LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT ( LPLPO )

PUSKESMAS : WARUNG JAMBU PELAPORAN BULAN / PERIODE : FEBRUARI 2023

KECAMATAN : BOGOR UTARA PERMINTAAN BULAN / PERIODE : FEBRUARI - APRIL 2023
KOTA BOGOR : BOGOR

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN STOK AKHIR STOK OPTIMUM PERMINTAAN PEMBERIAN KET

1 2 3 4 5 6 7 8 9 10 11 15
APBD

OBAT-OBATAN - - -

1 Alopurinol 100 mg Tablet 513 2400 2,913 518 2,395 - 2,395

2 Aminofilin 200 mg Tablet - - -

3 Amitriptilin HCL 25 mg Tablet 100 100 100 - 100

4 Amlodipin 5 mg Tablet 9857 27900 37,757 8,924 28,833 - 28,833

5 Amoksisilin 125 mg/5ml Syr kering Botol 186 400 586 89 497 - 497

6 Amoksisilin 500 mg Kaplet 8474 12100 20,574 4,042 16,532 - 16,532

7 Antasida Doen Tablet 7620 13700 21,320 5,540 15,780 - 15,780

8 Antasida sirup Botol - - -

9 Anti Hemoroid DOEN Unit 54 10 64 31 33 - 33

10 Asam Ascorbat 50 mg Tablet 2884 12700 15,584 3,330 12,254 - 12,254

11 Asam Mefenamat 500 mg Kaplet 180 2500 2,680 1,008 1,672 - 1,672

12 Asiklovir Tablet 400 mg Kaplet 156 900 1,056 258 798 - 798

13 Bacitracin Polymiyxin SK Tube - - -

14 Betahistin Mesilat 6 mg Tablet 166 200 366 78 288 - 288

15 Cetirizine sirup 5 mg / 5 ml Botol - - -

16 Clozapine tablet 25 mg Tablet - - -

17 Deksametason Injeksi 5 mg/ml Ampul 6 6 6 - 6

1 2 3 4 5 6 7 8 9 10 11 15
18 Deksametason Tablet 0.5 mg Tablet 812 600 1,412 1,384 28 - 28

19 Diazepam 2 mg Tablet Tablet 53 53 53 - 53

20 Domperidone Sirup Botol - - -

21 Erytromysin 500 mg Tablet 300 300 300 - 300

22 Ethambutol Tablet 250 mg Tablet 159 159 159 - 159

23 Etil Klorida Semprot- 200 ml Botol 7 7 7 - 7

24 Fenobarbital inj,50 mg/ml Ampul - - -

25 Fitomenadion (Vit K ) Tablet Tablet 281 500 781 144 637 - 637

26 Glass Ionomer Cement (GC 1X) Botol 3 3 1 2 - 2

27 Glibenklamid Tablet 5 mg Tablet 357 500 857 510 347 - 347

28 Glimepiride 2 mg Tablet 150 300 450 107 343 - 343

29 Glukosa Lart. Infus 10% - 500 ml Botol - - -

30 Glukosa Lart. Infus 5% - 500 ml Botol - - -

31 Griseofulvin Tablet 125 mg Tablet - - -

32 Haloperidol Tablet 1,5 Mg Tablet 58 300 358 358 - 358

33 Haloperidol Tablet 5 mg Tablet 330 1100 1,430 330 1,100 - 1,100

34 Hidroklortiazid (HCT) Tablet 25 mg Tablet 109 109 50 59 - 59

35 Hidrokortison Krim 2,5% Tube 0 552 552 128 424 - 424

36 Ibuprofen 200 mg Tablet 3016 12500 15,516 2,449 13,067 - 13,067

37 Kalsium Laktat (Kalk) Tab. 500 mg Tablet 1473 7600 9,073 2,702 6,371 - 6,371

38 Kaptopril 12,5 mg Tablet 1000 1,000 140 860 - 860

39 Kaptopril 25 mg Tablet 1200 1,200 115 1,085 - 1,085

40 Karbamazepin 200 mg Tablet 230 300 530 210 320 - 320

41 Karbogliserin Tetes Telinga 10% Botol 31 24 55 16 39 - 39

42 Ketokonazol Tablet 200 mg Tablet - - -

43 Kloramfenikol Salep Mata 1% Tube - - -

44 Kloramfenikol salap kulit 2 % Tube 70 384 454 174 280 - 280

1 2 3 4 5 6 7 8 9 10 11 15
45 Klorfeniramin Maleat (CTM) 4 mg Tablet 7587 5000 12,587 7,304 5,283 - 5,283

46 Klorpromazin HCl Tablet 100 mg Tablet 297 300 597 120 477 - 477

47 Kotrimoxazol Syrup Botol - - -

48 Kotrimoxazol 480 Dewasa Tablet 46 1000 1,046 44 1,002 - 1,002

49 Lidokain Komb 2 % Ampul 120 120 2 118 - 118

50 Loratadin 10 mg Tablet 1421 1000 2,421 1,938 483 - 483

51 Magnesium Sulfat inj. 40% Ampul 9 10 19 19 - 19

52 Metformin HCl tablet 500 mg Tablet 1683 9000 10,683 2,705 7,978 - 7,978

53 Metoklopramid tablet 5 mg Tablet 150 150 150 - 150

54 Metronidazol infus 5 mg/ml Botol - - -

55 Metronidazol tablet 500 mg Tablet 303 1000 1,303 197 1,106 - 1,106

56 Metylergometrin Maleat Tab 0,125 mg Tablet 60 60 10 50 - 50

57 Multivitamin (Geriavita) Tablet - - -

58 Myconazol SK Tube 29 29 29 - -

59 N-acetyl Sistein 200 mg Tablet 1710 1560 3,270 2,564 706 - 706

60 Natrium Diklofenak Tablet 25 mg Tablet 9 4400 4,409 1,812 2,597 - 2,597

61 Natrium Klorida 0,9% Infus Botol 8 20 28 2 26 - 26

62 Nistatin Vaginal 100 000 iu g Tablet 0 50 50 16 34 - 34

63 Omeprazol kapsul 20 mg Kapsul 882 800 1,682 170 1,512 - 1,512

64 Parasetamol Syrup 120 mg/5ml Botol 248 248 248 - 248

65 Parasetamol Tablet 500 mg Tablet 30187 47000 77,187 14,017 63,170 - 63,170

66 Parasetamol tetes 60 mg/0,6 ml Botol - - -

67 Permetrin krim 5 % Tube 60 85 145 35 110 - 110

68 Pirazinamid 500 mg Tablet - - -

69 Piridoksin HCl (Vit B6) 10 mg Tablet 0 8600 8,600 2,035 6,565 - 6,565

70 Povidon Iodida 10% 60 ml Botol - - -

71 Propanolol HCl 10 mg Tablet - - -

1 2 3 4 5 6 7 8 9 10 11 15
72 Ranitidin 150 mg Tablet 1827 5000 6,827 1,446 5,381 - 5,381

73 Ringar Laktat Lar. Infus Botol 5 48 53 20 33 - 33

74 Risperidon 2 mg Tablet 315 800 1,115 225 890 - 890

75 Salbutamol 2 mg Tablet 2300 2,300 228 2,072 - 2,072

76 Salep 2 - 4 Pot - - -

77 Sianokobalamin (Vit.B12) Tablet Tablet 889 9500 10,389 1,934 8,455 - 8,455

78 Silver Sulfadiazin cr 35 gram Tube 2 2 2 - 2

79 Simvastatin tablet 10 mg Tablet 261 2300 2,561 501 2,060 - 2,060

80 Siprofloxasin 500 mg Tablet 290 300 590 110 480 - 480

81 Stesolid Diazepam enema 10mg/2.5ml Tube 3 3 3 - -

82 Stesolid Diazepam enema 5mg/2.5ml Tube - - -

83 Thiamin HCl 50 mg Tablet/2021 Tablet 1409 6200 7,609 942 6,667 - 6,667

84 Triheksifenidil HCl 2 mg Tab Tablet 116 1700 1,816 270 1,546 - 1,546

85 Vitamin B Kompleks Tablet Tablet 6413 9500 15,913 3,862 12,051 - 12,051

86 Favipiravir 200 mg Tablet - - -

87 HBIG Hyperheb-B Syringe - - -

88 SD Bioline HIV/Syphilis Duo Box 0 6 6 6 - 6

Haloperidol Tablet 1,5 Mg Tablet

Hidroklortiazid (HCT) Tablet 25 mg Tablet

Kodein fosfat 10 mg Tablet

Metylergometrin Maleat Tab 0,125 mg Tablet

Pirantel pamoat 125 mg Tablet

BMHP Ampul

1 Alat Suntik Sekali Pakai 3 ml Set 0 1600 1,600 1,600 - 1,600

2 Alat Suntik Sekali Pakai 1 ml Set 300 500 800 100 700 - 700

3 Alkohol 70 % - 5 Liter Set 1 1 1 - 1

1 2 3 4 5 6 7 8 9 10 11 15
4 Alkohol Swab Box -

5 Alkohol Swab Antiku Box 0 30 30 4 26 - 26

6 Covid-19 Antigen Test Buah 400 400 400 - 400

7 Facesheild Botol 285 285 285 - 285

8 FIT-U Hair Net Box - - -

9 Genexpert MTB/RIF Cartridge Box - - -

10 Hand Sanitizer 110 ml Botol 72 72 72 - 72

11 Hand Sanitizer 500 ml Pcs 40 40 40 - 40

12 Hand Sanitizer 5 Liter Bgks 8 8 8 - 8

13 Handscoon Roll 391 391 22 369 - 369

14 Hospital Gown Box 484 484 484 - 484

15 Infusion Dewasa Pcs - - -

16 Kapas Pembalut/Adsorben 250 g Pak 3 3 3 - 3

17 Kasa hidrofil 40 yard x 80 cm Set 3 3 2 1 - 1

18 Kasa Lipat 5 x 5 cm Set - - -

19 Kasa Pembalut Hidrofil 4m x 15cm Box 10 20 30 15 15 - 15

20 Masker earloop box@50 pcs Box 55 40 95 59 36 - 36

21 Papertape 2.5 cm x 9.14 m Box 12 12 1 11 - 11

22 VTM Active Box 540 540 540 - 540

23 Spuit 0,5 ML Box - - -

24 Spuit 5 ML Test - - -

25 Safety Box Test - - -

Disposable [rotective coverall BOHO

Facesheild

Hazmat
Kassa 2x 80

Masker N95 Garuda safe

1 2 3 4 5 6 7 8 9 10 11 15

APBN

OBAT-OBATAN

1 Ampicillin serbuk inj.1000 mg Vial 2 2 2 - 2

2 Artesunate Cairan Inj 60 mg Ampul - - -

3 Dehydro Artemisin+Piperaquin Tablet - - -

4 Ethambutol 100 mg Tablet - - -

5 FDC Kategori 1 Paket 18 32 50 12 38 - 38

6 FDC Anak Paket 0 10 10 3 7 - 7

7 Fitomenadion (Vit K ) inj. 2 mg/ml Ampul 30 15 45 45 - 45

8 Garam Oralit 200 ml Sachet 498 900 1,398 588 810 - 810

9 Gentamicin 40 mg/ml injeksi Ampul - - -

10 Isoniazid 50 mg/Rifampisin 75 mg Kotak - - -

11 Isoniazid 300 mg/Ripafentin 300 mg Kotak 1 1 1 - 1

12 Levofloxacin 100 mg Tablet - - -

13 MDT COMBI MB ADULT Blister 7 1 8 2 6 - 6

14 MDT COMBI MB CHILD Blister - - -

15 Mineral Mix Serbuk 8 G Blister - - -

16 OAT KDT Dosis Harian Paket 0 10 10 2 8 - 8

17 Oksitosin Injeksi 10 IU/ml Ampul 0 100 100 20 80 - 80

18 Primaquin Tablet - - -

19 Retinol ( Vit.A ) 100 000 IU Kapsul 88 88 88 - 88

20 Retinol ( Vit.A ) 200 000 IU Kapsul 90 90 90 - 90

21 Tablet Tambah Darah Neo (TSG) Tablet 13478 26000 39,478 5,157 34,321 - 34,321

22 Tuberculin Injeksi Vial 11 11 2 9 - 9

23 Zinc tablet 20 mg Tablet 485 1800 2,285 945 1,340 - 1,340

24 Carestart Malaria PF/PAN Box - - -

1 2 3 4 5 6 7 8 9 10 11 15
25 RDT HBsAg Box 200 200 125 75 - 75

26 Reagen Z. Nelsen Kit 14 14 14 - 14

Albendazole 400 mg

Albendazole 400 mg

Reagen Z. Nelsen

OBAT ARV

1 Abacavir 120 mg + Lamivudin 60 mg Botol 1 1 1 - 1

2 Abacavir 300 mg Botol - - -

3 Benzatin Benzil Penisilin injeksi 2,4 mg Vial 1 2 3 1 2 - 2

4 Dolutegravir 50 mg Botol 0 3 3 1 2 - 2

5 Efavirenz 200 mg Botol - - -

6 Efavirenz 600 mg Botol 1 1 1 - 1

7 Fluconazole capsul 150 mg Kapsul - - -

8 Kotrimoksazol DOEN I tablet 960 mg Tablet 50 50 30 20 - 20

9 Kombipak Azithromycin-Cefixime Paket 10 10 10 - 10

10 Lamivudine 150 mg Botol 2 2 4 4 - 4

11 Lovinapir(100)+Ritonavir(25) Botol 1 1 1 - 1

12 Lovinapir(200)+Ritonavir(50) Botol - - -

13 Lovinapir(40)+Ritonavir(10) Kotak - - -

14 Neviraphine 200 mg Botol 3 4 7 1 6 - 6

15 TDF(300)+3TC(300)+DTG(50) Botol 5 81 86 17 69 - 69

16 TDF(300)+3TC(300)+EFV(600) Botol 15 23 38 10 28 - 28

17 Tenofovir 300 + Emtricitabine 200 Botol - - -

18 Tenofovir 300 mg Botol 2 2 4 4 - 4

19 Vitamin B6 Tablet 25 mg (Pyridoxin) Tablet 200 200 200 - -

20 Zidovudine 100 mg Botol - - -

1 2 3 4 5 6 7 8 9 10 11 15
21 Zidovudine(300)+Lamivudine(150) Botol 1 3 4 1 3 - 3

22 DBS Collection Kit Kit - - -

23 Diagnostar DS HIV 1/2 One Step Rapid Te Box - - -

24 Fokus RPR Antigen Test Box 0 1 1 1 - 1

25 Rapid Test HIV Turklab R3 Box - - -

26 Standar Q HIV 1/2 AB 3 Line Box - - -

27 Sifilis Trepocheck Box 0 50 50 50 - 50

28 Virocheck HIV 1/2 Box 0 150 150 150 - 150

Obat Covid-19

1 Asam Askorbat (Vit.C) tab 500 mg Tablet 670 1750 2,420 1,850 570 - 570

2 Azytromisin 500 mg Tablet 115 115 115 - 115

3 Favipiravir 200 mg Tablet - - -

4 Oseltamivir kapsul 75 mg Kapsul 10 10 10 - 10

5 Remdesivir inj 100 mg Ampul - - -

6 Vitamin D3 tablet 1.000 IU Tablet 990 2100 3,090 2,760 330 - 330

Vaksin Dasar

1 Vaksin BCG vial 24 25 49 18 31 - 31

2 Vaksin DPT-HB-HIB vial 0 80 80 49 31 - 31

3 Vaksin POLIO vial 19 100 119 48 71 - 71

4 Vaksin MR vial 30 50 80 35 45 - 45

5 Vaksin Hepatitis B ( Uniject ) vial 18 69 87 17 70 - 70

6 Tetanus difteri (Td) vial 16 50 66 16 50 - 50

7 Vaksin IPV vial 55 56 111 19 92 - 92

8 HBIG Hyperheb-B vial - - -

9 Pelarut BCG Ampul 24 25 49 18 31 - 31

1 2 3 4 5 6 7 8 9 10 11 15
10 Pelarut MR Ampul 30 50 80 35 45 - 45

11 Droper Polio Ampul 19 100 119 48 71 - 71

12 Vaksin PCV (Pneumococcal Conjugate Vacc vial 16 50 66 37 29 - 29

Vaksin Bian

1 Oral PoliomytelItis Drops 1 ML Vial - - -

2 DTP-HB-Hib Inj 2,5 ML Vial - - -

3 MR 0.5 ML/5 ML Vial - - -

4 Dropper Polio Botol - - -

5 Pelarut MR Ampul - - -

Vaksin Covid-19

1 Pfizer vial - - -

2 Indovax vial - - -

BMHP

BMHP Vaksin Dasar

1 Spuit 0,5 ML pcs 900 4000 4,900 1,265 3,635 - 3,635

2 Spuit 0.05 ML pcs 0 230 230 36 194 - 194

3 Spuit 5 ML pcs 338 300 638 40 598 - 598

4 Safety Box pcs 25 25 4 21 - 21

BMHP Vaksin Bian

1 Safety Box Pcs - - -

2 Indelible Ink Marker Pen For Measles Rube Pcs - - -

Spuit 0,5 mL

Spuit 5 mL
1 2 3 4 5 6 7 8 9 10 11 15

BMHP Vaksin Covid-19

1 ADS 0,5 ml pcs - - -

2 ADS 0.3 ML pcs - - -

3 ADS 3 ML pcs - - -

4 Alkohol Swab pcs - - -

5 Safety Box pcs - - -

6 Pelarut NaCl 0.9 % 10 ml botol - - -

BMHP Lainnya

1 Antigen/2022 Test - - -

2 Genexpert MTB/RIF Cartridge Test - - -

3 Masker Ekomed TB Box - - -

4 Masker Surgical Earloop Box - - -

5 Object Glass/Slide Box - - -

6 Pot Dahak pcs - - -

7 VTM-Inactived 2 Swab Test - - -

UMUM
BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK

BOGOR, …...................... 2023

Mengetahui/Menyetujui, Yang Menyerahkan, Yang Meminta, Yang Menerima,
Kepala Dinas Kesehatan Kota Bogor Ketua Tim Kerja Perbekkes & POM Kepala Puskesmas Petugas Pengelola Obat
...................................
1 2 3 4 5 6 7 8 9 10 11 15
Dr. SRI NOWO RETNO, MARS Dra.NURHAEDAH, Apt. ................................... ...................................
NIP. 19690415 199803 2 008 NIP.196812081997032004 NIP .............................. NIP .............................