KEBUTUHA PEMBER
NAMA OBAT SAT PEMA- KET
STOCK KADALUAR PENGEMBA STOCK N STOCK IAN
PENERIMA PERSEDIAA PERMINTA
AWAL SA LIAN AKHIR PERBULAN OPT DAK
AN N KAIAN AN
( RKO
)
2 3 4 5 6 7 8 9 10 11 12 13 14 15
A. OBAT-OBATAN
ALLOPURINOL TAB 100 mg TAB 655 200 855 230 - - 625 112 336 100
AMLODIPIN TAB 5 mg TAB 1,740 1,200 2,940 630 - - 2,310 630 1,890 -
AMLODIPIN TAB 10 mg TAB 1,200 1,200 2,400 790 - - 1,610 735 2,205 600
AMOKSISILIN TAB 500 mg KAPS 11,360 - 11,360 710 - - 10,650 5,737 17,211 -
ANTASIDA DOEN TAB KUNYAH TAB 8,330 - 8,330 1,790 - - 6,540 1,594 4,782 2,000
ANTI DIARE TAB(ATTAPULGIT TAB) TAB 730 1,000 1,730 100 - - 1,630 780 -
ASAM FOLAT (PROFOLAT) TAB 2,840 - 2,840 1,340 - - 1,500 990 2,970 -
ASAM MEFENAMAT TAB 500 mg TAB 2,755 - 2,755 485 - - 2,270 753 2,259 1,000
ASICLOVIR TAB 400 mg TAB 475 - 475 100 - - 375 138 414 100
CETIRIZIN TAB 10 mg TAB 2,955 1,000 3,955 895 - - 3,060 1,945 5,835 1,000
ERYTROMISIN TAB 500 mg CAPS 1,700 500 2,200 592 - - 1,608 502 1,506 2,000
FITOMENADION (VIT.K) TAB SAL 10 TAB 250 100 350 250 - - 100 81 243 -
GARAM ORALIT 200 ml TAB 310 - 310 310 - - - 185 555 200
IBUPROFEN TAB 400 mg TAB 2,445 - 2,445 433 - - 2,012 120 360 -
KALSIUM LAKTAT (KALK) TAB 500 m TAB 3,495 - 3,495 775 - - 2,720 250 750 1,000
KLINDAMISIN KAP 150 MG TAB 2,095 - 2,095 1,000 - - 1,095 100 300 -
KOTRIMOKSAZOL TAB 480 mg TAB 2,685 500 3,185 1,055 - - 2,130 65 195 2,500
METFORMIN TAB 500 mg TAB 4,640 1,000 5,640 775 - - 4,865 1,815 5,445 1,000
MULTIVITAMIN TABLET TAB 1,000 - 1,000 465 - - 535 1,507 4,521 2,000
NATRIUM DIKLOFENAK TAB 50 mg TAB 4,530 2,800 7,330 875 - - 6,455 1,728 5,184 -
OMEPRAZOL kaps 20 mg KAPS 645 2,000 2,645 320 - - 2,325 59 177 3,000
PARASETAMOL TAB 500 mg TAB 18,510 10,000 28,510 9,650 - - 18,860 11,500 34,500 10,000
PIRIDOKSIN HCL TAB 10 mg TAB 2,000 2,000 4,000 - - - 4,000 2,111 6,333 500
PREDNISON TAB 5 MG TAB 3,611 - 3,611 365 - - 3,246 2,347 7,041 1,000
SIPROFLOKSACIN TAB 500 mg TAB 750 300 1,050 550 - - 500 529 1,587 2,000
TABLET TAMBAH DARAH (FE/SF) TAB 25,600 4,000 29,600 22,120 - - 7,480 2,128 6,384 -
TIAMIN HCL (VIT B.1 ) TAB 50 mg TAB 3,930 2,000 5,930 880 - - 5,050 1,861 5,583 1,000
TRIHEKSIFENIDIL TAB. 2 MG - - - - - - - - -
VITAMIN B KOMPLEKS TAB 4,490 2,000 6,490 395 - - 6,095 1,483 4,449 -
AMOKSISILIN SYROP KERING 125 mg/ BTL 171 - 171 29 - - 142 113 339 -
PARASETAMOL SYROP 120 mg/5 ml BTL 267 - 267 33 - - 234 193 579 -
UNIBEBI BTL - - - - - - - -
3.1 INJEKSI - - - - - - - - -
COMBIVENT AMP - - - - - - - - -
4.1.SALEP/KRIM /BEDAK/JELLY - - - - - - - - -
hi
PARASETAMOL SUPP (DUMIN) SUPP 2 - 2 - - - 2 - -
L I S O L 50 % BTL 7 - 7 - - - 7 - -
5. OBAT GIGI - - - - - - - - -
IODOFORM BTL - - - - - - - - - -
1. ALAT KESEHATAN - - - - - - - - -
Alat suntik sekali pakai 0,5 ml Set 1,500 - 1,500 1,500 - - - - 3,000
Umbilicall buah - - - - - - - - -
Vacutaner buah - - - - - - - - -
Venoject buah - - - - - - - - -
- - - - - - - - -
1. REAGEN - - - - - - - - -
Anaskopi unit - - - - - - - - -
Rotator - - - - - - - - -
CD4 Control - - - - - - - - -
TAMBAHAN LAIN-LAIN - - - - - - - - -
- - - - -
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
OBAT DANA JKN
Nia Aminah Kurniati, S.Ip.,M.Si Devi Aulia, S.Si , Apt Drg. Ria Joesriati Desmia,Amd.Kes Suzan Sagita
NIP. 19740708 199311 2 001 NIP. 19760314 200501 2010 NIP. 1980112120070012003 1982062402014122001' 3275054312910000'
10 PENYAKIT TERBESAR -
NO NAMA PENYAKIT KODE JUMLAH
1 NASOFARINGITIS AKUT 614
2 ARTRITIS LAINNYA 89
3 KARIES GIGI 102
4 DYSPEPSIA 105
5 PENYAKIT PULPA DAN JARINGAN PERIAPIKAL 369
6 HIPERTENSI 134
7 NIDM 3 87
8 FARINGITIS AKUT 80
9 DERMATIS ATOPIK 78
10 PENYAKIT GUSI JARINGAN PERIDONTAL & TULANG 68
1726
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
KEBUTUHA PEMBER
NAMA OBAT SAT PEMA- KET
STOCK KADALUAR PENGEMBA STOCK N STOCK IAN
PENERIMA PERSEDIAA PERMINTA
AWAL SA LIAN AKHIR PERBULAN OPT DAK
AN N KAIAN AN
( RKO
)
2 3 4 5 6 7 8 9 10 11 12 13 14 15
A. OBAT-OBATAN
ALLOPURINOL TAB 100 mg TAB 625 100 725 410 - - 315 112 336 500
AMBROKSOL TAB 30 mg TAB 3,380 - 3,380 805 - - 2,575 1,981 5,943 1,000
AMLODIPIN TAB 5 mg TAB 2,310 - 2,310 1,170 - - 1,140 630 1,890 600
AMLODIPIN TAB 10 mg TAB 1,610 600 2,210 1,270 - - 940 735 2,205 1,800
AMOKSISILIN TAB 500 mg KAPS 10,650 - 10,650 3,070 - - 7,580 5,737 17,211 -
ANTASIDA DOEN TAB KUNYAH TAB 6,540 2,000 8,540 2,190 - - 6,350 1,594 4,782 2,000
ANTI DIARE TAB(ATTAPULGIT TAB) TAB 1,630 - 1,630 315 - - 1,315 780 -
ASAM FOLAT (PROFOLAT) TAB 1,500 - 1,500 900 - - 600 990 2,970 -
ASAM MEFENAMAT TAB 500 mg TAB 2,270 1,000 3,270 920 - - 2,350 753 2,259 -
ASETIL SISTEN TAB 200 MG TAB 7,590 - 7,590 2,280 - - 5,310 - 2,280
ASICLOVIR TAB 400 mg TAB 375 100 475 205 - - 270 138 414 100
CETIRIZIN TAB 10 mg TAB 3,060 1,000 4,060 1,560 - - 2,500 1,945 5,835 3,000
ERYTROMISIN TAB 500 mg CAPS 1,608 2,000 3,608 1,193 - - 2,415 502 1,506 2,000
FITOMENADION (VIT.K) TAB SAL 10 mg TAB 100 - 100 - - - 100 81 243 300
IBUPROFEN TAB 400 mg TAB 2,012 - 2,012 302 - - 1,710 120 360 -
KALSIUM LAKTAT (KALK) TAB 500 mg TAB 2,720 1,000 3,720 840 - - 2,880 250 750 1,000
KETOKONAZOL TAB 100 mg TAB 610 - 610 210 - - 400 200 600 -
KLINDAMISIN KAP 150 MG TAB 1,095 - 1,095 795 - - 300 100 300 -
KLORFENIRAMINA MALEAT ( CTM ) 4 mg KAPS 6,595 - 6,595 1,845 - - 4,750 3,282 9,846 -
KOTRIMOKSAZOL TAB 480 mg TAB 2,130 2,500 4,630 2,130 - - 2,500 65 195 3,000
METFORMIN TAB 500 mg TAB 4,865 1,000 5,865 1,430 - - 4,435 1,815 5,445 -
NATRIUM DIKLOFENAK TAB 50 mg TAB 6,455 - 6,455 1,925 - - 4,530 1,728 5,184 5,600
OMEPRAZOL kaps 20 mg KAPS 2,325 2,000 4,325 1,950 - - 2,375 59 177 3,000
PARASETAMOL TAB 500 mg TAB 18,860 10,000 28,860 2,310 - - 26,550 11,500 34,500 -
PIRIDOKSIN HCL TAB 10 mg TAB 4,000 500 4,500 1,500 - - 3,000 2,111 6,333 2,000
PREDNISON TAB 5 MG TAB 3,246 1,000 4,246 2,746 - - 1,500 2,347 7,041 2,000
SALBUTAMOL TAB 2 mg TAB 375 - 375 105 - - 270 249 747 100
SIMVASTATIN TAB 10 mg TAB 1,225 - 1,225 285 - - 940 288 864 1,000
SIPROFLOKSACIN TAB 500 mg TAB 500 1,500 2,000 500 - - 1,500 529 1,587 2,000
TABLET TAMBAH DARAH (FE/SF) TAB 7,480 - 7,480 3,280 - - 4,200 2,128 6,384 2,000
TIAMIN HCL (VIT B.1 ) TAB 50 mg TAB 5,050 1,000 6,050 3,550 - - 2,500 1,861 5,583 -
TRIHEKSIFENIDIL TAB. 2 MG - - - - - - - - -
VITAMIN B KOMPLEKS TAB 6,095 - 6,095 1,595 - - 4,500 1,483 4,449 1,000
ZINK TABLET 20 mg TAB 2,550 - 2,550 1,050 - - 1,500 241 723 1,500
AMOKSISILIN SYROP KERING 125 mg/5 ml BTL 142 - 142 20 - - 122 113 339 -
KOTRIMOKSAZOL SUSPENSI 200mg/5 ml BTL 100 100 200 100 - - 100 65 195 100
PARASETAMOL SYROP 120 mg/5 ml BTL 234 - 234 86 - - 148 193 579 100
UNIBEBI BTL - - - - - - - -
3.1 INJEKSI - - - - - - - - -
COMBIVENT AMP - - - - - - - - -
4.1.SALEP/KRIM /BEDAK/JELLY - - - - - - - - -
L I S O L 50 % BTL 7 - 7 7 - - - - -
5. OBAT GIGI - - - - - - - - -
IODOFORM BTL - - - - - - - - - -
1. ALAT KESEHATAN - - - - - - - - -
Alat suntik sekali pakai 0,05 ml Set - 200 200 200 - - - - 1,000
Alat suntik sekali pakai 0,5 ml Set - 3,000 3,000 3,000 - - - - 1,000
Alat suntik sekali pakai 5 ml Set 200 1,000 1,200 1,200 - - - - 500
Umbilicall buah - - - - - - - - -
Vacutaner buah - - - - - - - - -
Venoject buah - - - - - - - - -
- - - - - - - - -
1. REAGEN - - - - - - - - -
Anaskopi unit - - - - - - - - -
Rotator - - - - - - - - -
CD4 Control - - - - - - - - -
TAMBAHAN LAIN-LAIN - - - - - - - - -
- - - - -
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
OBAT DANA JKN
Nia Aminah Kurniati, S.Ip.,M.Si Devi Aulia, S.Si , Apt Drg. Ria Joesriati Desmia,Amd.Kes Suzan Sagita
NIP. 19740708 199311 2 001 NIP. 19760314 200501 2010 NIP. 1980112120070012003 1982062402014122001' 3275054312910000'
10 PENYAKIT TERBESAR -
NO NAMA PENYAKIT KODE JUMLAH
1 NASOFARINGITIS AKUT 614
2 ARTRITIS LAINNYA 89
3 KARIES GIGI 102
4 DYSPEPSIA 105
5 PENYAKIT PULPA DAN JARINGAN PERIAPIKAL 369
6 HIPERTENSI 134
7 NIDM 3 87
8 FARINGITIS AKUT 80
9 DERMATIS ATOPIK 78
10 PENYAKIT GUSI JARINGAN PERIDONTAL & TULANG 68
1726
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
KEBUTUHA PEMBER
NAMA OBAT SAT PEMA- KET
STOCK KADALUAR PENGEMBA STOCK N STOCK IAN
PENERIMA PERSEDIAA PERMINTA
AWAL SA LIAN AKHIR PERBULAN OPT DAK
AN N KAIAN AN
( RKO
)
2 3 4 5 6 7 8 9 10 11 12 13 14 15
A. OBAT-OBATAN
ALLOPURINOL TAB 100 mg TAB 315 500 815 225 - - 590 112 336 200
AMBROKSOL TAB 30 mg TAB 2,575 1,000 3,575 1,075 - - 2,500 1,981 5,943 3,000
AMLODIPIN TAB 5 mg TAB 1,140 600 1,740 470 - - 1,270 630 1,890 900
AMLODIPIN TAB 10 mg TAB 940 1,500 2,440 645 - - 1,795 735 2,205 1,200
AMOKSISILIN TAB 500 mg KAPS 7,580 - 7,580 1,005 - - 6,575 5,737 17,211 2,000
ANTASIDA DOEN TAB KUNYAH TAB 6,350 2,000 8,350 2,365 - - 5,985 1,594 4,782 3,000
ANTI DIARE TAB(ATTAPULGIT TAB) TAB 1,315 - 1,315 430 - - 885 780 500
ASAM FOLAT (PROFOLAT) TAB 600 - 600 600 - - - 990 2,970 2,000
ASAM MEFENAMAT TAB 500 mg TAB 2,350 - 2,350 710 - - 1,640 753 2,259 1,000
ASETIL SISTEN TAB 200 MG TAB 5,310 2,280 7,590 7,590 - - - - 2,280
ASICLOVIR TAB 400 mg TAB 270 100 370 60 - - 310 138 414 100
CETIRIZIN TAB 10 mg TAB 2,500 3,000 5,500 335 - - 5,165 1,945 5,835 2,000
DOMPERIDON TAB 10 mg TAB 1,104 - 1,104 444 - - 660 200 600 500
ERYTROMISIN TAB 500 mg CAPS 2,415 2,000 4,415 580 - - 3,835 502 1,506 1,000
FITOMENADION (VIT.K) TAB SAL 10 mg TAB 100 - 100 - - - 100 81 243 100
GARAM ORALIT 200 ml TAB 200 - 200 65 - - 135 185 555 200
IBUPROFEN TAB 400 mg TAB 1,710 - 1,710 140 - - 1,570 120 360 -
KALSIUM LAKTAT (KALK) TAB 500 mg TAB 2,880 1,000 3,880 3,880 - - - 250 750 1,000
KLINDAMISIN KAP 150 MG TAB 300 - 300 300 - - - 100 300 2,000
KLORFENIRAMINA MALEAT ( CTM ) 4 mg KAPS 4,750 - 4,750 2,250 - - 2,500 3,282 9,846 3,000
KOTRIMOKSAZOL TAB 480 mg TAB 2,500 3,000 5,500 600 - - 4,900 65 195 -
METFORMIN TAB 500 mg TAB 4,435 - 4,435 900 - - 3,535 1,815 5,445 -
NATRIUM DIKLOFENAK TAB 50 mg TAB 4,530 5,600 10,130 330 - - 9,800 1,728 5,184 -
OMEPRAZOL kaps 20 mg KAPS 2,375 3,000 5,375 1,645 - - 3,730 59 177 2,000
PARASETAMOL TAB 500 mg TAB 26,550 - 26,550 11,550 - - 15,000 11,500 34,500 10,000
PIRIDOKSIN HCL TAB 10 mg TAB 3,000 2,000 5,000 1,910 - - 3,090 2,111 6,333 3,000
PREDNISON TAB 5 MG TAB 1,500 2,000 3,500 2,050 - - 1,450 2,347 7,041 2,000
SIPROFLOKSACIN TAB 500 mg TAB 1,500 1,000 2,500 415 - - 2,085 529 1,587 500
TABLET TAMBAH DARAH (FE/SF) TAB 4,200 1,980 6,180 - - - 6,180 2,128 6,384 -
TIAMIN HCL (VIT B.1 ) TAB 50 mg TAB 2,500 - 2,500 2,500 - - - 1,861 5,583 3,000
TRIHEKSIFENIDIL TAB. 2 MG - - - - - - - - -
VITAMIN B KOMPLEKS TAB 4,500 1,000 5,500 3,990 - - 1,510 1,483 4,449 2,000
ZINK TABLET 20 mg TAB 1,500 1,500 3,000 1,090 - - 1,910 241 723 3,000
AMOKSISILIN SYROP KERING 125 mg/5 ml BTL 122 - 122 26 - - 96 113 339 50
KOTRIMOKSAZOL SUSPENSI 200mg/5 ml BTL 100 100 200 56 - - 144 65 195 100
PARASETAMOL SYROP 120 mg/5 ml BTL 148 100 248 68 - - 180 193 579 -
UNIBEBI BTL - - - - - - - -
3.1 INJEKSI - - - - - - - - -
COMBIVENT AMP - - - - - - - - -
4.1.SALEP/KRIM /BEDAK/JELLY - - - - - - - - -
L I S O L 50 % BTL - - - - - - - - -
5. OBAT GIGI - - - - - - - - -
IODOFORM BTL - - - - - - - - - -
1. ALAT KESEHATAN - - - - - - - - -
Alat suntik sekali pakai 0,05 ml Set - 100 100 - - - 100 - 1,000
Alat suntik sekali pakai 0,5 ml Set - 1,000 1,000 - - - 1,000 - 1,000
Masker Surgical 3 ply plus Earloop buah 5,700 - 5,700 5,700 - - - - 1,000
Umbilicall buah - - - - - - - - -
Vacutaner buah - - - - - - - - -
Venoject buah - - - - - - - - -
- - - - - - - - -
1. REAGEN - - - - - - - - -
Anaskopi unit - - - - - - - - -
Rotator - - - - - - - - -
CD4 Control - - - - - - - - -
HbIg vial - - 1
TAMBAHAN LAIN-LAIN - - - - - - - - -
- - - - -
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
OBAT DANA JKN
Nia Aminah Kurniati, S.Ip.,M.Si Devi Aulia, S.Si , Apt Drg. Ria Joesriati Desmia,Amd.Kes Suzan Sagita
NIP. 19740708 199311 2 001 NIP. 19760314 200501 2010 NIP. 1980112120070012003 1982062402014122001' 3275054312910000'
10 PENYAKIT TERBESAR -
NO NAMA PENYAKIT KODE JUMLAH
1 NASOFARINGITIS AKUT 614
2 ARTRITIS LAINNYA 89
3 KARIES GIGI 102
4 DYSPEPSIA 105
5 PENYAKIT PULPA DAN JARINGAN PERIAPIKAL 369
6 HIPERTENSI 134
7 NIDM 3 87
8 FARINGITIS AKUT 80
9 DERMATIS ATOPIK 78
10 PENYAKIT GUSI JARINGAN PERIDONTAL & TULANG 68
1726
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
KEBUTUHA PEMBER
NAMA OBAT SAT PEMA- KET
STOCK KADALUAR PENGEMBA STOCK N STOCK IAN
PENERIMA PERSEDIAA PERMINTA
AWAL SA LIAN AKHIR PERBULAN OPT DAK
AN N KAIAN AN
( RKO
)
2 3 4 5 6 7 8 9 10 11 12 13 14 15
A. OBAT-OBATAN
ALLOPURINOL TAB 100 mg TAB 590 200 790 205 - - 585 112 336 -
AMLODIPIN TAB 5 mg TAB 1,270 900 2,170 525 - - 1,645 630 1,890 900
AMLODIPIN TAB 10 mg TAB 1,795 - 1,795 1,130 - - 665 735 2,205 1,500
AMOKSISILIN KAP 250 mg TAB 500 - 500 180 - - 320 139 417 100
AMOKSISILIN TAB 500 mg KAPS 6,575 2,000 8,575 1,190 - - 7,385 5,737 17,211 1,000
ANTASIDA DOEN TAB KUNYAH TAB 5,985 3,000 8,985 1,005 - - 7,980 1,594 4,782 -
ANTI DIARE TAB(ATTAPULGIT TAB) TAB 885 500 1,385 - - - 1,385 780 -
ASAM FOLAT (PROFOLAT) TAB - 2,000 2,000 - - - 2,000 990 2,970 2,000
ASAM MEFENAMAT TAB 500 mg TAB 1,640 1,000 2,640 1,460 - - 1,180 753 2,259 1,500
ASICLOVIR TAB 400 mg TAB 310 100 410 15 - - 395 138 414 -
CETIRIZIN TAB 10 mg TAB 5,165 - 5,165 3,780 - - 1,385 1,945 5,835 5,000
DOMPERIDON TAB 10 mg TAB 660 - 660 190 - - 470 200 600 300
ERYTROMISIN TAB 500 mg CAPS 3,835 - 3,835 460 - - 3,375 502 1,506 -
GARAM ORALIT 200 ml TAB 135 200 335 40 - - 295 185 555 -
IBUPROFEN TAB 400 mg TAB 1,570 - 1,570 180 - - 1,390 120 360 -
KALSIUM LAKTAT (KALK) TAB 500 mg TAB - 1,000 1,000 - - - 1,000 250 750 -
KLORFENIRAMINA MALEAT ( CTM ) 4 mg KAPS 2,500 3,000 5,500 2,295 - - 3,205 3,282 9,846 3,000
KOTRIMOKSAZOL TAB 480 mg TAB 4,900 - 4,900 770 - - 4,130 65 195 1,000
METFORMIN TAB 500 mg TAB 3,535 - 3,535 965 - - 2,570 1,815 5,445 1,000
NATRIUM DIKLOFENAK TAB 50 mg TAB 9,800 - 9,800 2,290 - - 7,510 1,728 5,184 -
OMEPRAZOL kaps 20 mg KAPS 3,730 1,000 4,730 865 - - 3,865 59 177 1,000
PARASETAMOL TAB 500 mg TAB 15,000 10,000 25,000 10,535 - - 14,465 11,500 34,500 10,000
PIRIDOKSIN HCL TAB 10 mg TAB 3,090 3,000 6,090 1,730 - - 4,360 2,111 6,333 2,000
SIPROFLOKSACIN TAB 500 mg TAB 2,085 - 2,085 325 - - 1,760 529 1,587 -
TABLET TAMBAH DARAH (FE/SF) TAB 6,180 - 6,180 4,070 - - 2,110 2,128 6,384 5,000
TRIHEKSIFENIDIL TAB. 2 MG - - - - - - - - -
ZINK TABLET 20 mg TAB 1,910 2,000 3,910 1,300 - - 2,610 241 723 1,500
MULTIVITAMIN SIRUP BTL 228 100 328 210 - - 118 144 432 200
PARASETAMOL SYROP 120 mg/5 ml BTL 180 - 180 47 - - 133 193 579 100
UNIBEBI BTL - - - - - - - -
3.1 INJEKSI - - - - - - - - -
COMBIVENT AMP - - - - - - - - -
4.1.SALEP/KRIM /BEDAK/JELLY - - - - - - - - -
L I S O L 50 % BTL - - - - - - - - 4
5. OBAT GIGI - - - - - - - - -
IODOFORM BTL - - - - - - - - - -
1. ALAT KESEHATAN - - - - - - - - -
Alat suntik sekali pakai 0,05 ml Set 100 100 200 - - - 200 - 1,000
Alat suntik sekali pakai 0,5 ml Set 1,000 500 1,500 - - - 1,500 - 1,000
Umbilicall buah - - - - - - - - -
Vacutaner buah - - - - - - - - -
Venoject buah - - - - - - - - -
- - - - - - - - -
1. REAGEN - - - - - - - - -
Anaskopi unit - - - - - - - - -
Rotator - - - - - - - - -
CD4 Control - - - - - - - - -
HbIg vial - - - -
TAMBAHAN LAIN-LAIN - - - - - - - - -
- - - - -
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
OBAT DANA JKN
Nia Aminah Kurniati, S.Ip.,M.Si Devi Aulia, S.Si , Apt Drg. Ria Joesriati Desmia,Amd.Kes Suzan Sagita
NIP. 19740708 199311 2 001 NIP. 19760314 200501 2010 NIP. 1980112120070012003 1982062402014122001' 3275054312910000'
10 PENYAKIT TERBESAR -
NO NAMA PENYAKIT KODE JUMLAH
1 NASOFARINGITIS AKUT 614
2 ARTRITIS LAINNYA 89
3 KARIES GIGI 102
4 DYSPEPSIA 105
5 PENYAKIT PULPA DAN JARINGAN PERIAPIKAL 369
6 HIPERTENSI 134
7 NIDM 3 87
8 FARINGITIS AKUT 80
9 DERMATIS ATOPIK 78
10 PENYAKIT GUSI JARINGAN PERIDONTAL & TULANG 68
1726
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
PEMBER
NAMA OBAT SAT
IAN
KET
KEBUTUHA
PEMA-
STOCK KADALUAR PENGEMBA STOCK N STOCK
PENERIMAAN PERSEDIAAN PERMINTA
AWAL SA LIAN AKHIR PERBULAN OPT
KAIAN AN DAK
( RKO
)
2 3 4 5 6 7 8 9 10 11 12 13 14 15
A. OBAT-OBATAN
ALLOPURINOL TAB 100 mg TAB 585 - 585 195 - - 390 112 336 100
AMLODIPIN TAB 5 mg TAB 1,645 900 2,545 525 - - 2,020 630 1,890 600
AMOKSISILIN KAP 250 mg TAB 320 100 420 190 - - 230 139 417 500
AMOKSISILIN TAB 500 mg KAPS 7,385 1,000 8,385 6,205 - - 2,180 5,737 17,211 6,000
ANTASIDA DOEN TAB KUNYAH TAB 7,980 - 7,980 2,240 - - 5,740 1,594 4,782 3,000
ANTI DIARE TAB(ATTAPULGIT TAB) TAB 1,385 - 1,385 165 - - 1,220 780 300
ASAM FOLAT (PROFOLAT) TAB 2,000 1,500 3,500 1,420 - - 2,080 990 2,970 2,000
ASAM MEFENAMAT TAB 500 mg TAB 1,180 1,500 2,680 - - - 2,680 753 2,259 -
ASETIL SISTEN TAB 200 MG TAB 2,280 - 2,280 232 - - 2,048 - 4,560
CETIRIZIN TAB 10 mg TAB 1,385 - 1,385 1,009 - - 376 1,945 5,835 2,000
DOMPERIDON TAB 10 mg TAB 470 - 470 234 - - 236 200 600 500
ERYTROMISIN TAB 500 mg CAPS 3,375 - 3,375 575 - - 2,800 502 1,506 500
IBUPROFEN TAB 400 mg TAB 1,390 - 1,390 145 - - 1,245 120 360 -
KALSIUM LAKTAT (KALK) TAB 500 mg TAB 1,000 - 1,000 - - - 1,000 250 750 -
KLORFENIRAMINA MALEAT ( CTM ) 4 mg KAPS 3,205 3,000 6,205 678 - - 5,527 3,282 9,846 1,000
KOTRIMOKSAZOL TAB 480 mg TAB 4,130 1,000 5,130 750 - - 4,380 65 195 -
METFORMIN TAB 500 mg TAB 2,570 - 2,570 1,130 - - 1,440 1,815 5,445 2,000
NATRIUM DIKLOFENAK TAB 50 mg TAB 7,510 - 7,510 972 - - 6,538 1,728 5,184 -
OMEPRAZOL kaps 20 mg KAPS 3,865 400 4,265 2,020 - - 2,245 59 177 3,000
PARASETAMOL TAB 500 mg TAB 14,465 10,000 24,465 1,235 - - 23,230 11,500 34,500 -
PIRIDOKSIN HCL TAB 10 mg TAB 4,360 2,000 6,360 1,860 - - 4,500 2,111 6,333 2,000
SIPROFLOKSACIN TAB 500 mg TAB 1,760 - 1,760 300 - - 1,460 529 1,587 200
TABLET TAMBAH DARAH (FE/SF) TAB 2,110 5,000 7,110 680 - - 6,430 2,128 6,384 10,000
TRIHEKSIFENIDIL TAB. 2 MG - - - - - - - - -
ZINK TABLET 20 mg TAB 2,610 1,500 4,110 330 - - 3,780 241 723 2,000
MULTIVITAMIN SIRUP BTL 118 200 318 85 - - 233 144 432 100
PARASETAMOL SYROP 120 mg/5 ml BTL 133 100 233 46 - - 187 193 579 100
UNIBEBI BTL - - - - - - - -
3.1 INJEKSI - - - - - - - - -
COMBIVENT AMP - - - - - - - - -
4.1.SALEP/KRIM /BEDAK/JELLY - - - - - - - - -
KLORAMFENIKOL 20 MG +
PREDNISOLON 2,5 MG SALEP KULIT TUBE - - - - - - - - -
( KLORFESON)
L I S O L 50 % BTL - 4 4 - - - 4 - -
5. OBAT GIGI - - - - - - - - -
IODOFORM BTL - - - - - - - - - -
1. ALAT KESEHATAN - - - - - - - - -
Alat suntik sekali pakai 0,05 ml Set 200 100 300 300 - - - - -
Alat suntik sekali pakai 0,5 ml Set 1,500 1,000 2,500 1,770 - - 730 - -
Alat suntik sekali pakai 3 ml Set 500 1,000 1,500 500 - - 1,000 - -
Umbilicall buah - - - - - - - - -
Vacutaner buah - - - - - - - - -
Venoject buah - - - - - - - - -
- - - - - - - - -
1. REAGEN - - - - - - - - -
Anaskopi unit - - - - - - - - -
Rotator - - - - - - - - -
CD4 Control - - - - - - - - -
HbIg vial - - - -
TAMBAHAN LAIN-LAIN - - - - - - - - -
- - - - -
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
OBAT DANA JKN
Nia Aminah Kurniati, S.Ip.,M.Si Devi Aulia, S.Si , Apt Drg. Ria Joesriati Desmia,Amd.Kes Suzan Sagita
NIP. 19740708 199311 2 001 NIP. 19760314 200501 2010 NIP. 1980112120070012003 1982062402014122001' 3275054312910000'
10 PENYAKIT TERBESAR -
NO NAMA PENYAKIT KODE JUMLAH
1 NASOFARINGITIS AKUT 614
2 ARTRITIS LAINNYA 89
3 KARIES GIGI 102
4 DYSPEPSIA 105
5 PENYAKIT PULPA DAN JARINGAN PERIAPIKAL 369
6 HIPERTENSI 134
7 NIDM 3 87
8 FARINGITIS AKUT 80
9 DERMATIS ATOPIK 78
10 PENYAKIT GUSI JARINGAN PERIDONTAL & TULANG 68
1726
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
PEMBER
NAMA OBAT SAT
IAN
KET
KEBUTUHA
PEMA-
STOCK KADALUAR PENGEMBA STOCK N STOCK
PENERIMAAN PERSEDIAAN PERMINTAAN
AWAL SA LIAN AKHIR PERBULAN OPT
KAIAN DAK ED
( RKO
)
2 3 4 5 6 7 8 9 10 11 12 13 14 15
A. OBAT-OBATAN
ALLOPURINOL TAB 100 mg TAB 390 100 490 290 - - 200 112 336 200 feb 23
AMLODIPIN TAB 5 mg TAB 2,020 - 2,020 1,255 - - 765 630 1,890 1,500
AMOKSISILIN KAP 250 mg TAB 230 200 430 230 - - 200 139 417 200 sep 24
AMOKSISILIN TAB 500 mg KAPS 2,180 6,000 8,180 1,535 - - 6,645 5,737 17,211 - jul 22
ANTASIDA DOEN TAB KUNYAH TAB 5,740 1,000 6,740 1,880 - - 4,860 1,594 4,782 2,000 jan 23
ANTI DIARE TAB(ATTAPULGIT TAB) TAB 1,220 - 1,220 260 - - 960 780 400 nov 22
ASAM FOLAT (PROFOLAT) TAB 2,080 - 2,080 380 - - 1,700 990 2,970 2,000 jul 23
ASAM MEFENAMAT TAB 500 mg TAB 2,680 - 2,680 580 - - 2,100 753 2,259 2,000 aug 23
ASETIL SISTEN TAB 200 MG TAB 2,048 - 2,048 1,758 - - 290 - 3,000
ASICLOVIR TAB 400 mg TAB 315 - 315 80 - - 235 138 414 200 jan 23
ERYTROMISIN TAB 500 mg CAPS 2,800 - 2,800 880 - - 1,920 502 1,506 500 jul 23
GARAM ORALIT 200 ml TAB 200 - 200 200 - - - 185 555 200
IBUPROFEN TAB 400 mg TAB 1,245 - 1,245 310 - - 935 120 360 1,000 jul 25
KALSIUM LAKTAT (KALK) TAB 500 mg TAB 1,000 - 1,000 - - - 1,000 250 750 1,000 feb 23
KETOKONAZOL TAB 100 mg TAB 310 - 310 310 - - - 200 600 2,000
KLINDAMISIN KAP 300 MG KAPS 2,000 - 2,000 785 1,215 2,000 okt 24
KLORFENIRAMINA MALEAT ( CTM ) 4 mg KAPS 5,527 1,000 6,527 2,007 - - 4,520 3,282 9,846 500 agu 22
KOTRIMOKSAZOL TAB 480 mg TAB 4,380 - 4,380 800 - - 3,580 65 195 1,000 okt 22
METFORMIN TAB 500 mg TAB 1,440 - 1,440 1,040 - - 400 1,815 5,445 2,000 agu 23
NATRIUM DIKLOFENAK TAB 50 mg TAB 6,538 - 6,538 1,394 - - 5,144 1,728 5,184 2,800 jul 23
OMEPRAZOL kaps 20 mg KAPS 2,245 3,000 5,245 - - - 5,245 59 177 1,000 agu 23
PARASETAMOL TAB 500 mg TAB 23,230 - 23,230 - - - 23,230 11,500 34,500 - jun 23
PIRIDOKSIN HCL TAB 10 mg TAB 4,500 2,000 6,500 1,590 - - 4,910 2,111 6,333 - jul 22
RANITIDIN TAB 150 mg TAB - 2,000 2,000 - - - 2,000 1,316 3,948 3,000 apr 24
SALBUTAMOL TAB 2 mg TAB 246 - 246 94 - - 152 249 747 300 mar 23
SIMVASTATIN TAB 10 mg TAB 1,650 - 1,650 425 - - 1,225 288 864 300 jun 23
SIPROFLOKSACIN TAB 500 mg TAB 1,460 - 1,460 520 - - 940 529 1,587 500 jul 25
TABLET TAMBAH DARAH (FE/SF) TAB 6,430 10,000 16,430 14,720 - - 1,710 2,128 6,384 5,000 okt 24
TRIHEKSIFENIDIL TAB. 2 MG - - - - - - - - -
ZINK TABLET 20 mg TAB 3,780 500 4,280 1,270 - - 3,010 241 723 2,000 jun 23
KOTRIMOKSAZOL SUSPENSI 200mg/5 ml BTL 174 100 274 32 - - 242 65 195 50 nov 22
MULTIVITAMIN SIRUP BTL 233 50 283 69 - - 214 144 432 100 okt 23
PARASETAMOL SYROP 120 mg/5 ml BTL 187 100 287 89 - - 198 193 579 100
UNIBEBI BTL - - - - - - - -
3.1 INJEKSI - - - - - - - - -
COMBIVENT AMP - - - - - - - - -
4.1.SALEP/KRIM /BEDAK/JELLY - - - - - - - - -
KLORAMFENIKOL 20 MG +
PREDNISOLON 2,5 MG SALEP KULIT TUBE - - - - - - - - -
( KLORFESON)
L I S O L 50 % BTL 4 - 4 - - - 4 - -
5. OBAT GIGI - - - - - - - - -
IODOFORM BTL - - - - - - - - - -
1. ALAT KESEHATAN - - - - - - - - -
Umbilicall buah - - - - - - - - -
Vacutaner buah - - - - - - - - -
Venoject buah - - - - - - - - -
- - - - - - - - -
1. REAGEN - - - - - - - - -
Anaskopi unit - - - - - - - - -
Rotator - - - - - - - - -
CD4 Control - - - - - - - - -
HbIg vial - - - -
TAMBAHAN LAIN-LAIN - - - - - - - - -
- - - - -
LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO ) PUSKESMAS
OBAT DANA JKN
Nia Aminah Kurniati, S.Ip.,M.Si Devi Aulia, S.Si , Apt Drg. Ria Joesriati Desmia,Amd.Kes Suzan Sagita
NIP. 19740708 199311 2 001 NIP. 19760314 200501 2010 NIP. 1980112120070012003 1982062402014122001' 3275054312910000'
10 PENYAKIT TERBESAR -
NO NAMA PENYAKIT KODE JUMLAH
1 NASOFARINGITIS AKUT 9/5/01
2 ARTRITIS LAINNYA 3/29/00
3 KARIES GIGI 4/11/00
4 DYSPEPSIA 4/14/00
5 PENYAKIT PULPA DAN JARINGAN PERIAPIKAL 1/3/01
6 HIPERTENSI 5/13/00
7 NIDM 3 3/27/00
8 FARINGITIS AKUT 3/20/00
9 DERMATIS ATOPIK 3/18/00
10 PENYAKIT GUSI JARINGAN PERIDONTAL & TULANG 3/8/00
9/21/04
3275054312910000'