LAPORAN PEMAKAIAN DAN LEMBAR PERMINTAAN OBAT (LPLPO)

DINAS KESEHATAN KABUPATEN MUKOMUKO

PUSKESMAS : MALIN DEMAN BULAN : JANUARI

KECAMATAN : MALIN DEMAN TAHUN : 2023
KABUPATEN : MUKOMUKO
PROVINSI : BENGKULU

NO NAMA OBAT SATUAN STOK AWAL PENERIMAAN PERSEDIAAN PEMAKAIAN SISA STOK PERMINTAAN KETERANGAN

a b c d e f=d+e g h=f-g i j
1 Acyclovir Krim Tube
2 Acyclovir tablet 200 mg Tab
3 Acyclovir tablet 400 mg Tab 1,500 1,500 50 1,450 1,000
4 Air untuk injeksi amp 24 ml Ampul

5 Air untuk injeksi amp 25 ml Ampul 50

6 Albendazol susp 200 mg/5 ml Botol 100
7 Albendazol tab 400 mg Tab 100 100 100 2,000
8 Alopurinol tab 100 mg Tab 2,200 2,200 2,200 1,000
9 Alopurinol tab 300 mg Tab

10 Alprazolam tab 1 mg Tab

11 Ambroxol Syr Botol 15 15 15 - 100

12 Ambroxol Tab Tab 200 200 200 3,000
13 Amitriptilin tab sal 25 mg Tab sal 300 300 300
14 Amlodipin tab 10 mg Tab 2,600 2,600 200 2,400 2,000
15 Amlodipin tab 5 mg Tab 600 600 600 2,000
16 Amoksisilin drops 100 mg/ml Botol

17 Amoksisilin sir forte 250 mg/5 ml Botol 58 58 10 48 100

18 Amoksisilin sir kering 125 mg/5 ml Botol 100
19 Amoksisilin tab 250 mg Tab

20 Amoksisilin tab 500 mg Tab 500 500 500 - 3,000

21 Ampisilin serb inj 250 mg/vial Vial 70 70 70
Anestetik lokal gigi kombinasi : lidokain hcl 2% + Vial
22
epinefrin 1 : 80.000 inj 2 ml
23 Antalgin tab 500 mg Tab
Antasida, kombinasi : aluminium hidroksida 200 mg + Tab
24 3,200
magnesium hidroksida 200 mg 3,200 100 3,100 2,000
Antasida, kombinasi : aluminium hidroksida 200 mg + Botol
25 magnesium hidroksida 200 mg 100
 Antibakteri, kombinasi : basitrasin 500 UI/g+ Polimiskin Tube
26 B 10.000 UI/g
27 Anti Bisa Ular (ABU) Vial
Antifungi salep, kombinasi : asam benzoat 6%+ asam Tube
28
salisilat 3%
Antihemoroid, kombinasi: bismut subgalat 150 mg + Botol
29 heksaklorofen 2,5 mg + lidokain lidokain 10 mg+ seng 50 50 50
oksida 120 mg + sup ad 2 g

Antimalaria, Kombinasi : Sulfadoksin 500 mg + Tab

30 Pirimetamin 25 mg
1,000
31 Anti Tetanus Serum (ATS) Ampul

32 Asam asetilsalisilat tab 80 mg (MINIASPI) Tab

33 Asam askorbat (vitamin C) tab 250 mg Tab 2,000

34 Asam askorbat (vitamin C) tab 50 mg Tab 2,500 2,500 200 2,300 2,000
35 Asam folat tab 0,4 mg Tab 1,800 1,800 1,800 1,000
36 Asam folat tab 1 mg Tab

37 Asam mefenamat kaps 250 mg Kaps

38 Asam mefenamat kaps 500 mg Kaps 5,200 5,200 5,200 2,000

39 Asam Pipemidat 400 mg Tab

40 Asam Traneksamat inj 50 mg/ml Ampul 80 80 80

41 Atapulgit 600 mg Tab

42 Atapulgit tablet 650 mg Tab

43 Atenolol tab 100 mg Tab

44 Atenolol tab 50 mg Tab

45 Atropin inj 0,25 mg/ml (i.m./i.v./s.k) Ampul

46 Atropin tab 0,5 mg Tab

47 Azitromisin syr kering 200 mg/ 5 ml Botol

48 Betahistin 6 mg Tab 3,000

49 Betametason krim 0,1% ( Orsaderm ) Tube 44 44 4 40 50
50 Betametason tts mata 1 mg/ml Botol

51 Bisakodil sup 10 mg ( DULCOLAC) Botol 30 30 30

52 Bisakodil tab 5 mg Tab sal

53 Bacitrasin slp tube

54 Betadine Salep Tube 100

55 Deksametason inj 5 mg/ml (i.v./i.m.) Ampul 100 100 100
56 Deksametason tab 0,5 mg Tab 3,000
57 Desoksimetason 0,25% krim Tube 18 18 18 50
58 Diazepam inj 5 mg/ml (i.v./i.m.) Ampul 20 20 20
59 Diazepam larutan rektal 5mg/2,5 ml (Stesolid) Tube

60 Diazepam tab 2 mg Tab

61 Diazepam tab 5 mg Tab 200 200 200

62 Dietilkarbamazin tab 100 mg Tab

63 Difenhidramin inj 10 mg/ml (i.v./i.m.) Ampul 30 30 30

64 Digoksin tab 0,25 mg Tab 500 500 500
65 Dimenhidrinat tab 50 mg Tab 900 900 900
66 Doksisiklin kaps 100 mg Kaps

67 Domperidon susp 5 mg/5 ml Botol 100

68 Domperidon tab 10 mg Tab 1,200 1,200 1,200 2,000
69 Efedrin inj 50 mg / ml Ampul

70 Ekstrak Belladon tab 10 mg Tab

71 Epinefrin (adrenalin) inj 0,1% (i.v./s.k./i.m.) Ampul 20 20 20

72 Ergotamin tab 1 mg Tab

73 Eritromisin kaps 250 mg Kaps 1,200 1,200 1,200

74 Eritromisin sir 200 mg/5 ml Botol

75 Eritromisin tab 500 mg Tab

76 Eugenol Botol

77 Fenobarbital inj Ampul

78 Fenobarbital tab 30 mg Tab 200 200 200

79 penisilin tab 250 mg Tab 1,000 1,000 1,000
80 Ferro sulfat sir. 15 mg/5 ml Botol

81 Ferro sulfat tab salut 300 mg (TTD) Tab sal 8,190 8,190 8,190
82 Fitomenadion (vitamin K 1) inj 2 mg/ml (i.m.) Vial

83 Fitomenadion (vitamin K 1) tab sal 10 mg Tab sal 1,800 1,800 1,800

84 Fitomenadion (vitamin K1) inj 10 mg/ml (i.m) Ampul 30 30 30
85 Furosemid inj 10 mg/ml (i.v./i.m.) Ampul 50 50 50
86 Furosemid tab 40 mg Tab 800 800 800 1,000
Garam oralit kombinasi : natrium klorida 0,52 g + Sachet
87 kalium klorida 0,30 g + trinatrium sitrat 0,58 g + 200 200 200 500
glukosa anhidrat 2,7 g

88 Gentamicin krim 0,3% Tube 31 31 31 48

89 Gentamicin Salep Mata BTOL 96 96 96
90 Gentamicin Sulfat Tetes Mata 0,3% Botol 48 48 48
91 Gentian Violet Botol
92 Glibenklamid tab 5 mg Tab 2,600 2,600 2,600
93 Glimepirid tab 1 mg Tab

94 Glimepirid tab 2 mg Tab

95 Glipizid tab 5 mg Tab

96 Glukosa Larutan Infus 5% steril 100 ml Botol 84 84 4 80 40

97 Griseofulvin (micronized) tab 125 mg Tab

98 Griseofulvin (micronized) tab scored 250 mg Tab 1,000

99 Haloperidol inj 5 mg/ml (i.m.) Vial

100 Haloperidol tab 0,5 mg Tab

101 Haloperidol tab 1,5 mg Tab

102 Haloperidol tab 2 mg Tab

103 Haloperidol tab 5 mg Tab

104 Haloperidol tts 2 mg/ml Botol

105 Hidroklorotiazid tab 25 mg Tab

106 Hidrokortison krim 2,5% Tube 67 67 67

107 Hidrokortison serb inj 100 mg/vial Vial

108 Hiosina butilbromida tab 10 mg Tab

109 Ibuprofen sir 200 mg/5 ml Botol 30 30 30 100

110 Ibuprofen sir 100 mg/5 ml Botol 100
111 Ibuprofen tab 200 mg Tab

112 Ibuprofen tab 400 mg Tab 200 200 200 - 3,000

113 Irbesartan tab 150 mg Tab

114 Irbesartan tab 300 mg Tab

115 Isoniazid tab 100 mg Tab

116 Isoniazid tab 300 mg Tab

117 Isosorbid dinitrat tab 5 mg Tab

118 Kalsium glukonat inj 100 mg/ml Ampul

119 Kalsium karbonat tab 500 mg Tab

120 Kalsium laktat (kalk) tab 500 mg Tab 2,000 2,000 2,000 1,000
121 Kanamisin inj Vial 10 10 10
122 Kaptopril tab 12,5 mg Tab 2,200 2,200 2,200
123 Kaptopril tab 25 mg Tab 1,600 1,600 1,600
124 Kaptopril tab 50 mg Tab

125 Karbamazepin sir 100 mg/5 ml Botol

126 Karbamazepin tab 200 mg Tab

127 Karbogliserin tts telinga 10 % (Phenol Glycerol) Botol

128 Ketokonazol tab 200 mg Tab 1,600 1,600 1,600 1,000
129 Ketokonazol krim Tube 25 25 25 50
130 Klindamisin kaps 150 mg Kaps

131 Kloramfenikol kaps 250 mg Kaps 1,400 1,400 1,400

132 Kloramfenikol kaps 500 mg ( Chloramex ) Kaps

133 Kloramfenikol salep kulit 2% ( BUFACETIN ) Tube

134 Kloramfenikol salep mata 1% Tube 40 40 40

135 Kloramfenikol susp 125 mg/5 ml Botol

136 Kloramfenikol tetes telinga 3% Botol

137 Kloramfenikol tts mata 0,5% Botol

138 Kloramfenikol tts mata 1% Botol

139 Klorfeniramin Maleat (CTM) tab 4 mg Tab 3,000

140 Klorfenol kamfer mentol (CHKM) Botol

141 Klorpromazin inj 25 mg/ml (i.m.) Ampul

142 Klorpromazin inj 5 mg/ml (i.m.) Ampul

143 Klorpromazin tab sal 100 mg Tab sal

144 Klorpromazin tab sal 25 mg Tab sal

145 Kodein tab 10 mg Tab

146 Kombinasi : ergotamin 1 mg+ kafein 50 mg Tab

147 Kombinasi : ferro sulfat 200 mg+ as. Folat 0,25 mg Tab sal
Kotrimoksazol (dewasa) kombinasi : sulfametoksazol 400 Tab
148 mg+ trimetoprim 80 mg
3,800 3,800 3,800
149 Kotrimoksazol DOEN Pediatrik Kombinasi Tab
Kotrimoksazol (dewasa) kombinasi tiap 5 ml suspensi : Botol
150 75 75 75
sulfametoksazol 200 mg + trimetoprim 40 mg
151 Laktulosa syr 3,335 g/ 5 ml Botol

152 Lansoperazol tab 30 mg Tab

153 Loperamid tab 2 mg Tab 1,000

1,000 100 900 1,000
154 Loratadin tab 10 mg Tab
1,000
155 Lidokain Injeksi Ampul 180
180 180
156 Magnesium sulfat inj 20% Vial

157 Magnesium sulfat inj 40% Vial 18

18 18
158 Mebendazol sir 50 mg/ml Botol

159 Mebendazol tab 100 mg Tab

160 Mebendazol tab 500 mg (Vermox) Tab

161 Metformin tab 500 mg Tab 1,400

1,400 1,400 1,000
162 Metformin tab 850 mg Tab

163 Metilergometrin inj 0,2 mg/ml Ampul

10
164 Metilergometrin tab salut 0,125 mg Tab sal
500
165 Metilprednisolon tab 4 mg Tab 2,500
2,500 300 2,200 2,000
166 Metilprednisolon sebuk inj 125 mg Vial

167 Metoklopramid tab 10 mg Tab

168 Metoklopramid tab 5 mg Tab

169 Metoklopramid inj 5 mg/ml Ampul

170 Metoklopramid sir 5 mg/5 ml Botol

171 Metronidazol lar inf 5 mg/ml Botol

172 Metronidazol sir 125 mg/5 Ml Botol 50

50 50
173 Metronidazol tab 250 mg Tab

174 Metronidazol tab 500 mg Tab

1,000
175 Mikonazol krim 2% Tube
100
176 Mineral Mix Tab

177 NaCl 0,9% Larutan Botol 108

108 8 100
178 Natrium Bicarbonat inj 8,4% Botol

179 Natrium diklofenak tab 25 mg Tab

2,000
180 Natrium diklofenak tab 50 mg Tab
2,000
181 Nifedipin kaps 10 mg Kaps 1,100
1,100 1,100
182 Nistatin susp 100.000 UI/ml Botol

183 Nistatin tab salut 500.000 UI Tab

184 Nistatin tab vaginal 100.000 UI Tab 1,200

1,200 1,200
185 Obat Anti Tuberculosis FDC Kategori Anak Paket 2 5 5
186 Obat Anti Tuberculosis FDC Kategori II Paket

187 Obat Anti Tuberculosis Kategori I Paket

3 3
188 Oksitosin inj 10 UI/ml Ampul

189 Omeprazol kaps 20 mg Kaps 2,000

2,000 200 1,800 1,000
190 Ondansetron tab 4 mg Tab

191 Ondansetron inj 2 mg/ml Ampul

192 Parasetamol sir 120 mg/5 ml Botol 100

100 100
193 Parasetamol tab 500 mg Tab 2,000
2,000 700 1,300 3,000
194 Parasetamol tts 60 mg/0,6 ml drop Botol

195 Pirantel pamoat susp 125 mg/5 ml Botol

196 Pirantel pamoat tab scored 125 mg Tab 500

500 500
197 Piridoksin (vitamin B6) inj 100 mg/ml Ampul

198 Piridoksin (vitamin B6) tab 10 mg Tab

199 Piridoksin (vitamin B6) tab 25 mg Tab

200 Meloxicam 7,5 mg Tab 500

500 200 300 2,000
201 Prednison tab 5 mg Tab 1,500 1,500 1,500 1,000
202 Primakuin tab 15 mg Tab

203 Prokain benzilpenisilin serb inj 3 juta UI/vial (i.m.) Vial

204 Pethidine HCL 50mg/ml Ampul

205 Propranolol tab 10 mg Tab

206 Propranolol tab 40 mg Tab

207 Ranitidin tab 150 mg Tab 2,000

2,000 2,000 1,000
208 Ranitidin inj Ampul

209 Retinol (vitamin A) kaps lunak 100.000 UI Kaps lunak 100

100 100 500
210 Retinol (vitamin A) kaps lunak 200.000 UI Kaps lunak 500
500 500
211 Rifampisin kaps 300 mg Kaps

212 Ringer Laktat Larutan Botol 80

80 20 60 40
213 Risperidon tab 1 mg Tab

214 Risperidon tab 2 mg Tab 300

300 300
215 Salbutamol sir 2 mg/5 ml Botol

216 Salbutamol tab 2 mg Tab 1,800

1,800 1,800
217 Salbutamol tab 4 mg Tab 1,400
1,400 1,400
218 Salep 2-4, kombinasi : asam salisilat 2 %+ belerang Pot
endap 4 %
219 Setirizin sir 5 mg/5 ml. Botol 30
30 30 100
220 Setirizin tab 10 mg Tab 500
500 100 400 3,000
221 Sefadroksil tab 500 mg Tab
2,000
222 Sefadroksil tab sir kering 125 mg/5 ml Botol
100
223 Sefotaksim serbuk inj 1000 mg Vial

224 Sefiksim thryhidrat 200 mg Kap

225 Sefiksim sir 100 mg/ 5 ml Botol

226 Seftriakson Serbuk inj 1000 mg Vial

227 Sianokobalamin (vitamin B12) tab 50 mcg Tab 1,800

1,800 1,800
228 Sianokobalamin (vitamin B12) inj 500 mcg/ml Ampul 97
97 97
229 Simvastatin tab sal 10 mg Tab sal 2,000
2,000 500 1,500 2,000
230 Simvastatin tab sal 20 mg Tab sal 1,400
1,400 1,400 2,000
231 Siprofloksasin infus2% Fls
232 Siprofloksasin tab scored 500 mg Tab 3,600 500 4,100 600 3,500
233 Siprofloksasin tetes mata 3 mg/ml Botol

234 Spironolakton tab 25 mg Tab

235 Streptomicin inj 1000 mg/ml Ampul

236 Tetrasiklin kaps 250 mg Kaps

237 Tetrasiklin kaps 500 mg Kaps

238 Tiamin (vitamin B1) tab 50 mg Tab

239 Tramadol Inj 100 mg/2ml Ampul

240 Urinter Tab

241 Vitamin B kompleks Tab 1,100

1,100 200 900 2,000
242 Zinc sir 10 mg/ml Botol
50
243 Zinc sir 20 DROP mg/5 ml Botol
50
244 Zinc tab disp 20 mg Tab 800
800 800 1,000
245 Oksitetrasiklin salep mata 1% Tube
246 Salap whitfield Tube 54
54 54 50

NON GENERIK
1 Alpara sir Botol 100
2 Fedilis sir Botol 100
3 Dextral tab Tab 2,000
5 Alapara tab Tab 2,000
9 Dextral sir Botol 100
10 Bioplasenton salep Tube 100
11 Novaxicam Tab 2,000
12 Fitbes sir Botol
13 Nuvopec Tab tab 2,000
14 Novopec Syr Botol 100
15 Panviton tab Tab 1,000
16 Pehavral Vit Tab 500
500 500 1,000
17 Pritagesik kap Kap
18 Pronalges supp Supp
19 Rosidon syr Botol
20 Stimuno syr Botol
21 Superhoid supp Supp
22 Vagizol Supp
23 Wicold tab Tab
24 Calortusin tab Tab
25 Vitalamin D Tab
26 Omegesik Tab
27 Neo Diagon Tab
28 Remco cough syr syr

BMHP
1 Alkohol Steril pcs 422
422 422
2 Alat Suntik sekali pakai 0,5 ml pcs 581
581 581
3 Alat Suntik sekali pakai 1 ml Set 611
611 611
4 Alat Suntik sekali pakai 3 ml Set 300
300 20 280 300
5 Alat Suntik sekali pakai 5 ml Set 334
334 334
6 Bioplacenton Tulle 10 x 10 pcs
7 Blood Lanset kotak
8 Catgut plain no.2/0 Sak 15
15 15 12
9 Catgut plain no.3/0 Sak 15
15 15 12
10 Chromic Catgut 2/0 Pcs 15
15 2 13 12
11 Chromic Catgut 3/0 Pcs 21
21 21 12
12 Chatheter Norta 2 Way No 16 Pcs
13 Chatheter Norta 2 Way No 18 Pcs
14 Chatheter Norta 2 Way No 20 Pcs
15 Etakridina (rivanol) larutan 0,1 % 50 ml Pcs
16 Etakridina (rivanol) larutan 0,1 % 300 ml Btl 10
10 1 9 10
17 Etanol 70 % 100 ml Btl 6
6 6 10
18 Etanol 70 % 300 ml Btl 5
5 1 4 10
19 Etanol 70% 1000 ml Btl 30
30 30
20 Handscond M pcs
21 Handscoond L pcs 600
600 100 500 500
22 Handscoond 7 pcs
23 Handscoond 7 steril pcs 190
190 190
24 Hipafix / Fixomul Stretch 10 cm x 5 cm pcs
25 Human Hexagon Syphilis test
26 Humansens Plus Cholesterol Test Trips kotak
27 Humansens Plus Glukose Test Trips kotak
28 Humansens Plus Uric Acid Test Trips kotak
29 Infusion set anak Set 88
88 88
30 Infusion set dewasa Set 75
75 75
31 IV Chateter /Albocath No.18 Set 2
2 2
32 IV Chateter /Albocath No.24 Set 59
59 59
33 IV Chateter /Albocath No.20 Set 50
50 50
34 IV Chateter/ Albocath No. 22 Pcs 37
37 37
35 Kapas berlemak 500 mg Bks 24
24 1 23
36 Kapas pembalut absorben 500 mg Bks 5
5 5 10
37 Kasa kompres 40mx 40cm Rol 41
41 41
38 Kasa pembalut 2 m x 80 cm Rol 14
14 14 10
39 Kasa pembalut hirofil 3 m x 10 cm Rol 25
25 1 24 10
40 Kasa pembalut hirofil 3 m x 15 cm Rol 43
43 43 10
41 Kasa pembalut hirofil 40 m x 80 cm Rol 10
42 kasa gulung 40 yard x 80 cm rol 5
43 Kasa Pembalut Elastis rol
44 Kolesterol Test kotak
45 Lisol Btl
46 Masker pcs 600
600 600
47 Merkuri Btl
48 Nasal Oxygen Canula - Adult Strainghrt pcs
49 Nasal Oxygen Canula - Child Strainghrt pcs 4
4 4
50 Needle 24 G Pcs 95
95 95
51 Plester 5 yard x 450 Rol 6
6 1 5 10
52 Pot Sputum pcs
53 Silk 2/0 Paket 12
12 12 12
54 Salisil bedak Ktk 6
6 6 50
55 Silk 4/0 Unit 12
12 12
56 Silk 3/0 Pcs 12
12 12
57 Supratul / Cuticell Clasic 10 cm x 10 cm Pcs 30
30 30
58 Umbilical Cord Klem Steril Nylon Pcs 450
450 450
59 Underpad Pcs 100
100 100
60 Urine Bag Pcs 20
20 20
61 Wing no 22 Pcs
62 Wings Needle no 23 G Pcs
63 Wing No 24 Pcs
64 Wings Needle 25 Pcs
65 Xpert MTB / Cartridge test
66 Yodium povidon larutan 10 % 30 ml Btl
67 Yodium povidon larutan 10 % 60 ml Btl 72
72 2 70
68 Yodium povidon larutan 10 % 300 ml Btl 8
8 2 6 10
69 Yodium povidon larutan 10 % 1000 ml Btl
70 Masker N 95 pcs 50
50 50
71 Paper tape pcs 34
34 34
72 Hipafix / Fixomul Stretch 10 cm x 10 cm pcs 5 5 5
73 Covid 19 Ag Test pcs
74 Hazmat APD pcs 12
12 12

UMUM
BPJS JUMLAH
JUMLAH KUNJUNGAN RESEP BAYAR TIDAK BAYAR

Mengetahui Malin Deman, 30 Januari 2023

Kepala UPTD Puskesmas Malin Deman Pengelola Gudang Obat
UPTD Puskesmas Malin Deman

M.Zul, S.Sos Lestrina Julianti, SKM

NIP. 196607271988031005