lar 300 ml botol - - - - - - - - -
314 Neurosanbe injeksi ampul - - - - - - - - -
315 H2O2 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 1,262 - 126,200 37,860 88,340 - - - -
2 Alat Suntik 2.5 ml pcs 1,102 - - - - - - - -
3 Alat Suntik 3 ml pcs 1,010 - 101,000 21,210 79,790 - - - -
4 Alat Suntik 5 ml pcs 1,248 - 124,800 - 124,800 - - - -
5 Alat Suntik 10 ml pcs 1,694 - 84,700 16,940 67,760 - - - -
6 Alat Suntik 20 ml pcs 2,228 - - - - - - - -
7 Alat Suntik 50 ml pcs 10,350 - - - - - - - -
8 Alat Suntik ADS 0,5 ml pcs 1,925 - - - - - - - -
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 - - - - - - - -
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 - - - - - - - -
11 Alat Suntik ADS 5 ml BCG pcs 2,585 - - - - - - - -
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 - - - - - - - -
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 - - - - - - - -
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 - - - - - - - -
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 - - - - - - - -
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 - - - - - - - -
17 Catgut no.2/0 pcs 213,525 - 5,124,600 1,921,725 3,202,875 - - - -
18 Catgut no.3/0 pcs 213,525 15,373,800 5,124,600 640,575 19,857,825 - - - -
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 - - - - - - - -
20 Catheter (folley cathteter) no.10 pcs 13,750 - 137,500 - 137,500 - - - -
21 Catheter (folley cathteter) no.12 pcs 13,750 - 137,500 - 137,500 - - - -
22 Catheter (folley cathteter) no.14 pcs 13,750 - 137,500 - 137,500 - - - -
23 Catheter (folley cathteter) no.16 pcs 13,750 - 137,500 - 137,500 - - - -
24 Catheter (folley cathteter) no.18 pcs 13,750 - 137,500 - 137,500 - - - -
25 Cholesterol test btl/10 strip botol 320,000 - - - - - - - -
26 Copper T set 125,000 - - - - - - - -
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 - - - - - - - -
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 - - - - - - - -
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 - - - - - - - -
30 Glukosa test btl/25 strip botol 180,000 - - - - - - - -
31 Hand Schoen no 7 set 14,850 - 297,000 297,000 - - - - -
32 Hand Schoen no 7.5 set 14,850 - 297,000 222,750 74,250 - - - -
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
34 Hand Schoen no 8 set 14,850 - 297,000 118,800 178,200 - - - -
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 - - - - - - - -
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 - - - - - - - -
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 - - - - - - - -
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 - - - - - - - -
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 - - - - - - - -
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 - - - - - - - -
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 - - - - - - - -
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 - - - - - - - -
44 Hand Schoen (Examination Gloves Size S) set 57,750 - - - - - - - -
45 Hand Schoen (Examination Gloves Size M) set 57,750 - - - - - - - -
46 Hand Schoen (Examination Gloves Size L) set 57,750 - - - - - - - -
47 Infusion Set Anak set 6,375 229,500 127,500 12,750 344,250 - - - -
48 Infusion Set Dewasa set 12,100 - 242,000 169,400 72,600 - - - -
49 Infusion Set Macro 2 Cabang set 35,000 - - - - - - - -
50 IV Catheter no. 16 pcs 8,948 - - - - - - - -
51 IV Catheter no. 18 pcs 8,948 393,712 178,960 - 572,672 - - - -
52 IV Catheter no. 20 pcs 8,948 - 178,960 26,844 152,116 - - - -
53 IV Catheter no. 22 pcs 8,948 - 178,960 26,844 152,116 - - - -
54 IV Catheter no. 24 pcs 8,948 - 178,960 26,844 152,116 - - - -
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 - - - - - - - -
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 - - - - - - - -
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 - - - - - - - -
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 - - - - - - - -
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 - - - - - - - -
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 - - - - - - - -
61 Jarum Jahit Otot all size lusin 18,500 - - - - - - - -
62 Jarum Jahit 1/2 Surgical lusin 135,000 - 135,000 - 135,000 - - - -
63 Jarum Jahit 3/8 Surgical lusin 120,000 - 120,000 - 120,000 - - - -
64 Kaca Slide pcs 50,000 - - - - - - - -
65 Kapas Pembalut 250 g roll 22,000 - 220,000 44,000 176,000 - - - -
66 Kapas Pembalut 500 g roll 35,000 - 350,000 175,000 175,000 - - - -
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 - - - - - - - -
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 - 612,750 245,100 367,650 - - - -
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 - 27,230 10,892 16,338 - - - -
70 Kasa Pembalut 2 m x 80 cm roll 13,366 - - - - - - - -
71 Kasa Pembalut 4 m x 5 cm roll - - - - - - - - -
72 Kasa Pembalut 4 m x 10 cm roll 2,601 - - - - - - - -
73 Kasa Pembalut 4 m x 15 cm roll - - - - - - - - -
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 - 12,480 12,480 - - - - -
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 - 26,000 26,000 - - - - -
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 - 36,380 36,380 - - - - -
77 Kasa Steril 16 cm x 16 cm box 6,743 - 6,743 6,743 - - - - -
78 Kasa Steril 18 cm x 22 cm box 16,500 - 396,000 379,500 16,500 - - - -
79 Masker Ear Loop Pcs 495 - 49,500 49,500 - - - - -
80 Mata Pisau Bedah No. 10 pcs 9,750 - 48,750 19,500 29,250 - - - -
81 Mata Pisau Bedah No. 11 Pcs 9,750 - 48,750 9,750 39,000 - - - -
82 Mata Pisau Bedah No. 15 Pcs 9,750 - 97,500 - 97,500 - - - -
83 Mata Pisau Bedah No. 21 Pcs 9,750 - 97,500 19,500 78,000 - - - -
84 Nasal Oxygen (Aximed) size M Pcs 6,600 - - - - - - - -
85 Nasal Oxygen (Aximed) size L Pcs 6,600 - - - - - - - -
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 - - - - - - - -
87 Plester 5 yard x 2 inchi roll 7,186 - - - - - - - -
88 Plester 5 cm x 4,5 cm roll - - - - - - - - -
89 Plester 7,5 cm x 4,5 cm roll 34,650 - - - - - - - -
90 Pot Sputum pot 2,000 - - - - - - - -
91 RDT pcs - - - - - - - - -
92 Regulator Oxygen pcs 450,000 - - - - - - - -
93 Safety Box kotak - - - - - - - - -
94 Selang Oxygen pcs 8,250 - - - - - - - -
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 21,117,600 - 2,011,200 19,106,400 - - - -
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 1,240,674 - 620,337 620,337 - - - -
97 Sound Timer unit 1,219,143 3,657,429 - 1,219,143 2,438,286 - - - -
98 Stempel ISPA pcs - - - - - - - - -
99 Uric Acid test btl/25 strip botol 240,000 - - - - - - - -
100 Urine bag pcs 6,875 27,500 68,750 - 96,250 - - - -

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 15,000 15,000 - 15,000 - - - - -
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 - - - - - - - -
3 Larutan Asam Klorida (HCl) 0,1 N botol - - - - - - - - -
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 - - - - - - - -
5 Larutan Benedik botol 40,040 - - - - - - - -
6 Larutan Eosin 2% botol 36,595 - - - - - - - -
7 Larutan Etanol Asam botol 34,126 - - - - - - - -
8 Larutan Giemsa Stein botol 63,348 - - - - - - - -
9 Larutan Karbol Fuksin botol 23,231 - - - - - - - -
10 Larutan Metanol botol 118,300 - - - - - - - -
11 Larutan Metilen Biru botol 17,086 - - - - - - - -
12 Larutan Turk botol 54,600 - - - - - - - -
13 Reagen TBC kit - - - - - - - - -
14 Test Asam Urat test 250,000 - 250,000 250,000 - - - - -
15 Test Comburt Reagens set 251,200 - - - - - - - -
16 Test Golongan Darah set 286,365 - - - - - - - -
17 Test Golongan Darah Reagens set 251,200 - - - - - - - -
18 Test Gula Darah test 200,000 - 200,000 200,000 - - - - -
19 Test Kehamilan strip 2,400 - - - - - - - -
20 Test Kolesterol test 350,000 - 350,000 350,000 - - - - -
21 Test Urine Rutin strip 3,000 - - - - - - - -

GIGI
1 Air raksa Dental Use - 108,195 - - - - - - - -
2 Devitalisasi pasta (arsen) kotak 390,000 - - - - - - - -
3 Eugenol cairan 10 ml botol 18,333 - - - - - - - -
4 Fluoride 0.5 mg tablet 30,000 - - - - - - - -
5 Fluoride 1 mg tablet 4,456 - - - - - - - -
6 Hemospon (Spongostan Dental) pcs 536,250 - - - - - - - -
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 - - - - - - - -
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 - - - - - - - -
9 Kalsium Hidroksida Pasta tube 341,250 - - - - - - - -
10 Klorheksidin lar 0,2% botol - - - - - - - - -
11 Klorheksidin lar 15% botol - - - - - - - - -
12 Mata Bor Gigi pcs 48,750 - - - - - - - -
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 - - - - - - - -
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 - - - - - - - -
15 Trikresol Formalin (TKF) cairan botol 7,239 - - - - - - - -

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 - - - - - - - -
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 - - - - - - - -
3 Becefort sir 60 ml botol 26,230 - - - - - - - -
4 Bronex (Bromheksin) tab 8 mg tablet 82 - - - - - - - -
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 - - - - - - - -
6 Fluoride 1 mg tablet 976 - - - - - - - -
7 Kandistatin susp 12 ml botol 36,300 - - - - - - - -
8 KY Jelly tube 85,000 - - - - - - - -
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 - - - - - - - -
10 Norit (Karbon Aktif) tab 125 mg tablet - - - - - - - - -
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 - - - - - - - -
12 Pehavral tablet salut 70,785 - - - - - - - -
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 - - - - - - - -
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 - - - - - - - -
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 - - - - - - - -
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 - - - - - - - -
17 Vaksin Antirabies Vero (VAR) vial 48,400 - - - - - - - -
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 16,280 8,140 - 24,420 - - - -
19 Cendo Xytrol TM 5 ml botol 35,850 - - - - - - - -
20 Formalin 40 % botol 42,000 - - - - - - - -
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 - 545,000 327,000 218,000 - - - -
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 65,780 - 65,780 - - - - -
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 - - - - - - - -
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 7,234,500 - - 7,234,500 - - - -
25 Vical susp 100 ml botol 4,890 - 293,400 122,250 171,150 - - - -
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 326,400 - - 326,400 - - - -
27 Vinafluor (Fluoride) kapl 1 mg kaplet - - - - - - - - -
28 Sanmol (Parasetamol) 500 mg tablet 325 - 162,500 162,500 - - - - -
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 - - - - - - - -
30 Purecemia (Allopurinol) 300 mg tablet 3,269 - - - - - - - -
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 - - - - - - - -
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 - - - - - - - -
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 - - - - - - - -
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 - - - - - - - -
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 - - - - - - - -
36 Histigo (Betahistin) tab 6 mg tablet - - - - - - - - -
37 Novadium (Loperamid) tab 2 mg tablet - - - - - - - - -
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - - - - - - - - -
39 Metolon (Metoklorperamid) tab 10 mg tablet - - - - - - - - -
40 Novabion tablet - - - - - - - - -
41 Novagesic (Parasetamol) tab 500 mg tablet - - - - - - - - -
42 Defamol (Parasetamol) tab 500 mg tablet - - - - - - - - -
43 Sultrimix syrup botol - - - - - - - - -
44 Biovitan syrup botol - - - - - - - - -
45 Caviplex syrup botol - - - - - - - - -
46 Farsifen (Ibuprofen) syrup botol - - - - - - - - -
47 Novaxifen (Ibuprofen) tab 200 mg tablet - - - - - - - - -
48 Lexigo (Betahistin) tab 6 mg tablet - - - - - - - - -
49 Loric (Allopurinol) tab 100 mg tablet - - - - - - - - -
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - - - - - - - - -
51 Arkavit tablet - - - - - - - - -
52 Novadex (Dexametason) 0,5 mg tablet - - - - - - - - -
53 Carbidu (Dexametason) 0,5 mg tablet - - - - - - - - -
54 Gralixa (Furosemid) 40 mg tablet - - - - - - - - -
55 Grafazol (Metronidazol) tab 500 mg tablet - - - - - - - - -
56 Glikos (Metformin) tab 500 mg tablet - - - - - - - - -
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - - - - - - - - -
58 Metaneuron (Metamizolesodium + Diazepam) tablet - - - - - - - - -
59 Trifadium ( Loperamide HCL 2 mg) tablet - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

TOTAL 54,399,816 24,034,338 13,176,727 65,257,427 - - - -

MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Am. Keb

Nip. 19670824 198903 2 008
DIAAN, STOK OPNAME DAN MUTASI OBAT

BULAN : FEBRUARI
TAHUN : 2017

DAK BPJS - JKN JUMLAH KESELURUHAN

BUFFER PROVINSI PROGRAM
Stok Awal Penerimaan Pengeluaran Stok Akhir Stok Awal Penerimaan Pengeluaran
Awal Terima Keluar Akhir Awal Terima Keluar Akhir
- - - - - - - - - - - - 102,000 - 12,000
- - - - - - - - - - - - 780,450 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 71,500 14,300
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 131,875 131,875
- - - - - - - - - 100,000 40,000 60,000 - 240,000 120,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 112,200 - 112,200 - 112,200 168,300 280,500
- - - - - - - - - - - - - - -
- - - - - - - - 15,360 - 15,360 - 15,360 51,200 51,200
- - - - - - - - - - - - - - -
- - - - - - - - - 370,000 185,000 185,000 - 740,000 444,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 78,000 - 78,000 - 78,000 117,000 148,200
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 64,000 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 35,200 176,000 123,200 88,000 35,200 352,000 228,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 10,800 48,600 22,950
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 79,800 39,900 39,900 - 119,700 63,840
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 274,000 219,200 54,800 - 657,600 438,400
- - - - - - - - - - - - 100,434 264,300 42,288
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 500,000 400,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 20,400 68,000 88,400 - 20,400 68,000 88,400
- - - - - - - - 41,712 - 1,738 39,974 41,712 - 1,738
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 13,794 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 28,600 - 5,720 22,880 28,600 143,000 34,320
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 267,300 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 404,500 242,700 234,610
- - - - - - - - 27,280 - - 27,280 87,296 27,280 5,456
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 26,250 18,375
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 75,080 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 63,400 158,500 25,360
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 42,700 - 12,200 30,500 42,700 - 12,200
- - - - - - - - - - - - 27,800 55,600 13,900
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 26,618 - 26,618 - 53,236 10,647
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 429,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 103,500 115,000 34,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 163,000 - 16,300
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 31,400 - 31,400 - 31,400 - 31,400
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 9,800 - - 9,800 9,800 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 63,000 27,000
- - - - - - - - - - - - - 110,400 75,900
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 330,000 - 82,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 108,000 54,000 54,000 - 216,000 124,200
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 30,400 91,200 76,000 45,600 30,400 91,200 76,000
- - - - - - - - - 34,470 13,788 20,682 - 34,470 13,788
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 20,986 41,972 46,469 16,489 20,986 41,972 46,469
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 49,862 49,862
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 137,500 110,000 -
- - - - - - - - - - - - 17,500 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 38,400 12,800 2,560
- - - - - - - - - - - - 175,000 175,000 35,000
- - - - - - - - 154,700 - 18,200 136,500 154,700 54,600 18,200
- - - - - - - - - - - - - - -
- - - - - - - - 126,750 - - 126,750 126,750 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 10,000 - - 10,000 17,000 70,000 17,000
- - - - - - - - - - - - 92,800 46,400 11,600
- - - - - - - - 42,250 - - 42,250 194,350 84,500 33,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 63,000 75,600 34,650
- - - - - - - - - - - - - 73,000 65,700
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 517,000 - 51,700
- - - - - - - - - - - - 25,400 25,400 -
- - - - - - - - - - - - 153,120 105,600 -
- - - - - - - - - - - - 211,200 140,800 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 87,500 17,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 60,060 - 39,270 20,790 60,060 - 39,270
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 73,620 73,620
- - - - - - - - - - - - - - -
- - - - - - - - 17,600 88,000 61,600 44,000 17,600 88,000 61,600
- - - - - - - - - 16,885 6,140 10,745 - 16,885 6,140
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 159,000 - -
- - - - - - - - - - - - 100,100 136,500 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 84,700 121,000 90,750
- - - - - - - - - 59,600 14,900 44,700 - 59,600 14,900
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 192,000 192,000 - - 192,000 192,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 176,000 110,000 66,000 - 286,000 220,000
- - - - - - - - 33,500 - 4,020 29,480 33,500 - 4,020
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 99,267 283,620 99,267
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 147,000 44,100
- - - - - - - - - - - - - - -
- - - - - - - - 29,000 145,000 87,000 87,000 29,000 290,000 87,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 4,860 81,000 53,460
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 75,000 120,000 87,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 224,000 128,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 24,420 24,420
- - - - - - - - - 156,300 52,100 104,200 - 156,300 52,100
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - 16,406 - 6,310 10,096 16,406 126,200 44,170

- - - - - - - - - - - - - - -
- - - - - - - - - - (3,030) 3,030 - 101,000 18,180
- - - - - - - - - - - - - 124,800 -
- - - - - - - - - - - - - 84,700 16,940
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 5,124,600 1,921,725
- - - - - - - - 640,575 - - 640,575 16,014,375 5,124,600 640,575
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 137,500 -
- - - - - - - - - - - - - 137,500 -
- - - - - - - - - - - - - 137,500 -
- - - - - - - - - - - - - 137,500 -
- - - - - - - - - - - - - 137,500 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 297,000 297,000
- - - - - - - - - - - - - 297,000 222,750
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 297,000 118,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 924,000 - 924,000 - 924,000 - 924,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 229,500 127,500 12,750
- - - - - - - - - 24,200 24,200 - - 266,200 193,600
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 393,712 178,960 -
- - - - - - - - 89,480 223,700 205,804 107,376 89,480 402,660 232,648
- - - - - - - - - - - - - 178,960 26,844
- - - - - - - - 98,428 - - 98,428 98,428 178,960 26,844
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 135,000 -
- - - - - - - - - - - - - 120,000 -
- - - - - - - - - - - - - - -
- - - - - - - - - 88,000 44,000 44,000 - 308,000 88,000
- - - - - - - - - - - - - 350,000 175,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 612,750 245,100
- - - - - - - - - - - - - 27,230 10,892
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 12,480 12,480
- - - - - - - - - - - - - 26,000 26,000
- - - - - - - - - - - - - 36,380 36,380
- - - - - - - - - - - - - 6,743 6,743
- - - - - - - - - - - - - 396,000 379,500
- - - - - - - - 9,900 99,000 108,900 - 9,900 148,500 158,400
- - - - - - - - - - - - - 48,750 19,500
- - - - - - - - - - - - - 48,750 9,750
- - - - - - - - - - - - - 97,500 -
- - - - - - - - - - - - - 97,500 19,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 16,500 - 8,250 8,250 16,500 - 8,250
- - - - - - - - - - - - 21,117,600 - 2,011,200
- - - - - - - - - - - - 1,240,674 - 620,337
- - - - - - - - - - - - 3,657,429 - 1,219,143
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 27,500 68,750 -

- - - - - - - - - - - - 15,000 - 15,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 250,000 250,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 200,000 200,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 350,000 350,000
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 16,280 8,140 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 545,000 327,000
- - - - - - - - - - - - 65,780 - 65,780
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 7,234,500 - -
- - - - - - - - - - - - - 293,400 122,250
- - - - - - - - - - - - 326,400 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 162,500 162,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - 2,763,187 2,638,745 3,046,239 2,355,693 57,163,003 26,673,083 16,222,966

Inebenggi, 28 Februari 2017

TERLAMBAT
3/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
3/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
3/11/2017
Nip. 19890705 201504 2 001
N

Stok Akhir

90,000
780,450
-
57,200
-
-
120,000
-
-
-
-
-
-
15,360
-
296,000
-
-
46,800
-
-
64,000
-
-
-
-
 -
-
-
-
-
-
-
-
-
-
158,400
-
-
-
-
-
-
-
-
36,450
-
-
55,860
-
-
-
-
-
219,200
322,446
-
100,000
-
-
-
-
-
-
-
 39,974
-
-
13,794
-
-
-
-
-
-
-
-
-
-
-
137,280
-
267,300
-
-
-
-
412,590
109,120
-
-
7,875
-
-
-
-
-
-
-
75,080
-
-
-
-
 -
196,540
-
-
-
-
-
-
-
30,500
69,500
-
-
42,589
-
-
429,000
-
184,000
-
-
-
-
-
-
146,700
-
-
-
-
-
-
-
9,800
-
-
-
-
36,000
 34,500
-
-
-
-
-
-
-
-
-
-
-
-
247,500
-
-
-
-
-
-
91,800
-
-
-
-
-
-
45,600
20,682
-
-
-
-
-
-
-
16,489
-
-
 -
-
-
247,500
17,500
-
-
-
48,640
315,000
191,100
-
126,750
-
-
-
-
-
70,000
127,600
245,050
-
-
103,950
7,300
-
465,300
50,800
258,720
352,000
-
-
-
-
-
-
-
-
-
 70,000
-
-
-
-
-
20,790
-
-
-
-
44,000
10,745
-
-
-
159,000
236,600
-
-
114,950
44,700
-
-
-
-
-
-
-
-
-
-
66,000
29,480
-
-
-
-
-
283,620
-
-
-
-
-
-
-
-
-
-
-
-
-
102,900
-
232,000
-
-
-
-
32,400
-
-
108,000
-
-
-
-
-
-
-
-
95,200
-
-
104,200
-
-
 -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

98,436
-
82,820
124,800
67,760
-
-
 -
-
-
-
-
-
-
-
-
3,202,875
20,498,400
-
137,500
137,500
137,500
137,500
137,500
-
-
-
-
-
-
-
74,250
-
178,200
-
-
-
-
-
-
-
-
-
-
-
-
344,250
72,600
-
-
572,672
259,492
152,116
250,544
-
-
-
-
-
-
-
135,000
120,000
-
220,000
175,000
-
367,650
16,338
-
-
-
-
-
-
-
-
16,500
-
29,250
39,000
97,500
78,000
-
-
 -
-
-
-
-
-
-
-
8,250
19,106,400
620,337
2,438,286
-
-
96,250

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 -
-
24,420
-
-
218,000
-
-
7,234,500
171,150
326,400
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 -
-
-
-
-
-
-
-
-

67,613,120
 Menu

Peringatan

!
 LAPORAN ASSET PERSEDIAAN, ST

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

DAU/PKD
No. Nama Obat Satuan Harga PUSAT
Stok Awal Penerimaan Pengeluaran Stok Akhir
Awal Terima Keluar Akhir
1 Air Untuk Injeksi 20 ml vial 6,000 90,000 - 18,000 72,000 - - - -
2 Albendazole tab 400 mg tablet 363 780,450 - - 780,450 - - - -
3 Albendazole susp 200 mg/5 ml botol 4,234 - - - - - - - -
4 Allopurinol tab 100 mg tablet 143 57,200 - 28,600 28,600 - - - -
5 Allopurinol tab 300 mg tablet 233 - - - - - - - -
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 - - - - - - - -
7 Ambroksol tab 30 mg tablet 200 60,000 - 60,000 - - - - -
8 Aminophyllin tab 200 mg tablet 86 - - - - - - - -
9 Aminophyllin inj 24 mg ampul 4,204 - - - - - - - -
10 Amitriptiline HCl tab 25 mg tablet 123 - - - - - - - -
11 Amlodipin tab 5 mg tablet 197 - - - - - - - -
12 Amlodipin tab 10 mg tablet 935 - - - - - - - -
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 - - - - - - - -
14 Amoxicillin SK 125 mg/5 ml botol 2,560 15,360 - 15,360 - - - - -
15 Amoxicillin tab 250 mg tablet 220 - - - - - - - -
16 Amoxicillin tab 500 mg tablet 370 111,000 - 111,000 - - - - -
17 Ampicillin serb inj 1000 mg vial 5,610 - - - - - - - -
18 Antasida DOEN susp 60 ml botol 2,213 - - - - - - - -
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 78 46,800 - 31,200 15,600 - - - -
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 - - - - - - - -
21 Antifungi DOEN kombinasi 30 g pot 1,890 - - - - - - - -
22 Antihemoroid DOEN suppo supp 3,200 64,000 - - 64,000 - - - -
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - - - - - - - - -
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 3,220 - - - - - - - -
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 - - - - - - - -
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 149 - - - - - - - -
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 1,650 - - - - - - - -
28 Artemether inj 80 mg/mL ampul 24,384 - - - - - - - -
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 - - - - - - - -
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 - - - - - - - -
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 - - - - - - - -
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 - - - - - - - -
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 - - - - - - - -
34 Asam Folat tab 0,4 mg tablet 104 - - - - - - - -
35 Asam Folat tab 1 mg tablet 52 - - - - - - - -
36 Asam Mefenamat tab 250 mg tablet 175 - - - - - - - -
37 Asam Mefenamat tab 500 mg tablet 176 70,400 - 52,800 17,600 - - - -
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 - - - - - - - -
39 Asiklovir tab 200 mg tablet 251 - - - - - - - -
40 Asiklovir tab 400 mg tablet 357 - - - - - - - -
41 Atenolol tab 50 mg tablet 387 - - - - - - - -
42 Atapulgit tab 600 mg tablet 220 - - - - - - - -
43 Atropin tab 0,5 mg tablet 81 - - - - - - - -
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 - - - - - - - -
45 Azitromisin tablet 500 mg kaplet 4,725 - - - - - - - -
46 Bedak Salisil serb 2% Kotak 1,350 36,450 - 22,950 13,500 - - - -
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 - - - - - - - -
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 - - - - - - - -
49 Betametason krim 0,5 mg/g tube 1,596 15,960 - 15,960 - - - - -
50 Betametason tts mata 1 mg/ml botol 25,106 - - - - - - - -
51 Bisakodil sup 5 mg supp 4,990 - - - - - - - -
52 Bisakodil sup 10 mg supp 6,045 - - - - - - - -
53 Bromheksin tab 8 mg tablet 82 - - - - - - - -
54 Cefadroksil kaps 250 mg kapsul 564 - - - - - - - -
55 Cefadroksil kaps/tab 500 mg kapsul 548 164,400 - 164,400 - - - - -
56 Cefadroksil SK 125 mg/5 mL botol 5,286 322,446 - 95,148 227,298 - - - -
57 Cefadroksil SK 250 mg/5 mL botol 6,285 - - - - - - - -
58 Cefiksime tab 100 mg kapsul 1,000 100,000 - 100,000 - - - - -
59 Cefiksime sir 100 mg/5 mL botol 9,400 - - - - - - - -
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 - - - - - - - -
61 Cetrizine tab 10 mg tablet 190 - - - - - - - -
62 Cetrizine sir 5 mg/5 ml botol 8,799 - - - - - - - -
63 Cimetidine tab 200 mg tablet 205 - - - - - - - -
64 Copper T set/buah 125,483 - - - - - - - -
65 Deksametason tab 0,5 mg tablet 68 - - - - - - - -
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 - - - - - - - -
67 Diazepam tab 2 mg tablet 47 - - - - - - - -
68 Diazepam tab 5 mg tablet 179 - - - - - - - -
69 Diazepam inj 5 mg/ml ampul 4,598 13,794 - - 13,794 - - - -
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 - - - - - - - -
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 - - - - - - - -
72 Dietil Karbamazin tab 100 mg tablet 150 - - - - - - - -
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 - - - - - - - -
74 Digoksin tab 0,25 mg tablet 103 - - - - - - - -
75 Diltiazem kaps SR 100 mg kapsul 4,033 - - - - - - - -
76 Diltiazem kaps SR 200 mg kapsul 4,417 - - - - - - - -
77 Diltiazem tab 30 mg tablet 141 - - - - - - - -
78 Dimenhidrinat tab 50 mg tablet 109 - - - - - - - -
79 Doksisiklin kaps 100 mg kapsul 298 - - - - - - - -
80 Domperidon susp 5 mg/5 ml botol 3,490 - - - - - - - -
81 Domperidon tab 10 mg tablet 286 114,400 - 28,600 85,800 - - - -
82 Efedrin inj 50 mg/mL tablet 14,650 - - - - - - - -
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 267,300 - 8,910 258,390 - - - -
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 - - - - - - - -
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 - - - - - - - -
86 Eritromisin kaps 250 mg kapsul 522 - - - - - - - -
87 Eritromisin kaps 500 mg kapsul 1,023 - - - - - - - -
88 Erytromisin SK 200 mg/5 ml botol 8,090 412,590 - - 412,590 - - - -
89 Etakridin (Rivanol) lar 0,1% botol 5,456 81,840 - 32,736 49,104 - - - -
90 Etambutol tab 250 mg tablet 330 - - - - - - - -
91 Etambutol tab 500 mg tablet 478 - - - - - - - -
92 Etanol 70 % lar 100 ml botol 2,625 7,875 13,125 13,125 7,875 - - - -
93 Etil Klorida semprot 100 mL botol 175,500 - - - - - - - -
94 Etonogestrel implan 68 mg subd implant 128,779 - - - - - - - -
95 Fenobarbital tab 30 mg tablet 149 - - - - - - - -
96 Fenobarbital tab 100 mg tablet 242 - - - - - - - -
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 - - - - - - - -
98 Fenol Gliserol tts telinga 10% botol 1,920 - - - - - - - -
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 - - - - - - - -
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 75,080 - - 75,080 - - - -
101 Flukonazol kaps 150 mg kapsul 24,200 - - - - - - - -
102 Fluor tab 0,5 mg tablet 975 - - - - - - - -
103 Furosemid tab 40 mg tablet 84 - - - - - - - -
104 Furosemide inj 10 mg/ml ampul 2,012 - - - - - - - -
105 Gameksan lotion 1% - 30 ml botol 2,420 - - - - - - - -
106 Garam Oralit kombinasi sacchet 317 196,540 - 47,550 148,990 - - - -
107 Gemfibrozil kaps 300 mg kapsul 318 - - - - - - - -
108 Gentamicin krim 10% tube - - - - - - - - -
109 Gentamicin salep kulit 10% tube - - - - - - - - -
110 Gentamicin salep mata 0,3% tube 2,786 - - - - - - - -
111 Gentamicin tts mata 0,3% botol 3,513 - - - - - - - -
112 Gentamisin inj 40 mg/ml ampul 3,739 - - - - - - - -
113 Gentamisin inj 80 mg/ml vial 4,160 - - - - - - - -
114 Glibenklamid tab 5 mg tablet 61 - - - - - - - -
115 Glimepirid tab 1 mg tablet 278 69,500 - 27,800 41,700 - - - -
116 Glimepirid tab 2 mg tablet 458 - - - - - - - -
117 Glipizid tab 5 mg tablet 3,000 - - - - - - - -
118 Gliseril Guaikolat tab 100 mg tablet 27 15,971 - - 15,971 - - - -
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 - - - - - - - -
120 Gliserin lar 50% botol 5,867 - - - - - - - -
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 429,000 - - 429,000 - - - -
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 - - - - - - - -
123 Griseofulvin tab 125 mg tablet 230 184,000 - 23,000 161,000 - - - -
124 Haloperidol tab 0,5 mg tablet 62 - - - - - - - -
125 Haloperidol tab 1,5 mg tablet 76 - - - - - - - -
126 Haloperidol tab 2 mg tablet 134 - - - - - - - -
127 Haloperidol tab 5 mg tablet 105 - - - - - - - -
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 - - - - - - - -
129 Hiosina Butilbromida tab 10 mg tablet 648 - - - - - - - -
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 146,700 - - 146,700 - - - -
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 - - - - - - - -
132 Ibuprofen tab 200 mg tablet 121 - - - - - - - -
133 Ibuprofen tab 400 mg tablet 157 - - - - - - - -
134 Ibuprofen sir 100 mg/5 ml botol 3,849 - - - - - - - -
135 Ibuprofen sir 200 mg/5 ml botol 4,949 - - - - - - - -
136 Isoniazid tab 100 mg tablet 72 - - - - - - - -
137 Isoniazid tab 300 mg tablet 174 - - - - - - - -
138 Isosorbid Dinitrat tab 5 mg tablet 98 - - - - - - - -
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 - - - - - - - -
140 Kalsium Karbonat tab 500 mg tablet 448 - - - - - - - -
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 - - - - - - - -
142 Kanamisin inj 1.000 mg/vial vial 5,100 - - - - - - - -
143 Kaptopril tab 12,5 mg tablet 90 36,000 - 18,000 18,000 - - - -
144 Kaptopril tab 25 mg tablet 138 34,500 - 34,500 - - - - -
145 Kaptopril tab 50 mg tablet 141 - - - - - - - -
146 Karbamazepin tab 200 mg tablet 269 - - - - - - - -
147 Karbamazepin sir 100 mg/5 mL botol 44,770 - - - - - - - -
148 Karbogliserin tts telinga 10% botol 2,246 - - - - - - - -
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 - - - - - - - -
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 - - - - - - - -
151 Ketokonazole krim 2% - 15 g tube 5,150 - - - - - - - -
152 Ketokonazole tab 200 mg tablet 320 - - - - - - - -
153 Klaritromisin tab 500 mg tablet 3,600 - - - - - - - -
154 Klindamisin kaps 150 mg kapsul 405 - - - - - - - -
155 Klindamisin kaps 300 mg kapsul 619 - - - - - - - -
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 - - - - - - - -
157 Kloramfenikol kaps 250 mg kapsul 275 247,500 - - 247,500 - - - -
158 Kloramfenikol kaps 500 mg kapsul 935 - - - - - - - -
159 Kloramfenikol salap mata 1% tube 1,680 - - - - - - - -
160 Kloramfenikol salep kulit 2% tube 4,138 - - - - - - - -
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 - - - - - - - -
162 Kloramfenikol tts mata 0,5% botol 20,360 - - - - - - - -
163 Kloramfenikol tts telinga 3% botol 11,440 - - - - - - - -
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 37,800 - 10,800 27,000 - - - -
165 Klorpromazin HCl tab 25 mg tablet 75 - - - - - - - -
166 Klorpromazin HCl tab 100 mg tablet 162 - - - - - - - -
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 - - - - - - - -
168 Kodein HCL tab 10 mg tablet 550 - - - - - - - -
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - - - - - - - - -
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 2,298 - - - - - - - -
171 Kotrimoxazol tab 480 mg (adult) tablet 152 - - - - - - - -
172 Kotrimoxazol susp 60 ml botol 2,298 - - - - - - - -
173 Kuinin tab 200 mg tablet 737 - - - - - - - -
174 Kuinin tab 222 mg tablet 594 - - - - - - - -
175 Kuinin inj 25% (i.v) ampul 6,820 - - - - - - - -
176 Levofloxacin tab 500 mg tablet 581 - - - - - - - -
177 Levofloxacin inf 5 mg/mL botol 43,809 - - - - - - - -
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - - - - - - - - -
179 Lidokain inj 1% (infltr) ampul 929 - - - - - - - -
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 - - - - - - - -
181 Lidokain gel 2% botol 40,000 - - - - - - - -
182 Lidokain semprot 10% botol 156,200 - - - - - - - -
183 Lisol lar 1.000 ml botol 49,862 - - - - - - - -
184 Loratadin tab 10 mg tablet 333 - - - - - - - -
185 Magnesium Sulfat serb 30 g sacchet 3,803 - - - - - - - -
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 247,500 - - 247,500 - - - -
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 17,500 - - 17,500 - - - -
188 Mebendazol tab 100 mg tablet 7,150 - - - - - - - -
189 Mebendazol tab 500 mg tablet 7,854 - - - - - - - -
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 - - - - - - - -
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 48,640 - 2,560 46,080 - - - -
192 Metampiron (Antalgin) tab 500 mg tablet 350 315,000 - 70,000 245,000 - - - -
193 Metformin tab 500 mg tablet 182 54,600 - - 54,600 - - - -
194 Metformin tab 850 mg tablet 280 - - - - - - - -
195 Metilergometrin Maleat tab 0.125 mg tablet 169 - - - - - - - -
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 - - - - - - - -
197 Metilprednisolon tab 4 mg tablet 230 - - - - - - - -
198 Metilprednisolon tab 8 mg tablet 390 - - - - - - - -
199 Metilprednisolon tab 16 mg tablet 875 - - - - - - - -
200 Metoklopramid tab 5 mg tablet 113 - - - - - - - -
201 Metoklopramid tab 10 mg tablet 100 60,000 - 20,000 40,000 - - - -
202 Metronidazol tab 250 mg tablet 116 127,600 - - 127,600 - - - -
203 Metronidazol tab 500 mg tablet 169 202,800 - 16,900 185,900 - - - -
204 Metronidazol sir 125 mg/5 ml botol 4,350 - - - - - - - -
205 Metronidazol lar inf 5 mg/mL botol 12,980 - - - - - - - -
206 Miconazole krim 2% tube 3,150 103,950 - 18,900 85,050 - - - -
207 Natrium Diklofenak tab 25 mg tablet 146 7,300 - 7,300 - - - - -
208 Natrium Diklofenak tab 50 mg tablet 193 - - - - - - - -
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 465,300 - 51,700 413,600 - - - -
210 Nifedipine tab 10 mg tablet 127 50,800 - - 50,800 - - - -
211 Nistatin tab vaginal 100.000 IU ovula 528 258,720 - - 258,720 - - - -
212 Nistatin tab vaginal 500.000 IU tablet 704 352,000 - - 352,000 - - - -
213 Obat Anti TB Kategori Anak Paket 189,195 - - - - - - - -
214 Obat Anti TB Kategori Anak FDC Paket 236,490 - - - - - - - -
215 Obat Anti TB Kategori I Paket 317,015 - - - - - - - -
216 Obat Anti TB Kategori I FDC Paket 396,000 - - - - - - - -
217 Obat Anti TB Kategori I Kombipak Paket 316,920 - - - - - - - -
218 Obat Anti TB Kategori II Paket 1,320,000 - - - - - - - -
219 Obat Anti TB Kategori II FDC Paket 1,319,990 - - - - - - - -
220 Obat Anti TB Kategori III Paket 154,000 - - - - - - - -
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 - - - - - - - -
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 70,000 - 45,500 24,500 - - - -
223 Ofloxacin tab 200 mg tablet 440 - - - - - - - -
224 Ofloxacin tab 400 mg tablet 700 - - - - - - - -
225 Oksimetazolin tts hidung 0,025 % botol 30,305 - - - - - - - -
226 Oksimetazolin tts hidung 0,050 % botol 32,000 - - - - - - - -
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 - - - - - - - -
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 - - - - - - - -
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 - - - - - - - -
230 Olopatadin tts mata 0,1% botol 68,000 - - - - - - - -
231 Omeprazol kaps 20 mg kapsul 409 - - - - - - - -
232 Omeprazol inj 40 mg/10 mL vial 42,000 - - - - - - - -
233 Paracetamol tab 500 mg tablet 88 - - - - - - - -
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 - - - - - - - -
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 - - - - - - - -
236 Perak Sulfadiazin krim 1% tube 25,350 - - - - - - - -
237 Permetrin krim 5% tube 11,475 - - - - - - - -
238 Pirantel Pamoat tab 125 mg tablet 318 159,000 - 27,984 131,016 - - - -
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 236,600 - - 236,600 - - - -
240 Pirazinamid tab 500 mg tablet 225 - - - - - - - -
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 - - - - - - - -
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 114,950 - - 114,950 - - - -
243 Piroxicam tab 10 mg tablet 149 - - - - - - - -
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 - - - - - - - -
245 Povidon Iodida lar 10% - 300 ml botol 15,386 - - - - - - - -
246 Povidon Iodida lar 10% - 60 ml botol 6,500 - - - - - - - -
247 Povidon Iodida lar 10% - 30 ml botol 2,344 - 11,720 11,720 - - - - -
248 Prednison tab 5 mg tablet 192 - - - - - - - -
249 Primakuin tab 15 mg tablet 205 - - - - - - - -
250 Probenesid tab 500 mg tablet 1,815 - - - - - - - -
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 - - - - - - - -
252 Propranolol tab 10 mg tablet 80 - - - - - - - -
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 - - - - - - - -
254 Ranitidin tab 150 mg tablet 220 - - - - - - - -
255 Ranitidin inj 25 mg/mL ampul 1,340 - - - - - - - -
256 Retinol (Vit A) softcap 100.000 IU softcap 286 - - - - - - - -
257 Retinol (Vit A) softcap 200.000 IU softcap 505 - - - - - - - -
258 Rifampicin kaps 300 mg kapsul 670 - - - - - - - -
259 Rifampicin tab 450 mg tablet 868 - - - - - - - -
260 Rifampicin tab 600 mg tablet 1,209 - - - - - - - -
261 Ringer Laktat lar inf steril 500 ml botol 4,727 283,620 - 61,451 222,169 - - - -
262 Salbutamol tab 2 mg tablet 65 - - - - - - - -
263 Salbutamol tab 4 mg tablet 93 - - - - - - - -
264 Salbutamol cairan ih 0,1% botol 7,260 - - - - - - - -
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 - - - - - - - -
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 - - - - - - - -
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 - - - - - - - -
268 Serum Antidifteri inj 10,000 IU vial - - - - - - - - -
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 - - - - - - - -
270 Serum Antitetanus inj 1.500 IU vial 161,000 - - - - - - - -
271 Serum Antitetanus inj 10.000 IU vial - - - - - - - - -
272 Serum Antitetanus inj 20.000 IU vial 324,550 - - - - - - - -
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 - - - - - - - -
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 - - - - - - - -
275 Simvastatin tab 10 mg tablet 294 102,900 - 44,100 58,800 - - - -
276 Simvastatin tab 20 mg tablet 480 - - - - - - - -
277 Siprofloksasin tab 500 mg tablet 290 145,000 - 58,000 87,000 - - - -
278 Spironolakton tab 25 mg tablet 350 - - - - - - - -
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 - - - - - - - -
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 112 - - - - - - - -
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 - - - - - - - -
282 Tetrasiklin kaps 250 mg kapsul 162 32,400 - - 32,400 - - - -
283 Tetrasiklin kaps 500 mg kapsul 325 - - - - - - - -
284 Thiamfenikol kaps 500 mg kapsul 985 - - - - - - - -
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 108,000 - 48,000 60,000 - - - -
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 - - - - - - - -
287 Tramadol inj 50 mg/mL ampul 2,680 - - - - - - - -
288 Triheksipenidil tab 2 mg tablet 70 - - - - - - - -
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 - - - - - - - -
290 Valproat tab sal 250 mg tablet salut 1,680 - - - - - - - -
291 Valproat tab sal 500 mg tablet salut 5,450 - - - - - - - -
292 Valproat sir 250 mg/5 mL botol 41,800 - - - - - - - -
293 Vankomisin serb inj 500 mg/vial vial 142,000 - - - - - - - -
294 Vitamin B Kompleks tablet 112 95,200 - 95,200 - - - - -
295 Zinc sir 10 mg/ml botol 16,478 - - - - - - - -
296 Zinc sir 20 mg/5 ml botol 8,140 - - - - - - - -
297 Zinc dispersible 20 mg tablet 521 - - - - - - - -
298 Alprazolam tab 1 mg tablet 245 - - - - - - - -
299 Betahistin tab 6 mg tablet - - - - - - - - -
300 Idometasin kapl 25 mg kaplet 380 - - - - - - - -
301 Karbon Aktif tab 125 mg tablet 127 - - - - - - - -
302 Klobazam tab 10 mg tablet 950 - - - - - - - -
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 - - - - - - - -
304 Loperamid tab 2 mg tablet 97 - - - - - - - -
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 - - - - - - - -
306 Papaverin 40 mg tablet - - - - - - - - -
307 Piracetam tab 400 mg tablet - - - - - - - - -
308 Thiamfenikol tab 250 mg tablet - - - - - - - - -
309 Piracetam tab 800 mg tablet - - - - - - - - -
310 Piroxicam tab 20 mg tablet - - - - - - - - -
311 Asam Askorbat (Vit.C) tab 25 mg tablet - - - - - - - - -
312 Etanol 70% lar 1000 ml botol - - - - - - - - -
313 Etanol 70% lar 300 ml botol - - - - - - - - -
314 Neurosanbe injeksi ampul - - - - - - - - -
315 H2O2 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 1,262 88,340 - 39,122 49,218 - - - -
2 Alat Suntik 2.5 ml pcs 1,102 - - - - - - - -
3 Alat Suntik 3 ml pcs 1,010 79,790 - 41,410 38,380 - - - -
4 Alat Suntik 5 ml pcs 1,248 124,800 - - 124,800 - - - -
5 Alat Suntik 10 ml pcs 1,694 67,760 - 5,082 62,678 - - - -
6 Alat Suntik 20 ml pcs 2,228 - - - - - - - -
7 Alat Suntik 50 ml pcs 10,350 - - - - - - - -
8 Alat Suntik ADS 0,5 ml pcs 1,925 - - - - - - - -
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 - - - - - - - -
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 - - - - - - - -
11 Alat Suntik ADS 5 ml BCG pcs 2,585 - - - - - - - -
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 - - - - - - - -
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 - - - - - - - -
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 - - - - - - - -
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 - - - - - - - -
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 - - - - - - - -
17 Catgut no.2/0 pcs 213,525 3,202,875 - 2,135,250 1,067,625 - - - -
18 Catgut no.3/0 pcs 213,525 19,857,825 - - 19,857,825 - - - -
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 - - - - - - - -
20 Catheter (folley cathteter) no.10 pcs 13,750 137,500 - 13,750 123,750 - - - -
21 Catheter (folley cathteter) no.12 pcs 13,750 137,500 - - 137,500 - - - -
22 Catheter (folley cathteter) no.14 pcs 13,750 137,500 - 55,000 82,500 - - - -
23 Catheter (folley cathteter) no.16 pcs 13,750 137,500 - 27,500 110,000 - - - -
24 Catheter (folley cathteter) no.18 pcs 13,750 137,500 - - 137,500 - - - -
25 Cholesterol test btl/10 strip botol 320,000 - - - - - - - -
26 Copper T set 125,000 - - - - - - - -
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 - - - - - - - -
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 - - - - - - - -
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 - - - - - - - -
30 Glukosa test btl/25 strip botol 180,000 - - - - - - - -
31 Hand Schoen no 7 set 14,850 - - - - - - - -
32 Hand Schoen no 7.5 set 14,850 74,250 - 74,250 - - - - -
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
34 Hand Schoen no 8 set 14,850 178,200 - 178,200 - - - - -
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 - - - - - - - -
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 - - - - - - - -
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 - - - - - - - -
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 - - - - - - - -
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 - - - - - - - -
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 - - - - - - - -
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 - - - - - - - -
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 - - - - - - - -
44 Hand Schoen (Examination Gloves Size S) set 57,750 - - - - - - - -
45 Hand Schoen (Examination Gloves Size M) set 57,750 - - - - - - - -
46 Hand Schoen (Examination Gloves Size L) set 57,750 - - - - - - - -
47 Infusion Set Anak set 6,375 344,250 - 25,500 318,750 - - - -
48 Infusion Set Dewasa set 12,100 72,600 - 72,600 - - - - -
49 Infusion Set Macro 2 Cabang set 35,000 - - - - - - - -
50 IV Catheter no. 16 pcs 8,948 - - - - - - - -
51 IV Catheter no. 18 pcs 8,948 572,672 - - 572,672 - - - -
52 IV Catheter no. 20 pcs 8,948 152,116 - 80,532 71,584 - - - -
53 IV Catheter no. 22 pcs 8,948 152,116 - - 152,116 - - - -
54 IV Catheter no. 24 pcs 8,948 152,116 - 8,948 143,168 - - - -
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 - - - - - - - -
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 - - - - - - - -
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 - - - - - - - -
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 - - - - - - - -
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 - - - - - - - -
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 - - - - - - - -
61 Jarum Jahit Otot all size lusin 18,500 - - - - - - - -
62 Jarum Jahit 1/2 Surgical lusin 135,000 135,000 - - 135,000 - - - -
63 Jarum Jahit 3/8 Surgical lusin 120,000 120,000 - - 120,000 - - - -
64 Kaca Slide pcs 50,000 - - - - - - - -
65 Kapas Pembalut 250 g roll 22,000 176,000 - 44,000 132,000 - - - -
66 Kapas Pembalut 500 g roll 35,000 175,000 - - 175,000 - - - -
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 - - - - - - - -
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 367,650 - 122,550 245,100 - - - -
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 16,338 - 2,723 13,615 - - - -
70 Kasa Pembalut 2 m x 80 cm roll 13,366 - - - - - - - -
71 Kasa Pembalut 4 m x 5 cm roll - - - - - - - - -
72 Kasa Pembalut 4 m x 10 cm roll 2,601 - - - - - - - -
73 Kasa Pembalut 4 m x 15 cm roll - - - - - - - - -
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 - - - - - - - -
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 - - - - - - - -
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 - - - - - - - -
77 Kasa Steril 16 cm x 16 cm box 6,743 - - - - - - - -
78 Kasa Steril 18 cm x 22 cm box 16,500 16,500 - 16,500 - - - - -
79 Masker Ear Loop Pcs 495 - - - - - - - -
80 Mata Pisau Bedah No. 10 pcs 9,750 29,250 - 9,750 19,500 - - - -
81 Mata Pisau Bedah No. 11 Pcs 9,750 39,000 - 19,500 19,500 - - - -
82 Mata Pisau Bedah No. 15 Pcs 9,750 97,500 - 9,750 87,750 - - - -
83 Mata Pisau Bedah No. 21 Pcs 9,750 78,000 - 9,750 68,250 - - - -
84 Nasal Oxygen (Aximed) size M Pcs 6,600 - - - - - - - -
85 Nasal Oxygen (Aximed) size L Pcs 6,600 - - - - - - - -
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 - - - - - - - -
87 Plester 5 yard x 2 inchi roll 7,186 - - - - - - - -
88 Plester 5 cm x 4,5 cm roll - - - - - - - - -
89 Plester 7,5 cm x 4,5 cm roll 34,650 - - - - - - - -
90 Pot Sputum pot 2,000 - - - - - - - -
91 RDT pcs - - - - - - - - -
92 Regulator Oxygen pcs 450,000 - - - - - - - -
93 Safety Box kotak - - - - - - - - -
94 Selang Oxygen pcs 8,250 - - - - - - - -
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 19,106,400 - 1,005,600 18,100,800 - - - -
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 620,337 - 413,558 206,779 - - - -
97 Sound Timer unit 1,219,143 2,438,286 - - 2,438,286 - - - -
98 Stempel ISPA pcs - - - - - - - - -
99 Uric Acid test btl/25 strip botol 240,000 - - - - - - - -
100 Urine bag pcs 6,875 96,250 - - 96,250 - - - -

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 15,000 - - - - - - - -
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 - - - - - - - -
3 Larutan Asam Klorida (HCl) 0,1 N botol - - - - - - - - -
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 - - - - - - - -
5 Larutan Benedik botol 40,040 - - - - - - - -
6 Larutan Eosin 2% botol 36,595 - - - - - - - -
7 Larutan Etanol Asam botol 34,126 - - - - - - - -
8 Larutan Giemsa Stein botol 63,348 - - - - - - - -
9 Larutan Karbol Fuksin botol 23,231 - - - - - - - -
10 Larutan Metanol botol 118,300 - - - - - - - -
11 Larutan Metilen Biru botol 17,086 - - - - - - - -
12 Larutan Turk botol 54,600 - - - - - - - -
13 Reagen TBC kit - - - - - - - - -
14 Test Asam Urat test 250,000 - - - - - - - -
15 Test Comburt Reagens set 251,200 - - - - - - - -
16 Test Golongan Darah set 286,365 - - - - - - - -
17 Test Golongan Darah Reagens set 251,200 - - - - - - - -
18 Test Gula Darah test 200,000 - - - - - - - -
19 Test Kehamilan strip 2,400 - - - - - - - -
20 Test Kolesterol test 350,000 - - - - - - - -
21 Test Urine Rutin strip 3,000 - - - - - - - -

GIGI
1 Air raksa Dental Use - 108,195 - - - - - - - -
2 Devitalisasi pasta (arsen) kotak 390,000 - - - - - - - -
3 Eugenol cairan 10 ml botol 18,333 - - - - - - - -
4 Fluoride 0.5 mg tablet 30,000 - - - - - - - -
5 Fluoride 1 mg tablet 4,456 - - - - - - - -
6 Hemospon (Spongostan Dental) pcs 536,250 - - - - - - - -
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 - - - - - - - -
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 - - - - - - - -
9 Kalsium Hidroksida Pasta tube 341,250 - - - - - - - -
10 Klorheksidin lar 0,2% botol - - - - - - - - -
11 Klorheksidin lar 15% botol - - - - - - - - -
12 Mata Bor Gigi pcs 48,750 - - - - - - - -
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 - - - - - - - -
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 - - - - - - - -
15 Trikresol Formalin (TKF) cairan botol 7,239 - - - - - - - -

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 - - - - - - - -
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 - - - - - - - -
3 Becefort sir 60 ml botol 26,230 - - - - - - - -
4 Bronex (Bromheksin) tab 8 mg tablet 82 - - - - - - - -
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 - - - - - - - -
6 Fluoride 1 mg tablet 976 - - - - - - - -
7 Kandistatin susp 12 ml botol 36,300 - - - - - - - -
8 KY Jelly tube 85,000 - - - - - - - -
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 - - - - - - - -
10 Norit (Karbon Aktif) tab 125 mg tablet - - - - - - - - -
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 - - - - - - - -
12 Pehavral tablet salut 70,785 - - - - - - - -
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 - - - - - - - -
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 - - - - - - - -
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 - - - - - - - -
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 - - - - - - - -
17 Vaksin Antirabies Vero (VAR) vial 48,400 - - - - - - - -
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 24,420 - 24,420 - - - - -
19 Cendo Xytrol TM 5 ml botol 35,850 - - - - - - - -
20 Formalin 40 % botol 42,000 - - - - - - - -
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 218,000 - 218,000 - - - - -
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 - - - - - - - -
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 - - - - - - - -
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 7,234,500 - 1,446,900 5,787,600 - - - -
25 Vical susp 100 ml botol 4,890 171,150 - 88,020 83,130 - - - -
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 326,400 - - 326,400 - - - -
27 Vinafluor (Fluoride) kapl 1 mg kaplet - - - - - - - - -
28 Sanmol (Parasetamol) 500 mg tablet 325 - - - - - - - -
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 - - - - - - - -
30 Purecemia (Allopurinol) 300 mg tablet 3,269 - - - - - - - -
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 - - - - - - - -
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 - - - - - - - -
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 - - - - - - - -
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 - - - - - - - -
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 - - - - - - - -
36 Histigo (Betahistin) tab 6 mg tablet - - - - - - - - -
37 Novadium (Loperamid) tab 2 mg tablet - - - - - - - - -
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - - - - - - - - -
39 Metolon (Metoklorperamid) tab 10 mg tablet - - - - - - - - -
40 Novabion tablet - - - - - - - - -
41 Novagesic (Parasetamol) tab 500 mg tablet - - - - - - - - -
42 Defamol (Parasetamol) tab 500 mg tablet - - - - - - - - -
43 Sultrimix syrup botol - - - - - - - - -
44 Biovitan syrup botol - - - - - - - - -
45 Caviplex syrup botol - - - - - - - - -
46 Farsifen (Ibuprofen) syrup botol - - - - - - - - -
47 Novaxifen (Ibuprofen) tab 200 mg tablet - - - - - - - - -
48 Lexigo (Betahistin) tab 6 mg tablet - - - - - - - - -
49 Loric (Allopurinol) tab 100 mg tablet - - - - - - - - -
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - - - - - - - - -
51 Arkavit tablet - - - - - - - - -
52 Novadex (Dexametason) 0,5 mg tablet - - - - - - - - -
53 Carbidu (Dexametason) 0,5 mg tablet - - - - - - - - -
54 Gralixa (Furosemid) 40 mg tablet - - - - - - - - -
55 Grafazol (Metronidazol) tab 500 mg tablet - - - - - - - - -
56 Glikos (Metformin) tab 500 mg tablet - - - - - - - - -
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - - - - - - - - -
58 Metaneuron (Metamizolesodium + Diazepam) tablet - - - - - - - - -
59 Trifadium ( Loperamide HCL 2 mg) tablet - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

TOTAL 65,257,427 24,845 7,727,919 57,554,353 - - - -

MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
DIAAN, STOK OPNAME DAN MUTASI OBAT

BULAN : MARET
TAHUN : 2017

DAK BPJS - JKN JUMLAH KESELURUHAN

BUFFER PROVINSI PROGRAM
Stok Awal Penerimaan Pengeluaran Stok Akhir Stok Awal Penerimaan Pengeluaran
Awal Terima Keluar Akhir Awal Terima Keluar Akhir
- - - - - - - - - - - - 90,000 - 18,000
- - - - - - - - - - - - 780,450 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 57,200 - 28,600
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 60,000 - 20,000 40,000 120,000 - 80,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 15,360 - 15,360
- - - - - - - - - - - - - - -
- - - - - - - - 185,000 - 185,000 - 296,000 - 296,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 46,800 - 31,200
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 64,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 88,000 - 88,000 - 158,400 - 140,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 36,450 - 22,950
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 39,900 - 7,980 31,920 55,860 - 23,940
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 54,800 - 54,800 - 219,200 - 219,200
- - - - - - - - - - - - 322,446 - 95,148
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 100,000 - 100,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 39,974 - - 39,974 39,974 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 13,794 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 22,880 - - 22,880 137,280 - 28,600
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 267,300 - 8,910
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 412,590 - -
- - - - - - - - 27,280 - 5,456 21,824 109,120 - 38,192
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 7,875 13,125 13,125
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 75,080 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 196,540 - 47,550
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 30,500 - 6,100 24,400 30,500 - 6,100
- - - - - - - - - - - - 69,500 - 27,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 26,618 - 26,618 - 42,589 - 26,618
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 429,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 184,000 - 23,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 146,700 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 9,800 - - 9,800 9,800 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 36,000 - 18,000
- - - - - - - - - - - - 34,500 - 34,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 247,500 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 54,000 - - 54,000 91,800 - 10,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 45,600 - 15,200 30,400 45,600 - 15,200
- - - - - - - - 20,682 - 20,682 - 20,682 - 20,682
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 16,489 - 16,489 - 16,489 - 16,489
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 247,500 - -
- - - - - - - - - - - - 17,500 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 48,640 - 2,560
- - - - - - - - - - - - 315,000 - 70,000
- - - - - - - - 136,500 - 36,400 100,100 191,100 - 36,400
- - - - - - - - - - - - - - -
- - - - - - - - 126,750 - - 126,750 126,750 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 10,000 - - 10,000 70,000 - 20,000
- - - - - - - - - - - - 127,600 - -
- - - - - - - - 42,250 - - 42,250 245,050 - 16,900
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 103,950 - 18,900
- - - - - - - - - - - - 7,300 - 7,300
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 465,300 - 51,700
- - - - - - - - - - - - 50,800 - -
- - - - - - - - - - - - 258,720 - -
- - - - - - - - - - - - 352,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 70,000 - 45,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 20,790 - 20,790 - 20,790 - 20,790
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 44,000 - 44,000 - 44,000 - 44,000
- - - - - - - - 10,745 - 10,745 - 10,745 - 10,745
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 159,000 - 27,984
- - - - - - - - - - - - 236,600 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 114,950 - -
- - - - - - - - 44,700 - 44,700 - 44,700 - 44,700
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 11,720 11,720
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 66,000 - 66,000 - 66,000 - 66,000
- - - - - - - - 29,480 - 2,680 26,800 29,480 - 2,680
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 283,620 - 61,451
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 102,900 - 44,100
- - - - - - - - - - - - - - -
- - - - - - - - 87,000 - 29,000 58,000 232,000 - 87,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 32,400 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 108,000 - 48,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 95,200 - 95,200
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 104,200 - 52,100 52,100 104,200 - 52,100
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - 10,096 - - 10,096 98,436 - 39,122

- - - - - - - - - - - - - - -
- - - - - - - - 3,030 - 3,030 - 82,820 - 44,440
- - - - - - - - - - - - 124,800 - -
- - - - - - - - - - - - 67,760 - 5,082
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 3,202,875 - 2,135,250
- - - - - - - - 640,575 - 427,050 213,525 20,498,400 - 427,050
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 137,500 - 13,750
- - - - - - - - - - - - 137,500 - -
- - - - - - - - - - - - 137,500 - 55,000
- - - - - - - - - - - - 137,500 - 27,500
- - - - - - - - - - - - 137,500 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 74,250 - 74,250
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 178,200 - 178,200
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 344,250 - 25,500
- - - - - - - - - - - - 72,600 - 72,600
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 572,672 - -
- - - - - - - - 107,376 - 107,376 - 259,492 - 187,908
- - - - - - - - - - - - 152,116 - -
- - - - - - - - 98,428 - 53,688 44,740 250,544 - 62,636
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 135,000 - -
- - - - - - - - - - - - 120,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - 44,000 - - 44,000 220,000 - 44,000
- - - - - - - - - - - - 175,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 367,650 - 122,550
- - - - - - - - - - - - 16,338 - 2,723
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 16,500 - 16,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 29,250 - 9,750
- - - - - - - - - - - - 39,000 - 19,500
- - - - - - - - - - - - 97,500 - 9,750
- - - - - - - - - - - - 78,000 - 9,750
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 8,250 - 8,250 - 8,250 - 8,250
- - - - - - - - - - - - 19,106,400 - 1,005,600
- - - - - - - - - - - - 620,337 - 413,558
- - - - - - - - - - - - 2,438,286 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 96,250 - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 24,420 - 24,420
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 218,000 - 218,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 7,234,500 - 1,446,900
- - - - - - - - - - - - 171,150 - 88,020
- - - - - - - - - - - - 326,400 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - 2,355,693 - 1,352,134 1,003,559 67,613,120 24,845 9,080,053

Inebenggi, 31 Maret 2017

TERLAMBAT
4/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
4/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
4/11/2017
Nip. 19890705 201504 2 001
N

Stok Akhir

72,000
780,450
-
28,600
-
-
40,000
-
-
-
-
-
-
-
-
-
-
-
15,600
-
-
64,000
-
-
-
-
 -
-
-
-
-
-
-
-
-
-
17,600
-
-
-
-
-
-
-
-
13,500
-
-
31,920
-
-
-
-
-
-
227,298
-
-
-
-
-
-
-
-
-
 39,974
-
-
13,794
-
-
-
-
-
-
-
-
-
-
-
108,680
-
258,390
-
-
-
-
412,590
70,928
-
-
7,875
-
-
-
-
-
-
-
75,080
-
-
-
-
 -
148,990
-
-
-
-
-
-
-
24,400
41,700
-
-
15,971
-
-
429,000
-
161,000
-
-
-
-
-
-
146,700
-
-
-
-
-
-
-
9,800
-
-
-
-
18,000
 -
-
-
-
-
-
-
-
-
-
-
-
-
247,500
-
-
-
-
-
-
81,000
-
-
-
-
-
-
30,400
-
-
-
-
-
-
-
-
-
-
-
 -
-
-
247,500
17,500
-
-
-
46,080
245,000
154,700
-
126,750
-
-
-
-
-
50,000
127,600
228,150
-
-
85,050
-
-
413,600
50,800
258,720
352,000
-
-
-
-
-
-
-
-
-
 24,500
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
131,016
236,600
-
-
114,950
-
-
-
-
-
-
-
-
-
-
-
-
26,800
-
-
-
-
-
222,169
-
-
-
-
-
-
-
-
-
-
-
-
-
58,800
-
145,000
-
-
-
-
32,400
-
-
60,000
-
-
-
-
-
-
-
-
-
-
-
52,100
-
-
 -
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

59,314
-
38,380
124,800
62,678
-
-
 -
-
-
-
-
-
-
-
-
1,067,625
20,071,350
-
123,750
137,500
82,500
110,000
137,500
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
318,750
-
-
-
572,672
71,584
152,116
187,908
-
-
-
-
-
-
-
135,000
120,000
-
176,000
175,000
-
245,100
13,615
-
-
-
-
-
-
-
-
-
-
19,500
19,500
87,750
68,250
-
-
 -
-
-
-
-
-
-
-
-
18,100,800
206,779
2,438,286
-
-
96,250

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
-
-

-
-
-
-
-
-
-
-
-
-
-
-
-
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 Menu

Peringatan

!
 LAPORAN ASSET PERSEDIAAN, ST

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

DAU/PKD
No. Nama Obat Satuan Harga PUSAT
Stok Awal Penerimaan Pengeluaran Stok Akhir
Awal Terima Keluar Akhir
1 Air Untuk Injeksi 20 ml vial 6,000 72,000 - 24,000 48,000 - - - -
2 Albendazole tab 400 mg tablet 363 780,450 - - 780,450 - - - -
3 Albendazole susp 200 mg/5 ml botol 4,234 - - - - - - - -
4 Allopurinol tab 100 mg tablet 143 28,600 - 28,600 - - - - -
5 Allopurinol tab 300 mg tablet 233 - - - - - - - -
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 - - - - - - - -
7 Ambroksol tab 30 mg tablet 200 - - - - - - - -
8 Aminophyllin tab 200 mg tablet 86 - - - - - - - -
9 Aminophyllin inj 24 mg ampul 4,204 - - - - - - - -
10 Amitriptiline HCl tab 25 mg tablet 123 - - - - - - - -
11 Amlodipin tab 5 mg tablet 197 - - - - - - - -
12 Amlodipin tab 10 mg tablet 935 - - - - - - - -
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 - - - - - - - -
14 Amoxicillin SK 125 mg/5 ml botol 2,560 - - - - - - - -
15 Amoxicillin tab 250 mg tablet 220 - - - - - - - -
16 Amoxicillin tab 500 mg tablet 370 - - - - - - - -
17 Ampicillin serb inj 1000 mg vial 5,610 - - - - - - - -
18 Antasida DOEN susp 60 ml botol 2,213 - - - - - - - -
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidrotablet 78 15,600 - 15,600 - - - - -
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 - - - - - - - -
21 Antifungi DOEN kombinasi 30 g pot 1,890 - - - - - - - -
22 Antihemoroid DOEN suppo supp 3,200 64,000 - - 64,000 - - - -
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - - - - - - - - -
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 3,220 - - - - - - - -
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 - - - - - - - -
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 149 - - - - - - - -
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 1,650 - - - - - - - -
28 Artemether inj 80 mg/mL ampul 24,384 - - - - - - - -
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 - - - - - - - -
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 - - - - - - - -
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 - - - - - - - -
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 - - - - - - - -
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 - - - - - - - -
34 Asam Folat tab 0,4 mg tablet 104 - - - - - - - -
35 Asam Folat tab 1 mg tablet 52 - - - - - - - -
36 Asam Mefenamat tab 250 mg tablet 175 - - - - - - - -
37 Asam Mefenamat tab 500 mg tablet 176 17,600 - 17,600 - - - - -
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 - - - - - - - -
39 Asiklovir tab 200 mg tablet 251 - - - - - - - -
40 Asiklovir tab 400 mg tablet 357 - - - - - - - -
41 Atenolol tab 50 mg tablet 387 - - - - - - - -
42 Atapulgit tab 600 mg tablet 220 - - - - - - - -
43 Atropin tab 0,5 mg tablet 81 - - - - - - - -
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 - - - - - - - -
45 Azitromisin tablet 500 mg kaplet 4,725 - - - - - - - -
46 Bedak Salisil serb 2% Kotak 1,350 13,500 - 6,750 6,750 - - - -
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 - - - - - - - -
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 - - - - - - - -
49 Betametason krim 0,5 mg/g tube 1,596 - - - - - - - -
50 Betametason tts mata 1 mg/ml botol 25,106 - - - - - - - -
51 Bisakodil sup 5 mg supp 4,990 - - - - - - - -
52 Bisakodil sup 10 mg supp 6,045 - - - - - - - -
53 Bromheksin tab 8 mg tablet 82 - - - - - - - -
54 Cefadroksil kaps 250 mg kapsul 564 - - - - - - - -
55 Cefadroksil kaps/tab 500 mg kapsul 548 - - - - - - - -
56 Cefadroksil SK 125 mg/5 mL botol 5,286 227,298 - 126,864 100,434 - - - -
57 Cefadroksil SK 250 mg/5 mL botol 6,285 - - - - - - - -
58 Cefiksime tab 100 mg kapsul 1,000 - - - - - - - -
59 Cefiksime sir 100 mg/5 mL botol 9,400 - - - - - - - -
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 - - - - - - - -
61 Cetrizine tab 10 mg tablet 190 - - - - - - - -
62 Cetrizine sir 5 mg/5 ml botol 8,799 - - - - - - - -
63 Cimetidine tab 200 mg tablet 205 - - - - - - - -
64 Copper T set/buah 125,483 - - - - - - - -
65 Deksametason tab 0,5 mg tablet 68 - - - - - - - -
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 - - - - - - - -
67 Diazepam tab 2 mg tablet 47 - - - - - - - -
68 Diazepam tab 5 mg tablet 179 - - - - - - - -
69 Diazepam inj 5 mg/ml ampul 4,598 13,794 - - 13,794 - - - -
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 - - - - - - - -
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 - - - - - - - -
72 Dietil Karbamazin tab 100 mg tablet 150 - - - - - - - -
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 - - - - - - - -
74 Digoksin tab 0,25 mg tablet 103 - - - - - - - -
75 Diltiazem kaps SR 100 mg kapsul 4,033 - - - - - - - -
76 Diltiazem kaps SR 200 mg kapsul 4,417 - - - - - - - -
77 Diltiazem tab 30 mg tablet 141 - - - - - - - -
78 Dimenhidrinat tab 50 mg tablet 109 - - - - - - - -
79 Doksisiklin kaps 100 mg kapsul 298 - - - - - - - -
80 Domperidon susp 5 mg/5 ml botol 3,490 - - - - - - - -
81 Domperidon tab 10 mg tablet 286 85,800 - 28,600 57,200 - - - -
82 Efedrin inj 50 mg/mL tablet 14,650 - - - - - - - -
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 258,390 - - 258,390 - - - -
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 - - - - - - - -
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 - - - - - - - -
86 Eritromisin kaps 250 mg kapsul 522 - - - - - - - -
87 Eritromisin kaps 500 mg kapsul 1,023 - - - - - - - -
88 Erytromisin SK 200 mg/5 ml botol 8,090 412,590 - 24,270 388,320 - - - -
89 Etakridin (Rivanol) lar 0,1% botol 5,456 49,104 - - 49,104 - - - -
90 Etambutol tab 250 mg tablet 330 - - - - - - - -
91 Etambutol tab 500 mg tablet 478 - - - - - - - -
92 Etanol 70 % lar 100 ml botol 2,625 7,875 - 5,250 2,625 - - - -
93 Etil Klorida semprot 100 mL botol 175,500 - - - - - - - -
94 Etonogestrel implan 68 mg subd implant 128,779 - - - - - - - -
95 Fenobarbital tab 30 mg tablet 149 - - - - - - - -
96 Fenobarbital tab 100 mg tablet 242 - - - - - - - -
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 - - - - - - - -
98 Fenol Gliserol tts telinga 10% botol 1,920 - - - - - - - -
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 - - - - - - - -
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 75,080 - 63,818 11,262 - - - -
101 Flukonazol kaps 150 mg kapsul 24,200 - - - - - - - -
102 Fluor tab 0,5 mg tablet 975 - - - - - - - -
103 Furosemid tab 40 mg tablet 84 - - - - - - - -
104 Furosemide inj 10 mg/ml ampul 2,012 - - - - - - - -
105 Gameksan lotion 1% - 30 ml botol 2,420 - - - - - - - -
106 Garam Oralit kombinasi sacchet 317 148,990 - 22,190 126,800 - - - -
107 Gemfibrozil kaps 300 mg kapsul 318 - - - - - - - -
108 Gentamicin krim 10% tube - - - - - - - - -
109 Gentamicin salep kulit 10% tube - - - - - - - - -
110 Gentamicin salep mata 0,3% tube 2,786 - - - - - - - -
111 Gentamicin tts mata 0,3% botol 3,513 - - - - - - - -
112 Gentamisin inj 40 mg/ml ampul 3,739 - - - - - - - -
113 Gentamisin inj 80 mg/ml vial 4,160 - - - - - - - -
114 Glibenklamid tab 5 mg tablet 61 - - - - - - - -
115 Glimepirid tab 1 mg tablet 278 41,700 - - 41,700 - - - -
116 Glimepirid tab 2 mg tablet 458 - - - - - - - -
117 Glipizid tab 5 mg tablet 3,000 - - - - - - - -
118 Gliseril Guaikolat tab 100 mg tablet 27 15,971 - 15,971 - - - - -
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 - - - - - - - -
120 Gliserin lar 50% botol 5,867 - - - - - - - -
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 429,000 - - 429,000 - - - -
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 - - - - - - - -
123 Griseofulvin tab 125 mg tablet 230 161,000 - 23,000 138,000 - - - -
124 Haloperidol tab 0,5 mg tablet 62 - - - - - - - -
125 Haloperidol tab 1,5 mg tablet 76 - - - - - - - -
126 Haloperidol tab 2 mg tablet 134 - - - - - - - -
127 Haloperidol tab 5 mg tablet 105 - - - - - - - -
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 - - - - - - - -
129 Hiosina Butilbromida tab 10 mg tablet 648 - - - - - - - -
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 146,700 - 146,700 - - - - -
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 - - - - - - - -
132 Ibuprofen tab 200 mg tablet 121 - - - - - - - -
133 Ibuprofen tab 400 mg tablet 157 - - - - - - - -
134 Ibuprofen sir 100 mg/5 ml botol 3,849 - - - - - - - -
135 Ibuprofen sir 200 mg/5 ml botol 4,949 - - - - - - - -
136 Isoniazid tab 100 mg tablet 72 - - - - - - - -
137 Isoniazid tab 300 mg tablet 174 - - - - - - - -
138 Isosorbid Dinitrat tab 5 mg tablet 98 - - - - - - - -
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 - - - - - - - -
140 Kalsium Karbonat tab 500 mg tablet 448 - - - - - - - -
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 - - - - - - - -
142 Kanamisin inj 1.000 mg/vial vial 5,100 - - - - - - - -
143 Kaptopril tab 12,5 mg tablet 90 18,000 - 18,000 - - - - -
144 Kaptopril tab 25 mg tablet 138 - - - - - - - -
145 Kaptopril tab 50 mg tablet 141 - - - - - - - -
146 Karbamazepin tab 200 mg tablet 269 - - - - - - - -
147 Karbamazepin sir 100 mg/5 mL botol 44,770 - - - - - - - -
148 Karbogliserin tts telinga 10% botol 2,246 - - - - - - - -
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 - - - - - - - -
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 - - - - - - - -
151 Ketokonazole krim 2% - 15 g tube 5,150 - - - - - - - -
152 Ketokonazole tab 200 mg tablet 320 - - - - - - - -
153 Klaritromisin tab 500 mg tablet 3,600 - - - - - - - -
154 Klindamisin kaps 150 mg kapsul 405 - - - - - - - -
155 Klindamisin kaps 300 mg kapsul 619 - - - - - - - -
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 - - - - - - - -
157 Kloramfenikol kaps 250 mg kapsul 275 247,500 - - 247,500 - - - -
158 Kloramfenikol kaps 500 mg kapsul 935 - - - - - - - -
159 Kloramfenikol salap mata 1% tube 1,680 - - - - - - - -
160 Kloramfenikol salep kulit 2% tube 4,138 - - - - - - - -
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 - - - - - - - -
162 Kloramfenikol tts mata 0,5% botol 20,360 - - - - - - - -
163 Kloramfenikol tts telinga 3% botol 11,440 - - - - - - - -
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 27,000 - 2,700 24,300 - - - -
165 Klorpromazin HCl tab 25 mg tablet 75 - - - - - - - -
166 Klorpromazin HCl tab 100 mg tablet 162 - - - - - - - -
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 - - - - - - - -
168 Kodein HCL tab 10 mg tablet 550 - - - - - - - -
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - - - - - - - - -
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 2,298 - - - - - - - -
171 Kotrimoxazol tab 480 mg (adult) tablet 152 - - - - - - - -
172 Kotrimoxazol susp 60 ml botol 2,298 - - - - - - - -
173 Kuinin tab 200 mg tablet 737 - - - - - - - -
174 Kuinin tab 222 mg tablet 594 - - - - - - - -
175 Kuinin inj 25% (i.v) ampul 6,820 - - - - - - - -
176 Levofloxacin tab 500 mg tablet 581 - - - - - - - -
177 Levofloxacin inf 5 mg/mL botol 43,809 - - - - - - - -
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - - - - - - - - -
179 Lidokain inj 1% (infltr) ampul 929 - - - - - - - -
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 - - - - - - - -
181 Lidokain gel 2% botol 40,000 - - - - - - - -
182 Lidokain semprot 10% botol 156,200 - - - - - - - -
183 Lisol lar 1.000 ml botol 49,862 - - - - - - - -
184 Loratadin tab 10 mg tablet 333 - - - - - - - -
185 Magnesium Sulfat serb 30 g sacchet 3,803 - - - - - - - -
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 247,500 - - 247,500 - - - -
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 17,500 - - 17,500 - - - -
188 Mebendazol tab 100 mg tablet 7,150 - - - - - - - -
189 Mebendazol tab 500 mg tablet 7,854 - - - - - - - -
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 - - - - - - - -
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 46,080 - - 46,080 - - - -
192 Metampiron (Antalgin) tab 500 mg tablet 350 245,000 - - 245,000 - - - -
193 Metformin tab 500 mg tablet 182 54,600 - - 54,600 - - - -
194 Metformin tab 850 mg tablet 280 - - - - - - - -
195 Metilergometrin Maleat tab 0.125 mg tablet 169 - - - - - - - -
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 - - - - - - - -
197 Metilprednisolon tab 4 mg tablet 230 - - - - - - - -
198 Metilprednisolon tab 8 mg tablet 390 - - - - - - - -
199 Metilprednisolon tab 16 mg tablet 875 - - - - - - - -
200 Metoklopramid tab 5 mg tablet 113 - - - - - - - -
201 Metoklopramid tab 10 mg tablet 100 40,000 - - 40,000 - - - -
202 Metronidazol tab 250 mg tablet 116 127,600 - 11,600 116,000 - - - -
203 Metronidazol tab 500 mg tablet 169 185,900 - 16,900 169,000 - - - -
204 Metronidazol sir 125 mg/5 ml botol 4,350 - - - - - - - -
205 Metronidazol lar inf 5 mg/mL botol 12,980 - - - - - - - -
206 Miconazole krim 2% tube 3,150 85,050 - 9,450 75,600 - - - -
207 Natrium Diklofenak tab 25 mg tablet 146 - - - - - - - -
208 Natrium Diklofenak tab 50 mg tablet 193 - - - - - - - -
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 413,600 - 25,850 387,750 - - - -
210 Nifedipine tab 10 mg tablet 127 50,800 - - 50,800 - - - -
211 Nistatin tab vaginal 100.000 IU ovula 528 258,720 - - 258,720 - - - -
212 Nistatin tab vaginal 500.000 IU tablet 704 352,000 - - 352,000 - - - -
213 Obat Anti TB Kategori Anak Paket 189,195 - - - - - - - -
214 Obat Anti TB Kategori Anak FDC Paket 236,490 - - - - - - - -
215 Obat Anti TB Kategori I Paket 317,015 - - - - - - - -
216 Obat Anti TB Kategori I FDC Paket 396,000 - - - - - - - -
217 Obat Anti TB Kategori I Kombipak Paket 316,920 - - - - - - - -
218 Obat Anti TB Kategori II Paket 1,320,000 - - - - - - - -
219 Obat Anti TB Kategori II FDC Paket 1,319,990 - - - - - - - -
220 Obat Anti TB Kategori III Paket 154,000 - - - - - - - -
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 - - - - - - - -
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 24,500 - 24,500 - - - - -
223 Ofloxacin tab 200 mg tablet 440 - - - - - - - -
224 Ofloxacin tab 400 mg tablet 700 - - - - - - - -
225 Oksimetazolin tts hidung 0,025 % botol 30,305 - - - - - - - -
226 Oksimetazolin tts hidung 0,050 % botol 32,000 - - - - - - - -
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 - - - - - - - -
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 - - - - - - - -
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 - - - - - - - -
230 Olopatadin tts mata 0,1% botol 68,000 - - - - - - - -
231 Omeprazol kaps 20 mg kapsul 409 - - - - - - - -
232 Omeprazol inj 40 mg/10 mL vial 42,000 - - - - - - - -
233 Paracetamol tab 500 mg tablet 88 - - - - - - - -
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 - - - - - - - -
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 - - - - - - - -
236 Perak Sulfadiazin krim 1% tube 25,350 - - - - - - - -
237 Permetrin krim 5% tube 11,475 - - - - - - - -
238 Pirantel Pamoat tab 125 mg tablet 318 131,016 - - 131,016 - - - -
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 236,600 - - 236,600 - - - -
240 Pirazinamid tab 500 mg tablet 225 - - - - - - - -
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 - - - - - - - -
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 114,950 - - 114,950 - - - -
243 Piroxicam tab 10 mg tablet 149 - - - - - - - -
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 - - - - - - - -
245 Povidon Iodida lar 10% - 300 ml botol 15,386 - - - - - - - -
246 Povidon Iodida lar 10% - 60 ml botol 6,500 - - - - - - - -
247 Povidon Iodida lar 10% - 30 ml botol 2,344 - - - - - - - -
248 Prednison tab 5 mg tablet 192 - - - - - - - -
249 Primakuin tab 15 mg tablet 205 - - - - - - - -
250 Probenesid tab 500 mg tablet 1,815 - - - - - - - -
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 - - - - - - - -
252 Propranolol tab 10 mg tablet 80 - - - - - - - -
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 - - - - - - - -
254 Ranitidin tab 150 mg tablet 220 - - - - - - - -
255 Ranitidin inj 25 mg/mL ampul 1,340 - - - - - - - -
256 Retinol (Vit A) softcap 100.000 IU softcap 286 - - - - - - - -
257 Retinol (Vit A) softcap 200.000 IU softcap 505 - - - - - - - -
258 Rifampicin kaps 300 mg kapsul 670 - - - - - - - -
259 Rifampicin tab 450 mg tablet 868 - - - - - - - -
260 Rifampicin tab 600 mg tablet 1,209 - - - - - - - -
261 Ringer Laktat lar inf steril 500 ml botol 4,727 222,169 - 141,810 80,359 - - - -
262 Salbutamol tab 2 mg tablet 65 - - - - - - - -
263 Salbutamol tab 4 mg tablet 93 - - - - - - - -
264 Salbutamol cairan ih 0,1% botol 7,260 - - - - - - - -
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 - - - - - - - -
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 - - - - - - - -
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 - - - - - - - -
268 Serum Antidifteri inj 10,000 IU vial - - - - - - - - -
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 - - - - - - - -
270 Serum Antitetanus inj 1.500 IU vial 161,000 - - - - - - - -
271 Serum Antitetanus inj 10.000 IU vial - - - - - - - - -
272 Serum Antitetanus inj 20.000 IU vial 324,550 - - - - - - - -
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 - - - - - - - -
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 - - - - - - - -
275 Simvastatin tab 10 mg tablet 294 58,800 - 44,100 14,700 - - - -
276 Simvastatin tab 20 mg tablet 480 - - - - - - - -
277 Siprofloksasin tab 500 mg tablet 290 87,000 - 58,000 29,000 - - - -
278 Spironolakton tab 25 mg tablet 350 - - - - - - - -
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 - - - - - - - -
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 112 - - - - - - - -
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 - - - - - - - -
282 Tetrasiklin kaps 250 mg kapsul 162 32,400 - 16,200 16,200 - - - -
283 Tetrasiklin kaps 500 mg kapsul 325 - - - - - - - -
284 Thiamfenikol kaps 500 mg kapsul 985 - - - - - - - -
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 60,000 - 60,000 - - - - -
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 - - - - - - - -
287 Tramadol inj 50 mg/mL ampul 2,680 - - - - - - - -
288 Triheksipenidil tab 2 mg tablet 70 - - - - - - - -
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 - - - - - - - -
290 Valproat tab sal 250 mg tablet salut 1,680 - - - - - - - -
291 Valproat tab sal 500 mg tablet salut 5,450 - - - - - - - -
292 Valproat sir 250 mg/5 mL botol 41,800 - - - - - - - -
293 Vankomisin serb inj 500 mg/vial vial 142,000 - - - - - - - -
294 Vitamin B Kompleks tablet 112 - - - - - - - -
295 Zinc sir 10 mg/ml botol 16,478 - - - - - - - -
296 Zinc sir 20 mg/5 ml botol 8,140 - - - - - - - -
297 Zinc dispersible 20 mg tablet 521 - - - - - - - -
298 Alprazolam tab 1 mg tablet 245 - - - - - - - -
299 Betahistin tab 6 mg tablet - - - - - - - - -
300 Idometasin kapl 25 mg kaplet 380 - - - - - - - -
301 Karbon Aktif tab 125 mg tablet 127 - - - - - - - -
302 Klobazam tab 10 mg tablet 950 - - - - - - - -
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 - - - - - - - -
304 Loperamid tab 2 mg tablet 97 - - - - - - - -
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 - - - - - - - -
306 Papaverin 40 mg tablet - - - - - - - - -
307 Piracetam tab 400 mg tablet - - - - - - - - -
308 Thiamfenikol tab 250 mg tablet - - - - - - - - -
309 Piracetam tab 800 mg tablet - - - - - - - - -
310 Piroxicam tab 20 mg tablet - - - - - - - - -
311 Asam Askorbat (Vit.C) tab 25 mg tablet - - - - - - - - -
312 Etanol 70% lar 1000 ml botol - - - - - - - - -
313 Etanol 70% lar 300 ml botol - - - - - - - - -
314 Neurosanbe injeksi ampul - - - - - - - - -
315 H2O2 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 1,262 49,218 - 23,978 25,240 - - - -
2 Alat Suntik 2.5 ml pcs 1,102 - - - - - - - -
3 Alat Suntik 3 ml pcs 1,010 38,380 - 5,050 33,330 - - - -
4 Alat Suntik 5 ml pcs 1,248 124,800 - - 124,800 - - - -
5 Alat Suntik 10 ml pcs 1,694 62,678 - 10,164 52,514 - - - -
6 Alat Suntik 20 ml pcs 2,228 - - - - - - - -
7 Alat Suntik 50 ml pcs 10,350 - - - - - - - -
8 Alat Suntik ADS 0,5 ml pcs 1,925 - - - - - - - -
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 - - - - - - - -
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 - - - - - - - -
11 Alat Suntik ADS 5 ml BCG pcs 2,585 - - - - - - - -
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 - - - - - - - -
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 - - - - - - - -
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 - - - - - - - -
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 - - - - - - - -
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 - - - - - - - -
17 Catgut no.2/0 pcs 213,525 1,067,625 - 1,067,625 - - - - -
18 Catgut no.3/0 pcs 213,525 19,857,825 - 4,484,025 15,373,800 - - - -
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 - - - - - - - -
20 Catheter (folley cathteter) no.10 pcs 13,750 123,750 - - 123,750 - - - -
21 Catheter (folley cathteter) no.12 pcs 13,750 137,500 - - 137,500 - - - -
22 Catheter (folley cathteter) no.14 pcs 13,750 82,500 - 41,250 41,250 - - - -
23 Catheter (folley cathteter) no.16 pcs 13,750 110,000 - - 110,000 - - - -
24 Catheter (folley cathteter) no.18 pcs 13,750 137,500 - 41,250 96,250 - - - -
25 Cholesterol test btl/10 strip botol 320,000 - - - - - - - -
26 Copper T set 125,000 - - - - - - - -
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 - - - - - - - -
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 - - - - - - - -
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 - - - - - - - -
30 Glukosa test btl/25 strip botol 180,000 - - - - - - - -
31 Hand Schoen no 7 set 14,850 - - - - - - - -
32 Hand Schoen no 7.5 set 14,850 - - - - - - - -
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
34 Hand Schoen no 8 set 14,850 - - - - - - - -
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 - - - - - - - -
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 - - - - - - - -
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 - - - - - - - -
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 - - - - - - - -
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 - - - - - - - -
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 - - - - - - - -
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 - - - - - - - -
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 - - - - - - - -
44 Hand Schoen (Examination Gloves Size S) set 57,750 - - - - - - - -
45 Hand Schoen (Examination Gloves Size M) set 57,750 - - - - - - - -
46 Hand Schoen (Examination Gloves Size L) set 57,750 - - - - - - - -
47 Infusion Set Anak set 6,375 318,750 - 44,625 274,125 - - - -
48 Infusion Set Dewasa set 12,100 - - - - - - - -
49 Infusion Set Macro 2 Cabang set 35,000 - - - - - - - -
50 IV Catheter no. 16 pcs 8,948 - - - - - - - -
51 IV Catheter no. 18 pcs 8,948 572,672 - 17,896 554,776 - - - -
52 IV Catheter no. 20 pcs 8,948 71,584 - 71,584 - - - - -
53 IV Catheter no. 22 pcs 8,948 152,116 - 17,896 134,220 - - - -
54 IV Catheter no. 24 pcs 8,948 143,168 - 17,896 125,272 - - - -
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 - - - - - - - -
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 - - - - - - - -
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 - - - - - - - -
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 - - - - - - - -
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 - - - - - - - -
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 - - - - - - - -
61 Jarum Jahit Otot all size lusin 18,500 - - - - - - - -
62 Jarum Jahit 1/2 Surgical lusin 135,000 135,000 - - 135,000 - - - -
63 Jarum Jahit 3/8 Surgical lusin 120,000 120,000 - - 120,000 - - - -
64 Kaca Slide pcs 50,000 - - - - - - - -
65 Kapas Pembalut 250 g roll 22,000 132,000 - - 132,000 - - - -
66 Kapas Pembalut 500 g roll 35,000 175,000 - - 175,000 - - - -
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 - - - - - - - -
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 245,100 - 122,550 122,550 - - - -
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 13,615 - 2,723 10,892 - - - -
70 Kasa Pembalut 2 m x 80 cm roll 13,366 - - - - - - - -
71 Kasa Pembalut 4 m x 5 cm roll - - - - - - - - -
72 Kasa Pembalut 4 m x 10 cm roll 2,601 - - - - - - - -
73 Kasa Pembalut 4 m x 15 cm roll - - - - - - - - -
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 - - - - - - - -
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 - - - - - - - -
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 - - - - - - - -
77 Kasa Steril 16 cm x 16 cm box 6,743 - - - - - - - -
78 Kasa Steril 18 cm x 22 cm box 16,500 - - - - - - - -
79 Masker Ear Loop Pcs 495 - - - - - - - -
80 Mata Pisau Bedah No. 10 pcs 9,750 19,500 - 9,750 9,750 - - - -
81 Mata Pisau Bedah No. 11 Pcs 9,750 19,500 - 19,500 - - - - -
82 Mata Pisau Bedah No. 15 Pcs 9,750 87,750 - - 87,750 - - - -
83 Mata Pisau Bedah No. 21 Pcs 9,750 68,250 - 9,750 58,500 - - - -
84 Nasal Oxygen (Aximed) size M Pcs 6,600 - - - - - - - -
85 Nasal Oxygen (Aximed) size L Pcs 6,600 - - - - - - - -
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 - - - - - - - -
87 Plester 5 yard x 2 inchi roll 7,186 - - - - - - - -
88 Plester 5 cm x 4,5 cm roll - - - - - - - - -
89 Plester 7,5 cm x 4,5 cm roll 34,650 - - - - - - - -
90 Pot Sputum pot 2,000 - - - - - - - -
91 RDT pcs - - - - - - - - -
92 Regulator Oxygen pcs 450,000 - - - - - - - -
93 Safety Box kotak - - - - - - - - -
94 Selang Oxygen pcs 8,250 - - - - - - - -
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 18,100,800 - 3,016,800 15,084,000 - - - -
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 206,779 - 206,779 - - - - -
97 Sound Timer unit 1,219,143 2,438,286 - - 2,438,286 - - - -
98 Stempel ISPA pcs - - - - - - - - -
99 Uric Acid test btl/25 strip botol 240,000 - - - - - - - -
100 Urine bag pcs 6,875 96,250 - 41,250 55,000 - - - -

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 15,000 - - - - - - - -
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 - - - - - - - -
3 Larutan Asam Klorida (HCl) 0,1 N botol - - - - - - - - -
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 - - - - - - - -
5 Larutan Benedik botol 40,040 - - - - - - - -
6 Larutan Eosin 2% botol 36,595 - - - - - - - -
7 Larutan Etanol Asam botol 34,126 - - - - - - - -
8 Larutan Giemsa Stein botol 63,348 - - - - - - - -
9 Larutan Karbol Fuksin botol 23,231 - - - - - - - -
10 Larutan Metanol botol 118,300 - - - - - - - -
11 Larutan Metilen Biru botol 17,086 - - - - - - - -
12 Larutan Turk botol 54,600 - - - - - - - -
13 Reagen TBC kit - - - - - - - - -
14 Test Asam Urat test 250,000 - - - - - - - -
15 Test Comburt Reagens set 251,200 - - - - - - - -
16 Test Golongan Darah set 286,365 - - - - - - - -
17 Test Golongan Darah Reagens set 251,200 - - - - - - - -
18 Test Gula Darah test 200,000 - - - - - - - -
19 Test Kehamilan strip 2,400 - - - - - - - -
20 Test Kolesterol test 350,000 - - - - - - - -
21 Test Urine Rutin strip 3,000 - - - - - - - -

GIGI
1 Air raksa Dental Use - 108,195 - - - - - - - -
2 Devitalisasi pasta (arsen) kotak 390,000 - - - - - - - -
3 Eugenol cairan 10 ml botol 18,333 - - - - - - - -
4 Fluoride 0.5 mg tablet 30,000 - - - - - - - -
5 Fluoride 1 mg tablet 4,456 - - - - - - - -
6 Hemospon (Spongostan Dental) pcs 536,250 - - - - - - - -
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 - - - - - - - -
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 - - - - - - - -
9 Kalsium Hidroksida Pasta tube 341,250 - - - - - - - -
10 Klorheksidin lar 0,2% botol - - - - - - - - -
11 Klorheksidin lar 15% botol - - - - - - - - -
12 Mata Bor Gigi pcs 48,750 - - - - - - - -
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 - - - - - - - -
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 - - - - - - - -
15 Trikresol Formalin (TKF) cairan botol 7,239 - - - - - - - -

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 - - - - - - - -
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 - - - - - - - -
3 Becefort sir 60 ml botol 26,230 - - - - - - - -
4 Bronex (Bromheksin) tab 8 mg tablet 82 - - - - - - - -
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 - - - - - - - -
6 Fluoride 1 mg tablet 976 - - - - - - - -
7 Kandistatin susp 12 ml botol 36,300 - - - - - - - -
8 KY Jelly tube 85,000 - - - - - - - -
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 - - - - - - - -
10 Norit (Karbon Aktif) tab 125 mg tablet - - - - - - - - -
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 - - - - - - - -
12 Pehavral tablet salut 70,785 - - - - - - - -
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 - - - - - - - -
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 - - - - - - - -
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 - - - - - - - -
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 - - - - - - - -
17 Vaksin Antirabies Vero (VAR) vial 48,400 - - - - - - - -
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 - - - - - - - -
19 Cendo Xytrol TM 5 ml botol 35,850 - - - - - - - -
20 Formalin 40 % botol 42,000 - - - - - - - -
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 - - - - - - - -
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 - - - - - - - -
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 - - - - - - - -
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 5,787,600 - 1,446,900 4,340,700 - - - -
25 Vical susp 100 ml botol 4,890 83,130 - 29,340 53,790 - - - -
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 326,400 - - 326,400 - - - -
27 Vinafluor (Fluoride) kapl 1 mg kaplet - - - - - - - - -
28 Sanmol (Parasetamol) 500 mg tablet 325 - - - - - - - -
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 - - - - - - - -
30 Purecemia (Allopurinol) 300 mg tablet 3,269 - - - - - - - -
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 - - - - - - - -
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 - - - - - - - -
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 - - - - - - - -
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 - - - - - - - -
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 - - - - - - - -
36 Histigo (Betahistin) tab 6 mg tablet - - - - - - - - -
37 Novadium (Loperamid) tab 2 mg tablet - - - - - - - - -
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - - - - - - - - -
39 Metolon (Metoklorperamid) tab 10 mg tablet - - - - - - - - -
40 Novabion tablet - - - - - - - - -
41 Novagesic (Parasetamol) tab 500 mg tablet - - - - - - - - -
42 Defamol (Parasetamol) tab 500 mg tablet - - - - - - - - -
43 Sultrimix syrup botol - - - - - - - - -
44 Biovitan syrup botol - - - - - - - - -
45 Caviplex syrup botol - - - - - - - - -
46 Farsifen (Ibuprofen) syrup botol - - - - - - - - -
47 Novaxifen (Ibuprofen) tab 200 mg tablet - - - - - - - - -
48 Lexigo (Betahistin) tab 6 mg tablet - - - - - - - - -
49 Loric (Allopurinol) tab 100 mg tablet - - - - - - - - -
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - - - - - - - - -
51 Arkavit tablet - - - - - - - - -
52 Novadex (Dexametason) 0,5 mg tablet - - - - - - - - -
53 Carbidu (Dexametason) 0,5 mg tablet - - - - - - - - -
54 Gralixa (Furosemid) 40 mg tablet - - - - - - - - -
55 Grafazol (Metronidazol) tab 500 mg tablet - - - - - - - - -
56 Glikos (Metformin) tab 500 mg tablet - - - - - - - - -
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - - - - - - - - -
58 Metaneuron (Metamizolesodium + Diazepam) tablet - - - - - - - - -
59 Trifadium ( Loperamide HCL 2 mg) tablet - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

TOTAL 57,554,353 - 11,726,904 45,827,449 - - - -

MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
DIAAN, STOK OPNAME DAN MUTASI OBAT

BULAN : APRIL
TAHUN : 2017

DAK BPJS - JKN JUMLAH KESELURUHAN

BUFFER PROVINSI PROGRAM
Stok Awal Penerimaan Pengeluaran Stok Akhir Stok Awal Penerimaan Pengeluaran
Awal Terima Keluar Akhir Awal Terima Keluar Akhir
- - - - - - - - - - - - 72,000 - 24,000
- - - - - - - - - - - - 780,450 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 28,600 - 28,600
- - - - - - - - - - - - - - -
- - - - - - - - - 63,300 31,650 31,650 - 63,300 31,650
- - - - - - - - 40,000 - 40,000 - 40,000 - 40,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 140,250 140,250 - - 140,250 140,250
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 666,000 296,000 370,000 - 666,000 296,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 46,800 31,200 15,600 15,600 46,800 46,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 64,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 210,000 105,000 105,000 - 210,000 105,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 176,000 105,600 70,400 17,600 176,000 123,200
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 107,100 - 107,100 - 107,100 -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 13,500 - 6,750
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 31,920 - 23,940 7,980 31,920 - 23,940
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 227,298 - 126,864
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 39,974 - 5,214 34,760 39,974 - 5,214
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 13,794 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 22,880 - 22,880 - 108,680 - 51,480
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 258,390 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 412,590 - 24,270
- - - - - - - - 21,824 - 5,456 16,368 70,928 - 5,456
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 7,875 - 5,250
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 75,080 - 63,818
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 148,990 - 22,190
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 24,400 - - 24,400 24,400 - -
- - - - - - - - - - - - 41,700 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 15,971 - 15,971
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 429,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 161,000 - 23,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 146,700 - 146,700
- - - - - - - - - - - - - - -
- - - - - - - - - 121,000 96,800 24,200 - 121,000 96,800
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 9,800 - - 9,800 9,800 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 18,000 - 18,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 247,500 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 54,000 - 54,000 - 81,000 - 56,700
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 30,400 - - 30,400 30,400 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 247,500 - -
- - - - - - - - - - - - 17,500 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 46,080 - -
- - - - - - - - - - - - 245,000 - -
- - - - - - - - 100,100 - - 100,100 154,700 - -
- - - - - - - - - - - - - - -
- - - - - - - - 126,750 - - 126,750 126,750 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 10,000 - 10,000 - 50,000 - 10,000
- - - - - - - - - - - - 127,600 - 11,600
- - - - - - - - 42,250 - 8,450 33,800 228,150 - 25,350
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 85,050 - 9,450
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 413,600 - 25,850
- - - - - - - - - - - - 50,800 - -
- - - - - - - - - - - - 258,720 - -
- - - - - - - - - - - - 352,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 24,500 - 24,500
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - (27,500) 27,500 - - (27,500)
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 39,910 18,420 21,490 - 39,910 18,420
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 131,016 - -
- - - - - - - - - - - - 236,600 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 114,950 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 61,544 15,386 46,158 - 61,544 15,386
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 26,800 - 5,360 21,440 26,800 - 5,360
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 222,169 - 141,810
- - - - - - - - - 39,000 16,250 22,750 - 39,000 16,250
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 58,800 - 44,100
- - - - - - - - - - - - - - -
- - - - - - - - 58,000 - 58,000 - 145,000 - 116,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 32,400 - 16,200
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 60,000 - 60,000
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - 52,100 - 52,100 - 52,100 - 52,100
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - 10,096 - 10,096 - 59,314 - 34,074

- - - - - - - - - - - - - - -
- - - - - - - - - - - - 38,380 - 5,050
- - - - - - - - - - - - 124,800 - -
- - - - - - - - - - - - 62,678 - 10,164
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 1,067,625 - 1,067,625
- - - - - - - - 213,525 - 213,525 - 20,071,350 - 4,697,550
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 123,750 - -
- - - - - - - - - - - - 137,500 - -
- - - - - - - - - - - - 82,500 - 41,250
- - - - - - - - - - - - 110,000 - -
- - - - - - - - - - - - 137,500 - 41,250
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 115,500 57,750 57,750 - 115,500 57,750
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 318,750 - 44,625
- - - - - - - - - 314,600 193,600 121,000 - 314,600 193,600
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 572,672 - 17,896
- - - - - - - - - 232,648 143,168 89,480 71,584 232,648 214,752
- - - - - - - - - - - - 152,116 - 17,896
- - - - - - - - 44,740 - 8,948 35,792 187,908 - 26,844
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 135,000 - -
- - - - - - - - - - - - 120,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - 44,000 - - 44,000 176,000 - -
- - - - - - - - - - - - 175,000 - -
- - - - - - - - - - - - - - -
- - - - - - - - - 367,650 122,550 245,100 245,100 367,650 245,100
- - - - - - - - - - - - 13,615 - 2,723
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - 99,000 49,500 49,500 - 99,000 49,500
- - - - - - - - - - - - 19,500 - 9,750
- - - - - - - - - - - - 19,500 - 19,500
- - - - - - - - - - - - 87,750 - -
- - - - - - - - - - - - 68,250 - 9,750
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 18,100,800 - 3,016,800
- - - - - - - - - - - - 206,779 - 206,779
- - - - - - - - - - - - 2,438,286 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 96,250 - 41,250

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - 4,103,623 868,074 3,235,549 - 4,103,623 868,074

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - 5,787,600 - 1,446,900
- - - - - - - - - - - - 83,130 - 29,340
- - - - - - - - - - - - 326,400 - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - 1,003,559 6,903,925 2,781,667 5,125,817 58,557,912 6,903,925 14,508,571

Inebenggi, 28 April 2017

TERLAMBAT
5/25/2017

Penanggung Jawab Farmasi

TERLAMBAT
5/18/2017

DINA MARDIANA, A.Md.Far

TERLAMBAT
5/11/2017
Nip. 19890705 201504 2 001
N

Stok Akhir

48,000
780,450
-
-
-
31,650
-
-
-
-
-
-
-
-
-
370,000
-
-
15,600
-
-
64,000
-
-
-
-
 -
-
-
105,000
-
-
-
-
-
-
70,400
-
-
107,100
-
-
-
-
-
6,750
-
-
7,980
-
-
-
-
-
-
100,434
-
-
-
-
-
-
-
-
-
 34,760
-
-
13,794
-
-
-
-
-
-
-
-
-
-
-
57,200
-
258,390
-
-
-
-
388,320
65,472
-
-
2,625
-
-
-
-
-
-
-
11,262
-
-
-
-
 -
126,800
-
-
-
-
-
-
-
24,400
41,700
-
-
-
-
-
429,000
-
138,000
-
-
-
-
-
-
-
-
24,200
-
-
-
-
-
9,800
-
-
-
-
-
 -
-
-
-
-
-
-
-
-
-
-
-
-
247,500
-
-
-
-
-
-
24,300
-
-
-
-
-
-
30,400
-
-
-
-
-
-
-
-
-
-
-
 -
-
-
247,500
17,500
-
-
-
46,080
245,000
154,700
-
126,750
-
-
-
-
-
40,000
116,000
202,800
-
-
75,600
-
-
387,750
50,800
258,720
352,000
-
-
-
-
-
-
-
-
-
 -
-
-
-
-
-
-
27,500
-
-
-
-
21,490
-
-
-
131,016
236,600
-
-
114,950
-
-
46,158
-
-
-
-
-
-
-
-
-
21,440
-
-
-
-
-
80,359
22,750
-
-
-
-
-
-
-
-
-
-
-
-
14,700
-
29,000
-
-
-
-
16,200
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
 -
-
-
-
-
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-
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25,240
-
33,330
124,800
52,514
-
-
 -
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-
-
-
-
-
-
-
-
15,373,800
-
123,750
137,500
41,250
110,000
96,250
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
57,750
-
-
274,125
121,000
-
-
554,776
89,480
134,220
161,064
-
-
-
-
-
-
-
135,000
120,000
-
176,000
175,000
-
367,650
10,892
-
-
-
-
-
-
-
-
-
49,500
9,750
-
87,750
58,500
-
-
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-
-
-
-
-
-
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-
15,084,000
-
2,438,286
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55,000

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3,235,549
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4,340,700
53,790
326,400
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50,953,266
 Menu

Peringatan

!
 LAPORAN ASSET PERSEDIAAN, ST

PUSKESMAS : MOWEWE
KECAMATAN : MOWEWE
KAB/KOTA : KOLAKA TIMUR

DAU/PKD
No. Nama Obat Satuan Harga PUSAT
Stok Awal Penerimaan Pengeluaran Stok Akhir
Awal Terima Keluar Akhir
1 Air Untuk Injeksi 20 ml vial 6,000 48,000 60,000 12,000 96,000 - - - -
2 Albendazole tab 400 mg tablet 363 780,450 - - 780,450 - - - -
3 Albendazole susp 200 mg/5 ml botol 4,234 - - - - - - - -
4 Allopurinol tab 100 mg tablet 143 - 71,500 14,300 57,200 - - - -
5 Allopurinol tab 300 mg tablet 233 - - - - - - - -
6 Ambroksol sir 15 mg/ml - 60 ml botol 5,275 - 105,500 26,375 79,125 - - - -
7 Ambroksol tab 30 mg tablet 200 - 100,000 30,000 70,000 - - - -
8 Aminophyllin tab 200 mg tablet 86 - - - - - - - -
9 Aminophyllin inj 24 mg ampul 4,204 - - - - - - - -
10 Amitriptiline HCl tab 25 mg tablet 123 - - - - - - - -
11 Amlodipin tab 5 mg tablet 197 - - - - - - - -
12 Amlodipin tab 10 mg tablet 935 - 280,500 196,350 84,150 - - - -
13 Amoxicillin sir forte 250 mg/5 ml botol 4,730 - 236,500 122,980 113,520 - - - -
14 Amoxicillin SK 125 mg/5 ml botol 2,560 - - - - - - - -
15 Amoxicillin tab 250 mg tablet 220 - - - - - - - -
16 Amoxicillin tab 500 mg tablet 370 - 370,000 259,000 111,000 - - - -
17 Ampicillin serb inj 1000 mg vial 5,610 - - - - - - - -
18 Antasida DOEN susp 60 ml botol 2,213 - - - - - - - -
19 Antasida DOEN tab kombinasi Mg-Hidroksida 200 mg + Al.Hidro tablet 78 - 117,000 54,600 62,400 - - - -
20 Anti Bakteri DOEN salep kombinasi 5 g pot 2,767 - - - - - - - -
21 Antifungi DOEN kombinasi 30 g pot 1,890 - - - - - - - -
22 Antihemoroid DOEN suppo supp 3,200 64,000 32,000 - 96,000 - - - -
23 Antimalaria kombipak tab Artesunate 50 mg + tab Amodiakuin tablet - - - - - - - - -
24 Antimalaria kombinasi Artemether 20 mg + Lumefantrin 120 mgtablet 3,220 - - - - - - - -
25 Antimalaria DOEN kombinasi Pirim. 25 mg + Suldox 500 mg tablet 572 - - - - - - - -
26 Antimigren tab kombinasi Ergotamin tartrat 1 mg + Kofein 50 mtablet 149 - - - - - - - -
27 Anti Parkinson kombinasi Benserazid 25 mg + Levodopa 100 mgKapsul 1,650 - - - - - - - -
28 Artemether inj 80 mg/mL ampul 24,384 - - - - - - - -
29 Artesunate serb inj 60 mg/mL (i.v./i.m.) vial 38,999 - - - - - - - -
30 Asam Ascorbat (Vitamin C) tab 50 mg tablet 105 - - - - - - - -
31 Asam Ascorbat (Vitamin C) tab 250 mg tablet 167 - - - - - - - -
32 Asam Asetilsalisilat (Asetosal) tab 80 mg tablet 163 - - - - - - - -
33 Asam Asetilsalisilat (Asetosal) tab 100 mg tablet 127 - - - - - - - -
34 Asam Folat tab 0,4 mg tablet 104 - - - - - - - -
35 Asam Folat tab 1 mg tablet 52 - - - - - - - -
36 Asam Mefenamat tab 250 mg tablet 175 - - - - - - - -
37 Asam Mefenamat tab 500 mg tablet 176 - 176,000 123,200 52,800 - - - -
38 Asam Traneksamat inj 50 mg/mL ampul 2,950 - - - - - - - -
39 Asiklovir tab 200 mg tablet 251 - - - - - - - -
40 Asiklovir tab 400 mg tablet 357 - - - - - - - -
41 Atenolol tab 50 mg tablet 387 - - - - - - - -
42 Atapulgit tab 600 mg tablet 220 - - - - - - - -
43 Atropin tab 0,5 mg tablet 81 - - - - - - - -
44 Atropin Sulfat inj 0,25 mg/ml ampul 1,400 - - - - - - - -
45 Azitromisin tablet 500 mg kaplet 4,725 - - - - - - - -
46 Bedak Salisil serb 2% Kotak 1,350 6,750 8,100 1,350 13,500 - - - -
47 Benzatin Benzil Penisilin 1,2 juta IU/ vial vial 10,780 - - - - - - - -
48 Benzatin Benzil Penisilin 2,4 juta IU/ vial vial 14,740 - - - - - - - -
49 Betametason krim 0,5 mg/g tube 1,596 - 39,900 7,980 31,920 - - - -
50 Betametason tts mata 1 mg/ml botol 25,106 - - - - - - - -
51 Bisakodil sup 5 mg supp 4,990 - - - - - - - -
52 Bisakodil sup 10 mg supp 6,045 - - - - - - - -
53 Bromheksin tab 8 mg tablet 82 - - - - - - - -
54 Cefadroksil kaps 250 mg kapsul 564 - - - - - - - -
55 Cefadroksil kaps/tab 500 mg kapsul 548 - 548,000 274,000 274,000 - - - -
56 Cefadroksil SK 125 mg/5 mL botol 5,286 100,434 264,300 68,718 296,016 - - - -
57 Cefadroksil SK 250 mg/5 mL botol 6,285 - - - - - - - -
58 Cefiksime tab 100 mg kapsul 1,000 - 300,000 100,000 200,000 - - - -
59 Cefiksime sir 100 mg/5 mL botol 9,400 - - - - - - - -
60 Ceftriaxone serb inj 1.000 mg/vial vial 3,900 - - - - - - - -
61 Cetrizine tab 10 mg tablet 190 - - - - - - - -
62 Cetrizine sir 5 mg/5 ml botol 8,799 - - - - - - - -
63 Cimetidine tab 200 mg tablet 205 - - - - - - - -
64 Copper T set/buah 125,483 - 250,965 - 250,965 - - - -
65 Deksametason tab 0,5 mg tablet 68 - - - - - - - -
66 Deksamethason inj 5 mg/ml - 1 ml ampul 1,738 - - - - - - - -
67 Diazepam tab 2 mg tablet 47 - - - - - - - -
68 Diazepam tab 5 mg tablet 179 - - - - - - - -
69 Diazepam inj 5 mg/ml ampul 4,598 13,794 - - 13,794 - - - -
70 Diazepam lar rektal 10 mg/2,5 ml botol 18,461 - - - - - - - -
71 Diazepam lar rektal 5 mg/2,5 ml botol 12,751 - - - - - - - -
72 Dietil Karbamazin tab 100 mg tablet 150 - - - - - - - -
73 Difenhidramin HCl inj 10 mg/mL (i.v./i.m.) ampul 1,160 - - - - - - - -
74 Digoksin tab 0,25 mg tablet 103 - - - - - - - -
75 Diltiazem kaps SR 100 mg kapsul 4,033 - - - - - - - -
76 Diltiazem kaps SR 200 mg kapsul 4,417 - - - - - - - -
77 Diltiazem tab 30 mg tablet 141 - - - - - - - -
78 Dimenhidrinat tab 50 mg tablet 109 - - - - - - - -
79 Doksisiklin kaps 100 mg kapsul 298 - - - - - - - -
80 Domperidon susp 5 mg/5 ml botol 3,490 - - - - - - - -
81 Domperidon tab 10 mg tablet 286 57,200 85,800 28,600 114,400 - - - -
82 Efedrin inj 50 mg/mL tablet 14,650 - - - - - - - -
83 Ephinefrin (Adrenalin ) inj 0,1% 1 ml ampul 8,910 258,390 - - 258,390 - - - -
84 Ergokalsiferol (Vitamin D2) kaps 50.000 UI kapsul 680 - - - - - - - -
85 Ergokalsiferol (Vitamin D2) susp 10.000 UI/mL botol 8,000 - - - - - - - -
86 Eritromisin kaps 250 mg kapsul 522 - - - - - - - -
87 Eritromisin kaps 500 mg kapsul 1,023 - - - - - - - -
88 Erytromisin SK 200 mg/5 ml botol 8,090 388,320 - 121,350 266,970 - - - -
89 Etakridin (Rivanol) lar 0,1% botol 5,456 49,104 - 10,912 38,192 - - - -
90 Etambutol tab 250 mg tablet 330 - - - - - - - -
91 Etambutol tab 500 mg tablet 478 - - - - - - - -
92 Etanol 70 % lar 100 ml botol 2,625 2,625 39,375 10,500 31,500 - - - -
93 Etil Klorida semprot 100 mL botol 175,500 - - - - - - - -
94 Etonogestrel implan 68 mg subd implant 128,779 - - - - - - - -
95 Fenobarbital tab 30 mg tablet 149 - - - - - - - -
96 Fenobarbital tab 100 mg tablet 242 - - - - - - - -
97 Fenobarbital inj 50 mg/ml-1 ml ampul 1,980 - - - - - - - -
98 Fenol Gliserol tts telinga 10% botol 1,920 - - - - - - - -
99 Fitomenadion (Vitamin K1) tab salut 10 mg tab salut 698 - - - - - - - -
100 Fitomenadion (Vitamin K1) inj 2 mg/ml ampul 3,754 11,262 112,620 112,620 11,262 - - - -
101 Flukonazol kaps 150 mg kapsul 24,200 - - - - - - - -
102 Fluor tab 0,5 mg tablet 975 - - - - - - - -
103 Furosemid tab 40 mg tablet 84 - - - - - - - -
104 Furosemide inj 10 mg/ml ampul 2,012 - - - - - - - -
105 Gameksan lotion 1% - 30 ml botol 2,420 - - - - - - - -
106 Garam Oralit kombinasi sacchet 317 126,800 - 28,530 98,270 - - - -
107 Gemfibrozil kaps 300 mg kapsul 318 - - - - - - - -
108 Gentamicin krim 10% tube - - - - - - - - -
109 Gentamicin salep kulit 10% tube - - - - - - - - -
110 Gentamicin salep mata 0,3% tube 2,786 - - - - - - - -
111 Gentamicin tts mata 0,3% botol 3,513 - - - - - - - -
112 Gentamisin inj 40 mg/ml ampul 3,739 - - - - - - - -
113 Gentamisin inj 80 mg/ml vial 4,160 - - - - - - - -
114 Glibenklamid tab 5 mg tablet 61 - - - - - - - -
115 Glimepirid tab 1 mg tablet 278 41,700 - - 41,700 - - - -
116 Glimepirid tab 2 mg tablet 458 - - - - - - - -
117 Glipizid tab 5 mg tablet 3,000 - - - - - - - -
118 Gliseril Guaikolat tab 100 mg tablet 27 - 26,618 17,302 9,316 - - - -
119 Gliseril Trinitrat tab sublingual 0,5 mg tablet sub 1,650 - - - - - - - -
120 Gliserin lar 50% botol 5,867 - - - - - - - -
121 Glukosa lar infus steril 5% - 500 ml botol 5,720 429,000 - - 429,000 - - - -
122 Glukosa lar Infus steril 10% - 500 ml botol 6,270 - - - - - - - -
123 Griseofulvin tab 125 mg tablet 230 138,000 69,000 69,000 138,000 - - - -
124 Haloperidol tab 0,5 mg tablet 62 - - - - - - - -
125 Haloperidol tab 1,5 mg tablet 76 - - - - - - - -
126 Haloperidol tab 2 mg tablet 134 - - - - - - - -
127 Haloperidol tab 5 mg tablet 105 - - - - - - - -
128 Hidrogen Peroksida lar konsentrat 3% botol 34,223 - - - - - - - -
129 Hiosina Butilbromida tab 10 mg tablet 648 - - - - - - - -
130 Hydroklortiazid (HCT) tab 25 mg tablet 163 - - - - - - - -
131 Hydrokortison krim 2,5 % - 5 g tube 2,938 - - - - - - - -
132 Ibuprofen tab 200 mg tablet 121 - - - - - - - -
133 Ibuprofen tab 400 mg tablet 157 - - - - - - - -
134 Ibuprofen sir 100 mg/5 ml botol 3,849 - - - - - - - -
135 Ibuprofen sir 200 mg/5 ml botol 4,949 - - - - - - - -
136 Isoniazid tab 100 mg tablet 72 - - - - - - - -
137 Isoniazid tab 300 mg tablet 174 - - - - - - - -
138 Isosorbid Dinitrat tab 5 mg tablet 98 - - - - - - - -
139 Kalsium Glukonat inj 100 mg/mL ampul 7,800 - - - - - - - -
140 Kalsium Karbonat tab 500 mg tablet 448 - - - - - - - -
141 Kalsium Laktat (Kalk) tab 500 mg tablet 76 - - - - - - - -
142 Kanamisin inj 1.000 mg/vial vial 5,100 - - - - - - - -
143 Kaptopril tab 12,5 mg tablet 90 - - - - - - - -
144 Kaptopril tab 25 mg tablet 138 - 138,000 82,800 55,200 - - - -
145 Kaptopril tab 50 mg tablet 141 - - - - - - - -
146 Karbamazepin tab 200 mg tablet 269 - - - - - - - -
147 Karbamazepin sir 100 mg/5 mL botol 44,770 - - - - - - - -
148 Karbogliserin tts telinga 10% botol 2,246 - - - - - - - -
149 Ketamin inj 50 mg/ml - 20 ml ampul 63,400 - - - - - - - -
150 Ketamin inj 100 mg/ml - 20ml ampul 110,000 - - - - - - - -
151 Ketokonazole krim 2% - 15 g tube 5,150 - - - - - - - -
152 Ketokonazole tab 200 mg tablet 320 - - - - - - - -
153 Klaritromisin tab 500 mg tablet 3,600 - - - - - - - -
154 Klindamisin kaps 150 mg kapsul 405 - - - - - - - -
155 Klindamisin kaps 300 mg kapsul 619 - - - - - - - -
156 Kloramfenikol susp 125 mg/5 ml - 60 ml botol 5,500 - - - - - - - -
157 Kloramfenikol kaps 250 mg kapsul 275 247,500 - 55,000 192,500 - - - -
158 Kloramfenikol kaps 500 mg kapsul 935 - - - - - - - -
159 Kloramfenikol salap mata 1% tube 1,680 - 16,800 - 16,800 - - - -
160 Kloramfenikol salep kulit 2% tube 4,138 - - - - - - - -
161 Kloramfenikol susp 125 mg/5 ml botol 5,500 - - - - - - - -
162 Kloramfenikol tts mata 0,5% botol 20,360 - - - - - - - -
163 Kloramfenikol tts telinga 3% botol 11,440 - - - - - - - -
164 Klorfeniramin Maleat (CTM) tab 4 mg tablet 54 24,300 81,000 51,300 54,000 - - - -
165 Klorpromazin HCl tab 25 mg tablet 75 - - - - - - - -
166 Klorpromazin HCl tab 100 mg tablet 162 - - - - - - - -
167 Klorpromazin inj 5 mg/mL (i.m.) ampul 1,155 - - - - - - - -
168 Kodein HCL tab 10 mg tablet 550 - - - - - - - -
169 Kontrasepsi Progesteron Depot (3 Bulan) vial - - - - - - - - -
170 Kontrasepsi kombinasi Levonorgestrel 150 mcg + Etinilestradiol tablet 2,298 - - - - - - - -
171 Kotrimoxazol tab 480 mg (adult) tablet 152 - - - - - - - -
172 Kotrimoxazol susp 60 ml botol 2,298 - - - - - - - -
173 Kuinin tab 200 mg tablet 737 - - - - - - - -
174 Kuinin tab 222 mg tablet 594 - - - - - - - -
175 Kuinin inj 25% (i.v) ampul 6,820 - - - - - - - -
176 Levofloxacin tab 500 mg tablet 581 - - - - - - - -
177 Levofloxacin inf 5 mg/mL botol 43,809 - - - - - - - -
178 Levonorgestrel implan 2 rods - 75 mg subdermal imp - - - - - - - - -
179 Lidokain inj 1% (infltr) ampul 929 - - - - - - - -
180 Lidokain inj 2% (infiltr/p.v.) ampul 1,499 - - - - - - - -
181 Lidokain gel 2% botol 40,000 - - - - - - - -
182 Lidokain semprot 10% botol 156,200 - - - - - - - -
183 Lisol lar 1.000 ml botol 49,862 - 49,862 49,862 - - - - -
184 Loratadin tab 10 mg tablet 333 - 99,900 16,650 83,250 - - - -
185 Magnesium Sulfat serb 30 g sacchet 3,803 - - - - - - - -
186 Magnesium Sulfat inj 20% - 25 ml vial 5,500 247,500 - - 247,500 - - - -
187 Magnesium Sulfat inj 40% - 25 ml vial 3,500 17,500 - - 17,500 - - - -
188 Mebendazol tab 100 mg tablet 7,150 - - - - - - - -
189 Mebendazol tab 500 mg tablet 7,854 - - - - - - - -
190 Mebendazol sir 100 mg/5 ml - 30 ml botol 3,740 - - - - - - - -
191 Metampiron (Antalgin) inj 250 mg/ml - 2 ml ampul 2,560 46,080 - - 46,080 - - - -
192 Metampiron (Antalgin) tab 500 mg tablet 350 245,000 - 35,000 210,000 - - - -
193 Metformin tab 500 mg tablet 182 54,600 91,000 - 145,600 - - - -
194 Metformin tab 850 mg tablet 280 - - - - - - - -
195 Metilergometrin Maleat tab 0.125 mg tablet 169 - - - - - - - -
196 Metilergometrin Maleat inj 0.200 mg - 1 ml ampul 2,750 - - - - - - - -
197 Metilprednisolon tab 4 mg tablet 230 - - - - - - - -
198 Metilprednisolon tab 8 mg tablet 390 - - - - - - - -
199 Metilprednisolon tab 16 mg tablet 875 - - - - - - - -
200 Metoklopramid tab 5 mg tablet 113 - - - - - - - -
201 Metoklopramid tab 10 mg tablet 100 40,000 50,000 10,000 80,000 - - - -
202 Metronidazol tab 250 mg tablet 116 116,000 - - 116,000 - - - -
203 Metronidazol tab 500 mg tablet 169 169,000 - 16,900 152,100 - - - -
204 Metronidazol sir 125 mg/5 ml botol 4,350 - - - - - - - -
205 Metronidazol lar inf 5 mg/mL botol 12,980 - - - - - - - -
206 Miconazole krim 2% tube 3,150 75,600 75,600 34,650 116,550 - - - -
207 Natrium Diklofenak tab 25 mg tablet 146 - 146,000 36,500 109,500 - - - -
208 Natrium Diklofenak tab 50 mg tablet 193 - - - - - - - -
209 Natrium Klorida (NaCl) lar inf 0,9% - 500 ml botol 5,170 387,750 - - 387,750 - - - -
210 Nifedipine tab 10 mg tablet 127 50,800 - - 50,800 - - - -
211 Nistatin tab vaginal 100.000 IU ovula 528 258,720 - 47,520 211,200 - - - -
212 Nistatin tab vaginal 500.000 IU tablet 704 352,000 - - 352,000 - - - -
213 Obat Anti TB Kategori Anak Paket 189,195 - - - - - - - -
214 Obat Anti TB Kategori Anak FDC Paket 236,490 - - - - - - - -
215 Obat Anti TB Kategori I Paket 317,015 - - - - - - - -
216 Obat Anti TB Kategori I FDC Paket 396,000 - - - - - - - -
217 Obat Anti TB Kategori I Kombipak Paket 316,920 - - - - - - - -
218 Obat Anti TB Kategori II Paket 1,320,000 - - - - - - - -
219 Obat Anti TB Kategori II FDC Paket 1,319,990 - - - - - - - -
220 Obat Anti TB Kategori III Paket 154,000 - - - - - - - -
221 Obat Anti TB Kategori Sisipan FDC Paket 175,990 - - - - - - - -
222 Obat Batuk Hitam (OBH) sir 100 ml botol 3,500 - 105,000 56,000 49,000 - - - -
223 Ofloxacin tab 200 mg tablet 440 - - - - - - - -
224 Ofloxacin tab 400 mg tablet 700 - - - - - - - -
225 Oksimetazolin tts hidung 0,025 % botol 30,305 - - - - - - - -
226 Oksimetazolin tts hidung 0,050 % botol 32,000 - - - - - - - -
227 Oksitetrasiklin HCl salep kulit 3 % - 3,5 g tube 2,816 - - - - - - - -
228 Oksitetrasiklin HCl salep mata 1% - 3,5 g tube 2,310 - - - - - - - -
229 Oksitosin inj 10 IU/ml - 1 ml ampul 5,500 - - - - - - - -
230 Olopatadin tts mata 0,1% botol 68,000 - - - - - - - -
231 Omeprazol kaps 20 mg kapsul 409 - 184,050 53,170 130,880 - - - -
232 Omeprazol inj 40 mg/10 mL vial 42,000 - - - - - - - -
233 Paracetamol tab 500 mg tablet 88 - - - - - - - -
234 Paracetamol sir 120 mg/5 ml - 60 ml botol 1,535 - - - - - - - -
235 Paracetamol tts 60 mg/0,6 mL botol 7,350 - - - - - - - -
236 Perak Sulfadiazin krim 1% tube 25,350 - - - - - - - -
237 Permetrin krim 5% tube 11,475 - - - - - - - -
238 Pirantel Pamoat tab 125 mg tablet 318 131,016 - - 131,016 - - - -
239 Pirantel Pamoat sir 125 mg/5 ml - 60ml botol 9,100 236,600 - - 236,600 - - - -
240 Pirazinamid tab 500 mg tablet 225 - - - - - - - -
241 Piridoksin (Vitamin B6) inj 100 mg/ml ampul 1,100 - - - - - - - -
242 Piridoksin (Vitamin B6) tab 10 mg tablet 121 114,950 - - 114,950 - - - -
243 Piroxicam tab 10 mg tablet 149 - - - - - - - -
244 Povidon Iodida lar 10% - 1000 ml botol 40,202 - - - - - - - -
245 Povidon Iodida lar 10% - 300 ml botol 15,386 - - - - - - - -
246 Povidon Iodida lar 10% - 60 ml botol 6,500 - - - - - - - -
247 Povidon Iodida lar 10% - 30 ml botol 2,344 - - - - - - - -
248 Prednison tab 5 mg tablet 192 - - - - - - - -
249 Primakuin tab 15 mg tablet 205 - - - - - - - -
250 Probenesid tab 500 mg tablet 1,815 - - - - - - - -
251 Procain Benzil Penicillin G serb inj 3 Juta UI vial 9,768 - - - - - - - -
252 Propranolol tab 10 mg tablet 80 - - - - - - - -
253 Propiltiourasil ( PTU) tab 100 mg tablet 351 - - - - - - - -
254 Ranitidin tab 150 mg tablet 220 - 220,000 66,000 154,000 - - - -
255 Ranitidin inj 25 mg/mL ampul 1,340 - - - - - - - -
256 Retinol (Vit A) softcap 100.000 IU softcap 286 - - - - - - - -
257 Retinol (Vit A) softcap 200.000 IU softcap 505 - - - - - - - -
258 Rifampicin kaps 300 mg kapsul 670 - - - - - - - -
259 Rifampicin tab 450 mg tablet 868 - - - - - - - -
260 Rifampicin tab 600 mg tablet 1,209 - - - - - - - -
261 Ringer Laktat lar inf steril 500 ml botol 4,727 80,359 661,780 236,350 505,789 - - - -
262 Salbutamol tab 2 mg tablet 65 - - - - - - - -
263 Salbutamol tab 4 mg tablet 93 - - - - - - - -
264 Salbutamol cairan ih 0,1% botol 7,260 - - - - - - - -
265 Salep 2-4 kombinasi Asam Salisilat 2% + Belerang Endap 4% pot 2,200 - - - - - - - -
266 Serum Antibisa Ular inj 50 ml ( ABU II) vial 43,890,000 - - - - - - - -
267 Serum Antibisa Ular inj 5 ml (ABU I) vial 597,903 - - - - - - - -
268 Serum Antidifteri inj 10,000 IU vial - - - - - - - - -
269 Serum Antidifteri inj 20,000 IU vial 1,209,035 - - - - - - - -
270 Serum Antitetanus inj 1.500 IU vial 161,000 - - - - - - - -
271 Serum Antitetanus inj 10.000 IU vial - - - - - - - - -
272 Serum Antitetanus inj 20.000 IU vial 324,550 - - - - - - - -
273 Sianokobalamin (Vitamin B12) tab 50 mcg tablet 63 - - - - - - - -
274 Sianokobalamin (Vitamin B12) inj 500 mcg/mL ampul 1,150 - - - - - - - -
275 Simvastatin tab 10 mg tablet 294 14,700 147,000 14,700 147,000 - - - -
276 Simvastatin tab 20 mg tablet 480 - - - - - - - -
277 Siprofloksasin tab 500 mg tablet 290 29,000 - - 29,000 - - - -
278 Spironolakton tab 25 mg tablet 350 - - - - - - - -
279 Streptomisin serb inj 1,000 mg/vial vial 4,015 - - - - - - - -
280 Tablet tambah darah kombinasi Ferro Sulfat 200 mg + As.Folat tablet 112 - - - - - - - -
281 Tetracain HCl tts mata 0,5% - 5 ml botol 11,500 - - - - - - - -
282 Tetrasiklin kaps 250 mg kapsul 162 16,200 81,000 32,400 64,800 - - - -
283 Tetrasiklin kaps 500 mg kapsul 325 - - - - - - - -
284 Thiamfenikol kaps 500 mg kapsul 985 - - - - - - - -
285 Thiamin HCl (Vitamin B1) tab 50 mg tablet 60 - 60,000 15,000 45,000 - - - -
286 Thiamin HCl (Vitamin B1) inj 100 mg/ml - 1 ml ampul 1,500 - - - - - - - -
287 Tramadol inj 50 mg/mL ampul 2,680 - - - - - - - -
288 Triheksipenidil tab 2 mg tablet 70 - - - - - - - -
289 Vaksin rabies utk manusia serb inj (s.k/i.k) + booster ampul 160,339 - - - - - - - -
290 Valproat tab sal 250 mg tablet salut 1,680 - - - - - - - -
291 Valproat tab sal 500 mg tablet salut 5,450 - - - - - - - -
292 Valproat sir 250 mg/5 mL botol 41,800 - - - - - - - -
293 Vankomisin serb inj 500 mg/vial vial 142,000 - - - - - - - -
294 Vitamin B Kompleks tablet 112 - 336,000 190,400 145,600 - - - -
295 Zinc sir 10 mg/ml botol 16,478 - - - - - - - -
296 Zinc sir 20 mg/5 ml botol 8,140 - - - - - - - -
297 Zinc dispersible 20 mg tablet 521 - - - - - - - -
298 Alprazolam tab 1 mg tablet 245 - - - - - - - -
299 Betahistin tab 6 mg tablet - - - - - - - - -
300 Idometasin kapl 25 mg kaplet 380 - - - - - - - -
301 Karbon Aktif tab 125 mg tablet 127 - - - - - - - -
302 Klobazam tab 10 mg tablet 950 - - - - - - - -
303 Lidokain 2% (HCl) + Epinefrin 1 : 80.000 inj 2 ml ampul 1,499 - - - - - - - -
304 Loperamid tab 2 mg tablet 97 - - - - - - - -
305 Petidin inj i.m/s.k/i.v 50 mg/ml (HCl) - 2 ml ampul 15,950 - - - - - - - -
306 Papaverin 40 mg tablet - - - - - - - - -
307 Piracetam tab 400 mg tablet - - - - - - - - -
308 Thiamfenikol tab 250 mg tablet - - - - - - - - -
309 Piracetam tab 800 mg tablet - - - - - - - - -
310 Piroxicam tab 20 mg tablet - - - - - - - - -
311 Asam Askorbat (Vit.C) tab 25 mg tablet - - - - - - - - -
312 Etanol 70% lar 1000 ml botol - - - - - - - - -
313 Etanol 70% lar 300 ml botol - - - - - - - - -
314 Neurosanbe injeksi ampul - - - - - - - - -
315 H2O2 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

BAHAN MEDIS HABIS PAKAI

1 Alat Suntik 1 ml pcs 1,262 25,240 63,100 16,406 71,934 - - - -
2 Alat Suntik 2.5 ml pcs 1,102 - - - - - - - -
3 Alat Suntik 3 ml pcs 1,010 33,330 50,500 33,330 50,500 - - - -
4 Alat Suntik 5 ml pcs 1,248 124,800 - - 124,800 - - - -
5 Alat Suntik 10 ml pcs 1,694 52,514 - - 52,514 - - - -
6 Alat Suntik 20 ml pcs 2,228 - - - - - - - -
7 Alat Suntik 50 ml pcs 10,350 - - - - - - - -
8 Alat Suntik ADS 0,5 ml pcs 1,925 - - - - - - - -
9 Alat Suntik ADS 3 ml (BD) pcs 1,797 - - - - - - - -
10 Alat Suntik ADS 5 ml (BD) pcs 1,797 - - - - - - - -
11 Alat Suntik ADS 5 ml BCG pcs 2,585 - - - - - - - -
12 Alat Suntik ADS 10 ml (BD) pcs 2,900 - - - - - - - -
13 Alat Suntik (Nipro Syringe) 3 ml pcs 1,512 - - - - - - - -
14 Alat Suntik (Nipro Syringe) 5 ml pcs 2,000 - - - - - - - -
15 Alat Suntik (Nipro Syringe) 10 ml pcs 900 - - - - - - - -
16 Alat Test Darah 3 in 1 (gula darah, asam urat, kolesterol) Unit 1,100,000 - - - - - - - -
17 Catgut no.2/0 pcs 213,525 - 10,249,200 2,562,300 7,686,900 - - - -
18 Catgut no.3/0 pcs 213,525 15,373,800 - 5,124,600 10,249,200 - - - -
19 Catheter (Aximed Foleycath 2-Way no.14) pcs 11,000 - - - - - - - -
20 Catheter (folley cathteter) no.10 pcs 13,750 123,750 137,500 - 261,250 - - - -
21 Catheter (folley cathteter) no.12 pcs 13,750 137,500 137,500 - 275,000 - - - -
22 Catheter (folley cathteter) no.14 pcs 13,750 41,250 137,500 - 178,750 - - - -
23 Catheter (folley cathteter) no.16 pcs 13,750 110,000 137,500 13,750 233,750 - - - -
24 Catheter (folley cathteter) no.18 pcs 13,750 96,250 137,500 55,000 178,750 - - - -
25 Cholesterol test btl/10 strip botol 320,000 - - - - - - - -
26 Copper T set 125,000 - 500,000 500,000 - - - - -
27 Feeding Tube (Aximed) 40 cm no. 6 pcs 7,370 - - - - - - - -
28 Feeding Tube (Aximed) 40 cm no. 8 pcs 7,370 - - - - - - - -
29 Feeding Tube (Aximed) 40 cm no. 10 pcs 7,370 - - - - - - - -
30 Glukosa test btl/25 strip botol 180,000 - - - - - - - -
31 Hand Schoen no 7 set 14,850 - 742,500 252,450 490,050 - - - -
32 Hand Schoen no 7.5 set 14,850 - 386,100 222,750 163,350 - - - -
33 Hand Schoen no 7.5 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
34 Hand Schoen no 8 set 14,850 - - - - - - - -
35 Hand Schoen no 8 U/ manual Placenta ( Long) set 8,000 - - - - - - - -
36 Hand Schoen (Aximed Exam Gloves size S) pcs 46,200 - - - - - - - -
37 Hand Schoen (Aximed Exam Gloves size M) pcs 46,200 - - - - - - - -
38 Hand Schoen (Aximed Chirurgic Gloves no. 7,0) pcs 7,600 - - - - - - - -
39 Hand Schoen (Aximed Chirurgic Gloves no. 8,0) pcs 7,600 - - - - - - - -
40 Hand Schoen (Chirurgic Gloves no. 6,5) set 9,500 - - - - - - - -
41 Hand Schoen (Chirurgic Gloves no. 7,0) set 9,500 - - - - - - - -
42 Hand Schoen (Chirurgic Gloves no. 7,5) set 9,500 - - - - - - - -
43 Hand Schoen (Chirurgic Gloves no. 8,0) set 9,500 - - - - - - - -
44 Hand Schoen (Examination Gloves Size S) set 57,750 - - - - - - - -
45 Hand Schoen (Examination Gloves Size M) set 57,750 - - - - - - - -
46 Hand Schoen (Examination Gloves Size L) set 57,750 - - - - - - - -
47 Infusion Set Anak set 6,375 274,125 - 82,875 191,250 - - - -
48 Infusion Set Dewasa set 12,100 - 605,000 157,300 447,700 - - - -
49 Infusion Set Macro 2 Cabang set 35,000 - - - - - - - -
50 IV Catheter no. 16 pcs 8,948 - - - - - - - -
51 IV Catheter no. 18 pcs 8,948 554,776 89,480 89,480 554,776 - - - -
52 IV Catheter no. 20 pcs 8,948 - 89,480 89,480 - - - - -
53 IV Catheter no. 22 pcs 8,948 134,220 89,480 26,844 196,856 - - - -
54 IV Catheter no. 24 pcs 8,948 125,272 178,960 - 304,232 - - - -
55 IV Catheter (Nipro IV Catheter no. 18 G x 1 - 1/4") pcs 7,018 - - - - - - - -
56 IV Catheter (Nipro IV Catheter no. 18 G x 2") pcs 7,018 - - - - - - - -
57 IV Catheter (Nipro IV Catheter no. 20 G x 1 - 1/4") pcs 7,018 - - - - - - - -
58 IV Catheter (Nipro IV Catheter no. 20 G x 1") pcs 7,018 - - - - - - - -
59 IV Catheter (Nipro IV Catheter no. 22 G x 1") pcs 7,018 - - - - - - - -
60 IV Catheter (Nipro IV Catheter no. 24 G x 1") pcs 7,018 - - - - - - - -
61 Jarum Jahit Otot all size lusin 18,500 - - - - - - - -
62 Jarum Jahit 1/2 Surgical lusin 135,000 135,000 135,000 135,000 135,000 - - - -
63 Jarum Jahit 3/8 Surgical lusin 120,000 120,000 120,000 120,000 120,000 - - - -
64 Kaca Slide pcs 50,000 - - - - - - - -
65 Kapas Pembalut 250 g roll 22,000 132,000 110,000 22,000 220,000 - - - -
66 Kapas Pembalut 500 g roll 35,000 175,000 175,000 - 350,000 - - - -
67 Kasa Hydrofil 18 yard x 22 cm roll 4,750 - - - - - - - -
68 Kasa Hydrofil 40 yard x 80 cm roll 122,550 122,550 612,750 122,550 612,750 - - - -
69 Kasa Kompres Steril 40 x 40 cm bungkus 2,723 10,892 54,460 10,892 54,460 - - - -
70 Kasa Pembalut 2 m x 80 cm roll 13,366 - - - - - - - -
71 Kasa Pembalut 4 m x 5 cm roll - - - - - - - - -
72 Kasa Pembalut 4 m x 10 cm roll 2,601 - 26,010 26,010 - - - - -
73 Kasa Pembalut 4 m x 15 cm roll - - - - - - - - -
74 Kasa Pembalut Hydrofil 4 yard x 5 cm roll 1,248 - - - - - - - -
75 Kasa Pembalut Hydrofil 4 yard x 10 cm roll 2,600 - - - - - - - -
76 Kasa Pembalut Hydrofil 4 yard x 15 cm roll 3,638 - - - - - - - -
77 Kasa Steril 16 cm x 16 cm box 6,743 - - - - - - - -
78 Kasa Steril 18 cm x 22 cm box 16,500 - 82,500 - 82,500 - - - -
79 Masker Ear Loop Pcs 495 - 24,750 24,750 - - - - -
80 Mata Pisau Bedah No. 10 pcs 9,750 9,750 97,500 9,750 97,500 - - - -
81 Mata Pisau Bedah No. 11 Pcs 9,750 - 97,500 - 97,500 - - - -
82 Mata Pisau Bedah No. 15 Pcs 9,750 87,750 97,500 29,250 156,000 - - - -
83 Mata Pisau Bedah No. 21 Pcs 9,750 58,500 - 9,750 48,750 - - - -
84 Nasal Oxygen (Aximed) size M Pcs 6,600 - - - - - - - -
85 Nasal Oxygen (Aximed) size L Pcs 6,600 - - - - - - - -
86 Nasal Oxygen (Aximed) size XS Pcs 6,600 - - - - - - - -
87 Plester 5 yard x 2 inchi roll 7,186 - - - - - - - -
88 Plester 5 cm x 4,5 cm roll - - - - - - - - -
89 Plester 7,5 cm x 4,5 cm roll 34,650 - - - - - - - -
90 Pot Sputum pot 2,000 - - - - - - - -
91 RDT pcs - - - - - - - - -
92 Regulator Oxygen pcs 450,000 - - - - - - - -
93 Safety Box kotak - - - - - - - - -
94 Selang Oxygen pcs 8,250 - - - - - - - -
95 Silk (benang bedah sutra) no.2/0 pcs 251,400 15,084,000 6,033,600 754,200 20,363,400 - - - -
96 Silk (benang bedah sutra) no.3/0 pcs 206,779 - - - - - - - -
97 Sound Timer unit 1,219,143 2,438,286 - 2,438,286 - - - - -
98 Stempel ISPA pcs - - - - - - - - -
99 Uric Acid test btl/25 strip botol 240,000 - - - - - - - -
100 Urine bag pcs 6,875 55,000 - 13,750 41,250 - - - -

BHP/REAGENT LAB
1 Cairan Spritus 1000 ml botol 15,000 - - - - - - - -
2 Desinfektan Pembersih Tangan (Saflon) 300 ml botol 130,500 - - - - - - - -
3 Larutan Asam Klorida (HCl) 0,1 N botol - - - - - - - - -
4 Larutan Asam Sulfa Salisilat 20% botol 24,755 - - - - - - - -
5 Larutan Benedik botol 40,040 - - - - - - - -
6 Larutan Eosin 2% botol 36,595 - - - - - - - -
7 Larutan Etanol Asam botol 34,126 - - - - - - - -
8 Larutan Giemsa Stein botol 63,348 - - - - - - - -
9 Larutan Karbol Fuksin botol 23,231 - - - - - - - -
10 Larutan Metanol botol 118,300 - - - - - - - -
11 Larutan Metilen Biru botol 17,086 - - - - - - - -
12 Larutan Turk botol 54,600 - - - - - - - -
13 Reagen TBC kit - - - - - - - - -
14 Test Asam Urat test 250,000 - 6,250,000 6,250,000 - - - - -
15 Test Comburt Reagens set 251,200 - - - - - - - -
16 Test Golongan Darah set 286,365 - - - - - - - -
17 Test Golongan Darah Reagens set 251,200 - - - - - - - -
18 Test Gula Darah test 200,000 - 5,000,000 5,000,000 - - - - -
19 Test Kehamilan strip 2,400 - 120,000 7,200 112,800 - - - -
20 Test Kolesterol test 350,000 - 7,000,000 7,000,000 - - - - -
21 Test Urine Rutin strip 3,000 - - - - - - - -

GIGI
1 Air raksa Dental Use - 108,195 - - - - - - - -
2 Devitalisasi pasta (arsen) kotak 390,000 - - - - - - - -
3 Eugenol cairan 10 ml botol 18,333 - - - - - - - -
4 Fluoride 0.5 mg tablet 30,000 - - - - - - - -
5 Fluoride 1 mg tablet 4,456 - - - - - - - -
6 Hemospon (Spongostan Dental) pcs 536,250 - - - - - - - -
7 Iodoform Pasta (Mumyfyng Pasta) set 380,250 - - - - - - - -
8 Jarum Jahit u/ Gusi bentuk bulan sabit lusin 18,500 - - - - - - - -
9 Kalsium Hidroksida Pasta tube 341,250 - - - - - - - -
10 Klorheksidin lar 0,2% botol - - - - - - - - -
11 Klorheksidin lar 15% botol - - - - - - - - -
12 Mata Bor Gigi pcs 48,750 - - - - - - - -
13 Paramono (Klorfenol Kamfer Mentol (CHKM) 10 ml) botol 92,528 - - - - - - - -
14 Semen Seng Fosfat serbuk/cair 30 gram botol 93,500 - - - - - - - -
15 Trikresol Formalin (TKF) cairan botol 7,239 - - - - - - - -

OBAT KHUSUS
1 Pehacain inj (Lidokain HCl 2% + Epinefrin 1:80.000) ampul 78,916 - - - - - - - -
2 Albothyl (Polikresulen) lar 36% (g/g) - 5 mL botol 24,083 - - - - - - - -
3 Becefort sir 60 ml botol 26,230 - - - - - - - -
4 Bronex (Bromheksin) tab 8 mg tablet 82 - - - - - - - -
5 Erlamycetin (Kloramfenikol) tts mata 0.5% botol 5,070 - - - - - - - -
6 Fluoride 1 mg tablet 976 - - - - - - - -
7 Kandistatin susp 12 ml botol 36,300 - - - - - - - -
8 KY Jelly tube 85,000 - - - - - - - -
9 Mefamicetin (Kloramfenikol) susp 125 mg/ ml botol 8,800 - - - - - - - -
10 Norit (Karbon Aktif) tab 125 mg tablet - - - - - - - - -
11 Pantocain (Tetrakain HCl) tetes mata botol 31,688 - - - - - - - -
12 Pehavral tablet salut 70,785 - - - - - - - -
13 Reco (Kloramfenikol) salep mata 1% tube 2,501 - - - - - - - -
14 Reco (Kloramfenikol) tts telinga 3% botol 11,440 - - - - - - - -
15 Scabicid krim (Gamexan 10 mg, Asam usnat 10 mg) tube 24,716 - - - - - - - -
16 Scopamin inj (Hiosin Butilbromida) inj 20 mg/ml ampul 31,688 - - - - - - - -
17 Vaksin Antirabies Vero (VAR) vial 48,400 - - - - - - - -
18 Zircum Kid (Zinc) sir 20 mg/ml - 60 ml botol 8,140 - 40,700 - 40,700 - - - -
19 Cendo Xytrol TM 5 ml botol 35,850 - - - - - - - -
20 Formalin 40 % botol 42,000 - - - - - - - -
21 Lexavit (Multivitamin dan Mineral) kaplet kaplet 545 - 1,090,000 245,250 844,750 - - - -
22 Neurodial (Metampiron 500 mg + Diazepam 2 mg) kaplet kaplet 1,265 - 126,500 - 126,500 - - - -
23 Pritamox (Amoxicillin) tab 500 mg tablet 297 - - - - - - - -
24 Thiamex (Thiamfenikol) kaps 500 mg kapsul 14,469 4,340,700 1,446,900 - 5,787,600 - - - -
25 Vical susp 100 ml botol 4,890 53,790 73,350 39,120 88,020 - - - -
26 Vitamin D3 00 IU/D-Vit tablet tablet 680 326,400 - - 326,400 - - - -
27 Vinafluor (Fluoride) kapl 1 mg kaplet - - - - - - - - -
28 Sanmol (Parasetamol) 500 mg tablet 325 - 162,500 97,500 65,000 - - - -
29 Cardisan ( Amlodipine) 5 mg tablet 11,918 - - - - - - - -
30 Purecemia (Allopurinol) 300 mg tablet 3,269 - - - - - - - -
31 Mefinal (Asam Mefenamat) 500 mg kaplet 1,538 - - - - - - - -
32 Neurosanbe (Vit. B1 100 mg, B6 200 mg, B12 200 mg) tablet 2,757 - - - - - - - -
33 Santa E 200 (dl. α -Tocopheryl Acetate) 200 mg kaplet 2,244 - - - - - - - -
34 Mucohexin (Bromhexine HCl) 8 mg tablet 575 - - - - - - - -
35 Cholvastin (Lovastatin) 20 mg tablet 12,043 - - - - - - - -
36 Histigo (Betahistin) tab 6 mg tablet - - - - - - - - -
37 Novadium (Loperamid) tab 2 mg tablet - - - - - - - - -
38 Metolon (Metoklorperamid) 5 mg/5ml syrup botol - - - - - - - - -
39 Metolon (Metoklorperamid) tab 10 mg tablet - - - - - - - - -
40 Novabion tablet - - - - - - - - -
41 Novagesic (Parasetamol) tab 500 mg tablet - - - - - - - - -
42 Defamol (Parasetamol) tab 500 mg tablet - - - - - - - - -
43 Sultrimix syrup botol - - - - - - - - -
44 Biovitan syrup botol - - - - - - - - -
45 Caviplex syrup botol - - - - - - - - -
46 Farsifen (Ibuprofen) syrup botol - - - - - - - - -
47 Novaxifen (Ibuprofen) tab 200 mg tablet - - - - - - - - -
48 Lexigo (Betahistin) tab 6 mg tablet - - - - - - - - -
49 Loric (Allopurinol) tab 100 mg tablet - - - - - - - - -
50 Eryra Forte (Erytromicin) kaps 500 mg tablet - - - - - - - - -
51 Arkavit tablet - - - - - - - - -
52 Novadex (Dexametason) 0,5 mg tablet - - - - - - - - -
53 Carbidu (Dexametason) 0,5 mg tablet - - - - - - - - -
54 Gralixa (Furosemid) 40 mg tablet - - - - - - - - -
55 Grafazol (Metronidazol) tab 500 mg tablet - - - - - - - - -
56 Glikos (Metformin) tab 500 mg tablet - - - - - - - - -
57 Vesverum (Domperidon Maleat) tab 10 mg tablet - - - - - - - - -
58 Metaneuron (Metamizolesodium + Diazepam) tablet - - - - - - - - -
59 Trifadium ( Loperamide HCL 2 mg) tablet - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -
0 0 0 - - - - - - - - -

TOTAL 45,827,449 48,544,490 34,371,692 60,000,247 - - - -

MENGETAHUI
KEPALA PUSKESMAS MOWEWE

SELVINA LAKASA, Amd. Keb

Nip. 19670824 198903 2 008
DIAAN, STOK OPNAME DAN MUTASI OBAT

BULAN : MEI
TAHUN : 2017

DAK BPJS - JKN JUMLAH KESELURUHAN

BUFFER PROVINSI PROGRAM
Stok Awal Penerimaan Pengeluaran Stok Akhir Stok Awal Penerimaan Pengeluaran
Awal Terima Keluar Akhir Awal Terima Keluar Akhir
- - - - - - - - - - - - 48,000 60,000 12,000

- - - - - - - - - - - - 780,450 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 71,500 14,300

- - - - - - - - - - - - - - -

- - - - - - - - 31,650 - 31,650 - 31,650 105,500 58,025

- - - - - - - - - - - - - 100,000 30,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 280,500 196,350

- - - - - - - - - - - - - 236,500 122,980

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 370,000 - 370,000 - 370,000 370,000 629,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 15,600 - 15,600 - 15,600 117,000 70,200

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 64,000 32,000 -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 105,000 - 105,000 - 105,000 - 105,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 70,400 - 35,200 35,200 70,400 176,000 158,400

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 107,100 - 35,700 71,400 107,100 - 35,700

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 6,750 8,100 1,350

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 7,980 - 7,980 - 7,980 39,900 15,960

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 548,000 274,000

- - - - - - - - - - - - 100,434 264,300 68,718

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 300,000 100,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 250,965 -

- - - - - - - - - - - - - - -
- - - - - - - - 34,760 - - 34,760 34,760 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 13,794 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 57,200 85,800 28,600

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 258,390 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 388,320 - 121,350

- - - - - - - - 16,368 - 5,456 10,912 65,472 - 16,368

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 2,625 39,375 10,500

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 11,262 112,620 112,620

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - 126,800 - 28,530

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 24,400 - - 24,400 24,400 - -

- - - - - - - - - - - - 41,700 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 26,618 17,302

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 429,000 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 138,000 69,000 69,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 24,200 - 24,200 - 24,200 - 24,200

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 9,800 - - 9,800 9,800 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 138,000 82,800

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 247,500 - 55,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 16,800 -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 24,300 81,000 51,300

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 30,400 - 15,200 15,200 30,400 - 15,200

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - 77,948 2,998 74,950 - 77,948 2,998

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 49,862 49,862

- - - - - - - - - - - - - 99,900 16,650

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 247,500 - -

- - - - - - - - - - - - 17,500 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 46,080 - -

- - - - - - - - - - - - 245,000 - 35,000

- - - - - - - - 100,100 - - 100,100 154,700 91,000 -

- - - - - - - - - - - - - - -

- - - - - - - - 126,750 - - 126,750 126,750 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 40,000 50,000 10,000

- - - - - - - - - - - - 116,000 - -

- - - - - - - - 33,800 - - 33,800 202,800 - 16,900

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 75,600 75,600 34,650

- - - - - - - - - - - - - 146,000 36,500

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 387,750 - -

- - - - - - - - - - - - 50,800 - -

- - - - - - - - - - - - 258,720 - 47,520

- - - - - - - - - - - - 352,000 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - 105,000 56,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - 112,640 - 112,640 - 112,640 -

- - - - - - - - - - - - - - -

- - - - - - - - 27,500 - - 27,500 27,500 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 184,050 53,170

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 21,490 - 12,280 9,210 21,490 - 12,280

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 131,016 - -

- - - - - - - - - - - - 236,600 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 114,950 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 46,158 76,930 46,158 76,930 46,158 76,930 46,158

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 220,000 66,000

- - - - - - - - 21,440 - 21,440 - 21,440 - 21,440

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - 80,359 661,780 236,350

- - - - - - - - 22,750 - 22,750 - 22,750 - 22,750

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 14,700 147,000 14,700

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 29,000 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 16,200 81,000 32,400

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 60,000 15,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 336,000 190,400

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 25,240 63,100 16,406

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 33,330 50,500 33,330

- - - - - - - - - - - - 124,800 - -

- - - - - - - - - - - - 52,514 - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 10,249,200 2,562,300

- - - - - - - - - - - - 15,373,800 - 5,124,600

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 123,750 137,500 -

- - - - - - - - - - - - 137,500 137,500 -

- - - - - - - - - - - - 41,250 137,500 -

- - - - - - - - - - - - 110,000 137,500 13,750

- - - - - - - - - - - - 96,250 137,500 55,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 500,000 500,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 742,500 252,450

- - - - - - - - - - - - - 386,100 222,750

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 57,750 - 57,750 - 57,750 - 57,750

- - - - - - - - - 346,500 57,750 288,750 - 346,500 57,750

- - - - - - - - - - - - - - -
- - - - - - - - - - - - 274,125 - 82,875

- - - - - - - - 121,000 - 84,700 36,300 121,000 605,000 242,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - 26,844 - 26,844 554,776 116,324 89,480

- - - - - - - - 89,480 268,440 44,740 313,180 89,480 357,920 134,220

- - - - - - - - - - - - 134,220 89,480 26,844

- - - - - - - - 35,792 - - 35,792 161,064 178,960 -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 135,000 135,000 135,000

- - - - - - - - - - - - 120,000 120,000 120,000

- - - - - - - - - - - - - - -

- - - - - - - - 44,000 - - 44,000 176,000 110,000 22,000

- - - - - - - - - - - - 175,000 175,000 -

- - - - - - - - - - - - - - -

- - - - - - - - 245,100 - 245,100 - 367,650 612,750 367,650

- - - - - - - - - - - - 10,892 54,460 10,892

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 26,010 26,010

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 82,500 -

- - - - - - - - 49,500 - 49,500 - 49,500 24,750 74,250

- - - - - - - - - - - - 9,750 97,500 9,750

- - - - - - - - - - - - - 97,500 -

- - - - - - - - - - - - 87,750 97,500 29,250

- - - - - - - - - - - - 58,500 - 9,750

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 15,084,000 6,033,600 754,200

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 2,438,286 - 2,438,286

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - 55,000 - 13,750

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 6,250,000 6,250,000

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - 5,000,000 5,000,000

- - - - - - - - - - - - - 120,000 7,200

- - - - - - - - - - - - - 7,000,000 7,000,000
- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - - - - - - - -

- - - - - - - - 3,235,549 - 3,235,549 - 3,235,549 - 3,235,549

- - - -